Jess, Brad, Becky, PJ and Hannah Study Meeting

Hi all,

Group study meeting, Saturday 11am, Room 105.

If you go to the link below you will find pictures of the room locations

https://marvin.otago.ac.nz/group_rooms/maps.php

If you head into the Library using the same entrance used to get to the other room.

Head left and go up the stairs beside the lifts.

At level one veer left, then just past the first section of books towards room 105.

I will most likely be there early so send me a txt if you're lost, or wander around the first floor looking at the doors for the room numbers.

See you Saturday morning

Task 6 - Historical, cultural and philosphical approaches to massage

Task 6 – Historical, cultural and philosophical approaches to massage

Comparison of the development of massage in the eastern and western traditions

Eastern massage traditions are based around massage having a holistic view. It looks at the body, mind and spirit and the focus is on restoring, balancing and maintaining a persons life force or Qi (Fritz, 2003; Salvo, 2003; Tuchtan, Tuchtan & Stelfox, 2004). By eastern massage I am referring to massage developed in China, Japan, India and Egypt. Chinese records have illustrated that massage dates back as early as 3000 BC (Salvo, 2003) and Indian massage is said to have been around for about 3000 years (Fritz, 2003). This demonstrates that eastern massage is deeply engrained and has been shaped by years of cultural development. Accupuncture, Anmo and Amma from China, Shiatsu from Japan, Ayurveda from India and Foot massage in Eygpt are the massage techniques developed within those cultures. Tuchtan et al. (2004) state that eastern or asian massage techniques are “based on a different set of principles and philosophy than the western approaches to massage” (p. 8) and Salvo (2003) notes that eastern massage is about creating a partnership between the therapist and client.

Western massage in comparison is based on medical and scientific principles and sees the body as a machine that can be fixed and repaired (Salvo, 2003). The prominent historical figures of western massage all had some form of medical background before focusing on massage as a viable and worthy practice (Calvert, 2002). These include Hippocrates, Asclepius, Galen, Celsus, Ling, Mezger and Kellogg to name a few. The Greek and Roman traditional massage practices noted the importance of touch and focused on people within Bathing Houses and athletes in the Gymnasiums (Salvo, 2003; Fritz, 2003). It is within western cultures that Swedish massage was developed in the 19th Century and is still being practiced in contemporary massage

The role of western historical figures in the development of massage in the western tradition

Hippocrates
Hippocrates of Cos (460-377 BC) was the “first physician in Greek medicine to specifically describe the medical benefits of massage” (Fritz, 2003, p. 14). He is generally recognised as the ‘father of medicine’ (Salvo, 2003; Tuchtan et al., 2004; Calvert, 2002) and shifted the focus of massage from magic and ritual to medicine based on comprehensive observation and logic (Calvert, 2002). The methods Hippocrates developed survived well into the Middle Ages (Fritz, 2003) and many other prominent figures in massage history have based their ideas and practices on the work of Hippocrates.

Galen
Claudius Galenus or Galen (AD 129-199) was one of the people that followed and built on the work of Hippocrates and like Hippocrates was also a Greek physician (Fritz, 2003). Galen went on to describe exactly how the hands should move and the direction they should move in during massage (Calvert, 2002). He also used massage to treat injuries and pain and wrote extensively on the subject. Galen also began to teach his ideas in numerous lectures (Tuchtan et al., 2004) signalling a desire to teach and a desire of others to learn the techniques he developed.

Ling
Pehr Henrik Ling (1776 – 1839) is credited with the development of the popular contemporary massage practice of Swedish Massage (Fritz, 2003; Salvo, 2003; Calvert, 2002; Tuchtan et al., 2004). Lings primary focus was on medical gymnastics and exercise as applications to treat disease and injury (Fritz, 2003; Salvo, 2003). Ling made sure to only take on specific techniques and applications after vigorous testing and observation and even set up a school to continue his teachings and research (Fritz, 2003).

Mezger
Johan Georg Mezger (1839-1909) a Dutch practitioner was very successful in his work to get the mecical and scientific communities to accept massage as a form of treatment (Fritz, 2003; Salvo, 2003; Tuchtan et al., 2004). Mezger presented massage as a form of medical treatment and physical rehabilitation, which is an illustration of what we might refer to as Physiotherapy in contemporary society. He was also the one to introduce the French terms we use today – effleurage, petrissage and tapotment (Fritz, 2003; Salvo, 2003; Tuchtan et al., 2004).

