ABMP: Massage and Bodywork Application

Key Concepts in Massage and Bodywork

Terminology

Adaptive measures - Ways of altering pressure or technique to accommodate a client's condition and ensure comfort during the massage session.

Bodywork - A broad term that refers to many forms, methods, and styles of therapy (including massage) that positively influence the body through touch.

Clinical reasoning (also called critical thinking) - A step-by-step process of working through client information in order to plan a safe and competent massage for the client.

Closing the massage - A formal moment that establishes the end of the hands-on portion of the therapeutic session in order to "frame" the massage experience for the client (e.g., asking the client to take a deep breath as he/she returns to normal waking consciousness, using an aromatherapy cue by placing a drop of peppermint oil in the hands and holding them briefly over the client's nose, etc.).

Customization of a massage session - All of the methods a practitioner uses to craft a session specifically suited to an individual client, including the choice of lubricant and music, appropriate techniques likely to achieve predetermined session goals, and alterations to techniques that make them better match the client's reasonable wants and needs.

Depth - The amount of force and intensity with which a practitioner applies a technique. Practitioners with strong palpation skills, knowledge of soft-tissue structures, and self-confidence are likely to work at the appropriate level of power and concentration to provide therapeutic change and meet session goals.

Engaging the tissue - The use of strong palpation skills to sink into tissue at the right therapeutic depth, take hold of the tissue, move the body with confidence when using joint movement techniques, and then being able to slow down to work deeply and specifically in areas where muscle or fascia are adhered

Flow and continuity - The progression of massage strokes from one technique to another and from one body area to another. A practitioner with strong flow and continuity maintains contact with the client, makes smooth transitions between strokes, and maintains a regular rhythm and pace.

Knowledgeable use of lubricants - A well-rounded understanding of lubricant ingredients to prevent client allergic reactions, lubricant types for correct matching with particular forms or styles of soft-tissue work, and the ability to use just the right amount of lubricant for the particular stroke or body region where massage is applied.

Massage - The ethical and professional application of structured therapeutic touch to benefit soft-tissue health, movement, posture, and neurological patterns.

Massage environments - There are a variety of work environments where massage therapy is practiced including a chiropractor's office, cruise ship, day spa, fitness center, gym, hospice, hospital, massage clinic, naturopathic practice, nursing homes, on-site environments, pain management centers, physical therapy office, physician's office, private practice, resort spa, sports medicine clinic, and wellness center. Each environment is different and may require specialized skill sets. For example, a practitioner working in a sports medicine clinic and participating in soft-tissue rehabilitation will need a different set of skills than a practitioner working at a resort spa and offering relaxation massage and spa therapies.

Opening the massage - A formal moment that establishes the beginning of the hands-on portion of the therapeutic session in order to "frame" the massage experience for the client (e.g., using holding strokes to introduce the client to the practitioner's touch, ringing a chime directly before placing hands on the client, etc.).

Pacing - The speed of the practitioner's application of strokes and its appropriateness for meeting session goals. For example, the speed at which strokes are applied in a relaxation massage would be slower than the speed at which strokes are applied in a massage designed to energize a client.

Practitioner intention - A mental state that indicates how a practitioner will take action during the session. A practitioner with positive intention is centered and grounded, calm and focused, aware of appropriate boundaries, and committed to working in such a way that the client will not experience emotional, physical, mental, or spiritual damage during the session. The practitioner will work with the competency to ensure that chosen techniques will support the client in meeting his/her reasonable wants and needs for therapeutic change.

Quality of touch - A concept that refers to what a practitioner's hands communicate to a client. Warm, soft, dry, open, and confident hands tell the client a practitioner is relaxed, focused, self-assured and knows what to do. Cool, damp, uncertain hands can communicate practitioner anxiety or doubtfulness.

Rhythm - The pattern with which strokes are applied during massage. A practitioner with good rhythm applies strokes with a regular pattern and at a regular pace. A practitioner with less-than-optimal rhythm uses irregular patterns and pacing. Irregularity may cause client overstimulation or nervous system irritation.

Routines - A series of strokes that are planned in advance, delivered to body areas in a preset order, and practiced until they flow smoothly together. Sometimes full-body routines are developed by a clinic or spa to ensure consistency for clients. Sometimes routines are developed only for particular body areas (e.g., face, feet).

Sequencing - The order in which strokes are applied to a given body area, and the order in which body areas are massaged. In some massage forms, the strokes follow a defined progression (e.g., Swedish massage). In customized massage, a practitioner might be applying strokes from a variety of different forms based on the reasonable wants and needs of the client.

Session goals - The objectives for the session based on the client's reasonable expectations, wants, and needs, identified in partnership with the practitioner.

Stroke length - A concept that refers to the use of long strokes to tie body regions together, or to work the entire length of the muscle before changing techniques or lifting the hands off the client.

Therapeutic change - The experiences a client reports, or the postsession signs a practitioner observes, that indicate positive alterations in the client's physical, mental, or emotional health as a result of the massage session.

Therapeutic discomfort - The soreness or tenderness the client feels during the application of some techniques that elongate or compress the tissue. These sensations, while uncomfortable, feel right, appropriate, and good based on session goals and the perception of positive change the client experiences in his/her tissue from the work.

Therapeutic edge - The particular speed and depth of soft-tissue manipulation that allows the greatest possibility for therapeutic change to occur in the tissue. The client may experience some discomfort, but the discomfort feels right, appropriate, and good.

Tissue resistance - When the client's soft-tissue structures oppose a technique and defend against that technique by tightening, instead of surrendering and letting go. A practitioner with strong palpation skills recognizes tissue resistance and never forces a technique on a structure. Instead, he/she understands how to work with tissue in such a way that it can eventually release tension and experience therapeutic changes.

Use of breath (client) - Directions the practitioner gives to the client about breathing to support client relaxation, lymphatic movement, and the therapeutic goals of the session. For example, the practitioner might instruct a client to exhale while he/she applies a stroke that works the length of a muscle, or instruct the client to take a breath and exhale during uncomfortable soft-tissue manipulation to help the client reduce tension, etc.

Variety - The practitioner's ability to mix and match specific techniques to address an assortment of diverse soft-tissue needs in ways that are likely to support the achievement of session goals (using different methods to address different layers of tissue, having the ability to work at a general level with long strokes that tie body areas together and then work more specifically when areas of localized tension are encountered.

