Medical therapeutic massage. Therapeutic massage - types, technique, application, indications. chest massage

Therapeutic massage is the impact on the body by rubbing, kneading and vibration by the hands of a specialist, special devices (massagers, brushes), water or water-air jet.

The course of therapeutic massage for osteochondrosis and others pathological changes the musculoskeletal system may be the only way to restore the health of the spine.

An excellent prevention of diseases is a course of special therapeutic massage for babies. This contributes to the correct physical development child and softens the problems of adaptation of infants to the outside world - improves sleep, calms the nervous system, teaches the baby to feel his body.

It is difficult to overestimate the role of massage in combating the consequences of injuries, as well as in case of nervous exhaustion, chronic fatigue syndrome.

In what cases is the use of therapeutic classical massage will benefit, and when is it better to refuse it? How does massage affect various organs and systems?

Purpose and contraindications of therapeutic massage

Massage is most often complementary therapy in the main treatment of many diseases. However, it is important to remember that a number of diseases are incompatible with the classic type of this manipulation (and possibly with other types of its types - acupressure, oil, stone massage).

A course of massage will help in the fight against diseases:

1. osteochondrosis;
2. chronic arthritis;
3. radiculitis;
4. hypertension;
5. low pressure;
6. reduced bowel tone;
7. chronic gastritis with low acidity;
8. bronchitis;
9. pneumonia;
10. bronchial asthma;
11. paralysis of the limbs;
12. violation of capillary circulation;
13. poorly healing fractures;
14. muscle and tendon injuries.

Contraindications include any acute conditions of the diseases listed above, acute infarction myocardium, inflammatory processes on the skin, open or festering wounds.

Contraindications to therapeutic massage:

1. elevated body temperature (above 37.5 ° C);
2. nausea, vomiting, diarrhea;
3. viral cold, acute respiratory infections;
4. fungal skin lesions;
5. tumors of any quality;
6. blood diseases;
7. critical days with heavy bleeding;
8. pregnancy with the threat of failure;
9. autoimmune diseases;
10. sharp allergic reactions(aggressive rash, difficulty breathing);
11. sclerosis of cerebral vessels.

Therapeutic massage for back pain

Therapeutic back massage improves blood circulation, relaxes muscles and gradually restores the natural position of the spine, even with its strong curvature.

The position of the spine determines the functioning of the internal organs and muscular frame. So, the cervical region is responsible for the blood circulation of the brain and movement facial muscles. Thoracic - for the work of the heart, lungs, upper respiratory tract and mobility of the shoulders and arms. Lumbar - for the functions of the gastrointestinal tract and glands, the movement of the body. sacral department affects the internal genital organs, the rectum and provides balance when walking and sitting postures.

Thus, the study of the entire back or spine by department directly affects the quality of life, the ability to move, sit and lie down without pain, and also indirectly - the state of vital internal organs.

Classical massage can be done daily, alternating areas of influence on the back, or 2-3 times a week, if you focus on one part of the spine, for example, on the cervical.

Frequent complaints of headache, general weakness, characteristic pains and burning in the neck and between the shoulder blades speak of cervical osteochondrosis. The reason for the development of this particular type of osteochondrosis, unlike the pathology of other parts of the spine, is not in injuries or weight lifting. The cervical region suffers from poor posture, stoop, sedentary work, muscle tension and compression nerve fibers in one position.

A course of therapeutic massage for cervical osteochondrosis brings tangible results from the first week - an experienced massage therapist will restore the imbalance of muscle tension, restore mobility and elasticity to the vertebrae, and relieve pain in the neck. To eliminate the consequences of osteochondrosis cervical 20-25 sessions may be required, and in the future - repeated courses 1-2 times a year.

Massage to improve blood circulation

The characteristic technique of classical massage allows you to achieve better blood and lymph flow in muscle tissue. This happens thanks to special movements masseur's hands - techniques that are divided into stroking, kneading, rubbing and vibration. Moreover, each of these techniques can be both deep, with great application of force, and superficial, soft.

Regular massage stimulates tissues and has a warming effect. It can be used to achieve positive results to reduce inflammation, congestion, strengthen muscles, tone the skin.

Therapeutic, performed by a professional or independently, smoothes deep wrinkles and tightens drooping tissues.

The tone of the facial muscles can be significantly increased by shallow sliding movements, stroking and vibration along the massage lines:

1. on the forehead - from the bridge of the nose up to the hairline;
2. on the cheeks - from the nasolabial folds with upward movements to the temples;
3. on the chin - from the center with upward movements to the place behind the ears;
4. on the neck - up from the collarbone to the chin.

Massage perfectly helps in the fight against inflammatory processes in the genital area, both male and female. There is a technique for women and prostate massage for men. In both cases, it is quite difficult to perform the movements on your own, so it is better to contact a specialist.

Therapeutic massage of the prostate helps in cases where antibiotics do not penetrate well into the gland due to its swelling. Massaging is carried out through the rectum for 1-2 minutes with light movements in the form of a figure eight. Usually 10 sessions are enough to improve the patient's condition in acute prostatitis, and further treatment becomes much more efficient.

The practice of massage appeared in ancient times, when primitive man there was a need to somehow drown out the pain in the absence of any medication. As a method of therapy, therapeutic massage began to be used from the 3rd millennium BC. e. in China, and continued his triumphal march through Japan, Greece, India and Rome. Even the ancient Arabs have information about the healing properties of massage.

Therapeutic massage: the history of the development of the technique

Some are sure that the word "massage" comes from the Arabic word "mass" ("to touch"), others argue that it comes from the Latin word "mass" ("sticking to the fingers"), still others - from the Greek word for "knead, stroke, knead”, initially not related to the manipulation of the body.

On various frescoes, bas-reliefs, papyri and other ancient monuments, you can see various massage manipulations, indicating that the ancient Egyptians, Persians and Austrians were familiar with this technology. Today we will discuss therapeutic massage, its history and applications.

Therapeutic massage: history of development in the East

In China, therapeutic massage began to be used as early as the 3rd millennium BC. e., used it to treat rheumatic pains, dislocations, relieve spasms and muscle fatigue. At the same time, the Chinese rubbed the whole body with their hands and squeezed the muscles in such a way that a loud crack was heard when the limbs twitched. Even in ancient times, massage was known as a remedy for various diseases. At first, stroking, rubbing, kneading the sore spot were only purely instinctive. Only much later did massage become a full-fledged method of treatment and part of the medical art.

The ancient Indians described in detail the techniques of therapeutic massage in the medical treatise of Ayurveda. It was the first to indicate the use in the first steam baths therapeutic massage, and the procedures were performed simultaneously. The water poured onto the hot slabs evaporated and moistened the human body, and then the patient was stretched on the floor and two servants took turns massaging the relaxed muscles, starting with upper limbs to stop. At the same time, the first schools were created in India and China, in which they learned the techniques of therapeutic massage. The foundations of preventive medicine were laid, medical gymnastic schools were opened, teaching not only massage techniques, but also therapeutic exercises.

In general, therapeutic massage has been used in different countries and on different continents, which is confirmed by reliable sources. Baths and massage in the complex were used in Persia, Turkey and Ancient Russia. In Russia, massage procedures were combined with hardening and bathing, rubbing with snow and tapping with a broom scalded with hot water (a procedure called “tailing”).

