CONNECTIVE TISSUE MASSAGE
Connective tissue massage is a connective tissue massage performed in reflexively altered areas. This type of massage was developed in 1929 by E. Dicke.
In various diseases of organs and systems, an increase in the tone of interstitial connective tissue was found in body segments that have innervation with the affected organs. Connective tissue is located in three transition layers:
Between skin and subcutaneous layer;
Between the subcutaneous layer and fascia;
In the fascia of the trunk and limbs.
These increased areas of tissue tension are called connective tissue zones. In these areas, a finger moving over the skin with its tension feels resistance, a violation of the normal state.
CONNECTIVE TISSUE TECHNIQUEMASSAGE
The main techniques of connective tissue massage are: longitudinal stroke, short stroke, long stroke, roller technique. These techniques are used effectively on various areas of the body.
Longitudinal stroke performed with one or both hands, fingers II-V closed together. The long movement is most often used on the back area, chest, lower and upper limbs. The direction of the longitudinal stroke is always from bottom to top (from caudal to cranial). It is possible to perform the technique with weights from one hand to the other.
Short stroke performed with pads (end phalanges) from the III-IV fingers of one hand, located at an angle of 60-90° to the massaged surface. When performing the technique, the fingers should not slide over the massaged area, but grasp the underlying elephant along with the skin, with increasing impact from the midline in front of the chest to the midline on the back. When performing a technique on flat bone formations (scapula, sternum, clavicle, iliac crests, sacrum, etc.), the movement is carried out in the direction of the edges of the treated area. The bowl reception is performed with weights on the left hand of the right hand. The short stroke technique is used on various areas of the body according to diagnosis and indications.
Reception long stroke performed by the lateral surface of the first finger of one hand (usually the right one, burdened by the left one). In this case, the first finger is retracted at an angle of 90° to the others (from 1I-V). Applicable this technique on the back area, and all movements are carried out taking into account Benninghoff’s lines and are directed towards the spine, as well as from the caudal to cranial region. The technique of a long stroke is a technique of one-sided influence.
Reception of the roller roller lies in the fact that the first fingers of both hands are at an angle of 90° to the others (from II-V) and the ends of their phalanx are burdened. The movement is carried out only along the lateral surface of the back, towards the spinal column gradually from bottom to top, taking into account the diagnosis along Benninghoff's lines (Fig.).
Main linesdirections nwhen performing connective tissuemassage
(according to Benningoff)
Guidelines:
Before starting connective tissue massage, it is necessary to clearly determine the diagnosis, age, and profession of the patient. Apply the technique of identifying reflex changes:
1) visually (swelling, folds, asymmetrical depressions, areas of tension, color changes);
2) palpation-planar stroking, light pressure, short and longitudinal strokes, shifting, stretching"
3) taking into account the patient’s response - pain, scratching, pain, tension, stiffness;
4) instrumentally.
If identified diagnostic zones, which correspond to the affected organ, for example the cardiac zone, then manipulations should begin with silent zones (abstract), and then influence the diagnostic zones for this disease. After this, the patient’s vegetative state is determined (i.e. physiological - calm, excited, sweating, etc.). During the procedure, it is necessary to take into account autonomic responses. It is advisable not to ask leading questions, but to pay attention to subjective sensations - a feeling of pressure, poor condition, malaise, dizziness, etc. Before each procedure, find out if the patient has increased pain, fatigue, or hunger.
If during a connective tissue massage a feeling of cold, “goose bumps”, “goosebumps”, or numbness appears, this is the first signal indicating that the massage was performed incorrectly. The result of the massage is a parasympathetic reaction - a feeling of warmth, lightness, redness (hyperemia) of the skin. If this cannot be achieved, then it is necessary to carefully massage the iliac crests and the sacral area using the long stroke technique.
The duration of connective tissue massage depends on the initial condition of the patient. In case of significantly tense tissues, manipulations should be carried out slowly, with pauses.
As a rule, 1 procedure lasts 40-60 minutes. Further, subsequent sessions are reduced in time (20-30 minutes), which depends on the weakening of tissue tension. With a quick and short duration of massage, negative reactions may occur, which must be taken into account. After the massage, the patient can go home, but it should be taken into account that humoral responses develop (appear) after 2 hours. It is advisable that after the connective tissue massage procedure the patient does not perform heavy physical work. If he feels tired immediately after the procedure, he needs to eat a little (a piece of sugar, chocolate), which significantly slows down the onset of the parasympathetic action.
At acute diseases, with the exception of a runny nose, migraine, painful menstruation - do not massage.
Complete each session with planar stroking of the lower part of the chest and the iliac crest.
Location of reflex zones
Zone Bladder It has a round shape, the size of a 3-kopeck coin and is located above the anus in the coccyx area. This area is examined by sliding tissue across the sacroiliac joints. The initial position of the patient is sitting on a massage couch (you can lie down), the massage therapist is behind the patient on a low chair.
Intestinal zone no./ has the appearance of diarrhea, approximately 5 cm wide and begins in the area of the subgluteal fold in the middle between the greater trochanter and the ischial tuberosity, and ends at the outer edge of the sacrum. The zone is found in persons suffering from constipation or predisposed to it. During the examination, the arms are positioned perpendicular to the outer border of the zone.
