Review

Amputation stumps Postfracture care Edema (some forms)

INDICATIONS

Arthritic conditions (some) /Subcutaneous conditions/ Peripheral neuritis /Myositis

INDICATIONS

Stress reduction Mental or muscular fatigue Insomnia

INDICATIONS

Torticollis /Muscle strains and sprains /Poliomyelitis Prolonged bed rest/immobility of a part

INDICATIONS

sustained pressure held pressure applied with fingers , thumb , or whole hand

Ischemic compression

Good Samaritan Law

Laws or acts protecting those who aid others in an emergency situation from liability Intended to reduce bystanders' hesitation to assist, for fear of being sued or prosecuted for unintentional injury or wrongful death

LD, Sw.M,

Lymphatic Massage, Swedish Massage

OH PAIN Scale stands for

Onset How did it start P=Place A=Amount I=Interaction N=Neutralizers

Inventor of the Swedish Gymnastics

Pehr Henrik Ling

:Rhythmic lifting of muscle tissue away from the bone, squeezing and releasing

Petrissage

C&V - Ocean Waves - Fulling Skin Rolling are types of

Petrissage

Rhythmic lifting of muscle tissue away from the bone , squeezing and releasing

Petrissage

Typically follows effleurage/Milks tissue of metabolic wastes/Draws new blood & oxygen to the tissue

Petrissage

Effective massage treatments for glutes

Petrissage/Deep Frictioning/Compression/Stretching /Flex & extend lower spine

Father of Swedish massage Swedish physiologist, gymnastic instructor

Pher Hendrick Ling

Clean table between massages, wear clean clothes, use closed containers for lubricants, wear gloves if cuts and warts, do not massage when ill, avoid massage for people who are ill, maintain a clean facility, empty garbage daily are all part of

Sanitation Guidelines

What Other Things To Look At

Scapula 3 - 4 inches apart Inferior angle of scapula should be level with T - 7 Arm rotation Calcaneal tendon Pelvis tilted or high on one side

First trimester

School says not to if do avoid: ROM, Rocking Abdominal work Low back and sacral work Reflexology Contraindicated points (LI4, SP6, BL67, GB21)

Burning pain that radiates from lower back through glutes down leg - usually unilateral

Sciatica

other causes of _____ include pregnancy , piriformis syndrome , and stenosis of the spinal cord , cauda equina , or sciatic nerve roots .

Sciatica

Confidentiality exceptions

Written permission Potential harm to the client or a third party Court Subpoena

Latent TP is not felt until

compressed

Glute draping

consider efficacy of working through drape/sheet observe cultural norms-obtain verbal consent

a situation that requires the therapist to modify techniques or refrain from using them to avoid possible harm.is a

contraindication

90 % of_________ cases are due to a spinal disc herniation pressing on one of the lumbar or sacral nerve roots .

sciatica

superficial abductors and extenders insertion

on the superior femur

Deep lateral rotators insertion

onto the upper extremity of the femur

Primary TP -

original 1st trigger point ; formed first

Associated TP -

original for compensating Satellite - found in referral pattern of TP, Secondary

origin for the gluts

originate from the ilium and sacrum

ROM Active Movements are performed by the

performed by the client

ROM Passive Movements are performed by the

performed by the therapist

Effective massage treatments for glutes

petrissage deep frictioning compression stretching flex/extend lower spine

When a client has an absolute Client emergency contraindication, massage is not advised and should be

postponed

Indications for gluteal massage

sciatica herniated disc lower back muscle ache or fatigue "tight glutes" arthritis, bursitis or other pathologies of the hip joint speed recovery from hip or lower back surgery

Gluteal massage indications Gluteal massage may provide relief from :

sciatica herniated disc lower back muscle ache or fatigue "tight glutes" arthritis , bursitis or other pathologies of the hip joint speed recovery from hip or lower back surgery

Move one surface over another

Friction

Ischemic compression can be applied

Applied directly on skin or over drape, No lubricant required

Sciatica

Burning pain that radiates from lower back through glutes down leg- usually unilateral

What to do with accidental exposure?

1. Look away 2. Re-drape 3. Stay COMPOSED

Steps to turn client from prone to supine?

1. Remove positioning equipment 2. Move client down the table 3. Anchor the sheets with your thighs, elevate sheet holding at shoulder and hip 4. Turn the client toward to on to their back 5. Replace positioning equipment where needed

Steps for washing your hands

1. Wet hand to elbows 2. Apply soap 3. Thoroughly wash hands to elbows 4. Rinse 5. Dry with paper towel (not cloths) 6. Turn off faucet with paper towel

What is the cutoff BP for clinic?

170/100- call clinic person in charge

• No sacral/abdominal work in

1st trimester pregnancy

The swing phase of gait is approximately what percentage of the total gait cycle for a typical adult with a normal gait pattern?

40%

Where do you position yourself when helping the client get of the table?

At the head of the table

The stance phase of gait is approximately what percentage of the total gait cycle for a typical adult with a normal gait pattern?

