Rules and technique of classical massage. Neck massage

Guidelines

1. Before the massage, the patient's muscles should be relaxed as much as possible by comfortable laying of the limb.
2. When massaging individual areas, carry out a preparatory massage of the entire arm.
3. Do not massage the hand and forearm separately (when massaging the forearm, the hand must also be affected).
4. When massaging the shoulder - massage the entire shoulder girdle.
5. When massaging the muscles of the shoulder, do not act on the internal groove of the biceps muscle.
6. In case of injuries, start the massage from the overlying area or from a preparatory massage of the entire limb.
7. The duration of the procedure depends on the purpose of the massage and can be 3-10 minutes when massaging individual areas and 12-15 minutes when massaging the entire limb.
8. Massage of the hand is carried out in the position of the patient lying on his back or on his stomach

9. Indications for massage of the upper extremities: diseases and injuries of soft tissues, bones, joints; diseases of vessels, peripheral nerves; skin diseases.

Shoulder massage. Massage begins with the trapezius and deltoid muscles. Use the techniques of deep stroking, intense rubbing and light kneading. The direction of movement is from the VI-VII cervical vertebrae (if you bend your head, the VII vertebra will protrude more than the rest) to the end of the deltoid muscle. The deltoid muscle should be well rubbed and kneaded.

Next, massage the triceps muscle, which is the extensor of the forearm. Apply techniques of superficial and deep stroking, vigorous rubbing and light kneading. Movements go from the elbow joint along the outer back surface of the shoulder to the shoulder joint.

Then they move on to massage the biceps muscle, which is the flexor of the forearm and shoulder. Movements are performed from the cubital fossa along the inner front surface of the shoulder to the armpit. The brachial artery, veins and nerves pass along the inner surface of the shoulder (on the inner groove). Therefore, when performing a massage, one must be especially careful and in no case exert any pressure on this surface.

Stroking in the direction of the axillary fossa - planar, encircling, forceps; rubbing - rectilinear, circular, spiral, crossing, sawing, hatching; kneading - felting, transverse, longitudinal (flexors and extensors are kneaded separately), stretching, shifting, forceps, pressure; vibration - shaking, puncturing, tapping, patting, chopping, shaking,

Forearm massage.

Stroking from the wrist joint to the area of ​​the elbow, planar, wrapping, forceps, ironing; rubbing - rectilinear, circular, spiral, sawing, crossing, hatching; kneading - longitudinal, transverse, felting, pressing, shifting, stretching, squeezing to the elbow; vibration - tapping, patting, chopping, shaking, shaking

Massage of the hand and fingers.

Massage starts from the back of the fingers, then moves to the back of the hand. Stroking is planar, then pincer-like on the back of the hand, starting from the fingertips to the middle third of the forearm, then massage each finger separately towards its base along the back, palmar and lateral surfaces. Rubbing - along the palmar and lateral surfaces of each finger and hand is circular, rectilinear - along the inter-metacarpal spaces; kneading - tongs, pressure, stretching; vibration - puncturing, shaking, passive and active movements

Anatomical features of the lower limb

The lower limb is divided into the pelvic girdle and the free lower limb. The areas of the lower limb include: 1) the gluteal region, which passes into the back of the thigh. Its upper border is the iliac crest, the lower one is the gluteal groove, or crease; 2) thigh area: a) the anterior thigh area corresponds to the location of the quadriceps femoris and sartorius muscles. The lower border runs 4 cm above the patella; b) the posterior region of the thigh corresponds to the space bounded at the top by the gluteal fold and at the bottom by a transverse line drawn 3-4 cm above the base of the patella; 3) areas of the knee: a) the anterior area of ​​the knee is located on the anterolateral surfaces of the knee. This area includes the area of ​​the patella, corresponding to the contours of the patella and condyles of the thigh; b) the back of the knee is located on the back of the knee. This area includes the popliteal fossa; 4) region of the lower leg: a) the anterior region of the lower leg extends from the tuberosity of the tibia to the level of the base of the ankles and occupies the anterior surface of the lower leg; b) the posterior region of the lower leg, which includes the so-called calf, the most protruding upper part of the posterior region of the lower leg; 5) areas of the foot: a) the rear of the foot is located on the dorsal and lateral surfaces of the foot, ranging from the fold of the ankle joint to the proximal phalanges of the fingers; b) the sole of the foot is located on the plantar surface of the foot, ranging from the distal sections of the calcaneal tuber to the proximal phalanges of the fingers; c) the calcaneal region corresponds to the calcaneal tuberosity.

Figure 106. Bones of the lower limb 1. Pelvic bone 2. Patella 3. Fibula 4. Tibia 5. Tarsus 6. Metatarsus 7. Fingers 8. Foot 9. Lower leg 10. Knee 11. Femur 12. Femur 13. Pelvis.

A - front view

B - rear view

Figure 107. Muscles of the lower limb. A is a front view. B - rear view.

Figure 108. Muscles of the foot.

The muscles of the lower limb (Fig. 107, 108) are divided into the muscles of the pelvis and the muscles of the free lower limb. Among the latter, the muscles of the thigh, lower leg and foot are distinguished.

The muscles of the pelvis (pelvic girdle), in connection with the upright posture of a person, form a powerful muscle mass into which the hip joint is immersed. They implement the most important functions of the body, providing both the possibility of a vertical position of the body and movement in space. With wide ends, they begin on the bones of the pelvis or spine, and with narrowed tendons, they are attached to the upper part of the femur. The complex complementary work of these muscles allows you to fix the hip joint in different modes and positions.

Some of these muscles originate on the inner surface of the pelvic bone or from the lumbar vertebrae. Among them is the iliopsoas muscle, which extends into the upper part of the anterior surface of the thigh. Most of the muscles of the pelvic girdle are located in the gluteal region (large, middle and small gluteal muscles; piriformis, external and internal obturator; twin; quadratus femoris).

The thigh muscles are unequal in length. Some of them extend from the pelvis to the bones of the lower leg and act on both the hip and knee joints, others, shorter ones, only on one of them. They all make up three groups.

The anterior group includes the tailor and quadriceps muscles. The latter is one of the strongest human muscles and consists of four parts, which are connected at the bottom into a common tendon that contains the patella. This is the only muscle that extends the leg at the knee. Its parts (the rectus femoris, the external, internal and intermediate wide muscles of the thigh) have different masses and lengths.

The internal group of muscles of the thigh provides mainly the adduction of the limb, acting on the hip joint (comb, long, short and large adductor muscles, thin muscle). The posterior group consists of the semitendinosus, semimembranosus and biceps muscles of the hip extensors and flexors of the knee joints. The primary importance of the lower leg muscles is that they provide fixation of the ankle joint when standing, orientation and support functions of the foot during movement (walking, running, etc.) . Among them there are relatively shorter muscles, the tendons of which do not go to the fingers (tibial, peroneal, three-headed). The flexors and extensors of the fingers, on the contrary, act on all joints of the foot.

The anterior leg muscles include the tibialis anterior, extensor digitorum longus, and extensor thumb longus. Their tendons run along the anterior surface of the ankle joint. These are the extensors of the foot and fingers (movement when the toe of the foot rises).

The back group is represented by two layers. The more superficial layer includes the gastrocnemius and soleus muscles, which are combined as the triceps muscle of the lower leg. They form one tendon, known to everyone as the Achilles tendon, which attaches to the calcaneal tuberosity. Deeper are the posterior tibial muscle, the long flexor of the fingers and the long flexor of the first finger. All these muscles act as foot flexors at the ankle joint, and they are especially stressed when standing on tiptoe. They are also involved in holding the arches of the foot, and those that extend to the toes, especially the first, provide, in addition, their supporting role when standing and walking.

The outer group consists of the long and short peroneal muscles, their tendons pass behind the outer ankle, these are also ankle flexors.

Fixing on the foot closer to its outer or inner edge, the leg muscles ensure its adaptation to the angle of inclination of the supporting surface, raising or lowering these edges.

Muscles of the foot. On the dorsum of the foot there is only a short extensor of the fingers with a separate part for the first toe.

The muscles of the sole are divided into the muscles of the first toe, the little finger and the middle group. The first two groups have almost the same set of muscles: finger abductor, short flexor. In the group of the first toe there is also a well-developed adductor muscle, which is important for strengthening the transverse arch of the foot. Yes, and other muscles of the sole, including the middle group (worm-shaped, interosseous muscles, short flexor of the fingers), despite their names, are of primary importance precisely in keeping the arch of the foot. In addition, by ensuring that the fingers are fixed in a certain position, they turn them into reference points when standing and moving. That is why the muscles of the big, supporting toe are so well developed.

Table 8. Muscles of the pelvis and lower limb

Continuation of table 8. Muscles of the pelvis and lower limb

Continuation of table 8. Muscles of the pelvis and lower limb

Continuation of table 8. Muscles of the pelvis and lower limb

Figure 109. Blood vessels of the leg.

The lymphatic vessels and nodes of the pelvis are concentrated along the iliac arteries and veins and collect lymph from the walls of the pelvis, from the bladder, uterus, vagina, rectum, and prostate gland. From the external genital organs, lymph enters the superficial inguinal lymph nodes

Figure 110. Iliac and inguinal lymph nodes.
Front view.

1 - superficial inguinal lymph nodes; 2 - wide fascia of the thigh; 3 - superficial lymphatic vessels; 4 - great saphenous vein of the leg; 5 - femoral vein; 6 - deep inguinal lymph nodes; 7 - external iliac vein; 8 - inguinal ligament; 9 - external iliac lymph nodes; 10 - common iliac lymph nodes; 11 - inferior vena cava; 12 - abdominal part of the aorta; 13 - lumbar lymph nodes; 14 - subaortic lymph nodes.

Figure 111. Lymphatic vessels and lymph nodes of the lower limb; right. Front view. 1 - inguinal lymph nodes; 2 - medial group of lymphatic vessels; 3 - lateral group of lymphatic vessels.

On the lower extremities are popliteal and inguinal lymph nodes, which are divided into superficial and deep. Lymphatic vessels carry lymph away from the skin (superficial vessels) and muscles, joints, bones, and nerves (deep vessels).

Superficial vessels are divided into two main groups, which are concentrated along the great and small saphenous veins.

The most noticeable accumulation of lymph nodes of the lower limb is localized in the upper part of the thigh under the inguinal fold. These inguinal nodes collect lymph from the thigh, lower leg and foot, as well as from the anterior abdominal wall (below the navel), the gluteal region, the external genital organs, the perineum and part of the pelvic organs.

Massage technique. The position of the patient - lying on his stomach, on his back; to relax the muscles, special rollers are placed under the knee and ankle joints. Massage movements are carried out along the lymphatic vessels towards the popliteal and inguinal lymph nodes.

Ankle massage. The ankle joint is a trochlear joint formed by the articular surfaces of the distal ends of the tibia and fibula and the articular surface of the talus block. Both tibias are interconnected by ligaments and form, as it were, a fork covering the upper and lateral surfaces of the body of the talus (Fig. 113). The articular bag is reinforced with ligaments.

The blood supply to the ankle joint is provided by the anterior and posterior tibial arteries. The pulsation of the first of them is determined on the front surface of the joint., And the second - behind the inner ankle.

Movements in the ankle joint are possible mainly in two directions - in the plantar (flexion) and in the back (extension). The amplitude of these movements in adults reaches 60-70°.

Figure 113. Ankle and foot.

Figure 114. Movements in the ankle joint.

The main landmarks of the ankle region are the medial malleolus (the bony prominence at the distal end of the tibia) and the lateral malleolus (the distal end of the fibula). The ankle ligaments attach to the ankles and bones of the foot. The powerful Achilles tendon attaches to the posterior surface of the calcaneus.

Movement in the ankle joint is limited by plantar and dorsiflexion. Supination and pronation of the foot are possible due to the subtalar and transverse tarsal joints.

It is possible to influence the ankle joint simultaneously from the front and side surfaces. Circular uninterrupted embracing stroking, rubbing is performed. The most commonly used rubbing options are: “toncers” are straight-lined, when four fingers rub the outer surface of the ankle joint, and the thumb rubs the inside; circular pads of four fingers on both sides; the base of the palm at the ankles; rectilinear with the base of the palm and tubercles of the thumbs; spiral base of the palm.

Massage of the ankle joint is done from the heel bone - the place of attachment of the tendon - to the place where the tendon passes into the calf muscle. The following rubbing options are used: rectilinear "forceps" - four fingers rub the outer surface of the ankle joint, and the thumb rubs the inner one; circular-shaped pads of four fingers at the same time; the base of the palm at the ankles; rectilinear pads and tubercles of the thumbs; circular pads of the thumbs. All of these techniques are carried out slowly and alternate with stroking and active-passive movements.

The ankle pouch is accessible in three places: on the anterior surface, where it is widest and lies fairly superficially under the foot and toe extensor muscles; on both sides under the ankles; on the back, covered by the Achilles tendon.