Genital zone No. 1 located above the bladder area and occupies the lower two thirds of the sacrum, has a smooth surface for amenorrhea, dysmenorrhea and delayed menstruation. When examining it, the tissue is shifted along the outer border perpendicular to the spine, and then from bottom to top.
Lower head area No.I (insomnia zone) is located in the lower third of the sacrum, covered from above by genital zone No. 1. It is not studied separately.
Genital zone No. 2 located in the upper part of the sacrum.
Intestinal zone No. 2 located above upper limit sacrum along the paravertebral lines of the lumbar spine (2 vertebrae). The kidney zone is partially layered on top of it (for diarrhea).
Venous-lymphatic zone located above the iliac crest parallel to it. When examining it, the massage therapist spreads his elbows as wide as possible so that the fingers are directed perpendicular to the spine, and moves the tissue along the zone without moving to the iliac crest. Then the tissues are shifted from bottom to top, perpendicular to the lower border of this zone (Fig.).
Kidney area located on both sides of the spine at the level of L2-L5 or L1-L2. The zone is difficult to detect, since it does not have a bone base and is located only on the muscles. It is studied by moving tissue from bottom to top parallel to the spine, symmetrically on the left and right for comparison. The sequence of massage movements in this area is indicated below (Fig.).
Headache zone No. 2.(The middle area of the head is the main one). Located near the spine at the level of the CP between the liver and stomach areas.
Liver and gall bladder area - located at the level D6 - D12 under the right shoulder blade. Examined symmetrically on the left and right for comparison. Soft tissues are grabbed into the fold with 1 and 2-5 fingers, gently pulled back and slowly released. In one place the movement is repeated 3-4 times (Fig.).
Heart and stomach areas- the heart zone covers the stomach zone. It is located at the same level as the liver area, only under the left shoulder blade. Research is carried out as in the study of the liver area. The liver and gastrocardiac zones can be examined by moving the massaged tissue parallel to the spine from bottom to top (Fig.).
Headache area(“most important”) is located between the shoulder blades. Its upper border is at the level of the upper inner corners of the shoulder blades. It is examined by stroking the palms of both hands from top to bottom (Fig.). It is not recommended to touch the medial edges of the shoulder blades (the movements are repeated 8 times).
Shoulder girdle area located in the infraspinatus fossa, its lateral edge reaches the acromion. It is examined with the pads of the II-IV fingers by moving them towards the spine. Then the shift is made from bottom to top to the bone of the scapula (Fig.).
Head zone No. 4(upper zone of the head) is located on both sides of C7 to the width of two transverse fingers (its total width is from NW to TI (DI)). This area is not being explored (Fig.) .
Arterial zone of the legs(“smoking zone”) is located in the form of a cord from the ischial tuberosity to the greater trochanter. It is detected with any functional or organic changes in the vessels of the lower extremities.
Connective tissue massage
Connective tissue massage is a massage of reflex zones in connective tissue. The method was developed in 1929 by E. Dicke.
For diseases internal organs, blood vessels and joints, pronounced reflex changes in the subcutaneous connective tissue occur, primarily a violation of its elasticity.
An increase in the tension of the subcutaneous connective tissue causes a change in the relief of the body surface in this area in the form of retraction, swelling, etc. They are palpated primarily on the back and change its relief. Connective tissue areas are designated by the segments in which they are located and from which the corresponding organs or systems of the body are innervated.
In Fig. 51 schematically shows the following connective tissue zones:
The bladder zone (0.5 cm in diameter) is located in the lower part of the sacral region; patients complain, for example, of a feeling of coldness in the legs (up to the knees), sensitivity of the bladder to various irritations;
Zones of the arteries of the legs - cord-like retractions in the gluteal region on the affected side; patient complaints of calf muscle cramps;
Intestinal zone 1 - ribbon-like retraction extending from the middle third of the edge of the sacrum downwards; patient complaints of constipation;
Areas of veins and lymphatic vessels of the legs - ribbon-like retraction, localized 10 cm below the crest ilium parallel to it from the middle third of the sacrum towards the thigh; patient complaints about a tendency to swelling, leg ulcers;
Genital area 1 - flat retraction between the sacroiliac joints; patient complaints of dysmenorrhea;
Intestinal zone 2 - flat retraction in the sacral region at the level of the upper half of the iliac crests; patient complaints of a tendency to diarrhea;
Rice. 51. Schematic representation of visible reflex connecting zones
Liver and gallbladder area - large flat retraction on right side chest;
Heart and stomach area - large flat retraction on the left side of the chest; patient complaints about pressing sensations in the stomach before eating, functional disorders cardiac activity;
Head area - retraction primarily between the shoulder blades; patient complaints of headaches of various etiologies;
Arm area - flat retraction on the shoulder blade (on the affected side); patient complaints of shoulder pain.
Connective tissue zones adjacent to the fascia are determined by plane displacement of the skin or the skin fold method.
