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
