MEDICAL MASSAGE (RHPT 363). DEFINITION Massage is the systematic and scientific manipulation of the soft tissues of the body. Types of massage 1. Manual.

MEDICAL MASSAGE (RHPT 363)

INTRODUCTION TO MASSAGE

DEFINITION

Massage is the systematic and scientific manipulation of the soft tissues of the body.

Types of massage

1. Manual massage

2. Mechanical massage

Massage can also be applied by electrical equipment such as vibrators, rollers and etc.,

PURPOSE OF MASSAGE

Purpose of Massage

The purpose of massage is to bring about any of the physiological, mechanical, or psychological effects.

Relaxation, relief pain, reduction of certain types of edema, and increased range of motion can be accomplished through the use of massage.

Massage metabolically prepare the injured or involved muscles for exercise to their fullest capacity, but it will also encourage the confidence

In addition to the treatment of injured or ill people, massage can be used to prepare healthy muscles for strenuous sports activity, or to assist the body in recovering from the aftereffects of such activity.

Massage is a useful and integral part of the healing process.

BASIC PRINCIPLES OF MASSGE

Two basic principles should be kept in mind at all times

1.The therapist should have knowledge of the patient’s complete diagnosis , so that massage can be done as part of the patient’s total treatment plan.

2. Physical contact establishes a close relationship between operator and patient. This contact should be understanding and sympathetic, but never personal.

GENERAL PRINCIPLES OF MASSGE

1. Personal appearance

The personal appearance of the operator should be above scolding. Clothing should be neat, clean, and comfortable, allowing freedom of motion.

2. Surroundings

Massage can be given at almost anytime or place. It is important that room temperature should be warm enough so that the patient is comfortable.

A calm, peaceful, and cheerful atmosphere should be maintained.

Neatness and cleanliness should be most evident ; clean towels and sheets as well as other well- maintained equipment should be neatly arranged.

GENERAL PRINCIPLES OF MASSGE

3.Care of the hands, wrists and fingers

The hands are all important in giving massage

- hands should be washed before every treatment, and rings should not be worn because they might scratch the patients.

- the fingernails should be cut short.

- the hands should always be warm and dry.

- the therapist should do exercise to keep the fingers strong and to avoid pain.

GENERAL PRINCIPLES OF MASSGE

4. Posture

Attention to good posture is essential to avoid fatigue and backache.

The weight should rest evenly on both feet with the body in good postural alignment.

When massaging larger area, the weight should shift from one foot to the other.

A good operator can apply pressure by a shift of body weight instead of using muscle strength.

GENERAL PRINCIPLES OF MASSGE

5.Treatment table

The treatment table should be of wood or metal with a firm pad or a mattress without springs.

The treatment table should be the right height to allow for correct postural balance of weight.

6. Plinth heightstand side-on to the couch, resting your hand on it with the fingers loosely flexed

at the metacarpophalangeal joints and elbow not quite fully extended. Adjust the height of the couch until you can comfortably rest your hand as

above.

7. Positioning of the patient

Specific positioning depends upon the areas of the massage.

In general, the part to be massaged should be elevated in order to allow gravity to assist the venous return.

GENERAL PRINCIPLES OF MASSGE

8. Draping

Tight clothing should be removed and a sheet or towel used to cover the parts of the body not being treated.

The patient should not be unnecessarily exposed.

9. Contact medium

The purpose of a lubricant is to avoid uncomfortable friction between the hand of the operator and skin of the patient.

There are many types of lubricants. - lanolin oil - mineral oil or baby oil - olive oil - powder (odorless)

Care should be taken to avoid application of too much of lubricants since it prevents firm contact and the hands can slip over the surface of the skin.

GENERAL PRINCIPLES OF MASSGE

10. Feedback

The therapist can improve his techniques if he gets feedback from the patients about the pressure and comfortability.

11. Pressure and Rhythm

Pressure should be adjusted to the contours of the body and care should be taken over bony areas.