Planar skin displacement(Fig. 52, wavy lines) are carried out near the fascia, always in two symmetrical places, without pressure and without a cutting sensation. To identify differences between the parties, it is necessary to conduct the test with both hands. The skin is displaced at a right angle to the edge of the bone. Start from the lower part of the sacral region. The massage therapist places his fingers at such a distance from the edge of the bone that it is possible to shift the skin towards the edge of the bone (displacement boundary).
Rice. 52. Schematic representation of planar displacement (wavy lines) and skinfold technique (parallel lines)
Sequence of action: edge of the sacrum, sacroiliac joints, iliac crest, sacrum, lower costal arch, posterior surface of the chest, scapula. In this case, all zones presented in the diagram are palpated.
With the skin fold method (Fig. 2, parallel lines), the thumb and other fingers form a skin fold and elastically pull it back.
Physiological effects connective tissue massage on the body:
Increased metabolism;
Improving blood circulation in tissues;
Elimination of connective tissue tension and unwanted reactions of the nervous system.
Signs of increased tension in the subcutaneous connective tissue:
The tense tissue provides pronounced resistance to the doctor’s (massage therapist’s) finger;
When palpating tense tissue, pain occurs;
When massaging tense tissue, a thermographic reaction appears in the form of a wide band;
At sharp increase tension, the formation of a skin ridge at the site of the stroke is possible.
Massage technique consists of irritating the tension of the connective tissue with the tips of the third and fourth fingers.
There are the following types of massage techniques:
Skin - displacement is carried out between the skin and the subcutaneous layer;
Subcutaneous - displacement is carried out between the subcutaneous layer and the fascia;
Fascial - displacement is carried out in the fascia.
All types of equipment are combined by the presence of irritation by tension.
Connective tissue massage is carried out in IP. the patient sitting, lying on his side or lying on his back. I.p. Lying on your stomach is not recommended.
The optimal position for the patient is lying on his side, since the muscles relax better, the massage therapist works in a more physiological and thus economical diagonal position of the fingers, hands and shoulder girdle, and the patient eliminates unwanted autonomic reactions.
Massage is performed with the tips of the I–IV fingers and sometimes with only one finger, the radial, ulnar sides of the fingers or the entire surface of the fingertips.
Planar connective tissue massage consists of displacement along the plane of connective tissue from the edges of bones, muscles or fascia. The main massage movements are shown in Fig. 53.
Massage technique
The thumbs and other fingers of the hand work only alternately, since otherwise the tissues are “crushed”;
When displacing tissues with your thumbs, it is necessary to grasp the area of the wrist joints (movements such as rotation), since otherwise the result is kneading or felting;
Not only the superficial tissues, but also those adjacent to the fascia are displaced;
Displacement during massage is performed without applying pressure.
Rice. 53. Direction of massage movements during connective tissue massage of the upper (A) and lower (b) limbs
Massage techniques
At the edge of the sacrum. The pads of the first fingers are placed in longitudinal direction along the edge of the sacrum. The remaining spread fingers of both hands are placed on the buttocks (approximately 5 cm from the edge of the bone). The subcutaneous tissues are moved with the fingers of the hands towards the thumbs.
At the lumbosacral joints. The fingers, including the thumb, are placed at the edge of the sacrum. Massage movements end at top edge iliosacral joints.
From the edge of the sacrum to the greater trochanter. The massage begins in the same way as when massaging the edges of the sacrum. Small displacements are used to massage the tissues of the buttocks towards the greater trochanter.
From the lumbosacral joints. Parallel to the superior anterior iliac spine. The tissues are moved towards the spine with small displacements.
At the great skewer. The thumbs of the hand are placed dorsal to the trochanter region (approximately at the beginning of the gluteus maximus muscle), the remaining fingers are on the ventral side. The tissues are massaged towards the trochanter.
ATTENTION!
It must be remembered that the tissues above the trochanter are often swollen and sensitive to massage pressure.
From the spinous processes of the vertebrae to the lateral surface of the body. The thumbs of the hands are placed along the spine at the spinous processes, the remaining fingers are located at the lateral edge of the erector spinae muscle. Massage movements are carried out at a calm pace with tissue displacement in the transverse direction (across the entire back to the axillary line).
In the area of the erector spinae muscle. The thumbs of the hands are placed along the spine at the spinous processes, the index fingers are placed at the lateral edge of the muscle. The tissues are shifted towards the big toe. Use your thumb to displace the muscle at the medial edge. The massage therapist performs only short tissue displacements. This technique is recommended for massaging the lumbar region.
From the medial edge of the scapula in the lateral direction. The thumbs are placed at the edge of the shoulder blade, but not on the tissue between the shoulder blade and the spine. With short shifting movements, the massage therapist moves the tissue towards the acromion.
Subcutaneous fat layer massage
Healing tension- this is a tension in the connective tissue that immediately causes a cutting sensation if the connective tissue zones are identified.
The main massage techniques are: longitudinal and short movements (stroke), roller technique.
The longitudinal movement (stroke) is carried out by one or both hands of the massage therapist. The direction of movement is from bottom to top (from caudal to cranial). This movement is used in the back, chest and limbs.
A short movement (stroke) is carried out with the pads of the third–fourth fingers located perpendicular to the surface being massaged; the fingers should not slip during this technique.
