Transcript Document 7231116

Therapeutic Sports Massage
Jennifer Doherty-Restrepo, ATC, LAT
Entry-Level Athletic Training Education Program
PET 4995: Therapeutic Modalities
Physiologic Effects of Massage
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Mechanical stimulation of tissues by
rhythmically applied pressure and
stretching
Effects of massage may be either
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___________, or
___________
Effects differ depending on method
utilized, pressure exerted, and duration of
massage
Physiologic Effects of Massage
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Effects sensory and motor nerves locally
Elicits some central nervous system
response (ie: sedation)
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Makes mechanical or histological changes in
myofascial structures through direct force
applied superficially
Reflexive Effects
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Attempts to exert effects through ______
and superficial connective tissues
Contact stimulates _________ receptors
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Reflex mechanism is believed to be an
autonomic nervous system phenomenon
The reflex stimulus causes
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Sedation,
Relieves tension, and
Increases blood flow
Reflexive Effects cont.
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Effects on Pain
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Effects on Circulation
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Modulates pain through Gate Control & Endorphins theories
Increases blood and lymphatic flow
Effects on Metabolism
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Does not alter general metabolism
Increases fresh blood and oxygen to area
Assists in removal of lactic acid
Mechanical Effects
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Techniques which stretch a muscle, elongate
fascia, or mobilize soft tissue
adhesions/restrictions
Always accompanied by some reflex effects
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As mechanical stimulus becomes more effective, reflex
stimulus becomes less effective
Directed at deeper tissues, such as adhesions or
restrictions in muscle, tendons, and fascia.
Mechanical Effects
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Effects on Muscle
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Mechanical stretching of intramuscular
connective tissue to relieve pain and
discomfort associated with myofascial trigger
points
Increases blood flow to skeletal muscle
Slows muscle atrophy following injury
Increases range of motion
Does not increase strength or muscle tone
Mechanical Effects cont.
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Effects on Skin
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Increases skin temperature
Increases sweating
Decreases skin resistance to galvanic current
Mechanically loosens adhesions and softens
scar tissue
Stretches and breaks down fibrous scar tissue
 Breaks down adhesions between skin and
subcutaneous tissue
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Psychologic Effects of Massage
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Psychologic effects of massage can be
as beneficial as physiologic effects
” ___________" modality where patients
feel as if someone is helping them
Treatment Considerations and
Guidelines
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Knowledge of ___________ is essential
Understanding of existing pathology
Thorough knowledge of massage
principles
Positioning of Clinician
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Prevent ___________
Permit free movement of
arms, hands, and body
Evenly distribute weight by
shifting from one foot to
the other
Fit your hands to the
contour of area being treated
Hands should be clean, warm, dry, and soft
Treatment Techniques
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Pressure regulation
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Rhythm
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Determined by the type and amount of tissue
present and patient's condition
Must be steady and even
Strokes should overlap
Duration
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Depends on the pathology, size of the area
being treated, speed of motion, age, size,
and condition
Treatment Techniques
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Swelling
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Begin proximally to facilitate lymphatic flow
“___________“
Body part may be elevated if necessary
Direction of forces should parallel muscle
fibers
Make sure patient is warm and in a
comfortable, relaxed position
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Massage should never be ___________
Treatment Techniques
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Sufficient lubricant should be used
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Begin with superficial stroking to spread
lubricant
Begin and end with ___________
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Pressure should be in line with venous flow
followed by a return stroke
Equipment Set Up
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Table
Linens and pillows
Lubricant
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Should be absorbed
slightly by skin but
does not make it slippery
Combination of one part beeswax to three parts
coconut oil
Other types of lubricants that may be used are olive oil,
mineral oil, cocoa butter, hydrolanolin, analgesic
creams, alcohol, and powder
Preparation of Patient
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Patient should be in a
relaxed, comfortable
position
Part involved in treatment
must be adequately
supported
Prone, supine, seated
Patient should
appropriately draped
Hoffa Massage
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Classical massage technique which uses
a variety of superficial strokes
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Effleurage
Petrissage
Tapotment
Vibration
Effleurage
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Any stroke that glides
over skin without
attempting to move deep
muscles
Hands are molded to
treatment area
Apply constant pressure
moving toward _______
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Lighter pressure applied
on the return stroke
Every massage begins and
ends with effleurage!
