Types and techniques of performing medical massage - indications for treatment, rehabilitation and prevention of diseases. Massage technique
Massage at the clinic Restorative Medicine, Northern Administrative Okrug.
Therapeutic medical massage is carried out more intensively than classical or relaxing; the actions of the massage therapist are aimed at removing blocks and clamps, special attention is paid to problem areas where there are deviations and pathologies. During a therapeutic massage, the patient experiences quite intense sensations.
In principle, any professional massage can be called medicinal- it mobilizes the body's defenses, increases immunity, has a beneficial effect on the state of the cardiovascular, nervous, digestive, respiratory systems, blood circulation, relieves congestion, improves joint mobility, effective for radiculitis, osteochondrosis.
Therapeutic massage in Moscow - VosstMed clinic
The Restorative Medicine Medical Center practices massage as one of the main procedures for treating diseases of the musculoskeletal system, joints, muscles and ligaments.
Segmental and acupressure massage
Segmental medical massage involves influencing the segments in which changes have occurred (muscles, skin, bone). Reflex changes are corrected with special massage techniques. The affected areas are found by palpation; when painful areas and increased excitability of a particular segment are identified, work begins to eliminate the source of pathology.
Segmental massage includes acupressure, which is considered a species.
Each type medical massage has its advantages, the doctor in each individual case will be able to advise one or another type of mechanical action depending on the treatment objectives.
General therapeutic body massage
Professional body massage at the VostMed clinic, photo
General medical body massage is a special type of massage in which the entire body is massaged, rather than individual areas. This type of procedure helps to relax and get rid of many diseases; it helps to achieve an effect on all systems of the body - muscular, digestive, lymphatic, endocrine, nervous, and the circulatory system. General therapeutic massage affects all areas of the body, helps get rid of insomnia, fatigue, stress, improves skin condition, improves metabolic processes and digestion of food, reduces the patient’s weight, and calms the nervous system.
Features of classic massage
The most popular is classic therapeutic massage, on the basis of which all other massage techniques are built. Stroking, kneading, rubbing are present in different types of massage, but in the classical one they are used longer, repeated more often, and have a certain repetition order.
First, the collar area is massaged, then the hands move along the location of the lymphatic pathways. Stimulating movements give the body strength, relieve stress, and increase overall tone. After a session of classical therapeutic massage, a person experiences a surge of strength, pain goes away, sleep and appetite improve. Massage is good not only for improving well-being, but also for lifting your mood.
1.2.3. Basics of therapeutic massage
Characteristics of therapeutic massage. Therapeutic massage is an effective therapeutic and rehabilitation method used to normalize body functions in various diseases and injuries. The popularity of therapeutic massage is constantly growing, it has become the object of close attention and scientific study. It is used in surgery, traumatology, therapy, gynecology, neuropathology, cardiology, endocrinology, sports medicine and rehabilitation.
Therapeutic massage methods. The most common method is classical massage is the main method in therapeutic massage, as it has a variety of techniques, allows you to widely vary the dosage, visually and tactlessly control the accuracy of the techniques and evaluate their results, etc. Manual massage has an advantage over hardware, foot and combined massage, since it can be used not only in the ward, massage room, but also at home, in a bathhouse, bath, etc., as well as in the form of self-massage.
Hardware massage method used as an additional one. Depending on the variety, it can be performed either through direct contact with the skin or through air or water. Among the varieties of hardware massage methods, vibration, hydro and pneumatic massage are the most widespread. Electrical stimulation, ultrasound massage, etc. are also used in medical practice. Hardware types of massage, like manual massage, can be used in the process of segmental, acupressure, periosteal and other types of massage. Combined massage method. Combined massage is a massage that uses manual and hardware massage.
Foot massage method It is performed using the feet: the heel, toes, and also knees, most often in sanatorium-resort conditions, in water clinics and baths.
It is especially worth emphasizing the great effectiveness of manual massage, since only with their hands can a massage therapist identify changes in the tissues of the massaged area, highlight the necessary points and purposefully influence them. Without denying the positive effect of hardware massage, in medical practice it is still preferable to use a manual one, since none of the devices can replace the hands of a massage therapist.
Therapeutic massage can be classified according to the nosological units for which it is used: massage for injuries and diseases of the musculoskeletal system, massage for diseases and injuries nervous system, massage for diseases of internal organs, etc. Each group of diseases has its own characteristics of the technique and methodology of a massage session. For each disease, the massage technique depends on the etiology, pathogenesis, clinical form, course and is differentiated in connection with these factors.
Methodological features when conducting therapeutic massage. Massage is a more adequate therapeutic effect in the first days after injuries or illnesses than exercise therapy. Therefore, to achieve a greater therapeutic effect, massage should be performed before physical exercise, and, if necessary, again after it. The technique and methodology for performing techniques in therapeutic massage are similar to those in hygienic, sports and other types of massage, namely: stroking - combined, longitudinal, alternating, etc.; squeezing - with the edge of the palm, the base of the palm, etc.; kneading - double ring, double bar, pads of 1-4 fingers, base of the palm, etc.; rubbing - “pinks”, with fingertips, the comb of a fist, etc.; shaking; vibration; movements, etc. The choice of techniques for creating a specific massage session technique depends on the disease and the clinical forms of its course. The therapeutic technique of massage involves techniques of focal and extrafocal, or segmental-reflex, effects, a sequence of techniques, their combination with movements, and a gradual increase in impact.
Dosing of massage is carried out by: localization of segments of influence, choice of techniques, depth and area of influence on tissues, number of massage manipulations, speed and rhythm of movements and their amplitude, duration of procedures and alternating them with other influences, rest intervals (pauses) between procedures, number of procedures per course of treatment, etc.
Therapeutic massage for all diseases and injuries is carried out in accordance with the periods of treatment and stages of rehabilitation. A massage session consists of three sections: introductory, main and final. Massage should not cause pain. It can be done 1-2 times daily or every other day. The course of treatment is from 10 to 18-25 procedures, the break between courses is from 10 days to 2 months, depending on the disease and agreement with the doctor in each individual case.
General indications and contraindications for therapeutic massage. Massage is often combined with other treatment methods, especially with physical factors and physical therapy, but it can also be used as an independent method of rehabilitation. When prescribing a massage, it is necessary to clearly know the indications and contraindications for its use. It should be remembered that the use of undifferentiated techniques, the use of techniques indiscriminately can cause unfavorable responses, even aggravating the process. The same negative reactions occur when massage is prescribed at a time when massage is not yet indicated. It is important to take into account that when combining massage with physical factors, the latter may be accompanied by a reaction. Therefore, the massage technique should be more gentle; sometimes massage should be applied to an area of the body distant from the source of exacerbation, or the procedures should be canceled, resuming them after the acute phenomena have subsided, according to the doctor’s decision in accordance with individual indications.
Massage should be performed along the lymphatic pathways towards the nearest lymph nodes, which cannot be massaged. The patient's position should prevent tension on the parts being massaged and on the entire body. Massage techniques should not cause pain.
The duration of the massage session depends on the disease, body area, body weight of the person, his age and current condition, etc. The first massage sessions are always short and gentle, and then the time and strength of the impact increase. The time for performing individual massage techniques depends on the parts of the body being massaged, the nature of the injuries or diseases, as well as the patient’s well-being. The correct choice of techniques largely determines the therapeutic effect of massage.
When performing massage for the purpose of treatment and rehabilitation, there are the following contraindications.
Acute febrile condition and acute inflammatory processes.
Bleeding, bleeding.
Blood diseases.
Purulent processes of any localization.
A disease of skin infection, unknown or fungal etiology. Skin rashes, damage, skin irritation.
Acute inflammation of the veins, vascular thrombosis, significant varicose veins with trophic disorders.
Endarteritis, complicated by trophic disorders, gangrene.
Atherosclerosis of peripheral vessels, thromboangiitis in combination with atherosclerosis of cerebral vessels, accompanied by cerebral crises.
Aneurysms of blood vessels and heart.
Inflammation lymph nodes and vessels. Enlarged, painful lymph nodes adherent to the skin and underlying tissues.
Allergies with hemorrhagic and other rashes. Hemorrhages into the skin.
Excessive mental or physical fatigue.
Active form of tuberculosis.
Syphilis stage 1-2, AIDS.
Chronic osteomyelitis.
Causalgic syndrome after peripheral nerve injuries.
Malignant tumors of various locations.
Mental illness, with excessive agitation, significantly altered psyche.
In some cases, contraindications to massage are temporary and after an acute inflammatory process, feverish condition, purulent process, exacerbation of a disease of the autonomic nervous system, etc. massage can be used (according to indications). Massage should also be prescribed after radical tumor removal. It often happens that massage may be indicated for the underlying disease, but it cannot be prescribed due to concomitant diseases.
Concluding the general part, it should be emphasized that knowledge of massage techniques for individual parts of the body is necessary as the basis for subsequent mastery of private massage techniques for diseases and injuries. Only this approach to the study and use of massage makes it highly effective in the treatment and rehabilitation of various diseases and injuries. When prescribing a massage, the doctor must indicate in what combination and sequence with other procedures the massage should be used and constantly monitor the patient during the application of this method of treatment and rehabilitation.
A combination of therapeutic massage with exercise therapy and physiotherapy. In many cases, it is advisable to combine massage with various physiotherapeutic procedures: water therapy, light therapy, electrotherapy, etc. Physical treatments prepare the body tissues for massage. For example, it is advisable to pre-warm the limbs whose skin temperature is low (paresis, paralysis), or to reduce pain so that it becomes possible to deepen the massage, etc.
Massage And heat therapy. Heat significantly enhances the physiological effect of massage, causing active tissue hyperemia, reduces muscle excitability, relaxes spasms of muscles and blood vessels and significantly reduces pain. Therefore, in case of traumatic and inflammatory lesions of the joint-ligamentous and muscular system in the subacute period, as well as in chronic processes, joint stiffness, muscle contractures, vascular disorders with a tendency to spasms, it is advisable to combine massage with thermal procedures (water bath, paraffin applications, ozokerite, steam room , bathhouse, etc.).
The sequence of thermal procedures and massage in each case is determined by special indications. Thus, for functional disorders of the musculoskeletal system (joint stiffness, articular adhesions, delayed formation of callus, muscle atrophy, paresis, neuritis and neuralgia), it is recommended to first use heat and then massage. For vascular disorders (tissue swelling after a fracture, lymphostasis phenomena) - first massage, and then heat to avoid rupture of superficial vessels.
Massage and electrotherapy. With the combined use of massage and electro-gymnastics (amplipulse, electrical stimulation, etc.), massage is recommended to be carried out immediately after the electro-procedure. When prescribing electrophoresis with various medicinal substances in combination with massage, massage is first used, and then electrophoresis.
Massage and hydrotherapy. Depending on the indications, massage can be used before and after water procedures. For injuries and diseases of the musculoskeletal system (scar tissue adhesions, myogenic, arthrogenic contractures, joint stiffness, myofibrosis, tissue myosclerosis, etc.), as well as for injuries and diseases of the peripheral nervous system (lumbosacral radiculitis, neuromyositis, etc.) First, thermal and water procedures are used, and then massage; In case of severe pain, the massage is preceded by a hydrotherapy procedure.
You should not prescribe a general massage and a general light bath on the same day. The nature of the reaction is incompatible, for example, ultraviolet irradiation and massage or Charcot's shower and massage.
Physiotherapeutic procedures do not place a very large burden on the cardiovascular and nervous system and can be prescribed on the same day, but at different times: for example, a water bath (low temperature) and massage, mud therapy (local application) and massage.
Segmental reflex massage. In the arsenal of modern medicine there are many ways of reflex effects on the human body. Massage is largely based on the principles of such influence. Methods of reflex influence on the human body through pressure (pressure) include segmental, acupressure, connective tissue, periosteal and other types of massage. Their essence lies in the impact of certain techniques on individual parts of the body, zone or points of the skin surface, periosteum and other tissues of the human body. It should be noted that the body’s reactions are completely different depending on the type of exposure. These reactions are called reflex, and the method of influence (treatment) based on their use is called reflexology.
Segmental massage. Based on the physiological principles and theoretical principles of the teachings of I.P. Pavlova, A.E. Shcherbak (1903) proposed and substantiated a new direction in the development of therapeutic massage - segmental reflex massage, which is progressively developing and is effectively used in clinical and sanatorium practice in our country.
Segmental reflex massage provides for a direct effect not on the diseased organ, but on zones innervated by the same segments of the spinal cord (Table 1), i.e., indirectly influencing the mechanisms of pathogenesis. For example, by massaging the corresponding paravertebral zones and the epigastric region, you can influence the motor, secretory and evacuation functions of the stomach; for vascular diseases and injuries of the lower extremities, massage of the lumbar region has a positive effect on blood circulation, trophic processes in tissues and their regeneration, and improves the restoration of motor functions. Chest massage can help eliminate and resolve residual effects after inflammation of the lungs and pleura and prevent the development of adhesions; massage of the collar zone - reduces blood pressure in case of hypertension, eliminates headaches in case of neuroses and fatigue.
All tissues, organs and systems of the human body represent a single whole and are in certain relationships with each other. Therefore, not a single disease is local, but always causes reflex changes in segment-related functional formations, predominantly innervated by the same segments of the spinal cord. Reflex changes can occur in the skin, muscles, connective and other tissues and, in turn, affect the primary focus and support the pathological process. By eliminating these changes in tissues with the help of massage, it is possible to help eliminate the primary pathological process and restore the normal state of the body.
The interrelations of our body are carried out through viscerosensory, viscero-motor and viscero-visceral reflexes, which are of great importance in clinical practice.
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Table 1.Segmental innervation of internal organs |
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Spinal cord segments |
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Heart, ascending aorta | ||
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Lungs and bronchi | ||
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Rectum | ||
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Liver, gall bladder | ||
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Pancreas | ||
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Spleen | ||
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Kidneys, ureters | ||
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Bladder | ||
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Prostate gland | ||
Areas of the skin surface with increased sensitivity, in which pain occurs due to diseases of internal organs, are called Zakharyin-Ged zones. The Russian clinician G. A. Zakharyin first described them in 1889. The connections of various internal organs with certain areas of the skin were described in more detail by Ged in 1893-1896. Physiologically, the emergence of zones of increased sensitivity is explained by the fact that pain stimuli coming through sympathetic fibers from internal organs to spinal cord, irradiate to all sensitive cells of a given segment, exciting them. Such excitation is projected onto the areas of the skin associated with this segment. It is known, for example, that with cardiosclerosis and angina pectoris, pain occurs in the left arm, on the inner surface of the shoulder, in the axillary region, near the scapula. A reverse reflex process is also possible, when a pathological focus on the surface of the skin causes pain in the internal organs.
In diseases of the internal organs, long-term painful tension in the skeletal muscles sometimes occurs. For example, in diseases of the liver and biliary tract, reflex changes are observed in the trapezius muscle, in the latissimus dorsi muscle, in diseases of the pleura - in the intercostal muscles, in the sternocleidomastoid muscle, etc. In diseases of the internal organs, reflex changes in the periphery can manifest themselves as thickening or limited mobility of the skin, compactions in the subcutaneous tissue.
The establishment of functional connections between all parts of the human body laid the foundation for the development of segmental reflex methods in physiotherapy, including massage. Research has shown that by influencing the surface of the body in certain areas with physical factors, it is possible to influence the vital functions of the body for therapeutic purposes. Based on the study of anatomical and physiological data and the results of clinical studies, the special significance of certain skin areas has been determined. Thus, the cervico-occipital and upper thoracic areas (collar zone) include the skin of the back of the neck, back of the head, shoulder girdle, upper back and chest. This entire skin zone is closely connected with the cervical and upper thoracic segments of the spinal cord (C 4 -D 2) and the formations of the cervical autonomic nervous system. The cervical part of the autonomic nervous system is connected to the autonomic centers of the brain and has extensive peripheral connections, due to which it plays a large role in the innervation of the heart, lungs, liver and other organs and tissues of the head, neck, upper chest, back and upper extremities. By influencing the skin segments of the collar zone with massage, it is possible to cause functional changes in the central nervous system, where the control of the vegetative activity of the body is concentrated, and to obtain a reflex response in the form of various physiological reactions from organs and tissues (metabolic processes, thermoregulation, etc.).
The lumbosacral region includes the skin of the lower back, buttocks, lower abdomen and upper third of the front of the thighs. This entire skin zone is closely connected with the lower thoracic (D 10 -D 12). lumbar and sacral segments of the spinal cord, with the lumbar part of the sympathetic department of the autonomic nervous system and its parasympathetic centers. When skin segments associated with the nervous apparatus of the lumbar region are irritated by physical factors, functional changes occur in the organs and tissues of the pelvis, in the intestines and lower extremities. Based on experimental studies and clinical observations of A.E. Shcherbak was the first to recommend segmental reflex massage techniques - massage collar And waist massage. The first of them is prescribed for hypertension, sleep disorders, trophic disorders in upper limbs etc., the second - for vascular diseases and injuries of the lower extremities, to stimulate the hormonal function of the gonads, etc.
Segmental reflex massage differs from classical massage in that in addition to the effect on the affected organ, there is an additional extrafocal effect on the affected tissues, organs and systems of the body. In an internal medicine clinic, where direct massage of a diseased organ is not available, segmental reflex massage is especially important. During segmental massage, all the basic techniques of classical massage are used: stroking, squeezing, rubbing, kneading and vibration. Auxiliary techniques are also used, for example, hatching, sawing, squeezing, felting, stretching muscles, joint-ligamentous apparatus, shaking the chest, pelvis, internal organs, etc. In addition, special techniques are used: drilling, moving, sawing, etc. Segmental massage techniques should be carried out rhythmically, gently, without brute force, having previously given the massaged body segment an average physiological position. In addition to the accepted directions of massage manipulations, segmental reflex massage also carries out specific directions of movements, determined by the functional structure of the spinal innervation segment and its neuro-reflex connections. Under the term segmental massage imply not only an impact at the level of a certain segment of the spinal cord, but also a special massage technique. Features of the segmental massage technique are sequential differentiated effects on the skin - stroking and squeezing; to influence the muscles - kneading and squeezing, which cause muscle stretching. In addition to these techniques, rubbing techniques are also used: on joints, fascia, tendons, and ligaments. Pressure and muscle shifting are applied to the muscles. Shifting of the vertebrae is also used.
Method of using segmental massage:
start the massage session with superficial tissues;
start with the lower segments, gradually move to the higher-lying sections, for example from D 8 - D 1;
It is advisable to start performing techniques from the segmental roots at the exit point of the spinal column.
Acupressure. Unlike segmental massage, acupressure massages narrowly limited point areas of tissue. It has been established that acupressure has mechanical, humoral, reflex and bioelectric effects. It is carried out at the same points that are exposed to a needle or a wormwood cigarette during the therapeutic method of acupuncture and moxibustion. These healing methods originated in the countries of the Ancient East. Over the centuries, a whole system of therapeutic effects has developed, which included acupressure as one of the main methods of treatment. It has been established that some points on the human skin are functionally interconnected with various organs and systems of the body; they were called biologically active. In total, about 700 such points have been described, but most often 100-150 of them are used. The mechanism of therapeutic action on biologically active points (BAP) involves complex reflex physiological processes. When a particular area or point of the skin is irritated, a response can be evoked at the level of a specific organ in an area that has no visible anatomical connection with the irritated area.
Studies of biologically active points have shown that exposure to the point excites or calms (depending on the technique) the autonomic nervous system, enhances arterial blood supply, regulates the activity of the endocrine glands, soothes pain, and relieves nervous and muscle tension. Biologically active points have specific features that distinguish them from other areas of the skin: reduced electrocutaneous resistance, high electrical potential, increased temperature and pain sensitivity (hence the term massage in pain points), higher level of metabolic processes (V.I. Ibragimova, 1983). Pressure and rubbing at these points causes a feeling of aching, numbness, and acute pain (such sensations do not occur when pressure and rubbing are applied at some distance from these points). These sensations are so constant and characteristic of biologically active points that they are a criterion for the correctness of their location.
Dosed exposure to strictly defined points selectively affects the functions of various organs and systems. The use of massage in the armpits, mammary glands and in areas where large vessels are located is not indicated. Acupressure can be used in combination with drug therapy. It must be remembered that this ancient Eastern method of treatment only complements modern medical methods of treatment and restoration, but does not replace them.
Method for determining points. During palpation, the location of the BAP is identified using sliding squeezing movements with the pad of the most sensitive finger; when the point is found, a feeling of roughness, warmth, and increased pain appears.