Rice. 54. The location of the lines of greatest resistance to stretching of individual areas of the skin according to Benninghoff: A) anterior surface of the body; b) back surface of the body
A long movement (stroke) is carried out by the side surface thumb one hand (possibly with weights from the other hand of the massage therapist). The technique is performed in the back area, movements (taking into account Benninghoff's lines) are directed towards the spine, as well as from the caudal to the cranial (Fig. 54).
Reception of the roller. The thumbs of both hands of the massage therapist are perpendicular to the massaged area. Movements are carried out only along the lateral surface of the back, towards the spine (from bottom to top) along the Benninghoff lines.
Method of massage of the subcutaneous fat layer. Massage movements are performed between the subcutaneous tissues and fascia in the form of short movements directed perpendicular to the edge of the bones, muscles or fascia. The displacement of subcutaneous tissues is carried out to the possible limit of displacement. This path, depending on the degree of tissue tension, is 1–3 cm.
Therapeutic tension, in which a more or less sharp cutting sensation immediately occurs.
Fascia massage technique. The massage therapist places his fingers under slight pressure deep in the tissue - towards the edge of the fascia; in this case, the patient should not feel any pressure or pain. A sharp, sharp sensation occurs immediately, like a “sharp knife”.
When performing a massage, the fascia is worked only with short movements.
When performing a massage, it should be remembered that the fingers must be placed on the massaged area without pressure, the fingers in the connective tissue zone should not come out of the subcutaneous connective tissue, during therapeutic tension the tension force is applied without pressure on the tissue. Do not go over the edge of bones, muscles and fascia. It is recommended to displace not only the superficial, but also the tissue adjacent to the fascia. The massage therapist must achieve irritation by tension.
Skin massage technique. Provided that there are connective tissue zones in the displacement layer between the skin and subcutaneous tissues, they should be massaged using skin massage techniques.
Massage technique. Massaging movements are carried out from caudal to cranial areas along the skin folds (on the body they massage in the transverse direction, and on the limbs - in the longitudinal direction). The massage begins with the buttocks and thigh muscles, then moves to the lumbar and lower thoracic spine. Only in cases where tissue tension (connective tissue zones) has decreased in a given area, massage is performed in the upper parts of the chest. The fingertips are placed between the skin and subcutaneous tissues (without pressure!). The therapeutic tension along the folds should cause a slight cutting sensation. Massage movements are carried out both intermittently and continuously.
ATTENTION!
The massage should be performed precisely in the displaced layer between the skin and subcutaneous tissues. When massaging the skin, not only stroking is performed, but also irritation by tension (without this there will be no desired effect).
I.p. patient: children lying on their stomach or sitting, adults lying on their side or sitting.
Massage techniques
Massage in the buttocks and thighs area. The massage therapist places the fingers over the spinous processes of the sacral vertebrae (above the anal fold). Therapeutic tension is carried out continuously in small arcs to the side and down over the convexity of the buttock. Massage movements are performed tightly one next to the other until the spinous process of the L5 vertebra. At the lumbosacral joint, massage movements are carried out parallel to the iliac crest [the direction of movements is also possible from the lateral to the medial sections (Fig. 55)].
Massage in the lumbar region and lower thoracic spine. The fingers are located at the spinous processes of the lumbar and lower thoracic vertebrae. Therapeutic tension is applied to the middle of the axillary line. Massage movements are carried out to the lower angle of the scapula (Fig. 56).
Massage of the front surface of the body. The patient is positioned supine. Massage movements should be long, continuous, from the middle of the axillary line (below the costal arch) to the edge of the rectus abdominis muscle (approximately to the sternum). Above the iliac crest, massage movements continue from the anterior superior iliac spine to the pubic symphysis (Fig. 57).
Massage in the shoulder girdle and neck area. The massage therapist's fingers should be placed at the spinous processes of the thoracic vertebrae (at the level of the lower corners of the scapula). Therapeutic tension is carried out diagonally upward over the trapezius muscle and over the shoulder blades down to the lower portions of the deltoid muscle. Massage movements are carried out one next to the other (up to the acromion). On the spinous process of the C7 vertebra, short circular massage movements are performed in the direction from the lateral to the medial areas to the area of swelling or pain. Only after this are movements made to the spinous processes (Fig. 58.).
Rice. 55. Direction of massage movements during connective tissue massage of the lumbosacral region and pelvis
Rice. 56. Direction of massage movements during connective tissue massage of the back area at the level of segments Th 12-Th6 and pelvis
Rice. 57. Direction of massage movements during connective tissue massage of the chest (A) and belly (b)
Rice. 58. Direction of massage movements during connective tissue massage of the neck area (A) and shoulder girdle (b)
Neck area massage. Massage movements are performed in a horizontal direction from lateral to medial areas (with slight tissue tension - from caudal to cranial to the back of the head).
Limb massage. Massage movements are carried out in the longitudinal direction along the folds (from proximal to distal sections). Patient's sitting position during massage upper limbs, lying on your back while massaging the lower extremities.
