Fundamental Concepts of Massage Therapy – Flashcards
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What is the meaning of massage?
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Method of healing that applies various techniques. Primarily used are the hands, fingers, forearms, elbows, knees and feet.
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How is massage best applied?
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Massage involves acting on and manipulating the body with fixed or moveable pressure, holding, vibration, rocking, friction, kneading and compression of the muscular structure and soft tissues of the body.
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How does traditional medicine view massage therapy?
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Traditional medicine throughout the world recognizes the significance of therapeutic massage in managing stress, illnesses or chronic ailments.
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What is crucial for a therapist to know about their client?
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-If a person is indicated or contraindicated for massage. -Recognize the physiological and psychological effects of massage to his client.
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What are Contraindications?
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-Presence of a disease or physical condition making therapy in the usual manner impossible or undesirable. -It requires further evaluation by a physician before therapist can recommend a massage therapy plan.
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What are Indications?
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-A fitting therapeutic treatment for a given condition. -It has beneficial effects and promotes healing.
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What are miscellaneous effects?
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These are massage results that are either psychological in nature or byproduct of physiological effects.
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What are physiological effects?
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Tis refers to results from activities that affect organs and systemic functions without regard to a particular disease after undergoing massage.
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What traced origins are there with the word massage?
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-Hebrew - mashes -Arabic - massa which means "to touch, feel or handle" -Latin - massa meaning "mass, dough" -Greek verb - masso meaning "to handle, touch, to work with hands, to knead dough" -French - masser meaning "friction of kneading"
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When was the earliest indications of massage being practiced in the ancient world?
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3000 B.C.
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When was massage documented in China as a method for treating illnesses?
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second century B.C.
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What country is thought to have used blind therapists for the first time?
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China
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What century were the techniques and use of massage well established in China?
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sixth century A.D.
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How long has the Indian subcontinent practiced massage?
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more than 3,000 years
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When did massage emerge as an idea of healing and treatment in Greece into health science?
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around 500 B.C.
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When did the era of modern massage emerge?
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early nineteenth century
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Who was the most important writer who advocated for massage in the early 19th century?
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Per Henrik Ling, a Swedish Physiologist and gymnastics instructor
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What was the primary focus of Per Henrik Ling's work?
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Gymnastics applied to the treatment of disease and injury
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Who is commonly known as the father of Swedish massage?
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Per Henrik Ling
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What individual was responsible for making massage a fundamental component of physical rehabilitation?
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Dutch physician Johann Mezger (1817-1893)
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What is Mezger credited with influencing?
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The inclusion of the art of massage in the science of medicine.
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What administrative order sets the policies and guideline for accreditation of training institutions, training programs and training providers for massage therapy in the Philippines.
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AO No. 2008-0031 Dated 2008
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What presidential decree paved the way for massage therapy regulation in the Philippines?
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PD No. 856, dated December 23, 1975
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Who are the primary key figures in the modern Philippine Massage Industry?
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-Dr. Kenneth Ronquillo -Dr. Josephine Hipolito
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What organization do Doctors Ronquillo and Hipolito belong to?
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-Committee of Examiners for Massage Therapy -Dr. Ronquillo - Chairperson -Dr. Hipolito - Head
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When was the most recent Administrative order governing massage signed?
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Administrative order No 2010-0034 dated Dec 10, 2010
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Who signed the AO 2010-0034 which revised the existing implementing rules and regulations of PD 856?
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Secretary Enrique Ona
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What does PALMT stand for?
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Philippine Association of Philippine Licensed Massage Therapists
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Who is committed to ensuring the highest standard of massage therapy practice in the Philippines?
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-Department of Health -Accredited Training Institutions -Training Providers -PALMT
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Why is massage therapy popular today?
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-Due to the highly stressful conditions of modern living and harmful effects of unhealthy foods. -More people are increasingly looking for holistic and natural healthcare methods to remedy their health problems
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Who issues a COR (Certificate of Registration)?
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-Issued by the Committee of Examiners of Massage Therapy -Approved by the DOH
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What body systems are affected by massage?
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-Circulatory System -Lymphatic System -Integumentary System -Nervous System -Endocrine System -Muscular System -Respiratory System -Digestive System -Urinary System
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What effects does massage have on the Circulatory System?
