Therapeutic Massage Procedures
This article is written to augment the basic massage procedures with those of the medical or therapeutic procedures. These procedures should simply be added to those that are used for the basic massage that is given for relaxation. But, as stated in the massage magazine’s June issue SOAP notes should be taken on each and every client for various reasons to protect you the massage therapist.
The definition of Assessment - Reviewing any information available to understand present condition. History, Observation, Assess range of motion including contractile tissues, inert tissues, end feel, capsular patterns, active movements, passive movements, resisted movements, and finally palpation. Each of these different types of assessment can reveal the true underlying cause of pain and discomfort so all of them should be used when working with a patient.
The definition of Planning - the information is used to determine strategies which may include referral to another health care professional, frequency and estimated sessions, massage techniques to be used and the expected results of the massage in question. You also must remember that its ok to plan a massage but once you have started and fine something to radically alter your plans.
Performance - The is the act of actually applying of selected techniques that were done in the planing stages.
Evaluation - This portion of the massage examines the outcome of the techniques that were used and determines if the actual goals of the massage have been meet.
Sound familiar yet, yep were talking about SOAP Notes: SOAP is an acronym which stands for Subjective, Objective, Assessment, Plan. Lets look a little closer at SOAP and see if we can get a little closer to the heart of therapeutic massage. We will start with some of the basic definitions.
Subjective - Gathering information from the client, posture, what they say and how they act. (Example client complains of fatigue.)
Objective - This is information that the massage therapist gathers from a question and observation session with the patient.
Assessment - This is what you found during the massage and what you did during the massage and strokes that you may have applied to the client.
Plan - Client’s homework in essence, usually this is drink plenty of water to flush out metabolic waste, Shower or bath, and maybe some stretches to aid client in pain management.
The generic form of SOAP is to first interview the patient, then preform the massage and finally do an exit interview. Muscular deviation imbalances and structural deviations can be noted by observing the patient’s posture. Muscle weakness is called flaccidity. When assessing range of motion on the patient test the patients good side first then return to the side that the patient is complaining about. End feel is the quality or sensation that the therapist feels when moving a joint thru space doing a full range of motion test. Hard end feel is bone against bone. Soft end feel is motion is stopped due to contraction of soft tissues. Springy end feel is motion that stop due to stretching of fibrous tissues this is the most common of end feels. Contractile tissues or muscles, tendons and muscle attachments use memory techniques. Muscles contract therefore they are contractile tissues. Inert tissues are bones and ligaments they also use memory techniques. Bones do not contract and insert simply means does not do anything.
These are just some of the techniques that can be used to assist the therapist in applying therapeutic massage to a patient.