60%

Normal range for BP

80-140/50-88

The concept of health and medicine begin to take shape when

6th and 7th BC

Causes of sciatica

90% of cases are due to a spinal disc herniation pressing on one of the lumbar or sacral nerve rods others include pregnancy piriformis syndrome and/or stenosis of spinal chord, cauda equina, or sciatic nerve roots

Vibration

:Rapid shaking, quivering, trembling, or rocking movements applied with the fingertips, full hand, or an appliance

Local Twitch Response

:A reflexive impulse that causes the affected muscle or adjacent muscle to fire or twitch spontaneously Firing results from a summation of sensory nerve information

Boundaries

A set of parameters that indicates a border or limit Clarify roles, responsibilities, expectations, and limitations Linked to scope of practice

Jump Sign

A spontaneous reaction of pain or discomfort that may cause the client to wince, jump, or verbalize on application of pressure

Your client can receive massage with a few procedural or positional modifications is

A way to manage a contradiction

Session termination

An orderly close to a therapeutic relationship between the client and the therapist

__________ may cause radiating nerve pain in the lower extremities , including sciatica

Disc herniation

an injury to the cushioning and connective tissue between vertebrae , usually caused by excessive strain or trauma to the spine .

Disc herniation

Contagious disease is an

Abolute contradiction

A systemic contagious disease is an

Absolute Contraindication

Chronic disease in an exacerbation period or an acute stage

Absolute contraindication

Client in a state of medical emergency

Absolute contraindications

Contagious Widespread infection or systemic inflammation, often indicated by fever

Absolute contraindications

Trigger Point Classification

Active Latent Primary Associated;; Satellite , Secondary

Active ROM Movements can be

Active - Assisted/ Active Resisted

Therapy movement done by client is called

Active therapy

Name the three primary movements of Swedish Massage

Active, Passive and Duplicted

ADL

Activities of Daily Living

add, abd, protr., retr. Trac., WNL, DP, PRE means...

Adduction, abduction, protraction, retraction, traction, within normal limits, direct pressure, progressive resistive exercise

Greek priest, physician, gymnastics, god of medicine

Aesculaplus

Holy snake and staff, symbol of medical profession

Aesculaplus

Classified various massage movements

Amboise Pare-Renaissance

Discussed therapeutic effects of massage, esp. in orthopedic surgery

Amboise Pare-Renaissance

Rubbing, pressing & Manipulating of specific points, 5000 BC

Amma

Step 2: turning supine to prone: with thighs you....

Anchor sheet with your thighs, elevate sheet with hands at shoulder and hip

Professional standards are

Education Scope of practice Code of ethics Confidentiality Discrimination Standards of practice

Vascular supply to the gluteal region

Aorta common iliac arteries ( right and left) external and internal iliac arteries Vena cava < - common iliac vein < - internal iliac vein < inferior and superior gluteal veins

Wrote "De Medicina", bridged gap between Hippocrates & current times, 1st medical historian

Augustine Celsus - Roman

Fractures Foreign bodies/hardware Open wounds • No sacral/abdominal work in1st trimester pregnancy Varicosities • New scars Burns

Avoid Local Massage

Where to avoid tapotement

Avoid over endangerment sites Avoid immediately after exercise

plantar fasciitis the patient points their toe ______ from the knee

Away

Code of Life written in the and from where?

Ayurveda-Veda, India

For qualifier the student explains the benefits of 2-3 strokes and asks about/adjust this _____. Can you name 7 strokes?

Effeurage, petrissage, friction, tapotement, vibration, compression, ROM and pressure

Nerves/Small or prominent bony projections/Organs & Glands/Abnormalities/Blood vessels

Endangerment Sites

Small or prominent bony projections /Abnormalities ie cysts

Endangerment Sites

Massage can have a sedative or stimulating effect on the nervous system depending on the type of treatment given.

BENEFICIAL EFFECTS OF MASSAGE

Massage increases the number of red blood cells, especially in cases of anemia.

BENEFICIAL EFFECTS OF MASSAGE

Mobilize scapula is

Back routine consideration

Attachments at base of skull and top of pelvis are

Back routine considerations

Effleurage , petrissage , frictioning , compression , vibration and tapotement

Back routine considerations

Fingers , thumbs , knuckles , flat hand , heel of hand , pisiform , forearm , elbow are

Back routine considerations

Rate , rhythm , pressure are

Back routine considerations

Transitioning & Major muscles of interest - trapezius , supraspinatus , rhomboids , spinal erectors , quadratus lumborum are

Back routine considerations

Single cell organisms-most not pathogens, do not require to living living tissue to survive. ie: boils, TB, strep, tetanus

Bacteria

Name 4 types of stretching

Ballistic, Static, Proprioceptive Neuromuscular Facilation, and Active Isolated Stretching

When do you check the client comfort level?

