ABMP: Massage Theory

History of Massage

Terminology

"Ebers Papyrus" - An ancient document dating to 1550 BCE that contains around 700 formulae and remedies that demonstrate Egypt's advanced understanding of anatomy and pathology.

"Yellow Emperor's Classic of Internal Medicine" - An important early text on Chinese medicine believed to originate as early as 1000 BCE, which provides the philosophical foundation on which Chinese traditional medicine is founded.

Abhyanga - The Sanskrit word for oil massage in the ayurvedic medical system of India.

Alternative medicine - The use of non-mainstream healing methods in place of conventional medicine.

American Massage Therapy Association - A nonprofit, professional association serving massage therapists, massage students, and massage schools.

Andreas Vesalius - A Flemish anatomist, born in Brussels (1514–1564 CE) , who wrote "On the Workings of the Human Body" in 1543 and corrected many of the anatomical assertions made by Galen.

Arab medicine - After the fall of Rome in the 5th century, the Arabs preserved Greek and Roman medical knowledge and integrated it with their own understanding. By the 9th century, the Arabs had well-developed pharmacies and an advanced understanding of herbal medicine. Al-Razi (865–925 CE) and Ibn Sina (980–1037) are regarded as great thinkers and clinicians in Arab medicine.

Asclepius - The Greek god of healing (also known as Asklepios) depicted with a staff and single snake that is used today as part of the American Medical Association crest.

Associated Bodywork and Massage Professionals - The premiere membership association serving the massage and bodywork profession; ABMP provides comprehensive liability insurance, educational tools, and support to massage professionals, students, instructors, and schools. ABMP also created this program!

Ayurveda - The traditional medical system of India that developed in India and Sri Lanka more than 5,000 years ago and was written in four texts called "The Vedas." The "Rig Veda," compiled from an earlier oral history between 1700 and 1100 BCE, outlines the main concepts in ayurveda. Ayurveda includes a strong emphasis on manual therapies and massage.

Body armor - A term developed by Wilhelm Reich to describe what he called unreleased psychosexual energy that produced physical blocks in muscles and organs.

Body-mind therapy - Also referred to as somatic therapy and introduced by Wilhelm Reich, this therapeutic approach to the body and mind of an individual includes both manual therapy (like massage) and talk therapy (as in psychotherapy).

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

Claudius Galenus - A Greek physician (130–200 CE), also known as Galen, who built on the theories and medical practices of Hippocrates. He was the first to discover the circulation of blood.

Client - The person receiving the service of professional massage or bodywork.

Commission on Massage Therapy Accreditation - Accredits educational institutions and programs providing instruction in massage, bodywork, esthetics, and skin care.

Complementary medicine - A non-mainstream approach to healing used together with conventional medicine.

Conventional medicine - Medicine that is commonly practiced in hospitals or by medical professionals using drugs and surgery as the primary intervention.

Esalen Institute - A center for the exploration of human potential that included spiritual practices like meditation, Buddhism, and yoga, as well as massage and bodywork. It was founded by Michael Murphy and Dick Price in 1962 in Big Sur, California, and is still running as a massage school and human potential center today.

Federation of State Massage Therapy Boards - An organization that supports state massage boards in creating consistent and coherent licensing of massage therapists.

Frances Tappan - An American physical therapist (1915–1999) who wrote numerous important books on massage therapy, including "Massage Techniques: A Case Method Approach" (1961). She also helped promote the regulated practice of massage during her lifetime.

Geronimo Mercuriali - An Italian philologist and physician (1530–1606) who explained principles of physical therapy in the "Art of Gymnastics" (1569).

Greek medicine - In the early history of medicine, the Greeks are recognized as moving medicine away from magic, ritual, and superstition and toward observation and logical reasoning from 800 BCE to 200 CE.

Health-care-oriented massage - A massage provided to address chronic soft-tissue holding patterns, soft-tissue injury, or chronic pain. It also refers to massage provided in medical settings to provide comfort, therapeutic change, or condition management under the supervision of a physician.

Hippocrates - An early Greek physician (460–377 BCE), widely regarded as the "father of Western medicine," because he based his practice on observation, extensive study of anatomy, and rational explanations of symptoms and underlying causes.

Holistic health care - A system of medicine that seeks to address the needs of the whole person, not just symptoms or diseases.

Human potential movement - A spiritual and alternative health movement promoted at the Esalen Institute in California in the 1960s. The movement believed that humans have a large store of untapped creative and intellectual potential that can be improved through spiritual practice and bodywork.

Ibn Sina - An Arab physician and philosopher (980–1037 CE) who brought together and organized existing medical knowledge from the Romans, Greeks, and India in a monumental manuscript titled the "Canon of Medicine." It became a highly regarded standard European medical reference for over 500 years.

Ida Rolf - An American biochemist (1896–1979) who extensively researched musculoskeletal components and developed structural integration. Her methods continue to profoundly influence massage today.

