Ch. 6 - The Science of Body and Table Mechanics

Draping Rules

First rule: state and local rules. Can't drape with less than law requires without endangering license. Second Rule: client's request Third rule: therapist's comfort level.

Prevention of RSI

If symptoms occur, massage entire arm, pectorals major, minor, and neck. To further prevent injury frequently massage anterior forearm muscles while strengthening posterior forearm muscles (extensors).

Table Mechanics

Involves practical considerations concerning placement of client on massage table. Involves client positioning, positioning of equipment (bolsters & pillows), and draping using towels/sheets.

What are the primary symptoms of Inflammation?

Local Heat Swelling Redness Pain Decreased Function or (ROM) Range of Motion

Dantein

Navel - ancient center of gravity. The specific spot located two inches below and behind the navel

RSI in Clients

Primarily due to improper work habits. 100% Preventable Replace bad habits with good habits RSI takes time to occur, by the time symptoms occur, bad habits are already in place.

Client Positioning

Promotes client comfort through positional release. Promotes relaxation through proper body alignment. Addresses health conditions such as swelling or recent surgeries

Purpose of Draping

Provides a professional atmosphere. Supports client's needs for emotional privacy/modesty. Offers warmth. Provides access to individual parts of client's body.

Body Mechanics / Biomechanics

The proper use of postural techniques to deliver massage therapy with the utmost efficiency and with minimum trauma to the practitioner

Torque

The twisting and turning motion or force; in massage therapy these motions occur in the torso of the massage therapist.

Performing side-lying massage

Therapist should adjust his position for best leverage, may use stool, squat, or kneel. Performs majority of work with client on first side, then have client roll over to other side. Remove pillows and bolsters before client gets up from table.

Towel Draping

Thicker, heaver and more opaque than sheets. Typically 1 towel for men, 2 for women, more if requested by client. Should NOT be used in side lying position, too small. Never use to cover face rest, leaves marks on clients face.

Ways to reduce likelihood of RSI

Use a Variety of Strokes Rest hands by spacing clients Stretch between sessions Adjust height of massage table Avoid sustained pressure or delayed compression Keep fit using weights/flexibility training Use Proper Body Mechanics Get Massages

Warrior Stance / Horse Stance

Used for strokes that traverse relatively short distances, such as petrissage, or for reaching across the body. Feet are placed on the floor a bit wider than the hip distance apart and the back is kept straight. Shoulders are relaxed while hands and arms are moving.

Draping Warmth

Warmth is a primary comfort consideration.

Western concept of Fitness

Western focus is on strength and stamina.

Table Mechanics

Includes: Table Height Client Position Use of Bolsters Draping

Body Mechanic

Includes: Strength Stamina Breathing Stability Balance Groundedness/Centeredness

Use of Bolsters

Position bolster seam away from client. Cover bolster with drape or place under fitted sheet.

Side-lying position

Preferred for pregnancy, some older adults, and some other conditions. Clients back should be about 4 inches from edge of the table.

Positioning Equipment

Rolled up towel, pillow, or blanket, or commercially made bolster.

Repetitive Motion Injuries / Repetitive Strain Injuries (RSI)

Caused by a repetitive or constant motion, combined with compressive forces or joint hyperextension. Symptoms of RSI are related to inflammation. Example: most common are carpal tunnel syndrome, thoracic outlet syndrome, tennis elbow, and rotator cuff problems.

Guidelines for Proper Body Mechanics

Check table height, adjust if necessary. Wear comfortable attire. Warm up before massage. Use a variety of strokes, alternate if you notice fatigue. Get BEHIND your work. Check your lower body. Position your upper body by keeping shoulders relaxed and arms close to body. Keep wrists straight and do not hyperextend your digits. Keep back straight by tilting your pelvis backward. Hips should be level and knees slightly bent. Keep wrist as straight as possible, the greater the pressure the straighter wrist should be. Lean or sit depending on modality being performed. Apply pressure with your weight not your strength. When sitting keep feet flat on floor and back straight. Maintain head over neck and shoulders. Keep eyes forward when possible. Stretch, look up and away from work. Breath, use deep, full abdominal breathing. Move smoothly, find your own rhythm, move with it. Lift correctly, use legs not back, keep weight close to body.

How to begin a massage: Supine or Prone?

Either way, pros and cons for both.

Center of Gravity

Between the fourth and fifth lumbar vertebrae, or an inch or two behind and below the navel (dantein).

Use of Bolsters in Prone Position

Bolster is used most often under anterior ankles. Use prone pillow or face rest to head/neck if possible.

Two Main Foot Stances related to Body Mechanics

Bow Stance (Archer stance) Warrior Stance (Horse stance)

"Foundation of Massage" according to William Barry

Breathing

Seated Position

Can be performed with client in regular chair, massage chair, or wheelchair. Reasons to use seated position: if client prefers it, or has reservations about removing clothing, a massage table is not available, or insufficient space. If client has medical condition or pain that makes table use difficult.

Bow Stance / Archer Stance / Lunge Position

Feet are on the floor in 30-50 degree angle. Lead foot points forward; trailing foot points off to the side. During a stroke, weight shifts from rear to front foot as therapist lunges forward. Keep knees flexed while shifting weight between lead foot and trailing foot. Torso is kept as straight as possible. Is used when applying effleurage or other strokes where therapist MOVES from one point to another on client's body.

Use of Pillows

First pillow under head Second pillow under upper arm to support arm and shoulder. Third pillow under upper knee and ankle (align in one horizontal plane, use additional pillow if needed)

Eastern concept of Fitness

Eastern focus is on building balance and becoming grounded/centered.

Draping General Practice:

Expose only areas being massaged Do not lift or fluff drapes so that fabric leaves client's body. If client is accidentally uncovered, look away and redrape area. Apologize while remaining composed and professional.

Massage Therapy is classified as what kind of Occupation?

Stenuous Occupation: meaning it requires physical energy and use of torque. Physical fitness helps prepare the body for the practice of massage

Principles of Body mechanics

Strength Stamina Breathing Stability Balance Groundedness/Centeredness

Use of Bolsters in the Supine Position

Support posterior cervical (neck) region and posterior knees. Knee bolster helps relax lower back. Place cervical pillow at lower cervical region, not occipital region. To prepare a cervical pillow you can use a rolled up bath size towel. Use a pillow, cushion, or rolled towel under clients feet for easier access and proper body mechanics.

How does RSI present in Massage Therapists

The anterior forearm becomes large because of finger flexing, then the muscle compresses against tendons and nerves supplying the hand. Therapist may notice numbness or weakness in the forearm, wrist, or hand (especially thumb, middle, and ring fingers).

Hara

The lower abdomen, breathing in and out of the hard helps lower the center of gravity and contribues to stability.