Therapeutic massage: history of development in Europe

While the art of massage flourished in the East, therapeutic massage was not popular in Europe. In the Middle Ages in the West, the power belonged to the church, and massage was considered contrary to the idea of ​​asceticism and did not believe in it. healing properties. Therapeutic massage at that time was most often performed by charlatans and did not produce the desired effect, while scientists were looking for the philosopher's stone or the elixir of life.

Only in the Renaissance (XIV-XV centuries) in Europe did interest arise in gymnastics and therapeutic massage. This was caused by the appearance of works on the anatomy of Mondi de Siuchi. Further, the idea was continued by the Belgian anatomist Andries Visaly and the English physician William Harvey, who made a huge contribution to anatomy and physiology due to the characteristics of human organs and the circulatory system. Since the 19th century massage and therapeutic exercises are becoming increasingly popular on all continents. In Germany, France and England at this time there are numerous works on massage and the results of its application.

In Russia at the same time, the first clinical and experimental works appeared, in which the basic principles of massage were laid down, and indications were developed and; contraindications for long-term use, depending on the type of activity of the patient and his sports.

The meaning and application of therapeutic massage

Therapeutic massage in Ancient Greece and Rome was widely used in the system of physical education of warriors, fist fighters and gladiators, which laid the foundation for sports massage and therapeutic exercises.

In Europe in the Middle Ages, therapeutic massage was banned and persecuted by the Inquisition until the advent of the Renaissance. The propagandists of massage in our country can be considered M. Ya. Verbov and other founders of therapeutic and sports massage.

With rheumatism, the Slavs rubbed ointments based on herbs and roots into the sore spot, then they went into a badly burned room, and there the attendant whipped them with a birch broom and doused them alternately with warm and ice water from head to toes. This double dose provides hardening and good physical condition of a person, and also keeps the skin in good shape and protects the immune system.

Types of therapeutic massage

Therapeutic massage is defined as a complex of various mechanical effects on the body, leading to the restoration of the body after an illness, sports, and most importantly - preventing various diseases. Massage effects are performed with the help of hands, special devices and tools, as well as with the help of air or water currents. Massage is general and local, and according to the method and application is divided into several types; medical, sports, hygienic and cosmetic.

Hygienic therapeutic massage helps to maintain efficiency, as well as maintain the body in good shape, good physical condition. Very helpful hygienic massage in conjunction with; gymnastics; swimming, shower, bath and sauna. Is an effective treatment various diseases and trauma.

Therapeutic massage has many varieties of classic - this is a massage used without taking into account the reflex effect. It is carried out next to the damaged area of ​​​​the body or directly in the affected area;

reflex - a massage performed with the aim of a reflex effect on the internal organs and restoring their condition. With this type of therapeutic massage, special techniques are used that affect certain areas - dermatomes;

Connective massage is a massage that affects the connective tissue and subcutaneous tissue;

Periosteal massage is a massage that causes positive changes in the connective tissue membrane (periosteum). Produced by clicking on the points in a certain sequence;

Acupressure is one of the varieties of therapeutic massage. It acts on acupuncture (biologically active) points in a relaxing or stimulating way;

Hardware therapeutic massage is carried out using vibration, ultrasonic, vacuum, electrically stimulating and ionizing devices;

Therapeutic self-massage produced by the sick person on a specific part of the body, it is recommended by the attending physician.

Sports massage (developed by I. M. Sarkizov-Serazini). The following varieties of it are distinguished: hygienic, training, recovery, preliminary.

Self-massage is carried out by the patient independently and requires considerable physical effort and skills from the masseur. Knowing the basics of acupressure, you can effectively prevent various diseases. Consultation with a specialist is required. Self-massage is convenient because it does not require additional help masseur, can be performed at any time and in any convenient place.

Therapeutic massage technique

The masseur must know well the anatomy, the physiological impact of individual massage actions, have a developed sense of touch and the ability to conduct a diagnostic palpation (with the help of fingers) examination.

Therapeutic massage can be carried out directly in the affected area, and in case of swelling and pain - above the lesion or at a symmetrical distance. These procedures can be applied both separately and in combination with other types of treatment. They should not cause seizures! pain, only pleasant warmth, a state of comfort

The work of a massage therapist requires physical activity, so constant relaxation exercises (relaxation) are necessary. It is recommended to rest while sitting to prevent occupational diseases - congestion in the lower extremities, tension in the cervical and lumbar spine.

The appointment of therapeutic massage in frequency varies from 2-3 times a week to daily classes in combination with baths, ultraviolet irradiation and other types complex treatment.

A massage course can usually include from 5 to 25 complex procedures, and the duration of a session can be from 3 to 60 minutes. The duration and number of procedures depend on the degree of the disease and contraindications. Consider the indications and contraindications for the use of therapeutic massage.

Indications for therapeutic massage

It is useful to conduct courses of therapeutic massage with the following diseases.

Disorders of the nervous system: residual effects of poliomyelitis, cerebral atherosclerosis, insufficiency cerebral circulation, neuralgia, neuritis, plexitis, radiculitis.

Diseases of the musculoskeletal system: rheumatoid arthritis, dislocations, dystrophic processes in the joints, osteochondrosis, bruises, sprains, curvature of the spine, flat feet and poor posture.

Respiratory diseases: tonsillitis, pharyngitis, laryngitis, rhinitis, allergies, lung diseases (bronchitis, pleurisy, pneumonia).

Diseases of the cardiovascular system: heart attack, cardiosclerosis, hypertension, myocardial dystrophy, myocarditis, heart disease, arteries and veins.

Diseases of the digestive system (without exacerbation): colitis, gastritis, gallbladder dyskinesia, peptic ulcer and duodenum.

Inflammatory diseases male and female genital organs (urethritis, prostatitis, displacement of the uterus and vagina, anatomical anomaly of the genital organs, anatomical and functional disorders).

Diseases of the ear, throat, nose: tonsillitis, pharyngitis, laryngitis, rhinitis, nose bleed.

Metabolic disorders: overweight, diabetes, gout. Also, therapeutic massage is used for headaches, sleep disturbances, increased irritability and other types of diseases.

When scheduling a session, the massage therapist must indicate in combination with which procedures or medicines his procedures are effective.

Contraindications to therapeutic massage

Therapeutic massage and self-massage are contraindicated in febrile conditions, acute inflammatory processes, blood diseases, thrombosis, thrombophlebitis, active stage of tuberculosis, syphilis and others. sexually transmitted diseases, malignant tumors, mental illness, poor circulation, nausea, vomiting, and unexplained pain. But these are only general contraindications, and for a complete system analysis it is necessary to consider each specific case separately. On the recommendation of a specialist, one or another method of therapeutic massage can be used.

Many of us at least once in our lives have come across the term "massage" - whether it's an advertisement for a miracle simulator, a list of services at a medical institution, or massage on the recommendation of a doctor. Literally, the word "massage" is translated as "knead, rub." The list of types of massage is impressive: medical massage, cosmetic, children's, sports, anti-cellulite - and that's not all. But, perhaps, the main purpose of medical massage is healing and restoration of the body. Medical massage, done by skillful hands, can really work wonders, it is no coincidence that the age of this method of treatment is calculated in centuries, and geography includes the whole world. We will talk about what medical massage is, what indications and contraindications exist for it, what you need to know when going to a massage therapist.

