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Therapeutic Sports MassageTherapeutic Sports Massage
Jennifer Doherty-Restrepo, ATC, LATEntry-Level Athletic Training Education Program
PET 4995: Therapeutic Modalities
Physiologic Effects of MassagePhysiologic Effects of Massage
Mechanical stimulation of tissues by rhythmically applied pressure and stretching
Effects of massage may be either ___________, or ___________
Effects differ depending on method utilized, pressure exerted, and duration of massage
Mechanical stimulation of tissues by rhythmically applied pressure and stretching
Effects of massage may be either ___________, or ___________
Effects differ depending on method utilized, pressure exerted, and duration of massage
Physiologic Effects of MassagePhysiologic Effects of Massage
___________ Effects sensory and motor nerves locally Elicits some central nervous system
response (ie: sedation) ___________
Makes mechanical or histological changes in myofascial structures through direct force applied superficially
___________ Effects sensory and motor nerves locally Elicits some central nervous system
response (ie: sedation) ___________
Makes mechanical or histological changes in myofascial structures through direct force applied superficially
Reflexive EffectsReflexive Effects
Attempts to exert effects through ______ and superficial connective tissues
Contact stimulates _________ receptors Reflex mechanism is believed to be an
autonomic nervous system phenomenon The reflex stimulus causes
Sedation, Relieves tension, and Increases blood flow
Attempts to exert effects through ______ and superficial connective tissues
Contact stimulates _________ receptors Reflex mechanism is believed to be an
autonomic nervous system phenomenon The reflex stimulus causes
Sedation, Relieves tension, and Increases blood flow
Reflexive Effects cont.Reflexive Effects cont.
Effects on Pain Modulates pain through Gate Control & -
Endorphins theories Effects on Circulation
Increases blood and lymphatic flow Effects on Metabolism
Does not alter general metabolism Increases fresh blood and oxygen to area Assists in removal of lactic acid
Effects on Pain Modulates pain through Gate Control & -
Endorphins theories Effects on Circulation
Increases blood and lymphatic flow Effects on Metabolism
Does not alter general metabolism Increases fresh blood and oxygen to area Assists in removal of lactic acid
Mechanical EffectsMechanical Effects
Techniques which stretch a muscle, elongate fascia, or mobilize soft tissue adhesions/restrictions
Always accompanied by some reflex effects As mechanical stimulus becomes more effective,
reflex stimulus becomes less effective Directed at deeper tissues, such as
adhesions or restrictions in muscle, tendons, and fascia.
Techniques which stretch a muscle, elongate fascia, or mobilize soft tissue adhesions/restrictions
Always accompanied by some reflex effects As mechanical stimulus becomes more effective,
reflex stimulus becomes less effective Directed at deeper tissues, such as
adhesions or restrictions in muscle, tendons, and fascia.
Mechanical EffectsMechanical Effects
Effects on Muscle Mechanical stretching of intramuscular
connective tissue to relieve pain and discomfort associated with myofascial trigger points
Increases blood flow to skeletal muscle Slows muscle atrophy following injury Increases range of motion Does not increase strength or muscle
tone
Effects on Muscle Mechanical stretching of intramuscular
connective tissue to relieve pain and discomfort associated with myofascial trigger points
Increases blood flow to skeletal muscle Slows muscle atrophy following injury Increases range of motion Does not increase strength or muscle
tone
Mechanical Effects cont.Mechanical Effects cont.
