Massage Flashcards

1
Q

What’s the rationale behind massage as a treatment?

A

Headaches & neck pain
Back pain
Upper & lower limb issues
Sports injury pain relief
Fatigue
Scar tissue mobilisation & softening
Helps with anxiety & depression
Group therapy
Relaxation

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2
Q

What physiological systems does massage effect?

A

Circulatory & lymphatic
Nervous system
MSK
Respiratory
Skin

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3
Q

How does massage effect the circulatory & lymphatic system?

A

Arteriole & capillary dilation
Recruitment of dormant blood vessel
Irritant & waste removal
Increasing perfusion & oxygenated blood flow to local area (important in immobilised limbs)
Drainage of lymph and venous blood (↓ swelling)
Increase local and general circulation (↓ waste & ↑nutrients)
Blood shunting - redistributing blood to area under treatment.

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4
Q

What effects does massage have on the nervous system?

A

Sedation may take longer to achieve - ANS stimulation reduced
Stimulation of ANS (faster strokes and lighter touch)
Pain Control – stimulates sensory Receptors
Aids sensory recovery through sensory stimulation (Stimulates short and long term synapse potentiation)
Positive effect on sensory perception, calming receptor excitability and interrupting pain pathways through use of other afferent stimuli
Induces endorphin release = ↓pain
↑ immune response
Stimulates skin sensory & nerve fibres
It acts as a sedative or a stimulant (depends on method)
Messages go via afferent fibres to the spinal cord
Effleurage/slow stroking have sedating effect: activation of the PNS & stimulates the Vagus nerve to slow down the heart rate & ↑ peristalsis.
“Therapeutic touch” = ↑ blood haemoglobin
Relieves pinched nerves pain

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5
Q

What effects does massage have on the MSK system

A

Stretching = ↑ muscle tone, firmness & flexibility (reg. massage)
Petrissage/kneading + compression movements = ↑ venous flow, so body replaces the fluids that are removed from the muscle tissue & ↑ O2 + nutrients
Help eliminate scar tissue & reduce formation on muscle fibres.
Reduces tension in tissues
enhancing lactate & metabolite removal - ↓fatigue & recovery time
Can reduce muscle spasms (muscle spindle sensitivity)
Aids muscular pump effect (>circulation of blood and lymph)
Reduce DOMS
Improves flexibility/elasticity ↑ROM + ↓ associated pain
Nourishes periosteum of bones
Relieves muscle & joint soreness and stiffness *
Breaks down or prevents the formation of adhesions (knots)
Reduces inflammation & swelling by removal of waste + irritants

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6
Q

What effects does massage have on the respiratory system?

A

Loosens and mobilises lung and bronchial secretions (tapotement)

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7
Q

How does massage effect the skin?

A

Nourishes skin: erythema + ↑blood flow)
Cleanses skin: sweat gland stimulation.
Aids skin healing & condition
↑Cell metabolism stims Stratum Basale cells & ↑mitosis,
↑skin circulations, ↑ cell nutrition & regeneration.
↑sweating = ↑urea & waste products excretion through skin
Capillaries vasodilation improves colour and tone
↓ skin tension = ↑elasticity
↑sebum production, ↑ suppleness & infection resistance
↓Superficial scar tissue
↑ sebaceous & sweat glands use, skin = lubricated, clean, and cool
Re-moisturise, and soften dry skin

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8
Q

What structures does massage effect?

A

Blood & Lymph vessels
Soft tissue - muscle & tendons
Skin

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9
Q

How do you apply massage?

A

1) Introduce
2) Explain procedure & benefits for informed consent
3) Check area visually and ask about contraindications
4) Assess area using effleurage: stoking
5) Use effleurage (v, pisiform & flat hand) to promote circulation and prepare for other techniques
6) Petrissage: kneading picking up & wringing
7) Tapotement: clapping hacking & brushing
8) finish treatment with more effleurage
9) visually check area and ensure patient is feeling okay, check for dizziness if been lying down for long periods

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10
Q

Name some regional contraindications of massage.

A

Overactive bone growth
Benign tumours and abnormal lumps
Acute inflammation and oedema
Collagenous weakening
Varicose veins. (Deep massage)
Foreign body implants, bony fragments or glass imbedded in the tissue

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11
Q

What are some skin problems, injuries or conditions that massage could effect?

A

Bruises & scars; Open wound surfaces(i.e. Cuts, abrasions, ulcers) and blisters; Reduced skin sensation

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12
Q

What are some contagious conditions that are contraindications of massage?

A

athlete’s foot, ringworm, verrucae, warts, herpes
Rashes of indeterminate cause
Severe localised psoriasis, eczema or dermatitis as massage could cause further spread due to increased circulation

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13
Q

What are some general contraindications of massage?

A

Any contagious disease e.g. scabies, impetigo, herpes
Acute infections and feverish conditions (e.g. pneumonia, preeclampsia, influenza).
Acute infection of bones (e.g. osteomyelitis), joints (e.g. septic arthritis), skin (e.g. dermatitis), muscle (e.g. myositis) or subcutaneous tissue (e.g. cellulitis).
Influence of mind altering drugs or alcohol
Undiagnosed cancer or cancer in early stages
Dermatomyositis
Diabetes mellitus, uncontrolled
Post natal – abdominal area
Post-operative.
Epilepsy, uncontrolled
Allergic reactions
Severe widespread psoriasis, eczema or dermatitis
Hypersensitive skin

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14
Q

What are some cardiovascular conditions that are contraindications for massage?

