An Introduction to Remedial Massage Therapy

Authors: Susan L. Siegenthaler & Danny T. Siegenthaler (1997)

Definition of Massage: Massage is the systematic and scientific manipulation of the soft tissues of the body, and is performed directly upon the skin in a methodical manner for therapeutic purposes (Tappan, 1994).

Massage is

• Systematic
• Scientific
• Methodical
• Therapeutic

Skilfully used, Remedial Massage Therapy can assist the body in its own healing processes, where disease or injury has occurred in muscles, connective tissues, bones, joints and internal organs. Massage can also assist healing through its effect on the psychological condition of the patient, increasing a sense of confidence, well-being and relaxation.

When Do We Use Massage?

There are many situations which cause a metabolic imbalance within the soft tissues of the body. Most of these can be treated with Massage.

The PURPOSE of Massage is to bring about any of the PHYSIOLOGICAL, MECHANICAL, REFLEX or PSYCHOLOGICAL effects attributed to Remedial Massage Therapy. Relaxation, pain relief and increased range of movement can be achieved through the application of remedial massage techniques.

In addition to the treatment of ill and injured people, massage can be used in Athletics and Sport where it aids in the preparation of muscles, joints and associated structures for strenuous activity, or to assist these same tissues in recovery from strenuous activity. This reduces the incidence of injuries and improves the Athlete’s performance.

Massage is a useful and integral part of the healing process.

While giving a Massage, encourage the patient to understand the potential source of healing which lies within their own consciousness. The patient can be encouraged to not be a helpless party, but to become part of their healing defence mechanisms. Massage can help the patient to develop an increased awareness of their body, and the levels of relaxation and stress that they may experience.

Types of Massage Techniques

There are many types of Massage in use today, for example:

• Essalon Massage is a technique in which both sides of the body are massaged simultaneously. It is a symmetrical Massage technique, very gentle, and designed to enhance maximum relaxation in the patent.
  
• Deep Tissue Massage is a technique which is designed to manipulate the deep fascia layers and deep muscle layers of the body. It is based on the theory that stress can be stored deep within the body, and is arranged in “layers”, trauma after trauma, each layer relating to a different level of consciousness. It can be quite a painful experience for the patient, and is said to evoke emotional responses as each layer of stress and trauma is “unlocked” and released.
  
• Shiatsu / Chinese Massage are techniques with similar philosophical approaches. Each technique works with the concept of body energies. The techniques employed are designed to ”unblock” energy meridians and restore health by balancing the patient’s energy (Qi).
  
• Zone Therapy / Reflexology are techniques which are localised to specific body regions, e.g.: Hands, feet, ears. The various regions are said to have reflex relationships to all parts of the body, and various techniques are used to bring about specific reactions in a chosen body area.
  
• Swedish and Remedial Massage are the techniques with which this Course of study is primarily concerned. The techniques which have been developed and called Remedial Massage are a composite of many other forms of Massage.

Many individuals have contributed to the development of Massage as we know it today. “Swedish” Massage concentrates on working on one side of the body at a time. It is more intense than Essalon Massage, and unlike Deep Tissue Massage, it works within the pain / comfort threshold of the patient. encouraging the gentle release of tension and stress.

Remedial Massage makes use of Passive Movements and Joint Mobilising Techniques, working towards a specific goal in the treatment of the patient, and often working on a specific and limited body region until that goal is accomplished.

Local Versus General Massage

When faced with a patient, the massage therapist must decide what approach needs to be taken in order to best help the patient with their specific health problem.

Many people, who do not know much about massage, erroneously think that every massage is a “Full Body” Massage and the longer it takes the better - but this is far from the truth of the matter.

When treating a patient with a specific problem e.g.: Sciatica, Osteoarthritis in the cervical spine, and the like, and Massage is the choice to help with the symptoms of pain or loss of mobility, the treatment approach must be primarily aimed at the treatment of the specific problem area in order to obtain the best results.

On the other hand, if a patient presents with problems of stress, tension and anxiety, a “Full Body” Massage would be the prescription most likely given. Full Body Massage is mostly employed for relaxation therapy, and it is recommended that a Full Body Massage should never exceed 45-60 minutes duration, as after this time the positive effects of the Massage treatment are reversed.

