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MASSAGE
PRATIGYA DEUJA
DEFINITION
 Massage is defined as the scientific manipulation
done with hands on the soft tissues of the body
in order to produce effects on the nervous,
muscular and circulating system to improve
function.
PREPARATION OF MASSAGE
1. SELF PREPARATION: Self preparation by
therapist before contacting the patient.
 Free from hindrance
 Easy clothing
 Avoid jewellery
 Hair tied
 Stretching- to get good grasp
 Walk/lunge standing
Preparation cont.....
2. PREPARATION OF EQUIPMENT AND
ENVIRONMENT:
Ventilation
Adjustable height- towel, couch,
pillow
Contact material: Talcum powder,
olive oil, water based lubricants

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This document discusses interferential therapy (IFT), a type of electrical stimulation treatment. IFT involves applying two medium frequency currents to generate a low frequency interference current in the tissues for therapeutic effects. It provides pain relief and motor stimulation while avoiding skin irritation experienced with other currents. IFT is indicated for various painful conditions and edema and uses specific frequencies for different treatments, like 1-10Hz rhythmic mode for reducing swelling. Precautions include avoiding direct electrode contact and proper placement to ensure current passes through tissues as intended.

iftinterferential therapyindications
Contrast Bath in Physiotherapy SRS
Contrast Bath in Physiotherapy SRS Contrast Bath in Physiotherapy SRS
Contrast Bath in Physiotherapy SRS

Contrast bath therapy involves soaking an injured area in alternating hot and cold water baths to increase blood flow and decrease joint stiffness. The temperature changes from hot to cold and back again produce a "pumping effect" that helps remove swelling through improved venous and lymphatic drainage. A full contrast bath treatment consists of soaking in warm water for 10 minutes, cold water for 1 minute, repeated three times, ending with warm water. Contrast baths can help relieve pain, stiffness and swelling through induced vasodilation and vasoconstriction of blood vessels.

contrast bathphysiotherapy
MWD
MWDMWD
MWD

Microwave diathermy (MWD) uses electromagnetic radiation in the microwave frequency range to generate heat in tissue. MWD uses a magnetron to produce microwaves with frequencies commonly between 300 MHz to 300 GHz. These short wavelength microwaves generate strong electrical fields that cause heating through ionic movements and molecular distortion within tissues. MWD provides superficial heating that is more localized than shortwave diathermy and penetrates deeper than infrared radiation. Key uses of MWD include reducing pain, swelling and muscle spasm in inflammatory conditions like tendinitis as well as accelerating healing for injuries and infections.

Preparation cont……
3. PREPARATION OF PATIENT:
 Proper introduction
 Palpate the area to be massaged so that s/he
gets sensory awareness of your touch.
 Ask patient to undress and cover the part well.
Relaxation position.
Preparation cont…..
4. PALPATION / EXAMINATION OF PATIENT:
 Hands should be relaxed
 Firm contact
 Fine pressure
 Touch should not hurt patient nor create
the tingling sensation.
Look Skin state( dry, hairness, oily,
edema)
Feel Muscle tension
Check Mental condition
CLASSIFICATION
1) Stroking: Stroking, Effleurage
2) Petrissage: Kneading, Picking up, Wringing,
Shaking, Rolling
3) Friction: Circular, Transverse
4) Percussion/tapotment: Clapping, Hacking,
Vibration, Pounding, Beating, Tapping
STROKING
a) Stroking:
 These are unidirectional manipulation in which
operator’s hand pass from proximal to distal.
 2 type of effects: stimulative and sedative
Effects:
 Stimulates CNS and can be used in cases of
depression.
 On scalp stimulate hair follicles which increases
granular activity and increase hair growth.
 Slow and deeply helps in relaxation in HTN,
recent injuries and spasm.

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This document discusses different types of voluntary movements used in physical therapy exercises. It classifies exercises as free, assisted, assisted-resisted, or resisted based on whether they involve gravity, external assistance, or resistance. Free exercises work against gravity alone and are used to improve relaxation, muscle tone, coordination, and confidence. They can help cure or rehabilitate patients, though some patients may be unable to perform them. The document outlines techniques for free exercises and their effects, including improved relaxation, joint mobility, muscle power, neuromuscular coordination, and confidence. It also describes circulatory and respiratory changes that occur with exercise like increased heart rate, blood flow, and respiration to meet tissue needs and regulate functions.