Before and during therapy

Capillary flush - Increases cellular nutrition - Spreads and broadens muscle - Stimulates vasodilation - Interrupts pain spasm - pain cycle

Benefits of Compression

Capillary flush/Increases cellular nutrition/Spreads and broadens muscle

Benefits of Compression

Stimulates vasodilation/Interrupts pain - spasm - pain cycle

Benefits of Compression

Generates heat Dilates capillaries Increases circulation

Benefits of Friction

Generates heat/Dilates capillaries/Increases circulation

Benefits of Friction

Promotes proper scar formation Reduces trigger & tender point formation & activity Breaks down adhesions

Benefits of Friction

Promotes proper scar formation/Reduces trigger & tender point formation & activity/Breaks down adhesions

Benefits of Friction

Increases blood flow/Removes metabolic wastes/Reduces local swelling

Benefits of Petrissage

Reduces muscle soreness & stiffness Stimulates the nervous system Softens superficial fascia • Produces analgesia (skin rolling)

Benefits of Petrissage

Reduces muscle soreness & stiffness/Stimulates the nervous system/Softens superficial fascia/Produces analgesia ( skin rolling )

Benefits of Petrissage

Aids in rehabilitation Increases / maintains flexibility & ROM Improves alignment & posture

Benefits of Stretching

Proper use of postural techniques

Body mechanics

What happens in the parasympathetic state?

Body temperature and BP decreases

Anatomical dissections, muscular contrations

Borelli

Name two types of stances

Bow/archer/lunge AND Horse/warrior

Vibration does not

Break contact w skin

The Big Six

C - cold R - referral i - ischemia O - overload T - trauma S - stress

CRITOS

C-Cold R-Referral I-Ischemia T-Trauma O-Overuse S-Stress

Direction of the massage is

Centripetal- towards the heart-venous fluid toward the heart

Education professional standards

Certification Licensure Registration National Certification

In 90 BC this country introduce acupuncture & medical writings

China

What Ancient world 3000 BC country that introduced massage to treat illness

China

WHO OBSERVES IN Subjective in SOAP

Client observation

Why drape?

Client's privacy, warmth, boundary between client and therapist

info

Collect all info about current and past pregnancies in your pre-massage interview

Applied directly on the skin or over the drape/No lubricant required

Compression

Rhythmic pumping performed perpendicular to the muscle belly

Compression

warms tissue ; rhythmic pumping performed perpendicular to the muscle belly

Compression

Chair strokes

Compression Sustained pressure Petrissage Friction Stretching Tapotement Nerve stroking

Draping considerations for gluteal massage

Consider efficacy of working through drape / sheet Observe cultural norms - obtain verbal consent

A systemic _______ ________ is an Absolute Contraindication

Contagious disease

Uninterrupted flow of strokes/unbeknownst transition. Between strokes

Continuity

The anterior neck is a four-sided region delineated by the two anterior margins of the trapezius, the lower border of the mandible, and the superior borders of the clavicles

Endangerment Sites

The abdomen is bordered by the diaphragm superiorly and the pelvis inferiorly.

Endangerment site

Safety considerations before begin chair massage

Demo how to sit on and get off the chair Ensure client is positioned correctly and comfortably

QD, BID, TID, QID means...

Daily, twice a day, 3/day, 4 times/day

Flexion is the bending of the joint to ______ the angle between the bones

Decrease

Little or no lubricant

Deep Friction

Moving the skin and superficial fascia across the deeper layers of tissue

Deep Friction

The therapist's hands do not slide over the skin

Deep Friction

The therapist's hands do not slide over the skin/Little or no lubricant

Deep Friction

Professional standards

Define and distinguish our profession; give the profession limitations

_________ is a tear in the outer , fibrous ring of an intervertebral disc allows the soft , central portion to bulge out

Disc herniation

The process that eliminates many pathogens, except bacteria spores, on inanimate objects

Disinfection

Second Trimester

Do not use prone after 18 weeks-use side lying or supine elevated 30 degrees(pillow under right hip) No deep low back or sacral work No reflexology; general light foot work only Treat mild edema Light abdominal work with MD clearance

A patient has an Achilles' heel surgery what should you avoid

Dorsiflexion-pointing the toe toward the knee

Length of time spent on a specific area

Duration

Severe Hematoma (blood clot) /Phlebitis /Thrombophebitis

EXTREME CAUTIONS

Always begin what type of massage & why

Effleurage, use gliding to assess tight muscles

Body mechanics, Intention, pressure, depth, direction, excursion, speed, rhythm, continuity, duration, sequence and routine are all part of

Elements of Stroke

Areas of the body that contain superficial delicate anatomical structures that are relatively unprotected and are therefore prone to injury

Endangerment Sites

Nerves Blood vessels Organs & Glands

Endangerment Sites

Benefits of Vibration

Enhances relaxation Moves gas in gi Increases circulation Stimulates synovial fluid production creates min muscle contractions Relieves pain Reduce trigger & tender point activity Relieves chest& sinus congestion Acess deeper structures Stimulates peristalsis Reduces TP activity

The scientific study of individual anatomy and physiology as it relates to performing work

Ergonomics

increased blood circulation • reduced swelling • reduced scar tissue formation are

Examples of Mechanical Response of massage

Length of stroke

Excursion-ankle to hip verses calf to knee

_________ is straightening a joint so the angle between the bones increase

Extension

You do not have to change sheets between clients?