Practice Quiz

1. The order in which a series of strokes are applied to one body region is referred to as:

A:Clinical reasoning

B:Pace

C:Adaptive measures

D:Sequencing

2. One consideration related to the flow and continuity in a massage and bodywork session is:

A:That continuity is related only to the amount of pressure used

B:That flow cannot be taught

C:A smooth transition from one body part to another

D:An uneven transition from one body part to another

3. One reason that the breath is incorporated into a massage and bodywork session is to:

A:Increase lymphocyte production

B:Help release tension

C:Increase blood flow to the area

D:Make sure the client does not pass out

4. What type of pace would probably increase relaxation?

A:Fast

B:Slow

C:Irregular

D:Varied

5. One reason that the breath is incorporated into a massage and bodywork session is to:

A:Increase pain threshold

B:Assist with lymphatic flow

C:Decrease blood pressure

D:Reduce lymphatic flow

6. One reason to be aware of the stroke length used in massage and bodywork is:

A:To connect body areas together

B:To move blood evenly throughout the body

C:To stimulate the sympathetic nervous system response

D:To use the massage as a moving meditation for the practitioner

7. If the client reports that he/she feels soreness or tenderness during the application of strokes, but that positive change in the tissue is also being experienced, the client is experiencing:

A:Client resistance

B:Tissue resistance

C:Therapeutic evolution

D:Therapeutic discomfort

8. When a practitioner instructs a client to inhale and then exhale as he drops deeper into the tissue, he demonstrates:

A:The ability to instruct clients in the use of their breath to support the release of tension

B:The ability to instruct clients in the use of their breath to distract them from tissue damage

C:The ability to distract the client from their resistance edge

D:The ability to push through tissue resistance to ensure tissue surrender

9. The pattern and pace at which strokes are applied during the massage is referred to as:

A:Depth

B:Rhythm

C:Resistance

D:Adaptation

10. What is an important aspect of engaging the tissue during a massage and bodywork session?

A:Establishing which methods work best for the client

B:Knowing that clients have no idea what works best

C:Telling the client to breathe if she says the technique is too painful

D:Pushing through tissue resistance if it is encountered

11. One consideration related to the use of lubricants is:

A:Client goals

B:Sponsorship from product manufacturers

C:Client skin color

D:Practitioner preferences

12. A massage practitioner working at a hospice would want to know about:

A:Thalassotherapy and fangotherapy

B:Neuromuscular and pain assessment

C:End-of-life care

D:Reflexology and infant massage certification

13. One reason that the breath is incorporated into a massage and bodywork session is to:

A:Increase pain awareness

B:Release inflammatory mediators

C:Reduce pain sensation

D:Make sure the client does not fall asleep

14. Name an important aspect of engaging the tissue during a massage and bodywork session:

A:Pushing through tissue resistance if it is encountered

B:Allowing the client to sleep

C:Regular communication with the client

D:Working one notch deeper than the client likes, to promote tissue change

15. One consideration related to the use of lubricants is:

A:Client exercise schedule

B:Client diet

C:Client skin sensitivities

D:Client work schedule

16. A spa or clinic's full-body routine, that all its practitioners are expected to provide, was most likely created to:

A:Ensure consistency for clients

B:Increase practitioner clinical reasoning skills

C:Reduce liability insurance claims

D:Ensure therapeutic intervention

17. One factor that contributes to lack of practitioner intention:

A:Practitioner is focused on client

B:Practitioner is too old

C:Practitioner is too young

D:Practitioner is self-absorbed

18. If you ring a chime at the end of the hands-on portion of a session, or if you place your hands on the client and ask the client to take a full cleansing breath to end the session, you are demonstrating attention to the:

A:Flow and consistency of the massage strokes

B:Closing of a massage in a formal manner that helps a client "frame" their massage experience

C:Adaptive measures that are important for ensuring client safety

D:Tissue resistance clients often experience at the end of sessions

19.

20.

21.

Practice Quiz Answer Key

1. D

2. C

3. B

4. B

5. B

6. A

7. D

8. A

9. B

10. A

11. A

12. C

13. C

14. C

15. C

16. A

17. D

18. B

19.

20.

21.

Overview of Forums and Styles

Terminology

Aromatherapy - The use of essential oils from aromatic plants and other plant products for healing. Essential oils are complex mixtures of chemical compounds that have physiological and psychological effects on the body. They are often used in combination with other therapies, such as massage, to promote relaxation and wellness.

Ayurvedic bodywork - Ayurveda is the traditional medical system of India. Massage, called abyanga, is performed by one, two, or more practitioners working in synchronicity as part of an external treatment to improve health. The techniques, specialized oils, and herbs used on the client are varied based on the client's condition.

Body-mind approaches - Also referred to as psychology-based approaches, these are systems that involve a variety of methods to improve the mind's positive impact on the body and the body's positive impact on the mind. Examples include Hakomi, Somatic Experiencing, somatic psychology, Core Energetics, and others.

Bodywork - A broad term that refers to many forms, methods, and styles of therapy (including massage) that positively influence the body through touch.

Chair massage - Known as seated massage, chair massage, or on-site massage, this technique involves the use of a specially designed massage chair in which the fully clothed client sits comfortably to receive a variety of techniques from various systems and approaches. Chair massage was originally developed by David Palmer, in an effort to make structured therapeutic touch more accessible to the public. It is provided in a number of settings including airports, businesses, and at street fairs.

Clinical approaches - Massage and bodywork systems developed to address soft-tissue conditions such as repetitive stress injuries, car injuries, and sports injuries with a focus on pain reduction or elimination, and rehabilitation of injured soft tissues. Therapeutic discomfort is often experienced as the adhesions, trigger points, and myofascial restrictions are reduced. Examples include orthopedic massage, treatment massage, soft tissue release, clinical massage, and others.

Eastern approaches - Massage and bodywork systems that developed in Asian cultures in countries such as Japan, China, India, Tibet, Korea, and Indonesia. The Eastern tradition of healing is based on the concepts of yin and yang, qi, and the five elements. Examples of Eastern approaches include shiatsu, Thai massage, ayurvedic bodywork, tui na, and Jin Shin Jyutsu.

Energetic approaches - Energetic approaches focus on energy flowing through the body and how the patterns and nature of this energy flow are affected by internal and external influences. Examples include polarity therapy, reiki, Healing Touch, Pranic Healing, and others.

Health-care-oriented massage - Massage performed to address chronic soft-tissue holding patterns that cause dysfunction, soft-tissue injury, or chronic pain; or massage performed in medical and clinical settings for condition management or for therapeutic change.

Hydrotherapy - A system of bodywork that uses water in one of its three forms for healing: solid (ice), liquid (water), or vapor (steam). Techniques include the use of heat packs, ice packs, specialized showers, whirlpool baths, hot and cold contrast treatments, and others.

Lomilomi - The massage technique of the ancient Polynesians and Hawaiian people. It is characterized by long, flowing, rhythmic strokes using the forearms and hands. The practitioner moves around the massage table using hula dance movement and breath work, which aim to increase healing energy and promote fluid techniques.

Lymphatic approaches - Massage and bodywork systems that aim to promote lymph movement and flow via very light strokes that act on the lymphatic system. Manual lymph drainage was pioneered by Danish doctors Emil Vodder and Estrid Vodder in the 1930s for the treatment of swelling, sinusitis, and other immune disorders. These methods, and their variations, are now recognized as a primary tool in the management of lymphedema and are also used to reduce swelling related to soft-tissue injury.

Massage - The ethical and professional application of structured, therapeutic touch to benefit soft-tissue health, movement, posture, and neurological patterns.

Massage or bodywork approach - A group of massage and/or bodywork systems that use similar techniques, base their work on similar philosophies, or seek to achieve comparable results. For example, Rolfing, structural integration, SOMA neuromuscular training, postural integration, and Hellerwork are all based on the philosophies and methods developed by Ida Rolf, and are focused on optimal posture.

