It will explore the use of massage generally then focus on specific techniques used in myofascial pathologies. It will also describe the techniques employed, the clinical reasoning for their choice and the relevant supporting evidence.
The relevant anatomy will be discussed as well as the proposed influences of massage on these structures using current literature to support these hypotheses.
Massage has been used around the world for thousands of years for rehabilitation and relaxation (Weerapong et al, 2005). Massage is the treatment and practice of manipulation of the soft body …show more content…
Prone lying; double hand stroking to lumbar spine, skin rolling to check for tethering, left and right, none found. Double elbow stroking, with distraction revealed some tenderness in the left quadratus lumborum, hence I continued for several minutes.
MTrP was found in TFL and as he had restriction of hip extension; digital ischaemic pressure was performed on ilio-psoas and TFL.
These muscles are classically heightened in tone with this pathology, and as it is usually indicated it is best to work proximal to distal (Archer, 2004).
Travell and Simons (1998) report soft tissue limitations such as adaptive shortening of muscles and improper body alignment can result in overcompensation by muscles in other regions, which is associated with injury. A prospective study by Noehren et al (2007) showed the major influencing factor in ITBS is weakness in pelvic stabilisers i.e. gluteus medius and minimus. In this case due to the unusual onset, i.e. traumatic, the weakness was only secondary and probably as a result of the pain rather than causative.
The patient was then positioned in right side lying; stroking then kneading to gluteals, stroking to ITB, tenderness and restriction middle third of ITB. This position was adopted as it is usually easier to identify focal sites of abnormality (Brukner