Classification of massage movements. How to do a back massage
During massage, certain techniques are used, they can be divided into five main groups. These include:
- stroking;
- trituration;
- squeezing;
- kneading;
- vibration.
In turn, techniques can be classified as medium-deep (stroking, rubbing, squeezing), deep (kneading) and shock (vibration).
When conducting a massage, you need to alternate techniques, without taking breaks between them. You should also not massage the lymph nodes during the massage.
Starting to master massage techniques, you can massage your foot, while you will simultaneously recognize and feel what sensations the person being massaged is experiencing.
Massage should be started gently and gently, then it should gradually intensify, and at the end soft, relaxing techniques should be repeated. The number of repetitions of individual massage techniques is different and depends on the individual characteristics of the patient and some other factors (age, health status, etc.). Certain techniques have to be repeated up to 4-5 times, others less often.
The strength and dosage of the massage is of great importance. Rough, hasty, unsystematic and non-rhythmic movements, as well as excessive duration of massage can cause pain, convulsive muscle contractions, irritation of the cerebral cortex and overexcitation of the nervous system. This kind of massage can be harmful.
You should also not start the massage with sudden movements and stop suddenly. The first sessions should not be long and intense, the muscles need special preparation for intense exposure. The muscles of the person being massaged should be relaxed.
It is important to change the force of finger pressure on the body and carefully record the sensations that arise. It is necessary to do such training sessions of massage in order to have a sense of rhythm, in which the hands move continuously, changing one technique to another.
It must be remembered that massage movements should be directed along the lymphatic tract towards the nearest lymph nodes. When massaging the upper limbs, the direction of movement should go from the hand to the elbow joint, then from the elbow joint to the armpit.
When massaging the lower extremities, movements should be directed from the foot to the knee joint, then from the knee joint to the inguinal region.
When massaging the trunk, neck, head, movements should be directed from the sternum to the sides, to the armpits, from the sacrum up to the neck, from the scalp to the subclavian nodes.
When massaging the abdomen, the rectus muscles are massaged from top to bottom, and oblique, on the contrary, from bottom to top.
Massage should start from large areas of the body, and then you need to move on to smaller ones, this sequence helps to improve lymph circulation and blood circulation in the body.
CHAPTER 1. STROKE
This technique is used at the beginning and end of the massage, as well as when changing one technique to another.
Stroking has a significant effect on the body. It cleanses the skin of keratinized scales and remnants of the secretion of sweat and sebaceous glands. As a result of such exposure, skin respiration is cleared, the function of the sebaceous and sweat glands is activated. Metabolic processes in the skin are enhanced, skin tone is increased, as a result of which it becomes smooth and elastic.
It promotes stroking and improves blood circulation, because as a result of the opening of reserve capillaries, the amount of oxygen entering the tissues increases. This technique also has a beneficial effect on blood vessels, making their walls more elastic.
In the presence of edema, stroking helps to reduce it, because it helps the outflow of lymph and blood. Promotes stroking and cleansing of the body, because as a result of this effect, decay products are removed. Stroking is used for pain relief in injuries and other diseases.
The effect of stroking on the nervous system depends on the dosage and methods: deep stroking can excite the nervous system, while superficial stroking, on the contrary, calms.
It is especially useful to perform stroking techniques for insomnia and increased excitability of the nervous system, after heavy physical exertion, with traumatic injuries, etc.
Stroking also helps to relax the muscles before subsequent massage techniques.
When stroking, the hands slide freely over the body, the movements are soft and rhythmic. These techniques never affect the deep layers of muscle mass, the skin should not move. Oil is first applied to the skin, and then, with the help of wide smooth movements, the oil is rubbed into the body, which at the same time relaxes and warms up.
When stroking, the hands are relaxed, they glide over the surface of the skin, touching it very lightly. It is necessary to perform stroking in one direction, as a rule, along the course of the lymphatic vessels and veins. The exception is planar superficial stroking, which can be carried out regardless of the direction of the lymph flow. If there is swelling or congestion, then you need to start stroking from the overlying areas to facilitate the outflow of fluid.
Stroking can be used independently, in the form of a separate massage effect. But most often stroking is used in combination with other massage techniques. Usually the massage procedure begins with stroking. Stroking can end each individual massage.
When performing the stroking technique, it should be remembered that a superficial stroking is always used first, only after it can a deep stroking be applied. When stroking, excessively strong pressure should not be produced, which can cause pain and discomfort in the person being massaged.
Stroking the flexion areas of the limbs should be deeper, it is here that the largest blood and lymphatic vessels pass.
All stroking techniques are performed slowly, rhythmically, approximately 24-26 sliding strokes should be performed in 1 minute. Stroking should not be done with too sharp and fast movements so that the skin does not shift. The surface of the palms should fit snugly against the massaged surface. When performing each stroking session, you can choose only those techniques that will most effectively affect a given area of \u200b\u200bthe massaged body.
STROKING TECHNIQUES AND TECHNIQUES
The two most important stroking techniques are planar and enveloping stroking. You need to make them with the whole brush, putting it on the massaged surface.
Planar stroking is used on even and extensive surfaces of the body, such as the back, abdomen, chest. With such stroking, the hand is relaxed, the fingers should be straightened and closed. Directions
movements may be different. You can perform movements transversely, longitudinally, in a circle or in a spiral. Stroking movements can be performed with both one and two hands (Fig. 65).
Embracing stroking is used to massage the upper and lower extremities, the buttocks, neck, and side surfaces of the body. They make hugging strokes with a relaxed hand, while the thumb should be laid aside, and the remaining fingers should be closed. The brush should tightly wrap around the massaged surface (Fig. 66). Movements can be continuous, or they can be intermittent (depending on the goals).
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Figure 65 |
Stroking can be done with one hand, or with both hands, while the hands should follow in parallel and in a rhythmic sequence. If stroking is performed on large areas in which an excess subcutaneous fat layer is concentrated, pressure can be increased by massaging with a weighted brush. In this case, one brush is superimposed on top of the other, thereby creating additional pressure.
Stroking movements can be superficial and deep.
Surface stroking is characterized by particularly gentle and light movements, has a calming effect on the nervous system, helps muscle relaxation, improves blood circulation and metabolism in the skin.
Deep massage should be done with effort, while pressure is best done with the wrist. This stroking technique helps to remove from tanya of metabolic products, elimination of edema and congestion. After deep stroking, the work of the circulatory and lymphatic systems of the body improves significantly. Figure 66
Stroking, especially planar, can be done not only with the entire inner surface of the palm, but also with the back of two or more folds, the lateral surfaces of the fingers - this depends on the part of the body that is being massaged. For example, when massaging small areas of the facial surface, at the site of callus formation, as well as when massaging the interosseous muscles of the foot or hand, stroking with the pads of the index or thumb can be used. Stroking with the fingertips is used for massaging individual muscles and tendons, for massaging the fingers and face.
When massaging large surfaces of the muscles of the back, chest, thigh, stroking with the palm of your hand or a brush folded into a fist can be used. In addition, stroking can be continuous and intermittent. With continuous stroking, the palm should fit snugly against the massaged surface, as if sliding along it. Such stroking causes inhibition of the reaction from the nervous system, calming it down. In addition, continuous stroking contributes to the outflow of lymph and the destruction of edema.
Continuous stroking can be alternate, while the second hand should be brought over the first, which completes the stroking, and perform the same movements, but in the opposite direction.
When performing intermittent stroking, the position of the hands is the same as with continuous stroking, but the movements of the hands should be short, abrupt and rhythmic. Intermittent stroking has an irritating effect on the nerve receptors of the skin, so this massage excites the central nervous system. Due to this, intermittent stroking can activate the blood circulation of tissues, tones blood vessels and activates muscle activity.
Depending on the direction of stroking movements, stroking can be divided into the following varieties:
- rectilinear;
- zigzag;
- spiral;
- combined;
- circular;
- concentric;
- longitudinal stroking with one or two hands (Finnish version).
When performing rectilinear stroking, movements are made with the palm of your hand, the hand should be relaxed, and the fingers should be pressed against each other, except for the big one, which should be taken a little to the side. The hand should fit snugly against the massaged surface of the body, movements should be made with the thumb and forefinger. They should be light and slippery.
When carrying out a zigzag stroke, the hand should make a quick and smooth zigzag movement directed forward. Zigzag stroking causes a feeling of warmth and calms the central nervous system. You can perform this stroking with different pressure forces.
Spiral stroking is performed without tension, with light and sliding movements, like zigzag. The trajectory of the movement of the hands should resemble a spiral. Such stroking has a tonic effect.
You can combine straight, zigzag and spiral movements into a combined stroke. It is necessary to perform combined stroking continuously in different directions.
When massaging small joints, you can perform circular stroking. Movements should be made with the base of the palm, making circular movements towards the little finger. In this case, the movements with the right hand will be directed clockwise, and the movements with the left hand - counterclockwise.
To massage large joints, you can use a different circular stroking - concentric. The palms should be placed on the massaged area, placing them close to each other. In this case, the thumbs will act on the outer side of the joint, and the remaining fingers on the inner side. Thus, a figure-eight movement is performed. At the beginning of the movement, the pressure should be increased, and towards the end of the movement, slightly loosen. After that, the hands should return to their original position and repeat the movement.
