Massage

Sports injury results from acute trauma or repetitive stress associated with athletic activities affecting bone of soft tissue. Treatment varies on the person, injury and rehabilitation aims. 

Massage effects:
  • Increased blood flow
  • Increased muscle length --> increased mobility
  • Relieves swelling
  • Lymphatic drainage
  • Relieves adhesions in fascia
  • Relaxing --> reduced anxiety
  • Prevents injuries

Total Contraindications
  • Cancer - increased blood flow circulates cancer cells
  • First trimester of pregnancy
  • Infectious diseases - makes the patient feel rough
  • Acute injury (first 24-48 hours)
  • Suspected DVT
  • Fever or hyperthermia - makes them feel rough

DVT and strains have the same symptoms, handily. Therefore to tell the difference you need to enquire as to their lifestyle and case history. Are they post-op, on the pill or have they recently travelled on a long-haul flight?

Localised Contraindications
  • Skin disease - can work around if localised
  • Any allergies - almond oil used in many lotions
  • Cuts or bruises - may exacerbate
  • Varicose veins - work proximal not distal
  • Surgical scar tissue
  • Fracture sites
  • Undiagnosed lumps
  • Pregnancy - avoid the abdomen or prone lying
  • Sunburn
  • Undiagnosed pain
In addition be wary of:
  • Loss of sensation
  • Anti-coagulants
  • Haemophilia
  • Verrucas

Technique

Massage should generally be for a minimum of 10 minutes with strokes directed towards the heart. A number of movements can be used:

Stroking

Light, long, rhythmic strokes that relaxes the patient and gets them used to the touch and temperature of hands

Effleurage

  • General gliding movements with varying centripetal pressures
  • 2-3 inches at a time in direction of fibres
  • Induces relaxation and is good for tendon attachments and lymphatic drainiage
  • Faster speed increases circulation
  • More pressure works on deeper structures
  • Use to begin and end session as well as break up petrissage techniques

Physiological effects of effleurage include vasodilation, release of histamine to increase blood flow, increased venous and lymphatic flow, reduced oedema, reduced pain and an initial increase in blood pressure but an overall reduced BP.

  • Single handed - pressure towards heart, contact away from
  • Single reinforced - hands on top of each other to increase pressure
  • Double handed - both hands in tandem for broader area
  • Double alternating - one hand after the other for speed
  • Forearm - use of extensors (fist up) or ulna (fist sideways)
  • Knuckles, heel of hand or blade (side of hand)

Petrissage

Massage movements with deep applied pressure that compress underlying muscles. It helps to reduce muscle tone and loosen adhesions of muscle fibres and connective tissue. Petrissage also stretches tissue, increases circulation and reduces toxins.
  • Kneading
    • Gliding neuromuscular technique performed in circles which repeatedly compresses and releases muscle
  • Picking up
    • One or two handed gliding technique in which muscle is lifted and squeezed between the fingers and thumb
  • Rolling
    • A technique that lifts the skin between the thumb and fingers and is gently rolled over the area at a very slow speed
  • Muscle compressions
    • Pressing and releasing of soft tissues with fingers and palms of hands. It empties venous beds and so encourages a fresh capillary flow. It relaxes hypertonic muscles and leads to an increase of parasympathetic circulation
  • Wringing
    • Rhythmic application of pressure on opposite sides of the tissue to reduce stiffness caused by ischaemia, stretch fibres and increase muscle tone
  • Skin rolling
    • Cutaneous and subcutaneous tissues are grasped and lifted from underlying with rolling and pressure towards underlying tissues. Loosens adhered cutaneous and fascial layers
  • Tapotement
    • Percussive movements applied briskly
      • Hacking
      • Knuckle
      • Pounding
      • Cupping
  • Shaking and jostling
    • Course vibration applied to a muscle group or limb
    • Pick up and shake side to side/up and down to mobilise muscle

Deep Frictions
  • Longitudinal to realign
  • Transverse to break down
  • Circular
  • Prevents adhesion formation and ruptures
  • Induces a traumatic hyperemia
  • Vasodilation and increased blood flow
  • Stimulate nerve tissue
  • Tightens loose tissue
  • Uncomfortable and could cause bruising
  • Deliver in short, sharp bursts
  • Soreness next day = good.

Effective with tendinosis, tennis elbow, IT band syndrome and plantar fasciatis. Reinforce fingers or thumb and use body weight to apply pressure through the elbow. Always finish with longitudinal to realign.

2 comments:

  1. Thank you for promoting physiotherapy and its technique There are many people who have no idea about physio therapy.I think after reading your article people will convinced to do so.
    Thanks
    best physiotherapist in sydney

    ReplyDelete
  2. Nice blog about physiotherapy! it is very helpful treatment for reducing chronic pain and you give all information step by step thanks, keep sharing.
    Physiotherapy clinics in Surrey

    ReplyDelete