[libribook.com] Traumatic Scar Tissue Management 1st Edition

Figure 9.5
Rotary (thorax). Half-moon/circles are generated with the hand elevated, the thumb abducted, with
the finger joints neutral and the fingertips in contact with the skin and SF. The MT places the hand
on the skin with the ulnar side without pressure, while the thumb goes into abduction. The SF is
displaced with increasing stretch toward the drainage area with the thumb moving to adduction at
the end of the stroke. The MT then moves the hand to the next area to be manipulated and repeats
the technique. The MT may use one or both hands. All strokes begin proximal to the terminus and
move distal. (A–D) Red arrows indicate the direction of lymph flow.
• Begin with clearing the head area first. Start proximal to distal on the SCM
using half circles toward the terminus.
• Proceed with half circles proximal to distal along the mandible, masseter,
temporalis, and the occipitofrontalis.
• Use pumping or scooping techniques on the upper extremites, one extremity at
a time.
• For the thorax, use the rotary technique.
• Repeat pumping or scooping technique on the lower extremities, one extremity
at a time.