FALSE

From the posterior view you can assess the EAM? True or False

False

You can massage acute injuries. T or F

False

Variations of Vibration

Fine Coarse (Jostling) Rocking

Variations of Vibration

Fine - small movement ; fingertips ; applied over muscles abdomen Course jostling bigger movement ; grasping shaking ; with traction Rocking - pitch & catch motion ; more relaxing :

The ability of muscles and other soft tissues to lengthen and shorten through the ROM for which they are intended

Flexibility

The ability of muscles and other soft tissues to lengthen and shorten through the ROM for which they are intended is called

Flexibility

Hip ROM Flexion is _____, Extension is _____, Abduction is ______, Adduction is ______ and Rotation is _______.

Flexion = 120, Extension 10, Abduction = 40, Adduction = 20-30, and Rotation = 40

Cervical ROM Flexion is ______, Extension is ______, Lat Flexion is ________, and Rotation is __________.

Flexion is 90, Extension is 70, Lat Flexion is 45, and Rotation is 90.

Applied with the palm , thumbs , fingers , or elbow/Move one surface over another/Increases circulation/Beneficial in areas that have little or no blood supply

Friction

Applied with the palm, thumbs, fingers, or elbow

Friction

Molds and yeast are types of _______. ie. Thrush, ringworm, athlete's foot

Fungi

A person's walking pattern

Gait

Posture is erect , eyes looking forward , arms are extended at the side and swinging forward in opposition to the legs

Gait - A person's walking pattern

Should be smooth , coordinated and rhythmic

Gait - A person's walking pattern

Discovered that arteries and veins carry blood Stressed hygiene,massage & specific exercise for physical disorders

Galen

His medical text was used for more than 1000 years

Galen

What areas must stay draped?

Genital region, gluteal cleft and breast area (no nipples)

superficial abductors and extenders

Gluteus maximus Gluteus medius Gluteus minimus Tensor fascia lata

Muscles of Gluteal region

Gluteus maximus Gluteus medius Gluteus minimus Tensor fascia lata

Author of Classic scripture of Traditional Chinese Medicine

Haung -ti nei-ching

Step 3: supine to prone:

Have client turn turn toward you, over onto abdomen

Name the 4 stance phases:

Heel strike Flat Mid-stance Toe off

Father of modern, western medicine, emphasized individual, cause no harm

Hippocrates

Proponent of massage, esp. friction, Wrote the code of ethics

Hippocrates

Who said PHYSICIANS SHOULD DO NO HARM?

Hippocrates

Who is the Father of a Modern Medicine?

Hippocrates (or Western Medicine)

_____ is overextending beyond normal straightening.

Hyperextension

Hpotn., Horton., T.P. ,lord, kyph means

Hypotonicity, hypertonicity, trigger point, adhesion, lordosis, kyphosis

Seated massage

If you only have a short time Client is unable to get on table client is not comfortable getting undressed

Name 3 benefits of petrissage

Increases blood flow Removes metabolic wastes • Reduces local swelling Relieves fatigue Improves cellular nutrition Relaxes & lengthens muscle • Relieves tension under the surface

1800 BC-Ayurveda books describe massage- come from

India

Your client cannot receive massage that day

Is an example an absolute contraindication

Record keeping

Intake form Informed consent treatment notes (SOAPs)

The effects depend on

Intensity Speed Duration

Step 4: supine to prone: ask client to move...

Into face into cradle

Chair massage facts

Introduced on-site by David Palmer, 1980s Can be performed just about anywhere Shot time commitment Convenient and affordable Use to introduce new clients to massage therapy Client does not have to disrobe No lubricant is used

The purpose of effleurage manipulations is to:

Introduction of touch, assessment, warm up tissue, transition stroke

Stimulates Golgi Tendon Organs , which inhibits muscle contractions

Inverse Stretch Reflex

Who's decision is it for the therapist to wear gloves?

It is the choice of the client and therapist for the therapist to wear gloves. If the client requests gloves then the therapist must wear gloves.

Proposed massage to medical field for treatment of disease

Johann Mezgar

Responsible for making massage a fundamental component of physical rehabilitation

Johann Mezgar

Introduce massage technique terminology

Johann Mezger

Introduced French terminology into massage

Johann Mezger

Helped popularized massage with the general public Wrote many articles, texts, published "Good Health" magazine

John Henry Kellogg

spontaneous reaction of pain of discomfort that may cause the cilent to wince, Jump or verbalize on application or pressurre

Jump Sign

Recently injured areas

Local Contraindication

Reflective impsule that causes the affected muscle adjacent muscle to fire or twitch spontaneously

Local Twitch Response

S.O.A.P. Notes Format L,M,N,O,P,Q, R, S, T, U

Location, mechanism(how happen), neurological symptoms, onset(when begin), Palliative ( what makes better), Quality of Pain (sharp, dull, etc), Radiates, Sleep type, Temporal (time of day worse?), Urinary issues

"It may take 4 - 6 weeks to resolve ..." and ROM are examples of

Long term goals

Pregnancy massage can help with

Loose ligaments Fatigue Shifting proprioception

What would a trimester pregnant woman experience?

