Massage/Soft Tissue Mobilization (STM) Study Guide

Flashcards relating to massage and soft tissue mobilization

Why do people seek massage services?

Medical reasons, relaxation/stress, pampering, other.

What are the effects of immobilization and trauma on connective tissue?

Permanent loss of GAGs and H2O, collagen synthesis degradation, irregular laying down of collagen and cross links, ligaments, tendons, and joint capsules weaken, altered sensory input.

What are the effects of immobilization and trauma on muscle tissue?

Loss of sarcomeres/muscle weight, decreased protein, mitochondria, and enzymes, increased fibrosis at musculotendinous junction in healing tissue, muscle contusions heal with scare tissue made of dense irregular connective tissue, decreased muscle extensibility.

What are the mechanical effects/benefits of Massage/STM?

Movement of venous and lymphatic flow, hematoma, lung secretions, intestinal contents.

What are the mobilization effects/benefits of Massage/STM?

Mobilization of muscle fibers, tendons and tendons in sheath, skin and subcutaneous tissue, scare tissue, adhesions. Stretches connective tissue

What are the physiological effects/benefits of Massage/STM?

Increase skin temperature, increase skin and muscle blood flow, increase flow of nutrients and removal of wastes, stimulation OR inhibition of healing process, increase parasympathetic activity

How does the amount of pressure applied and the speed of the stroke during massage impact the body?

Light, slow stroking evokes systemic relaxation, Fast, deep strokes increase blood flow to the area.

What are the neurologic effects/benefits of Massage/STM?

Decrease neuromuscular excitability, decrease pain via removal of edema and waste, decrease pain via sensory stimulation, decrease muscle spasm or tension.

In what stage of healing is manual therapy most effective/beneficial?

Fibroblastic stage (1-12 weeks).

Tensegrity = ?

Tension + Integrity

What are the considerations in Massage/STM?

Age, gender, beliefs, preferences; PMHx/Medications; Prior STM- purpose/response; Allergies; Precautions/contraindications; Evidence

Contraindications of Massage/STM

Malignancy, Inflammatory skin disorders, Acute fracture, Hemorrhage, Heart failure, Obstructive edema, Localized infection, Acute rheumatoid disorders, Clotting or bleeding disorders, Suspected thrombophlebitis, DVT, Varicose veins, Abdomen during pregnancy, 24 hrs after scuba diving

Precautions of Massage/STM

Intoxication/drug use, Psychosis (severe), Decreased sensation, Hypermobile joints, Osteoporosis, Skin disorders, Degenerative changes, Sensitive superficial tissues

What are the potential adverse effects of Massage?

Post massage soreness and malaise, Ecchymosis, Nerve damage, Rhabdomyolysis, Cervical-headache/vertigo

Effleurage

Superficial rhythmic stroking

Petrissage

Lifting and kneading of skin, subcutaneous tissue, and muscle

Friction

Circular or perpendicular; Applied with fingertips or thumbs working in circular motion or perpendicular to muscle fibers/tissues

Transverse/Cross friction

Applied with thumbs or fingertips stroking the tissue across the fiber direction; Begin lightly and then move to firmer strokes

Tapotement

Hacking, chopping, clapping, beating, pounding, tapping

Typical massage sequence for Therapeutic Massage and Edema Management?

Gentle and slow movements to start -> rapid and light or slow and heavy -> slow and gently at the end of treatment

Function of medium for massage

Used to decrease friction between the patient’s skin and the clinician’s hand.

Key elements of patient positioning when performing a massage/STM

Make sure the patient is warm, comfortable, supported, and relaxed position, Make sure the patient is properly draped, Support- filling in negative spaces

Key elements of therapist positioning when performing a massage/STM?

Avoid hyperextension or hyperflexion of any joints which may lead to hypermobility, Must obtain good posture/neutral joints to prevent fatigue and pain, Weight should be evenly distributed on both feet, You must be able to fit your hands to the contour of the area being treated, A good position is required to allow for correct application of pressure and rhythmic strokes during the application

Ethical issues for Massage/STM?

Respect privacy and patient sensitivity, Ask for consent, Continuous communication, Professional appearance, Personal hygiene, Avoid inappropriate touching and unnecessary exposure, Avoid interruptions

Care of hands for Massage/STM?

Wash prior to and after treatment, Jewelry off, Nails short with no edges, Contact precautions if appropriate

What should be included in documentation of Massage/STM interventions?

Client position, Contraindications/precautions reviewed, Medium used- denies allergies, Strokes/techniques performed, Intensity of pressure provided, Duration, Intensity