Any, including medical massage, can be general - when the doctor massages the whole body, or local - depending on your disease. Massage methods are very different, but most often - manual and hardware. Usually a massage therapist combines these methods - with manual massage, he can feel what is happening to the body, how the tissue changes, and the use of devices gives an effect that does not work with manual massaging. We did not make a reservation by using the word “doctor” - despite the fact that there are quite a lot of massage tutorials today, medical massage should be performed by a specialist, or you can do self-massage under the guidance of a doctor. Mastering medical massage on your own, you are practically self-medicating: its consequences can be very unexpected and unpleasant.

How medical massage is done

Let's take a look at the massage therapist's office. Usually, this is a spacious bright room in which there is a special couch or table; a set of massage devices - from mechanical massagers to an apparatus for electromanual massage and other massage devices; a closet where clean sheets and towels, oil, cream, talc are stored; clock - hourglass or procedural; stopwatch; first aid kit. All these are the most necessary things, without which massage is impossible. And, nevertheless, the main tool of the massage therapist are his hands. Medical massage is therapeutic, which means that you need to know exactly how and for how long to massage, and what the patient should do after the procedure. The doctor will tell you about all this before the start of the course.

On average, a medical massage session lasts from 3 to 60 or 90 minutes, depending on whether you are massaging one muscle group or the whole body, daily or every other day - as the doctor prescribes. The duration of the session depends on the age of the patient, the nature of the disease, the general condition of the body, but the first few sessions - when the body adapts, as a rule, are a little shorter in duration. The massage course is a minimum of 5 sessions, a maximum of 20-25. Medical massage includes standard techniques that have become classic during their use. These are familiar to all stroking, rubbing, kneading, vibration, which are usually supplemented by hardware impact. The degree of exposure and the number of repetitions of each of them is determined by the doctor.

What does medical massage treat: indications and contraindications

The range of application of massage as a means of combating the disease is very wide. Judge for yourself: medical massage is used in the treatment of back diseases, angina pectoris, hypertension, certain heart diseases, gastritis, even with pain of unknown origin, bruises and sprains, massage is often prescribed. Naturally, the technique for each disease is different, in addition, you always need to take into account the stage and period of the disease. That is why the massage therapist must know the anatomy and physiology of a person, the causes of diseases, and must be able to determine the effectiveness of treatment.

However, medical massage cannot be considered a panacea for all diseases. Like any method or medicine, it has a number of contraindications. Among them are such as: blood diseases, aortic aneurysm, tumors, colds, high temperature or acute inflammation blood vessels, thrombosis. The list of contraindications is quite extensive, but do not be afraid of this: many of them, such as acute respiratory infections, refer to "temporary" conditions of the body, and after treatment, you may well undergo a course of medical massage.

Medical massage and consequences

Apart from therapeutic effect, medical massage, as you might guess, also affects other body systems: after all, the hands of a masseur act not only on a diseased organ. The effect of massage is most clearly manifested on the skin: due to increased blood supply, venous stasis disappears, metabolic processes are accelerated, as in skin tissues as well as in the body. You will notice: the skin will become smooth and elastic. Massage also affects the nervous system: after it you will feel younger: fatigue will disappear, a feeling of pleasant warmth will appear, pain will decrease or disappear.

Medical massage increases the performance of muscles, while increasing their elasticity. The blood supply to the joints improves, moreover, deposits dissolve under the influence of massage. Due to the blood supply, the work of the heart also improves. At the same time, massage helps to accelerate the flow of lymph - as you know, the lymphatic system serves as a kind of "barrier" on the way pathogenic bacteria, which means that massage has a preventive effect. Thus, even if you have chosen medical massage as a treatment, be prepared for the fact that you will change in better side- both externally and internally.

First session: what you need to know when coming for a medical massage

There are no strict restrictions and rules for massage, but still, if you decide to sign up for a medical massage, pay attention to the following recommendations. Make sure that the skin in the place of the forthcoming massage is clean and not injured - that is, without scratches or cuts: otherwise the massage may be painful, and there is a risk of infection. By the way, for the same reason, you should not shave your hair before the session, but it is advisable to take a shower.

It is best to come for a medical massage not earlier than an hour after eating. An exception is a massage of the abdomen, which is done either an hour before a meal or not earlier than 3 hours after a meal. After the session, it is advisable to lie down for 10-15 minutes. During massaging, the muscles should be relaxed - for a greater effect. It is recommended to remove jewelry: chains, rings or earrings (depending on which area you will be massaged), lenses or glasses.

Medical massage - results

Of course, it is impossible to cure the disease using only medical massage as a medicine. But in combination with other methods of treatment, physiotherapy, acupuncture, and taking into account medical supervision, medical massage can have a significant impact on the course of treatment. It is no coincidence that many people undergo a course of medical massage repeatedly - 2-3 times a year.

In principle, almost any kind of this "dosed physical impact on the body ”you can say - medical massage. After all, all types of massage are somehow designed to help a person physically and psychologically. The only difference is that classic medical massage is still aimed at treating the disease.

1.2.3. Fundamentals of therapeutic massage

Characteristics of therapeutic massage. Therapeutic massage is an effective therapeutic and rehabilitation method used to normalize body functions in various diseases and injuries. The popularity of therapeutic massage is constantly growing, it has become the object of close attention and scientific study. It is used in surgery, traumatology, therapy, gynecology, neuropathology, cardiology, endocrinology, sports medicine and rehabilitation.

Methods of therapeutic massage. The most common method is classical massage is the main method in therapeutic massage, as it has a variety of techniques, allows you to widely vary the dosage, visually and tactilely control the accuracy of the techniques and evaluate their results, etc. Manual massage has an advantage over hardware, foot and combined, as it can be used not only in the ward, massage room, but also at home, in a bath, bath, etc., as well as in the form of self-massage.

Hardware massage method used as an extra. Depending on the varieties, it can be performed both by direct contact with the skin, and through air or water. Among the varieties of the hardware method of massage, vibration, hydro- and pneumatic massage are most widely used. In medical practice, electrical stimulation, ultrasonic massage, etc. are also used. Hardware types of massage, like manual massage, can be used in the process of segmental, acupressure, periosteal and other types of massage. Combined massage method. A combination massage is a massage in which manual and hardware massage is used.

Foot massage method performed with the help of the feet: the heel, fingers, and knees, most often in sanatorium conditions, in water clinics and baths.

Especially it is necessary to emphasize the great efficiency of manual massage, since only with the hands of a massage therapist can identify changes in the tissues of the massaged area, highlight the necessary points and purposefully influence them. Without denying the positive impact of hardware massage, in medical practice nevertheless, it is preferable to use a manual one, since none of the devices can replace the hands of a massage therapist.

Therapeutic massage can be classified according to the nosological units in which it is used: massage for injuries and diseases of the musculoskeletal system, massage for diseases and injuries of the nervous system, massage for diseases of internal organs, etc. Each group of diseases is characterized by its own characteristics of the technique and methodology of the massage session. With each disease, the massage technique depends on: etiology, pathogenesis, clinical form, course, and is differentiated in connection with these factors.

Methodological features during therapeutic massage. Massage is a more adequate therapeutic effect in the first days after injuries or diseases than exercise therapy. Therefore, in order to achieve a greater effect of the therapeutic effect, massage should be carried out before physical exercises, and if necessary, again after them. Technique and methodology for conducting techniques in therapeutic massage are similar to those in hygienic, sports and other types of massage, namely: stroking - combined, longitudinal, alternate, etc.; squeezing - with the edge of the palm, the base of the palm, etc .; kneading - double ring, double neck, pads of 1-4 fingers, the base of the palm, etc .; rubbing - "nippers", fingertips, fist comb, etc .; shaking; vibration; movements, etc. The choice of techniques for creating a specific technique for a massage session depends on the disease and clinical forms its currents. The therapeutic massage technique provides for methods of focal and extrafocal, or segmental-reflex, effects, a sequence of techniques, their combination with movements, and a gradual increase in exposure.

