General information about massage, therapeutic massage. Therapeutic (medical) massage

Therapeutic massage is one of the most ancient ways to strengthen and improve health. It appeared when a person had no medicines, no medical science. For centuries, methods have been improved, and now modern doctors use massage as one of the highly effective means for the treatment of many diseases.

The main benefits of therapeutic massage are: wide range actions, not a large number of contraindications, beneficial effect on the general state and the fact that the treatment is carried out without the use of medications.

In a previous article, we mentioned that massage and manual therapy should not be confused. Massage affects the skin and soft tissues, while manual therapy- this is work with joints, ligaments, muscles, bones.

Therapeutic massage is effective:

1. for general strengthening of the body;
2. during rehabilitation after an injury or illness;
3. as part of complex therapy or how independent remedy for the treatment of diseases:

• of cardio-vascular system,
• nervous system,
• musculoskeletal system,
• joints,
• digestive systems s,
• respiratory tract,
• as well as the treatment of flat feet, obesity, salt deposits, posture disorders, neuritis and neuralgia, blood pressure, disorders in the field of gynecology, ophthalmology, dermatology.

Of course, the appropriateness of the massage should be determined by the attending physician. Depending on individual indications, he decides which massage is necessary, how often and how many procedures the patient needs to achieve positive result treatment.

Therapeutic massage can be of different types and gives significant results only when it is prescribed by a doctor and performed by a highly qualified massage therapist.

There are the following types of therapeutic massage:

1. Classic

It is produced directly in the affected area or in the area adjacent to it. We use the usual techniques for us without taking into account the reflex component.

2. Spot

Techniques are used classical massage, as well as reflexogenic points are being worked out. Impact on such points affects the organs associated with them, relieves pain, relieves spasm and nervous tension.

3. Periosteal

It implies an impact on pain points that have a reflex connection with damaged systems and organs. It is effective for the treatment of the musculoskeletal system and joints.

4. Connective tissue

As the name implies, this type of massage affects the connective tissue in reflex areas.

5. Reflex

Impact on internal organs through certain areas of the skin. It is carried out by stimulating the nerve endings associated with the spinal cord, which send impulses to the organs.

6. Hardware

This massage is performed using devices that use various technologies of exposure: ultrasound, radio waves, infrared radiation, electrical impulses, vacuum, vibration, mechanical impact with a roller massager. Sometimes the device implements a combination of effects, such as vacuum-roller massage.

7. Self-massage

You can massage yourself, but how and in what cases, the attending physician should explain.

Once again, we emphasize that therapeutic massage is medical procedure, and therefore, it is necessary to strictly observe the appointments. The doctor will determine the type of massage, as well as the number and intensity of procedures. Massage is a course procedure, and results should not be expected from one session.

The Apecsmed clinic employs qualified neurologists and massage therapists. We prescribe massage both in complex therapy and separately for the successful solution of the above-mentioned health problems.

Massage is ancient remedy to get rid of many diseases. Its therapeutic effect is based on the stimulation of blood circulation and metabolism, calming and relaxing effect on the nervous system.

The effect of massage on injured muscles and ligaments, with scoliosis and for recovery from fractures is very effective. After it, the pain passes faster and the mobility of the joints is restored.

The most common problem of our time is back pain. They affect not only the elderly, but also young people. Their main cause is disease. intervertebral discs, or osteochondrosis. Most often this comes from stress, weakness and underdevelopment of the muscles that support the spine.

Constants can lead to depression, disturbances in the work of all organs. Therefore, you need to start fighting them as early as possible. The main treatment for all diseases of the spine is a back massage. Therapeutic effect it is due to the fact that weakened ligaments are removed and strengthened. This helps to relax, and the vertebrae are not pressed against each other so much.

The back stimulates blood circulation and opens the flow of oxygen and nutrients to the affected areas. It helps relieve swelling

and inflammation, reduces discomfort.

Therapeutic for any localization of pain should be along the entire length of the spine. It is advisable to massage the limbs associated with the inflamed area, be sure to act on the neck and collar zone to improve blood circulation in the brain.

A therapeutic massage begins with stroking the entire back. Then kneading and rubbing of areas with less pronounced pain occurs. Techniques such as vibration, patting, sawing are used. All movements are performed towards the lymph nodes. They need to be alternated, done without interruptions, stroking is recommended between movements.

After warming up the entire area of ​​the back, neck and chest you can move on to massage areas of pain. In the acute stage, intensive exposure cannot be carried out. At

sciatica in the lumbar region, it is good to massage the pelvic region and gluteal muscles.

When you start a therapeutic back massage for a person with back pain, the first session should be no more than 10 minutes. With a decrease in pain, the duration of treatment increases. Then you can more intensively influence the affected area.