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-Dilates blood vessels -Improves blood circulation -Decreases blood pressure -Replenishes nutritive materials -Helps in removal of waste products -Reduces heart and pulse rates -Increases red blood cell count -Increases white blood cell count
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Describe how massage dilates blood vessels.
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Aids in the widening or stretching of superficial blood vessels
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Describe how massage improves blood circulation.
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Deep strokes improve blood circulation by mechanically assisting venous blood flow back to the heart
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Describe how massage decreases blood pressure.
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When blood vessel dilates, the blood pressure decreases
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Describe how massage replenishes nutritive materials.
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Increased circulation helps in the deliver of nutrients and oxygen to cells and tissues
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Describe how massage helps in removal of waste products.
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Increases circulation also in the removal of metabolic wastes
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Describe how massage reduces heart and pulse rates.
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Massage decreases heart rate through activation of the relaxation response
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Describe how massage increases RBC count.
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-The number of RBCs and their oxygen-carrying capacity are increased. -Stagnant capillary beds are stimulated, returning this blood into general circulation.
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Describe how massage increases WBC count.
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-As the body sees massage as a mild stressor, it recruits additional WBCs leading to an increase in number of WBC. -They enable the body to protect itself more effectively against disease.
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What effects does massage have on the Lymphatic System?
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-Improves lymph circulation -Reduces edema (accumulation of excessive amounts of watery fluid in cells, tissues, or body cavities) -Decreases circumference of an area affected with edema -Decreases weight in patients with edema
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Describe how massage increases improves lymph circulation.
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-Lymph circulation depends on pressure from muscle contraction. -Pressure changes in the thorax and abdomen during breathing or applied pressure from massage.
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Describe how massage reduces edema.
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Improves lymph circulation
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Describe how massage decreases circumference of an area affected with edema.
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When an area swells, the diameter increases and when it subsides, circumference decreases
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Describe how massage decreases weight in patients with edema.
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Fluid retention adds weight to a person so when edema is addressed with massage, weight is reduced
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What effects does massage have on the Integumentary System?
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-Increases skin temperature -Improves skin condition -Stimulates oil glands -Reduces skin dryness
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Describe how massage increases skin temperature.
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Warming of the skin indicates a reduction of stress
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Describe how massage improves skin condition.
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As circulation increases, added nutrients are made available to the skin thus improving its condition, texture and tone
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Describe how massage stimulates oil glands.
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Stimulation of the sebaceous oil glands causes an increase in oil (sebum) production
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Describe how massage reduces skin dryness.
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Due to the increase in oil (sebum) production
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What effects does massage have on the Nervous System?
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-Reduces stress -Reduces anxiety -Improves ability to relax -Decreases beta wave activity -Increases delta wave activity Activates sensory receptors
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Describe how massage reduces stress.
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Activating the relaxation response reduces stress
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Describe how massage reduces anxiety.
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-Since relaxation response is activated, anxiety or nervousness is reduced. -A study showed that it affects both the receiver and giver of the massage. (especially when Daddy Ben massages Momma Tess.)
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Describe how massage improves ability to relax.
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-General relaxation is promoted through activation of the relaxation response. -Relaxation has a diminishing effect on pain.
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Describe how massage decreases beta wave activity.
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-Beta brain waves are seen during wakefulness and associated with relaxation. -A decrease in beta brainwave activity was confirmed by EEG during and after a massage.
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Describe how massage increases delta wave activity.
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Delta wave activities which is typically noted during deep sleep increases as confirmed by EEG during a massage.
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Describe how massage activates sensory receptors.
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Depending on factors such as stroke choice, direction, speed, and pressure, massage can stimulate different sensory receptors e.g. cross-fiber tapotement stimulates muscle spindles which activates muscular contraction.
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What effects does massage have on the Endocrine System?
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-Increases dopamine levels -Increases serotonin levels -Reduces analgesic use
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Describe how massage increases dopamine levels.
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-Massage stimulates the increase production of dopamine. -This decreases stress and reduces depression
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Describe how massage increases serotonin levels.