Massage or bodywork system, form, or modality - A collection of techniques organized into a complex whole based on a philosophy of the body and of soft-tissue manipulation. Examples include Swedish massage, structural integration, myofascial release, Alexander Technique, and Rosen Method, and many others. Approximately 260 defined systems, forms, or modalities have been identified in massage and bodywork practice.

Movement approaches - Systems of bodywork based on the idea that all people "learn" how to move in a particular way based on their needs and the surrounding environment. In most people, habitual and often dysfunctional movement patterns become locked in the neuromuscular-myofascial system over time. These approaches aim to improve self-awareness and retrain movement patterns to promote optimal health and wellness. Examples include Alexander Technique, Aston-Patterning, Feldenkrais Method, and Trager Approach.

Myofascial approaches - Massage and bodywork systems that aim to release fascial restrictions to decrease pain, restore free movement to the body, and allow the body to function in an optimal state. Examples include myofascial release, connective tissue massage, core somatic therapies, and others.

Neuromuscular approaches - Massage and bodywork systems that explore the relationship between the nervous system and muscular system functions to create positive reflex responses in the body in order to change muscle length and kinesthetic perception. The manipulation of myofascial trigger points are often a focus. Examples include neuromuscular therapy, trigger point therapy, muscle energy technique, strain/counterstrain, proprioceptive neuromuscular facilitation, and others.

Polarity therapy - An energetic approach to health and healing developed by Dr. Randolph Stone that aims to address the body, mind, and spirit of the client by balancing the energy in and around the body to promote good health. Techniques include the use of hand positions that use the natural polarity (positive, negative, or neutral changes of different points on the body) to balance energy.

Reflexology - A method based on the belief that there are points on the feet, hands, and ears that stimulate the function of different parts of the body, including the glands and organs.

Reiki - An energetic approach to health and healing, created in Japan, in which a reiki practitioner places his or her hands on or above a recipient, or heals energetically from a distance.

Relaxation massage - A general term for massage provided to reduce overall stress and tension in the body, with an emphasis on techniques that feel pleasurable to receive and which facilitate a period of deep rest and recovery for the body.

Russian massage - A form of massage that was developed in the former Soviet Union that shares many characteristics with Swedish massage. This system includes mild and moderate pressure, but also deep and vigorous work. Some forms are quite forceful and use rapid friction and tapotement techniques.

Spa therapies - Methods and treatments that aim to relax or revitalize the body and stimulate natural detoxification through the application of naturally occurring substances (e.g., thalassotherapy - healing with seaweed, balneotherapy - therapeutic use of baths, and fangotherapy - the use of mud, clay, and peat for healing). Spas have evolved in the United States to embrace concepts of wellness and beauty, and today, many treatments are for skin beautification and out of the massage therapy scope of practice.

Stone massage - A form of massage, usually based on Swedish massage techniques, in which heated or cooled stones are held in the practitioner's hands and applied to the body. Hot stone massage is the use of warm stones; cold stone massage is the use of cold stones.

Structural approaches - Massage and bodywork systems based on the idea that an efficiently organized body, demonstrated by excellent posture and muscular balance, functions optimally when it interacts with gravity. Examples include Rolfing, structural integration, soma neuromuscular training, postural integration, Hellerwork, and others.

Swedish massage - A form of massage developed by Per Henrik Ling of Sweden based on the movement therapies of the late 1700s and formalized into a comprehensive system first called "The Swedish Movements." Today, Swedish massage is most often used for relaxation, but it can also be used for clinical practice. Widely recognized and popular with clients, Swedish massage is frequently the foundation of a practitioner's techniques and the foundation upon which many other forms, systems, and modalities are built.

Thai massage - Thai massage is part of the broader practice of traditional Thai medicine. It is applied to a fully clothed client without lubricant, often on a mat on the floor. The goal of Thai massage is to support healthy digestion, ensure deep breathing, reduce mental confusion, and promote longevity through techniques that manipulate soft tissue and stretch the body.

Tui na - This Asian bodywork system, also commonly spelled tuina, has been practiced as part of traditional Chinese medicine for more than 4,000 years. Tui means "push" and na means "grasp" in Chinese, conveying the vigorous and firm quality of this massage system.

Wellness - A state of being healthy in body, mind, and spirit as the result of deliberate effort through attention to diet, exercise, lifestyle, and sense of community and belonging. It is an approach to personal health that emphasizes preventing illness and living a fulfilling life.

Wellness-oriented massage - Massage performed in wellness- or relaxation-oriented environments to facilitate stress reduction, relaxation, or the balanced health of body, mind, and spirit.

Western approaches - Massage and bodywork systems developed in Western cultures in countries such as the United States and Europe, in alignment with applied science that identifies and treats illness or conditions to restore health. Western approaches are evolving based on current research and thinking to include more holistic (body, mind, spirit) and preventative approaches. Examples of Western approaches include clinical massage, orthopedic massage, myofascial release, structural integration, Swedish massage, and others.

Practice Quiz

1. What is a massage approach that emphasizes the reduction of fascial restrictions?

A:Zen shiatsu

B:Myofascial

C:Integrative

D:Meridian therapy

2. A form of massage that developed in the former Soviet Union and shares many characteristics with Swedish massage is:

A:Muscle energy technique

B:Soft-tissue release

C:Lomilomi

D:Russian massage

3. What is the general term for massage that's designed to reduce overall stress and tension?

A:Neuromuscular massage

B:Relaxation massage

C:Clinical massage

D:Alexander Technique

4. A massage approach that emphasizes the prevention of illness and living a full life is called:

A:Clinical

B:Medical

C:Wellness

D:Strain counterstrain

5. What is a massage approach that incorporates heat and rocks?

A:Hot stone

B:Meridian

C:Granite manipulation

D:Hydrorock

6. An approach that involves the mind's positive impact on the body and the body's positive impact on the mind is:

A:Swedish massage

B:Reflexology

C:Somatic Experiencing

D:Hydrotherapy

7. What is a massage approach that emphasizes rehabilitation?

A:Hot stone massage

B:Meridian therapy

C:Clinical

D:Wellness

8. The name of this system translates to "push" and "grasp:"

A:Lomilomi

B:Abyanga

C:Shiatsu

D:Tui na

9. What is a bodywork approach that originated in Hawaii?

A:Anatomy trains

B:Lomilomi

C:Deep tissue

D:Myoskeletal

10. A bodywork approach that emphasizes or incorporates emotional and psychological connection:

A:Color therapy

B:Sound healing

C:Body-mind

D:Moxibustion

11. The use of essential oils extracted from aromatic plants is called:

A:Hakomi

B:Polarity

C:Reflexology

D:Aromatherapy

12. A bodywork approach that emphasizes increased quality of movement is called:

A:Alexander Technique

B:Reiki

C:Polarity

D:Ayurvedic

13. A form of massage developed by Per Henrik Ling based on the movement therapies of the late 1700s is:

A:Swedish massage

B:Manual lymphatic drainage

C:Russian massage

D:Myofascial release

14. If the elimination or reduction of myofascial trigger points is a focus, the system is likely a(n):

A:Polarity approach

B:Eastern approach

C:Neuromuscular approach

D:Movement approach

15. Massage to address chronic soft-tissue holding patterns, or in medical settings for condition management, is generally referred to as:

