133572666 Massage Therapy

8/13/2019 133572666 Massage Therapy

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Massage Therapy


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History of Massage

Natural reaction to when the body hurts is to rub it Dates back to at least the ancient Olympics

In Europe in the Middle Ages, the Church of Rome &

its religious teachings discouraged massage as a

healing practice

Massage is derived from 2 sources

Arabic verb massto touch

Greek wordmassein

to knead Egyptians, Romans, Japanese, Persians, & Chinese

were known to practice massage therapy


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History of Massage

Swedenearly 19thcentury, Peter Ling (acknowledged

founder of curative gymnastics)appears to be founder of

modern day massage techniques, incorporated with

French massage techniques

Techniques have changed dramatically in the past 50years

Based on research by Albert Hoffa (1859-1907), James

Mennell 1880-1957), & Gertrude Beard (1887-1971).

Scientific basis to massage was added Late 1980s, Amer. Massage Therapy Association was

organized (1992Natl Cert. Exam. For Therapeutic

Massage & Bodywork was formed)


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What is Massage Therapy?

Mechanical modality Used to manipulate the bodys tissue

Effective in promoting local & systemic relaxation,

increasing local b. flow, breaking down adhesions, &

encouraging venous return

Act of rubbing, kneading, or stroking the superficial

parts of the body with the hand or an instrument for

the purpose of modifying nutrition, restoring powerof movement or breaking up adhesions

Time-consuming


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Treatment Considerations &

Guidelines Need to know underlying pathology

Need to know basic massage principles (must havemanual dexterity, coordination, & concentration). Mustalso exhibit patience & courteousness.

Hands must be clean, warm, dry & soft. Nails must beshort and smooth. Hands should be warm.

Avoid constant hyperextension or hyperflexion of anyjoints which may lead to hypermobility.

Must obtain correct positioning that will allow forrelaxation, prevent fatigue & permit free movement ofarms, hands, & body.


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Treatment Considerations &

Guidelines

Must obtain good posture to prevent fatigue &backache.

Weight should be evenly distributed on both

feet. You must be able to fit your hands to the

contour of the area being treated.

A good position is required to allow for correctapplication of pressure and rhythmic strokesduring the procedure.


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Points for Consideration

Pressure regulation should be determined bythe type & amount of tissue present. Also,pressure is governed by the condition & whichtissues are affected.

Each stroke must have equal pressure & time(rhythm present).

Duration depends on pathology, size of area,

speed of motion, age, size, & condition ofathlete. Also, massage may not be warrantedon a daily basis (e.g. friction massage).

Some areas may take 30 minutes.


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Points for Consideration

If swelling is present in an extremity, treatmentshould begin proximally.

Uncorking the bottle, uncorking effect

Massage should never be painful, exceptpossibly for friction massage. It should not

cause ecchymosis.

Direction of forces should be applied in thedirection of the muscle fibers.

Each session should begin & end with

effleurage.


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Points for Consideration Make sure the patient is warm and in a comfortable,

relaxed position. Also, make sure the patient is

properly draped.

The body part may be elevated if necessary.

Massage should begin with superficial stroking.

Each stroke should start at the joint or just below the

joint (unless contraindicated) and finish above the

joint so that strokes overlap. Pressure should be in line with venous flow.

Bony prominences & painful joints should be avoided

if possible.


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Massage Media Used to decrease friction between the

patients skin and the clinicians hand Massage can be given without any medium

being used

Lotions, peanut oil, powder, analgesicbalms

More medium should be used onhairy areas

During petrissagelubricants

interfere with the kneading & lifting

During friction massagelubricants may interfere with

the certain results you want to

obtain


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Massage Strokes

Effleurage

Petrissage

Friction (circular, transverse)

Tapotement

Vibration

Myofascial release techniques

Various other formssome may combinestrokes


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Physiological Effects of Massage

Therapy

Depending on the amount of pressure applied & thespeed of the stroke, many results can occur

Light, slow strokingevokes systemic relaxation

Fast, deep strokes increase blood flow to the area

Cardiovascular changesdeep friction or vigorousmassage was thought to produce vascular changes