Guidelines
The massage therapist must regulate the severity of cutting sensations by changing the tempo of the massage, taking into account tissue tension:
The smaller the angle of the fingers, the more superficially they act on the tissue;
If there is a strong cutting sensation, it is necessary to pay attention to the placement of the fingers;
A cutting sensation is not a sign of correct dosing; it allows one to judge the presence of connective tissue zones, the patient’s adequate response and correct technique massage.
If massage techniques are performed harshly, skin hemorrhages are possible.
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Connective tissue massage is a massage of reflex zones in connective tissue. The method was developed in 1929 by E. Dicke,
In diseases of internal organs, blood vessels and joints, pronounced reflex changes in the subcutaneous connective tissue occur, primarily a violation of its elasticity.
Connective tissue massage enhances metabolism, improves blood circulation in tissues, eliminates tension in connective tissue and unwanted reactions nervous system.
Signs of increased tension in the subcutaneous connective tissue:
Provides pronounced resistance to the finger of the doctor (massage therapist);
Pain occurs on palpation;
When massaging, a dermographic reaction appears in the form of a wide band;
With a sharp increase in voltage, a skin ridge may form at the site of the stroke.
Massage technique: tension the connective tissue with the pads of the 3rd and 4th fingers.
Massage technique: skin - displacement is carried out between the skin and the subcutaneous layer; subcutaneous - displacement is carried out between the subcutaneous layer and the fascia; fascial - displacement is carried out in the fascia.
All types of technology are united irritation by tension (Fig. 4.4-4.5).
Connective tissue massage is performed with the patient in the initial position sitting, lying on his side or lying on his back. The starting position lying on your stomach is not recommended. The position of the patient lying on his side is considered optimal, since the muscles relax better, and the diagonal position of the massage therapist’s fingers, hands and shoulder girdle is more physiological and economical: the patient eliminates unwanted vegetative reactions.
Massage is performed with the fingers of the J-IV fingers, sometimes with just one finger, the radial, ulnar sides of the fingers or the entire surface of the fingertips.
Irritation by tension is performed with the whole hand, in no case only with the fingers, hand or forearm.
Plane connective tissue massage involves moving connective tissue along the plane - from the edges of bones, muscles or fascia.
Rice. ¥.5.
Direction of massage
movements during connective tissue massage of the scapula muscles.
Massage techniques
At the edge of the sacrum. The pads of the first fingers are placed longitudinally along the edge of the sacrum; the remaining spread fingers of both hands are placed on the buttocks (approximately 5 cm from the edge of the bone). The subcutaneous tissues are moved with the fingers of the hands to the first fingers.
At the lumbosacral joints. The fingers, including the first one, are placed at the edge of the sacrum. Massage movements end at the upper edge of the iliosacral joints.
From the edge of the sacrum to the greater trochanter. The massage begins in the same way as when massaging the edges of the sacrum. Small displacements are used to massage the tissues of the buttocks towards the greater trochanter.
From the lumbosacral joints. Parallel to the superior anterior iliac spine. The tissues are moved to the spine with small movements.
At the great skewer. The first fingers of the hands are placed dorsal to the trochanteric region (approximately at the beginning of the gluteus maximus muscle), the remaining fingers are placed on the ventral side. The tissues are massaged towards the trochanter.
Massage of the subcutaneous fat layer and fascia. Therapeutic tension is a tension in the connective tissue that immediately produces a cutting sensation if the connective tissue zones are identified.
Massage technique. Massage movements are performed between the subcutaneous tissues and the fascia - these are “short” movements directed perpendicular to the edge of the bones, muscles or fascia. They are carried out one next to the other along the edges of bones, muscles or fascia.
When performing a subcutaneous massage, the fingers are placed between the subcutaneous layer and the fascia, depending on the tissue tension, a few centimeters from the edge of the bone, muscle or fascia. The displacement of the subcutaneous tissues is carried out up to the possible shift limit - depending on the degree of tissue tension by 1-3 cm.
Therapeutic tension is characterized by the appearance of a more or less sharp, cutting sensation.
When performing a fascia massage, the fingers are placed under slight pressure deep in the tissue - towards the edge of the fascia; in this case, the patient should not feel any pressure or pain. A sharp, sharp sensation occurs immediately, like a “sharp knife”. When performing a massage, the fascia is worked only with short movements.
Skin massage. If there are connective tissue areas in the displacement layer between the skin and subcutaneous tissues, they should be massaged using skin massage techniques.
Massage technique. Massaging movements are carried out from caudal to cranial areas along the skin folds (on the body they massage in the transverse direction, on the limbs - in the longitudinal direction). The massage begins with the buttocks and thigh muscles, then moves to the lumbar and lower thoracic spine. In cases where tissue tension (connective tissue zones) in a given area has decreased, massage is performed in the upper parts of the chest.
When performing a massage, the fingertips are placed between the skin and subcutaneous tissues (without pressure!). The therapeutic tension along the folds should cause a slight cutting sensation. Massage movements are carried out both intermittently and continuously.
Periosteal massage
Periosteal massage is a type of acupressure performed on bone surfaces. The method was developed in 1928 by Volgler.
