Unit L Therapy and Sports Medicine

Objectives  2H12- Apply therapeutic skills for rehabilitation and injury prevention  2H Demonstrate assistive and therapeutic techniques  2H Analyze the therapeutic role of massage therapy and sports medicine

Terminology Abduction: to pull something, for example, a muscle, away from the midpoint or midline of the body or of a limb

Adduction: to pull a leg or arm toward the central line of the body or a toe or finger toward the axis of a leg or arm

Flexion: the bending of a limb or joint

Extension: increasing the size or range

Hyperextension: the movement of a limb beyond its normal range

Rotation: a turning motion like that of a wheel around an axis or a fixed point, or the act or process of turning in such a way

Pronation: turning a body part downward- turning the “palms down”. Supination: turning a body part upward; turn the “palms up”.

Inversion: turning a body part inward Eversion: turning a body part outward

Dorsiflexion: the bending back of a hand or foot, or of the fingers or toes Plantar Flexion: bending the sole of the foot

Massage Therapy Basics Encourage the patient to understand the potential source of healing in his/her own consciousness. 1. It is a passive exercise that relieves tension/pain. 2. Activates thicker tactile receptors in skin. 3. Can affectively relieve pain. 4. Increases range of motion. 5. Reduces some types of edema. 6. Increases circulation. 7. Better lymphatic flow. 8. Improves conditioning of scar tissue. 9. Improves health of the skin.

Relaxation Stress relief Sense of increased energy and vitality Psychological Benefits of Massage Therapy:

Massage Therapies Effleurage Used most Involves gentle strokes, glide over skin Often used during childbirth to cause relaxation of the abdominal muscles.

Petrissage Involves deeper massage where muscles are lifted/ squeezed gently in a kneading/ rolling action. Practiced on the back before any other parts of the body.

Massage Therapies Friction –Uses the fingertips, thumb, or heel of hand to make small movements that press into muscles. –Used to massage deep into joint spaces and is generally used for back rubs. –Useful around well-healed scar tissue to break down adhesions between the skin and tissues beneath.

Vibration –Can be accomplished by making fine, tremulous movements with the fingers or by using a mechanical device.

Tapotement –uses a series of brisk blows of various types Hacking –hold hands out, palms parallel, strike patients back gently w/ backs of 3rd 4th and 5th fingertips progressing from hips to shoulders, avoiding the kidney area

Cupping- using cupped hands to strike the patient’s back with one hand, then the other. Some people use cup shaped objects for this massage technique. Slapping- same as above with flat hands.

Tapping- Using the tips of fingers, tap the back with one hand then the other. Quacking- Hold both palms together w/ fingers apart, tap back w/ tips of little finger and ring finger, allowing the fingers to fall together on impact.

Pincement- Gently pinch the back, pulling up small tissue between the thumb and 1 st finger. Skritchies- gentle pinching or plucking of the scalp.

Certified Athletic Trainer What type of training is needed to become a certified athletic trainer? Bachelor’s Degree A certified athletic trainer is an allied health care professional trained in the area of sports medicine. Athletic trainers can be found in many different settings. The most traditional settings include working with high school, college, and professional teams, providing health care for athletes. Many athletic trainers have a masters degree in a related science field, or an advanced degree in athletic training.

Orthopedics Orthopedics is the study of the musculoskeletal system. Orthopedic doctors help patients with the diagnosis of problems associated with the bone, joints, ligaments, tendons, muscles, and nerves of the body. Orthopedics is one of many medical specialties. A massage therapist would be a good addition to this practice.

Range of Motion (ROM) When patients have limited movement, range of motion exercises help keep muscles/ joints functioning. ROM- ordered by a physician and administered by a physical therapist, nurse, assistant, or other authorized person.

Contractures- tightening/shortening of muscle, causing permanent flexing of the joint. Muscle atrophy or stiff joints. Circulatory impairment (leading to blood clots/decubitus ulcers). Other problems: poor appetite, constipation, urinary infections, respiratory problems, and hypostatic pneumonia. ROM Avoids:

Active ROM- performed by patients who are able to move each joint without assistance. Passive ROM- These exercises are carried out by the nurse/PT without assistance from the patient. Resistive ROM- These are active exercises performed by the patient by pulling or pushing against an opposing force. ng_Fundamentals_1/lesson_5_Section_1.htm

Principles for Performing ROM: 1.Movements should be slow, smooth, and gentle 2.Support provided to parts above and below joint being exercised. 3.Never force joint beyond range or point of pain. 4.If patient complains, stop exercise and report it to supervisor.

Principles for Performing ROM Continued… 1.Repeat 3 times or as ordered. 2.Encourage patient to assist as much as possible. 3.Prevent unnecessary exposure of patient. 4.Close door/ provide privacy 5.Use correct body mechanics at all times.

Principles of Ambulatory Assistance Crutches- usually prescribed by a physician. –Therapist or authorized person fits crutches. –Appropriate gait must be taught. –Must properly fit- axillary pressure can cause damage to radial nerve.

Fitting Crutches: 1.Patient should wear good fitting walking shoes w/ low broad heels. 2.Position patient against wall for support (if possible) 3.Position crutches 4-6” in front and 4-6” to the side of patient’s foot. 4.Allow 2” space between underarm and axillary bar. 5.Adjust hand pieces so that each elbow is flexed at degree angle. 6.Patient must be taught to support weight on hand bars NOT axillary supports.

Using A Walker The walker should be properly fitted to the patient. Position the walker at arm's length in front of you with all four legs level on the floor. Use the handles of the walker for balance. Move your weak leg forward first, gripping the top of the walker for support. Place the walker one step ahead of you and take small steps when turning. Keep your back upright while pushing the walker forward. Do not walk behind your walker; step into it instead.

Cane –Provides balance and support –Some have 3-4 legs for additional support –Used on unaffected (good) side. Walker –4-legged device –Often used for weak patients w/out leg injuries –Must be properly fitted –Patient must lift walker, place it in front of the body, and walk into it –Patient must NOT slide walker

Gait Belt Band of fabric or leather around patient’s waist During transfers or ambulation, health care worker can hold belt to provide additional support Gait belt must be the proper size- secure fit around waist but not too tight Hold the back of the belt using an underhand grasp. Grasp belt at back during ambulation Grasp belt on both sides while facing the patient Apply belt at the waist and over the clothes.

Safety Checks Remain alert when ambulating the patient. Walk on the weak side and slightly behind the patient. If the patient starts to fall, use your body to brace the patient. Ease the patient to the floor as slowly as possible. Protect the patient’s head and neck. Stay w/ the patient and call for help. If the patient falls, an accident report must be filled out in most agencies.

Sitz bath A type of a moist heat application used for patients who have hemorrhoids or patients who had an episiotomy from giving birth.

Ankle wraps Under wrap/ pre-wrap is used to protect the skin. Ace wrap is then wrapped over pre- wrap. When taping an ankle the anchor is the first piece of tape to go on the ankle.

Oxygen If a patient is cyanotic, you need to give him/her OXYGEN. If a humidifier is empty you need to notify your supervisor immediately.

Oxygen O2 is given via nasal cannula-N/C Mask Ventilator

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