1. Massage Therapy Alzona, Lauren Joshua A.

2. History of Massage Natural reaction to when the body hurts is to rub it Natural reaction to when the body hurts is to rub it Dates back to at least the ancient Olympics Dates back to at least the ancient Olympics In Europe in the Middle Ages, the Church of Rome & its religious teachings discouraged massage as a healing practice In Europe in the Middle Ages, the Church of Rome & its religious teachings discouraged massage as a healing practice Massage is derived from 2 sources Massage is derived from 2 sources Arabic verb mass “to touch” Arabic verb mass “to touch” Greek word massein “to knead” Greek word massein “to knead” Egyptians, Romans, Japanese, Persians, & Chinese were known to practice massage therapy Egyptians, Romans, Japanese, Persians, & Chinese were known to practice massage therapy

4. History of Massage Sweden – early 19 th century, Peter Ling (acknowledged founder of curative gymnastics) – appears to be founder of modern day massage techniques, incorporated with French massage techniques Sweden – early 19 th century, Peter Ling (acknowledged founder of curative gymnastics) – appears to be founder of modern day massage techniques, incorporated with French massage techniques Techniques have changed dramatically in the past 50 years Techniques have changed dramatically in the past 50 years Based on research by Albert Hoffa (1859-1907), James Mennell 1880-1957), & Gertrude Beard (1887-1971). Based on research by Albert Hoffa (1859-1907), James Mennell 1880-1957), & Gertrude Beard (1887-1971). Scientific basis to massage was added Scientific basis to massage was added Late 1980’s, Amer. Massage Therapy Association was organized (1992 – Nat’l Cert. Exam. For Therapeutic Massage & Bodywork was formed) Late 1980’s, Amer. Massage Therapy Association was organized (1992 – Nat’l Cert. Exam. For Therapeutic Massage & Bodywork was formed)

5. What is Massage Therapy? Mechanical modality Mechanical modality Used to manipulate the body’s tissue Used to manipulate the body’s tissue Effective in promoting local & systemic relaxation, increasing local b. flow, breaking down adhesions, & encouraging venous return Effective in promoting local & systemic relaxation, increasing local b. flow, breaking down adhesions, & encouraging venous return Act of rubbing, kneading, or stroking the superficial parts of the body with the hand or an instrument for the purpose of modifying nutrition, restoring power of movement or breaking up adhesions Act of rubbing, kneading, or stroking the superficial parts of the body with the hand or an instrument for the purpose of modifying nutrition, restoring power of movement or breaking up adhesions Time-consuming Time-consuming

7. Treatment Considerations & Guidelines Need to know underlying pathology Need to know underlying pathology Need to know basic massage principles (must have manual dexterity, coordination, & concentration). Must also exhibit patience & courteousness. Need to know basic massage principles (must have manual dexterity, coordination, & concentration). Must also exhibit patience & courteousness. Hands must be clean, warm, dry & soft. Nails must be short and smooth. Hands should be warm. Hands must be clean, warm, dry & soft. Nails must be short and smooth. Hands should be warm. Avoid constant hyperextension or hyperflexion of any joints which may lead to hypermobility. Avoid constant hyperextension or hyperflexion of any joints which may lead to hypermobility. Must obtain correct positioning that will allow for relaxation, prevent fatigue & permit free movement of arms, hands, & body. Must obtain correct positioning that will allow for relaxation, prevent fatigue & permit free movement of arms, hands, & body.

9. Treatment Considerations & Guidelines Must obtain good posture to prevent fatigue & backache. Must obtain good posture to prevent fatigue & backache. Weight should be evenly distributed on both feet. Weight should be evenly distributed on both feet. You must be able to fit your hands to the contour of the area being treated. You must be able to fit your hands to the contour of the area being treated. A good position is required to allow for correct application of pressure and rhythmic strokes during the procedure. A good position is required to allow for correct application of pressure and rhythmic strokes during the procedure.

