PHTY102 Lecture Notes - Lecture 11: Delayed Onset Muscle Soreness, Cutaneous Condition, Contracture
12. Massage principles and effects
• Define touch
o Come into or be in contact with
o Receptors - mechanoreceptors, nocioceptors and thermoreceptors
o Increased number of receptors in finger pads
• Outline the effects of touch on the human body
• Define the term therapeutic touch
• Outline how therapeutic touch may be used in clinical practice
• Define the term palpation
o Technique used in physical examination in which the examiner feels the texture, size,
consistency and location of certain body parts with the hands
• Outline how palpation is used in physiotherapy clinical practice
o Used to gain information on
• Joint play/end feel
• Weakness in muscles
• Tightness in muscles
• Oedema in soft tissues
• Fibrosis in soft tissues
• Tenderness
• Outline and describe the general principles of massage techniques
o Massage
• The term used to designate certain manipulations of the soft tissues of the
ody…adiistered for the purpose of produig effets o the ervous, usular ad
respiratory systems and the local and general circulation of the blood and lymph
o Positioning
• Same principles as per passive movements
• Patient
▪ Comfortable
▪ Support and stability
▪ Area accessible
• Therapist
▪ Maintain joints in neutral position where possible
▪ Wide stance
▪ Use legs (not back)
▪ Face direction of movement
o Body mechanics
o Draping
find more resources at oneclass.com
find more resources at oneclass.com
• Preserve patient modesty
• Expose area to be treated whilst protecting others
• Protect clothing
• Maintain comfortable temperature
o Medium/lubricant
• Reduces friction on skin during gliding-type massage strokes
• Oil, cream, powder
• Beware of using fragrance
• Small amount
• Apply to one area at a time using stroking or effleurage
o Therapist considerations
• Hands and hygiene
• Jewellery, hair, fingernails
• Development of therapeutic relationship
▪ Communication
▪ Trust
▪ Respect patient rights
o Rate
• Speed at which massage movement is executed
• Slower for relaxation
• Faster for stimulation
o Pressure
• Application of force to patient's tissues
• Generally start light and progress to desired effect
• Increased pressure = increased depth
o Depth
• Distance travelled into body's tissues
• Related to technique being used
• Also relates to
▪ Area of body (endangerment sites)
▪ Anatomy - deep tissue e.g. piriformis
▪ Response of patient (and tissues)
• Describe the known therapeutic effects of massage used in physiotherapy intervention
o Mechanical effects
• Movement of oedema, venous blood, hematoma contents, lymph (know where lymph
nodes are - drainage points)
• Mobilisation (loosening, stretching/elongation) of muscle fibres, tendons, skin,
subcutaneous tissue, scar tissue, adhesions (know muscle anatomy to allow specific
effective treatment)
o Physiological effects
• Blood and lymph flow
▪ Increased movement from tissues to blood -> reduced oedema
▪ Improved circulation (venous blood flow back to heart)
▪ Associated effects: nutrition, removal of waste
• Skin and subcutaneous tissue
▪ Vasodilation (redness) histamine-mast cells
▪ Heat-friction
▪ Mobilisation/stretching
▪ Reduces superficial keloid formation
• Metabolism and healing
▪ Related to circulatory effects
find more resources at oneclass.com
find more resources at oneclass.com
▪ Increase flow of nutrients
▪ Improved removal of waste products
• 'normal' muscle
▪ Relieves muscle tension and spasm
▪ Reduces negative effects of exercise
• Pathological/injured muscle
▪ Prevention of adhesions
▪ Maintain state of nutrition, flexibility
• Nervous system
▪ Inhibitory effect on H-reflex amplitude (reduced excitability of spinal motor
neuron)
▪ Promotion of parasympathetic activity
• Hormones
▪ Altered level of biochemical indicators of stress e.g. cortisol, serotonin, dopamine
▪ Endorphin release into blood stream
• Pain relief
▪ Gating mechanism: stimulates skin receptors (large diameter) which block
transmission of pain signals (small diameter)
▪ Via circulatory effect (removal of pain metabolites)
▪ Via reduction of muscle spasm
▪ Endorphin release
• Immune system
▪ Some evidence of positive effect of massage on immune system (HIV/AIDS)
▪ Related to reduction in cortisol, and increases in serotonin and dopamine levels
following massage
o Psychological effects
• Relaxation
▪ Promotes physical relaxation which in turn encourages conscious effort to 'let go'
• Stress/anxiety
▪ Linked to promotion of relaxation
• Laying on of hands
▪ Psychological construct that healing will take place with laying of hands
• Identify contraindications/precautions for massage and common endangerment sites on the body
o Contraindications
• Acute injury sustained within last 48 hours
• Acute infection e.g. osteomyelitis, septic arthritis, dermatitis, myositis, cellulitis
find more resources at oneclass.com
find more resources at oneclass.com
Document Summary
Massage principles and effects, define touch, come into or be in contact with, receptors - mechanoreceptors, nocioceptors and thermoreceptors. Joint play/end feel: weakness in muscles, tightness in muscles, oedema in soft tissues. Same principles as per passive movements: patient, comfortable, area accessible. Support and stability: therapist, maintain joints in neutral position where possible, wide stance, use legs (not back) Small amount: therapist considerations, hands and hygiene, development of therapeutic relationship. Jewellery, hair, fingernails: communication, trust, respect patient rights, rate. Faster for stimulation: pressure, application of force to patient"s tissues, generally start light and progress to desired effect. Increased movement from tissues to blood -> reduced oedema. Improved circulation (venous blood flow back to heart: associated effects: nutrition, removal of waste. Skin and subcutaneous tissue: vasodilation (redness) histamine-mast cells, heat-friction, mobilisation/stretching, reduces superficial keloid formation, metabolism and healing, related to circulatory effects.
