Integrated Manual Therapy & Orthopedic Massage For Complicated Forearm, Wrist & Hand Conditions Assessment Protocols Treatment Protocols Treatment Protocols Corrective Exercises Artwork and slides taken from the book Clinical Massage Therapy: A Structural Approach to Pain Management Published by Pearson Education By Author & International Lecturer James Waslaski LMT, CPT
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Integrated Manual Therapy & Orthopedic Massage For Complicated
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Integrated Manual Therapy & Orthopedic Massage
For Complicated Forearm, Wrist & Hand Conditions
Assessment Protocols Treatment Protocols
Treatment Protocols Corrective Exercises
Artwork and slides taken from the book Clinical Massage Therapy: A Structural
Approach to Pain Management Published by Pearson Education
By
Author & International Lecturer
James Waslaski LMT, CPT
Integrated Manual Therapy & Orthopedic Massage
For Complicated Forearm, Wrist, & Hand Conditions Today’s manual therapist needs to have multiple skills in order to address a wide variety
of complicated musculoskeletal pain conditions. Specialization in just one modality is
becoming a thing of the past because of limited patient outcomes. This unique total
system consists of orthopedic assessment, clinical reasoning, multidisciplinary and multi-
modality therapies, and precise corrective stretching and strengthening exercises.
Participants will learn to integrate the skills of leading practitioners from the fields of
massage therapy, physical therapy, athletic training, personal training, osteopathic and
chiropractic to restore balance, posture, function and pain free living. Recent clinical
studies will forever change the way manual therapists look at musculoskeletal pain,
muscle-tendon strain pain, and adhesive capsular pain. This seminar will teach manual
therapists to isolate and treat multiple nerve compression areas, tendonitis and tendinosis
of the elbow, pronator teres syndrome, carpal tunnel syndrome, tenosynovitis, fixated
joints, and trigger finger. Corrective stretching and strengthening techniques will be also
taught to keep the muscles balanced, and joints aligned for pain free living.
Twelve Steps: 1. Client History 2. Assess Active Range of Motion 3. Assess Passive Range of Motion 4. Assess Resisted Range of Motion 5. Area Preparation 6. Myofascial Release/ Compression Broadening 7. Cross Fiber Gliding/Trigger Point Therapy 8. Multidirectional Friction 9. Pain Free Movement 10. Eccentric Scar Tissue Alignment 11. Stretching 12. Strengthening James Waslaski is an Author & International Lecturer who teaches approximately
40 seminars per year around the globe. He’s served as AMTA Sports massage Chair
and FSMTA Professional Relations Chair. He’s developed 8 Orthopedic Massage and
Sports Injury DVDs, and authored manuals on Advanced Orthopedic Massage and
Client Self Care. His new book, Clinical Massage Therapy: A Structural Approach to
Pain Management was published by Pearson Education in 2011. James presents at
state, national and international massage, chiropractic, and osteopathic
conventions including keynote addresses at the FSMTA, World of Wellness, New
England Regional Conference, the World Massage Festival, and Australian National
Massage Conventions. His audience includes massage and physical therapists as
well as athletic trainers, chiropractors, osteopaths, nurses and physicians. He is a
certified personal trainer with NASM. James received the 1999 FSMTA International
Achievement Award and was inducted into the 2008 Massage Therapy Hall of
Clinical Massage Therapy: A Structural Approach to Pain ManagementJames Waslaski
Figure 7-32B Carpal Bone Mobilization.
Clinical Massage Therapy: A Structural Approach to Pain ManagementJames Waslaski
Figure 7-32C Carpal Bone Mobilization.
Clinical Massage Therapy: A Structural Approach to Pain ManagementJames Waslaski
Figure 7-33A Carpal Bone Mobilization—Ulnar Deviation.
Clinical Massage Therapy: A Structural Approach to Pain ManagementJames Waslaski
Figure 7-33D Carpal Bone Mobilization—Radial Deviation.
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Clinical Massage Therapy: A Structural Approach to Pain ManagementJames Waslaski
Figure 7-33B Carpal Bone Mobilization—Wrist Flexion.
Clinical Massage Therapy: A Structural Approach to Pain ManagementJames Waslaski
Figure 7-33C Carpal Bone Mobilization—Wrist Extension.
Clinical Massage Therapy: A Structural Approach to Pain ManagementJames Waslaski
Figure 7-33E Deep Gliding Strokes Through Carpal Tunnel.
Clinical Massage Therapy: A Structural Approach to Pain ManagementJames Waslaski
Stretching (Client Self-Care)
• Client self-care is important to maintain the soft-tissue balance that was restored by therapy. As the client goes back to normal day-to-day activities, muscle groups (usually the wrist flexors, hand flexors, and forearm pronators) will become short and tight and the antagonists (usually the forearm supinator and wrist extensors) will become weak and inhibited.
Clinical Massage Therapy: A Structural Approach to Pain ManagementJames Waslaski
Stretching
• Daily stretches and therapeutic exercise will help keep those muscle groups in balance.
Clinical Massage Therapy: A Structural Approach to Pain ManagementJames Waslaski
Figure 7-36 Forearm/Wrist Flexors Stretch.
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Clinical Massage Therapy: A Structural Approach to Pain ManagementJames Waslaski
Figure 7-37 Hand Flexors Stretch.
Clinical Massage Therapy: A Structural Approach to Pain ManagementJames Waslaski
Figure 7-38 Pronator Teres Stretch.
Clinical Massage Therapy: A Structural Approach to Pain ManagementJames Waslaski
Strengthening (Client Self-Care)
• Wrist and Hand Extensors–The client’s elbow is bent at 90 degrees
along the side of the body.–He or she wraps a Thera-Band around
the involved hand, both ends anchored with the other hand.
–The client slowly extends the fingers and then the wrist from the neutral position taking 2 seconds (concentric contraction).
Clinical Massage Therapy: A Structural Approach to Pain ManagementJames Waslaski
Strengthening
• Wrist and Hand Extensors–He or she slowly returns the fingers and
wrist back to the neutral position taking 4 seconds (eccentric contraction)
–The client repeats this exercise 8 to 10 times
Clinical Massage Therapy: A Structural Approach to Pain ManagementJames Waslaski
Figure 7-39 Strengthen Hand and Wrist Extensors.
Clinical Massage Therapy: A Structural Approach to Pain ManagementJames Waslaski
Figure 7-39 (continued) Strengthen Hand and Wrist Extensors.
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Clinical Massage Therapy: A Structural Approach to Pain ManagementJames Waslaski
Figure 7-40 Strengthen Forearm Supinator.
Clinical Massage Therapy: A Structural Approach to Pain ManagementJames Waslaski