Chapter 5: Orthopedic Tests for Massage Therapists 1 CE Hour
By: John Vinacci, LMT Learning objectives Define an orthopedic test. Identify techniques common to orthopedic massage. Analyze the difference between structural and functional soft- tissue dysfunctions. Determine if an orthopedic test is necessary. Implicit bias in healthcare Implicit bias significantly affects how healthcare professionals perceive and make treatment decisions, ultimately resulting in disparities in health outcomes. These biases, often unconscious and unintentional, can shape behavior and produce differences in medical care along various lines, including race, ethnicity, gender identity, sexual orientation, age, and socioeconomic status. Healthcare disparities stemming from implicit bias can manifest in several ways. For example, a healthcare provider might unconsciously give less attention to a patient or make assumptions about their medical needs based on race, gender, or age. The unconscious assumptions can lead to delayed or inadequate care, misdiagnoses, or inappropriate treatments, all of which can adversely impact health outcomes. Addressing Pain due to muscle, tendon or ligament injury is often accompanied by a weakness or loss of movement. Within their scope of practice, massage therapists massage the skeletal muscles and their associated tendons; however, they may also find themselves massaging ligaments since all these tissues relate directly to the skeleton and how it moves. A massage therapist may assist with a client’s movements by helping to build their strength, resisting their movements to conduct facilitated stretches, or loosening a joint by taking it through a range of motion (ROM). However, there are times when certain techniques are contraindicated based on the condition of skeleton and related soft tissues and how these conditions may impair other systems of the body, such as the nervous system. Therefore, it is important to properly assess a client’s condition before beginning a massage. For injured clients seeking relief from their pain and movement dysfunctions, a quality massage therapist should seek short- and long-term solutions. This requires knowing what tissues are at fault and how. While this may seem simple and obvious (for example, pain in the neck is due to some neck muscle dysfunction) precisely pinpointing the causes of pain and dysfunction can be more complex. While it may not always be possible to know exactly what tissues are primarily at fault, there are many tests for soft tissue and joint injuries that therapists can conduct prior to (or even during) the massage treatment. Commonly referred to as “orthopedic tests,” these are assessments that test for skeletomuscular injuries and help sort out whether an injury is functional (muscular) or structural (skeletal) in nature. Identifying where pain and/or dysfunction is coming from helps narrow the focus of treatment and may allow the massage therapist to treat more of the client’s body. This is important if a dysfunction is affecting a client’s body in other ways, such as a sprain of the ankle ligaments affecting one, or even both, knees. The more a massage therapist understands the underlying causes of their client’s pain and dysfunctions, the greater the success in fulfilling their goal to be pain-free and functional. This level of treatment planning requires assessment skills not often taught in massage schools. Before conducting soft-tissue
Recognize the most accurate and common orthopedic tests used by physicians and physical therapists. Demonstrate how the most accurate and common orthopedic tests are conducted.
implicit bias in healthcare is crucial for achieving equity in medical treatment. Strategies to combat these biases involve education and awareness programs for healthcare professionals. These programs help individuals recognize and acknowledge their biases, fostering a more empathetic and unbiased approach to patient care. Additionally, implementing policies and procedures prioritizing equitable treatment for all patients can play a pivotal role in reducing healthcare disparities. Ultimately, confronting implicit bias in healthcare is essential to creating a more just and equitable healthcare system where everyone receives fair and equal treatment regardless of their background or characteristics.
INTRODUCTION
assessments, a knowledge of kinesiology – muscles and their actions on the skeleton – is of the utmost importance. This allows a massage therapist to assess tissues accurately and immediately in a clinical setting and requires a commitment to learning and practice. The benefits quick assessment skills are twofold: First, addressing a client’s pain and dysfunction quickly; and second, the therapist may provide psychological comfort by letting a client know why they have pain or dysfunction. While effective treatment relies on applying massage techniques that fit the client’s goals, it is important to let a client know when their injury involves something a massage therapist can only treat minimally at best, such as a meniscus tear. Understand that massage itself can be a contraindication if poorly thought out. Improper treatment plans can be ineffective for the client at the least, and at worst, increase the pain or dysfunction. The assessment tests provided in this course are commonly used by physicians and physical therapists but can be used by massage therapists as well. They will help narrow the focus of the massage treatment and identify the source or sources of pain or dysfunction. Keep in mind that although massage therapists cannot diagnose, these tests can help them determine what they can and cannot treat as well as advise a client when a referral to another health practitioner is appropriate. This course is designed to help massage therapists gain insight to the value of assessments during the interview process of treatment planning. The course begins with assessments for the head and neck and proceeds down the body. Sections are divided into tests for all the major joints and their surrounding musculature. Almost all assessments are performed with the massage therapist’s hands upon the client’s body except for the last section where a client’s walk – their gait – is visually analyzed. In some instances, the course will provide massage techniques for the positive result of a given dysfunction. Finally, before beginning this course, it is important to review some terminology used in these tests as well as techniques commonly used in orthopedic massage, that is, massage aimed primarily at pain relief, injury recovery and the restoration of movement.
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Book Code: MTX1324B
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