Integrative medicine - Collaborative health care that uses a team of medical and alternative health professionals to address all aspects of health.

Janet Travell - An American physician (1901–1997) who had a special interest in musculoskeletal pain and developed a number of methods for treating muscle pain in her extensive work on trigger points. "The Trigger Point Manual" (that she co-wrote in 1968) continues to profoundly influence massage today.

Johann Mezger - A Dutch physician (1838–1909) who provided the names for passive soft-tissue manipulation in Swedish massage.

John Harvey Kellogg - An American physician (1852–1943) who embraced massage as part of a healthy lifestyle and wrote "The Art of Massage, Its Physiological Effects and Therapeutic Applications," which outlined the mechanical, reflexive, and metabolic effects of massage on different body systems.

Leonardo da Vinci - An Italian painter (1452–1519 CE) who is widely regarded as one of the greatest painters of all time. He advanced anatomy as part of his studies in painting.

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

Massage Therapy Foundation - An organization that promotes research on the benefits of massage, spreads knowledge, and encourages community outreach.

Mondino de Liuzzi - An Italian anatomist and author (1275–1326 CE) who systemized dissection and published a manual called "Anathomia" (1315), which became a medical textbook that was used by schools for three centuries.

National Center for Complementary and Integrative Health - An organization that promotes shared research between conventional physicians and CAM therapists and provides information to the public.

National Certification Board for Therapeutic Massage & Bodywork - An organization providing certification, education, and information to massage and bodywork students and practitioners.

Per Henrik Ling - A Swedish theologist and fencing master (1776–1839) who developed a structured movement system called the Swedish Movements, building off the work of many other people. Ling's work was integrated with the work of Dutch physician Dr. Johann Mezger, resulting in many of the methods that we now call Swedish massage.

Special population - Any client base for which a particular type of massage has been developed to serve specific needs.

Swedish gymnastics - The system developed by Per Henrik Ling that classified movements as "active," "passive," and "active-passive" and formed the basis for modern Swedish massage.

Tiffany Field - An American psychologist who founded the Touch Research Institute in 1992 to scientifically prove the benefits of massage.

Touch Research Institute - An organization founded by American psychologist Tiffany Field in 1992 to scientifically prove the benefits of massage.

Wellness-oriented massage - Massage performed in wellness- or relaxation-oriented environments to facilitate stress reduction, relaxation, or wellness.

Wilhelm Reich - An Austrian psychoanalyst (1897–1957) who studied with Sigmund Freud and is considered the founder of psychotherapeutic body therapies, sometimes called body-mind therapy or somatic therapy. Reich introduced the idea of "body armor" to explain what he called unreleased psychosexual energy that produced physical blocks in muscles and organs. He is the author of a number of books, most notably "Character Analysis" (1933).

Practice Quiz

1. The "Ebers Papyrus" is important to medical history because it:

A: Demonstrates South America's advanced understanding of anatomy and pathology

B: Demonstrates China's advanced understanding of anatomy and pathology

C: Demonstrates Egypt's advanced understanding of anatomy and pathology

D: Demonstrates India's advanced understanding of anatomy and pathology

2. Thai medicine has four traditional elements including:

A: Mud bathing

B: Surgery

C: Herbal medicine

D: Roman hydrotherapy

3. In the early history (3500 BCE or before) of many cultures, little distinction was made between:

A: The health of the body and heavenly influences

B: The health of the body and the health of relationships

C: The health of the body and correct spiritual practice

D: The health of the body and health of the spirit

4. In the early history (3500 BCE or before) of many cultures around the world, medicine was closely associated with:

A: Christian beliefs

B: Magic, superstition, and ritual

C: Eastern spirituality

D: Cave painting and art

5. In Swedish gymnastics, this type of movement was performed under the direction of an attendant and was basically an exercise routine:

A: Passive

B: Passive-Resisted

C: Active-Passive

D: Active

6. The key proponent of Swedish gymnastics for health was:

A: Geronimo Mercuriali

B: Andreas Vesalius

C: Mondino de Liuzzi

D: Per Henrik Ling

7. The Egyptians documented their medical practices on a type of paper called:

A: Tabloid

B: Patter

C: Papyrus

D: Daphne

8. By the 9th century, the Arabs had well-developed:

A: Pharmacies

B: Surgical practices

C :Yoga practices

D: Massage clinics

9. Michael Murphy and Dick Price established the Esalen Institute in 1962 in Big Sur, California, as the center for:

A: The Per Henrik Ling Movement

B: The Psychotherapeutic Body Therapies Movement

C: The Human Potential Movement

D: The Mind-Body-Spirit Movement

10. China's medical systems were developed some 5,000 years ago and led to the formation of:

A: The "Chinese Medical Textbook"

B: The "Chinese Medical Dictionary"

C: "The Canon of Medicine"

D: Traditional Chinese medicine

11. Hippocrates (460–377 BCE) is widely regarded as:

A: The "Father of Western Medicine"

