Chapter X Drugs acting on the peripheral nervous system

Impact of massage Impact of massage on the skin By massaging the skin, we act on all its layers, on the skin vessels and muscles, on the sweat and sebaceous glands, and also affect the central nervous system, with which the skin is inextricably linked. Massage has

The effect of massage on the skin By massaging the skin, we act on all its layers, on the skin vessels and muscles, on the sweat and sebaceous glands, and also affect the central nervous system, with which the skin is inextricably linked. Massage has a diverse physiological

The impact of massage on the nervous system The nervous system is the first to perceive the effect of massage, because there are a huge number of nerve endings in the skin. By changing the strength, nature, duration of the massage, you can reduce or increase nervous excitability, strengthen and

Impact of massage on muscles and joints Under the influence of massage, the elasticity of muscle fibers, their contractile function increases, muscle atrophy slows down, and already developed malnutrition decreases. Massage improves muscle performance

The impact of massage on metabolism Massage has a variety of effects on metabolic processes. Under the influence of massage, urination increases. In the blood, the amount of hemoglobin, erythrocytes and leukocytes increases. Massage does not cause an increase in the muscles

The impact of massage on the subcutaneous fat layer On adipose tissue, massage acts indirectly, through a general effect on metabolism. By increasing metabolic processes in the body, increasing the release of fat from fat depots, massage contributes to the "burning" of fats that are in

The effect of massage on the circulatory and lymphatic systems Massage causes the expansion of functioning capillaries, the opening of reserve capillaries, which creates more abundant blood irrigation not only of the massaged area, but reflexively and internal

Massage improves the functional capacity of the central nervous system, enhances its regulatory and coordinating function, stimulates regenerative processes and the processes of restoring the function of peripheral nerves.

The excitability of the nervous system, depending on its initial functional state and massage technique, may decrease or increase. It is known, in particular, that subjective sensations during massage are usually manifested by positive emotions of a pleasant state of rest, freshness and lightness. At the same time, massage can also have a stimulating effect on the central nervous system. With incorrectly established indications and selection of a technique, the effect of massage can be manifested by a deterioration in the general condition, irritability, general weakness, pain in the tissues or increased pain in the pathological focus, up to an exacerbation of the process. When practicing massage, one should not allow the appearance of pain, since painful stimuli reflexively cause a number of unfavorable vegetative reactions, which may be accompanied by an increase in the level of adrenaline and glucose in the blood, an increase in blood pressure and blood clotting.

In the laboratory of IP Pavlov, it was established that the leading role in the formation of the feeling of pain belongs to the cerebral cortex and that the reaction to pain stimulation can be suppressed by a conditioned stimulus. Such an irritant is massage, if it is applied differentially according to indications, taking into account the state of the reactivity of the patient's body, the form and stage of his disease. An adequate reaction to the massage procedure is manifested by a pleasant sensation of warming the tissues, easing their tension, reducing pain, and improving overall well-being. If massage increases pain, causes adverse reactions from the cardiovascular and other systems, is accompanied by the appearance of general weakness, deterioration of the patient's well-being, such procedures are contraindicated. In such cases, it is necessary to more carefully, differentially select the method and dosage. In the elderly, a negative reaction to massage can manifest itself in the form of pain, hemorrhages in the skin, vasospasm, and increased muscle tone (AF Verbov, 1966). When prescribing massage to patients in the acute period of the disease, paradoxical reactions of the borderline sympathetic trunk can be observed, expressed in increased pain, stiffness, deterioration in the contractile function of the myocardium and peripheral circulation, and a decrease in the electrical activity of the muscles.

Applying massage manipulations differentiated in form, strength and duration, it seems possible to change the functional state of the cerebral cortex, reduce or increase general nervous excitability, enhance deep and revitalize lost reflexes, improve tissue trophism, as well as the activity of various internal organs and tissues (A. F Verbov, 1966).

V. M. Andreeva and N. A. Belaya (1965) studied the effect of massage on the functional state of the cerebral cortex in patients with cervicothoracic and lumbosacral sciatica. According to the data of electroencephalography, the authors found that after massage (lumbar region, leg, back, arm), indicators of the bioelectrical activity of the cerebral cortex improved. Under the influence of massage, an increase in the severity of the alpha rhythm, a slight increase in its index and amplitude, an improvement in the form of vibrations, and more distinct reactions to a light stimulus were noted. At the same time, the registered changes "were more pronounced on the side opposite to the massaged one, and in case of damage to the sympathetic nodes - on the side of exposure." N. A. Belaya also indicates that under the influence of massage, an increase in the lability of the receptor apparatus of the skin is observed.

I. M. Sarkizov-Serazini (1957) noted that weak strokes have a calming effect, and with prolonged action they are one of the most effective "local anesthetics and anesthetics." Massage techniques act on the basis of reflex acts, and a conditioned reflex can be formed on any effect of massage techniques. If stroking is used as a conditioned stimulus and a conditioned reflex is developed to it, then other tactile skin stimuli can also cause a conditioned reaction.

E. I. Sorokina (1966), observing patients with neurasthenia with increased sensitivity of the heart area to various stimuli, showed that massage of the heart area reduces heart pain syndrome, has a reflex effect on heart function, slowing down its rhythm by 5-15 beats and several improving contractile function. Massage of the heart area reduces the sensitivity of skin receptors to pain stimuli and contributes to the appearance of an inhibitory reaction from the central nervous system. Light stroking and rubbing of the precordial region, initially short-term (from 4 minutes) with a gradual increase in their duration to 8-12 minutes during the course of treatment (10-12 procedures), is, according to the author, training the heart area to external stimuli. Light monotonous stimuli, gradually increasing in time, contribute not only to the training of skin receptors for external stimuli, but also cause inhibition at the cortical end of the skin analyzer, which, irradiating, can help restore the disturbed balance of the brain.

Metameric relationships between internal organs and skin explain the possibility of metameric and segmental-reflex reactions in the body. Such reactions include viscero-cutaneous reflexes (Zakharyin-Ged zones), viscero-motor reflexes (Mackenzie zones), viscero-visceral and other reflexes. Influencing massage techniques on reflexogenic zones rich in vegetative innervation and metameric relationships associated with the skin, it is possible to have a reflex therapeutic effect on the pathologically altered activity of various tissues and internal organs (Fig. 8, 9). There is a two-way relationship between the striated and non-striated muscle tissue of the internal organs and blood vessels: an increase in the tone of the striated muscle tissue contributes to an increase in the tone of the non-striated muscle tissue and vice versa. It is known, for example, that mental stress is accompanied by increased electrical activity of muscles, as well as zonal or generalized tension of striated muscle tissue. The greater the mental load and the stronger the fatigue, the stronger the generalized muscle tension (A. A. Krauklis, 1964). According to the observations of N. A. Akimova (1970), in most cases, during fatigue, points of increased muscle tone are localized in the cervical and thoracic segments from Dxv up on both sides of the spinal column. At the same time, clearly defined zones of hyperalgesia are often found in the neck (Civ-Cvni), interscapular region (Dn-Div), to the right and left of the spinal column (Dvi-Dvin), in front and below the collarbone (Di). When studying the effectiveness of the use of certain means of muscle relaxation in mental fatigue, it was found that in cases where there is a strong increase in muscle tone, as well as persistent emotional arousal that cannot be weakened, a light massage in the cervical and thoracic segments up from Dxn is advisable.

AV Sirotkina (1964) studied changes in the bioelectrical activity of muscles under the influence of massage in patients with paresis and paralysis of central origin. With severe rigidity and contractures, light stroking of contracted flexors was used, and weakened muscles were massaged with stroking and rubbing techniques. Based on electromyographic studies, it was found that such massage procedures reduce the excitability of the motor cells of the spinal cord, contributing to the improvement of the functional state of the neuromuscular apparatus.

Massage has a pronounced effect on the peripheral nervous system. By activating the dynamics of the main nervous processes, massage improves blood circulation, redox and metabolic processes in the nervous tissue. It has been proven that massage causes pronounced reactive changes in the terminal sections of the nervous system. The study of microscopic preparations of the skin of experimental animals found that massage causes a variety of changes in skin receptors, ranging from irritation to destruction and disintegration, depending on the number of procedures. Such changes are dyschromia of axial cylinders, swelling of their neuroplasm, expansion of myelin notches and perineural sheaths. Massage has a stimulating effect on the regeneration of the nerve when it is cut, causing an acceleration in the growth of axons, a slowdown in the maturation of scar tissue and a more intense resorption of decay products.

Vibration massage has the most pronounced reflex effect on the body. M. Ya. Breitman (1908) wrote that mechanical vibration "is capable of awakening to life that which is still viable."

The mechanism of action of vibration on the body is reduced to the perception of mechanical stimuli by the nerve receptors of tissues and the transmission of nerve impulses to the central nervous system, where sensations arise. Vibration sensitivity is classified as a variety of tactile sensitivity, considering it as the reception of intermittent pressure. However, a number of authors recognize the independence of vibrational reception.

A.E. Shcherbak believed that vibration acts on the nerve endings in the periosteum, from here the excitation goes to the spinal cord and along special paths to the cerebellum and other accumulation centers of the brain stem. He pointed out that the effect of vibration massage is selective and directed at the nerve endings adapted to the perception of mechanical stimuli.

The influence of vibrations on the nervous system is closely related to the degree of excitability of the nerves. Weak vibrations excite inactive nerves, and relatively strong vibrations cause a decrease in nervous excitability.

E. K. Sepp (1941) noted that vibration in trigeminal neuralgia causes not only vasomotor phenomena, but also long-term changes in the peripheral nervous system, manifested in a decrease in pain. At the same time, two phases are revealed in the mechanism of action of vibration: in the first, there is no anesthetic and vasodilating effect, and a vasoconstrictive effect is achieved; the second phase occurs after the first. Pain relief lasts from half an hour to several days. At a certain vibration frequency, it can have a pronounced analgesic and even anesthetic effect. Vibration, having a pronounced reflex action, causes an increase and sometimes a restoration of extinct deep reflexes. Depending on the place of impact and the nature of the vibration causes distant skin-visceral, motor-visceral and in some cases viscero-visceral reflexes.

IMPACT OF MASSAGE ON THE ORGANISM

For a long time, the influence of massage was reduced mainly to a mechanical effect on the massaged tissues. In fact, the mechanism of its action is based on physiological processes that affect many systems and organs of the human body. In the mechanism of action of massage, three main factors can be distinguished: mechanical, humoral and nervous.

Initially, the nerve endings located in various skin layers and having a direct connection with the autonomic and central nervous system are exposed to massaging movements. The mechanical energy transmitted by it undergoes transformation into the energy of nervous excitation, which will be the initial starting point for a number of complex reflex reactions of the body. It is caused by irritation of skin receptors and those that are in the muscles, tendons, ligaments, articular bags, receptors of the walls of blood vessels.

The central nervous system receives impulses that are transmitted to areas of the cerebral cortex. There, they are synthesized into a general reaction, as a result of which various functional shifts occur. As a result of the ability of impulses to change the functional state, changes also occur in the cerebral cortex, as well as in its other departments (cerebellum, spinal cord, functional formations of the brain stem).

The process of transformation of any stimulus (external or internal) can be characterized as a blow to the body's receptor apparatus, which then becomes a phenomenon of nervous excitation, being modified into a nervous process. Then, along the nerve fibers, the excitation is transmitted to the central nervous system, from where it enters through certain channels to one or another internal organ, where the received signal is modified into a specific process of the cells of this organ. This is how the effect of any stimulus on a particular system of the body and its activity is carried out. Changes in the work of the heart, lungs, intestines, muscles and other tissues are explained by the neuro-reflex effect of massage on them.

Depending on the state of the central nervous system, the body's responses may be different. It is also affected by the functional state of the nerve endings, which are primarily irritated. The role and dosage, the nature of massage techniques, the methodology and technique of their implementation and other conditions play a role.

A significant role in the mechanism of the impact of massage on the body is assigned to the humoral factor. They cause the formation of biologically active substances in the skin and their further entry into the blood. These substances belong to tissue hormones and take part in the processes of vascular reactions, the transmission of nerve impulses and other reactions of the body.

Massage has an effect on increasing the vital activity of the elements of the deep layers of the skin, since they tend to produce highly active substances, as they have an intrasecretory function. Through the blood and lymphatic vessels, they are carried throughout the body, while, in turn, affecting individual organs and its systems.

The humoral factor is controlled by the cerebral cortex and therefore is not independent. In interaction with the nervous, it provides the necessary combination of body reactions.

In addition to direct exposure, during massage, tissues are subjected to mechanical stress - displacement, stretching, pressure as a result of massage movements. All this contributes to the fact that the circulation of blood, lymph, interstitial fluid improves. Stagnation is also eliminated, metabolism is enhanced, skin respiration in the massaged area is improved.

From the foregoing, it follows that the effect of massage on the body is a very complex physiological process, which includes the interaction of nervous, humoral and mechanical factors, among which the first dominates.

Choosing massage as a way of influencing the body, you can change the functional state of the first one, depending on what kind of impact is currently required. There are five main types of effects: tonic, soothing, trophic, energy-tropic, normalization of functions.