Neck massage should be more gentle. Strong pressure and kneading are excluded. An incorrectly performed procedure can cause muscle spasms and increased pain.

The movements of the massage therapist should be unsharp, calm, smooth and rhythmic. The duration of the session should not be delayed. During massage, you should monitor how the patient feels.

You can not do therapeutic back massage with acute inflammation, exacerbation and skin diseases. But even in the absence of back pain, it is recommended to do this procedure at least twice a year.

1.2.3. Fundamentals 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 damage. 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.

Methods of therapeutic massage. 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 tactilely control the accuracy of the techniques and evaluate their results, etc. Manual massage has an advantage over hardware, foot and combined, as it can be used not only in the ward, massage room, but also at home, in a bath, bath, etc., as well as in the form of self-massage.

Hardware massage method used as an extra. Depending on the varieties, it can be performed both by direct contact with the skin, and through air or water. Among the varieties of the hardware method of massage, vibration, hydro- and pneumatic massage are most widely used. In medical practice, electrical stimulation, ultrasonic massage, etc. are also used. 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. A combination massage is a massage in which manual and hardware massage is used.

Foot massage method performed with the help of the feet: the heel, fingers, and knees, most often in sanatorium conditions, in water clinics and baths.

Especially it is necessary to emphasize the great effectiveness of manual massage, since only with the hands of a massage therapist can identify changes in the tissues of the massaged area, highlight the necessary points and purposefully influence them. Without denying the positive impact of hardware massage, in medical practice nevertheless, it is 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 in which it is used: massage for injuries and diseases of the musculoskeletal system, massage for diseases and injuries of the nervous system, massage for diseases of internal organs, etc. Each group of diseases is characterized by its own characteristics of the technique and methodology of the massage session. For each disease, the massage technique depends on: etiology, pathogenesis, clinical form, course, and is differentiated in connection with these factors.

Methodological features during therapeutic massage. Massage is a more adequate therapeutic effect in the first days after injuries or diseases than exercise therapy. Therefore, to achieve a greater effect of the therapeutic effect, massage should be carried out before physical exercises, and if necessary, again after them. Technique and methodology for conducting techniques in therapeutic massage are similar to those in hygienic, sports and other types of massage, namely: stroking - combined, longitudinal, alternate, etc.; squeezing - with the edge of the palm, the base of the palm, etc .; kneading - double ring, double neck, pads of 1-4 fingers, the base of the palm, etc .; rubbing - "nippers", fingertips, fist comb, etc .; shaking; vibration; movements, etc. The choice of techniques for creating a specific technique for a massage session depends on the disease and clinical forms its currents. The therapeutic massage technique provides for methods of focal and extrafocal, or segmental-reflex, effects, a sequence of techniques, their combination with movements, and a gradual increase in exposure.

Dosing of massage is carried out by: localization of exposure segments, choice of techniques, depth and area of ​​impact on tissues, number of massage manipulations, speed and rhythm of movements and their amplitude, duration of procedures and their alternation 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 carried out 1-2 times daily or every other day. The course of treatment - from 10 to 18-25 procedures, a break between courses - 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 therapies, especially physical factors, 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 indiscriminate techniques can cause adverse responses, up to an exacerbation of the process. The same negative reactions occur when a massage is prescribed at a time when the massage is not yet shown. It is important to take into account that when massage is combined 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 a part of the body remote from the focus of exacerbation, or the procedures should be canceled, resuming them after the removal of acute phenomena at the discretion of the doctor in accordance with individual indications.

Massage should be performed along the lymphatic tract towards the nearest lymph nodes, which cannot be massaged. The position of the patient should exclude the tension of the massaged parts and the whole body. Massage techniques should not cause pain.

The duration of a massage session depends on the disease, body area, body weight of a person, his age and current condition, etc. The first massage sessions are always short, gentle, and then the time and strength of the impact increase. The time for performing individual massage techniques depends on the massaged parts of the body, the nature of injuries or diseases, as well as the patient's well-being. The right choice of techniques largely determines the effect of the therapeutic effect of massage.

When conducting massage for the purpose of treatment and rehabilitation, there are the following contraindications.

Acute febrile state and acute inflammatory processes.

Bleeding, bleeding.

Diseases of the blood.

Purulent processes of any localization.

A disease of a skin-infectious, unexplained 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 vessels and heart.

Inflammation of the lymph nodes and blood vessels. Enlarged, painful lymph nodes, soldered to the skin and underlying tissues.

Allergy with hemorrhagic and other eruptions. Hemorrhages in the skin.

Excessive mental or physical fatigue.

active form of tuberculosis.

Syphilis of the 1st-2nd stage, AIDS.

Chronic osteomyelitis.