B: The "Father of Movement Therapies"

C: The "Father of Psychotherapy"

D: The "Father of Hydrotherapy"

12. During the 17th and 18th centuries, advances in the physical sciences (especially the popularity of exercise as a means of healing) led to:

A: The Swedish exercise craze

B: The Swedish Movements

C: The English Movements

D: The English exercise craze

13. This practitioner is considered the founder of psychotherapeutic body therapies, sometimes called body-mind therapy or somatic therapy:

A: Mondino de Liuzzi

B: Wilhelm Reich

C: Andreas Vesalius

D: Geronimo Mercuriali

14. Massage was a highly regarded therapy practiced at:

A: Roman baths

B: Pagan rituals

C: Religious ceremonies

D: Philosophical gatherings

15. In 19th-century America, massage therapy was:

A: Embraced by quacks and charlatans

B: Rejected by physicians and the public

C: Embraced by physicians and the public

D: Rejected by quacks and charlatans

16. Beginning in the 1950s, the term "massage" has often been used as a cover for:

A: Money laundering

B: Drug dealing

C: Tax evasion

D: Prostitution

17. The study of anatomy dramatically advanced during the period known as:

A: The Age of Enlightenment

B: The Renaissance

C: The Age of Despair

D: The Dark Ages

18. The Dutch physician who provided the names for passive soft-tissue manipulation in Swedish massage was:

A: Mondino de Liuzzi

B: Andreas Vesalius

C: Per Henrik Ling

D: Dr. Johann Mezger

19. From 800 BCE to 200 CE, Greek medicine:

A: Moved away from magic, ritual, and superstition toward logical reasoning

B: Adopted practices from Chinese healers

C: Moved away from logical reasoning to magic, superstition, and ritual

D: Adopted practices from Arab healers

20. Through a desire to maintain a healthy army, the Romans developed:

A: A public health system that included ritual and magic

B: A public health system that included psychotherapy

C: A public health system that included hydrotherapy

D: A public health system that included acupuncture

21. A massage provided to decrease stress, promote relaxation, and support the body's natural restorative mechanisms is defined as:

A: Animal massage

B: Wellness massage

C: Health-care massage

D: Orthopedic massage

22. Documentation of early Native American healers demonstrates that they were skilled:

A: Herbalists

B: Physicians

C: Physical therapists

D: Psychologists

Practice Quiz Answer Key

1. C

2. C

3. D

4. B

5. D

6. D

7. C

8. A

9. C

10. D

11. A

12. B

13. B

14. A

15. C

16. D

17. B

18. D

19. A

20. C

21. B

22. A

Research Literacy

Terminology

Abstract - A statement that summarizes research.

Active treatment group - The active treatment group (one of two groups in a research study) receives the treatment being researched, as opposed to the control group that receives the standard treatment, no treatment, a placebo treatment, or a second treatment.

Case control study - A study that examines health histories of similar people with and without a particular condition to identify risk factors for the condition.

Case report - A study that describes an outcome from treatment of one patient/client.

Case series - A study that describes outcomes from treatment protocol for more than one patient/client.

Clinical trial - A study that compares a treatment to a placebo or to another treatment to establish safety and efficacy, using randomization and controls.

Control group - The control group (one of two groups in a research study) receives the standard treatment (if there is one), no treatment, a placebo treatment, or a second treatment, as opposed to the active treatment group that receives the treatment being researched.

Correlation study - A study that demonstrates a relationship or lack thereof between two variables.

Discussion - A section of a research article that discusses the results of a study, interprets their meaning, explains their implications, provides links to other research, and draws conclusions from the study.

Empirical evidence - Information gathered through observation or experimentation.

Evidence-informed massage practice - A massage practice that is shaped by an understanding and integration of scientific studies relevant to that practice.

Introduction - A section of a research article that provides the history of the research, or the question being investigated. It may indicate other related research findings or describe why the research is important.

Massage Therapy Foundation - An organization that promotes research on the benefits of massage, spreads knowledge, and encourages community outreach.

Meta-analysis - A type of systematic review that uses defined statistical methods to combine the findings of several primary studies.

Methods/methodology - A section of a research article that outlines the research plan and how each step was carried out.

National Center for Complementary and Integrative Health - An organization that promotes shared research between conventional physicians and CAM therapists and provides information to the public.

Placebo effect - The effect of an inactive treatment or a medication with no active ingredients.

PubMed - A service of the National Library of Medicine that includes 15 million citations from peer-reviewed scientific journals.

References - A section of a research report that lists the resources and references used in designing and implementing the study.

Reliability - The degree to which results or findings of a study can be relied upon in making assertions or taking certain actions.

Research - The systematic study or investigation of materials and sources to determine facts and state conclusions.

Research literacy - The ability to find, read, and evaluate research articles and apply this information to a massage practice.

Results/findings - A section of a research article that analyzes the data gathered.

