1. massage is
    a mechanical stimulation of the tissues by means of rhythmically applied pressure and stretching
  2. reflex effects
    • ans phenomenon
    • can occur alone or with mechanical effect
    • sedation, relief of tension, and inc blood flow
  3. reflex effect on pain
    • cutaneous stimulation of large diameter afferent nerve fibers effectively block transmission of pain
    • stimulation of painful areas in the skin or myofascia can facilitate the release of B-endorphins and enkephalin; affect transmission in descending spinal tract
  4. effects on circulation
    • emptying of blood vessels by squeezing and also by reflex action on blood vesels from sympathetic division on the NS
    • inc blood volume and blood flow resulting in inc temp of the area
    • inc lymphatic flow, which helps to reduce edema in interstitial space
  5. effects on metabolism
    • inc blood circulation which then inc the clearing of waste products and inc of blood and oxygen
    • help remove lactic acid
  6. mechanical effects of massage
    stretching of muscle, elongated fascia or mobilize soft tissue adhesions or restrictions and they tend to be accompanied by some reflex effects
  7. mechanical effects on muscles
    • inc blood flow to skeletal muscles and inc venous return
    • dec in neuromuscular exciability (muscles spasm)
    • stretching of muscle and scar tissue
    • inc of ROM
  8. effects on skin
    • inc temp
    • inc sweating
    • dec skin resistance to electrical current
    • breaks down adhesions and soften scar
    • removal of dead cells that may result from prolonged casting
  9. psychological effects of massage
    • feeling of "helping hand"
    • sedative effect
    • reduction of tension and anxiety
    • inc feeling of well being
  10. indication of massage
    inc coordination, dec pain, dec neuromuscular excitability, stimulate circulation, facilitate healing, restore jt mobility, remove lactic acid, alleviate muscle cramps, inc blood flow, inc venous return, retard muscle atrophy, inc ROM, edema, myositis, bursitis, fibrositis, tendonitis, revascularization, headaches/migraines
  11. contraindications of massage
    circulatory disorders, cellulitis, absceses, synovitis, skin infections, malignancies, acute inflammatory conditions, fever
  12. lymhatic system
    • accessory route by which fluid can flow from interstitial spaces into the blood flow
    • can carry protein and large particulat matter away from tissue spaces
  13. what does not have lymphatic system
    skin, bones, CNS, peripheral nerves, endomysium of muscles
  14. where does the lymphatic system empty
    thoracic duct and right lymph duct
  15. transportation of lymph
    • internal factor
    • external factor
  16. external factor
    • contraction of surrounding muscles of the body
    • mvmt of the parts of the body
    • pumping force of the heart
    • compression of the tissues by objects outside the body (pressure bandage)
  17. guidelines of massage
    • hands must be clean
    • proper positioning of pt
    • rhythm must be steady and even
    • large area > time than large jt
    • massage proximal area first than move distal but direction is from distal to proximal
    • begin with effleurage and end with effleurage
    • elevate body part if needed
  18. direction of forces should be applied in the
    direction of muscle fibers
  19. each stroke should start and finish
    • at or below
    • above
  20. effleurage
    • a relaxing stroke on superfical area
    • helps the return flow of the venous and lymphatic system
    • direction should be towards the heart
  21. different types of efflerage
    • general
    • bilateral tree
    • shingles
    • knuckling
    • three count traps
    • horizontal stroke
  22. bilateral tree
    go up a little, out, back to the middle, and then up further
  23. shingles
    • one side at a time with both hands. one hand out one hand in
    • lead with ulnar border of hand
  24. knuckling
    same as others except use knuckles
  25. three count trapezius
    go from lower to middle to upper trap
  26. horizontal stroke
    one hand on either side of pelvis at low back lift and squeeze across
  27. petrissage (kneading)
    • consist of grasping, wringing, lifting, rolling, or pressing part of a muscle
    • inc venous and lymphatic return and to break up adhesions in the skin
    • mvmt of hands is from distal to proximal point of muscle insertion
    • grasping must be parallel to or at a right angle to muscle fibers
  28. types of petrissage
    • two handed petrissage
    • one handed petrissage
    • creepy crawly
  29. two handed petrissage
    both hands do circles in the same direction on same side pushing hard to move fluids
  30. one handed petrissage
    pick up muscle group and squeeze
  31. creepy crawly
    alternating two handed petrissage thumb of one hand and fingers of the other hand work together trying to move a wave of tissue
  32. tapotement-percussion
    • series of brisk blows for stimulation
    • inc blood flow
    • peripheral nerve endings are stimulated to produce stronger impulses
  33. types of tapotement-percussion
    • hacking
    • slapping
    • beating
    • tapping
    • clapping
  34. hacking
    alternating striking of patient with ulnar border of the hand
  35. slapping
    alternate slapping with fingers
  36. beating
    half closed fist using the hypothenar eminence of the hand
  37. tapping
    with the tips of the fingers
  38. clapping or cupping
    • using fingers, thumb, and palm together to form a concave surface
    • used in postural drainage and for breathing exercises
  39. vibration
    • rhythmic trembling mvmt that causes the part to vibrate
    • force come from forearm and elbow
    • useful for dislodging congestion when postural drainage or productive coughing is being performed
    • used after cupping
  40. massage routine
    • superficial stroking
    • deep stroking
    • kneading
    • superficial stroking
    • frictional or tapotement
    • deep stroking
    • superficial
  41. friction massage
    • is a technique of small mvmts that penetrate into the depth of muscle, tendon, and ligament by moving the tissues under the skin
    • used to maintain or restore mobility
  42. effects of friction massage
    • traumatic hyperemia
    • frees adherent fibrous tissue (scar)
    • aid in the absorption of local edema or effusions
    • inc tissue perfusion
    • reduce local muscular spasm
    • reduce inflammation around jt and prevent the formation of adhesions
  43. preventing early scar formation in muscular tissue
    • prevents debilitating scar from forming during remodeling stage of healing
    • re-institues inflammatory processes until a point where inflammatory process is brought to a successful end
    • useful in chronic cases and overue problems
  44. preventing early scar formation in decubitus ulcer healing
    • normal healing is from base membrane
    • in ulcers start from top rather than from base
    • friction on edge delays this closing to allow ulcer to close or heal from bottom
  45. friction massage can help
    • get rid of painful crepitus
    • and put tendon in a sheath
  46. contraindications for friction massage
    • ossification in soft tissue
    • bursitis
    • RA
    • pressure on nerve
    • cancer, TB, and infected nodule
  47. guidelines for friction massage
    • identify spot to be treated
    • tendon in slight stretch
    • massage with thumb or index finger, or the heel of the hand
    • friction must be given across the affected area in case of a tendon, or circular if it is a trigger or acupressure point
    • 7-10 min`
  48. acupressure and trigger point massage
    using trigger pressure over acupunture points or trigger points to decrease pain
  49. where are trigger points found
    • muscle, tendons, myofascia, ligaments and capsules surrounding joins, periosteum and in skin
    • may become active b/c of some trauma to the muscle
  50. guidlines for trigger point massage
    • ohmmeter may be used to locate trigger point
    • massage with index or middle finger, the thumb or elbow
    • small circular motions
    • pressure determined by pt
    • more pressure more effective
    • 1-5 min single point
    • start distally proceed proximally
    • dulling or numbing effect is indication of relief
Card Set