Peroneal Tendon Massage
Question:Thank you for your informative website and the opportunity to ask questions.
I'm a newly graduated massage therapist awaiting my temporary license. A potential client of mine had surgery of the peroneal tendon several years ago and still has severe pain. I know that massage therapy is indicated to relieve muscle tension and to assist healing, but I'm not sure how to proceed. Can you guide me as to the best techniques or strokes to apply, and other than avoiding any acute lesions, how often should the area me massaged?
- Deborah
Answer:
To help in relieving the muscle tension in the peroneal (fibular) muscles of the lower leg after surgery, you must first consider the time span since the surgery and the structures involved.
Generally, the aim in treatment would be to massage the lower back and then the unaffected side, progressing to the affected leg and muscles. This would be indicated as the opposing side will have had to take on a lot more stress and function due to compensation from the affected side.
When working on the affected side you must consider the length in time from the surgery. There are stages to the healing process that you must consider during therapeutic massage treatment and thus, the massage will have to be adapted to the stage of the healing processes. In an acute stage, there will be a lot of inflammation present. Thus you must avoid working below the swelling as this will only cause more congestion. At this point you would use swelling technique to aid in reducing the congestion, with perhaps some hydrotherapy, and elevation to the injured area post treatment. The opposing musculature, which would be the calves and also the quadriceps and hamstrings, will all have to be addressed; there will be increased tension and trigger points to these muscles due to compensation.
In your case several years have past, now you will be dealing with scar tissue and fibrosing of the tissues. This would indicate increasing the depth and pressure of the massage. A similar aim in treatment as with an acute case however, an increase in depth and pressure and more chronic type of techniques such as muscle stripping, trigger point therapy, and myofacial release.
The length in treatment depends on the primary and secondary complaints; half hour or one hour treatments may be required two to three times a week. The outcome depends largely on the elimination of all the perpetuating factors. Some cases more frequent visits will help to eliminate the muscle tension more quickly depending on the length in time since the surgery and the issues that would be found to the tissues. A self-care program would also be important to the outcome of the treatment, as full lengthening of the affected muscle is a key factor.
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