Systematic review - A review that analyzes and summarizes published literature on a particular question or treatment.

The scientific method - A procedure used by researchers for testing knowledge by observing phenomena, formulating a hypothesis, defining a question to test the hypothesis, designing a research study to answer relevant questions, collecting data, analyzing data, interpreting the data and drawing conclusions, and publishing the results.

Touch Research Institute - An organization founded by American psychologist Tiffany Field in 1992 to prove scientifically the benefits of massage.

Practice Quiz

1. An inactive treatment or a medication with no active ingredient is called a(n):

A: Active treatment group

B: A false med

C: An inactive treatment group

D: Placebo

2. A process that researchers use to investigate phenomena is called:

A: A placebo

B: The scientific method

C: The modern research method

D: A premise

3. In a clinical trial, randomized group selection:

A: Increases the amount of bias that may occur in a group study

B: Reduces the amount of bias that might occur in a study

C: Reduces the likelihood that results are accurate

D: Increases the likelihood that results are unusable

4. The first organization in the world dedicated to scientifically exploring how touch affects health and well-being was:

A: The Massage Therapy Foundation

B: The Touch Research Institute

C: The Massage Therapy Institute

D: The Touch Research Foundation

5. A careful study that is done to find and report new knowledge about something is:

A: Research

B: Premise

C: Theory

D: Outcome

6. In a clinical trial, the control group:

A: Receives the placebo

B: Is selected using a nonrandomized premise

C: Is selected using a randomized premise

D: Receives the real treatment

7. This section of a research article lists the texts, articles, or other research used in the development of the study:

A: Introduction

B: References

C: Results

D: Methods

8. This service of the US National Library of Medicine includes 15 million citations from peer-reviewed scientific journals and is a good resource for massage therapists:

A: Touch Research Method

B: Publications Unlimited

C: NCCAM

D: PubMed

9. This section of a research article describes the research plan and how each step was carried out:

A: Abstract

B: Results

C: Introduction

D: Methods

10. This organization was established to promote research into the benefits of massage:

A: The Massage Therapy Foundation

B: PubMed

C: Premise International

D: The Empirical Evidence Group

11. Collaborative health care that uses a team of medical and alternative health professionals to address aspects of health is called:

A: Alternative medicine

B: Reliable evidence medicine

C: Integrative medicine

D: Complementary medicine

12. This section of a research article describes the history of the question under investigation, why the research study is important, and its objectives:

A: References

B: Introduction

C: Results

D: Methods

13. A massage therapist with an evidence-based practice would:

A: Use placebo medications to support client health and wellness

B: Use reliable research studies to guide the selection of methods used during client treatment

C: Suggest the use of medically proven herbs or supplements to promote client health and wellness

D: Use clinical trials with fewer than 5 participants to determine the efficacy of a massage treatment

14. This section of a research article analyzes the data gathered and outcomes:

A: Introduction

B: References

C: Methods

D: Results

15. This section of a research article interprets the meaning of results, explains their implications, provides links to other research, and draws conclusions:

A: Introduction

B: Abstract

C: Discussion

D: Methods

16. The ability to recognize when information is needed and have the skills to locate, evaluate, and use the needed information effectively is called:

A: Research literacy

B: Deductive reasoning

C: Inductive reasoning

D: Applied theory

17. A study that demonstrates a relationship or lack of relationship between two variables is called:

A: Correlation study

B: Case-control study

C: Case series

D: Case report

18. A study that describes the outcome from the treatment of one client or patient is called a:

A: Meta-analysis

B: Case report

C: Clinical trial

D: Correlation study

19. Using randomization and controls in its design, a study that compares a treatment to one with a placebo (inactive treatment), to another treatment, or to standard treatment to establish safety and efficacy is called:

A: Case report

B: Case series

C: Case-control study

D: Clinical trial

20. Alternative healing methods used to supplement conventional medicine to address a condition or disease is called:

A: Complementary medicine

B: Alternative medicine

C: Reliable evidence medicine

D: Touch research

21. A study that examines the health histories of similar people with and without a particular condition to identify risk factors for the condition is called a:

A: Meta-analysis

B: Case-control study

C: Case report

D: Case series

22. A study that analyzes and summarizes published literature on a particular question or treatment is called:

A: Case-control study

B: Clinical trial

C: Systematic review

D: Correlation study

23. In the scientific method, bias means:

A: The unreliable way in which people observe phenomena

B: The use of an inactive treatment

C: The way in which people are selected for research groups

D: The reliable way in which people observe phenomena

24. A study that performs a systematic review using defined statistical methods to combine the findings of several primary studies is called:

A: Correlation study

B: Clinical trial

C: Case report

D: Meta-analysis

25. A careful study that is done to find and report new knowledge about something is:

A: Premise

B: Theory

C: Outcome

D: Research

Practice Quiz Answer Key

1. D

2. B

3. B

4. B

5. A

6. A

7. B

8. D

9. D

10. A

11. C

12. B

13. B

14. D

15. Chttps://www.abmp.com/examcoach/app/subjects/massage-theory/research-literacy/quiz/review

16. A

17. A

18. B

19. D

20. A

21. B

22. C

23. A

24. D

25. D

Benefits and Effects

Terminology

Anxiety - A feeling of worry, nervousness, and unease.