Fluidotherapy
FluidotherapyFluidotherapy
Fluidotherapy

This document summarizes fluidotherapy, a dry heating modality. It transfers heat to the body through convection using a cabinet containing heated air and finely ground cellulose particles. This creates a fluid-like medium allowing limbs to float and exercises to be performed. Key effects include increased blood flow, pain relief and improved range of motion. It is used to treat distal extremities for conditions like pain, swelling and post-operative rehabilitation. Contraindications include fever, anesthesia or severe circulatory issues. Advantages include ease of use and allowing some active exercise in a comfortable, dry environment.

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Cyclotherm
CyclothermCyclotherm
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Cyclotherm is a device that circulates fluid through an applicator to heat or cool the skin surface and vary the temperature between 1-40°C at a rate of 13°C per minute. It can be programmed to apply preset temperatures for predetermined times for therapies like thermotherapy, cryotherapy, and thermal contrast therapy. Heat is used to increase circulation, metabolism, and inflammation/wound healing while decreasing pain and muscle spasm. Cold causes vasoconstriction, lowers metabolic rate, and provides pain relief. Therapies include using heat before stretching/mobilization and cold for acute injuries, pain relief, and reducing inflammation/spasm. Contraindications include vascular diseases and inability to sense

electrotherapyphysiotherapythermal agents
STROKING
b) Effleurage:
 It is unidirectional manipulation.
 Hands pass through distal to proximal with
access of depth performed with palmar surface
of whole hand and in small area can use pulp of
fingers.
 The starting fingers exert the pressure.
STROKING
b) Effleurage:
Effects:
Increase circulation
Edema- increase venous and lymphatic drainage
Deep massage- vasodilation of Artery by
lubrication of H cells.
Improve mobility and elasticity
Reflex sedative effect- Reduce muscle tension
and pain.
PETRISSAGE
a) Kneading: It is a circular manipulation
performed so that the skin and subcutaneous
tissues moved in circular manner. ( whole
kneading, palmar kneading, fingers- flat, tip and
pad, thumb- pad & tip, both hands when one
superimposed on other, elbow kneading, heel or
hand kneading)
 Pressure in following manner:- 4-10 o’clock, 8-
11 o’clock, 6-9 o’clock and 3-6 o’clock
Effects
-Increase blood supply, - decrease tone, -
decrease adhesion, -stretching tight fascia
PETRISSAGE
b) Picking up:
Tissue are compressed within underlying bone,
then lifted, squeezed and relaxed.
 Done with thumb and thenar eminence as one
component and medial 2-3 fingers and
hypothenar eminence as other compartments.
 Grasp can be C-shape, V-shape
Effects
a) Same as kneading
b) Compression and squeeze will increase
drainage.

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A technique which uses water as a therapeutic modality. This therapy is usually used by Physiotherapist for healing wound, edema drainage, improving balance and posture and decreasing pain.

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Wax therapy
Wax therapyWax therapy
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Wax therapy, which uses a bath of molten paraffin wax, is one of the most effective ways of applying heat to improve mobility by warming the connective tissues. Wax therapy is mainly used on your hands along with an exercise program.

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Traction
TractionTraction
Traction

The document discusses different types and methods of traction used in physiotherapy. It defines traction as a mechanical force applied to separate joint structures and stretch surrounding soft tissues. There are four main types of traction: mechanical, self, positional, and manual. Mechanical traction can be further divided into over door cervical traction and electrical traction. The document then covers application techniques for cervical, thoracic, and lumbar traction, highlighting factors like force levels, durations, angles, and positioning. Recommended parameters are provided for initial treatment phases and specific treatment goals for each spinal region.