For rubbing, the leg is placed on the couch, the foot should be slightly unbent. Circular movements are made with the pads of all fingers (four fingers are alternately fixed, then one). First, the area under the outer ankle is rubbed, then the front of the bag, and finally the inner ankle. After that, the massage therapist moves the pads of the fingers down, beyond the ankles, and performs rubbing movements in the area of ​​the Achilles tendon. Rubbing ends with stroking.

Leg massage. The position of the patient - lying on his back or stomach, or sitting. Initially, a preliminary massage is performed: planar and embracing continuous stroking from the fingertips to the condyles of the thigh; semicircular or spiral rubbing in ascending and descending directions.

In the area of ​​the calf muscles, continuous vibration is applied in the form of shaking (shaking). Then the anterior muscle group is massaged - separately the tibial, the long common extensor of the fingers and the long extensor of the thumb. The following options are used: 1) stroking: rectilinear; "forceps"; the base of the palm; 2) kneading: with the pads of four fingers; phalanges of the fingers.

Massaging the back muscle group, the masseur should focus on the calf muscle - separately massage its outer and inner abdomen. When massaging the inner abdomen, it simultaneously affects the posterior tibial muscle and the flexors of the fingers. Longitudinal stroking with two hands, transverse and spiral, as well as kneading - ordinary (longitudinal and transverse), double ring, longitudinal with the pads of the thumbs, the base of the palm are also used. In addition, continuous vibration is made in the form of shaking. When massaging the left leg, the masseur's left hand fixes the foot, and vice versa.

If the massage is performed in the supine position, the thumb of the right hand (during the massage of the left leg) moves along the inner edge, and the remaining fingers along the tibia; the thumb of the left hand is along the tibia, and the rest along the inner edge of the gastrocnemius muscle. The Achilles tendon and the place of its attachment to the calcaneal tuber are especially carefully massaged.

Due to the fact that most of the muscles of the lower leg with their long tendons end on the metatarsal bones, as well as on the phalanges of the fingers, the massage of the lower leg should always cover the foot (starting from the fingertips). Massage only the foot or lower leg separately should not be.

Massage of the knee joint. The knee joint is a block and ball joint (Fig. 115), formed by the lateral and medial condyles of the femur, the upper articular surfaces of the tibia and the patella.

Figure 115. Knee-joint.

The patella (patella) is embedded in the tendon of the quadriceps muscle, the continuation of which is the ligament of the patella. The articular surfaces of the condyles of the femur, tibia and patella are covered with hyaline cartilage. The articular bag of the knee joint is extensive, its synovial membrane forms inversions, synovial bags and folds containing adipose tissue. The anterior section of the articular capsule is formed by the tendon of the quadriceps femoris muscle.

The main ligamentous apparatus of the knee joint consists of the lateral peroneal and tibial ligaments located on the lateral surfaces of the joint, as well as the cruciate (anterior and posterior) and transverse ligaments located in the cavity of the knee joint. Between the articular surfaces of the femur and tibia are two crescent-shaped cartilages - the inner and outer menisci. The main movements in the knee joint are flexion and extension. In a small range, rotation of the lower leg outward and inward in a bent position of the joint is possible.

The medial and lateral menisci are semilunar structures of cartilage located on the articular surface of the tibia. They act as cushion pads between the femur and tibia.

The blood supply to the knee joint is carried out by branches of the femoral and popliteal arteries, and the venous outflow occurs in the popliteal and femoral veins. The knee joint is innervated by branches of the lumbar and sacral plexuses. Movements in the knee joint: mainly flexion and extension. There may also be slight hyperextension beyond the neutral position, as well as rotation of the tibia relative to the femur.

.Figure 116. Movement in the knee joint.

The hip joint (Fig. 119) is formed by the acetabulum and the head of the femur. The acetabulum is located at the confluence of the ilium, ischium, and pubis. It is smaller than the head of the femur in size; it is increased by a fibrous cartilaginous rim that runs along the edge of the cavity - the acetabular lip. The head of the femur is covered almost over its entire surface with a thin layer of hyaline cartilage, and the acetabulum is covered only along the semilunar surface. The articular bag of the hip joint goes along the edge of the articular cavity, passes to the femur and is attached in front above the intertrochanteric line, so most of the femoral neck is in the joint cavity. The articular bag of the joint is very strong, ligaments are woven into it: in front - ilio-femoral, from below and from the inside - pubic-femoral, behind - ischio-femoral, in depth the bag is strengthened by a circular ligament. The ligament of the femoral head is located inside the joint, its mechanical significance is not great, but the vessels feeding the femoral head pass through its thickness.

The hip joint belongs to multiaxial joints, however, the range of motion in it is limited by the large depth of the acetabulum and a powerful ligamentous apparatus. In the joint, flexion and extension, abduction and adduction, as well as outward and inward rotation are possible. Flexion is produced by the iliopsoas muscle, the rectus head of the quadriceps femoris, the tailor and tender muscles. Extension is carried out by the semimembranosus and semitendinosus muscles, the long head of the biceps femoris; the gluteus maximus and the adductor maximus muscles of the thigh take part in extension. The thigh is abducted by the middle and small gluteal muscles, and the muscles of the adductor group are adducted. Blood supply - along the branches of the lower gluteal and obturator arteries. Venous drainage occurs through the deep vein of the thigh and the internal iliac vein. The outflow of lymph goes to the internal iliac lymph nodes. hip joint. Innervated by branches of the femoral, obturator and sciatic nerves.

Figure 119. hip joint.

Movements in the hip joint (fig. 120): flexion is possible in a larger volume with a bent knee. Rotation of the hip with a bent knee is difficult. In this case, when the femur is rotated inward, the lower leg moves outward. Outward rotation of the thigh is accompanied by a medial displacement of the lower leg. It is thanks to the movements of the thigh that the indicated movements of the lower limb are possible.

Since the hip joint is closed on all sides by large muscles, this makes massage difficult. Planar stroking, rubbing with the base of the palm, phalanges of bent fingers in various directions are used. The massage of the hip joint ends with active-passive movements.

Massage of the most important nerve trunks of the upper limbs. The lumbar plexus is formed by the anterior branches of the 1st-4th lumbar spinal nerves, it is located in the thickness of the muscles on the anterolateral surface of the lumbar vertebrae. Its branches penetrate the inner, anterior and outer surfaces of the thigh.

The sacral plexus is located in the small pelvis, it is formed by the connecting anterior branches from the 5th lumbar to the 4th sacral spinal nerves. The branches given to them go to the gluteal region. The largest of these is the sciatic nerve.

The nerves of the lumbar and sacral plexuses innervate the skin and muscles of the pelvic girdle and the free lower limb, as well as the external genitalia. They provide sensory and motor innervation of the gluteal region, perineum, thigh, lower leg and foot.

Figure 120. Movements in the hip joint.

The sciatic nerve is massaged in the most accessible place: along the line from the lower edge of the ischial tuberosity to the middle of the popliteal fossa. Here, planar continuous deep kneading is used with the thumbs of both hands; rubbing with thumbs moving one after the other and describing semicircles in opposite directions; continuous and intermittent vibration at the tip of the thumb. The force of pressure during vibration increases gradually towards the sciatic tubercle, since as it moves away from the knee joint, the sciatic nerve is more and more covered with a layer of muscles.

The femoral nerve is massaged under the inguinal ligament in the femoral triangle along the anterior and medial surfaces of the thigh. Sparing techniques are used - stroking and rubbing.

The peroneal nerve is massaged at the head of the fibula. The same methods are applied.

The tibial nerve is massaged in the area of ​​the medial malleolus and popliteal fossa. Apply rubbing and vibration.

Indications: in the treatment of diseases of the cardiovascular system, injuries of soft tissues, bones, joints, peripheral nerves, central paralysis.

The tasks and methods of massage are determined in combination with other methods of treatment.

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Currently, massage as an effective method of functional therapy is widely used in various areas of clinical discipline. It is used at all stages of medical rehabilitation of patients. In this regard, caregivers need to become familiar with the basic requirements of massage at home, as well as its simplest techniques. More complex techniques can be mastered in massage courses and specialized literature.

1. During the massage, the whole body, especially the massaged muscles and joints, should be as relaxed as possible. The most complete relaxation of muscles and joints occurs in a position when the joints of the limbs are bent at a certain angle (average physiological position).

When massaging the back, the person being massaged lies on the stomach, the arms are located along the body and slightly bent at the elbow joints, the face is turned towards the massage therapist, a roller is placed under the shins. All this allows you to further relax the muscles of the body.

When massaging the front surface of the body, a small pillow is placed under the head of the person being massaged, and a roller is placed under the knee joints.

2. The hands of the massage therapist should be warm, clean, without roughness. Long nails are not allowed.

3. The room for massage should be warm (not lower than +20 °C), previously ventilated.

4. Massage is carried out before taking or 1.5-2 hours after eating.

5. Massage should not cause pain.

6. Late massage is unacceptable (after 18-19 hours).

8. Massage movements are performed mainly along the lymph flow to the nearest lymph nodes. On the upper limbs - this is the direction from the hand to the elbow and axillary nodes; on the lower extremities - from the foot to the popliteal and inguinal nodes; on the chest - from the sternum in both directions to the axillary nodes; on the back - from the spine in both directions. When massaging the upper and middle parts of the body, the movements are directed to the axillary nodes, while massaging the lumbar and sacral regions - to the inguinal nodes; on the neck, head movements lead from top to bottom to the subclavian nodes.

9. The first massage sessions should be short and not intense. Time and intensity of massage increase gradually. The duration of the massage also depends on the massaged area (hand massage - 5 minutes, back - 20 minutes). The duration of the general massage increases from 15-20 to 40-50 minutes.

In terms of intensity, the massage procedure should be built as follows: min-max-min. First, stroking is performed, then - light rubbing, kneading, vibration, shock techniques. The massage procedure always ends with smoothing.

10. Massage is carried out based on knowledge of the main muscle groups.

11. The intensity and duration of the massage depends on the age, gender, physique, as well as the condition of the patient.

12. Before the massage, the patient needs to take a shower or wipe himself with a damp towel.

13. After the massage procedure, the patient needs to rest for 15-30 minutes.

Massage contraindications

Every caregiver should know the main contraindications to massage. They are divided into absolute (massage is completely contraindicated), temporary and local (i.e. massage is contraindicated in certain areas of the body).

Absolute contraindications to massage:

• malignant tumors (before their radical treatment);
• gangrene;
• thrombosis;
• active form of tuberculosis;
• acute venereal diseases;
• acute and chronic osteomyelitis;
• causal syndrome after injury of peripheral nerves;
• circulatory failure and heart failure of the 3rd degree;
• angiitis (disease of the arteries);
• diseases with severe mental changes;
• aneurysms of blood vessels, aorta;
• scurvy;
• HIV infection;
• blood diseases, tendency to bleeding;
• atherosclerosis of peripheral vessels, thromboangiitis in combination with atherosclerosis of cerebral vessels.

Temporary contraindications to massage:

• acute febrile conditions;
• acute inflammatory process;
• bleeding;
• purulent, infectious processes (furunculosis, etc.);
• lymphadenitis, lymphangitis;
• crises: hypertensive, hypotonic and cerebral;
• multiple allergic skin rashes, as well as hemorrhages and swelling;
• nausea, vomiting, abdominal pain;
• alcohol intoxication;
• acute pain requiring narcotic analgesics;
• acute cardiovascular, renal failure.

Local contraindications:

• massage of body parts affected by fungal, viral and other pathogens - warts, herpes, cracks, eczema, etc.;
• body massage in the area where a benign tumor is located, massage of other parts of the body is performed using a sparing technique (only stroking);
• body massage in areas adjacent to the site of excision of a malignant tumor;
• massage of the anterior surface of the chest with mastopathy;
• massage of the lumbar region, abdomen, thighs with ovarian cysts, fibroids, myomas, adenomas (in men);
• massage near protruding moles;
• massage in places of varicose veins;
• massage of the abdomen with hernia, pregnancy, menstruation, stones in the gallbladder and kidneys; massage of the lumbar region is performed according to a gentle technique;
• massage of the mammary glands, inguinal region, nipples;
• massage of the lymph nodes.

Basic massage techniques

Stroking technique

This technique is performed with the entire palmar surface of the hand, if the muscle is large (on the back, chest, arm, leg), and with the fingers of the hand, if the muscle is small (on the phalanges, toes).

When performing this technique, the massage therapist's brush should be as relaxed as possible and easily glide over the skin without moving it into deep folds. Stroking can be superficial (the palm lightly touches the skin) and deep. With this technique, we begin, finish the massage and alternate the rest of the techniques.

Despite the simplicity of its implementation, it has a huge positive effect on the entire body, having an analgesic and calming effect. The pace of strokes is slow and rhythmic. The trajectory of the movement of the hands can be different: rectangular, zigzag, spiral. This technique is performed with one or two hands.

If you perform deep stroking, it will have a tonic effect on the muscle and body. Stroking certain parts of the body, we also have a therapeutic effect on the organ with which this area is associated. For example, stroking the interscapular region, we have a beneficial effect on the heart. Thanks to this technique, the patient, in addition, adapts to the hands of the massage therapist.

