Massage Techniques and Information PDF

Massage Definition Uses Indications Effects Application/ Precautions & Technique Biomechanics...

Massage Definition Uses Indications Effects Application/ Precautions & Technique Biomechanics Contraindications ROCKING Pushing the pelvis or Introductory Anxiety Stimulating or sedating NO OIL All General and Local torso from a midline (depending on rate of CI’s resting position into Assessment tool Insomnia application) APPLIED OVER SHEETS lateral deviation and Dizziness then allowing it to Decrease anxiety Mental and physical Reflexively relaxes Full palmar contact to area return to resting fatigue muscles by activating with hands molded to fit Vertigo position Decrease perception PNS contours of body of pain Pain Inner ear infection Mobilizes joint capsule Gentle push with release Decrease muscle Restricted joint ROM phase so body comes back Nausea guarding Increase successive Muscle guarding actions at joints Follow patients rhythm Motion sickness Increase mobility of soft tissues Muscle hypertonicity Body is in wringing stance Tinnitus Increase patient Keeping one hand and Unstable spinal or breath awareness pelvis or torso and bringing peripheral joints other hand away and back (either upper or lower trunk) Biomechanics Wringing or effleurage stance No hyperextension of wrists Soft relaxed hands moulded to body MUSCLE Compressing and Palpation Assessment Local edema (not Decrease muscle Full palmar contact to area Bruises, contusions, COMPRESSIONS release of soft Tool related to cardiac, resting tone with hands molded to fit sunburns tissues liver, kidney disease) contours General mobilization Decrease muscle Hands slowly sink of soft tissues Muscle spasm, guarding NO OIL into tissue muscle guarding, May reset muscle APPLIED OVER SHEETS Introductory and Muscle hypertonicity spindle/golgi tendon finishing technique organ Pressure exerted down Pre/post sports towards belly of muscle or Local warm up prior to Increase interstitial muscle groups specific or deeper fluid (reduces edema) work Pressure progressively Increase local increased with subsequent Applied quickly – use circulation strokes as pre-event sports massage application Sedating effect of NS Biomechanics (increase PNS) Wringing or effleurage stance Lean in with body weight Do not lock elbows  Feet slightly apart Knees bent, pelvic tilt Shoulders dropped No hyperextension of wrists LIGHT STROKING DON’T NEED TO Introductory, Insomnia Decrease SNS firing 1 or 2 hands in rhythmic All General & Local WORK IN CAN BE transitioning, or fashion CI’s APPLIED AT ANY finishing stroke Muscle spasms or Increase lymphatic TIME spasticity return when applied of Minimal pressure Precaution – ticklish Sedate or stimulate venous and lymphatic patient CAN BE APPLIED depending on rate and Painful conditions return Breaking contact with body OVERTOP OF direction of application such as neuralgia & CLOTHING neuritis Stimulation of Maintain consistent Pain moderation cutaneous sensory direction Application of Stress neurons stroking where Stimulating towards head hands lightly pass (cephalon) over body part with minimal pressure Sedating towards feet (caudal) Any direction as long as maintained Biomechanics One or two hands in rhythmical fashion Applied with palmar surface or fingertips Hands and wrists relaxed of one hand or with but not floppy both simultaneously or alternately Minimal pressure Rate determines Return stroke off body stimulating or sedating Direction of movement can be in several directions but not at the same time Maintain consistent direction EFFLEURAGE Continuous gliding Apply lubricant Areas of edema Mechanical: Evenly distributed pressure All General & Local technique applied to Decrease edema from whole hand CI’s body or limbs Introductory & Conditions of poor finishing circulation Increase lymphatic Smooth and rhythmical with Distal to areas of Performed with light return pressure on upstroke and acute/subacute pressure in direction Blending/transitional Muscle tension light on return stroke inflammation, injury, of venous return Increase venous return