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PETRISSAGE
c) Wringing:
In this manipulation, tissue are compressed
against the underlying structures prior to lifting
them and once lifted, pull gentle towards yourself
with one hand and other side with the fingers at
other hand.
Alternate movements
 Smaller areas – tips of finger are used.
Effects
To lengthen the muscle.
PETRISSAGE
d) Rolling
 2 Types- skin rolling, muscle rolling
 Skin rolling- Skin is lifted and rolled between the
thumb and finger of the hand which are kept parallel
to each other and thumb moved towards fingers.
 Muscle rolling- working across the muscle fibers and
along the long axis of muscle. Place both hands on
the surface area, move distal from you, palms in full
contact with your thumb tips touching and parallel.
 Pull underlying muscle/skin up apply pressure with
your thumb as you adduct and oppose it with rolling.
Effects : Same as picking
PETRISSAGE
e) Muscle shaking
All long muscle of body is shaken and
manipulation is performed.
 Done on large muscle.
Thumb and finger are placed opposite to each
other on the muscle palm in and off contact.
 Then the hand is shaken front side to side.
Effects
a) Give a sensory response.
FRICTION
These are small range, deep manipulation
performed in specific anatomical structure with
the tips of fingers or thumb, no other part is in
contact.
 2 types: A) circular
B) Transverse

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1. A hydro-collator pack is a fabric envelope containing silica gel or bentonite crystal packs that are heated in a hydro-collator unit to provide moist heat therapy. 2. The hydro-collator unit maintains water at 70-80°C to heat the packs for 30-40 minutes of moist heat application. 3. When applied with adequate toweling insulation, hydro-collator packs provide penetrating heat therapy above 75°C without raising skin temperature excessively, helping to reduce pain, muscle spasm, and inflammation.

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FRICTION
A) Circular
 Performed with finger tips
 Pressure with small stationary manipulation in
circular manner.
 Can be used on ligaments and myofascial
junction.
FRICTION
B) Transverse
The tip of thumb is reinforced by any other tip of
finger. Example: Index finger.
 Place finger across longitudinal axis.
 Perform friction by moving your digit, hand and
forearm in a line parallel to movement.
 Does not allow movement between your finger
and patient’s skin as it can cause pain.
 Use 2 fingers when long structure is altered,
place fingers across the length of collagen.
Uses - Inflammation, scar tissue and adhesion
TAPOTMENT
 These are percussive manipulations where we give
soft blow with hand.
A) Clapping
 Whole palmar aspect of the hand is used to strike
the body parts.
 The hand is cupped so that the center doesn’t
touch the part, it is in hollow position.
 Fingers are slightly flexed, the thumb is adducted.
 The movement of clapping should totally be on the
wrist joint, arm movement should not be done.
Effects – Slow- greater depth
-- Skin stimulator
TAPOTMENT
B) Hacking
 Here, we struck skin with the help of dorsal tips of 3
medial finger.
 The only movement applied to supination and
pronation at radio-ulnar joints.
 Wrist should be in mild extension above 50 degree
and fingers in relaxed flexion. Fingers should be
1.5cm away from eachother.
 10 strikes/5 seconds are initially imported.
Effects
Fastly: effects on circular (skin)
Slow: Mechanical effect on hollow organ.

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This document discusses cold therapy (cryotherapy) for injuries. It describes how applying ice reduces tissue temperature, which causes blood vessels to constrict, reducing swelling and pain. Ice therapy is used to reduce pain, swelling, muscle spasms and promote healing after injuries. The document outlines the physiological effects of cold on blood flow, inflammation and nerve conduction. It provides contraindications for ice therapy and different techniques for application, such as ice towels, packs, immersion and spray.

TAPOTMENT
C) Vibration
It involves movement in which the tissues are
pressed and released using an up and down
motion.
These can be fine and very coarse.
Can be performed by whole hand or finger tips.
Our pectorals should alternatively contracted
relax.
No movements at wrist ,elbow or hand.
TAPOTMENT
D) Beating
 Loosely clenched fist is used for the strike.
 Fingers are flexed at MCP and PIP joints but
extended at DIP joints.
 Thumb is kept flat.
 Abduct Arm– allow the wrist to drop in
relaxation.
TAPOTMENT
E) Pounding
 A bound of hacking with clench fist.
 Fingers flexed and thumb ties at the lateral side
 Pronation / Supination
F) Tapping
 Performed with tips of finger pads.
 Used in small areas.
 Hand is relaxed and fingers tap slowly to
produce hollow hand.
PHYSIOLOGICAL EFFECTS
a) On circulatory system:
 Increase venous flow and lymphatic flow by
increasing forward movement of fluid.
 Increases the arterial flow by stimulating the
mast cells
Histamine releases
Vasodilation
 Increase blood supply increase oxygen
carrying capacity compensation of O₂ demand

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Resistance exercises
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The document defines and describes various aspects of resistance exercises. It discusses types of muscle contractions like isotonic, isometric and eccentric. It explains principles of resistance training like overload and specificity. It describes adaptations to resistance training including neural, muscular and bone changes. Determinants of resistance training programs are outlined including intensity, time, volume and periodization. Guidelines for progressive resistance exercises and precautions are provided.

