Chapter 5: Client Examination for Massage Outcome-Based Massage: From Evidence to Practice

Chapter 5: Client Examination for Massage

Chapter 5: Client Examination for Massage

Outcome-Based Massage: From Evidence to Practice

Outcome-Based Massage: From Evidence to Practice © 2009 LWW

ObjectivesObjectives

At the end of this presentation, you will have the information needed to:

• Describe the unique elements of a client examination for massage

• Discuss how to perform palpation

• Identify the impairments that can be assessed using palpation

• Describe a variety of nonpalpatory approaches to assessing the impairments that are relevant to massage


Focus of the Client Examination for Massage Focus of the Client Examination for Massage

1. Treatment of Impairments Resulting from Medical Conditions

• Identification of:

– Soft tissue dysfunction related to the client’s clinical condition

– Other primary and secondary impairments that therapists can treat with massage techniques

– Functional limitations associated with the client’s impairments


Focus of the Client Examination for Massage Focus of the Client Examination for Massage

2. Wellness Interventions

• Identification of:

– Body structures and functions for client’s wellness goals that therapists can treat with massage techniques


Relevant Clinical Outcomes for MassageRelevant Clinical Outcomes for Massage

• See Table 5-1 in Chapter 5.


Issues in a Client History That Suggest Soft Tissue Dysfunction Issues in a Client History That Suggest Soft Tissue Dysfunction


Using Palpation in the Client Examination Using Palpation in the Client Examination

• Objects of Palpation

• Contact Surfaces Used for Palpation

• Force of Palpation

• Rate of Palpation

• Pressure of Palpation

• Direction of Palpation

• Duration of Palpation

• Integration of Information from Other Senses


Assessing Objects of PalpationAssessing Objects of Palpation

• Temperature

• Contour and Bulk

• Texture and Consistency

• Fluid Status

• Palpating Soft Tissue Layers (“Layer Palpation”)


Tissue LayersTissue Layers


Tissue LayersTissue Layers

• Skin: epithelium, epidermis, and dermis

• Superficial fascia: deep to skin, houses fat and water, provides a path for nerves and vessels, and sometimes contains striated muscle

• Deep fascia: dense connective tissue that lies between the superficial fascia and muscle

• Muscle

• Periosteum


Tissue Mobility and Restrictive Barriers: Normal Range of MotionTissue Mobility and Restrictive Barriers: Normal Range of Motion


Tissue Mobility and Restrictive Barriers: Restrictive BarriersTissue Mobility and Restrictive Barriers: Restrictive Barriers


Barrier-Release PhenomenonBarrier-Release Phenomenon

• Tissue barrier: the point at which therapists palpate a resistance to tissue motion.

• If therapists sustain the pressure on the tissue barrier, a “release” may occur after a latency period.

• Latency period varies with the nature of the tissue and its state of health.

• Release results in a reduction of the resistance that enables therapists to move the tissue beyond the original barrier without increasing the pressure of palpation.


Selected Impairments Evaluated through Palpation Selected Impairments Evaluated through Palpation


Examples of Outcomes and Examination Techniques for Massage Examples of Outcomes and Examination Techniques for Massage

• See Table 5-1 in Chapter 5.


ReferencesReferences

• The references for the material in this PowerPoint presentation are found in Chapter 5: Client Examination for Massage.

Documents

Chapter 5: Client Examination for Massage Outcome-Based Massage: From Evidence to Practice