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Therapeutic Massage Chapter 16. Historical Perspective Dating back to the ancient Olympians Dating back to the ancient Olympians Late 1980’s Late 1980’s.

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Presentation on theme: "Therapeutic Massage Chapter 16. Historical Perspective Dating back to the ancient Olympians Dating back to the ancient Olympians Late 1980’s Late 1980’s."— Presentation transcript:

1 Therapeutic Massage Chapter 16

2 Historical Perspective Dating back to the ancient Olympians Dating back to the ancient Olympians Late 1980’s Late 1980’s –American Massage Therapy –National Certification Examination for Therapeutic Massage and Bodywork

3 Purpose Manipulates the the body’s tissues to: Manipulates the the body’s tissues to: –Reduce muscle spasm –Promote relaxation –Improve blood flow –Increase venous drainage Broad range of massage theories, techniques, and effects Broad range of massage theories, techniques, and effects

4 Basic Massage Strokes Effleurage Effleurage Pétrissage Pétrissage Friction Friction Tapotement Tapotement Vibration Vibration Myofascial Release J-Strokes J-Strokes Focused Stretching Focused Stretching Skin Rolling Skin Rolling Arm Pull / Leg Pull Arm Pull / Leg Pull Diagonal Release Diagonal Release Types of Massage

5 Effleurage “Stroking of the skin” “Stroking of the skin” Spread massage lubricant Spread massage lubricant Use at the beginning and end of the massage Use at the beginning and end of the massage Superficial: Superficial: –slow strokes for relaxation Deep: Deep: –Elongates muscle fibers –Stretches fascia –Forces fluids in the direction of the stroke  towards the heart

6 Pétrissage “Lifting and kneading” “Lifting and kneading” Frees adhesions: Frees adhesions: –Stretches and separates muscle fiber, fascia, and scar tissue If only technique used, it may be performed without the use of lubricant If only technique used, it may be performed without the use of lubricant

7 Friction “Deep pressure” “Deep pressure” Effects muscle mobilization, tissue separation, and trigger points Effects muscle mobilization, tissue separation, and trigger points Two types: Two types: –Circular –Transverse

8 Circular Friction Massage Use a circular motion Use a circular motion –Thumbs –Elbow –Commercial device

9 Transverse Friction Massage Strokes perpendicular to tissue fibers Strokes perpendicular to tissue fibers The thumbs or fingertips stroke in opposite directions The thumbs or fingertips stroke in opposite directions

10 Tapotement “Tapping or pounding” of the skin “Tapping or pounding” of the skin Variations: Variations: –Hacking –Cupping –Pincement (pinching) –Rapping –Tapping

11 Tapotement Technique Performed with a light, fast tempo Performed with a light, fast tempo Promotes muscular and systemic relaxation and desensitization of irritated nerve endings Promotes muscular and systemic relaxation and desensitization of irritated nerve endings

12 Vibration “Rapid Shaking” “Rapid Shaking” Increases blood flow and provides systemic invigoration of tissues Increases blood flow and provides systemic invigoration of tissues Mechanical devices available Mechanical devices available

13 Myofascial Release Stroking and stretching of tissues: Stroking and stretching of tissues: –Relax tense tissues –Release adhered tissues –Restore tissue mobility Clinician receives cues and feedback from the patient’s tissue Clinician receives cues and feedback from the patient’s tissue –This indicates the appropriate strokes and stretches Specialized training in myofascial release techniques is needed to become proficient in these skills Specialized training in myofascial release techniques is needed to become proficient in these skills

14 J-Strokes One hand places the adhesion on stretch One hand places the adhesion on stretch Other hand’s 2 nd and 3 rd fingers stroke in the opposite direction forming a ‘J’ Other hand’s 2 nd and 3 rd fingers stroke in the opposite direction forming a ‘J’ Mobilize scar tissue Mobilize scar tissue

