INTRO
What is therapeutic massage ?
Involves the manipulation of soft tissue structures of the body to increase wellbeing
Improves the functioning of circulatory, lymphatic, muscular, skeletal and nervous systems &
may improve the rate at which body recovers from injury & illness
USES
Induce relaxation in tense & tired muscles
Improve circulation to area → warms the muscle prior to exercise
Remove toxins from muscles → toxins build up that cause muscle soreness & stiffness
Promotes calmness & serenity, particularly in patients suffering from depression
Promotes thriving in premature infants
Mobilises soft tissue → prevents adhesions
Effect of massage
1. Mechanical
o Squeezing, compression & pushing components of the massage manipulations bring
about drainage of venous blood & lymph. It also allows fresh blood an unimpeded
flow
o Mobilises using frictional forces to underlying structures, preventing adhesions
o Percussive techniques(cup hand on area) done over the lungs assists with the
removal of mucous from the bronchial tree
1. Physiological
Neurological
o Effects are counter-irritant, inhibitory and excitatory
o Counter-irritant → competition for recognition by two stimuli
o Inhibitory → constant repetition of slow, rhythmical manipulation brings about
accommodation by raising the threshold of perception
o Excitatory → stimulation of skin receptors or stretch of muscle spindles reflexly increases the
muscle tone
o Stimulation of sweat glands & increased heart rate
Circulatory
o Removal of metabolites
o Improved blood flow - increases metabolism as the oxygen & nutrition to the part is
enhanced
o Pressure of massage manipulations ↑ the interstitial pressure & thus aids in absorption
across capillary walls
Connective tissue
o Reduces keloid formation (excessive collagen being placed on skin, when body heals → can
make movement more restrictive)
o Pressure & heat converts fascia from gel state to sol state, thereby reducing
hyperplasia(excessive building)
o Deep pressure massage causes proliferation & activation of fibroblasts
Fibroblasts generate connective tissue matrix → promotes tissue healing
The skin
, o Constant movement of hands over the skin will remove dead surface and improve the
function of skin cells
o Flattens fatty deposits under the skin - thus making skin appear smoother
o It temporarily alters shape & appearance of cellulite
o Stimulates sebaceous glands (that secrete natural oils to skin)
REFLEX RESPONSE
Involuntary reaction to the organs to the stimuli
Vasodilation
Decrease in HR, BP, stress hormone production
CONTRAINDICATIONS
Infective conditions
Open wound
Presence of malignant tumours
Early bruising
Deep vein thrombosis (clot in vein)
o Don’t massage cause you could dislodge it & cause heart attack
Adjacent fracture sites
Inflammation of veins (phlebitis)
PREPARATION FOR MASSAGE
1. Therapist
o Attention given to personal appearance, hygiene & manicure (short & clean nails)
o Hair must be tired back and jewellery(necklaces, rings & watches) removed
o Hands must be washed before & after each treatment
o warm hands up by rubbing & ensure flexibility
TECHNIQUES
Swedish massage uses a system of long strokes
o Kneading, wringing, rolling, percussive & vibration techniques
Deep transverse frictions use deep massage directly across the fibres
o Used for ligaments, tendons & muscles
o Adhesions are broken down & normal acute healing process is allowed to proceed
2. Environment
, Treatment area must be at comfortable temp & well ventilated
Plinth must be firm & covered with clean linen
Plinth should be position to allow access to all parts of patient & adequate movement of
therapist
3. Patient
Must be in a comfortable relaxed position
Parts to be treated must be adequately supported & exposed
Areas not being treated must be covered
Prone position
A pillow under abdomen, to prevent hyperextension of back
A pillow or roll must be placed under ankles, to allow slight flexion of knees (prevent
hyperextension of knees)
Arms can be placed by the side of the patient, supported by the plinth or arms slight
abducted and rest above the bed
Supine position
A pillow must be placed under head
A pillow must be placed under knee (slight flexion)
Sitting
Used if prone position is too uncomfortable for patient
Patient sitting on chair facing table, while leaning forward supported by pillows
CONTACT MATERIALS
Talcum powder → non-perfumed or baby powder
Corn starch is a heavy powder which absorbs moisture
o Should be used in presence of profound sweating by patient or therapist
Oils:
o Pure lanolin → drag effect on skin due to thick & heavy texture
o Lanolin cream → water based less drag
o Liquid oils (e.g. olive oil, liquid paraffin) → provide easy glide effect
o Medicated creams → Voltaren, deep heat etc.
o Arnica oils, baby oils etc.
MEDICAL CONTRAINDICATIONS TO MASSAGE
Cancer
Cardiovascular conditions (thrombosis, phlebitis, untreated hypertension, CCF)
Untreated diabetes - peripheral neuropathy
Eczema (broken skin)
Epilepsy - more precautions than CI
Intreated hyper- or hypo
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