Techniques Midterm Review Flashcards
1
Q
What are the 6 Effects of massage?
A
Mechanical, Reflex, Physiologic, Psychological, Energetic, Psychoneuroimmunological
2
Q
Mechanical (Description)
A
Effects are caused by physically moving the tissues by compression, tension, (stretch), shearingm bending, or twisting
3
Q
Mechanical (Outcome)
A
-Increased lymphatic return
-Mobilized bronchial secretions
4
Q
Reflex (Description)
A
Involves a change in biomedical body processes
5
Q
Reflex (Outcome)
A
-Sedation or stimulation/arousal
-Facilitation of skeletal muscle contraction
6
Q
Physiologic (Description)
A
Involves a change in biochemical body processes
7
Q
Physiologic (Outcome)
A
-Improved modelling of connective tissue
-Reduced muscle spasm
8
Q
Psychological (Description)
A
Effect occurs in the mind, emotions, or behaviour
9
Q
Psychological (Outcome)
A
-Improved social interaction
-Improved physical self-image
10
Q
Energetic (Description)
A
Direct effects on the patient’s biomagnetic field and possible secondary effects on clients body structures and function
11
Q
Energetic (Outcome)
A
-Improved biomagnetic field pattern
-Improved energy flow
12
Q
Psychoneuroimmunological (Description)
A
Altered feeling state is accompanied by changes in hormone levels or immune function
13
Q
Psychoneuroimmunological (Outcome)
A
-Decreased cortisol levels
-Improved T-cell function
14
Q
Client-Centered Outcomes
A
Outcomes based on patient’s Physical, psychological, social, and spiritual needs
15
Q
Whole Systems-Oriented Outcomes
A
Outcomes that consider the therapeutic environment and the therapist-patient interaction
16
Q
5 Key points therapists must remember for each treatment
A
- Understand potential therapeutic effects of massage
- Identify which of the patient’s body structures and functions or aspects or activity or participation level can be treated appropriately with massage techniques
- Consider, based on the patient’s health history and present condition, which techniques or approaches are contraindicated or require modification in areas such as: treatment time, level of tissue engagement, etc.
- Determine the appropriate type of intervention
- Through palpation, observation and verbal communication continually re-asses the patients responses to treatment as it proceeds.
17
Q
Draping
A
Draping is the process by which the therapist uncovers and covers portions of the patient’s body during treatment while maintaining modesty and respecting appropriate therapist/patient boundaries.
18
Q
Where are pillows places in supine position?
A
- Under knees
-to support low back to rest on the table - Under head and neck (if needed)
-for comfort
19
Q
What are the draping landmarks for supine position?
A
- Anterior Lower Limb = ASIS
- Abdomen = ASIS, xiphoid process of the sternum
- Upper Limb = Under back at the level of axilla
- Upper Chest = Under back at the level of axilla
- Head/Neck/Shoulders = Under back at the level of axilla
20
Q
Where are pillows places in prone position?
A
- Under Abdomen
-To support and relax low back - Under ankles, feet and toes
-To stabilize lower limbs, and to relax posterior lower limb muscles
21
Q
What are the draping landmarks for prone position?
A
- Back = PSIS
- Posterior Lower Limb = greater trochanter of femur
- Posterior lower limb including gluteals = iliac crest, lateral border of the sacrum
22
Q
Direction of pressure should be?
A
Centripetal = Towards the Heart
23
Q
What are the 4 principals of massage?
A
- General - Specific - General
- Superficial - Deep - Superficial
- Proximal - Distal - Proximal
- Periphery - Centre - Periphery
24
Q
Massage Principal (General - Specific - General)
A
- Area of the body being treated
-Massage of a body part begins with techniques which cover the GENERAL area. Moving into a SPECIFIC area, muscle group pr area of complaint. Ending with techniques which again cover the whole GENERAL area - The part of the therapist’s hand being used
-To work on GENERAL area the largest surface of the therapist’s hand is used. Fingertips and thumbs provide SPECIFIC work. Returning to GENERAL area, to vascular flush and finis treatment of the area. - Techniques being used
-GENERAL techniques: effleurage, muscle squeezing, palmar kneading, stroking SPECIFIC techniques: fingertip kneading, thumb kneading
25
Massage Principal (Superficial - Deep - Superficial)
Refers to the amount of pressure used, and therefore the level of tissue that is being engaged.