Dosing of massage is carried out by: localization of exposure segments, choice of techniques, depth and area of ​​impact on tissues, number of massage manipulations, speed and rhythm of movements and their amplitude, duration of procedures and their alternation with other influences, rest intervals (pauses) between procedures, number of procedures per course of treatment, etc.

Therapeutic massage for all diseases and injuries is carried out in accordance with the periods of treatment and stages of rehabilitation. A massage session consists of three sections: introductory, main and final. Massage should not cause pain. It can be carried out 1-2 times daily or every other day. The course of treatment - from 10 to 18-25 procedures, a break between courses - from 10 days to 2 months, depending on the disease and agreement with the doctor in each individual case.

General indications and contraindications for therapeutic massage. Often massage is combined with other methods of treatment, especially with physical factors, physical therapy, but it can also be used as an independent method of rehabilitation. When prescribing a massage, it is necessary to clearly know the indications and contraindications for its use. It should be remembered that the use of undifferentiated techniques, the use of indiscriminate techniques can cause adverse responses, up to an exacerbation of the process. The same negative reactions occur when a massage is prescribed at a time when the massage is not yet indicated. It is important to take into account that when massage is combined with physical factors, the latter may be accompanied by a reaction. Therefore, the massage technique should be more gentle, sometimes massage should be applied to a part of the body that is distant from the focus of exacerbation, or the procedures should be canceled, resuming them after the removal of acute phenomena at the discretion of the doctor in accordance with individual indications.

Massage should be performed along the lymphatic tract towards the nearest lymph nodes, which cannot be massaged. The position of the patient should exclude the tension of the massaged parts and the whole body. Massage techniques should not cause pain.

The duration of a massage session depends on the disease, body area, body weight of a person, his age and condition at the moment, etc. The first massage sessions are always short, gentle, and then the time and strength of the impact increase. The time for performing individual massage techniques depends on the massaged parts of the body, the nature of injuries or diseases, as well as the patient's well-being. Right choice receptions largely determines the effect of the therapeutic effect of massage.

When conducting massage for the purpose of treatment and rehabilitation, there are the following contraindications.

Acute febrile state and acute inflammatory processes.

Bleeding, bleeding.

Diseases of the blood.

Purulent processes of any localization.

A disease of a skin-infectious, unexplained or fungal etiology. Skin rashes, lesions, skin irritations.

Acute inflammation of the veins, vascular thrombosis, significant varicose veins with trophic disorders.

Endarteritis complicated by trophic disorders, gangrene.

Atherosclerosis peripheral vessels, thromboangiitis in combination with atherosclerosis of the cerebral vessels, accompanied by cerebral crises.

Aneurysms of vessels and heart.

Inflammation of the lymph nodes and blood vessels. Enlarged, painful lymph nodes, soldered to the skin and underlying tissues.

Allergy with hemorrhagic and other eruptions. Hemorrhages in the skin.

Excessive mental or physical fatigue.

active form of tuberculosis.

Syphilis of the 1st-2nd stage, AIDS.

Chronic osteomyelitis.

Causalgic syndrome after injuries of peripheral nerves.

Malignant tumors of various localization.

Mental illness, with excessive excitement, greatly altered mind.

In some cases, contraindications to massage are temporary and after an acute inflammatory process, a feverish state, a purulent process, an exacerbation of a disease of the autonomic nervous system, etc. massage can be applied (according to indications). Massage should also be prescribed after radical removal of the tumor. It often happens that massage can be indicated for the underlying disease, but it cannot be prescribed due to concomitant diseases.

Concluding the general part, it should be emphasized that knowledge of the massage technique for individual parts of the body is necessary as a basis for the subsequent mastery of private massage techniques for diseases and injuries. Only this approach to the study and application of massage makes it highly effective in the treatment and rehabilitation of various diseases and injuries. When prescribing a massage, the doctor must indicate in what combination and sequence with other procedures massage should be applied and constantly monitor the patient in the process of applying this method of treatment and rehabilitation.

The combination of therapeutic massage with exercise therapy and physiotherapy. In many cases, it is advisable to combine massage with various physiotherapeutic procedures: water, phototherapy, electrotherapy, etc. Physical therapies prepare body tissues for massage. For example, it is advisable to pre-warm the limbs, the skin temperature of which is lowered (paresis, paralysis), or to reduce pain so that the massage can be deepened, etc.

Massage and thermotherapy. Heat greatly enhances the physiological effect of massage, causing active hyperemia of tissues, reduces muscle excitability, relaxes spasm of muscles and blood vessels, and significantly reduces pain. Therefore, with traumatic and inflammatory lesions of the articular-ligamentous and muscular apparatus in subacute period, as well as in chronic processes, joint stiffness, muscle contractures, vascular disorders with a tendency to spasms, it is advisable to combine massage with thermal procedures (water bath, paraffin, ozokerite applications, steam room, bath, etc.).

The sequence of thermal procedures and massage in each case is determined by special indications. So, with functional disorders of the musculoskeletal system (joint stiffness, articular adhesions, delayed formation callus, muscle atrophy, paresis, neuritis and neuralgia) it is recommended to apply heat first and then massage. In case of vascular disorders (swelling of tissues after a fracture, lymphostasis phenomena) - first massage, and then heat to avoid rupture of superficial vessels.

Massage and electrotherapy. With the combined use of massage and electro-gymnastics (amplipulse, electrical stimulation, etc.), massage is recommended immediately after the electro-procedure. When prescribing electrophoresis with various medicinal substances in combination with massage, massage is first used, and then electrophoresis.

Massage and hydrotherapy. Depending on the indications, massage can be used before and after water procedures. In case of injuries and diseases of the organs of movement (cicatricial adhesions of tissues, myogenic, arthrogenic contractures, joint stiffness, myofibrosis, myosclerosis of tissues, etc.), as well as injuries and diseases of the peripheral nervous system (lumbosacral sciatica, neuromyositis, etc.) first apply thermal, water procedures, and then massage; in case of severe pain syndrome, the massage is preceded by a hydrotherapy procedure.

General massage and general light bath should not be prescribed on the same day. Incompatible by the nature of the reaction, for example, ultraviolet irradiation and massage or Charcot's shower and massage.

Physiotherapeutic procedures are not a very big load on the cardiovascular and nervous system and can be prescribed on the same day, but at different times: for example, a water bath (low temperature) and massage, mud therapy (local application) and massage.

Segmental reflex massage. In the arsenal of modern medicine there are many ways of reflex effects on the human body. Massage is largely based on the principles of such an impact. The methods of reflex action on the human body by pressure (pressure) include segmental, point, connective tissue, periosteal and other types of massage. Their essence lies in the impact of certain techniques on certain parts of the body, zone or points of the skin surface, periosteum and other tissues of the human body. At the same time, it should be noted that the reactions of the body, depending on the type of exposure, are completely different. These reactions are called reflex, and the method of exposure (treatment) based on their use is called reflex therapy.

