Massage Therapy Journal Summer 2024

54 • Massage Therapy Journal

AMTA Continuing Education

• Thoracic and lumbar curves : Assess the thoracic and lumbar spine for any compensatory changes or abnormalities. Upper Body Symmetry • Asymmetry : Check for any asymmetry in the upper body. Note if one shoulder is higher than the other or if there is a noticeable tilt, as these asymmetries may be linked to device-related postures. Arm and Hand Position • Position during device use : Observe the position of the arms and hands during simulated device use. Look for excessive flexion at the elbows and wrists, which can contribute to musculoskeletal strain. Observe the positions of hands and arms as they fall naturally by their side. Are the palms facing posteriorly, are the elbows flexed? Pelvic Tilt and Lower Body Alignment • Pelvic alignment : Check for any anterior • Lower body posture : Consider the alignment of the lower body, including the knees and feet, to identify any compensatory changes. Dynamic Postural Assessment Key elements to consider during a Dynamic Postural Assessment on your clients with suspected TNS are detailed below. Range of motion and body mechanics (remember to only have them move up to their current threshold of pain) • If you can, remember to watch how they walk into your treatment space. This is the best way to assess their natural walking patterns. Observe if they seem well balanced, if their gait seems comfortable, and if you notice any obvious compensation patterns. • Ask the client to perform movements that mimic daily activities, such as looking down at a smartphone or tablet. Observe how the head, or posterior pelvic tilt, as alterations in pelvic alignment can influence the entire spinal curvature.

neck and upper body adjust dynamically (note: this may not give you the best information if the client is trying to be on their best behavior and self-correct their movements. Ask them to completely relax first, and remind them you are not judging them, but trying to help them feel better.) • Watch them perform a chin tuck exercise: Does this cause pain or discomfort? How much pain do they have and where is the pain (unilateral or bilateral?) • Assess length of pectoralis, biceps and front of chest and neck. Have the client grab their hands behind their back if they can, or else have them use a sock or small towel. How difficult is this? How is the range of motion in their chest musculature? Does this produce pain or tingling? Where? • Ask the client to perform all neck motions (flexion and extension as well as lateral flexion and rotation to both sides). Ask if any shooting pain or nerve sensations are present in arms or hands during these movements. Does any pain travel into the jaw or the head? Assessment During Active Palpation or Massage Session The key elements to consider during a during active palpation or massage sessions are listed below along with things to keep in mind or ask the client. Muscle Tension and Imbalance • Muscle tightness: Palpate the neck, shoulders and upper back muscles for tightness and tenderness. Note any hypertonicity, which may indicate chronic muscle strain. • Muscle imbalance: Assess for muscle imbalances between the anterior and posterior neck muscles, as well as imbalances in the upper back and shoulder muscles. Additionally, you may want to use these documentation and measurement processes: • Photographic documentation: Consider taking photographs from different angles to document the client’s baseline posture. Always ask for permission, as many people do not like being

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