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.
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. Glossary of terms Many massage therapists are well-versed in the terminology related to anatomical movements. It is helpful to review, though, some other anatomical terms and acronyms before continuing. The following list includes terms encountered throughout this course, followed by their meaning: ● ROM: Range of motion. ● Hypermobility : Mobility beyond the normal ROM. ● Hypomobility : Mobility beneath the normal ROM. ● Hypertonicity : Increased muscle tension. ● Hypotonicity : Decreased or flaccid muscle tension.
● Inflammation : The body’s first response to physical injury. Symptoms include swelling, heat, loss of function, redness, and/or pain. Two symptoms must be present to properly characterize an area as inflamed. Do not apply heat to inflamed tissue. ● ASIS : Anterior superior iliac spine. ● AIIS : Anterior inferior iliac spine. ● PSIS : Posterior superior iliac spine. ● PIIS : Posterior inferior iliac spine. ● Traction : Pulling a limb or the head away from the torso.
TECHNIQUES FOR ORTHOPEDIC MASSAGE
There are several massage techniques common to almost all massage modalities. These include all of the classic Swedish massage techniques such as effleurage, petrissage, friction, vibration and tapotement. Other techniques that can be commonly employed include the various methods of tissue Cross fiber friction This technique can loosen hypertonic muscles by realigning their fibers, reducing scar tissue that may affect a client’s ROM, or initiate the repair of damaged ligaments. To perform this technique, apply medium to firm pressure with the thumbs or fingertips at either the belly, origin or insertion of a muscle, at a site of scar tissue formation, or at the site of ligament damage. Move quickly back and force perpendicular to the affected tissue fibers. (A circular motion may also be worked in for variety, though you should always start and finish with the perpendicular movement.) Cross fiber friction is generally one of the more Directional massage This technique is similar to the myofascial release technique described below except that it is applied to muscle fibers instead of the body’s connective tissue (or fascia), is deeper, and is most effective during the acute phase of a muscle’s injury (24 to 48 hours after the initial injury) between the application of ice to reduce inflammation. Without using any lubricant, this technique begins by placing fingers or thumbs in line with a muscle’s fibers near the muscle’s origin with light to medium pressure. Once the fingers or thumbs have made contact with the muscle tissue, the therapist uses short 1-inch-deep strokes to push the muscle toward its insertion. The massage therapist should be sure to check Myofascial release This technique is designed to eliminate restrictions that develop in fascia, the broad, thin sheaths of connective tissue that run throughout the body and surround muscles, bones and organs. It is thought that loosening this connective tissue can correct mechanical issues such as range-of-motion limitations. Myofascial release utilizes light finger, thumb or knuckle pressure across superficial areas of muscle and bone. Generally, this technique begins by placing fingers, thumbs or knuckles upon a muscle’s origin with light pressure and taking a moment to “sink in” to the soft tissue. Then, the massage therapist moves in the direction of the muscle’s fibers toward the insertion of the muscle, feeling for any superficial restrictions along the tissue. Once a restriction is encountered, light pressure is
compression and passive stretching. Following are some techniques not commonly used for relaxation massages but can be very useful in treating a client’s pain or dysfunction when traditional techniques are ineffective.
uncomfortable techniques for clients and commonly results in soreness or inflammation of the targeted area. However, this is necessary to help initiate the healing process, and the inflammation should be short-lived. Icing the targeted area before the end of the treatment can help reduce prolonged inflammation. Make a note not to use cross fiber friction if inflammation is already present at the injury site. It is important to let a client who is unfamiliar with this technique know why it is being used, that it may be uncomfortable, and what may result from its use. in with or monitor their client to see if they are experiencing any sharp pain; if so, do not use this technique. If the client is not experiencing sharp pain, the therapist can continue by slowly lifting the fingers or thumbs out of the muscle and repositioning them 1 inch closer to the insertion and repeating the technique until reaching the origin. The length of the muscle will dictate how many strokes are needed to go from origin to insertion, but generally speaking there should be at least three. On occasion, this technique is more effective when moving from insertion to origin, so if working from origin to insertion proves to be ineffective for relieving hypertonicity, apply it in the opposite direction. maintained at the restriction for up to five minutes until the tissue begins to feel warm to the touch and subsequently becomes softer. Finally, the stroke continues to move toward the insertion until completing the stroke and removing the fingers, thumbs or knuckles from the skin slowly. In case a restriction does not react to the initial stroke, the massage therapist may try softly pinning the muscle’s origin with one hand while performing the stroke with the other hand. This technique is sometimes uncomfortable for a client as no lubricant is used on their skin and friction may generate heat in a manner the client is not used to. This technique is almost always safe to use after the acute phase of the injury has passed, unless the client’s discomfort is an issue.
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Book Code: MNJ0524
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