Spa Vargas University MT101 Introduction to Massage
Therapy
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Spa Vargas University MT101 Introduction to Massage Therapy
Chapter 6: Assessment Introduction General Assessments Postural
Assessment Gait Assessment Range-of-Motion Assessment Appearance of
Tissues Palpation Assessment Functional Assessments Post Treatment
Assessment Copyright 2010 Spa Vargas University
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Spa Vargas University MT101 Introduction to Massage Therapy
Chapter 6: Assessment General Assessments Does not need to be
extensive or time-consuming for nonspecific relaxation massage for
wellness Gives better idea about contraindications, which soft
tissues to address, and how to address them Fascia and Fascial
adhesions Understanding key to massage Can cause the location of
clients pain to differ from where the pain originates fascial
adhesions adhere to near by tissue been crumpled or kinked Caused
by dehydration accumulated scar tissue Repetitive motion Copyright
2010 Spa Vargas University
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Spa Vargas University MT101 Introduction to Massage Therapy
Chapter 6: Assessment Copyright 2010 Spa Vargas University
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Spa Vargas University MT101 Introduction to Massage Therapy
Chapter 6: Assessment General Assessments Compensation patterns
Offset to injury or other imbalance Registered in muscles and
nerves Implications for massage Helps determine treatment focus
Facial lines of tension that radiate from facial restriction
Assessment documentation Initial observations can be recorded in O
section of SOAP Copyright 2010 Spa Vargas University
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Spa Vargas University MT101 Introduction to Massage Therapy
Chapter 6: Assessment Postural Assessment Posture can affect a
persons health Evaluate clients stance Ideal posture Minimizes
stress and strain Maximizes efficiency Anterior aspect Nose and
chin Sternum Spine and navel Shoulders and ears Pelvis, hands,
feet, knees Copyright 2010 Spa Vargas University
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Spa Vargas University MT101 Introduction to Massage Therapy
Chapter 6: Assessment Postural Assessment Ideal posture Posterior
aspect Cranium and shoulders Pelvis and spine Hands and scapula
Lateral aspect Cranium and shoulders Hands Pelvis Knee Copyright
2010 Spa Vargas University
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Spa Vargas University MT101 Introduction to Massage Therapy
Chapter 6: Assessment Copyright 2010 Spa Vargas University
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Spa Vargas University MT101 Introduction to Massage Therapy
Chapter 6: Assessment Postural Deviations Can add to or cause
soft-tissue dysfunction Stress Exhaustion Incorrect posture can be
learned and reinforced Abnormal spinal curvature Swayback posture
Flat-back posture Scoliosis (lateral curvature of spine) Excessive
kyphosis, lordosis Rotation (appearance of turned shoulders)
Copyright 2010 Spa Vargas University
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Spa Vargas University MT101 Introduction to Massage Therapy
Chapter 6: Assessment Copyright 2010 Spa Vargas University
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Spa Vargas University MT101 Introduction to Massage Therapy
Chapter 6: Assessment Feet Foundation of balance Imbalance can lead
to multiple compensation patterns Postural assessment performed
without shoes Check height of arches Determine if feet deviate
medially (toes point in) Determine if feet deviate laterally (toes
point out) Observe wear patterns on shoe soles Refer to other
healthcare professionals when appropriate Copyright 2010 Spa Vargas
University
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Spa Vargas University MT101 Introduction to Massage Therapy
Chapter 6: Assessment Gait Assessment Observe clients walking
pattern Quantity, quality, fluidity, evenness of steps Alignment of
head over spine Position of shoulders Arm swing is equal from side
to side Medial or lateral deviation of feet Extent of knee flexion,
amount of bounce Hip movement is even and fluid Copyright 2010 Spa
Vargas University
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Spa Vargas University MT101 Introduction to Massage Therapy
Chapter 6: Assessment Copyright 2010 Spa Vargas University
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Spa Vargas University MT101 Introduction to Massage Therapy
Chapter 6: Assessment Range of Motion Focus on clients area of
concern Determine which joint movements are affected, how they are
affected, and which soft tissues are involved Specific joint
determines direction and amount Measured in quality and restriction
May determine contraindication for massage Copyright 2010 Spa
Vargas University
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Spa Vargas University MT101 Introduction to Massage Therapy
Chapter 6: Assessment Range of Motion Two kinds of range of motion
Active (AROM): client moves joint to demonstrate how much of the
full range can be completed comfortably and without restriction
Passive (PROM): therapist moves relaxed client through a ROM to
determine full-range limitation Pain and discomfort caused by PROM
can suggest problems with ligaments and joint structures which are
outside the massage scope of practice Copyright 2010 Spa Vargas
University
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Spa Vargas University MT101 Introduction to Massage Therapy
Chapter 6: Assessment Active Range of Motion Assesses the muscles
and tendons actively involved in the joint movement Movement should
be slow Movement performed at steady speed Movement must be
isolated, rest of body still Movement continues to point of
restriction Therapist should demonstrate movement before client
performs the movement Watch for nonverbal clues Copyright 2010 Spa
Vargas University
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Spa Vargas University MT101 Introduction to Massage Therapy
Chapter 6: Assessment Passive Range of Motion Evaluates passive
tissues (ligaments, joints, and joint capsules) Active range of
motion should be performed first Requires client to be relaxed
Client must trust therapist Use gentle, knowledgeable tone of voice