To perform longitudinal stroking, the thumb should be taken as far as possible, then the brush should be applied along the massaged surface. Movement should be done with your fingertips forward. If longitudinal stroking is performed with two hands, the movements must be performed alternately.
When stroking, auxiliary techniques are also used:
- comb-shaped;
- rake-like;
- pincer-shaped;
- cruciform;
- ironing.
Comb-like stroking is used for deep massaging of large muscles in the dorsal and pelvic regions, as well as on the palmar and plantar surfaces. Such stroking helps to penetrate into the depth of massive muscle layers, and is also used for significant subcutaneous fat deposits. Comb-like stroking is performed with the help of bony protrusions of the phalanges of the fingers, half-bent into a fist. The fingers of the hand should be bent freely and without tension, they should not be pressed tightly against each other (Fig. 67). You can perform comb-like stroking with one or two hands.
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Figure 67 |
Rake-like stroking is used when massaging the intercostal spaces, the scalp, as well as on those areas of the skin where it is necessary to bypass the damaged areas.
To perform rake-like movements, you need to spread your fingers and straighten them. The fingers should touch the massaged surface at an angle of 45 degrees. Rake strokes should be carried out in the longitudinal, transverse, zigzag, circular directions. You can perform them with one or two hands. If the movements are performed with two hands, the hands can move
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Figure 68 |
in parallel or in series. To increase the pressure, rake-like movements can be done with weights (the fingers of one hand are superimposed on the fingers of the other hand) (Fig. 68).
Forceps-like stroking is used for massaging tendons, fingers, feet, face, nose, auricles, as well as small muscle groups. Fingers should be folded tongs, and, grabbing a muscle, tendon or skin fold with the thumb, index and middle fingers, make rectilinear stroking movements (Fig. 69).
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Figure 69 |
Cross stroking is commonly used in sports massage and is used when massaging the limbs. Cross-shaped stroking is also carried out in the system of rehabilitation measures after serious illnesses and operations. In these cases, you can do cruciform stroking of the back, pelvic region, buttocks, rear surfaces of the lower extremities. Cruciform stroking helps in the prevention of bedsores. When performing cruciform stroking, the hands must be locked into the lock and grasp the massaged surface. Such stroking is performed with the inner surfaces of the palms of both hands (Fig. 70).
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Figure 71. |
Ironing- the reception is soft and gentle, so it is often used in baby massage (Fig. 71). Ironing is also used to massage the skin and muscles of the face and neck, as well as massage the back, abdomen and soles. Weighted ironing is used to massage the internal organs.
Ironing is performed with one or two hands. The fingers should be bent at the metacarpophalangeal joints at a right angle. If ironing needs to be done with weights, you should put the brush of the other hand on the fingers of one hand clenched into a fist.
CHAPTER 2
After stroking comes the next technique, which has a deeper effect, since during its implementation movement, displacement and stretching of body tissues occur. When rubbing, fingers or hands should not slide over the skin, as when stroking.
Rubbing is widely used in almost all types of massage. Rubbing techniques dilate blood vessels and increase blood circulation, while the local skin temperature rises. This contributes to a better saturation of tissues with oxygen and nutrients, as well as the rapid removal of metabolic products.
Typically, rubbing is applied to areas that are poorly supplied with blood: on the outer side of the thigh, on the sole, heel, as well as at the locations of the tendons and joints.
Rubbing is used for neuritis, neuralgic diseases, because rubbing reduces the excitability of the nervous system, as a result of which the pain sensations characteristic of these diseases disappear.
Rubbing techniques help to heal sore joints, restore them after injuries and injuries.” Rubbing also has a beneficial effect on muscles, making them more mobile and elastic.
By rubbing, which increases tissue mobility, fusion of the skin with underlying surfaces can be avoided. Rubbing helps to stretch adhesions and scars, promote the resorption of swelling and accumulation of fluids in the tissues.
Usually rubbing is performed in combination with other massage movements. When rubbing surfaces with swelling and pathological deposits, rubbing should be combined with stroking. Rubbing is also used before kneading.
Grinding should be done at a slow pace. In 1 minute, from 60 to 100 movements should be made. Without extreme necessity, you can not linger in one area for more than 10 seconds. Longer rubbing of the same area can cause pain in the massaged.
If you need to increase the pressure, rubbing can be done with weights. The pressure increases if the angle between the brush and the massaged surface increases.
When performing rubbing, it is not necessary to take into account the direction of the lymph flow, the direction of movements during rubbing depends only on the configuration of the massaged surface.
RECEPTIONS AND TECHNIQUE OF GRINDING
The main rubbing techniques are rubbing with fingers, the edge of the palm and the supporting part of the hand.
Rubbing with fingers is used for massage of the scalp, massage of the face, intercostal spaces, back, hands, feet, joints and tendons, iliac crests. Rubbing is performed with the help of the fingertips or the back of their phalanges. You can perform rubbing with one thumb, while the remaining fingers should rest on the massaged surface (Fig. 72).
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Figure 72 |
If rubbing is performed with all fingers except the thumb, the thumb or the supporting part of the hand performs the supporting function. Figure 72.
Can be used for rubbing
only the middle finger, performing straight, circular or dashed rubbing with its pad. This method of rubbing is very convenient to use when massaging the intercostal and intermetacarpal spaces.
You can rub with the fingers of one hand or both hands. The second hand can be used for weighting (Fig. 73), or you can perform rubbing movements in parallel.
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Figure 73 |
As mentioned above, the choice of direction during rubbing depends on the configuration of the massaged surface, i.e., on the anatomical structure of the joints, muscles, tendons, as well as on the location of scars, adhesions, edema and swelling on the massaged area. Depending on this, grinding can be carried out in the longitudinal, transverse, circular, zigzag and spiral directions.
Rubbing with the elbow edge of the hand is used to massage such large joints as the knee, shoulder and hip joints. You can apply rubbing with the elbow edge of the brush when massaging the back and abdomen, the edges of the shoulder blades and the iliac crests (Fig. 74).
When rubbing with the ulnar edge of the brush, the underlying tissues should also be displaced, forming a skin fold when displaced.
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Figure 74 |
On large muscle layers, such an intensive technique is used as rubbing with the supporting part of the brush. It is usually used for massage of the back, thighs, buttocks. Rubbing with the supporting part of the brush can be done with one or two hands. With this technique, movements are performed in a straight line or spiral. Depending on the direction of movement, rubbing happens:
- straightforward;
- circular;
- spiral.
Rectilinear rubbing is usually done with the pads of one or more fingers. Rectilinear rubbing should be used when massaging the face, hand, foot, small muscle groups and joints.
Circular rubbing is done with the help of fingertips. In this case, the brush should rest on the thumb or on the base of the palm. It is possible to carry out circular rubbing with the back of all half-bent fingers, as well as with one finger. This method of rubbing can be carried out with weights or alternately with both hands. Circular rubbing is used to massage the back, abdomen, chest, limbs and other parts of the body. Spiral rubbing, used to massage the back, abdomen, chest, limbs and pelvic areas, is performed with the ulnar edge of the hand bent into a fist, or the supporting part of the hand. With this method of rubbing, you can use both brushes or one brush with weights. When rubbing, auxiliary techniques are also used:
Hatching. Properly performed hatching technique helps to increase the mobility and elasticity of the tissues undergoing massage. This technique is used in the treatment of post-burn skin scars, cicatricial
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Figure 75 |
adhesions after other skin injuries, postoperative adhesions, pathological seals. In certain doses, shading can reduce the excitability of the central nervous system, which contributes to the analgesic effect. Hatching is done with the pads of the thumb, index and middle fingers (each separately). Can be carried out
shading with index and middle fingers together. When performing hatching, straightened fingers should be at an angle of 30 degrees to the massaged surface (Fig. 75).
Hatching is done with short and straight strokes. The fingers should not slide over the surface, the underlying tissues are displaced in different directions during the reception.
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Figure 76 |
Planing. This auxiliary rubbing technique is used when
in the treatment of psoriasis and eczema, when it is necessary to exclude the effect on the affected areas of the skin, as well as in the restorative treatment of skin with significant cicatricial lesions. This technique is used to increase muscle tone, since planing has an exciting effect on the neuromuscular system (Fig. 76). positive action has a planing and in the fight against increased body fat in some parts of the body. Planing is done with one or both hands. When performing a massage with two hands, both hands should move sequentially, one after the other. Fingers should be folded together, while they should be unbent at the joints. The pads of the fingers produce pressure, and then the displacement of the tissues.
Sawing. The technique is used to massage the back, thighs, lower leg, abdomen, as well as those parts of the body where large muscles and joints are located.
Sawing should be done with one or two hands. Movements are made by the ulnar edge of the hand. Sawing with one hand should be done in a forward-backward direction, while the underlying tissues are displaced and stretched. If sawing is done with two hands, the hands should be placed on the massaged surface with palms facing each other at a distance of 2-3 cm. They should move in the opposite direction. It is necessary to perform the movement so that the hands do not slip, but move the underlying tissues (Fig. 77).
