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Pathology B for Massage Therapists

Baker’s  Ganglion Cyst

Definition:  Cyst in synovial lining of knee containing fluid

Causes: trauma, hereditary, infection, or parasitic obstruction

Signs/Symptoms: round to ovoid mass that may be soft but more often is firm due to the fluid build up
Indications:  Treat area above cyst; addressing hamstrings, adductors

Contraindications: Avoid deep direct pressure on cyst; Cyst may become large enough that it impinges nerves or blood flow through leg;  Blood clotting is also a possibility; have checked for thrombosis if necessary.  Watch for signs of coldness, clamminess and edema.

Baker’s Cysts By Ben Benjamin, PhD

Bell’s Palsy

Definition: Paralysis of facial muscles (peripheral neuritis-inflammation of nerve)

Causes:  Infection or compression of VII cranial nerve (motor neuron responsible for facial expression, blinking eyes and some taste): TMJ, stress induced, tumor, bone spur, upper cervical misalignment/subluxation, middle ear infections; sometimes associated with diabetes, Lyme disease, Guillain-Barre, toxins, upper respiratory infection, herpes virus.

Signs/Symptoms: loss of taste, loss of feeling in face, lack of muscle control in cheek, face, eyelids, mouth; usually on one side.

Indications: Relaxation massage: facial exercises for reawakening face muscles; hot/cold contrast therapy; work cervical vertebrae to relieve any compression, TMJ re-alignment.  Chiropractic may assist healing.

Contraindications: Refer to physician for diagnosis to rule out stroke; Do Not Knead or over-stretch flaccid facial muscles.

Biceps Strain

Biceps vs. Brachialis Strain  By Ben Benjamin, PhD

Boil (furnuncle)

Definition: Pus filled cavity formed by infection of hair follicle or sebaceous gland. (staphylococcus infection)

Causes: bacterial, trauma, chemical irritation, excessive sweating, infection

Signs/Symptoms: subcutaneous swelling around hair shaft, with pain and tenderness

Indications: Massage may assist in healing by increasing circulation; Hot compresses, clay compresses.

Contraindications: Avoid infected, inflamed area; Contraindicated if other symptoms such as fever, inflamed lymph nodes are present.

Breast Cancer

Definition: There are many types of breast cancer. abnormal, malignant growth in breast tissue; found in both men and women.

Causes: Excess estrogen, environmental toxins, high fat diets, stress

Signs/Symptoms: firm lump which are usually pain free( but not always) Biopsy is the only way to diagnose cancer

Indications: Massage may spread cancer although this has not been proven; working on sides of rib cage and under bra line may increase circulation to reduce risk.  Relaxation and moving lymph is the focus

Contraindications: Get physicians referral and clients permission. Explain all the possibilities.  Refer to Naturopath and/or acupuncturist for treatment

Books – Medicine Hands: Massage Therapy for People With Cancer (Paperback)
by Gayle MacDonald.

Bronchitis

Definition: Inflammation or obstruction of the bronchi ( breathing tubes that lead to lungs)

Causes: infection, viral, bacterial, chlamydial, mycoplasmal, or a combination of agents, May be also brought on by exposure to smoke or other fumes, allergies

Signs/Symptoms: upper respiratory infection, build up of mucus, coughing, fever, pain fatigue, sore throat, chills, spasm; heart works harder when breathing limited

Indications: Massage to relieve congestion, open breathing in rib area, cleansing;  Eucalyptus oil may assist in breathing. Add moisture to the air. Breathing exercises may stimulate nervous system and ease breathing difficulties.

Contraindications: Do not work on when fever present:  May be contagious so use caution.

Bruising

Definition: pooling of blood from injury to tissue beneath the skin; resistance to or lack of feeling in body

Causes: If from bodywork- lack of awareness  and resistance in client and/or lack of awareness in practitioner: Trauma, poor diet, anemia, overweight, menstruation, anticlotting drugs; bruising without a known cause can be an early sign of cancer

Signs/symptoms: pain, swelling, discoloration of skin starting out red or purple/bluish and may turn yellow/green

Indications: If bruising is from treatment, adjust pressure ; suggest icing of area after treatment ; apply witch hazel after treatment.

Contraindications:  If client bruises easily, refer to Naturopath and/or Acupuncturist for nutritional and herbal therapySee My personal story on bruising

Bruxism (tooth grinding)

Definition:  grinding of teeth together, most often during sleep

Causes:  Stress, tooth sensitivity to heat or cold, problems in blood sugar levels, neck problems such as C1 misalignment, scoliosis or other postural deviation

Signs/Symptoms: loosened teeth, cracked teeth, headaches, jaw pain, TMJ

Indications: Massage for stress reduction, cranio-sacral work to realign cranium, TMJ realignment

Contraindications: Refer to appropriate health care provider

Bunions (hallux valgu – laterally deviated big toe)

Definition: Inflammation of the big toe joint

Causes: genetic, improper alignment of posture with weight distributed on medial foot (scoliosis), bad fitting shoes, high heels which cause the foot to overarch and places more pressure on the medial side of the foot.

Signs/Symptoms: enlarged big toe joint, redness, inflammation, pain

Indications: Massage to break up adhesions: Move toe laterally and tap on side of joint; Work area between big toe and second toe.  Realign foot;  Structural realignment. Castor oil poultices may relieve pain.

Contraindications: Caution around inflammation.  Surgery may be done to remove the bunion in extreme cases.

Burns

Definition:

1st degree – affects only outer layer of skin, causing redness and sensitivity; sunburn

2nd degree – extend into the underlying skin layers and are characterized by redness, blistering, and acute pain

3rd degree – destroys skin layer and possibly more;  skin may be red, white or yellowish, or leathery and black.  Nerves in skin may be damaged

Indications: 1st degree may be ok to massage lightly mainly to apply cream or aloe vera gel;  All others direct contact contraindicated until healed. Work around area to tolerance. Manual Lymph Drainage.
Contraindications: Refer to appropriate health care provider.

Bursitis

Definition: Inflammation of a bursa – the small fluid filled synovial sacs between tendons, ligaments and bone that minimize friction. Sacs are very rich in nerves and blood vessels. False bursas may form over some bony point that has become prominent due to disease or deformity.

Causes: bacterial infection, injury, chronic overuse, misalignment of joint, allergic reactions to food or airborne particles, calcium deposits, tight muscles; Hip and shoulder and elbow joints most affected.

Signs/Symptoms: pain, tenderness, limitation of movement, redness, swelling: dull persistent pain that increases with movement;

Common locations: subdeltoid, subacromion (jackhammerer’s shoulder), olecranon (student’s elbow), pre and supra patella (housemaid’s knee), retrocalcaneal (achilles), ischial (weaver’s bottom), first metacarpal.

Indications: Massage to reduce pain and inflammation, relieve tight muscles, realign areas affected to reduce area of friction, limit adhesion formation, relieve trigger points, gymnastics.  Heat to relax muscle, Ice to reduce swelling or pain.

Contraindications: May need to work above and below area, not directly on it unless you know otherwise. Be cautious working on a painful ROM limited joint that is undiagnosed. Bursa easily aggravated by movement and pressure in early stages of inflammation. Once aggravated they are easily re-aggravated.

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