Lordosis

Types of Seated massage

Massage chair Desktop face support Stacked pillows Stool or chair

Documented sing massage for colic and labor pains-Americas

Mayas and Incas

Occurs as result of of motion pressure or range

Mechanical Response:

increased blood circulation - reduced swelling - reduced scar tissue formation

Mechanical Response:

In the Plumb Line Analysis from the Posterior View what landmarks would you be looking at

Middle of medial malleoli (fixed point) Middle of knees Gluteal cleft Mid - line of trunk ( spine ) External Occipital Protuberance

First sports medicine book

Mercuriale

MVA, PRN, P, I stand for

Motor Vehicle Accident, as necessary (needed), Pain, Inflammation

Stimulates muscle spindles , which initiates muscle contraction

Myotatic Stretch Reflex

Contagious disease - Inflammatory conditions • Acute conditions Meds that weaken • Plebitis or thrombosis tissue or increase bleeding Edema re: organ failure - Decreased sensation

NYS Extreme Cautions

Inflammatory conditions • Acute conditions Meds that weaken tissue or increase bleeding Decreased sensation

NYS Extreme Cautions

Joints to position

Neck Back Knees Ankles

Cleanliness, wipe down surfaces is called

Sanitation

When a client refuses to let confer with you MD

New York State Contraindications

When the therapist or client is in an altered state of awareness

New York State Contraindications

Is it recommended to wear latex gloves? Why?

No, due to allergies.

A client has had several falls that affected their shoulder. You should call their family?

No-violation of HIPPA

Common in elderly women is a loss of bone density within the skeletal structure causing a decrease in height is caused by

Osteoporosis and Kyphosis (Dowager's Hump)

1. Pain 2. Contracted Muscles 3. Decreases BF, Increases Edema. 4. build - up of metabolic wastes

PAIN CYCLE

Therapy movement for the client by the therapy is called

Passive therapy

Biological agent capable causing infectious disease

Pathogen

PT., c/o, TP, GSM, Petr means

Patient, complains of, Trigger Point, General Swedish Massage, Petrosage

Which analysis view would you use to assess the inside of the ankles?

Plumb Line Analysis Posterior View

Which Plumb Anaylsis view point would you use to observe the protrudent of the neck?

Posterior

Which Plumb Anaylsis would you use to observe a cocked butt?

Posterior View

The position of the body in space

Posture (e.g. sitting , standing , lying prone or supine )

Reasons to use chair massage

Primary or secondary source of income Promotional tool Portibility Sporting events, fundraisers, health fairs, etc. Clients that have difficulty getting on and off the table

strength and stamina, breathing, balance, flexibility, grounded ness, centerness are

Principles of Body Mechanics

As the client gets off the table remember to maintain

Professional and ethical boundaries, client safety

Benefits of abdominal massage

Promotes digestion relieves gastric upset soothes stimulates bowel movement

Name benefits of stretching

Promotes relaxation Increases circulation Decreases pain , soreness Aids in rehabilitation Increases / maintains flexibility & ROM Improves alignment & posture Assists in assessment

What position is the client in face down on the table?

Prone

Positioning terms

Prone (Face Down) Supine (Dorsal Recumbent/ Face Up) Side Lying (Lateral Recumbent) Seated

Start how, 3.5 per leg, __ minutes for back, neck, shoulders then change to ____ position

Prone, 23, supine

Deep lateral rotators

Quadratus femoris Piriformis Gemellus superior Gemellus inferior Obturator internus

Deep lateral rotators

Quadratus femoris Piriformis Gemellus superior Gemellus inferior Obturator internus

Goniometer measures your

ROM-RANGE OF MOTION

All joints have a normal restrictions and an End feel

Range of Motion

All joints have a normal restrictions and the End feel

Range of Motion

The movement of a joint from one extreme of the articulation to the other

Range of Motion

Decreased arousal of the sympathetic nervous system (general relaxation)

Reflex Response:

Triggering of stretch receptors (muscle spindles)

Reflex Response:

Fractures Foreign bodies/hardware Open wounds • New scars

Reasons to Avoid Local Massage

Foreign bodies/hardware • No sacral/abdominal work in1st trimester pregnancy Burns

Reasons to avoid local massage

Benefits of massage

Reduce stress and swelling Enhance blood circulation & Relaxation Decrease pain Increase O2 capacity of blood (hemoglobin) Promote sleep

More benefits of Petrissage

Reduces muscle soreness & stiffness Stimulates the nervous system Softens superficial fascia Produces analgesia (skin rolling)

Benefits of Effleurage

Reduces muscle soreness & stiffness Stimulates the nervous system Softens superficial fascia • Produces analgesia (skin rolling)

Benefits of chair massage in the workplace

Reduces stress Addresses specific complaints Prevents injuries Improves morale Enhances productivity

As the session progresses, the client becomes more

Relaxed.