With the help of stroking, we exfoliate the upper dead layer of the epidermis on the skin, remove the remnants of sweat and fat, which means we improve breathing, blood and lymph circulation in the surface layers of the skin.

However, when performing even this simple technique, the dosage must be observed so as not to cause irritation in the patient. Even if you stroke a cat, at first she purrs with pleasure, and when she gets tired, she can scratch.

Technique for performing the "rubbing" technique

This technique consists in shifting, stretching the skin and underlying tissues. The masseur's hand does not slip, but shifts the skin, forming folds. The vigorous implementation of this technique contributes to the heating of all tissues. The skin at the same time slightly reddens, becomes more elastic and displaced. Rubbing helps to increase blood flow to the tissues and improve their nutrition. As a result, tissue mobility increases, scars and adhesions, pathological deposits soften. The trajectory of the movement of the hands may be different, but with edema - along the lymph flow to the nearest lymph nodes.

This technique should be performed with the base of the palm or fingertips, using one or two hands. You can also clench your hand into a fist and rub the skin with the back of your fingers or the ridges of your fist, making movements reminiscent of planing, hatching and sawing. Directions of movement can be straight (translational, zigzag), circular and spiral.

Rubbing with pads of 4 fingers. Reception is performed with the pads of 4 closed, slightly bent fingers, resting on the thumb and the base of the hand. The fingers can be slightly apart, making movements in a spiral, in a circle, or forward and backward.

Rubbing with the pad of the thumb. This technique is performed with the pad of the thumb while relying on 4 remaining fingers that are maximally laid aside. The movement of the thumb can be straight, spiral, circular.

Rubbing with the base and edges of the palm. When performing this technique, the brush is slightly extended, 4 fingers are slightly bent and raised above the skin. The movements of the brush are translational: back and forth, spiral or circular.

Rubbing can also be performed with the elbow edge of the brush - in circular and spiral movements.

Sawing performed by the ulnar edge of the brushes, located parallel to each other at a distance of 2 cm and moving in opposite directions. Soft fabrics should be rubbed between the palms.

crossing used on rounded surfaces (neck, buttocks, lateral surfaces of the body). It is performed by the radial edges of the hands with the maximum abduction of the first finger. The brushes are parallel and move in opposite directions.

Rubbing with phalanges of 4 fingers. This technique is performed with the back side of the middle phalanges of 4 fingers, slightly clenched into a fist. With such a rather harsh effect on the muscle, it is, as it were, pressed against the bone. The thumb rests against the massaged area, helps to fix the brush and move it forward. Brush movements can be progressive: up and down, spiral or circular.

Technique for performing the "kneading" technique

This technique contributes to the passive gymnastics of blood vessels and muscles. When performing kneading, the massaged muscle is captured, lifted and pulled, squeezed and, as it were, squeezed out. And if the previous techniques had an effect on the skin (stroking), the subcutaneous fat layer and the surface layer of the muscles (rubbing), then kneading affects the state of the deep layers of the muscles. When kneading, the muscle tone increases, they become strong and elastic, the blood supply not only to the massaged area, but also to nearby ones, improves significantly. This technique also enhances the contractility of the muscles.

Kneading is carried out in different directions with one or two hands:

a) on small surfaces - the palmar surface of the nail phalanges of the I and II fingers (i.e., as if with the fingertips);

b) on large muscles - with all fingers.

Single kneading performed with one hand. Tightly clasping the massaged muscle with the palm of your hand (on one side of the muscle is the thumb, and on the other - all the rest), it is lifted, squeezing between the fingers and making translational movements forward or towards the little finger. When tearing and squeezing the muscle, there should be no gap between the palmar surface of the hand and the skin of the muscle. The first movement is reminiscent of squeezing a sponge. In the second case, the muscle, as it were, breaks away from the bone bed, is compressed, rotates towards the little finger and thus moves forward in a spiral. The movement is performed along the muscle, so it is also called longitudinal.

Kneading with two hands("double ring" or transverse) is performed as follows. The masseur tightly grasps the massaged muscle with both hands so that they are in the same plane at an angle of 45 ° to the surface of the patient's body. All fingers cover the massaged surface, but one hand pulls, squeezes the tissues away from itself, and the other pulls them towards itself. Then the direction of movement of the hands is reversed. Massage movements should be soft, without jerks and a bit like kneading dough.

This technique is performed slowly, smoothly, there should be no muscle twisting and pain. Kneading always alternates with stroking and is performed along the lymph flow.

Forceps kneading performed on one side with a large, and on the other - with the rest of the fingers (they take the form of tongs); the muscle is captured, pulled up, and then kneaded between the fingers. On small muscles (fingers, toes) 2-3 fingers work. The execution technique is the same as for longitudinal and transverse kneading.

Wallow used on the extremities, mainly to reduce muscle tone in hypertonicity. Parallelly set palms tightly cover the limb and move in opposite directions.

pressure used to increase muscle tone in hypotension. The masseur firmly presses the palm to the skin and gradually increases the pressure with a delay of up to 3-5 seconds at the end point. Then also gradually reduces the force of pressure. Pressing can be carried out more vigorously. Reception is performed with fingertips, the back of the hand or a fist set flat.

shift performed with the thumbs on one side and all the others on the other. The underlying tissues are lifted, captured in a fold with the formation of a muscle roller, which is then rolled in any direction.

pinching performed with the thumb and forefinger (or the thumb and all others) of one or both hands. At the same time, muscle tissue is captured and pulled upward. The movement is performed vigorously and helps to increase muscle tone in case of hypotension.

Vibration technique

Vibration is the transfer of oscillatory movements to the massaged area of ​​the body, produced evenly, but with different speeds and amplitudes. It is performed with the palmar surface, nail phalanges of one finger, thumb and index or index, middle and ring, thumb and other fingers. Oscillatory movements performed with a large amplitude and oscillation frequency of up to 120 movements per minute will increase muscle tone, and with a frequency of more than 120 and with a small amplitude - reduce muscle tone. In other words, weak vibration increases muscle tone, and strong vibration reduces it. Vibration has a strong and varied effect on deep tissues. The movements of the massage therapist's hands should be gentle, soft, painless.

labile vibration done with a brush. It makes oscillatory movements, moving in any direction along the massaged area. If the vibration continues for at least 10 seconds, it is called continuous. If the exposure time is less than 10 seconds, and the hands are periodically taken away from the body, then this will be an intermittent vibration. Continuous vibration includes shaking, shaking and shaking (to reduce muscle tone), intermittent vibration - chopping, patting, quilting, puncturing (to increase muscle tone).

The direction of movements during oscillations is mainly from right to left and only on the stomach, while massaging certain organs - from top to bottom (pushing).

stable vibration performed in place with the pad of one or more slightly bent fingers (point vibration).

Shake. The masseur grabs the muscle by the abdomen (middle) with his fingers, pulls it back a little and shakes it with the brush with the required frequency. The technique is used in the massage of the limbs.

Shaking. This technique is also performed on the limbs and on large muscles (for example, on the latissimus dorsi muscle). The muscle is captured between the first and fifth fingers, the other three fingers are located above the skin. The brush performs oscillatory movements from side to side from one end of the muscle to the other (from the lower to the upper section).

Shaking. The masseur takes the patient's hand or foot with both hands and performs oscillatory movements of the entire arm or leg from top to bottom or from right to left.

Chopping. It is performed with the elbow edges of the brushes, set in parallel, at a distance of 2-3 cm from each other at an angle of 20-30 °. The brushes are relaxed. 4 fingers are slightly spread and bent. The movements of the brushes occur in opposite directions at a speed of 80-120 beats per minute. Chopping is done along the muscle fibers.

Pat. When performed correctly, a dull sound should be heard. Patting is carried out with the palmar surface of the hand (thumb pressed) with slightly bent fingers. The brush takes the form of a box. Reception is performed with one or two hands alternately in opposite directions.

tapping. It is performed with a flat fist, and in small areas (on the hand, on the back of the foot) - with the fingertips.

Punctuation(for the elderly). It is performed with the pads of half-bent fingers moving alternately, like the movements of a typist.

Quilting. It is performed with the palmar surface of the brushes moving tangentially up and down.

Stroke Massage

From a medical point of view, a stroke is a severe and dangerous vascular lesion of the central nervous system. And if before a stroke was the lot of the elderly, in recent years he has dramatically "younger". In the first month after a stroke, rehabilitation measures begin. The sooner treatment is started, the more favorable the outcome of the disease! The success of recovery is largely determined by the mood of the patient himself, as well as his loved ones. Optimism, the desire to achieve the goal, diverse interests, an active attitude to life help to defeat the disease even more than drugs. It is clear that the treatment of stroke in a specialized stroke unit improves its clinical outcome. In such departments, specially developed programs of restorative procedures are used and specialists of various profiles work, including experienced massage therapists and exercise therapy instructors who specialize in this particular disease. But after the patient is discharged from the hospital, it is necessary to continue with him therapeutic exercises and massage for many months, and sometimes years.

Unfortunately, in our time, due to the difficult financial situation of most people, not every close relative can allow the patient to use the services of such specialists. In this regard, it became necessary to acquaint those caring for this category of patients with the basics of rehabilitation gymnastics and massage.

Before proceeding with these procedures, you should find out from the attending physician if the patient has any contraindications to them, and also clarify (ask to show) which muscles in your patient are relaxed and which are tense. It is also necessary to define specific goals, i.e. tasks of massage and therapeutic gymnastics:

• increase blood and lymph circulation in paralyzed limbs and throughout the body;
• improve the nutrition of all tissues;
• contribute to the restoration of the function of movement in the affected limbs;
• counteract the formation of contractures;
• reduce muscle tone in spastic muscles and reduce the severity of friendly movements;
• reduce or relieve pain;
• increase the emotional tone (mood) of the patient;
• prevent congestive pneumonia in the elderly;
• prevent the formation of bedsores.

In the first months after a stroke, only local massage is allowed, involving paralyzed or paretic limbs, the back with the lumbar region, and the chest (on the side of the lesion). General massage is allowed only in the late rehabilitation period, since prolonged exposure can cause overwork of the patient, which is unacceptable.

During the massage, each technique is repeated 3-4 times. During the first procedures in the early stages after a stroke, the area of ​​influence is small, only the shoulder and thigh are massaged, without turning the patient on the stomach. At the 4-5th procedure, depending on the patient's condition, a massage of the chest, forearm, hand, lower leg, foot is added. From the 6-8th procedure, the back and lumbar region are covered in the position of the patient lying on a healthy side. The prone position is used at a later date and only in the absence of contraindications due to heart disease.

In the early stages of bed rest for spastic muscles, only stroking techniques are used, and for muscles with reduced tone, stroking and rubbing.

To increase the effectiveness of massage and therapeutic exercises, it is advisable to pre-warm the paralyzed limbs. For this purpose, you can use a saline reusable heating pad applicator.

It must be emphasized once again that the increase in the intensity of exposure is strictly individual and depends on the patient's condition. After a stroke, in the absence of contraindications, massage is prescribed for uncomplicated ischemic variant- on the 2nd - 4th day, and when hemorrhagic- on the 6th - 8th day. The duration of the massage is gradually increased from 10 to 20 minutes. During strict bed rest, massage should only be performed by a highly qualified massage therapist and under medical supervision. A caregiver of such a patient can be massaged only in the late recovery and rehabilitation period, when the patient's condition improves significantly and he is discharged from the hospital. But there are also unforeseen circumstances, and the caregiver's help may be needed in the early stages. It should be noted that massage is an additional method of treatment, while the main ones include positional treatment (special styling) and therapeutic exercises.

Position treatment

Principles of treatment consist in giving the paralyzed limbs the correct position during the time while the patient is in bed. It is currently believed that the development of hemiplegic contracture with the formation of the Wernicke-Mann posture (the hand is pressed to the body, the fingers are clenched into a fist, the leg is turned outward, straightened, the foot hangs and is turned inward) may be associated with a long stay of paralyzed limbs in one and the same volume. the same position in the early period of the disease. There are various options for laying paretic limbs.

Laying in the supine position. The paralyzed arm is placed on a pillow so that it is at the same level in the horizontal plane throughout. Then the arm is abducted to the side at an angle of 90 ° (for pain, they start from a smaller angle of abduction, gradually increasing it to 90 °), straighten and turn outward. The hand with fingers extended and spread apart is fixed with a splint, and the forearm is fixed with a bag of sand or salt weighing about 0.5 kg (any light material can be used as a splint - plywood, light metal, covered with gauze). A cotton roll covered with oilcloth is placed in the forearm cavity, and the fingers, hand and forearm are bandaged to the splint.

The paralyzed leg is bent at the knee joint by 15-20° and a roller is placed under it. The foot is flexed at a right angle and held in this functionally advantageous position by means of a wooden box ("leg case"). The sore leg should rest against one of its walls with the sole. For more reliable fixation, the case is tied to the back of the bed. The patient should be in this position for 1.5-2 hours. During the day, a similar procedure can be repeated 2-3 times.

