Diseases of the Skeletal System

BONE FRACTURES

Contradictions/indications: work proximal and distal to the site of the injury but not on the fracture until complete union occurs (usually 6 to 8 weeks from injury, depending on individual factors such as age); obtain approval of client's doctor before performing bodywork.

Simple (closed) fracture-a complete break in the bone without protrusion from the skin.

Compound (open) fracture-a complete break in a bone with protrusion of the bone from the skin.

Communicated fracture-a bone broken into several pieces (shattered).

Greenstick fracture-an incomplete break in a bone.

Stress (fatigue) fracture-tiny, sometimes microscopic, fracture in the bone.

Impacted fracture-one end of a broken bone is pushed into the other broken end of the bone.

Avulsion fracture-a piece of a bone is chipped or broken off.

Depressed fracture-a broken portion of a bone is pushed inward (e.g., skull fracture).

Spiral fracture-"twisting" fracture in which the fracture line wraps around the bone.

Nonunion-failure of the fractured ends of a bone to unite.

Malunion-faulty or poor union of the two fractured ends of a bone.

SKELETAL DISORDERS

Kyphosis (hyperkyphosis)-exaggerated posterior curvature of the thoracic spine.

            Causes: spinal disorders (e.g. bone disease, poor posture, weakened ligaments) resulting from trauma.

            Contraindications/indications: do not massage in severe cases; consult with client's doctor.

Lordosis (hyperlordosis)-exaggerated anterior curvature of the lumbar spine.

            Causes: spinal disorders (e.g., bone disease, poor posture, weakened ligaments) resulting from trauma.

             Contraindications/indications: do not massage in severe cases; consult with client's doctor.

Scoliosis-lateral curvature of the spine; often creates a hanging arm length discrepancy and a "full chest" on the contralateral side; bracing is a common treatment; surgery is rare (only if very serious condition).

            Causes-leg length discrepancy; spina bifida; spinal root nerve damage.

             Contraindications/indications: do not massage in severe cases; consult with client's doctor.

Cleft palate-failure of the palatine processes of the maxillae bones in the face to fuse together during fetal development.

            Causes: nutritional deficiencies.

             Contraindications/indications: consult with client's doctor; avoid the area if painful.

Osteoporosis [osteo = bone;porosis = porus]-loss of bone tissue leading to weak, fragile bones; commonly leads to postural changes of the spine and bone fractures in the pelvis, hips, wrists, and vertebrae.

            Cause: unkown; influenced by hormonal imbalances and insufficient levels of vitamin D or calcium.

             Contraindications/indications: all body work should be light because although bones of the pelvis, lumbar, and cervical spine are most affected, all bones may be brittle; consult with client's doctor.

Osteogenesis imperfect-defective development of connective tissue, particularly bone tissue; bone tissue becomes this and fragile and often bows under weight-bearing forces; often accompanied by multiple bone fractures.

            Causes: genetic trait causing abnormal synthesis of collagen, an elastic protein that makes up about 90% of bone tissue.

            Contraindications/indications: massage is most often contradicted; consult with client's doctor.

Osteitis deformans (Paget disease)-common chronic condition characterized by disorganized bone tissue reabsorption and reformation leading to thinning and thickening of bone tissue and overall brittle bones; microfractures are common; may be accompanied by deformed teeth, skull enlargement, osteoarthritis, nerve compression, and faulty hearing.

            Cause: slow viral infection affecting osteoblasts and osteoclasts.

            Contraindications/indications: massage is contradicted because bones are fragile.

Osteomalacia (rickets in small children)-softening of a bone and loss of bone mass; common in underdeveloped countries.

            Cause: vitamin D deficiency.

            Contraindications/indications:        massage is contradicted because bones are fragile.

Osteomyelitis-painful infection of bone tissue and bone marrow; sometimes pus-filled abscesses form; leads to necrosis and destruction of bone tissue.

            Cause: staphylococcal infection resulting from bone fracture, surgery, or a penetrating wound.

            Contraindications/indications: massage in contradicted; consult with client's doctor.