13.2 Different types of massage techniques.pptx
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This document discusses different types of massage techniques. It describes techniques like effleurage, petrissage, kneading, friction and their application methods. Effleurage involves long, gliding strokes and improves circulation. Petrissage involves lifting and squeezing muscles. Kneading uses circular pressure on muscles and fascia. Friction involves small oscillatory movements on deeper structures. The techniques have effects like improved circulation, reduced edema and adhesions, increased range of motion. They are used to treat conditions like muscle fatigue, injuries and post-surgical scarring.

physiotherapy
PHYSIOLOGICAL EFFECTS
b) On metabolic system
increase blood flow
increase oxygen supply
provide proper nutrition supply to the system
increase venous/lymphatic flow
removal of waste production
increase arterial blood flow & venous drainage
increases various metabolic activities.
PHYSIOLOGICAL EFFECTS
c) Nervous system
I. Sensory system
 Sedative effect with slow rhythm.
 It reduces pain by stimulating A beta, A delta
fibers and bring parasympathetic inhibition.
 Technique: Effleurage, stroking, hacking,
tapping, beating
PHYSIOLOGICAL EFFECTS
ii. Motor system
 May reflexly increases the muscle tone by
stimulating the skin receptors of stretch spindle.
 Stroking, tapping, hacking
 It can reduce tone of muscle if slow stroking is
carried out, activation of GTO– inhibit stretch
reflex.
 Deep rhythmic massage is given.
PHYSIOLOGICAL EFFECTS
iii. ANS
It Influences HR, Cardiac output, BP, RR, Skin
temperature and work of certain glands.
Massage : Increase temperature of skin
: Activates sweat gland
: Increases skin conductance

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The document describes various massage techniques including effleurage/stroking, petrissage, friction, and percussion. Effleurage involves long gliding strokes and is used to initiate and end treatments. Petrissage techniques like kneading, picking up, and wringing compress tissues against underlying structures. Friction restores mobility through localized manipulation. Percussion includes tapping techniques like hacking, clapping, and beating applied with brisk striking actions to stimulate circulation. Each technique is defined and its effects are outlined. Techniques are also classified by grade based on depth of pressure.

Massage therapy (2)
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Massage therapy has a long history dating back thousands of years. It involves manipulating the soft tissues of the body through techniques like effleurage, petrissage, friction, tapotement, and vibration. The physiological effects of massage include relaxation, reduced muscle soreness, decreased anxiety, and increased blood flow. Massage can help reduce pain, swelling, and tension in the muscles and soft tissues.

Mardana chikitsa - Dr Prabhu C N
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This document provides an overview of chikitsa or massage therapy. It discusses the history and origins of massage, defines different types of massage strokes like effleurage, petrissage, friction and tapotement. It outlines the physiological effects of massage on circulation, metabolism, musculature and psychological state. Benefits of massage for conditions affecting muscles, tendons and joints are described. Points for proper massage technique and considerations for the masseur are also reviewed.

mardanamardhana chikitsamassage techniques
PHYSIOLOGICAL EFFECTS
d) Soft tissue
 It effects elasticity, plasticity, and mobility
 It stretches collagen fibers Adhesion broken
and maximum mobility.
 Friction, kneading is used
 Release muscle tension by releasing plasma
myoglobins and working on GTO.
 Relives pain in soft tissue.
 Provides relaxation of soft tissues by increasing
the circulation and fulfilling oxygen demand.
PHYSIOLOGICAL EFFECTS
e) Effect on skin
 Facilitate movement of skin over subcutaneous
structures.
 Skin becomes soften, supple and later makes it
more elastic over adipose tissue.
 Removes deposited adipose tissue.
f) Psychological effects
 Lower the psychoemotional and somatic
arousal such as anxiety and tension.
INDICATION
1. Edema- Relived with elevation and massage.
2. Radial mastectomy- Facilitates the lymphatic
drainage and relieves pain and congestion.
3. Venous ulcers- decrease edema, increase
circulation and mobilize soft tissue
4. LMN lesion- Massage facilitate stretch reflex
and enhances the absorption of tissue fluid.
5. Bell’s palsy- maintains elasticity of the muscle
and improves circulation.
6. sprain
INDICATION
7. Tenosynovitis- Massage restore range and
increase mobility
8. Tendinitis/ Sprain- can regain mobility by
breaking scar and relieve pain
9. Removal of secretion from Respiratory system
10. Decrease pain