Kellogg
Dr John Harvey Kellogg was an American medical physician that founded the Battle Creek Sanitarium in Michigan (Fritz, 2003; Salvo, 2003; Calvert, 2002). The sanitarium focused on healthy eating and healthy actions by promoting good health and regular exercise. Fritz (2003) notes that Kellogg was interested and practiced the notion of massage and hydrotherapy at the sanitarium. Kellogg was also responsible for popularising massage with the American public. This was achieved through the magazine Good Health that Kellogg published regularly (Fritz, 2003; Salvo, 2003).

Vodder
Dr Emil Vodder (1896-1986) developed manual lymphatic drainage. This is characterised by “light circular motion on the skin to work directly with the lymphatic system” (Tuchtan et al., 2004, p. 19). His work has spread worldwide and he now has an International School.

Travell
Janet Travell is most commonly known for her work on Trigger points and especially in reference to myofascial pain and dysfunction (Salvo, 2003; Tuchtan et al., 2004).

Comparison of Maori massage with western massage

Massage is know in Maori culture as mirimiri and is practiced by Maori healers. There are three main types of massage practiced within Maori culture – romiromi, toto and takahi (Tuchtan et al., 2004). Romiromi is similar to western massage because it uses pinching and squeezing strokes like petrissage in Swedish massage (Tuchtan et al., 2004). Toto is a form of infant massage and takahi involves walking on parts of the body that are injured (Tuchtan et al., 2004) which illustrates the differences between Maori and western massage. These two forms of massage are also different because Maori massage takes a holistic view of the body and looks at Hauora or wellbeing.

Massage scandals of the 1800s and their impact on the massage industry

The massage scandals of the 1800s destroyed the public’s perception and confidence in massage as a legitimate medical practice (Fritz, 2003). The downfall began because of the inconsistent nature of the massage industry. Training institutions were not regulated or monitored and neither were practitioners. Because no standards applied in the massage industry many individuals took advantage of this and contributed to the downfall and negative image of the massage industry. Various massage societies were created in the late 1800s to try and sort out some of the training institutions (Fritz, 2003).

Development of professional massage in New Zealand including MINZI, NZATMP, TMA and MNZ

MINZI or the Massage Institution of New Zealand Incorporated was founded by Bill Wareham in 1985 in Auckland. The focus was on the education of massage therapists and MINZI supports all their members to gain higher qualifications (Tuchtan et al., 2004).

NZATMP of the New Zealand Association of Therapeutic Massage Practitioners was established in the late 1980s by Jim Sandford. It was started with an emphasis that it was a national body to cater for the national professional community (Tuchtan et al., 2004). The NZATMP developed and implemented a programme of education for individuals throughout the country. It is now known as the Therapeutic Massage Association or TMA and its main function is to keep a register of all therapists with a National Diploma of Therapeutic Massage (Tuchtan et al., 2004).

Massage New Zealand or MNZ is a national body for professional massage therapists in New Zealand. As stated on their website (www.massagenewzealand.org), MNZs purpose and mission is to “promote health and wellness in New Zealand (Aotearoa) through quality massage, and advocate the successful development of the association” (Massage New Zealand, 2009). MNZ has developed different levels of membership and outlines a specific Scope of Practice for each membership level. They also have a Code of Ethics and a clearly defined complaints procedure.

Philosophical approaches to massage

Body-mind-spirit or Bodywork therapeutic massage takes into consideration the wholeness of the individual (Fritz, 2003). This type of massage considers the connection between the body, mind and spirit and understands that one may affect the other. This notion of massage is very similar to eastern massage and Maori massage that have been explained above. These concepts of massage take a holistic view of the individual and focus on the whole being and not just the body. Western massage is very different as it is based on scientific and medical approaches to massage.


References

Calvert, R. N. (2002). The history of massage: an illustrated survey from around the world. Vermont: Healing Arts Press.

Fritz, S. (2003). Mosby’s fundamentals of therapeutic massage (3rd ed.). St Louis: Mosby.

Massage New Zealand (2009) Retrieved 26 August, 2009 from http://www.massagenewzealand.org/

Salvo, S. (2003) Massage Therapy: Principles and Practice (2nd ed.). St Louis: Mosby.

