5-1 Kinesiology for Manual Therapies Chapter 5 Dimensional Massage Techniques for the Shoulder Girdle Muscles McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

5-2 Learning Outcomes o 5-1 Define key terms. o 5-2 List goals of individual techniques. o 5-3 Describe deep-tissue therapy. o 5-4 Give examples of some general principles of body mechanics. McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved 5-2

5-3 Learning Outcomes (cont.)  5-5 Practice safe body mechanics.  5-6 Demonstrate specific techniques on shoulder girdle muscles.  5-7 Incorporate dimensional massage therapy techniques in a regular routine or use them when needed. McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

5-4 Learning Outcomes  5-8 Identify two underlying principles for the theory of dimensional massage.  5-9 Determine safe treatment protocols and refer clients to other health professionals when necessary. McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

5-5 Introduction Two significant principles of motion:  Aggregate muscle action: muscles work in groups and in paired opposition.  Law of reaction: For every action there is an opposite and equal reaction. McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

5-6 Introduction (cont.)  Dimensional massage therapy is a philosophical approach to therapy that is based on science, structure, and soft-tissue functions.  A variety of techniques are used for the client’s benefit. McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

5-7 Introduction (cont.)  Muscles perform roles in the functional unit.  Agonists, antagonists, synergists, stabilizers, and neutralizers make up the functional unit. McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

5-8 Treatment Protocol  A treatment protocol is a synopsis of an overall approach to a massage session.  It must be based on a medical history, interview and SOAP notes, structure of the client, observation skills, palpation, and a dimensional approach to treatment. McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

5-9 Treatment Protocol (cont.) McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

5-10 Technique Goals and the Mystery of Deep-Tissue Therapy  Technique goals are the outcomes expected from choosing techniques for a particular purpose. McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

5-11 Technique Goals and the Mystery of Deep-Tissue Therapy (cont.)  Deep-tissue therapy is a series of specific techniques designed to unwind the soft tissue in a particular pattern or sequence with an end result that includes meeting specific goals. McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

5-12 Technique Goals and the Mystery of Deep-Tissue Therapy (cont.) Deep-Tissue Techniques  Jostling  Compression  Stripping McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

5-13 Technique Goals and the Mystery of Deep-Tissue Therapy (cont.) Deep-Tissue Techniques  Deep transverse friction or cross-fiber friction  Myofascial stretches  Elliptical movement McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

5-14 Technique Goals and the Mystery of Deep-Tissue Therapy (cont.) Deep-Tissue Techniques  Trigger points: latent, active, satellite  Ischemic compression, trigger point release, pincer palpation McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

5-15 Technique Goals and the Mystery of Deep-Tissue Therapy (cont.) Deep-Tissue Techniques  Parallel thumbs McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

5-16 Sequence  Sequence is a specific series of techniques chosen to accomplish a particular goal in a session.  Always use treatment protocols to determine the sequence of a therapeutic session. McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

5-17 Body Mechanics  Good body mechanics utilize ergonomically safe methods and practices to execute techniques that can prevent therapist injury, support self-care, provide balanced energy, and promote a long career in manual therapies. McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

5-18 Body Mechanics (cont.)  Keep your back straight  Use momentum of movement to assist action  Maintain balance  Bend your knees  Stay over your hands as much as possible McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

5-19 Body Mechanics (cont.)  Relax your thumbs, hands, and arms between techniques  Place your feet in the direction you are headed  Sink into the soft-tissue structures  Never sacrifice yourself to a technique or to the client’s structure McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

5-20 Body Mechanics (cont.)  Breathe  Center yourself often McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

5-21 Dimensional Massage Therapy for the Shoulder Girdle Muscles  Start with the supine position.  Slide the shoulders superiorly to passively shorten the upper and middle trapezius. McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

5-22 Dimensional Massage Therapy for the Shoulder Girdle Muscles (cont.) Effleurage around the shoulders McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

5-23 Dimensional Massage Therapy for the Shoulder Girdle Muscles (cont.) Petrissage of the trapezius McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

5-24 Dimensional Massage Therapy for the Shoulder Girdle Muscles (cont.) Closed-palm shaping McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

5-25 Dimensional Massage Therapy for the Shoulder Girdle Muscles (cont.) Alternating-hands neck stretch McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

