Massage Therapy & Hydrotherapy

An Overview

PurposeThe purpose of this module is to

provide you with a basic knowledge and understanding of the methodology, science, technique and effects of massage therapy and the industry as a whole.

Learning ObjectivesUpon completion of this module you will be able to:• Comprehend how and why massage therapy, in

conjunction with heat and hydrotherapy, effects the body.

• Communicate with massage therapists and clinicians with a shared understanding of the industry, using the appropriate terminology.

• Demonstrate the correlation between the effects of massage, heat and hydrotherapy and how Vescent equipment incorporates these elements into an all-inclusive modality.

What is Massage Therapy?

• By Definition: – a variety of techniques using the hands,

mechanical or electrical apparatus to manipulate muscles and other soft tissue with the intent of improving well-being or health. 

• This is a general term for a range of therapeutic approaches  with roots in both Eastern and Western cultures. 

History of Massage• Massage Therapy is one of the oldest

healthcare methods.• References to massage are found in

Chinese medical texts 4,000 years old.• In 4th century B.C., Hippocrates (“father

of medicine”) wrote:– “The physician must be acquainted with

many things and assuredly with rubbing”

History of Massage• 1817: The father of massage therapy in

the United States, Cornelius E. De Puy, MD,  published the first journal on the subject in 1817.

• Early 1900’s: physician’s began prescribing massage as the healthcare system in the U.S. became more influenced by biomedicine.

History of Massage• 1930-1940: massage therapy virtually

abandoned by medical professionals due to its labor-intensive nature.

• 1970: New interest surges in massage therapy in the realm of alternative health care, thereby revitalizing the field.

What is the Minimum Schooling Required for a

Massage Therapist?• No national standard for regulating massage. • Only 30 states and Washington D.C. regulate

massage. • Massage therapists are licensed (LMT) or

registered (RMT).• Many massage therapists have also been

"certified" (CMT) by specific school, bodywork organization, or national regulating body.

• Training hours required vary from state to state

Massage Practice Requirements in Florida

• Regulated by the Florida Dept. of Health• 500 hours from state board approved

school or completed 1,453 hours apprentice program.

• 3 hours HIV / Aids education• CEU: 12 hours every two years and 3

hours HIV/AIDS update classes

National Certification• National Certification Board for Therapeutic

Massage and Bodywork (NCBTMB):– administers the National Certification Examination– certifies massage therapists who pass the exam – maintains their status through continuing

education.

• Certification represents the highest professional credentials in the field.

Where Do Massage Therapists Work?

• Top Five:– Private Practice :35.2%– Freelance/Home: 23.8%– Chiropractic Clinics: 6.5%– Health Clubs 5.8%– Beauty Salons/Spas: 2.4%

• Other:– Physical Therapy Clinics– Sports Teams– Wellness Clinics

The Massage Industry Today

• Growth! Within the last eight years:– The number of massage therapists in

the United States has increased approximately 41%.

– The number of adult Americans who say they have had a massage in the previous 12 months has more than doubled.

Why is the Industry Growing?

• 1992: Touch Research Institute (TRI) established by Director Tiffany Field, Ph.D. at the University of Miami School of Medicine (http://www.miami.edu/touch-research)

• Increased Awareness of the Benefits of massage:– within the medical field– by insurance companies– among consumers (primarily ‘Baby

Boomers’)

Why People Get Massages

• To get relief from injuries and certain chronic and acute conditions

• To help them deal with the stresses of daily life

• To maintain good health • IT FEELS GOOD!

Why People Don’t Get Massages • Fear

– Disrobing (body image, modesty)– Stranger touching them (distrust,

embarrassment)– Doesn’t feel good; hurts (stereotype of therapist)

• Myths– It’s sexual (massage “parlors”)– No real health benefits (superficial rub)– Luxury Expense (nice if you’re rich; not

associated with maintaining wellness)

"Massage is to the human body what a tune up is to a car. It provides a physical and mental boost to the weary, sore, and stressed..."

— Chicago Tribune, April 6, 1995

Scientific Studies on the Effects of Massage Therapy

• Increases lymph flow rate by seven to nine times.

• Reduces edema.• Three studies show that massage increases

activity level of the body’s natural "killer cells.”• Stimulates the brain to produce endorphins,

the body’s natural pain killer.• Reduces acute and chronic pain and increases

muscle flexibility and tone. • Reduces anxiety levels for employees.

Effects of Massage on the Body & Systems

• Massage Therapy:– improves functioning of the circulatory,

lymphatic, muscular, skeletal, and nervous systems.

