Textbook of Remedial Massage

Preface

Acknowledgements

Foreword

Contributors

Reviewers

1. Remedial massage in Australian healthcare

Defining remedial massage

The context of remedial massage: use of complementary and alternative medicine in Australian healthcare

The remedial massage workforce in Australia

Attitudes towards CAM by medical and other healthcare practitioners

Evidence for remedial massage practice

Evidence for the effectiveness of massage therapy

Future directions

Appendix 1.1: Massage therapy: systematic reviews

References

2. Assessment procedures for remedial massage: an evidence-based approach 

Introduction

Principles of assessment in remedial massage practice

Purpose of assessments

Demonstrating treatment effectiveness

Assessment procedures

Client history

Outcome measures

Postural analysis

Gait analysis

Functional tests

Palpation

Legal and ethical requirements for remedial

massage assessment

Key messages

Review questions

Appendix 2.1: Skin cancer

References

Contents

3. Planning remedial massage therapy

Introduction

Principles of treatment

Prioritising client safety

Swedish massage before remedial massage

Active movements before passive

Treating within pain tolerance

Overview of a remedial massage treatment approach

Short- and long-term treatment plans

Client education and self-help

Clients preferences

Treatment protocols

Aligning treatment to assessment findings

Monitoring and reviewing treatment plans

Recording remedial massage treatments

Key messages

Review questions

References

4. Remedial massage techniques for muscles

Introduction

Assessing muscle function

Functional defi cit demonstration

Postural assessment

Testing muscles for length

Testing muscles for strength

Palpation

Remedial massage techniques

Deep gliding (with-fi bre) frictions and cross-fibre frictions

Deep transverse friction (DTF)

Soft tissue release (STR)

Key messages

Review questions

References

5. Muscle stretching

Introduction

Functional anatomy

Tissue range of motion

Muscle functions

Types of muscle contractions

CONTENTS

vi

Physical characteristics and neurological refl exesassociated with stretching

Active and passive insuffi ciency

Neurological events that mediate stretching

Types of muscle stretching

1. Passive stretch

2. Active, active-assisted stretch

3. Muscle energy technique

4. Active isolated stretch

5. Ballistic stretch

6. Dynamic stretch

7. Static stretch

8. Proprioceptive Neuromuscular Facilitation

Stretching treatment goals

Assessing clients suitability

History

Postural analysis

Gait analysis

Functional tests

Palpation

Evidence for effectiveness

Contraindications and precautions

Applying muscle stretching in remedial massage

Adapting stretches for individual clients

Therapists position

Recommendations

Muscle stretching in practice

Review questions

References

6. Myofascial trigger points

Introduction

What is a trigger point?

Locating trigger points

Classifying trigger points

Active and latent trigger points

What causes trigger points?

Identifying trigger points

Characteristics of trigger points

Treating trigger points

Manual techniques

Evidence-base of treatments for trigger points

Contraindications and precautions

Key messages

Review questions

Appendix 6.1: Some key trigger points

References

7. Joint articulation

Introduction

What is joint articulation?

Evidence for the effectiveness of joint articulation and mobilisation

Assessing clients for treatment

History

Functional tests

Palpation

Treating clients

Guidelines

Techniques

Contraindications

Key messages

Review questions

References

8. Myofascial release

Introduction

Functional anatomy review

What is myofascial release?