The tonic effect of massage is characterized by an increase in excitation processes in the central nervous system. This is due to two reasons: firstly, an increase in the number of nerve impulses coming from the proprioreceptors of the massaged muscles to the cerebral cortex, and secondly, an increase in the functional activity of the reticular formation of the brain. The tonic effect can be used when there is a need to eliminate the negative effects of physical inactivity, which can be caused by various factors - a forced sedentary lifestyle, pathology (trauma, mental disorders, etc.). Techniques that have the ability to have a good tonic effect include vigorous deep kneading, shaking, shaking, and all percussive techniques (chopping, tapping, patting). To achieve the maximum tonic effect, the massage is performed at a fast pace with a short duration.

The consequence of the calming effect of massage is the inhibition of all processes of the central nervous system. It is caused by the fact that the extero- and proprioreceptors are moderate, rhythmic and prolonged irritation. Techniques such as rhythmic stroking and rubbing, carried out slowly and for a long time, have a good calming effect.

The trophic effect of massage, as a result of which the speed of blood and lymph flow through the vessels increases, is aimed at improving the delivery of oxygen and nutrients to tissue cells. Trophic action is especially important for restoring muscle performance.

The purpose of the energy-tropic effect of massage is primarily to increase the efficiency of the neuromuscular apparatus. This is manifested in the activation of muscle bioenergetics, improvement of the metabolic process in muscles, acceleration of enzymatic processes, as well as an increase in the speed of muscle contraction.

Normalization of body functions under the influence of massage is expressed mainly in the regulation of the dynamics of nervous processes in the cerebral cortex. This is of great importance when the processes of excitation of the nervous system predominate too much over the processes of inhibition, or vice versa. During the massage, a focus of excitation appears in the area of ​​the motor analyzer. According to the law of negative induction, it can suppress the focus of congestive, pathological excitation in the cerebral cortex. The normalizing effect of massage is used in the treatment of injuries, as it contributes to the speedy restoration of tissues, the elimination of muscle atrophy. With the necessary normalization of the functions of various organs, segmental massage of certain reflexogenic zones is usually used.

The skin protects the body from various external influences. This is due to the large number of receptors that perceive irritation, i.e., the endings of nerve fibers. In addition, the skin is also involved in the processes of respiration, blood circulation, the metabolic process, has the ability to regulate body temperature, as well as cleanse the body of excessive accumulation of fluid and harmful substances.

Among the functions of the skin can be attributed secretory, metabolic functions, the function of thermoregulation of the body. Therefore, through the skin, massage affects the activity of various systems and organs of the human body. This is due to the many different receptor "devices" that are interconnected with the cerebrospinal and autonomic nervous systems.

The skin consists of three layers: epidermis and dermis and subcutaneous fatty tissue. The first is the superficial layer. It, in turn, consists of several layers of keratinized cells, which, desquamating, are replaced by others from the lower, germinal layer of the epidermis. In the deep layers, the pigment melanin is also produced, which is very important for the normal condition of the skin. The greater the amount, the better the skin can withstand negative mechanical influences, chemical irritants. Massage contributes to the fact that this pigment is produced in greater quantities.

In different parts of the body, the epidermis has a different thickness. In those areas that experience more pressure than others, its thickness is also greater (soles, buttocks, palms, fingertips).

As a result of massage movements, the keratinized layer of obsolete cells is better removed, which has a positive effect: the excretory activity of the sebaceous and sweat glands improves, and skin respiration increases. Massage affects the condition of the skin, increasing its firmness and elasticity.

The next layer - the dermis - includes smooth muscle and elastic collagen fibers of the connective tissue, which make the skin supple and smooth. Also in this layer are sweat and sebaceous glands, blood and lymphatic vessels, nerve fibers.

An even deeper layer is subcutaneous fat. It is a loose connective tissue containing accumulations of fat cells. This layer also varies in thickness in different parts of the body. Its greatest thickness is on the anterior wall of the abdomen, mammary glands, in the pelvic region, as well as on the palms and soles. The function of the subcutaneous adipose tissue is to protect the body from the temperature effects of the external environment (hypothermia) and mechanical influences, such as shocks.

As a result of massage, it is possible to change the thickness of this layer, because when the metabolism is accelerated, substances unnecessary to the body are released more quickly and, thus, excess cells of adipose tissue are burned.

When massaging, the activity of the lymphatic and circulatory systems improves, the elimination of congestion is observed, and the blood supply to the skin improves. This is due to the fact that during the execution of massage movements, the lymph seems to move in their direction, and due to the emptying of the vessels, the tissues and organs of the massaged area receive more nutrients, and the decay products are removed faster. Since the skin vessels expand, the number of capillaries increases, and the flow of arterial blood to the massaged area also increases. Thus, massage helps to improve trophism, i.e. skin nutrition.

In addition to the fact that massage directly affects the condition of the skin, it affects the central nervous system, contributing to the appearance of one or another necessary response.

The muscular system has about 400 muscles, which make up about a third of the entire human body weight. All muscles are subdivided according to their location - posterior (muscles of the back, neck), anterior (muscles of the neck, chest, abdomen) and by appearance - striated (skeletal), smooth and cardiac. The former are responsible for supporting the body in a certain position and movement, as well as for the processes of breathing, chewing, and facial expressions. Smooth muscles are those that are a component of the walls of internal organs, blood vessels, and skin. Their difference is that they contract, as well as relax, absolutely involuntarily, that is, regardless of the person’s desire. The contraction of the heart muscle occurs as a result of impulses that arise in it.

For the correct conduct of massage movements, it is required to know the shape of a particular muscle, its junction with the bone and tendon. The beginning of the muscle is the tendon head, followed by the abdomen (it is the striated fibers that form it) and at the end is the tendon. Above is dense connective tissue. Therefore, in order for the massage to be most effective, the techniques should be carried out deep enough, with vigorous movements.

The muscle has the ability to contract when impulses sent by the central nervous system reach it, as well as the ability to shorten or, conversely, stretch. Promotion through the blood vessels occurs due to muscle contraction, as a result of which oxygen and nutrients are delivered to tissues and organs, and decay products are excreted. Massage helps to activate these processes.

As a result of muscle massaging, the level of lactic acid and organic acids in them decreases. That is why with the help of massage you can eliminate muscle fatigue, increase efficiency. At the same time, massage acts 4 times more efficiently and faster than passive rest. It helps to avoid injuries that occur due to physical exertion on tired muscles, in which there are painful hardenings, and also prevents the loss of muscle elasticity.

Massaging the muscles has a positive effect on the state of the joints, tendon-ligamentous apparatus, thereby contributing to greater elasticity, mobility, activation of redox processes.

The task of the circulatory system is to constantly maintain the circulation of blood and lymph in the body, since the nutrition of organs and tissues depends on this, to which the necessary substances are delivered by blood, and with its help metabolic processes also occur (the release of decay products), humoral regulation. The heart, blood vessels (arteries, veins, capillaries) make up the circulatory system, and also form two circles of blood circulation (large and small), through which blood moves. The systemic circulation begins with the aorta, which emerges from the left ventricle and carries arterial blood throughout the body; it ends with hollow veins. The small (pulmonary) circle begins with the pulmonary trunk, which emerges from the right ventricle and brings venous blood to the lungs.

As a result of rhythmic contractions (systole) and relaxation (diastole) of the heart, blood moves through the vessels. The heart is a four-chambered hollow muscular organ, which consists of two ventricles and two atria. In the ventricle and atrium, arterial blood flows on the left side, and venous blood flows on the right side.

The organs receive blood from the arteries flowing from the heart. From the organs to the heart, blood flows through the veins. Arteries are large, medium and small (arterioles that pass into capillaries), as well as intraorgan and extraorgan. It is with the help of capillaries that metabolic processes are carried out. The arterial system is connected to the venous system through capillaries. On the walls of both arteries and veins are nerves and nerve endings.

Massage is of great importance for the cardiovascular system. As a result of massaging, the movement of blood to the surface of the skin and muscle layers improves, the blood supply to the organs is improved, congestion is eliminated. Since there is an increase in the number of capillaries, the tissues receive better nutrition, and the metabolic process is also activated.

Thus, massage helps to improve the activity of the circulatory system, activating the process of supplying tissues and organs with nutrients and the process of excreting decay products. In addition, the physico-chemical state of tissues changes, their elasticity improves.

The lymphatic system is a component of the cardiovascular system. In turn, its components are lymphatic capillaries, plexuses of lymphatic vessels and nodes, lymphatic trunks and two lymphatic ducts.

The task of the lymphatic system is to remove excess interstitial fluid and its subsequent entry into the venous bed. Lymph nodes carry out hematopoietic and barrier functions, forming lymphocytes (white blood cells), which are activated when protecting against various infections and foreign substances.

Lymph is a clear liquid that is a nutrient medium into which metabolic products are also excreted.

Massage eliminates swelling, as it enhances lymph circulation, thereby also contributing to the improvement of tissue and cell trophism, and activation of metabolic processes. This is due to the fact that massaging accelerates the circulation of lymph.

Massage movements should be carried out strictly along the course of the lymphatic flow, towards the lymph nodes. This is due to the fact that lymph moves in one direction - from tissues to the heart, and massage facilitates the outflow of lymph from organs and tissues. So, the correct massage, according to the massage lines, helps to accelerate the lymph flow.

The nervous system plays a huge role in the life of the human body, influencing the work of all human organs and systems, carrying out their interconnection. Thanks to the nervous system, the regulation of all physiological processes that occur in all organs, tissues and cells, as well as the manifestation of emotions, the control of the heart, muscles, metabolism, the activity of all endocrine glands, human movements. Thus, the functional unity of the organism is achieved, closely connected with the environment and reacting to all its changes. To any irritant of the external or internal environment, the body reacts with a nervous reaction.

Nerve endings perceive all the stimuli of the outside world, transmitting excitation along the nerve fibers to the central nervous system, from where it goes to various organs and muscles.

The nervous system can be divided into two sections: the central, consisting of the brain and spinal cord, and the peripheral, which includes nerve fibers that connect the brain and spinal cord with other organs (cranial, spinal nerves, nerve nodes coming from the brain and spinal cord). It is also possible to conditionally divide the nervous system into two sections: somatic and autonomic. The first is responsible for the connection of the organism with the environment. At the same time, the perception of external stimuli is provided by nerve endings and sensory organs. Also, this department of the nervous system is involved in the control of skeletal muscles when moving the body.

The autonomic (autonomic) nervous system regulates the activity of internal organs and thus affects metabolism and blood circulation.

Massage can influence the central and peripheral nervous system. So, depending on the tasks set, it is possible to change the state of the cerebral cortex, causing an increase or decrease in excitability; influence the activity of individual organs and tissues, improving their functions, nutrition. It depends on the methodology and technique of the massage, its duration, the strength of the impact.

A deep massage takes a lot of effort, a superficial one - less. The first contributes to the appearance of inhibitory processes, the second, on the contrary, excitatory.

Depending on the pace, massage can be fast, medium and slow. The faster the pace, the greater the excitability. At an average pace, it is neutral. Plays the role and duration of the massage. So, a deep massage, carried out for a long time and at a slow pace, reduces the excitability of the nervous system, causing inhibition, and the opposite - superficial, performed quickly and for a short time, will excite, i.e., tone up the nervous processes.

Massage has a very beneficial effect on the nervous system. It improves the excitability of the nerves and the conductivity of the impulses they send. When massaging, the blood supply to the nerve centers and peripheral nerve formations improves through the arterial vessels that extend to large and small nerves.

Therefore, we can conclude that the neuro-reflex factor in the mechanism of influence of massage on the body is the leading one.

Metabolism refers to a number of chemical transformations in the body of substances that have entered it from the environment.

Undoubtedly, massage has a huge healing and healing effect on the body. Thanks to the massage, gas exchange, mineral and protein metabolism, as well as excretory processes that remove decay products from the body are activated. This improves the formation of substances of protein metabolism, which play the role of irritants of the tissues of internal organs, blood vessels, receptors of the nervous system. This explains the restoration of working capacity of tired muscles even when massaging those muscles that were not involved in the work.

The improvement of gas exchange is due to the fact that during massaging the tissues begin to consume more oxygen and there is an increase in breathing volume. This causes the respiratory muscles to activate (especially when massaging the chest, intercostal spaces). This improves ventilation of the lungs, their blood circulation.

Massage acts reflexively, that is, it affects all systems and organs of the human body, their functional activity. Thus, there is an activation of the activity of smooth muscle fibers, stimulation of those functions that are controlled by the autonomic nervous system: respiratory, digestive, blood circulation, secretory function of the endocrine glands.

So, massage can be described as a general tonic and therapeutic agent that normalizes the activity of all systems and organs, contributing to their recovery.

A person who decides to learn how to competently master the techniques of massage must first of all carefully study the methods and rules for its use, as well as the mechanism of the effect of massage on the body as a whole.

All movements of the massage therapist should be directed along the lymphatic pathways. For example, movements during limb massage will be directed in ascending order: hand massage - from the elbow to the armpit, from the fingertips to the elbow; thighs - from the knee to the groin; shins - from the ankle to the knee joint. Back massage is carried out with movements directed to the sides of the spine, and in the lumbar and sacral region - up and to the sides, in the direction of the inguinal nodes. The chest area, as well as the back, is massaged with movements directed in different directions - from the center of the chest to the shoulder girdle and armpits. Cervical - along the hairline - down to the subclavian and axillary lymph nodes. When massaging the abdomen, different muscles are massaged in different ways: straight muscles - from top to bottom, oblique ones - from bottom to top.

