Medical Massage

5/2/23

The fundamental distinction between medical massage and other forms of bodywork is the fact that medical massage is performed only on people with diseases diagnosed by a doctor or chiropractor.

The goal of medical massage is to apply therapeutic impact on parts, systems and organs of the body using direct (local) and indirect (reflex) methods of treatment.

Thus, medical massage is a method of treatment with the same goals as any other medical procedure.

Must first understand and recognize:

- Indications/ Contraindications

- Injury

- Disease processes

- Abnormal function

No lubricant is used unless classical massage techniques are part of the treatment

Medical massage is restricted to parts of the body related to the pathological process. A full-body massage is not warranted. (Make sure the client understand that they must return consistently to help with their problem)

- requires less than 1hr, generally 40-45mins

- may fluctuate between 30min-1hr

- after first session, wait 1-2 days, you may proceed with 5-15 sessions

- start with Diagnostic Session determining what the client needs

Contraindications

Shock and emergency conditions Sepsis/ high fever Diseases of the blood Tuberculosis Venereal disease in an acute state Inner organ disease Malignant tumors Acute psychosis Stroke Heart Failure Failure Eclampsia

Types of Medical Massage to perform

Migraines TMJ Prenatal Low Back Pain Lymphatic Sciatica Fibromyalgia Plantar Fasciitis

Conditions that benefit from Medical Massage:

Anxiety Athletic injuries Back pain Carpal tunnel Edema Emotional stress Fibromyalgia Headaches Insomnia Migraines Myofascial Pain Neck Pain Osteoarthritis Post-injury rehabilitation Sciatica Sprain/ Strain Joint dysfunction Tendinosis Whiplash

Different types of headaches

Sinus: pain is behind browbone and/or cheekbones

Cluster: pain in/around one eye

Tension: pain is like a bank squeezing the head

Migraine: pain, nausea and visual changes are typical of classic form

Muscles of the Head & Neck (Anatomy Model)

Medical Massage Terminology

Acute - symptoms that develop quickly after a short amount of time

Adhesion - tissues that have abnormally grown together after inflammation

Allopathic Medicine - Mainstream medical practice using pharmacologic agents or physical interventions to treat or suppress diseases or injury (physical therapy, dialysis, x-ray, anything don't medically to correct/ prevent physical ailments); opposite of homeopathic

Anterior - front

Biofeedback - a type of mind-body technique used to control body functions, such as your heart rate, breathing patterns and muscle responses

Chronic - develops slowly and lasts a long time

Distal - towards to the end of a structure; opposite of proximal

Dorsal - back

Edema - swelling/ inflammation of excess interstitial fluid

Endangerment Site - places where careless massage could damage some of the body's most delicate tissues

Hyperemia - increasing oxygen in blood where blood is congested in the body

Hyperextension - straightening or movement that increases the angle between body parts beyond normal positioning; opposite of hyperflexion

Hyperflexion - the bending movement that decreases the angle between body parts beyond normal positioning

Inferior - lower/ below

Inflammation - swelling, heat, redness, pain (your body's way of trying to heal itsself)

Inflammatory response - normal mechanism characterized by pain, heat, redness and swelling, that speeds recovery from infection or injury

Ischemia - lack of blood flow

Lateral - of or towards the side

Medial - towards the middle

Myositis - muscle inflammation as an infection or injury

Neuralgia - a disorder of the cranial nerves

NSAID (non-steroidal inflammatory drugs) -

Neuritis - nerve inflammation

Palliative care - care intended to relieve or reduce the intensity of uncomfortable symptoms but that cannot affect a cure

Posterior - behind

Pronation - rotation of the forearm that moves the palm from an anterior-facing position to a posterior-facing position; opposite of supination

Superior - higher

Supination - when you rotate that palm so that is faces anteriorly

Tendonitis - inflammation of the tendon

TMJ (temporal mandibular joint) - refers to the joint that hinges the mandible to the temporal bone of the skull, in front of the ear on both sides of the head

Vasoconstriction - constriction of blood vessels

Vasodilation - when blood vessels in the body become wider, following the relaxation of the smooth muscles in the vessel wall; reduces blood pressure and is the opposite of vasoconstriction

5/9/23

TMJ - temporomandibular joint

Mandible (lower jaw) joins temporal bone of skull, immediately in front of ear on each side of head. Small cartilage disc separates bones, so that the mandible may slide easily.

Joint is used for chewing, talking, and swallowing; one of the most frequently used joints in body

Locate joint and its movement by feeling triangular structure in front of ear. Then move slightly forwards and press firmly while opening and closing jaw all the way.

There are 2 TMJs: one in front of each ear connecting lower jaw bone to the skull

- Allows movement side to side, up and down, forward and backward

- Dysfunction of TMJ is commonly referred to as "TMJ

(Refer to TMJ packet)

TMJ Anatomy

Temporomandibular joint - articulation between condyle of mandible and squamos portion of temporal bone (insert picture)

Condyle - elliptically shaped with its long axis oriented mediolaterally

The articular surface of temporal bone is composed of concave articular fossa and convex articular eminence (Insert android picture)

Meniscus - fibrous, saddle-shaped structure that separates condyle and temporal bone. Posteriorly, meniscus is contiguous with posterior attachment tissues called 'bilaminar zone'

Bilaminar zone - vascular, innervated tissue that helps condyle move forward

(look for meniscus and condyle articulation picture)

What causes TMJ dysfunction?

- Displacement of cartilage disc that separates TMJ bones causes pressure and stretching of associated sensory nerves.

- Mastication muscles may spasm and not function efficiently, causing pain and tenderness

- Major and minor jaw trauma

- Habitual teeth clenching, gritting, or grinding increases wear on cartilage lining of joint without time for recovery

- Excessive gum chewing

- Teeth that do not fit together properly (improper bit) malpositioned jaws, and arthritis

- Dull aching or sharp searing pain in jaw joint

- May also include ear

- If no pain then patients have problems using jaws

- unable to open mouth comfortably

- Clicking, popping, or grating sounds in jaw joint

- Cartilage disc snapping back into place

- Locking of jaw when attempting to open mouth

- Headaches

- Bite that feels uncomfortable or "off"

- Neck, shoulder, and back pain

- swelling on side of face

TMJ MRI (insert iphone picture of normal/ abnormal TMJ MRI)

• Normal TMJ MRI

Meniscus is posterior and superior to condyle

• Abnormal TMJ MRI

Displaced meniscus is anterior to condyle and auditory canal, beneath articular eminence

Treatment

- moist heat (chronic) or ice (acute) for 10 minutes - jaw stretching exercises - eat soft foods - avoid extreme jaw movements - undergo corrective dental treatments - good posture/ jaw positioning - wear splint or night guard as this prevents upper and lower teeth from coming together, lessening the effects of clenching or grinding teeth

Medications

- nonsteroidal anti-inflammatory drugs (NSAID) (aspirin, ibuprofen) - dentist can prescribe higher doses of NSAIDs or narcotic analgesic - muscle relaxers can help relax tight jaw muscles for patients who grind or clench teeth - anti-anxiety medication can help relieve stress which can aggravate TMJ disease