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Figure 77 |
Crossing. The technique is used when massaging the muscles of the back and abdomen, limbs, cervical region, trapezius muscle. Crossing can be done with one or two hands. Movements are made by the radial edge of the hand, the thumb should be maximally laid aside (Fig. 78).
If the crossing is done with one hand, rhythmic movements should be made from oneself and towards oneself. When performing the reception with two hands, the brushes should be placed at a distance of 2-3 cm from each other. Hands should move in the direction away from you and towards you alternately, displacing the underlying tissues.
Forceps rubbing. The technique is used to massage the face, nose, auricles, tendons and small muscles.
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Figure 78 |
Forcep-like rubbing should be performed with the ends of the thumb and index or thumb, index and middle fingers. The fingers take the form of forceps and move in a circle or in a straight line.
Comb-shaped trituration. This technique is used when massaging the palms and soles of the foot, as well as in areas with large muscles: on the back, buttocks, and the outer surface of the thigh. Comb-like rubbing should be done with a brush clenched into a fist, placing it on the massaged surface with bony protrusions of the middle phalanges of the fingers.
rake-like trituration. The technique is used if it is necessary to bypass the affected areas on the massaged surface. It is used for varicose veins, in order to massage the areas between the veins with spread fingers, without touching the veins themselves.
Apply rake-like rubbing and massage the intercostal spaces, the scalp.
Perform movements with widely spaced fingers, while the pads of the fingers perform rubbing movements in a straight line, circle, zigzag, spiral or hatching. Rake-like rubbing is usually performed with two hands; movements can be made not only with the fingertips, but also with the back surfaces of the bent nail phalanges.
CHAPTER 3
The main massage techniques include the squeezing technique, which is somewhat reminiscent of stroking, but is performed more energetically and with greater speed of movement. Unlike stroking, squeezing affects not only the skin, but also the subcutaneous tissue, connective tissue and upper muscle layers.
Squeezing improves the blood supply to the tissues of the body, enhances the outflow of lymph and helps to get rid of edema and congestion, improves tissue nutrition, increases the temperature in the massaged area, and has an analgesic effect.
Due to its effect on the body, squeezing is widely used in therapeutic, hygienic and sports massage.
Squeezing is usually carried out before kneading. Movement during the squeeze should be directed along the course of the blood and lymphatic vessels. When carrying out squeezing in order to reduce swelling, movements should begin from the area located above the edema and closer to the lymph node. For example, squeezing for swelling in the foot area should be started from the thigh, and then the lower leg, only after that you can proceed to foot massage.
Squeezing should be done slowly and rhythmically, failure to comply with these requirements can lead to pain in the massaged, as well as damage to the lymphatic vessels. Squeezing on the surface of the muscles should occur along the muscle fibers. The pressure force should "depend on which part of the body surface is being massaged. If the massage is performed on a painful area or area with increased sensitivity, as well as at the location of bone protrusions, the pressure force should be reduced. At the locations of large muscles, large vessels , as well as in areas with a thick layer of subcutaneous fat, the pressure must be increased.
RECEPTIONS AND TECHNIQUE OF SPRING
The main methods of squeezing should include:
- transverse squeeze;
- squeezing, carried out by the edge of the palm;
- squeezing, carried out by the base of the palm;
- squeezing, carried out with two hands (with weights).
Cross squeeze. To perform this technique, place the palm across the muscle fibers, press the thumb to the index finger, and press the remaining fingers against each other and bend at the joints. Movements must be made with the base of the thumb and the entire thumb, moving the hand forward.
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Figure 79 |
Squeezing the edge of the palm. To perform the technique, place the edge of the palm across the massaged area (across the direction of the blood vessels), put the thumb on the index finger and move forward. The remaining fingers should be slightly bent at the joints (Fig. 79).
Squeezing with the base of the palm. The hand, palm down, should be placed on the massaged surface along the muscle fibers. The thumb must be pressed to the edge of the palm, moving the nail phalanx to the side (Fig. 80).
The pressure on the massaged surface is produced by the base of the thumb and the base of the entire palm. The remaining fingers should be slightly lifted and taken towards the little finger. Figure 80
Squeezing with two hands is performed with weights. This technique enhances the impact on the massaged area. If weighting is performed perpendicularly, three fingers (index, middle and ring fingers) should put pressure on the radial edge of the thumb of the hand that massages (Fig. 81). If weighting is performed in the transverse direction, the second hand should put pressure on the entire hand, performing massage (Fig. 82).
In addition to the basic squeeze techniques, there is also an auxiliary technique called the beak. Coracoid squeeze is performed in the following several ways:
- ulnar part of the hand;
- the radial part of the brush;
- the front part of the brush;
- the back of the hand.
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Figure 81 |
When performing a beak-shaped squeeze, the fingers should be folded in the shape of a bird's beak, pressing the thumb to the little finger, the index finger to the thumb, put the ring finger on the little finger from above, and place the middle finger over the ring and index fingers. When performing a beak-shaped squeeze with the elbow part of the hand, movements should be made with the edge of the little finger, moving the hand forward (Fig. 83). When performing coracoid squeezing with the radial part of the hand, forward movements should be made with the edge of the thumb (Fig. 84).
CHAPTER 4
This technique is one of the main in massage. More than half of the time allotted for a massage session is spent on kneading. In order for the kneading effect to be more noticeable, the muscles of the person being massaged should be as relaxed as possible.
With the help of kneading, access to the deep muscle layers is provided. When using it, you need to grab muscle tissue and press it against the bones. The capture of tissues is carried out with their simultaneous squeezing, lifting and displacement. The whole process of kneading can be divided into three phases: grabbing the muscle, pulling and squeezing, and then rolling and squeezing.
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Figure 84 |
The kneading technique should be done with the thumbs, fingertips and upper part of the palm. The movements should be short, fast and sliding.
When kneading, you need to strive to capture ever deeper layers of muscle tissue. To increase the pressure, you can use your body weight and laying one hand on top of the other. It is as if squeezing and squeezing the skin of the massaged area is performed.
Kneading should be done slowly, painlessly, increasing its intensity gradually. 50-60 kneading movements should be made per minute. When kneading, the hands should not slip off, and sharp jerks and twisting of the tissues should not be made either.
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Figure 85 |
The movements should be continuous, from the belly of the muscle to the tendon and back, while the muscle should not be released, jumping from one area to another. You need to start the massage from the place where the muscle passes into the tendon.
The positive effect of kneading is that it improves the circulation of blood, lymph and tissue fluid. This significantly increases the nutrition of the tissues of the massaged area, the saturation of tissues with oxygen, and improves muscle tone.
Kneading contributes to the rapid removal of carbon dioxide and lactic acid from the tissues, so kneading is necessary after great physical and sports loads. Kneading significantly reduces muscle fatigue.
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Figure 86 |
With the help of kneading, muscle fibers are stretched, as a result of which the elasticity of muscle tissue increases. With regular exposure, muscle strength increases.
TECHNIQUES AND TECHNIQUES
There are two main methods of kneading - longitudinal and transverse.
Longitudinal stretch. It is usually used to massage the muscles of the limbs, the sides of the neck, the muscles of the back, abdomen, chest, and pelvic areas. Longitudinal kneading should be performed along the course of the muscle fibers that form the belly (body) of the muscle, along the axis of the muscles, through which the tendon of the beginning (head) and the tendon of attachment (tail) are connected (Fig. 87).
Before carrying out longitudinal kneading, straightened fingers should be placed on the massaged surface so that the thumb is on the opposite side of the massaged area from the rest of the fingers. Having fixed the fingers in this position, you should lift the muscle and pull it back. Then you need to make kneading movements directed to the center. You can not let go of the muscle even for a moment, the fingers should tightly wrap around it. First, the pressure on the muscle should be towards the thumb, and then the thumb exerts pressure on the muscle towards the rest of the fingers. Thus, the muscle is under pressure from two sides.
You can perform longitudinal kneading with both hands, while all movements are performed alternately, one hand moves after the other. Movements are made until the entire muscle is completely warmed up.
You can carry out longitudinal kneading with intermittent movements, jumps. With this method, the brush massages individual sections of the muscle. Usually, intermittent kneading is used when it is necessary to bypass the affected areas of the skin, as well as to stimulate the activity of the neuromuscular apparatus.
Cross kneading. It is used for massage of the limbs, back and abdomen, pelvic and cervical areas.
With transverse kneading, the hands should be placed across the muscle that is being kneaded. The angle between the hands superimposed on the massaged surface should be approximately 45 degrees. The thumbs of both hands are located next to one side of the massaged surface, and the remaining fingers of both hands - on the other side. All kneading phases are performed simultaneously or alternately. If kneading is performed simultaneously, both hands move the muscle in one direction (Fig. 88), while in the case of alternating transverse kneading, one hand must move the muscle towards itself, and the other away from itself (Fig. 89).
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Figure 89 |
If kneading is carried out with one hand, the other hand can be used for weighting (Fig. 90).
