| Massage Notes--continued |
| Chp 11: Specialized System of massage Trigger Point Techniques Myofacial Triggers and myodysneuric points are sensitive points produce referred pain when palpated: they trigger the painful experience. The following signs or phenomena may be associated with sensitivity at the point: movement restriction, muscle weakness, protective muscle spasm, lowered skin resistance, fibrositic nodules, the "jump" sign of palpation, secondary trigger points in agonistic and antagonistic muscles, and autonomic responses. Pressure points can be palpated with one or two fingers, a knuckle, an elbow or by strumming (friction). Myofacial Release Techniques: First of all facia is the connective tissue that surrounds th muscle fibers (it has 3 layers: superficial, potential space, and deep). It assists in maintaining muscle force. The goal is optimal alignment of body. The following assumptions prevail aboutr myofacial techniques: 1) they are successful even though no relation to a neurophysiologic mechanism has been proven; 2) feedback ensures greater efficacy and confort than traditional methods afford; 3) there are no restrictions, either from the patient or the therapist, when feed back is correctly interpreted; 4) safety is ensured by the fact that client and therapist work together. Mobilization of peripheral nerves and breaking down of adhesion in the fascia that is continiuous with nerve root promotes pain relief. |
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| PRECAUTIONS FOR MASSAGE ENDANGERMENT SITES) Avoid deep pressure to these structures FACE� eye socket (orbit). Armpit (axillary nerves) NECK-- CAROTID artery / JUGULAR vein NECK� MASTOID PROCESS (bony structure below ear) Xiphoid process--Sternum Umbilicus area: sensitive superficial to descending aorta & abdominal aorta. Avoid direct heavy pressure. KIDNEYS� between 3rd lumbar and 12th thoracic. Deep pressure to surrounding areas is fine. Avoid pressure directly into kidney area. Percussion should be light. Groin� Femoral nerve, artery in flexed hip. Can be done but only with more training. Popliteal fossa: space in the middle (central) . IN GENERAL If you feel a pulse: STOP applying pressure to the spot. Move to a nearby area. If the person getting the massage complains of needles and pins, numbnes, electrial sensations, burning, shooting or seering pains�STOP�.you are probably on a nerve. Your supervisor might want to see what position the person is in when this happens�so leave the person in the same position (unless that it is what is causing the problem). TELL YOUR SUPERVISOR IMMEDIATELY Do no harm. Err on the side of caution |
| Study Guide to Massage I. Definition of Massage: Orignating from the Hebrew word, "mashesh," Arabic word, "mass," or the Greek word, "massin." Or from the French word, "masseur (male)" and masseuse (female)." The scientific mode of treating certain forms of a disease by systematic manipulations. Great number of manipulation of the tissues and organs of the body for therapeutic purposes. II. Description of Massage Petrissage (rolling, squeezing, lifitng, kneading, grasped and pressed-down) - applied to muscle groups, indivdual muscles or some part of it. - skin and subcutaneous are grasped and manipulated Kneading (separate technique; instead of picking-up movement with lateral compression in petrissage, kneading is compression in vertical directions. -performed with two hands on opposite sides of the limb, whoe palmar surface beign in contact with the part. Gentle pressure, usually as hands work in opposite directions. -gentle alternating waves of compression and relaxation are applied to a series of points and pressure is greatest when the hand is engaged with the lowest part of the circumference of the circle and least when at opposite poles. Friction -deep transverse frictions of muscles, tendons, and ligaments -might occur between skin and hand. -More focus on hand being used be kept in contact with skin and superficial tissues be moved over the deeper (underlying) ones. Stroking and Effleurage -Stroking and Effleurage are very simialar -stroking is more applied pressure -effleurage is going towards the heart, whereas stroking is applied in various directions and harder pressure. III. Components of Massage Direction - varied depending on purpose of massage; "from below upwards" and in the direction fo the muscle fibers; should be congruent with the venous and lymphatic circulation; deep movements of massage should be performed centripetally to aid venous and lymphatic flow. Pressure -three kinds of friction (gentle, medium, and vigorous); effluerage was gentle and friction was vigorous; treatment were applied with gentle pressure and worked ip to the pressure tolerance level of the patient; amount of pressure depends solely on the relaxation of the muscle; movement can be deep without in any sense being forcible; connective tissue massage techniques use firm pressure but avoiding pain. Rate and Rhythm -gentle and slow movement in the beginning, rapid and heavy ones next, and slow and gentle movements to end; Rate varied according to the type of movement:effleurage should be given slowly; rolling, shaking, and tapotment rapidly; effleurage should be given slowly. Mennel identified these essentials of surperficial stroking: 1) movements must be slow, gentle, and rhythmic, and there must be no hesitancy or irregularity about it; 2) the time between the end of the stroke and the begining of the next should be identical with the time of stroking throughout the movement . rhythm must be even to produce an even stimulus; deep stroking does not require great speed, ad the flow of venous blood is slow and that of the lymph is even slower; frictions' rhythm should be slow and steady. Media -Liquid Lubricants--Olive oil, glycerine, coconut oil, oil of sweet almonds, and neat's foot oil were a preferred medium; -Solid Lubricants--wool fat, petroleum jelly, lanolin, hog's lard, cold cream, and cocoa butter. -several tools were created for percussion and tapotment techniques; powder (talcum or boric acid powder). -Medium is a personal choice for the therapist. ; Positioning of Therapist and Patient -Patient's position should be an assessment of both the therapist's and patient's feedback. Position should be comfortable for the muscles to relax. The lighting of the patient's target area must be Duration -Local massage should not take longer than 8-10 minutes (4 min was sufficient enough). 30 - 45 minutes for general massage. (duration is affected by size of target area and age of patient). Frequency -daily treatment (more or less as the case would permit) gradually increased to three times daily. physical and psychological reactions would determine or affect the frequency as well. IV. Chapters 2, 3, 4 Indications 1. Why are you doing massage? - tight muscle, post surgical treatment, relief of pain, or increase healing process by increasing blood flow. Contraindications 1. When wouldn't you do a massage? - Acute infections; bones (osteomyelitis), joints (septic arthritis), skin (dermatitis), muscle (myositis), subcutaneous tissue (cellulitis) - skin disease (psoriasis) - Cancer or tuberculosis in the area to be treated - Areas of severe hyperesthesi - Presence of foreign bodies (grit, glass) - Diseases of blood vessels (thrombophlebitis) - Massage may be given, but with great care of varicose viens, hemophili, or gross edema patients. Precautions (before, during, and after massage) 1. Obtain an accurate medical diagnosis 2. Perform an appropriate physical examination 3. Check carefully for possible contraindications to treatment. 4. Drape, position, and support the patient properly. 5. Ensure a high standard of cleanliness, especially for therapist's hands. 6. perform the massage properly while monitoring the patient's response. 7. Asses and document the patient's response to treatment for future modifications. Effects - Mechanical and Physiological - Mechanical Effects - Movement of lymph, venous blood, lung secretions, edema, intestinal contents, hematoma contents - Mobilization of muscle fibers, muscle masses, tendons (in sheath), skin and subcutaneous tissue, scar tissue, adhesions - Physiological Effects - increased blood and lymph flow - increased flow of nutrients - removal of waste products and metabolities - stimulation of the healing process - resolution of chronic edema and hematoma - increased extensibility of connective tissue - pain relief - increased joint movement - facilitation of muscle activity - stimulation oof autonomic functions - stimulation of visceral functions -removal of lung secretions - sexual arousal and promotion of local and general relaxation 1. What color should the skin change to to? light Pinkish red 2. Heat production? warm 3. Pain with massage? V.Superficial Muscles |
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