The effect of periosteal massage on the body:
Local increase in blood circulation;
Regeneration of cells, especially periosteal tissues;
Analgesic effect;
Reflex effect on organs connected by nerve pathways to the massaged surface of the periosteum;
Increasing the efficiency of cardiac activity;
Improving breathing excursions;
Normalization of tone and stimulation of peristaltic movements of the stomach.
Periosteal massage is characterized by a local effect on the periosteum, the ability to approach hard-to-reach tissue layers that cannot be worked through with therapeutic or connective tissue massage, and an intense, prolonged reflex effect on internal organs.
Methods and techniques of periosteal massage
The patient's starting position is lying on his back, on his stomach, on his side or sitting. For better contact with the bone surface, it should be in the area treatment point(JIT) move soft fabrics, primarily muscles.
By increasing the pressure with your finger, even a slight tissue resistance is determined, then the massage therapist makes circular movements in the JTT zone with his finger. The diameter of the circle should not exceed 5 mm.
The finger pressure is gradually reduced, but contact with the skin is not interrupted.
Cosmetic massage
Massage of the face, neck and head is one of the methods of preventing aging of the skin of the face and neck, treating dysfunction sebaceous glands(dry or oily skin), facial pastiness, paresis facial nerve, hair loss. In addition, massage improves the overall appearance of the face, maintains turgor and natural skin color. Self-massage of the face (manual or using a device) is not recommended, as it can cause undesirable consequences: stretching of the skin, deepening of wrinkles, changes in the oval of the face, infection.
Massage lines of the face are located mainly from the center to the periphery: from the middle of the chin towards the earlobes, from the middle upper lip and from the outer corner of the eye - to the tragus ears; from the middle of the forehead - to the temporal hollows.
Facial massage involves massaging the skin, muscles and nerves of the face. General techniques facial massage should be consistent with the anatomical location of the draining lymphatic vessels directed from the midline of the face in both directions. In the forehead area lymphatic vessels located almost parallel to the edge of the scalp, at the temples they descend downwards, near the ear area they approach the corner lower jaw. The lymphatic vessels of the nose, eyes, and upper half of the necks are also directed to the angle of the lower jaw; vessels of the lips and lower jaw - at different distances from its angle; The lymphatic vessels of the chin descend straight down to the middle of the submandibular region.
When massaging the face, stroking, rubbing, kneading, effleurage and vibration are used.
A massage course is 15-20 sessions, carried out 2-3 times a year. The initial position of the patient is lying on his back, sitting. The duration of a facial massage together with a massage of the front and back of the neck should not exceed 15 minutes; an overdose has a depressing effect and, therefore, reduces the effect of the massage.
There are cosmetic massage based on cream, plastic and therapeutic-cosmetic massage.
Cosmetic massage with cream
This type massage aimed at improving general view faces, warning premature aging, eliminating dryness, wrinkles, swelling, etc.
Indications for facial massage:
Reduced sebaceous secretion of the facial skin;
Beginning aging of the skin of the face and neck (preventive massage);
Swelling skin, puffiness of the face;
Facial nerve paresis;
Scleroderma;
Fresh hypertrophic scars.
Contraindications to facial massage:
Feverish state;
Acute inflammatory processes(furuncle, carbuncle, abscess);
Facial skin diseases (pustules, dermatitis, eczema, herpes, etc.);
Severe hypertrichosis;
Flat warts.
Basic massage techniques
Stroking is performed freely, the muscles of the massage therapist’s hands are as relaxed as possible. Contact of the massage therapist's hand with the patient's facial skin should be complete.
Rubbing is carried out with the palmar surface or middle interphalangeal joints fingers folded into a fist, which has a deeper effect on the tissue.
Kneading: the massage therapist grabs the tissues with the end phalanges of the fingers and with short, fairly quick movements presses them to the bones.
Vibration is performed by the palmar surface of the phalanges of several fingers of the hand.
Tapping is performed on the palmar surface of all fingers; movements are intermittent, in the form of separate shocks following each other.
Chopping is indicated only when massaging the skin of the back of the neck in the presence of fatty deposits. Performed with the ulnar edge of the hand, the hands should move quickly and rhythmically. Palms facing each other, fingers open. The strength, softness and elasticity of the blow depend on the degree of closure of the fingers.
Connective tissue massage is a massage of connective tissue in reflexogenic zones. This type of massage was developed in 1929.
At various diseases organs and systems, an increase in the tone of interstitial connective tissue was detected in body segments that have common innervation with the affected organs. Connective tissue is located in three transitional layers - between the skin and the subcutaneous layer, between the subcutaneous layer and the fascia, and in the fascia of the trunk and limbs. These highly stressed areas of tissue are called connective tissue zones. In these areas, a finger moving over the skin with its tension feels resistance.
Areas with reflex changes in the subcutaneous connective tissue, close to the skin, are observed with articular rheumatism, with polio in children, and those close to the fascia are more common with chronic diseases.
