By Capt Harveer Singh, DMT, Toronto, Canada
Massage therapy is one of the latest concepts which has come up in the medical field in the western world. Maximum research has taken place in Sweden, a North European country. That is why it is also sometimes called as Swedish massage. This concept has become very popular in Europe and North America, mainly in USA and Canada. Clinical Massage therapy has marked potentials and is being used for treating over 70 conditions.
A Massage therapist is a specialist of soft tissues and joint problems. Soft tissues consist of skin, muscle, ligaments, tendons and fascia. A ligament is a sheet of strong fibrous connective tissues, connecting the articular ends of the bones, binding them together, thus facilitating or limiting motion. Tendon is a fibrous connective tissue serving for the attachment of the muscles to bones. Fascia is a fibrous membrane covering, supporting and separating muscles (Deep Fascia); the subcutaneous tissue that connects the skin to the muscle (Superficial Fascia). To give an example of the same; if you bring a chicken, remove its feathers, peel its skin you will find a thin white dotted layer on the chicken which wraps all its body. This layer is termed as fascia.
A Massage therapist examines the patient and forms his or her clinical impression and finally treats the patients accordingly. Following types of tests are conducted by a massage therapist:
- Physical Observation: These are the observations made from the patient’s gait and body posture.
- Orthopedic Tests: These tests are specially physically conducted on the patient to ascertain the nature of ailment in a particular affected part of the body.
- Myo Tone Test: These tests indicate the strength of the muscles.
- Physical examination: By touching and physically examining a patient as a whole and specifically the affected part.
- Lastly, through the various diagnostic and sophisticated procedures like X-Rays, MRI etc.
Benefits of Massage:
1. Massage and Pain Control: One of the mechanisms of pain is due to Local Ischemia. It is reduction of local blood supply resulting in less oxygen and nourishment and accumulation of certain metabolites (chemicals) thus causing pain. There are trigger points present in muscle or Fascia, which are hyper-irritable spots from where the pain gets triggered and spreads to the surrounding area. There are two types of trigger points: (a) Active trigger point and (b) Latent trigger point (sleeping ones). The active trigger point is continuously triggering the pain at rest or with the movement of the muscle. Latent trigger point produces pain only when palpated. Latent are more common than the active one’s, and may persist for years after the initial injury. The Latent Trigger points may become Active by new pathology like Osteoarthritis, overuse, overstretching or chilling of muscles. The massage techniques like Slow Skin Rolling, Slow Repetitive Muscle Stripping, Alternating Ischemic Compression and Prolonged Ischemic Compression, removes the trigger points. Prolonged Ischemic Compression is used for deep muscles such as Piriformis, Quadratus Lumborum. Sometimes elbow (Olecranon) is used to apply pressure. Thus the local blood circulation of the particular affected tissues increases. Thus, the muscle become healthier and hence gets devoid of pain.
2. Massage and Blood circulation: When massage is done certain potent chemical are released leading to Vasodilatation, as a result caliber of the blood vessels increases, allowing more blood in that local area. The Research has shown that if the calf muscle is massaged for 10 minutes, it doubles the blood flow in the calf muscle for successive forty minutes, thus bringing more oxygen and nourishment to the affected muscle and flushing out the metabolites thus improving the health of the affected muscle or tissue.
3. Massage and Adhesion: An abnormal union of two parts is known as adhesion. Adhesions occur within skin, muscle, tendons and even in joint capsules. In our body there is a collagen fiber that helps in stitching the wounds, thus healing takes place. However sometimes a proper stitching/healing does not take place so scar tissue adhesion occurs. Adhesion sometimes obstructs the proper flow of blood and transmission of messages in the nerves. A massage therapist removes the improper adhesions with massage techniques known as Cross Fiber Friction Technique. This improves the blood flow. This technique is a painful technique because the Adhesion has to be broken. Other techniques of removing Adhesion in the skin are Facial techniques (which are painful skin rolling techniques) by which adhesions in the skin are removed. By reducing the adhesions the hypertonicty of a toned muscle reduces thus increasing the flow of local blood circulation hence improving the health of the particular muscle and tissue. Successful release is indicated by Hyperemia- palpable release of heat, decrease of pain, softening or lengthening of the tissue.