Start transverse kneading should be from the abdomen (body) of the muscle. Further, the movements should be gradually directed towards the tendon.
It is better to knead the muscle and tendon with one hand longitudinally, therefore, approaching the tendon, the other hand can be removed and the kneading can be completed with one hand. After the tendon and the place of attachment of the muscle have been massaged, you can start moving in the opposite direction, in this case, you need to put a second, free hand on the muscle and perform transverse kneading with both hands. One muscle should be massaged in this way several times, changing the transverse kneading to the longitudinal one.
Varieties of longitudinal and transverse kneading include:
- ordinary;
- double ordinary;
- double neck;
- double ring;
- double ring combined kneading;
- double ring longitudinal kneading;
- ordinary-longitudinal;
- circular;
- kneading with the base of the palm with a roll.
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Figure 90 |
Ordinary dissection. This type of kneading is used to massage the muscles of the neck, large dorsal and gluteal muscles, the front and back of the thigh, the back of the lower leg, shoulder, and abdomen.
When performing ordinary kneading, the muscle must be very tightly grasped across with straight fingers. Then the muscle should be lifted, moving the thumb and all other fingers towards each other. The fingers should move with the muscle, not slide over it. The next step is to return the muscle to its original position. At the same time, the fingers should not let go of the muscle, the palm should fit snugly against the muscle. Only when the muscle takes its original position, the fingers can be unclenched. So massage all parts of the muscle.
Double ordinary kneading. This approach effectively stimulates
cervical activity.
When massaging the muscles of the back surface of the lower leg and shoulder, the person being massaged should lie on his back. If the thigh muscles are massaged, the leg should be bent at the knee.
The difference between this technique and the usual ordinary kneading is that with two hands you need to alternately carry out two ordinary kneadings. In this case, the movements should be directed from the bottom up.
Double neck. This method is used to massage the muscles of the anterior and posterior surfaces of the thigh, the oblique muscles of the abdomen, the muscles of the back and buttocks, and the muscles of the shoulder.
A double bar is performed in the same way as an ordinary kneading, but the double bar must be carried out with weights. There are two options for the double neck.
1 option. When performing this version of the double neck, the brush of one hand is weighed down by the other so that the thumb of one hand presses on the thumb of the other hand. The remaining fingers of one hand apply pressure to the fingers of the other hand.
Option 2. The double bar in this variant is performed with weighting the base of the palm of one hand on the thumb of the other hand.
Double ring kneading. It is used for massage of the trapezius muscles, abdominal muscles, chest, latissimus dorsi, muscles of the limbs, neck and buttocks. When massaging flat muscles, double ring kneading cannot be used due to the impossibility of pulling these muscles up.
It is more convenient to do this kneading by laying the person being massaged on a flat surface. The person being massaged should relax the muscles as much as possible. The hands of both hands should be placed on the massaged area so that the distance between them is equal to the width of the brush. The thumbs should be located on the opposite side of the massaged surface from the rest of the fingers.
Next, you should grab and lift the muscle with straightened fingers. In this case, one hand displaces the muscle in the direction away from itself, and the other - towards itself. Then the direction is reversed. You should not release the muscle from your hands, this kneading should be done smoothly, without sudden jumps, so as not to cause pain to the person being massaged.
Double ring combined kneading. The technique is used when kneading the rectus abdominis muscles, the latissimus dorsi, gluteal muscles, pectoralis major muscles, thigh muscles, back of the lower leg, and shoulder muscles. This technique is similar to the double ring kneading technique. The difference is that when performing double ring combined kneading, the right hand performs ordinary kneading of the muscle, and the left hand kneads the same muscle. For the convenience of performing this technique, you should put the index finger of your left hand on the middle finger of your right hand. The movements performed by each hand must be made in opposite directions.
Double ring longitudinal kneading. It is used for massage of the front surface of the thigh and the back of the lower leg.
To perform this kneading technique, you need to put your hands on the massaged area, squeezing your fingers together (thumbs should be moved to the sides). Having seized the muscle with both hands, one should make circular movements with the fingers, the hands should move towards each other. Having met, they continue to move, moving away from each other at a distance of 5-6 cm. Thus, you need to massage all parts of the muscle.
When massaging the right thigh and left shin, the right hand should be placed in front of the left, and when massaging the left thigh and right shin, in the reverse order.
Ordinary-longitudinal kneading. The technique is used to knead the back of the thigh.
This technique combines ordinary and longitudinal kneading: longitudinal kneading is used to massage the outer surface of the thigh, and ordinary (transverse) kneading is used to massage the inner surface.
Circular kneading can be divided into the following subspecies:
- round-shaped beak-shaped;
- circular kneading with the pads of four fingers;
- circular kneading with the pad of the thumb;
- circular kneading with phalanges of fingers clenched into a fist;
- circular kneading with the base of the palm.
Circular coracoid kneading is used to massage the long and latissimus dorsi muscles, neck muscles and limb muscles.
When performing this technique, the fingers are folded in the shape of a bird's beak: press the index and little fingers to the thumb, place the ring finger on top, and then the middle finger. When massaging, the hand moves in a circular or spiral fashion towards the little finger. You can carry out such kneading with the hands of both hands alternately.
Circular kneading with the pads of four fingers. The technique is used for massage of the back muscles, neck muscles and muscles of the limbs, as well as for head massage. Kneading should be carried out with the pads of four fingers, placing them diagonally to the muscles. The thumb should be located along the muscle fibers. He does not take a direct part in kneading, he only glides over the surface, and the pads of four fingers press on the massaged surface, making circular movements towards the little finger.
Circular kneading with the pad of the thumb. The technique is used for massage of the spinal muscles, muscles of the limbs and sternum.
The reception is performed with the pad of the thumb in the same way as the circular kneading with the pads of four fingers, only in this case the four fingers do not take any part in kneading.
Reception can be performed with one hand, making circular movements with the thumb towards the index finger. The pressure of the finger on the massaged surface should be different, the strongest at the beginning, and weaker when the finger returns to its original position. Every 2-3 cm, you should move your finger to a new area of the massaged surface in order to stretch the entire muscle in this way. When performing this technique, it is necessary to ensure that the thumb does not slide over the surface, but moves the muscle. Reception can be performed with two hands alternately or with one hand with weights.
Circular kneading with phalanges of fingers clenched into a fist. The technique is used for massage of the muscles of the back, limbs, sternum. It is also used for massage of the anterior tibial and calf muscles, but in this case the massage is performed with both hands. When carrying out this kneading technique, the phalanxes of the fingers bent into a fist put pressure on the muscle, and then shift it in a circular motion towards the little finger. When performing the reception with two hands, the brushes, clenched into a fist, should be placed on the massaged surface at a distance of about 5-8 cm from each other. Circular movements towards the little finger are made with two hands alternately. You can perform this technique with one hand with weights.
Circular kneading with the base of the palm. Reception is used to massage the muscles of the back, buttocks, limbs, sternum. Circular movements are performed with the base of the palm towards the little finger. You can perform this technique with both hands, placing them on the massaged surface at a distance of 5-8 cm from each other. You can perform kneading with one hand with weights.
Kneading with the base of the palm with a roll. The technique is used for massage of the deltoid muscles, long muscles of the back, pectoralis major muscles,
muscles. The brush with fingers pressed to each other is located palm down along the muscle fibers. Raising your fingers, you should apply pressure, rolling the brush from the base of the thumb to the base of the little finger through the base of the palm. So it is necessary to move further throughout the muscle.
In addition to the above methods, there are auxiliary methods:
- wallow;
- rolling;
- shift;
- stretching;
- pressure;
- compression;
- twitching;
- tong-like kneading.
Wallow. Typically, the technique is used to massage the muscles of the shoulder and forearm, thigh and lower leg. In addition, due to the gentle effect of felting, it is used for damage to muscle fibers and blood vessels as a result of injuries, for sclerotic lesions of blood vessels, etc. A two-handed technique is performed. The brushes of both hands should be clasped on both sides of the massaged area, while the hands are parallel to each other, the fingers are straight. The movements of each hand are performed in opposite directions, the hands should be gradually moved over the entire area of the massaged surface (Fig. 91).
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Figure 91 |
Rolling. The technique is used when massaging the anterior wall of the abdomen, as well as the muscles of the lateral surfaces of the back, chest, in the presence of significant fat deposits, with muscle flabbiness. When massaging the abdominal muscles, you should first relax the muscles by performing a planar circular stroking of the massaged surface of the abdomen. After that, place the edge of the palm of the left hand on the surface of the abdomen and try to deeply immerse it in the thickness of the abdominal wall. With your right hand, grab the soft tissues of the abdomen and roll them onto the left hand. Knead the captured part in a circular motion, and then proceed to rolling the areas located nearby (Fig. 92).
Shift. The reception is usually used for massage of long muscles for the treatment of scar formations, skin diseases, in the treatment of paralysis and paresis. The shift enhances blood circulation and lymph flow, improves metabolism in tissues, this technique warms the tissues and has a stimulating effect on the body. Figure 92
When performing the shifting technique, it is necessary to lift and grab the massaged area with the thumbs of both hands, and then move it to the side. It is possible, without grabbing the tissue, to press on the massaged surface and move the tissues towards each other with the help of the palms or fingertips. It should be moved both in the longitudinal and transverse directions.