infection Introduction to deeper Pain Direction of venous return Full palmar contact techniques Reflex:  Decreases SNS Enough oil to avoid No repetitive Applied with cutaneous irritation but not application to limbs of pressure evenly on Decrease pain cause loss of control patients with upstroke (more hypertension, heart pressure), light on Biomechanics disease, varicose return Relaxed hands veins or edema cause by thrombus in vein Evenly distributed pressure from whole hand Smooth and rhythmical w/ pressure on upstroke light on return stroke On limbs direction of venous return Avoid “L shape” with thumb Use legs, transferring weight from rear to front leg (Split stance parallel to table) DEEP STROKING Even, rhythmical Blending or connecting Area of edema, not Increase lymphatic and Can follow direction of All General & Local movement stroke between systemic -> (except venous return muscle fiber CI’s techniques related to cardiac, Applied with any liver, kidney, or Decrease SNS firing Not necessarily following part of hand Clearing stroke lungs) venous return Physiological effects Moderate to deep Decreasing muscle Muscle hypertonicity same as effleurage Finish treatment with pressure hypertonicity strokes to promote venous Sluggish or poor Reduce edema return Directed toward Introduction to new circulation underlying soft part of body Stimulate large Pressure not continuous tissue cutaneous mechanoreceptors that Start lightly, increase Palmar surface of moderate pain having a pressure gradually and whole hand, ulnar soothing effect decrease towards end of border, knuckle, stroke fingers or thumb Stretches muscles when applied parallel Biomechanics Single hand, to fiber direction Effleurage stance reinforced, simultaneous or Stable relaxed position (to alternately be able to bring weight into hands)  Allow rhythmical even stroke Leaning into stroke Push off back leg to increase depth of stroke PETRISSAGE Alternate pressure Promote relaxation Inefficient circulation Increase local All General and Local and release of soft circulation CI’s Compressive tissue Decrease perception Edema Techniques of pain Decrease edema Severe muscle -kneading (palmar, French “Petrir” “to Decrease AROM atrophy thumb, fingertip, knead” Increase local Maintain or increase open C knuckle) circulation Hyper toned muscles ROM Severely atonic, -muscle squeezing Used after tissues flaccid muscles -muscle striping are warmed Decrease edema Muscular pain Reflexively decrease (Could tear or rip (increased pressure) muscle hypertonicity muscles) Lifting Decrease muscle Muscular Tecnhiques Applied with one or hypertonicity contractures Decrease muscle pain -picking up both hands -wringing Increase connective Digestive disorders Release adhered -skin rolling Pressure applied tissue mobility (atonic constipation) muscles compressing down toward underlying Increase joint ROM Insomnia Sedating/stimulating on structures or by nervous system lifting soft tissues up Spastic paralysis from underlying structures Compressive applications may be reinforced Petrissage Petrissage technique Pre/post sports Hands placed on opposite (Lifting technique) applied with equal massage sides of area being treated Wringing pressure on opposite sides of part of the Equal pressure applied by body palmar aspect of hands Full palmar aspect of Moulded hands hands molded to body part NO “L THUMBS” Underlying tissue Hands lift tissue up in compressed in opposite direction and then opposing directions release at maximum height moving towards midline then away Repeat Biomechanics  Tissue lifted then Perpendicular to table released “Wringing stance” Applied proximal to distal (legs & back) Load stays in centered in middle of body Lifting comes from movement of legs & arms NOT SHOULDERS Petrissage Primarily applied to Hands parallel to limb (Lifting Technique) limbs Picking Up Wrists and hands soft and Tissues moulded simultaneously compressed Simultaneously compress together and lifted and lift tissues away from up from underlying underlying structures structures Pressure released on Pressure released on upward and returning