Research failed to support those theories

No increase in cardiac output, b.p., or increased arterial b.

flow were revealed

Massage can produce decreased heart rate, breathing rate,

& b.p. if the purpose is for inducing system relaxation


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Physiological Effects Petrissagehas been shown to decrease

neuromuscular excitability, but only during themassage (effects confined to muscle beingmassaged)

Deep effleurage, circular & transverse frictionhas shown to improve flexibility

Massage is less effective in decreasing

muscular recovery time, but may be effective(2 hrs post) in reducing amount of DOMS

Little reduction in m. fatigue when performingbetween exercise (pitcher, sprinter)


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Physiological Effects

Edema reductionwhen performed properly itcan increase venous & lymphatic flow

Reduces pain

By decreasing pressure from swelling, mechanicalpain can be reduced

By interrupting m. spasm, mechanical pain can bereduced

By reducing edema, mechanical pain can be reduced By increasing b. flow & encouraging waste removal,

chemical pain can be reduced

Activates sensory nervesinhibits pain


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Mechanical Effects

Techniques that stretch a muscle, elongate

fascia, or mobilize soft-tissue adhesions or

restrictions are all mechanical techniques

Mechanical effects are always accompanied by

some reflex effects

As mechanical stimulus becomes more effective,

reflex stimulus becomes less effective

Musclemassage is done either formechanical stretching or to relieve pain

associated with trigger points


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Mechanical Effects

Skinmassage has been shown to increase

skin temperature, increase sweating &

decrease resistance to electrical current

It has been shown to toughen yet soften the

skin

Acts directly on the surface of the skin to

remove dead cells

Stretches & breaks down fibrous tissue


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Psychological Effects

One-on-One treatment

Reduces patient anxiety, depression, & mental

stress

Patient compliance is increased

Patient gains confidence in clinician


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Effleurage Stroking of the skin

Performed with palm of hand

Stimulates deep tissues

Performed with fingertips Stimulates sensory nerves

Superficial, rhythmic stroking:

Contours the body or relates to direction ofunderlying muscles

Deep stroking:

Follows course of veins & lymph vessels


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Effleurage May be performed slowly for relaxation or

rapidly to encourage blood flow & stimulatethe tissues

Performed in rhythmic manner

One hand should always be in contact w/ skin Light effleurage is performed at beginning &

end of massage or may be used betweenpetrissage strokes

At beginningrelaxes patient & indicates area tobe treated

At endcalms down any irritated areas


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Petrissage Lifting & kneading of skin,

subcutaneous tissue, & muscles Performed with fingers or hand

Skin is gently lifted betweenthumb & fingers or fingers &

palm & gently rolled & kneadedin the hand

Often performed without lotion

Frees adhesions by stretching &separating muscle fiber, fascia,

& scar tissue while assistingwith venous return & milkingout waste products
http://images.google.com/imgres?imgurl=http://www.sportsinjuryclinic.net/gallery/sportsmassage/hamstrings_3.jpg&imgrefurl=http://www.sportsinjuryclinic.net/cybertherapist/front/frontthigh/groin_inflammation/sports_massage.php&h=150&w=150&sz=5&hl=en&start=3&tbnid=PNfyl8cZXJZWzM:&tbnh=96&tbnw=96&prev=/images%3Fq%3Dpetrissage%26svnum%3D10%26hl%3Den%26lr%3D


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Friction

Goal is to mobilize muscle & separate adhesions

that restrict movement & cause pain Facilitates local blood profusion

Not necessarily a pleasing treatment

Circular: Applied with thumbs working in circular motion

Effective in treating muscle spasm & trigger pts.


