Transcript Using therapeutic modalities

Massage and Traction
 Mechanical response
 Encourage venous and lymphatic drainage
 Mildly stretch superficial and scar tissues
 Avoid stagnation of circulation during immobilization or when edema surrounds a joint
 Physiological response
 Increased circulation
 Increased metabolism
 Removal of metabolites (lactic acid)
 Body relaxation
 Stimulation
 Effleurage (stroking)
 Light stroking: designed to be sedative, used in early stages of treatment
 Deep stroking: therapeutic compression of soft tissue
 Encourages venous and lymphatic drainage
Light and deep stroking can be used alternatively
 Hand over hand method: one hand immediately follows the other
 Good for areas that are unyielding
 Cross body method: hands stroke simultaneously away from the spine and then
towards
 Good for low back
 Petrissage (kneading)
 Used at loose and heavy tissue areas
 Pick up muscle between thumb and forefinger of eat hand rolling and twisting it in
opposite directions
 Kneading action rings out the muscle loosening adhesions and increasing circulation
 Friction
 Often used over areas of thin unyielding tissues
 Motions start at a central point then a circular movement is initiated with hands moving in
opposite directions away from the center point
 Stretch underlying tissues
 Increase circulation in a joint
 Tapotement (percussion)
 Cupping – hands are cupped so the beat emits a dull and hollow sound
 Produces an invigorating and stimulating sensation and should be used until skin develops a
pinkish color
 Hacking – ulnar border of the hand is used as a striking surface
 Only heavy muscles should be treated in this manner
 Pincing – alternating hands lift small amounts of tissue between the first finger and
thumb in quick gentle pinching movements
 Vibration
 Rapid movement that produces a quivering or trembling effect
 Used because of its ability to relax and soothe
 Machines often used
 Deep Transverse Friction Massage
 Move transversely across a ligament or tendon to mobilize as much as possible
 Massage must be directly over the site of the lesion and pain
 Fingers move with skin and do not slide over it
 Do not perform to acute injuries or highly swollen tissues
 Acupressure Massage
 Massage point of pain with the index, middle fingers, thumb or elbow using small circular
motions on the point
 Treatments will last 1-5 minutes over a single point
 During treatment patient may report dulling or numbing effect
 This indicates that the pain is diminished or subsided
 Lingering effects can be a few minutes to several hours
The use of a pulling force to treat musculoskeletal disorders
Usually applied to the cervical or lumbar vertebra
 Produce separation of vertebral bodies
 Stretching of ligaments or joint capsule
 Stretching of spinal and paraspinal muscles
 Increased separation of articular facet joints
 Relief in pressure on nerves and nerve roots
 Decrease in central pressure of the intervertebral discs
 Increase and change in joint proprioception
 Relief of the compressive effects of normal pressure
 Spinal nerve root impingement
 Disc herniation, spondylolisthesis
 Decreased muscle guarding
 Treat muscle strain
 Treat sprain of spinal ligaments
 Relax discomfort resulting from normal spinal compression
 Manual Traction – more adaptable and offers greater flexibility
 Changes in force, direction, duration, patient position can be made instantaneously
 Mechanical Traction – musct be used to allow for smooth nonrestricted traction
 Positional Traction – used on a trial and error basis to determine the maximum
position of comfort or to accomplish a specific treatment goal
 Wall-Mounted Traction – cervical traction
 Plates, sand bags or water bags can be used for weights
 Inverted traction – places person in an inverted position where stretch is provided
by the weight of the trunk
 Lumbar – sustained traction most effective
 Intermittent traction is the most comfortable
 Progressive traction will allow the patient to adapt slowly and keep them relaxed
 Lumbar traction force can be up to 50% of body weight
 Cervical traction force 20-50 lbs depending on the patient’s comfort and response