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Flashcards in Massage: INDICATIONS AND CONTRAINDICATIONS Deck (25)
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1

Indications for Massage

  1. Pain
  2. Edema
  3. Muscle Spasm
  4. Trigger Points
  5. Insufficiencies of Circulation
  6. Contracted Tissues
  7. Specific or general Relaxation

2

Painful Musculoskeletal

Back pain

General orthopedic conditions

Post-operative conditions

Fibromyalgia

Degenerative joint conditions

 

3

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,  tends to be regional. (ex. Removal of cancerous lymph nodes)

4

Functions of the Lymphatic System

1. Remove excess fluids from tissues

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

3. Production of immune cells

 

5

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.

 

6

Primary Lymphedema

Is a rare and congenital. Caused by poor development of lymph vessels. (ex.Milroys Disease)

7

Secondary Lymphedema

Is caused by damage to lymph vessels or nodes. May result from surgery, radiation, or infection.

8

Lymphedema Massage

Manual Lymphatic Drainage: form of massage utilizing light pressure (30-40mmHg) and brush like strokes to encourage the movement of lymph through lymphatic vessels and lymph nodes.

9

Muscle Spasms

Involuntary contraction due to inflammation, irritation

Often are tissues that are gaurding other injured tissues.

10

11

Muscle Spasm Massage Purpose

Used to relax muscle spasms

Help local blood flow.

reduce pain associated with spasm

Helps break the pain - spasm - pain cycle

12

Trigger Points

A focus of irritability in a tissue that, when compressed, is locally tender and, if sufficiently hypersensitive gives rise to referred pain and tenderness, and sometimes are reffered to autonomic phenomena and distortion of proprioception,

13

Benefits of Massage and Relaxation

Relaxation is a nice side effect which can enable us to carry out other treatments.

14

Contraindications

  1. When increased circulation is not desired
  2. Severe Distress (severe pain, febrile state)
  3. Contagious skin condition
  4. Over foreign bodies or sharp bony prominences
  5. Massage Too soon: Acute conditions
  6. Areas of decreased sensation
  7. Over Recent surgery
  8. Systemic Edema
  9. Areas of Active Bone growth
  10. Tuberculosis
  11. Pregnancy (over abdomen)

15

Conditions where increased Circulation is not Desired

Systemic Edeman - Occurs throughout the body (ex Congestive Heart failure. If you push back too much fluid it overwhelms the heart leading to more damage)

Primary Lymphedema - Edema resulting from compromise ot the lymphatic system

Infections - May be spread by blood or by lymph (ex. Osteomyelitis, Septic arthritis, dermatitis, cellulitis, myositis

Blood Clots - DVT mechanical stimulation can break down clot and release to freely roam.

16

Contraindication for Severe Distress

Do not perform massage on patient that has severe distress or is in a febrile condition.

Physically ill or Nauseated

Is in severe pain

Has a fever or a systemic process occuring.

17

Skin Conditions (Contraindications)

Avoid massage in areas where a condition may be contagious or worsened or spread by applying pressure or rubbing,.

Rashes

Boils

Athlete's foot

Allergies (oils or lotions always good to double check)

18

Foreign Bodies or sharp prominences (contraindication)

Massage can shear and compress tissues.

Massage over foreign bodies (nails, screws, shrapnel) or over sharp bony prominences (scap, Shoulder) may lead to tissue damage.

 

19

Acute Conditions (contraindications)

Massaging leaking or damaged blood vessels will increase bleeding and form edema.

Should wait a minimum of 48 hours after acute episode.

If you massage too early you may damage the cellular and fibrous network and delay healing.

Avoid massaging any conditions with the ending "itis" (RA, Phlebitis- vein inflammation)

20

Areas of Decreased Sensation (Containdication)

Patients cannot give proper feedback.

(diabetes, stroke, spinal cord injury, frostbite)

21

Recent Surgery / Loss of structural function (contraindication)

Careful of MD's protocol, special care taken with scar massage techniques.

SKin grafts - tisssue may not accomodate shearing forces.

22

Active Bone growth (Contraindication)

Healing fracture site

Myositis Ossificans

Osgood-Schlatters Disease

Severs disease

23

Tuberculosis (Contraindication)

Highly contagious bacterial infection that usually begins in the lungs, Spread through bodily fluids (especially coughing and spitum).

Goal is to avoid distributing or spreading the infection through massage.

24

Pregnancy

Jusat dont rub over the baby.

25

Precautions

Hematomas

Non-union Fractures

Herniated Disks

Debilitated patients

Malignancies

Conditions with collagen weakening (steriods, diabetes, RA)