Effleurage cont.
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Moderate pressure according to patient and
condition
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Deep stroking is a form of effleurage, except it is
given with more pressure to produce a mechanical
effect
Increases venous and lymphatic return
Increases circulation to skin surface
Petrissage
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Kneading manipulations
Muscles are gently lifted,
rolled, and released
Pressure is applied
intermittently
Hands may remain
stationary or move along
length of muscle or limb
Petrissage cont.
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Increases venous
and lymphatic
return
Removes metabolic
waste products
Breaks up
adhesions between
skin and underlying
tissue
Tapotment
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Percussion massage
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Series of rapid, brisk blows
Increases circulation and blood flow
Stimulates peripheral nerve endings
Tapotment cont.
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Hacking
Tapotment cont.
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Hacking
Slapping
Tapotment cont.
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Hacking
Slapping
Beating
Tapotment cont.
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Hacking
Slapping
Beating
Tapping
Tapotment cont.
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Hacking
Slapping
Beating
Tapping
Clapping or
cupping
Vibration
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Shaking massage
Tremulous movement
made by hand or fingers
placed firmly against a
body part
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Rhythmical trembling
movement will come from
___________
Hands should remain in
contact with the body
part
Transverse Friction Massage
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Technique used for treating chronic tendon inflammation or
connective tissue adhesions
Stimulates ___________ ___________ to progress
healing process
Apply small circular motions penetrating to deeper tissues
Apply strong pressure in ___________ direction to fibers
for 7 to 10 minutes every other day
Acupresure and Myofascial Trigger
Point Massage
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Acupressure points are based on ancient
Chinese art of acupuncture
Myofascial trigger points found in…
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Muscle and tendon myofascia
Ligaments and capsules surrounding joints
Periosteum
Acupressure points and myofascial
trigger points are similar
Acupresure and Myofascial Trigger
Point Massage
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Pain results due to inflammatory
response following direct trauma or
overuse
Pain usually referred to areas which
follow a specific pattern
Stimulation of these points has been
demonstrated to result in pain relief
Acupressure Massage Techniques
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Locate points from chart
Use fingers, or elbow, to
apply small friction-like
circular motions
Amount of pressure
applied should be
intense and painful
Patient reports a dulling
or numbing effect
Treatment times range from 1-5 minutes at several
points
Myofascial Release
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Also called soft tissue mobilization
Techniques used to relieve soft tissue from
abnormal grip of tight fascia
Myofascial restrictions are unpredictable and
may occur in many different planes and
directions
Based on localizing restriction and moving into
the direction of the restriction
Myofascial manipulation is subjective and relies
heavily on the experience of the clinician
Myofascial Release Technique
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Protecting the clinician’s hands
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Use limited lubricant
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Use fist or elbow if necessary
Avoid slipping of hands on the skin
Positoning of the patient is critical
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Maximize effects of treatment
Indications For Massage
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Increase coordination
Decrease pain
Decrease
neuromuscular
excitibility
Stimulate circulation
Facilitate healing
Restore joint mobility
Remove lactic acid
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Alleviate muscle cramps
Increase blood flow
Increase venous return
Retard muscle atrophy
Increase range of motion
Edema
Myofascial trigger points
Stretching scar tissue
Indications For Massage
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Adhesions
Muscle spasm
Myositis
Bursitis
Fibrositis
Tendinitis
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Revascularization
Raynaud's disease
Intermittent claudication
Dysmenorrhea
Headaches
Migraines
Contraindications For Massage
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Arteriosclerosis
Thrombosis
Embolism
Severe varicose
veins
Acute phlebitis
Cellulitis
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Synovitis
Abscesses
Skin infections
Cancers
Acute inflammatory
conditions