Laying the patient in a position on a healthy side. With this laying, the paralyzed limbs are given a bent position. The arm is bent at the shoulder and elbow joints and placed on a pillow, the leg - at the hip, knee and ankle joints, placed on another pillow. If muscle tone has not increased, laying in the supine position and healthy side is changed every 1.5-2 hours. In cases of early and pronounced increase in tone, treatment with the supine position lasts 1.5-2 hours, and on the healthy side - 30-50 min.

The sequence of the massage

The procedure begins with a massage of the front surface of the affected leg, since with hemiparesis the lower limbs are less affected than the upper ones. Then the pectoralis major muscle, arm, back of the leg, and back are massaged in succession. Foot massage is performed according to a certain scheme - first the thigh is massaged, then the shin, foot. On the upper limb - shoulder, forearm, hand, fingers. The direction of movement is along the lymphatic flow.

Massage techniques include various types of surface stroking, light rubbing and light continuous vibration (shaking, shaking) - for spastic muscles. The spastic state is distinguished by:

• muscles of the inner (front) surface of the shoulder, forearm and palmar surface of the hand;
• pectoral muscle on the side of the lesion;
• muscles that extend the knee (quadriceps) and turn the thigh outward;
• muscles of the back surface of the lower leg (calf, posterior tibial, long flexor and 1 fingers);
• muscles located on the sole.

During the massage of these muscle groups, light stroking and, somewhat later, rubbing techniques are used. For some muscles, light vibration is applicable.

In other areas - the back (outer) surface of the arm, the front surface of the lower leg, on the back of the foot - the muscles are not spastic. Therefore, here you can perform deep stroking, more intense rubbing, as well as light kneading.

Percussion techniques are contraindicated: patting, chopping, tapping, etc.

The position of the patient during the massage

The patient lies on his back, a roller is placed under his knees, a pillow is placed under his head. In cases of occurrence synkinesis(friendly movements) non-massage limb is fixed with sandbags. Massage of the outer surface of the leg can be carried out in the position of the patient on a healthy side. The back surface of the leg is massaged in the position of the patient on the stomach, a small pillow is placed under the stomach, a roller is placed under the ankle joints; under the head - a small pillow. In case of violations of the heart, the patient is massaged on his side. To keep warm, it is covered with a blanket and during the massage, only the massaged area is exposed.

With spastic paralysis, the patient has no voluntary movements, muscle tone increases, all tendon reflexes increase, and involuntary friendly movements occur. So, when a healthy limb moves, exactly the same movement is reproduced by a paretic one and vice versa. Sometimes the affected lower limb mimics the movement of the upper limb, for example, bending the arm causes the leg to flex. It must also be remembered that unrest, physical stress, fatigue, cold impair the ability to move.

Therefore, before starting to perform massage techniques, it is necessary to achieve a maximum decrease in muscle tone, i.e. muscle relaxation. To do this, apply special relaxation exercises, first on a healthy hand, and then on the affected one. To test the ability to relax the muscles, the massage therapist lifts the healthy limb of the patient and releases it - the limb should fall freely. The masseur at the same time insures the hand from bruising.

Hand exercises

1. The caregiver supports the patient's elbow with one hand, and the hand with the other. Raises and lowers the hand with shaking movements. Rubs the area around the elbow.

2. The caregiver makes circular outward movements in the shoulder joint with simultaneous pressure on the head of the humerus. The range of motion should be small. Exercises are performed very slowly, gently and accurately. You can not cause overwork of the patient, so the number of exercises at first should be minimal (1-2 times). If, nevertheless, friendly movements arose during the exercise, then the other limb should be pressed against the body.

After the described exercises for the hands, they begin to perform techniques of stroking and shaking the pectoralis major muscle on the side of the paresis. Then the hand massage begins.

Leg exercises

1. The caregiver, supporting the foot, slowly raises the leg with shaking movements and gently swings it to the sides. Before the exercise, the patient takes a breath, and during the movements - exhale.

2. Then a slight concussion of the thigh muscles is performed.

3. The caregiver, with one hand supporting the leg under the knee joint, with the other, bends and unbends it, not bringing it to the limit of extension.

4. To relax the muscles of the foot, gently shake the calf muscle on the back of the leg. The leg should be bent at the knee joint.

5. The essence of muscle relaxation is explained to the patient, the signs indicating its onset are called (feelings of heaviness of the diseased limb). Next, the caregiver shows on himself what the state of the muscles is at rest, with tension and relaxation.

Massage technique

Foot massage

Hip massage. The front and inner surfaces of the thigh are massaged in the position of the patient lying on his back. First, light superficial strokes are performed on the inner, middle (front) and outer surfaces of the thigh. Movements go from the knee joint to the inguinal region. Then light, slow spiral and zigzag strokes are added. The criterion for correct execution is a slight relaxation of the spastic muscles. In the future, light rubbing with the pads of 4 fingers and the base of the palm is added to these techniques. All these techniques are combined with stroking. Each technique is performed 3-4 times.

Massage of the back of the thigh is carried out in the position of the patient on the stomach or on the side. On the back of the thigh are the gluteus maximus, biceps, semitendinosus, and semimembranosus. All these muscles are involved in hip extension, and, given their spastic state, sparing techniques should be used: stroking and light rubbing. Movements are performed from the popliteal fossa to the gluteal fold. The buttock is stroked from the back surface, the sacrum to the greater trochanter (it protrudes on the upper outer surface of the thigh and is well palpable on palpation).

Leg massage. On the anterior surface of the lower leg are the extensors of the foot - usually they are less spastic. Therefore, more intensive techniques are allowed here: first superficial and then deep stroking, more vigorous rubbing techniques, as well as transverse and longitudinal kneading. Massage is carried out with all fingers and palm. Movements go from the ankle up to the knee joint.

The gastrocnemius and soleus muscles extend to the posterior surface of the lower leg, which flex the lower leg at the knee joint and foot. They are very spastic, and therefore they must be massaged in a gentle manner. Movements go from the calcaneal tuber to the popliteal fossa.

Foot massage. On the back of the foot there are muscles - extensors of the fingers with unexpressed spasticity. Therefore, techniques of stroking, rubbing and kneading are used here. The caregiver fixes the foot with one hand (puts the heel of the patient in his palm so that the toes are pointing upwards), and II-IV fingers with the other massages its back surface from the fingertips to the lower leg. Then I finger strokes and rubs the interosseous spaces. If you spread your toes, then the interosseous spaces will stand out well in the form of depressions on the back of the foot.

On the plantar side of the foot there are muscles with increased tone, and they are massaged using a gentle technique. The direction of movement is from the toes to the heel.

Massage of the pectoralis major muscle on the affected side

With hemiparesis, this muscle has a very high tone, so the massage here should be very gentle. Apply superficial stroking, very light rubbing with the pads of 4 fingers and light vibration in the form of shaking or light shaking. Shaking can be done with fingers I-II, or by placing the entire brush on the chest and moving it along the massaged area in the direction from the sternum to the armpit.

Hand massage

Hand massage is carried out in the position of the patient lying on his back, and at the end of bed rest - in a sitting position (the patient's hand is on a nearby table, and the caregiver sits opposite him).

Shoulder massage. Massage begins with the trapezius and deltoid muscles. Their tone is not increased, so they use the techniques of deep stroking, intense rubbing and light kneading. The direction of movement is from the VI-VII cervical vertebrae (if you bend your head, the VII vertebra will protrude more than the rest) to the end of the deltoid muscle. The deltoid muscle should be well rubbed and kneaded.

Next, massage the triceps muscle, which is the extensor of the forearm. The tone of this muscle is not so high, so when hemiplegia it is advisable to start the massage with this particular muscle. Apply techniques of superficial and deep stroking, vigorous rubbing and light kneading. Movements go from the elbow joint along the outer back surface of the shoulder to the shoulder joint.

Then they move on to massage the biceps muscle, which is the flexor of the forearm and shoulder. She is very spastic, so only light stroking and rubbing is used here. Movements are performed from the cubital fossa along the inner front surface of the shoulder to the armpit. The brachial artery, veins and nerves pass along the inner surface of the shoulder (on the inner groove). Therefore, when performing a massage, one must be especially careful and in no case exert any pressure on this surface.

Forearm massage. The muscles of the back (outer) surface of the forearm - the extensors of the hand and forearm - are overstretched, so it is advisable to start massaging the forearm with them. Perform techniques of deep and superficial stroking, rubbing, kneading. Movements go from the wrist joint along the back of the forearm to the olecranon.

The muscles of the anterior (inner) surface of the forearm - the flexors of the hand and forearm - are spastic in hemiparesis, so they are easily stroked and rubbed in the direction from the wrist joint to the cubital fossa.

Massage of the hand and fingers. The muscles of the back of the hand are overstretched. Therefore, the massage starts from the back of the fingers, then they move to the back of the hand. Here energetic techniques are performed: deep stroking, rubbing, kneading.

The tone of the muscles of the palmar surface of the hand is very high, so the massage is performed according to a sparing technique - only superficial stroking.

Back massage

The patient lies on his stomach or on a healthy side, a pillow is placed under his head. When massaging the back, all techniques are used, but they must be soft and gentle so that muscle tone does not increase and tissue nutrition improves. The direction of movement was described in the previous sections.

Therapeutic gymnastics and massage for the elderly

Numerous examples of the beneficial effects of therapeutic exercises and light massage on the body of the elderly put beyond doubt the expediency of their use. Twenty years ago, the motto of the elderly was the words: "We grow up to a hundred years without old age." Every day on the racetracks of our stadiums one could see numerous groups of people who are over 60, 70, and even over 80 years old. Today there is a completely different picture. In medical and physical education dispensaries and specialized centers one can meet only small groups of 3-4 people who have suffered strokes, heart attacks and other diseases or injuries. This suggests that in our troubled times there is no attention or money left for the elderly, and they sometimes feel they are useless and are in dire need of the care and help of loved ones.

We can provide such assistance by doing short gymnastics with them, performing simple massage manipulations on limited areas of the body. The technique of massage and therapeutic exercises, as in diseases, is different in each case.

Physiotherapy

When drawing up a plan for therapeutic exercises, it is necessary to take into account:

• age;
• accompanying illnesses;
• human condition: blood pressure, pulse, muscle tone, general well-being;
• contraindications (see earlier).

Therapeutic exercises with the elderly should be carried out every other day or 2-3 times a week. The load should be minimal, the time of classes should be from 10 to 30 minutes, the exercises should be performed in lightweight starting positions: sitting, lying down. To make sure that you are doing everything right, you can keep a journal in which you need to note the following indicators:

• mood;
• fatigue;
• feeling of cheerfulness;
• performance;
• headache;
• dyspnea;
• pain and discomfort in the region of the heart or other places;
• appetite;
• pulse;
• arterial pressure;
• activity of the gastrointestinal tract.

We should try to make such observations unobtrusively, not particularly focusing the attention of older people, since among them there is such a category that likes to delve into their feelings and aggravate their condition.

Gradually, it is necessary to ensure that your wards independently daily, for 5 - 10 minutes. doing exercises, doing daily housework. Then they will have an incentive in life and many "sores" will pass by themselves.

Massage

Massage for the elderly is done mainly in a sitting position. Perform light strokes of the collar zone, i.e. from the scalp down the neck to the shoulders. You can iron and rub your hands easily, starting from the fingers up to the shoulder joints. Light shaking is acceptable. Kneading and percussion techniques are excluded. You can massage your toes, feet and legs slightly to the knees, and then the thighs - from the bottom up. Massage of the arms and legs is best performed in the supine position, half-sitting.

Approximate complex of therapeutic exercises

1. Arms extended in front of the chest. At the expense of "one - two" spread your arms to the sides and take a breath. At the expense of "three - four" return to the starting position (sp).

3. Put your hands on your knees, raise your shoulders at the expense of "one", lower them at the expense of "two". (You can raise your shoulders at the same time, or you can alternately).

4. Perform turns of the torso in one direction or the other.

5. On the count of "one", spread your arms to the sides and inhale, on the count of "two", wrap your arms around yourself and exhale.

6. On the count of "one", bend the torso forward and stretch your chest to your knees, on the count of "two", take the SP.

7. At the expense of "one", straighten one leg, at the expense of "two" - the second, at the expense of "three" return one leg to the SP, at the expense of "four" - the other. This exercise can be combined with arm movements. In addition to physical activity, exercises will develop attention and coordination of movements. Hands can be straightened with the same name as the legs, or opposite ones. At the expense of "one" straighten the right leg and left arm, at the expense of "two" - the left leg and right arm, at the expense of "three" bend the right leg and put it on the knee, at the expense of "four" return the left leg and right hand to and .P.

8. In i.p. while sitting, lower your arms along the body. At the expense of "one - two" slowly tilt the torso to the right, the left hand slides along the torso up to the armpit, and the right hand reaches for the floor. At the expense of "three - four" return to I.p. Then repeat everything on the other side.

