Treatment technique Oedematous leg

Prepare the client as for a general massage. Make sure that all restrictive clothing is removed and that there is no tight elastic if underwear is not removed.

Figure 8.1

Position of client with leg in elevation.

Place the client in the supine position (face up). Make sure that the legs lie on the elevating end of the couch.

Elevate the leg to between 30° and 45° from the horizontal by raising the end of the bed if possible, or by using an arrangement of firm pillows. Make sure that the lymphatic nodes in the groin are neither stretched nor compressed.

The legs must be allowed to drain in this position for half to one hour (you may massage other areas during this time). Massaging the abdomen can increase the effectiveness of the following leg massage. This is because lymph flow through the abdominal vessels, iliac nodes and lymphatic ducts is stimulated and drained away, reducing backward pressure. Deep breathing is also beneficial because, as the client breathes in and out, the pressure within the thoracic and abdominal cavities increases and decreases. The alternating high to low pressure acts as a pump, moving fluid along; this also reduces backward pressure.

Examine the leg carefully before starting the massage. Check the skin and the degree of hardness of the oedema (does it 'pit' easily under pressure and refill quickly or slowly?). This will give some indication of how much pressure can be applied. If it is hard and unyielding, start with lighter pressure.

Take up a walk standing stance, level with the knee.

Imagine that you are pushing fluid through a tube or many tubes. To be effective, pressure must be applied to all the surfaces of the tube.

Begin just below the inguinal nodes in the groin. With one hand on the inner leg and the other on the outer side, cover as much of the circumference as possible; now squeeze inward and upward, 4 to 6 times.

Now place one hand on the front and one on the back and squeeze in an upward direction, 4 to 6 times.

Repeat this squeezing until the area softens.

As you feel the area softening slightly, perform small circular palmar kneading movements over the area (both palms pressing together). Cover the sides, front and back thoroughly.

12 Next, effleurage slowly towards the groin.

^^ Move the hands down the leg, one hand width only at a time, overlapping the previous area. Repeat the manipulations as described. Work gently and slowly in this way until you reach the knee.

Now perform palmar kneading then effleurage over the entire thigh. As the tissues soften, deeper pressure may be applied and larger movements performed.

^^ Move below the knee to drain the lower leg into the popliteal nodes. Begin just below the knee.

^^ Avoid the anterior border of the tibia (shin bone). Cup the hands around the calf with the heels of the hands on either side of the shin bone. Squeeze in and upwards until the oedema softens. Vibrate the hands in and out. Knead the calf then effleurage.

Work gradually down the leg, one hand width at a time.

^^ Work thoroughly around the ankles as fluid frequently stagnates around the medial and lateral malleoli.

^^ Cup one hand behind the ankle joint - the thumb and thenar eminence on one side and the fingers on the other side of the Achilles' tendon. Place the other hand across the front of the joint.

^^ Squeeze all the areas together in a pumping and upward push manner until the tissues soften. Work around the malleoli with the pads of the index, middle and ring fingers. Make small pressure circles around the bones. Then, with the fingers on either side of the Achilles' tendon, push in and up.

^^ Press and knead the sole and dorsum of the foot with single-handed kneading.

^^ Effleurage the lower leg again.

^^ Effleurage the entire leg to complete the massage.

After the massage, active muscle contractions should be performed to exert a pumping action: ® pull foot up and down very slowly ® turn foot in and out ® circle foot around slowly tighten the quadriceps by pressing the back of the knee into the pillow and pulling the knee cap towards the groin repeat these movements 10-15 times.

How To Reduce Acne Scarring

How To Reduce Acne Scarring

Acne is a name that is famous in its own right, but for all of the wrong reasons. Most teenagers know, and dread, the very word, as it so prevalently wrecks havoc on their faces throughout their adolescent years.

Get My Free Ebook

Post a comment