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-Massage stimulates signals that increase the production of serotonin. -Serotonin is believed to inhibit pain signals, thus reducing pain
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Describe how massage reduces analgesic use.
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Since pain is reduced with massage, the need for excessive use of pain medication is also reduced
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What effects does massage have on the Muscular system?
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-Relieves muscular tension -Relaxes muscles -Reduces muscle soreness and fatigue -Manually separates muscle fibers -Increases range of motion -Improves performance (balance and posture) -Lengthens muscles -Increases flexibility -Tones weak muscles
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Describe how massage relieves muscular tension.
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-There is a relationship between muscle tension and blood flow. -As massage enhances blood circulation, it relieves muscular restrictions, tightness, stiffness, and spasms
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Describe how massage relaxes muscles.
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Muscles relax as massage reduces excitability in the sympathetic nervous system
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Describe how massage reduces muscle soreness and fatigue.
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-Massage enhances blood circulation increasing the amount of oxygen and nutrients available to muscles. -This reduces muscle fatigue and post exercise soreness
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Describe how massage manually separates muscle fibers.
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Compressive strokes and cross-fiber friction strokes separate muscle fibers resulting in reduced muscle pain
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Describe how massage increases range of motion.
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-When muscular tension is reduced, range of motion is improved. -The freedom of the joints is dictated by the freedom of the muscles
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Describe how massage improves performance in balance and posture.
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-When trigger points and muscle tensions are reduced, many postural distortions are removed. -Range of motions increases, posture is more aligned and balanced, and performance is improved.
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Describe how massage lengthens muscles.
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Massage mechanically stretches and broadens tissue especially when combined with joint mobilization and stretches.
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Describe how massage increases flexibility.
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By lengthening muscles and promoting relaxation.
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Describe how massage tones weak muscles.
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-Muscle spindle activity is increased during massage stroke (e.g. tapotement, vibration). -This further stimulates tiny muscle contractions and help tone weak muscles.
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What effects does massage have on the Respiratory system?
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-Reduced respiratory rate -Strengthens respiratory muscles -Decreases asthma attack -Increases fluid discharge from the lungs
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Describe how massage reduces respiratory rate.
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Massage slows down breathing because of activation of the relaxation response
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Describe how massage strengthens respiratory rate.
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The muscles of respiration have a greater capacity to contract, thus helping improve pulmonary functions
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Describe how massage decreases asthma attack.
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Through increased relaxation and improved pulmonary functions, a person with asthma experiences fewer attacks after massage.
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Describe how massage increases fluid discharge from the lungs.
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The mechanical loosening and discharge of phlegm increases with rhythmic pressures like tapotement (cupping) and vibration on the rib cage
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What effects does massage have on the Digestive System?
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-Improves evacuation of the colon -Relieves constipation -Relieves colic and intestinal gas -Stimulates digestion
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Describe how massage improves evacuation of the colon.
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By increasing peristaltic activity in the colon through massage, movements of bowel content toward the anus for elimination is facilitated
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Describe how massage relieves constipation.
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Because evacuation of the colon is promoted, constipation is relieved.
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Describe how massage relieves colic and intestinal gas.
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-Increased peristaltic activity. -It also relieves colic and the expulsion of intestinal gases.
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Describe how massage stimulates digestion.
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Massage also promotes activation of the relaxation response which stimulates digestion.
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What effects does massage have on the Urinary System?
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-Increases urine output -Improves excretion of metabolic wastes
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Describe how massage increases urine output.
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-Massage activates dormant capillary beds and recovers lymphatic fluids for filtration by the kidney. -This increases the frequency of urination and the amount of urine produced.
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Describe how massage improves excretion of metabolic wastes.
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Levels of metabolic wastes like nitrogen, inorganic phosphorus and sodium chloride in urine are increased after massage.
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What are the miscellaneous psychological effects that massage has on a client?
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-Reduces fatigue and increases vigor -Improves patterns -Reduces job related and post traumatic stress -Improves mood -Decreases feeling of anger -Improves self-esteem -Eases communication and expression -Improves lifestyle habits -Increases physical well being -Reduces touch aversion and touch sensitivity -Increases academic ability -Increases mental alertness -Satisfies emotional needs
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Describe how massage reduce fatigue and increase vigor.