Effects on Skin Increases skin temperature Increases sweating Decreases skin resistance to galvanic
current Mechanically loosens adhesions and
softens scar tissue Stretches and breaks down fibrous scar
tissue Breaks down adhesions between skin and
subcutaneous tissue
Effects on Skin Increases skin temperature Increases sweating Decreases skin resistance to galvanic
current Mechanically loosens adhesions and
softens scar tissue Stretches and breaks down fibrous scar
tissue Breaks down adhesions between skin and
subcutaneous tissue
Psychologic Effects of MassagePsychologic Effects of Massage
Psychologic effects of massage can be as beneficial as physiologic effects
” ___________" modality where patients feel as if someone is helping them
Psychologic effects of massage can be as beneficial as physiologic effects
” ___________" modality where patients feel as if someone is helping them
Treatment Considerations and GuidelinesTreatment Considerations and Guidelines
Knowledge of ___________ is essential
Understanding of existing pathology Thorough knowledge of massage
principles
Knowledge of ___________ is essential
Understanding of existing pathology Thorough knowledge of massage
principles
Positioning of ClinicianPositioning of Clinician
Prevent ___________ Permit free movement of
arms, hands, and body Evenly distribute weight by
shifting from one foot to the other
Fit your hands to the contour of area being treated
Hands should be clean, warm, dry, and soft
Prevent ___________ Permit free movement of
arms, hands, and body Evenly distribute weight by
shifting from one foot to the other
Fit your hands to the contour of area being treated
Hands should be clean, warm, dry, and soft
Treatment TechniquesTreatment Techniques
Pressure regulation Determined by the type and amount of
tissue present and patient's condition Rhythm
Must be steady and even Strokes should overlap
Duration Depends on the pathology, size of the
area being treated, speed of motion, age, size, and condition
Pressure regulation Determined by the type and amount of
tissue present and patient's condition Rhythm
Must be steady and even Strokes should overlap
Duration Depends on the pathology, size of the
area being treated, speed of motion, age, size, and condition
Treatment TechniquesTreatment Techniques
Swelling Begin proximally to facilitate lymphatic
flow “___________“ Body part may be elevated if necessary
Direction of forces should parallel muscle fibers
Make sure patient is warm and in a comfortable, relaxed position Massage should never be ___________
Swelling Begin proximally to facilitate lymphatic
flow “___________“ Body part may be elevated if necessary
Direction of forces should parallel muscle fibers
Make sure patient is warm and in a comfortable, relaxed position Massage should never be ___________
Treatment TechniquesTreatment Techniques
Sufficient lubricant should be used Begin with superficial stroking to spread
lubricant Begin and end with ___________
Pressure should be in line with venous flow followed by a return stroke
Sufficient lubricant should be used Begin with superficial stroking to spread
lubricant Begin and end with ___________
Pressure should be in line with venous flow followed by a return stroke
Equipment Set UpEquipment Set Up
Table Linens and pillows Lubricant
Should be absorbed slightly by skin but does not make it slippery
Combination of one part beeswax to three parts coconut oil
Other types of lubricants that may be used are olive oil, mineral oil, cocoa butter, hydrolanolin, analgesic creams, alcohol, and powder
Table Linens and pillows Lubricant
Should be absorbed slightly by skin but does not make it slippery
Combination of one part beeswax to three parts coconut oil
Other types of lubricants that may be used are olive oil, mineral oil, cocoa butter, hydrolanolin, analgesic creams, alcohol, and powder
Preparation of PatientPreparation of Patient
Patient should be in a relaxed, comfortable position
Part involved in treatment must be adequately supported
Prone, supine, seated Patient should
appropriately draped
Patient should be in a relaxed, comfortable position
Part involved in treatment must be adequately supported
Prone, supine, seated Patient should
appropriately draped
Hoffa MassageHoffa Massage
Classical massage technique which uses a variety of superficial strokes Effleurage Petrissage Tapotment Vibration
Classical massage technique which uses a variety of superficial strokes Effleurage Petrissage Tapotment Vibration
Effleurage Effleurage
Any stroke that glides over skin without attempting to move deep muscles
Hands are molded to treatment area
Apply constant pressure moving toward _______ Lighter pressure applied
on the return stroke
Any stroke that glides over skin without attempting to move deep muscles
Hands are molded to treatment area
Apply constant pressure moving toward _______ Lighter pressure applied
on the return stroke
Every massage begins and ends with effleurage!
Effleurage cont.Effleurage cont.
Moderate pressure according to patient and condition Deep stroking is a form of effleurage, except it
is given with more pressure to produce a mechanical effect
Increases venous and lymphatic return Increases circulation to skin surface
Moderate pressure according to patient and condition Deep stroking is a form of effleurage, except it
is given with more pressure to produce a mechanical effect
Increases venous and lymphatic return Increases circulation to skin surface
PetrissagePetrissage
Kneading manipulations
Muscles are gently lifted, rolled, and released
Pressure is applied intermittently
Hands may remain stationary or move along length of muscle or limb
Kneading manipulations
Muscles are gently lifted, rolled, and released
Pressure is applied intermittently
Hands may remain stationary or move along length of muscle or limb
Petrissage cont.Petrissage cont.
Increases venous and lymphatic return
Removes metabolic waste products
Breaks up adhesions between skin and underlying tissue
Increases venous and lymphatic return
Removes metabolic waste products
Breaks up adhesions between skin and underlying tissue
TapotmentTapotment
Percussion massage Series of rapid, brisk blows
Increases circulation and blood flow Stimulates peripheral nerve endings
Percussion massage Series of rapid, brisk blows
Increases circulation and blood flow Stimulates peripheral nerve endings
Tapotment cont.Tapotment cont.
Hacking Hacking
Tapotment cont.Tapotment cont.
Hacking Slapping
Hacking Slapping
Tapotment cont.Tapotment cont.
Hacking Slapping Beating
Hacking Slapping Beating
Tapotment cont.Tapotment cont.
Hacking Slapping Beating Tapping
Hacking Slapping Beating Tapping
Tapotment cont.Tapotment cont.