There is a rule: before massaging a small area of ​​the body, such as the lower back, you must first slightly warm up the entire back area, which will help activate blood circulation and inflow of fresh lymph. In relation to the limbs, this approach provides a more powerful blood circulation in their lower parts. If pain interferes with the massage procedure, then it is recommended to massage the area of ​​the body located slightly lower. This will allow you not to disturb the sore spot once again and nevertheless cause blood and lymph flow, speed up recovery.

The impact of massage on the body as a whole depends on the choice of techniques and their combination. Massage techniques are divided into two groups, one of which affects the skin and subcutaneous tissue, the other - on the thickness of the muscles. A. F. Verbov called the latter the term “vibration”, replacing the previously existing term “concussion”. The concept of "vibration" combines such techniques as patting, shaking, tapping, shaking, shaking and chopping. Physiological effects on the skin have shock techniques, as well as stroking and rubbing.

The above massage techniques can be supplemented with auxiliary ones, which brings a much greater therapeutic effect. All secondary moves are also subject to the same rules as the main moves. In order for massage sessions to bring the greatest effect, an exhaustive consultation with a doctor is necessary, since it is necessary to take into account the age of the person being massaged, the general condition of his body, and the presence of somatic diseases. It would also be useful to have a practical study of the technique of performing certain techniques, both individually and in combination, as well as a thorough study of the directions of hand movement.

The palm is divided into two areas: the base and the surface of the fingers. On the palm there are two elevations - I and V fingers (thumb and little finger). The thumb has two phalanges, the rest - three each: the nail, middle and main. The terms "radial" and "ulnar" refer to different edges of the hand ( rice. one).

Rice. 1. Sides of the palm: a - palmar, b - back

When performing various massage techniques, you can use both the palmar and the back of the hand, as well as the combs of the fingers (fingers bent at a right angle into a fist).

One of the most common massage techniques is stroking. At the same time, the skin does not move or stretch, only a slight sliding over the surface is carried out. The pressure force can be arbitrary. It is with stroking that the massage session begins. Stroking is used after the most severe techniques, and at the end of the session as a sedative.

Stroking is performed smoothly, extremely relaxed palmar side of the brush. The thumb is laid aside, the rest are connected and tightly pressed to the massaged surface. Stroking can be done with one hand or two. Moving sequentially and rectilinearly, one hand repeats the movements of the other, trying to grasp the largest possible surface of the massaged area.

Long-term stroking is used as an analgesic technique and has a calming effect on the central nervous system, relieves general excitability. When a massage session is conducted by a good specialist, in the process of stroking the patient's breathing slows down. This indicates a decrease in the excitability of the respiratory centers and the process of inhibition that began in the cerebral cortex. Thus, it is with the help of stroking that it is possible to control the functions of the higher parts of the central nervous system.

Stroking is divided into planar ( rice. 2) and embracing (Fig. 3).

Rice. 2. Planar stroking

Rice. 3. Embracing stroking

With planar stroking, the fingers are straightened, the hand is relaxed and is in the same plane with the fingers. Massage can be performed with one or two hands. Hands move in a transverse, longitudinal, circular or spiral direction.

In an encircling stroke, the fingers are folded into a groove shape. Depending on the prescriptions, the movements of the brush can be either continuous or intermittent. For a deeper impact, weights are applied.

Planar stroking is used when massaging large surfaces of the body. When massaging rounded areas - the neck, buttocks and limbs - embracing stroking is used.

Both types of stroking in their effect can be both superficial and deep. With superficial stroking, the hand performs movements smoothly, gently, easily.

With deep stroking, some pressure is added to the massaging movements of the brush. In this case, the use of the wrist, the supporting part of the hand, gives a greater effect. It is also possible to use other parts of the hand: the lateral or back surface of the fingers or the ulnar edge of the hand. It all depends on the structure of the body area on which the massage is performed.

On large areas of the body - such as the back, chest, hips - stroking is performed with the supporting part of the palm or even with a fist. When massaging the tendons and individual muscles, as well as the interosseous muscles of the foot or hand, the palmar side of the end phalanges of the fingers is used for stroking, in the latter case, the thumb and forefinger.

The muscle mass and subcutaneous base of large areas of the body are large enough to use weights when stroking. To do this, stroking should be done by laying one brush on the other, which exerts pressure and a deeper effect on the tissues than conventional stroking performed with two hands in series or in parallel.

As mentioned above, stroking can be carried out with continuous and intermittent movements. Continuous stroking is characterized by smooth, gentle movements, the patient's breathing deepens, slows down, and the central nervous system in this case reacts with a process of inhibition. Alternate stroking, on the contrary, is characterized by rhythmic, spasmodic movements. During the session, the second hand also repeats the movements of the first, without stopping, but in the opposite direction.

This kind of massaging movements increase the sensitivity of the skin. In this case, the central nervous system reacts with excitation, and blood circulation and contractile work of the muscles are activated on the massaged area of ​​the body.

Stroking can also be divided into rectilinear, zigzag, circular, spiral, concentric and combined. Rectilinear stroking is performed with the palmar side of the hand, all fingers are connected, the thumb is laid aside. A part of the body is grasped by the palm, and the thumb and forefinger move forward with sliding movements. With spiral and zigzag strokes, the hand, without straining, moves in the same direction.

Combined stroking combines all three types of stroking mentioned earlier. This type of stroking is characterized by continuous sliding movements along the massaged area in different directions.

When massaging large joints, concentric stroking is used. Hands are placed as close to each other as possible. The thumb, located on the outer side of the joint, performs the main massage movements. The remaining fingers are placed on its inner side. Hands perform movements resembling the number eight. At the beginning of the movement, the hands should work most intensively, with the reverse movement, the intensity decreases.

Circular stroking is used when massaging small joints. The bases of the palms move towards the little finger, performing circular movements: the right hand is clockwise, the left is against.

Longitudinal stroking is performed with two hands. More precisely, the second hand replaces the first after it has completed the movement. This is called longitudinal alternating stroking. One hand can also perform this kind of stroking. In both cases, the end phalanges of the fingers should be located in the direction of movement, and the hand itself should lie in the direction along the massaged area of ​​the body.

Of the auxiliary types of stroking, ironing is tong-shaped, cruciform, comb-shaped and rake-shaped.

Forceps-like stroking is used to massage the edge of the foot and hand, tendons and small muscle groups. A forceps-like stroking is usually performed with three fingers: thumb, middle and index ( rice. four). The massaged muscle is grasped like forceps, the fingers perform stroking, the movements are straightforward.

Rice. 4. Pinch-shaped stroking Comb-like stroking is indicated for massaging large muscle layers in the pelvis and back, deep stroking of large muscles. This type of stroking is also used when it is necessary to influence areas of the body equipped with a dense skin - palms and feet. The stroking technique is as follows: the fingers are half-bent into a fist and spaced so that the bony protrusions of the main phalanges of the fingers form the so-called crest ( rice. 5). This comb, formed on the back of the hand, is used for this technique. Hand movements should be free. It is necessary to ensure that the fingers in the metacarpophalangeal joints are not fixed.

Rice. 5. Comb stroking Rake stroking ( rice. 6) is used for massage effects on the abdomen and intercostal spaces. The position of the fingers with this type of stroking resembles a garden rake. The hand touches the massaged area at an angle of 30-45°. Movements can be longitudinal, transverse, circular and zigzag. This type of stroking can be done with one or two hands.

Rice. 6. Rake stroking

In this case, the hands move along the massaged area sequentially - one after the other, or simultaneously - in parallel. If necessary, weights are applied. In the latter case, the fingers are superimposed on each other as follows: the index finger on the little finger, the middle finger on the ring finger, etc. The thumbs do not participate in weighting.

Cross-shaped stroking is performed in the pelvis and gluteal muscles, on the back of the legs and back. The technique of execution is as follows: with fingers clasped crosswise into a lock, grasp the massaged area and make stroking movements ( rice. 7).

Rice. 7. Cross stroking

Ironing is a technique using which the body can have a variety of effects, both mild (for example, in the neck area, where the skin is most sensitive), and quite strong when weights are applied (on the muscles of the back and abdomen). Reception is performed with the back surface of the fingers bent at the metacarpophalangeal joints, with one or two hands. In order to perform ironing with weights, the free hand is placed on the massaging hand.

The stroking technique in massage practice is used not only in combination with others, but also as an independent, quite effective technique. When conducting a massage session, the person being massaged should take a comfortable position, such that all muscles are relaxed. Begin the session with superficial strokes, gradually moving to deeper ones. When carrying out planar surface stroking, the most basic rule of massage is not fulfilled - the direction of movements is strictly along the lymphatic tract. It is not necessary to use both the main and auxiliary types of stroking at once; usually, for the session, the types of stroking that are most effective for a particular area of ​​the body are chosen. For example, on the bend of the limbs, where the veins and large lymphatic vessels are located, stroking should be deeper. But nevertheless, changing the depth and strength of the impact on the massaged area, one should not forget that all strokes are carried out rhythmically and rather slowly - 24-26 movements per minute.

A few mistakes most often made by beginners to master massage techniques:

- displacement of the skin, hands do not slip on its surface (the reception is performed too quickly and abruptly);

- the person being massaged has unpleasant sensations during flat stroking (fingers are too wide apart and do not fit snugly against the skin);

– pain when stroking (too much pressure).

As widely as stroking, rubbing is used in massage practice. The principle of rubbing is that the skin of the massaged surface is vigorously displaced. Hands stretch and shift it in various directions. In this case, there is a very significant pressure on the tissue. Rubbing is used on those parts of the body where congestion may occur due to insufficient blood circulation. This is the outer side of the thigh, hypochondrium, foot (both heel and sole). Rubbing is successfully used to massage joints, ligaments, tendons and fascia.

When rubbing, displacing and stretching the tissues, the nerve receptors are irritated. Blood circulation is accelerated, blood vessels expand, gas exchange increases. The tissues of the massaged area are enriched with oxygen, nutrients and chemically active substances. Metabolic processes and removal of decay products are activated. The purpose of rubbing is, as it were, to crush all kinds of pathological formations and, through the lymphatic vessels and the circulatory system, remove substances harmful to the body in the process of metabolism.

As a result of rubbing, the muscles become more mobile and elastic, their contractility increases. The temperature of the massaged area rises by 3-5°.

Rubbing can be performed with two hands acting in parallel: with weights (one on top of the other) or with the supporting part of the hand and the ulnar edge of the palm. In the latter case, the tissues are shifted forward and to the side, the movements of the hand are translational, forming a skin fold in front, a roller. Rubbing should not turn into stroking, otherwise the therapeutic effect of this technique will not be achieved. The direction of hand movements depends on many factors: the anatomical structure of the muscles and tendons, the location of the ligaments, the shape and size of the joints, as well as the purpose of rubbing.

Circular, spiral and rectilinear rubbing is performed with fingers, the supporting part of the hand and the ulnar edge of the palm. The principle of the implementation of these techniques can be seen in rice. 8, 9, 10.

Rice. 8. Circular rubbing

Rice. 9. Spiral rubbing

With finger rubbing, the pads of the fingers (the palmar surface of the nail phalanges) are involved. If rubbing is carried out with all fingers, then the thumb or the supporting part of the hand should rest against the surface of the massaged area of ​​the body. If rubbing is more convenient to carry out with one thumb, then all other fingers of the hand are fixed on the massaged area.

On the intercarpal and intercostal spaces, rubbing is carried out with the pad of the middle finger.

Rubbing is performed in the longitudinal, transverse, circular, spiral and zigzag directions.

Finger rubbing is used to massage the feet, hands, tendons, iliac crests, back and intercostal spaces. When rubbing large joints - knee, shoulder and hip - rubbing is used with the ulnar edge of the hand. Large muscle layers - gluteal, long back muscles - are rubbed with the supporting part of the brush.

Now for directions. Rectilinear rubbing is used to massage the hands, feet and small muscle groups. It is performed by the terminal phalanges of one or more fingers.

Circular rubbing is carried out with weights with one hand or two hands alternately. At the same time, the terminal phalanges of the fingers are involved, displacing the skin in the same direction. The hand rests on the base of the palm or on the thumb. For this technique, you can use the back of one or all fingers, while slightly bent ( rice. eleven). The technique is used to massage all areas of the body.

Rice. 11. Rubbing with the back of your fingers

To carry out spiral rubbing, use the base of the palm or the ulnar edge of the hand, gathered into a fist. Depending on the shape of the part of the body on which the reception is carried out, either both hands are involved, or one with weights. This technique is used for massage of the chest, pelvis, abdomen, limbs and back.

Like stroking, rubbing has its own auxiliary techniques. These are tong-shaped, comb-shaped and rake-shaped rubbing, as well as sawing, hatching, crossing and planing.

Rice. 12. Hatching

Hatching is carried out with two (middle and index) and three (middle, index and thumb) fingers ( rice. 12). When hatching, only the pads of the nail phalanges are used. The fingers should be maximally unbent in the interphalangeal joints and directed towards the massaged part of the body at an angle of 30°. This massage technique puts pressure on the tissues of the massaged area of ​​the body, increases their mobility and elasticity. The skin, when performed correctly, should be displaced by short translational movements in different directions, longitudinal and transverse.

Planing helps to accelerate metabolic processes in tissues and, like hatching, increases their elasticity. Planing can be done with one or two hands. When planing with both hands, one hand is placed in front of the other, making, as it were, planing, but at the same time, translational movements. The pads of the extended fingers, plunging into the tissues of the massaged area, press on the tissues until a roller is formed in front in the direction of travel, causing displacement and stretching.