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-Many clients experienced a sense of renewed energy after massage. -This is attributed to effects on muscular system.
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Describe how massage improves sleep patterns.
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-Clients of massage therapy reported deeper sleep. -They felt more rested after waking due to effects on the endocrine system.
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Describe how massage reduces job related and post traumatic stress.
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-Massage reduces many types of stress, including job related and post traumatic stress. -This is due to increased production of dopamine levels that decreases stress.
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Describe how massage improves mood.
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The mental health status and mood improved after massage due to effects on the endocrine system
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Describe how massage decreases feeling of anger.
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-Clients reported a decreased feeling of anger after massage. -This is due to lesser stress and good state of mind
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Describe how massage improves self esteem.
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Because clients feel good physically, their self-esteem is improved.
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Describe how massage eases communication and expression.
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Massage can assist the ease of emotional expression with relaxation.
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Describe how massage improves lifestyle habits.
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Lifestyle habits include increased activities of daily living, fewer physical symptoms, fewer visits to physician, and increased level of exercising.
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Describe how massage increases physical well being.
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-Massage enhances well-being through stress reduction and subsequent relaxation
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Describe how massage reduces touch aversion and touch sensitivity.
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-After a massage done with much care and empathy, victims of rape and spousal abuse reported a reduction in touch aversion. Hypersensitivity to touch was reduced in other individual.
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Describe how massage Increases academic ability.
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A decrease in math computation time and an increase in accuracy were noted in massage studies.
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Describe how massage increases mental alertness.
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Massage increases alertness by relaxing the body and mind by removing stress.
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Describe how massage satisfies emotional needs.
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Using the therapeutic relationship, clients' emotional needs for attention, acceptance, caring and nurturing touch is satisfied
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What conditions are categorized as indications for massage?
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-Anxiety -Depression -Insomnia -Lumbago -Myalgia -Myofascial pain Syndrome -Neuralgia -Paralysis -Sciatica -Pre and Post Stress Syndrome
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What is anxiety?
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A feeling of apprehension, uncertainty, and fear without apparent stimulus, associated with physiological changes.
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What is depression?
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In psychiatry, a mental state of altered mood characterized by feelings of sadness, despair, and discouragement; Distinguished from grief, which is realistic and proportionate to a personal loss
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What is insomnia?
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Inability to get quality sleep either by not falling asleep or keeping asleep.
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What is lumbago?
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Lower back pain
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What is myalgia?
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Muscle pain
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What is Myofascial Pain Syndrome?
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Pain in a localized area rather than the entire body.
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What is neuralgia?
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Nerve Pain
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What is Paralysis?
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A complete loss of strength in an affected limb or muscle group
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What is sciatica?
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Sciatic nerve inflammation.
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What is Pre and Post Stress Syndrome.
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A set of symptoms occurring together either before or after being stressed.
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What conditions are categorized as local contraindications for massage?
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-Abdominal diastasis -Abnormal lumps -Acne vulgaris (chronic acne) -Athlete's foot (Tinea pedis or foot ringworm) -Blister -Bruise -Burn -Decubitus Ulcers -Folliculitis -Fracture -Furuncle/carbuncle (boil) -Herpes simplex -Local inflammation -Open wounds -Phlebitis -Shingles -Varicose Veins -Wart
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What is abdominal diastasis and what should be avoided?
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-An abnormally large separation between associated bones, as between the ribs. -Avoid abdomen
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What are abnormal lumps and what should be avoided?
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-Unusual swelling as in skin lumps -Avoid Area
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What is Acne vulgaris and what should be avoided?
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-A skin disease characterized by pimples on the face, chest and back. -It occurs when the pores of the skin become clogged with oil, dead skin cells and bacteria. -Avoid infected area
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What is Athlete's foot (tinea pedis or foot ringworm) and what should be avoided?
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-A common fungus infection between the toes in which the skin becomes itchy and sore, cracking and peeling away -Avoid infected area
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What is a blister and what should be avoided?
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-A local swelling of the skin that contains watery fluid and is caused by burning, infection or irritation -Avoid area
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What is a bruise and what should be avoided?
