Physiological Effects of Massage

Physiological Effects of Massage

• Massage affects metabolism by removing toxins built up after strenuous activity.
• Insufficient muscle activity prompts massage to aid venous and lymphatic flow.
• Massage enhances blood flow, delivering more nutrients and oxygen to muscles, thereby reducing fatigue and pain.

Effect on Blood Flow

• Massage improves venous return, particularly in superficial veins.
• It increases arterial circulation by reducing venous pressure, preventing venous stasis.
• Massage has an anticoagulant effect.

Effect on Lymphatic Flow

• Massage boosts lymphatic drainage, decreasing edema.
• Residual products are removed, leading to a reduction in swelling.
• Regular massage enhances white blood cell counts, strengthening the immune system.

Effects on Musculoskeletal System

• Massage diminishes delayed muscle soreness following physical activity.
• It promotes blood flow to the muscles, removing lactic acid through increased oxidation and diffusion.
• The massage reduces white blood cell accumulation in vascular walls from muscle damage after intense exercise.
• Massage reduces fatigue levels.
• Massage increases blood volume within muscles

Effects on Nervous and Cardiovascular System

• Massage creates a calming, relaxing effect.
• It has reflexive effects on the autonomic and endocrine systems.
• It boosts the parasympathetic system, assisting in sympathetic inhibition.
• It temporarily reduces motor neuron excitability.
• It reduces heart rate through relaxation.
• It temporarily reduces blood pressure due to capillary dilation.
• Massage releases endorphins to alleviate pain.
• Ischemia is reduced.

Effects on Respiratory System

• Massage reduces tension in the respiratory muscles, improving breathing and lung capacity.
• It slows the respiratory rate by stimulating the parasympathetic nervous system.

Effects on Urinary System

• Massage increases blood and lymph drainage in tissues, leading to greater urine excretion.

Psychological Effects

• Massage reduces stress and anxiety through relaxation.
• Massage enhances feelings of well-being and self-confidence.
• Massage improves body image and perception through relaxation.
• It helps cope with emotional trauma through relaxation.

Clinical Indications of Massage

• Waist and neck issues: whiplash, mechanical low back pain, disc herniation
• Neurological problems: multiple sclerosis, Parkinson's disease, paralysis, headaches, restless leg syndrome
• Vascular issues: Raynaud's phenomenon, lymphoedema
• Rheumatic diseases: osteoarthritis, temporomandibular joint dysfunction, fibromyalgia
• Gastrointestinal problems: ulcerative colitis, colic, flatulence, constipation, eating disorders
• Obstetric and gynecological problems: pregnancy, menstrual cramps, premenstrual syndrome
• Pulmonary problems: asthma, bronchitis
• Orthopaedic problems: epicondylitis, scoliosis
• Soft tissue problems: sprains, strains
• Psychological problems: post-traumatic stress disorder, sleep disorders, anxiety, depression, stress

Contraindications

• General: acute conditions requiring first aid, advanced renal failure, advanced respiratory failure, anemia, diabetes complications, hemophilia, metastatic cancer, liver failure, severe atherosclerosis, shock, high fever, systemic infectious diseases, unstable hypertension, unstable cerebrovascular accident, unstable myocardial infarction
• Local: acute inflammatory arthritis (rheumatoid arthritis, lupus), sensory impairment, infectious skin disease, ectopic pregnancy, malignancy, undiagnosed swellings, local skin irritation, local infection, open wounds, new burns

Pain Treatment with Massage

• Massage influences pain perception in multiple ways.
• It controls pain by affecting the pain threshold.
• Harmful chemicals, produced by injury, carry pain signals to the CNS.
• Massage is effective in reducing pain in damaged areas.
• Massage increases local circulation, minimizing pain-causing chemicals.
• It competes with pain signals through afferent input to the CNS (via large diameter A-beta fibers).

Clinical Decision Making Process

• Patient's problem is identified.
• Patient history and subjective evaluations are taken.
• A hypothesis on the patient's condition is formed and observations are made.
• The hypothesis is clarified, and objective tests are performed.
• Clinical findings are analyzed.
• The hypothesis is confirmed.
• Treatment is planned.

Maximizing Treatment Effectiveness

• An accurate diagnosis of the disease is important.
• The stage of the disease (acute, subacute, or chronic) must be known.
• The patient's condition's stability is assessed.
• The patient's overall health status is considered.

Body Mechanics in Massage Application

• Incorrect static and dynamic postures during massage can harm the musculoskeletal system.
• Massage therapy necessitates specific posture and strength.
• Therapists applying pressure with upper extremity force often experience shoulder and neck problems.
• Using body weight, instead of upper limb muscle strength, is recommended for pressure application.
• Hands should be relaxed during massage.
• Palms should be positioned at a 45-degree angle to the body part being massaged.
• Avoid pressure using fingers and thumbs on joints.
• Low back issues usually stem from incorrect or static bending postures.
• Maintain an upright waist during massage; avoid simultaneous bending and rotation.
• Frequent posture changes are beneficial instead of prolonged static postures.
• Body weight should be shifted periodically from one foot to the other to prevent knee issues.
• The optimal standing position for massage is asymmetric; this reduces energy expenditure. Avoid symmetrical stance, as it leads to fatigue and poor circulation.
• Body weight should be placed mainly on the foot located behind the massage recipient.

Massage Equipment

• Massage Tables (Beds): automatically adjustable length, tilt feature, arm support, face cavity (for prone position)
• The table legs are helpful for varying heights.
• Massage Chairs: ideal for pregnant women in third trimester, those with swallowing issues, or patients with respiratory, vascular, or cardiac problems (who cannot be in supine position).
• Supporting materials: cushions, rubber, varying sizes, heights, and hardness levels are used for positioning.

Massage Oils

• Oils in massage reduce friction and provide lubrication.
• They provide no medical or cosmetic benefits.
• Oils, creams, and powders can be used.

Treatment Environment

• Massage rooms should be quiet, clean, and well-lit.
• Room temperature should be between 23-24°C.
• Patients should feel relaxed; avoid cold temperatures.
• Therapist hands should be properly maintained; use clean clothes with sweat absorption capabilities.

Positioning and Covering

• Positioning aims to relax the patient and to utilize gravity for improved venous return.
• Use pillows, folded towels, rubberized materials.
• Patients remove clothes from the treatment area.
• Remaining body parts are covered with a sheet.
• Privacy and relaxation are crucial considerations during covering.
• Tight clothing near the treatment area is discouraged.