Therapeutic Massage Chapter 16. Historical Perspective Dating back to the ancient Olympians Dating...
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Transcript of Therapeutic Massage Chapter 16. Historical Perspective Dating back to the ancient Olympians Dating...
Historical PerspectiveHistorical Perspective
Dating back to the ancient Dating back to the ancient OlympiansOlympians
Late 1980’s Late 1980’s – American Massage Therapy American Massage Therapy
1992 1992 – National Certification Examination for National Certification Examination for
Therapeutic Massage and Bodywork Therapeutic Massage and Bodywork
PurposePurpose Manipulates the the body’s tissues Manipulates the the body’s tissues
to:to:– Reduce muscle spasmReduce muscle spasm– Promote relaxationPromote relaxation– Improve blood flowImprove blood flow– Increase venous drainageIncrease venous drainage
Broad range of massage theories, Broad range of massage theories, techniques, and effectstechniques, and effects
Basic Massage Basic Massage StrokesStrokes
EffleurageEffleurage PétrissagePétrissage FrictionFriction TapotementTapotement VibrationVibration
Myofascial ReleaseMyofascial Release J-StrokesJ-Strokes Focused StretchingFocused Stretching Skin RollingSkin Rolling Arm Pull / Leg PullArm Pull / Leg Pull Diagonal ReleaseDiagonal Release
Types of MassageTypes of Massage
EffleurageEffleurage ““Stroking of the skin”Stroking of the skin” Spread massage lubricantSpread massage lubricant Use at the beginning and Use at the beginning and
end of the massageend of the massage Superficial: Superficial:
– slow strokes for relaxationslow strokes for relaxation Deep: Deep:
– Elongates muscle fibersElongates muscle fibers– Stretches fasciaStretches fascia– Forces fluids in the direction of Forces fluids in the direction of
the strokethe stroke towards the hearttowards the heart
PétrissagePétrissage ““Lifting and Lifting and
kneading”kneading” Frees adhesions:Frees adhesions:
– Stretches and Stretches and separates muscle separates muscle fiber, fascia, and scar fiber, fascia, and scar tissuetissue
If only technique If only technique used, it may be used, it may be performed without performed without the use of lubricantthe use of lubricant
FrictionFriction
““Deep pressure”Deep pressure” Effects muscle mobilization, tissue Effects muscle mobilization, tissue
separation, and trigger pointsseparation, and trigger points Two types:Two types:
– CircularCircular– TransverseTransverse
Circular Friction MassageCircular Friction Massage
Use a circular Use a circular motionmotion– ThumbsThumbs– ElbowElbow– Commercial deviceCommercial device
Transverse Friction MassageTransverse Friction Massage Strokes perpendicular Strokes perpendicular
to tissue fibersto tissue fibers The thumbs or The thumbs or
fingertips stroke in fingertips stroke in opposite directionsopposite directions
TapotementTapotement
““Tapping or pounding” of the skinTapping or pounding” of the skin Variations:Variations:
– HackingHacking– CuppingCupping– Pincement (pinching)Pincement (pinching)– RappingRapping– TappingTapping
Tapotement TechniqueTapotement Technique
Performed with a Performed with a light, fast tempolight, fast tempo
Promotes muscular Promotes muscular and systemic and systemic relaxation and relaxation and desensitization of desensitization of irritated nerve irritated nerve endingsendings
VibrationVibration
““Rapid Shaking”Rapid Shaking” Increases blood flow and provides Increases blood flow and provides
systemic invigoration of tissuessystemic invigoration of tissues Mechanical devices availableMechanical devices available
Myofascial ReleaseMyofascial Release Stroking and stretching of tissues:Stroking and stretching of tissues:
– Relax tense tissuesRelax tense tissues– Release adhered tissuesRelease adhered tissues– Restore tissue mobilityRestore tissue mobility
Clinician receives cues and feedback from Clinician receives cues and feedback from the patient’s tissue the patient’s tissue – This indicates the appropriate strokes and This indicates the appropriate strokes and
stretches stretches Specialized training in myofascial release Specialized training in myofascial release
techniques is needed to become proficient techniques is needed to become proficient in these skillsin these skills
J-StrokesJ-Strokes
One hand places the One hand places the adhesion on stretchadhesion on stretch
Other hand’s 2Other hand’s 2ndnd and 3 and 3rdrd fingers stroke in the fingers stroke in the opposite direction opposite direction forming a ‘J’forming a ‘J’
Mobilize scar tissueMobilize scar tissue
Focused StretchingFocused Stretching Heel of one hand in the area of restrictionHeel of one hand in the area of restriction Heel of other hand crossed in frontHeel of other hand crossed in front Stretch the tissue using slow, deep pressureStretch the tissue using slow, deep pressure Reduces superficial or Reduces superficial or
