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Artwork and slides taken from the book Clinical Massage Therapy: A Structural Approach to Pain Management Published by Pearson Education
Integrated Manual Therapy & Orthopedic Massage For Complicated Knee Conditions
Todays manual therapist needs to have multiple skills in order to address a wide variety of complicated musculoskeletal pain conditions. Specialization in just one modality is becoming a thing of the past because of limited patient outcomes. This unique total system consists of orthopedic assessment, clinical reasoning, multidisciplinary and multimodality therapies, and precise corrective stretching and strengthening exercises. Participants will learn to integrate the skills of leading practitioners from the fields of massage therapy, physical therapy, athletic training, personal training, osteopathic and chiropractic to restore balance, posture, function and pain free living. Recent clinical studies will forever change the way manual therapists look at musculoskeletal pain, muscle-tendon strain pain, and adhesive capsular pain. This seminar will teach manual therapists to address ACL & PCL sprains, medial collateral ligament (MCL) sprains, lateral collateral ligament (LCL) sprains, medial and lateral meniscus injuries, patellar tendinosis, chondromalacia, bursitis, IT band friction syndrome, hamstring strains, posterior fixated fibular head pain, and posterior knee pain .Corrective stretching and strengthening techniques will be also taught to keep the muscles balanced, and joints aligned for pain free living. Twelve Steps: 1. Client History 2. Assess Active Range of Motion 3. Assess Passive Range of Motion 4. Assess Resisted Range of Motion 5. Area Preparation 6. Myofascial Release/ Compression Broadening 7. Cross Fiber Gliding/Trigger Point Therapy 8. Multidirectional Friction 9. Pain Free Movement 10. Eccentric Scar Tissue Alignment 11. Stretching 12. Strengthening James Waslaski is an Author & International Lecturer who teaches approximately 40 seminars per year around the globe. Hes served as AMTA Sports massage Chair and FSMTA Professional Relations Chair. Hes developed 8 Orthopedic Massage and Sports Injury DVDs, and authored manuals on Advanced Orthopedic Massage and Client Self Care. His new book, Clinical Massage Therapy: A Structural Approach to Pain Management was published by Pearson Education in 2011. James presents at state, national and international massage, chiropractic, and osteopathic conventions including keynote addresses at the FSMTA, World of Wellness, New England Regional Conference, the World Massage Festival, and Australian National Massage Conventions. His audience includes massage and physical therapists as well as athletic trainers, chiropractors, osteopaths, nurses and physicians. He is a certified personal trainer with NASM. James received the 1999 FSMTA International Achievement Award and was inducted into the 2008 Massage Therapy Hall of Fame. www.orthomassage.net
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Chapter Outline
Twelve-Step Approach to Knee and Thigh Conditions Anterior Cruciate Ligament (ACL) and Posterior Cruciate Ligament (PCL) Instability Patellar Tendinosis and Chondromalacia Quadriceps Protocol Plantaris Strain
Clinical Massage Therapy: A Structural Approach to Pain Management James Waslaski
CHAPTER
Chapter Outline
Popliteus Strain Medial Meniscus Injury and Medial Collateral Ligament (MCL) Sprain Iliotibial Band Friction Syndrome Lateral Meniscus Injury and Lateral Collateral Ligament (LCL) Sprain
Learning Objectives
Choose the appropriate massage modality or treatment protocol for each specific clinical knee condition Release all the forces surrounding the knee, and eliminate the underlying cause of the knee conditions before addressing the clinical symptoms
Learning Objectives
Determine if there is an imbalance among the muscle groups that surround the knee Restore pain-free knee joint normal range of motion
Learning Objectives
Differentiate between soft-tissue problems caused by:
instability or hypermobility of the knee myofascial restrictions Muscletendon tension muscle imbalance
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Learning Objectives
Differentiate between soft-tissue problems caused by:
myoskeletal alignment problems trigger point tension strained muscle or sprained ligament fibers scar tissue
Learning Objectives
Teach the client self-care stretching and strengthening exercises (if needed) to perform at home to maintain muscle balance, joint alignment, and pain-free movement following therapy
Precautionary Note
Do not work on a client with a recent injury (acute condition) exhibiting inflammation, heat, redness, or swelling. RICE therapy (rest, ice, compression, elevation) may be the appropriate treatment in this situation. Clients with a hypermobile knee due to excess ligament laxity should consult with their physician. If in doubt, refer out!
Clinical Massage Therapy: A Structural Approach to Pain Management James Waslaski
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TFL Stretch.
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Quadriceps Stretch.
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Precautionary Note
If it is a springy end feel, it could be a fixated posterior fibular head due to a short biceps femoris. This can be corrected by lengthening the biceps femoris and performing a simple myoskeletal alignment technique.
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Hamstrings.
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Figure 3-20 Cross-Fiber Gliding Strokes and Trigger Point Work, Plantaris.
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Figure 3-24B Distal Lateral Hamstring Stretch Only to Correct External Tibial Rotation (Caution)
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Figure 2-59 Use Muscles to Stretch the Intermuscular Septums and Deep Investing Fascia.
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Adductors Stretch.
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Precautionary Note
Stretching is not suggested for the muscle groups around a hypermobile joint. Strengthening would be more appropriate to stabilize any joint that has excessive movement due to ligamentous laxity.
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Quadriceps Stretch.
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TFL Stretch.
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Gastrocnemius Stretch.
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