Segmental massage. Based on the physiological principles and theoretical provisions of the teachings of I.P. Pavlova, A.E. Shcherbak (1903) proposed and substantiated a new direction in the development of therapeutic massage - segmental reflex massage, which is progressively developing and effectively used in clinical and spa practice in our country.

Segmental-reflex massage provides a direct effect not on the diseased organ, but on the zones innervated by the same segments spinal cord(Table 1), i.e. indirectly affecting the mechanisms of pathogenesis. For example, by massaging the corresponding paravertebral zones and the epigastric region, one can influence the motor, secretory and evacuation function of the stomach; in vascular diseases and injuries lower extremities massage of the lumbar region - positively affect blood circulation, trophic processes in tissues and their regeneration, improve the recovery of motor functions. Massage chest can contribute to the elimination and resorption of residual effects after inflammation of the lungs and pleura and prevent the development of adhesions; massage of the collar zone - to reduce blood pressure in hypertension, eliminate headaches in case of neurosis and fatigue.

All tissues, organs and systems of the human body are a single whole and are interconnected in certain relationships. Therefore, no disease is local, but always causes reflex changes in segment-related functional formations, predominantly innervated by the same segments of the spinal cord. Reflex changes can occur in the skin, muscles, connective and other tissues and, in turn, affect primary focus and support the pathological process. By eliminating these changes in tissues with the help of massage, it is possible to contribute to the elimination of the primary pathological process and the restoration of the normal state of the body.

The interconnections of our body are carried out by viscerosensory, viscero-motor and viscero-visceral reflexes, which are of great importance in clinical practice.

Areas of the skin surface with hypersensitivity, in which there are pain in diseases of the internal organs, they were called the Zakharyin-Ged zones. The Russian clinician G. A. Zakharyin first described them in 1889. In more detail, the connections of various internal organs with certain areas of the skin are described by Ged in 1893-1896. Physiologically, the appearance of hypersensitivity zones is explained by the fact that pain stimuli coming through sympathetic fibers from the internal organs to the spinal cord radiate to all sensitive cells of this segment, exciting them. Such excitation is projected onto the areas of the skin associated with this segment. It is known, for example, that with cardiosclerosis and angina symptoms, pain occurs in the left arm, on the inner surface of the shoulder, in the armpit, near the shoulder blade. A reverse reflex process is also possible, when a pathological focus on the surface of the skin causes pain in the internal organs.

In diseases of the internal organs, prolonged painful tensions of the skeletal muscles sometimes occur. For example, in diseases of the liver and biliary tract, reflex changes are observed in the trapezius muscle, in the latissimus dorsi muscle, in diseases of the pleura - in the intercostal muscles, in the sternocleidomastoid muscle, etc. In diseases of the internal organs, reflex changes in the periphery can be manifested by thickening or limitation of skin mobility, seals in the subcutaneous tissue.

The establishment of functional connections between all parts of the human body laid the foundation for the development of segmental-reflex methods in physiotherapy, including massage. Studies have shown that by influencing physical factors on the surface of the body in certain areas, it is possible to influence the vital functions of the body for therapeutic purposes. Based on the study of anatomical and physiological data and the results of clinical studies, the special significance of certain skin zones was determined. So, the cervical-occipital and upper chest regions (collar zone) include the skin of the back of the neck, neck, shoulder girdle, upper back and chest. All this skin zone is closely connected with the cervical and upper thoracic segments of the spinal cord (C 4 -D 2) and the formations of the cervical autonomic nervous system. The cervical region of the autonomic nervous system is associated with the autonomic centers of the brain and has extensive peripheral connections, due to which it plays an important role in the innervation of the heart, lungs, liver and other organs and tissues of the head, neck, upper chest, back and upper limbs. By influencing the skin segments of the collar zone with massage, it is possible to cause functional changes in the central nervous system, where the control of the autonomic activity of the body is concentrated, and to receive a reflex response in the form of a variety of physiological reactions from organs and tissues (metabolic processes, thermoregulation, etc.).

The lumbosacral region includes the skin of the lower back, buttocks, the lower half of the abdomen and the upper third of the front of the thighs. All this skin zone is closely connected with the lower chest (D 10 -D 12). lumbar and sacral segments of the spinal cord, with the lumbar part of the sympathetic division of the autonomic nervous system and its parasympathetic centers. When the skin segments associated with the nervous apparatus of the lumbar region are irritated by physical factors, functional changes occur in the organs and tissues of the small pelvis, in the intestines and lower extremities. Based on experimental studies and clinical observations, A.E. Shcherbak was the first to recommend segmental-reflex massage techniques - massage collar and waist massage. The first of them is prescribed for hypertension, sleep disorders, trophic disorders in the upper limbs, etc., the second - for vascular diseases and injuries of the lower limbs, to stimulate the hormonal function of the sex glands, etc.

Segmental reflex massage differs from classical massage in that, in addition to affecting the affected organ, there is an additional extrafocal effect on the affected tissues, organs and body systems. In the clinic of internal diseases, where direct massage of the diseased organ is not available, segmental reflex massage is of particular importance. With segmental massage, all the basic techniques of classical massage are used: stroking, squeezing, rubbing, kneading and vibration. Auxiliary techniques are also used, for example, hatching, sawing, squeezing, felting, stretching the muscles, articular-ligamentous apparatus, concussion of the chest, pelvis, internal organs, etc. In addition, special techniques are used: drilling, moving, sawing, etc. Segmental massage techniques should be carried out rhythmically, gently, without rough effort, after giving the massaged segment of the body a mid-physiological position. In addition to the accepted directions of massage manipulations in segmental-reflex massage, specific directions of movements are also carried out, determined by the functional structure of the spinal innervation segment and its neuro-reflex connections. Under the term segmental massage imply not only the impact at the level of a certain segment of the spinal cord, but also a special massage technique. The peculiarities of the segmental massage technique are a consistent differentiated effect on the skin - stroking and squeezing; to influence the muscles - kneading and squeezing, which cause muscle stretching. In addition to these techniques, rubbing techniques are also used: on the joints, fascia, tendons, ligaments. On the muscles, pressure, muscle shifting is applied. The shifting of the vertebrae is also used.

The technique of using segmental massage:

start a massage session with superficial tissues;

start from the lower segments, gradually move to the higher departments, for example, from D8-D1;

it is advisable to start performing techniques with segmental roots at the exit point at the spinal column.

Acupressure. Unlike segmental massage, with acupressure, narrowly limited point areas of tissues are massaged. It has been established that acupressure has a mechanical, humoral, reflex and bioelectric effect. It is carried out at the same points that are exposed to a needle or a wormwood cigarette in the therapeutic method of acupuncture and moxibustion. These medical methods originated in the countries of the Ancient East. Over the centuries, a whole system of therapeutic effects has developed, which included acupressure as one of the main methods of treatment. It has been established that some points on the human skin are functionally interconnected with various organs and systems of the body, they were called biologically active. In total, about 700 such points are described, but 100-150 of them are most often used. In the mechanism therapeutic effect biologically active points(BAP) are complex reflex physiological processes. When a particular zone or point of the skin is irritated, a response can be elicited at the level of a certain organ in a zone that has no visible anatomical connection with the irritated one.