Sawing is performed with the elbow edge of the brush in short back and forth movements ( rice. 13). When sawing with two hands, when the hands are facing each other with their palms, and their movements are directed in different directions, a roller is formed. This roller is moved, trying not to slide on the massaged surface. Sawing is used as a massage technique on large muscle layers and joints.

Rice. 13. Sawing Crossing is used to massage large joints and abdominal muscles, as well as the trapezius muscle and cervical region ( rice. fourteen). To perform this technique, the radial edge of the brush is used. The thumb is moved to the side as much as possible. When crossing with one hand, the hand makes rhythmic movements in the direction away from itself or towards itself. If both hands are involved, then they are placed with their back surfaces to each other at a distance of approximately 2-3 cm. The movements should be transverse, they try to shift the layers of the massaged tissue as deeply as possible.

Rice. 14. Crossing

With rake-like rubbing, either the pads of widely spaced fingers or the back surface of the nail phalanges are used. The direction of movement is rectilinear, circular, zigzag.

Rake-like rubbing on the back is carried out with fingertips located on both sides of the spinal column. The movements of the fingers, pressing on the skin and deeper layers, are directed downward to the lumbar region. The pads of bent fingers also participate in the reverse movement from bottom to top. The direction of movement is zigzag and spiral.

Intercostal spaces are massaged with fingertips in straight and circular motions. Up and down strokes are also used. The fingers are located between the ribs.

With comb-like rubbing, the back side of the main phalanges of the fingers is involved. The brush is clenched into a fist. The movements are circular. This technique is indicated for massaging large muscle layers on the thighs, back and buttocks, as well as the palms and soles.

Forceps rubbing is used to massage tendons and small muscle groups. Massage is carried out with three (big, middle, index), less often - with two fingers. The fingers, folded in the form of tongs (the thumb is opposed to the rest), perform rubbing movements, sliding in a straight or circular manner.

When rubbing for one minute, 60 to 100 movements are carried out. Therefore, in one place of the massaged area of ​​​​the body, you should not linger longer than 8-10 seconds. To enhance the effect of the reception on the massaged area, simply increase the angle (up to 90 °) between the skin surface of the massaged and the hand of the massage therapist, or apply weights.

For rubbing, as well as for stroking, there is an exception to the general rules of massage: the direction of movements during rubbing does not depend on the direction of the lymphatic pathways. Rubbing is usually alternated with stroking. The types of rubbing used during one massage session depend on the general condition of the body.

The main mistakes when rubbing:

- stroking instead of rubbing;

- pain associated with the inept actions of the massage therapist.

Kneading is the main technique used in massage, as it takes up most of the time allotted for a session, and is actually a passive gymnastics for the muscles. Kneading is carried out in three stages: the capture of the massaged area, its retraction and compression, crushing by rolling. The third stage, in fact, is the main part of kneading.

As a result of kneading, reflex changes are observed in the neuromuscular apparatus of the person being massaged. Vigorous ten-minute kneading leads to increased breathing. This indicates the processes of excitation that affected the higher parts of the central nervous system. On the massaged part of the body, as a result of stretching, the contractile function of the muscles is activated and the elasticity of the tendons increases. Due to the stimulation of blood circulation and lymph circulation, metabolic processes are accelerated, and decay products, lactic acid and carbon dioxide are removed from the tissues faster.

Kneading is longitudinal and transverse. Longitudinal kneading is carried out along the fibers that form the body (abdomen) of the muscle from the initial tendon (head) to the tendon of attachment (tail). The hand on the massaged surface is positioned so that the thumb is opposed to all the others, the palm covers the muscle (fixation), lifts it, the fingers, performing kneading movements, seem to pull the muscle away from the bone. The massage therapist's brush should fit snugly against the skin, leaving no air gap between the masseur's palm and the massaged area. In the first phase of kneading, the main massage effect is directed towards the thumb. In the second and third phases, pressure on the muscle is produced by all fingers (including the thumb) with equal force on both sides of the massaged area.

Rice. 15. Longitudinal kneading Longitudinal kneading ( rice. fifteen) is used for massage of the lateral muscles of the cervical region, the abdomen, pelvis, chest, back and limbs. This technique is performed by rhythmic continuous movements with a frequency of 40-50 kneading per minute with one or two hands. When kneading individual sections of the muscles, intermittent kneading is used, which is performed with short, energetic, spasmodic movements.

Rice. 16. Cross kneading With cross kneading ( rice. 16) the movements of the massage therapist's hands are directed across the line of muscle fibers. Hands in relation to the massaged surface are located at an angle of 45-50 °. The massage effect should include all three of the above phases of kneading ( rice. 17).

Rice. 17. Three phase kneading

When clasping the muscle, the hands of the massage therapist should not slip off the skin, which can lead to pain and even injury. To obtain a greater effect from the performed kneading technique, the hands are placed at a distance of the width of the palm, along an oblique relative to the longitudinal axis of the muscle.

When performing a reception with two hands, one hand alternately shifts the massaged muscle towards itself, the other - away from itself. On large muscles and thick muscle layers, weights can be used ( rice. eighteen).

Rice. 18. Kneading with weights

The direction of movement during transverse kneading depends on the goal that you want to achieve with this technique. If the goal is resorption, for example, of an inflammatory process, then kneading is carried out strictly along the lymphatic pathways, which activates blood and lymph circulation. If it is only necessary to stimulate the muscle, increase its contractility and elasticity, then kneading is carried out in different directions relative to the axis of the massaged muscle. Cross kneading is recommended to be carried out in the pelvis, abdomen, back, as well as the cervical region and limbs.

Kneading the muscles is performed with both hands, massage movements in the same place are repeated several times. For the abdomen of the muscle, transverse kneading is recommended, the head of the muscle and the tendon are massaged longitudinally. It looks like this: one hand carefully massages the head of the muscle and the tendon longitudinally, while the other kneads the belly of the muscle transversely. After massaging the place of attachment of the muscle, one hand begins to move along the muscle to its opposite end, the other hand, massaging the abdomen, allows the first hand to reach the opposite end of the muscle, then again covers the abdomen, continuing to knead it.

The main methods of longitudinal and transverse kneading: ordinary, double ordinary, ordinary-longitudinal, double ring, double neck, circular, kneading with a roll.

Ordinary dissection. The massaged muscle is tightly grasped with fingers so that there is no gap between the surface of the skin and the hand of the massage therapist. At the same time, the fingers perform rotational movements, while simultaneously lifting the muscle and moving towards each other. At the end of the massage movement, the fingers return to their original position, continuing to hold the muscle. It is important that the fingers move with the skin during the movement, and not slide over it.

Thus, each part of the muscle is massaged. The ordinary kneading technique is used to massage the back of the lower leg, the flexors of the forearm, the gluteus maximus, the latissimus dorsi, the anterior and posterior surfaces of the thighs, as well as the abdomen and shoulder.

With a double ordinary kneading, each hand performs an ordinary kneading alternately, moving in the direction from the bottom up ( rice. 19). This technique most effectively stimulates the muscles. To perform it on the muscles of the forearm and the back of the lower leg, the massaged person must take a supine position.

Rice. 19. Double single kneading

Receiving a double neck is performed in two ways. The first method involves the imposition of the fingers of one hand on the fingers of the same name of the other hand. In the second method, only the thumb of one hand is weighted with the base of the palm of the other. The double bar is used to massage the gluteus maximus muscles, the front and back surfaces of the thighs, the oblique muscles of the abdomen, the shoulders and the latissimus dorsi.

With double ring kneading, the person being massaged takes a prone position. The hands of the massage therapist are located at a distance equal to the width of the palm, across the massaged area, the elbows are separated. Reception is performed with two hands. The massaged muscle is grasped in such a way that the thumbs are on one side of the muscle, and the rest on the other ( rice. twenty).

Rice. 20. Double ring kneading

Straightened fingers tightly grasp the muscle, kneading movements are carried out with its simultaneous pulling. In this case, the hands move the muscle in opposite directions, as if passing it from one hand to another. Massage movements are performed smoothly, without jerking, without twisting the muscle. The person being massaged after the session should not have bruises.

Double ring kneading is used on any muscles of the body, excluding flat ones, since it is not recommended to delay them.

The next technique is very similar in technique to the previous one. Double ring combined kneading involves performing a double ring kneading technique in combination with an ordinary one. While one hand is doing a single kneading, the other is doing a double ring kneading on the same muscle as the first. The index finger of the second hand is placed on the middle one for greater convenience. Reception is used for the rectus abdominis, femoral and gluteal muscles, latissimus dorsi, shoulder, back of the leg and pectoralis major muscles.

Ring longitudinal kneading is used to massage the front surface of the thigh and the back of the lower leg. First of all, you should pay attention to the location of the hands. When massaging the left thigh and right shin, the left hand is located in front of the right, while massaging the right thigh and left shin, the right hand is in front of the left. Technique of the reception: the muscle is captured with two hands, the fingers are tightly pressed to each other, the thumb is laid aside, the elbows are brought together. The hands then converge, then diverge at a distance of about 5 cm, performing ring-shaped movements and moving towards each other.

Ordinary-longitudinal kneading involves massaging the muscle both along and across. It is used for massage of the back of the thigh. On the inside of the thigh, ordinary kneading is used, on the outer - longitudinal.

Circular beak-shaped kneading is performed with both one and two hands. To carry out this technique, the hand is folded like a beak. The index finger is tightly pressed to the thumb, the ring and little fingers also touch the thumb, the middle one is located on top of the others. Circular or spiral movements are directed towards the little finger. In the case of performing a reception with two hands, the hands, moving in one direction, perform movements alternately ( rice. 21).

Rice. 21. Coracoid kneading

Circular coracoid kneading is indicated for massage of the limbs, neck, latissimus dorsi and long back muscles.

Circular kneading with the terminal phalanges of four fingers involves a massage effect with the pads of four fingers on the massaged area of ​​the body. In this case, the fingers are located diagonally relative to the massaged muscle, rotational massage movements are directed towards the little finger. The thumb is not involved in this technique. Large muscles are massaged with slightly apart fingers. When massaging the flat muscles, the fingers are pressed tightly against each other.

Circular kneading with the end phalanges of four fingers is used to massage the neck muscles, muscles of the limbs, trapezius and long muscles of the back.

With circular kneading with the terminal phalanx of the thumb, the remaining fingers are relaxed and only touch the massaged surface. At the very beginning, circular movements exert maximum pressure on the muscle, shifting it towards the index finger. When you return to the starting position, the pressure on the muscle should weaken. After performing the technique in one area, the muscles move to the next, 2-3 cm higher than the previous one.

This technique can also be performed with both hands alternately or with weights. Carrying out weighting, the thumb of the free hand is applied either across the entire brush of the working hand, or along its thumb. Circular kneading with the terminal phalanx of the thumb is shown when massaging the limbs, back muscles and sternum.

Rice. 22. Circular kneading with phalanges of fingers clenched into a fist

Circular kneading with phalanges of fingers clenched into a fist is performed with the back of the phalanges of the fingers with the thumb resting on the massaged area of ​​the body ( rice. 22). The massaged muscle is pressed against the bone, then in a circular motion it moves towards the little finger. The reception is carried out with one hand with weights or with two hands alternately, while the palms are located at a distance of 3-8 cm from each other. The technique is used for massaging the limbs, in particular the calf and anterior tibial muscles, as well as for massaging the muscles of the back and chest.

Circular kneading with the base of the palms. With this technique, the hands of the massage therapist, located on the massaged area, perform circular movements towards the little finger. Reception can be performed with one hand, two and with weights. It is indicated for massage of the chest, long and latissimus dorsi muscles, muscles of the lower extremities and gluteus maximus muscles. Kneading with the base of the palm with a roll is used to massage the long back muscles, pectoralis major, gluteal and deltoid muscles. Technique for performing the reception: fingers are tightly pressed to each other and slightly raised. The massaging hand is located along the massaged area. The palm rolls over its base from the elevation of the thumb to the side of the little finger.

Auxiliary kneading techniques: shifting, squeezing, pressing, rolling, felting, stretching, twitching, as well as comb-like and tong-like kneading, felting ( rice. 23).

Rice. 23. Felting

With both hands, the massage therapist wraps around the massaged area on both sides. The hands move in opposite directions. An energetically performed technique, deforming the muscles, has a strong stimulating effect on them.

Felting refers to kneading techniques. It is used to influence the muscles of the shoulder, forearm, lower leg and thigh.

Before performing a technique called rolling, the massaged muscles are relaxed by performing planar circular stroking. Then, already performing the main technique, the left hand of the massage therapist, fixing the massaged area, should apply pressure, as if crashing into the thickness of the muscles. At the same time, the right hand rolls onto the left captured soft tissues, while simultaneously performing circular kneading. Gradually, moving from site to site, the masseur conducts a technique over the entire surface of the massaged part of the body. Felting is indicated if it is necessary to massage the front wall of the abdomen, pectoral muscles, lateral surfaces of the back and some internal organs.