Benefit - A good effect that promotes well-being.

Body-mind effect - Refers to the belief that massage affects the body both physiologically and psychologically.

Combined effect - An effect that occurs because of two or more therapies used in combination.

Cumulative effect - The belief that regular massage leads to improved health over time.

Depression - A state of sadness, hopelessness, and despair, usually felt over a period of time

Energetic effect - An effect that occurs on the subtle energy system of the body.

Gate control theory - Theory that points to a "gating mechanism" of the spinal cord, where nerve fibers carrying somatic stimuli (such as that provided by massage techniques) can "close the gate" to dull, aching pain.

Indication - A piece of information that points to the usefulness of a treatment or action.

Insomnia - An inability to fall asleep, stay asleep, or to experience restful, continuous sleep.

Long-term effect - An effect that continues for a long period of time.

Mechanical effect - An effect from direct manipulation of a client's tissue.

Mental clarity - A state of psychological lucidity that gives a person the ability to read reality accurately.

Pain - A signal that alerts the central nervous system to damage being done to the body's tissues.

Pain management - A treatment that focuses on the reduction or elimination of pain.

Pain-spasm-pain cycle theory - A persistent cycle in which pain triggers muscle spasms, which then trigger more pain response.

Parasympathetic nervous system response - A response of the nervous system that allows the body to rest and recover.

Physiological effect - An effect that occurs in the body.

Primary effect - The first effect to occur in the tissue, organ, or system.

Psychological effect - An effect that occurs in the mind and/or emotions.

Reflexive effect - An effect from an indirect response of the client's nervous system.

Secondary effect - An effect that occurs as a result of the primary effect.

Short-term effect - An effect that only lasts a short period of time, usually a few days.

Somatic reflex - A reflex that involves skeletal muscle contraction in response to stimuli from the somatic nervous system.

Stress - Any event that threatens homeostasis and causes the fight-or-flight response.

Stress management - Treatments or actions that reduce stressful stimuli and promote well-being and relaxation in the mind and body.

Stretch reflex - A reflex that prevents a muscle from being overstretched, and sets muscle tone by monitoring the amount of stretch placed on a muscle.

Structural effect - An effect that occurs in the structures of the body.

Systemic effect - An effect that influences the whole body as opposed to one local region; often related to effects on the nervous or circulatory system, or because of changes to the body’s chemistry and metabolism.

Tendon reflex - A reflex monitored by Golgi tendon organs that prevent muscles from overcontracting and causing tendon injury.

Practice Quiz

1. This chemical causes local blood vessels to dilate, thus increasing local circulation when it is released.

A:Serotonin

B:Cortisol

C:Histamine

D:Adrenaline

2. Reflexive effects from massage occur from:

A:The direct manipulation of the client's nervous system through trigger-point work

B:A voluntary response of the nervous system

C:The indirect manipulation of the client's nervous system through trigger-point work

D:An involuntary response of the nervous system

3. This type of massage stroke stops the flow of blood, building temporary pressure that, when released, results in stronger circulation and warming of soft tissues:

A:Compression

B:Effleurage

C:Tapotement

D:Friction

4. Massage has been shown to stimulate more rapid and elaborate development of this part of the brain, which is related to memory:

A:Pituitary gland

B:Hippocampus

C:Pineal gland

D:Hypothalamus

5. Physical changes that improve the health of soft tissues in the body are referred to as:

A:Systemic effects

B:Structural effects

C:Psychological effects

D:Nerve effects

6. Massage can reduce stress by regulating the body’s wake and sleep cycles, also known as:

A:Oscillation

B:Circadian rhythm

C:Cyclic rhythm

D:Homeostasis

7. Mechanical effects from massage occur from:

A:The direct manipulation of the client's tissue by the therapist's hands

B:The indirect manipulation of the client's electromagnetic field by the therapist's intent

C:The indirect manipulation of the client's tissue by use of massage tools

D:The direct manipulation of the client's electromagnetic field by the therapist's intent

8. An "effect" in massage is best described as:

A:The result or consequence of a thought pattern

B:The result or consequence of an action

C:The result or consequence of an area of caution

D:The result or consequence of a contraindication

9. The application of cross-fiber friction and with-fiber friction to scar tissue is designed to cause:

A:A psychological effect of massage

B:A systemic effect of massage

C:An energetic effect of massage

D:A physiological effect of massage

10. Massage has been shown to DECREASE this type of brain wave, thus stimulating greater relaxation:

A:Alpha

B:Beta

C:Theta

D:Delta

11. Studies have documented the positive effect massage has on these brain waves, associated with deep relaxation and sleep.