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Myofascial release is a manual therapy technique that aims to relax and elongate the fascia through slow, sustained pressure. Fascia is the connective tissue that surrounds and connects muscles, bones, and organs. Injuries, immobilization, and aging can cause fascial adhesions or restrictions that impair movement. Myofascial release techniques like crosshand strokes, skin rolling, and deep tissue stroking apply moderate pressure to "creep" or elongate the fascia and increase range of motion. It can help remove waste from injuries and is often used with other treatments like exercise. Precautions include acute injuries or conditions affecting the skin, blood vessels, or nerves.

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Back care ppt and back care steps nursing procedure
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This document provides information on back care, including its definition, purposes, contraindications, necessary articles, and procedures. Back care involves cleaning and massaging the back, paying attention to pressure points, to stimulate blood circulation, prevent bedsores, relax tension, and promote rest and sleep. The procedure section outlines specific massage techniques - effleurage, friction, tapotement, vibration, and kneading - used to massage the entire back.

13.1 Definition & Classification of Massage.pptx
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This document defines massage and discusses different massage techniques. It defines massage as any manual or mechanical technique that imparts mechanical energy to soft tissues without moving joints, to elicit physiological or psychological effects for therapeutic, restorative or preventive purposes. Massage techniques are classified based on factors like depth, applied force, duration, means of application and region treated. Common techniques discussed include stroking, kneading, friction, vibration and percussion. The document provides detailed descriptions of different types of strokes, pressures, vibrations and percussion techniques used in massage.

CONTRADICTIONS
GENERAL LOCAL
i. High fever
ii. Severe renal or cardiac
diseases
iii. Deep x-ray therapy
iv. Osteoporosis
v. Severe spasticity
vi. Very hairy skin
i. Acute inflammation
ii. Skin disorder
iii. Recent fracture
iv. Severe varicose vein
v. Atherosclerosis
vi. Thrombosis
vii. Myositis ossificans
viii. Malignancy
ix. Open wound