With the help of capture, the pectoralis major and gluteal muscles are shifted. When massaging the muscles of the back, it is not necessary to capture when shifting. The shift of the sternocleidomastoid muscles occurs with the help of a forceps grip.
When massaging the tissues of the cranium, the hands are superimposed on the forehead and the back of the head, with light pressure, the hands should alternately move slowly from the forehead to the back of the head. If the frontal plane of the skull is being massaged, the brushes should be applied to the temples. In this case, the shift occurs towards the ears.
When massaging the hand, the shifting of the interosseous muscles of the hand occurs as follows. Fingers of both hands should grab the brush massaged by the radial and ulnar edge. With short movements, the fabrics move up and down. In a similar way, you can shift the muscles of the foot (Fig. 93).
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Figure 93 |
Stretching. This technique has an effect on the nervous system, with the help of it they treat paralysis and paresis, scars after injuries and burns, postoperative adhesions.
As with the shift, you should grab the muscle, and if this is not possible, put pressure on it. Then you need to push the tissues in opposite directions, while the muscles are stretched (Fig. 94). You should not make sudden movements, because this can cause pain to the person being massaged.
To capture a large muscle, the entire hand should be used, small muscles should be grasped with forceps with fingers. If the muscles cannot be grasped (flat muscles), they must be smoothed out with the fingers or palm, thus also stretching occurs. When stretching adhesions and scars, use the thumbs of both hands, placing them against each other. To stimulate muscles in paresis and paralysis, it is advisable to alternate rhythmic passive stretching with gentle passive stretching, directing movement in the direction of muscle contraction. This procedure has a positive effect on the tendons of the muscles. Figure 94
pressure. With the help of this technique, tissue receptors are excited, as a result of which tissue nutrition and blood supply are improved. It also exerts pressure on the internal organs, activating the secretory and excretory functions of the body, as well as the peristalsis of the internal organs.
Pressure is used in the treatment of diseases of the musculoskeletal system (injuries to the spine, the consequences of bone fractures, etc.).
This technique is performed with intermittent pressures, the pace of movements is different - from 25 to 60 pressures per minute.
Pressing can be done with the palm or the back of the fingers, the fingertips, the supporting part of the palm, as well as the brush clenched into a fist.
While massaging the anterior wall of the abdomen, it is best to press with the palmar or back surface of the fingers or fist at a pace of 20-25 times per 1 minute. At the same pace, you can massage the internal organs. When massaging the abdomen, you can use pressure with weights. When massaging the back, in order to activate muscle activity, pressure should be applied in the region of the spine. In this case, the hands should be placed across the spinal column, the distance between the hands should be approximately 10-15 cm, while the fingers should be placed on one side of the spinal column, and the wrists on the other. Rhythmic movements (20-25 movements in 1 minute) should move the hands up the spinal column to the cervical region, and then down to the sacrum, thus applying pressure in the muscles along the entire spinal column (Fig. 95).
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Figure 95 |
The mimic muscles of the face are massaged with the palmar and back surfaces of the fingers folded together. For 1 minute it is necessary to produce approximately 45 pressures.
Massage of the scalp can be done with fingertips, placing them rake-like, producing 50 to 60 pressures in 1 minute.
You can also press the scalp with the palmar surface of the hands, clasping the head with the palms on both sides. With this method, 40 to 50 movements should be performed in 1 minute.
Compression. The technique is used for massaging the muscles of the trunk and limbs. Compression promotes activation of blood circulation and lymph flow, increases blood supply to muscles, increases muscle tone and improves their contractile work.
Compression is used during facial massage in order to improve the nutrition of the skin. As a result, there is an increase in the tone of facial muscles, the skin becomes more elastic and supple. Compression should be made with short squeezing movements of the fingers or the hand (Fig. 96).
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Figure 96 |
The pace during the reception should be about 30-40 movements in 1 minute. Compression during facial massage should be performed at a pace of 40 to 60 movements in 1 minute.
Twitch. This technique is used during facial massage in order to activate the work of facial muscles, as well as to increase the elasticity and firmness of the skin of the face. Twitching is also used for flabbiness of the muscles of the anterior wall of the abdomen, in the treatment of paresis and paralysis of the muscles of the upper and lower extremities.
Twitching is also used in the treatment of scars after burns and injuries, as well as postoperative adhesions, since this technique improves skin mobility and elasticity.
Twitching should be performed with two fingers: thumb and forefinger, which should grab a piece of tissue, pull, and then release it. You can twitch with three fingers: thumb, index and middle. The rate of twitches should be from 100 to 120 movements in 1 minute. You can perform movements with one or two hands.
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Figure 97 |
Forceps kneading. This technique is used to massage the muscles of the back, chest, neck, face. Forceps kneading is good for massaging small muscles and their outer edges, as well as tendons and muscle heads. The reception should be performed with the thumb and forefinger, folded in the form of tongs (Fig. 97). You can also use your thumb, index and middle fingers. Forceps kneading can be transverse or longitudinal. When performing transverse forceps kneading, the muscle must be grasped and pulled. Then, with alternating movements from yourself and towards you, knead the muscle with your fingers. If longitudinal forceps kneading is performed, the muscle (or tendon) should be grasped with the thumb and middle fingers, pulled, and then kneading between the fingers in a spiral manner.
CHAPTER 5. VIBRATION
Massage techniques in which vibrations of different speeds and amplitudes are communicated to the massaged area are called vibration. The vibrations propagate from the massaged surface to the deeper muscles and tissues of the body. The difference between vibration and other massage techniques is that under certain conditions it reaches deep-lying internal organs, vessels and nerves. The physiological effect of vibration on the body is characterized by the fact that it enhances the reflex reactions of the body, depending on the frequency and amplitude, it can expand or increase blood vessels. Vibration is used to lower blood pressure and reduce heart rate. After fractures, vibration reduces the time of callus formation. Vibration is capable of changing the secretory activity of some organs. When carrying out vibration, it should be remembered that the strength of the impact of the reception depends on the angle between the massaged surface and the massage therapist's brush. The impact is stronger, the larger this angle. To maximize the impact of vibration, the brush must be positioned perpendicular to the massaged surface. Vibration should not be performed in one area for more than 10 seconds, while it is desirable to combine it with other massage techniques. Vibrations with a large amplitude (deep vibrations), which take a short time, cause irritation on the massaged area, and long-term vibrations with a small amplitude (small vibrations), on the contrary, soothe and relax. Conducting vibration too intensely can cause pain in the massaged person. Intermittent vibrations (knocking, chopping, etc.) on unrelaxed muscles also cause pain in the person being massaged. It is impossible to carry out intermittent vibrations on the inner surface of the thigh, in the popliteal region, in the region of the heart and kidneys. Particular care should be taken to perform intermittent vibrations when massaging the elderly. Painful sensations can be caused by intermittent vibration while performing it with both hands. Caution should also be observed when performing the shaking technique. The use of this technique on areas of the upper and lower extremities without observing the direction of movement can lead to damage to the joints. In particular, shaking of the upper limbs leads to damage to the elbow joint if it is performed not in a horizontal, but in a vertical area. It is impossible to shake the lower limb bent at the knee joint, this can lead to damage to the bag-ligamentous apparatus. Manual vibration (with the help of hands) usually causes a quick fatigue of the massage therapist, so it is more convenient to produce hardware vibration. RECEPTIONS AND TECHNIQUE OF VIBRATION Vibration techniques can be divided into two types: continuous vibration and intermittent vibration. Continuous vibration is a technique in which the massage therapist's brush acts on the massaged surface without breaking away from it, transmitting continuous oscillatory movements to it. Movements must be performed rhythmically. You can perform continuous vibration with the pads of one, two, and also all fingers of the hand; palmar surface of the fingers, back of the fingers; palm or the supporting part of the palm; brush, bent into a fist. The duration of continuous vibration should be 10-15 seconds, after which stroking techniques should be performed for 3-5 seconds. l It is necessary to start performing continuous vibration at a speed of 100-120 vibrational movements per 1 minute, then the vibration speed must be gradually increased so that by the middle of the session it reaches 200 vibrations per minute. Towards the end, the speed of the vibrations should be reduced. When performing continuous vibration, not only the speed must change, but also the pressure. At the beginning and at the end of the session, the pressure on the massaged tissues should be weak, in the middle of the session - deeper. Continuous vibration can be performed longitudinally and transversely, zigzag and spirally, as well as vertically. If during vibration the hand does not move from one place, the vibration is called stable. Stable vibration is used for massage of internal organs: stomach, liver, heart, intestines, etc. Stable vibration improves cardiac activity, enhances the excretory function of the glands, improves the functioning of the intestines, stomach. There is also point vibration - stable vibration performed Figure 98
with one finger (Fig. 98). Point vibration, acting on the peripheral
smooth endings, helps to reduce pain in myositis, neuralgia.