Superficial zones of subcutaneous connective tissues often coincide with Ged's zones. However, Ged's zones are sensitive to temperature stimuli. Zones of subcutaneous connective tissues close to the skin, on the contrary, appear painful sensations with palpation and even with stroking. In the back area, subcutaneous connective tissues are detected by swelling in the corresponding areas. The zones of subcutaneous connective tissue are interconnected, like internal organs with a viscero-visceral reflex. Zones with reflex changes in the surface layers of subcutaneous connective tissues are observed only in acute diseases or during periods of exacerbation of chronic ones. After the cessation of acute phenomena, these zones disappear. In the deep layers, connective tissue zones remain noticeable. They are found in the following cases:
- after the cessation of acute phenomena;
- with functional changes;
- clinically healthy people, whose fathers had stomach diseases, and whose mother had migraines.
There are so-called clinically silent zones. These areas are more difficult to palpate, but they play an important role in therapy. Areas of subcutaneous connective tissue are found mainly on the back, buttocks, thighs, sacrum, chest and shoulder blades. Clinically silent areas are the most vulnerable place or the place with the least resistance.
There are 3 ways to identify connective tissue areas:
- interviewing the patient (for functional disorders);
- identification of organic changes;
- identifying imbalances in the vegetative nervous system.
Connective tissue reaction and massage. The connective tissue zones in acute, subacute and chronic diseases are quite pronounced. Under the influence of a typical massage technique, tension in connective tissues decreases. The reaction of connective tissues is specific not only for internal organs and segments, but also for the entire autonomic system. The consequence is the normalization of its tone. Connective tissue massage is therefore a holistic technique and not just a local treatment. It has been established that the more pronounced the complaints and reflex changes in connective tissues, the stronger the neuro-reflex reaction to connective tissue massage. Connective tissue massage causes certain reactions of the skin and autonomic nervous system.
Subjective sensations and skin reactions to connective tissue massage. During a connective tissue massage, the patient feels pain and scratching in places where connective tissues are tense. This feeling is typical for massage. When massaging deep connective tissues - between the subcutaneous layer and fascia - very strong scratching occurs. Sometimes patients find these sensations unpleasant. Before the first connective tissue massage procedure, it is necessary to prepare the patient for these sensations. The patient must tell the massage therapist about his feelings to monitor the correctness of the massage. As the tension in the connective tissues disappears, the feeling of scratching and cutting also decreases. The slower the massage movements are made, the easier the sensations of cutting and scratching are tolerated. In angiospastic and acute kidney diseases, these sensations are absent.
During a connective tissue massage, a skin reaction appears in the form of a stripe - hyperemia. When there is severe tension in the connective tissues, a swelling that can be easily felt by the fingers appears at the massage site. As the tension decreases, the skin reaction to the massage also decreases. In exceptional cases, these reactions can last up to 36 hours after the end of the procedure. The patient should be warned that sometimes itching may appear in the massaged area. With rheumatoid arthritis, these sensations during massage are less pronounced, but sometimes “bruises” appear. The massage therapist must warn the patient about this. A sign of a very deep incorrect massage is pain. At the same time, the massage therapist must continue to work softer and slower.
Autonomic reactions. Connective tissue massage affects internal organs reflexively. From the receptor apparatus, irritation is transmitted to the autonomic nervous system. The massage therapist must determine how massage affects the patient. Connective tissue massage affects the body primarily through the parasympathetic department of the autonomic nervous system. Signs of a parasympathetic reaction are “goose bumps” and pale skin. Humoral reactions are closely related to nervous ones and proceed slowly, appearing 1-2 hours after the end of the procedure. If after the massage the patient feels tired, he should rest at home, otherwise he may experience headache or even collapse. If the patient feels tired immediately after the massage, it is recommended to eat something (chocolate, sugar).
Connective tissue is made up of cells and intercellular substance. Connective tissues contain reticular cells and fibrocytes, which form cellular network where fat and basophil cells are located. Connective tissue consists of lattice fibers that form membranes and collagen fibers that stretch well.
All these fibers are found in the skin, lungs, vessel walls, and joint capsules.
Reticular connective tissue is found in the spleen, lymph nodes, bone marrow. They form part of the reticuloendothelial system (RES). Reticular tissue has fat cells, especially around small blood vessels. This tissue has a high regenerative ability.
Fibrous connective tissues contain collagen and elastic fibers. These fibers connect the skin with the underlying tissues; they are also located between the muscle bundles where blood vessels and nerves pass. The displacement of other tissues in relation to each other depends on the presence of such connective tissue. Some of these fibers form a tense network and are found in tendons and ligaments, capsules and dermis.
Thus, connective tissues form the basis of the skin, vascular fascia, the sheath of nerve trunks, the basis of internal organs (stroma), tendons and ligaments. Connective tissue connects all parts of the body, gives it shape and allows the free movement of various segments.
Dosing procedures
Massage is carried out daily, at least 4 times a week. Massage once a week is not successful. If the patient's condition improves, massage can be performed once a week to maintain the improved condition. For a course of treatment - 12-18 procedures, in severe angiospastic conditions - 30 procedures or more. After completing the course there is a break of 8-12 weeks. In the absence of complaints, too frequent connective tissue massage procedures are contraindicated. Rarely massage cannot be performed. The patient must adapt his regimen to the treatment: do not smoke, do not drink 2 hours before the procedure. You should not drink alcohol, as existing changes in tissues and corresponding reactions interfere with the massage. If the patient smokes, the massage course is extended.