Rice. 24. Shift Shift ( rice. 24). The thumbs of both hands, moving towards each other, press on the massaged surface, lifting it. The resulting tissue fold is shifted in the longitudinal or transverse direction with rhythmic movements. Reception can be carried out with one pressure, without tissue capture. The shift has a warming effect on the massaged area, the temperature of the tissues rises, and the central nervous system reacts with a process of excitation. Usually, the technique is used on the long muscles of the limbs. By massaging the gluteal, pectoralis major and sternocleidomastoid muscles, various kinds of grips are added. It is not recommended to use the grip when massaging the back. Carrying out the procedure on the interosseous muscles of the hand, the tissues are shifted with short up and down movements. In this case, one hand is placed on the elbow, the other - on the radial edge of the brush.

Rice. 25. Stretch

Stretching is very similar to shifting, with the only difference that the hands perform not shifting, but stretching massage movements ( rice. 25). Large muscles are captured with the whole brush, small ones - forceps. Flat muscles are smoothed with palms or fingers. Stretching is performed with slow, smooth movements, without causing pain to the massaged person.

Pressure is used to massage the anterior wall of the abdomen and the internal organs of the abdominal cavity. Reception is carried out using the back or palmar surface of the fingers ( rice. 26). The working hand is weighed down with the help of the fingers of the other hand, bent into a fist. The anterior wall of the abdomen is massaged by intermittent pressing on the tissues with a frequency of 20-25 times per minute. In the same rhythm, the large intestine is massaged, in the direction of its course.

Rice. 26. Pressure

Pressure improves intestinal peristalsis and normalizes the secretory and excretory functions of the internal organs of the abdominal cavity.

Twitching is performed with two (thumb and index) and three (thumb, index, middle) fingers ( rice. 27). The massaged tissues are grasped and pulled, after which they are released quite sharply, as when playing plucked stringed instruments. Massage movements are performed with two hands (less often with one) with a frequency of 100-120 movements per minute.

Rice. 27. Twitching Compression stimulates the contractile work of the muscles, increases the intensity of blood circulation. Massage movements are short, rhythmic. 30-40 movements are carried out per minute, squeezing and, as it were, squeezing out the massaged tissues ( rice. 28).

Rice. 28. Compression Comb kneading is commonly used to massage the neck, chin and anterior abdominal wall ( rice. 29). Technique: the hand is relaxed, the fingers are half-bent and slightly apart, the thumb touches the index finger in the region of the middle phalanx. Massaged tissues are captured and kneaded in a spiral.

Rice. 29. Comb kneading Forceps kneading ( rice. thirty) is indicated for massage of the back, chest, neck, small muscle groups, outer edges of large muscles, as well as their heads and tendons. Reception is carried out with two (thumb, index) and three fingers (middle is added). When performing transverse forceps-like kneading, fingers folded in the form of forceps capture a small (1-2 cm) area of ​​the muscle, pull and knead it alternately in opposite directions (away from you and towards you). Longitudinal tong-shaped kneading characterizes the spiral direction of movement.

Rice. 30. Forceps kneading

Since kneading, as mentioned above, is the main massage technique, recommendations for its use include a number of rules, the exact implementation of which allows you to make the technique most effective. So, for example, it is necessary to ensure that the muscles of the person being massaged during the session are extremely relaxed, and the technique used does not cause pain. Hands should not slip off the skin, muscle twisting is also not allowed. The intensity of kneading is not increased immediately, but gradually, from session to session. The massage movements themselves are carried out slowly, smoothly, without jerks, with a frequency of 50-60 movements per minute. The masseur's hand should start moving from the belly of the muscle and move continuously, smoothly and consistently towards the tendon.

Novice masseurs make a large number of mistakes when kneading:

- pinching instead of kneading in the first phase of the reception as a result of bending the fingers in the interphalangeal joints;

- capture and squeezing of the skin instead of muscles in the second phase of the reception, as a result of which the massaged person experiences pain and kneading as such does not occur due to the loose fit of the massage therapist’s brush to the surface of the massaged area of ​​the body;

- pain during longitudinal kneading as a result of a sharp displacement of the muscles in different directions;

- rapid fatigue of the massage therapist due to the tension of the hands.

Techniques characterized by fluctuations of various strengths, speeds and amplitudes are united under the name "vibration". The principle of vibration is based on the elasticity of the tissues of the human body, capable of transmitting mechanical surface vibrations to deeper layers. Using vibration, both manual and obtained with the help of a special apparatus, it is possible to achieve vibrations that can affect layers of tissues and muscles of various depths. Depending on the frequency, strength and intensity, vibration affects both the muscle mass and individual vessels, nerves, and internal organs of a person located far enough from the skin surface.

The impact of vibration on physiological processes is determined not only by its intensity and frequency characteristics. The reaction of the human body, in particular the central nervous system (excitation or inhibition), directly depends on the duration of the vibration and the area of ​​its conduction. Vibration activates metabolic processes in the tissues of the body, promotes the restoration of somatic cells, and normalizes the heart rate.

There are two types of vibration: continuous and intermittent. To obtain different intensity of exposure in vibration techniques, you can use either the fingertips or the edge of the palm, or one or both brushes clenched into a fist. Intermittent vibration is characterized by single blows applied rhythmically and sequentially. With continuous vibration, the masseur produces vibrations of the massaged tissues continuously, without taking his hands off.

Intermittent vibration includes techniques such as puncturing, patting, tapping, shaking, chopping, shaking, quilting.

Punctuation is performed with the pads of the index and middle fingers. Blows can be applied with each finger individually or synchronously. On massaged areas that are close to each other, the fingers of the second hand are connected to the reception.

Rice. 31. Stable vibration Vibration is also divided into stable and labile ( rice. 31, 32). With stable vibration, massage movements are performed without moving the massaging hand. With labile vibration, the masseur's hand, performing movements, moves along the massaged area in the direction corresponding to the course of the lymphatic tracts.

Rice. 32. Labile vibration

Rice. 33. Punctuation

The impact force depends on the angle between the massage therapist's hand and the surface of the massaged area. The larger the angle, the stronger the impact, and vice versa.

Punctuation ( rice. 33) is effective on areas of the body with thin delicate skin, small muscles and ligaments.

Tapping, as a rule, is carried out with two hands, less often with one ( rice. 34). Strikes, depending on the area of ​​application, are applied with the pads of the fingers, the back or palmar surface of the hand, or with fingers clenched into a fist.

Rice. 34. Tapping

When performing various types of vibration, it is important to remember that the massage therapist's hands should be relaxed in the area of ​​​​the hand and wrist joint. Otherwise, the reception will cause pain in the massaged person, which is unacceptable.

Tapping with one finger is used on limited areas of the body, small muscles and individual tendons. Blows are applied with the index finger with a span of 5-10 cm and a frequency of approximately 100-130 beats per minute.

In tapping with several fingers, all fingers of the hand, except for the thumb, participate. The hand of the working hand is placed on the massaged area. Blows are applied with bent fingers, extending them to the limit in the metacarpophalangeal joints.

Light tapping is carried out with the back of bent fingers. At the same time, the fingers are freely bent so that an air space is formed inside, softening the blows. Massage movements are performed with the back of the finger phalanges, which corresponds to its name. In practice, the technique is used to massage the thick muscle layers in the back, thighs and buttocks.

Tapping with the ulnar edge of the fingers bent into a fist is performed with the corresponding edge of the brush. The fingers of the working hand are freely bent so that their pads only lightly touch the palmar surface. At the same time, the thumb is slightly pressed against the radial surface of the index finger, the little finger is set aside and completely relaxed. The hands of the massage therapist bend only at the very last moment before striking. Massage movements (strokes) are applied rhythmically and sequentially, perpendicular to the massaged area. Apply the technique, as well as the previous one, in areas of the body with large muscle mass.

Rice. 35. Pat

When patting, the blows applied by the masseur's hand are also softened by the formation of an air cushion between the masseur's brush and the massaged surface ( rice. 35). The blows are applied by bending and unbending the wrist in the wrist joint, while the fingers are slightly bent, and the forearms form an angle with respect to the massaged area. Reception can be performed with two hands, acting alternately.

Vigorous patting causes the expansion of blood vessels. Intense massage movements raise the temperature of the massaged area of ​​the body. This technique in massage practice is used very widely. In addition to areas of the body with large muscle mass - the buttocks, hips and back, patting affects the muscles of the limbs, chest and abdomen.

Chopping differs from the above techniques in that the massage movements of this technique are directed not across, but along the muscle fibers ( rice. 36). Chopping is done at a fairly high speed: up to 250-300 beats per minute. Particular attention should be paid to the position of the brush upon impact.

Rice. 36. Chopping

The air cushions characteristic of the aforementioned tapping technique and softening the blow are moved into the interdigital space. The phalanges of the fingers close only at the moment of impact on the massaged surface. Blows are applied with the ulnar edge of the hand as a result of flexion and extension movements of the arm in the wrist joint. The forearms form an angle with respect to the massaged surface. Reception is carried out with two hands. Ignoring the rules for performing this technique will lead to pain in the massaged, which is highly undesirable.

Chopping has an effect not only on the massaged muscles. The latter, contracting upon impact, ensure the penetration of vibration into the deeper layers of the tissues of the human body, as well as into the internal organs. As a result of the application of this technique in the body, metabolic processes, blood and lymph circulation processes and, as a result, nutrition and gas exchange in the massaged tissues are normalized. In addition to the normalization of the already mentioned metabolic processes, the activity of the sebaceous and sweat glands increases in the thickness of the skin, which ensures the removal of substances harmful to the body through the pores.

Rice. 37. Concussion

Movements made in opposite directions with the help of individual fingers or the entire hand and resembling sifting flour through a sieve are called shaking ( rice. 37).

One of the concussion techniques - shaking - is performed with both one and two hands ( rice. 38). Shaking is used only for massaging the limbs. During the reception, either the hand or the ankle joint is rigidly fixed, respectively.

Rice. 38. Shaking

When using this technique on the lower extremities, massage movements are performed in a horizontal plane. Massaged lies on his back, foot and knee joint are straight. When performing a reception on the upper limbs, the hand is fixed with a “handshake”, and shaking movements are carried out in the vertical direction.

Quilting is effective on large areas of the body ( rice. 39). Reception can be carried out both with the whole palm, and with one or more fingers. At the same time, the massage therapist's hand strikes, only touching the massaged surface.

Rice. 39. Quilting

Continuous vibration implies the transfer to the massaged tissues of constant vibrations of the massage therapist's hand, which occur in the process of continuous exposure to the massaged area. Depending on the strength of the impact, the palmar and back sides of one or more fingers, the palmar or supporting part of the hand, or fingers gathered into a fist are used to perform continuous vibration.

During the massage, vibration should be alternated with stroking. It looks like this: vibrating movements are carried out for 5-15 seconds, followed by a 3-5-second stroking. In this case, one or both hands can be used.

The speed of vibration and the pressure on the massaged area during the session change. At the beginning and at the end of the massage procedure, the vibration frequency is 100-200 movements per minute. In the middle of the session, the frequency increases to 200-300 oscillations. The same applies to pressure on muscle mass. If at the beginning and at the end it is superficial, then closer to the middle of the procedure it becomes quite intense. It is important to make sure that the pressure does not become too strong, as it can turn into pressure.

Vibrating movements can be longitudinal, transverse, vertical, zigzag and spiral. Fixed vibration, performed with one finger of the hand, is called point, or stable.

Unlike stable vibration, labile vibration involves the movement of the massage therapist's hands throughout the massaged area.

Large areas of the body, such as the back, thighs, buttocks, and abdomen, are vibrated with fingers clenched into a fist. In this case, the massage therapist touches the massed area of ​​the body with the palmar surface of the phalanges of all four fingers of the hand (except for the thumb) or its elbow edge. Massage movements (vibrations) are carried out in the longitudinal or transverse direction.

Continuous vibration with tissue capture involves forceps-like fixation of small muscles and tendons with the help of fingers.

Rice. 40. Shaking

Continuous vibration includes the following techniques: pushing, shaking, shaking, shaking.

Shaking is performed on extremely relaxed muscles of the massaged area of ​​the body ( rice. 40). With a hand with fingers as far apart as possible, the massage therapist grabs a large muscle or a group of small muscles. Reception is carried out in the longitudinal or transverse direction. At the same time, the speed and intensity of movements change, as mentioned above, that is, at the beginning of the procedure and at its completion, the shaking is more measured and calm, and in the middle of the session, the amplitude of the massage technique increases.

Shaking improves joint mobility ( rice. 41), and makes ligaments and muscles more elastic. As already clear from the above, this technique is used in the massage of the limbs. Shaking is done as follows: with both hands, the massage therapist grabs the foot or hand of the person being massaged and shakes it up and down. At the same time, oscillatory movements should not be very sharp or have too large an amplitude so as not to cause pain in the massaged area of ​​​​the joints.

Rice. 41. Shaking

Rice. 42. Concussion

Concussion is used as a technique that most effectively affects the internal organs ( rice. 42). The technique is as follows: the hands are placed parallel to each other, so that the right hand is on the surface of the body in the region of the desired abdominal organ. The thumbs should lie side by side, on one side of the massaged area. Massage movements (shaking) are performed due to vibrations. The pace is fast, the hands alternately approach each other, then part, shaking the integumentary tissues and, together with them, the internal organ, which is the object of the massage effect.

General shaking of the abdomen strengthens the abdominal muscles and smooth muscles of the peritoneum, relieves many ailments associated with indigestion, improves intestinal motility. The position of the person being massaged during the reception is lying on the back.