A:Health-care-oriented massage

B:Polarity therapy

C:Relaxation massage

D:Wellness-oriented massage

16. Abyanga is performed by one, two, or more practitioners working in synchronicity as part of treatments to improve health in this traditional medical system:

A:Traditional Chinese medicine

B:Ayurveda

C:Hakomi medicine

D:Thai medicine

17. If you practice a therapy where you manipulate points on the feet that correspond to glands or organs of the body, you provide:

A:Ayurvedic massage

B:Reflexology

C:Hakomi massage

D:Polarity

18. If the massage includes the application of peat or soaking in a tub filled with sea salt, it is likely:

A:Aromatherapy

B:A spa therapy

C:Manual lymphatic drainage therapy

D:Structural integrative therapy

19. The therapeutic application of structured touch to manipulate soft tissue is:

A:Massage

B:Joint manipulation

C:Bodywork

D:High velocity thrust maneuver

20. What is a massage approach that emphasizes pain relief and rehabilitation?

A:Clinical

B:Manipulation

C:Joint play

D:Wellness

21.Energetic approaches to bodywork focus on energy flowing through the body and how the patterns and nature of this flow are affected by internal and external influences. One example of an energetic approach to bodywork is:

A:Myofascial release

B:Manual lymphatic drainage

C:Structural integration

D:Healing Touch

22. The ethical and professional application of structured, therapeutic touch to benefit soft-tissue health, movement, posture, and neurological patterns describes:

A:Polarity

B:Massage

C:Energetic approaches

D:Movement approaches

23. While performing chair massage at a corporate office, your client informs you he is starting to feel dizzy and is seeing stars. What action should be taken to safely support the client through this experience?

A:Readjust the angle of the head rest to a more upright position

B:Have the client sit up and get him a glass of water

C:Direct the client to take deep breaths until it passes

D:Assist the client from the chair to lying on the floor

24. A system based on the idea that an efficiently organized body, demonstrated by excellent posture and muscular balance, functions optimally when it interacts with gravity is called:

A:Myofascial release

B:Manual lymphatic drainage

C:Fangotherapy

D:Structural integration

Practice Quiz Answer Key

1. B

2. D

3. B

4. C

5. A

6. C

7. C

8. D

9. B

10. C

11. D

12. A

13. A

14. C

15. A

16. B

17. B

18. B

19. A

20. A

21. D

22. B

23. D

24. D

Positioning Clients

Terminology

Bolster - Foam supports that come in a variety of shapes and sizes. They are placed under the neck, knees, ankles, abdominal area, or upper chest, or along the side of the body to decrease stress on joints and provide soft surfaces to cushion clients. Pillows and folded, or rolled, towels are also used. Bolsters are always removed before a client changes position (e.g., rolls from the supine to prone position) and at the end of the massage before the client gets off the table.

Full-body cushion systems - Foam forms that match the body's contours with many different pieces that can be held together with Velcro straps to fill in gaps where a client needs support. They are particularly useful with pregnant clients, larger clients, or clients with large breasts or abdomens.

Lateral recumbent position - A position where a client is on a massage table, lying on one side. Also called the side-lying position.

Prone - A position where a client is on a massage table, laying face down on the abdominal muscles. The face is situated in a face cradle to maintain the cervical spine in a neutral position. A bolster is placed under the ankles to reduce stress on the ankles, knees, and low back. A pillow is sometimes placed under the client's abdominal muscles if the client experiences back tension or pain while in this position. Clients with chronic sinus problems or headaches may feel discomfort in this position due to the pressure the face cradle exerts on the sinus cavity.

Recumbent - A general term that simply means resting in a reclining position.

Seated - A position where the client sits in a regular chair or a massage chair with the upper body supported. In a regular chair, pillows on the massage table or a face cradle or special desktop face cradle support the upper body. In a massage chair, the chair's structure supports the client's chest and face. This position is used on fully clothed clients for on-side work or because the client has a physical issue that makes the seated position more comfortable.

Semi-reclined - A position where the client is on a massage table, face up, on the spine but with the upper body elevated to a semi-sitting position. Pillows and special foam wedges are used to support the back, neck, head, and sometimes under each arm. The knees are also bolstered in this position, which is used in the later stages of pregnancy, with clients who have allergies that cause nasal congestion, with chronic sinus conditions, and with a headache.

Side-lying - A position where a client is on a massage table, lying on one side. Also called the lateral recumbent position. A bolster is placed under the knee and ankle of the upper leg so that the client can roll forward slightly and rest against the bolster. A second bolster or pillow is placed in front of the chest to provide a resting place for the uppermost arm. Another pillow is placed under the neck and head. Clients who dislike the face cradle, who are uncomfortable in the supine and prone positions because of back problems, who have large bellies, who have large breasts, or who are pregnant may prefer the side-lying position.

Supine - A position where a client is on a massage table, laying face up on the spine. A bolster is placed under the knees to relieve tension on the knees and low back. A small rolled towel or pillow might be placed under the neck to support the neck and head. Clients can observe the practitioner from this position which may decrease their anxiety while they get to know a new practitioner. Lights can sometimes be a distraction but an eye pillow can be used to dampen light if necessary.

Practice Quiz

1. In the supine position:

A:Clients might want a pillow under the abdominal area

B:Clients might want the face cradle adjusted

C:Clients might want their ankles elevated to take pressure off the back

D:Clients might find they need an eye pillow to block out light

2. If the client has a physical issue that makes recumbent positions difficult, this position might be used:

A:Prone

B:Seated

C:Supine

D:Side-lying

3. The side-lying position might be used if:

A:The client likes massage in the prone position

B:The client dislikes a face cradle

C:The client wants adductor work

D:The practitioner wants to create the easiest draping option

4. In the prone position:

A:A rolled hand towel is placed under the neck

B:A face cradle maintains the cervical spine in a neutral position

C:A bolster is placed under the upper knee and leg

D:A bolster is placed under the knees

5. A pregnant client in the last trimester would most likely be positioned:

A:Prone

B:Face down

C:Side-lying

D:Massage is contraindicated for pregnancy

6. One benefit of starting a client in the supine position is:

A:There is no benefit

B:Ability to access the erector spine muscles

C:Ability to see the color of their eyes

D:Ability to monitor facial expressions

7. When a client is turned over from the prone to supine position:

A:The practitioner leaves the room in case the client accidently exposes herself

B:The body is elevated to a semi-sitting position first

C:The bolster is first removed from under the client's ankles

D:The practitioner gets out of the way so the client can turn on her own

8. Name the position where the client is not fully lying back:

A:Semi-reclined

B:Reclined

C:Supine

D:Face up

9. In the side-lying position:

A:A pillow is placed under the abdominal area if low-back pain is an issue

B:A bolster or pillow is placed in front of the chest to provide a resting position for the arm

C:A pillow is placed under the lower leg

D:A pillow is placed under the lower arm

10. Foam forms that match the body's contours with pieces that can be held together with Velcro straps are known as:

A:Foam rollers

B:Neck collars

C:Knee pads

D:Full-body cushion systems

11. When would you need to help a client off the table?

A:After cross-fiber friction

B:After every session

C:After using too much lubricant

D:After abdominal surgery

12. In a semi-reclined position:

A:A pillow is placed under the lower leg

B:A bolster is placed under the upper knee and leg

C:The upper body is elevated with pillows or special foam wedges

D:A bolster is placed under the abdominal area if the client has back pain

13. When positioning clients with back pain in the prone position, they typically need a bolster under their:

A:Chest

B:Ankles

C:Knees

D:Arms

14. The primary purpose of bolsters is to:

A:Dampen light levels when the client is supine

B:Increase stress on joints

C:Decrease stress on joints

D:Provide places for practitioners to lean their bodies on the massage table

15. Your client suffers from chronic asthma attacks. What position on the massage table should be avoided to ensure she is comfortable and not likely to be triggered into an asthma attack?