Use point vibration in the treatment of paralysis and paresis, with
innovative treatment after fractures, since point vibration contributes to the accelerated formation of callus. Continuous vibration can be labile, with this method the massage therapist's hand moves over the entire massaged surface (Fig. 99).
Apply labile vibration in the treatment of paralysis, to restore weakened muscles and tendons. They produce a labile vibration along the nerve trunks.
Continuous vibration can be performed with the pad of one finger (point vibration). It is possible to carry out vibration with the entire back or palmar side of the finger, this method is widely used in the treatment of paresis of facial muscles, with trigeminal neuralgia, as well as in cosmetic massage.
You can perform continuous vibration with your palm. This method is used to massage the internal organs (heart, stomach, intestines, liver, etc.). It is necessary to produce vibration at a pace of 200-250 vibrations per 1 minute, the movements should be gentle and painless. When massaging the abdomen, back, thighs, buttocks, continuous vibration can be applied with fingers clenched into a fist. With this method, the hand, folded into a fist, should touch the massaged surface with the phalanges of four fingers or the ulnar edge of the hand. Such vibrations must be performed longitudinally or transversely. Continuous vibration can be performed with tissue capture. This technique should be used when massaging muscles and tendons. Small muscles and tendons are grasped with fingers in a forceps-like manner, and large muscles are grasped with a brush.
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Figure 99 |
Auxiliary methods should be attributed to continuous vibration:
shaking;
- shaking;
- push;
- concussion.
Shaking. The reception is used in the rehabilitation treatment of muscles after fractures, with paralysis and paresis, since the main feature of shaking is the activation of the contractile activity of the muscles. Shaking increases lymph flow, so it is often used to reduce swelling. Shaking is used to treat damaged soft tissues, to smooth out traumatic scars and postoperative adhesions, and it is also used as an anesthetic. Before performing the shaking technique, the muscles of the person being massaged must be relaxed. The fingers should be spread wide and wrap around the area to be massaged. Then you should perform shaking movements in the longitudinal or transverse direction (Fig. 100). Movement should we must be rhythmic, they should be performed at different speeds, increasing to
When shaking the lower limb with one hand, you need to fix the ankle joint, and with the other hand grab the instep of the foot and slightly pull the leg. In this case, it is necessary to ensure that the leg is straight. Then you should rhythmically produce oscillatory movements.
When carrying out shaking of the limbs in the elderly, special care should be taken.
Nudge. The technique is used to massage the internal organs.
To perform the technique, put the left hand on the area of the organ that
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Figure 102 |
you need to subject it to indirect massage, and lightly press, fixing the hand in this position. Then, with the right hand, make short pushing movements, pressing on the nearby surface, as if pushing the massaged organ towards the left hand (Fig. 103). Oscillatory movements must be performed rhythmically.
Shake. It is used for indirect massage of internal organs (liver, gallbladder, stomach, etc.).
When performing a concussion, the right hand must be fixed on the body in the area where the internal organ is located, which must be traced. The left hand should be placed on the massaged surface parallel to the right so that the thumbs of both hands are located side by side. Fast and rhythmic
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Figure 103 |
movements (either bringing the hands together, then moving them away from each other), it is necessary to oscillate the massaged surface in the vertical direction.
Concussions of the abdomen are used to dissolve adhesions in the abdominal cavity, to enhance intestinal motility, in chronic gastritis with secretory insufficiency, to increase the tone of the smooth muscles of the abdominal wall, etc.
When performing a concussion of the abdomen, both hands should be positioned so that the thumbs are on an imaginary line crossing the navel, and the remaining fingers wrap around the sides. Then you should make oscillatory movements horizontally and vertically (Fig. 104).
Concussion of the chest. This technique helps to improve blood circulation and increase the elasticity of the lung tissue, so it is used for diseases of the respiratory system. Chest concussion is used for chest injuries, osteochondrosis, etc.
When performing this technique with the hands of both hands, you need to grab the chest on the sides and perform oscillatory movements in the horizontal direction. Movements must be performed rhythmically (Fig. 105).
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Figure 104 |
Concussion of the pelvis. The technique is used to treat adhesive processes in the pelvic area, osteochondrosis and spondylosis, etc.
The reception should be performed with the massaged person lying on his stomach or back. The pelvis should be clasped with the hands of both hands so that the fingers are located on the lateral surfaces of the iliac bones. Oscillatory movements should be carried out rhythmically in a horizontal direction, slowly moving the hands towards the spine.
Intermittent vibration. This type of vibration (sometimes also called percussion) consists of single strikes that must be performed rhythmically, one
after another. Unlike continuous vibration, the massage therapist's hand separates from the massaged surface after each individual stroke. Figure 105
When performing intermittent vibration, blows should be applied with the tips of the fingers, half-bent at the joints. You can strike with the ulnar edge of the palm (edge of the palm), with a hand clenched into a fist, with the back surface of the fingers. It is possible to produce shock vibration both with one hand and with two hands alternately.
Basic Intermittent Vibration Techniques:
- puncture;
- tapping;
- hacking;
- pat;
- quilting.
Punctuation. This technique should be used on small areas of the body surface, where the subcutaneous fat layer is practically absent (for example, on the face, in the chest area), in places where callus is formed after fractures, on ligaments, tendons, small muscles, in places where important nerve trunks exit.
Puncture should be done with the pads of the index and middle fingers together or with each of these fingers separately. You can perform this technique with four fingers at the same time. It is possible to perform punctuation reception both simultaneously and sequentially (like ~ typing on a typewriter). One or both hands can be used for puncturing (Fig. 106).
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Figure 106 |
When massaging the muscles of the limbs and the scalp, puncture with movement (labile) can be used. Movements during labile puncture should be performed in the direction of the massage lines to the nearby lymph nodes.
Punctuation without movement (stable) is performed in the places of formation of callus after fractures.
To make the impact of puncture deeper, it is necessary to increase the angle between the finger (fingers) that produces the puncture and the massaged surface.
The speed of movements during puncturing should be from 100 to 120 beats per 1 minute.
tapping. This technique has a positive effect on the skeletal and smooth muscles, causing its rhythmic reflex contraction. As a result of this, there is an improvement in the blood supply to tissues, and their elasticity increases. Most often, tapping together with kneading is used for paresis and muscle atrophy.
When tapping, one or more fingers, the palmar or back of the hand, as well as a hand clenched into a fist should be struck. Usually tapping is performed with the participation of both hands. It is necessary to perform tapping with a brush relaxed in the wrist joint.
Tapping with one finger. This tapping method should be used when massaging the face, in places of fractures, on small muscles and tendons.
You need to perform this technique with the back surface of the index finger or its ulnar edge. The rate of beats should be from 100 to 130 beats per 1 minute. Strikes should be made with a hand relaxed in the wrist joint.
Tapping with several fingers. The technique is used for facial massage
by the method of circular effleurage (“staccato”), as well as during massage of the hairy
parts of the head.
This technique should be performed with the palmar surface of all fingers, straightening the straightened fingers in the metacarpophalangeal joints as wide as possible. Tapping should be done alternately, as when playing the piano. You can also tap with the back of your fingers.
Reception can be performed simultaneously with all fingers, using the palmar surface of the ends of four fingers.
Tapping with bent fingers. The reception should be used with a mass "in places of a significant muscle layer: on the back, hips, buttocks. This technique improves muscle tone, activates the secretory and vascular nerves. When performing the reception, the fingers should be freely bent so that the index and middle lightly touch the palm , and inside the bent brush there was free space.Strikes should be applied with the back of the bent fingers, placing the brush across the massaged surface (Fig. 107).
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Figure 107 |
punching. Reception should be used in locations
significant muscle layers: on the back, buttocks, thighs.
When performing the reception, the hands and muscles of the forearm of the massager should be as relaxed as possible, otherwise the massaged person will experience pain. The fingers must be freely bent into a fist so that the ends of the fingers lightly touch the surface of the palm, and the thumb is adjacent to the index finger without tension. The little finger needs to be slightly removed from the rest of the fingers and relaxed. The blows are applied with the ulnar surface of the fist, the brushes, upon impact, fall perpendicularly onto the massaged surface (Fig. 108).
Chopping. The reception has an effect on the skin, improves blood circulation, as a result of which the flow of oxygen and nutrients to the massaged areas increases. The lymph flow increases, metabolism and the work of the sweat and sebaceous glands improve.
Chopping has a positive effect on muscles, especially smooth and striated.
The fingers should be slightly relaxed and slightly moved away from each other. The forearms should be bent at a right or obtuse angle. The brushes should rhythmically strike the massaged surface, at the moment of impact, the fingers are connected to each other. Strokes with the fingers initially closed can be painful for the massaged person, the free space between the fingers softens the blow. You need to place the brushes along the muscle fibers (Fig. 109). Chopping blows should be made at a speed of 250 to 300 blows per 1 minute.
Pat. Reception promotes vasodilation, with its help you can reduce the sensitivity of nerve endings and increase the temperature on the massaged surface.
Patting should be used when massaging the chest, abdomen, back, thighs, buttocks, limbs.
