The authors concluded that massage appears to be the most effective method that was studied for reducing DOMS and perceived fatigue.
This is not a list of precautions or contraindications for massage therapy. Rather it is list of miscellaneous, somewhat random, “dos and don’ts” that I believe would improve massage therapy sessions with clients.
To transition to perform deep strokes and maintain proper body mechanics, it is necessary to transition from being perpendicular to be slightly horizontal to glide along the client’s body. However, minimize the horizontal direction or pressure into the client’s tissues will be lost.
Stacked joints are aligned in a straight line; in other words, the joints are extended as in anatomic position. This allows for the force from your core to travel through your upper extremity and into the client with little or no loss of strength.
Being able to feel tissue tension barriers is the one most important hands-on skill that an orthopedic manual therapist needs. Clinical orthopedic manual therapy (massage and stretching) only effects change if we reach tissue tension and then apply slightly more force beyond it.
When working the low back, a good strategy is to begin with a smaller treatment contact such as thumb or finger pads to assess and begin treatment of the lumbar region, and then switch to a larger contact such as the palm or elbow to deliver deeper pressure.
For proper body mechanics, it is important to support your contact. Place the thumb pad of your right hand over the thumb pad contact of the left hand to brace/support it. Proper location of the brace is to place the right thumb pad on the dorsal surface of the distal phalanx of the thumb.
The therapist performed a static assessment of the client’s posture and noted the typical upper crossed syndrome with a hyperkyphotic thoracic spine, a hypolordotic lower cervical spine, a hyperlordotic upper cervical spine, protracted head, protracted scapulae, and medially (internally) rotated arms.
Especially effective for the pectoralis musculature is to use pin and stretch technique. With the client/patient supine and positioned toward the side of the table, pin the musculature with your finger pads as you bring the client/patient’s abducted arm off the side of the table and down into horizontal extension.
It is necessary to determine what condition is causing the sciatic nerve compression and address that. If the cause is a pathologic disc, then addressing factors that affect disc compression is appropriate.