Massage

Encyclopedia of Medicine by Jeffrey Peter Larson

Massage is a manual means of rubbing and kneading soft tissues of the body to stimulate circulation and promote relaxation of muscles. There are many forms of massage in use throughout the world, including Swedish, deep tissue, Tui Na, Hawaiian, and others. For the most part, this article discusses the form most commonly used in sports medicine in the United States, a derivation of Swedish massage.

Massage helps the muscles relax by stimulating a reflex response of the nervous system. The application of smooth, steady, rhythmical massage can relieve tension and soothe sore muscles. This decrease in muscle tension causes the muscle to become more relaxed and elastic. Also, massage's effect on the circulatory system is beneficial for the healing of soft tissue injuries.

Massage's ability to aid in the recovery from soft tissue injuries, such as sprains and strains, is an important use of massage. Many soft tissue injuries are not serious enough to cause a visit to the doctor or hospital for treatment. Therefore, many injuries are treated with first aid; but they still may cause some discomfort and disability long after the initial injury. Massage can speed and improve the rate of recovery and reduce discomfort from such mishaps.

To understand how massage helps healing in cases of soft tissue injury, it is important to understand the inflammatory process. Inflammation begins because blood circulates to the injured area to bring important chemicals essential for healing. After a period of time, the initial inflammation stops. If applied at this point, massage will help again increase circulation, and thus promote healing, as the increased blood flow brings additional oxygen and nutrients to the injured area. In this way, massage helps bridge the gap between common neglect of injury and major expensive medical intervention.

Massage can also help stimulate the flow of lymph, the fluid that helps the body remove waste products. Massage helps facilitate the flow of lymph to areas where pain has slowed down the ability of this natural cleanser to remove the waste products of the injury.

Massage can affect muscles directly by stimulating inactive muscles whose inactivity is due to illness or injury. Deep continuous massage can relieve muscle tension and help prevent painful muscle spasms, which are common following injury. Also, massage can stretch and break down fibrous scar tissue that is not healing properly because it is not aligned to the adjoining muscle fibers.

Massage affects pain through the central nervous system. In one particular theory of pain called the "gate theory," messages of pain which normally travel from the injury to the brain, are blocked before reaching the centers responsible for interpreting pain. Massage helps stimulate and close the so-called gate of pain messages. As a result, the intensity of the pain perceived by the brain is decreased.

Psychosomatic studies show how stress factors can cause migraines, hypertension, depression, some peptic ulcers, etc. Some researchers have estimated that 80% of disease is stress related. Soothing and relaxing massage therapy can help reduce illness by counteracting stress effects.

Massage usually is not recommended for individuals with a circulatory problem; it could produce complications in individuals with high blood pressure or a history of heart trouble. Injury to bone can occur if massage is performed too soon after injury over an area of advanced osteoporosis or bone fracture. Also, in cases of cancer, massage is contra-indicted because an increase in circulation might help the cancer spread more rapidly. Severe diabetes, skin infection, tubercular joints, burns, or abrasions may also be indications that massage should be avoided.

When selecting a massage therapist, it is important to check his or her credentials, including whether he or she has graduated from a school approved by a credible accrediting agency, such as the Commission for Massage Training Accreditation (COMTA). Also one could check whether the therapist is a member of AMTA (American Massage Therapy Association).

Massage is a valuable tool in the management of many musculoskeletal disorders. While there are many forms of massage in use around the world, Swedish type massage is the type most commonly used in sports medicine in the United States. Sports medicine massage can be separated into five basic categories.

Effleurage is primarily a stroking technique that is divided into light and deep methods. Light stroking methods are used to sedate, while deeper stroking provides a method to compress the soft tissue and encourage circulation.

Petrissage is a kneading procedure used on loose, heavy tissues found in larger muscle groups of the body. This kneading action wrings out the muscle, which results in loosening adhesions left from the healing process, and squeezing out unwanted waste materials, thus facilitating movement of these waste products back into the circulatory system.

Friction massage is a useful method applied around joints and other areas where tissues are thin and more resilient. This includes scars and adhesions -- the goal being to stretch underlying tissues and exert friction on the area. Friction massage is also utilized to increase circulation, especially around a joint.