All massage should begin lightly, as depth of the stroke increases, the operator increases the pressure but it should not be greater than tolerability of the patient.

It is important to maintain physical contact with the patient once the treatment begins.

GENERAL PRINCIPLES OF MASSGE

12. Rest

Rest for the patient following treatment is always advised, especially in cases where the involved part is a weight bearing limb.

Length of time for this rest must be judged by the operator.

13 .Duration

Depends upon the part of the body treated.

THE LYMPHATIC SYSTEMThe Origin of Lymph

Lymph originates as plasma, which is the fluid portion of blood. The arterial blood that flows out of the heart slows as it moves through a capillary bed. This slowing allows some plasma to leave the arterioles and flow into the tissues where it becomes tissue fluid.

Also known as intercellular fluid, or interstitial fluid, this tissue fluid delivers nutrients, oxygen, and hormones to the cells.

As this fluid leaves the cells, it takes with it cellular waste products and protein cells.

Approximately 90 % of this tissue fluid flows into the venules. Here it enters the venous circulation as plasma and continues in the circulatory system.

The remaining 10 % of the fluid that is left behind is now known as lymph.

THE LYMPHATIC SYSTEM

THE LYMPHATIC SYSTEMLymphoid tissue

Lymphoid tissue associated with the lymphatic system is concerned with immune functions in defending the body against the infections and spread of tumors. It consists of connective tissue with various types of white blood cells enmeshed in it, most numerous being the lymphocytes.

A lymph node

There are between 600-700 lymph nodes present in the average human body. It is the role of these nodes to filter the lymph before it can be returned to the circulatory system.

THE CIRCULATORY AND LYMPHATIC SYSTEMS COMPARED

CARDIOVASCULAR SYSTEM(BLOOD)

Blood is responsible for collecting and distributing oxygen, nutrients and hormones to the tissues of entire body.

Blood flows in a closed continuous loop throughout the body via the arteries, capillaries, and veins.

Blood is pumped. The heart pumps blood into the arteries that carry it to all of the body. Veins return blood from all parts of the body to the heart.

Blood consists of the liquid plasma that transports the red and white blood cells and platelets.

Blood is filtered by the kidneys. All blood flows through the kidneys where waste products and excess fluids are removed. Necessary fluids are returned to the cardiovascular circulation.

LYMPHATIC SYSTEM(LYMPH)

Lymph is responsible for collecting and removing waste products left behind in the tissues.

Lymph flows in an open circuit from the tissues into lymphatic vessels. Once within these vessels, lymph flows in only one direction.

Lymph is not pumped. It passively flows from the tissues into the lymph capillaries. Flow within the lymphatic vessels is aided by other body movements.

Lymph that has been filtered and is ready to return to the cardiovascular system is a clear or milky white fluid.

Lymph is filtered by lymph nodes located throughout the body. These nodes remove some fluid and debris. They also kill pathogens and some cancer cells.

FUNCTIONS OF LYMPHATIC SYSTEM

FunctionsThe lymphatic system works in close cooperation with other body systems to perform these important functions:

The lymphatic system aids the immune system in destroying pathogens and filtering waste so that the lymph can be safely returned to the circulatory system.

To remove excess fluid, waste, debris, dead blood cells, pathogens, cancer cells, and toxins from these cells and the tissue spaces between them. 

The lymphatic system also works with the circulatory system to deliver nutrients, oxygen, and hormones from the blood to the cells that make up the tissues of the body.

It absorbs and transports fatty acids and fats  to the circulatory system

Diseases of the lymphatic system

Lymphedema is the swelling caused by the accumulation of lymph fluid,[6] which may occur if the lymphatic system is damaged or has malformations. It usually affects the limbs, though face, neck and abdomen may also be affected.

Some common causes of swollen lymph nodes include infections, infectious mononucleosis, and cancer.

