Indications for Massage
- Muscle Spasm
- Trigger Points
- Insufficiencies of Circulation
- Contracted Tissues
- Specific or general Relaxation
General orthopedic conditions
Degenerative joint conditions
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)
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
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.
Is a rare and congenital. Caused by poor development of lymph vessels. (ex.Milroys Disease)
Is caused by damage to lymph vessels or nodes. May result from surgery, radiation, or infection.
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.
Involuntary contraction due to inflammation, irritation
Often are tissues that are gaurding other injured tissues.
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
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,
Benefits of Massage and Relaxation
Relaxation is a nice side effect which can enable us to carry out other treatments.
- When increased circulation is not desired
- Severe Distress (severe pain, febrile state)
- Contagious skin condition
- Over foreign bodies or sharp bony prominences
- Massage Too soon: Acute conditions
- Areas of decreased sensation
- Over Recent surgery
- Systemic Edema
- Areas of Active Bone growth
- Pregnancy (over abdomen)
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.
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.
Skin Conditions (Contraindications)
Avoid massage in areas where a condition may be contagious or worsened or spread by applying pressure or rubbing,.
Allergies (oils or lotions always good to double check)
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.
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)
Areas of Decreased Sensation (Containdication)
Patients cannot give proper feedback.
(diabetes, stroke, spinal cord injury, frostbite)
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.
Active Bone growth (Contraindication)
Healing fracture site
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.
Jusat dont rub over the baby.
Conditions with collagen weakening (steriods, diabetes, RA)