– can help with a wide range of medical conditions

– “benefits” can bring about harm (contraindications)

Massage Strokes

• Effleurage – long, rhythmic stroke• Petrissage – “milking” or kneading• Friction – deep, narrow, non-gliding

stroke• Tapotement – brief, brisk, rapid: light

striking• Vibration – tremulous, somewhat gliding

Demonstration

Cells, Tissues, Organs

• Cells-the building blocks of the body

• Tissues-any group of cells that perform specific functions

• Organs-any group of tissues that perform specific functions

Fascia• Complex, supportive web of tissue• Covers, supports and separates

muscles and organs• Unites skin with underlying tissue • Retains tensions from physical and

emotional traumas; chronic pain

Connective Tissue: “The Ties That Bind”

• Bone: "structural frame" for the human skeleton that provides movement

• Tendons: connect muscles to bones.• Ligaments: connect muscles to

muscles.• Fascia: covers and supports

muscles and organs

Meet ADAM!

Muscular System• Muscle—tissues composed of fibers

that effect movement of organs and body parts.

• Acts as a lever to create movement:– Shortens– Contracts– Relaxes– Never lengthens

How Massage Impacts the Muscular System

• Increases the blood supply and nutrition to muscles without adding to their load of toxic lactic acid, produced through voluntary muscle contraction. 

• Stretches connective tissue, improves its circulation and nutrition.

Results Produced By Massage On Muscular

System • Helps reduce the danger of

fibrosis– Scar tissue– Collagen breaks down due to chemical

imbalance or injury– Causes muscle tissue to harden and

stick together: adhesions

Results Produced By Massage On Muscular

System• Improves muscle tone • Helps prevent or delay muscular

atrophy– Weakening or loss of muscle

tone/mass– Due to inactivity; lack of use

Results Produced By Massage On Muscular

System• Massage relieves tension and

relaxes muscle spasms – Acute contraction of muscle– Due to chemical imbalance or injury– Causes sharp, deep, pervasive pain– “Charlie Horse”

Effects of Massage: Skeletal System

• Improves the circulation and nutrition of joints and hastens the elimination of harmful particles.

• Helps lessen inflammation and swelling in joints and so alleviates pain. 

• Massage encourages the retention of nitrogen, phosphorous and sulfur necessary for tissue repair in persons convalescing from bone fractures.

Communication Systems:Nervous and Endocrine

• Interface as the master communicators, integrators and regulators of our bodies.

• Goal: maintain homeostasis (the maintenance of the internal environment within tolerable limits)

The Nervous System• The body's information gatherer, storage

center and control system. • Overall function: collect, analyze and

initiate appropriate responses in relation to the body's external state.

• The nerves do not form one single system, but several which are interrelated

• The brain and spinal cord make up the central nervous system.

The Endocrine System• Releases hormones and body chemicals

into the bloodstream, enabling them to circulate throughout the body.

• Most body chemicals are specific in their actions, and will therefore only affect specific targets.– Cortisol: stress hormone– Endorphins: ‘natural pain killers’– Seratonin: induces feelings of well-being

How Massage Impacts The Nervous & Endocrine

Systems• Massage may have a sedative,

stimulating, or even exhausting effect on the nervous system, depending on the type and length of massage treatment given.

• Increases serotonin.• Decreases cortisol levels.• Increases release of endorphins;

analgesic effect (gate theory.)

Demonstration

Transport Systems:Cardiovascular, Lymphatic and

Respiratory• Transportation of fluids, cells and gases is

a crucial function of these three systems.• The basic action of these systems enable:

– Proper gas exchange to take place– Oxygenation of the cells to occur– Cellular removal of wastes to take place

Blood• Blood is the only fluid form of tissue in the

body• Blood is a form of connective tissue,

consisting of living cells and non-living fluid (plasma.)

• “Whole Blood” is a term used to describe both the formed elements and the plasma.– Formed elements: red blood cells (RBCs), white

blood cells (WBCs) and platelets.– Functions involve transportation, regulation and

protection.

Functions of Whole BloodTransportatio

nRegulation Protection

•Transports oxygen from the lungs and nutrients from digestive tract to all cells of body

•Absorbs and distributes body heat, regulating core body temperature

•Protects from blood loss through clotting mechanism

•Transports metabolic waste products from cells to elimination sites

•Regulates PH in body tissues

•Protects from infection, defending the body from bacteria, virus and toxins

•Transports hormones from endocrine organs

•Regulates adequate fluid volume

How Massage Impacts The Cardiovascular System• Improves the general circulation and

nutrition of tissues.  • Increased interchange of substances

between the blood and tissue cells; heightens tissue metabolism. 

• Dilates or opens up blood vessels, improving the circulation and relieving congestion.

• Increases the number of red blood cells.

The Lymphatic System

• Filters waste from tissues via lymph:– Collects fluids not absorbed at capillary

level in tissues– Returns these fluids back into the

bloodstream

• Defends against bacteria and disease

How Massage ImpactsThe Lymphatic System

• Strengthens immune function by increasing number of “natural killer” T-cells.

• Massage acts as a "mechanical cleanser“:– open system vs. closed– no barriers to function

• Reduces edema.

