Lecture 6:

Theme: “ THE BASIC MASSAGE”Nekhanevich Oleg Borisovich

Cathedra of medical physical culture, sports medicine and valeology

MASSAGE is exactly dosed MASSAGE is exactly dosed mechanic application to the tissue mechanic application to the tissue of the body by massager's hands of the body by massager's hands

or special equipments for or special equipments for therapeutic purposestherapeutic purposes Use of hand is considered the most effective method of Use of hand is considered the most effective method of

application because palpation may be used as an application because palpation may be used as an assessment as well as a treatment toolassessment as well as a treatment tool

KLASSIFICATION OF MASSAGE:KLASSIFICATION OF MASSAGE:

1.1. Kinds of massageKinds of massage::

HygienicHygienic

CosmeticCosmetic

Sports: a) training, b) before training, c) rehabilitativeSports: a) training, b) before training, c) rehabilitative

Therapeutic: a) classical, b) segmento-reflectoryTherapeutic: a) classical, b) segmento-reflectory

2.2. Methods Methods of massageof massage

ManualManual

With devices and electrical equipmentWith devices and electrical equipment

3.3. Forms of massageForms of massage

CommonCommon

Particular Particular

4.4. WesternWestern

EasternEastern

1. Local (mechanical) effects on nervous receptors: a) Mechanoreceptors of the - skin (exteroreceptors); - muscles, ligaments, tendons (proprioreceptors); - vessels (enteroreceptors); - internal organs (interoreceptors)

EFFECTS OF MASSAGE

Increase in superficial blood flow, as evidenced by hyperemia of Increase in superficial blood flow, as evidenced by hyperemia of the skin following response could be due to stimulation of mast induce the skin following response could be due to stimulation of mast induce a histaminelike substance which cause-superficial arterioles. a histaminelike substance which cause-superficial arterioles. Mechanical stimulation of sensory endings caused a reflex response Mechanical stimulation of sensory endings caused a reflex response mediated by the spinal cord.mediated by the spinal cord.

2. Reflexive effect

Based on changes in electrical threshold Based on changes in electrical threshold and activity of neurological system.and activity of neurological system.

Stimulation motorno-visceral, relative Stimulation motorno-visceral, relative and irrelative reflexes. and irrelative reflexes.

3. Psychological effectsOur current psychological understanding of massage indicant’s

that it is best viewed at three levels:

1. The physical act of touching another person

2. The symbolic meaning of one individual entering into another person’s “life area”

3. The specific individualized answer based upon values and past experience of the person

The patient-physician relationship, trust, mutual respect The patient-physician relationship, trust, mutual respect and an appreciation for personal sensitivities will and an appreciation for personal sensitivities will maximize the physiological result of treatmentmaximize the physiological result of treatment

INDICATIONS TO MASSAGEINDICATIONS TO MASSAGE

To all healthy persons

Cardiovascular diseases: IHD, hyper- and hypotension, myocarditis, valvular heart diseases, cardiosclerosis, failure of blood circulation and others

Respiratory system diseases: chronic nonspecific lung diseases, pneumosclerosis, pneumonia, pleuritis and others

Musculo-skeletal injuries and diseases: rheumatoid and others arthritis, osteochondrosis, spondiloarthritis, tears of ligaments and others

Diseases of digestive and another systems

Neurological system injuries and diseases: paralytics and spasticNeurological system injuries and diseases: paralytics and spastic

conditions, conditions, failure of the brain blood circulation, neuritis and others

CONTRAINDICATIONS TO MASSAGECONTRAINDICATIONS TO MASSAGE

1. Acute infectious diseases and inflammatory processes with increase of temperature more 37,5°C

2. Deep bleeding or tendency to bleeding3. Thrombosis, varicose veins (dangerous of thromboemboly)

4. Skin diseases: infectious, virus etiology, deep damages, trophic 4. Skin diseases: infectious, virus etiology, deep damages, trophic ulcers ulcers

5. Chronic diseases in active stage5. Chronic diseases in active stage6. Active form of tuberculosis, 6. Active form of tuberculosis,

7. Aneurysm of heart and vessels8. Oncology diseases9. Deep insufficient of mains systems10. Psychiatric diseases

Common principles of patient Common principles of patient preparationpreparation

• 1. 1. Common environmental concernsCommon environmental concerns. For maximal therapeutic . For maximal therapeutic results, massage should be applied in a warm, comfortable area, results, massage should be applied in a warm, comfortable area, from distracting stimuli. Rhythmic quiet sound at low volume also is from distracting stimuli. Rhythmic quiet sound at low volume also is to reduce unwanted muscle contraction.to reduce unwanted muscle contraction.