This is based upon the concept of “The Principle of Sensory Adaptation”. Sensory receptors in the body have a characteristic function called adaptation, that is, a change in sensitivity (usually a decrease) to a prolonged stimulus. Receptors associated with touch and pressure in the skin rapidly adapt and can lead to further adaptation in the central nervous system as incoming signals are processed. Excessive stimulii can also produce undesirable Reflex Responses.

The level of general health of the patient must also be considered. Debilitated and very ill persons do not tolerate long duration massage well. Once a patient has had a course of several Massage Treatments and is in reasonably good health, long duration Massage can be given.

 

Contra-Indications of Massage

Regardless of the injury or illness from which the patient is suffering, the Therapist will be dealing with a wide variety of conditions like pain, swelling, scar tissue, muscle spasm, fibrocystic nodules, skin conditions, contractures, and insufficient circulation.

It is imperative that, when PAIN is a presenting symptom, Massage should NEVER be done until its CAUSE has been discovered, AND it can be seen that massage is a SAFE and an APPROPRIATE form of treatment.

There are conditions for which massage is INDICATED, i.e. Massage is the appropriate form of treatment for the condition.

There are conditions for which Massage is CONTRA-INDICATED, i.e.: Massage is not an appropriate form of treatment, and performing Massage in these circumstances may cause further injuries to tissues or even endanger the health or the LIFE of the patient. These include:

• Acute inflammatory conditions, which may be local or systemic (i.e. Fever).
• When there is pus or any other body discharge present.
• Where there is an abnormal skin condition, e.g.: Eczema, Dermatitis, Psoriasis, recently healed burns.
• Varicose veins or thrombosis.
• Cancers or tumours, especially after recent surgery or chemotherapy. A Doctor’s clearance should be obtained before proceeding with Massage Therapy in such a  case.
• Abdominal Massage in Pregnancy during the first Trimester and where there is a history of repeated miscarriage.
• Poisonous foci, e.g.: Snake and spider bites, other insect bites, abscesses and boils.
• Where there may be danger of haemorrhage, e.g.: After recent surgery or recent internal bleeding / bruising.
• Heart weakness due to Chronic Congestive Heart Disease or following recent Heart  Attack.
• Untreated mental disorders, e.g.: Manic depression, Schizophrenia.
• Neurological disorders where there may be loss of sensation in the skin or abnormal reflexes, e.g.: Multiple Sclerosis, Cerebral Palsy, Quadriplegia, Nerve damage.
• Oedema due to Heart or Kidney weakness or thrombosis.
• Undiagnosed severe or persistent headache or migraine.
• While the patient is under the influence of drugs or alcohol.
• Variations in the general treatment approach can be used and the therapist should have a sound understanding of the nature of the problem.

General Effects of Massage

Restoration of function

Massage has a beneficial influence on virtually all body systems, including the skin, musculo-skeletal, nervous, cardiovascular, lymphatic - immune, digestive and glandular systems.

Aids Elimination

Massage can aid the elimination of toxic metabolic wastes via the bowels, lungs, kidneys and skin.

Facilitates local blood supply

Massage aids and increases local blood supply to tissues, which in turn increases the nourishment of the cells composing those tissues and promotes waste removal. This enables cellular activities to be carried out normally.

Promotes relaxation

Massage relaxes tight, shortened and spastic muscles and connective tissues.

Loosens scar tissue

Massage can loosen and diminish fibrous and scar tissue. Timely application of Massage in the healing process can even prevent the formation of scar tissue.

Disperses acid deposits

Massage can disperse uric and lactic acid deposits that can accumulate in and around joints, igaments, tendons, muscles and fascia. These acids disturb the chemical activities of the cells.

Sedate, stimulate or balance the nervous system

Depending upon the techniques used, Massage can have either: sedating, stimulating or balancing effects upon the nervous system function.

Normalise Glandular functions

Massage can either increase or decrease the functions of glands in the body, especially this effect is marked in the glands of the skin.

 

Remedial Massage Therapy in Context

Massage is a useful and integral part of the healing process. It should be used where indicated and appropriate by qualified remedial massage therapists. Remedial massage is an ideal treatment to aid in the recovery from physical injury, certain chronic disorders and musculo-skeletal disorders. Massage promotes flexibility in joints and muscles and is often used as an adjunct therapy to other forms of treatment such as Acupuncture, Herbal medicine, etc. in a variety of diseases.

© Northern School of Traditional Medicine (Wildcrafted Herbal Products), 1997