stroke upward and in circular motion returning stroke of circular motion Contact remains constant Contact remains Can be applied single continuous handed if hand-body ratio throughout the allow (calf) whole movement Applied proximal to distal Full palmar contact Biomechanics Hands moulded Deep effleurage stance body Stand parallel to table Lift with legs and core Arms are extension of body Keep majority of weight of the limb as close to the center of your body as possible Abdominal Grounded & focused Constipation Diaphragmatic breathing Absolute: Massage Severe hypertension Inform of what you Breathing or Palpation and tissue or high BP are doing and pulmonary conditions assessment (160/115mmHG) results to expect  Anxiety Effleurage Acute attack of colitis, Use washroom IBC, Crohn’s before treatment Promotion of Full sun half moon (palmar relaxation through stroke) Acute abdominal Follow directions of breathing techniques hernia peristalsis when Wringing massaging colon Muscle hypertonicity Nausea, vomiting, (rectus abdominis, Palmar, fingertip and thumb diarrhea Treating ext/int obliques, deep stroking constipation, psoas, intercostals, First trimester of perform in a pec major, etc. Palmar, fingertip and thumb pregnancy counterclockwise kneading direction Acute inflammation of (Descending colon - Light shaking of the one of the organs > transverse colon - abdominal area > ascending colon) Undiagnosed lump or Light vibrations tumor At least 2 on pressure/pain scale, Reassessment of tissue Relative: 1 can feel ticklish High BP and uncomfortable Diaphragmatic breathing (160/90mmHG) – controlled by medication History of colitis, IBS, Crohn’s Chronic or history of abdominal hernia Benign cyst or tumor 2nd or 3rd trimester of pregnancy Dysmenorrhea 1st or 2nd day of menstruation (if painful) Petrissage Petrissage technique Assess for superficial Decreased joint ROM Loosens adhered tissue Assess tissue first, 4 All General & Local (Lifting facial restrictions due to fascial in cutaneous & directions, pick up skin to CI’s Technique) Skin Cutaneous and restrictions subcutaneous layers of find restrictions Rolling subcutaneous tissue Decrease cutaneous or dermis (skin/fascia) Acute inflammation grasped & lifted subcutaneous Decreased superficial Local muscle compressions, away from adhesisions formed as tissue mobility Stretched superficial palmar stroking, warm up Hypersensitive cannot underlying a result of scar tissue fascia without oil or slight amount tolerate pain structures formation or the Restrictions in to create friction and heat overuse/misuse of a superficial fascia Decreases peripheral Poor skin quality Skin rolled between particular muscle of which result from resistance of superficial Grasp/lift skin with fingers & (elderly, cortical fingers and thumbs muscle group chronic-stage burns, lymph and venous thumb – move slowly in any steroid topical use) very slowly wounds, surgery and vessels prompting direction (but usually into Increase skin & orthopaedic increase in lymphatic resistance) Severe histamine Moved in any subcutaneous tissue conditions (post 6- and venous return reaction direction (skin roll mobility week healing) Use C or S bowing if unable into adhesion) Increases local skin to roll Patient does not like it Increase cutaneous circulation (local cirtculation hyperemia) Monitor patients reaction with pain scale (fingernails/histamine reaction) Hold until you feel the tissue release or pain intensity decreases Re-asses tissue Use clearing massage techniques -> effleurage & deep palmar stroking Hydrotherapy Treatment or Relieve pain and Pain and Thermal: using temps 1. Know and understand COLD: management plan discomfort inflammation above or below human indications of your Very high/low BP Applied: body temp treatments Constitutional – Use of water in any First aid (PRICE in Sports, overuse, 2. Contraindications Pleurisy whole body (bath, 3 elements (liquid, sports or acute repetitive strain Physiologically increase and precautions of (inflammation of steam) solid, vapor) injuries) injuries or decrease temp and treatment pleura, tissue