A:Side-lying

B:Prone

C:Semi-reclined

D:Supine

16. Why is it important to limit the time a client spends in a prone position?

A:To avoid ischemia in the face

B:To avoid "face cradle face"

C:To avoid hyperventilation

D:To avoid nasal congestion

17.

18.

19.

20.

21.

Practice Quiz Answer Key

1. D

2. B

3. B

4. B

5. C

6. D

7. C

8. A

9. B

10. D

11. D

12. C

13. B

14. C

15. B

16. D

17.

18.

19.

20.

21.

Draping Methods

Terminology

Anterior leg drape - A drape used to expose either the left or right anterior leg, while keeping the rest of the body, except the head, covered.

Anterior pelvic drape - A spa draping method where a separate breast drape is used along with a drape that covers the anterior pelvic region and genitals, but exposes both anterior legs at the same time. It is used when spa products like fango or seaweed are applied to the anterior arms, upper chest, abdominal region, and anterior legs at the same time.

Arm drape - A drape used to expose either the left or right arm, while keeping the rest of the body, except the head, covered.

Back drape - A drape used to expose the back while keeping the rest of the body, except the head, covered.

Breast drape - A drape used to expose the abdominal area but keep the breasts and the rest of the body, except the head, covered.

Draping - The use of a sheet, towel, blanket, or combination of these to cover any body regions that are not being massaged. Draping establishes professional boundaries, preserves the modesty of both the client and practitioner, and ensures the client stays warm during the session.

Gluteal drape - A drape used to expose either the left or right gluteal muscles (it is not used to expose bilateral gluteal muscles at the same time, which would expose the anus), while keeping the rest of the body, except the head, covered.

Posterior leg drape - A drape used to expose either the left or right posterior leg but keep the rest of the body, except the head, covered.

Posterior pelvic drape - A spa draping method where the back is exposed but a drape covers the posterior pelvic region and genitals, but exposes both posterior legs at the same time. It is used when spa products like fango or seaweed are applied to the posterior arms, back, and legs at the same time.

Practice Quiz

1. Areas that are never undraped during a massage include:

A:The breasts

B:The upper thighs

C:The low back

D:The abdominal region

2. A drape used to expose the abdominal area but keep the rest of the body, except the head, covered is called a:

A:Posterior pelvic drape

B:Gluteal drape

C:Breast drape

D:Anterior pelvic drape

3. One of the benefits of good draping is to:

A:Establish professional boundaries

B:Decrease sensitivity

C:Allow the skin to breathe

D:Show the client you know what you are doing

4. One way to secure the drape on the gluteal region of a client who is positioned side-lying would be to:

A:Grab another sheet and cover the buttocks

B:Neatly roll the sheet under itself to expose the region

C:Never work the glutes from this position

D:Ask the client to hold the sheet into position

5. When working the pectoralis minor on a female client from a side-lying position, you may have to have them:

A:Tighten their core muscles

B:Hold a bolster between their knees so they don’t fall off the table

C:Hold their breath to allow better access to the muscle

D:Hold on to a pillow to secure the drape on their breasts

6. One of the benefits of good draping is to:

A:Allow the client to feel comfortable

B:Decrease heart rate

C:Increase heat production of the body

D:Enhance circulation

7. What draping technique would help you access the upper abdominal region on a female client?

A:Breast drape

B:Thigh drape

C:Back drape

D:Axilla drape

8. Areas that are never undraped during a massage include:

A:The gluteals

B:The abdominal region

C:The upper chest

D:The anus

9. One of the benefits of good draping is to:

A:Visually evaluate an injury site

B:Increase heart rate

C:Decrease friction

D:Reduce the need for lubrication

10. Areas that are never undraped during a massage include:

A:The upper chest

B:The genitals

C:The gluteals

D:The upper arms

11. The best way to become comfortable and skilled at draping is to:

A:Watch your classmates

B:Hope for the best

C:Look at a textbook

D:Practice on a variety of male and female clients

12. What draping technique would help you access the origin of the iliopsoas on a male client?

A:Thigh drape

B:Breast drape

C:Back drape

D:Abdominal drape

13. What type of draping technique would be required if a client reports having piriformis syndrome?

A:Gluteal drape

B:Back drape

C:Abdominal drape

D:Posterior thigh drape

14. A spa draping method that allows products to be applied to both arms, the upper chest, the abdominal area, and the anterior legs at the same time while preserving the client's modesty is:

A:A breast drape and anterior pelvic drape

B:Posterior thigh drape

C:Gluteal drape

D:A breast drape and gluteal drape

15. A spa draping method that allows spa product to be applied to both posterior legs, the posterior arms, and the back at the same time, while preserving the client's modesty is the:

A:Abdominal drape

B:Breast drape

C:Posterior pelvic drape

D:Anterior pelvic drape

16. The primary purpose of draping is to:

A:Help with the decor of a room

B:Protect the client's modesty

C:Have a place to wipe off lubrication

D:Serve as a barrier to the skin

17.

18.

19.

20.

21.

22.

Practice Quiz Answer Key

1. A

2. C

3. A

4. B

5. D

6. A

7. A

8. D

9. A

10. B

11. D

12. D

13. A

14. A

15. C

16. B

17.

18.

19.

20.

21.

22.

Soft Tissue Techniques

Terminology

Active joint movement (Swedish massage) - In Swedish massage, active joint movement refers to techniques where the client performs a movement at a joint while the therapist applies a lengthening stroke from the origin to the insertion of the muscle or muscle group performing the movement. This technique is also used in many other massage and bodywork systems.

Active range of motion (myofascial approaches) - At the end of a session, when a client has finished dressing, practitioners direct clients to move the joints for each region addressed during the session actively through all of its movements. This practice is believed to assist the body in resetting the resting lengths of muscles and improve the long-term effects experienced from the session.

Active trigger point - A trigger point that causes pain even when the client is at rest and not receiving stimulation through palpation of the point.

Adhesiveness - The quality of soft tissue where collagen fibers become "packed down" through increased hydrogen bonding that occurs in response to tissue stress.

Associated trigger point - A trigger point in one muscle that occurs in tandem with a trigger point in another muscle, usually originating from the same mechanical or neurological cause.

Attachment trigger point - A trigger point that develops where muscles attach to bone.

Central trigger point - A trigger point that forms near the center of the muscle's fibers and is associated with dysfunctional motor end plate activity.

Contracted sarcomere theory - The theory that trigger points are formed as a result of contracted sarcomeres caused by a chemical imbalance at the point where a nerve and muscle communicate.