Hacking Slapping Beating Tapping Clapping or
cupping
Hacking Slapping Beating Tapping Clapping or
cupping
VibrationVibration
Shaking massage Tremulous movement
made by hand or fingers placed firmly against a body part Rhythmical trembling
movement will come from ___________
Hands should remain in contact with the body part
Shaking massage Tremulous movement
made by hand or fingers placed firmly against a body part Rhythmical trembling
movement will come from ___________
Hands should remain in contact with the body part
Transverse Friction MassageTransverse Friction Massage Technique used for treating chronic tendon
inflammation or connective tissue adhesions Stimulates ___________ ___________ to progress
healing process Apply small circular motions penetrating to deeper
tissues Apply strong pressure in ___________ direction to
fibers for 7 to 10 minutes every other day
Technique used for treating chronic tendon inflammation or connective tissue adhesions
Stimulates ___________ ___________ to progress healing process
Apply small circular motions penetrating to deeper tissues
Apply strong pressure in ___________ direction to fibers for 7 to 10 minutes every other day
Acupresure and Myofascial Trigger Point MassageAcupresure and Myofascial Trigger Point Massage
Acupressure points are based on ancient Chinese art of acupuncture
Myofascial trigger points found in… Muscle and tendon myofascia Ligaments and capsules surrounding
joints Periosteum
Acupressure points and myofascial trigger points are similar
Acupressure points are based on ancient Chinese art of acupuncture
Myofascial trigger points found in… Muscle and tendon myofascia Ligaments and capsules surrounding
joints Periosteum
Acupressure points and myofascial trigger points are similar
Acupresure and Myofascial Trigger Point MassageAcupresure and Myofascial Trigger Point Massage
Pain results due to inflammatory response following direct trauma or overuse
Pain usually referred to areas which follow a specific pattern
Stimulation of these points has been demonstrated to result in pain relief
Pain results due to inflammatory response following direct trauma or overuse
Pain usually referred to areas which follow a specific pattern
Stimulation of these points has been demonstrated to result in pain relief
Acupressure Massage TechniquesAcupressure Massage Techniques
Locate points from chart Use fingers, or elbow, to
apply small friction-like circular motions
Amount of pressure applied should be intense and painful
Patient reports a dulling or numbing effect
Treatment times range from 1-5 minutes at several points
Locate points from chart Use fingers, or elbow, to
apply small friction-like circular motions
Amount of pressure applied should be intense and painful
Patient reports a dulling or numbing effect
Treatment times range from 1-5 minutes at several points
Myofascial ReleaseMyofascial Release
Also called soft tissue mobilization Techniques used to relieve soft tissue from
abnormal grip of tight fascia Myofascial restrictions are unpredictable
and may occur in many different planes and directions
Based on localizing restriction and moving into the direction of the restriction
Myofascial manipulation is subjective and relies heavily on the experience of the clinician
Also called soft tissue mobilization Techniques used to relieve soft tissue from
abnormal grip of tight fascia Myofascial restrictions are unpredictable
and may occur in many different planes and directions
Based on localizing restriction and moving into the direction of the restriction
Myofascial manipulation is subjective and relies heavily on the experience of the clinician
Myofascial Release TechniqueMyofascial Release Technique
Protecting the clinician’s hands Use fist or elbow if necessary
Use limited lubricant Avoid slipping of hands on the skin
Positoning of the patient is critical Maximize effects of treatment
Protecting the clinician’s hands Use fist or elbow if necessary
Use limited lubricant Avoid slipping of hands on the skin
Positoning of the patient is critical Maximize effects of treatment
Indications For MassageIndications For Massage
Increase coordination Decrease pain Decrease
neuromuscular excitibility
Stimulate circulation Facilitate healing Restore joint mobility Remove lactic acid
Increase coordination Decrease pain Decrease
neuromuscular excitibility
Stimulate circulation Facilitate healing Restore joint mobility Remove lactic acid
Alleviate muscle cramps Increase blood flow Increase venous return Retard muscle atrophy Increase range of motion Edema Myofascial trigger points Stretching scar tissue
Alleviate muscle cramps Increase blood flow Increase venous return Retard muscle atrophy Increase range of motion Edema Myofascial trigger points Stretching scar tissue
Indications For MassageIndications For Massage
Adhesions Muscle spasm Myositis Bursitis Fibrositis Tendinitis
Adhesions Muscle spasm Myositis Bursitis Fibrositis Tendinitis
Revascularization Raynaud's disease Intermittent
claudication Dysmenorrhea Headaches Migraines
Revascularization Raynaud's disease Intermittent
claudication Dysmenorrhea Headaches Migraines
Contraindications For MassageContraindications For Massage
Arteriosclerosis Thrombosis Embolism Severe varicose
veins Acute phlebitis Cellulitis
Arteriosclerosis Thrombosis Embolism Severe varicose
veins Acute phlebitis Cellulitis
Synovitis Abscesses Skin infections Cancers Acute inflammatory
conditions
Synovitis Abscesses Skin infections Cancers Acute inflammatory
conditions
