Winning Hands Massage

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Appendices

Stages of Inflammation

• Acute
• Subacute
• Chronic

Acute:  first 4 days after injury

• Signs: swelling, redness, heat, loss of function
• Assess:  use passive ROM, pain at rest or early in ROM
• Treatment goals: reduce swelling, reduce pain, reduce spasm
• Treatment techniques: lymphatic drainage, rice
• ROM goals: maintain ROM (active and passive ROM within pain tolerance)
• Hydro: cold/ice

Subacute:  4 – 14 days post-injury

• Signs:  see above, scar tissue starts to form
• Assess: use passive ROM, pain at midrange
• Tx goals: increase circulation, decrease hypertonicity, decrease waste and debris
• Tx techniques: cyriax cross fiber friction, work proximal
• ROM goals: increase ROM, active and passive
• Hydro: cold vascular flush, with cold emphasis (3 x cold, 1 x hot, 3 x cold, end with cold)

Chronic:  14 – 21 days post injury

• Signs: pain and loss of function, adhesions
• Assess: use passive ROM, pain at end of ROM (tissue stretch)
• Treatment goals: decrease pain from contractures, decrease adhesions, increase soft tissue mobility
• Treatment techniques: cross fiber friction, contract-relax, pin and stretch
• ROM goals: strengthen, resistive ROM
• Hydro: hot (moist heat), hot vascular flush (3 x hot, 1 x cold, 3 x hot, end with cold)

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