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Friction

Transverse: Applied with thumbs or fingertips stroking the

tissue from opposite directions

Can use elbow, end of rolling pin, etc. for larger

areas

Reaches deep tissues

Begin lightly and then move to firmer strokes

Muscle should be placed in relaxed position

Should be avoided in acute conditions

Effective in tendonitis or other joint adhesions
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Tapotement

Gentle tapping or pounding of the skin Most common form uses ulnar side of wrist to

contact skin karate chop

Wrist & fingers are usually limp, alternatemethod cups the hand

Promotes relaxation & densitization of irritated

nerve endings


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Vibration

Rapid shaking of the tissues

Soothes peripheral nerves

A mechanical device can be used


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Myofascial

Release

Involves effleurage, petrissage & friction massagestrokes with stretching of muscles & fascia

Tries to obtain relaxation of tense and/or adheredtissues (myomuscle; fasciaband; ease the tensionof fibrous CT bands)

No structured pattern

Involves pulling of tissues in opposite directions,

stabilizing the proximal/superior position w/ one handwhile applying a stretch w/ opposite hand, or usingthe patients body weight to stabilize the extremitywhile a longitudinal stress is applied

Can involve more than one clinician


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Myofascial Release Purpose is to relieve soft tissue from abnormal

grip of tight fascia

May also be known as soft-tissue mobilization

Treatment is based on localizing the restriction

& moving into the direction of the restriction

Very subjective & relies on experience of

clinician

Recommended to treat at least 3 x per week


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Acupressure

Acupressurebased on Chinese art of Acupuncture The Chinese make no distinction between arteries,

veins, or nerves when explaining function of the body.

Concentrate on the system of forces that regulate all bodily

functions.

Qi (pronounced che exists in everyone & controls all

aspects of life)

Qi is governed by two opposing forces, Yang (positive) &Yin (negative) forces. Disease results from some imbalance

between these two forces.

Yin & Yang pass flow through passageways/lines in the body

called jing (Chinese) or meridians (West).


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Acupressure

12 meridians in the bodynamed according to the partof the body with which theyare associated. The

meridians on one side of thebody are duplicated on theother side; however, twoadditional meridians existthat cant be paired.

*not paired

Lung (L) Large Intestine (LI)

Stomach (ST)

Spleen (SP)

Heart (H)

Small Intestine (SI)

Urinary bladder (UB)

Kidney (K)

Pericardium (P)

Triple warmet (TW)

Gall bladder (GB)

Liver (LIV)

Governing vessel (VB)*

Conception vessel (CV)*


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Acupressure

Along the meridians lie the acupuncture points Whenever there is pain or illness, certain points on

the surface of the body become tender

When pain is eliminated, these tender spots

disappear

According to acupuncture theory, stimulation of

specific points through needling can reduce

pain in areas associated with a particular point

Thousands of points have been identified


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Acupressure

Electrical resistance of the skin at certain

points corresponding to the acupuncture points

is lower than that of surrounding skin,

especially when a disease state is present.

Russian research has shown evidence of skin

temperature difference at these points.


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Myofascial Trigger Points

Trigger points are the counterpart of

acupuncture points

May be found in muscle, tendons, myofascia,

ligaments & capsules surrounding joints, in

periosteum, & in the skin

May activate & become painful due to trauma

Stimulation of these points have resulted in

pain relief


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What to do.

Location of points: Use an ohmmeter to differentiate the

electrical impedance of areas ORpalpate the area untileither a small fibrous nodule or strip of tense muscletissue that is tender to the touch is felt.

Once located, massage is begun using the thumb, index

or middle fingers or the elbow. Perform small friction-like circular motions over the

point.

Amount of pressure should be determined by patienttolerance, and may be intense and painful.

Treatment time1-5 minutes at a single point.

Patient will report a dulling/numbing effect & willreport the pain diminishes.


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Rolfing

May also see it is structural integration

Goal- to balance the body within agravitational field through a technique

involving manual soft-tissue manipulation Improve balance, posture, flexibility, movement

efficiency

Basic principle of treatment is - if balancedmovement is essential at a particular joint, yetnearby tissue is restrained, both the tissue & the

joint will relocate to a position that accomplishes amore appropriate equilibrium.