10. Points for Consideration Pressure regulation should be determined by the type & amount of tissue present. Also, pressure is governed by the condition & which tissues are affected. Pressure regulation should be determined by the type & amount of tissue present. Also, pressure is governed by the condition & which tissues are affected. Each stroke must have equal pressure & time (rhythm present). Each stroke must have equal pressure & time (rhythm present). Duration depends on pathology, size of area, speed of motion, age, size, & condition of athlete. Also, massage may not be warranted on a daily basis (e.g. friction massage). Duration depends on pathology, size of area, speed of motion, age, size, & condition of athlete. Also, massage may not be warranted on a daily basis (e.g. friction massage). Some areas may take 30 minutes. Some areas may take 30 minutes.

11. Points for Consideration If swelling is present in an extremity, treatment should begin proximally. If swelling is present in an extremity, treatment should begin proximally. “Uncorking the bottle”, “uncorking effect” “Uncorking the bottle”, “uncorking effect” Massage should never be painful, except possibly for friction massage. It should not cause ecchymosis. Massage should never be painful, except possibly for friction massage. It should not cause ecchymosis. Direction of forces should be applied in the direction of the muscle fibers. Direction of forces should be applied in the direction of the muscle fibers. Each session should begin & end with effleurage. Each session should begin & end with effleurage.

12. Points for Consideration Make sure the patient is warm and in a comfortable, relaxed position. Also, make sure the patient is properly draped. Make sure the patient is warm and in a comfortable, relaxed position. Also, make sure the patient is properly draped. The body part may be elevated if necessary. The body part may be elevated if necessary. Massage should begin with superficial stroking. Massage should begin with superficial stroking. Each stroke should start at the joint or just below the joint (unless contraindicated) and finish above the joint so that strokes overlap. Each stroke should start at the joint or just below the joint (unless contraindicated) and finish above the joint so that strokes overlap. Pressure should be in line with venous flow. Pressure should be in line with venous flow. Bony prominences & painful joints should be avoided if possible. Bony prominences & painful joints should be avoided if possible.

13. Massage Media Used to decrease friction between the patient’s skin and the clinician’s hand Used to decrease friction between the patient’s skin and the clinician’s hand Massage can be given without any medium being used Massage can be given without any medium being used Lotions, peanut oil, powder, analgesic balms Lotions, peanut oil, powder, analgesic balms More medium should be used on More medium should be used on hairy areas During petrissage – lubricants During petrissage – lubricants interfere with the kneading & lifting During friction massage – During friction massage – lubricants may interfere with the certain results you want to obtain

14. Massage Strokes Effleurage Effleurage Petrissage Petrissage Friction (circular, transverse) Friction (circular, transverse) Tapotement Tapotement Vibration Vibration Myofascial release techniques Myofascial release techniques Various other forms – some may combine strokes Various other forms – some may combine strokes

15. Mechanical Effects Techniques that stretch a muscle, elongate fascia, or mobilize soft-tissue adhesions or restrictions are all mechanical techniques Techniques that stretch a muscle, elongate fascia, or mobilize soft-tissue adhesions or restrictions are all mechanical techniques Mechanical effects are always accompanied by some reflex effects Mechanical effects are always accompanied by some reflex effects As mechanical stimulus becomes more effective, reflex stimulus becomes less effective As mechanical stimulus becomes more effective, reflex stimulus becomes less effective Muscle – massage is done either for mechanical stretching or to relieve pain associated with trigger points Muscle – massage is done either for mechanical stretching or to relieve pain associated with trigger points

16. Mechanical Effects Skin – massage has been shown to increase skin temperature, increase sweating & decrease resistance to electrical current Skin – massage has been shown to increase skin temperature, increase sweating & decrease resistance to electrical current It has been shown to toughen yet soften the skin It has been shown to toughen yet soften the skin Acts directly on the surface of the skin to remove dead cells Acts directly on the surface of the skin to remove dead cells Stretches & breaks down fibrous tissue Stretches & breaks down fibrous tissue

17. Effleurage Stroking of the skin Stroking of the skin Performed with palm of hand Performed with palm of hand Stimulates deep tissues Stimulates deep tissues Performed with fingertips Performed with fingertips Stimulates sensory nerves Stimulates sensory nerves Superficial, rhythmic stroking: Superficial, rhythmic stroking: Contours the body or relates to direction of underlying muscles Contours the body or relates to direction of underlying muscles Deep stroking: Deep stroking: Follows course of veins & lymph vessels Follows course of veins & lymph vessels

