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What is gout?
Inflammatory arthritis caused by uric acid crystals in and around joints
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Is wear and tear/autoimmune causes for gout?
No
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What parts of the body are most affected by gout?
Feet and toes and smaller joints
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Is it indicated to perform massage therapy on someone with gout?
Systemic contraindication in the acute stage and local contraindication in all joints affected by gout
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Define Lyme Disease:
Bacterial infection due to bite from deer tick
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What are the S/S of Lyme Disease?
Bull's-eye rash, fever, headache, stiff neck, swollen lymph nodes 50% do not develop rash inflammation of one or more large joints (knee)
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Can you perform massage therapy on someone with Lyme Disease?
It is a contraindication in the acute phase
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What is Osteoarthritis also known as?
DJD or Degenerative Joint Disease
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What causes Degenerative Joint Disease (Osteoarthritis)?
Wear and tear on joints causing inflammation and irritation, affects weight bearing joints (hips, knees, spine...), most common form of arthritis
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Is it indicated to perform MT on someone with Osteoarthritis?
Massage is used to help maintain ROM, decrease spasm in the surrounding muscles. NO local MT in the acute phase (like when they are inflamed).
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What causes patellar cartilage damage due to overuse?
Patellofemoral Syndrome
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What are the S/S of Patellofemoral Syndrome?
- Pain in and around the patella
- knee stiffness
- crepitus (clicking of the knee)
- difficulty going down stairs
- squatting (weight of femur pushing down on patella)
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Is it indicated to perform MT on someone with Patellofemoral Syndrome?
Yes, in the acute stage MT can help a lot. Address the structures that cross the knee joint/causing patella to be pulled laterally.
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What type of arthritis is an autoimmune disease affecting synovial membranes, mainly hands and feet (often symmetrical)?
Rheumatoid arthritis
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Is MT indicated for Rheumatoid arthritis?
Yes in the subacute phase. Address the tendons/MS that cross the joint. Helps to decrease clients stress levels.
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What type of arthritis is a bacterial infection of the joint capsule, causing inflammation?
Septic arthritis
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S/S of Septic arthritis?
Can become serious in a matter of hours
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MT for Septic arthritis?
No, contraindicated
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What is a degenerative joint disease (DJD) of the spine that usually affects the cervical and lumbar area?
Spondylosis aka spinal stenosis
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What are the causes of Spondylosis?
Degenerative Disc Disease (DDD) (lack of shock absorption & chronic misalignment)
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What is a narrowing of the spinal canal?
Spinal Stenosis
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Is MT indicated for someone with Spondylosis?
Yes, but with caution. Can help to reduce but not remove muscle spasm/splinting, work with a health care team to determine tx.
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What is an injury/tear in a ligament (bone to bone)?
Sprain
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What are the different degrees of sprains?
- 1st degree - mild/minor
- 2nd degree - moderate (some or many fibers torn)
- 3rd degree - severe (complete rupture)
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What are some S/S of sprains?
More serious than strains (injury/tear to MS, takes longer to heal), Ligaments in wrist/ankle most often sprained
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Is it indicated to perform MT on a sprain?
Yes in the subacute phase, can help to decrease adhesions, muscle spasm/joint stiffness
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What can cause TMJD?
- Malocclusion (dysfunctional bite)
- Bruxism (teeth grinding)
- Loose ligaments
- Trauma Stress (all sorts of jaw dysfunction)
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What are some S/S of TMD(J)?
Difficulty opening/closing the jaw, chewing, or swallowing, jaw clicking, ear pain, mouth pain, headache, serious subluxation (misalignment), jaw, neck, shoulder, and ear pain, grinding of teeth
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Is MT indicated for TMD(J)?
Yes, MT can be beneficial
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What is a posterior fluid filled extension/sac of the synovial membrane of the knee? Where does it normally protrude?
Baker cyst, Protrudes into poplitial fossa (back of knee)
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Is a Baker's cyst typically painful?
No
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What are Baker's cysts typically associated with? Why are they dangerous?
Often associated with: osteoarthritis, RA, meniscus tears. Dangerous because of possible impingement of nerves or blood vessels
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What is a laterally deviated big toe/ protrusion at the 1st metatarsal phalangeal joint?