15 Focused Stretching Heel of one hand in the area of restriction Heel of one hand in the area of restriction Heel of other hand crossed in front Heel of other hand crossed in front Stretch the tissue using slow, deep pressure Stretch the tissue using slow, deep pressure Reduces superficial or deep adhesions Reduces superficial or deep adhesions

16 Skin Rolling Use fingers and thumb to lift and separate the skin from the underlying tissue Use fingers and thumb to lift and separate the skin from the underlying tissue –Similar to Pétrissage Roll skin between fingers noting restriction Roll skin between fingers noting restriction Lift skin and move it in the direction of the restriction Lift skin and move it in the direction of the restriction Reduces superficial myofascial adhesions Reduces superficial myofascial adhesions

17 Arm Pull/Leg Pull Arm pull (example): Arm pull (example): Grasp extremity proximal to wrist Grasp extremity proximal to wrist Apply gentle traction that is in line with anterior deltoid Apply gentle traction that is in line with anterior deltoid Continue to abduct degrees until full abduction is reached Continue to abduct degrees until full abduction is reached Stretches large areas of fascia Stretches large areas of fascia

18 Diagonal Release One clinician grasps the leg proximal to talocrural joint One clinician grasps the leg proximal to talocrural joint Other grasps the opposite arm proximal to wrist Other grasps the opposite arm proximal to wrist Keep extremities horizontal to each other Keep extremities horizontal to each other One moves the limb until adhesions are felt while the other stabilizes the extremity One moves the limb until adhesions are felt while the other stabilizes the extremity Stretch large area of fascia Stretch large area of fascia

19 Physiological Effects Cardiovascular Cardiovascular –Increase blood flow, histamine release, and temperature –Decreased heart rate, respiratory rate, and blood pressure Neuromuscular Neuromuscular –Increase flexibility, decrease neuromuscular excitability (relaxation), edema reduction, and stretch muscle and scar tissue Pain Pain –Activate spinal gate and the release of endogenous opiates Psychological Psychological –Reduces patient anxiety, depression, and mental stress

20 Indications Increase blood flow Increase blood flow Facilitate healing Facilitate healing Increase range of motion Increase range of motion Remove edema Remove edema Alleviate muscle cramps Alleviate muscle cramps Stretch scar tissue/adhesions Stretch scar tissue/adhesions Decrease pain Decrease pain

21 Contraindications Acute inflammatory conditions Acute inflammatory conditions Severe varicose veins Severe varicose veins Open wounds Open wounds Skin infections Skin infections Failed or incomplete fracture healing Failed or incomplete fracture healing Thrombophlebitis Thrombophlebitis

22 Preparation Table Table Linens and pillows Linens and pillows Massage lubricant Massage lubricant Patient position Patient position Masseuse position Masseuse position

23 Traditional Massage Apply massage medium with light, slow Apply massage medium with light, slow Build to deeper effleurage Build to deeper effleurage Pétrissage Pétrissage Wipe medium before applying deep friction (if applicable) Wipe medium before applying deep friction (if applicable) Reapply pétrissage and deep effleurage Reapply pétrissage and deep effleurage End with light effleurage End with light effleurage

24 Edema Reduction Massage

25 Preparation Elevate the body area Elevate the body area Apply massage lubricant to the skin Apply massage lubricant to the skin Clinician is positioned distal to the extremity Clinician is positioned distal to the extremity

26 Stroke Sequence Begin proximal to the edematous area Begin proximal to the edematous area Long, slow, deep strokes towards the torso Long, slow, deep strokes towards the torso Move starting point slightly distal every fourth or fifth stroke Move starting point slightly distal every fourth or fifth stroke When the starting point moves distal to the edema, begin working back towards the starting point When the starting point moves distal to the edema, begin working back towards the starting point

27 Termination Remove medium Remove medium If appropriate: If appropriate: –Active range of motion exercises –Compression wrap Encourage patient to drink water to assist in flushing metabolic waste Encourage patient to drink water to assist in flushing metabolic waste


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