Causalgic syndrome after injuries of peripheral nerves.

Malignant tumors of various localization.

Mental illness, with excessive excitement, greatly altered mind.

In some cases, contraindications to massage are temporary and after an acute inflammatory process, a feverish state, a purulent process, an exacerbation of a disease of the autonomic nervous system, etc. massage can be applied (according to indications). Massage should also be prescribed after radical removal of the tumor. It often happens that massage can 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 the massage technique for individual parts of the body is necessary as a basis for the subsequent mastery of private massage techniques for diseases and injuries. Only this approach to the study and application 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 massage should be applied and constantly monitor the patient in the process of applying this method of treatment and rehabilitation.

The combination of therapeutic massage with exercise therapy and physiotherapy. In many cases, it is advisable to combine massage with various physiotherapeutic procedures: water, phototherapy, electrotherapy, etc. Physical therapies prepare body tissues for massage. For example, it is advisable to pre-warm the limbs, the skin temperature of which is lowered (paresis, paralysis), or to reduce pain so that the massage can be deepened, etc.

Massage and thermotherapy. Heat greatly enhances the physiological effect of massage, causing active hyperemia of tissues, reduces muscle excitability, relaxes spasm of muscles and blood vessels, and significantly reduces pain. Therefore, in case of traumatic and inflammatory lesions of the articular-ligamentous and muscular apparatus 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, ozocerite, steam room , bath, etc.).

The sequence of thermal procedures and massage in each case is determined by special indications. So, with functional disorders of the musculoskeletal system (joint stiffness, articular adhesions, delayed formation callus, muscle atrophy, paresis, neuritis and neuralgia) it is recommended to apply heat first and then massage. In case of vascular disorders (swelling of tissues 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 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. In case of injuries and diseases of the organs of movement (cicatricial adhesions of tissues, myogenic, arthrogenic contractures, joint stiffness, myofibrosis, myosclerosis of tissues, etc.), as well as injuries and diseases of the peripheral nervous system (lumbosacral sciatica, neuromyositis, etc.) first apply thermal, water procedures, and then massage; in case of severe pain syndrome, the massage is preceded by a hydrotherapy procedure.

General massage and general light bath should not be prescribed on the same day. Incompatible by the nature of the reaction, for example, ultraviolet irradiation and massage or Charcot's shower and massage.

Physiotherapeutic procedures are not a very big 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 an impact. The methods of reflex action on the human body by pressure (pressure) include segmental, point, connective tissue, periosteal and other types of massage. Their essence lies in the impact of certain techniques on certain parts of the body, zone or points of the skin surface, periosteum and other tissues of the human body. At the same time, it should be noted that the reactions of the body, depending on the type of exposure, are completely different. These reactions are called reflex, and the method of exposure (treatment) based on their use is called reflex therapy.

Segmental massage. Based on the physiological principles and theoretical provisions 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 effectively used in clinical and spa practice in our country.

Segmental-reflex massage provides a direct effect not on the diseased organ, but on the zones innervated by the same segments spinal cord(Table 1), i.e. indirectly affecting the mechanisms of pathogenesis. For example, by massaging the corresponding paravertebral zones and the epigastric region, one can influence the motor, secretory and evacuation function of the stomach; in case of vascular diseases and injuries of the lower extremities with a massage of the lumbar region - a positive effect on blood circulation, trophic processes in tissues and their regeneration, improve the recovery of motor functions. Chest massage can contribute to the elimination and resorption of residual effects after inflammation of the lungs and pleura and prevent the development of adhesions; massage of the collar zone - reduce blood pressure with hypertension, eliminate headaches with neuroses and fatigue.

All tissues, organs and systems of the human body are a single whole and are interconnected in certain relationships. Therefore, no 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 contribute to the elimination of the primary pathological process and the restoration of the normal state of the body.

The interconnections of our body are carried out by viscerosensory, viscero-motor and viscero-visceral reflexes, which are of great importance in clinical practice.

Areas of the skin surface with increased sensitivity, in which pain occurs in diseases of the internal organs, are called Zakharyin-Ged zones. The Russian clinician G. A. Zakharyin first described them in 1889. In more detail, the connections of various internal organs with certain areas of the skin are described by Ged in 1893-1896. Physiologically, the appearance of hypersensitivity zones is explained by the fact that pain stimuli coming through the sympathetic fibers from the internal organs to the spinal cord radiate to all sensitive cells of this 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 symptoms, pain occurs in the left arm, on the inner surface of the shoulder, in the armpit, near the shoulder blade. 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, prolonged painful tensions of the skeletal muscles sometimes occur. 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 be manifested by thickening or limitation of skin mobility, seals in the subcutaneous tissue.