around internally or increase/decrease 3. Maintain detailed lungs, tissue is Regional – externally in Pre-heat for massage Stress circulation, depending records of patients fragile) section/part of prevention, or exercise on temp of stimulus treatments and body (abdominal treatment or healing Insomnia review before every Raynaud’s disease wash) ailment or disease Promote relaxation Mechanical: produced treatment (Flared up) – inability and reduction in stress Decreased ROM by impact of water on 4. Fully explain for blood vessels to Local – smaller body hydrotherapy constrict and relax area/part of body Increase circulation to Patients with weak, 1. Friction procedures before (ice massage, heat skin, extremities and bedridden or unable 2. Strike treatment Hypersensitivity to pack) joints to support their (CLARITY=SAFETY) cold (ex. Hives or weight increased pain)  Stimulate immune Increase or improve 5. Monitor patient system Hyper toned muscles movement (ex. Add closely, comfort at Peripheral neuropathy water pressure with all times (lack of diminished An exercise Arthritis (NOT effusions or friction of 6. Thoroughly and sensation in environment (pool ACUTE/FLARED UP) salt glow, jets in hot evenly warm extremities) exercises assist in tub) patient before increasing ROM) Decreased treatment (never Previous history of circulation, poor or Chemical: water cold on cold frostbite Increase joint ROM sluggish circulation ingested by mouth or patient) exchanges of body 7. Chilled by Sinusitis (tissues chemicals through treatment – stop already constricted skin/tissues (ex. Epsom immediately and due to nasal salt bath, drinking hot warm patient congestion tea) (either internally 8. Treatment followed or externally with use by rest period NEVER cold on a of additives) (after warm/hot chilled/cold patient treatments) or Additives can be light, monitored HOT: stimulating, sedating or exercise (after Very high/low BP detoxifying cool/cold treatment) Circulatory 1. Applied to skin 9. Circadian rhythm dysfunction 2. Absorbed (heating 3am-3pm, (hemophilia, varicose 3. Inhaled cooling 3pm-3am) veins, numbness, - Morning: intense severe diabetes, treatments kidney disease) - Afternoon: medium intensity treatments Infections (open - Evening: light wounds, burns, sores) treatments (too intense could cause Cancer (unless insomnia) palliative care and/or 10. Use hot/warm MD approved) before cold/cool. - Heat application Tuberculosis (fragile bigger and longer lung tissue) than cold application - End with cold Acute inflammation, - Minimum 10 degrees high fever Celsius between temps to creat Medications (impairs physiological changes sensation, pain relievers, blood thinners, corticosteroids CRYOTHERAPY Ice gently massaged First Aid 1. Explain procedure to Hypersensitivity to 1. Ice Massage over injured area patient cold using overlapping Flushing - ice directly applied to skin Cold allergy  strokes to cover Rehabilitation - 1st (coolness), 2nd entire area (burning), Aching, Lack of diminished Numbness sensation to area Stimulates 2. Overlapping circles or being treated mechanoreceptors back and forth and provides a movement to cover Frostbitten at any superficial cooling treatment area time in area to be effect that 3. Treat areas no more treated decreases surface than 6 inches inches tissue temperature in diameter at one Caution over bony and produces time prominences and anesthesia 4. Speed on movement 4 superficial nerves inches per second 5. Pressure firm not heavy 6. Massage each area separately until 4 effects have been attained (C-BAN) 7. Avoid bony prominences and areas of superficial nerves 8. Catch drips of water with cloth Finishing Treatment: - Stop treatment when anesthesia has been attained typically 5-10 minutes - Dry patient thoroughly, but without using friction, gently pat dry CRYOTHERAPY The use of cold to Treating sprains, Placing cubed, chipped or Hypersensitivity to 2. Ice Packs treat injuries strains, tennis elbow, crushed ice into plastic cold backache, bags, towels or cups then headaches, applied to affected area Lack of diminished appendicitis, sensation