Massage Study Guide

medical, relaxation/stress, pampering, and others

what are the reasons people seek massages?

massage CPT code

includes effleurage, petrissage, and/or tapotement

- generally for relaxation and circulation

manual therapy CPT code

mobilizations/manipulations, manual lymphatic drainage, and manual traction

- generally for enhancing function and reducing discomfort

immobilization

effects of ______ and trauma on CT and muscle:

- 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

mechanical effects

- increased skin temp --> increased sweating --> decreased resistance to electrical current

- pressure toughens and softens skin

- removes dead skin cells

- stretches and breaks down fibrous tissue

physiological effects

- increased skin temp

- increased skin and muscle BF

- increased flow of nutrients and removal of wastes

- stimulation/inhibition of healing process (depends on when performed)

- increased PSNS activity

- increased relaxation hormones

- decreased stress hormones

neurological effects

- decreased NM excitability

- decreased pain via removal of edema/wastes and sensory stimulation

- decreased muscle spasm or tension

psychological effects

increases relaxation

decreases anxiety

releases endorphins in brain

fibroblastic stage

in what stages of healing is massage/manual therapy most beneficial?

considerations for massage

patient's age, gender, beliefs, and preferences

PMHx/medications

Prior STM- purpose/response

allergies

precautions/CIs

evidence

adverse effects

post massage soreness and malaise

ecchymosis

nerve damage

rhabdomyolysis

cervical headache/vertigo

effleurage

Light, continuous-stroking massage movement applied with fingers and palms in a slow and rhythmic manner.

- intent: relaxation or encourage BF and stimulate tissues

petrissage

Kneading movement performed by lifting, squeezing, and pressing the tissue with a light, firm pressure.

- intent: free adhesions by stretching and separating muscle fibers, fascia, and scar tissue

tapotement

Also known as percussion; movements consisting of short, quick tapping, slapping, and hacking movements.

- intent: promote relaxation and desensitization of irritated nerve endings

cross friction

Firm pressure applied across the fibers of the muscles and tendons

- intent: mobilize tissues and separate adhesions that restrict movement and cause pain

trigger point release

designed to elongate the muscle fascia and decrease muscle tension

- find a tender spot and place firm pressure over area until tissue starts to release/soften (2-5 min)

myofascial release

intent: obtain relaxation and elongation of tense and/or adhered tissues

- arm pull, leg pull, etc.

edema massage

begin proximal to edematous area

long slow strokes towards the torso

move starting point slightly distal every 4th/5th stroke

once distal to edema, then move proximally to milk the fluid back to the heart

therapeutic massage order

effleurage

petrissage/tapotement/cross friction/TP release/MF release

effleurage

medium

used to decrease friction between patient's skin and clinician's hands

- use more when on hairy areas

friction and petrissage

when would you possibly not want any medium or little amounts?

therapist positioning

avoid hyperextension/hyperflexion of any joints

obtain and maintain good posture and neutral spine

distribute weight evenly on both feet

be able to fit hands to the contour of area being treated

good positioning allows correct technique

professional considerations

respect privacy and patient sensitivity

ask for consent

continuous communication

professional appearance

personal hygiene

avoid inappropriate touching and unnecessary exposure

avoid interruptions

wash hands prior to and after treatment

jewelry should be off or minimal

nails need to be short

contact precautions if appropriate

documentation

client position

contraindications/precautions reviewed

medium used (allergies denied)

areas of massage

strokes/techniques provided

intensity of pressure provided

duration

intensity

tissue response

patient response

j stroke

c stroke