Академический Документы
Профессиональный Документы
Культура Документы
There is a long history to massage from the earliest accounts of medical care. The
purpose of massage is to produce therapeutic effects on the tissues of the nervous,
muscular, and respiratory systems of the body and on the local and general circulation
of the blood and lymph. The definitions of massage are many but all of them describe
the use of the hands as a means to bring about responses in the soft tissues. In the
healing arts the responses are therapeutic ones.
The major indication for massage is post-acute soft tissue trauma, particularly sprains
and strains. Massage should not be conducted in areas of acute injuries with on-going
hemorrhaging, infections, thromboses, and neural damage.
Massage Movements
Vibration: this involves rapid shaking of the tissues or a slower and rhythmic pattern of
vibration.
Kneading: this is a lifting and compression that is vertical to the tissues. Some have
referred to this as a petrissage movement, so the process is the same.
Components of Massage
Direction: the direction of most massage may be centripetal (the direction of venous
blood flow) even though the succession of the movements is in the opposite direction
(centrifugal).
Pressure: the amount of pressure is solely dependent on the relaxation of muscle. Even
light pressure could influence every structure throughout the part if muscle relaxation
has occurred. Deep pressures may be applied without any sense of being forceful. Firm
pressure may be used but avoid pain.
Rate and Rhythm: the movements must be slow, gentle, and rhythmical with no
hesitancy or irregularity about it. The time between the end of the stroke and the
beginning of the next stroke should be identical to the time of the stroke during the
movement. Breathing rates offer a slow and rhythmic rate.
Media: Dry massage is very common, but use of talcum powder, or an oily medium are
used.
Position of the Patient: the position should be on a table for most body parts so that
the limb and body are supported in a comfortable position. The operator should be able
to work in a comfortable position. Gravity is often used to assist the process.
Duration: the range of massage duration is quite long 5-75 minutes. Massage for
edema reduction is often given for 5-10 minutes. Friction massage is given for about 5
minutes.
Physiologic Effects
Changes in blood flow: deep, friction, or vigorous massage can produce an increase in
blood flow, histamine release, and increased temperature. It does not appear to affect
an increase in cardiac output, blood pressure, or lactic acid concentration.
Reduction of edema: properly done, massage can increase venous and lymphatic flow
that assists in the removal of edema. This type of massage forces the fluid within the
vessels to move toward the heart. The strategy with edema removal is to mobilize
proximal areas of edema before attempting to move more distal areas.
Pain control: mechanical pain is interrupted through reducing muscle spasm and
reducing edema. Chemical pain is reduced by increasing blood flow and encouraging
the removal of cellular wastes. Simple touching can reduce pain by activating sensory
receptors.
Precautions
Both your hands and the patient’s skin should be clean. Your hands should be warm
and your nails trimmed. Remove rungs, watches and wrist jewelry. Use less lubricant
with petrissage and even less with fractioning.
General Application
Before beginning, position the patient comfortably with the part to be massaged
properly exposed. If edema reduction is the goal, elevate the part to enhance drainage.
Explain what you are going to do and for the patient to inform you if painful. For
effleurage and petrissage the direction of stroking is toward the heart and the hands
should not lose contact with the skin. The rhythm of the stroke should be slow to
promote relaxation. Maintain a comfortable position during the treatment and use
proper body mechanics. When using friction massage you should warn the patient that
the treatment will be uncomfortable but it will not last. Use the thumb or finger pads in
a cross pattern. Firm, consistent pressure and rhythm are used. Often a cross-friction
pattern is used perpendicular to the tissues fiber arrangement.