of area toothache, bursitis, Ice should be covered with being treated goiter, inflammation, cloth then applied to rapid or weak heart affected areas Arteriosclerosis action Indicated for immediate Frostbite at any time Reduction in local care of musculoskeletal in area being treated metabolism injury to limit edema  Immediate treatment Different size ice packs Precaution of bony for burns depending on size of area prominences and for treatment superficial nerves Cold allergy CRYOTHERAPY Ice added to Decrease in: Ice added to container filled Hypersensitivity to 3. Ice container filled with - Temperature with water to lower the cold Immersion water to lower - Metabolism temp temperature - Inflammation Lack of diminished - Circulation Optimal 4.4 degrees Celsius sensation of area More uncomfortable - Pain being treated than ice message - Muscle spasm More uncomfortable than ice massage Arteriosclerosis Optimal 4.4 degrees Celsius/ 40 degrees Ice immersion discontinued Frostbite at any time farenheit when state of numbness is in area being treated reached Precaution of bony Followed by AROM & prominences and mobility exercises superficial nerves For hands, feet, ankles and arms Procedure: - Ensure patient warm and comfortable - Take baseline BP and pulse - Explain procedure and progression of sensation - Proper placement of bucket for ease of application - Towels ready - Fill bucket with cold water and ice - Measure temp of water with thermometer - Immerse body part until numbness has been reached - Patient will experience C-BAN - Remove body part from ice immersion  - Perform AROM (repeat 2-3x) - Gently pat dry area when finished AROM CRYOTHERAPY ** do not apply ice Promoting Pain & swelling; dry, Hypersensitivity to 4. Cold Towels to both sides of neck vasodilation, decrease weeping areas, cold at the same time** local blood flow headaches, constipation Lack of or diminished ** do not apply ice Slows HR when sensation to area or heat over carotid increasing force of being treated arteries or veins** beat Arteriosclerosis Increases blood pressure, decreases Frostbite at any time pain and swelling in area to be treated Precaution over body prominences and superficial nerves Cold allergy CRYOTHERAPY Enclosed in heavy vinyl Hypersensitivity to 5. Cold Gel cover that may be chilled in cold Packs refrigerator and may be reused Lack of or diminished sensation to area **gel can be chilled below being treated freezing point of water** Arteriosclerosis Not to be used more than 15-20 minutes at a time Frostbite at any time in area being treated Should be applied over a damp towel Precaution over body prominences For treating sprains, strains, tennis elbow, backache, headaches, appendicitis, toothache, bursitis, goiter, inflammation, rapid or weak heart action PETRISSAGE Compressive Decrease muscle Adhered muscle and Decrease muscle pain Knuckle kneading All General & Local petrissage hypertonicity fascia - Keep hand relatively CI’s Compressive movement applied Maintain and increase relaxed and loose, Technique with palms, thumbs, Increase peristalsis Fatigued muscles ROM small hole when you Bony prominences fingertips or when applied directly look through fingers (sacrum, scapula, - KNEADING knuckles over colon Atonic constipation Release adhered and palm spinous processes, 1. Open-C (digestive disorders) muscle clavicle) 2. Palmer Palmer kneading  3. Fingertip Applied in short Increase muscle and Local edema (not Stretch muscle and - For larger surface Severely atrophied or 4. Knuckle rhythmical, soft tissue mobility systemic) connective tissue fibers areas position legs, atonic muscles 5. Thumb unidirectional torso and arms as you circular motion and Increase local Non acute digestive Decrease fibrous would for effleurage Precaution over released on circulation disorders (IBS, thickenings organs downstroke of circle Crohn’s) Smaller more specific areas Promote relaxation Decrease muscle - Position hips either Hypertoned muscles hypertonicity (reflex perpendicular or Decrease edema relaxation and parallel to area being (Same as petrissage) elongated to treated hypertoned