Palpation Objectives

Having completed this lesson, you will be able to:

• List three general goals of palpation (e.g., detect irregularity in tissue textures, detect irregularity in tissue tone, sense differences in tissue temperature, notice variations in tissue hydration, spot structural asymmetry, identify restrictions that are causing a reduction in range of motion, recognize areas that are painful, locate a specific structure, identify fiber direction of a muscle to apply a specific technique correctly, distinguish between changes in tissue from the beginning of a session to the end of a session, etc.).

Different types of massage sessions require different levels of palpation, but good massage therapists are palpating attentively and continuously throughout all sessions. In a wellness session the general objective is to palpate in order to adjust techniques appropriately during the massage. You wouldn’t want to plow through bound up tissue as this could cause the client to tighten the muscles in a protective reflex. Similarly, you wouldn’t just skim the surface of pliable tissue that needs deeper work. In both cases, a lack of attention to the needs of the tissue could cause the client discomfort or dissatisfaction. A therapist who understands what healthy tissue feels like and can differentiate tissue textures and temperatures is better able to choose, moment by moment, techniques that will cause positive changes in the client’s tissue and produce results and satisfaction.

In a health care massage, where you are likely to work with the client over many sessions, you will probably conduct a systematic palpation assessment before, during, and after the massage. It will include feeling the quality of the client’s movement patterns and using your hands, as well as eyes, to assess the symmetry of physical structures. Specific techniques for palpation during a posture assessment and range of motion assessment are used to evaluate the tissue and inform session planning (these particular techniques are discussed in Chapter 19. The documentation of pre-session and post-session palpation findings allows the therapist to gage the effectiveness of the overall session and plan techniques for the next session. Palpation findings charted over many sessions demonstrate positive (or negative) changes that have occurred over time. General palpation objectives, regardless of how they are used for treatment planning, could be broken down into these areas:

• Detect irregularity in tissue textures
• Detect irregularity in tissue tone
• Sense differences in tissue temperature
• Notice variations in tissue hydration
• Spot structural asymmetry
• Identify restrictions that are causing reductions in range of motion
• Recognize areas that are painful
• Locate a particular structure, or identify the fiber direction of a muscle to apply specific techniques correctly
• Distinguish changes in tissue from the beginning of a session to the end of the session, or over a series of sessions

Methods to accomplish these objectives will become clear as you progress through the topic and develop your understanding of the layers and structures you can assess, and how to identify and name what you are feeling.