Establishment of functional links between all parts human body laid the foundation for the development of segmental-reflex methods in physiotherapy, including massage. Studies have shown that by influencing physical factors on the surface of the body in certain areas, 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 zones was determined. So, the cervical-occipital and upper chest regions (collar zone) include the skin of the back of the neck, neck, shoulder girdle, upper back and chest. All this skin area is closely related to 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 region of the autonomic nervous system is associated with vegetative centers 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 limbs. 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 autonomic activity of the body is concentrated, and to receive a reflex response in the form of a variety of physiological reactions from organs and tissues (metabolic processes, thermoregulation, etc.).

The lumbosacral region includes the skin of the lower back, buttocks, the lower half of the abdomen and the upper third of the front of the thighs. All this skin zone is closely connected with the lower chest (D 10 -D 12). lumbar and sacral segments of the spinal cord, with the lumbar part of the sympathetic division of the autonomic nervous system and its parasympathetic centers. When the 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 small pelvis, in the intestines and lower extremities. Based on experimental studies and clinical observations, 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 the upper limbs, etc., the second - for vascular diseases and injuries of the lower limbs, to stimulate the hormonal function of the sex glands, etc.

Segmental reflex massage differs from classical massage in that, in addition to affecting the affected organ, there is an additional extrafocal effect on the affected tissues, organs and body systems. In the clinic of internal diseases, where direct massage of the diseased organ is not available, segmental reflex massage is of particular importance. With 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 the muscles, articular-ligamentous apparatus, concussion of the chest, pelvis, internal organs, etc. In addition, special techniques are used: drilling, moving, sawing, etc. tricks segmental massage should be carried out rhythmically, gently, without rough effort, after giving the massaged segment of the body a mid-physiological position. In addition to the accepted directions of massage manipulations in segmental-reflex massage, specific directions of movements are also carried out, determined by the functional structure of the spinal innervation segment and its neuro-reflex connections. Under the term segmental massage imply not only the impact at the level of a certain segment of the spinal cord, but also a special massage technique. The peculiarities of the segmental massage technique are a consistent differentiated effect 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 the joints, fascia, tendons, ligaments. On the muscles, pressure, muscle shifting is applied. The shifting of the vertebrae is also used.

The technique of using segmental massage:

start a massage session with superficial tissues;

start from the lower segments, gradually move to the higher departments, for example, from D8-D1;

it is advisable to start performing techniques with segmental roots at the exit point at the spinal column.

Acupressure. Unlike segmental massage, with acupressure, narrowly limited point areas of tissues are massaged. It has been established that acupressure has a mechanical, humoral, reflex and bioelectric effect. It is carried out at the same points that are exposed to a needle or a wormwood cigarette in the therapeutic method of acupuncture and moxibustion. These medical 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 are described, but 100-150 of them are most often used. In the mechanism therapeutic effect biologically active points(BAP) are complex reflex physiological processes. When a particular zone or point of the skin is irritated, a response can be elicited at the level of a certain organ in a zone that has no visible anatomical connection with the irritated one.

Studies of biologically active points have shown that exposure to a point excites or calms (depending on the method) the autonomic nervous system, enhances arterial blood supply, regulates the activity of 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 electrical skin resistance, high electrical potential, elevated temperature and pain sensitivity (hence the term pain point massage) a higher level of metabolic processes (V.I. Ibragimova, 1983). Pressure, rubbing at these points causes a feeling of ache, numbness, acute pain(similar sensations do not occur with pressure and rubbing 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 at the locations of large vessels is not shown. 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 recovery, but does not replace them.

Method for determining points. On palpation, the location of the BAP is revealed 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 by topographic maps, diagrams and drawings informing about the location of points, as well as using ELAP, ELAP-VEF, ELITE-04, "Reflex - 3-01" devices.

Point massage technique. Depending on the technique of influencing a local point, the method can be exciting or calming. So, with violations of muscle tone, with an increase in it, contractures of a central or peripheral nature (spastic paralysis, paresis, cerebral palsy, contractures of the muscles of the face with complicated neuritis facial nerve), as well as for pain, especially of a muscular, articular nature, the task of exposure is relaxation, relaxation, sedation, i.e. sedative effect. At the same time, a braking, sedative method is used: within 1-2 s, they find the necessary point, within 5-6 s, perform rotational movements clockwise, deepen, pressing on this point and gradually increasing the effort, 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 for 1 minute in a sedative way, 4 entries and exits are made, each for 15 seconds, if it is necessary to act for 2 minutes, then 8 entries and exits are made). With each impact, the pressing force on the point increases depending on the sensation of the person being massaged (bursting, numbness, soreness, warmth, etc.).