18. Effleurage May be performed slowly for relaxation or rapidly to encourage blood flow & stimulate the tissues May be performed slowly for relaxation or rapidly to encourage blood flow & stimulate the tissues Performed in rhythmic manner Performed in rhythmic manner One hand should always be in contact w/ skin One hand should always be in contact w/ skin Light effleurage is performed at beginning & end of massage or may be used between petrissage strokes Light effleurage is performed at beginning & end of massage or may be used between petrissage strokes At beginning – relaxes patient & indicates area to be treated At beginning – relaxes patient & indicates area to be treated At end – calms down any irritated areas At end – calms down any irritated areas

19. Petrissage Lifting & kneading of skin, subcutaneous tissue, & muscles Lifting & kneading of skin, subcutaneous tissue, & muscles Performed with fingers or hand Performed with fingers or hand Skin is gently lifted between thumb & fingers or fingers & palm & gently rolled & kneaded in the hand Skin is gently lifted between thumb & fingers or fingers & palm & gently rolled & kneaded in the hand Often performed without lotion Often performed without lotion Frees adhesions by stretching & separating muscle fiber, fascia, & scar tissue while assisting with venous return & milking out waste products Frees adhesions by stretching & separating muscle fiber, fascia, & scar tissue while assisting with venous return & milking out waste products

20. Friction Goal is to mobilize muscle & separate adhesions that restrict movement & cause pain Goal is to mobilize muscle & separate adhesions that restrict movement & cause pain Facilitates local blood profusion Facilitates local blood profusion Not necessarily a “pleasing” treatment Not necessarily a “pleasing” treatment Circular: Circular: Applied with thumbs working in circular motion Applied with thumbs working in circular motion Effective in treating muscle spasm & trigger pts. Effective in treating muscle spasm & trigger pts.

21. Friction Transverse: Transverse: Applied with thumbs or fingertips stroking the tissue from opposite directions Applied with thumbs or fingertips stroking the tissue from opposite directions Can use elbow, end of rolling pin, etc. for larger areas Can use elbow, end of rolling pin, etc. for larger areas Reaches deep tissues Reaches deep tissues Begin lightly and then move to firmer strokes Begin lightly and then move to firmer strokes Muscle should be placed in relaxed position Muscle should be placed in relaxed position Should be avoided in acute conditions Should be avoided in acute conditions Effective in tendonitis or other joint adhesions Effective in tendonitis or other joint adhesions

22. Tapotement Gentle tapping or pounding of the skin Gentle tapping or pounding of the skin Most common form uses ulnar side of wrist to contact skin “karate chop” Most common form uses ulnar side of wrist to contact skin “karate chop” Wrist & fingers are usually limp, alternate method “cups” the hand Wrist & fingers are usually limp, alternate method “cups” the hand Promotes relaxation & densitization of irritated nerve endings Promotes relaxation & densitization of irritated nerve endings

23. Vibration Rapid shaking of the tissues Rapid shaking of the tissues Soothes peripheral nerves Soothes peripheral nerves A mechanical device can be used A mechanical device can be used

24. Acupressure Acupressure – based on Chinese art of Acupuncture Acupressure – based on Chinese art of Acupuncture The Chinese make no distinction between arteries, veins, or nerves when explaining function of the body. The Chinese make no distinction between arteries, veins, or nerves when explaining function of the body. Concentrate on the system of forces that regulate all bodily functions. Concentrate on the system of forces that regulate all bodily functions. Qi (pronounced “che” exists in everyone & controls all aspects of life) Qi (pronounced “che” exists in everyone & controls all aspects of life) Qi is governed by two opposing forces, Yang (positive) & Yin (negative) forces. Disease results from some imbalance between these two forces. Qi is governed by two opposing forces, Yang (positive) & Yin (negative) forces. Disease results from some imbalance between these two forces. Yin & Yang pass flow through passageways/lines in the body called “jing” (Chinese) or “meridians” (West). Yin & Yang pass flow through passageways/lines in the body called “jing” (Chinese) or “meridians” (West).