Cross-fiber friction - A method developed by James Cyriax in the 1930s to address scar tissue and adhered tissue. The technique is applied across muscle fibers with a deep, transverse rubbing action that creates inflammation in the tissue to stimulate tissue-repair mechanisms.

Crossed-hand stretch - A technique used in myofascial approaches where the hands are crossed with the fingers pointing in opposite directions and the slack is taken out of the tissue in order to stretch broad sheets of fascia.

Deep fascia - Fascia, at all layers of the body, providing framework for organs and tissues.

Deep friction - A circular, linear, or cross-fiber stroke used to pull perpendicular sections of a structure in opposite directions, or by shifting juxtaposed structures across each other to break up adhered tissue. The word "friction" comes from the Latin "frictio" meaning "to rub." This stroke is part of the traditional Swedish massage progression, but is now used in many other forms and systems of massage and bodywork. The fingertips, thumbs, elbows, knuckles, and other anatomical tools are used to apply these strokes.

Effleurage - A long, gliding stroke delivered with light, medium, or deep pressure that usually follows the direction of the muscle fibers. The name derives from the French verb meaning "to skim" and is traditionally used as part of Swedish massage. This stroke is often the first applied to the body and used to spread lubricant, warm the muscles in anticipation of deeper work, or as a transition between other strokes.

Fascial bands - Superficial fascia in horizontal strips that restrict fat deposits.

Fascial bowing - A number of related techniques used in myofascial approaches where the thumbs, fingers, or hands are used to deform tissue by bending the tissue into S shapes or C shapes.

Fascial cutting - A technique used in myofascial approaches where reinforced fingers, a knuckle, or the edge of one hand is used to outline muscle or bones at progressively deeper levels to work specific areas of myofascia.

Fascial spreading - A technique used in myofascial approaches where the fingers are placed side by side and separated in order to stretch very specific areas of fascia. In some related techniques, one hand might lock down an area of fascia while the other hand is used to push the tissue away to create a stretch.

Fascial torquing - A technique used in myofascial approaches where the tissue in an area is lifted until the slack is removed and then deformed by twisting it back and forth until it is soft and pliable.

Focused myofascial stretches - Techniques that address fascial restrictions in particular areas or around joints, or that work with deeper fascia in a particular area, or that release the tissue of a particular muscle. Fascial spreading, fascial torquing, fascial cutting, and fascial bowing are categorized as focused myofascial stretches.

Gliding stroke - A long, sweeping stroke delivered with light, medium, or deep pressure that usually follows the direction of the muscle fibers and is used in many different massage forms and systems. In Swedish massage, this stroke is referred to as effleurage.

Gross myofascial stretches - Techniques that stretch larger sections of fascia or help the practitioner identify regions of fascial restrictions. Arm and leg pulling and broad crossed-hand stretches are categorized as gross myofascial stretches.

Ground substance - A fluid produced by fibroblasts that looks like egg white and surrounds all the cells in the body to support cellular metabolism. It provides nutritional support to cells, while binding them together and providing a medium through which substances can be exchanged between blood and cells. It also serves as a spacer between collagen fibers to keep them from sticking together.

Horizontal planes of fascia - Places where fascial sheets converge at joints.

Joint movement (Swedish massage) - Therapeutic movement intended to improve joint flexibility. In traditional Swedish massage, joint movement methods were referred to as "gymnastics" and this term is still used occasionally. In the Swedish system, various active, passive, and resisted joint movements are used to improve or maintain range of motion.

Key trigger point - A trigger point that activates one or more satellite trigger points.

Kneading stokes - A rhythmic stroke that lifts the muscle off the bone and other muscles, compresses it between the fingers, and rolls the muscle fibers as the muscle falls back into position. It is used in many different massage forms and systems. In Swedish massage, this stroke is referred to as petrissage.

Latent trigger point - A trigger point that causes pain when it is palpated, but is not recognized by the client as a primary cause of their pain or limited range of motion.

Myofascial chains - The quality of fascia, where it creates long chains (both superficial and deep) from the foot to the top of the head on both the anterior and posterior body.

Myofascial dysfunction - A term that refers to poor myofascia health that impacts body function. It is caused by postural habits, diet, repetitive mechanical stress, injury, chronic stress, or a sedentary lifestyle, among others.

Myofascial skin rolling - A technique used in myofascial approaches where the superficial tissue is rolled very slowly through the fingers (without lubricant) in order to assess fascial restrictions, to warm the tissue in anticipation of other myofascial techniques, and to reduce fascial adhesions and restrictions.

Neuromuscular therapy - A form of bodywork that aims to locate, treat, and prevent chronic pain associated with myofascial trigger points.

Pain scale (neuromuscular approaches) - The scale used in communication with clients about pain during neuromuscular approaches to deactivate trigger points. The scale ranges from 1–3, with 1 meaning very little pain and too little pressure on the point, 2 meaning tolerable pain with the right amount of pressure on the point, and 3 meaning too much pain and too much pressure on the point.

Passive joint movement (Swedish massage) - In Swedish massage, passive joint movement refers to techniques like jostling (a form of vibration) where an extremity, such as the arm, is lifted and swung back and forth to loosen it and relax the muscles surrounding the joint. The muscles around a joint might also be taken into a gentle stretch as part of passive joint movement used in Swedish massage. This technique is also used in many other massage and bodywork systems.

Passive range of motion (myofascial approaches) - In myofascial approaches, passive joint movement is administered at the end of work on a particular region to reeducate the muscles and connective tissue around a joint as to their normal resting length.

Passive stretches (Swedish massage) - In Swedish massage, passive stretches are used at the end of a massage of a particular body area. A joint is taken to end feel in a particular movement, and then a gentle stretch is applied to the tissue.

Percussion - A rapid, rhythmic stroke using the hands in various formations to drum on the client. In Swedish massage, this stroke is called tapotement.

Petrissage - A rhythmic stroke that lifts the muscle off the bone and other muscles, compresses it between the fingers, and rolls the muscle fibers as the muscle falls back into position. The name derives from the French verb meaning "to knead." Variations include wringing, fulling, and skin rolling.

Piezoelectricity - A term that means "pressure electricity" and refers to the ability of living tissue to generate electrical potentials in response to mechanical deformation.

Pincer compression - A technique used in neuromuscular approaches where the practitioner grasps the belly of the muscle in which a trigger point is located and "pinches" the muscle between the fingers and thumb for 8–12 seconds or longer (so long as the pain produced by the point continues to decrease).

Primary trigger point - A central trigger point activated by acute trauma or by chronic overuse of the muscle in which it occurs.

Reciprocal inhibition (reflex) - A reflex mechanism in the body that ensures coordinated movement between groups of opposing muscles. For one muscle to contract during movement, the contraction of the opposing muscle must be inhibited. Some proprioceptive techniques employ this reflex mechanism for therapeutic purposes to decrease muscle spasm and hypertonicities in a target muscle.

Reciprocal inhibition (technique) - A method where a target muscle is identified and the antagonist of the target muscle is contracted isometrically for 10 seconds against resistance from the therapist to reduce spasm or hypertonicity in the target muscle.

Resisted joint movement (Swedish massage) - In Swedish massage, resisted joint movement refers to techniques where the client carries out a particular movement at a joint while the practitioner resists the movement in order to build client strength or help a muscle regain its normal firing pattern. This technique is also used in many other massage and bodywork systems.