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Massage

  • 2. DEFINITION  Massage is defined as the scientific manipulation done with hands on the soft tissues of the body in order to produce effects on the nervous, muscular and circulating system to improve function.
  • 3. PREPARATION OF MASSAGE 1. SELF PREPARATION: Self preparation by therapist before contacting the patient.  Free from hindrance  Easy clothing  Avoid jewellery  Hair tied  Stretching- to get good grasp  Walk/lunge standing
  • 4. Preparation cont..... 2. PREPARATION OF EQUIPMENT AND ENVIRONMENT: Ventilation Adjustable height- towel, couch, pillow Contact material: Talcum powder, olive oil, water based lubricants
  • 5. Preparation cont…… 3. PREPARATION OF PATIENT:  Proper introduction  Palpate the area to be massaged so that s/he gets sensory awareness of your touch.  Ask patient to undress and cover the part well. Relaxation position.
  • 6. Preparation cont….. 4. PALPATION / EXAMINATION OF PATIENT:  Hands should be relaxed  Firm contact  Fine pressure  Touch should not hurt patient nor create the tingling sensation. Look Skin state( dry, hairness, oily, edema) Feel Muscle tension Check Mental condition
  • 7. CLASSIFICATION 1) Stroking: Stroking, Effleurage 2) Petrissage: Kneading, Picking up, Wringing, Shaking, Rolling 3) Friction: Circular, Transverse 4) Percussion/tapotment: Clapping, Hacking, Vibration, Pounding, Beating, Tapping
  • 8. STROKING a) Stroking:  These are unidirectional manipulation in which operator’s hand pass from proximal to distal.  2 type of effects: stimulative and sedative Effects:  Stimulates CNS and can be used in cases of depression.  On scalp stimulate hair follicles which increases granular activity and increase hair growth.  Slow and deeply helps in relaxation in HTN, recent injuries and spasm.
  • 9. STROKING b) Effleurage:  It is unidirectional manipulation.  Hands pass through distal to proximal with access of depth performed with palmar surface of whole hand and in small area can use pulp of fingers.  The starting fingers exert the pressure.
  • 10. STROKING b) Effleurage: Effects: Increase circulation Edema- increase venous and lymphatic drainage Deep massage- vasodilation of Artery by lubrication of H cells. Improve mobility and elasticity Reflex sedative effect- Reduce muscle tension and pain.
  • 11. PETRISSAGE a) Kneading: It is a circular manipulation performed so that the skin and subcutaneous tissues moved in circular manner. ( whole kneading, palmar kneading, fingers- flat, tip and pad, thumb- pad & tip, both hands when one superimposed on other, elbow kneading, heel or hand kneading)  Pressure in following manner:- 4-10 o’clock, 8- 11 o’clock, 6-9 o’clock and 3-6 o’clock Effects -Increase blood supply, - decrease tone, - decrease adhesion, -stretching tight fascia
  • 12. PETRISSAGE b) Picking up: Tissue are compressed within underlying bone, then lifted, squeezed and relaxed.  Done with thumb and thenar eminence as one component and medial 2-3 fingers and hypothenar eminence as other compartments.  Grasp can be C-shape, V-shape Effects a) Same as kneading b) Compression and squeeze will increase drainage.
  • 13. PETRISSAGE c) Wringing: In this manipulation, tissue are compressed against the underlying structures prior to lifting them and once lifted, pull gentle towards yourself with one hand and other side with the fingers at other hand. Alternate movements  Smaller areas – tips of finger are used. Effects To lengthen the muscle.
  • 14. PETRISSAGE d) Rolling  2 Types- skin rolling, muscle rolling  Skin rolling- Skin is lifted and rolled between the thumb and finger of the hand which are kept parallel to each other and thumb moved towards fingers.  Muscle rolling- working across the muscle fibers and along the long axis of muscle. Place both hands on the surface area, move distal from you, palms in full contact with your thumb tips touching and parallel.  Pull underlying muscle/skin up apply pressure with your thumb as you adduct and oppose it with rolling. Effects : Same as picking
  • 15. PETRISSAGE e) Muscle shaking All long muscle of body is shaken and manipulation is performed.  Done on large muscle. Thumb and finger are placed opposite to each other on the muscle palm in and off contact.  Then the hand is shaken front side to side. Effects a) Give a sensory response.
  • 16. FRICTION These are small range, deep manipulation performed in specific anatomical structure with the tips of fingers or thumb, no other part is in contact.  2 types: A) circular B) Transverse
  • 17. FRICTION A) Circular  Performed with finger tips  Pressure with small stationary manipulation in circular manner.  Can be used on ligaments and myofascial junction.
  • 18. FRICTION B) Transverse The tip of thumb is reinforced by any other tip of finger. Example: Index finger.  Place finger across longitudinal axis.  Perform friction by moving your digit, hand and forearm in a line parallel to movement.  Does not allow movement between your finger and patient’s skin as it can cause pain.  Use 2 fingers when long structure is altered, place fingers across the length of collagen. Uses - Inflammation, scar tissue and adhesion