25. Acupressure 12 meridians in the body named according to the part of the body with which they are associated. The meridians on one side of the body are duplicated on the other side; however, two additional meridians exist that can’t be paired. 12 meridians in the body named according to the part of the body with which they are associated. The meridians on one side of the body are duplicated on the other side; however, two additional meridians exist that can’t be paired. *not paired *not paired Lung (L) Lung (L) Large Intestine (LI) Large Intestine (LI) Stomach (ST) Stomach (ST) Spleen (SP) Spleen (SP) Heart (H) Heart (H) Small Intestine (SI) Small Intestine (SI) Urinary bladder (UB) Urinary bladder (UB) Kidney (K) Kidney (K) Pericardium (P) Pericardium (P) Triple warmet (TW) Triple warmet (TW) Gall bladder (GB) Gall bladder (GB) Liver (LIV) Liver (LIV) Governing vessel (VB)* Governing vessel (VB)* Conception vessel (CV)* Conception vessel (CV)*

26. Acupressure Along the meridians lie the acupuncture points Along the meridians lie the acupuncture points Whenever there is pain or illness, certain points on the surface of the body become tender Whenever there is pain or illness, certain points on the surface of the body become tender When pain is eliminated, these tender spots disappear When pain is eliminated, these tender spots disappear According to acupuncture theory, stimulation of specific points through needling can reduce pain in areas associated with a particular point According to acupuncture theory, stimulation of specific points through needling can reduce pain in areas associated with a particular point Thousands of points have been identified Thousands of points have been identified

27. Acupressure Electrical resistance of the skin at certain points corresponding to the acupuncture points is lower than that of surrounding skin, especially when a disease state is present. Electrical resistance of the skin at certain points corresponding to the acupuncture points is lower than that of surrounding skin, especially when a disease state is present. Russian research has shown evidence of skin temperature difference at these points. Russian research has shown evidence of skin temperature difference at these points.

28. Myofascial Trigger Points Trigger points are the counterpart of acupuncture points Trigger points are the counterpart of acupuncture points May be found in muscle, tendons, myofascia, ligaments & capsules surrounding joints, in periosteum, & in the skin May be found in muscle, tendons, myofascia, ligaments & capsules surrounding joints, in periosteum, & in the skin May activate & become painful due to trauma May activate & become painful due to trauma Stimulation of these points have resulted in pain relief Stimulation of these points have resulted in pain relief

29. Rolfing May also see it is “structural integration” May also see it is “structural integration” Goal - to balance the body within a gravitational field through a technique involving manual soft-tissue manipulation Goal - to balance the body within a gravitational field through a technique involving manual soft-tissue manipulation Improve balance, posture, flexibility, movement efficiency Improve balance, posture, flexibility, movement efficiency Basic principle of treatment is - if balanced movement is essential at a particular joint, yet nearby tissue is restrained, both the tissue & the joint will relocate to a position that accomplishes a more appropriate equilibrium. Basic principle of treatment is - if balanced movement is essential at a particular joint, yet nearby tissue is restrained, both the tissue & the joint will relocate to a position that accomplishes a more appropriate equilibrium.

30. Rolfing Standardized approach that is administered without regard to symptoms or pathologies Standardized approach that is administered without regard to symptoms or pathologies Technique involves 10 hour-long sessions, each emphasizing some aspect of posture Technique involves 10 hour-long sessions, each emphasizing some aspect of posture 10 sessions include: 10 sessions include: Respiration, balance under the body (legs/feet), sagittal plane balance (lateral line from front to back), balance left to right (base of body to midline), pelvic balance (rectus abdominis & psoas), weight transfer from head to feet – sacrum, relationship of head to rest of body, upper ½ of body to lower ½ of body relationship, balance throughout the system Respiration, balance under the body (legs/feet), sagittal plane balance (lateral line from front to back), balance left to right (base of body to midline), pelvic balance (rectus abdominis & psoas), weight transfer from head to feet – sacrum, relationship of head to rest of body, upper ½ of body to lower ½ of body relationship, balance throughout the system Additional “tune-up” sessions may be required Additional “tune-up” sessions may be required Integrates structural with psychological approach Integrates structural with psychological approach