With phenomena low tone, atrophy of muscle groups, neuritis of individual nerve trunks, paresis, a stimulating (toning, exciting; acupressure technique is used: a point is found for 1-2 s, then rotational movements are carried out clockwise for 3-4 s, “screwing” the finger and pressing on point, and then sharply torn off from the point, just like a bird beats with its beak, this movement is repeated 8-10 times at one point (40-60 s).Such an impact on the points is carried out in a certain sequence, purposefully, according to the recommendations for the corresponding disease , syndrome Fig. 1 shows the position of the fingers and hand when performing acupressure.

Connective tissue massage. Areas of tissues with increased stress are referred to as connective tissue zones. Here there is limited mobility of the skin, which can be determined by palpation. With diseases of some internal organs or with functional disorders in them, mobility connective tissue may be completely absent (for example, in severe angiopathy). Massage of reflex zones located in the connective tissue is called connective tissue massage. The technique of its implementation consists in influencing tense areas of the connective tissue (most often with the tips of the 3rd and 4th fingers). At the same time, in places with pronounced tension, an acute sensation arises, resembling a cutting movement with a fingernail or a sharp pinch of the skin.

Connective tissue massage according to the method of execution is divided into 3 types:

skin, when only the skin is displaced, and the subcutaneous layer is not affected;

subcutaneous, when the subcutaneous layer is displaced, and the fascia is not affected;

fascial, when the displacement is made in the fascia.

The basis of connective tissue massage is the tension of certain receptors (mechanoreceptors of the skin, subcutaneous tissues and vascular connective tissue), which causes various reflexes that can affect the organs innervated by the autonomic nervous system.

Periosteal massage. The effect of periosteal massage (according to the classification - pressure massage) is directed to the bone surfaces or periosteum (it is carried out with the fingertips or interphalangeal joints) and lies in the fact that blood circulation and cell regeneration increase in the place of pressure, mainly in the periosteal tissue, and there is a reflex effect on organs connected by nerve pathways with the massaged surface of the periosteum. There are experimental data that allow us to say that after periosteal massage in the region of the cervical vertebrae or the occipital region, visual acuity increases, and after massage in the region of the ribs and sternum, the 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 aid in the treatment of patients with impaired respiratory function. It is especially useful for a sharp decrease in the respiratory 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 to the painful point, the soft tissues covering it (primarily muscles) are shifted to achieve the best contact with the periosteum, and, gradually increasing pressure, they press on it, simultaneously performing rhythmic small circular movements. Then also gradually reduce the pressure, without interrupting contact with the skin. Cycles of increase and decrease in pressure last 4-6 s and are repeated for 2-4 minutes. After influencing each point with the tip of the thumb (or tubercle of the thumb), a squeeze is performed. 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 (ODA). The objectives of massage for musculoskeletal injuries are as follows:

in strengthening 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 area of ​​damage;

in accelerating regeneration processes, in particular, the formation of callus in case of bone fractures;

in relieving muscle tension;

in preventing the formation of contractures and stiffness in the joints; muscle atrophy.

Massage, due to mechanical action and reflex influence, enhances blood and lymph circulation in the area of ​​damage, improves trophism and promotes the speedy healing of the damaged link of the musculoskeletal system.

Under the influence of massage, elasticity improves and the 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 bruise (if there is no rupture of large vessels and muscles, thrombosis). Massage is started above the injury site, stimulating the outflow of lymph and blood from the bruised area (suction massage technique). Stroking, light kneading and squeezing techniques are used in the direction of the nearest, upstream lymph nodes. In the absence of pain, you can begin to massage the bruised area, the intensity of exposure depends on the sensation of the patient. At the first massage session in the bruised area, they are limited to light stroking techniques. As the pain decreases, stroking begins to alternate with light rubbing and gentle kneading with the fingertips, 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 next - 18-20. Gradually, passive movements and active exercises are added to the massage.

Massage for sprains. Massage begins on the 2nd-3rd day after stretching. The affected limb fits into several exalted position, and massage begins above the lesion, using mainly stroking and rubbing techniques. From the 3rd-4th procedure, rubbing and active movements in the joint are added, gradually increasing the range of motion. Massage is best done after thermal procedures.

With dislocations, massage begins after reduction and temporary immobilization with working out the muscles surrounding the joint, using stroking and kneading. Later, they begin to rub the articular elements and perform movements in the joint.

Massage for fractures. With open fractures, massage is contraindicated (danger of infection of the wound), with closed fractures, massage and therapeutic exercises are essential elements of the 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 a healthy limb is useful. After removing the immobilization, a suction massage is applied first, and then the fracture site is massaged using intermittent stroking, and a little later, rubbing and kneading the muscles. With a slow fusion of fragments in the area of ​​injury, more active techniques are used: chopping, patting, tapping with a wooden mallet, vibration, with cicatricial contractures on the side of stretched and weakened muscles, deep stroking is used, then kneading and light tapping. For stretching scars and adhesions, such techniques as stretching, shifting, forceps-like rubbing and crossing are shown, for stretching muscles with muscle contractures - flat and covering stroking. Massage should be combined with gradual redressing - stretching of muscle contractures with hands with light swaying movements in the joint.