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-An injury to underlying tissues or bone in which the skin is unbroken, often characterized by ruptured blood vessels and discolorations; a contusion -Avoid bruised area if less than 72 hours.
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What is a burn and what should be avoided?
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-Injury to tissues caused by contact with heat, flame, chemicals, electricity or radiation. -Avoid area
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What are decubitus ulcers and what should be avoided
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-An ulcer due to local interference with the circulation; also called pressure sore. -Avoid ulcerated area
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What are Follicultis and what should be avoided?
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-Inflammation or infection of one or more hair follicles (openings in the skin that enclose hair) -Avoid infested area
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What is a fracture and what should be avoided?
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Breaking of a part, especially a bone.
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What is furuncle/carbuncle and what should be avoided?
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-It is almost always caused by infection by bacteria resulting in painful swollen area on the skin caused caused by an accumulation of pus and dead tissue. -Avoid infected areas
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What is herpes simplex and what should be avoided?
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A contagious Viral disease caused by herpes simplex virus. -8 months confinement suspended
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What is local inflammation and what should be avoided?
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-Usually a result of an injury or infection characterized by pain, heat, redness and swelling -Avoid infected area
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What are open wounds and what should be avoided?
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-Any break in the skin or an organ or part as the result of violence or a surgical incision. -Avoid wounded area
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What is phlebitis and what should be avoided?
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-Inflammation of a vein -Lightly over affected area
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What is shingles and what should be avoided?
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-An acute viral disease affecting the ganglia of ceratin nerves, characterized by inflammation, pain and skin eruptions along the course of the affected nerve -Avoid infected area
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What are varicose veins and what should be avoided?
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-Dilated, tortuous, elongated superficial veins that are usually seen in the legs. -Lightly over affected area
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What is a wart and what should be avoided?
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-A skin virus that develops a rough, hard bump, usually appearing on a hand or foot and often with tiny black dots in the bump. -Avoid infected area
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What conditions are considered absolute contraindications?
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-Cardiac arrest -Chickenpox -Contact dermatitis (if widespread) -Fever -German measles -Gout -Hepatitis (during acute phase) -Hypertension -Infectious Disease -Influenza -Lice -Liver Cirrhosis (if due to viral agent) -Migraine headache (during the migraine headache episode) -Multiple Sclerosis (during flareup) -Mumps -Pneumonia (during acute phase)
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What is cardiac arrest?
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Sudden cessation of the pumping function of the heart with disappearance of arterial blood pressure
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What is chicken pox?
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Itchy rash of spots that look like blisters appear all over the body and accompanied by flu-like symptoms caused by the varicella-zoster virus
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What is contact dermatitis (widespread)?
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Any skin inflammation that occurs when the skin's surface comes in contact with a substance originating outside the body
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What is a fever?
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Any body temperature elevation over 100f or 37.8c
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What are german measles (rubella)?
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Highly contagious viral disease, spread through contact with discharge from the nose and throat of an infected person
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What is gout?
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A form of acute arthritis that causes severe pain and swelling in the joints.
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What is Hepatitis?
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Inflammation of the liver
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What is an infectious disease?
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Caused by pathogenic mocroorganisms, such as bacteria, viruses, parasites or fungi; the diseases can be spread, directly or indirectly from one person to another e.g. cholera, malaria
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What is Influenza?
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A highly infectious that attacks cells in the upper respiratory tract, causing typical flu symptoms such as fatigue, fever and chills, a hacking cough and body aches.
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What are Lice?
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A flat wingless parasitic insect that may be a carrier of pathogens.
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What is liver cirrhosis from a viral agent?
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-A condition in which the liver fails to fulfill its function or is unstable to meet the demand made on it. -It may occur as a result of trauma, neoplastic invasion, prolonged biliary obstruction, viral infections (hepatitis C), or chronic alcoholism
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What is a migraine headache?
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A sever recurring headache, usually affecting only one side of the head, that is characterized by sharp pain and is often accompanied by nausea, vomiting and visual disturbances.
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What is multiple sclerosis?
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chronic autoimmune disorder affecting movement, sensation, and bodily functions, it is caused by destruction of the myelin insulation covering nerve fibers in the central nervous system.
