MASSAGE Massage is one of the oldest of

MASSAGE

�Massage is one of the oldest of the Health sciences and has been used for curative purposes since time immemorial. Massage treatment uses "TOUCH" to apply pressure to the body's skin, muscles, tendons, ligaments. The Idea of Massage is to ease disorders by; �relieving tension �promoting blood flow �calming nerves �loosening muscle

CLASSIFICATION OF MASSAGE : �CLASSIFICATION OF MASSAGE: 4 types � On the basis of character of technique � 1. Stroking � 2. Pressure � 3. Purcussion � 4. vibration �On the basis of depth of tissues approached � 1. Light massage � 2. Deep massage

�On the basis of part massaged � 1. Local massage � 2. General massage � On the basis of means of administration of technique � 1. Mannual massage � 2. Mechanical massage

�Modes of Therapeutic Massage �Stroking �Effleurage �Kneading �Friction �Wringing �Picking up �Hacking �Clapping �Shaking & Vibration

�Stroking - Stroking is performed with the whole hand or fingers. It comprises the usage of relaxed hand over the patient's skin with a rhythm and pressure that produce a relaxing effect.

�Effleurage - Effleurage is performed by spreading and moving the hands with pressure and speed, to gain relaxation and lymph drainage.

Effleurage �Stroking of the skin �Performed with palm of hand �Stimulates deep tissues �Performed with fingertips �Stimulates sensory nerves �Superficial, rhythmic stroking: �Contours the body or relates to direction of underlying muscles �Deep stroking: �Follows course of veins & lymph vessels

Effleurage �May be performed slowly for relaxation or rapidly to encourage blood flow & stimulate the tissues �Performed in rhythmic manner �One hand should always be in contact w/ skin �Light effleurage is performed at beginning & end of massage or may be used between petrissage strokes �At beginning – relaxes patient & indicates area to be treated �At end – calms down any irritated areas

Petrissage �Lifting & kneading of skin, subcutaneous tissue, & muscles �Performed with fingers or hand �Skin is gently lifted between thumb & fingers or fingers & palm & gently rolled & kneaded in the hand �Often performed without lotion �Frees adhesions by stretching & separating muscle fiber, fascia, & scar tissue while assisting with venous return & milking out waste products

�Kneading - Kneading involves alternate compression and release of the part to be manipulated.

�Picking up - Picking up involves lifting up of tissue from underlying bone, releasing it after squeezing it.

�Wringing -Wringing technique lifts up the tissue and applies a twist to enhance stretching effect.

Friction �Transverse: �Applied with thumbs or fingertips stroking the tissue from opposite directions �Can use elbow, end of rolling pin, etc. for larger areas �Reaches deep tissues �Begin lightly and then move to firmer strokes �Muscle should be placed in relaxed position �Should be avoided in acute conditions �Effective in tendonitis or other joint adhesions

Friction �Goal is to mobilize muscle & separate adhesions that restrict movement & cause pain �Facilitates local blood profusion �Not necessarily a “pleasing” treatment �Circular: �Applied with thumbs working in circular motion �Effective in treating muscle spasm & trigger pts.

�Friction - Friction is a small movement applied with thumb or finger where pressure is applied from superficial to depth of the tissue.

Tapotement �Gentle tapping or pounding of the skin �Most common form uses ulnar side of wrist to contact skin “karate chop” �Wrist & fingers are usually limp, alternate method “cups” the hand �Promotes relaxation & densitization of irritated nerve endings

�Hacking - Hacking is performed with extended forearm and striking the skin using the side of the hand.

�Clapping -Clapping is done by striking the skin with cupped hands.

�Shaking and Vibration -Shaking and vibration involves gentle strokes of shakes and vibrations respectively

�Advantages �Relief of pain �Muscle tightness is relieved �General relaxation �Induce sleep in insomnia (sleepless nights) �Relieves tension �Skin is toned �Drainage of oedema or swelling �Loosens secretion in the Lungs

�Where not to Massage? �Large open wounds �Burns �Skin Ulcers �Gross Oedema (severe swelling) �Extremely Hairy areas �Sensitive skin �Bacterial infections �Skin disease �Malignancies like cancer

PHYSOILOGICAL EFFECTS OF MASSAGE: �As therapeutic modality, massage is used for the relief of pain, � Swelling � muscle sprain, � restricted movements, � tension and anxiety associated with a large no. of disorders afflicting muscular, nervous, cardiovascular, respiratory and other systems. � It is the magnitude , duration and the direction of force applied during massage that determines the effect produced on the body. �Massage affects almost all systems of the body

�Increased venous and lymphatic flow. � Increased arterial blood flow to the muscle and skin � Decreased stagnation of fluid in tissues spaces. � Increased removal of waste products of metabolism � Increased WBC, RBC, and platelet count in blood. � Increased nutritive exchange between blood and cells � Increased trophic status of the part massaged �Induce sedation � Decrease pain �Facilitate contraction in hypotonic muscles � Modulate autonomic responses

� Decreased excitability of motoneuronal pool in neurologically healthy person � Increased removal of secretions from lungs � Increased gaseous exchange across pulmonary capillaries � Increased removal of dead cell from the skin � Increased activity of sweat and sebaceous glands �Lowers psychosomatic arousal such as anxiety and stress � Mobilize soft tissues and breaks soft tissue adhesions �Accelerates various metabolic processes by increasing arterial blood flow and venous lymphatic drainage �Promotes lypoylsis

UTIC USES: THERAPE � Massage is one of the oldest form of treatment for human ills � In physiotherapy, massage is used for the following purposes: �To improve the mobility of soft tissues � To reduce muscle spasm and pain To reduce edema � To increase blood circulation � To mobilize general secretions in the lungs � For local and general relaxation � massage is indicated in a number of neurological , musculoskeletal and psychosomatic disorders as follows; � hemiplagia, paraplegia, quadriplegia �facial/ bells palsy

�Muscular weakness, muscular dystrophy, hemiparesis Cerebral disorders upper and lower motor neuron lesions � sciatica �Anxiety � insomnia � Hysteria � Different types of headache � obesity, flatulance, constipation, inflammation �Muscular injury and sprain Venous congestion Teno synovitis, tendenitis, fibrositis