deep adhesionsdeep adhesions
Skin RollingSkin Rolling Use fingers and thumb to Use fingers and thumb to
lift and separate the skin lift and separate the skin from the underlying tissuefrom the underlying tissue– Similar to PétrissageSimilar to Pétrissage
Roll skin between fingers Roll skin between fingers noting restrictionnoting restriction
Lift skin and move it in the Lift skin and move it in the direction of the restrictiondirection of the restriction
Reduces superficial Reduces superficial myofascial adhesionsmyofascial adhesions
Arm Pull/Leg PullArm Pull/Leg Pull
Arm pull (example):Arm pull (example): Grasp extremity proximal Grasp extremity proximal
to wristto wrist Apply gentle traction that Apply gentle traction that
is in line with anterior is in line with anterior deltoiddeltoid
Continue to abduct 10-15 Continue to abduct 10-15 degrees until full degrees until full abduction is reachedabduction is reached
Stretches large areas of Stretches large areas of fascia fascia
Diagonal ReleaseDiagonal Release
One clinician grasps the leg proximal to One clinician grasps the leg proximal to talocrural jointtalocrural joint
Other grasps the opposite arm proximal Other grasps the opposite arm proximal to wristto wrist
Keep extremities horizontal to each otherKeep extremities horizontal to each other One moves the limb until adhesions are One moves the limb until adhesions are
felt while the other stabilizes the felt while the other stabilizes the extremityextremity
Stretch large area of fasciaStretch large area of fascia
Physiological EffectsPhysiological Effects CardiovascularCardiovascular
– Increase blood flow, histamine release, and temperatureIncrease blood flow, histamine release, and temperature– Decreased heart rate, respiratory rate, and blood Decreased heart rate, respiratory rate, and blood
pressurepressure NeuromuscularNeuromuscular
– Increase flexibility, decrease neuromuscular excitability Increase flexibility, decrease neuromuscular excitability (relaxation), edema reduction, and stretch muscle and (relaxation), edema reduction, and stretch muscle and scar tissuescar tissue
PainPain– Activate spinal gate and the release of endogenous Activate spinal gate and the release of endogenous
opiatesopiates PsychologicalPsychological
– Reduces patient anxiety, depression, and mental stressReduces patient anxiety, depression, and mental stress
IndicationsIndications
Increase blood flowIncrease blood flow Facilitate healingFacilitate healing Increase range of motionIncrease range of motion Remove edemaRemove edema Alleviate muscle crampsAlleviate muscle cramps Stretch scar tissue/adhesionsStretch scar tissue/adhesions Decrease painDecrease pain
ContraindicationsContraindications
Acute inflammatory conditionsAcute inflammatory conditions Severe varicose veinsSevere varicose veins Open woundsOpen wounds Skin infectionsSkin infections Failed or incomplete fracture healingFailed or incomplete fracture healing ThrombophlebitisThrombophlebitis
PreparationPreparation
TableTable Linens and pillowsLinens and pillows Massage lubricantMassage lubricant Patient positionPatient position Masseuse positionMasseuse position
Traditional MassageTraditional Massage
Apply massage medium Apply massage medium with light, slowwith light, slow
Build to deeper effleurageBuild to deeper effleurage PétrissagePétrissage Wipe medium before Wipe medium before
applying deep friction (if applying deep friction (if applicable)applicable)
Reapply pétrissage and Reapply pétrissage and deep effleuragedeep effleurage
End with light effleurageEnd with light effleurage
PreparationPreparation
Elevate the body areaElevate the body area Apply massage lubricant to the skinApply massage lubricant to the skin Clinician is positioned distal to the Clinician is positioned distal to the
extremityextremity
Stroke SequenceStroke Sequence Begin proximal to the Begin proximal to the
edematous areaedematous area Long, slow, deep Long, slow, deep
strokes towards the strokes towards the torsotorso
Move starting point Move starting point slightly distal every slightly distal every fourth or fifth strokefourth or fifth stroke
When the starting When the starting point moves distal to point moves distal to the edema, begin the edema, begin working back towards working back towards the starting pointthe starting point
TerminationTermination
Remove mediumRemove medium If appropriate:If appropriate:
– Active range of motion exercisesActive range of motion exercises– Compression wrapCompression wrap
Encourage patient to drink water to Encourage patient to drink water to assist in flushing metabolic wasteassist in flushing metabolic waste