9. At the expense of "one" pull one knee to the chest and grab it with your hands. On the count of "two" take ip. At the expense of "three - four" pull up the other knee and return to the sp.

10. At the expense of "one - two" raise your hands through the sides up and inhale, at the expense of "three - four" lower your hands through the sides down and exhale.

Perform each exercise 3-4 times. You can also connect exercises with massagers. Periodically roll the rolling pin with your hands, feet, and also rub your fingers and hands, you can lightly rub your ears.

The main "tool" of exposure is the hand, and there are 2 areas used for massage on it: the base of the palm and the palmar surface of the finger.

tsev. When performing individual techniques, not only the palmar, but also the back surface of the hand is used. The massage technique is made up of many separate techniques and rules.

1. Massage is best done in a room at an air temperature of 22 C.

2. The procedure should be carried out in complete silence, bright lighting is not recommended.

3. Hair must be removed under a scarf, the use of perfume, cologne and other odorous substances is not allowed. Do not smoke while working.

4. Only clean skin should be massaged, so before the session it is advisable to take a shower, remove makeup, wash off the cream.

5. You can not do massage if there are unhealed wounds on the body, because if there are abrasions and scratches, they may become infected. Signs of infectious or other skin diseases are unacceptable.

6. Massage - general or local - should be done no earlier than half an hour after eating.

7. Local massage can be done daily or every other day, and general - no more than 2 times a week.

8. The duration and intensity of exposure should be increased gradually.

9. Massage can be combined with warming, relaxing or healing ointments, creams, liquids, especially if the massage is prevented by abundant vegetation on the body. Oil-based liquids and lubricants are used to improve glide, and if there are contraindications for their use, then cosmetic talc is used.

10. A massage session should consist of an introductory, main and final part. First, a diagnostic examination of the massaged areas is carried out for 3-5 minutes and the patient is prepared with sparing techniques (stroking and rubbing), and during self-massage they prepare themselves for the main part of the session. Receptions can be performed at a faster pace to create a pleasant feeling of warmth. In the main part, a differentiated massage is carried out in accordance with the tasks. At the end of the massage, the intensity of the techniques is reduced for 1-3 minutes, ending the session by stroking the entire massaged area.

Lubricants should be applied to the hands of the massage therapist, and talc (in a small amount) - to the skin of the person being massaged.

11. It is advisable to start a general massage with massaging the back, and then move on to the corresponding reflexogenic zones.

12. All deep stroking movements are performed along the lymph flow to the nearest lymph nodes.

14. If you feel worse and any discomfort occurs, the massage time should be reduced, and if they are repeated, temporarily cancel the sessions and consult a doctor.

There are five basic massage techniques: stroking, rubbing, kneading, percussion and vibration.

Stroking- one of the simplest and most frequently used techniques, which begins (if there are no specific indications) and ends the massage. In order to apply this technique, it is necessary to put the brush, relaxing it, on any massaged area and make movements in a certain direction: longitudinal, transverse, spiral and circular. One hand or both can be involved. It is important that the fingers remain straight and relaxed during the stroke.

It is desirable to carry out stroking with wide strokes, lightly, gently, slowly (frequency should not exceed 24-26 movements per minute) and rhythmically: the palm should slide over the skin without making skin folds on the massaged area. Hasty non-rhythmic stroking causes an unpleasant sensation. Sliding movements can also be grasping. Often, beginners make the same mistakes: firstly, they put a lot of pressure on the massaged area; secondly, they work with spread fingers; thirdly, they perform the reception sharply, which leads to a displacement of the skin.

Depending on the time of stroking and the degree of pressure, the technique can have a twofold effect:

superficial - helps to calm the nervous system;

deeper - excites nervous processes. This increases the flow of blood to the skin and muscles, transmits irritation not only to the terminal nerves, but also to those that are laid more deeply. Thus, the reflex effect is increased.

Finishing stroking, you should also not randomly slide your hands, it is easy enough to raise your hands and move them to the next point.

Trituration- the second most popular massage technique, acting stronger than stroking, causing a significant expansion of blood vessels, affecting the deeper layers of the skin, providing a more energetic reflex effect, even contributing to the resorption of small seals. Unlike stroking, rubbing can be done with the pads of the fingers (one separate - index, middle or ring finger, or all together, including the little finger), the base of the palm, the back surface of the fingers folded into a fist, the ulnar edge of the hand. The reception technique is quite diverse. When rubbing, the skin on the massaged area should not slip, it should move and move in the right directions. In this case, the fingers make rectilinear, circular, spiral movements.

There is a special kind of rubbing, which has a special name - "sawing". Its essence is that the palmar surfaces of the hands move along the rubbed area in the opposite direction. This method is used to rapidly heat the skin and underlying tissues. Rubbing and "sawing" can also be done in zigzag movements.

kneading- a commonly used technique that acts more deeply than the previous two, and improves blood and lymph circulation. It can be considered passive gymnastics for muscles. Kneading is used effectively for preventive purposes to eliminate the atrophy of the muscular system.

The reception is carried out with two hands, starting with light superficial movements, and only after a few sessions can you move on to more energetic actions. Massage should be done slowly: the slower the kneading is carried out, the better the therapeutic effect. The essence of the reception is in grabbing, lifting, squeezing and displacing tissues from the massaged area. Distinguish between transverse and longitudinal kneading. There are auxiliary techniques: felting, rolling, shifting, stretching, pressing, squeezing, twitching and tong-like kneading.

The advantages of stroking are that it cleanses the skin, enhances the movement of blood and lymph, strengthens muscles, and has an effect on nerve endings and the nervous system as a whole.

Kneading using auxiliary techniques improves tissue nutrition, circulation of blood, lymph and tissue fluid, activates redox processes.

Vibration- a technique consisting of quick oscillatory movements of the brushes in a limited area or on the entire massaged surface. Reception has an analgesic effect, so it is used for injuries and diseases of the musculoskeletal system. Vibration is a rather energetic stimulus, its duration is measured in seconds. Light shaking has a calming effect on the nervous system, and intense shaking is exciting. Vibration may be intermittent or continuous. Auxiliary methods of vibration include shaking, shaking, shaking and pushing.

Percussion techniques have a pronounced effect on the peripheral and central nervous system. All percussion techniques can be carried out with one or two hands: with the palmar surface of the hands, fist, fingertips. There are several types of massage strokes: tapping, puncturing (“finger shower”), patting, chopping, quilting.

tapping is a fairly common practice. The massage technique consists in the fact that with the fingers (I-IV, except for the big one) of both hands, their tips, and the fist, jerky blows are applied. The movement is carried out due to the free swing of the hands in the wrist joint. Tapping can also be carried out with the back surface of the fingers, straightening them at the moment of impact. Tapping with all fingers is simultaneously used in obese individuals, with large fat deposits. Reception causes heating of tissues, expansion of deeply embedded vessels, actively affects the nervous system and reflexively increases muscle tone.

Punctuation- a technique in which, when tapping, the ends of the bent fingers fall on the massaged areas not all at once, but sequentially - one after the other. This technique is also called "finger shower".

Patting is performed with the palmar surface with slightly bent fingers, which ensures the formation of an air cushion at the moment of impact between the body and the palm. Strikes can be applied simultaneously with both hands or alternately.

Chopping perform with both hands, using the elbow edges of the hand, while the palms are facing each other. Work should be carried out rhythmically, at a speed of 250-300 beats per minute. Chopping has a profound effect on tissues and muscles, causing a profuse rush of blood. At the same time, the flow of oxygen and nutrients to the massaged area increases, lymph outflow and metabolism improve, and the function of the sebaceous and sweat glands increases.

Quilting- a technique in which tangential blows are applied with the edge of the palm of one or both hands. This massage is useful for obesity, cicatricial changes in the skin, in cosmetic procedures. Quilting improves skin tone, elasticity, enhances metabolic processes and activates the excretory function.

With classic manual massage, all the basic techniques are used. As a rule, all massage techniques are combined. 30-40% of the total time is allocated for rubbing, 50-60% for kneading, and 10% for all other techniques. Percussion techniques and vibration should be used in the last stages of the massage, as they are especially active on the tissue.

There are various forms and methods of massage. It is these that will be discussed in this chapter. The techniques of classical massage and the technique of their implementation will be considered in more detail.

Forms of massage

There are 5 forms of massage: general, private, couples, mutual and self-massage. Usually the procedure is carried out by one person, but quite often the technique of paired massaging and self-massage is used.

When conducting a general massage covering the entire surface of the human body, a strict sequence of techniques is observed. In this case, first of all, stroking, rubbing, then kneading and vibration techniques are performed. At the end of the procedure, stroking is again performed.

The time spent on the massage is determined by the weight of the person being massaged, his age and gender.

It is most effective to start the massage from the back, gradually moving to the neck and arms. This is followed by a massage of the buttocks and thighs. After that, massage of the knee joint, calf muscle, heel, plantar surface of the foot is performed. This is followed by massage techniques for the toes, ankles and shins. The next stage is massaging the breasts, and lastly, they massage the abdomen.

Private (local) massage consists in massaging individual parts of the body

human, muscles, joints, ligaments. Usually it takes from 3 to 25 minutes. When conducting private massage sessions, it is necessary to follow the sequence of techniques. For example, massaging the upper limbs should start from the inner surface of the shoulder, gradually move to the outer, and then proceed to massaging the elbow joint, forearm, hand and fingers. Conducting a private massage of the hand should begin with massaging the forearm.

Couples massage is usually performed before sports competitions and training, after competitions and morning exercises. It should be borne in mind that such a massage is not recommended for spinal injuries, paralysis of the limbs, lumbosacral radiculitis, pneumonia, bronchial asthma, gastritis and colitis.

The time spent on a couples massage depends on the gender, weight and age of the person being massaged. The procedure usually takes 5 to 8 minutes. The session is carried out by two massage therapists using a vacuum or vibration apparatus. In this case, one specialist massages the back, chest, arms and abdomen of the person being massaged, and the other massages the knee joints, calf muscles, heels, soles of the feet, toes and legs.

Mutual massage consists in massaging each other in turn by two people using the basic forms of massage. Mutual massage can be private, general manual and hardware. The duration of the procedure is 10-15 minutes.

With self-massage, a person massages himself. This form of massage is effective for bruises and diseases, after morning exercises. Self-massage includes stroking, rubbing, kneading, patting and is divided into private and general. At the same time, it takes from 3 to 5 minutes to conduct a general massage, and from 5 to 20 minutes for a private massage. With self-massage, you can use special devices: brushes, massagers, vibration devices.

Massage methods

There are the following methods of performing massage: manual, hardware, combined and foot.

The most effective is manual massage. In this case, the massage therapist feels the massaged tissues with his hands, in addition, he can use all the known methods of classical massage, combine and alternate them.

With manual massage, the main tool of the massage therapist is the hand. The study of the site can be carried out with the palmar and back of the hand (Fig. 8 a, b), bent fingers and the edge of the palm (the terms "radial and ulnar edges of the hand" are used).

//-- Rice. eight --//

Vibromassage, pneumomassage and hydromassage are methods of hardware massaging. Despite the fact that this method involves the use of special devices, and not the direct impact of hands on the body, hardware massage is no less effective than manual massage.

Vibromassage is based on the transfer of oscillatory movements of different amplitude (0.1-3 mm) and frequency (10-200 Hz) to the massaged surface. It is carried out with the help of a vibration apparatus, while it affects various organs and systems of the human body. Vibromassage improves the functioning of the nervous system, has an analgesic effect (Fig. 9).

Vibratory massagers are selected depending on the size of the massaged surface and the degree of impact on it. Nozzles made of materials of different hardness (plastics, rubber, sponges) allow you to adjust the intensity of the procedure, and their shape depends on the specific area of ​​the body to be massaged. The selected nozzle is fixed in the apparatus and applied to the massaged area. In this case, you can use both a constant effect on it, and move the massager, performing stroking and rubbing movements. The massage course depends on the nature of the disease and usually consists of 10-15 procedures performed every other day. The duration of the sessions is determined individually, depending on the general condition of the patient. First, the massage is carried out for 8-10 minutes, then the session time is gradually increased to 15 minutes.

Pneumomassage is based on the creation of variable air pressure on the massaged area. This procedure is performed using a special vacuum device (Fig. 10). At the same time, the massage therapist carefully moves the aspirator over the surface of the patient's body or applies it to certain areas for 30-40 seconds. At the beginning of the procedure, the pressure is set at 500-600 mm Hg. Art., then decreases to 200 mm Hg. Art.

//-- Rice. 9 --//

Usually, pneumomassage is prescribed in courses, the procedures are performed in 1-2 days. Their number is determined individually, depending on the type of disease and the general condition of the patient.

//-- Rice. ten --//

Hydromassage is carried out in pools and baths in a sitting or lying position. Local baths are also used for massaging the limbs. This massage method involves the impact of water pressure on certain parts of the body, for hydromassage, flexible hoses with various nozzles are used, as well as vibration devices that allow you to change the intensity of the impact of the water jet (Fig. 11).

