Issue link: https://www.massageandbodyworkdigital.com/i/72121
ESSENTIAL SKILLS For access to free videos and articles and the latest news on upcoming trainings, join Benjamin on Facebook at Facebook.com/ drbenbenjamin. or with the leg extended on the table. If the treatment needs to be performed on the tendon body, move down a half- inch or so until you find the tender area on the tendon. Then apply friction in this region. If the injury is in the muscle belly itself, identify that area and then perform friction therapy on the muscle. This is often a fairly large area, so it is usually a good idea to use three or four fingers at once while performing the friction treatment. Exercise Therapy Both stretching and strength building are important parts of the rehabilitation process. Start out with a warm-up. You can either walk around for 3–4 minutes, or sit on the edge of a table and swing your legs back and forth. Now perform a series of stretches of the quadriceps muscles. A simple way to do this is by lying on your side with a pillow under your head. Bend your knee and take hold of your ankle with your hand, and gently pull your heel toward your buttock. Do this for about 2 seconds and then straighten your leg out again. Now bend your leg and repeat that process 10–15 times. Then roll over to the other side and do the same thing again on the good leg to keep your legs balanced. If that is too easy for you, lie prone, place a few large pillows under your knee, and try doing the same stretch in that position. This places a greater angle of stretch on the anterior thigh. Now, try some strengthening exercises. This can be as simple as sitting on the edge of the table with a 5- or 10-pound weight strapped around your ankle and extending your leg 15–20 times. Once you are stronger, progress to standing squats and lunges. When you do a squat, keep your legs hip-width apart, and when you bend your knees, keep them over your toes and do not turn inward. You can begin with 10 or 15 squats and then progress by holding a weight in front of your chest while doing the squats. Start out with 10 pounds and progress up as high as you can. If you can do 12 or 15 squats and not feel tired, you do not have enough weight. If you can do 15 squats holding 40–50 pounds, you are pretty strong. Lunges can be done in a similar manner, first with no weight and then holding a 5-,10-, or 20-pound weight as you progress through your lunges. SUMMARY Injuries to the quadriceps muscles and tendons are fairly easy to assess and treat. Once you find the injury, first perform friction therapy followed by massage. After a few sessions, start the client on stretching and strength-building exercises. Retest the client every two weeks to monitor their progress. Editor's note: Massage & Bodywork is dedicated to educating readers within the scope of practice for massage therapy. Essential Skills is based on author Ben E. Benjamin's years of experience and education. The column is meant to add to readers' knowledge, not to dictate their treatment protocols. Ben E. Benjamin, PhD, holds a doctorate in education and sports medicine, and is founder of the Muscular Therapy Institute. Benjamin has been in private practice for more than 45 years and has taught extensively across the country on topics including orthopedic massage, Active Isolated Stretching and Strengthening, and ethics. He is the author of Listen to Your Pain (Penguin, 2007), Are You Tense? (Pantheon, 1978), and Exercise Without Injury (MTI, 1979), and coauthor of The Ethics of Touch (Sohnen-Moe Associates, 2003). Presently, he is offering continuing education for massage therapists around the world via webinars. He can be contacted at Ben@BenBenjamin.com. Celebrate ABMP's 25th anniversary and you may win a refund on your membership. ABMP.com. 111