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Flashcards in Massage Deck (72)
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General Effects of Massage: Cardiovascular System

- Dilation of superficial vessels via local reflexes
-Increase in stroke volume via promotion of venous return (for some pt's. this may not be good because the heart would be able to handle the increased blood volume).
-Decrease incidence of DVT via decrease in blood viscosity and hematocrit.

- Increases lymph flow via mechanical pressure.


Massage has 3 effects

1. Psychological
2. Physiological
3. Mechanical


General Effects of Massage: Connective Tissue

Decreases pain and improves tissue mobility (Mechanical)

Cyriax Friction (for injury only)
- Traumatic hyperemia
- Prevents/Disrupts adhesion
- Temporary analgesia


General Effects of Massage: Muscle Tissue & Nervous System

Muscle Tissue
- Decreases muscle spasm
- Decreases muscle hypertension
- Increases muscle extensibility

Nervous System
- Decreases pain, possibly via the Gate Theory of Pain and via an increase an opiate production.


Indication for Massage

Muscle Spasms
Trigger Points
Inefficiencies of Circulation
Contracted Tissue
Specific or General Tension


Contraindication for Massage

For this course:

Severe Distress (severe pain, febrile state)
Systemic Edema
Acute Conditions (0-48 hrs, minimum)
Over Recent Surgery
Increased Circulation is not Desired
Contagious Skin Conditions
Over Foreign Bodies or Sharp Bony Prominence
Over Areas of Active Bone Growth
Over Areas of Decreased Sensation
Tuberculosis Diagnosis
Over the Pregnant Abdomen


What is the Role of Touch (How Does Touch Effect)

Interaction is both physical and physiological (gets the pt. used to you and visa versa)

Helps you identify the pt's. state

Touch can communicate your state of being

How are your hands? (how do they feel)


How are your hands?

Always wash your hands before and after a treatment (H2O and Soap).

Hot Water, 15+ seconds.

Hands warm and dry prior to touching the pt.

Always consider short finger nails and rings.


Positioning of the Patient

Support should be given to natural joint curvatures.

Pt. Limbs should be elevated to allow gravity to assist (when possible) with circulation.

Patient should not be holding /supporting any part of themselves

Above all else, the pt. should be comfortable.



You want to expose the area that you will be treating.

Parts not treated should be covered by a towel or a sheet.

Draping should be tight.

The Drape Line - The line of the drape you DO NOT cross.


Massage Media (lotion/creams)

The purpose for massage media is to avoid uncomfortable friction between the clinicians hands and the pt's skin.

It is best if it is unscented, hypo allergenic.

Avoid lotions: Many absorb too quickly into the skin requiring repeated pauses/interruptions to the massage.


Positioning the Therapist

Always monitor your own body mechanics.

Shift your weight.

When possible, face the pt. when performing massage (this allows you to monitor non-verbal cues, and gives them more assurance if they can see you and what you are doing).


Where should the table be for the Therapist?

The table height is usually between the therapist's wrist and the ends of the fingers.

This may vary though; therapist may need to use a step.


Effleurage Massage

A rhythmic, consistent, stroking

This can be superficial or deep.

Superficial effects - reflex effect and is calming.

Deep effects - reflex and mechanical effect

Effleurage also helps with:
Information gathering
Warming of superficial tissues (skin and fascia).


Petrissage and Compression

This is intermittent Kneading

This can be done unilaterally, bilaterally, or digitally (by the therapist)

Petrissage helps to:
Increase circulation
Softens and lengthens tissue


Friction Massage

This type of massage is sustained pressure with movement.

Friction massage may be done linear, cross fiber and circular.

Cyriax Cross Fiber is a particular technique.



Is a rhythmic shaking of tissue or a limb.

This helps to:
Decrease muscle guarding.
Helps the pt. to relax.



This includes:
Gorilla Punching*


Direct Pressure (Type of Massage)

This is a sustained pressure without movement. (One point)


Myofacial Release

Look Up


Trigger Point Technique

Look Up


Principles Regarding Massage Strokes (Consider?)

Direction - linear, cross fibers, digital, proximal (Always distal to proximal or end that way, towards the direction of the heart).

Duration - Take adequate time to achieve goal

Pressure - this varies based on intent, body region, pathology and pt. tolerance.

Rate & Rhythm - This should be purposeful and consistent (like massage should)


Principles regarding Stokes

Work broad and light - specific and deep

Mold your hands to the pt's body.

Deep pressure: always distal to proximal

Address the entire length of the muscle of interest.

Minimize interruptions (lifting hands, stopping abruptly, taking phone calls etc)



Massage helps painful musculoskeletal conditions
Massage may be potentially beneficial for:
Back pain
General orthopedic conditions
Post-operative conditions
Degenerative joint conditions



Edema is swelling caused by an increase in fluid in the interstitial, intra-articular, or intracellular space.

Massage is proposed as a treatment for helping to reduce edema caused by injury, illness or surgery.


Types of Edema

Local: Edema is confined to an area ex. ligament sprain

Systemic Edema: Occurs throughout the body ex. Congestive Heart Failure

Lymphedema: Edema resulting from compromise of lymphatic system ex. Removal of cancerous lymph nodes


The Lymphatic System

The lymph system is comprised of:
Lymph fluid/Interstitial fluid
Lymph Nodes
Lymph Ducts
Associated lymph tissues, capillaries and vessels that produce and transport lymph fluid

Tissues --> Circulatory system


Functions of the Lymphatic System

1. Remove excess fluids from tissues

2. Absorption of fatty acids and subsequent transport of fat to the circulatory system.

3. Production of immune cells

Side note: There are no pumps in the lymphatic system. Lymphatic fluid is moved by muscular contraction (body movements) through one way valves.


Lymphatic System: Lymphedema

Lymphedema is an accumulation of high-protein fluid that can collect in any body part, but most typically in arms or legs. It usually occurs when the lymph vessels or lymph nodes are blocked or removed.

There is two types:
Primary Lymphedema
Secondary Lymphedema


Primary Lyphedema

This is rare and congenital. Caused by poor development of lymph vessels. Ex. Milroy's Disease.

Massage is not indicated for primary lymphedema.