Parasitic infection (Filariasis)

PHYSIOLOGICAL EFFECTS OF MASSAGE ON VARIOUS SYSTEMS

1. Effects on circulatory system 2. Effects on mobility of soft tissue 3. Effects on metabolism 4. Effects on respiratory system 5. Effects on excretory system 6. Effects on nervous system 7. Psychological effects.

PHYSIOLOGICAL EFFECTS OF MASSAGE

1.Effects on circulatory system

Assists in venous Flow

When normal activity is inhibited by injury or illness, this will result in decreased circulation.

The mechanical effect of deep stroking on the superficial veins in the direction of venous flow will increase arterial circulation. when possible, gravity should be considered to assist.

Assists Lymphatic Flow

Lymph is a viscid fluid that moves slowly through the lymphatic system. Movement of lymph depends upon outside forces such as contraction of muscles and pressure generated by filtration of fluid from the capillaries. Immobility due to pain or paralysis seriously interferes with lymph drainage.

Massage strokes can encourage lymphatic flow, preventing the edema .

PHYSIOLOGICAL EFFECTS OF MASSAGE

2. Effects on mobility of soft tissues

Massage has significant effect on the properties of soft tissues.

The tissues which can be effected by massage includes muscles, sheaths, ligaments, tendons, joint capsules, superficial and deep fascia.

Subcutaneous scar tissues can be loosened by persistent friction massage.

Contractures and adhesion formation in muscles and joints can be stretched and mobilized by pressure manipulation. By this way massage can maintain and restore mobility of the soft tissues.

PHYSIOLOGICAL EFFECTS OF MASSAGE

3. Effects on Metabolism

Metabolically muscle maintain a chemical balance through normal activity. When muscle contract they get rid of toxic products into the lymphatic's and venous flow.

Over activity (Sports, exercise & etc.,)disturbs balance by not allowing sufficient relaxation time for the inflow of nutritive product and removal of metabolic waste products.

The massage (deep stroking) can promote the disposal of waste products and supply of nutritive material by assist in lymphatic and venous flow.

PHYSIOLOGICAL EFFECTS OF MASSAGE

4.Effects on excretory system

a) SKIN

The massage improves nutritive states of the skin and it improves movement of skin over subcutaneous structures. As a result of this the skin become more soft, pliable and elastic.

The massage activates sweat and sebaceous glands. So that temperature and healthy skin is maintained

b) KIDNEY

By deep abdominal and lumbar massage stimulates the renal plexus (which supplies the kidneys). This will result in increased blood supply to the kidneys and there by it helps in improving functions of the kidney.

PHYSIOLOGICAL EFFECTS OF MASSAGE

5. Effects on respiratory system

The Percussion and Vibration technique of massage performed over the chest assist in removal of secretion from the larger airways through their effect on small airways.

This is because the vibration and percussion technique will loosen and advances the secretions from the smaller airways to central airways.

The removal secretions will help in gaseous exchange ( Air entry into the lungs will increase) and thereby it improves the function of the lungs.

PHYSIOLOGICAL EFFECTS OF MASSAGE

6. Effects of massage on Nervous system

a) On SENSORY nerves

Massage(Superficial stroking)has sedative effect on the central nervous system.

Massage stimulates the peripheral sensory receptors mainly touch and pressure receptors present in the skin and soft tissues.

Massage relieves pain by inducing sedative effect over sensory nerves.

PHYSIOLOGICAL EFFECTS OF MASSAGE

b) On MOTOR system

Most of the massage techniques stretches the muscle spindle which facilitate the muscle contraction.

Massage can reduce the muscle spasm by producing inhibitory effect on motor system.

C) On Autonomic nervous system (ANS)

Massage has a definite reflexive effect and it influence the function of visceral organ by stimulating the autonomic nervous system.

Physiological responses associated with ANS are heart rate, blood pressure, respiratory rate, temperature and activity of the sweat glands. These all function can be influenced by massage.