Studies of biologically active points have shown that exposure to a point excites or calms (depending on the method) the autonomic nervous system, enhances arterial blood supply, regulates the activity of endocrine glands, soothes pain, and relieves nervous and muscle tension. Biologically active points have specific features that distinguish them from other areas of the skin: reduced electrical skin resistance, high electrical potential, elevated temperature and pain sensitivity (hence the term pain point massage) a higher level of metabolic processes (V.I. Ibragimova, 1983). Pressure, rubbing at these points causes a feeling of ache, numbness, acute pain(similar sensations do not occur with pressure and rubbing at some distance from these points). These sensations are so constant and characteristic of biologically active points that they are a criterion for the correctness of their location.

Dosed exposure to strictly defined points selectively affects the functions of various organs and systems. The use of massage in the armpits, mammary glands and at locations large vessels not shown. Acupressure can be used in combination with drug therapy. It must be remembered that this ancient Eastern method of treatment only complements modern medical methods of treatment and recovery, but does not replace them.

Method for determining points. On palpation, the location of the BAP is revealed using sliding squeezing movements with the pad of the most sensitive finger; when the point is found, a feeling of roughness, warmth, and increased pain appears.

The location of points can be identified by topographic maps, diagrams and drawings informing about the location of points, as well as using ELAP, ELAP-VEF, ELITE-04, "Reflex - 3-01" devices.

Point massage technique. Depending on the technique of influencing a local point, the method can be exciting or calming. So, with violations of muscle tone, with an increase in it, contractures of a central or peripheral nature (spastic paralysis, paresis, children's cerebral palsy, contractures of the muscles of the face with complicated neuritis of the facial nerve), as well as pain, especially of a muscular, articular nature, the task of exposure is relaxation, relaxation, sedation, i.e. sedative effect. In this case, a braking, sedative method is used: within 1-2 s, they find the necessary point, within 5-6 s, perform rotational movements clockwise, deepen, pressing on this point and gradually increasing the effort, fix the achieved level for 1-2 s , then make the opposite movement, "unscrewing" the finger counterclockwise, gradually reduce the pressure force, performing rotations for 5-6 s. Then, without lifting the finger from the fixed point, this cycle of movements is repeated (when exposed for 1 minute in a sedative way, 4 entrances and exits are performed, each for 15 seconds, if it is necessary to act for 2 minutes, then 8 entries and exits are made). With each impact, the pressing force on the point increases depending on the sensation of the person being massaged (bursting, numbness, soreness, warmth, etc.).

With phenomena of reduced tone, atrophy of muscle groups, neuritis of individual nerve trunks, paresis, a stimulating (tonifying, exciting; acupressure technique is used: a point is found for 1-2 s, then rotational movements are carried out clockwise for 3-4 s, “screwing” finger and pressing on the point, and then sharply torn off from the point, just as a bird beats with its beak, this movement is repeated 8-10 times at one point (40-60 s).Such an impact on the points is carried out in a certain sequence, purposefully, according to recommendations for the corresponding disease, syndrome Fig. 1 shows the position of the fingers and hand when performing acupressure.

Connective tissue massage. Areas of tissues with increased stress are referred to as connective tissue zones. Here there is limited mobility of the skin, which can be determined by palpation. With diseases of some internal organs or with functional disorders in them, the mobility of the connective tissue may be completely absent (for example, with severe angiopathy). Massage of reflex zones located in the connective tissue is called connective tissue massage. The technique of its implementation consists in influencing tense areas of the connective tissue (most often with the tips of the 3rd and 4th fingers). At the same time, in places with pronounced tension, there is thrill, resembling a cutting movement with a fingernail or a sharp pinch of the skin.

Connective tissue massage according to the method of execution is divided into 3 types:

skin, when only the skin is displaced, and the subcutaneous layer is not affected;

subcutaneous, when the subcutaneous layer is displaced, and the fascia is not affected;

fascial, when the displacement is made in the fascia.

The basis of connective tissue massage is the tension of certain receptors (mechanoreceptors of the skin, subcutaneous tissues and connective tissue of blood vessels), which causes various reflexes that can affect the organs innervated by the autonomic nervous system.

Periosteal massage. The effect of periosteal massage (according to the classification - pressure massage) is directed to the bone surfaces or periosteum (it is carried out with the fingertips or interphalangeal joints) and lies in the fact that blood circulation and cell regeneration increase at the pressure site, mainly in the periosteal tissue, and a reflex effect is exerted on organs connected by nerve pathways with the massaged surface of the periosteum. There are experimental data that allow us to say that after periosteal massage in the region of the cervical vertebrae or the occipital region, visual acuity increases, and after massage in the region of the ribs and sternum, the heart rate decreases, i.e., the efficiency of the activity of the heart muscle increases. Periosteal massage significantly affects breathing, so it is used as an aid in the treatment of patients with impaired respiratory function. It is especially useful for a sharp decrease in the respiratory volume of the lungs and impaired gas exchange. Periosteal massage is also indicated for pain or morphological changes in the periosteum and is the best method for arthrosis of the costovertebral or intervertebral joints with pain.

The technique of periosteal massage is simple: the fingertip or interphalangeal joint is lowered to the painful point, the soft tissues covering it (primarily muscles) are shifted to achieve the best contact with the periosteum, and, gradually increasing pressure, they press on it, performing at the same time rhythmic small circular movements. Then also gradually reduce the pressure, without interrupting contact with the skin. Cycles of increase and decrease in pressure last 4-6 s and are repeated for 2-4 minutes. After influencing each point with the tip of the thumb (or tubercle of the thumb), a squeeze is performed. The average duration of a massage session should not exceed 18 minutes. The frequency of procedures is 3 times a week.

Massage for diseases and injuries of the musculoskeletal system (ODA). The objectives of massage for musculoskeletal injuries are as follows:

in strengthening blood and lymph circulation and metabolic (trophic) processes in the damaged area of ​​the musculoskeletal system;

in reducing pain;

in promoting the resorption of infiltrates, effusions, edema, hemorrhages in the area of ​​damage;

in accelerating regeneration processes, in particular, the formation of callus in case of bone fractures;

in relieving muscle tension;

in preventing the formation of contractures and stiffness in the joints; muscle atrophy.

Massage, due to mechanical action and reflex influence, enhances blood and lymph circulation in the area of ​​damage, improves trophism and promotes the speedy healing of the damaged link of the musculoskeletal system.

Under the influence of massage, the elasticity improves and the mobility of the ligamentous-capsular apparatus increases, the secretion of the synovial membrane of the joint is activated, helping to reduce swelling and normalize its function.

Massage for bruises Massage is carried out on the 2-3rd day after the bruise (if there is no rupture of large vessels and muscles, thrombosis). Massage is started above the injury site, stimulating the outflow of lymph and blood from the bruised area (suction massage technique). Stroking, light kneading and squeezing techniques are used in the direction of the nearest, upstream lymph nodes. In the absence of pain, you can begin to massage the bruised area, the intensity of exposure depends on the sensation of the patient. At the first massage session in the bruised area, they are limited to light stroking techniques. As the pain decreases, stroking begins to alternate with light rubbing and gentle kneading with the fingertips, in larger areas - with the base of the palm.

The duration of the massage procedure in the first days is 8-10 minutes. in the next - 18-20. Gradually, passive movements and active exercises are added to the massage.

Massage for sprains. Massage begins on the 2nd-3rd day after stretching. The affected limb is placed in a somewhat elevated position, and the massage begins above the site of the lesion, using mainly stroking and rubbing techniques. From the 3rd-4th procedure, rubbing and active movements in the joint are added, gradually increasing the range of motion. Massage is best done after thermal procedures.