Bunion aka hallux valgus (genetics/shoes=common cause)
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MT of a bunion?
Local contraindication
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Where is the most common bursa?
Subacromial bursa (shoulder)
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What is a bursa?
A small flat, fluid filled sack. Acts as a protective cushion at areas of recurring pressure (where tendons/ligaments are constantly moving over bony areas).
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What causes a bursa to become inflamed? What happens to the surrounding structures?
Overuse of surrounding structures, causing splinting/spasming/ TP's/ pain and decreased ROM w/ any movement (active, passive, resisted). Often accompanies other inflammatory conditions
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MT with Bursitis?
Locally contraindicated in the acute phase
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What is an idiopathic contracture of the palmar fascia?
Depuytren contracture (palmar fasciitis)
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What area is most affected with Depuytren contracture (palmar fasciitis)?
4th & 5th digits, usually painless
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Is MT indicated with Depuytren contracture (palmar fasciitis)?
Yes, but be careful of nerve damage, surgery
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What is a small CT pouch filled with fluid on joint capsule and tendon sheaths? Where is it most typically found?
- o Ganglion cyst
- o Usually found on wrist and dorsal surface of ankle/foot
- o Usually painless
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What is a protrusion of an organ/ part of an organ through the cavity that contains it?
Hernia
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What type of hernia is most common in men?
Inguinal hernia, intestines/inguinal ring
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What type of hernia is most common in women?
Femoral hernia, intestines/femoral ring
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Is MT indicated for a hernia?
Contraindicated for deep, facial stretching techniques, post surgery. OK locally, if old and no longer painful.
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What is an irritation and inflammation at the tibial tuberosity (musculo skeletal condition) usually there is a bump?
Osgood-Schlatter Disease
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S/S/causes of Osgood-Schlatter's?
Overuse/strong contraction of Quads, pulling on tibial tuberosity, usually seen in adolescents/ teens during growth spurts
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Is MT indicated for Osgood-Schlatter's?
Yes to address the spasms in quads and tendonitis when appropriate, address tight hamstrings, general hypertonicity of the upper leg
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Another name for flat feet
Pes planus
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Is MT indicated for Pes palnus?
Yes, can help with the various parts of the body affected headache relief, knee, back, hip etc...
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What is an autoimmune disorder damaging arterioles, stimulating excessive production of collagen in the skin?
Scleroderma
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What parts of the body does Scleroderma usually affect?
Skin of hands & face (localized), then it can move to the internal organs (systemic)
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Cause of Scleroderma?
Unknown (idiopathic)
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S/S of Scleroderma?
"CREST syndrome" calcium deposits in skin, impaired circulation, trouble swallowing, hardening of fingers, skin discoloration
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Is MT indicated for Scleroderma?
Depends on which tissues are involved. Inappropriate to push fluid through inflamed or scarred vessels. No circulatory work.
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What is a unilateral spasm on a neck muscle that causes the head to be "stuck" in flexion and rotation?
- o Torticollis
- o Congenital- unilateral development of SCM
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What is an acute acquired torticollis, caused by activated TP's?
Wryneck
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Is it ok to perform MT on someone suffering from Torticollis?
Indicated if no other contraindication involved. Avoid stretching the involved MS's when in the acute phase.
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What is a permanent shortening of a muscle group?
Contracture
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Is MT indicated with a contracture?
Yes after the cause has been corrected and with permission from MD. Never in areas with nerve damage (lacking pain scale) and avoid deep specific work in fragile tissue. Atrophied MS may be fragile.
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What is another name for CAD (cervical acceleration/deceleration)?
Whiplash or WAD (whiplash associated disorders), MT only in subacute phase and with MD approval, be conservative, may contraindications.
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What is an entrapment of the median nerve?
Carpal Tunnel Syndrome
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What causes Carpal Tunnel Syndrome?
RSI (repetitive stress injury) to the wrist, flexion/extension, puts pressure on the nerve
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What condition is indicated when there is pain/numbness/tingling in the later 3.5 fingers?
CTS
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Is MT indicated for CTS?
Yes, but do not continue techniques that may increase or recreate symptoms, accurate diagnosis is a must, and let the ct. know that you are not treating CTS, rather the symptoms associated with it.
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What is an autoimmune disease affecting ACH receptor sites at the neuromuscular junction?
