1
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2
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- Mechanical stimulation of tissues by rhythmically applied pressure and
stretching
- Effects of massage may be either reflexive or mechanical
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3
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- Reflexive
- Effects sensory and motor nerves locally and some central nervous
system response
- Mechanical
- Makes mechanical or histological changes in myofascial structures
through direct force applied superficially
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4
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- Attempts to exert effects through skin and superficial connective
tissues
- Contact stimulates cutaneous receptors
- Reflex mechanism is believed to be an autonomic nervous system
phenomenon
- The reflex stimulus causes sedation, relieves tension, increases blood
flow
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5
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- Effects on pain
- Modulates pain through gate control & b-endorphins
- Effects on Circulation
- Increase blood and lymphatic flow
- Effects on Metabolism
- Does not alter general metabolism
- Assists in removal and hastens resynthesis of lactic acid
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6
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- Techniques which stretch a muscle, elongate fascia or mobilize soft
tissue adhesions or restrictions
- Always accompanied by some reflex effects
- As mechanical stimulus becomes more effective, reflex stimulus becomes
less effective
- Directed at deeper tissues, such as adhesions or restrictions in muscle,
tendons, and fascia.
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7
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- Effects on muscle
- Mechanical stretching of intramuscular connective tissue
- To relieve pain and discomfort associated with myofascial trigger
points
- Increase blood flow to skeletal
muscle
- To retard muscle atrophy
following injury
- To increase range of motion
- Does not increase strength or
muscle tone
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8
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- Effects on skin
- Increase in skin temperature
- Increases sweating
- Decreases skin resistance to galvanic current
- Mechanically loosens adhesions and softens scar
- Stretches and breaks down fibrous scar tissue
- Breaks down adhesions between skin and subcutaneous tissue
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9
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- Psychologic effects of massage can be as beneficial as physiologic
effects
- ”Hands on" effect helps patients feel as if someone is helping them
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10
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- Knowledge of anatomy essential
- Understanding of existing pathology
- Thorough knowledge of massage principles
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11
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- Positioning will allow relaxation, prevent fatigue, and permit
free movement of arms,
hands, and body
- Weight evenly distributed and should shift from one foot to the
other
- Fit your hands to contour of area being treated
- Hands should be warm
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12
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- Pressure regulation determined by the type and amount of tissue present
and patient's condition
- Rhythm must be steady and even
- Duration depends on the pathology, size of the area being treated,
speed of motion, age, size, and condition
- With swelling begin proximally to facilitate lymphatic flow
-"uncorking effect"
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13
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- Massage should never be painful
- Direction of forces should parallel muscle fibers
- Begin and end with effleurage
- Make sure patient is warm and in a comfortable, relaxed position
- Body part may be elevated if necessary
- Sufficient lubricant should be used
- Begin with superficial stroking to spread lubricant
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14
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- Stroke should overlap
- Pressure should be in line with venous flow followed by a return stroke
- All strokes should be rhythmic
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15
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- Table
- Linens and pillows
- Lubricant
- Should be absorbed slightly
by skin but does not make it slippery
- Combination of one part beeswax to three parts coconut oil
- Other types of lubricants that may be used are olive oil, mineral oil,
cocoa butter, hydrolanolin,
analgesic creams, alcohol, powder
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16
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- Patient should be in a relaxed, comfortable position
- Part involved in treatment must be adequately supported
- Prone, supine, seated
- Clothing should be removed from part being treated
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17
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- Classical massage technique which uses a variety of superficial strokes
- Effleurage
- Petrissage
- Tapotment
- Vibration
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18
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- Every massage begins and ends with effleurage
- Increases venous and lymphatic flow
- Increases circulation to skin surface
- Start with a light pressure, move centripetally or centrifugally consistently
throughout treatment
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19
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- Deep stroking is a form of effleurage, except it is given with more
pressure to produce a mechanical effect
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20
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- Consists of kneading manipulations that press and roll muscles under
fingers or hands
- Muscles are gently squeezed, lifted, and relaxed
- Hands may remain stationary or move along length of muscle or limb
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21
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- Purpose is to increase venous and lymphatic return and to press
metabolic waste products out of affected areas through intensive
vigorous action
- Can also break up adhesions between skin and underlying tissue
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22
