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Pathology for Massage Therapists

Definition: inflammation of a tendon or musculotendinous junction
Causes: overuse, repetitive stress, improper healing, or tearing from sustained overloading of muscle
Signs/Symptoms: pain, persistent pain worse at night, pain referral, pain worse after use, muscle weakness,  inflammation, limited ROM; usually occurs where the tendon attaches to the bone or where the muscle attaches to the tendon or in the tendon.
Common areas: rotator cuff tendonitis, infraspinatus tendonitis, carpal tunnel syndrome, tennis elbow, shin splints
Indications: Massage as per your level of training.  Trigger point treatments, relieve inflammation, re-educate movement. Slow to heal because of lack of vascularity.
Contraindications: Cortisone shots may be administered; Use caution

Temporal Mandibular Joint Syndrome
Definition:  dysfunction of the temporal mandibular joint (jaw): displacement of cartilage disk
Causes: jaw misalignment, cranial misalignment, vertebral misalignment, scoliosis, tooth grinding, stress, bad posture, hypoglycemia (tooth grinding and clenching more prevalent), whiplash, poor dental work, trauma,
Signs/Symptoms: jaw pain, muscle spasms around joint, clicking, tooth grinding, popping, pain, headaches, neck and shoulder pain, tinnitus
Indications: Massage to realign problem areas, especially, temporalis, masseter, pterygoids, cranial realignment, cervical realignment.  Intra oral work is usually needed but may be out of the scope of practice in your state.
Contraindications: none: Refer to appropriate health care practitioner; Surgery can be avoided

Article on TMJ  by Judith Walker Delaney

Definition: inflammation of the tendon sheath - the gliding surface of the tendon and surrounding sheath.
Causes: overuse, repetitive motion, repetitive strain, improper posture, misalignment
Signs/Symptoms: pain, inflammation, stiffness
Indications: Massage as per your level of training;  Reduce inflammation, relieve trigger points, realign problem area
Contraindications: None; Check for medications - steroids may be used in treatment.

Trigeminal Neuralgia
Definition: compression of fifth cranial nerve; may cause degeneration of nerve
Causes: vertebral misalignment, cranial misalignment, TMJ
Signs/Symptoms: pain in face area
Indications: Massage for pain reduction, realign problem areas
Contraindications: None. Refer to appropriate health care provider.

Thoracic Outlet Syndrome
Definition: compression of brachial nerve plexus; C8-T1; may also be referred to as Brachial Plexus syndrome which may involve C5-C8.
Causes:  tightness in pectoral muscles, intercostals, muscles around clavicle, upper back, neck; misalignment in one or all or these areas; disc protrusion or herniation, fibromyalgia, degenerative changes in the spine causing nerve impingement, inter-scalene triangle impingement, fibrositis of the cervical and shoulder area,
Signs/Symptoms: pain in arm, shoulder, hand, forearm; cold hands and fingers due to compression of axillary artery
Indications: Massage; realignment and release compression
Contraindications: none; Refer to appropriate health care practitioner; Have clear diagnosis to rule out neuritis.

see also massage treatment for thoracic outlet syndrome

Definition: inflammation of a vein
Causes: thrombus(blood clot) from trauma, environmental allergies, lack of exercise and movement, standing for long periods of time, aging, poor circulation, abnormal clotting
Signs/Symptoms: swelling, pain, discoloration of the skin (bluish)
Indications: massage above area
Contraindications: Do not work directly on the area involved

Definition: wry neck, asymmetry in the strength or function of the Sternocleidomastoid muscle causing rotation of the head to one side with a tilt in another direction (lateral, forward or backwards)
Causes: bad sleeping position, stress, TMJ, vertebral misalignment, spasm in SCM, emotional trauma,
Signs/Symptoms: pain, lack of rotation of the neck
Indications: massage to relieve muscle contraction, realign problem areas, lengthen SCM
Contraindications: none; Refer to appropriate health care practitioner.

Definition: infectious disease of the lungs
Causes: bacterial
Signs/Symptoms: flulike symptoms, cough, chest pain, fever, night sweats, shortness of breath
Contraindications: Refer to Physician; Highly contagious

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