- o Myasthenia gravis
- o Weakness, fatigue, no sensory loss, just motor loss.
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What is a neurovascular entrapment of the brachial plexus?
Thoracic Outlet Syndrome
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What travels this path: intervertebral foramen-between anterior & middle scalene-between clavicle & 1st rib-under pec minor near corticoid process-around head of humerus?
TOS
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What is the most common area for disc herniation?
L4-L5, L5-S1
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What is an autoimmune disease affecting the ACH (acetylcholine) receptor sites at the neuromuscular junction?
Myasthenia Gravis
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What is a shortage of RBC, hemoglobin or both?
Anemia
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What are you deficient in if you have pernicious anemia?
B12, reduced RBC production, can lead to CNS damage
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S/S of anemia?
pallor (pale skin), dyspnea (shortness of breath), palpitations, fatigue, intolerance to cold
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MT with anemia?
Contraindicated
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What is a travelling clot, debris?
Emoblism
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What is a clot lodged w/in blood vessels of the lungs (veins)?
Pulmonary embolism (PE)
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What is clot that lodges anywhere but the lungs called?
Arterial embolism
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MT of an embolism?
Local and circulatory contraindication
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What is a stationary clot?
Thrombus
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What is bleeding between muscle sheaths called?
Hematoma aka bruising
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What is a genetic disorder in which certain blood clotting factors are absent or inactive? Where males bleed longer, not faster.
Hemophilia
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What is a cancer of WBCs produced in bone marrow?
Leukemia
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What is an inflammation of superficial veins d/t clot?
Thrombophlebitis
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What is an inflammation of deeper veins d/t clot (often found in the calves, pelvis & thighs)?
Deep vein thrombosis
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What are risk factors for DVT?
- o trauma
- o chemo
- o pain
- o surgery
- o reduced circulation
- o high estrogen birth control
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MT and vein conditions?
Do not want to make symptoms worse, if there is a clot do not want to break it loose. Be very cautious.
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What sort of MT is indicated for leukemia?
Modify MT depending upon S/S and tx. Do they bruise easily? Are they at risk for infection? DVT or blood clot? If Ct. is cancer free for 5 years or more any method is appropriate.
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What is a permanent bulge in wall of a blood vessel or the heart? Can lead to a rupture (hemorrhage) - bleed to death
Aneurysm
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What is it called when arteries become inelastic and brittle due to plaque?
- o Atherosclerosis
- o "hardening of the arteries"
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What are risk factors for atherosclerosis?
- o Smoking
- o High cholesterol
- o Hypertension
- o Sedentary lifestyle
- o Diabetes
- o Family history
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MT and atherosclerosis?
Systemically contraindicated for advanced cases. Ask yourself: will the person be able to adjust to the change in internal environment brought on by MT?
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Episodes of vasospasm of the arterioles
- o Raynaud's syndrome
- o Usually in the hands and feet
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Hypertension (HTN) is also known as? Is MT indicated?
High blood pressure, MT is contraindicated unless MD consent, be careful of SNS stimulation and neck vasculature
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Damage to the internal valves of superficial veins
Varicose veins
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What is an espisode(s) of vasospasms of the arterioles that usually occurs in hands/feet (stress, cold, meds...) Skin changes from white to blue to red, cold hands
Raynaud's syndrome
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Is MT indicated with Raynaud�s syndrome?
Yes as long as it is not from a pathology that is a contraindication (arthritis/diabetes)
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Damage to myocardium d/t ischemia (blockage or clogging of the arteries)
Heart attack aka myocardial infarction
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Heart cannot pump blood to the body efficiently
Heart failure aka congestive heart failure (CHF)
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MT and heart failure?
Depends on damage, can their heart withstand changes in circulation brought about my MT? Medications? Circulatory work is contraindicated.
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What heals faster, a strain or a sprain?
Strain
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Is a weak psoas involved in hyperlordosis?
No!
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Does someone with functional scoliosis have abnormally shaped vertibrae?
No
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What is Parasthesia?
numbness/tingling
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A condition in which blood supply to a bone is interrupted
- o Avascular osteonecrosis
- o Head of the femur is the most common
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Type of broken bone where the bone protrudes through skin or into the body cavity
Compound (or open)
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Green stick fracture
Bending with partial break
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