muscles due to pressure and Hands in front, soft and stretch of the relaxed hands and wrists, techniques) fingertip or thumb kneading in these areas Maintain or improve muscle tone (via reflex Avoid hyperextension effects on motor “bridging” thumbs by using nerves) pad of thumb Maintain palmar contact and/or reinforcing the joint 4 S’s - Slow - Small - Specific - Circular Petrissage Stand perpendicular to body being Compression Technique Wringing stance, body moves with hand shifting Open-C weight Supports the pressure being applied by the hands Applied in wave like motion More pressure on upstroke to follow venous return Hand make “v” shape Moist Heat Preheat before Decreased ROM Analgesic effect (a Impaired skin 1. Hydrocollat massage sense of normal sensation or pack Delayed onset muscle sense of pain) by 2. Thermaphor Decrease muscle soreness elevating pain Severe swelling e spasm and pain threshold  3. Paraffin Arthritis (non acute) Acute inflammation Wax Decrease joint pain Helps to speed 4. Hot Chronic conditions healing process, Circulatory Compress Decrease myofascial increase nutrients, impairment trigger points post Labour pain WBC and neutrophils treatment Adhesions and scars Vascular Relaxes muscle insufficiency/disease Increase tissue spasms and muscle pliability tension Open wounds Ease respiration Prolonged Mod to severe applications can varicose veins Promote tissue mobilize body’s healing defense against Cancer (unless MD disease by increasing approved) WBC production Infections Respiration rate can increase by 5-6 Analgesic drugs respirations/min per (topicals/pain killers) degrees rise in temp Hemophiliacs (lack Cell changed – factor in blood to clot) leukocytes and neutrophils are Active or acute increased dermatological (WBC/inflammation conditions helpers) Hypersensitivity to heat = heat rash Recent application of heat rub or liniments (A535) Caution in pregnant patients Moist Heat Pre-heat for Penetrates tissues Local application of hot All CI’s for moist heat massage below melted paraffin wax to the - Paraffin skin surface – mild heat Long term steroid Wax Deep heat Induces hyperemia therapy Treatment application for distal (increase circulation Applied to hands, forearms extremities and skin redness) and the feet by immersion Weak/elderly due to into the hot wax tissue fragility Chronic arthritic Relaxes connective joints, hands, wrists, tissues May also pain wax on area Remove nail polish feet, ankles of treatment, or use cheese and acrylic nails Reflexively affect cloth (bacteria on nails) Stiff joints muscle tissues  Chronic scars and Conducts heat slowly adhesions compared to water Allow tissues to heat up slowly First dip traps air and moisture to create even heat distribution Moist Heat Portable electric Maintain desired heat for - Thermophor device that provides 20-30 min max. e moist heat Retain more heat by Penetrates deeper covering with a towel, into tissue than dry blanket or pillowcase heating pad (uses moisture from air to Monitor heat sensitivity and facilitate conduction adapt treatment of heat deeper into tissues) Wipe off body part after removal of thermophore Draws humidity from (perspiration) air then retains it in the outer flannel Treatment time 30 min, 2-3x cover per day with 2 hour intervals of no heat The rapid heat increase forces moisture out of the flannel onto the patient’s skin Temperature approx. 65-75 degrees Moist Heat Canvas cases filled 20-30 min max - Hydrocollat with bentonite or Packs 1. Lay down brown towel Bentonite is a by tank hydrophilic silicate 2. Using heavy gloves or tongs lift pack out Silicate gel absorbs 3. Let pack drip over large quantity of tank water and has high 4. Wrap pack by placing heat capacity it in the middle of towel and fold over Stored in large hot until completely water tank enclosed  5. 