4. Massage and Manual Lymphatic drainage: Lymphatic System like blood vessels is another network of channels which contains Lymph. Lymph carries plasma proteins, white cells and maybe bacteria and virus and some metabolic products. The above goes to the nearest Lymph Nodes (Lymph node is a junction of various Lymphatic Channels) where the bacteria and viruses are killed and the Lymph travels to another group of Lymph nodes and finally drains into the large blood venous system called Subclavian vein. If Lymphatic System does not function well we have Edema, in lay man’s language called swelling. Edema is a local or general accumulation of fluid in the interstitial tissue space. Equilibrium is maintained as long as the fluid entering the interstitial tissue via the arterioles equals the fluid leaving through the Venules. The lymphatic edema results if this equilibrium is upset.
A massage therapist thus advices RICE; that is “R” for REST, “I” for ICE,” C” for COMPRESSION and “E” for ELEVATION- of the affects area above the heart level. All this helps in reducing edema and pain. Beside RICE other massage techniques for reducing the edema are Nodal Pumping, Shaving and Flushing Technique etc.
5. Massage and Immune System: Research has shown massage boosts the immune system of HIV positive patients as the count of White Blood Cells increases. Similar massage treatment if given to other types of patients, the results are much better.
6. Massage and Joints: Joints are articulation between bones, for example knee joint is an articulation among three bones namely Femur (thigh bone) Patella (knee cap) and Tibia (one of the lower leg bones). A joint is usually formed of fibrous connective tissue and cartilage. It is classified as being immobile (Synarthrosis), slightly movable (Amphiothrosis), or freely movable (Diarthrosis). Blood vessels cannot function between bones because they will get ruptured, so nature has provided Synovial Fluid in the joints. Synovial fluid provides lubrication to the joints, acts as a shock absorber; it also provides nourishment and oxygen to the joints by extracting the same from the surrounding blood vessels of the joint capsule. At the same time it flushes out carbon dioxide and other waste material from the joints. To make the joints functional and efficient we give joint mobilization of various degrees. We will like to point out here that joints functions with help of muscles and if we remove the spasm and strengthen the muscles the function of the joint will improve.
7. Reflexive Massage: The peripheral nerves are affected due to various causes which may be toxic, infectious, metabolic, direct injury, entrapment or immunological. By virtue of doing massage on a particular point the impulse created travels from the periphery to the spinal cord and brain (as afferent impulses). Then the brain-(certain centers), sends back impulses to the periphery (as efferent impulses) resulting in release of chemicals and growth factors which have healing effect. It is pointed out here that the massage is not the alternative to the allopathic system of medicine but it is complementary to it. The basic cause of peripheral nerve damage must be corrected first and then reflexive massage will enhance further healing.
8. Psychological effects of Massage: Massage is able to reduce stress, anxiety and depression and give client a feeling of well being and better alertness. An interesting research on athletes has shown that massage helps in reducing their tension, depression, fatigue, anger and confusion significantly.
9. Massage and Respiratory System: A massage therapist does not treat the patients of Asthma or Chronic Obstructive Airway Diseases when it is in the flared up stage. Even after the cure with allopathic medicines(In the remission period) still there are residuals of sputum in air passages and accessory muscles of respiration like Scalene muscle in neck leading to the first and second ribs, Intercostals muscle between the ribs, Diaphragm etc mostly remain in spasm. The massage postural drainage techniques like Tapotment, Rib Racking, Rib Springing, and Muscle Stripping etc. helps in drainage of thick sputum which is blocking the air passages of lungs and relaxes the accessory muscles of respiration. In turn massage helps in delaying the future attacks.
In an era where people are looking for alternative treatments along with Allopathic Medicines, Massage treatments due to its nature is a natural way of healing with negligible side-effects.
Canadian Massage Treatments
Capt Harveer Singh, DMT, Toronto, Canada.