Technique: the masseur puts his hands on his stomach so that the thumbs are in the navel area, and the other four with their end phalanges are directed in opposite directions - to the sides and back. Oscillatory massage movements are performed in vertical and horizontal directions.

In contrast to shaking, when pushing, the left hand is placed on the surface of the massaged area in the area of ​​\u200b\u200bthe desired internal organ. At the same time, the right hand with short jerks, as it were, shifts the organ towards the left. Pushing refers to varieties of indirect massage of internal organs.

As noted above, many massage techniques (including vibration), their strength and intensity of impact on the skin, muscles and internal organs of the human body directly depend on the position of the hands, for example, on the angle formed by the forearms of the massage therapist and the surface of the body being massaged. The duration of exposure also matters. In particular, when performing a certain shock technique, you should not linger on one massaged area for more than 10 seconds. And vibration techniques are recommended to be combined with softer massage techniques, such as stroking.

Depending on the nature and amplitude, the impact of vibration on the human body can be very different. So, short and deep fluctuations of large amplitude cause excitation and even irritation of the massaged area and the body as a whole. A series of small movements, long in time, with a small amplitude of vibration, relaxes and calms the central nervous system.

Like any other massage techniques, vibration should not cause pain in the patient, especially characteristic of a deep and intermittent reception.

Performing intermittent vibration is contraindicated in the area of ​​​​the location of the internal organs and in areas of the body with sensitive skin, where blood vessels and nerve endings come close to its surface. Techniques such as tapping and chopping are not carried out in the popliteal region, in the abdomen and on the inner thighs. Hard vibration techniques are not indicated for use by the elderly. Manual vibration also tires the massage therapist, therefore, if necessary, hardware vibration is preferable, during which it is possible to more clearly dose the time and force of the procedure on the body.

Mistakes of novice massage therapists, typical for improper vibration techniques:

- the vibration intensity is too high, and the person being massaged has a low threshold of sensitivity, so he refuses to conduct the reception;

- the masseur conducts a hard reception, without first relaxing the muscles of the massaged area, which causes pain in the patient when chopping, tapping or patting;

- incorrect position of the massaged limb and non-observance of the direction of movements, as a result of which not only pain sensations or violations of its functions occur in the elbow or knee joint, but the bag-ligamentous apparatus may even be damaged;

- intermittent vibration is performed too intensely or on the area of ​​the body where vibration techniques are not recommended, because it causes pain.

Squeezing as a technique is classified as a separate group, although the technique of its implementation is very similar to the technique of stroking. The difference is that the squeeze is carried out vigorously. Hands move over the surface of the massaged area at a faster pace than when stroking, and quite a lot of pressure is added to this. Squeezing affects not only the skin and subcutaneous tissue, but also the connective tissue, muscles and tendons.

The local effect of squeezing is manifested in a warming and analgesic effect. When performing this technique, the blood vessels are quickly emptied and just as quickly filled with fresh blood. Due to mechanical action, local temperature rise and stimulation of blood circulation, metabolic processes in the massaged tissues are activated. The lymph flow increases, swelling and congestion disappear. Squeezing has a stimulating effect on the central nervous system, increases the vitality of both the whole organism and individual organs, including skin and muscles. Squeezing is widespread in massage practice, and in some types of massage it takes up to 60% of the time allotted for a session.

Cross squeezing is carried out with the edge or base of the palm, as well as with two hands with weights. When performing the reception of transverse squeezing, the hand is placed across the direction of the muscle fibers. Fingers, tightly pressed to each other, should be bent at the interphalangeal joints, the thumb should be pressed against the index finger. Massage movements directed forward are performed with the thumb and its elevation.

Rice. 43. Squeezing with the edge of the palm

When squeezing out with the edge of the palm, the direction of movement is preserved ( rice. 43). The massage therapist's brush on the massaged area is located across the course of the blood vessels. The fingers are folded in such a way that the thumb is on top of the index finger. Massage movements are performed with the edge of the palm, four fingers of which are naturally, without tension, bent.

Squeezing with the base of the palm is performed, respectively, with the base of the palm of the masseur's working hand and the elevation of the thumb ( rice. 44). The remaining four fingers of the hand are laid in the same direction and slightly raised. The thumb is connected to the index finger, its terminal phalanx is also abducted. The reception is carried out by pressing on the tissues of the massaged area along the direction of the muscle fibers. It is important to remember that when carrying out squeezing techniques, the masseur's hand, which is closer to the person being massaged, is involved.

Rice. 44. Squeezing with the base of the palm

Rice. 45. Squeezing with two hands with weights rice. 45). In this case, one hand performs massage movements, and the other - weights. Perpendicular weighting is carried out by pressing with three fingers (ring, middle, index) of the free hand on the thumb of the working, its radial edge. Transverse weighting is performed with the entire brush of the free hand, placing it across the massaging brush.

Rice. 46. ​​Coracoid squeeze

Squeezing includes only one auxiliary technique - beak squeeze ( rice. 46). Depending on the location and shape of the massaged area, beak-shaped squeezing is performed with different parts of the hand: facial, ulnar, dorsal or radial. The massage movements of this technique are carried out with the fingers of the working hand, folded in the form of a beak, closely pressing them to the thumb. The middle finger thus occupies a position on top of all the others.

Coracoid squeezing with the ulnar part of the hand is performed with the edge of the little finger. Massage movements of the working brush are directed forward ( rice. 47).

Rice. 47. Coracoid squeeze with the elbow part of the hand

With beak-shaped squeezing with the front part of the hand, the massage therapist's hand also moves forward. The little finger and thumb of the working hand are involved in the reception.

Also, moving the hand forward, a beak-shaped squeezing is performed with the radial part of the hand. With this type of squeezing, the edge of the thumb is used as a working surface.

With beak-shaped squeezing with the back of the hand, the movements of the hand are directed in the opposite direction ( rice. 48).

Rice. 48. Coracoid squeezing with the back of the hand

Squeezing, like any other massage technique, requires certain rules to be followed. For example, during the session, squeezing is alternated with kneading, massage movements are directed along the lymphatic tract. The reception must be carried out rhythmically and slowly enough, so that the person being massaged does not experience pain, and the blood and lymphatic vessels located in the tissues of the massaged area have time to react to the procedure being performed.

Performing a squeeze on the muscles, massage movements are directed along the muscle fibers.

If it is required to eliminate puffiness, for example, of the feet, the limb is massaged from the area located above the area that shows the massage effect. In this case, the squeeze begins with the muscles of the thigh, gradually descending to the lower leg and then to the foot. One condition must be met: when edema is eliminated, massage begins from the part of the body that is located above the lymph nodes located in the area affected by the massage.

The pressure force during squeezing is adjusted depending on the individual tolerance of the person being massaged. Performing the reception should not cause pain. Of great importance is the nature of the massaged area of ​​the body. So, in areas with increased sensitivity, the pressure should be negligible. Large muscle layers, on the contrary, require a stronger impact.

In addition to techniques performed on the soft tissues of the human body, flexion and extension movements of the joints are used in massage. The actions of the massage therapist, the intensity and nature of his movements are determined by the physiological mobility of a particular joint, its structure and size.

The movements produced in the joints during a massage session are divided into several types. These are flexion, extension, pronation, supination, adduction, abduction and rotation. All movements are performed by the massage therapist around an imaginary axis: frontal, longitudinal or sagittal. The choice of axis depends on the physiological characteristics of the joints, i.e. on their natural mobility. During a massage session, 20-30% of the total time is allotted for the procedure. Movements in the joints, having a beneficial effect on the entire musculoskeletal system, are indicated for use after significant physical exertion. They are also used as a rehabilitation therapy after illness or injury.

Movements help to improve joint mobility and cartilage tissue trophism, activate the secretion of synovial fluid and blood circulation. The higher nervous sections of the central nervous system react to the slow pace of movements by the process of inhibition. Normalization of nutrition and joint mobility affects the body as a whole, increasing its protective functions.

Movements are divided into active, passive and movements with resistance.

The active type of movements is performed by the patient himself, without the help of a massage therapist. This type of movement precedes the massage of the corresponding joint and adjacent muscles. The duration and intensity of movements depends on the physical capabilities of the massaged and the mobility of the joint. So, for example, after an injury, flexion or extension movements can be limited by pain. The purpose of massage in a particular case will be to restore joint mobility and functions of peripheral nerve endings.

Passive movements are preceded by a massage, after which the masseur himself conducts the corresponding movements. The patient at the same time takes a comfortable position so that the muscles are extremely relaxed. Before starting the procedure, through active movements, the massage therapist determines the mobility of the joint. The range of motion should be increased gradually.

The criterion for assessing the mobility of the joint and the angle of flexion of the limb is a slight pain sensation in the area of ​​the joint or adjacent muscle. In the absence of such a movement will not produce the desired effect.

In addition to the action that restores the functions of the joints, movements have a beneficial effect on muscle fibers, stimulating their contractile function and increasing elasticity.

When performing movements with resistance, the muscles or ligamentous apparatus must overcome the resistance provided by the massage therapist or the patient himself, taking into account the strength of the muscle and its ability to contract. The intensity of resistance increases towards the middle of the procedure. At the beginning of the movement and at its end, it is much weaker.

There are two types of resistance: in the first case, resistance is directed against the actions of the massage therapist, in the second, it is directed against the actions of the patient. Neither in the first nor in the second case is it recommended to delay the movements of the limbs or strain the muscles. The resistance provided should be smooth, without unexpected sharp relaxations and jolts. All of the above applies to the resistance provided to the actions of the massage therapist.

Movements are very different.

When moving the body, tilts and turns in different directions are used - to the right and left, tilts (flexions) and back bends (extensions), circular movements of the body. This type of movement contributes to greater mobility of the spinal column. For the procedure, the person being massaged is offered to sit on a hard chair without a back. The massage therapist takes a standing position behind the patient. When performing flexion and extension movements, the masseur's hands lie on the client's shoulders, smoothly bending the torso forward, then just as smoothly unbending it back. Turns are performed first to the left, then the body is fixed in its original position, followed by a turn to the right, and the body again returns to its original position. When performing turns, the massage therapist's hands should be on the deltoid muscles of the patient.

Abduction and adduction in the shoulder joint are combined with pronation and supination, i.e., turning the joint in and out; perform also the reception of a circular motion of the hands. The position of the body being massaged and the position of the massage therapist are the same as when performing movements with the body. The masseur puts his hand on the opposite shoulder of the patient, fixing it. The hand of the same name captures the forearm in the area of ​​the elbow joint and performs movements depending on the prescription: flexion, extension, circular movements, rotation ( rice. 49). In the horizontal position of the massaged movement back and forth in the shoulder joint, it is carried out with simultaneous pronation and supination of the joint.

Rice. 49. Hand joint work

When performing movements in the elbow joint, the person being massaged can take a sitting or lying position. In his sitting position, the masseur with the opposite hand fixes the patient's hand as close as possible to the elbow joint. The hand of the same name, tightly clasping the wrist, flexes and extends the elbow joint. When the patient is lying down, the massage therapist brings his hands from below, clasping the corresponding area of ​​the massaged hand. During flexion and extension, simultaneous pronation and supination are carried out using palm turns.

The movements of the hand are performed by fixing the hand being massaged in the area of ​​the forearm, just above the wrist joint. The masseur, clasping the patient's hand, performs flexion, extension, abduction, adduction and circular movements of the brush in both directions - to the right and to the left.

When moving the fingers, flexion, extension, reduction and breeding are performed. One hand of the massage therapist fixes the massaged hand in the wrist joint, the other performs flexion and extension of the fingers alternately in each individual joint. Warming up the joints of the fingers, they are reduced and diluted.

Passive movements of the hand and fingers can be performed by grabbing the hand with both hands so that the masseur's thumbs are on the back of the patient's hand, and the remaining four fingers are on the bottom, on the palmar. The movements of the massage therapist's hands resemble squeezing and stretching, as if rubbing against each other the small joints of the hand and fingers. Before the described procedure, it is recommended to conduct a massage.

Rice. 50. Work with the hip joint Flexion and extension of the hip joint is carried out with the massaged person lying on his back. One hand of the massage therapist, brought down from below, fixes the knee joint, the other is located on top of the ankle. The massaged leg is bent in the above joints, directing the thigh up to the abdomen, then the limb is returned to its original position ( rice. 50, 51).

Rice. 51. Work with the knee joint

When performing abduction and adduction of the hip joint, the massaged person should lie on his side. The masseur, resting on the iliac crest with one hand, and grabbing the lower leg with the other, raises the straightened leg of the massaged to the maximum possible height, simultaneously performing pronation and supination. Then return the leg to its original position.

Circular movements in the hip joint are performed with the massaged person lying on his back. The massage therapist places one hand on the patient's knee joint, the other grabs the foot from below, in the heel area. Circular movements are carried out first in one direction, then in the other direction, slightly bending the leg of the person being massaged in the knee and hip joints.

During flexion and extension in the knee joint, the person being massaged lies on the stomach. In order to exclude accidental injury, with one hand the masseur fixes the lower part of the thigh, with the other he captures either the lower leg in the ankle joint or the calcaneus. With an ideally executed movement and good stretching of the muscles of the massaged, the heel bone should reach the gluteus maximus muscle.

To perform movement in the ankle joint, the person being massaged assumes a supine position. With one hand, the masseur fixes the joint from above, with the other he grabs the foot by the calcaneus ( rice. 52). The nature of the movements is the same as for the brush.