Step 1 when turning client From supine to prone

Remove positioning equipment

Self-Inflicted Injuries due to poor body mechanics is

Repetitive Motion Injury

Tapotement

Repetitive staccato striking movements of the hands, moving simultaneously or alternately, with loose wrists and fingers, for the purpose of stimulating underlying tissue Start soft & slow, build to forceful & quick, soften & slow to finish

Step 5: supine to prone: last step is to

Replace bolster under ankles.

Decreased arousal of the sympathetic nervous system (general relaxation) Triggering of stretch receptors (muscle spindles) Increased diameter of blood vessel, reduced blood pressure are examples of

Responses to Massage - Reflex Response:

Repetition of regularity of massage movements

Rhythm

Used bathing, diet, massage, few drugs for healing

Roman Empire-Methodists. Greek physicians living in Rome

SOAP stands for what?

S-Subjective, O-Objective, A-Assessment, P-Plan

Order of massage

Sequence

Code of Ethics

Set of guiding moral principles that govern one's course of action

Brings balance between body and mind, Finger pressing

Shiatsu-JAPAN

STG stands for ___________, LTG stands for ___________, ROM stands for ___________.

Short Term Goals, Long Term Goals, Range of Motion

"We should be able to help alleviate your pain today." Is what type of goal.

Short term goal

Treatment of Trigger Points

Should be polymodal Lengthen the muscle Ischemic compression Adjust lifestyle/habits

Third Trimester

Side Lying position (client on left side as much as possible) Swmi-Fowlers position (45-60 degrees) No deep low back or sacral work No reflexology; general light foot work only Treat mild edema Light abdominal work

In the Plumb Line Analysis from the Lateral View what landmarks would you be looking at

Slightly anterior to lateral malleolus ( fixed point ) Slightly anterior to the mid - line of the knee Through the greater trochanter Through the midline of the trunk Through the shoulder joint Through the external auditory meatus ( EAM )

Plumb Line Analysis (Lateral View )

Slightly anterior to lateral malleolus ( fixed point) Slightly anterior to the mid - line of the knee Through the greater trochanter Through the midline of the trunk Through the shoulder joint Through the external auditory meatus ( EAM )

Benefits of Tapotement

Stimulates, then Increases local blood flow sedates nerve endings Relieves pain Aids in decongesting the lungs Desensitizes a hypersensitive area after a few minutes Tones atrophied of stimulation muscles

Vibration Characteristics

Stimulating/Relaxing/ if longer-numbness/Do NOT break contact with the skin/ Effects depend on : Intensity , speed , duration

Non-living entities that depend on a host cell for growth and replication- ie. cold, flu, HIV, MEASLES, MUSCLES, Mumps, rabies. Transmitted person to person, animal to person

Virus

Scope of Practice

The profession's working parameters According to state law No diagnosis or spinal manipulation

You should assume everyone is infections. T or F

True

You should warm your hands & fingers before give a massage. T or F

True

Sheet draping sheet size and lay out

Twin size, fold top sheet down, make a triangle to be more inviting

How do you expose the abdomen?

Use a towel or pillowcase to cover breasts, then expose the abdomen

Remove spores

Sterilization

Benefits of Compression

Spreads and broadens muscle Stimulates vasodilation Interrupts pain-spasm-pain cycle

Two phases of the gait cycle

Stance phase = 60 % Swing phase 40 %

Tx, Hx, Rx short for....

Treatment, History, Prescription

Involves a muscle and its synergist being drawn out to its fullest length

Stretching

_______ Involves a muscle and its synergist being drawn out to its fullest length

Stretching

Can cause degenerative disc disease , chronic myofascial pain , compensation

Structural misalignment

Lordosis , kyphosis , scoliosis , Dowager's hum caused from

Structural misalignment

Rounded shoulders , pelvis tilt / high on one sideis caused by

Structural misalignment

_____ _______ is often the source of chronic pain

Structural misalignment

What position is the client in facing up on the table?

Supine- soup's UP

Improves circulation, relieves muscle tension, improves ROM & promotes relaxation

Swedish Massage

Massage strokes in tandem with movement

Swedish Massage

Acceleration - Mid - Stance - Deceleration are three parts of the

Swing Phase of your Gait

Was Compiled under the mythical yellow emperor

TCM- Traditional Chinese Medicine

Height, position of client, bolstering, draping

Table mechanics

Repetitive staccato striking movements of the hands , moving simultaneously or alternately with loose wrists and fingers , for the purpose of stimulating underlying tissue

Tapotement

Start soft & slow , build to forceful & quick , soften & slow to finish

Tapotement

It is an ok practice to layer sheets and remove one layer with each client?

Terrible practice - do NOT do!