-Begin with light pressure (SUPERFICIAL). Progress to deeper pressure to work more deeply into the soft tissue (DEEP). Finish with light pressure (SUPERFICIAL).
26
Massage Principal (Proximal - Distal - Proximal)
Refers to relative location of work being done
-Started PROXIMALLY, progress DISTALLY, and then return to PROXIMAL.
-Work can be done from proximal to distal joint, or by muscle group from proximal to distal attachment.
-General techniques that are inclusive of the proximal area can be interspersed throughout and used as transition strokes, such as effleurage.
27
Massage Principal (Periphery - Centre - Periphery)
Refers to the method of approach to a problem site
-Area of complaint (PERIPHERY) is treated in order to increase circulation and to relax surrounding muscles. Gradually proceed to the problem site (CENTRE). This allows for more effective work because the tissue is better prepared, client has less apprehension to pain. In the treatment of swelling, work is done (PERIPHERALLY) to the site gradually working toward the centre to increase drainage of the fluid from the area. Only the area proximal to the site is treated.
28
Mechanical Effects (Definition)
Mechanical effects are direct effects which result from the physical movement of the tissues by compressing, stretching, shearing, twisting or bending them.
29
Mechanical Effects (Examples)
-Increase venous and lymph return to the body's core
-Increase circulation and glandular activity of the skin
-Helps loosen and reduce adhesions; increases ROM of affected joints
-Improves joint health
-Loosens mucus in the lungs and promotes expectorant coughing
30
Reflex (Definition)
The reflex effects of massage are indirect effects. They are responses that have ben mediated by the nervous system.
-Effects may be local and/or distant from the site being worked on.
-All massage manipulations have some degree of reflex effect.
31
Proximal
Next to the point of attachment or origin, a central point; located toward the centre of the body, the trunk
32
Distal
Situated away from the point of attachment or origin or a central point of the body
33
Reflex Effects (Examples)
-Decrease sympathetic nervous system activity, resulting in relaxation
-Increase sympathetic nervous system activity, resulting in Stimulation
-Increases peristalsis when certain techniques are performed over the abdomen or low back
-Increases or decreases muscle resting tension and pain depending on how the sympathetic nervous system is affected; decreased sympathetic NS firing decreases muscle resting tension and pain
-Increases local circulation
34
Treatment Modification
A change to the initial treatment plan when massage is appropriate for the client, to allow for safe, effective treatment.
-Modifications may be made in technique choice, pressure and direction of technique, position of the client...area treated and duration of treatment.
34
Contraindications (CI)
Is a symptom or circumstance that makes a particular treatment inadvisable
-Contradiction may be absolute; in other words, massage is an inappropriate method of treating a particular condition that affects either at the whole body or a body part
34
Contraindications to Treatment
Contraindications to treatment noted in an assessment are discussed with the client before treatment begins so the necessary modifications can be made, or occasionally the client can be referred to another health care practitioner.
35
What are the 5 Steps to designing a sequence of massage techniques?
1. Summarizing the clinical findings and outcomes
2. Select treatment techniques
3. Specify the scope and duration of the sequence of massage techniques
4. Choose a framing general massage technique
5. Sequence the chosen massage techniques according to principals of massage
36
Static Contact
Static contact is motionless contact of the therapist's hands on the patient's body with minimal pressure.
-Full palmar contact is used and maintained, with the relaxed hands conforming evenly to the shape of the parts being engaged. Only the surface of the sin is engaged, there is no manipulation of tissue involved.
37
What body system is most affected by static contact?
Nervous
38
How long is static contact maintained?