• 2. 2. Position. Position. The patient must be relaxed with the part to treated well The patient must be relaxed with the part to treated well supported. If the patient of the treatment is to reduce edema, the supported. If the patient of the treatment is to reduce edema, the extremity must be lift above the level of the heart to allow the force extremity must be lift above the level of the heart to allow the force of gravity to assist in the drainage of excessive fluid. The patient of gravity to assist in the drainage of excessive fluid. The patient should be in a recumbent posture in order to promote relaxation; should be in a recumbent posture in order to promote relaxation; bolsters and pillows can be used as necessary. The therapist must bolsters and pillows can be used as necessary. The therapist must assume a comfortable standing position that will allow easy access assume a comfortable standing position that will allow easy access to the entire treatment area. to the entire treatment area.

• 3. 3. Draping. Draping. With only the part being treated exposed, the rest of the With only the part being treated exposed, the rest of the patient’s body should be good covered for warmth as well as patient’s body should be good covered for warmth as well as modesty. Tight clothing should be loosened, particularly proximal to modesty. Tight clothing should be loosened, particularly proximal to the treatment region.the treatment region.

Common principles of patient Common principles of patient preparationpreparation

4. Massage means.

Selection of massage means is dependent upon the therapeutic intent of treatment. In cases of muscle tightness and spasm or edema, a medium is necessary to allow the hands to slide smoothly over the skin and to avoid abrasions of the skin and pulling of the hair. Mineral oil, glycerin, coconut oil, cocoa butter, Balet cream or oil.

General principles of massage

Characteristics are determined by the specific therapeutic intent of the procedure employed. The must be differentiated from generalized approaches associated with different schools of massage.

The main characteristics of massage are: - rhythm and rate - pressure - direction - frequency and duration

N.B.!

The rhythmThe rhythm of massage movement mast be even. Rate of massage movement mast be even. Rate

may vary, but in general terms, massage given to achieve a may vary, but in general terms, massage given to achieve a relaxation affect or to reduce edema should be slow and may relaxation affect or to reduce edema should be slow and may equal the patient’s respiratory rate. The rate should be faster equal the patient’s respiratory rate. The rate should be faster

when applying friction massage to stretch or loosen adhesions in when applying friction massage to stretch or loosen adhesions in superficial or deep structures.superficial or deep structures.

The amount of The amount of pressure pressure applied is critical to achieving theapplied is critical to achieving thedesired effect in any manipulation. A sedative or relaxation resultsdesired effect in any manipulation. A sedative or relaxation resultsIs obtained with light to medium pressure. The amount ofIs obtained with light to medium pressure. The amount ofpressure may vary during the treatment of muscle tightness,pressure may vary during the treatment of muscle tightness,starting out light, then deepening painful areas finishing lightstarting out light, then deepening painful areas finishing lightagain. In order to have any mechanical effects on adhesions, mustagain. In order to have any mechanical effects on adhesions, mustbe sufficiently strong to both stabilize as good as distortbe sufficiently strong to both stabilize as good as distortappropriate structures.appropriate structures.

Direction. Knowledge of anatomy and physiology is imperativewhen deciding upon the appropriate direction of massage

movement. The most generally employed direction of movement is centripetal (toward the heart) and parallel to the muscle fibers when the objective is relaxation or reduction of edema. When treating fibrotic regions, the movement must apply tractive forces to the involved structures. Pressure should be applied in the direction of restriction. For detection of fibrositic nodules and the prevention and treatment of adhesions in soft tissue, deep friction should be carried out perpendicular to the direction of the affected fibers and specifically applied at the site of pathology.

The duration of massage technique is dependent upon the size of the region be treated, the pathology included, and the tolerance of the patient. There is wide variation appropriate frequency showed in literature.

FREQUENCY AND DURATION

The duration of massage technique is dependent upon the size of the region be treated, the pathology included, and the tolerance of the patient. There is wide variation appropriate frequency showed in literature.

• negative as it indicates a severe weakness negative as it indicates a severe weakness of the circulatory system due to an acute of the circulatory system due to an acute disorder of the neural regulation of the disorder of the neural regulation of the vessels (especially microcirculatory). vessels (especially microcirculatory).

• It is noted in disorders of the autonomic It is noted in disorders of the autonomic portion of the nervous system, neuroses, portion of the nervous system, neuroses, following recuperation from infection following recuperation from infection diseases, frequently in teenagers during diseases, frequently in teenagers during prepuberty and puberty, and in athletes prepuberty and puberty, and in athletes who are excessively fatigued or strained.who are excessively fatigued or strained.

«Non progredi est regredi»«Non progredi est regredi»

Thank you for attentionThank you for attention