Heel Strike - Foot Flat - Mid - stance - Toe Off

The Stance Phase - Four parts

Who introduce Swedish Massage to the US, 1956

The Taylor Brothers-George Henry Taylor & Charles Fayetteville Taylor

Published the first Swedish American textbook on Swedish massage, 1960

The Taylor brothers

Active Movement is by

The client

action for the gluts

Their action is to extend , abduct , and both internally and externally rotate the femur at the hip joint .

WHO OBSERVES IN OBJECTIVE in SOAP

Therapist

passive movement is by the

Therapist

What is the drawback to wearing gloves?

Therapist does not feel as much, creates more friction, gloves may degrade because of the oils

Discrimination/Right of Refusal

Therapist or client can terminate the therapeutic relationship Therapist should inform client of reason May not refuse based on race, nationality, gender, religion, or sexual preference

Active TP is painful without

Touching it

Adduction is movement ______ the midline of the body.

Toward

TCM

Traditional Chinese Medicine

hyperirritable focus usually found within a taut band of skeletal muscle or muscle fascia, that is painful on compression & can give rise to characteristics referred pain, tenderness, and autonomic phenomena ( ex . sweating , tearing , goose bumps , change in skin temperature)

Trigger Point

state-dependent memory

Triggered by duplicating the original position, location, amount of pressure, movement, or emotion present at the time the experience occured

Energy point

Tsubo

C & V Ocean Waves Fulling Skin Rolling

Types of Petrissage

Ballistic Stretching/Static Stretching/Proprioceptive Neuromuscular Facilation/Active Isolated Stretching

Types of Stretching

Ballistic/Static/Proprioceptive Neuromuscular Facilitation/Active Isolated

Types of Stretching

Neglect

Unintentional physical or emotional harm to the client resulting from insensitivity or lack of knowledge of the therapist

Assume everyone has an infection is the _________ _________

Universal Precautions

What muscle is responsible for the Swing Phase of your gait?

Upper anterior leg-quadrecipt-front of thigh

Sanitation and Hygiene

Use a face cradle cover Antimicrobial disposable wipes (after each use clean: face support, arm rest, and chest pad) Cleanse your hands after each client

Cross Fiber Chucking Circular

Variations of Friction

Superficial Warming Rolling Wringing

Variations of Friction

Superficial Warming/Cross Fiber/Rolling/Chucking/Wringing/Circular

Variations of Friction

Tapping/Pounding/Pincement/Clapping/Hacking/Diffused/Cupping

Variations of Tapotement

tapping /plucking/Hacking/ /Cupping/Pounding/Clapping

Variations of Tapotement

Fine, Coarse ( Jostling ), and Rocking

Variations of Vibration

Do not break contact with the skin ! The effect depends on : Intensity, Speed, and Duration

Vibration

Rapid shaking , quivering , trembling , or rocking movements applied with the fingertips , full hand , or an appliance

Vibration

rapid shaking , quivering , trembling , or rocking movements applied with fingertips , full hand , an appliance ; most physically demanding stroke

Vibration

Thumbs and wrists-up, down, circles shoulders forward/backward, forearm- make fists and rub briskly are examples of....

Warm up exercises

Primary comfort consideration is

Warmth

Assessment in SOAP is

What you do

Demonstrated that blood was circulated through arteries and by the beat of the heart

William Harvey

Enhanced the acceptance of massage as therapeutic

William Harvey

Dissociation

a person dissociates by not being in his/her body and retreating into a disembodied world of thoughts and fantasies, but not feelings

Define massage

a systematic and scientific manipulation of soft tissues of the body for the purpose of obtaining or maintaining health

disc herniation

an injury to the cushioning and connective tissue between vertebrae, a bulging of an intervertebral disc out of normal space

sexual misconduct

any sexual contact, sexual assault or sexual battery between a patient and a health- care provider

Abduction - movement _______ from the midline

away

Duplicated movements Are completed by

both the client and the therapist

Check table height/size, comfortable clothes/shoes, warm up, correct stance, vary strokes, breathing, brace digits, stretch, sit when appropriate, lift with legs, find your rhythm and honor your limits are all

elements of proper body mechanics

Superior and Inferior gluteal nerves originate

from L4, L5, S1 and S2 spinal roots

Second part of massage supine massage....

hands, arms, tops of legs, feet

Deep lateral rotators origin

ilium, ischium and pubic structures of the pelvic bone

insertion for the gluts

insert on the superior femur

The presence of a contraindication is usually determined during the

intake process

A lump, lesion, suspicious mole, localized rash, or enlarged lymph nodes

local contraindication

Acutely inflamed areas

local contraindication

Areas that contain medicated transdermal patches, chemotherapy ports, pacemakers, or other medical devices

local contraindication

Endangerment sites

local contraindication

Your client can receive massage, but only a specific area needs to be avoided is called a

local contraindication

local contraindication an area in which massage must be avoided because it is injured or inflamed, is part of a disease process, has a medical device.

local contraindication

Abuse

physical or emotional harm sustained by the client resulting from deliberate acts of the therapist

Dual Relationship

refers to any situation where multiple roles exist between a therapist and a client. Examples of dual relationships are when the client is also a student, friend, family member, employee or business associate of the therapist.