Min 10 sec per location, unless cueing in teaching diaphragmatic breathing
39
Static Contact Reflex Effects
-Generalized relaxation/sedation
-Reduced anxiety
-Reduced perception of pain/Analgesia
-Decreased local resting muscle tension or neuromuscular tone
-Increased feeling of wellbeing
40
Static Contact Indications/Uses
-Conditions of over-stimulation
-Trauma, illness, dying, emotional distress, post traumatic stress disorder
-Conditions in which pressure and/or soft tissue manipulation is painful or contraindicated
-Acute or chronic pain intractable pain
-Where this effect is desired and other techniques are contraindicated
-Post-surgery, convalescence poor physical self-image
41
Static Contact Cautions and Contraindications
-If touch is generally or locally undesirable or intolerable
-Some extreme painful conditions
42
Stroking
Manipulation performed with very little pressure, either through the sheets or directly on the skin
-Superficial technique is applied with palmar or sometimes dorsal surface of hands, used either singly, simultaneously or alternately. Hand(s) maintain even, gentle contact with the skin. Stroking can be applied over a comparatively extensive area of the body. Evenness rhythm is essential
43
What body system is most affected by Stroking?
Nervous
44
What are the 2 types of stroking techniques?
Soothing, Stimulating
45
Soothing
Hands are held in a relaxed manner and rhythmically glided down the body part. Contact is maintained using very light pressure. Soothing stroking is applied unidirectional, usually in the direction of hair growth. Evenness of of the rhythm is essential to create the desired sedation effect. When contact is broken, the hands glide through the air back to the beginning place, taking the same amount of time moving through the air as on the body. Rate is slow. Palmar surface of both hands are used simultaneously, alternately, reinforced, or singly; stroking can also be applied using dorsal surface of the hand. Frequently used as a beginning and/or a finishing stroke.
46
Stimulating
Hands rhythmically stroke the body part, again with gentle pressure, but this technique differs in that it is applied in a multidirectional manner and at a rapid rate. this technique can be applied at the end of the massage when the desired effect is to leave the person mildly stimulated and alert.
47
Soothing Stroking Reflex Effects
-Decreases sympathetic nervous system activity, resulting in relaxation
-Decreases perception of pain
-Reduces resting muscle tension
-Increases peristalsis when performed over abdomen or low back
-Promotes feeling of well-being and being cared for
48
Soothing Stroking Mechanical Effects
Generally none
49
Soothing Stroking Indications/Uses
-When an overall sedation effect is desired
-Introduces therapist's touch, calming effect
-May contribute analgesic effect
-Muscle spasm
-Irritable bowel syndrome
-May be permissible after acute myocardial infraction
-Conditions where direct mechanical pressure in contraindicated
50
Soothing Stroking Cautions & Contraindications
-Ticklishness or irritation caused by application of the technique
-Acute pain, syndromes
-May be contraindicated locally in areas of acute inflammation because of pain
51
Stimulating Stroking Reflex Effects
Increases sympathetic nervous system activity resulting in mild stimulation, a "pick-up" effect
52
Stimulating Stroking Mechanical Effects
Generally none
53
Stimulating Stroking Indications/Uses
-Hypotonicity
-General Invigoration
-Flaccid Paralysis
-Atonic Constipation
-Conditions needing stimulation where mechanical pressure is contraindicated
54
Stimulating Stroking Cautions & Contraindications
-Most painful conditions
-Insomnia, nervous, exhaustion
-Spastic paralysis
-Muscle spasm
-Ticklishness
55
Vibration Types
Fine, Coarse
56
Vibration Applications
Running, Static
57
What are the 4 T's
Temperature, Tone, Texture, Tenderness
58
Intro
Effleurage, Muscle Squeezing, Stroking, Static Contact
59
Intermediate
Petrissage, Picking up, C-Scoop, Wringing
60
Specific
Fingertip Kneading, Thumb Kneading, Tapotment
61
Where are pillows places for sidelying position?
1. Between knees and ankles (1 or 2), usually lengthwise
-to stabilize, to keep hips neutral, for comfort
2. Under head (1 or 2)
-For comfort
3. In front of the client's torso under their uppermost arm
-to help stabilize torso, draping security, support
62
What are the landmarks for sidelying position?