A:Theta

B:Alpha

C:Delta

D:Beta

12. Massage can help reduce feelings of anxiety commonly associated with hyperstimulation of this branch of the autonomic nervous system:

A:Peripheral

B:Motor

C:Parasympathetic

D:Sympathetic

13. By inducing this type of nervous system response, massage promotes relaxation.

A:Parasympathetic

B:Sympathetic

C:Somatic

D:Motor

14. Combined effects of massage refer to:

A:Effects that occur because two or more therapies are used together (e.g., massage and a hot pack)

B:Effects that occur when massage is paired with specific medications (e.g., massage and heart medications)

C:Effects that occur when two or more strokes are used at one time (e.g., effleurage and petrissage)

D:Effects that occur when massage is paired with psychotherapy (e.g., massage and hypnosis)

15. The nervous system branch that is responsible for slowing the heart rate, increasing digestive activity, and encouraging rest is the:

A:Sympathetic nervous system

B:Motor nervous system

C:Sensory nervous system

D:Parasympathetic nervous system

16. The movement of the therapist's hands over the skin desquamates dead skin cells. This is a physiological effect of massage on the:

A:Muscular system

B:Nervous system

C:Endocrine system

D:Integumentary system

17. Anxiety is defined as:

A:An endocrine condition that leads to an imbalance in hormone levels

B:Flashbacks from past events that are stressful

C:Fear or nervousness about what might happen

D:A muscular condition that leads to shortness of breath

18. Which of the following is an effect of massage on the respiratory system?

A:Reduces spread of lung cancer

B:Increases respiration rate

C:Slows respiration rate

D:Reduces lung damage from heavy metals

19. Systemic effects of massage are:

A:Effects that cause the nervous system to become hyperactive, and lead to homeostatic shifts at a cellular level

B:Effects that cause changes to the entire skeletal system and thereby influence muscular length and tone

C:Effects that cause reflexes to fire and change the resting length of muscles

D:Effects that cause changes to the body's chemistry, circulation, metabolism, and nervous system

20. The increase in serotonin production stimulated by massage is linked to a DECREASE in symptoms of depression and:

A:Injury

B:Sleep

C:Stress

D:Memory

21.

22.

Practice Quiz Answer Key

1. C

2. D

3. A

4. B

5. B

6. B

7. A

8. B

9. D

10. B

11. C

12. D

13. A

14. A

15. D

16. D

17. C

18. C

19. D

20. C

21.

22.

Cautions and Contraindications

Terminology

Absolute contraindication - A situation, such as a significant fever, vomiting, a cold, etc., in which a client should not receive massage at all.

Acute inflammation - Initial inflammation in response to injury, usually described as inflammation within the first 48–72 hours of injury.

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

Advanced understanding/special training - Continued education or training that enables a therapist to work with clients with specific conditions.

American Red Cross - A national organization that aims to alleviate human suffering by means of various health, safety, and disaster relief programs.

Analgesic - A substance that has a pain-relieving effect.

Anti-inflammatory - Medications that reduce inflammation in the body.

Anticoagulant - Medications that reduce the ability of the blood to clot.

Antidepressant - Medications designed to reduce symptoms of depression.

Antidiabetic medications - Insulin and other medications designed to either lower or raise glucose levels depending on the type of diabetes.

Automated external defibrillator (AED) - A portable electronic device used to identify a life-threatening abnormality in cardiac rhythm, and which stops the heart (defibrillation) and resets it to a normal rhythm.

Blood vessel - An elastic tubular channel, such as an artery or vein, through which blood circulates.

Bony prominence - Projections of bones that protrude beyond the otherwise smooth contours of the body.

Cancer - A condition in which abnormal cells divide excessively and are able to invade other tissues.

Cardiopulmonary resuscitation (CPR) - An emergency procedure performed when a person's breathing and heart have stopped, comprised of manual compressions to the thoracic cavity and breathing assistance.

Caution - A condition that requires some adaptation to massage pressure or technique.

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.

Conscious choking - A condition in which a person is choking but still conscious.

Contraindication - Client conditions that render certain techniques or massage treatments inadvisable.

Diabetes - A group of related diseases that result in elevated levels of blood sugar.

Drug - A medicine or other substance which has a physiological or psychological effect when introduced into the body.

Drug reference - A document that lists common drugs along with their indications, side effects, and other cautions.

Edema - Swelling caused by an excess of fluids in the tissues of the body.

Endangerment area - Regions of the body where delicate structures are superficial and unprotected and thus merit caution with massage strokes.

Fever - An elevated body temperature (thought to be significant in adults when elevated above 100 degrees F).

First aid - Help given to a sick or injured person before professional medical help is available.

General contraindication - A condition that affects the entire body, such as the flu, for which a client should not receive massage.

Health history form - A document that clients complete before their first session that provides personal contact information, current health conditions, medications, past health conditions, and health-related goals.