A variation of hydromassage is a whirlpool massage, in which water is mixed with air using a pump, and a current of water is created in the bath, affecting the patient's body. You can increase the effectiveness of hydromassage by using a certain temperature of water.

Foot massage is performed using the feet. This method allows you to increase the degree of impact on the body and, in particular, on the human musculoskeletal system. With foot massage, the area is worked out with all toes, nail phalanges of three fingers, rib, heel and arch of the foot, as well as the entire foot.

//-- Rice. eleven --//

During the procedure, the massage therapist can also use a special device - a massage machine, which allows you to adjust the pressure force on the massaged area, taking into account the patient's weight, age, type of disease and individual tolerance of certain techniques.

Combined massage involves the use of both manual and hardware massage during the session. This allows you to choose the most suitable methods of exposure for each patient and increase their effectiveness in the treatment of various diseases.

Classical massage techniques

Conducting a classic massage session involves the use of the following techniques: stroking, squeezing, kneading, shaking, rubbing, active and passive movements, movements with resistance, shock techniques, shaking. Foot massage uses stroking, rubbing, vibration, squeezing, shifting, shock techniques, pressure. All massage techniques are performed in a certain order and continuously follow each other. Recall that the muscles of the person being massaged should be as relaxed as possible; exposure should be made towards the nearest lymph nodes, adhering to a certain pace and adjusting the degree of impact on the massaged areas; it is undesirable to carry out hard techniques on painful areas and in places close to the lymph nodes.

Stroking is the first technique with which the massage begins. It is performed in order to increase the tone of the skin and blood vessels, enhance metabolic processes, and relax the patient's muscles. Stroking allows you to increase the blood circulation of the massaged areas and supply them with oxygen. It is also used in the middle and at the end of the procedure, providing a calming effect on the patient's nervous system.

According to the execution technique, planar and encircling strokes are distinguished.

With planar stroking, the massage therapist makes sliding movements along the surface of the patient's body with the entire brush of one or both hands (Fig. 12). Movements are performed calmly, without tension. Their directions can be different - longitudinal, transverse, circular, spiral. Planar stroking is used to massage the back, abdomen and chest.

//-- Rice. 12 --//

With embracing stroking, the massage therapist clasps the massaged area with the hand, pressing it tightly to the skin surface (Fig. 13). This technique is used when massaging the limbs, neck, side surfaces and other rounded parts of the body.

//-- Rice. 13 --//

Depending on the degree of pressure on the massaged area, superficial and deep stroking are distinguished.

With superficial stroking, the massage therapist makes slow, calm movements with the palmar surface of the brush. This technique has a calming and relaxing effect.

With deep stroking, the masseur enhances the effect on the massaged areas, making movements with the palm, the back of the hand, the wrist, the edge of the hand, the side surfaces of the fingers. Deep massaging enhances blood circulation, lymph outflow, and reduces swelling.

There are also continuous, intermittent and alternate stroking.

With continuous stroking, the massage therapist makes slow, constant movements on the surface of the massaged area, exerting uniform pressure. The result of this technique is a decrease in the excitability of the central nervous system.

With intermittent stroking, the massage therapist performs individual movements, rhythmically increasing pressure on the massaged area. This technique has a stimulating effect on the central nervous system, warms up muscle tissue, and enhances blood circulation.

With alternate stroking, the massage therapist first works with one hand, then with the other hand performs the same movements in the opposite direction.

Stroking techniques also differ in the direction of movement during the procedure.

Rectilinear stroking (Fig. 14 a) implies the movement of the massage therapist's palm in one direction, while the brush should be relaxed, the fingers are pressed to each other, the thumb is laid aside. Reception can be done with one or two hands alternately.

With zigzag stroking (Fig. 14 b), the massage therapist performs the corresponding movements in the main direction, performing them smoothly, without tension.

With spiral stroking (Fig. 14 c), the massage therapist makes movements in the form of a spiral in the direction of the nearest lymph nodes, without putting pressure on the massaged area.

With circular stroking (Fig. 14 d), the massage therapist performs circular movements with the base of the palm, with the right hand - clockwise, with the left - counterclockwise. This technique is used when massaging small joints.

With concentric stroking, the massage therapist grabs the massaged area with both hands and makes movements in the form of a figure eight. This technique is used when massaging large joints, while the masseur strokes the outer side of the joint with his thumbs, and the inner side with the rest.

//-- Rice. fourteen --//

Combined stroking is a combination of previous techniques, while the effect on the massaged area should be continuous. This technique is performed with two hands alternately.

There are also auxiliary stroking techniques: pincer-shaped, comb-shaped, rake-shaped and cruciform, as well as ironing.

Tong-like stroking is carried out with fingers folded in the form of tongs. The muscle, tendon and skin fold are captured with the thumb, forefinger and middle or thumb and forefinger, after which a stroking movement is performed in a straight line. This technique is used to massage small muscle groups.

Comb-like stroking is performed by bony protrusions of the main phalanges of fingers half-bent into a fist. The movement is free, the fingers are relaxed and slightly apart. The reception is carried out both with one and two hands, it is used to work out large muscles in the back and pelvis, as well as in areas with large fat deposits.

Rake-like stroking is performed with half-bent fingers widely spaced to the sides (the thumb is opposed to the rest), touching the massaged surface at an angle of 30-45 °. Reception is carried out in the longitudinal, transverse, zigzag and circular directions with either one or two hands. Rake-like stroking can be carried out with weights, performed by placing the fingers of one hand on the fingers of the other (index - on the little finger, middle - on the ring finger, etc.). This technique is used in cases where it is necessary to gently massage the affected areas.

Cross-shaped stroking is carried out by hands clasped crosswise into a lock, clasping the massaged surface. The reception is carried out with the palmar surfaces of both hands, it is used mainly when massaging the limbs, as well as the gluteal muscles and back muscles in order to avoid the formation of bedsores.

Ironing is performed with the back of the fingers of one or two hands bent into a fist. Reception can be carried out with weights, produced by imposing on the massaging fist of the other hand. The technique is used when working out the muscles of the back, soles, abdomen and affecting the internal organs (without weights).

Rubbing is carried out by moving the skin with movements and has a stronger effect on the massaged area than stroking. As a result of rubbing, the metabolism in the tissues of the body improves, the elasticity and extensibility of the muscles increase. Rubbing has a beneficial effect on blood circulation, reduces swelling, relieves pain, and helps to dissolve deposits in the joints. This technique is carried out with fingers, the edge of the palm and the supporting part of the hand, while it is important that the masseur's actions do not cause pain to the patient, and the subcutaneous tissues are displaced in different directions.

Rubbing with fingers (Fig. 15) can be carried out in the longitudinal, transverse, zigzag, circular and spiral directions. Massage is performed with the fingertips or their phalanges, and the massage therapist can work with one or two hands. Finger rubbing is effective in massaging the back, hands, feet, small joints and tendons.

//-- Rice. fifteen --//

Rubbing with the edge of the palm is shown when massaging the abdomen, back and large joints (Fig. 16). Rubbing with the supporting part of the hand is used to massage the muscles of the back, buttocks and thighs.

//-- Rice. 16 --//

With rectilinear rubbing, the masseur performs movements alternately with the palm and fingertips on small areas of the patient's body (Fig. 17).

//-- Rice. 17 --//

With circular rubbing, the massage therapist leans on the base of the palm and performs circular movements with his fingers. This technique can be carried out with two hands alternately or with one hand with weights (Fig. 18). Circular rubbing is used on all parts of the body.

//-- Rice. eighteen --//

With spiral rubbing, the masseur performs movements with the supporting part of the hand or the ulnar edge of the palm (Fig. 19). Depending on the massaged area, the reception can be carried out either with one brush with weights, or with two alternately. Spiral rubbing is used to massage the chest, back, abdomen, arms and legs.

//-- Rice. 19 --//

Auxiliary techniques are hatching, planing, crossing, sawing, rake-like, comb-like and tong-shaped rubbing.

Hatching is performed alternately with the pads of the terminal phalanges of the thumb, index and middle fingers, or with the index and middle fingers folded together. To achieve a greater effect during the reception, the fingers should be straightened, maximally unbent in the interphalangeal joints and placed at an angle of 30 ° to the massaged surface. Short translational movements are made, as a result of which the tissues are displaced in the transverse and longitudinal directions.

This technique has an exciting effect on the human body, and with the right dosage it has an analgesic effect and helps to reduce the excessive excitability of the nervous system.

Planing is carried out with one or two hands placed one behind the other. The fingers folded together and maximally extended in the joints, translational movements are made, while the fingertips are immersed in the tissues, form a roller when pressed and stretch or displace the tissues. Planing helps to increase muscle tone, so it is necessary for muscle atrophy and the presence of large fat deposits in the subcutaneous tissue.

The intersection is performed by the radial edge of the hand, while the thumb is maximally laid aside. The reception can be performed with one or two hands: in the first case, rhythmic movements are made with the brush away from oneself (in the direction of the index finger) and towards oneself (in the direction of the thumb). When massaging with both hands, the hands should be located with their back surfaces to each other at a distance of 3-4 cm, by moving away from themselves and towards themselves, a deep displacement of the tissues is performed. The correct implementation of this technique is evidenced by a roller formed from massaged tissues and moving along with the hands.

Sawing is performed by the elbow edge of one or both brushes. In the first case, the tissues are displaced after the hand in the direction back and forth, in the second case, rubbing is carried out as a result of movement in opposite directions of the brushes facing each other with palmar surfaces. As with crossing, when sawing, a roller of massaged tissue is formed, which moves after the hands.

Comb-like rubbing is carried out in a circular direction with a brush clenched into a fist and the back sides of the main phalanges of the fingers. This technique is effective for massaging thick muscle layers on the back, hips and buttocks.

Rake-like rubbing is performed with widely spaced fingers (pads and the back of the end phalanges) of one or two hands in a zigzag, rectilinear and circular directions. The fingers are placed on both sides of the spinal column and the pads are used to press on the skin and the tissues located under it, the direction of movement is down from the base of the neck to the lower back. During the reverse movement, the reception is performed by the back side of the terminal phalanges. Rake-like rubbing can be used when massaging the tissues between the affected areas, as well as the intercostal spaces.

Tong-like rubbing is carried out with the thumb and index or thumb, index and middle fingers, folded in the form of tongs. Rectilinear and circular movements are performed, the technique is used to massage tendons and small muscle groups.

Kneading is one of the main massage techniques and takes half the time allotted for the entire procedure. It is performed with the aim of deep impact on muscle tissue, increases their elasticity and extensibility. When kneading, the flow of blood and lymph improves both in the massaged area and around it, tissue nutrition and oxygen supply are activated, as well as the removal of metabolic products from them. This technique is divided into three stages: fixing the massaged area, lifting and pulling the muscle, and actually kneading.

With longitudinal kneading, the massage therapist fixes the hands on the massaged area so that the thumbs are located on one side of it, and the rest on the opposite side. Then he lifts the muscle and performs kneading movements from the edges to the center, squeezing it from both sides (Fig. 20). The rate of admission is 40-50 rhythmic movements per minute in the direction of muscle fibers. Longitudinal kneading is performed until the entire muscle is massaged. Longitudinal kneading is used for the muscles of the back, chest, abdomen, pelvis, neck and limbs.

//-- Rice. twenty --//

During transverse kneading, the masseur fixes his hands on the muscle, placing them at a distance of 10 cm from each other at an angle of 45 ° (Fig. 21). Movements are made across the direction of the muscle fibers from the middle of the muscle to the tendons, while the attachment points of the muscles are also massaged. It is permissible to perform this technique with two hands together, alternately (movements are performed with both hands in opposite directions) and with one hand with weights produced by placing the palm of one hand on the back surface of the other. Transverse kneading is performed by massaging the back, pelvic region, abdomen, neck and limbs.

//-- Rice. 21 --//

Ordinary kneading is used to massage the muscles of the neck, back, buttocks, abdomen, shoulder, forearm, front and back of the thigh, back of the leg. To perform this technique, the massage therapist tightly grabs the muscle across the arm, then lifts it and performs rotational movements so that the thumb and other fingers move towards each other. After that, it is necessary to return the fingers to their original position, without taking them off the massaged area, and release the muscle.

Double ordinary kneading is carried out similarly to ordinary, while the masseur performs the movement with both hands alternately from bottom to top. This technique activates the work of the muscles, it can be used when working out the muscles of the neck, thigh, back of the lower leg, shoulder, abdomen, back and buttocks. The double bar is performed as an ordinary kneading, while to increase pressure on the muscle, one hand is weighed down with the other. This technique is used to massage the oblique muscles of the abdomen, the latissimus dorsi, gluteus maximus, muscles of the front and back of the thigh and shoulder.

Double ring kneading is used on different parts of the patient's body. The masseur places his hands across the massaged area at a distance of 10 cm from each other. Then he firmly presses his palm to the surface of the patient's body, without bending his fingers, grabs the muscle and performs smooth oncoming movements, kneading it.