1. Back = PSIS
2. Anterior lower limb = Greater Trochanter of Femur or ASIS if assessing proximal areas (e.g. upper attachment of quads)
3.Posterior lower limb = Greater Trochanter of Femur or Iliac Crest/Lateral sacral border if including Gluteals
63
Vibrations
Fast, oscillating or trembling movement that is produced on the clients skin and that results in minimal deformation of subcutaneous tissues
-Performed using palmar surface of hand or fingertips. Part of hand used is rested on an area of the body and vibrated while maintaining contact with the skin. Manipulation must be performed for at least 30sec
64
Body systems most affected by vibrations?
-Nervous
-Lymphatic
-Respiratory
-Digestive
65
Fine Vibrations
Hand or fingertips rest on the area and are vibrated at a rapid rate, using minimal pressure. Often vibration is barely visible, amplitude is generally less than 1-5mm. (fine or coarse vibrations) May be done with the hand moving side-to-side or up-and-down. Vibrating hand may be reinforced with other hand. Gentler effect occurs when top hand does vibrations and bottom acts as a buffer
66
Coarse Vibrations
Hand or fingers rest on the area and vibrate rapidly and strongly, again with minimal pressure. Movement is visible
67
Static Vibrations
Vibrations, fine or coarse, are applied to a specific area. when performed correctly, continuous contact is made with the tissue without gliding over the patients skin.
68
Running Vibrations
Vibrations, fine or coarse, are performed using a gliding motion to cover a broader area of the body. The vibrating bands are glided, as with stroking, generally in the direction of hair growth.
69
Fine Vibrations (relax effects)
-Decrease sympathetic nervous system (SNS) response (especially when applied over neck and sacrum)
-General soothing effects on musculature, viscera
-Stimulates peristalsis and therefore reduces flatulence (when performed over abdomen)
70
Fine Vibrations (mechanical effects)
-Stimulates local circulation (stimulates lymph nodes and lymphatic drainage)
-Minimal effects below the surface of the skin
71
Fine Vibrations (indications)
-Pain (relief with 5-40 min of application)
-Circulatory congestion
-Muscle spasm
-Atonic constipation, irritable bowel syndrome, flatulence
72
Fine Vibrations (contraindications)
-If all touch is painful or contraindicated
73
Coarse Vibrations (reflex effects)
-Mildly stimulating effects to musculature, viscera
-Greater stimulating effect on peristalsis (when applied over abdomen)
74
Coarse Vibrations (mechanical effects)
-Possible loosening of mucus (when strongly applied over lungs)
-Stimulation of local lymphatic circulation
75
Coarse Vibrations (indications)
-When mildly stimulating effects are desired generally or locally e.g. hypotonic muscles, flaccid paralysis (when used cautiously)
-Respiratory congestion
-Atonic constipation
76
Coarse Vibrations (contraindications)
-Over-stimulated nerves locally (e.g. muscle spasm, spastic constipation) or generally (e.g. insomnia, anxiety)
-Painful conditions, including neuritis and neuralgia
77
Effleurage
Gliding Technique performed with light pressure that engages the tissues superficial to the muscles in the direction of venous and lymphatic flow to increase the return flow of those fluids.
(when applied deeply, engaging and deforming muscles, effleurage is being used as a neuromuscular technique)
78
Body systems most effected by effleurage?
-Circulatory (when applied with more tissue engagement)
-Nervous
-Muscular
-Lymphatic
79
Effleurage (reflex effects)
-Generalized relaxation/sedation if performed at a slow rate
-Generalized stimulation if the technique is performed at a faster rate
-Decreased perception of pain
80
Effleurage (mechanical effects)
-If performed with more tissue engagement, increases venous circulation, and indirectly increases arterial circulation (which provides fuel for increased cellular and therefore organic function)
-Increases lymphatic return, if performed superficially
81
Effleurage (indications)
-Conditions of overstimulation (e.g. muscular tension, anxiety, excitability, insomnia) where overall relaxation/sedation is desired
-Pain
-To reduce swelling (by increasing lymph return) and promote circulation in conditions in which circulation is temporarily comprised (e.g. in cases of musculoskeletal injuries such as: sprain, strain, bursitis, contusions, dislocations, separations, and fractures)
82
Effleurage (contraindications)
-Extreme pain (use caution)
-Conditions in which venous return is compromised (e.g. varicose veins, severe edema, over areas of possible infection)
-Conditions in which increased circulation would not be desirable (e.g. shortly after heart surgery, congestive heart failure)
-Conditions in which organic function is compromised (e.g. serious kidney pathology, serious nutritional deficiency)
83
Petrissage
Group of techniques that repetitively compress, shear, and release soft tissue with varying amounts of drag, lift and glide, which stretch layers relative to each other. Direction of pressure is variable.