Tuchtan, C., Tuchtan, V., & Stelfox, D. (2004). Foundations of massage. Australia: Churchill Livingstone/Elsevier.

Task 5 - Sustainable Massage Practice

Fundamentals of Massage

Task 5 - Sustainable Massage Practice

Sustainability is a concept many people are now aware of and are becoming passionate about. It is also a concept that has lead many local and global companies to consider and potentially act upon. I am going to look specifically at three principles of sustainability – economic, environmental and social and how these three principles relate to massage practice. I will also look specifically at how I can improve the sustainability of my massage practice.

For something to be sustainable it should be able to be maintained at a certain rate or level (Sutton, 2000) and should not lead to “depletion of resources or degradation of the environment” (Shorter Oxford English Dictionary, 2002, n.p). The most common understanding of sustainability is that of environmental sustainability, however a lot of people mean a combination of social, economic and environmental sustainability (Sutton, 2000). It is therefore important to split each principle and describe and define each as its own.

Daly (cited in Goodland, 2002) defines environmental sustainability as when “waste emissions…. should be kept within the assimilative capacity of the local environment” (p.1). It is also the protection of life systems and the prevention of extinction (Sutton, 2000). Environmental sustainability needs to be managed by a stable and knowledgeable population (Goodland, 2002) to avoid the destruction of the environment.

Environmental sustainability relates to massage practice in numerous ways. How the clinic space is heated and lit is important. Is solar energy a viable option? Can natural light be utilised as much as possible? Is the use of energy saving light bulbs an option? These are all questions a massage therapist should ask themselves if they are concerned about environmental sustainability. It is also important to heat the clinic space effectively and efficiently to reduce unnecessary heat consumption. A massage practice must carefully consider the laundering of draping materials and must use these materials wisely. A practice may consider using environmentally friendly washing powder and may find it useful to discuss environmentally friendly practices with colleagues. It is worthwhile engaging in conversations to discuss new ideas and perspectives which leads into social sustainability.

Social sustainability refers to the maintenance of social quality and social capital (Sutton, 2000; Goodland, 2002), where “social capital is investments and services that create the basic framework for society” (Goodland, 2002, p2). Social sustainability is encouraged by a sense of community that has shared laws, values and knowledge. A massage therapist should engage in and build meaningful relationships within their social and professional communities. It is important to network within the local community so that you can begin to be seen as providing a worthwhile service. A massage therapist should also become part of their professional community by becoming a member of their professional association, ie. Massage New Zealand.

The last principle of sustainability I will be looking at is economic sustainability. Goodland (2002) describes the widely accepted notion of economic sustainability as the “maintenance of capital, or keeping capital intact” (p.2). So to become economically sustainable – money or capital goods should be maintained and be seen as important. A massage practice must be profitable to illustrate economic sustainability. There are a number of different ways for a practice to become profitable and the possibilities are almost endless. A therapist should adhere to professional principles and work in a professional environment and also build and maintain good client therapist relationships. The massage practice should convey professionalism at all times so that clients want to come back and also recommend the practice to others, ensuring profitability and economic sustainability. A therapist must also pay special attention to self-care and professional development. You must be physically able and mentally knowledgeable to sustain a practice and become economically sustainable.

As illustrated above there are many different ways that the principles of sustainability relate to massage practice and there are many more ways not mentioned. In order for my massage practice to become more sustainable I need to join Massage New Zealand so that I can communicate with the massage community around New Zealand. I also need to continue to learn and develop my skills and knowledge base so that I can pass those skills onto my clients. I also need to look closely at the draping materials I use and in turn examine the way I wash those materials. I would like to start using eco-friendly washing powder and utilise the sun wherever possible to dry my washing. It may take, time, money and effort in order to create a sustainable massage practice but the rewards far out way the costs.