Double circular combined kneading is used for massaging the rectus abdominis, latissimus dorsi, gluteal muscles, shoulder, thigh, and lower leg muscles. When performing the reception, the masseur with his right hand performs an ordinary kneading of the massaged area, and with the palm of his left hand he kneads the same area in the opposite direction.

Double ring longitudinal kneading is indicated for massaging the muscles of the front of the thigh and the back of the lower leg. The masseur grabs the muscle from both sides with both hands and makes circular movements with his fingers, first shifting the brushes to the center, then repeating the movement in the opposite direction.

Ordinary-longitudinal kneading is performed with a massage of the back of the thigh. This technique combines ordinary and longitudinal kneading, and on the outer surface of the thigh, movements are made in the direction of the muscle fibers, and on the inside - across the muscle.

Circular beak-shaped kneading is used to massage the muscles of the neck, back and limbs. To carry out this technique, the massage therapist must press the index finger and little finger to the thumb, place the ring finger over the little finger, and the middle finger on top. After that, you should perform kneading movements in a circle or in a spiral.

Kneading with fingertips is used when massaging the head, neck, trapezius and long muscles of the back, muscles of the limbs. The masseur positions the hand in such a way that the thumb lies across the muscle, and the rest diagonally. In this case, the thumb should be relaxed, and circular movements are performed with the pads of four fingers.

Kneading with the thumb is used to massage the muscles of the chest, back and limbs. The technique for performing this technique is the same as for kneading with four fingers. The difference is that the pressure on the massaged area is made by circular movements of the thumb, the rest remain relaxed. This technique can be carried out with one or two hands alternately or with one hand with weights.

Kneading with the phalanges of the fingers is used when massaging the muscles of the chest, back and limbs. To perform this technique, the masseur must bend his fingers into a fist and firmly press the phalanges to the massaged area, leaning on the thumb. Then circular kneading movements are made.

Kneading with the base of the palm is used to massage the muscles of the back, buttocks, chest and lower extremities. During the reception, the masseur places the hand with the palm down, transfers pressure to the base of the palm and performs circular movements. You can also carry out this technique with weights or two hands.

Auxiliary techniques for kneading are felting, shearing, rolling, stretching, pressing, squeezing, twitching, comb-like and tong-like kneading. Felting is performed with both hands, while the masseur places his hands in parallel, clasping the massaged area, and performs kneading movements, gradually moving his hands along the surface of the patient's body (Fig. 22). This technique can have a sparing effect on the tissues, or (if performed vigorously) promote muscle excitation. It is used when kneading the muscles of the shoulder, forearm, thigh and lower leg.

//-- Rice. 22 --//

The shift is performed by massaging the muscles of the back and limbs. During the reception, the massage therapist grabs the massaged area with his thumbs and shifts it to the side with energetic movements. It is allowed to carry out shifting without preliminary grasping, while the displacement of tissues is carried out with all fingers or a palm, with two hands towards each other. Rolling is used when massaging the abdomen, chest, back, and also if there are large fat deposits on the patient's body. The technique of this technique is as follows: with the edge of the left palm, the massage therapist presses on the relaxed muscles, and with the right hand he grabs the massaged area, rolling it over his left hand, and performs kneading movements. Then, in the same way, neighboring zones are massaged (Fig. 23).

//-- Rice. 23 --//

Stretching is performed in the same way as shifting, except that the massage therapist makes slow movements with his hands from the center to the sides, stretching the muscle (Fig. 24). The movements are reminiscent of playing the harmonica, the reception is performed at a slow pace. Stretching has a positive effect not only on the subcutaneous muscles, but also on the receptors located here and on the nervous system as a whole.

//-- Rice. 24 --//

Pressure is used in the treatment of diseases of the spine, increases muscle tone, improves blood circulation, oxygen flow to tissues, and affects internal organs. When massaging the back, the masseur should place his hands across the spine at a distance of 10-15 cm from each other so that the fingers are on one side of the spine, and the bases of the palms are on the other. Then you should perform rhythmic pressure (20-25 movements per minute), gradually moving your hands up to the neck and down to the lower back. This technique can be carried out with the back of the fingers bent into a fist, however, the impact in this case should be less intense (Fig. 25).

//-- Rice. 25. --//

Compression is performed with fingers or hands. The masseur rhythmically presses on the massaged area at a speed of 30-40 movements per minute (Fig. 26). This technique has a beneficial effect on lymph and blood circulation, increases muscle tone.

//-- Rice. 26 --//

Twitching is performed with one, more often with both hands. The massage therapist grabs the massaged area with the thumb and forefinger, slightly pulls it back and then releases it. This technique is carried out at a speed of 100-120 movements per minute. Twitching is used for muscle flabbiness, paresis and paralysis of the limbs.

Comb-like kneading is carried out by massaging the muscles of the abdomen and neck, which helps to increase muscle tone. To perform this technique, the massaged area is captured by the thumb and forefinger, the remaining fingers are half-bent (do not touch the palmar surface) and slightly apart. Spiral kneading movements are made.

Tong-like kneading is shown when massaging the muscles of the back, chest, neck, it can be carried out in the transverse or longitudinal direction. The masseur folds the thumb and index or thumb, index and middle fingers in the form of tongs, grabs the massaged area with them and performs kneading movements (Fig. 27).

Vibration is a type of percussion technique. When it is performed, the masseur produces tapping movements, as a result of which vibrations occur on the massaged area, which are transmitted to the muscles. As with hardware massage, manual vibration can have a different frequency and strength. Depending on this, its effect on the body also changes: intermittent short vibration with a large amplitude of movements has an irritating effect, and a long one with a small amplitude has a relaxing effect.

//-- Rice. 27 --//

Vibration enhances reflexes, helps to reduce heart rate and lower blood pressure, expands or constricts blood vessels. Vibration must be combined with other massage techniques, while the time of exposure to one area should be approximately 5-15 seconds, after which stroking is mandatory. Like other techniques, vibrations should not cause pain in the massaged person. It should be borne in mind that at high intensity, vibrations can be transmitted to internal organs, so this technique must be carried out with extreme caution when massaging the elderly.

Techniques and methods for conducting intermittent and continuous vibration have some differences.

Intermittent vibration is performed in the form of a series of rhythmic strokes, while the massage therapist's brush comes off the massaged area after each movement. Reception can be carried out with a palm with bent fingers, the edge of the palm, a hand clenched into a fist, pads of slightly bent fingers and their back surface.

Varieties of intermittent vibration are puncturing, tapping, chopping, patting, shaking, shaking, and quilting.

Punctuation is performed when massaging small areas of the body in the places where the nerve trunks pass. This technique is carried out with the pads of one or more fingers, in one area or with movement along the lymphatic tract, with one or two hands, simultaneously or sequentially (Fig. 28). The degree of impact depends on the location of the massaged hand in relation to the massaged surface, the larger the angle, the deeper the vibration spreads.

//-- Rice. 28 --//

Tapping is a rhythmic blow on the massaged area with one or more fingers, both sides of the hand, a hand bent into a fist. At the same time, the massage therapist's hand should be relaxed so as not to cause pain to the patient.

Tapping with one finger is used when massaging individual muscles and tendons, tapping with the back of bent fingers - when massaging the muscles of the back, buttocks and thighs.

Tapping with the elbow edge of the fist is performed with two hands, bent so that the fingers freely touch the palm (Fig. 29). The movements are made alternately, the massage therapist's hands are located at an angle of 90 ° to the massaged surface.

Chopping is used to massage the back, chest, limbs and has a profound effect on the muscles, increasing blood circulation and metabolism in the massaged area. The reception is carried out with the edge of the palms with slightly apart fingers, connecting at the moment of contact with the massaged surface.

//-- Rice. 29 --//

The hands of the massage therapist should be at a distance of 2-4 cm from each other. The movements are performed rhythmically, with a frequency of 250-300 beats per minute, along the direction of the muscle fibers (Fig. 30).

//-- Rice. thirty --//

Tapping and chopping should not be carried out on the inner surface of the thigh, in the popliteal and axillary cavities, in the region of the heart and kidneys.

Patting is used when massaging the muscles of the chest, abdomen, back, buttocks, upper and lower extremities. Movements are performed energetically, with the palms of one or both hands alternately. In this case, the fingers should be in a slightly bent position (Fig. 31).

//-- Rice. 31 --//

Shaking is used exclusively for limb massage. First, the massage therapist fixes the patient's hand or ankle joint, and only after that does the reception. When massaging the upper limbs, shaking is carried out in a horizontal plane, while massaging the lower limbs - in a vertical one (Fig. 32).

//-- Rice. 32 --//

Concussion is used for spasm of the muscles of the abdomen and limbs. This technique can be carried out with fingers or the palmar surface of the hand, making movements in different directions (Fig. 33). Actions resemble movements when sifting flour through a sieve.

//-- Rice. 33 --//

Quilting has a beneficial effect on the skin, metabolic processes in tissues, and improves blood circulation. Movements can be performed with one or more fingers, while the direction of blows is tangential to the massaged surface (Fig. 34).

//-- Rice. 34 --//

Continuous vibration is performed with constant contact of the massage therapist's brush with the massaged area. Reception is carried out by pressing with the fingertips, their palmar or back side, the entire palm or its supporting part, as well as a brush clenched into a fist.

Continuous vibration can be carried out in one place, in this case it will be a point vibration carried out with one finger. Thanks to this technique, there is a calming effect on pain points.

With continuous vibration, the massage therapist's brush can move along the massaged area in a certain direction. This method is used when massaging weakened muscles and tendons.

When massaging the back, abdomen, buttocks, continuous vibration is performed with a brush clenched into a fist, making movements both along and across the massaged area. A vibration technique is also used, in which the massage therapist grabs the tissues with the hand. This method is indicated for massaging muscles and tendons.

Techniques for continuous vibration are shaking, shaking, shaking, and pushing.

Shaking is carried out with a hand, while the masseur slightly grasps the massaged area and makes movements in the longitudinal or transverse direction, changing the speed of vibrations. During this technique, the patient's muscles should be completely relaxed.

Shaking is carried out while massaging the limbs, improves blood circulation and mobility of the ligaments and joints, and relaxes the muscles. When massaging the hand, the massage therapist must fix the patient's hand with both hands and perform shaking up and down alternately. When massaging the leg with one hand, the masseur grasps the ankle joint, and the other - the arch of the foot, then makes rhythmic movements (Fig. 35).

//-- Rice. 35 --//

Concussion can be carried out on different parts of the body. So, with osteochondrosis, concussion of the chest is indicated. Carrying out this technique, the massage therapist wraps both hands around the chest of the patient lying on his back and performs continuous rhythmic movements in a horizontal direction.

In some diseases of the spine, a continuous concussion of the pelvis is also performed. In this case, the person being massaged lies on his stomach, the masseur places his hands on both sides so that the thumbs are on top, and the rest are on the pelvic region. Movements are made rhythmically in different directions: forward-backward, from left to right and from right to left.

Pushing is used for indirect massaging of internal organs. This technique is carried out with two hands: the left one is located on the area of ​​​​the projection of the massaged organ, and the right one - on the neighboring area, then pressure is applied.

Squeezing is usually performed in combination with kneading. Movements are made rhythmically, in the direction of the blood and lymphatic vessels, along the muscle fibers. The strength of the impact is determined depending on the location of the massaged area.

The squeezing technique is similar to stroking, but the movements are performed more intensively. This technique affects both the skin and connective and muscle tissues, enhances blood circulation and metabolic processes, has an exciting effect on the central nervous system, helps to reduce pain and swelling.

Transverse squeezing is carried out with the thumb, while the massage therapist's hand is located across the massaged area, movements are performed forward towards the nearest lymph nodes.

Squeezing with the edge of the palm is performed with a slightly bent brush. The masseur places his hand across the massaged area and moves forward, in the direction of the blood vessels (Fig. 36).

//-- Rice. 36 --//

Squeezing with the base of the palm is carried out along the direction of the muscle fibers. The thumb should be pressed against the index finger, and its terminal phalanx should be laid aside. Squeezing is performed with the base of the palm and the elevation of the thumb (Fig. 37).

//-- Rice. 37 --//

To enhance the impact, you can squeeze out with both hands with a perpendicular (Fig. 38 a) or transverse weight (Fig. 38 b).

//-- Rice. 38 --//

An auxiliary technique is the beak squeeze. To perform it, the masseur folds his fingers in the form of a beak and moves forward with the ulnar or radial side of the hand, the edge of the thumb or the edge of the palm towards himself (Fig. 39 a, b, c, d).

//-- Rice. 39 --//

Movements are used in combination with other basic massage techniques to restore mobility in the joints and have a positive effect on the musculoskeletal system as a whole. The movements are performed slowly, the load on the joints should not be more than the patient can bear. As with other massage techniques, the occurrence of painful sensations is unacceptable during movements.

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

Active movements are performed by the patient independently under the supervision of a massage therapist after the massage of a particular area. Their number and intensity depend on the specific case and the individual characteristics of the person being massaged. Active movements strengthen muscles, have a positive effect on the nervous system.