-Petrissage is considered part of neuromuscular techniques group, which palpate muscle, affect the level or resting tension of the muscles, and have additional psycho-neuro-immunological effects
84
All types of kneading are performed __________________.
Centripetally
85
Petrissage may be soothing or stimulating depending on the _______________ and the amount of ______________ or _________________ applied to the tissues as the tissue layers are manipulated and stretched relative to each other.
rate, compression or drag
86
Petrissage (description)
Group of techniques consists of a variety of manipulations in which the soft tissues are rhythmically compressed and/or lifted, distorted, and then released.
87
What body systems are most affected by petrissage?
-Musculoskeletal
-Cardiopulmonary
-Digestive
-Nervous
88
What are the types of petrissage?
1. Muscle Squeezing
2. Wringing
3. Picking up/C Scooping
4. Kneading
89
Muscle Squeezing
Used as intro technique prior to or following superficial effleurage, as a finishing technique, or bu itself to address a region with more tissue engagement and pressure in a short time frame
-Rate is slow (1-3 sec per squeeze) rhythm is even, and pressure of compression is light to moderate
-Engages muscle and associated fascia
90
Wringing
Applied with palmar surfaces of both hands grasping the tissues
*Leaving space between hands maximized torqueing of the muscle tissue that occurs as the hands compress and shear the muscle between them in a smooth, continuous motion.
-Performed smoothly and rhythmically
-Pressure can be light to heavy. Engages muscle, associated fascia, and contained tissues.
91
Picking up/C-Scooping
Applied parallel to long axis of the body segment. Applied by gathering and grasping, Tissues are lifted away from underlying structures
-Pressure is light to moderate, with more distal hand engaging with more force, as it is encouraging centripetal pressure.
-Engages muscle and associated fascia
92
Kneading
Technique is circular, performed in a series, and continuous contact with the patient's skin is maintained throughout the stroke.
-May be applied with broader contact: entire surface of the hand (palmar kneading), soft fist or proximal forearm (ulnar border). Can also be applied with specific engagement with fingertips or fingerpads (fingertip kneading), or (thumb kneading)
-Rate is slow to moderate to sooth, moderate to fast to stimulate
-Consistent rhythm is maintained throughout the series
93
Petrissage (reflex effects)
-May be soothing or stimulating, depending on the application used, rate and location
-Decreases perception of pain
94
Petrissage (mechanical effects)
-Increases local circulation of blood and lymph fluid
-Loosens and stretches muscle fibres
-May help prevent and/or loosen adhesions
-Improves connective tissue extensibility
-Increases glandular activity of the skin
-May mechanically move intestinal contents when applied to the abdomen
95
Petrissage (indications)
-Increase perception of relaxation
-To reduce perception of anxiety
-Pain
-Most conditions of muscles, especially increased resting muscle tension and hypotonicity
-Increase reduced joint ROM
-Adhesions, contracture, fibrosis
-Constipation
96
Petrissage (contraindications)
-Most acute conditions
-Moderate to severe varicosities
-Local edema
-Severely atrophied muscles (gentle petrissage only)
-Hypertrophied muscles (gentle petrissage only)
-Spastic paralysis (slow, gentle petrissage only)
-Diarrhea
97
Tapotement
Percussive techniques, a group of manipulations in which a series of rhythmic, repeditive, rapid, springy blows are administered by various surfaces of the hands and fingers following these guidelines:
-Wrists are kept flexible
-Hands used alternately to make contact
-Rate is rapid and rhythm is constant
-Pressure varies from light to heavy, depending on desired effects
-Light techniques do not create force below the skin and superficial tissues
-Heavy techniques create force that reaches deeper into muscle tissue and contained viscera
-Pressure is directed downward into the part treated
-Manipulation must be performed for at least 30 sec to achieve desired effects, and may be performed for 20 min or more
98
Body Systems most affected by tapotment?