  • 19. TAPOTMENT  These are percussive manipulations where we give soft blow with hand. A) Clapping  Whole palmar aspect of the hand is used to strike the body parts.  The hand is cupped so that the center doesn’t touch the part, it is in hollow position.  Fingers are slightly flexed, the thumb is adducted.  The movement of clapping should totally be on the wrist joint, arm movement should not be done. Effects – Slow- greater depth -- Skin stimulator
  • 20. TAPOTMENT B) Hacking  Here, we struck skin with the help of dorsal tips of 3 medial finger.  The only movement applied to supination and pronation at radio-ulnar joints.  Wrist should be in mild extension above 50 degree and fingers in relaxed flexion. Fingers should be 1.5cm away from eachother.  10 strikes/5 seconds are initially imported. Effects Fastly: effects on circular (skin) Slow: Mechanical effect on hollow organ.
  • 21. TAPOTMENT C) Vibration It involves movement in which the tissues are pressed and released using an up and down motion. These can be fine and very coarse. Can be performed by whole hand or finger tips. Our pectorals should alternatively contracted relax. No movements at wrist ,elbow or hand.
  • 22. TAPOTMENT D) Beating  Loosely clenched fist is used for the strike.  Fingers are flexed at MCP and PIP joints but extended at DIP joints.  Thumb is kept flat.  Abduct Arm– allow the wrist to drop in relaxation.
  • 23. TAPOTMENT E) Pounding  A bound of hacking with clench fist.  Fingers flexed and thumb ties at the lateral side  Pronation / Supination F) Tapping  Performed with tips of finger pads.  Used in small areas.  Hand is relaxed and fingers tap slowly to produce hollow hand.
  • 24. PHYSIOLOGICAL EFFECTS a) On circulatory system:  Increase venous flow and lymphatic flow by increasing forward movement of fluid.  Increases the arterial flow by stimulating the mast cells Histamine releases Vasodilation  Increase blood supply increase oxygen carrying capacity compensation of O₂ demand
  • 25. PHYSIOLOGICAL EFFECTS b) On metabolic system increase blood flow increase oxygen supply provide proper nutrition supply to the system increase venous/lymphatic flow removal of waste production increase arterial blood flow & venous drainage increases various metabolic activities.
  • 26. PHYSIOLOGICAL EFFECTS c) Nervous system I. Sensory system  Sedative effect with slow rhythm.  It reduces pain by stimulating A beta, A delta fibers and bring parasympathetic inhibition.  Technique: Effleurage, stroking, hacking, tapping, beating
  • 27. PHYSIOLOGICAL EFFECTS ii. Motor system  May reflexly increases the muscle tone by stimulating the skin receptors of stretch spindle.  Stroking, tapping, hacking  It can reduce tone of muscle if slow stroking is carried out, activation of GTO– inhibit stretch reflex.  Deep rhythmic massage is given.
  • 28. PHYSIOLOGICAL EFFECTS iii. ANS It Influences HR, Cardiac output, BP, RR, Skin temperature and work of certain glands. Massage : Increase temperature of skin : Activates sweat gland : Increases skin conductance
  • 29. PHYSIOLOGICAL EFFECTS d) Soft tissue  It effects elasticity, plasticity, and mobility  It stretches collagen fibers Adhesion broken and maximum mobility.  Friction, kneading is used  Release muscle tension by releasing plasma myoglobins and working on GTO.  Relives pain in soft tissue.  Provides relaxation of soft tissues by increasing the circulation and fulfilling oxygen demand.
  • 30. PHYSIOLOGICAL EFFECTS e) Effect on skin  Facilitate movement of skin over subcutaneous structures.  Skin becomes soften, supple and later makes it more elastic over adipose tissue.  Removes deposited adipose tissue. f) Psychological effects  Lower the psychoemotional and somatic arousal such as anxiety and tension.
  • 31. INDICATION 1. Edema- Relived with elevation and massage. 2. Radial mastectomy- Facilitates the lymphatic drainage and relieves pain and congestion. 3. Venous ulcers- decrease edema, increase circulation and mobilize soft tissue 4. LMN lesion- Massage facilitate stretch reflex and enhances the absorption of tissue fluid. 5. Bell’s palsy- maintains elasticity of the muscle and improves circulation. 6. sprain
  • 32. INDICATION 7. Tenosynovitis- Massage restore range and increase mobility 8. Tendinitis/ Sprain- can regain mobility by breaking scar and relieve pain 9. Removal of secretion from Respiratory system 10. Decrease pain
  • 33. CONTRADICTIONS GENERAL LOCAL i. High fever ii. Severe renal or cardiac diseases iii. Deep x-ray therapy iv. Osteoporosis v. Severe spasticity vi. Very hairy skin i. Acute inflammation ii. Skin disorder iii. Recent fracture iv. Severe varicose vein v. Atherosclerosis vi. Thrombosis vii. Myositis ossificans viii. Malignancy ix. Open wound