Chapter 1

1. Chapter 1 Massage from Past to Present

2. Topic 1-1: The History of Massage • Medicine, Magic, and Massage • Early history: medicine and magic closely connected. • Ancient Egypt: evil spirits believed to cause disease. • Massage part of Egyptian medical practice. • The Australia aboriginal healers massage patients and sing over them during rituals; the young encouraged to massage elders.

3. Topic 1-1: The History of Massage • Medicine, Magic, and Massage (cont’d) • Ancient Maya believed illness natural and supernatural causes. • Aztecs understood healing properties of plants. • Massage part of Aztec Medicine; used by midwives. • Native Americans live connected to land and seasons; herbalists (teas, tinctures, ointments, salves).

4. Topic 1-1: The History of Massage • The Classical World • Greek medicine moved away from magic toward observation and logical reasoning. • Greek doctors massaged from extremities toward core of body to support movement of fluids. • Romans developed public health systems; well-developed sense of hydrotherapy. • Massage was offered at the baths.

5. Topic 1-1: The History of Massage • The Classical World • Islamic world advanced medical understanding, sciences, literature, philosophy. • Arabs well-developed pharmacies with extensive pharmacopoeia.

6. Topic 1-1: The History of Massage • Eastern Wisdom • Ancient China: TCM and Eastern approaches to healing based on Yin and Yang, Qi, the five elements (wood, fire, earth, metal, water). • India: Ayurveda medical and philosophical system; keys for creating harmony and balance in life; massage part of daily life.

7. Topic 1-1: The History of Massage • Eastern Wisdom • Thailand: Thai medicine four elements: nutritional counseling, herbal medicines, spiritual counseling, physical treatment. • Tibet and Bhutan: Tibetan medicine based on teachings of Buddha; “The Knowledge of Healing.”

8. Topic 1-1: The History of Massage • Europe in Darkness and Light • Dark Ages: 5th to 8th century; decline in art, science, literature, medicine. • Massage in midwifery Middle Ages to present day. • Renaissance: 14th-16th century; study of anatomy dramatically advanced. • Age of Enlightenment: 17th-18th century; popularity of exercise means of achieving health; Swedish massage.

9. Topic 1-1: The History of Massage • American Massage History • 19th-century: physicians and public embraced massage as health-promoting practice. • Massage in nursing: massage training part of nursing curriculum until 1950s. • Body–mind connection: massage techniques closely intertwined with natural medicine movement.

10. Topic 1-1: The History of Massage • American Massage History • Skepticism: massage cover for prostitution; general public skeptical about legitimacy. • Human Potential Movement: 1960s; humans have large store of untapped creative and intellectual potential. • 1970s-1990s: number of massage therapists increased dramatically.

11. Chapter 1 Massage from Past to Present

12. Topic 1-2: Overview of Techniques, Systems, and Approaches • Structural Integration: name Ida Rolf gave to her revolutionary bodywork system in mid-1900s. • Rolf Institute and Guild for Structural Integration teach different versions of Rolf ’s work. • Massage and bodywork industry continue to define and categorize different branches of profession.

13. Topic 1-2: Overview of Techniques, Systems, and Approaches • Broad Categories: Massage, Bodywork, and Somatic Therapies • Massage: structured, professional, therapeutic touch. • Massage techniques: manually manipulate soft-tissue to promote health and wellness. • Scope of practice: techniques, activities, methods licensed therapists permitted to practice under law.

14. Topic 1-2: Overview of Techniques, Systems, and Approaches • Broad Categories: Massage, Bodywork, and Somatic Therapies • Bodywork may include massage; includes techniques and systems that are not massage. • Somatic therapies: client’s psychological aspects; do not use massage.

15. Topic 1-2: Overview of Techniques, Systems, and Approaches • Massage Technique • Specific procedure used to produce particular therapeutic outcome. • Applied to variety of body areas with minor adaptations. • Active isolated stretching (AIS) advanced technique. • Muscle energy technique considered system.

16. Topic 1-2: Overview of Techniques, Systems, and Approaches • Massage or Bodywork Systems • Collection of techniques organized in complex whole. • May include set of procedures carried out in particular order to achieve specific goal. • Swedish massage and Tui Na examples.

