Soft tissue mobilization Flashcards
What does the word massage come from?
the arabic word for mass meaning to press
what is massage definition
the manipulation of soft tissue of body with hands in order to produce effects in the nervous, muscular, and circulatory systems to help restore function
Mechanical effects of massage
1) remove dead skin cells
2) allows better function for the glands
3) increases lubricant effect
4) increases warmth
5) treatment scar tissue
6) in the lungs it frees adherent mucus from bronchial tree
7) encourages hyperaemia
Physiological effects - circulatory system of massage
1) change in skin color due to increased blood flow, velocity and visscosity
2) effect on BP, HR, skin temperature, conductivity, and oxygen consumption
3) incrased release of histamine from mast calls, basophills and platelets from blood (dilation of minute blood vessels, flush, and slight swelling)
Physiological effects - nervous system of massage
1) inhibitory influence on a motor neuron excitability but no carryover
2) releases endorphine
Physiological effects - MS system of massage
affects muscle fatigue
affects muscle tone
Psychological effect of massage
1) positive effects of well being
2) increase feeling of relaxation and rest
3) decreases anxiety level and stress hormone level
4) increased levels of immunoglobin A - improve the immune system
5) Helps in reducing depression and adjustment disorders
6) improves pain outcomes, mental energy, and self rated health
7) improve sleep
Absolute contraindications for massage
1) tissue inflammation or malignancy
2) circulatory disorders
3) abnormal sensations
4) skin disorders
5) early bruising
6) unhealed scars or open wounds
7) adjacent to recent fracture sites
8) acute inflammation and tubercular infection of joint and tissue
9) h/o or suspected DVT
10) burns
11) advanced osteoporosis
Relative Contraindications
1) older people
2) those with fragile skin
3) early stage of osteoporosis
4) children
5) adults with learning or physical disabilities
6) people recovering form infections and bone issues
How to determine indications?
based on the examination, observations and palpation, determine the nature of the tissue glide
check before starting massage that
1) you are able to reach the body part
2) stand in walk or lunge standing
3) change in position without hesitation
where should your hands be
in full contact with the patient the whole time and be relaxed yourself
what is the contact medium
to reduce friction you should use powder, oils, liquid oils and creams
what are the boundaries for upper limb massage
neck to fingers
what are the boundaries for the lower limb
groin to toe
what are the boundaries for the back
head to buttock
what are the boundaries for the neck
head to T12
what are the boundaries for the face
hairline to just below clavicle
what should the temperature of the room be for massage
warm
what should you do for ticklish subjects?
1) always put hand in very firm contact and never lift hands off by tackling
2) no one hand component
3) light works tickle so perform manipulations with depth
why would you use soft tissue mobilization (STM)
1) decrease muscle tension
2) improve skin mobility and reduce scar tissue adhesion or limitation
3) general patient relaxation
4) move fluid trapped in tissue
5) stretching or lengthening fascia
Effleurage
very light, gentle brushing technique applied to muscle and soft tissue from distal to proximal for lymth drainage . Pressure should be on the palms of the hands and it is a continuous stroke
what is the goal of effleurage
relaxation; increased venous and lymphatic drainage
Good for people with edema
Stroking
A long superficial stroke applied along the length of the tissue. Deeper than effleurage. PT should move along the muscle fibers applying pressure on the way up
Stroking goal
relaxation
Petrissage
groups of techniques that involve compression of soft tissue. Kneading by using the hand and fingers together
Petrissage goal
release areas of muscle fibrosis and to “milk” the muscle of waste product
Strumming
The application of repeated rhythmic deformations of a muscle belly in a strumming fashion
Cross Friction massage
repeated cross-grain massage applied to tendon and tendon sheaths. move 2-3 cycles per second for 3-5 minutes
Goal of cross friction massage
increase mobility and extensibility of MS tissues; prevent and treat inflammatory scar tissue
Contraindications for cross friction massage
1) hematomas
2) debilited or open skin
3) peripheral nerve or diminished sensation
Therapeutic effects of cross friction massage
1) increase blood and lymph flow
2) removal of chemical irritant by products of inflammation
3) reduces venous congestion (edema)
4) stimulates mechanoreceptors
5) reduce scar tissue and improve scar tissue mobility
Skin rolling
the gathering up of tissue between the thumb, index and middle finger to continue a rolling pattern over the tissue.
goal of skin rolling
to assist with movement of superficial layer and superficial fascia
Graston or IASTM
1) used designed stainless steel tool to treat scar tissue
2) allows for faster rehab
3) requires additional training
Strain counterstain
- used passive positioning to relieve muscle, joint, and tissue tightness
- PT identifies specific pain points and hold the position for 90 secs to 3 mins to relax the soft tissue, reduce pain and stiffness
- requires additional training
Manual lymphatic drainage
- used specific manual hand movements that allow for anatomical lymph pathways, helping to move fluid and improve circulation
-manual lympathic drainage for headaches, migraines, swollen legs
Trigger point / myofascial release
- treatment for chronic muscle pain and immobility
- focuses on reducing pain by easing the tension and tightness in the specified areas of pain
Cupping
-using suction to create negative pressure and allow for myofascial decompression
- wet, dry, static, or dynamic