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Rolfing Standardized approach that is administered without

regard to symptoms or pathologies Technique involves 10 hour-long sessions, each

emphasizing some aspect of posture

10 sessions include:

Respiration, balance under the body (legs/feet), sagittalplane balance (lateral line from front to back), balance leftto right (base of body to midline), pelvic balance (rectusabdominis & psoas), weight transfer from head to feetsacrum, relationship of head to rest of body, upper of

body to lower of body relationship, balance throughoutthe system

Additional tune-up sessions may be required

Integrates structural with psychological approach


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Underwater Pressure Massage

The therapeutic benefit of the underwater

massage comes from the relaxing effect of

warm water, applied at variable force on the

muscles, particularly on deep-lying musclelayers, subcutaneous tissues, skin and the

abdominal organs (intestines).


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In the underwater massage, the client lies

relaxed in a large tub of warm water. A stream

of water under pressure, (ranging from 0.5 to a

maximum of 7.0 bar absolute pressure units),is applied by means of a hose that has

interchangeable nozzles.

The water needed for the massage is drawnfrom the tub and returned under pressure

through the hose. The high-pressure stream of

water is created by an internal pump.


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WATER TEMPERATURE

The temperature of the water in the tub should

be 36oC; (96.8o F to 100.4oF). The

temperature of the pressurized stream can be

adjusted to a higher or lower temperature than

the water in the tub. The water temperature is

precisely measured by a built-in thermometer.

PRESSURE CONTROL


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PRESSURE CONTROL

Pressure is controlled by a manometer. However,

because the stream of pressurized water has to travelthrough the water in the tub, the pressure shown on

the manometer is not necessarily the pressure that is

felt by the client. For clients who have sensitive tissue such as track

and field athletes one must begin with low water

pressure (0.5-1.5 bar), and raise the pressure slowly.

Conversely clients with large muscle mass, such as

heavyweight wrestlers and boxers, can usually

withstand higher water pressures (2.0-4.0 bar).


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TREATMENT POSITIONS

When massaging the back the client is always

lying on their side. In this position, the hips

and knees are slightly bent, the head and neck

rest on a support

The thorax and the abdomen are massaged

with the client in the supine position


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LENGTH OF MASSAGE

Generally, the length of a massage is 20 to 30

minutes. Its necessary for the person to get

used to the water for a few minutes before

starting the massage.

After the massage, the client may want a cold

affusion to stimulate circulation. The client

should then rest for approximately 30 minutes.


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INDICATIONS

Fractures

Osteosynthesis

Dislocation

Sprains Contusions in the subacute stages after a

patient has been released

Sciatica Lumbalgia

Brachialgia

Joint and Scar contractures


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Degenerative Spinal Disorders

Chronic Joint Rheumatism

Muscular Rheumatism

BechterevsDisease (ankylosing spondylitis) Scoliosis

Flaccid and Spastic Paralyses

The underwater massage can also be utilizedfor muscular hypertonia and for uninjured

athletes as a warm-down massage after

strenuous training and competition.

CONTRAINDICATIONS


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CONTRAINDICATIONS

The underwater massage is contraindicated for

cardiovascular insufficiencies

venous disorders

thromboses

varices.

ABOUT THE TUB


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ABOUT THE TUB

An easy to operate modern bathtub, the

bathtub assembly is made of reinforced fibre,polyester-resin casting (GFK), especially

tempered to provide heat and shock resistance.

The surface will resist thermal and seawater,

plant extracts and chemicals. All surfaces are

smooth and free of pores making the tub

hygienic and easy to clean.

The water pump is noiseless, enclosed in a

plastic casing with a conveying efficiency of

2001/min., infinitely variable from 0 to 6 bars.

All fittings are chrome plated.

DEEP CONNECTIVE TISSUE


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DEEP CONNECTIVE TISSUE

MASSAGE

Deep connective tissue massage is a form of

intense massage that aims to release

myofascial (connective tissue) restrictions in

the body, and to break up any restrictive scartissue. It has also been known to help relieve

chronic tension, to increase the bodys range of

motion, to improve posture and to enhance thenatural harmony of the entire body and mind

Deep connective tissue massage is also said to

restore the length and flexibility to the fascia


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Deep connective tissue massage borrows many

of its techniques from traditional Swedish

massage. However the pressure that a massage

therapist applies during a deep connectivetissue massage is more intense, and massage

oil or lotion isnt typically used

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133572666 Massage Therapy