With dislocations, massage begins after reduction and temporary immobilization with working out the muscles surrounding the joint, using stroking and kneading. Later, they begin to rub the articular elements and perform movements in the joint.

Massage for fractures. With open fractures, massage is contraindicated (danger of infection of the wound), with closed fractures, massage and therapeutic exercises are essential elements of the complex treatment of fractures. On top of the plaster cast, vibration massage is used in the area of ​​the fracture from the 2-3rd day after the injury. Before removing immobilization, massage of a healthy limb is useful. After removing the immobilization, a suction massage is first applied, and then the fracture site is massaged using intermittent stroking, and a little later, rubbing and kneading the muscles. With a slow fusion of fragments in the injury zone, more active techniques are used: chopping, patting, tapping with a wooden mallet, vibration, with cicatricial contractures on the side of stretched and weakened muscles, deep stroking is used, then kneading and light tapping. For stretching scars and adhesions, such techniques as stretching, shifting, forceps-like rubbing and crossing are shown, for stretching muscles with muscle contractures - flat and covering stroking. Massage should be combined with gradual redressing - stretching of muscle contractures with hands with light swaying movements in the joint.

In case of traumatic injuries, it is also necessary to act on the corresponding reflex-segmental area. So, in case of damage to the upper limb, paravertebral zones are massaged in the area of ​​the exit of the nerve roots of the spinal cord to the right and left of the cervical-occipital and upper thoracic spine, in case of damage to the lower extremities - the lower thoracic and lumbar spine.

Massage for joint diseases carried out to promote the resorption of inflammatory exudate in arthritis; increase blood circulation in the affected joint with osteoarthritis; reduce pain and stiffness of movements in the joint; contribute to the restoration of normal range of motion in the joints; strengthen muscles, prevent muscle hypotrophy and increase their performance; prevent the development of contractures and stiffness in the joints.

Arthritis massage. The first procedures are carried out according to a sparing technique without a special effect on the joints, with the help of stroking and light kneading, trying to relieve tension in the muscles. From the 2nd or 3rd procedure, the muscles surrounding the affected joint and the joint itself are affected. During massage, it is important to be able to determine how the muscle tone has changed: whether it is increased or decreased, to find areas of muscle thickening and knots, differentially influencing these changes and trying to eliminate them. So, it is necessary to influence areas of reduced muscle tone with strong techniques - rubbing, kneading, acting slowly. In the area with muscle hypertonicity, on the contrary, soft tricks and continuous vibration are shown. With the defeat of the upper and lower extremities, the patient can be massaged when he lies and sits, achieving maximum relaxation of the muscles.

The duration of the massage procedure for one limb in the first procedures is 5-7 minutes, in the subsequent 10-15 minutes, for the course - 15-17 procedures, after 0.5-1 month the massage course can be repeated.

Massage for arthrosis are carried out more intensively, using all the methods of classical massage, depending on the clinical features of the manifestation of the disease and its severity. A lot of time is devoted to rubbing the articular elements and strengthening the muscle groups around the joint, combined with passive and active movements in the affected joint.

The duration of one procedure at the beginning of the course is 8-10 minutes and 20-25 minutes at the end, in total 10-12 procedures.

Massage for diseases and injuries of the nervous system and osteochondrosis of the spine It is also used for autonomic disorders and neurosis in order to improve blood circulation, as well as tissue trophism in flaccid and spastic paralysis, strengthen paretic muscles, muscles in a state of contracture, preventing the development of muscle atrophy, reducing pain and activating nerve regeneration. Massage with spastic incisions and paralysis should be carried out with great care. Before the massage, the diseased limb, if possible, is warmed with a heating pad or lamp, achieving maximum relaxation of the muscles. At the beginning of the disease, in order not to cause an increase in hypertonicity of the spastic muscles, it is necessary to use only the methods of superficial stroking and light rubbing.

Massage starts from the lower extremities, from the proximal sections. Muscles in which the tone is increased are massaged with gentle, soft strokes and rubbing at a slow pace. Stretched, atrophic, weakened muscles are massaged with passive movements. To reduce the excitability of the motor cells of the spinal cord and impact on trophic processes, massage the paravertebral spinal segments - for the upper limbs - cervicothoracic - (C 5 -D 1); for the lower extremities - lumbar - (L 1 -S 2). Due to the rapid fatigue of patients, the duration of massage with spastic paralysis at the beginning of the course is 6-8 minutes, gradually increasing to 15-20 minutes.

The use of massage in various diseases accompanied by flaccid paralysis is aimed at strengthening weakened muscles and relaxing antagonist muscles. Private massage techniques depend on the characteristics of the clinical forms of the lesion. Almost all the basic techniques of classical massage are used. With bilateral lesions - flaccid tetraplegia or tetraparesis - a paired massage is used by two massage therapists.

Massage for neuritis and neuralgia is used to reduce pain, improve tissue trophism and nerve conduction, and improve sensitivity. The corresponding paravertebral zones are massaged, along the course of the nerve, the exit points of the nerve and the places of irradiation of pain. In the presence of severe pain, massage is carried out according to a sparing technique using mainly stroking and gentle rubbing.

Massage for neuritis of the facial nerve has some specifics. In the acute stage, the healthy half of the face is massaged easily (gently). On the affected side, massage is started in the recovery stage, stroking is performed from the middle of the forehead, nose and chin to the submandibular glands, light stroking around the eye; stroking the neck in front and behind; rubbing and vibration along the course of the nerve. They also produce skin vibration of paralyzed muscles. The duration of the massage is 3-5-8 minutes daily. Course 15-18 procedures.

Massage for diseases of the cardiovascular system It is aimed at eliminating congestion in the pulmonary and systemic circulation, improving blood flow to the heart, developing collateral circulation, normalizing blood pressure, improving the adaptation of the cardiovascular system to changing external conditions, and increasing physical activity. Massage of the chest enhances its suction action, facilitating the work of the heart, and reduces congestion. It is also indicated for hypertension, neurocircular dystonia, angina pectoris, post-infarction condition, myocardial dystrophy. cardiac neurosis, heart disease in stage of compensation, chronic myocarditis, circulatory failure, vascular diseases (varicose veins, obliterating endarteritis). In diseases of the heart muscle (IHD, myocardial dystrophy, myocarditis, cardiosclerosis), a general massage is indicated, which is recommended to start from the back, where a large skin surface and muscles with an abundant network of capillaries are located relatively superficially. Thanks to the massage, which causes the expansion of the capillary network, the blood flow in the periphery increases, which greatly facilitates the work of the left ventricle of the heart.

Massage begins with stroking and kneading the interscapular region. Then massage the shoulder girdle in the direction from spinal column to the shoulder joints and shoulder blades, back and side surfaces of the neck. After stroking, rubbing and kneading the same areas are performed. Then, a gentle stroking of the heart area is carried out, a rake-like stroking and rubbing of the intercostal spaces from the sternum to the spinal column, at the end, a concussion and gentle tapping of the chest are performed. After that, circular strokes and rubbing of the area of ​​​​the mastoid processes of the temporal bone are used and occiput, alternating them with stroking the neck and shoulder girdle. Then, light tapping is performed along the spinous process of the VII cervical vertebra and the upper and lower limbs are massaged with wide strokes, in the direction of the lymphatic vessels. The duration of the procedure is 15-20 minutes, the course of treatment is 12-15 procedures daily or every other day.

