The intentional and systematic manipulation of the soft tissues of the body to enhance health and healing. The primary characteristics of massage are touch and movement. (Freeman, 2001) MASSAGE DEFINED

 Massage can be applied to the entire body or to specific body parts only.  Most commons site specific massages:  Hands  Feet  Back FULL BODY VS. SITE SPECIFIC

Physical Relaxation (decreased anxiety) Relieving of minor aches & pains Increased blood circulation Increased flow of oxygen & nutrients to cells Softening of contracted muscles Increased immune function (Field, 1998) BENEFITS OF MASSAGE Psychosocial Mental & Tactile stimulation Unconditional 1:1 attention A means of non-verbal communication Sense of nurturing, companionship and pleasure Can ground disoriented individuals by connecting them with physical reality (Sansone & Schmidt, 2000)

Often focuses more on “Compassionate Touch” and gentle movements Provided for short periods of time (typically interventions of 5 to 20 minutes) Often provided with individual in seated position (chair/wheelchair) or in bed MASSAGE WITH CLIENTS AS PART OF A RT INTERVENTION

Individuals with the following conditions often respond well to massage Muscle aches Poor circulation Limited range of motion Stiffness and pain Insomnia, anxiety (Miesler, 1991) GOOD CANDIDATES FOR MASSAGE

Contraindications Fever Hemorrhage/ Uncontrolled bleeding Varicose Veins Open wounds/broken bone Acute injury within 72 hours Cautions Poor skin integrity Blood thinners (bruising) Undiagnosed diseases or pain CONSIDERATIONS FOR MASSAGE Avoid Areas of inflammation/infection Site of an injury, surgery, procedure Fractured ribs Skin ulcers Burns, wounds Physician Order Obtain physician clearance before administering massage

Self Take off all jewelry that may scratch clients (rings, bracelets, watches) Make sure your nails are short and free of sharp areas Wash your hands and have hand sanitizer nearby at all times Create relaxing environment (lower lights, close doors, reduce noise, etc.) BEFORE YOU START Client Remove unnecessary clothing items from resident (e.g., jacket, sweater - appropriate to setting/situation) Be aware of client’s jewelry (remove if they will allow – e.g., remove rings for hand massage)

Explain what you will be doing (at a level appropriate for the client). Ask the client to let you know if anything feels uncomfortable or they want you to stop for any reason. (If individual is non-verbal, identify signal he/she can use). Anticipate any issues clients may have to touch related to your gender and theirs. Be sensitive to how touch may be experienced/interpreted in different cultures. IMPLEMENTATION

Oils – Avoid if possible. Many people find unappealing. Can also damage clothing and linens. Lotions – Massage lotions will have more “glide” than hand lotions. Use hypoallergenic products. Creams – Provides most moisture to skin and best “glide.” Use special massage creams. DIFFERENT TYPES OF LUBRICATION

Effleurage (long, gliding) Petrissage (kneading, squeezing, rolling) Feather strokes, nerve strokes Tapotement (percussive) Vibration Friction (deep, for scars) Joint Movements BASIC MASSAGE STROKES Most can be done over the clothing if necessary. However, skin to skin contact is better whenever possible. Also, human to human contact (without gloves) is better than object to human contact (wooden massage tools, etc).

When is it “massage” and when is it “massage therapy”? MASSAGE VS. MASSAGE THERAPY

Seated Massage Sequence for Sensory Stimulation Hand Massage SPECIFIC MASSAGE TECHNIQUES