6 layers of toweling Temperature is between pack and approx 70-80 patients skin, once degrees knowing patients response add more or less layers of toweling 6. Constantly monitor patient 7. Do not lie or sit on pack Moist Heat Applied with cloth or PRECAUTIONS: - Hot towel wrung out Compress from hot water at Make sure towels are wrung temp of 40-42 out properly degrees Watch compress not too hot May be applied to for patient tolerance anybody surface Fit compress to contour of body part being treated – prevents air from entering and cooling compress Contrast Alt. Warm/hot, Increase alertness General fatigue Increased alertness 3 minutes warm High BP or very low Treatment cold/cool to body or 30 sec-1 minute cold BP body part Decrease delayed Tired achy Decreased soreness onset muscle soreness arms/feet/body post workout Repeat 3x Weak or debilitating Applied in cycles of conditions warm & cold 3x Increase circulation in Poor circulation in Increased circulation Start with warm, end with extremities extremities (not cold Acute injuries or local Always end with cold related to primary Stimulation of the NS infections Decrease sinus organ failure or Make sure to remember to Minimum of 10 congestion blockage) Decreased recovery reward patient following Peripheral vascular degrees difference time cold immersion conditions to achieve positive Headaches (sinus, effect migraines) CAB (contrast arm bath) Medications affecting tone or sensation Greater difference in CFB (contrast foot bath) (NSAIDS, BP, Pain) temperature = stronger the effect Contrast shower Severe varicose veins on legs for CFB Contrast compresses Set Up & Interview Prepare base camp Preheat room Gather all towels and buckets 2 thermometers Pre-heat treatment clinic form BP and pulse, interview room Explain procedure and obtain patient consent Completing Tx Pat patient dry Check and record BP and pulse Check and record any adverse reactions  Arms should have even pink, red Drain and clean tubs Wipe area dry with towel TAPOTEMENT Repeated rhythmical Stimulate receptors of Lung conditions Analgesic effect First 3 are skin All general & local light striking skin and muscles (include secretions) (applied for over 3 min) Other 6 are muscle CI’s Pincement 1. Pincement French “tapoter” – Decrease muscle Sinus congestion Decreases muscular 2. Fingertip tapping Acute inflammation Fingertip tapping rap, drum or pat hypertonicity tone 3. Point percussion Neurological 4. Loose digital ulnar Acute Neuritis/Acute Point hacking Series of alternating, Dislodge mucous and conditions Expel mucous and border percussion Neralgia (point rapid, rhythmic, mucoprulent materials mucopurulent material 5. Stiff digital ulnar percussion) percussive strikes to with congestive lung Hypertoned / tight border percussion Acute Painful surface of body conditions and sinus muscles Increase local 6. Clapping Conditions Loose Digital congestions circulation 7. Cupping Ulnar Border Applied with either Pain 8. Knuckle percussion Insomnia Percussion palmar surface of Increase local Increase peristalsis 9. Pounding (Hacking) hand, ulnar border circulation Pre-competitive Spastic Paralysis of hand fingertips, sports massage Lighter applications Just apply numbers 3-5, 8-9 Ulnar Border gently closed fist Stimulation of stimulate muscle to us on Glutes and overtop of Deep Tapotement: Percussion hypotonic muscle sheet Loss of sensation to (Hacking) Sedative – 30sec to 3 an area Reflexively stimulate min NO WARM UP CAN GO Clapping peristalsis STRAIGHT TO 1 OF Lumbar area during (Slapping) Stimulatory – less than TAPOTEMENT heavy menstruation 30 seconds Cupping CAN BE OVERTOP OF Over kidney or Analgesic >3min CLOTHING abdomen Knuckle Percussion Over abdomen, (Beating or sacrum, or lumbar Rapping) during pregnancy Pounding Disc herniation (deep Tapotement could cause vibrations which could cause pain or spasm) Bony prominences or joints SHAKING & Coarse vibratory Decrease muscle Muscle hypertonicity Dislodges mucous in JOSTLING AND SHAKING All General & local JOSTLING movements applied guarding bronchi SKIN ON SKIN CI’s to muscle groups Muscle guarding Hold limb securely limbs or torso Stimulates peristalsis Muscle atrophy  Decrease muscle Bronchitis Shake body part Body part is grasped hypertonicity Synovial lubrication in rhythmically with two hands Joint pathology and physically Decreased joint ROM joints - Shaking torso