Massage technique for certain diseases will be presented in the relevant sections.

Therapeutic massage (medical massage) is a proven, effective method of therapy that has been widely practiced all over the world for more than a hundred years for the treatment of various ailments, injuries and their consequences. It has its own methodology and rules for implementation, is used in various modifications, has a wide range indications and a small list of contraindications.

Along with this, depending on the nature, type and severity of the disease, therapeutic massage can act as independent method therapy, and auxiliary means or integral part complex treatment. In addition, therapeutic massage is indispensable in the rehabilitation phase, as it is effective tool, contributing to the restoration of normal activity of the body after injury or illness.

Types of medical massage

All therapeutic massage is divided into types, which are determined by various techniques and methods of influence. The following types of medical massage are widely practiced:

• European classic medical massage. Such a massage is performed in the affected area of ​​​​the body or in the area adjacent to this area (say, if direct impact cannot be done due to plaster). In this case, the usual massage techniques are used, as well as auxiliary massage tools.
• Acupressure massage. This type massage is also called acupressure, it uses almost all the same techniques that are used in the classical one. However, the impact occurs on certain points located on the human body, which are called reflexogenic or biologically active. the main task acupressure is to alleviate pain syndrome relieve muscle spasms nervous tension. As a rule, acupressure is carried out with the index or thumb, as well as with the elbow. In the past few years, such a technique of this type of massage as pressure has been widely demanded.
• Periosteal therapeutic massage. This type of massage has a beneficial effect on pain points bodies that have a reflex connection with different systems of the body or its internal organs. It is prescribed for ailments of the musculoskeletal system, for diseases of the joints, for some diseases of the internal organs. Periosteal massage has a positive effect on the circulation of lymph and blood, on metabolic processes and trophic processes. This massage should be carried out in those painful points where unpleasant, painful sensations are concentrated. In this case, one should take into account how severe the pain in a person is.
• Connective tissue medical massage. This massage affects the connective tissues in the reflex areas. Most often, it is prescribed for the pathology of the musculoskeletal system and some diseases of the internal organs.
• Reflex therapeutic massage. This type of massage is indicated for various diseases internal organs. It is based on the doctrine that the entire human body is complete system and all its parts are somehow interconnected. With reflex massage, mechanical stimulation of the skin areas where the nerve endings associated with the areas of the spinal cord, which sends impulses to internal organs.
• Hardware medical massage. From the name it becomes clear that this massage produced not by hands, but by means of certain apparatuses, special devices which affect the human body in different ways. Treatment of damaged organs and tissues can be carried out with infrared and ultrasound devices. It can also be electrostimulation, cupping, vacuum-roller and pneumo-vibration massage.
• Self-massage. This is a type of massage when the patient independently affects a certain area of ​​his body. Such a massage is widespread all over the world, and its task is to improve the body, normalize the process of blood circulation, increase blood flow to internal organs, accelerate lymph flow, improve overall well-being and improve tissue nutrition. In addition, self-massage is a fairly effective tool for preventing and treating colds.

Mandatory rules for the use of therapeutic massage

Before you turn to medical massage, you need to learn a number of rules:

1. This type of massage should not be used without prior consultation with a highly qualified specialist and his specific prescriptions. This is not a method of self-treatment, but a rather serious procedure that, if performed and prescribed correctly, will bring benefits, and if incorrectly performed, it will harm the body, and can even aggravate the patient's condition or his illness.
2. Therapeutic massage is always a course therapy, which means that you should not count on the fact that after the first procedure or a single session, all diseases will disappear in an instant. On average, as a rule, about ten or even fifteen sessions are prescribed.
3. The frequency of sessions is determined by the doctor and is determined by the nature and degree of the disease. In some situations, therapeutic massage is performed every day, in others - such therapy stretches for several weeks and even months.
4. For medical massage individual approach for each patient, that is, factors such as age, general condition, existing diseases should be taken into account, on the basis of which the doctor writes out a conclusion and determines one or another type of massage.

When is medical massage prescribed?

As mentioned earlier, medical massage should be prescribed only by the attending physician or other highly qualified specialist, based on the patient's condition and disease. It should be recognized that this type of treatment has practically no limits for its application. Its effectiveness has been proven in the following cases:

• diseases of the cardiovascular system (heart disease, coronary disease, angina pectoris);
• high or low blood pressure;
• diseases of the nervous system (atherosclerosis, cerebral palsy, local lesions of the nervous system, osteochondrosis);
• diseases of the musculoskeletal system;
• inflammatory processes in the joints, including chronic ones;
• fractures, bruises, injuries and dislocations in the rehabilitation phase to eliminate their consequences and all kinds of functional disorders(lost joint mobility, formation of scar tissue);
• violation of posture;
• neuritis or neuralgia, which are not in the acute stage;
• salt deposits;
• severe headaches;
• diseases of the digestive tract (gastritis, gastric or duodenal ulcer, colitis, impaired motor function large intestine);
• respiratory diseases (bronchitis, asthma, pneumonia in the recovery phase);
• problems in gynecology, ophthalmology, dermatology;
• ruptures of muscle tissue, which are accompanied by hemorrhages or their necrosis;
• obesity;
• flat feet.

What the patient should know when coming to a therapeutic massage session.

• visit the shower before the massage procedure, as the skin must be clean;
• medical massage is performed at least one hour after the last meal. And, for example, if the abdominal area is massaged, then the session is carried out no earlier than three hours later;
• after the session, it is recommended to lie down for ten minutes and refrain from eating for at least half an hour;
• on the area of ​​the body that will be exposed should not be open wounds- cuts, scratches, burns, otherwise the massage will not only be very painful, but there is also a possibility of infection. By the way, it is for this reason that experts do not advise shaving hair before a massage;
• in order for the effect of the massage to be more effective, do not strain your muscles during the procedure, but, on the contrary, relax them as much as possible;
• before the massage, it is better to remove all jewelry from the body so that they do not interfere with the massage therapist and do not distort the effect of devices during hardware treatment.

Are there any contraindications for medical massage?

There are many more contraindications to medical massage than restrictions to the use of classical or, for example, cosmetic massage. This is due to the fact that other types of massage are done to people not in order to cure any disease, but for the purpose of prevention, prevention of disease, general strengthening of the body, or elimination of not so significant problems.

While therapeutic massage is prescribed to patients, which means to this tool therapy should be approached with particular caution so that it does not harm, but benefits the patient. So, medical massage can not be used in the following cases:

• in the presence of benign or malignant formations;
• during the acute course of any disease, since at this time the body is very weakened, and additional exposure can adversely affect the functioning of its systems and organs;
• at high temperature and acute febrile condition;
• in the presence of various diseases skin, especially if there are any rashes or foci in the place that will be massaged;
• during critical conditions that pose a direct threat to the health and life of the patient (stroke, heart attack, convulsions, etc.);
• with purulent processes in the internal organs;
• after recently stopped bleeding;
• with reduced blood clotting and the patient's predisposition to bleeding;
• with an unstable state of health of the patient (for example, if an exacerbation of the disease occurs every two days or seizures occur);
• at varicose veins veins;
• with a tendency to thrombosis;
• with vascular or cardiac aneurysm;
• with atherosclerosis of the vessels of the brain and peripheral vessels.

It is also not recommended to resort to therapeutic massage if the doctor has not yet put accurate diagnosis. Even if the patient has any symptoms certain disease, it is necessary to carry out all necessary tests and wait for their results.