High blood pressure - A blood pressure reading that is consistently over 140 mm Hg systolic and 90 mm Hg diastolic.

Local contraindication - A condition, such as a broken bone, for which a client should not receive massage in that area but can still receive massage in other areas.

Low blood pressure - A blood pressure reading that is lower than 90 mm Hg systolic and 60 mm Hg diastolic.

Lymph nodes - Small bodies along lymphatic vessels that filter waste from the lymph fluid.

Muscle relaxant medications - Medications that reduce muscle spasms and muscle pain.

Nausea - A feeling of unease or discomfort in the upper stomach, with an inclination to vomit.

Nerve - A fiber that transmits information between the central nervous system (brain and spinal cord) and the rest of the body.

Older adult - An elderly person; generally those older than 60 or 65.

Osteoporsis - A medical condition in which bones become brittle and fragile due to degeneration of tissue.

Over-the-counter medications - Medication that can be purchased without a prescription by the general population.

Pharmacology - The scientific study of pharmacological drugs.

Physician's release - A written document produced by a physician clearing a client to receive a treatment like massage.

Prescription medications - A medication prescribed by a physician to treat a diagnosed disease or condition.

Rescue breathing - A collection of procedures designed to assist someone who has stopped breathing by forcing air into the person's lungs.

Severe bleeding - The loss of a large amount of blood from the circulatory system, including internal bleeding.

Side effect - A secondary effect of a medication or therapy that goes beyond the desired effect.

Skin conditions - Any abnormal condition of the skin requiring caution or contraindicating massage for the client.

Steroids - Medications that suppress immune system responses and decrease inflammation.

Stroke - A condition in which blood supply, and thus oxygen, to the brain is interrupted or reduced, resulting in tissue death within minutes.

Supplement - Refers to vitamin, mineral, or other nutrients designed to supplement dietary nutrition.

Surgery - The treatment of an injury or disorder involving incision with instruments.

Unconscious choking - A condition in which a person is choking, is not conscious (indicating significant oxygen depletion), and whose chest does not rise with rescue breaths.

Vein - Structures that carry deoxygenated blood from the tissues of the body back to the heart.

Practice Quiz

1. The clavicles, sternocleidomastoid muscles, and the trapezius muscles define the:

A: Anterior triangle endangerment areas

B: Popliteal triangle endangerment area

C: Posterior triangle endangerment areas

D: Femoral triangle endangerment area

2. If the client has an absolute contraindication, he or she should:

A: Not receive massage until a physician's release is obtained

B: Not receive massage

C: Receive a shortened massage that lasts no longer than 30 minutes

D: Receive a massage only on the proximal regions of the body

3. If you block an artery with a massage stroke in the anterior region of the client's neck, it can lead to feelings of:

A: Discomfort, panic, or loss of consciousness

B: Pain and throbbing in the hands

C: Discomfort and panic, but clients do not lose consciousness no matter how long pressure is applied

D: Pain and throbbing in the feet

4. The neck can be divided into four triangular endangerment areas. These areas are:

A: Two lymphatic zones and two muscle zones

B: Two sternocleidomastoid zones and two mandible zones

C: Two anterior triangles, a posterior triangle, and a posterior zero point

D: Two anterior triangles and two posterior triangles

5. Older adult clients often:

A: Experience greater side effects from medications than younger clients, and may require session adaptations as a result

B: Experience fewer side effects from medications than younger clients, because their systems do not process medications as effectively; they don't require session adaptations related to medications

C: Experience extreme side effects from medications. As a result, older adult clients on medications are contraindicated for massage

D: Require a physician's release whenever they are taking medications

6. A client with a common cold who seeks massage five days after symptoms presented themselves:

A: Must obtain a physician's release before he/she can receive massage

B: Is contraindicated for massage

C: Is no longer contagious and can receive massage

D: Can receive massage so long as he/she has started antibiotics

7. A sudden onset headache with associated neck stiffness, a fever, and possible slurred speech is:

A: A cervical contraindication (massage the face but not the cervical region)

B: A local indication (only massage the face, head, and cervical region)

C: An absolute contraindication

D: A local contraindication (avoid the face)

8. Deep compression of a nerve by a massage stroke can:

A: Cause appropriate stretching of the nerve to increase motor firing rates

B: Cause appropriate reduction in muscle tissue using the nerve reflex

C: Cause pain, numbness, tingling, and discomfort

D: Cause increased edema in a region

9. If a client is seeking massage for relaxation but presents with a swollen knee from a skiing accident, the practitioner would:

A: Provide massage to the client with extra focus on the knee and the areas surrounding the knee

B: Provide massage to appropriate areas of the body but avoid the knee and the area proximal to the swelling

C: Provide massage to appropriate areas of the body but avoid the knee and the area distal to the swelling

