- onset

-any pathlogies that could have contributed to condition

- diagnosis/treatment

- surgery/hardware

-meds

-ADLs

-symptoms

- casted or otherwise immobilized

- compensation

- infection/hardware

- pain local and distant

- callus formations/tissue repair: adhesions are developing

-reduced circulation/edema/disuse atrophy/ct tissue contracture

- hypertonicity and trigger points in compensating structures

-short term: compartment syndrome, nerve compression, infection, plaster sores, poor cast fit, non-union

- fx site is healing and remodeling

- decrease tissue health; tissue fragile, muscle tone likely decreased

- matured adhesions around the injury/ct tissue contractures

-with open reduction scars will be present

-hypertonicity and tp in muscles crossing the fracture site but also compensating structures

- muscle weakness/disuse atrophy

- occasionally a pocket of edema around injury

- long term: delayed union, non-union, malunion, myositis ossifican, nerve compression, volkman's ischemic contracture

- do not traction limb

-no hot hydro aps distal or immediately proximal to the cast

-on-site work avoided until skin has healed

- infection

- used for relaxation and support

-positional restrictions possible

- if colostomy, no abdominal massage

- overpressure

- hydrotherapy extremes

- deep longitudinal techniques on muscles that were casted

- passive stretching done carefully

treatment goals when working with fractures during immobilization

- reduce inflammation

-reduce pain

- reduce sympathetic nervous system firing

- treat compensating structures

-reduce edema

- maintain range of motion

- maintain local circulation proximal to injury

- used for stress reduction

- post treatment postural changes secondary to surgery can be treated

- swedish techniques to address fascial restrictions

- if cancer is terminal, stress reduction and client support are the focus

- reduce pain

- decrease sympathetic nervous system firing

- treat compensatory structures

- reduce edema

- reduce hypertonicity and tp

-maintain range of motion

-mobilize hypomobile joints

-increase local circulation and venous return

- reduce adhesions

- maintain ROM and joint health

- avoid exacerbating and decrease spastcity

- maintain proper body alignment

- decrease sympathetic nervous system firing

- prevent fatigue

-provide emotional support

-improve and maintain tissue health

- decrease edema

- limit contractures

-address postural changes and muscle imbalances

- decrease pain

address secondary conditions

- maintain joint health and range of motion

-provide emotional support

-encourage whole body integration

- ADLs/pacing to avoid fatigue

- modified strengthening program

-tx for tissue health/cool hydrotherapy/basic lymphatic drainage/signs of necrosis/gangrene

- relaxation techniques/diaphragmatic breathing (no diabetes/kidney disease present)/visualization/meditation

- local support group/another professional

contraindications for cancer massage

- post surgical local massage

- if radiation, tender and damaged tissue, avoid local massage

- nausea side effect from chemo and radiation/may feel good for some/case by case

- lymphatic massage if untreated or metastasizing neoplasms

- hot hydrotherapy with lymphedema

-heavy pressure techniques and friction with lymphedema

- deep pressure over tumor sites

-long duration, vigorous or stimulating techniques