17. Topic 1-2: Overview of Techniques, Systems, and Approaches • Massage and Bodywork Approaches • Approach: massage and bodywork systems that use similar techniques to achieve comparable results. • Swedish Massage • Deep-Tissue Massage • Clinical Approaches • Structural Integration Approaches • Neuromuscular Approaches

18. Topic 1-2: Overview of Techniques, Systems, and Approaches • Massage and Bodywork Approaches (cont’d) • Myofascial Approaches • Energetic Approaches • Approaches Based on Movement • Systems from Other Countries and Cultures • Eastern Approaches

19. Topic 1-2: Overview of Techniques, Systems, and Approaches • Massage and Bodywork Approaches (cont’d) • Psychological (Mind–Body) Approaches • Craniosacral Therapy • Manual Lymphatic Drainage • Spa Therapies

20. Topic 1-2: Overview of Techniques, Systems, and Approaches • Massage and Bodywork Approaches (cont’d) • Reflexology • Hydrotherapy • Aromatherapy

21. Chapter 1 Massage from Past to Present

22. Topic 1-3: Contemporary American Massage • Massage Clients • Spa clients focus on health, fitness, anti-aging, increased energy, stress reduction. • Massage most frequently requested spa service. • Massage for: wellness and health care. • Wellness massage: decrease stress, promote relaxation, support body’s natural restorative mechanisms.

23. Topic 1-3: Contemporary American Massage • Massage Clients (cont’d) • Health care massage (treatment, rehabilitative, or therapeutic massage): addresses chronic soft-tissue dysfunction, soft-tissue injury, or pain. • Popularity of massage: increasing; women comprise 71% of massage clients. • Massage therapy increases productivity; reduces stress levels in employees; viewed as luxury.

24. Topic 1-3: Contemporary American Massage • The Massage Profession • Therapists work in environments that attract preferred types of clients. • Job market for massage therapists expanding. • Private practice: own business; run practice in leased commercial space or separate area of home. • Massage clinic: massage therapists work cooperatively.

25. Topic 1-3: Contemporary American Massage • The Massage Profession (cont’d) • Wellness centers: employ many different types of health care providers; health for body, mind, spirit. • Like wellness centers, spas employ wide variety of health care professionals; offer services that address body, mind, spirit. • Each spa unique; work can be varied and creative.

26. Topic 1-3: Contemporary American Massage • The Massage Profession (cont’d) • Medical environments: chiropractors; hospitals; hospices; naturopathic practices; sports medicine clinics; clinical massage practices; physical therapy offices; rehabilitation centers. • Cruise ship spas: wellness massage enhanced with luxurious touches.

27. Topic 1-3: Contemporary American Massage • The Massage Profession (cont’d) • Seated, on-site massage • Pregnancy and infant massage • Sports massage • Animal massage • Massage diverse field; graduates pursue unique occupations. • 250 known types of massage and bodywork.

28. Topic 1-3: Contemporary American Massage • Massage as Part of the American Health Care System • Massage and bodywork are type of CAM. • Complementary medicine: alternative healing practices used in conjunction with conventional medicine. • Alternative medicine: alternative to conventional care where focus of treatment is more holistic. • Integrative medicine, holistic healthcare, holistic medicine: refers to complementary medicine.

29. Topic 1-3: Contemporary American Massage • Massage as Part of the American Health Care System (cont’d) • Integrated medicine practiced in spa industry. • Spa programs focus on fitness, healthy diet, detoxification, lifestyle education. • Integrative medicine practiced at wellness centers that focus on alternative medical systems.

30. Topic 1-3: Contemporary American Massage • Massage as Part of the American Health Care System (cont’d) • Many research studies have focused on massage. • Massage shown to have positive effect on depression and quality of life. • AMTA founded Massage Therapy Foundation in 1990. • Touch Research Institute (TRI) at University of Miami School of Medicine.

31. Chapter 5 Massage Cautions and Contraindications

32. Topic 5-1: Areas of Caution • Delicate Structures • Nerves, blood vessels, bones, organs delicate; can be damaged if strokes applied too forcefully or for prolonged time. • Abnormal occurrences: lumps or masses directly under skin; often benign cysts or fatty deposits.