You should not smoke for 2 hours after a massage session.
Combination of connective tissue massage with other physiotherapeutic procedures
The combination of massage with light, thermal, and short-wave treatments is undesirable. With such combinations, violations that cannot be corrected appear. Gymnastics are performed after the massage. If the patient takes baths, then he should receive baths in the morning, and massage in the evening after lunch.
Connective tissue is, in fact, the main support of the human body, forming the stroma and dermis. It consists of cells various types(osteocytes, osteoclasts, osteoblasts, fibroblasts, fibroclasts, chondroblasts, macrophages, mast cells, melanocytes, endothelial cells). It has protective, supporting and trophic functions. Connective tissue is found in the body in liquid, gel, fibrous and solid states. Connective tissue is cartilage, joints and joint capsules, bones, tendons and ligaments, synovial fluid, vessels and capillaries, lymph and blood, iris and sclera, fascia, microglia, extracellular matrix and intercellular fluid. Connective tissue fibers form membranes and have good extensibility. Collagen fibers located under the skin provide communication with deeper tissues. The normal functioning of all organs depends on the condition of connective tissue.
Connective tissue, which contains fat cells and has a high ability to regenerate, is found in the lymph nodes, spleen and bone marrow. Its fat cells and capillaries surround it.
There are connective tissue zones in the body, they are called highly stressed areas of tissue. These zones are located between the subcutaneous layer and the skin itself, in the connective tissue membranes of the limbs and torso.
Connective tissue is the basis for the connection between all organs and parts of the body, gives shape to the body and allows it to function normally. It forms the dermis, joints, blood vessels, sheath of nerve trunks, bones, internal organs, tendons.
Articular rheumatism, poliomyelitis in children, scoliosis, osteochondrosis, osteoporosis, flat feet, fractures, blood diseases, prolapse of internal organs, retinal detachment, ligament rupture, joint hypermobility - this is far from full list diseases associated with disruption of the normal functioning of connective tissue.
The peculiarity of connective tissue massage is that, unlike traditional, it is not a simple local impact, but a whole technique.
Under the influence of such a massage, excessive tension in connective tissue areas is relieved and tone is normalized. Since our body is literally “permeated” with connective tissue, and it makes up approximately half of the mass of the entire body, its normal functioning is extremely important for a healthy human condition.
Reactions during massage are observed more strongly if changes are pronounced in the connective tissues. In other words, reactions that are associated with the autonomic nervous system and dermis. Therefore, patients may experience such discomfort during connective tissue massage, as a specific scratching and even cutting. That is why connective tissue massage uses smooth, soft, slow massage movements. In order for the procedure to be as effective and painless as possible, the patient should inform the osteopathic specialist about how he feels during the massage. To reassure you, it should be noted that the more tension in the connective tissues is relieved, the less discomfort becomes.
Some patients are alarmed by the fact that during and even after (up to almost two days) stripes, swelling, and itching may appear on the skin for some time. They can be expressed as weakly (as with rheumatoid arthritis), and quite strongly. However, when the functioning of connective tissues begins to return to normal, all these phenomena disappear.
As you know, all human skin is covered with receptors that transmit impulses to the autonomic nervous system. During connective tissue massage, an effect occurs through receptors on the parasympathetic department (i.e., ganglia that are located either in organs or near them). Changes (eg, paleness) in the skin may indicate a parasympathetic response during the procedure. Humoral reactions may occur later, an hour or two after the session, and they proceed more slowly.
Various neuralgic and organic diseases, rheumatoid tissue lesions, rheumatic joint diseases, dysfunction of internal organs - for all these ailments, connective tissue massage can be prescribed.
Patients should remember that if they are undergoing a course of connective tissue massage, then for this period it is advisable to abandon other procedures that can not only negate the efforts of the osteopath, but also give new complications that are subsequently very difficult to correct. Therefore, you should refrain from light, short-wave and thermal procedures. But after a massage session you can perform certain physical exercises.
At the end of the connective tissue massage procedure, the patient should be aware of the appearance of “late” humoral reactions. If there are angiospastic diseases or dizziness, he should rest for about an hour or two. If the patient feels tired after the session, he may be advised to immediately take some food (usually chocolate, which quickly replenishes lost energy). If the patient feels fine, he can safely go home. However, he must remember that it is undesirable to engage in heavy work after the massage procedure. physical work, which can neutralize the result of treatment.
The standard course of connective tissue massage ranges from 12 to 18 sessions. If the patient has a severe angiospastic condition, in this case the number of sessions may increase to 30 or more. The duration of the first massage session is from 40 minutes to 60. Subsequently, the time is reduced to half an hour (this is the minimum procedure time). A couple of hours before the start of the massage session, it is forbidden to drink alcohol or smoke. The effect of alcohol on the body is such that it creates obstacles to the normal conduct of the procedure. If the patient smokes, then the massage may last longer than usual, and at the end of it you should refrain from smoking for two hours. After completing the full course of connective tissue massage, you need to take a break of 2 to 3 months.