Rice. 52. Work with the ankle joint The movements of the toes are very limited, of all the above methods, only flexion and extension are performed. At the same time, the foot is fixed, the movement is performed for each finger separately. During the execution of movements, it is necessary to control the reaction of the body to the procedure being carried out: a change in the nature of breathing and heart rate. The physical capabilities of the person being massaged must also be taken into account. When movements in the joints are limited, for example, after an injury or due to advanced age, it is necessary to carefully monitor that the person being massaged does not experience pain. Also, in order to protect the patient from accidental injuries during a massage session, all movements in the joints, without exception, must be carried out evenly, without jerks, at a slow pace.

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Topic: The influence of massage on the human nervous system

Completed by: Elena Korablina

human nervous system

nervous system human classified :

according to the conditions of formation and type of management as:

Inferior nervous activity

Higher nervous activity

according to the method of transmitting information as:

Neurohumoral regulation

reflex activity

by area of ​​localization as:

Central nervous system

peripheral nervous system

by functional affiliation as:

Vegetative nervous system

Somatic nervous system

sympathetic nervous system

Parasympathetic nervous system

nervous system (sustema nervosum) - a complex of anatomical structures that ensure the individual adaptation of the body to the external environment and the regulation of the activity of individual organs and tissues.

The nervous system acts like integrative system, linking together sensitivity, motor activity and the work of other regulatory systems (endocrine and immune). The nervous system, together with the endocrine glands (endocrine glands), is the main integrating and coordinating apparatus, which, on the one hand, ensures the integrity of the body, on the other hand, its behavior, adequate to the external environment.

The nervous system includes the brain and spinal cord , as well as nerves, ganglions, plexuses, etc. All these formations are predominantly built from nervous tissue, which: - is able to be excited under the influence of irritation from the internal or external environment for the body and - conduct excitation in the form of a nerve impulse to various nerve centers for analysis, and then - transmit the “order” generated in the center to executive organs to perform the body's response in the form of movement (movement in space) or changes in the function of internal organs. Excitation- an active physiological process by which some types of cells respond to external influences. The ability of cells to generate excitation is called excitability. Excitable cells include nerve, muscle, and glandular cells. All other cells have only irritability, i.e. the ability to change their metabolic processes when exposed to any factors (irritants). In excitable tissues, especially in the nervous one, excitation can spread along the nerve fiber and is a carrier of information about the properties of the stimulus. In muscle and glandular cells, excitation is a factor that triggers their specific activity - contraction, secretion. Braking in the central nervous system - an active physiological process, the result of which is a delay in the excitation of a nerve cell. Together with excitation, inhibition forms the basis of the integrative activity of the nervous system and ensures the coordination of all body functions.

As a result of a long evolutionary development, the nervous system turned out to be represented by two departments. They are distinctly different externally, but structurally and functionally form a single whole. This is the central nervous system in the form of the brain and spinal cord and the peripheral nervous system, represented by nerves, nerve plexuses and nodes.

Central nervous systems and (systema nervosum centrale) is represented by the brain and spinal cord. In their thickness, areas of gray color (gray matter) are clearly defined, clusters of neuron bodies have this appearance, and white matter formed by the processes of nerve cells, through which they establish connections with each other. The number of neurons and the degree of their concentration are much higher in the upper section, which as a result takes on the appearance of a bulky brain.

Head brain consists of three main parts, or departments. Its trunk is an extension of the spinal cord and serves as a support for the large cerebral vault - the brain responsible for most of the conscious thought. Below is the cerebellum. Although many sensory and motor neurons, respectively, end and start in the brain, most brain neurons are intermediate neurons whose task is to filter, analyze, and store information.

One of the most important functions of the brain is the storage of information received from the senses. Subsequently, this information can be called up and used in decision making. For example, the pain sensation when touching a hot stove is remembered, and later the memory will influence the decision whether to touch other stoves.

The upper part, or cortex, of the brain is responsible for most conscious actions. Some of its parts are involved in the perception of information, others are responsible for speech and language, and the rest serve as the beginning of motor pathways and control movements.

Between these motor-sensory and speech areas of the cerebral cortex are associated areas, consisting of millions of interconnected neurons. They are related to reasoning, emotions and decision making. The cerebellum is attached to the brain stem just below the brain and is mainly responsible for motor activity. It sends signals that cause involuntary movements in the muscles, allowing you to maintain posture and balance, and together with the motor areas of the brain ensures the coordination of body movements.

The brain stem itself is made up of a number of different structures that perform different tasks, and the most important of these are the "centers" that control the functioning of the lungs, heart, and blood vessels. It also controls functions such as blinking and vomiting. Other structures act as relay stations, relaying signals from the spinal cord or cranial nerves.

Although the hypothalamus is one of the smallest elements of the brainstem, it controls the body's chemical, hormonal, and temperature balance.

Dorsal brain located in the spinal canal from the 1st cervical to the 2nd lumbar vertebrae. Outwardly, the spinal cord resembles a cylindrical cord. 31 pairs of spinal nerves depart from the spinal cord, which leave the spinal canal through the corresponding intervertebral foramina and branch symmetrically in the right and left halves of the body. In the spinal cord, the cervical, thoracic, lumbar, sacral and coccygeal regions are distinguished, respectively, among the spinal nerves, 8 cervical, 12 thoracic, 5 lumbar, 5 sacral and 1-3 coccygeal nerves are considered.

The section of the spinal cord corresponding to a pair (right and left) of the spinal nerves is called a segment of the spinal cord. Each spinal nerve is formed as a result of the fusion of the anterior and posterior roots extending from the spinal cord. On the back root there is a thickening - the spinal ganglion, here are the bodies of sensitive neurons.

Through the processes of sensory neurons, excitation is carried from receptors to the spinal cord. The anterior roots of the spinal nerves are formed by the processes of motor neurons, through which commands are transmitted from the central nervous system to the skeletal muscles and internal organs. At the level of the spinal cord, reflex arcs are closed, providing the simplest reflex reactions, such as tendon reflexes (for example, a knee jerk), flexion reflexes when pain receptors of the skin, muscles and internal organs are irritated. An example of the simplest spinal reflex is the withdrawal of a hand when it touches a hot object. The reflex activity of the spinal cord is associated with maintaining a posture, maintaining a stable body position when turning and tilting the head, alternating flexion and extension of paired limbs when walking, running, etc. In addition, the spinal cord plays an important role in regulating the activity of internal organs, in particular, the intestines, bladder, and blood vessels.

Peripheral nervous system

a conditionally allocated part of the nervous system, the structures of which are located outside the brain and spinal cord. The PNS provides a two-way connection between the central parts of the nervous system and the organs and systems of the body. Anatomically, the PNS is represented by cranial (cranial) and spinal nerves, as well as a relatively autonomous enteric nervous system localized in the intestinal wall. All cranial nerves (12 pairs) are divided into motor, sensory or mixed. The motor nerves originate in the motor nuclei of the trunk, formed by the bodies of the motor neurons themselves, and the sensory nerves are formed from the fibers of those neurons whose bodies lie in the ganglia outside the brain. 31 pairs of spinal nerves depart from the spinal cord: 8 pairs of cervical, 12 thoracic, 5 lumbar, 5 sacral and 1 coccygeal. They are designated according to the position of the vertebrae adjacent to the intervertebral foramen from which these nerves emerge. Each spinal nerve has an anterior and a posterior root that merges to form the nerve itself. The back root contains sensory fibers; it is closely related to the spinal ganglion (posterior root ganglion), which consists of the bodies of neurons whose axons form these fibers. The anterior root consists of motor fibers formed by neurons whose cell bodies lie in the spinal cord.

The peripheral nervous system includes 12 pairs of cranial nerves (Cranial nerves), their roots, sensory and autonomic ganglia located along the trunks and branches of these nerves, as well as the anterior and posterior roots of the spinal cord and 31 pairs of spinal nerves, sensory ganglia, nerve plexuses (see Cervical plexus, Brachial plexus, Lumbosacral plexus), peripheral nerve trunks of the trunk and extremities, right and left sympathetic trunks, autonomic plexuses, ganglia and nerves. The conditionality of the anatomical separation of the central and peripheral nervous system is determined by the fact that the nerve fibers that make up the nerve are either axons of motor neurons located in the anterior horns of the spinal cord segment, or dendrites of sensory neurons of the intervertebral ganglia (the axons of these cells are sent along the posterior roots to the spinal cord) .

Thus, the bodies of neurons are located in the central nervous system, and their processes are located in the peripheral (for motor cells), or, conversely, the processes of neurons located in the peripheral nervous system make up the pathways of c. n. With. (for sensitive cells). The main function of P. n. With. is to provide communication c. n. With. with the environment and target organs. It is carried out either by conducting nerve impulses from extero-, proprio- and interoreceptors to the corresponding segmental and suprasegmental formations of the spinal cord and brain, or in the opposite direction - regulatory signals from c. n. With. to the muscles that ensure the movement of the body in the surrounding space, to internal organs and systems. P.'s structures n. With. have their own vascular and innervation supply that supports the trophism of nerve fibers and ganglia; as well as its own liquor system in the form of capillary gaps along the nerves and plexuses. It is formed starting from the intervertebral ganglia (right in front of which, on the spinal roots, the subarachnoid space ends with blind sacs with cerebrospinal fluid washing the central nervous system). Thus, both cerebrospinal fluid systems (central and peripheral nervous systems) are separate and have a kind of barrier between them at the level of the intervertebral ganglia. In the peripheral nervous system, nerve trunks may contain motor fibers (anterior roots of the spinal cord, facial, abducens, trochlear, accessory and hypoglossal cranial nerves), sensory (posterior roots of the spinal cord, sensory part of the trigeminal nerve, auditory nerve) or autonomic (visceral branches of the sympathetic nerve). and parasympathetic systems). But the main part of the upper trunks and limbs is mixed (contains motor, sensory and autonomic fibers). Mixed nerves include intercostal nerves, trunks of the cervical, brachial and lumbosacral plexuses and the nerves of the upper (radial, median, ulnar, etc.) and lower (femoral, sciatic, tibial, deep peroneal, etc.) extremities. The ratio of motor, sensory and autonomic fibers in the trunks of mixed nerves can vary significantly. The largest number of autonomic fibers contain the median and tibial nerves, as well as the vagus nerve. Despite the external disunity of a separate nerve trunks P. n. N of page, between them there is a certain functional interrelation provided by nonspecific structures of c. n. With.

This or that lesion of an individual nerve trunk affects the functional state not only of the symmetrical nerve, but also of distant nerves on its own and opposite side of the body: in the experiment, the performance of the contralateral neuromuscular preparation increases, and in the clinic, with mononeuritis, the conduction indicators along other nerve trunks increase . The specified functional interrelation to some extent (along with other factors) determines the characteristic for P. n. With. the multiplicity of lesions of its structures - polyneuritis and polyneuropathy, polyganglionitis, etc.

P.'s defeats n. With. can be caused by a variety of factors: trauma, metabolic and vascular disorders, infections, intoxications (domestic, industrial and medicinal), vitamin deficiency and other deficient conditions. A large group of diseases P. n. With. make up hereditary polyneuropathies: Charcot's neural amyotrophy - Marie - Tuta (see Amyotrophy), Roussy - Levy syndrome, Dejerine's hypertrophic polyneuropathy - Sotta and Marie - Boveri, etc. In addition, a number of hereditary diseases of c. n. With. is followed by P.'s defeat of n. S.: Friedreich's family ataxia (see Ataxia), Shtryumpell's family paraplegia (see Paraplegia (Paraplegia)), Louis-Bar ataxia-telangiectasia, etc. Depending on the primary localization of P.'s lesion n. With. There are Radiculitis, Plexitis, Ganglionitis, Neuritis, as well as combined lesions - polyradiculoneuritis, polyneuritis (Polyneuropathies). The most common cause of radiculitis is metabolic-dystrophic changes in the spine with osteochondrosis, herniated discs. Plexitis is more often caused by compression of the trunks of the cervical, brachial and lumbosacral plexuses by pathologically altered muscles, ligaments, vessels, the so-called cervical ribs and other formations "for example, tumors, enlarged lymph nodes). The spinal ganglia are affected mainly by the herpes virus. A large group of compression lesions has been described P. N. S. associated with squeezing of its structures in fibrous, bone, muscle channels (Tunnel syndromes). paresis, muscle atrophy, disorders of superficial and deep sensitivity in the area of ​​impaired innervation in the form of pain, paresthesia, anesthesia, causalgia syndromes and phantom sensations, vegetative-vascular and trophic disorders more often in the distal extremities). Ekayut in isolation, not accompanied by symptoms of loss of functions - neuralgia, plexalgia, radiculalgia.

The most severe pain syndromes are observed with ganglionitis (sympathalgia), as well as injuries of the median and tibial nerves with the development of causalgia (causalgia).

At children's age a special form of pathology of P. of n. With. are birth injuries of the spinal roots (mainly at the level of the cervical, less often lumbar segments), as well as trunks of the brachial plexus with the development of birth traumatic paralysis of the arm, less often the leg. With a birth injury of the brachial plexus and its branches, Duchenne-Erb or Dejerine-Klumpke paralysis occurs (see Brachial plexus).

Tumors P. n. With. (neurinomas, neurofibromas, glomus tumors) are relatively rare, but can occur at various levels.