33. Topic 5-1: Areas of Caution • Delicate Structures (cont’d) • Blood vessels: arteries superficial; receive full force of massage stroke. • Veins: superficial; heavy pressure can cause damage. • Bones: caution applying strokes over bony prominences; special caution with frail clients or have bones weakened by osteoporosis.

34. Topic 5-1: Areas of Caution • Delicate Structures (cont’d) • Nerves: compressed, pinched, or pressed; pain, numbness, tingling, discomfort can result. • Organs: lymph nodes; other organs unprotected (kidneys, liver, trachea) and require caution.

35. Topic 5-1: Areas of Caution • Regions of Superficial Structures - Head and Face • Temporal artery • Facial artery • Styloid process • Mastoid process • Trigeminal nerve • Facial nerve • Parotid glands

36. Topic 5-1: Areas of Caution • Regions of Superficial Structures – Neck • Trachea; mandible • Sternocleidomastoid and trapezius muscles • Carotid and subclavian arteries • Jugular and subclavian veins • Vagus nerve; hyoid bone • Thyroid gland; clavicles • Lymph nodes; brachial plexus

37. Topic 5-1: Areas of Caution • Regions of Superficial Structures – Trunk • Abdominal aorta; inferior vena cava • Xiphoid process • Floating ribs (11 and 12) • Lumbar plexus • Lymph nodes around sternum • Liver; spleen; kidney • Large and small intestines

38. Topic 5-1: Areas of Caution • Regions of Superficial Structures – Upper Extremity • Axillary, brachial, radial, ulner arteries • Cephalic, antebrachial, basilic, brachial, axillary, subclavian veins • Cubital notch (ulnar nerve) • Brachial plexus • Lymph nodes (axillary area, cubitalfossa)

39. Topic 5-1: Areas of Caution • Regions of Superficial Structures – Lower Extremity • Inguinal ligament and lymph nodes • Sartorius • Adductor longus • Femoral artery, vein, and nerve • Gastrocnemius • Biceps femoris • Semimembranosus

40. Topic 5-1: Areas of Caution • Regions of Superficial Structures – Lower Extremity (cont’d) • Lymph nodes • Common peroneal nerve • Popliteal artery and vein • Tibial nerve • Great saphenous vein • Sciatic nerve

41. Chapter 5 Massage Cautions and Contraindications

42. Topic 5-2: Medications and Massage • Massage should not be given to any client under influence of alcohol or illegal substance. • Provided to clients taking prescription medications. • Pharmacology: science and study of drugs including: • Sources • Chemistry • Production • Use in treating diseases; Side effects

43. Topic 5-2: Medications and Massage • Side Effects of Medications • Side effect: secondary effect; goes beyond desired effect or causes unwanted responses. • Each client’s response to medications unique. • In some cases, clients not aware their symptoms are side effects.

44. Topic 5-2: Medications and Massage • Side Effects of Medications (cont’d) • Elderly clients often experience greater side effects from medications. • Therapists can help clients set realistic expectations for massage session by researching client’s medications.

45. Topic 5-2: Medications and Massage • Side Effects of Medications (cont’d) • Adverse effect: extreme reaction to drug that causes severe side effects or places client in medical danger. • If client exhibits unusual symptoms or rapid increase of a symptom at any time during session: • Call client’s health care provider OR; • Emergency services, depending on severity of reaction.

46. Topic 5-2: Medications and Massage • Evaluation of Medications in the Application of Massage • Evaluate impact of massage on medication or client and to adapt treatment if needed. • Conduct thorough health history intake. • Ask clients for list of medications.

47. Topic 5-2: Medications and Massage • Evaluation of Medications in the Application of Massage (cont’d) • Look up medications in current drug reference book. • Ask clients to describe any side effects. • Reviewing medications can be time consuming.

48. Topic 5-2: Medications and Massage • Evaluation of Medications in the Application of Massage (cont’d) • Clients usually want specific results from massage. • Client and therapist set treatment goals for session.

49. Topic 5-2: Medications and Massage • Evaluation of Medications in the Application of Massage (cont’d) • Important to discuss limitations of massage in relationship to medications before session begins. • If necessary, obtain physician’s release.

50. Topic 5-2: Medications and Massage • Evaluation of Medications in the Application of Massage (cont’d) • See Table 5-1: Examples of Drugs with Implications for Massage. • Purchase new drug reference when you start to encounter drug names not covered in current reference book.