References

Goodland, R. (2002). Sustainability: human, social, economic, and environmental. Retrieved 13 August, 2009 from http://www.wiley.co.uk/egec/pdf/GA811-W.PDF

Shorter Oxford English Dictionary (5th ed). (2002). New York: Oxford Press

Sutton, P. (2000). Sustainability: What does it mean?. Retrieved 13 August, 2009 from http://www.green-innovations.asn.au/sustblty.htm

Task 4 - The Ethics of Professional Practice

FM Task 4 – The Ethics of Professional Practice

Ethics and ethical considerations need to play an important role in any Massage Therapists professional practice. There are a number of aspects of ethics that a therapist must keep in mind throughout a massage and throughout their professional career. Below I have outlined and described a few ethical considerations that a massage therapist needs to make but this list is by no means definitive.

Client-centred care

Client-centred care is about the massage therapist having the clients best interests and needs in mind throughout the entire massage. It also means that the clients opinions, voice and approval matter. The client must agree to and approve the treatment plan and they must be aware that they have the right to terminate the massage at any time (Benjamin & Sohnen-Moe, 2004).

Informed consent

Informed consent is relevant to professional practice because it ensures that the client is informed of every aspect of your practice and the massage process. Informed consent works to allow knowledgeable evaluation of adequate information, risks and benefits presented to the client before the massage. Fritz (2003) notes that informed consent “supports professional behaviour” (p. 43) and this is why massage therapists must keep this in mind throughout their professional career.

Scope of practice

A massage therapist must only work within their own scope of practice to make sure that the client is not put at risk. As stated in the Massage New Zealand (2009) Code of Ethics in regards to scope of practice, a massage therapist should represent their training, qualifications and abilities honestly. A massage therapists scope of practice defines the particular working parameters for this profession (Salvo, 2003) and outlines the limitations of a massage therapists practice. It is important in terms of ethical considerations because it allows the client to become fully informed.

Confidentiality

Confidentiality is the principle that clients information is private and should not be discussed with anyone without the clients permission (Fritz, 2003). For this reason confidentiality is an important ethical consideration in any massage therapists professional practice. Client records should at all times be kept in a locked cabinet and access is only granted to other practitioners with the clients authorisation (Salvo, 2003). Confidentiality within the massage setting should also take into account what is said between client and therapist before and during the massage.

Boundaries

There are a number of different boundaries that require ethical considerations as a massage therapist. Boundaries can be personal, for example physical (touch) and emotional. Or boundaries can be professional in terms if the limits of behaviour between acceptable and unacceptable behaviour (Yardley-Nohr, 2006). Boundaries must be clearly communicated and well managed as part of a massage therapists professional practice (Salvo, 2003).

Power differentials

Every therapeutic relationship has an innate power differential. This can be due to the acknowledged difference of knowledge and skills between therapist and client (Salvo, 2003). Power differentials also exist between client and therapist due to the physical aspects of massage therapy (Benjamin & Sohnen-Moe, 2004). A therapist must always keep these power differentials in mind throughout any massage and it is important ethically that power differentials are not abused.

Relationships

There are a number of different relationships in a massage therapists life. What is ethically important is that the therapist maintains a professional client – therapist relationship. It is also important that the therapist dies not cross any boundaries from professional to personal relationship (Salvo, 2003). But a therapist must build some rapport with their client in order to build trust and to provide the client with the benefits of their service (Salvo, 2003).

Transference and Counter-transference

Benjamin & Sohnen-Moe (2004) note that “transference and counter-transference are usually unconscious” (p. 23) and occur respectively from client to therapist and therapist to client. Transference is the “personalization of the professional relationship by the client” (Fritz, 2003, p. 53) and often occurs when the client-therapist relationship has become personal rather than staying professional. On the other side, counter-transference is the therapists personalization of the client-therapist relationship (Fritz, 2003). A therapist is more likely to want their needs met through interaction rather than the clients needs and in the extreme case the relationship develops into an intimate one (Salvo, 2003). To continue to be ethically responsible a therapist must be able to recognise the signs of both transference and counter-transference. They must also have the ability to, or have access to help, to diffuse and deal with these types of situations.

As is illustrated above there are numerous ethical considerations to be made and kept in mind for massage therapists throughout their professional practice. Those listed above are only a snapshot and any massage therapist must take a further in-depth look at these and other ethical considerations.

References

Benjamin, B.E., & Sohnen-Moe, C. (2004). The ethics of touch: the hands-on practitioner’s guide to creating a professional, safe and enduring practice. Retrieved 28 July, 2009 from http://books.google.co.nz/books?id=qLFqSh3xo7kC&printsec=frontcover#v=onepage&q=&f=false.