Diagnosis of lesions P. n. With. based primarily on the data of the clinical examination of the patient. Predominantly distal paralysis and paresis with impaired sensitivity, vegetative-vascular and trophic disorders in the zone of innervation of one or another nerve trunk are characteristic. In case of damage to the peripheral nerve trunks, a thermal imaging study has a certain diagnostic value, which reveals the so-called amputation syndrome in the denervation zone due to a violation of thermoregulation in it and a decrease in skin temperature. They also conduct electrodiagnostics and chronaximetry, but recently these methods are inferior to electromyography and electroneuromyography, the results of which are much more informative. Electromyography reveals a characteristic denervation type of change in the bioelectrical activity of paretic muscles in neural lesions. The study of the speeds of impulse conduction along the nerves makes it possible to determine the exact localization of the lesion of the nerve trunk by their decrease, as well as to identify the degree of involvement of motor or sensory nerve fibers in the pathological process. For P.'s defeat n. With. a decrease in the amplitudes of the evoked potentials of the affected nerve and denervated muscles is also characteristic. To clarify the nature of the pathological process in polyneuropathies, nerve tumors, a biopsy of the skin nerves is used, followed by histological and histochemical examination. With clinically diagnosed tumors of the nerve trunks, computed tomography can be used, which is of particular importance in cases of tumors of the cranial nerves (for example, with acoustic neuroma). Computed tomography allows you to establish the localization of a herniated disc, which is important for its subsequent surgical removal.

Treatment of diseases P. n. With. It is aimed at eliminating the action of the etiological factor, as well as at improving microcirculation and metabolic and trophic processes in the nervous system. B vitamins, potassium preparations and anabolic hormones, anticholinesterase preparations and other neural conduction stimulants, nicotinic acid preparations, cavinton, trental, as well as drug metameric therapy are effective. Physiotherapeutic procedures (electrophoresis, pulsed currents, electrical stimulation, diathermy and other thermal effects), massage, physiotherapy exercises, spa treatment are prescribed. With tumors of the nerves, as well as with their injuries, according to indications, surgical treatment is performed. In recent years, the drug kronasial has been developed, containing a certain composition of gangliosides - receptors of neuronal membranes; its intramuscular application stimulates synaptogenesis and regeneration of nerve fibers.

autonomic nervous system

The autonomic, or autonomic, nervous system regulates the activity of the involuntary muscles, the heart muscle, and various glands. Its structures are located both in the central nervous system and in the peripheral. The activity of the autonomic nervous system is aimed at maintaining homeostasis, i.e. a relatively stable state of the internal environment of the body, such as a constant body temperature or blood pressure corresponding to the needs of the body.

Signals from the CNS arrive at the working (effector) organs through pairs of series-connected neurons. The bodies of neurons of the first level are located in the CNS, and their axons terminate in the autonomic ganglia lying outside the CNS, and here they form synapses with the bodies of neurons of the second level, the axons of which directly contact the effector organs. The first neurons are called preganglionic, the second - postganglionic. In that part of the autonomic nervous system, which is called the sympathetic, the bodies of preganglionic neurons are located in the gray matter of the thoracic (thoracic) and lumbar (lumbar) spinal cord. Therefore, the sympathetic system is also called the thoraco-lumbar system. The axons of its preganglionic neurons terminate and form synapses with postganglionic neurons in the ganglia located in a chain along the spine. Axons of postganglionic neurons are in contact with effector organs. The endings of postganglionic fibers secrete norepinephrine (a substance close to adrenaline) as a neurotransmitter, and therefore the sympathetic system is also defined as adrenergic. The sympathetic system is complemented by the parasympathetic nervous system.

The bodies of its pregangliar neurons are located in the brainstem (intracranial, i.e. inside the skull) and the sacral (sacral) section of the spinal cord. Therefore, the parasympathetic system is also called the craniosacral system. Axons of preganglionic parasympathetic neurons terminate and form synapses with postganglionic neurons in the ganglia located near the working organs. The endings of postganglionic parasympathetic fibers release the neurotransmitter acetylcholine, on the basis of which the parasympathetic system is also called the cholinergic system. As a rule, the sympathetic system stimulates those processes that are aimed at mobilizing the body's forces in extreme situations or under stress. The parasympathetic system contributes to the accumulation or restoration of the body's energy resources. The reactions of the sympathetic system are accompanied by the consumption of energy resources, an increase in the frequency and strength of heart contractions, an increase in blood pressure and blood sugar, as well as an increase in blood flow to skeletal muscles due to a decrease in its flow to internal organs and skin. All of these changes are characteristic of the "fright, flight or fight" response. The parasympathetic system, on the contrary, reduces the frequency and strength of heart contractions, lowers blood pressure, and stimulates the digestive system. The sympathetic and parasympathetic systems act in a coordinated manner and cannot be seen as antagonistic. Together they support the functioning of internal organs and tissues at a level corresponding to the intensity of stress and the emotional state of a person.

Both systems function continuously, but their activity levels fluctuate depending on the situation.

massage has a positive effect on functional circulatory disorders, diseases of the respiratory system, digestion, chronic degenerative diseases of the spine and joints, the genitourinary system, the consequences of injuries, functional disorders of the endocrine system and the autonomic nervous system.

Massage gives a therapeutic effect, alleviates the condition of patients, improves the body's resistance to respiratory diseases, increases the tone of skeletal muscles and can be used for cosmetic purposes.

The effect of massage on the nervous system

Since the action of the massage procedure is mediated by the nervous structures in its physiological essence, massage therapy has a significant effect on the nervous system: it changes the ratio of the processes of excitation and inhibition (it can selectively calm - sedate or excite - tone the nervous system), improves adaptive reactions, increases the ability to withstand a stress factor , increases the speed of regenerative processes in the peripheral nervous system.

Noteworthy is the work of I. B. Granovskaya (1960), who studied the effect of massage on the state of the peripheral nervous system of dogs in an experiment with transection of the sciatic nerve. It was found that the nervous component reacts first of all to massage. At the same time, the greatest changes in the spinal ganglia and nerve trunks were noted after 15 massage sessions and were manifested by an acceleration of the regeneration of the sciatic nerve. Interestingly, with the continuation of the course of massage, the body's responses decreased. Thus, the dosage of the massage course was experimentally substantiated - 10 - 15 procedures.

The human somatic muscular system includes about 550 muscles located on the body in several layers and built from striated muscle tissue. The skeletal muscles are innervated by the anterior and posterior branches of the spinal nerves extending from the spinal cord, and are controlled by commands from the higher parts of the central nervous system - the cerebral cortex and are controlled by commands from the higher parts of the central nervous system - the cerebral cortex and the subcortical centers of the extrapyramidal system. Due to this, the skeletal muscles are voluntary, i.e. capable of contracting, obeying a conscious volitional command. This command in the form of an electrical impulse comes from the cerebral cortex to the intercalary neurons of the spinal cord, which, based on extrapyramidal information, model the activity of motor nerve cells, the axons of which end directly on the muscles.

massage nervous system peripheral

Axons of motor neurons and dendrites of sensitive nerve cells that perceive sensations from muscles and skin are combined into nerve trunks (nerves).

These nerves run along the bones, lie between the muscles. Pressing on the points of close location of the nerve trunks causes their irritation and "switching on" the arc of the skin-somatic reflex. At the same time, the functional state of the muscles and underlying tissues innervated by this nerve changes.

Under the influence of acupressure of the nerve trunks or wrapping and linear massage of the muscles themselves, the number and diameter of open capillaries in the muscles increases. The fact is that the number of functioning muscle capillaries in a muscle is not constant and depends on the state of the muscle and regulatory systems.

In a non-working muscle, a narrowing and partial destruction of the capillary bed (decapillaryization) occurs, which causes a narrowing of muscle tone, degeneration of muscle tissue and clogging of the muscle with metabolites. Such a muscle cannot be considered completely healthy.

With massage, just like with physical exertion, the level of metabolic processes increases. The higher the metabolism in the tissue, the more functioning capillaries in it. It was proved that under the influence of massage, the number of open capillaries in the muscle reaches 1400 per 1 mm2 of cross section, and its blood supply increases by 9-140 times (Kunichev L.A. 1985).

In addition, massage, unlike physical activity, does not cause the formation of lactic acid in the muscles. On the contrary, it contributes to the leaching of kenotoxins (the so-called motion poisons) and metabolites, improves trophism, and accelerates the recovery processes in tissues.

As a result, massage has a restorative and therapeutic (in cases of myositis, hypertonicity, muscle atrophy, etc.) effect on the muscular system.

Under the influence of massage, elasticity and muscle tone increase, contractile function improves, strength increases, efficiency increases, fascia strengthens.

The influence of kneading techniques on the muscular system is especially great.

Kneading is an active irritant and helps to maximize the performance of tired muscles, since massage is a kind of passive gymnastics for muscle fibers. An increase in efficiency is also observed when massaging muscles that did not take part in physical work. This is due to the generation of sensitive nerve impulses under the influence of massage, which, getting into the central nervous system, increase the excitability of the control centers of the massaged and neighboring muscles. Therefore, when individual muscle groups are fatigued, it is advisable to massage not only tired muscles, but also their anatomical and functional antagonists (Kunichev L.A. 1985).

The main task of massage is to restore the normal course of metabolic processes (metabolism, energy, bioenergy) in tissues, organs, organ systems. Of course, the formations of the cardiovascular system are of paramount importance here as a structural base, a kind of "transport network" for metabolism. This point of view is shared by both traditional and alternative medicine.

It has been established that during massage therapy of local, segmental and meridian points, the lumen of aoterioles, precapillary sphincters and true capillaries expands. Such a massage effect on the underlying and projective vascular bed is realized through the following main factors:

1) an increase in the concentration of histamine - a biologically active substance that affects vascular tone and is intensively released by skin cells when pressed, especially in the area of ​​​​the active point;

2) mechanical irritation of skin and vascular receptors, which causes reflex motor reactions of the muscular layer of the vessel wall;

3) an increase in the concentration of hormones (for example, adrenaline and noradrenaline, causing a central vasoconstrictor effect and, as a result, an increase in blood pressure) during massage of the projection skin zones of the adrenal glands;

4) local increase in skin temperature (local hyperthermia), causing a vasodilating reflex through temperature skin receptors.

The whole complex of these and a number of other mechanisms involved in massage therapy leads to an increase in blood flow, the level of metabolic reactions and the rate of oxygen consumption, the elimination of congestion and a decrease in the concentration of metabolites in the underlying tissues and projecting internal organs. This is the basis and a necessary condition for maintaining a normal functional state and treating individual organs and the body as a whole.

References

1. Badalyan L.O. and Skvortsov I.A. Clinical electroneuromyography, M., 1986;

2. Gusev E.I., Grechko V.E. and Buryag S. Nervous diseases, p. 379, M. 1988;

3. Popelyansky Ya.Yu. Diseases of the peripheral nervous system, M., 1989

4. Biryukov A.A. Massage - M .: Fi S, 1988 Biryukov A.A., Kafarov K.A. Means of restoring the health of an athlete M .: Fi S, 1979-151s.

5. Belaya N.A. Massage Therapy Guide. M.: Medicine, 1983 Vasichkin V.I. Massage Handbook. St. Petersburg, - 1991

Application

1) Ganglion (other - Greek gbnglypn - node) or nerve ganglion - an accumulation of nerve cells, consisting of bodies, dendrites and axons of nerve cells and glial cells. Usually the ganglion also has a sheath of connective tissue. Found in many invertebrates and all vertebrates. Often interconnected, forming various structures (nerve plexuses, nerve chains, etc.).

There are two large groups of ganglia: spinal ganglia and autonomous. The former contain the bodies of sensory (afferent) neurons, the latter contain the bodies of neurons of the autonomic nervous system.

2) NERVE PLEXUS - (plexus ervorum), a mesh connection of nerve fibers, as part of somatic and autonomic nerves; provides sensitivity and motor innervation of the skin, skeletal muscles and internal organs in vertebrates.

3) Neuron (from the Greek nyuron - nerve) is a structural and functional unit of the nervous system. This cell has a complex structure, is highly specialized and contains a nucleus, a cell body and processes in structure.

4) Dendrite (from the Greek dEndspn - "tree") - a dichotomously branching process of a nerve cell (neuron) that receives signals from other neurons, receptor cells or directly from external stimuli.

5) Axon (Greek ?opn - axis) - a neuritis, an axial cylinder, a process of a nerve cell, along which nerve impulses go from the cell body (soma) to the innervated organs and other nerve cells.

6) Simnaps (Greek wenbshite, from uhnrfein - hug, embrace, shake hands) - the place of contact between two neurons or between a neuron and an effector cell receiving a signal.

7) Pericarion - the body of a neuron, can have a different size and shape. Numerous synaptic contacts with processes of other neurons are formed on the cytolemma of the perikaryon.

8) Polyneuritis (from poly... and Greek nuron - nerve) - multiple lesions of the nerves. The main causes of polyneuritis are infectious (especially viral) diseases, intoxications (usually alcohol).

9) polyneuropathy It is a multiple lesion of the peripheral nerves. This lesion can develop in various diseases of the internal organs and in some cases can be hereditary.

10) Polyganglionitis - (polyganglionitis; Poly - + Ganglionitis) multiple inflammation of the nerve ganglia.

11) Causalgia (Causalgia) - a persistent unpleasant burning sensation in a limb after partial damage to the sympathetic and somatic sensory nerves in it.

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