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Figure 110 |
You need to pat with the palmar surface of the hand, slightly bending your fingers so that when you strike, an air cushion forms between the brush and the massaged surface - this will soften the blow and make it painless
(rice, 110). The arm must be bent at a right or obtuse angle. Blows are applied with one or two hands when they are bent at the wrist joint. Quilting. The technique is used in cosmetic massage to increase elasticity. Figure 111
guests skin elasticity. Quilting is used in therapeutic massage for paresis
muscles, in the treatment of obesity, cicatricial tissue changes. Quilting enhances
blood circulation of the massaged surface, improves metabolic processes.
When performing a technique, blows are applied with the edge of the palm, one or more
fingers (Fig. 111). On large areas of the body, quilting is done with the entire surface of the palm.
Classical massage is an excellent way to treat and prevent many diseases. With the help of the correct implementation of the basic techniques, you can get rid of pain, adhesions, swelling, activate blood circulation, eliminate cosmetic ailments, and also normalize the process of tissue regeneration. It is possible to restore vitality, working capacity and strengthen joints without taking medicines.
Basic principles
Classical massage originated in the nineteenth century, its basic principles were developed by Russian clinicians. For massage, movements should be soft, capturing a large surface. In the middle of the massage, the force of the impact on the area should increase, and at the end, soft stroking movements are required again. It is this effect on the human body that provides the best blood supply for all layers of tissues.
The main rule when conducting a classic massage is to make massage movements in the direction of the lymphatic tract, from the periphery to the lymph node. The classic massage begins with warming the body, and then gradually begin to massage small areas.
With classical massage, techniques are performed that have both mechanical and reflex effects on the human body.
Classical massage is used for prophylactic purposes against a variety of diseases, to maintain working capacity for a long time, for the general improvement of the body.
In classical massage, the back, legs, arms, chest and other parts of the body are massaged.
Classical massage allows the patient to feel fresh and feel great. And the reason for this is the improved functioning of all organs of the body and the cessation of tension in the muscles.
An experienced massage therapist will return all the patient's muscles to the proper tone, producing a classic massage. With this type of massage, the patient completely relaxes, and the massage, stimulating blood circulation processes, returns the patient to a full life.
Classical massage removes toxins from the body, breaks down fats and activates the metabolic process in the body. At the same time, the skin condition improves significantly, the muscles become more elastic literally after several massage sessions.
Since classical massage activates the natural abilities of the human body, it makes it possible to restore the functioning of internal organs.
Classical massage also helps with joint diseases. In addition, with the help of classical massage, diseases of the nervous system and digestive system can be cured, this type of massage helps to improve the respiratory process, it corrects the problems of the musculoskeletal system.
Classical massage helps to recover much faster after injuries, it helps the patient with increased stress on the body and mind.
Classical massage technique
1. Any massage always starts with stroking. It should be performed with a palm with constant pressure of low intensity, and the masseur's hand movements are directed towards the nearest large lymph nodes. The main purpose of stroking is to warm up the skin and subcutaneous structures, to prepare them for more intense exposure methods.
2. Stroking is followed by rubbing - performed with the palm of the hand, knuckles, thumbs or the edge of the palm. Rubbing is performed with perceptible pressure on the skin of the person being massaged at the level of the threshold of pain sensitivity, the goal is to affect the skin and deep tissues.
There are many options for performing this technique - superficial and deep, tong-shaped and spiral, comb-shaped and with pressure with two hands.
3. After rubbing, we proceed to kneading. In principle, it is this technique in the case of therapeutic and sports massage of the back, limbs and collar zone that can be called the main one in terms of depth and intensity of exposure. Our task is to grab and knead deeply located muscles and tissues with our hands, increase their mobility, improve the outflow of venous blood and lymphatic drainage.
Kneading is a difficult technique, it is impossible to learn it remotely, because the masseur must determine the state of the muscle fibers with his fingertips. Kneading should be carried out on relaxed muscles, and in the case when they are tense, it is worth achieving relaxation by stroking and rubbing.
4. Vibration - the last technique of the main phase of the massage. It is performed by shaking, tapping and patting on the body of the person being massaged. The goal is to stimulate the neuromuscular apparatus and deep receptors, to enhance the processes of blood supply to tissues.
Massage Sequence
For effective massage, and to achieve the desired therapeutic effect, it is extremely necessary to follow the sequence of massage movements.
- back
- back of left leg
- back of right leg
- patient rolls over
- anterior surface of the right leg
- anterior surface of the left leg
- left hand
- right hand
- stomach
- neck-collar zone
- head
This order represents the standard by which massage procedures should be carried out. But in any case, the time you spend on each part of the body depends solely on the individual needs of the individual patient. Most importantly, you need to ensure that the massage affects all areas of the body, and distribute an equal amount of time on the right and left parts: it means that the right leg should be massaged in exactly the same way as the left. The same goes for the hands. The patient should not have the feeling that any part of the body has not been properly treated.
Classical facial massage - technique
The duration of one session is from 5 to 15 minutes, which is mainly determined by the thickness and sensitivity of the skin. The thinner the tissue, the less time is spent on massaging. Usually a course of 15 or 50 sessions is prescribed, between which an interval of 1 to 2 days must be observed. But, no one will limit the number of procedures that you can carry out at home on your own. You can do them, for example, after a bath, before going to bed.
Rules
The main thing, in order not to harm your skin, you must follow the rules for performing massage:
- conduct a session only on cleansed and warmed skin, with warm hands;
- only gentle and careful movements - no strong pressure, pulling, jerking, twisting and the like;
- you can direct your palms strictly along the massage lines, ingenuity is not needed here; - it is necessary to use oil or cream to lubricate the skin.
Massage lines
Movements can be made in the following directions:
- from the corners of the mouth - to the earlobe;
- from the middle of the chin along the circumference of the lower jaw - to the earlobe;
- from the bottom of the wings of the nose - to the top of the auricle;
- from the top of the wings of the nose to the top of the ear;
- along the lower edge of the orbit, from the outer corner of the upper eyelid to the inner;
- under the eyebrow, from a point above the inner corner of the eye - to the outer corner;
- from the point of the base of the nose, above the eyebrows - to the temples;
- from the same point above the superciliary arches and temples;
- from the base of the nose up to the hairline;
- the base of the nose is its tip;
- from the back of the nose along its lateral surfaces - to the cheek.
Effects of classic facial massage
Regular facial massage allows you to:
- prevent wrinkles;
- improve skin tone;
- improve blood circulation and lymphatic drainage;
- increase the shape of the eyes and the volume of the lips;
- tighten the skin of the forehead, cheeks and chin;
- remove swelling from the eyes;
- significantly rejuvenate the skin of the face;
- improve the condition of the teeth;
- improve eyesight;
- improve complexion;
- warm up the muscles, while making the skin and muscles soft and sensitive.
Contraindications
Despite the fact that the classical massage technique has a pronounced therapeutic effect, classical massage has a number of contraindications:
- Acute inflammatory processes
- Skin diseases
- Blood diseases
- Purulent processes
- Inflammation of the lymphatic system
- Neoplasms of various origins
- Pulmonary, cardiac, renal failure
- HIV disease
Classical massage is a wonderful method of healing the whole body, and a preventive method for many diseases.
By properly performing massage, you can get rid of soreness in the body, improve blood circulation by stimulating it, improve the regenerative abilities of the body and much more, all without the use of medicines.
The main principles of general classical massage were developed back in the 19th century by Russian doctors. For proper massage, smooth execution of all movements is necessary. One movement should smoothly pass into another, without sharp jerks.
It is necessary to capture multiple areas of the body surface with soft and painless pressing on certain points that stimulate the body.
It should be noted that the best therapeutic and relaxing effect from the therapy can be achieved when it is performed in a bath. This achieves the most tangible therapeutic effect.
During the massage, the impact on the points should gradually increase, but it should also not be painful, and by the end of the manipulations there should be a transition to soft stroking movements.
For the human body, it is this type of exposure that is most acceptable, since only in this way can blood circulation be stimulated and improved, i.e. stimulate tissue trophism and excretion of negative metabolites.
The main rule that should be followed in classical massage is its conduction along the lines of the lymphatic vessels to the lymph nodes for better removal of toxins and other negative metabolic products from peripheral tissues.
Many types of massage are now popular. The most famous among the practices performed are classical and therapeutic massage.
Peculiarities
What is the difference between them?
The most optimal way to prevent a wide variety of diseases is a classic massage. It is used as a general health-improving set of exercises to improve the general condition and well-being of the patient. Its varieties include:
- health-improving and preventive;
- hygienic;
- relaxing (relaxing) types.
According to the properties of the impact on the body, both classical and therapeutic have no special differences. Both of them improve tissue trophism, the functioning of internal organs, rejuvenate the skin, stimulate lymph flow, muscle mass, and, in general, have a beneficial effect on the entire body.
Unlike classical massage, which can be done by a person who has completed courses in this specialty, therapeutic massage can only be done by a specialist with a medical education who knows the anatomical and physiological features of the structure of our body.
The specifics of these types of massage are very similar to each other, but therapeutic massage is aimed only at influencing problem areas, only where there is an affected area, where specialized medical care is needed.