The location of points can be identified using topographic maps, diagrams and drawings that inform about the location of points, as well as using ELAP, ELAP-VEF, ELITE-04, and “Reflex - 3-01” devices.
Acupressure technique. Depending on the technique of influencing a local point, the method can be stimulating or calming. Thus, in case of disturbances of muscle tone, with its increase, contractures of a central or peripheral nature (spastic paralysis, paresis, cerebral palsy, contractures of the facial muscles with complicated neuritis of the facial nerve), as well as for pain, especially of a muscular, joint nature, the task of treatment is relaxation, relaxation, tranquility, i.e. sedative effect. In this case, an inhibitory, sedative method is used: within 1-2 s they find the required point, within 5-6 s they make clockwise rotational movements, go deeper, pressing on this point and gradually increasing the force, fix the achieved level for 1-2 s , then make the opposite movement, “unscrewing” the finger counterclockwise, gradually reduce the pressure force, performing rotations for 5-6 s. Then, without lifting the finger from the fixed point, this cycle of movements is repeated (when exposed to a sedative method for 1 minute, 4 entries and exits are made, each for 15 s; if it is necessary to act for 2 minutes, then 8 entries and exits are made). With each impact, the pressure on the point increases depending on the sensation of the person being massaged (bloating, numbness, pain, warmth, etc.).
For symptoms of decreased tone, atrophy of muscle groups, neuritis of individual nerve trunks, paresis, a stimulating (tonic, stimulating; acupressure technique is used: find a point for 1-2 s, then perform clockwise rotational movements for 3-4 s, “screwing in” finger and pressing on the point, and then sharply pulled away from the point, just as a bird hits with its beak, this movement is repeated 8-10 times at one point (40-60 s). recommendations for the corresponding disease or syndrome. Figure 1 shows the position of the fingers and hand when performing acupressure.
Connective tissue massage. Areas of tissue with increased tension are designated as connective tissue zones. There is limited skin mobility here, which can be determined by palpation. With diseases of some internal organs or with functional disorders in them, the mobility of connective tissue may be completely absent (for example, in severe angiopathy). Massage of reflex zones located in connective tissue is called connective tissue massage. The technique of its implementation is to influence tense areas of connective tissue (most often with the tips of the 3rd and 4th fingers). In this case, in places with pronounced tension, a sharp sensation occurs, reminiscent of a cutting movement with a nail or a sharp pinch of the skin.
According to the method of execution, connective tissue massage is divided into 3 types:
cutaneous, when only the skin is displaced and the subcutaneous layer is not affected;
subcutaneous, when the subcutaneous layer is displaced, but the fascia is not affected;
fascial, when the displacement is made in the fascia.
Connective tissue massage is based on the tension of certain receptors (mechanoreceptors of the skin, subcutaneous tissues and vascular connective tissue), which causes various reflexes that can affect organs innervated by the autonomic nervous system.
Periosteal massage. The effect of periosteal massage (classified as pressure massage) is aimed at the bone surfaces or periosteum (it is carried out with the fingertips or interphalangeal joints) and consists in the fact that at the point of pressure, blood circulation and cell regeneration increase, mainly in the periosteal tissue, and there is a reflex effect on organs connected by nerve pathways to the massaged surface of the periosteum. There are experimental data that suggest that after periosteal massage in the area of the cervical vertebrae or occipital region, visual acuity increases, and after massage in the area of the ribs and sternum, heart rate decreases, i.e., the efficiency of the activity of the heart muscle increases. Periosteal massage significantly affects breathing, so it is used as an adjunct in the treatment of patients with impaired respiratory function. It is especially useful in case of a sharp decrease in the tidal volume of the lungs and impaired gas exchange. Periosteal massage is also indicated for pain or morphological changes in the periosteum and is the best method for arthrosis of the costovertebral or intervertebral joints with pain.
The technique of periosteal massage is simple: the fingertip or interphalangeal joint is lowered onto the painful point, the soft tissues covering it are shifted (primarily muscles) to achieve the best contact with the periosteum, and, gradually increasing the pressure, press on it, simultaneously performing rhythmic small circular movements. Then the pressure is also gradually reduced without interrupting contact with the skin. Cycles of increasing and decreasing pressure last 4-6 s and are repeated for 2-4 minutes. After applying pressure to each point with the tip of the thumb (or the tubercle of the thumb), squeeze. The average duration of a massage session should not exceed 18 minutes. The frequency of procedures is 3 times a week.
Massage for diseases and injuries of the musculoskeletal system (MSA). The objectives of massage for musculoskeletal injuries are as follows:
in enhancing blood and lymph circulation and metabolic (trophic) processes in the damaged area of the musculoskeletal system;
in reducing pain;
in promoting the resorption of infiltrates, effusions, edema, hemorrhages in the damaged area;
in accelerating regeneration processes, in particular the formation of callus during bone fractures;
in relieving muscle tension;
in preventing the formation of contractures and stiffness in joints; muscle atrophy.
Massage, due to mechanical effects and reflex effects, helps to increase blood and lymph circulation in the damaged area, improving trophism and promoting rapid healing of the damaged part of the musculoskeletal system.
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VSE. In fact, detoxification: |
Under the influence of massage, elasticity improves and mobility of the ligamentous-capsular apparatus increases, the secretion of the synovial membrane of the joint is activated, helping to reduce swelling and normalize its function.
Massage for bruises Massage is carried out on the 2-3rd day after the injury (if there is no rupture of large vessels and muscles, thrombosis). The massage begins above the site of injury, stimulating the outflow of lymph and blood from the area of the bruise (suction massage technique). The techniques of stroking, light kneading and squeezing in the direction of the nearest, higher-lying lymph nodes are used. If there is no pain, you can begin to massage the area of the bruise; the intensity of the effect depends on the patient’s sensation. At the first massage session in the area of the bruise, light stroking techniques are limited. As the pain decreases, stroking begins to alternate with light rubbing and soft kneading with the pads of the fingers, in larger areas - with the base of the palm.
The duration of the massage procedure in the first days is 8-10 minutes. in the subsequent ones - 18-20. Gradually, passive movements and active exercises are added to the massage.
Massage for sprains. Massage begins on the 2nd or 3rd day after the sprain. The affected limb is placed in a slightly elevated position, and the massage begins above the affected area, using mainly stroking and rubbing techniques. From the 3-4th procedure, rubbing and active movements in the joint are added, gradually increasing the range of movements. It is better to perform a massage after thermal procedures.
For dislocations, massage begins after reduction and temporary immobilization by working out the muscles surrounding the joint, using stroking and kneading. Later they begin to rub the joint elements and perform movements in the joint.
Massage for fractures. For open fractures, massage is contraindicated (risk of wound infection); for closed fractures, massage and therapeutic exercises are mandatory elements of complex treatment of fractures. On top of the plaster cast, vibration massage is used in the area of the fracture from the 2-3rd day after the injury. Before removing immobilization, massage of the healthy limb is useful. After the immobilization is removed, a suction massage is first applied, and then the fracture site is massaged using intermittent stroking, and a little later - rubbing and kneading the muscles. With slow fusion of fragments in the area of injury, more active techniques are used: chopping, patting, tapping with a wooden hammer, vibration; for scar contractures on the side of stretched and weakened muscles, deep stroking is used, then kneading and light tapping. To stretch scars and adhesions, techniques such as stretching, shifting, forceps-like rubbing and crossing are indicated; for stretching muscles with muscle contractures - flat and enveloping stroking. Massage should be combined with gradual relaxation - stretching muscle contractures with your hands using light rocking movements in the joint.
In case of traumatic injuries, it is also necessary to act on the corresponding reflex-segmental area. Thus, in case of injuries to the upper limb, paravertebral zones are massaged in the area where the nerve roots of the spinal cord exit to the right and left of the cervico-occipital and upper thoracic spine, and in case of injuries to the lower extremities - the lower thoracic and lumbar spine.
Massage for joint diseases carried out to promote the resorption of inflammatory exudate in arthritis; increase blood circulation in the affected joint with osteoarthritis; reduce pain and stiffness in the joint; help restore normal range of motion in joints; strengthen muscles, prevent muscle wasting and increase their performance; prevent the development of contractures and stiffness in the joints.
Massage for arthritis. The first procedures are carried out using a gentle method without special impact on the joints, using stroking and light kneading, trying to relieve tension in the muscles. From the 2-3rd procedure, the muscles surrounding the affected joint and the joint itself are affected. When performing a massage, it is important to be able to determine how muscle tone has changed: whether it is increased or decreased, to find areas of muscle compaction and knots, differentially influencing these changes and trying to eliminate them. Thus, areas of reduced muscle tone must be affected with strong techniques - rubbing, kneading, acting slowly. In the area with muscle hypertonicity, on the contrary, soft techniques and continuous vibration are indicated. If the upper and lower extremities are affected, massage can be performed on the patient while he is lying and sitting, achieving maximum muscle relaxation.
The duration of the massage procedure for one limb in the first procedures is 5-7 minutes, subsequently 10-15 minutes, per course - 15-17 procedures, after 0.5-1 month the massage course can be repeated.
Massage for arthrosis carried out more intensively, using all techniques classic massage depending on the clinical features of the disease and its severity. Much time is spent rubbing the joint elements and strengthening the muscle groups around the joint in combination with passive and active movements in the affected joint.
The duration of one procedure at the beginning of the course is 8-10 minutes and 20-25 at the end, a total of 10-12 procedures.
Massage for diseases and injuries of the nervous system and spinal osteochondrosis It is also used for vegetative disorders and neuroses in order to improve blood circulation, as well as tissue trophism in flaccid and spastic paralysis, strengthen paretic muscles, muscles in a state of contracture, preventing the development of muscle atrophy, reducing pain and activating nerve regeneration. Massage for spastic cuts and paralysis should be carried out with great care. Before the massage, if possible, warm the sore limb with a heating pad or lamp, achieving maximum muscle relaxation. At the beginning of the disease, in order not to cause an increase in hypertonicity of the spastic muscles, you need to use only the techniques of superficial stroking and gentle rubbing.
The massage begins from the lower extremities, from the proximal parts. Muscles in which the tone is increased are massaged with gentle, soft stroking and rubbing techniques at a slow pace. Stretched, atrophic, weakened muscles are massaged with passive movements. To reduce the excitability of the motor cells of the spinal cord and influence trophic processes, the paravertebral spinal segments are massaged - for the upper extremities - cervicothoracic - (C 5 - D 1); for the lower extremities - lumbar - (L 1 -S 2). Due to the rapid fatigue of patients, the duration of massage for spastic paralysis at the beginning of the course is 6-8 minutes, gradually increasing to 15-20 minutes.
The use of massage for various diseases accompanied by flaccid paralysis is aimed at strengthening weakened muscles and relaxing antagonist muscles. Private massage techniques depend on the characteristics of the clinical forms of the lesion. Almost all the basic techniques of classical massage are used. For bilateral lesions - flaccid tetraplegia or tetraparesis - a pair massage is used by two massage therapists.
Massage for neuritis and neuralgia is used to reduce pain, improve tissue trophism and nerve conductivity, and improve sensitivity. The corresponding paravertebral zones are massaged along the course of the nerve, the point of exit of the nerve and the place of irradiation of pain. In the presence of severe pain, massage is carried out using a gentle technique using mainly stroking and gentle rubbing.
Massage for neuritis of the facial nerve has some specifics. In the acute stage, massage the healthy half of the face lightly (gently). On the affected side, the massage begins in the recovery stage, stroking is performed from the middle of the forehead, nose and chin to the submandibular glands, light stroking around the eye; stroking the neck from front and back; rubbing and vibration along the nerve. They also produce skin vibration of paralyzed muscles. Duration of massage is 3-5-8 minutes daily. A course of 15-18 procedures.
Massage for diseases of the cardiovascular system is aimed at eliminating congestion in the pulmonary and systemic circulation, improving blood flow to the heart, developing collateral circulation, normalizing blood pressure, improving adaptation of the cardiovascular system to changing external conditions, and increasing physical activity. Massaging the chest enhances its suction effect, facilitating the work of the heart, and reduces congestion. It is also indicated for hypertension, neurocircular dystonia, angina pectoris, post-infarction condition, myocardial dystrophy. heart neurosis, heart disease V stage of compensation, chronic myocarditis, circulatory failure, vascular diseases (varicose veins, obliterating endarteritis). For diseases of the heart muscle (IHD, myocardial dystrophy, myocarditis, cardiosclerosis), a general massage is indicated, which is recommended to start from the back, where the large skin surface and muscles with an abundant network of capillaries are located relatively superficially. Thanks to the massage, which causes expansion of the capillary network, blood flow in the periphery increases, which significantly facilitates the work of the left ventricle of the heart.
The massage begins with stroking and kneading the interscapular area. Then massage the shoulder girdle in the direction from the spinal column to the shoulder joints and shoulder blades, the back and sides of the neck. After stroking, rub and knead the same areas. Then, gentle stroking of the heart area is carried out, rake-like stroking and rubbing of the intercostal spaces from the sternum to the spinal column, and finally shaking and gentle tapping of the chest. After this, apply circular stroking and rubbing of the area of the mastoid processes of the temporal bone and occipital protuberance, alternating them with stroking the neck and shoulder girdle. Then light tapping is performed on the spinous process of the VII cervical vertebra and the upper and lower limbs are massaged with broad strokes in the direction of the lymphatic vessels. The duration of the procedure is 15-20 minutes, the course of treatment is 12-15 procedures daily or every other day.
Massage technique for certain diseases will be presented in the relevant sections.
This massage is a complex procedure that requires special knowledge and experience. The skin of the face has good elasticity, so misuse massage techniques can lead to the appearance rather than elimination of wrinkles, the formation of skin folds, etc.
Particular care should be taken when performing facial massage in older people, whose skin is no longer as elastic as in youth. You should also be careful with lubricants, the choice of which depends on your skin type (dry or
Fat). Before performing a massage, you should consult with a cosmetologist and dermatologist to find out what lubricant is best to use during a massage.
When starting a massage, you must perform the following requirements:
1. Free your neck from clothes, since facial massage also involves neck massage.
2. Before the massage, thoroughly clean the skin with a cotton swab moistened with lotion or alcohol-water solution.
3. After cleansing your face, warm it with a hot and damp compress. To do this, you can use a napkin or terry towel. A steam bath is also possible, the water temperature of which is approximately 50 degrees and the duration is 8 minutes.
4. Massage techniques should be performed using gentle and light movements, without strong pressure or stretching of the skin.
5. To avoid irritation on the skin, the first massage sessions should not be long, and the movements of the massager should be energetic. The first session should be no more than 6 minutes. Gradually this time should be increased to 12 minutes.
6. Delicate facial skin with impaired elasticity should be massaged very carefully.
7. Make sure that the speed and strength of movements of both hands are the same.
8. Particular care should be taken when kneading the skin of the face. When performing this technique, the skin should not stretch.
9. Sluggish and flabby facial skin should be massaged only once a week. Depending on the doctor’s recommendations, massage can be performed after 1-2 days.
Massage of the forehead, temporal and frontal muscles
1. Stroking:
a) planar, surface linear;
b) planar, surface wavy.
This technique is performed with all fingers, except the thumb, in the direction from the middle of the forehead to the temples. In the temporal region, circular spiral stroking is performed (Fig. 150). The procedure must be repeated 4 times.
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Figure 150. |
2. Stroking in the forehead area from bottom to top, either with the right or with the left hand, with the palmar part of all fingers except the thumb (Fig. 151). k g This massage technique should not be used if the person being massaged has skin folds or wrinkles on the forehead.
3. Rubbing: spiral or semicircular (in the direction from the middle of the butt to the temples).
4. Kneading should be done in the form of squeezing the skin with two fingers, pressing or pinching. Finish each technique with stroking.
5. Vibration is intermittent (alternately with the index and middle fingers at a fast pace).
Starting from the eyebrows, stroking is done along the upper part of the eye sockets in the direction of the temples with the index (above the eyebrow) and middle (under the eyebrow) fingers. Then, in the same direction, the movement is repeated along the lower edge of the orbicularis oculi muscle to its inner corner. Repeat the procedure 3 or 4 times.
2. Intermittent vibration (in the area of the infraorbital nerve).
This technique is performed in case of special need.
Massage techniques in the eyelid area should be performed very carefully, without strong pressure or shifting. Stroking the eyelids in a circle is not recommended.
Massage of the chin, upper lip, nose
It is recommended to follow the massage lines shown in the figure (Fig. 153). Chin massage should begin with stroking and circular rubbing in the direction from under the lower edge of the lower jaw to the fossa of the chin, to the corners of the mouth. If the skin of the person being massaged is wrinkled and flabby, then stroking and rubbing
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Figure 153. |
should be done this way: use the phalanges of the middle and ring fingers of the left hand to fix the skin at the left corner of the mouth. From this place, use the ring and middle fingers of your right hand to alternately stroke and rub in the direction of the right corner of the mouth. Repeat the procedure 3 or 4 times. Then change hands, i.e., use the phalanges of the middle and ring fingers of the right hand to fix the skin at the right corner of the mouth. From this area, use the ring and middle fingers of the left hand to alternately stroke and rub from the right corner of the mouth to the left.
Massage the upper lip using the pads of the ring and middle fingers. Stroking from the corners of the mouth to the wings of the nose. Particular attention should be paid to massaging the nasolabial fold. Movements should be performed in the direction from the corners of the mouth to the nasal root, then along the back of the nose to its tip. Repeat the procedure 3-4 times.
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Figure 154. |
The nose massage should begin with stroking, rubbing and squeezing. Apply compression in the area of the wings of the nose in the direction from the tip of the nose to the bridge of the nose. Finish the nose massage with light vibration in the temple area.
Cheek massage
This massage should be performed in the following position of the hands: place the thumbs under the chin and cover the nose with the rest. Then, with sliding movements, move your thumbs to the corners of the lower jaw, and with your palms, gently stroke the skin of the cheeks towards the temples and again to the corners of the mouth. Perform the movement 3-4 times. Rubbing in the shape of a circle is done using the middle and terminal phalanges of the four fingers in the direction from the lower jaw to the nose (Fig. 154). Repeat the procedure 3 or 4 times.
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Figure 155. |
After rubbing, knead as follows: use your index finger and thumb to grab the skin in the cheek area and squeeze. Perform the technique at a fast pace. At correct execution reception, the skin slips out from under the fingers.
Replace kneading with shaking, which must be done with fingers clenched into a fist (Fig. 155).
Intermittent pressure in this area should be done using the thumb and index finger.
Perform tapping with the end phalanges of the index, middle and ring fingers.
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Figure 156. |
Massage in the ear area
The massage should begin with stroking, which is performed with the index finger and thumb. The index finger strokes the area of the earlobe, then moves up and passes alternately along all the recesses of the inner surface of the ear. Use your thumb to stroke the back of the ear. Kneading should be done in the form of intermittent compression.
Massage of nerve endings on the face
Usually the following nerve endings of the face are massaged: supraorbital, infraorbital. To influence the supraorbital nerve, you need to massage the brow ridge (Fig. 156). The infraorbital nerve should be massaged as shown in Figure 157.
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Figure 157. |
Facial massage techniques can be supplemented with one more technique: use your index finger and thumb to grab the thickness of the skin * with the subcutaneous muscles. Do circular kneading in the form of pinching. Keep kneading short and smooth movements so that subcutaneous hemorrhage does not appear. This technique is used for weakened sebum secretion. In case of excessive secretion, kneading should be used in the form of compression or push-ups. Using your index finger and thumb, grab the entire thickness of your facial skin and squeeze with quick and short movements in all directions.
MASSAGE FOR ECZEMA AND PSORIASIS
Place your thumb near one edge of the affected area, and the rest of your fingers near the other. You need to ensure that your fingers do not move from the skin surface. It is necessary to spread your fingers so that the skin is slightly stretched, and then squeeze again. Massage in the back, thigh or chest area is done with the palms of your hands. The session should last from 5 to 10 minutes. It is recommended to perform 45-50 stretches per minute. During a massage session, the following skin changes occur: it stretches up to 2 cm or more and then returns to its previous state.
For eczema affecting the joints, massage techniques should be performed:
1. Stretch the skin of the fingers by bending and extending them at the metacarpophalangeal joints.
2. Stretching the interdigital spaces by spreading and moving the fingers.
3. Stretch the skin in the area of the wrist joint, bending and unbending the joint.
4. Stretch the skin of the toes by bending and unbending them.
5. Stretch the skin of the sole by bending and straightening your fingers.
6. Stretch the skin of the extensor part of the knee joint, bending and straightening the knee joint.
7. Stretch the skin of the lumbosacral spine by bending forward.
The duration of the massage is 6-10 minutes. This is followed by redness, which sometimes lasts for several hours. This massage is good because it can be used already on early stages many skin conditions because it does not cause irritation that can result from friction.
MASSAGE FOR DRY SEBORHEA AND BALDING
For these diseases, it is necessary to do a head massage. And in case of baldness, you need to supplement it with a massage of the neck and upper back. Massage of the scalp can be done in two ways: with bare skin and without exposure. It is produced in the direction of the excretory ducts of the sebaceous glands and hair growth. It is advisable to place your fingers closer to the hair roots.
For seborrhea, it is recommended to massage with the exposed surface of the codes . To do this, parting is done in the direction from the middle of the hairline towards the back of the head. Then the fingers (except the thumb) are positioned along the parting so that they touch each other. Perform 3-4 flat stroking, 3-4 deep stroking, semicircular or zigzag rubbing with the second and third fingers of the right hand (the left hand should hold the scalp at a distance of 2-3 cm from the parting), kneading in the form of shifting thumbs, which you need to press on the scalp and thereby move it towards you and away from you. The shearing technique can be combined with the stretching technique. Then you should make intermittent vibration in the form of puncturing using the index and middle fingers alternately with quick strikes.
After completing the techniques described above, you need to make a new parting, departing from the previous one by about 2 cm, and repeat all the techniques again. The same techniques must be performed in the direction along the forehead line.
Massaging without exposing the scalp is carried out in the same way as with exposure.
MASSAGE FOR SIMPLE ACNE
“Facial massage should not be performed with suppurating acne.
Before the massage you need to cleanse your face. To do this, soak a cotton swab in refined peach, olive, almond or sunflower oil and wipe your face with it. Then apply a thin layer of cream to your face.
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Figure 158. |
To remove sebaceous plugs from the excretory ducts of the sebaceous glands, it is necessary to knead in the form of compression. With the thumb and forefinger
Drawing 158.
grab the entire thickness of the skin and apply compression using quick movements. Perform reception in all directions. In this case, the contents of the eel should come out.
CHAPTER 3.MASSAGE FOR MUSCULOCAL DISEASES AND INJURIES
Massage is one of the important means for treating diseases of the musculoskeletal system. It is prescribed for bruises with hemorrhage, sprained muscles, ligaments and tendons, fractures, dislocations, etc. Massage helps relieve pain. Thanks to it, swelling subsides, hemorrhage resolves, muscles become stronger, the functions of joints and muscles are restored, callus grows faster, etc.
MASSAGE FOR SCOLIOSIS
Scoliosis is a curvature of the spine to the right or left (in the frontal plane). There are two types of scoliosis: C-shaped, or simple scoliosis (the spine has one curve) and S-shaped, or complex scoliosis (the spine has two or three curves in different directions).
Scoliosis occurs in many people as a result of incorrect posture. In addition, the causes of its occurrence may be paralysis, rickets or radiculitis. Scoliosis can develop due to heavy physical activity or due to infrequent physical activity. Sometimes the cause of spinal curvature is not clear. Such scoliosis is called idiotic. With this disease, pathological kyphosis to the right or left side is often observed.
Scoliosis has 4 degrees of severity.
Scoliosis of the first degree can be determined by the following signs:
1. Lowered head position.
2. Shrugged shoulders.
3. Slouching.
4. The shoulder girdle on the side of the curvature is higher than the other.
5. Waist asymmetry.
6. The rotation of the vertebrae around the vertical axis is planned.
To determine the arc of curvature, you need to tilt the patient forward and mark the arc along the spinous processes with brilliant green or a felt-tip pen. When the patient straightens, the curvature disappears. The x-ray should show a 10 degree angle of curvature.
Scoliosis II degree is characterized by the presence of the following signs:
1. Torsion (rotation of the vertebrae around a vertical axis).
2. Asymmetry of the contours of the neck and waist triangle.
3. The pelvis on the side of the curvature is lowered.
4. On the side of the curvature, there is a muscle roll in the lumbar region, and a protrusion in the thoracic region.
5. Curvature is observed in any position of the body. The radiograph records the angle of curvature of 10-20 degrees.
Scoliosis of the third degree is determined by the following signs:
1. Strongly expressed torsion.
2. The presence of all signs of stage II scoliosis.
3. Well defined costal hump.
4. Recession of the rib.
5. Muscle contractures.
6. Weakening of the abdominal muscles.
7. Protrusion of the anterior costal arches.
8. The muscles sink, the arch of the rib approaches the ilium on the side of the concavity. The x-ray shows a curvature angle of 20-30 degrees.
Scoliosis IV degree is characterized by severe deformation of the spine. The above-described symptoms of scoliosis intensify. The muscles in the curvature area are significantly stretched. Recession of the ribs in the area of concavity of thoracic scoliosis and the presence of a rib hump are noted. An x-ray shows a curvature angle of 30 degrees or more.
In patients with scoliosis, there may be a slowdown in the speed of blood flow in the “lungs-ear” area, dysfunction of the cardiovascular system and breathing.
It helps correct the curvature of not only the spine itself, but also the entire body, normalizes the tone of the back muscles and strengthens them, increases the speed of lymph and blood circulation, reduces the feeling of fatigue, and reduces pain.
Massage for thoracic C-shaped scoliosis
Back massage
Back massage is performed on both sides. First, the techniques are performed on the side of the curvature in the following sequence: 1. Stroking:
a) rectangular;
b) alternate.
2. Squeezing with the base and edge of the palm along the same lines as stroking.
3. Kneading the long and latissimus dorsi muscles:
a) circular with the pad of the thumb;
b) circular pads of four fingers;
c) circular phalanges of bent fingers;
d) “shape-shaped”;
e) circular pads of the thumbs;
f) circular tubercle of the thumb;
g) compression;
h) double ring tong-shaped.
On the latissimus muscles:
a) ordinary;
b) double ring;
c) combined;
e) circular with the base of the palm or the tubercle of the thumb.
At the intercostal spaces:
f) circular with the pad of the middle finger.
In the area of the rhomboid muscles and the levator scapulae muscle, you need to perform the following kneading techniques:
d) circular phalanges of bent fingers;
d) “pincer-shaped”.
First of all, you need to do kneading:
a) ordinary;
b) double ring;
c) circular with the pads of four fingers;
d) circular phalanges of bent fingers;
The duration and pace of performing techniques over the entire surface of the massaged area should be the same.
The lower part of the trapezius and rhomboid muscles (opposite the convexity of the flexural arc) should be massaged especially carefully, because this helps to completely relax these muscles. Massage techniques must be performed alternating them with stroking and shaking.
Having finished massaging the back half of the neck and back, you should begin performing techniques on the convex parts. To do this, you need to bring the patient's shoulder blade to the midline, pull the shoulder back (you need to place a cushion or pad under it), then carefully and gently press on the protruding ribs. Then try to move the protruding part of the spine into place with your fingers, alternately tapping the end phalanges of the fingers on the spinous processes of the arch. Holding your shoulder back with your hand, you need to massage the interscapular and scapular muscles with your other hand.
The first massage sessions of the neck and other half of the back should relax the muscles well. Subsequent massage sessions should strengthen the muscles and increase their tone in the area of the concavity of the arch. After massaging the back and neck, the hand on the side of the protruding arch is massaged.
Front chest massage
The purpose of this massage is to relax the muscles and return the shoulder to its normal position. You need to grab and pull the shoulder with your hand so that it becomes symmetrical with respect to the other shoulder. Perform the following techniques on the pectoralis major muscle:
Kneading:
a) ordinary;
b) double neck;
c) double finger;
d) combined.
At the intercostal spaces:
a) straight;
b) circular;
c) the pads of four fingers;
d) the pad of the thumb and middle finger.
Techniques that serve to relax the muscles and widen the spaces between the ribs by penetrating into their recesses should be used on the side on which the muscles are contracted, the ribs are brought closer together, and the intercostal spaces are narrowed.
Abdominal massage
Abdominal muscles with scoliosis are weakened, so it is necessary to use classical massage techniques to strengthen them:
1. Circular stroking.
a) ordinary;
b) double ring;
c) circular with phalanges of bent fingers of one and both hands. 3. Kneading on the oblique abdominal muscles:
a) ordinary;
b) double;
c) ring;
d) circular phalanges of bent fingers;
Massage for lumbar C-shaped scoliosis
Back massage
The following steps must be followed:
1. Stroking:
a) straight;
a) the base of the palm;
b) coracoid.
c) “pincer-shaped”;
a) ordinary;
b) double neck;
c) double ring;
d) combined;
e) circular with phalanges of bent fingers.
5. Kneading on the intercostal spaces:
a) straight with the pads of four fingers;
b) circular with the pads of four fingers;
c) straight with the pad of the thumb;
d) zigzag with the pad of the thumb;
e) circular with the pad of the thumb,
f) straight with the pad of the middle finger;
g) circular with the pad of the middle finger.
6. Kneading on the lumbar region:
a) straight with the pad and tubercle of the thumb;
b) circular with the pads of four fingers;
7. Sawing.
8. Intersection.
Massage to relax the muscles should be done on the side of the convex part of the scoliosis. Massage to tighten and strengthen the muscles should be done on the concavity side.
Pelvic area massage
Techniques are performed on the gluteal muscles:
1. Stroking:
a) straight;
b) spiral;
c) zigzag.
2. Squeeze:
a) the edge of the palm;
b) coracoid.
3. Kneading:
a) ordinary;
b) double neck;
c) double ring;
d) circular with two fists;
e) circular beak-shaped.
4. Kneading on the sacrum:
a) circular with the pad of the thumb;
b) circular with the pads of four fingers;
c) compression;
b) circle-shaped by the phalanges of bent fingers;
c) circular with the crest of a fist;
After performing massage techniques on the back and pelvic area, it is necessary to influence the convex part of the spine with the end phalanges of the fingers, trying to move it into place.
If the arch of the rib is located in close proximity to the wing of the ilium and the muscle attachment points are close, then the massage should be
is aimed at relaxing the muscles and increasing the gap between the arch of the rib and the wing of the ilium. First you need to forcefully stretch this gap, thereby increasing the space between the wing of the ilium and the costal arch, and then massage this area.
Massage the leg muscles on the side of the arch convexity
Techniques should be carried out in the following order:
1. Back surface:
a) thigh (biceps muscle);
b) knee joint;
c) calf muscle;
d) Achilles tendon;
d) sole.
2. Front surface:
a) thigh (quadriceps muscle);
b) knee joint;
c) lower leg;
d) ankle joint.
Massage for S-shaped scoliosis
Massage for S-shaped scoliosis also extends to the thoracic and lumbar regions. When performing it, you must use the above methods. Massage helps eliminate curvature of the spine and strengthen the muscle corset. To achieve the best results, you need to conduct at least 12 sessions (from 4 to 8 days - daily, from 8 to 12 - every other day).
MASSAGE FOR CERVICO-THORACIC OSTEOCHONDROSIS
Osteochondrosis is a disease of the spine that affects the intervertebral discs. The cause of osteochondrosis is severe overload of the spine, as a result of which the intervertebral discs do not regenerate, their blood supply is disrupted, and degenerative changes develop. In the fibrous ring of the disc, ruptures and cracks are noted, through which masses of the altered nucleus pulposus fall outside the ring (disc herniation develops). The herniated disc is located in the weak posterolateral portion of the annulus fibrosus. Moreover, compression of blood vessels and spinal nerve roots is observed. Due to changes occurring in the intervertebral discs, dystrophic processes appear in the facet joints.
Osteochondrosis of the cervical spine can be identified by pain in the occipital and interscapular areas, neck, a feeling of heaviness in the shoulder girdle, limited neck mobility, numbness of the fingers during sleep, dizziness, tension in the cervical muscles.
Osteochondrosis of the thoracic spine is indicated by rapid fatigue of the back muscles, the inability to stand for a long time, and incessant monotonous pain in the spine. Light tapping reveals pain in the area of the spinous processes, located at the apex of the thoracic kyphosis, and painful paravertebral points.
With lumbar osteochondrosis, there is a feeling of fatigue and constant pain when bending the body forward, coughing, laughing, sneezing; pain in the buttocks, on the back of the rib; muscle tension in the lumbar region; inactivity of the affected area of the spine. The gluteal muscles, thigh muscles, and lower legs become hypotrophic.
Massage at cervicothoracic osteochondrosis pursues the following goals:
1. Reducing pain.
2. Improving lymph and blood circulation in the neck, back, and arms.
3. Increasing the strength of the arm muscles by reducing their hypotrophy.
4. Reducing tension in the muscles of the neck and back.
In the acute stage of the disease, massage is not recommended. When performing massage techniques, it is necessary to take into account whether the patient has diseases of the cardiovascular system, for example, hypertension, hypotension, circulatory disorders, etc. In addition, you need to remember that with osteochondrosis of the cervical spine, the occipital nerves are also affected.
When certain areas of the lesion are localized in the cervicothoracic region, it is necessary to act on the following paravertebral zones: D6-D1, SZ-C7.
Before performing massage techniques, you need to select the area that is most susceptible to the disease. Massage of the arm and back should be carried out if there is severe pain in the back, arm, tension in the back muscles, or wasting of the arm muscles.
For severe pain in the chest area, a chest massage is used, for pain in the neck area, a neck massage is used. Massage of the cervicothoracic region is recommended for almost any course of osteochondrosis.
Back massage
In case of unilateral osteochondrosis, first of all it is necessary to massage the healthy half of the back. With bilateral osteochondrosis, you need to massage that half of the back on which the pain is weaker.
The following techniques should be performed along the entire back:
1. Stroking:
a) straight;
b) alternate.
2. Squeezing (carried out along the stroking lines):
a) longitudinal;
b) coracoid.
3. Kneading on the long back muscles:
a) circular with the pad of the thumb;
b) circle-shaped by the phalanges of bent fingers;
c) “pincer-shaped”;
4. Kneading on the latissimus dorsi muscles:
a) ordinary;
b) double neck;
c) double ring;
d) combined;
5. Kneading on the fascia of the trapezius muscle:
a) straight with the pad and tubercle of the thumb;
b) circular with the pad of the thumb;
c) circular with the pads of four fingers;
d) circular phalanges of bent fingers;
d) “pincer-shaped”.
6. Rubbing the intercostal spaces:
a) straight with the pads of the fingers alternately with one and the other hand;
c) circular with the pads of four fingers;
e) circular with the pad of the thumb.
Neck massage
The neck must be massaged on both sides. You need to perform the following steps:
1. Stroking.
2. Squeezing.
3. Kneading:
a) ordinary;
b) double ring;
c) circular with phalanges of bent fingers. 4. Rubbing the muscles along the spinal column:
a) straight with the pads of the thumbs;
b) circular with the pads of four fingers;
The following techniques should be performed on the back of the head:
2. Straight beak squeezing.
3. Rubbing:
a) circular with the pads of the fingers of both one and both hands;
c) circular beak-shaped of both one and both hands.
Then it is necessary to influence the exit points of the greater occipital nerves on the outer side of the tubercle of the occipital bone. The lesser occipital nerves should be massaged at the superior posterior border of the sternocleidomastoid muscle. Massage techniques are performed at the site of its attachment to the mastoid process.
Breast massage
The patient should be placed on his back, and a cushion should be placed under his knees. The massage should be performed according to the classical scheme:
1. Stroking.
2. Squeezing.
3. Kneading on the pectoralis major muscle in men:
a) ordinary;
b) double ring;
c) combined;
d) circular phalanges of the thumbs.
4. Kneading the pectoralis major muscle in women (above the mammary gland):
a) ordinary;
b) double ring;
c) circular with the pads of four fingers.
Massage of the intercostal spaces in front should be done in the same way as massage of the intercostal spaces in the back. Then again you need to massage the back muscles, but only in the painful area.
Massage of the arm or hands (for a bilateral process)
Forearm flexor massage:
1. Stroking.
2. Squeezing.
3. Kneading:
a) ordinary;
b) circle-shaped by the phalanges of bent fingers;
d) a circular tubercle of the thumb.
Deltoid muscle massage:
1. Stroking.
2. Squeezing.
3. Kneading:
a) ordinary;
b) double ring;
c) circular with phalanges of bent fingers.
Triceps brachii massage:
1. Squeeze.
2. Kneading:
a) ordinary;
b) double ring;
c) combined;
Massage back side palms:
1. Stroking.
2. Rubbing:
a) straight with the pads of four fingers;
b) circular with the pads of four fingers;
c) straight with the pad of the thumb;
Massage on the sore side of the back:
1. Stroking:
a) straight;
b) alternate;
2. Squeezing with the edge of the palm.
3. Stroking is straightforward.
Shoulder massage:
2. Rubbing:
a) circular with the pads of four fingers;
c) circular beak-shaped;
Massage of the sore part of the back: 1. Stroking:
a) straight;
b) squeezing (with the edge of the palm).
Massage the shoulder joint again:
2. Concentric stroking.
3. Rubbing:
a) circular with the pads of four fingers;
b) circular ridges of the fist;
c) circular beak-shaped;
d) circular edge of the thumb.
When performing a massage in the area of skin hyperesthesia, all techniques must be done in a gentle manner.
In case of hypotonia of the arm muscles, massage techniques should be carried out at a fast pace with a small amplitude. In case of hand muscle wasting - intensively, including a large number of striking techniques and alternating them with shaking and stroking.
MASSAGE FOR RADICULITIS
With radiculitis, damage to the roots of the spinal nerves occurs. The causes of this disease can be osteochondrosis of the spine, dystrophy of the intervertebral discs, diseases of internal organs, inflammatory and degenerative lesions of the spine, joints, tumors of the peripheral nervous system, etc. Radiculitis can be lumbosacral, cervical or cervicothoracic.
Patients with radiculitis experience spontaneous pain in the area of innervation of the affected roots, which intensifies with movements, sneezing, coughing, and straining; painful sensations when pressing on the spinous processes of the vertebrae and at paravertebral points; weakness. They experience muscle wasting in the area of radicular innervation and poor mobility of the spine.
Lumbosacral radiculitis has two phases: radicular and lumbargic. During the lumbalgic phase, pain appears suddenly after hypothermia or physical exertion or increases gradually.
During the radicular phase of the disease, the pain is much stronger, it radiates to the gluteal region, spreading along the posterior surface of the thigh and lower leg.
Massage techniques for radiculitis are the same as for osteochondrosis. But before doing a massage, you need to have an idea of the course of the disease. So,
with cervicothoracic radiculitis, which is accompanied by damage to the nodes sympathetic trunk, massage can be used only after the process has subsided on the part of the nodes of the border sympathetic trunk. All techniques must be performed in a gentle manner.
MASSAGE FOR BRUISES
Bruises are injuries to soft tissues without compromising the integrity of their outer coverings. With severe bruises, there may be ruptures of muscles, small blood vessels, and nerves. In the area of the bruise, as a rule, there is pain, local hemorrhages, accompanied by an increase in skin temperature at the site of the bruise, and swelling. Purulent inflammation is also possible (in case of infection).
Massage helps relieve pain in the injured area and improve metabolism. Thanks to it, more intense muscle contraction occurs, which helps eliminate muscle atrophy, resolve infiltrates, swelling and hemorrhages.
If there is muscle damage, the massage should be carried out in two stages: first preparatory, then main.
Preparatory massage - massage of uninjured areas that are located above the injury. Massage techniques in this case create favorable conditions for the suction of venous blood and lymph from the site of injury without contact with it. Preparatory massage can be carried out 7-8 hours after the injury. When performing techniques, you need to take into account the nature of the injury and the patient’s pain. You should carry out 4-6 sessions of this massage, and then alternate it with sessions of the main massage (massage of the damaged area).
In case of injury to the calf muscle, the main techniques will be:
1. Stroking:
a) alternate;
b) spiral.
2. Beak-shaped squeeze with the front part of the hand.
3. Kneading:
a) ordinary;
b) double ring;
d) coracoid with the hand towards you (must be performed in a gentle manner).
4. Shaking off.
5. Spiral stroking.
6. Kneading:
a) double circular longitudinal;
b) circular phalanges of bent fingers of both one and both hands;
c) circular beak-shaped with two hands.
6. Squeezing.
7. Shaking.
8. Stroking.
9. Beak-shaped squeeze with the front part of the hand.
To achieve best result, you need to massage not only on the injured limb, but also on the symmetrically located part of the second limb. It is necessary to perform 12-16 massage sessions.
MASSAGE FOR JOINT STRAINS
Sprained ligaments are injuries accompanied by displacement and disruption of the integrity of the joints. The places of attachment of ligaments, the tissue surrounding the joint, the synovial membrane of the joints, tendons, cartilage, muscles, blood vessels, and nerves may be injured. There may be other damage. A sprain is accompanied by severe pain when moving, swelling at the site of injury, and inflammation of the joints.
Massage helps reduce pain, improve blood and lymph flow in the damaged area, and restore normal joint activity.
In case of sprained ligaments, it is recommended to perform massage techniques only 24 hours after the injury. Warming up should be done before the massage. It is necessary to perform a massage without causing pain to the patient, because this can lead to a worsening of his condition.
Before massaging the damaged area, massage the upper areas. So, in case of injury to the ligamentous apparatus of the ankle joint, it is necessary to massage the lower leg, in case of sprain of the knee joint - the thigh, in case of damage to the wrist joint - the forearm, etc.
As with bruises, when spraining joints, you must first carry out a preparatory massage (1-2 times a day for 5-10 minutes), and then the main one (massage of the injured area). The massage time should be gradually increased to 15 minutes.
Ankle joint
First, you should conduct a preparatory massage session on the relaxed anterior tibial muscle. You need to do the following:
2. Beak-shaped squeezing with the elbow.
3. Circular kneading with the pads of four fingers. All techniques must be repeated 4-5 times.
If the person being massaged experiences pain in the ankle joint, then the techniques should be performed in a gentle manner.
After the preparatory massage, the main massage should be performed:
2. Rubbing:
a) straight “tongs”;
b) spiral-shaped “forceps” (directed downwards, along the ankle gap);
3. Stroking.
4. Beak-shaped rubbing, first with one hand and then with the other.
5. Stroking the shin.
6. Squeeze on the shins.
7. Concentric stroking on the ankle joint.
8. Rubbing on the ankle joint:
a) straight “tongs”;
b) spiral “forceps”.
9. Concentric stroking of the ankle joint. All techniques must be performed 3-4 times, without causing pain to the person being massaged.
Shoulder joint
Before performing massage techniques on the shoulder joint, you should ensure that the muscles are completely relaxed. The following steps must be taken:
1. Stroking.
2. Squeezing the upper back (both techniques must be performed first on the healthy part and then on the sore part).
a) ordinary;
b) double ring;
c) combined.
4. Shaking.
5. Stroking.
6. Rubbing on the fascia of the trapezius muscle:
a) straight with the pad and tubercle of the thumb;
b) circular with the pad of the thumb;
c) circular with the pads of four fingers;
Massage of the triceps muscle of the sore shoulder:
7. Stroking.
8. Squeezing.
9. Two or three kneading steps. Shoulder massage:
10. Concentric stroking.
11. Circular rubbing.
12. Upper back push-ups.
13. Rubbing on the shoulder joint.
14. Concentric stroking.
Passive and active movements should be used as the joint is restored.
MASSAGE FOR JOINT STIGHTNESS AND CONTRACTURES
With the help of massage you can restore joint mobility. It is better to combine it with therapeutic exercises. Massage for joint stiffness and contractures ensures their normal functioning and helps improve blood and lymph flow in the area of injury.
Massage for limited mobility in the shoulder joint
Upper back massage
1. Stroking:
a) straight;
b) spiral. 2. Push-ups:
a) the base of the palm;
b) coracoid.
3. Kneading on the latissimus dorsi muscles:
a) ordinary;
b) double ring;
c) coracoid.
4. Rubbing on the fascia of the trapezius muscle:
a) straight with the pad and tubercle of the thumb;
b) circular with the pad of the thumb;
c) circular with the pads of four fingers;
d) circular phalanges of bent fingers.
Shoulder muscle massage
Massage techniques should be performed on the shoulder extensor muscles (first on deltoid muscle, and then on the triceps muscle). The following steps need to be taken:
1. Stroking:
a) straight;
b) spiral.
2. Squeeze:
a) coracoid;
b) transverse.
3. Kneading:
a) ordinary;
b) double ring;
c) circular with the pads of four fingers;
d) circular phalanges of bent fingers.
Chest muscle massage
To massage the chest muscles, you need to place the person being massaged on his back, and a small cushion under his head. The massage should first be done on the healthy side, then on the sick side. Techniques:
2. Squeezing with the heel of the palm.
3. Kneading:
a) ordinary;
b) double ring;
c) beak-shaped.
4. Several circular strokes in the area where the collarbone attaches.
Upper back massage
The following techniques should be performed on this part of the back: 1. Stroking:
a) straight;
b) zigzag. 2. Squeeze:
a) the base of the palm;
b) coracoid.
Shoulder massage
Massage techniques should be performed in the following sequence:
1. Concentric stroking.
2. Rubbing:
a) circular with the pads of four fingers;
b) circle-shaped by the phalanges of bent fingers;
c) circular beak-shaped;
d) circular ridge of the fist (as the functions of the joint are restored);
e) circular edge of the thumb (as the functions of the joint are restored).
You need to complete the session with both active and passive movements. The techniques should be performed in a gentle manner. Before, during and after the massage, it is recommended to use active movements. They are excluded only if the person being massaged experiences pain and severe swelling. In this case, active movements are best done on nearby healthy joints while fixing the damaged joint.
Massage for limited mobility of the elbow joint
Massage of shoulder extensor and flexor muscles
It is necessary to perform the following techniques: 1. Stroking:
a) straight;
b) alternate. 2. Squeeze:
a) transverse;
b) coracoid. 3. Kneading:
a) ordinary;
b) double ring;
c) combined;
d) circular phalanges of bent fingers.
Forearm muscle massage
On the forearm you need to massage the extensor and flexor muscles.
Techniques for flexor muscles:
1. Straight-line stroking.
2. Beak squeeze.
3. Kneading:
a) ordinary;
b) circle-shaped by the phalanges of bent fingers;
c) circular beak-shaped.
The following are performed on the extensor muscles:
1. Alternate stroking.
2. Beak squeeze.
3. Kneading:
a) circular with the pads of four fingers;
b) circle-shaped by the phalanges of bent fingers;
c) circular beak-shaped.
On the shoulder you should perform 1-2 types of stroking and 1-2 types of squeezing.
Elbow joint massage
Massage techniques can be performed in two positions of the massaged person’s hand. 1. The arm hangs along the body. In this position, the inner area of the joint is massaged:
2) rubbing:
a) circular with the pads of four fingers;
b) circular with phalanges of bent fingers;
c) circular beak-shaped.
2. The patient holds his hand in front of him. In this case, the outer part of the elbow joint is massaged:
1) circular stroking with the base of the palm;
2) rubbing:
a) circular with the pads of four fingers;
d) a circular tubercle of the thumb. All techniques should be performed 2 or 3 times.
MASSAGE FOR DISLOCATIONS
Dislocation is a joint injury in which the articular ends of bones are displaced. In case of such an injury, massage can be done only a day after the joint is reset. For dislocations, you should perform the same massage techniques as for sprained joints.
MASSAGE FOR FRACTURES OF LIMB BONES
Bone fractures can be closed or open. In the second case, there are violations of the integrity of the skin, damage to nerves, blood vessels, and soft tissues (fiber and muscles). In addition, there is pain, swelling at the fracture site, and the person’s inability to move normally. At the site of the fracture, as a rule, a callus appears, which ensures fusion of the bones. The healing time depends on the thickness of the bone, the nature of the fracture, and the age of the injured person.
Massage is an effective treatment closed fractures For open fractures, massage is contraindicated because they can be complicated by local or general infection.
improves tissue trophism at the fracture site, reduces the time of callus formation and restoration of functions of the injured limb, and prevents muscle atrophy.
Massage of the injured limb can be carried out in a plaster cast or when applying any type of traction.
For fractures of the bones of the arm, massage should be performed in the area of the cervical-occipital and upper thoracic regions, at the exit of the roots on the left and right. Innervation zones of the spinal segments are SZ-C1.
For fractures of the bones of the lower extremities, massage is recommended in the area of the lumbosacral and lower thoracic regions. Innervation zones - D12-D11, S3-S1, L5-L1.
After performing massage techniques on the above areas, it is necessary to massage the muscles of the uninjured limb and massage the parts of the affected limb that are free from the plaster cast.
If there are local injuries on the upper extremities, you need to perform massage techniques on the muscles of the upper back from the line that connects the lower corners of the shoulder blades to the shoulder girdle. The following methods are used:
1. Stroking:
a) straight;
b) alternate. 2. Squeeze:
a) the base of the palm;
b) the edge of the palm.
3. Circular movements that are performed when massaging the fascia of the trapezius muscle:
a) circular with the pad of the thumb;
b) circular with the pads of four fingers;
d) a circular tubercle of the thumb.
When massaging where the nerve roots exit, it is recommended to use a massage technique along the spinal column:
1. Straight-line rubbing with fingers 2 and 3, between which there should be a column of the spine (the technique should be performed in the direction from bottom to top, from the sacrum to the 7 cervical vertebra);
2. Shading with the pads of the 2nd and 3rd fingers.
3. Shift:
a) in the direction away from you to the left and to the right of the spine;
b) towards you (from the lower back to the shoulder blades). 4. Rubbing:
a) double ring forceps in the direction along the paravertebral zones;
b) pads of 2, 3, 4, 5 fingers and fists (place the thumb of the right hand, clenched into a fist, in the fist of the left hand; fists connected in this way -
place the ki with their knuckles down in the lumbar region and move them upward to the neck; then unclench your fists and use your fingertips to make zigzag movements from top to bottom);
c) zigzag with the bases of the palms (place the bases of the palms on the lower back, and raise the fingers; perform the exercise in the direction from bottom to top).
5. Shaking.
6. Any striking technique.
7. Longitudinal stroking.
Innervation zones - SZ-C2. They should be massaged using the same technique as when massaging the neck muscles. First you need to massage the back of your neck. To do this, the person being massaged must lie on his stomach, place his palms in front of him at forehead level and lower his head onto his hands, tucking his chin to his chest. Then you need to do the following:
1. Stroking (in a downward direction from the place of hair growth to the shoulder joint):
a) straight;
b) alternate.
2. Squeeze:
a) coracoid with the facial part;
b) the edge of the palm;
c) transverse.
3. Kneading (with a brush on both sides of the neck):
a) ordinary;
b) double ring;
c) double ring forceps;
d) circular with the pads of four fingers;
e) circle-shaped by the phalanges of bent fingers; f) circular beak-shaped facial part; g) circular with the radial side of the hand.
4. Stroking.
5. Rubbing (along the spinal column down to the seventh cervical vertebra):
a) straight with the pads of the thumbs (both simultaneously and alternately);
B) circular with the pads of the thumbs (alternately);
c) circular with the pads of all fingers except the thumb (first with one, and then with both hands);
d) circular phalanges of bent fingers (first with one hand, and then with both);
e) circular with the terminal phalanges of the fingers of the back (both hands).
6. Longitudinal stroking (four fingers of one hand should be placed on the neck with fingers forward downwards; the thumb should be placed on the spine).
Massage of the muscles around the 7th cervical vertebra
a) between the index fingers and thumbs;
b) between the backs of the thumbs. 2. Rubbing:
a) circular with the pads of the thumbs;
b) circular with the pads of four fingers (first with one hand, and then with the other hand).
3. Double ring kneading tongs.
Massage of the front of the neck
To perform massage techniques on the front surface of the neck, you need to tilt the head of the person being massaged back (while the neck muscles should be relaxed). All techniques should be done in a top-down direction. First you need to massage the side of your neck:
1. Stroking (the index finger moves along the inner edge of the sternocleidomastoid muscle; the middle, ring, little finger - along the belly of the muscle to the thyroid cartilage, in which the massage technique is performed with the palmar surface of the hand to the jugular notch of the sternum. Then the palm is located under the edge of the lower jaw and extends down to the sternum).
2. Rubbing:
a) circular with pads of 2, 3, 4, 5 fingers;
b) phalanges of bent fingers.
On the sternocleidomastoid muscle, in addition to stroking in the form of forceps, you can use circular kneading with the pads of four fingers and forceps-like kneading.
Massage of an uninjured limb should be carried out according to the method of massaging the muscles of the shoulder joint, upper arm, forearm and hand.
When massaging the chest muscles, you should do the following:
1. Stroking.
2. Shaking.
3. Kneading.
For fractures of the bones of the fingers and hand The massage should be carried out in this order: the muscles of the shoulder, forearm and the area located above the plaster cast. After removing the splint, it is recommended to do the following:
1. Stroking.
2. Rubbing.
3. Kneading the fingers.
4. Vibration of the fracture area with fingers.
For forearm bone fractures You need to massage the muscles of the shoulder, elbow joint, areas located above and below the damaged area, and hands. After applying a removable splint, you should massage the muscles of the forearm in the following order:
1. Gentle stroking.
2. Light punctation.
3. Rubbing.
4. Kneading.
The massage must be done for 15 minutes.
In the presence of local injuries on the lower extremities massage techniques should be done on the lower back, in the pelvic, lumbar areas, on the uninjured limb, in areas located above and below the fracture site. After removing the plaster, the affected area should also be massaged.
Massage on the muscles of the lower back
1. Stroking (1-2 types).
2. Squeezes (1-2 types).
Both techniques must be performed in the direction from the iliac bones to the line that connects the angles of the shoulder blades.
Massage on the long back muscles (from the sacrum to the lower corners of the shoulder blades)
1. Kneading:
a) circular with the pad of the thumb;
b) circle-shaped by the phalanges of bent fingers;
c) circular beak-shaped;
d) “pincer-shaped”.
The techniques must be performed first on one side and then on the other side of the back!
Massage the muscles located along the spinal column
1. Straight-line stroking of the muscles with the pads of the index and middle fingers.
2. Other types of effects on the areas between the spinous processes.
Lumbar massage
1. Straight stroking with the tubercle and the pad of the thumb.
2. Rubbing:
a) circular with the pad of the thumb;
b) circular with the pads of four fingers;
c) circular beak-shaped;
Massage of the pelvis and healthy limbs
It is recommended to massage the pelvic muscles and muscles of a healthy limb in accordance with generally accepted techniques. But the number of receptions should be reduced.
Massage for fractured foot bones
On the injured leg, you need to massage the muscles of the thigh, knee joint and lower leg. After removing the splint, you need to do the following:
1. Stroking.
2. Rubbing the foot.
3. Vibration in the fracture area.
It is necessary to use both active and passive movements.
Massage for a broken leg bone
Massage techniques should be performed on the thigh muscles, in areas located above and below the fracture area. Seven days after injury to the limb, you can make a hole in the plaster and vibrate the fracture site using your fingers or a device. After removing the cast, massage should be done on the entire limb.
Massage for hip fractures
For hip fractures, you need to massage the abdomen, chest, massage areas located below and above the fracture site. Techniques of stroking and rubbing the muscles of the lower thigh should be performed. 21 days after a hip fracture, vibration should be performed on the damaged area, having first made a hole in the plaster. After removing the cast, massage should be done on the entire limb.
Massage helps combat the residual effects of bone fractures, for example, muscle atrophy, contractures, delayed callus formation, the formation of excess callus, and late edema.
Massage for muscle wasting
1. Stroking:
a) zigzag;
b) spiral.
2. Kneading (at a fast pace).
3. Shaking.
4. Quilting.
5. Vibration (gentle).
6. Shift.
7. Stretching of soft tissues that are fused to the callus. If the fracture heals slowly, the following massage techniques should be added to the massage techniques described above:
1. Hatching.
2. Pressure.
3. Puncturing.
4. Impact techniques.
The techniques must be performed rhythmically, alternating them with stroking. It is recommended to add self-massage to the main block of techniques, which should be carried out in the form of tapping at the site of the fracture with the pads of the fingers. If there is a plaster cast on the injured limb, you can use vibration through the cast.
There is no need to use intense movements at the fracture site, which can lead to the formation of excess callus.
To speed up the healing of open fractures, massage should be done on the paravertebral areas of the back and on healthy areas of the body. The recommended number of sessions is 16. Sometimes after a course of massage with the person being massaged! Muscle contractures, residual stiffness, etc. may be observed. In this case, it is necessary to repeat the massage course after a 14-day break.
MASSAGE FOR ARTHROSIS
Osteoarthritis is a chronic joint disease. Arthrosis is divided into primary and secondary. The causes of primary arthrosis are still unknown. Specialist scientists only assume that the disease occurs as a result of a metabolic disorder of cartilage tissue. This type of arthrosis includes nodular arthrosis of the joints of the hands.
Secondary arthrosis develops as a result of overload of the articular cartilage, i.e. as a result of excess body weight, decreased length of the lower limb, X- and 0-shaped lower leg, etc.
The main symptom of arthrosis is the presence of pain in the joint (arthralgia), which has mechanical character(occurs during exercise and disappears during moments of rest). There are other signs of the disease, they all depend on the location of the onset of arthrosis.
Massage for nodular arthrosis of the joints of the hands
With this disease, thickening occurs interphalangeal joints brushes in the form of nodules, formation of quite dense painful cysts near the nail bed. Arthrosis of the joints of the hands is accompanied by severe pain, impaired motor ability of the fingers, and the appearance of flexion contractures.
Massage is an effective treatment for arthrosis of the joints because it improves peripheral blood circulation, supplying the limbs and tissues of the diseased joint with oxygen and other nutrients.
The goals of massage for arthrosis of the joints:
1. Reducing pain.
2. Overcoming Stiffness.
3. Improving blood and lymph circulation in affected areas.
4. Prevention of joint stiffness and contracture development.
5. Improving the supply of limb tissues with oxygen and other nutrients.
6. Prevent muscle atrophy.
Massage of the back of the hand
On the dorsum of the hand, the intermetacarpal areas should be massaged in the direction from the knuckles to the wrist joint.
1. Straight-line stroking (in this case, it is necessary to stroke your fingers).
2. Rubbing:
a) straight with the pads of four fingers;
b) zigzag with the pads of four fingers;
c) circular with the pads of four fingers;
d) straight with the pad of the thumb;
e) circular with the pad of the thumb;
f) circular with the pad of the 3rd finger;
g) straight with the ulnar surface of the little finger;
h) circular shape with the ulnar surface of the palm across the hand;
i) spiral-shaped with the base of the palm.
Massage of fingers
Techniques should be performed in the direction from the fingertips to the knuckles,
1. Rubbing (each finger needs to be rubbed separately):
b) “pincer-shaped” zigzag;
c) straight with the pad of the thumb;
d) circular with the pad of the thumb;
e) circular with the pads of four fingers;
f) circular with the pad of the index finger;
g) circular with the ulnar surface of the palm;
h) spiral-shaped with the base of the palm.
2. Shaking the brush.
Deforming arthrosis hip joint. Treating illness with massage
Lower back massage
1. Stroking.
2. Squeezing.
3. Kneading:
a) circular with the pad of the thumb;
b) circle-shaped by the phalanges of bent fingers;
d) “pincer-shaped”.
Lumbar massage
Rubbing techniques are performed:
a) straight with the pad of the thumb and the tubercle of the thumb;
b) circular with the pad of the thumb;
c) circular with the pads of four fingers;
d) circular phalanges of bent fingers;
e) circular with the palmar surface of the hand.
Massage of the gluteal-sacral area
First you need to perform techniques on the gluteus maximus and gluteus medius muscles
1. Stroking.
2. Squeezes.
3. Kneading:
a) ordinary;
6) double neck;
c) double ring;
d) combined;
e) circular with phalanges of bent fingers. Then knead on the sacral muscles:
a) circular with the pad of the thumb;
b) circular with the pads of four fingers;
c) circle-shaped by the phalanges of bent fingers;
d) coracoid.
On the muscles of the hip joint (next to the painful area) rubbing:
b) circular with the pads of four fingers;
c) circular with phalanges of bent fingers.
Thigh muscle massage
1. Stroking.
2. Squeezing.
3. Kneading:
a) ordinary;
b) double neck;
c) double ring;
d) ordinary-longitudinal;
D) circular phalanges of bent fingers;
e) coracoid.
Lower back muscle massage
The following techniques should be performed on the sore area of the back:
1. Stroking (2 or 3 types).
2. Squeezing (1 or 2 types).
Massage of the muscles of the sore hip joint
Massage techniques should be carried out in a gentle manner, gradually increasing the load on the massaged area. Best effect, as a rule, is achieved after 2-3 massage sessions. ; Kneading:
a) circular base of the palm;
b) circular with the pads of four fingers;
c) circle-shaped by the phalanges of bent fingers;
d) circular shape with the knuckles of a fist;
e) circular with the ulnar surface of the index finger; f) circular base of the palm.
DEFORMING ARTHROSIS OF THE KNEE JOINT. TREATING DISEASES WITH MASSAGE
Massage the muscles along the spine
1. Stroking (2 types).
2. Squeezing (2 types).
3. Rubbing (from the sacrum to the lower corners of the scapula):
a) straight with the pads of the index and middle fingers;
b) “shading”;
c) “fork”;
d) circular with the pad of the index finger;
e) circular with the pad of the middle finger.
4. Circular rubbing in the spaces between the spinous processes
pads of the thumbs (fingers are located 1-2 cm from the spine).
Muscle massage in the sacral region
Muscle massage in the sacral region should be carried out using the following method: Rubbing (all types of techniques should be carried out in the direction from bottom to top and to the side):
b) circular with the pad of the thumb;
c) circular with the pads of four fingers;
d) circular phalanges of bent fingers;
e) circular beak-shaped with the terminal phalanges of the fingers (their back side);
f) zigzag-shaped base of the palm; g) a circular tubercle of the thumb; h) zigzag-shaped base of the palm; i) shifting.
Buttock muscle massage
Massage techniques must be performed in the direction from the subgluteal fold up, and then down to the groin nodes:
1. Stroking:
a) straight;
b) alternate;
c) zigzag;
d) spiral;
d) combined. 2. Squeeze:
a) longitudinal;
b) transverse;
c) ulnar surface of the palm;
d) coracoid. 3. Kneading:
a) ordinary;
b) double neck;
c) double ring;
d) double ring combined;
e) circle-shaped by the phalanges of bent fingers;
f) circular beak-shaped (with the brush away from you and forward);
g) circular base of the palm.
Massage of the knee joint and thigh muscles on an uninjured limb
Massage techniques are carried out in the following order:
1. Massage the muscles of the back of the thigh.
2. Massage of the knee joint.
3. Massage the muscles of the anterior thigh.
4. Massage the knee joint on the side of the kneecap. The massage is carried out according to the classical method.
Massage of the knee joint and thigh on the injured limb
The techniques must be done in this order. Posterior thigh:
1. Stroking.
2. Squeezing.
3. Kneading:
a) ordinary,
b) double neck;
c) double ring;
d) circular phalanges of bent fingers;
e) circular beak-shaped.
4. Rubbing the fascia of the quadriceps femoris muscle:
b) circular with the far hand by the phalanges of the index and middle;
c) circular fist.
Knee massage
1. Concentric stroking.
2. Rubbing:
b) circle-shaped by the phalanges of bent fingers;
c) circular with the pads of the fingers;
d) circular tubercles of the thumbs. 3. Concentric stroking.
Anterior thigh massage
1. Stroking.
2. Squeezing.
3. Kneading:
a) ordinary;
b) double neck;
c) double ring;
d) double ordinary;
e) double circular longitudinal; e) coracoid.
Massage the fascia of the quadriceps femoris muscle
1. Rubbing:
a) straight with the base of the palm;
b) circle-shaped by the phalanges of bent fingers;
c) circular with the radial side of the hand.
Massage of the knee joint on the cup side
1. Concentric stroking.
2. Rubbing:
a) straight “pincer-shaped”;
b) circular with the pads of the thumbs;
c) circular with the pads of four fingers;
d) circular tubercles of the thumbs.
3. Offset (O-shaped).
4. Squeeze on the thigh muscles.
5. Stroking on the thigh muscles.
6. Rubbing on the knee joint (see point 2).
At the end of the massage session, active movements should be used (with great care).
DEFORMING ARTHROSIS OF THE ANKLE JOINT. TREATING DISEASES WITH MASSAGE
The cause of the disease can be frequent traumatic subluxations and dislocations. It is accompanied by aching pain, limited ability to move, crunching during movement, and hardening of the periarticular tissues.
Calf muscle massage
1. Stroking (2 or 3 types, which need to be performed 2-3 times).
3. Shaking.
4. Kneading:
a) ordinary; "
b) double ring;
c) double circular longitudinal;
d) circular phalanges of bent fingers;
e) circular beak-shaped.
5. Shaking.
6. Stroking.
Achilles tendon massage
1. Rubbing:
a) straight “pincer-shaped”;
b) zigzag;
c) straight with the pads of the thumbs;
d) circular with the pads of all fingers.
2. Shaking.
3. Stroking.
4. Circular beak-shaped rubbing.
Massage of the anterior tibial muscles
The person being massaged should be placed on his back, and a cushion should be placed under his knees.
1. Stroking.
2. Squeezing.
3. Kneading:
b) circular base of the palm;
d) circular phalanges of bent fingers. 4. Stroking.
Foot massage
1. Stroking.
2. Rubbing:
b) circular with the pads of four fingers;
c) straight with the pad of the thumb;
d) circular with the pad of the thumb;
e) circular with the edge of the palm.
Massage of the anterior tibial muscles (repeat)
1. Squeeze:
a) straight with the base of the palm;
b) coracoid from itself. 2. Stroking:
a) straight;
b) spiral.
Ankle massage
1. Concentric stroking.
2. Rubbing:
a) straight “pincer-shaped”;
b) circular with the pads of the fingers (one and both hands);
c) coracoid with one and the other hand;
d) straight with the pads and tubercles of the thumbs. 3. Squeezing on the shin muscles.
4. Stroking on the shin muscles.
5. Rubbing the muscles of the ankle joint.
6. Concentric stroking.
DEFORMING ARTHROSIS OF THE ELBOW JOINT. TREATING DISEASES WITH MASSAGE
The person being massaged should be placed on his stomach.
Upper back massage
Techniques are carried out in the direction from the lower corners of the shoulder blades to the shoulder girdle:
1. Stroking (1 or 2 types).
2. Rubbing on the fascia of the trapezius muscle:
a) circular with the pad of the thumb;
b) circular with the pads of four fingers;
c) circle-shaped by the phalanges of bent fingers;
d) a circular tubercle of the thumb.
Neck muscle massage
The massage should be done along the spine from the border of the hairline to the seventh cervical vertebra.
1. Stroking.
2. Squeezing.
3. Kneading:
a) ordinary;
b) double ring;
c) circular with the pads of four fingers;
d) circular phalanges of bent fingers.
Shoulder muscle massage (deltoid, biceps, triceps)
Massage of the deltoid and triceps muscles:
1. Stroking.
2. Squeezing.
3. Kneading:
a) ordinary;
b) double ring;
c) circular with the pads of four fingers;
d) circular phalanges of bent fingers;
e) circular beak-shaped.
Biceps muscle massage:
1. Stroking.
2. Squeezing.
3. Kneading:
a) ordinary;
b) double ring;
c) circular beak-shaped;
d) circular phalanges of bent fingers.
Massage of the flexor and extensor muscles of the forearm
1. Stroking.
2. Squeezing.
3. Kneading (on flexor muscles):
a) ordinary;
b) circle-shaped by the phalanges of bent fingers;
c) circular beak-shaped (hands away from you and towards you). 4. Kneading (on extensor muscles)
a) circular with the pads of four fingers;
b) circle-shaped by the phalanges of bent fingers;
c) circular beak-shaped.
Elbow joint massage
Figure 159.
Figure 161.
It is necessary to perform massage techniques on the outer and inner parts of the elbow joint. When massaging the inside of a joint, the hand of the person being massaged should be lowered along the body:
2. Rubbing:
a) circular with the pads of four fingers;
b) circle-shaped by the phalanges of bent fingers;
c) circular beak-shaped;
d) circular with the pad of the thumb;
e) circular with the base of the palm.
When massaging the outer part of the elbow joint, the arm of the person being massaged should be bent at the elbow joint and placed in front of the chest:
1. Circular stroking with the base of the palm.
2. Rubbing:
a) circular with the pads of four fingers;
b) circular beak-shaped;
c) circular edge of the thumb;
d) circular base of the palm.
CULT MASSAGE
Massage of the stump is recommended when preparing it for prosthetics.
Massage of the stump should be carried out with the utmost caution, since improper execution of techniques can lead to increased sensitivity of the stump. In addition, it can take on a flask shape.
1. Presence of chronic osteomyelitis.
2. The presence of purulent processes in soft tissues.
3. The patient has severe forms of damage to joints and bones.
4. The presence of infectious diseases of the joints, the causes of which are unknown.
5. The presence of tuberculosis (in the acute stage) of joints and bones.
6. Various neoplasms of joints and bones.
7. Skin diseases accompanied by purulent processes.
8. The presence of various common infections and other diseases for which massage should not be performed.
You can begin massaging the stump after the sutures are removed. But for the first seven days you do not need to touch the seam area to give it the opportunity to get stronger.
It is recommended to perform the following techniques:
1. Stroking (all its types).
2. Rubbing (various types).
3. Spiral kneading (must be done in the longitudinal direction). If there are scars on the stump that are fused to its tissues, then first you need to It is possible to carry out kneading in the form of shifting the scar.
In the area of the distal end, the following technique should be used:
1. Vibration in the form:
a) beating;
b) quilting;
c) chopping.
The duration of the first stump massage sessions should not be more than 10 minutes. Gradually this time should be increased to 15 or 20 minutes.
FLAT FOOT. TREATING DISEASES WITH MASSAGE
Flat feet are called flattening of the arches of the feet. Flat feet can be longitudinal (flattening of the longitudinal arch of the foot) and transverse (flatness of the forefoot). There are other types of flat feet.
There are congenital flat feet and acquired ones. Congenital is quite rare. Usually this is longitudinal flatfoot, combined with pronation of the foot (planovalgus foot). The cause of this flatfoot is the improper intrauterine development of the structural elements of the foot.
The cause of acquired flatfoot may be paralysis and paresis of the muscles of the lower extremities, complications after traumatic injuries, disturbance of calcium-phosphorus metabolism, rickets.
With flat feet, there is a lack of shock-absorbing properties of the foot, which causes rapid fatigue when walking, pain in the feet, hips, lower legs, and lumbar region.
Massage is an excellent remedy for flat feet. It reduces pain, improves lymph and blood circulation, and strengthens weakened muscles.
The massage should be carried out in the following sequence:
1. Massage the calf muscle.
2. Massage the Achilles tendon.
3. Massage on the outside of the lower leg.
4. Massage the back of the foot.
5. Sole massage.
6. Massage the calf muscle.
7. Sole massage.
Calf muscle massage
To perform massage techniques on the calf muscle, the person being massaged should be placed on his stomach, and a roller should be placed under his ankle joints. It is necessary to carry out the following procedures:
1. Stroking:
a) straight;
b) alternate.
2. Squeeze:
a) coracoid;
b) transverse.
3. Kneading:
a) ordinary;
b) double ring;
c) combined;
d) circle-shaped with phalanges of bent fingers, first with one and then with two hands;
e) circular beak-shaped, first with one and then with both hands. 4. Stroking is straightforward.
Achilles tendon massage
Trituration:
a) straight “pincer-shaped”;
b) spiral “pincer-shaped”;
c) straight with tubercles and pads of the thumbs;
d) circular phalanges of bent fingers;
f) circular edge of the thumb.
Massage of the outer side of the leg
The person being massaged should be placed on his back, with a cushion placed under his knees. With your far hand you should:
1. Stroking is straightforward.
2. Kneading:
a) circular with the pads of four fingers;
b) circle-shaped by the phalanges of bent fingers;
c) circular beak-shaped;
d) circular edge of the thumb.
Near hand:
Squeezing with the heel of the palm.
Back of foot massage
Without changing the position of the person being massaged, you should grab his foot from the side of the sole with your near hand and perform massage techniques with your far hand:
1. Stroking is straight in the direction from the fingertips to the ankle joint.
2. Rubbing:
a) rectilinear pads of the four fingers of the intermetatarsal spaces;
b) circular pads of the four fingers of the intermetatarsal spaces;
c) straight with the pad of the thumb;
d) circular with the pad of the thumb;
e) straight with the pad of the middle finger;
f) circular with the pad of the middle finger;
g) circular with the edge of the palm.
3. Stroking (on the back of the shin).
4. Squeeze (on the back of the shin).
Sole massage
1. Stroking the sole with the back of the hand.
2. Rubbing in the direction from toes to heel:
a) circular with the pad of the thumb;
b) circular with the pads of four fingers;
c) straight with a fist across and along;
d) circular ridge of the fist. 3. Compression of the foot.
Calf muscle massage
1. Stroking is straightforward.
2. Squeeze beak-shaped.
3. Kneading:
a) ordinary;
b) circle-shaped by the phalanges of bent fingers;
c) circular beak-shaped.
Sole massage
Trituration:
a) straight with a fist;
b) circular with phalanges of bent fingers.
To strengthen the muscles that support the inner arch of the foot, it is recommended to combine massage sessions with corrective exercises, with passive and active movements of the foot:
1. Flexion.
2. Turns inward.
3. Extension.
4. Spreading and moving your toes.
5. Picking up various small objects with your toes.
6. Rolling a small ball.
7. Sliding movements of the foot of one leg along the shin of the other.
8. Squats on a stick lying across the foot.
CHAPTER 4. MASSAGE FOR CARDIOVASCULAR SYSTEM DISEASES
Massage for diseases of the cardiovascular system helps improve blood circulation in the heart muscle.
In addition, massage increases the tone of the heart muscle and its contractile function, helps prevent congestion in the systemic and pulmonary circulation, normalizes blood pressure, etc.
MASSAGE FOR HYPERTENSION
Hypertension is high blood pressure.
The cause of hypertension is disturbances in the functional state of the central nervous system and other body systems that affect the regulation of vascular tone.
In addition, psycho-emotional stress plays an important role, hereditary predisposition, concussions, etc.
With hypertension, blood pressure increases, the tone of blood vessels (most often the vessels of the brain) changes, as a result of which the arterioles narrow, and a cardiac output of blood occurs that does not correspond to the norm.
In modern science and medicine, 3 stages of hypertension are known: initial, stable, sclerotic.
The initial stage of hypertension is characterized by a short-term increase in blood pressure, which normalizes under normal, favorable conditions.
An increase in pressure can be caused by weather changes, excitement, overwork and a number of other reasons.
As a result of the above factors, a person experiences heaviness in the head, headaches, dizziness, insomnia, rapid or uneven heartbeat.
The stable stage, in addition to high blood pressure, which requires appropriate treatment, is also accompanied by organic changes in vessels and organs, changes in the retina, the appearance of left ventricular hypertrophy.
The sclerotic (irreversible) stage of hypertension is characterized not only by high blood pressure, organic changes in internal organs, but also by renal and coronary insufficiency.
People with this stage of hypertension are disabled.
Treatment of the disease with massage can be carried out regardless of what stage it is in. But there are some contraindications that should not be ignored.
Contraindications for massage:
1. Hypertensive crisis that occurred suddenly.
2. Frequent cerebral crises.
3. Presence of severe diabetes mellitus.
4. General indications for which massage is not recommended.
Massage for hypertension helps reduce headaches and dizziness, lower blood pressure, and improve psycho-emotional state.
Massage techniques should be performed in this order:
1. Upper back massage.
2. Neck massage.
3. Massage of the scalp.
4. Massage of the anterior surface of the chest.
5. Massage of the neck, back of the head and pain points.
Massage the upper part of the spoke
To carry out the massage, the patient should be placed on his stomach, and a roller should be placed under his ankle joints. In this position of the person being massaged, you need to perform the following techniques:
1. Stroking:
a) straight;
b) alternate.
2. Squeeze:
a) the base of the palm;
b) coracoid.
On the long back muscle:
1. Kneading:
a) arched pad of the thumb;
b) circular with the pads of four fingers;
c) “pincer-shaped”;
d) circular with the pads of the thumbs.
2. Stroking.
On the latissimus dorsi muscle:
1. Kneading:
a) ordinary;
b) double ring;
c) combined.
2. Stroking.
Between the spine and scapula, as well as on the suprascapular region:
1. Rubbing:
a) straight tubercle and pad of the thumb;
c) steep-shaped tubercle of the thumb;
The massage should be performed on both sides of the back. It is completed by rubbing along the spine from the lower corners of the shoulder blades to the seventh cervical vertebra:
a) straight with the pads of the index and middle fingers (the spinal column should be between the fingers);
b) impact on areas between the spinous processes.
Neck massage
Neck massage should be carried out simultaneously with massage of the trapezius muscle on the left and right sides:
1. Stroking.
2. Squeezing.
3. Kneading:
a) ordinary;
b) double ring;
c) circular with the pads of four fingers;
d) circular phalanges of bent fingers.
4. Stroking.
Scalp massage
The massage should be performed in the following position: the person being massaged lies on his stomach, his head rests on his folded hands.
1. Stroking with the pads of open fingers in the direction from the crown down to the occipital, frontal and temporal regions;
2. Rubbing (in the direction from the crown down to the occipital, frontal and temporal areas):
c) circular beak-shaped.
Then you should change the position of the person being massaged: put him on his back, and a roller under his head. In this position, the patient needs to perform massage techniques on the frontal part.
1. Straight-line stroking with fingertips (in the direction from the middle of the forehead, along the hairline to the temples).
2. Rubbing:
a) zigzag with fingertips;
b) circular with fingertips.
c) pressure with fingertips.
3. Pinching.
4. Stroking.
After this, it is necessary to massage the temporal areas one by one, performing circular movements with the pads of four fingers.
1. Spiral stroking.
2. Squeezing with the tubercle of the thumb.
3. Kneading the pectoralis major muscles:
a) ordinary;
b) circle-shaped by the phalanges of bent fingers;
c) circular beak-shaped.
4. Shaking.
5. Stroking.
Massage of the neck, occipital region of the head and pain points
The person being massaged should be placed on his stomach.
1. Stroking.
2. Squeezing.
3. Kneading (2 or 3 types).
Then you should act (by palpation) on pain points located in the area of the mastoid processes (bone protrusions behind the earlobe), between the eyebrows, on the temples, in the center of the parietal region. Massage (12-14 sessions of 15-20 minutes each) should be carried out simultaneously with physical therapy and drug treatment. Massage can be done daily or every other day.
MASSAGE FOR NEUROCIRCULATORY DYSTONIA
A type of neurocirculatory dystonia is hypotension. Hypotension is low blood pressure.
Symptoms of hypotension: low blood pressure, headaches, general weakness, fatigue, darkening of the eyes when changing body position, dizziness, frequent pain in the heart, vascular crises.
Massage is an effective remedy for treating the disease. It prevents the occurrence of a crisis, increases blood pressure, reduces headaches, and normalizes the patient’s psycho-emotional state.
But there are some contraindications to massage:
1. Acute hypotensive crisis.
2. General contraindications for which massage should not be used.
Massage should be performed on the following areas:
1. Bottom part backs.
2. Pelvic area.
3. Lower limbs.
4. Abdominal area.
Lower back massage
1. Stroking (in the direction from the pelvic area to the lower corners of the shoulder blades):
a) straight;
b) alternate;
c) spiral.
2. Squeeze (same direction):
a) the base of the palm;
b) transverse.
3. Kneading (on the long back muscles):
a) circular with the pad of the thumb;
b) circular with the pads of four fingers;
c) circular edge of the thumb;
d) “pincer-shaped”;
e) the base of the palm with a roll.
4. Rubbing (on the lumbar region):
a) straight with the pad and tubercle of the thumb;
b) circular with the pads of four fingers;
c) circular with the radial side of the hand;
d) circular base of the palm;
e) sawing;
e) intersection.
5. Rubbing (along the spinal column from the sacrum to the lower corners of the shoulder blades):
a) straight with the pads of the 2nd-3rd fingers;
b) rubbing in the spaces between the spinous processes;
c) circular with the pad of the 2nd finger;
d) circular with the pad of the 3rd finger.
Pelvic area massage
On the gluteal muscles: 1. Stroking:
a) straight;
b) alternate.
2. Squeeze beak-shaped.
3. Kneading:
a) Ordinary;
b) double ring;
c) circular with both fists;
d) circular beak-shaped.
4. Kneading on the sacrum:
a) straight with the pad and tubercle of the thumb;
b) circular with the pads of four fingers;
c) circular edge of the thumb.
5. Kneading on the iliac crest:
a) circular with the pads of four fingers;
b) circle-shaped by the phalanges of bent fingers;
c) circular beak-shaped.
Lower limb massage
It is performed first on the back surface in the following sequence: thigh, calf muscle, sole.
1. Stroking.
2. Squeezing.
3. Kneading (3-4 types).
When massaging the sole, special attention should be paid to the areas of the heart and solar plexus. Then you need to massage the front surface of the thigh and the outer surface of the lower leg.
Abdominal massage
1. Stroking (with the palmar surface of the hand clockwise).
2. Horseshoe squeeze.
3. Kneading on the rectus abdominis muscles:
a) ordinary;
b) double ring;
c) combined;
d) phalanges of bent fingers.
4. Stroking.
5. Massaging the solar plexus area.
A total of 12-14 sessions are required (daily or every other day).
The massage can be supplemented with soft water procedures, which consist of short-term cooling of the feet by stepping in water or dousing them, balneophysiotherapeutic procedures, physical therapy exercises, etc.
MASSAGE FOR CHRONIC CARDIAC MUSCLE FAILURE
The cause of heart muscle failure may be excessive physical activity, the toxic effects of infectious agents, diseases of the endocrine glands, etc. Massage helps expand the capillary network, strengthening peripheral and general blood circulation. Performing techniques should begin with the back muscles:
1. Stroking (from the sacrum to the axillary cavities):
a) flat base of the palms;
b) clasping the continuous base of the palms.
2. Semicircular rubbing with the tips of 2-5 fingers;
3. Stroking.
Then, according to the generally accepted method, you need to massage the long, latissimus and trapezius muscles of the back:
1. Deep continuous comb-like stroking.
2. Rubbing in the form of sawing.
3. Kneading:
a) longitudinal;
b) transverse.
4. Vibration intermittent:
a) in the form of chopping;
b) in the form of a pat.
Chopping and patting techniques in the area between the shoulder blades should be done carefully, not forgetting the stimulating effect of these techniques on the lungs and heart.
5. Continuous grasping stroking.
If the patient has cardiovascular insufficiency of the first degree, then the following techniques are allowed:
1. Vibration intermittent:
a) in the form of gentle (light) chopping in the heart area;
b) in the form of patting in the heart area.
2. Rhythmic compression in the chest area.
When expanding the boundaries of the heart, intermittent vibration should be performed in the form of puncture in the area of the spinous process of the seventh cervical vertebra.
Massage of lower and upper limbs
It is recommended to carry out the massage with broad strokes using the suction massage technique, but without delay in individual areas. The techniques should be performed daily for 20 minutes for 20-30 days.
During a massage session, it is necessary to monitor the patient’s condition, his breathing and pulse. The massage should be interrupted if the patient's face turns red or pale, there is a feeling of tightness in the chest, or pain in the heart area.
MASSAGE FOR ANGINA
Angina pectoris (angina pectoris) belongs to the group of ischemic heart diseases
tsa. The cause of its occurrence may be atherosclerosis of the coronary arteries of the heart.
ca, spasms of coronary vessels, syphilitic aortitis, rheumatic vasculitis,
obliterating endarteritis, periarteritis nodosa, etc.
One of the symptoms of the disease is an attack of pain behind the sternum (usually in the upper part or to the left of it).
In addition to pain, angina may be accompanied by sensations of heaviness, burning, pressure and constriction in the sternum. As a rule, pain radiates to the left shoulder blade, left arm, neck, and sometimes to the lower jaw.
The use of massage techniques for this disease helps improve blood circulation and metabolic processes in the heart muscle, dilate the coronary arteries, which reduces the tendency of the arteries to spasm and reduces or eliminates pain in the heart area.
Before the massage, you should determine the skin zones of Zakharyin-Ged, the zones of reflex reflected changes in the muscles (Mekenzie) and subcutaneous connective tissue (Leibe and Dicke). And then perform the massage techniques described in the “Segmental massage” section.
MASSAGE FOR VARICOSE VEINS
Varicose veins most often occur on the lower extremities. This occurs because the veins in the lower extremities are subject to hydrostatic pressure more than in other parts of the body.
The disease can develop as a result of constant carrying of heavy objects, prolonged standing, excess weight, frequent pregnancies, etc.
For varicose veins, it is recommended to do a massage, the technique of which depends on the area, severity and nature of the lesion. Massage improves tissue trophism, helps relieve the lymphatic and venous network, and enhances blood and lymph circulation.
Contraindications for massage:
1. Heart defects in the decompensation stage.
2. III stage of hypertension.
3. Thrombophlebitis and phlebitis.
4. Spicy inflammatory diseases membranes of the heart and myocardium.
5. Circulatory insufficiency BE degree and III degree.
6. Coronary insufficiency with frequent attacks of angina.
7. Arrhythmia.
8. Thrombobliterating diseases of peripheral arteries in the gangrenous stage.
9. Thrombobliterating diseases of peripheral arteries with clear signs atherosclerosis of cerebral vessels and the presence of a tendency to cerebrovascular accident.
10. Vascular aneurysm.
11. Presence of systemic allergic angitis.
Massage for uncomplicated dilatation of the saphenous veins of the leg
Before performing a massage, the patient should be placed on his back, his legs slightly bent at the knees and raised at an angle of 45 degrees.
Massage techniques should be carried out in the following sequence:
1. Massage the thigh and buttock area.
2. Calf massage.
3. Foot massage. 1. Stroking:
b) embracing continuous.
2. Rubbing (light semicircular without affecting damaged veins).
With unilateral dilatation of the veins of the lower extremities, you need to start the massage with a healthy limb.
To improve blood and lymph circulation, improve the trophism of the skin in areas where the saphenous veins are dilated, you can gently pinch the skin and subcutaneous fat in an up and down direction.
For varicose veins, accompanied by a varicose symptom complex, it is recommended to perform reflex segmental massage of the lumbosacral region (L4-S4).
In the presence of inducing diseases of the skin and subcutaneous tissue in places of varicose veins, massage can be used for skin diseases (see “Massage for skin diseases”). This massage will improve tissue trophism, reduce itching, prevent cramps, numbness in the lower extremities, and relieve the feeling of heaviness.
People suffering from this disease are also recommended for massage, which is used for cardiovascular failure(“Massage at chronic failure heart muscle").
MASSAGE FOR DECREASED CARDIAC ACTIVITY
Decline (weakening) of cardiac activity is characterized by a rare pulse and a sharp drop in blood pressure.
In the area of the heart, the following techniques must be performed:
1. Intermittent vibration in the form of puncturing.
2. Patting.
3. Chopping.
Manual massage can be supplemented with vibration massage using an electric vibrator. The massage session should be carried out for 2 or 3 minutes.
In the interscapular area, it is recommended to carry out vibration in the form of patting and chopping. This technique should be alternated with chest compressions. To do this, both palms should be placed on the left and right sides of the chest in the area of the fourth rib downwards and rhythmic intermittent compression should be performed as the patient exhales.
MASSAGE FOR SUDDEN HEART STOP
The cause of sudden cardiac arrest can be accidents: defeat electric shock, drowning, etc.
In case of cardiac arrest, indirect (external) manual cardiac massage is performed. Massage techniques are performed in the area between the thoracic spine and the sternum. To perform a massage, the patient should be placed on his back on a hard surface and a small cushion should be placed under his shoulders. The massager needs to position himself to the left of the patient, place the palm of his left hand on the lower third of his sternum, and on top of it the palm of his right hand and perform rhythmic pressure in the form of pushes (60-70 times per minute), quickly removing his palms after each pressure (this will give chest the cell has the opportunity to expand, and the heart to fill with venous blood) (Fig. 159). It is recommended to apply pressure in this order:
3-4 pressures - pause 2-3 seconds - 3-4 pressures - pause 2-3 seconds. 
Massage techniques should be used until cardiac activity is restored. In this case, you do not need to put too much pressure on the ribs so as not to break them.
To make the massage more effective, it must be alternated with artificial respiration (blowing air into the patient’s lungs through the mouth, through the nose, from mouth to mouth using a tube).
CHAPTER 5. MASSAGE FOR NERVOUS SYSTEM DISEASES
Massage for diseases of the nervous system is an effective treatment. It improves blood circulation, tissue trophism in case of paralysis, strengthens muscles, stretches muscles that are in a state of contracture, prevents muscle atrophy, relieves or reduces pain, activates the process of restoration of nervous tissue, and increases the patient’s vitality.
MASSAGE FOR INTERCOSTAL NEURALGIA
Intercostal neuralgia appears as a consequence of scoliosis, rib injuries, spinal osteochondrosis, deforming spondyloarthrosis, influenza, intoxication, and diseases of internal organs. With intercostal neuralgia, constant or paroxysmal pain is noted on the left side in the back and lateral surface of the chest.
At some points the pain can be especially severe, and it spreads in a semi-circle along the intercostal nerves (from the spine to the sternum).
Massage techniques are recommended for the following areas:
1. Back area.
2. Chest area.
Back massage
Before performing the techniques, you should determine the location of the pain. The massage should first be done on the healthy side, and then on the sore side. If pain spreads over the left and right half of the back, massage should be performed on the half on which the pain is less.
1. Stroking (done along 3 and 4 lines from the sacrum to the shoulder girdle):
a) straight;
b) alternate.
2. Squeeze beak-shaped with the base of the palm along 3 and 4 lines from the sacrum to the shoulder girdle.
3. Kneading on the long back muscles:
a) circular with the pad of the thumb;
b) circular with the pads of four fingers;
c) circle-shaped by the phalanges of bent fingers;
d) circular with the pads of bent fingers;
e) circular base of the palm with a roll. 4. Kneading on the latissimus muscles:
a) ordinary;
b) double neck;
c) double ring;
d) circular phalanges of bent fingers.
5. Kneading on the fascia of the trapezius muscle and suprascapular region:
a) circular with the pad of the thumb;
b) circular with the pads of four fingers;
c) circular edge of the thumb;
d) “pincer-shaped”;
e) a circular tubercle of the thumb;
f) straight line with the pad and tubercle of the thumb.
6. Kneading on the intercostal spaces:
a) straight with the pads of the four fingers alternately;
b) straight with the pads of four fingers;
c) straight with the pad of the thumb;
d) circular with the pad of the thumb;
e) straight with the pads of the middle finger;
e) “stroke-like” with the pads of the middle finger.
When performing techniques, you should not exceed the pain threshold of the person being massaged.
Chest massage
To carry out a massage, the patient should be placed on his back and his chest should be lubricated with cream, vegetable oil or warming ointments. Massage of the pectoralis major muscles:
1. Stroking.
2. Squeezing.
3. Kneading:
a) ordinary;
b) double neck;
c) double ring;
d) combined;
e) circular with phalanges of bent fingers.
Massage of the intercostal spaces of the chest:
1. Rubbing:
a) straight with the pads of four fingers;
b) circular with the pads of four fingers;
c) straight with the pad of the thumb;
d) circular with the pad of the thumb;
e) straight with the pad of the middle finger; e) “stroke-shaped” with the pad of the middle finger. Subcostal angle massage:
Rubbing (performed in the classic way).
The massage session should be carried out for 15-20 minutes. The recommended number of sessions is 8-10.
MASSAGE FOR LUBOSACRAL RADICULITIS (NEURALGIC MANIFESTATIONS OF LUMBAR OSTEOCHONDROSIS)
The disease is characterized by pain in the lower extremities, sacrum, buttock areas, tension in the back muscles, hypotension and wasting of the muscles of the buttocks, thighs and legs, pain on palpation of paravertebral points, spinous processes and points along the sciatic nerve.
For this disease, it is recommended to carry out massage, which helps reduce pain, increase blood and lymph circulation in the lumbar region and limbs, and reduce muscle wasting in the back of the thigh, lower leg and buttocks.
The massage involves influencing the paravertebral zones of the lower thoracic, lumbar, sacral spinal segments D12 - D4, L5 - L1, S3 - S1.
Massage techniques are performed in the following areas:
1. Back area.
2. Pelvic area.
3. Lumbar region.
4. Lower limb on the affected side (posterior and anterior surfaces).
Back massage
1. Stroking:
a) straight;
b) alternate. 2. Squeeze:
a) longitudinal;
b) coracoid.
3. Kneading on the long back muscles:
a) circular with the pad of the thumb;
b) circular with the pads of four fingers;
c) circle-shaped by the phalanges of bent fingers;
d) circular with the pads of the thumbs;
e) circular with the tubercles of the thumbs.
Pelvic area massage
First, you need to carry out the techniques on the healthy half, and then on the sick half.
Gluteal muscle massage
1. Stroking.
2. Squeezing.
3. Kneading:
a) ordinary;
b) double neck;
c) double ring;
d) circular phalanges of bent fingers;
e) circular beak-shaped.
Sacrum massage
1. Rubbing:
a) straight with the pad of the thumb;
b) circular with the pads of four fingers;
c) circle-shaped by the phalanges of bent fingers;
d) circular with the edge of the palm.
Back muscle massage (from the lumbar region to the lower corners of the shoulder blades):
1. Squeeze.
2. Stroking.
Lumbar massage
1. Rubbing:
a) straight with the pad of the thumb along three lines;
b) circular with the pad of the thumb;
c) circular with the pads of four fingers;
d) circular phalanges of bent fingers;
e) circular beak-shaped.
One series of techniques should be carried out on a healthy area, and two or three on a sick area. All techniques should be alternated with stroking and squeezing on the lower back.
Massage of the lower limb on the affected side (posterior and anterior surface)
Massage of the muscles of the back of the thigh:
1. Stroking.
2. Squeezing.
3. Kneading:
a) ordinary;
b) double ring;
c) combined;
d) ordinary-longitudinal;
e) circular beak-shaped.
When massaging the sciatic nerve, vibration should be used.
Calf muscle massage:
1. Stroking.
2. Squeezing.
3. Kneading:
a) ordinary;
b) double circular longitudinal;
c) circle-shaped by the phalanges of bent fingers;
d) circular beak-shaped.
Massage on the front of the thigh:
1. Stroking.
2. Squeezing.
3. Kneading:
a) ordinary;
b) double ring;
c) double ordinary;
d) double circular longitudinal;
e) circular beak-shaped.
Massage on the anterior muscles of the calf:
1. Stroking.
2. Squeezing.
3. Kneading:
a) circular with the pads of four fingers;
b) circle-shaped by the phalanges of bent fingers;
c) circular beak-shaped;
d) circular base of the palm.
Vibration should be performed in the area of the popliteal nerve.
Ankle massage:
1. Concentric stroking.
2. Rubbing:
a) “pincer-shaped” rectilinear;
b) circular with the pads of four fingers, first of one, then of both hands;
c) a circular beak-shaped first with one hand, then with the other;
d) straight with tubercles and thumb pads from top to bottom.
Back of foot massage:
Rubbing (from the base of the fingers to ankle joint):
a) straight with fingertips;
b) circular with fingertips;
c) straight with the pad of the thumb;
d) circular with the pad of the thumb.
Particular attention should be paid to pain points and nerve trunks. Pain points can be identified by palpation of the paravertebral zones, interspinous spaces, as well as the area of the iliac crests and the femur along the sciatic nerve. The following steps must be followed:
1. Stroking.
2. Palpation in the areas of the above places.
3. Palpation directly in the area of pain points.
Massage can be combined with physical therapy and thermal treatments.
MASSAGE FOR OCCUPITAL NERVE NEURALGIA
The cause of occipital neuralgia can be cervical osteochondrosis and complications after the flu. The disease is characterized by inflammation of the nerve endings in the upper cervical vertebrae. It is accompanied by severe pain in the back of the head and neck, radiating to the shoulder blade, and increased tone of the muscles of the back of the head and neck.
For occipital neuralgia, massage is recommended, as it significantly reduces pain, ensures normal conduction of the peripheral nerve, and eliminates the inflammatory process.
The massage should be performed in the following sequence:
1. Back massage.
2. Massage the neck along with the trapezius muscle.
3. Massage of the back of the head.
Back massage
1. Stroking.
2. Squeezing.
3. Kneading on the long back muscles:
a) circular with the pad of the thumb;
b) circular with the pads of four fingers;
c) “pincer-shaped”;
d) circular edge of the thumb.
4. Kneading the back muscles between the spine and shoulder blade:
a) straight with the pad and tubercle of the thumb;
b) circular with the pad of the thumb;
c) circular with the pads of four fingers;
d) circular edge of the thumb;
e) a circular tubercle of the thumb.
5. Stroking all over the back.
6. Squeeze over the entire back.
Massage the neck with the trapezius muscle
1. Stroking.
2. Squeezing.
3. Kneading:
a) ordinary;
b) circular with the pads of four fingers;
c) circle-shaped by the phalanges of bent fingers;
d) double ring.
Massage of the back of the head
1. Rake-like stroking.
2. Squeeze beak-shaped.
3. Rubbing:
a) straight;
b) zigzag;
c) circular with the pads of four fingers;
d) circular phalanges of bent fingers;
e) circular beak-shaped;
e) a circular tubercle of the thumb.
After 3-5 sessions, including the above techniques, you need to perform a massage with the addition of new techniques:
4. Rubbing along the cervical spine:
a) straight with the pads of four fingers;
b) circular with the pads of four fingers;
c) circular with phalanges of bent fingers of one or the other hand.
Particular attention should be paid to nerve exit points and pain points:
5. Rubbing.
6. Vibration (along the nerves with the pad of the middle finger).
The area of the greater occipital nerve should be massaged in the middle between the upper cervical vertebra (at the skull) and the mastoid process. The area of the lesser occipital nerve should be massaged behind the mastoid process.
In addition, you should massage the sternocleidomastoid muscles.
After performing massage techniques, it is recommended to do gymnastic exercises for the arms and head. The duration of each session is 15 minutes. The recommended number of sessions is 12-14.
MASSAGE FOR TRIGEMINAL NEURALGIA
The disease can occur as a result of colds, various infectious diseases, sinusitis, sinusitis, dental diseases, etc. It is characterized by paroxysmal acute pain that appears when sneezing, movements of the neck and head, and chewing. Pain may spread from one branch trigeminal nerve to the other two branches, may extend beyond the boundaries of the innervation zone.
If the trigeminal nerve is damaged, the following massage techniques must be used:
1. Circular rubbing.
2. Vibration is continuous.
In areas where nerves exit the surface of the face, it is recommended to massage using a vibrator.
MASSAGE FOR FACIAL NERVE NEURitis
The cause of the disease can be hypothermia, otitis media (inflammation of the middle ear), mumps (inflammation parotid gland), damage to the facial nerve, etc. As a rule, the disease is accompanied by paralysis of the muscles of half the face. The patient cannot perform many simple movements, for example, closing an eye on the affected part of the face, frowning, puffing out his cheeks, etc. Often, with neuritis of the facial nerve, pain in the ear area is noted.
For neuritis of the facial nerve, facial massage is indicated (about directions massage movements says in the article “Massage of the skin and muscles of the face”).
The following steps should be followed:
1. Semicircular rubbing (do it gently and easily).
2. Continuous stroking.
The techniques must be performed alternately.
Vibration massage also has a positive effect.
MASSAGE FOR SOLAR PLEXUS NEURALGIA
The cause of the disease may be postoperative adhesions in the abdominal cavity, various chronic inflammatory processes in the female genital organs, etc. The disease is characterized by paroxysmal burning or boring pains that occur in the epigastric region, sometimes spreading throughout the entire abdominal area, radiating to the thoracic and lumbar spine. On palpation, painful sensations appear in the epigastric region between the xiphoid process and the navel. In addition, a patient with solar plexus neuralgia may have bloating, constipation, or diarrhea.
For solar plexus neuralgia, it is recommended to massage the areas in the back:
1. Grinding with strokes.
2. Stroking the end phalanges of the middle and ring fingers.
In the area of increased muscle tone:
3. Light mechanical vibration.
If, as a result of vigorous exposure, the person massaged in the area of the lower angle of the scapula develops pain, a feeling of numbness and itching, then it is necessary to perform a stroking technique in the area under the alar cavity.
You can massage the epigastric region only after reducing the muscle tone of the areas on the back. In the area of the solar plexus, do not put too much pressure on it. painful points because it may cause sharp decline blood pressure, slowing pulse, the appearance of peripheral vascular spasm. The massage session should last 5-10 minutes.
CHAPTER 6. MASSAGE FOR DISEASES OF THE DIGESTIVE SYSTEM
A large number of people suffer from diseases digestive system. The causes of their occurrence are food poisoning, infectious diseases, various inflammatory processes in the organs of the system, etc. For many diseases, it is recommended to carry out massage, which has a positive effect on the entire body as a whole.
MASSAGE FOR ULCER DISEASE OF THE STOMACH AND DUODENAL
Gastric ulcer and duodenum may occur as a result of neuropsychic stress, poor nutrition, smoking, alcohol abuse, etc. It is characterized by the presence of pain
in the epigastric region, occurring after meals or on an empty stomach, the formation of ulcers in the mucous membrane of the stomach or duodenum. In patients with gastric and duodenal ulcers, seasonal exacerbations are observed (in spring and autumn), which can be complicated by bleeding and perforation of the stomach walls.
Massage is recommended during the period of attenuation of the exacerbation and during the period of incomplete remission of stages I-III. It promotes rapid scarring of ulcers, improvement of blood circulation and motor and secretory functions.
Contraindications for massage:
1. Exacerbation of the disease.
2. Bleeding.
3. Acute cholecystitis.
4. Inflammatory processes in the genital organs in women.
5. Tuberculosis.
6. Pregnancy and the postpartum period, the period after an abortion (within 2 months).
7. General contraindications.
Massage techniques must be performed in the following sequence:
1. Back muscle massage.
2. Massage of the neck and trapezius muscles.
3. Massage the chest muscles.
4. Massage the abdominal muscles.
Back muscle massage
1. Stroking.
2. Squeezing.
a) circular with the pad of the thumb;
b) circular with the pads of four fingers;
c) circle-shaped by the phalanges of bent fingers;
d) “pincer-shaped”;
e) circular with the pads of the thumbs.
Particular attention should be paid to the areas D7-D9, D10-L1 on the left and D9-D12-L1 on the right because they are associated with the affected organs. 4. Kneading the latissimus dorsi muscles:
a) ordinary;
b) double neck;
c) double ring;
d) circular phalanges of bent fingers.
5. Rubbing the fascia of the trapezius muscle, interscapular area, supraspinatus and infraspinatus areas:
a) straight with the pad and tubercle of the thumb;
b) circular edge of the thumb;
Massage of neck and trapezius muscles
1. Stroking.
2. Squeezing.
3. Kneading:
a) ordinary;
b) double ring;
d) radial side of the hand.
Abdominal muscle massage
Techniques should be performed on the rectus and oblique abdominal muscles, in areas that are directly connected to the stomach and duodenum.
1. Circular stroking.
2. Kneading on the rectus abdominis muscles:
a) ordinary;
b) double ring;
c) circular shape with phalanges of bent fingers of one and both hands alternately; 3. Kneading on the oblique abdominal muscles:
a) ordinary;
b) double ring;
c) circle-shaped by the phalanges of bent fingers;
d) circular beak-shaped.
It is necessary to conduct 12-14 massage sessions.
MASSAGE FOR GALL BLADDER AND LIVER DISEASES
Massage, as a rule, is prescribed in the presence of inflammatory processes in the gallbladder, in cases of dysfunction of the liver and biliary tract, after hepatitis, and in case of pain after cholecystectomy. Massage helps reduce pain, improves blood circulation and motor function of the gallbladder.
Contraindications for massage:
1. The presence of general contraindications.
2. Acute diseases of the gallbladder and liver.
3. Peritonitis.
4. Acute cholecystitis.
5. Purulent inflammatory processes in the gallbladder.
6. Pancreatitis.
It is recommended to perform massage techniques in the following sequence:
1. Back massage.
2. Neck massage.
3. Massage of the anterior surface of the chest.
4. Massage of the rectus abdominis muscles.
Back massage
1. Stroking.
2. Squeezing.
3. Kneading on the long back muscles:
a) circular with fingertips;
b) “pincer-shaped”;
c) circular with the pads of the thumbs;
d) a circular tubercle of the thumb;
e) circular with the base of the palm.
4. Kneading on the latissimus dorsi muscles.
5. Rubbing the area between the spine and the inner edge of the scapula. If there is muscle hypertonicity, massage should be done with great caution. Techniques such as beating and chopping should not be used.
Neck massage
1. Stroking.
2. Squeezing.
3. Kneading.
It is necessary to carefully massage zones SZ-C4.
Massage of the anterior chest
1. Stroking.
2. Squeezing.
3. Kneading the pectoralis major muscle.
Massage of the rectus abdominis muscles
1. Stroking in a circular manner.
2. Horseshoe squeeze.
3. Kneading.
4. Rubbing at the edge of the costal arches:
a) straight with your thumbs in a downward direction toward you;
b) “shading” with the edges of the palms.
It is recommended to conduct 12-14 sessions. They should be performed every other day.
MASSAGE FOR DISORDERS OF MOTOR FUNCTION OF THE LARGE INTESTINE
The basis for impaired motor function of the large intestine, as a rule, is an increase in the tone of its muscles, causing a slowdown in the movement of feces through the intestine (constipation). An increase in tone usually does not appear in the entire intestinal musculature, but only in certain parts of it. Most often, disorders occur in the sigmoid and descending segments of the colon. An important role in both the promotion and removal of feces from the body is played by the condition of the muscles of the peritoneum, pelvis, diaphragm, etc.
For constipation, reflex-segmental massage is indicated. Segmental massage should be preceded by classical massage techniques aimed at relaxing the abdominal muscles. Before starting the session, to speed up the relaxation of the abdominal muscles and muscles of the large intestine, it is recommended to warm up the abdominal and lower back area with a heating pad for 5-7 minutes.
The patient should be placed on his back and asked to relax his abdominal muscles as much as possible.
The massage begins with stroking - light and slow circular movements with the tips of 2-4 fingers of the right hand, performed from the navel in a clockwise direction (2-3 minutes).
The reception should be repeated 2-3 times a day. It is also recommended to do it during bowel movements to strengthen the skin-intestinal reflex of the body.
For atonic constipation, you can perform the following techniques:
1. Slow intermittent pressure with the palmar surface of the hand along the ascending colon, descending colon and transverse colon with gradual penetration into the depths of the abdomen.
2. Intermittent vibration:
a) in the form of punctuation;
b) in the form of light chopping.
3. Vibration in the sacral area (3-5 minutes).
4. Mechanical vibration on the anterior wall of the rectum (4 cm above anus) in the direction from top to bottom.
5. Intermittent vibration in the area of the spinous processes L1-3.
For persistent constipation, you should perform techniques aimed at strengthening the abdominal press, especially if the abdominal wall is in a stretched state.
MASSAGE FOR HEMORRHOIDS
Hemorrhoids are a disease in which pathological varicose veins lower rectum. The causes of hemorrhoids are chronic constipation, liver disease, sedentary lifestyle, etc.
For this disease, it is recommended to do a massage, which improves lymph and blood circulation and removes venous congestion in the rectal area.
Contraindications for massage:
1. Acute inflammatory diseases of the abdominal organs.
2. Tuberculosis of the intestines and peritoneum.
3. Various tumors of the abdominal organs.
4. Acute form diseases of the intestines and stomach.
5. Diseases of the intestines and stomach, which may cause bleeding.
Before the session begins, the patient must empty the bladder and rectum. Massage should be done with the patient in the knee-elbow position.
The massage therapist should put a rubber fingertip lubricated with sterile Vaseline on the index finger of the right hand. Then the finger must be inserted into the rectum of the person being massaged and carefully, without causing pain, in the direction from bottom to top and from top to bottom, perform the following massage techniques:
1. Stroking with light pressure on the internal nodes of hemorrhoids. Existing external nodes must be moved inward during the procedure.
Stroking should be repeated 3-4 times with breaks of 30 seconds.
2. Vibration of the mucous membrane of the walls of the rectum using an electric vibrator.
The disease may be accompanied by the appearance of cracks in the rectal area. In this case, 10-15 minutes before the massage, you need to insert a belladonna suppository into the anus.
It is recommended to end the massage session with special physical exercises.
CHAPTER 7. MASSAGE FOR DISEASES OF THE RESPIRATORY SYSTEM
Diseases of the respiratory system include bronchitis, pneumonia, laryngitis, tracheitis, pleurisy, etc. These diseases are widespread across all continents. Both adults and children suffer from them. For many respiratory diseases, massage is prescribed as one of the components complex method treatment.
MASSAGE FOR PNEUMONIA (PULMONARY INFLAMMATION)
Pneumonia is an infectious disease caused by hypothermia, neuropsychic and physical overload and other factors that cause a decrease in the body's resistance. There is a high temperature (38-40 degrees), cough (dry, then with sputum), chills, pain in the chest, increasing with coughing and inhalation, rapid shallow breathing. Massage for pneumonia is prescribed for final stage treatment to eliminate residual effects of the disease. In this case, it improves the general condition of the patient, strengthens his respiratory muscles, and increases blood and lymph circulation in the lungs.
The massage is carried out in the following sequence:
1. Massage the anterior surface of the chest.
2. Back massage.
3. Neck massage.
4. Repeated massage of the anterior surface of the chest.
Massage of the anterior chest
1. Stroking (from bottom to top to the axillary lymph nodes).
2. Squeezing (excluding the mammary gland in women and the nipple area in men).
3. Kneading the pectoralis major muscle:
a) ordinary;
b) double ring;
c) phalanges of bent fingers;
d) circular beak-shaped.
4. Shaking.
5. Stroking.
6. Kneading the intercostal spaces:
a) straight with the pads of the fingers (alternately);
b) straight with the pads of four fingers;
c) circular with the pads of four fingers;
d) straight with the pad of the thumb;
e) zigzag with the pad of the thumb.
7. Rubbing the sternum.
8. Rubbing the collarbone and its attachment points.
Back massage
1. Stroking the entire surface of the back.
2. Squeezing.
3. Kneading the long back muscles:
a) circular with the pad of the thumb;
b) circular with the pads of four fingers;
c) “pincer-shaped”;
d) circular with the pads of the thumbs. 4. Kneading the latissimus dorsi muscles:
a) ordinary;
b) double neck;
c) double ring;
d) circular phalanges of bent fingers.
5. Kneading the area between the spine, scapula, suprascapular region:
a) straight with the phalanges of bent fingers;
b) circular edge of the thumb;
c) a circular tubercle of the thumb.
Neck and trapezius muscle massage
1. Stroking.
2. Squeezing.
3. Kneading:
a) ordinary;
b) double ring;
c) circular with the pads of four fingers;
d) circular phalanges of bent fingers;
e) circular with the radial side of the hand.
Repeated massage of the anterior surface of the chest (see above).
CHAPTER 8. MASSAGE FOR DISEASES OF THE ENDOCRINE SYSTEM
Diseases of the endocrine system primarily include diabetes mellitus, obesity and gout. Drug treatment of diseases can be combined with massage.
MASSAGE FOR GOUT
The causes of gout are a violation of the metabolism of uric acid, the uric acid salts of which are deposited in organs and tissues, frequent overeating, alcohol abuse, etc. The disease is usually associated with
is accompanied by inflammation of the joints (arthritis), in which there are sensations of pain and stiffness in the affected area, high temperature, and swelling in the affected area.
For gout, massage is recommended. It reduces pain and stiffness of the affected joint, tension in the muscles of the limbs, improves tissue trophism, and increases the overall tone of the body. If the joints of the hands are affected, it is necessary to massage the back, neck, and arms. If the joints of the legs are affected, you need to massage the back, pelvic area, and lower limbs.
First, you should perform massage techniques that relieve pain, tension in the muscles, relax the muscles, and then techniques aimed at developing muscle strength and reducing malnutrition. Techniques on the affected joint should be performed only after performing techniques on the areas around it.
The less affected joints should be treated first. The impact should be gentle and light. A massage session should last no more than 35 minutes. The recommended number of sessions is 12-16.
CHAPTER 9. MASSAGE FOR DISEASES OF THE MALE GENITAL SPHERE
Massage is recommended for many diseases of the male genital area. It should only be carried out by a specialist who has undergone training and practice in a hospital or clinic. Massage for diseases of the male genital area has some contraindications:
1. Presence of tuberculosis of the genital organs.
2. Presence of acute cystitis.
3. Diseases of the male genital organs of an infectious nature in the acute stage.
4. Presence of epididymitis.
5. Trauma to the testicle and its epididymis, accompanied by an increase in both general and local temperature.
6. Presence of diseases of the rectum.
URETHRAL MASSAGE
Urethral massage is prescribed for chronic inflammation. The massage is performed using a bougie (a special metal rod). Before performing massage techniques, the urethra should be treated with a solution of mercuric oxycyanide (1: 6000). This is necessary to influence the secondary flora. Then you need to fill the bladder with the same solution.
The person being massaged should be placed on his back. The massage therapist should put on rubber gloves, insert a bougie into the anterior urethra and, fixing it with his left hand, with the tips of the index and thumb with your right hand, apply pressure stroking in the direction from the root of the penis to the external opening of the urethral canal. Massage using a bougie should be carried out for 30-60 seconds. It is recommended to repeat the session after 1 or 2 days. After performing massage techniques, you need to rinse the urethral canal with a solution of mercuric oxycyanide.
PROSTATE MASSAGE
The causes of inflammation of the prostate gland are infectious diseases, sexual abstinence or sexual excess. It is recommended to carry out a massage, which improves blood circulation in the gland and helps remove pathological secretions. Massage should be performed only after the patient has passed acute symptoms of prostatitis, the temperature is within normal limits, and the second portion of urine is clear. Before performing massage techniques, the person being massaged should be placed on the right side (knees should be pressed to the stomach).
Massage should be done with a full bladder. The massage therapist should put a rubber glove on his right hand and insert his index finger, lubricated with sterile Vaseline, into the rectum and massage the lobules of the prostate gland, using the following techniques:
1. Stroking in the direction of the excretory ducts of the glands - from the outside and from above to the midline (Fig. 160):
a) superficial planar;
b) sliding.
The use of other, rougher techniques is not recommended for the first 2 sessions, because this can lead to pain in the patient urethra, anus, tingling, etc.
2. Light pressure on the prostate gland with a gradual increase in pressure.
During the techniques, the person being massaged should not experience painful sensations. The pressure force must be increased in the presence of a dense gland; in the presence of a soft gland, this is not necessary. Particular attention should be paid to the edges of the gland, since the inflammatory process is most often concentrated on them.
Massage sessions are recommended every other day. The duration of each session is no more than 30-60 seconds.
After the massage, the person being massaged must empty the bladder, after which the bladder and canal should be washed with a weak solution of potassium permanganate (potassium permanganate).
If the inflammatory process worsens, it is necessary to interrupt the massage for 3, and if necessary, for 10 days.
SEMINAL VESTICAL MASSAGE
A disease such as urethritis is often accompanied by inflammation of the seminal vesicles, for which massage is recommended.
The massage therapist should wear a rubber glove and lubricate the index finger with sterile Vaseline, then carefully insert the index finger into the rectum in the direction of the prostate gland.
The massage must begin from below the vas deferens and move gradually upward to the seminal vesicles (Fig. 160). The massage should be performed in the form of light pressure on the seminal vesicles. The pressure should be gradually increased. Pressure techniques should be performed 2 or 3 times, alternating them with pauses.
Session duration is 30-60 seconds. Massage is recommended every other day.
COOPER GLANDS MASSAGE
A disease such as gonorrheal urethritis is often accompanied by inflammation of the Cooper glands. Massage of these glands is possible only after the inflammatory process has subsided.
Before performing a massage, the patient should empty the bladder. Then the bladder needs to be filled with a solution (20%) using a catheter. boric acid or a weak solution of potassium permanganate.
The person being massaged must be placed on his back with his legs apart and pressed to his stomach. The massage therapist needs to put a rubber glove on his right hand and lubricate the index finger with sterile Vaseline. Then the index finger (palm surface to the anterior wall of the intestine) should be carefully inserted into the rectum, and the thumb of the same hand should be placed on the perineum of the person being massaged. Having reached the apex of the prostate gland, it is necessary to bend the index finger and apply pressure on the intestinal wall from back to front. The technique must be carried out simultaneously with pressure on the perineum, which must be done using the thumb in the direction from front to back from the side of the midline. After influencing the painful Cooper's gland, pressure should be applied to the perineum in the direction from the anus to the bulbous part of the urethra.
The massage should be carried out for 30-120 seconds every other day. After the session, the person being massaged must empty the bladder.
MASSAGE FOR DISEASES OF THE TESTICLES AND APPENDIXES
For diseases of the testicle and appendages, it is recommended to carry out therapeutic massage, which helps reduce pain, improve lymph flow in the presence of stagnation in the testicles, increase the tone of the vessels of the spermatic cord, improve contractile function muscles, etc.
Massage of the spermatic cord
The massage therapist should be on the right side of the person being massaged. The massage therapist should use his left hand to fix the sore testicle and perform massage techniques on the spermatic cord with his right hand:
1. Light stroking.
2. Rubbing from the top of the testicle to the outer inguinal ring.
Massage of the sore testicle and its appendages
Massage of the diseased testicle and its appendages should be carried out only after 2 or 3 massage sessions on the spermatic cord.
First you should act on the appendage:
1. Light rubbing.
2. Pressure stroking in the direction from head to tail. After this, you need to perform the techniques on the spermatic cord again. It is recommended to perform the following techniques on a sore testicle: 1. Pressure stroking.
2. Rubbing, which must be alternated with stroking. All techniques in the testicular area should be done in the direction of the maxillary body. Then you should go back to the spermatic cord.
Massage techniques should be performed every day for 60-120 seconds.
CHAPTER 10. MASSAGE FOR DISEASES OF THE FEMALE GENITAL SPHERE
Massage is widely used for many gynecological diseases. Thanks to it, blood circulation in the pelvic area is significantly improved, the tone of the uterus and its contractility are increased, congestion in both the circulatory and lymphatic systems of the pelvis is reduced, adhesions are resolved, etc.
Massage of the female genital organs, like massage of the male genital organs, should be performed by a specialist who has undergone training and practice in a hospital or clinic.
Massage should only be performed under the following conditions:
1. The patient has a normal temperature.
2. There are no abnormalities in the patient’s vaginal discharge or blood picture.
3. The patient does not have cervical erosion.
4. The patient's bladder and rectum are empty.
5. The abdominal muscles are completely relaxed.
6. The external genitalia are washed well with warm water.
.,7. During the massage, the massage therapist's fingers should not touch the clitoris, cause pain when stretching cicatricial adhesions, etc. In addition, the massage therapist must handle the urethra carefully.
Contraindications for massage:
1. Menstruation.
2. Sharp and subacute inflammation internal and external genitalia.
3. Availability various neoplasms uterus and its appendages.
4. Tuberculosis of the peritoneum and genital organs.
5. The presence of gonococci in the vaginal discharge.
6. The presence of trichomonas colpitis and urethritis.
7. Presence of cervical erosion.
8. The presence of severe pain during and after the massage.
9. Pregnancy.
10. The period after childbirth or abortion for 2 months.
11. During breastfeeding.
12. Congenital malposition of the uterus.
13. Diseases of the genital area in combination with intestinal diseases.
14. Purulent processes in the pelvic organs.
15. The patient has high temperature, third degree of purity of vaginal secretion, acceleration of ROE (above 20 mm per hour).
Massage for gynecological diseases should be carried out on a gynecological chair or on a massage table.
The patient must be placed so that the buttocks extend slightly beyond the edge of the table, the legs are slightly pulled towards the stomach, and the feet are placed on the footrests of the table or chair.
A cushion should be placed under the patient's head.
Before performing a massage, the patient should determine:
1. Position of the uterus.
2. The ability of the uterus to move in different directions.
3. General condition of the uterosacral ligaments.
4. Painful places.
Massage techniques should be performed gently and carefully, without causing pain to the person being massaged. If painful sensations appear, it is necessary to reduce the intensity of movements or stop the massage.
You should massage the uterus with both hands.
Use the index and middle fingers of one hand to perform techniques in the vaginal and pelvic cavity areas, and with the fingers of the other hand - in the abdominal area 
Before performing massage techniques on the hand acting from the abdominal integument and vagina, it is recommended to put on a glove and lubricate the index and middle fingers toilet soap.
MASSAGE FOR WEAKNESS OF THE UTERINE MUSCULATE
If the uterine muscles are weak, massage is recommended. It helps to enhance the contractile function of the uterus, improve blood circulation in the pelvic area, and tone the uterine muscles.
The following techniques are performed:
1. Vibration of the abdominal wall in the midline area above the pubic bone using an electric vibrator for 2-3 minutes.
2. Vibration in the form of tapping in the sacral area for 2-3 minutes.
Massage techniques should be alternated with physical exercise to strengthen the ligamentous uterine apparatus, increase the tone of the uterine muscles, and improve blood circulation in the pelvic area.
MASSAGE FOR BLEEDING,
RELATED TO INSUFFICIENT CONTRACTILITY
UTERINE MUSCULATE
For bleeding associated with insufficient contractility It is recommended to massage the uterine muscles using an electric vibrator. The vibration is performed midway between the navel and pubic bone towards the navel. The electric vibrator is placed almost perpendicular to the abdominal wall.
Massage (from the French massage - to rub) is a set of scientifically based techniques of mechanical dosed influence on the surface of the human body, performed by the hands of a massage therapist, a device or a stream of water.
The mechanism of action of massage is similar to physical exercise.
Massage can be called passive gymnastics.
Massage classification
The following types of massage are distinguished.I. By purpose:
1. Medicinal (used for many diseases).
2. Hygienic (used to promote health, improve functional status, and prevent complications).
3. Sports:
a) preliminary (used by athletes to prepare for training or competition);
b) restorative (used after sports training or competition);
c) training (used in addition to training).
4. Cosmetic (facial massage):
a) hygienic (used for hygienic purposes and to prevent skin aging);
b) medicinal (used for diseases of the maxillofacial area).
5. Gynecological - therapeutic bimanual massage (used in gynecology).
II. According to the method:
- Classical (based on layer-by-layer effects on tissue using four basic classical techniques).
- Segmental-reflex (based on the impact on reflexogenic zones, areas with increased sensitivity).
- Point (impact on biologically active points).
- Other types: periosteal, connective tissue, intestinal, oriental, Swedish, Finnish. These types of massages are rarely used here.
III. By technique:
1. Manual.
2. Instrumental (brush, cup, massagers).
3. Hardware.
4. Hydromassage.
The action of massage is based on complex interdependent reflex, neurohumoral and local processes caused by dosed mechanical action.
Mechanical irritations applied to tissues by special techniques cause excitation of mechanoreceptors designed to convert the energy of mechanical action into the energy of nervous excitation (the initial link in the chain of neuroreflex reactions). Excitation of receptors in the form of centripetal (afferent) impulses is transmitted along sensitive pathways to the central nervous system (spinal cord, cerebellum, functional formations of the brain stem and cortex cerebral hemispheres brain), where it is formed into a general complex reaction and causes various functional changes in the body.
When performing massage techniques, heat is generated in the tissues. Therefore, massage acts as a thermal stimulus and excites the thermal receptor system. The resulting excitation is transmitted to the regulating vasomotor center located in medulla oblongata, and then, moving to the sympathetic and parasympathetic nerves, causes a reflex change in the lumen of the blood vessels.
Massage promotes formation in the skin chemicals, histamine and acetylcholine, which dilate arterioles, mobilize the body's defenses, stimulate muscle activity, increase the rate of transmission of nerve excitation from one nerve cell to another and from a nerve cell to a muscle cell (neurohumoral mechanism of massage).
In addition to neuroreflex and neurohumoral, massage has a mechanical effect on muscle capillaries, which can contract due to Rouget cells located in their walls. However, the lumen of the capillaries is also affected by chemical irritants: adrenaline, norepinephrine, lactic acid, ATP.
For a variety of diseases, massage has a beneficial effect on the normalization of gas exchange, mineral and protein metabolism, promotes the removal of metabolic products from the body, stimulates protective and adaptive mechanisms, as well as factors of specific and nonspecific immunity (N.A. Belaya, 1983).
The most physiological massage is considered to be performed by the hands of a qualified specialist. The duration and intensity of the procedure depend on the nature and activity of the pathological process, the clinical form of the disease, the location of the massaged area, age and concomitant diseases. Based on this, there are indications and contraindications for therapeutic massage.
General indications
General indications for massage in acute diseases are: satisfactory condition of the patient; completion of the acute phase of the disease; periods of early and late convalescence; absence of signs of exacerbation and relapse of the disease, as well as exacerbation of concomitant diseases; patient consent to the procedure.General indications for massage for chronic diseases: completion of the exacerbation phase, satisfactory condition of the patient; absence of febrile temperature, signs of decompensation of the underlying and concomitant diseases.
In each specific case, the indications are determined by the characteristics of the course of the disease, the predominant damage to one or another system, organ, area, etc. In this regard, with the predominant damage to the cardiovascular system, the indications for massage are (N. A. Belaya, 1987 ): ischemic disease heart disease, myocardial infarction, cardiosclerosis, hypertension, hypotension, myocardial dystrophy, heart defects, diseases of the arteries and veins.
Indications for massage for diseases of the respiratory system: chronic nonspecific diseases lungs - chronic pneumonia, bronchitis, emphysema, pneumosclerosis, bronchial asthma.
Indications for massage for pathologies of the gastrointestinal tract along with chronic diseases of this system without exacerbation, there are syndromes that reflect damage to individual digestive organs: esophagitis, gastritis, duodenitis, enteritis, colitis, their combination (gastroenterocolitis, etc.), cholecystitis, cholangitis, hepatitis, pancreatitis, peptic ulcer of the stomach and duodenum, Crohn's disease, ulcerative colitis, allergic and autoimmune diseases, others pathological conditions. The above syndromes often develop with food toxic infections, acute and chronic intestinal infections, acute and chronic viral hepatitis, cholangitis, amebiasis and other diseases.
Diseases of the central nervous system, predominantly of traumatic origin, are often found in general somatic hospitals. Massage is prescribed for injuries, consequences of cerebrovascular accident, cerebral atherosclerosis, cerebral palsy, neurological manifestations of osteochondrosis, consequences of polio, etc.
Indications for injuries of the musculoskeletal system are soft tissue bruises, sprains of ligaments and tendons, fractures and their consequences. Massage is used for rheumatoid arthritis, ankylosing spondylitis-Strumpel-Marie disease, deforming osteoarthritis, scoliotic disease, flat feet.
General contraindications
General contraindications The following are used for massage: the acute phase of the disease, the presence of febrile temperature, hypotonic (collaptoid) conditions, dizziness, severe weakness, bleeding and inclination to it, vascular thrombosis, severe cardiac arrhythmias, circulatory failure of the third degree, blood diseases, purulent processes of any localization , excessive mental or physical fatigue, benign and malignant tumors, general serious condition, Quincke's edema and other severe manifestations of allergies.Contraindications for cardiovascular diseases are: acute myocardial ischemia that occurs suddenly, hypertensive or hypotensive crisis, thrombus-obliterating diseases of the arteries of the lower extremities in the stage of decompensation, vascular aneurysms, aorta, heart, acute inflammation, thrombosis, significant varicose veins with trophic disorders, inflammation of the lymph nodes, blood vessels, pulmonary heart failure of the third degree.
Contraindications for massage in case of respiratory pathology: acute febrile conditions, exudative pleurisy in the acute phase, bronchiectasis in the acute stage (with decay), stage III pulmonary heart failure, active form of tuberculosis, neoplasms, acute trauma and burns of the respiratory system.
With the development of infectious diseases, contraindications are: hemoptysis, acute bronchospasm, croup of degrees II-III, indomitable cough with sputum production, artificial ventilation lungs, inflammatory processes on the skin of the chest (pyoderma, bedsores), etc.
Contraindications for prescribing massage for pathologies of the gastrointestinal tract: pain on palpation of the abdomen, nausea, vomiting and signs of exacerbation of the inflammatory process, a tendency to bleeding, as well as acute inflammatory processes in the pelvic cavity in women, pregnancy, early postpartum and post-abortion period, tuberculosis peritoneum and intestines, tumors of the abdominal organs.
Therapeutic massage is not used for acute (subacute) liver failure, renal failure, toxic hepatic encephalopathy, disseminated intravascular coagulation syndrome, severe diarrhea (colitic) syndrome, ascites, diseases of the skin of the abdomen and related areas.
In diseases of the central and peripheral nervous system, contraindications for massage are: acute pain of various localizations, including causalgia, acute radiculoneuritis with ganglionitis, acute radicular syndrome due to osteochondrosis or another genesis, encephalitis, myelitis with trophic disorders in the acute phase, tumors of various localizations, diencephalic crisis, vasomotor disorders associated with a disorder of the endocrine system, neuroses with affective outbursts, obsession, seizures, sexual neuroses, impotence due to irritable weakness, excessive mental or physical fatigue. Massage is also not performed if symptoms of intoxication (temperature) persist, the process worsens (appearance of meningeal, focal and pathological symptoms), with an unknown diagnosis, complications associated with the underlying disease, and in some other situations.
Contraindications for massage for various diseases are: the presence of a rash of any origin on the skin, hemorrhagic exanthems, “bruises”, staphylo-, strepto- and other dermatitis, bedsores, wounds, aseptic dressings. Do not massage for tuberculosis and skin tumors, eczema, fungal nail diseases, hairy parts body and skin and for some other diseases.
Types of therapeutic massage
As already noted, in clinical practice, classical, segmental reflex and acupressure manual massage are predominantly used.Classic massage
The main techniques of classical massage are stroking, rubbing, kneading and vibration.Stroking
With this technique, the massaging hand glides over the skin, pressing on it and not collecting it into folds. There are planar (superficial, deep), grasping (continuous, intermittent), as well as forceps, rake, comb-shaped stroking, cross-shaped stroking and ironing. These techniques begin the massage, they are included between other main techniques and they complete the procedure. As a result of stroking, lymph and blood flow accelerates, the function of the sweat glands improves, and a hemostimulating effect occurs (V.N. Moshkov, 1954). The effect of this technique is aimed at the superficial layers of the skin (epidermis and dermis).
Trituration
This is a movement of the hand along the surface of the body with deep pressure and displacement of the underlying tissues. As a result, a shift occurs and formation occurs in front of the moving hand. skin fold. Rubbing is performed with the fingers, the edge of the elbow or the base of the palm in a straight line or spiral. Auxiliary techniques are also used: pliers and comb-like rubbing, sawing, hatching, planing. This technique precedes kneading and affects all layers of the skin, including subcutaneous fat and fascia.
Kneading
Designed to target muscles. The essence of this technique is that the massaged muscle is grabbed by the hands, lifted and pulled, and then squeezed and, as it were, squeezed out. There are longitudinal and transverse kneading. Auxiliary techniques include: felting, rolling, sliding, stretching, squeezing, pressing, twitching.
Vibration
The most profound technique with a pronounced reflex effect. A distinction is made between continuous and intermittent vibration. Continuous vibration consists of communicating a series of continuous oscillatory movements to the body. When performing this technique, the massage therapist's hand, pressing on the tissue, does not leave the massaged area and produces trembling movements with a frequency of 100 to 300 vibrations per minute. Auxiliary techniques for continuous vibration include stable and labile vibration, shaking, shaking and nudging. Intermittent vibration techniques: puncturing, tapping, patting, chopping and quilting. They cause vasodilation, hyperemia, decreased sensitivity of nerve endings, increased flow of oxygen and nutrients, and other beneficial effects.
The general requirement when performing a massage is to achieve average physiological state due to the optimal position of the body or its area, at which maximum muscle relaxation occurs.
It must be remembered that different areas of the skin have different thresholds of tactile sensitivity. The least sensitivity of the skin to pressure is observed in the back area along the midline - it is conventionally taken as 1. midline the abdomen has a sensitivity of 1.06, the midline on the chest - 1.39, the flexor surface of the shoulders - 3.01, the dorsum of the foot - 3.38, the wrist joint - 3.80, the forehead - 7.54 (L.A. Kunichev , 1979).
Segmental reflex massage
In 1889, Russian clinician G.A. Zakharyin gave a description of areas of increased sensitivity (hyperesthesia) that occur on the skin due to diseases of the internal organs. More detailed description these zones were made by Ged in 1898. These zones, called the Zakharyin-Ged zones, are often used for massage. Their existence is closely related to the segmental innervation of internal organs.Functional relationships between internal organs and segments of spinal innervation are the basis for the use of segmental reflex massage.
The type of massage under consideration is based on the use of features of the segmental structure of the body: irritation of receptors in certain zones (Zakharyin - Ged) has an effect on the corresponding organs and systems innervated by the same segments of the spinal cord.
The most widely used are segmental reflex massage techniques proposed by A.E. Shcherbak and his staff - collar and lumbar massage. Collar massage is used for hypertension, migraines, sleep disorders, trophic disorders in the upper extremities, lumbar - for vascular diseases of the lower extremities, to stimulate the hormonal function of the gonads and for other conditions.
With the segmental-reflex method, all the techniques of classical massage and its variants are used, taking into account the stage, activity, localization of the pathological process and the patient’s condition.
Acupressure
It is a type of Zhen Ju therapy (Chinese traditional medicine). Acupressure involves influencing biologically active points (BAP) using pressure, rubbing or stable continuous vibration until a feeling of fullness, heaviness, numbness, aching, and the passage of electric current appears.There are three types of acupressure:
1) strong - inhibitory option, which has an analgesic and relaxing effect (time of influence on BAP - 5 minutes);
2) medium - inhibitory option, which has a relaxing effect (time of influence on BAP - 2-3 minutes);
3) weak - stimulating option, which has a stimulating and tonic effect (time of influence on BAP - 11.5 minutes).
For massage, various corporal and auricular points can be used.
The figure shows biologically active points of the foot. By massaging them, you can relieve pain and provide therapeutic effect to certain organs.
Massage should only be performed by a specialist.
Before starting the procedure, he must perform a number of exercises to prepare his hands (A.F. Akhabadze, V.Ya. Arutyunov, 1986):
1. Rise on your toes, arms to the sides - up (inhale), lower, arms down (exhale).
2. Bend your arms at the elbow joints, hands to the shoulders, make circular movements in the shoulder joints.
3. Raising your hands up, at the same time forcefully clench and unclench your fingers in your fists.
4. Relax your hands, raising and lowering your arms up and to the sides, shake your hands.
5. Connect your palms in front of your chest, pressing with tension on the ends of your fingers, tilt your hands to the right and left.
6. Bring your hands together and, with tension, focusing on the ends of your fingers, move your hands to the sides without moving the ends of your fingers.
7. Stretch your arms forward and make circular movements with your hands.
8. Hands in front of the chest, flex and extend the fingers at the inter- and metacarpophalangeal joints.
9. Interlace your fingers and make sideways movements at the wrist joints.
10. Clench your fingers into fists and make rotational movements in the wrist joints.
Massage is a means of preventing and treating diseases, restoring impaired body functions, working capacity (in case of physical and mental fatigue), and one of the ways of physical improvement.
Knowledge of the basics of general, segmental reflex, acupressure massage, their adequate purpose, combination with other methods of restorative treatment, correct implementation of massage procedures (in accordance with the methodology) significantly increases the effectiveness of treatment and MR, and can reduce the percentage of disability in various pathological conditions.
Top picture (according to Konig, Wancura): 1 - headache, dizziness, prolonged labor; 2 - orchitis; 3 - epilepsy, pain in the fingers; 4 - hypertension, palpitations, pain and cramps in the legs; 5 - Yongguan point; 6 - headache, menorrhagia, convulsions calf muscles; 7 - insomnia, pain in the sole.
Bottom figure (according to Bergson, Tiejak): 1 - brain reflexes, 2 - eye; 3 - outer ear; 4 - shoulder; 5 - liver; 6 - gallbladder; 7 - appendix; 8 - thigh and knee; 9 - skeletal system; 10 - sacrum; 11 - sciatic nerve; 12 - small intestine; 13 - bladder; 14 - intestines; 15 - adrenal gland; 16 - pancreas; 17 - stomach; 18 - parathyroid gland; 19 - thyroid gland; 20 - lungs; 21 - trachea; 22— pituitary gland; 23 — cervical region spine; 24 - heart; 25 - thymus gland; 26 - spleen; 27 - kidney; 28 - ureter; 29 - genital area.
Pirogova L.A., Ulashchik V.S.
Therapeutic massage includes almost all types and techniques of massage that affect the body in certain ways. medicinal purposes. Currently this procedure is an excellent remedy for the treatment of many ailments and diseases. With its help, the body begins to restore normal activity. It is used to speed up the body’s recovery after illness and to treat various diseases.
Depending on the nature of the disease, a certain classification can be distinguished. Today there are such types of procedures as:
- For injuries and diseases of the musculoskeletal system
- For diseases of the digestive system
- For respiratory diseases
Depending on how the nature of a particular disease changes, the method of implementation also changes. For diseases of the musculoskeletal system, the technique is used for diseases of the spine and joint diseases. If you have problems with the digestive tract organs, a technique of massage of the stomach, intestines, etc. is performed. If the cardiovascular system is in disarray, the technique is performed for heart disease, hypertension, etc.
For a specific disease, a specific massage technique is performed, which, in turn, depends on factors such as the specifics of the disease, the cause, the clinical form of manifestation and other reasons. That is why, for example, back massage for osteochondrosis differs in the specificity of back massage for scoliosis.
In addition, you need to take into account the fact that at different stages of the same disease, different techniques. Also, the treatment procedure for the same disease will take place differently for everyone, since different organisms perceive treatment in their own way.
Techniques and methods of implementation include:
- Stroking
- Kneading
- Squeezing
- Vibration
- Trituration
Depending on where the movements need to be carried out, on the nature of the disease and on the individual characteristics of the muscles, a selection of techniques is performed. The effectiveness of the procedure can be increased several times if you add types of massage such as segmental to the basic techniques.
With its help, the body recovers from illness much faster
The effect of therapeutic massage on the human body
If the techniques are performed correctly, the technique chosen and the correct dosage, like any other massage, this procedure has a beneficial effect on the body. During the procedure, the patient feels a pleasant sensation of warmth, general condition improves, and vitality increases.
Using this procedure, you can reduce nervous excitability and relieve tension. If the intensity of the techniques is increased, the action will work in the opposite direction. It is also possible to restore reflexes lost by the patient, improve tissue trophism, etc. The functioning of the pathways is restored, reflex connections of internal organs and blood vessels are improved.
The positive effect of massage has also been noticed on the peripheral nervous system. Certain techniques can relieve pain and speed up the process of recovery and treatment after injuries.
Of course, external factors can also affect the positive results and effects of massage. Therapeutic effect decreases if the patient is faced with noise, long lines, loud conversations, etc.
Undoubtedly, the procedure has positive effect and on the condition of the skin and subcutaneous tissue. Through the techniques performed, the skin is cleansed of keratinized particles, foreign microbes and particles. The work of the sebaceous and sweat glands is normalized. Under the influence of massage, the skin becomes firm, velvety, elastic, and skin-muscle tone increases.
The procedure also has a positive effect on the action of skin capillaries; a peculiar opening of reserve capillaries occurs. The massaged area is better supplied with blood and enriched with oxygen. The overall blood circulation of the whole body is significantly improved.
Forms of therapeutic massage
The form of influence of the procedure can be divided into general and specific. General form performed on all parts of the body, but with special attention to those parts and areas of the body that are associated with a specific disease. Typically, a general massage lasts less than 1 hour. Period of execution: every other day or in series, depending on the form of the disease.
A private form of the procedure is performed on specific parts of the body. This could be a leg, arm, hand, finger, joint, etc. The duration of the procedure depends on which organ is being massaged. The duration can vary from 3 to 30 minutes. The private massage technique is carried out according to the general technique, only with special care and a large number of techniques.
What needs to be done before the session:
- The patient should take a position in which his joints and muscles are relaxed.
- The patient's body should be covered with a sheet. Only the parts of the body being massaged should remain open.
- There is no need to change the patient's position during the entire session unless absolutely necessary.
- In the room for the session, you need to create the necessary environment, i.e. exclude the presence of unauthorized persons, noise or bright light.
- Use pillows when necessary. For example, hand massage, back massage for curvature of the spine, etc.
Massage for bruises
Using this procedure, it is necessary to relieve general pain, improve metabolism in the damaged area, accelerate the resorption of swelling, activate muscle contractions, etc.
Main tasks:
- Relieve pain
- Improve metabolism and blood circulation in the affected area
Basic Techniques:
- Alternating and spiral stroking
- Circular and longitudinal kneading (performed in a gentle mode)
- Light patting and spiral stroking
- Longitudinal kneading, circular with two hands, circular with phalanges of bent fingers.
- Stroking and patting.
Massage for high blood pressure
For this disease, this therapeutic therapy has a hypotensive effect. This impact very useful and effective, especially in the early stages of the disease. The technique for arterial hypertension does not include intense movements, having a deep effect on the tissue. IN in this case The technique is aimed at relaxing the body and calming the central nervous system, which is directly related to the pathological narrowing of blood vessels in hypertension.
First, the neck and collar area are massaged, gradually moving to the back area. Each muscle is carefully and slowly worked out. The massage therapist uses techniques such as stroking, squeezing and kneading.
Contraindications
Before you begin massage and physical therapy, you must take into account all contraindications. Namely:
- Acute inflammatory process
- Blood diseases
- Purulent processes
- Various skin diseases
- Varicose veins
- Mental illness
- Acute allergic diseases
Possessing the skills of professional therapeutic massage, specialists take modern medicine and everything connected with it to a higher level. With its help, you can not only solve a health problem, but also improve your overall well-being and vitality.