D: Explain to the client that he/she is contraindicated for massage

10. The collection of nerves that innervates the upper extremity is the:

A: Median plexus

B: Brachial plexus

C: Ulnar plexus

D: Deltoid plexus

11. Endangerment areas are:

A: Massage establishments where massage is practiced illegally

B: An injury site most often contraindicated for massage

C: Regions of the body where massage could cause adverse reactions due to somatic reflexes

D: Regions of the body where delicate structures are superficial and may be damaged by techniques applied too forcefully

12. A secondary effect of a medication or therapy that goes beyond the desired effect, or causes unwanted responses in addition to the therapeutic effect, is a(n):

A: Adverse effect

B: Side effect

C: Placebo effect

D: Contraindication

13. The femoral triangle is defined by:

A: The inguinal ligament, sartorius, and adductor longus

B: The inguinal ligament, gastrocnemius, and biceps femoris

C: The gastrocnemius, biceps femoris, and adductor longus

D: The sartorius, adductor longus, and gastrocnemius

14. A structure that requires caution in the posterior triangle of the neck is the:

A: Brachial plexus

B: Internal jugular vein

C: Carotid artery

D: Trachea

15. A structure that requires caution in the posterior triangle of the neck is the:

A: Carotid artery

B: External jugular vein

C: Trachea

D: Internal jugular vein

16. A client with mild depression:

A: Must obtain a physician's release before he/she can receive massage

B: Is contraindicated for massage

C: Can only receive massage from a practitioner with specialized training

D: Is indicated for massage

17. If a client reports pain, numbness, or tingling when a massage stroke is applied to a region, the practitioner:

A: Deepen the stroke because temporary numbness, tingling, or pain is a sign that the techniques are working

B: Communicate with the client about breathing and therapeutic pain

C: Should immediately lighten the pressure to prevent irritation to superficial nerves

D: Should maintain the same pressure but encourage the client to breathe, facilitating proper therapeutic change

18. If a client has a rash on her lower leg, this is an example of a(n):

A: Local contraindication

B: Extreme contraindication

C: General contraindication

D: Absolute contraindication

19. Antianginal medications may cause:

A: Peripheral neuropathy that contraindicates massage for this client

B: Peripheral neuropathy that contraindicates massage to the extremities

C: Low blood pressure and dizziness at the end of the massage

D: High blood pressure and hyperactivity at the end of the massage

20. A client reports she has a slight fever with sinus headache pain and pressure around the eyes, cheeks, and forehead. This is:

A: A local indication (only massage the face, head, and cervical region)

B: Require a physician's release

C: A local contraindication (avoid the face)

D: An absolute contraindication

21. A client with pinkeye is:

A: Contraindicated for massage of the neck and face

B: Contraindicated for massage for 24 hours

C: Contraindicated for massage

D: Contraindicated for massage without a note from a physician

22. An organ that is unprotected and requires caution when applying certain massage techniques to the back is/are the:

A: Kidneys

B: Trachea

C: Liver

D: Lymph node

23. Acute rheumatoid arthritis:

A: Is contraindicated for massage

B: Is indicated for massage

C: Is a local contraindication

D: Is a condition that requires a physician's release

24. An acute, systemic condition is defined as:

A: A condition that influences the client's response to hot and cold. Massage is OK, but hydrotherapy is contraindicated

B: A condition that affects the nervous system

C: A condition that affects the entire body and not just one local region

D: A condition that affects the immune system and causes the client to pick up diseases more easily

25. Osteoarthritis is:

A: A condition related to the wear and tear of a synovial joint's structure

B: A condition related to the wear and tear of a gliding joint's structure

C: A condition related to the wear and tear of a suture's structure

D: A condition related to the wear and tear of the temporomandibular joint's structure

26. Clients taking over-the-counter medications like antalgics, or allergy medication:

A: Are not contraindicated for massage, do not require a physician's release, and do not require session adaptations to receive massage

B: May require session adaptations to ensure the massage is safe for the client

C: Usually require a physician's release to receive massage

D: Are contraindicated for massage until they have been medication-free for 24 hours

27. Anticoagulant medications may cause:

A: The client to bruise more easily in response to massage

B: The client to faint more easily at the end of the massage

C: The client to experience hot flashes and the need for better ventilation in the session room

D: The client to experience numbness and the need for deeper work to "feel" the massage

28. Older adult clients often:

A: Experience greater side effects from medications than younger clients, and may require session adaptations as a result

B: Require a physician's release whenever they are taking medications

C: Experience extreme side effects from medications. As a result, older adult clients on medications are contraindicated for massage

D: Experience fewer side effects from medications than younger clients, because their systems do not process medications as effectively; they don't require session adaptations related to medications

Practice Quiz Answer Key

1. C

2. B

3. A

4. D

5. A

6. C

7. C

8. C

9. C

10. B

11. D

12. B

13. A

14. A

15. B

16. D

17. C

18. A

19. C

20. D

21. C

22. A

23. A

24. C

25. A

26. B

27. A

28. A