Demonstration

The Respiratory System• Function:

– Supply cells in the body with oxygen– Dispose of carbon dioxide cell waste

• Respiration= inhalation + exhalation– Inhalation: breathing in, inhaling. Air is

transported to the lungs.– Exhalation: breathing out, exhaling. Gases

are leaving the lungs.

How Massage ImpactsThe Respiratory System

• Increases oxygenation via red blood cells.

• Stimulates expectoration of mucus from lungs.

Demonstration

Contraindications• Despite the many benefits of

massage, these “benefits” can also bring about harm with certain medical conditions.

• See Contraindication handout

Thermal Therapy• Deep Heat—penetrates tissues beyond

the superficial level.– ultrasound – electrical stimulation

• Superficial Heat—does not heat deep tissues.– hot packs– Whirlpool– Paraffin

• See “Modalities” handout

When to Use Superficial Heat

• Chronic pain from muscle spasms• Muscle adhesions• Joint conditions• Arthritis• Before or after chiropractic

adjustments• Before or after exercise

Thermal Therapy: Impacts

• “Superficial Heat”: – Enlarges blood vessels just beneath skin. – Increased blood flow causes a cooling reaction

as it removes the heat that is applied externally.

• Transfer of heat is classified into 3 general types:– Conduction: direct contact between source and

tissues– Conversion: heat transfers from source to body

heat– Convection: heat transferred by movement of

source

Vescent Dry Hydrotherapy:A Combination of Thermal

Types• Both conduction and convection:

– direct contact of source on body– medium movement (water) transfers

heat

• Not conversion or deep heat• All-in-one modality

Shared Benefits of Massage and Superficial Heat

• Helps increase circulation to speed healing– Blood flow– Vasodilation

• Encourages migration of “Killer T-Cells”• Facilitates removal of waste from tissues• Local analgesia (pain reliever)• Relaxes muscles • Reduces joint stiffness• Increases flexibility and range of motion

Dry Heat vs. Moist Heat• Dry heat pulls away your body’s

natural moisture and leaves your skin dehydrated and prone to damage.

• Moist heat provides infusion of moisture to the top layer of skin and prevents moisture loss, thus maintaining improved hydration of the skin and cells.

Vescent Dry Hydrotherapy:A Heat Hybrid

• The barrier protects you from the water, keeping users dry

• The moisture transferred via the water provides the benefits of moist heat

Cryotherapy: Therapeutic Cold

• Primary effect: cools tissue to relieve acute pain and swelling

• Common methods include cold packs, cold immersion, ice massage (R.I.C.E.—Rest, Ice, Elevation & Compression)

• Use the first 24 to 48 hours after injury; immediately following trauma

Heat vs. Cold• Cold treatments used for pain in the acute phase;

heat used for chronic pain.• Heat treatments return muscle to normal

temperature more quickly than cold treatments.• Increased tissue metabolism occurs with heat;

decreases with cold modalities. • Blood flow increases with heat and decreases with

cold. • Heat increases blood/lymph flow to an area; cold

restricts.• Joint stiffness is decreased with heating,

increased with cold.

Degrees Fahrenheit

Description of Sensation

Sensation

32 Ice Pain

32-34 Very Cold Pain and Numbness

55-70 Cold Sensation of cold

71-80 Cool Cool

81-92 Tepid Slightly Cooling

Body temp Neutral No Sensation

93-100 Warm Comfortably Warm

101-104 Hot Skin redness

105-110 Very Hot Tolerable for a short time

111-120 Painfully Hot Pain, possible tissue damage

125+ Damaging Pain and tissue damage

TemperaturesFor

Treatments

Hydrotherapy• By definition:

– The use of water in any of its forms (solid, liquid, vapor) for the treatment of disease or the maintenance of health

– Mostly influencing:• nervous system• circulatory system • skin.

Types of Hydrotherapy Treatments

• Whirlpool• Baths• Sauna• Steam• Local Heat/Cold• Tonic Friction• Showers

Vescent Dry Hydrotherapy

• The incorporation of medical and computer technology that combines hydrotherapy, massage therapy, soft tissue manipulation, whirlpool therapy and heat in one modality.

• The combined benefits create a synergy effect whereby the overall results exceed those produced by each of these therapies separately.

Combined Effects of Vescent Dry Hydrotherapy

• Simulates massage strokes: – Effleurage (movement, contact)– Petrissage (area massage)– Tapotement (striking and vibration of

water)

• Provides benefits of both massage and thermal therapy.

Conclusion• The benefits produced from Vescent Dry

Hydrotherapy incorporate multiple modalities and therapies in a non-invasive manner.

• These benefits can greatly influence health and help relieve pain associated with numerous conditions.

• Just as the massage industry has progressed into mainstream clinical and leisure environments, so is Vescent Dry Hydrotherapy.