Satellite trigger point - A trigger point that is activated because of key trigger points in a referral zone or in an overloaded synergist muscle compensating for the muscle in which the key trigger point is located.

Skin rolling - A variation of petrissage or kneading techniques where the thumbs push the tissue away and the finger pads "walk" ahead of the thumbs to gather the tissue and compress it between the fingers and thumbs. This technique is often used to assess fascial restrictions or reduce fascial adhesions.

Static compression - Also called ischemic compression. A technique where direct, downward pressure is placed on the tender nodule that forms a trigger point for 8–12 seconds or longer (so long as the pain produced by the point continues to decrease).

Superficial fascia - Fascia that lies just below the skin.

Superficial friction - A heat-producing, chafing technique applied with light, brisk strokes used to produce heat in the tissue. The word "friction" comes from the Latin "frictio" meaning "to rub." This stroke is part of the traditional Swedish massage progression, but is now used in many other forms and systems of massage and bodywork.

Tapotement - A rapid, rhythmic percussion stroke using the hands in various formations to "drum" on the client. The name comes from the old French for "a light blow." Variations include hacking (the ulnar sides of the hand are used to drum on the client), cupping (the hands are held in a cupped formation and used to drum on the client), beating (the hands are held in fists and used to drum on the client), slapping (the hands are held flat and used to drum on the client), pincement (the fingertips are used to pick up and then release small bits of superficial tissue in a percussive rhythm), and tapping (the fingertips are used in a gentle drumming on the face). This stroke is part of traditional Swedish massage, but is now used in many different forms and systems, most notably in sports massage. It is never performed over the kidneys, over bones, or after athletic performance as it might cause injury or muscle cramping.

Thixotropy - A phenomenon in which gels become more fluid when they are stirred up and more solid when they are undisturbed. The ground substance in connective tissue, especially fascia, has the unique ability to move between a more fluid sol state and a viscous gel state. The application of massage techniques that lift, twist, compress, vibrate, and stretch the tissue, mechanically stir the ground substance to improve tissue health.

Trigger points - A hyperirritable spot in skeletal muscle that is associated with a hypersensitive palpable nodule in a taut band.

Vibration - A pulsating, tremor-like, or oscillating stroke that stimulates or relaxes the nervous system, specific body area, or the whole body, depending on how it is applied. The word "vibration" comes from the Latin word for "to shake" and is traditionally used as part of Swedish massage. Variations of this stroke include fine vibration, jostling, shaking, or rocking.

Viscoelasticity - The quality of connective tissue that allows it to be deformed by an outside force and remain deformed for a period of time after deformation occurs. The term is composed of the words "viscous" (thick, sticky, gummy) and "elastic" (stretchy, expandable, flexible).

Practice Quiz

1. A primary goal of myofascial work is to:

A:Apply lubrication

B:Reduce fascial restrictions

C:Enhance inflammatory response

D:Increase the fascial bind

2. A percussion stroke is called:

A:Friction

B:Tapotement

C:Petrissage

D:Effleurage

3. A hacking stroke, a pincement stroke, a tapping stroke, or a cupping stroke are forms of:

A:Petrissage

B:Friction

C:Vibration

D:Tapotement

4. An example of an anatomical tool is:

A:Lotion

B:The thumb

C:Sheets

D:The anterior cruciate ligament

5. A long, gliding stroke delivered with light, medium, or deep pressure that usually follows the direction of the muscle fibers is:

A:Crossed-hand stretch

B:Effleurage

C:Vibration

D:Petrissage

6. Effleurage strokes repetitively applied to the extremities are contraindicated for:

A:Muscle strains

B:Ligament sprains

C:Torn cartilage

D:Cardiovascular disease

7. The quality of soft tissue where collagen fibers become "packed down" through increased hydrogen bonding that occurs in response to tissue stress is:

A:Piezoelectricity

B:Adhesiveness

C:Thixotropy

D:Viscoelasticity

8. A trigger point that activates one or more satellite trigger points is a:

A:Associated trigger point

B:Key trigger point

C:Active trigger point

D:Latent trigger point

9. In Swedish massage, a technique where the client carries out a particular movement at a joint while the practitioner resists the movement in order to help a muscle regain its normal firing pattern is called:

A:Cross-joint movement

B:Passive joint movement

C:Resisted joint movement

D:Active joint movement

10. Friction strokes are typically contraindicated for:

A:Bruises

B:Taut bands

C:Hypertonic muscles

D:Muscle spasms

11. Excessive abduction of the hip is contraindicated for:

A:Tight abductors

B:Tight adductors

C:Menstrual cramps

D:Hip replacement

12. A trigger point that is activated because of key trigger points in a referral zone or in an overloaded synergist muscle compensating for the muscle in which the key trigger point is located is called a:

A:Satellite trigger point

B:Associated trigger point

C:Latent trigger point

D:Primary trigger point

13. This approach places an emphasis on trigger point therapy:

A:Hot stones

B:Swedish

C:Neuromuscular

D:Reflexology

14. Shaking, jostling, or rocking a muscle is a form of:

A:Myofascial therapy

B:Petrissage

C:Neuromuscular therapy

D:Vibration

15. An example of an anatomical tool is:

A:Linens

B:The patellar ligament

C:The elbow

D:Essential oils

16. A method developed to address scar tissue applied across muscle fibers with a deep, transverse rubbing action is:

A:Superficial friction

B:Cross-fiber kneading

C:Cross-fiber friction

D:Chafing friction

17. The quality of connective tissue that allows it to be deformed by an outside force and remain deformed for a period of time after deformation occurs is called:

A:Piezoelectricity

B:Viscoelasticity

C:Thixotropy

D:Adhesiveness

18. A primary use of vibration on the abdominal area is to:

A:Stimulate the secretion of growth hormone

B:Stimulate sexual arousal

C:Stimulate peristalsis

D:Stimulate the release of toxins

19. Petrissage strokes are typically contraindicated for:

A:Taut bands

B:Referral zones

C:Adhesions

D:Varicose veins

20.

21.

22.

Practice Quiz Answer Key

1. B

2. B

3. D

4. B

5. B

6. D

7. B

8. B

9. C

10. A

11. D

12. A

13. C

14. D

15. C

16. C

17. B

18. C

19.

20.

21.

22.

Hot and Cold Applications

Terminology

Absorbs temperatures (characteristic of water) - The characteristic of water that allows it to be heated or cooled to specific temperatures for therapeutic application to the body.

Balneotherapy - A term that means "therapeutic bath" and encompasses a range of different hydrotherapy treatments including footbaths, whirlpool baths, steam baths, saunas, full immersion baths (the body is completely covered in water heated or cooled to a specific therapeutic temperature,) and partial baths (bathing one body area such as an extremity).

Body wraps - A treatment where sheets are soaked in dissolved substances (like herbs) at specific temperatures and wrapped around the body to achieve various therapeutic effects.

Buoyancy (characteristic of water) - A term that refers to floating in water. When immersed in water, body weight displaces water and there is an upward thrust of water that lifts the body. This is why exercising in water reduces the stress on joints and other body areas.

