500 Hour Program Class Outline Form
Class Title: 89b Clinical Hydrotherapy #1
Course(s) and Hours:
Class Description -
Learning Objectives – Teacher and Students review kinds of questions that might be on MBLEX or NESL and their answers. And discuss, demo and practice clinical applications of hydrotherapy.
Class Outline
Time Description Assignment/Resources
10:15-10:25 / Set up massage tables – and sit at them for initial lecture/demoRoll and Opening meditation
10:25-11:25 / Review of Hydrotherapy academic information – Go through Part 1 Hydrotherapy PowerPoint
and cite samples of MBLex-type questions
11:25-11:40 / break
11:40-12:00 / Lecture and discussion of relevant uses of hydrotherapy in more clinical contexts – drawn from Whitney Lowe’s book.
Thermal agents such as ice bags, hot packs, ultra-sound units used to increase circulation and soft –tissue extensibility, increase or decrease the local tissue metabolic rate, and to decrease inflammation, and help manage pain.
Theories how thermal therapies help:
· Gate theory – initially the idea that two signals passing through “gate” of nervous system (e.g. cold and pain) diminishes the pain signal.
· Newer theory (neuromatrix) suggests pain is something produced BY the brain and so has cognitive and emotional elements that can be affected by thermal experience.
· Conduction – heat is transferred from object with higher temperature to object with lower temperature. (heat packs & ice bags)
· Convection – the medium is moving (e.g. Jacuzzi or foot baths) – medium’s movement allows a more efficient transfer of heat.
· Radiation – electromagnetic energy moving through space (e.g. infrared heat lamps a saunas)
· Conversion – outside of our scope. Transformation of non-thermal energy into heat (e.g. ultrasound)
Ultrasound – the denser the tissue the faster it absorbs ultrasound energy. So it is the only “thermal” medium to penetrate to level of ligament and bone.
Most thermal applications don’t go deeper than 1 cm below the skin. They can though be neurologically impactful (relaxing the ANS or distracting from the pain – decrease excessive sensory activity in the nervous system)
Benefits of Heat
· Increases local tissue metabolism
· Increase local circulation bringing nutrition and removing waste
· Viscosity of blood is reduced improving blood flow
· Increases lymphatic fluid movement, removing damaged cellular debris
· Increases extensibility and elasticity of various connective tissues
· Relaxes neurological cells within fascia that govern fascial contractility
· Increases elasticity in superficial connective tissues and reduces fascial tension
· Relaxes deeper muscles through neurological effects
· Assists therapeutic stretching procedures
· Decreases excess neurological activity and hypertonicity
· Improves motor nerve conduction so reduces biomechanical dysfunction
· Increases nerve conduction velocity so reduces muscle tightness
· Break the pain-spasm-pain cycle and reduces pain
Benefits of Cold
· Cellular metabolism is slowed, shortening healing time
· Swelling from acute injuries is reduced
· Blood flow is inhibited, also reducing inflammation
· Heat from inflammation is reduced
· Sensory signals are slowed, reducing pain
· Pain tolerance is heightened
· Acute spasm may be inhibited
· Reduces muscle soreness
· Decreases muscle tightness
· Helps break the pain-spasm-pain cycle
Topical Analgesics (e.g. Icy Hot, Ben Gay, Tiger Balm, etc.)
Majority used are counterirritants. E.g. one that provides a sensation of heat or cold on the skin. Neurological responses most significant (based on gate theory) – distracts the nervous system from the pain sensation. Otherwise, minimal physiological or anatomic benefits to these.