Assessing clients

History

Postural analysis

Functional tests

Palpation

Treating clients

Evidence for the effectiveness of fascial releasing techniques

Applying the techniques

Integrating myofascial releasing techniques with remedial massage

Contraindications and precautions

Key messages

Review questions

References

9. Lymphatic drainage massage

Introduction

Evidence for the effectiveness of lymphatic drainage massage

Functional anatomy review

Function of the lymphatic system

Oedema

Assessing clients

History

Red fl ag conditions for oedema

Postural analysis

Functional tests

CONTENTS

vii

Palpation 128

Differential diagnosis 128

Treating clients 129

Basic principles 129

Length of treatment 129

Explanation of treatment 129

Regional lymphatic drainage massage 131

Contraindications and precautions 135

Absolute contraindications 136

Relative contraindications 136

Local contraindications 136

Review questions 137

References 137

10. The low back and pelvis 138

Introduction 138

Functional anatomy review 138

Assessment of the lumbar and sacroiliac

region 139

Case history 140

Outcome measures 143

Postural analysis 143

Gait assessment 144

Functional tests 144

Palpation 151

Remedial massage treatment 152

Muscle strain 153

Non-specifi c low back pain 153

Degenerative joint disease (Osteoarthritis/

Degenerative arthritis) 161

Lower crossed syndrome 163

Lumbar disc syndrome 164

Spondylolisthesis 166

Sacroiliac syndrome 168

Key messages 171

Appendix 10.1: McKenzie self-treatments for

sciatica 171

Review questions 172

References 172

11. The thoracic region 173

Introduction 173

Functional anatomy review 173

Typical vertebrae - T2-T8 173

Special features of T1 and T9-12 173

Assessment 174

Case history 176

Outcome measures 176

Postural analysis 176

Gait analysis 176

Functional tests 176

Palpation 182

Remedial massage treatment 182

Muscle strain 182

Thoracic facet syndrome 183

Degenerative joint disease (Osteoarthritis/

Degenerative arthritis) 189

Hyperkyphosis of the upper thoracic spine

(Dowagers hump) 191

Scheuermanns disease (Vertebral

epiphysitis) 192

Osteoporosis 193

Scoliosis 194

Thoracic outlet syndrome (Anterior scalene

syndrome) 197

Key messages 198

Review questions 198

References 199

12. The cervical region 200

Introduction 200

Functional anatomy review 200

Assessment 201

Case history 201

Outcome measures 203

Postural analysis 203

Functional tests 204

Palpation 210

Remedial massage treatment 210

Muscle strain 211

Non-specifi c neck pain (including cervical

sprain, strain and vertebral subluxation) 211

Degenerative joint disease (Osteoarthritis/

Degenerative arthritis) 217

Upper crossed syndrome 218

Mechanical/acquired torticollis 220

Cervical disc syndrome 221

Whiplash (acceleration/deceleration) associated

disorders 222

Key messages 224

Review questions 224

References 225

13. The head and face 226

Introduction 226

Headache 226

Assessment of the headache client 226

Remedial massage treatment for headache 231

CONTENTS

viii

Sinusitis 233

Assessment of the client with sinus pain 234

Remedial massage treatment for sinusitis 235

Temporomandibular joint disorders 238

Disorders of the temporomandibular joint 238

Assessment of the client with TMJ

disorder 238

Remedial massage treatments for TMJ

disorders 240

Key messages 241

Headache 241

Sinusitis 241

Temporomandibular joint 241

Review questions 242

Appendix 13.1: MIDAS (The Migraine Disability

Assessment Test) 242

References 243

14. The chest 244

Introduction 244

Functional anatomy review 244

Assessment 246

Case history 246

Outcome measures 247

Postural analysis 247

Functional tests 247

Palpation 250

Remedial massage treatment 250

Muscle strain 250

Rib subluxation/fracture 251

Respiratory conditions 254

Key messages 259

Review questions 260

References 260

15. The shoulder region 261

Introduction 261

Functional anatomy 261

Assessment 261

Case history 262

Outcome measures 264

Postural analysis 264

Functional tests 264

Palpation 269

Remedial massage treatment 271

Overview 272

Muscle strain 272

Shoulder impingement syndrome 282

Degenerative joint disease (Degenerative

arthritis, osteoarthritis) 283

Adhesive capsulitis (frozen shoulder) 284

Acromioclavicular sprains, clavicle fractures and

glenohumeral dislocations 285

Key messages 286

Review questions 286

Appendix 15.1: Shoulder Pain and Disability

Index 287

References 288

16. The elbow region 289

Introduction 289

Functional anatomy 289

Assessing the elbow and forearm 290

Case history 291

Outcome measures 291

Postural analysis 295

Functional tests 296

Palpation 300

Remedial massage treatment 301

Overview 301

Muscle strain 301

Olecranon bursitis 308

Elbow sprain 308

Fractures and dislocations 308

Key messages 308

Review questions 309

References 309

17. The wrist and hand 310

Introduction 310

Functional anatomy 310

Assessment 311

Case history 311

Outcome measures 314

Postural analysis 314

Functional tests 319

Palpation 325

Remedial massage treatment 326

Overview 326

Tendinitis and tenosynovitis 326

De Quervains tenosynovitis 327

Carpal tunnel syndrome 330

Sprains 332

Fractures and dislocations 333

Degenerative joint disease and rheumatoid

arthritis 334

CONTENTS

ix

Key messages 335

Review questions 335

References 335

18. The hip region 337

Introduction 337

Functional anatomy 337

Assessment 338

Case history 340

Outcome measures 341

Postural analysis 341

Gait analysis 341

Functional tests 341

Palpation 345

Remedial massage treatment 347

Overview 347

Muscle strain 348

Degenerative joint disease (Degenerative

arthritis, osteoarthritis) 353

Trochanteric bursitis 354

Key messages 355

Review questions 355

References 356

19. The knee 357

Introduction 357

Functional anatomy 357

Assessment 360

Case history 360

Outcome measures 362

Postural analysis 362

Gait analysis 362

Functional tests 362

Palpation 367

Remedial massage treatment 368

Overview 368

Muscle strain 369

Iliotibial band syndrome 370

Patellofemoral pain syndrome 373

Chondromalacia patella 374

Patella dislocation 375

Ligament sprain 375

Meniscal injury 377

Degenerative joint disease (Degenerative

arthritis, osteoarthritis) 377

Bursitis 379

Osgood-Schlatters disease 379

Key messages 379

Review questions 380

References 380

20. The leg, ankle and foot 382

Introduction 382

Deep venous thrombosis 382

Functional anatomy 382

Nerve supply to muscles of the leg, ankle and

foot 384

Assessment 384

Case history 386

Outcome measures 387

Postural analysis 388

Gait analysis 389

Functional tests 389

Palpation 396

Remedial massage treatment 398

Overview 398

Leg 398

Muscle strains of the leg 398

Gastrocnemius strain (tennis leg) 398

Shin splints 399

Chronic compartment syndrome 405

Stress fracture of the tibia 407

Varicose veins and spider veins 407

Ankle 407

Achilles tendinopathy 408

Calcaneal bursitis 409

Severs disease 409

Ankle sprain 409

Degenerative joint disease of the ankle 411

Foot 411

Plantar fasciitis (heel spur) 412

Forefoot 413

Metatarsalgia 413

Mortons neuroma (Interdigital

neuroma) 413

Key messages 413

Review questions 414

References 414

21. Specifi c client groups 415

Introduction 415

Children and adolescents 415

Important considerations for assessing and

treating children 415

Evidence for the effectiveness of massage for

children 417

CONTENTS

x

Women 418

Important considerations for assessing and

treating women 418

Evidence for the effectiveness of massage for

womens health 418

Men 419

Important considerations for assessing and

treating men 419

Geriatric clients 419

Important considerations for assessing and

treating geriatric clients 420

Evidence for the effectiveness of massage for

older clients 420

Clients with a mental illness 420

Important considerations for assessing

and treating clients with a mental

illness 420

Evidence for the effectiveness of massage for

clients with a mental illness 421

Key messages 421

Review questions 422

References 422

Index 424