Compress - A wet cloth soaked in warm, hot, cool, or cold water (sometimes with additives dissolved in the water) and wrung out before it is applied to the skin.

Cryotherapy (cold therapy) - A form of hydrotherapy in which the body is exposed to cold (32°F to 70°F) through the use of an ice pack, shower, immersion bath, or partial bath (e.g., foot bath, hand bath, etc.). The physiological responses of the body to cold result from the body's attempt to prevent a drop in body temperature.

Dissolves therapeutic substances (characteristic of water) - Water is called the universal solvent because it dissolves many other substances such as minerals and plants. Additives dissolved in water may have physiological or psychological effects that enhance and support the benefits of hydrotherapy application. Dissolved substances include herbs, milk, minerals, seaweed, and essential oils.

Friction treatments - A treatment in which the hands, mitts, or rough textured cloths are rubbed over the skin briskly to invigorate the body. Types of frictions include salt glows, loofah scrubs, and cold mitt friction.

Homeostasis - The relative constancy of the body's internal environment. Humans are able to maintain internal stability because intricate regulatory mechanisms continually monitor and correct the body's internal environment by adjusting physiological functions.

Hunting reaction - The unusual reaction of digital blood vessels exposed to cold (first observed in wintertime hunting expeditions, hence the name); vasoconstriction is alternated with vasodilation in irregular repeated sequences. It was once believed to protect the fingers from tissue damage during prolonged exposure to cold, however, research demonstrates this is not the case.

Hydrocollator - A specialized heating unit that maintains professional hot packs at 165°F.

Hydrocollator pack - A pack composed of a canvas casing filled with either silicon granules or clay particles that hold moist heat for up to 30 minutes. These packs are submerged in water kept at 165°F in a specialized heating unit called a hydrocollator.

Hydrostatic pressure (characteristic of water) - A term that refers to the amount of pressure exerted by a liquid when the liquid is at rest. In other words, water has weight. This characteristic of water pushes blood and fluid upward from the lower body when people stand in water, because the weight of water that is deeper is heavier than the weight of water at the surface.

Hydrotherapy - The external application of water as a liquid, solid, or vapor for therapeutic purposes. Water has a number of characteristics that make it useful as a therapeutic application. It is versatile and changes forms, dissolves other therapeutic substances, exerts hydrostatic pressure, causes buoyancy, and absorbs and transfers hot and cold temperatures.

Ice massage - Massage of a body region or area with ice.

Neutral - In some hydrotherapy applications, such as showers or immersion baths, the body is exposed to neutral temperatures (90°F to 98°F) to produce a tonic and balancing effect on the body.

Pack - Any local hydrotherapy treatment (hot, warm, cool, cold) that uses bundled materials to transfer temperatures to the body. Hot packs warm areas and increase vasodilation, while cold packs cool areas and increase vasoconstriction.

Paraffin dip - The practice of dipping the hands and feet into a waxy substance called paraffin obtained from the distillates of wood, coal, petroleum, or shale oils. It is used to coat the skin and trap heat and moisture at the skin's surface for therapeutic purposes. It is often used to treat the stiff joints of arthritis.

Plaster - Herbal pastes (herbs mixed with either water or oil) that are spread on a particular body area or onto a piece of cloth that is then applied to a particular body region.

Therapeutic showers - Showers that use hot, warm, neutral, cool, or cold temperatures for specific amounts of time for therapeutic purposes.

Thermotherapy (heat therapy) - A form of hydrotherapy in which the body is exposed to heat (98°F to 104°F) through the use of a hot pack, full-immersion bath, steam bath, sauna, or partial bath (e.g., foot bath or hand bath, etc.). The physiological responses of the body to heat result from the body's attempt to prevent a rise in body temperature and provide physiological benefits when used correctly.

Transference of temperatures (characteristic of water) - The characteristic of water that allows it to effectively transfer hot or cold temperatures to the body in two different ways. Conduction occurs when heated or cooled water makes contact with the body and transfers its warmth or coolness. Convection is the process by which hot or cold temperatures are transferred via air or gas (e.g., cold wind or steam).

Versatility (characteristic of water) - Water is a liquid that can easily be changed into ice or vapor for use in a variety of environments including baths and showers, ice or hot packs, or in steam rooms, etc.

Practice Quiz

1. Exercising in water reduces the stress on joints and other body areas due to:

A:Buoyancy

B:Absorbency

C:Convection

D:Transference

2. What is the local or general use of cold application?

A:Theraice

B:Plyometrics

C:Aquatics

D:Cryotherapy

3. What is a term that means therapeutic bath?

A:Balneotherapy

B:Thalassotherapy

C:Fangotherapy

D:Aromatherapy

4. Water is a liquid that can easily be changed into ice or vapor for use in a variety of treatments. This reflects water's characteristic of:

A:Conversion

B:Absorption

C:Versatility

D:Buoyancy

5. A treatment in which the hands, mitts, or rough, textured cloths are rubbed over the skin briskly to invigorate the body are called:

A:Cryotherapy

B:Friction treatments

C:Body wrap treatments

D:Thermotherapy

6. In some hydrotherapy applications, such as showers or immersion baths, the body is exposed to these temperatures to produce a tonic and balancing effect on the body:

A:Neutral

B:Cold

C:Hot

D:Warm

7. What is the characteristic of water that allows it to be heated or cooled to specific temperatures for therapeutic application to the body?

A:Hydrostatic pressure

B:Versatility

C:Absorbency

D:Buoyancy

8. Why is water a good form of therapy?

A:Increases the load on joints during exercise in pools

B:Obstructs cold

C:Increases the fluid retention in the lower limbs when people stand in it

D:Conducts cold

9. The use of water as a treatment for different conditions:

A:Hydrotherapy

B:Hydrometer

C:Hydrocodone

D:Aquatic cure

10. A good local analgesic for pain is:

A:Antibiotics

B:Probiotics

C:Ice massage

D:Pharmacokinesis

11. Why is water a good form of therapy?

A:Won't cause burns

B:Increases revenue

C:Stores heat

D:Lack of side effects

12. A heating unit with hot packs is called a:

A:Hydrocollator

B:Kinesis

C:Pharmacokinesis

D:Cryosauna

13. A unique therapy used for arthritis of the hands is a:

A:Theracane

B:Squeeze ball

C:Paraffin dip

D:Kinesiotaping

14. Cold packs increase:

A:Tissue swelling

B:Plyometrics

C:Vasoconstriction

D:Vasodilation

15. A treatment where sheets are soaked in dissolved substances like herbs at specific temperatures and then applied to the body are called:

A:Thermossage

B:Body wraps

C:Friction wraps

D:Cryossage

16. Substances that are commonly dissolved in water to benefit the body through hydrotherapy include all of the following EXCEPT:

A:Herbs

B:Sea salt

C:Table salt

D:Seaweed

17. Hot packs increase:

A:Vasodilation

B:Vasocontriction

C:Plyometrics

D:Tissue tension

18.

19.

20.

21.

22.

Practice Quiz Answer Key

1. A

2. D

3. A

4. C

5. B

6. A

7. C

8. D

9. A

10. C

11. C

12. A

13. C

14. C

15. B

16. C

17.

18.

19.

20.

21.

22.