Better determination of indication or contraindication for massage
Perform carefully to avoid injury If pain, massage is
contraindicated If no pain, massage indicated Copyright 2010 Spa
Vargas University
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Spa Vargas University MT101 Introduction to Massage Therapy
Chapter 6: Assessment Copyright 2010 Spa Vargas University
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Spa Vargas University MT101 Introduction to Massage Therapy
Chapter 6: Assessment End Feels Resistance sensation at end of
joint range Specific to structure Normal end feels classified as
hard, soft, firm Abnormal end feels classified as hard, soft, firm,
springy block, empty, spasm Work on recognizing normal versus
abnormal end feels before identifying specific abnormal end feels
Copyright 2010 Spa Vargas University
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Spa Vargas University MT101 Introduction to Massage Therapy
Chapter 6: Assessment Direction of Ease Good tool when clients
cannot relax Uses the direction in which the tissues move with
least resistance Clients body position helps determine starting
point Apply when client continues to tense his muscles during PROM
Client pushes or pulls against resistance Hold for 5 seconds Muscle
naturally relaxes Copyright 2010 Spa Vargas University
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Spa Vargas University MT101 Introduction to Massage Therapy
Chapter 6: Assessment Appearance of Tissues Visual assessment Skin
coloration Redness may indicate increased circulation Paler skin
may indicate reduced blood supply Bilateral symmetry Marks (moles,
varicose veins, scars) Wounds (sores, rashes, bruises) Fullness and
thickness of soft tissues can point out Hypertonicity Difference in
muscle mass Edema (swelling from accumulated interstitial fluid)
Copyright 2010 Spa Vargas University
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Spa Vargas University MT101 Introduction to Massage Therapy
Chapter 6: Assessment Palpation Assessment Good palpation skills
are critical for massage therapy Touching and exploring the body,
locating different structures, and assessing the quality of
structural characteristics Massage Therapists need to have relaxed
hands Less is more is a guideline for palpation and treatment of
soft tissues Evaluate soft tissues for Temperature (local hot or
cold) Textures (hypertonic muscles, scar tissue, restricted fascia,
trigger points, tissue edema) Movement (fascial adhesions and
restrictions) Rhythm (breathing, pulse, craniosacral) Copyright
2010 Spa Vargas University
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Spa Vargas University MT101 Introduction to Massage Therapy
Chapter 6: Assessment Assessment of Skin Temperature Temperature
can be circulation indicator Excessive heat can be caused by Fever:
systemic contraindication Inflammation response to injury Determine
how long Less than 72 hours in local area contraindicates massage
Cold skin can indicate decreased circulation Ischemia (reduced
blood supply) Massage indicated Copyright 2010 Spa Vargas
University
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Spa Vargas University MT101 Introduction to Massage Therapy
Chapter 6: Assessment Texture and Movement of Soft Tissues Scar
tissue and restricted fascia feel bound and stuck together
Hypertonic muscles feel tight and resistant Trigger points feel
like knots; pain radiates to another body part Tissue edema feels
spongy or full and squishy Copyright 2010 Spa Vargas
University
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Spa Vargas University MT101 Introduction to Massage Therapy
Chapter 6: Assessment Textures and Movements of Muscles Normal,
healthy muscles feel warm and pliable Open up to receive additional
pressure Slip smoothly past neighboring tissues Not painful Muscles
lacking nutrition feel deteriorated and insubstantial (dissolving)
Injured muscle tissue Feels ropelike Massage stroke may slow down
or bounce over Repetitive motion muscles feel resistant, tough,
inelastic, and sticky Copyright 2010 Spa Vargas University
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Spa Vargas University MT101 Introduction to Massage Therapy
Chapter 6: Assessment Rhythms Body rhythms can provide information
about client Breathing rhythm Check rib cage movement for Slow,
deep breathing Fast, shallow breathing Upper chest breathing Good
topic for self-care Cardiac pulse Check for difference in strength
of pulse, side to side Craniosacral rhythm Ebb and flow of
cerebrospinal fluid Evaluated for quality, quantity, fluidity
Copyright 2010 Spa Vargas University
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Spa Vargas University MT101 Introduction to Massage Therapy
Chapter 6: Assessment Functional Assessments Evaluate the clients
area of concern to discover the likelihood of dysfunctions Manual
muscle tests Clients perform isometric muscle contractions against
counterforce Determine where muscles have abnormal function because
they are shortened, overstretched, or weak Manual resistive tests
Active isometric muscle contractions Determine problem with muscle
or tendon Could possibly indicate more severe neurological
condition* Special orthopedic tests Find conditions related to
fascia, ligaments, nerves, joints *Caution: Do not diagnose; refer
to healthcare practitioner Copyright 2010 Spa Vargas
University
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Spa Vargas University MT101 Introduction to Massage Therapy
Chapter 6: Assessment Post Treatment Assessment Reevaluate original
findings Example: Client complained about tight left shoulder
before session Hypertonicity can be assessed during massage
Shoulder elevation and range of motion assessed after client is off
table and dressed Document changes in activity and analysis section
of SOAP note Copyright 2010 Spa Vargas University
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Spa Vargas University MT101 Introduction to Massage Therapy
Chapter 6: Assessment Summary Assessment is a critical first step
to massage therapy Determining underlying cause is more beneficial
and produces longer-lasting results than just giving a massage
Suspect compensation patterns; treat them to restore optimal
function Treat where it hurts, where it is compensated, and at the
ends of fascial restriction Copyright 2010 Spa Vargas
University