12:00-12:30 / DEMO hot wet towels treatment
12:30-12:45 / break
12:45-1:30 / Practice and Switch
1. Which condition is a contraindication for the paraffin bath?
a. Subacute bursitis
b. Arthritic joints
c. Acute bursitis
d. Stiff joints after fractures of sprains
2. How does most of the body’s heat leave?
a. Respiratory system
b. Urinary system
c. Skin
d. Defecation
3. Which is contraindicated for a hot foot bath?
a. Congestive headaches
b. Peripheral vascular disease and swollen feet
c. Pelvic congestion
d. Chest congestion
4. After a decrease in blood flows as an initial effect of ice, what is the secondary effect?
a. Increase in blood flow
b. Decrease in blood flow
c. Stoppage of blood flow
d. Stimulates release of endorphins
5. Define the hydrotherapy modality in which the client is in a steam cabinet with his head protruding?
a. Sitz bath
b. Russian bath
c. Steam room
d. Whirlpool
6. What is the most beneficial effect of hydrotherapy?
a. thermal reactioni
b. chemical reaction
c. Mechanical reaction
d. None of the options
7. What is the initial reaction to cold by the skin?
a. Release of adrenalin
b. Vasodilation
c. Vasoconstriction
d. Relaxation
8. How do you treat frostbitten feet?
a. Use of warm water
b. Deep effleurage
c. Kneading
d. Vibration
9. When is a whirlpool bath indicated?
a. Post-operative orthopedic conditions
b. Stiffness and sore muscles
c. Low blood pressure
d. All of the options
10. What is the main effect from using a whirlpool?
a. Stimulate general circulation
b. Slow circulation
c. Decrease blood flow
d. Increase localized circulation
Clinical Hydrotherapy #1
Hot Towel Application-
Students should bring 2 hand towels to class. Upon arrival the students are instructed to take their hand towels to the rest room and soak their towels under the faucets, then wring them out thoroughly, bring them back to class, and have assistant help them organize towels in hot towel cabinet.
With the allotted time of lecture and demo, towels should be hot enough to be effective.
The Hot Towel application, although effective for superficial circulation is mostly a complimentary addition to a Swedish, deep massage, deep tissue or any of the clinical protocols taught at TLC. It can enhance a client’s deeper sense of relaxation when applied at the end of several body segments in a given treatment.
Example #1- Back
Once a full back treatment is concluded remove hot towel from cabinet. Unravel towel shake out momentarily to take out the intense heat (be sure not to burn the client) and place towel on back. Immediately apply relaxing rocking compressions to the entire back (you will want to work fairly quickly as a moist towel will cool quickly and turn cold fast).
Using the moist wet terry cloth, grasp the upper traps using relaxing, sedative kneading strokes. Move then to the rhomboids and muscles at the medial border of the scapula. Once again use the moist terry to grasp the muscle, picking it up off the body and rocking it in a rhythmic circular motion. This can also be applied at the erectors.
Once finished, cover the towel with sheet and blanket and pull wet towel from underneath the draping. Using compressions, blot the area. This will relax the muscle further and pick up any residual moisture left behind.
Example #2 (Prone)-Glutes, Hamstrings, Calf muscles
Once a glute, upper and lower leg treatment is concluded remove hot towel from cabinet. Unravel towel, shake out momentarily to take out the intense heat (be sure not to burn the client), fold towel in half (long ways) and place it on glute, TFL and upper hamstring muscles. Immediately apply relaxing rocking compressions to the entire area (you will want to work fairly quickly as a moist towel will cool quickly and turn cold fast). Once complete, cover the muscle with the sheet and the blanket then slide the wet towel down to the hamstrings.
Apply relaxing compressions to hamstrings. Using the moist wet terry cloth, grasp the muscles using relaxing, sedative kneading. Once complete, cover the muscle with the sheet and the blanket then slide the wet towel down to the calf muscles (you will want to work fairly quickly as a moist towel will cool quickly and turn cold fast).
Apply relaxing compressions to calf muscles (focus to gastrocs and soleus). Using the moist wet terry cloth, grasp the muscles of the calf using relaxing, sedative kneading strokes. Once finished cover the towel with sheet and blanket and pull wet towel from underneath the draping. Using compressions, blot the area. This will relax the muscles further and pick up any residual moisture left behind.
Example #3 Feet (prone or supine)
Once a full foot treatment is concluded, remove hot towel from cabinet. Unravel towel, shake out momentarily to take out the intense heat (be sure not to burn the client) and place towel on feet. Immediately apply relaxing kneading compressions to the both feet (you will want to work fairly quickly as a moist towel will cool quickly and turn cold fast).
Once finished cover the towel with sheet and blanket and pull wet towel from underneath the draping. Using compressions, blot the area. This will relax the muscles further and pick up any residual moisture left behind.
July 15, 2013