5-26 Dimensional Massage Therapy for the Shoulder Girdle Muscles (cont.) Cup stripping the upper trapezius McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

5-27 Dimensional Massage Therapy for the Shoulder Girdle Muscles (cont.) Edging the upper trapezius McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

5-28 Dimensional Massage Therapy for the Shoulder Girdle Muscles (cont.) Neck stretch to side McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

5-29 Dimensional Massage Therapy for the Shoulder Girdle Muscles (cont.) Comb the trapezius McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

5-30 Dimensional Massage Therapy for the Shoulder Girdle Muscles (cont.) Hands under back McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

5-31 Dimensional Massage Therapy for the Shoulder Girdle Muscles (cont.) Head rock McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

5-32 Dimensional Massage Therapy for the Shoulder Girdle Muscles (cont.) Prone - Myofascial warm-up half-moon McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

5-33 Dimensional Massage Therapy for the Shoulder Girdle Muscles (cont.) Prone - Myofascial warm-up technique McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

5-34 Dimensional Massage Therapy for the Shoulder Girdle Muscles (cont.) Prone - Myofascial pull on the upper trapezius McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

5-35 Dimensional Massage Therapy for the Shoulder Girdle Muscles (cont.) Prone - Myofascial stretch on the middle trapezius McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

5-36 Dimensional Massage Therapy for the Shoulder Girdle Muscles (cont.) Prone - Movement 1 McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

5-37 Dimensional Massage Therapy for the Shoulder Girdle Muscles (cont.) Prone - Movement 2 McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

5-38 Dimensional Massage Therapy for the Shoulder Girdle Muscles (cont.) Prone - Movement 3 McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

5-39 Dimensional Massage Therapy for the Shoulder Girdle Muscles (cont.) Prone - Movement 4 McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

5-40 Dimensional Massage Therapy for the Shoulder Girdle Muscles (cont.) Prone - Elliptical movement of the scapula McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

5-41 Dimensional Massage Therapy for the Shoulder Girdle Muscles (cont.) Prone - Jostling the middle trapezius McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

5-42 Dimensional Massage Therapy for the Shoulder Girdle Muscles (cont.) Prone - C ompression of the rhomboids McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

5-43 Dimensional Massage Therapy for the Shoulder Girdle Muscles (cont.) Prone - Alternating petrissage and compression McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

5-44 Dimensional Massage Therapy for the Shoulder Girdle Muscles (cont.) Prone - Claw strip the rhomboids McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

5-45 Dimensional Massage Therapy for the Shoulder Girdle Muscles (cont.) Prone - Deep transverse friction McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

5-46 Dimensional Massage Therapy for the Shoulder Girdle Muscles (cont.) Prone - Straddle and strip McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

5-47 Dimensional Massage Therapy for the Shoulder Girdle Muscles (cont.) Prone - Strip the levator McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

5-48 Dimensional Massage Therapy for the Shoulder Girdle Muscles (cont.) Prone - Anchor and stretch McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

5-49 Dimensional Massage Therapy for the Shoulder Girdle Muscles (cont.) Prone - DTF rhomboid insertion McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

5-50 Dimensional Massage Therapy for the Shoulder Girdle Muscles (cont.) Prone - Parallel thumbs McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

5-51 Chapter Summary  This chapter introduces the philosophy of dimensional massage, defines treatment protocol, sequence, and specific techniques for deep-tissue therapy. McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

5-52 Chapter Summary (cont.)  Dimensional massage techniques for the shoulder girdle region are described and depicted in full-color photographs.  The supine and prone positions are utilized to assist the unwinding of the soft- tissue of the shoulder girdle structures. McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

5-53 Chapter Review  The Chapter Review is divided into true and false, short answers, and multiple choice questions.  The questions are designed for the students to test their knowledge. McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

5-54 Explore and Practice  Activities in this section are for practice and demonstration.  Every opportunity should be utilized to locate muscular attachments on as many different bodies as possible to support kinesthetic learning. McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved

5-55 Explore and Practice  Use the muscle cards and book in technique classes, for log hours, or for case studies for reference purposes. McGraw-Hill © 2011 by The McGraw-Hill Companies, Inc. All rights reserved