Passive movements are carried out by the massage therapist without effort on the part of the patient after massaging the muscles. They improve the mobility of the joints, increase the elasticity of the ligaments, and are effective in the deposition of salts.

//-- Rice. 40 --//

Movements can be performed with resistance. In this case, the resistance force changes during the execution of the movement, at first gradually increasing and then decreasing at the end of the action. Carrying out movements with resistance, the massage therapist must control the patient's condition and how he reacts to the load.

There are two types of resistance. In the first case, the masseur performs the movement, and the patient resists; in the second case, they change roles. Regardless of who puts up resistance, it is necessary to overcome it smoothly, without sudden tension and relaxation of the muscles.

Head movements are carried out by tilting forward, backward, left and right, rotating in both directions. With passive execution, the patient sits down, the massage therapist is located behind him and fixes his head with his palms above his ears. Then the massage therapist gently tilts the patient's head to the right and left, performs circular movements (Fig. 40). To perform movements back and forth, the masseur fixes one hand on the back of the patient's head, and the other on his forehead (Fig. 41).

//-- Rice. 41 --//

Body movements are also performed in a sitting position. The massage therapist stands behind the patient, puts his hands on his shoulders and leans forward, then straightens and slightly unbends the body back (Fig. 42). To perform turns, the masseur fixes his hands on the deltoid muscles and turns the torso to the sides.

//-- Rice. 42 --//

Movements in the shoulder joint are carried out in different directions. The patient sits on a chair, the massage therapist stands behind, places one hand on the shoulder, and the other fixes the forearm near the elbow and performs up and down movements, then positions the patient’s hand horizontally and turns it in and out, after which it performs rotational movements (Fig. 43) .

//-- Rice. 43 --//

Movements in the elbow joint are divided into flexion, extension, up and down turns. Massaged sits on a chair, putting his hand on the table. The masseur grabs his shoulder in the elbow area with one brush, and the wrist with the other. Then he carries out flexion and extension in the elbow joint with the greatest possible amplitude, and also turns the patient's hand with the palm up and down (Fig. 44). Movements in the elbow joint can be carried out in the prone position.

//-- Rice. 44 --//

The movements of the hand are divided into abduction and adduction, flexion and extension, circular movements. With one hand, the masseur fixes the wrist of the person being massaged, with the other he clasps his fingers, after which he carries out the movements mentioned above.

Finger movements are performed as follows. The masseur fixes the metacarpal-carpal joint with one hand, and with the other alternately flexes and unbends the fingers, performs movements of information and breeding.

Movements in the hip joint are carried out in the supine position and on the side. To carry out flexion and extension, the patient lies on his back, the masseur puts one hand on the knee, the other on the ankle joint and bends the patient's leg so as to bring the thigh as close to the stomach as possible, then carefully unbends the leg.

To perform turns, the massage therapist fixes one hand on the iliac crest, the other grabs the patient's lower leg below the knee and alternately turns the leg in and out (Fig. 45).

//-- Rice. 45 --//

To carry out circular movements, the massage therapist fixes the patient's knee joint with one hand, wraps the other around the foot and performs movements in the knee and hip joints alternately in different directions.

To perform the next group of movements, the patient must turn on his side. The masseur leans on the iliac crest with one hand, the other grabs the lower leg in its upper part and slowly raises and then lowers the straight leg of the person being massaged. Such movements are called "abduction" and "adduction". Movements in the knee joint are carried out in the supine position and sometimes on the back. The masseur leans with one hand on the lower part of the patient's thigh, with the other he fixes the ankle joint and starts bending. Then he removes his hand from the thigh and carries out a movement with weights, so that the heel of the person being massaged comes as close as possible to the buttock (Fig. 46). After that, extension is slowly performed.

//-- Rice. 46 --//

When performing flexion in the supine position, the massage therapist fixes the ankle joint with one hand, places the other on the patient's knee and smoothly performs movements (Fig. 47).

//-- Rice. 47 --//

Movements in the ankle joint are divided into flexion, extension, adduction, abduction and circular movements. To perform this technique, the patient must lie on his back. The masseur grabs the foot from below with one hand, with the other he fixes the leg in the knee area and carefully carries out all these movements.

The movements of the toes are carried out as follows: the masseur takes a position lying on his back, the massage therapist grabs the foot with one hand, and with the other performs alternate flexion and extension of each finger.

A certain effect on the human body allows you to bring an unforgettable experience, a positive effect on health. Some diseases are treated precisely during massage.

People in varying degrees experienced the sensations of massage, as it can be carried out by an ordinary person or a specialist who has undergone special training.

However, not all types of effects on the body can be attributed to massage. So what is massage, and how does it happen?

What is a massage?

Massage is a reflex-mechanical effect on human tissues and organs, which comes from the hands of a person or a special apparatus. It can be carried out using special massage, fragrant and aromatic oils.

The following reflex-mechanical effects can be distinguished:

1. Vibration.
2. Pressure.
3. Trituration.

Massage oils are a special mixture, the creation of which takes into account the specifics of the impact. They are able to facilitate the process by reducing friction, can have a warming effect if necessary.

The influence is due to external irritation, which is perceived by the receptors of muscles and skin, reflex points. All signals are sent to the central nervous system.

In this case, depending on the characteristics of the massage, the following kind of effect may be exerted:

1. Stimulation and toning central nervous system.
2. Inhibitory and calming effect, which positively affects the passage of all physiological processes.

Proper selection of massage oils can enhance the impact. However, mistakes made during the massage, also associated with the choice of oil, can lead to a negative impact.

When is a back massage needed?

Back massage can be called a pleasant and extremely beneficial effect that allows you to relax after a hard day, get rid of pain, and so on. It is worth remembering that proper and good rest is the key to effective work.

It is difficult to find a person who would not need a back massage. The modern rhythm of life determines that the mobility of many people is significantly reduced: car trips, office work, evenings in front of the TV or computer.

The result of low mobility is back pain, headaches, and excess weight. Low mobility determines the development of various diseases, for example, osteochondrosis.

High-quality back massage allows you to:

1. Restore circulation.
2. Increase stimulation of metabolism.
3. Relax tension in the muscles.
4. Get rid of constant pain.

It is worth remembering that only regular courses can have a complex effect on the body.

Only a few massages performed can reduce local pain and solve health problems in the short term.

But periodic high-quality massage significantly improves the quality of life.

An important point can be called the fact that many diseases can be cured with massage only at the initial stage of their development.

That is why it is necessary to consult a doctor in time for help, since with the progression of the disease, medications have to be used.

It is possible to single out a group of people for whom periodic back massage can be called a condition for maintaining health.

It includes:

1. Office workers spend a lot of time immobile. Violations of the recommendations on the organization of the workplace, incorrect posture during work and other reasons lead to the fact that a large load is placed on the spine and back muscles. The result of this is the appearance of pain, which can only be removed by massage.
2. Schoolchildren during the period of active growth can also attend professional massage courses. This is due to the fact that during the period of active growth, the skeleton is formed, and low activity, incorrect posture at the table can lead to serious consequences, which can only be corrected by a doctor's prescription.
3. Students who spend quite a lot of time on textbooks can also attend special massage courses. In this case, the impact under consideration allows you to relieve the tension that arises from a long stay at the table.
4. Long-distance drivers become frequent visitors to the massage parlor, who have an inactive lifestyle.
5. Overweight people can increase the effectiveness of the fight against the process of gaining mass through massage for the reason that the impact under consideration can significantly increase the rate of metabolism in the body.

Back massage can be prescribed by a doctor or you can visit a specialist yourself. However, it should be borne in mind that in some diseases, such exposure can be harmful to health.

Therefore, one should be careful when choosing the type of massage to be carried out.

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Rules for effective massage

There are several rules for massage, the implementation of which will significantly increase the effectiveness of the procedure.

To begin with, it is worth noting that the specialist must conditionally divide the entire back into three main zones:

1. collar part, which starts at the base of the skull and extends to the shoulder blades.
2. central part starts from the edge of the shoulder blades and ends in the zone of the lower part of the ribs.
3. Lumbar starts from the bottom of the ribs and ends at the line of the coccyx.

An important step that many novice massage therapists skip is patient preparation.

Preparation consists of two main stages:

1. Pose selection.
2. Preparing the back for exposure.

The choice of posture is carried out taking into account the fact that for a back massage the patient can choose two main positions:

1. The position lying on the stomach is the most common, as the massage therapist gets full access to the entire body. The person being massaged, in this case, stretches his arms along his body and places them with his palms up. The head is turned to the side, unless a special massage table is used.
2. Sitting on a chair. In this case, the person is facing the back of the chair, if the back is hard, then you can put a pillow.

The first position is more effective, as the patient assumes the most correct position. Health problems can lead to the fact that the spine during the massage in a sitting position will be curved.

The preparation of the back for the procedure should also be given a certain amount of time.

1. Perform straight strokes with soft, slightly pressing movements.
2. The skin is rubbing when performing straight or circular movements.
3. A movement is performed that resembles sawing. This movement is performed with the edge of the palm in the longitudinal and transverse direction of the back.

When preparing the back, the main thing to understand is that massage should not become a sudden effect on the body. The load should increase gradually.

Also, for an effective massage, attention should be paid to some recommendations that relate directly to the main part of the procedure.

1. When performing the procedure, it is important to ensure that all movements begin in the lumbar region. and smoothly passed into the collar zone.
2. If the patient feels pain in certain areas of the back, then they should be given special attention: are developed more carefully, the movements should be smooth.

As a rule, the duration of one session is approximately 40 minutes. This time is enough to develop the main points and to tone the muscles.

The main types of back massage

There are two main types of back massage:

1. Relaxing.
2. Therapeutic.

In turn, the treatment is divided into the following types:

1. Swedish or Classic can be found more often than others. This is due to the fact that it is suitable for a patient of almost any age, has no contraindications, the range of diseases in which it is carried out is very large. Therefore, classical massage is in demand, it is carried out by many specialists.
2. dot type can be characterized by the fact that the massage therapist affects certain reflex points on the back. These points affect the internal organs.
3. vibrating also has a wide distribution, since it can be carried out using a special device. There are a huge number of devices that can be used to carry out vibration massage.
4. Hydromassage recently it has become popular, it is referred to as a hardware type, since the massage therapist’s hands affect the back, and the water jet from the shower.
5. vacuum type involves the use of special Their use significantly increases blood circulation.
6. Sports often carried out before performing certain exercises, as a warm-up before upcoming competitions.
7. Medical type in the detection of pathologies of the spine. In each case, it is carried out by a qualified specialist who, on the basis of the studies carried out, the obtained images, selects the type and area of ​​exposure, duration and frequency.

Relaxing massage has practically no varieties, as it is carried out only to relieve fatigue and relieve depression.

Pain and crunch in the back over time can lead to dire consequences - local or complete restriction of movement, up to disability.

People, taught by bitter experience, use a natural remedy recommended by orthopedists to cure their back and joints...

Basic massage techniques

There are several basic techniques that are combined and modified to affect the back.

These include:

1. Stroking. This technique, as a rule, is used at the beginning of the massage, and it also ends with it. It should be done with both hands. The effect is relaxation.
2. Trituration held by the palms, the movement is zigzag. It is performed from the lumbar to the shoulders. The reception is used to significantly improve blood circulation in the tissues.
3. kneading- an effect that is somewhat reminiscent of the previous one. When it is performed, one hand rests on the other, which significantly increases the pressure force. This exercise has a strong effect on the back, especially on the muscles.
4. patting perform quick blows with the hands on the body. A similar effect has a place-irritating effect on the tissues of the back.
5. Vibration is a quick and strong shaking of the body. The masseur exerts influence with the middle and index fingers on the patient's body.

The above techniques are combined to provide a complex effect on the back.

Back massage technique

Each type of massage is carried out according to its unique technique. That is why the massage therapist can always improve his skills, find new, more effective ways to influence the back.

There are the following main types of massage:

1. Lower thoracic region.
2. Section under the shoulder blades.
3. Collar zone.
4. Lumbar region.

The collar zone is more affected than others, and improper sleep and posture can lead to pain.

The massage technique in this area is as follows:

1. To start with a warm-up by warming up the muscles and skin by stroking.
2. Sawing is performed from the shoulders to the base of the skull about 3 times each side. You shouldn't press hard. This is due to the fact that this zone is more susceptible to exposure than the rest.
3. Squeezing is carried out with fingertips. Movement in the direction from the shoulder blades to the base. Repeat this exercise 3 times.
4. Squeezing palms from the shoulders to the base of the skull. The sides should be alternated, 5 repetitions are performed for each.
5. Point kneading with thumbs. The exercise is carried out with the palms around the neck, thumbs should be pressed along the spine. The procedure is repeated 3 times.

Stroking is the end.

Massage under the shoulder blade is performed as follows:

1. Begin the impact with stroking.
2. The final stage of kneading the zone is stroking in the direction of the axillary nodes.
3. All types of rubbing, passive movement with muscle stretching are performed.
4. The subscapularis muscle is being worked out.
5. The procedure is also completed by stroking.

The lumbar region can cause a lot of problems if not properly massaged.