Soft tissue manipulation on the lower limb

It describes on the massage section and it's types along with soft tissue manipulation and mobilization on lower limb which is a part of exercise therapy

1. Soft Tissue
Manipulation On
Lower Limb
(Exercise therapy)

Definition of STM:
• Soft tissue manipulation (STM) is used to designate certain
manipulations of the soft tissues of the body.
• These manipulations are most effectively performed with the
hands and are administered for the purpose of producing effects
on the nervous, muscular and respiratory systems and the local
and general circulation of the blood and the lymph.

Classification of therapeutic massage:

2. Effleurage
Consists of long, soothing,
stroking movements
performed by palmar aspect
or fingers.

-
-
Superficial
Deep


Petrissage
Includes various types of
strokes in which tissues are
compressed, lifted, squeezed
and released with varying
amount of pressure, drag
and glide.

-




-
-
-
Kneading
Picking up
Wringing
Skin rolling

Palmer
Finger pad
Thumb pad
Knuckle
Reinforced

Tapotement
In this, the part being
treated is striked repeatedly
by the various modified
position of hand(s).
Tapotement strokes are fast
and precision action.


-
-
-
-
Clapping
Beating
Hacking
Pounding


Friction
Involves brisk, repetitive,
specific, compressive strokes.
-
-
Superficial
Deep


Deep transverse friction
Circular deep friction

Vibration
Fine shaking strokes


Shaking
Rhythmic shaking strokes

3. Techniques of Stm for lower limb:
• The sequence begins with the patient in supine lying
with the therapist on the side of the patient to be
treated.
• A small pillow may be useful under the patient’s
knees.

1. Superficial Effleurage to the thigh:
• Both hands reach around the thigh, covering it
as much as possible, and stroke from the
anterior superior iliac spine (ASIS) of the ilium to
the knee.
• The stroke may be performed with the hands
working alternately or simultaneously.
• The technique is repeated 4 times.

4. 2. Superficial Effleurage to the leg:
• Both hands stroke from the knee to the ankle in
the standard method for this technique,
covering the entire surface of leg. This is
repeated for 3 times.

5. 3. Deep Effleurage to the thigh:
Both hand grasp around the thigh just proximal to
the knee joint, with the thumbs abducted and the
fingers held together. The finger tips of opposite
hands are in contact with each other on the
posterior surface. With firm pressure of the entire
palmar surface, the hands stroke upward to the
upper portion of the thigh and then return to the
knee with a superficial stroke. These movements are
repeated for 3 times.

4. Deep Effleurage to the entire leg:
Both hands begin the stroke at the ankle. Both
hands then stroke firmly towards the knee,
returning to their starting position with a light,
superficial stroke. This is repeated for 3 times.

5. Palmar kneading:

6. The whole palm is used to direct the pressure upward
and inward in a circular motion and the skin moves with
hand(s) over the underlying structure. Pressure is applied
during half of the circle and released during another half
of the circle and then repeated on the adjacent area.
Palmar kneading to the quadriceps


Palmar kneading to the calf muscles

7. 6. Thumb pad kneading:
The pressure over the tissues are applied by the pad
of one or both thumbs. The basic direction of
movement is circular which includes pressure and
release phase. Thumbs of both hands are used to
work side by side. To The Anterior tibial muscles: