General Principles of Massage

1. General Principles of Massage

2. Definition of massage • Recreational massage: The use of a variety of manual techniques designed to relieve stress, promote relaxation and general wellness in a person who has no definable health problem

3. Therapeutic massage: the use of variety of manual techniques designed to promote stress relief and relaxation, mobilize various structures, relieve pain and swelling, prevent deformity and promote functional independence in a person who has a specific health problem

4. Components of massage • Direction of the movement • Amount of pressure • Rate and rhythm of the movements • Media used (including instruments other than hands) • Position of patient and therapist • Duration and frequency of the treatment

5. Basic requirements for therapeutic massage • Ethical Issues: • Privacy of the patient • PT should work without jewelry to avoid scratching the patient • Knowledge of surface anatomy

6. Hand preparations: • Hand must be cleaned and well groomed • Nails should be kept short and rounded • Ideal hands: well-padded, warm, supple and dry • Sensitivity and gentleness, firmness and strength • Never do massage with damaged hands • Wash before and after treatment

7. lubricants: powders, oils and creams • This facilitate movement of hands over body tissues • powder----- baby powder • Soap and hot water----- dirty or dry skin----- after plaster • Oils and creams----- baby oil or olive oil

8. Small amount of lubricants should be used • Excessive lubricants should be removed after treatment • Lubricants should be applied to therapist’s hands rather than patient’s skin

9. equipment: • The treatment table should be: • Adjustable in height • Equipped with a face/nose hole • Made in at least three sections, of which the two end portions can be lifted • Adjustable forearm rests • Casters and lift/lock mechanism

10. Prone pillow supports the head and shoulders • Movable wedge to support the patient while sitting or lying

11. Draping and positioning of the patient: • Patient should be relaxed • Unnecessary body parts should be covered • Room must be warm and quite • Position of therapist: • Therapist should avoid getting injured

12. Physiological effects of massage • Increase blood and lymph flow • Removal of waste products and metabolites • Stimulation of the healing process • Resolution of chronic edema and hematoma • Increase extensibility of connective tissue • Pain relief • Increased joints movement • Facilitation of muscle activity • Removal of lung secretions • Promotion of local and general relaxation

13. Psychological effects of massage • Relief of anxiety and tension • Stimulation of physical activity • Pain relief • General feeling of well-being

14. Principal use of therapeutic massage • To aid general or local relaxation • To relief pain • To treat specific problems: Chronic edema Scar tissue Lesions of muscles, tendons, ligaments, or joints Chronic constipation Facilitation of movement Prevention of deformity

15. General contraindications of massage • Acute infection (bones, joints, skin, muscle, subcutaneous tissue) • Skin disease • Cancer or tuberculosis in the area to be treated • Presence of foreign bodies (glass) • Disease of blood vessels • Massage may be given, but with great care, to patients who have marked varicosity of the veins, or gross edema

16. General precautions • Obtain an accurate medical diagnosis • Perform an appropriate physical examination, and use massage in combination with other rehabilitation techniques • Check carefully for possible contraindications • Drape, position, and support the patient properly • Ensure a high standard of cleanliness • Perform the massage properly while monitoring the patient’s response • Assess and document the patient’s response to treatment so that modifications can be made if necessary

17. Classification and description of massage strokes • Stroking • Effleurage • Petri sage (pressure) [kneading, picking up, wringing, skin rolling] • Tapotement (percussion) [clapping, beating, hacking, pounding] • Vibration • Shaking • Friction

18. Therapeutic effects of: • Effleurage, stroking, skin rolling: stimulation of superficial blood and lymph flow, mobilization of skin and subcutaneous tissue; promotion of local and general relaxation; relief of pain • Kneading, wringing, picking up: mobilization of muscle tissue; stimulation of deeper circulation; promotion of relaxation; relief of pain

19. Hacking, beating, pounding, clapping: stimulation of muscle activity and deep circulation • Clapping, vibrations, shaking: mobilization and removal of lung secretions • Deep friction: mobilization and pain relief in tendons, muscle, ligaments, and joint capsules

20. Massage is not used only as a technique of treatment, but it is a very useful assessment tool, can be used to assess muscle tone, spasm, contracture and stiffness