Fritz, S. (2003). Mosby’s fundamentals of therapeutic massage (3rd ed.). St. Louis: Mosby. Massage New Zealand. (2009).

Massage New Zealand: Code of Ethics. Retrieved 30 July, 2009, from http://massagenewzealand.org.nz/about-us/code-of-ethics/.

Salvo, S. (2003). Massage therapy: principles and practice (2nd ed.). St. Louis: Mosby.

Yardley-Nohr, T. (2006). Ethics for Massage Therapists. Retrieved 29 July, 2009 from http://books.google.co.nz/books?id=vOyYuVjKetIC&printsec=frontcover#v=onepage&q=&f=false.

Hi Everyone

This is a new blog, go me.

FM Task 2 - Effects of massage strokes

Task 2 - The effects of massage strokes

The autonomic nervous system (ANS) is an involuntary system that supplies impulses to smooth muscle, cardiac muscle and glands (Salvo, 2003) for example, breathing and keeping the heart beating. The ANS is split into two divisions, the parasympathetic nervous system (PNS) and the sympathetic nervous system (SNS). These two divisions work complementary to maintain homeostasis (balance) through a feedback loop (Fritz, 2003). The effects of massage can be seen through both systems and are outlined below.

The sympathetic nervous system (SNS) is involved in “active involuntary motor functions” (Holey & Cook, 2004, p47) and is responsible for the fight or flight response. Activation of the SNS generally results in stress and the release of cortisol a ‘stress hormone’ (Fritz, 2003). Massage reduces sympathetic arousal so decreases the chance of high levels of cortisol and lessens the chance of hypertension, muscle weakness and fatigue (Fritz, 2003). Fritz (2003) also states that “massage methods that require the client’s active participation help dissipate sympathetic stress hormones, allowing the system to re-establish homeostasis (p137).

The parasympathetic nervous system (PNS) works complimentarily with the SNS and activates the body’s relaxation and restorative responses (Fritz, 2003). Massage “encourages parasympathetic dominance… to counter the effects of the sympathetic overarousal” (Fritz, 2003, p135). Massage encourages peace, calmness and relaxation through the PNS.

While the effects of massage can be seen specifically on the autonomic nervous system, each massage stroke can also have various effects on the body. Each massage stroke has a different effect on the body although there are some similarities between the strokes and these are outlined below.

Touch is an excellent way of establishing initial contact between client and massage therapist. Holding via touch allows the client to become accustomed to the therapists touch. "Positive touch in the form of massage therapy has been shown to release ‘feel good’ and ‘feel close’ neuropeptides” (Tuchtan, Tuchtan & Stelfox, 2004, p51). The long flowing effleurage strokes help to spread the lubricant, warm the tissue and help to “flush out the tissue after using other strokes” (Salvo, 2003, p151). Fast effleurage stimulates the SNS whereas the PNS is stimulated through slow effleurage (Salvo, 2003). The use of petrissage should occur after effleurage has warmed the tissue, this stroke reduces muscle tension and mechanically softens the superficial fascia (Fritz, 2003). It also helps to flush metabolic wastes and draw new, healthier fluid back in (Salvo, 2003). However, this stroke is very labour intensive for the massage therapist unlike holds and effleurage.

Compression can be either fast and stimulating or relaxing with holds. Compression can be useful for working over clothing, without wax or with a client who is particularly hairy (Fritz, 2003). This stroke is useful for increasing circulating, relaxing muscles, breaking down adhesions and it imitates muscle stretching that occurs in normal muscle movement (Salvo, 2003). Tapotment can also be performed over clothing and is a stroke that stimulates the tissue and because of this the massage therapist needs to be wary of using tapotment around certain endangerment sites like the kidneys and the popliteal fossa (Salvo, 2003). Tapotment “initiates or enhances sympathetic activity of the autonomic nervous system” (Fritz, 2003, p326). It can also be used to loosen and move mucus in the chest of children with cystic fibrosis (Fritz, 2003). Vibration differs from tapotment because the therapists’ hands don’t break contact with the clients skin (Salvo, 2003). This stroke also increases circulation, relieves pain and improves general relaxation (Salvo, 2003). Just like petrissage, vibration can be physically demanding.

Massage strokes can effect the body specifically as identified above. And they can also have an effect on various bodily functions, mood and concentration levels as explained below.