-Nervous
-Musculoskeletal
-Respiratory
-Digestive
99
Tapotement (types)
-Light
-Medium
-Heavy
100
Tapotement (light types)
pincement, tapping, point hacking
101
Tapotement (medium types)
loose hacking, stiff hacking, clapping
102
Tapotement (heavy types)
cupping, beating, pounding
103
Pincement
Affects superficial tissues, done rapidely and gently, alternate plucking of the superficial tissues between thumbs and fingertips. Pressure is light.
104
Tapping
Individual fingertips rhythmically and rappidly tap the superficial layers of the part being treated, similar to keyboarding. Pressure is light.
104
Loose Hacking
Alternate, rapid, springy blows are given with ulnar border of the hand, with the fingers held loosely. Pressure is light to moderate.
104
Point Hacking
Wrists flexible, fingers adducted and flexed, rapid, light springy blows are administered to the superficial tissue layers by the fingertips, alternating hands. Pressure is light.
105
Stiff Hacking
Hand position is similar to loose hacking, but with fingers held stiffly. Heavier pressure is applied.
106
Clapping
Wrists, hands, and fingers relaxed to avoid causing pain, contact is made with the full palmar surface. The hand comes off the patients skin to avoid any stinging sensation. Pressure is moderate.
107
Cupping
Hands are held in cupped position, with the fingers and thumbs closely adducted. This hang position creates a pocked of air in the palm. With relaxed wrists, the cupped hands alternately contact the part being treated and spring away. Pressure is moderate.
108
Beating
Hands are held in a soft fist, and forearms are pronated. Rapid alternate blows are given, contact being made with the underside of the fist. Pressure is moderate to heavy.
109
Pounding
Similar to beating, but the blows are given with the forearms in neutral rotated so that contact is made with the ulnar border of the fist. Pressure is heavy
110
Tapotement (reflex effects)
-Vasoconstriction/Vasodilation response
-Increases/stimulates neuromuscular tone. Secondary responses may be sedative
-Production of transient hyperstimulation, and may be analgesic if performed for long durations
-Increases parasympathetic nervous system response when applied lightly over the sacrum
-Affects various organs when applied to the back, usually increasing their activity and improving their function e.g.:
Upper Thoracic: Stimulates HR and increases rate and strength of contraction
Lower Thoracic: Stimulates stomach activity
Low Back: Stimulates organs in the abdominal cavity
Respiratory System: Effects primarily of increase SNS, promoting dilation of bronchial tubes; subsequent decrease of SNS is secondary effect.
111
Tapotement (mechanical effects)
-Increases local circulation and muscle temp
-Increases local metabolism
-Increases glandular activity of the skin
-Loosens mucus, increases metabolism and gaseous exchange
-Promotes expectoration and coughing
112
Tapotement (indications)
-Stimulation of local circulation (may cause local hyperemia)
-Promotion of local metabolism
-Hypo-trophied muscles (light techniques only) to facilitate contraction and increase neuromuscular tone
-May be suitable for pain relief in cases of neuralgia or amputation (phantom limb pain)
-Visceral hypofunction (promotes reflex responses in viscera)
-Where airway clearance is needed
113
Tapotement (contraindications)
To all Tapotement:
-Spastic Paralysis
-Neuritis, Neuralgia
-Most painful Conditions
To heavy Tapotement:
-Over kidneys
-On abdomen
-Over low back
-Sacrum (especially in pregnancy)
-hypotrophic, atrophied muscle
-Insomnia, nervous excitability, Convalescense, neurasthenia
-Over bony prominences, local area where bone is subcutaneous
-Many heart conditions
-Severe osteoporosis
-Arthritis
-High blood pressure, other cardiovascular conditions
-Degenerative disk disease