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- Uses a variety of percussive or beating techniques
- Used to increase circulation and
blood flow
- Used to stimulate peripheral nerve endings
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23
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24
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25
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26
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- Hacking
- Slapping
- Beating
- Tapping
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27
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- Hacking
- Slapping
- Beating
- Tapping
- Clapping or cupping
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28
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- A fine tremulous movement, made by hand or fingers placed firmly against
a part causing a part to vibrate
- Hands should remain in contact and a rhythmical trembling movement will
come from arms
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29
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- Technique for treating chronic tendon inflammation
- Purpose is to increase inflammatory response to progress healing process
- Use strong pressure in perpendicular direction to fibers for 7
to 10 minutes every other
day
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30
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- Stroking technique carried out in layers of connective tissue on body
surface
- Abnormal tension in one part of tissue is reflected in other parts
- Stroking produces a relaxation of muscular tension and a prickling
warmth in area
- Used mostly in Europe
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31
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- Patient is usually in sitting position
- Basic stroke of pulling performed with tips, or pads, of the middle and
ring fingers of either hand
- Stroking technique characterized by a tangential pull on skin and
subcutaneous tissues away from fascia
- Technique causes sharp pain in tissue
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32
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- No lubricant is used
- Treatments last about 15 to 25 minutes After 15 treatments 2-3 times per
week, there should be a rest period of 4 weeks
- Connective tissue massage must be learned and performed initially under
direct supervision of someone who has been taught these highly
specialized techniques
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33
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- Acupressure and Shiatsu points based on ancient Chinese art of
acupuncture
- Myofascial trigger points found in skeletal muscle and tendons, in
myofascia, in ligaments and capsules surrounding joints, in periosteum,
in skin
- May be activated and become painful due to some trauma to muscle
occuring either from direct trauma or from overuse
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34
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- Pain results from inflammatory response
- Pain usually referred to areas which follow a specific pattern
- Stimulation of these points has
been demonstrated to result in pain relief
- Acupressure points and myofascial trigger points are similar
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35
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- Locate points from chart
- Use fingers or elbow to
do small friction- like
circular motions
- Amount of pressure applied
should be intense and
painful
- Patient reports a dulling or numbing effect
- Treatment times range from 1-5 min at several points
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36
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- Has also been referred to as soft tissue mobilization
- Group of stretching techniques used to relieve soft tissue from abnormal
grip of tight fascia
- Myofascial restrictions are unpredictable and may occur in many
different planes and directions
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37
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- Treatment is on localizing restriction and moving into the direction of
the restriction
- Myofascial manipulation relies heavily on experience of clinician
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38
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- Preparing clinician’s hands
- Use limited lubricant
- Positoning critical to maximize effects of treatment
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39
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- Goal is to balance body within a gravitational field through manual soft
tissue manipulation
- If balanced movement is essential at a particular joint but nearby
tissue is restrained, both the tissue and the joint will relocate to a
position which accomplishes a more appropriate equilibrium
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40
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- Technique involves 10 hour long sessions each of which emphasizes some
aspect of posture with massage directed toward the myofascia
- Major aspect is to intregrate structural with psychological and
emotional aspects
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41
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- Combines mechanical soft tissue mobilization and neurophysiological
reeducation
- Uses gentle, passive, rocking oscillations emphasizing traction and
rotation as a relaxation technique
- Attempts to establish neuromuscular control so that more normal movement
patterns can be routinely performed
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42
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- alleviate muscle cramps
- increase blood flow
- increase venous return
- retard muscle atrophy
- increase range of motion
- edema
- myofascial trigger points
- stretching scar tissue
- increase coordination
- decrease pain
- decrease neuromuscular excitibility
- stimulate circulation
- facilitate healing
- restore joint mobility
- remove lactic acid
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43
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- revascularization
- Raynaud's disease
- intermittent claudication
- dysmenorrhea
- headaches
- migraines
- adhesions
- muscle spasm
- myositis
- bursitis
- fibrositis
- tendinitis
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44
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- synovitis
- abscesses
- skin infections
- cancers
- acute inflammatory conditions
- arteriosclerosis
- thrombosis
- embolism
- severe varicose veins
- acute phlebitis
- cellulitis
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