Massage can effect blood flow and blood pressure as the body reacts by dilating blood vessels which aids circulation and lowers blood pressure (Salvo, 2003). Tuchtan et al. (2004) state “local circulation is enhanced through the application of massage” (p38). As well as blood flow massage can effect lymph flow. Massage applied to lymphedema (swelling) reduces fluid retention and subsequently lowers swelling (Salvo, 2003).

Massage using direct pressure can relieve muscle tension, tightness and stiffness (Salvo, 2003). “Muscles relax as massage reduces excitability in the sympathetic nervous system” (Salvo, 2003, p90). Massage also effects connective tissue because it can help to reduce excessive scar formation and applied pressure helps to release fascial adhesions by loosening and melting the fascia (Salvo, 2003).

Massage has been reported to aid sleep patterns (Tuchtan et al., 2004) and may be reported as “deeper” or “better” because of all the other changes and benefits of massage (reduced muscle tension, increased circulation and improved mood). Satiety is a feeling of emotional satisfaction which can be fulfilled with massage. Unmet emotional needs for attention, acceptance and caring can be met through massage.

The PNS is dominant during the digestion of food, “massage promotes activation of the parasympathetic nervous system, which stimulates digestion” (Salvo, 2003, p93). Massage therapy is also a useful method to reduce local and referred pain. Massage elevates endorphin levels, reduces pain perceptions and increases circulation all leading to a reduction in pain (Tuchtan et al., 2004; Salvo, 2003). Salvo (2003) outlines a number of reasons how massage can improve a clients mood, it can improve body image, improve self esteem, decrease feelings of anger and reduce stress levels. Mood will improve with the increase of endorphin levels. By relaxing the body and mind and reducing stress levels, massage can increase mental alertness and help with concentration levels (Salvo, 2003).

Overall, massage therapy can have huge and far ranging effects as described above. Most importantly in Relaxation massage I believe is the ability to reduce stress levels, improve mood and reduce pain levels.

References

Fritz, S. (2003) Mosby’s fundamentals of therapeutic massage (3rd ed.). St. Louis: Mosby.

Holey, E., & Cook, E. (2003) Evidence-based therapeutic massage : a practical guide for therapists (2nd ed.). Edinburgh: Churchill Livingstone.

Salvo, S. (2003) Massage therapy: principles and practice (2nd ed.). St. Louis: Mosby.

Tuchtan, C., Tuchtan, V., & Stelfox, D. (2004) Foundations of massage (2nd ed.). Australia: Churchill Livingstone/Elsevier.

Definition - Posture

Posture for me has come to mean something different when thought of in the context of Massage Therapy.

A Massage Therapist must be equally aware of themselves as well as their client. It is impotant to learn the correct stance and posture at the beginning of the learning process so that little/few "bad habits" are formed. The Massage Therapist must create a strong base of support from which their weight can be transferred easily throughout the massage. If the correct posture is adopted both the client and massage therapist will benetit greatly. 

I belive that the clients posture needs to remain neutral on the table in order for the massage to be most beneficial. They may also need to be educated as to the correct posture so that they can reduce injury and pain in the future.

Reflection...post first week

Phew, what a week...my head has finally recovered from the concentration required last week.

I have learnt so much more than I expected and can't wait to keep learning. I have begun to look through my old Anatomy notes and lab manuals to try and familiarise myself with the muscles of the back that we worked on last week. I have also been over in my head the process of setting up my table and drapping the client. I am sure I'm missing things though...practice practice practice. 

I can't wait to get into more of the practical aspect of the course and to hopefully back that up with some knowlege from our text books. I am yet to purchase any of our required text books but I will be looking at getting the Practical Guide text shortly. I already have an Anatomy textbook from my Physed Degree and have also picked up another text book from a former Physio student. I am sure that I will be frequenting the library within the next couple of weeks.

About me

My name is Hannah Joseph
I grew up in Auckland but now reside in Dunedin where I have been living for the past six years. I graduated in 2007 with a Bachelor of Physical Education from Otago University. I am now studying part time towards a Diploma of Massage Therapy. I am interested in studying sports massage, deep tissue massage as well as relaxation massage (basically the whole lot). Ultimately I would like to set up a business with my partner who is a chef.