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What are mumps?
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Relatively contagious mild short-term viral infection of the salivary glands.
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What is phneumonia (acute phases.)
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-This is an inflammation of the lung tissue affecting one or both sides of the chest. It often occurs as a result of an infection.
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What is the focus for both Wellness Massage and Therapeutic Massage for the factor of Customer Relationship?
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Wellness - Client Therapeutic - Patient
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What is the focus for both Wellness Massage and Therapeutic Massage for the factor of Dominant Paradigm?
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Wellness - Intuitive, nurturing Therapeutic - Scientific, problem solving
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What is the focus for both Wellness Massage and Therapeutic Massage for the factor of Reason for Treatment?
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Wellness - Client request Therapeutic - Medical necessity
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What is the focus for both Wellness Massage and Therapeutic Massage for the factor of Focus?
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Wellness - Client satisfaction Therapeutic - Functional outcomes
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What is the focus for both Wellness Massage and Therapeutic Massage for the factor of Termination of Care?
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Wellness - When client's needs are met or change Therapeutic - Maximum medical improvement (usually)
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What is the focus for both Wellness Massage and Therapeutic Massage for the factor of Primary Massage Treatment Techniques?
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Wellness - Relaxation massage techniques like Swedish, deep tissue, circulatory massage, and craniosacral Therapeutic - Clincal massage techniques like myofascial treatments, deep tissue massage, cross-fiber friction, neuromuscular "trigger point" technique, and muscle energy technique
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What is the focus for both Wellness Massage and Therapeutic Massage for the factor of Therapist Accountability?
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Wellness - Clients Therapeutic - patients, referring providers and other HCPs involved in the case
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What is the focus for both Wellness Massage and Therapeutic Massage for the factor of time spent on documentation, coordination and communication?
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Wellness - 1-5 minutes or less per session Therapeutic - 5-20 minutes or more per session
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What is the focus for both Wellness Massage and Therapeutic Massage for the factor of Training?
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Wellness - Basic massage certification course Therapeutic - Basic massage certification course plus advanced training in orthopedic assessment and treatment protocol, pathologies and contraindications, medical terminology, pharmacology, documentation and communication skills
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What is the focus for both Wellness Massage and Therapeutic Massage for the factor of Experience?
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Wellness - Can start practicing right after passing DOH licensure exam for massage therapist Therapeutic - Need clinical and professional experience and/or an internship
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What is the focus for both Wellness Massage and Therapeutic Massage for the factor of Receiver's Emotional State or Level Pro-activeness?
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Wellness - Proactively seeking care, typically healthy and active Therapeutic - Didn't ask to be injured, may be depressed, anxious, or otherwise distressed by both the injury/accident and/or ensuing work, life and health complications
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What is the focus for both Wellness Massage and Therapeutic Massage for the factor of Physical Demands on Practitioner?
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Wellness - May be lighter-Swedish and some other techniques are less demanding, but deep tissue massage can be hard on your body Therapeutic - Can be heavy - orthopedic assessments, muscle energy techniques, myofascial treatments, cross-fiber fractioning, and other injury-treatment techniques can be hard on your body.
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What is the focus for both Wellness Massage and Therapeutic Massage for the factor of Emotional Demands on Practitioner?
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Wellness - Typically light and/or manageable Therapeutic - Can be heavy - patients can be disengaged, distraught or otherwise unengaged or difficult rot engage
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What is the focus for both Wellness Massage and Therapeutic Massage for the factor of Client Education?
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Wellness - OK within scope of practice ("drink plenty of water" as daddy ben would say, "do the stretch I showed you"; "put and ice pack on it"; etc...) Therapeutic - May be OK (therapist should ask the prescribing referrer about this) but shouldn't contradict what the rest of the medical team is saying
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What is the focus for both Wellness Massage and Therapeutic Massage for the factor of Marketing Model?
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Wellness - Consumer marketing (much like a tax preparer, hair dresser, real estate agent etc...) gift certificates, referral discounts, and other consumer marketing practices are ok. Therapeutic - Business to business networking with referring providers, health care networks etc...; many legal and ethical considerations regarding referral relationships