In case of traumatic injuries, it is also necessary to act on the corresponding reflex-segmental area. So, in case of damage to the upper limb, paravertebral zones are massaged in the area of ​​the exit of the nerve roots of the spinal cord to the right and left of the cervical-occipital and upper thoracic spine, in case of damage 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 of movements in the joint; contribute to the restoration of normal range of motion in the joints; strengthen muscles, prevent muscle hypotrophy and increase their performance; prevent the development of contractures and stiffness in the joints.

Arthritis massage. The first procedures are carried out according to a sparing technique without a special effect on the joints, with the help of stroking and light kneading, trying to relieve tension in the muscles. From the 2nd or 3rd procedure, the muscles surrounding the affected joint and the joint itself are affected. During massage, it is important to be able to determine how the muscle tone has changed: whether it is increased or decreased, to find areas of muscle thickening and knots, differentially influencing these changes and trying to eliminate them. So, it is necessary to influence areas of reduced muscle tone with strong techniques - rubbing, kneading, acting slowly. In the area with muscle hypertonicity, on the contrary, soft tricks and continuous vibration are shown. With the defeat of the upper and lower extremities, the patient can be massaged when he lies and sits, achieving maximum relaxation of the muscles.

The duration of the massage procedure for one limb in the first procedures is 5-7 minutes, in the subsequent 10-15 minutes, for the course - 15-17 procedures, after 0.5-1 month the massage course can be repeated.

Massage for arthrosis are carried out more intensively, using all the techniques of classical massage, depending on clinical features manifestations of the disease and its severity. A lot of time is devoted to rubbing the articular elements and strengthening the muscle groups around the joint, combined 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 minutes at the end, in total 10-12 procedures.

Massage for diseases and injuries of the nervous system and osteochondrosis of the spine It is also used for vegetative disorders and neurosis 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 with spastic incisions and paralysis should be carried out with great care. Before the massage, the diseased limb, if possible, is warmed 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, it is necessary to use only the methods of superficial stroking and light rubbing.

Massage starts from the lower extremities, from the proximal sections. Muscles in which the tone is increased are massaged with gentle, soft strokes and rubbing 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 impact on trophic processes, massage the paravertebral spinal segments - for the upper limbs - cervicothoracic - (C 5 -D 1); for the lower extremities - lumbar - (L 1 -S 2). In view of fatigue for patients, the duration of massage with spastic paralysis at the beginning of the course is 6-8 minutes, gradually increasing to 15-20 minutes.

The use of massage in 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. With bilateral lesions - flaccid tetraplegia or tetraparesis - a paired massage is used by two massage therapists.

Massage for neuritis and neuralgia is used to reduce pain, improve tissue trophism and nerve conduction, and improve sensitivity. The corresponding paravertebral zones are massaged, along the course of the nerve, the exit points of the nerve and the places of irradiation of pain. In the presence of severe pain, massage is carried out according to a sparing technique using mainly stroking and gentle rubbing.

Massage for neuritis of the facial nerve has some specifics. AT acute stage massage easily (sparingly) the healthy half of the face. On the affected side, massage is started 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 in front and behind; rubbing and vibration along the course of the nerve. They also produce skin vibration of paralyzed muscles. The duration of the massage is 3-5-8 minutes daily. Course 15-18 procedures.

Massage for diseases of the cardiovascular system aims to eliminate congestion in the small and large circles of blood circulation, improving blood flow to the heart, developing collateral circulation, normalizing blood pressure, improving the adaptation of the cardiovascular system to changing external conditions, increasing physical activity. Massage of the chest enhances its suction action, facilitating the work of the heart, and reduces congestion. It is also indicated for hypertension, neurocircular dystonia, angina pectoris, post-infarction condition, myocardial dystrophy. cardiac neurosis, heart disease in stage of compensation, chronic myocarditis, circulatory failure, vascular diseases (varicose veins, obliterating endarteritis). In diseases of the heart muscle (IHD, myocardial dystrophy, myocarditis, cardiosclerosis), a general massage is indicated, which is recommended to start from the back, where a large skin surface and muscles with an abundant network of capillaries are located relatively superficially. Thanks to the massage, which causes the expansion of the capillary network, the blood flow in the periphery increases, which greatly facilitates the work of the left ventricle of the heart.