the presence of allergies, diseases and their complications, surgeries, recent injuries, the use of devices such as pacemakers or artificial joints, the use of certain medications or their administration routes.

represent contraindications

Countertransference

the emotional reaction of the therapist that reflects their own inner needs and conflicts Therapist has difficulty maintaining professional distance

Way to remember: Plantar flexion PLANTS...

the toes in the earth

Endangerment sites are à type of local contraindication, because areas contain

tissues such as nerves, blood vessels, organs, and glands vulnerable to harm from pressure.

superficial abductors and extenders action

to extend, abduct, and both internally and externally rotate the femur at the hip joint

Deep lateral rotators action

to externally (laterally) rotate the femur

Ischemic compression pressure held used for treating

trigger points & muscle spasms

Transference

unconscious tendency of the client to assign feelings and attitudes associated with significant people in their earlier life, to the therapist

Three types of communication

verbal, nonverbal, written

Endangerment sites are

vulnerable to harm from pressure.

Variations of Tapotement

Тapping Pounding Pincement Clapping Diffused Hacking Cupping

Cancer Tumors Acute/Chronic infection you will need to

• Confer with MD

Increased diameter of blood vessel, reduced blood pressure

• Reflex Response:

Cancer Tumors Acute/Chronic infection

•MUST Confer with MD

Steps to greeting a patient-professional communication

1. Greet/Welcome The Guest Within 2 minutes-Lobby 2. Explain services 3.Health History Form 4. Reason for visit 5. Explain side effects 6. Written consent 7. Set goal-STG & LTG 8. Point tissues?, orient to room

Rules of draping

1. Only expose what you are working on 2. Don't lift, fluff or move sheets away from their body 3. Follow local law 4. Honor clients requests 5. RESPECT therapists comfort level 6. If you expose, look away, re-drape, stay COMPOSED

Bleach ratio for cleaning

1:10 parts bleach to water

Enhances relaxation Increases circulation Creates minute muscle contractions Relieves pain Relieves chest & sinus congestion Stimulates peristalsis, Moves gas in gastrointestinal tract Stimulates synovial fluid production Reduces trigger & tender point activity Accesses deeper structures

Benefits of vibration

Trigger Points

:Hyperirritable focus, usually found within a taut band of skeletal muscle or muscle fascia, that is painful on compression & can give rise to characteristic referred pain, tenderness, and autonomic phenomena (e.g. sweating, tearing, goose bumps, and changes in skin temperature)

Compression

:Rhythmic pumping performed perpendicular to the muscle belly Applied directly or over drape No lube required

Relieves pain/Relieves chest & sinus congestion/ Stimulates peristalsis

Benefits of Vibration

Relieves fatigue/Improves cellular nutrition/Relaxes & lengthens muscle/Relieves tension under the surface

Benefits of Petrissage

Increases & maintains flexibility & ROM/Improves alignment & posture/Assists in assessment

Benefits of Stretching

Promotes relaxation/Increases circulation/Decreases pain , soreness/Aids in rehabilitation

Benefits of Stretching

relaxation Increases circulation Decreases pain , soreness

Benefits of Stretching

Relieves pain Desensitizes a hypersensitive area Tones atrophied after a few minutes muscles of stimulation

Benefits of Tapotement

Stimulates , then Increases local blood sedates nerve flow endings Aids in decongesting the lungs

Benefits of Tapotement

What are the following: Stimulates then sedated nerve ( when applied longer )/Aids in decongesting the lungs /Tones atrophied muscles - after cast/Increases local blood flow/Relleves pain/Desensitizes a hypersensitive area after a few minutes of stimulation

Benefits of Tapotement

Accesses deeper structures/Reduces TP activity

Benefits of Vibration

Enhances relaxation/Increases circulation/Creates minute muscle contractions

Benefits of Vibration

Moves gas in gastrointestinal tract/Stimulates synovial fluid production/Reduce trigger & tender point activity

Benefits of Vibration

Beneficial in areas that have little or no blood supply

Friction

Increases circulation

Friction

Means to rub

Friction

Plumb Line Analysis Posterior View looks for

Middle of medial malleoli - fixed point Middle of knees Gluteal cleft Mid - line of trunk ( spine ) External Occipital Protuberance

Simple forms of animal life

Protozoa

Nerves are stimulated which in turn activate a reflex arc is a

Reflex Response to maassage

Sliding the hands , palm , fingers , or knuckles back and forth over the client's skin

Superficial Friction

Sliding the hands, palm, fingers, or knuckles back and forth over the client's skin

Superficial Friction

Innervation of the gluteal region

Superior and inferior gluteal nerves originating from L4 , L5 , S1 and S2 spinal roots

superficial abductors and extenders origin

The ilium and sacrum

Plan in SOAP is

The plan includes what will be done as a consequence of the assessment

When washing hands, do you start with water or soap?

Water, wet hands to elbows

Body fluids, break in the skin, hygiene reasons(smell) are all reasons to

Wear Gloves