needs shaken Decrease chest/lung further consent (SP- Severe muscle spasm congestion Constipation Reduces muscle >erectors->ribs) Jostling -> muscle guarding starts at xiphoid Unstable joints groups Increase joint ROM Pre-event sports process massage ** shorter applications - Moving down the back Disc herniation Shaking -> Stimulate peristalsis are stimulating - Underneath bottom Limbs sheet Pregnancy Stimulate muscles for Either up/down or side/side pre-events Jostle muscle groups vigorously Shaking to abdomen/thorax Avoid excessive joint movement/traction Monitor patient closely NO JOSTLING ON GLUTES SHAKING AND JOSTLING FOR ATHLETES ABOVE CLOTHING Fine Vibrations Fast, oscillating or Decrease pain Muscle pain Increase superficial Moving SLOW All General & Local trembling movement associated with: lymph return and that is produced on - Acute muscle Muscle hypertonicity decrease lymphatic Pushing or pulling skin resulting in spasm congestion minimal deformation - Neuralgia Muscle spasm Movement coming from of subcutaneous - Neuritis Sedative effect by forearm & hands tissue - Inflammation Lymphatic congestion stimulating cutaneous - Sinus congestion nerve endings -> Superficial light, Sinus congestion reflexively decrease very brief and fast, pain + muscle minimal amplitude, Chest congestion hypertonicity via Pain barely visible Gate Theory movement Constipation - Reduces the transmission of Both Course and pain Fine: Static: stationary, hand is in continuous contact with no movement  over the body part of skin Running: treatment hand is moving in constant vibration contact with body part or skin Coarse Vibrations Larger amplitude of Maintain present tone Flaccid or atrophied Stimulate/sedate Running Vibrations: All General & Local vibration movement, and decrease muscles (innervated) cutaneous nerve - Need to move feet see visible deterioration of endings - Transfer weight Acute muscle spasm movement muscles Muscle pain - Push vs. Pull Stimulate peristalsis Spastic muscles (Innervated) Muscle hypertonicity (performed over Static Vibrations: abdomen) - Standing or seated 1st trimester of Decrease pain Lymphatic congestion pregnancy Increase expectoration Application of Technique: (Lumbar, Sacrum, Decrease muscle Sinus congestion when applied over - Relaxed hands Abdomen) hypertonicity lungs - Focused & breathing Chest constipation - Palmar surface, one or Decrease lymph 30 sec vs. 3 min both hands molded congestion Atonic constipation - Back/forth or up & down Decrease sinus Have to be in the - Fingertip vibrations congestion correct location to (still palmar surface have the effect contact) Increase expectoration - Simultaneous isometric contraction Increase peristalsis of forearm muscles - Shake hands out if fatigued Muscle Stripping Slow specific gliding Decrease trigger point Trigger points Decrease pain due to 1. Consent All General & Local technique from one activity and muscle trigger points (trigger 2. 4 T’s CI’s attachment of pain Adhesions/scars points cause pain) 3. PROM for muscle muscle to other in 4. Warm up areas Acute inflammation order to reduce Decrease Hyper toned muscles Reduce adhesions proximal to distal that activity of adhesions/break down breaks down scar you are muscle Early stages of myofascial release scar tissue Shortened tissue striping healing trigger points muscles/muscle 5. Reassess tissue and Decrease muscle contracture Decrease muscle proceed Atonic/hypotonic DISTAL -> hypertonicity hypertonicity 6. Reestablish pain scale muscles PROXIMAL Decreased ROM 7. Fire off affected Increase muscle hyper Increases ROM muscle, when Severe muscle With knuckles, extensibility (more palpating so you know atrophy fingertips, ulnar circulation, more you are on it pliable)  border, thumb or 8. Think, sink, apply Caution around areas elbow slow, deliberate of muscle spasm strokes parallel to Gliding pressure muscle fiber direction Suspected or known along muscle fiber 9. Check in with patient osteoporosis, after a few passes to anticoagulants see if you need to continue 10. Reassess 11. Repeat stripping if necessary or if not, clear out