Massage begins with stroking and kneading the interscapular region. Then the shoulder girdle is massaged in the direction from the spinal column to the shoulder joints and shoulder blades, the back and side surfaces of the neck. After stroking, rubbing and kneading the same areas are performed. Then, gentle stroking of the heart area, rake-like stroking and rubbing of the intercostal spaces from the sternum to the spinal column are carried out, at the end, shaking and gentle tapping of the chest are performed. After that, circular strokes and rubbing of the area of ​​​​the mastoid processes of the temporal bone and the occipital protuberance are used, alternating them with stroking the neck and shoulder girdle. Then, light tapping is performed along the spinous process of the VII cervical vertebra and the upper and lower limbs 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.

Therapeutic massage for the back is effective method therapy various pathologies musculoskeletal system. It's the same important element treatment, such as recreational gymnastics, physiotherapy or the use of medications. But in order to achieve maximum therapeutic effect when massaging the back, you need to follow some rules. Otherwise, you can harm an already weakened body. Read more about the performance of therapeutic massage and will be discussed in this article.

First of all, massage is considered a passive form. physical activity, since during its implementation the tone of the muscular skeleton of the back increases. Proper execution procedure allows you to remove the emotional and physical stress, stress, and also has a general calming effect on the body.

Massage is a passive physical activity

The main benefits of therapeutic massage include:

On a note! With the help of healing, you can not only stimulate the nervous system, but also increase immunity, thereby protecting the body from various ailments. It is worth noting that this procedure also has a beneficial effect on the work of internal organs.

Varieties

Depending on the method of execution, therapeutic massage is divided into several types, including:

If you want to learn more about the execution technique, as well as consider the benefits of this procedure, you can read an article about this on our portal.

Back massage can also be classified according to the features of its purpose. In medicine, there are such types:

Each of these types of massage has its own characteristics and benefits. Often, when treating a particular ailment, doctors prescribe several types of massage at once. This allows you to speed up the healing process and prevent unpleasant consequences.

Indications and contraindications

As a rule, spinal massage is most often prescribed for damage to the nervous system or spine. Consider the main indications for its implementation:

• sprain, abnormal development of the spine, the consequences of previous injuries;
• pain in the back;
• decline muscle tone;
• development of sciatica;
• the appearance of various scars or scars on the surface of the back;
• work problems musculoskeletal system person;
• mild forms of some diseases of the spine (in such cases, doctors prescribe therapeutic exercises in combination with massage procedures).

Despite the large number positive properties, therapeutic back massage has contraindications that must be taken into account when treating a particular disease:

• mental disorders;
• period of pregnancy;
• poor blood clotting;
• development dermatological diseases or consequences mechanical damage in the form of hematomas, abrasions or wounds in the back;
• development malignant formations, tuberculosis;
• problems with the respiratory or cardiovascular system;
• increase in body temperature;
• course of disease infectious nature(SARS, influenza, etc.);
• acute form of diseases of the spine, accompanied by pain.

On a note! To avoid serious consequences You should definitely consult with your doctor before massage. In this case, the help of a neuropathologist and a therapist is required. Only after conducting appropriate studies, the doctor will be able to determine whether it is possible to start a back massage.

Features of the massage

Of all reflex zones human body the back is the largest. In addition, some of its parts are responsible for the functioning of internal organs. From all this we can conclude that a properly performed back massage has a positive effect on all internal organs and systems of the human body.

During the massage, the specialist carefully treats the muscles and joints, due to which the body has a tonic and relaxing effect. But depending on the course of a particular disease, doctors prescribe different types massage therapy. Therefore, it is highly not recommended to engage in therapy on your own, without consulting with your doctor beforehand. Below is step-by-step instruction performing massage, which is used in medicine most often.

Table. Back massage technique.

If you want to know in more detail what types and features of massage are, as well as how to do it, you can read an article about this on our portal.

To improve efficiency massage treatments, they are recommended to be carried out before therapeutic gymnastics. In this case, the exercises will be performed already sufficiently warmed up by the body. In addition, after a massage session, all tension will be removed from the muscles, and the metabolism will accelerate significantly.

Video - Secrets of the master of therapeutic back massage

Massage is a mechanical effect on the tissue of the human body with the help of various physical actions: stroking, rubbing, kneading, pinching, tapping and vibration. After the adoption of massage procedures, the patient's tone increases, stress is relieved and efficiency increases.

The receptors of the skin and muscles of the patient receive a mechanical effect, which is transmitted to the central nervous system. This transmitted signal depends on what techniques and massage techniques were used. Massage techniques can be both stimulating the tone of the body, and relaxing. Also competently applying during the massage special massage oils and creams in parallel with the right tricks on the different areas body of the patient, you can achieve a relaxing or stimulating effect.