A

Extreme high/low blood pressure, Severe/acute heart conditions
Arteriosclerosis
Aneurisms
Deep vein thrombosis and emboli
Phlebitis

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15
Q

Name some precautions to consider before applying massage?

A

Radiotherapy
Oedema
Skin condition
Cancer
Recent injury/surgery
Infectious diseases
MS
Diabetes
Acute inflammation
Fractures
Pre-eclampsia
Umbilical hernias
Abdominal diastasis
Psychological issues
Hepatitis
Blood disorders
Medication
Endangerment sites
Pregnancy
Osteoporosis
Asthma
HIV

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16
Q

What questions should you ask to check for contraindications of massage?

A

Are you feeling well in yourself?
Do you have any cardiovascular conditions?
Do you have any skin conditions or open wounds?
Do you have any injuries or pain?
Have you recently undergone any other procedures like surgery or radiotherapy?

17
Q

Peripheral limb massage step by step:

A

1) stroking
2) Effleurage - v technique, pisiform, flat hand drainage into node
3) Segmental effleurage
4) Crossing over
5) Kneading, Picking up & ringing
6) Effleurage to close

18
Q

How do you prepare a patient for a back massage?

A

Fold blanket in half
Wrap around torso & bring together
Hold in place as they lie down
Open up blanket & roll - tuck into arms
Tuck towel into shorts

19
Q

Back massage step by step:

A

1) Stroking
2) Effleurage: Start at sacrum, push over top of glutes into axillary nodes, then waist, bottom of ribs, straight up into axilla, to paravertebals, superclavicular nodes, flat hand @ scapula
3) Kneading: top of glutes use heel, full hand for paravertebrals, finger reinforced @ lumbar, protract scapula (Hand off bed) heal glides & finger kneading

20
Q

How do you prepare a patient for a neck massage?

A

Fold blanket in half
Wrap around torso & bring together, tuck in & tie
Client sits on chair sideways, arms rest on plinth
Layer pillows, rest forehead on top
Client can rest arms on lap

21
Q

Neck massage step by step

A

1) Stroking - for longer than just assessment purposes
2) Effleurage: SCM to supraclavicular nodes, increase area to upper traps, the paravertebrals & scapula to axilla
3) Kneading: Finger knead SCM & upper traps, effleurage inbetween - do one side at a time, progress onto middle fibres of traps full hands & heel then finger kneading
4) Petrissage: Pick up traps, push @ 45’, squeeze & relax ; ringing, use fingers up & down traps

22
Q

What are the 4 techniques of effleurage.

A

Stroking
V technique
Pisiform technique
Flat hand technique

23
Q

Describe application of and rationale behind stroking technique

A

Run hands across whole area
Used as assessment - looking for abnormalities
Allows patient to get used to hands
Therapist gets used to feel of the limb
Warms and prepares skin for other techniques

24
Q

Describe application of and rationale behind V technique

A

Hands are together, form a v with the L shapes between index and thumb
Least pressure @ top, most @ bottom
Apply pressure distally to proximally into a lymph node
Stroke gently back down
Drains fluid into nodes

25
Q

Describe application of and rationale behind pisiform technique

A

Leading with pisiform, fingers point outside of limb & other hand on top
Apply pressure distally to proximally into a lymph node
Stroke gently back down
Least pressure @ front, most @ thumb
Drains fluid into nodes

26
Q

Describe application of and rationale behind flat hand technique

A

One hand over the other, fingers pointing in the direction of travel
Lead with fingers
Distal to proximal direction
Least pressure @ beginning, most pressure following

27
Q

What 3 techniques make up petrissage?

A

Kneading, picking up & ringing

28
Q

Describe application of and rationale behind kneading technique

A

Hands move in circular motion, R= clockwise, L= anticlockwise
Stretch muscle on way up, relax on way down
Move down muscle
Can reinforce- one hand over the other
Use heel of hand in tight area to increase depth
@ specific areas (musculotendinous junction / small muscles) use fingers or thumb - can also be reinforced

29
Q

Describe application of and rationale behind picking up technique

A

Push down into muscle, squeeze hands together & let muscle lift up between fingers and thumb
Crab claw handling

30
Q

Describe application of and rationale behind ringing technique

A

Push down and squeeze with both hands
Alternate pushing L thumb to R index finger and vice versa

31
Q

Principles of tapotement

A

Striking techniques
Stimulates muscles
Expels chest secretions

32
Q

Types of tapotement

A

Cupping
Pinching to promote aggression
Brushing with pushes and claps

33
Q

Describe application of and rationale behind cupping technique

A

Cup hands & strike area
Force air under hands when striking
Avoid slapping
Relax wrist to prevent fatigue
Can be:
Single/double handed
varying speeds
varying depths

34
Q

What is important when preparing a patient for massage?

A

Maintain their dignity