Mechanical impact on muscle tissue leads to expansion blood vessels, due to which the blood supply to the massaged areas of the body and the whole organism as a whole increases. Human muscles begin to receive more nutrition, begin to relax, their mobility increases, and pain from tension recedes. During the massage, the nutrition of the skin tissue increases, the skin becomes more elastic and resilient. By stimulating certain parts of the body, you can improve the functioning of internal organs.

One of the most popular and ancient types of massages is the therapeutic classical type of massage. It is prescribed for many diseases and injuries. If there are no contraindications, it can be performed in chronic or exacerbated diseases. With a general classical therapeutic massage, the patient is massaged: upper and lower limbs, back, abdomen, chest and most of of the whole body.

Daily life in modern world often gives a person stressful situations, due to which the normal activity of the human body or its individual systems is disturbed. No less harm to human health is the frequent load on his musculoskeletal system. Applying as prophylactic this medicinal look massage, you can relieve fatigue, gain confidence, increase efficiency and thereby reduce the risk of diseases.

The sequence of actions during the general classical therapeutic massage

With this procedure, the back is first massaged, then the shoulder girdle and neck are massaged, then gradually the masseur begins to massage the lower back and upper part buttocks. After that, the back surface of the legs and the lower part of the buttocks are massaged. At the next stage, the patient lies on his back and his stomach, legs and chest are massaged. The last step in this procedure is massaging the front and back of the hands.

During the procedure of general therapeutic massage of the back and other parts of the body, the massage therapist performs a sequence of movements. First, stroking the back is done, then kneading, rubbing, vibration, patting and squeezing. It also happens with the rest of the body, starting from the back and ending with the arms. The repetition of some techniques is performed 4-5 times.

The main rule of this massage is that all movements made by the massage therapist should be directed to the nearest lymph nodes. In this process, first you need to pay attention to large areas of the body (massage of the back, abdomen, chest, shoulder girdle and lower back), then small areas (buttocks, legs and arms are massaged). However, do not forget about the sequence described above.

General massage has a very good effect on the cardiovascular system and respiratory organs of a person. It is used for problems with the patient's musculoskeletal system, digestive disorders and disorders in the nervous system. Therapeutic classic full body massage can speed up recovery processes after trauma and after mental or physical fatigue.

Indications and contraindications for massage procedures

Before starting treatment, the patient must know in which cases he can take a general classical massage, and in which he cannot. General massage is allowed to be used after bruises and sprains, during the treatment of the back or lower back, with hypertension and minor heart problems, with gastritis. Receiving a general massage, the patient improves the circulation of blood and lymphatic fluid, joints, muscles and tendons become more elastic, the body begins to remove toxins more intensively. In the vast majority of patients, the nervous and immune systems stabilize.

You can not perform general classical massage for colds, high temperature, with blood diseases, tumors and thrombosis. Before using general classical massage as a treatment, the patient must be examined by a specialist who can determine the indications and contraindications individually for each patient.

In addition to the general classical massage, there are also many other types of it. Among them, it is worth noting the medical cosmetic massage according to the Jacquet method.

The advantage of cosmetic therapeutic massage according to Jacquet

Massage according to Jacquet is called a medical cosmetic procedure for the skin of the face, which has many indications and contraindications for its use. Fulfill this massage should only be done by a qualified person. The pinch massage procedure according to Jacquet normalizes the workflow sebaceous glands, reduces inflammatory process during the formation of acne, removes comedones and milia from the skin of the face.

This cosmetic procedure also improves blood circulation in the part where it is directed and performs a stimulating effect for trophic processes. In addition, when performing this Jacquet procedure, facial tissues are regenerated and updated.

Indications for massage according to Jacquet

The main indications for the use of therapeutic massage according to Jacquet are diseases of the skin of the face, such as: acne, post-acne and seborrhea. These diseases can be combined according to one factor - the neuroendocrine regulation of the sebaceous glands is disrupted. changing biochemical and physical structure secreted glands, which causes oily or dry seborrhea. In addition, massage can be used during hyperkeratosis, hyperpigmentation and in the presence of cicatricial formations and scars on the face.

Contraindications to massage according to Jacquet

Not all patients can perform this procedure according to Jacquet. There are strict restrictions. It cannot be done to people with a violation of integrity skin having suppuration and viral infections on the face. It is strictly contraindicated to perform this procedure people suffering from chronic dermatosis (psoriasis), allergic diseases and atopic dermatitis. It is forbidden to apply the Jacquet massage procedure if it is inflamed trigeminal nerve or there are others neuralgic diseases. Remember that if you do not take into account the contraindications to this type of massage, the price in the future may be high. This is especially true for women who take care of the beauty of their face. The therapeutic type of massage according to the Jacquet method is a very responsible and serious procedure.