When, in the classical form, the effect is aimed at a general strengthening and preventive effect. At the same time, classic massage at home is not forbidden, and therapeutic massage is carried out in a salon or hospital.
Also, in the treatment option, drugs prescribed by the doctor are used for superficial effects.
When is it necessary and when is this procedure contraindicated?
Like any wellness manipulation, classical massage has its own indications and contraindications regarding human health.
The indications include:
- dry skin;
- poor hair growth on the head, split ends;
- skin laxity;
- manifestations of cellulite;
- osteochondrosis of the spine in any of the departments;
- diseases of the nervous system such as polyneuropathy, multiple sclerosis;
- post-stroke conditions;
- arterial hypertension;
- violation of the functions of the musculoskeletal system without violating its integrity;
- chronic fatigue syndrome;
- asthenic syndrome;
- stomach ulcer;
- headache;
- excess weight;
- weakening of the immune system.
Please note that anti-cellulite massage is more suitable for weight loss.
Attention! Before carrying out a massage complex, it is recommended to consult with your doctor and choose the right type and method of the procedure.
Main contraindications:
- exacerbation of diseases of the skin (inflammatory and infectious diseases);
- acute manifestations of cardiovascular pathology;
- thyroid dysfunction;
- dystrophy of subcutaneous fat;
- alopecia;
- fungal pathology of the skin;
- menstruation;
- oncopathology;
- swollen lymph nodes;
- venereal diseases;
- cholelithiasis and urolithiasis;
- varicose disease;
- pregnancy;
- hyperthermic syndrome;
- tuberculosis.
Methodology
As with all therapeutic and preventive measures, classical massage needs preparation:
- have a meal no later than 2 hours before the procedure, because. possible dyspeptic disorders (disorders of the digestive tract), feelings of discomfort;
- taking a warm shower to relax the muscles;
- remove jewelry and think about what the patient will be wearing for comfortable manipulation;
- warn the specialist about allergic reactions to certain components; about diseases in order to discuss contraindications and the possibility of performing the procedure;
- if during the procedure there is a feeling of discomfort, it is necessary to tell the specialist about it;
- after the procedure, you must lie down for at least 10 minutes.
As a prophylactic, you can do this massage in the bath.
tricks
Classical massage techniques are performed in four stages
- The first stage is stroking, necessary to relax the whole body;
- The second is rubbing, for warming the whole body, accelerating blood supply in the area of the procedure;
- The third stage is kneading, massaging all areas;
- The fourth stage is vibration (finger stimulation, finger rain), for point stimulation of surface receptors, followed by relaxation of the body.
In the classical type, manipulations are carried out that affect the body, both in a dynamic type (improving blood flow and metabolic reactions in tissues), and stimulating reflex arcs (the path represented by the nerve tracts along which the nerve impulses of natural reflexes pass) of our body.
This procedure is necessary as a preventive measure for various diseases., to increase working capacity, as a health element for our body. In such a massage, the spinal column, parts of the arms, legs, abdomen, chest, neck, gluteal-sacral region are affected.
After the procedure, the client feels a surge of strength, freshness and at the same time relaxation. Since this manipulation leads to an improvement in the functioning of organs, relaxation of the muscle frame, stimulation of blood supply to tissues.
Classical body massage is aimed at stimulating natural exchanges in the human body, improving its general condition. Thanks to this type, it is possible to prevent pathologies of the nervous, respiratory, digestive, musculoskeletal, and most importantly, the cardiovascular systems.
It allows the client to quickly recover from trauma, in the postoperative period, during overwork by physical and mental factors, and normalizes metabolic processes.
At the same time, it improves the functioning of the sweat and sebaceous glands, improves sleep, reduces the intensity of edema, the skin is cleansed of dead cells, lowers blood pressure, improving the general condition, leading to a general recovery.
To achieve the best effect from this type of procedure, it is necessary to carry it out in the order provided by the standard:
- spinal column;
- back surface of the left leg;
- back surface of the right leg;
Then the patient must roll over on his back for the procedure on:
- front surface of the right leg;
- front surface of the left leg;
- left hand;
- right hand;
- stomach;
- neck-collar region;
- face and head;
You can also have a classic back massage and a classic facial massage separately.
Consider several paces of this procedure:
- a fast pace at which there is an increase in the excitability of the nervous system.
- medium and slow pace at which the excitability of the nervous system decreases.
According to the duration of the massage, it is considered that the longer the process itself, the higher it affects the decrease in the excitability of the nervous system.
Video lesson: the basic techniques of classical massage
Watch a video on how to do a classic massage correctly:
4 massage methods
There are four methods of massage:
- Manual carried out by hand.
- The hardware type is carried out with the help of special technical devices that affect the skin.
- The combined method combines the manual method and the hardware method (often consider such a ratio, and such a combination: manual - 75%, hardware - 25%).
- Foot - performed with the foot.
Basic forms
Forms of classical massage:
- local form (massaging is performed in isolation in any of the departments of the human body);
- with a general form, the whole body is massaged.
What are massage lines
This procedure is preferably carried out along physiologically determined massage lines.
Massage lines are the areas of the least stretching of the skin, the vectors are directed towards the physiological actions of a person, such as: washing, skin care, cleansing, massage.
Using massage line vectors, you can apply massage more efficiently, prevent the appearance of wrinkles, improve the blood supply to tissues more correctly and intensively and, in general, improve your body.
Errors during the run
There are a number of errors in the tactics of massage in different methods:
Stroking technique:
- too much pressure;
- creation of a skin fold causing a feeling of discomfort;
- displacement of the skin instead of a sliding effect;
- incomplete contact of the palms and fingers with the massaged area;
- wide spreading of the fingers (increased finger spaces) with planar stroking;
- the sharpness of the manipulation and the high rate of massage.
Carefully! Improper performance of massage techniques or the application of more force than recommended can lead to the development of various diseases and complications.
Rubbing method:
- instead of shifting and shifting the skin, sliding occurs.
Massaging technique:
- pain with too much pressure;
- sliding or pinching fingers instead of the necessary kneading of the skin and muscle mass.
The price of pleasure
Classical massage – the price of the procedure differs depending on the level of the specialist.
Massage is evaluated by employees of a massage agency or a medical institution in units. 1 unit is equal to 10 minutes of work in a medical institution, or 10-20 minutes in a private one. 1 unit of work is estimated from 50 to 200 rubles, depending on the level of specialization of the massage parlor. Here are some examples of assessing massage zones:
- Head - 1 unit
- Arm or upper limb 1.5 units.
- Vertebral column - 2.5 units.
- Leg, lower limb - 1.5 units.
- General children's massage - 3 units.
- General adult massage - 6 units.
Number of sessions
When conducting a course of classical massage, often it is 10-15 sessions, you can observe a noticeable result. This is an increase in the tone and elasticity of the skin, muscle tissues, a positive effect on the bone and joint apparatus, the normalization of the functions of the nervous, digestive, cardiovascular systems.
Attention! The number of sessions is determined by the attending physician or specialist, depending on various factors and indications.
Outcome
Classical massage has become the basis for a wide variety of massage techniques, such as sports, anti-cellulite, etc.
Only one massage procedure performed by a professional can lead the human body to recovery, cheer up, give strength and energy.
If you need to solve more specific problems with health or aesthetic appearance of the body, you can choose one of the more suitable
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 one. 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 area can be done 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 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 the toes, the nail phalanges of three fingers, the rib, heel and arch of the foot, as well as the entire foot.
//-- Rice. eleven --//
During the procedure, the masseur 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 impact on the massaged areas, making movements with the palm, back of the hand, wrist, edge of the hand, 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 the 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 unbent in the joints make translational movements, 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 forward-backward direction, 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 tissues between the affected areas, as well as 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 massage therapist 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 over 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 masseur'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 --//
Beating 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 when massaging the limbs. 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 performed in one place, in this case it will be a point vibration conducted 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 massage therapist grabs 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, then 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 massage therapist 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 carry out 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, grabs the foot with the other 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 hip 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 massaged takes a position lying on his back, the massage therapist grabs the foot with one hand, the other performs alternate flexion and extension of each finger.
MASSAGE OF THE HEAD, FACE, NECK
The skin of the scalp is quite dense, but freely displaced, contains a significant amount of sebaceous and sweat glands. The blood supply to the scalp is carried out by arteries that are part of the system of internal and external carotid arteries. The lymphatic vessels of the scalp run from the crown down, back and to the sides to the lymph nodes located near the auricles and on the back of the head.
Massage of the scalp. Massage of the scalp can be carried out over the hair and with skin exposed.
Pose massaged - sitting, lying down. The masseur sits or stands behind him.
Massage over hair. Stroking is applied from the forehead to the back of the head, from the crown of the head to the auricles, from the top of the head down radially in all directions. The direction of massage movements should correspond to the direction of hair growth and the excretory ducts of the glands (do not carry out massage techniques against the direction of hair growth) - planar, encircling, rake-like, ironing; rubbing - rectilinear, circular, spiral; hatching - intermittent pressure, shifting, stretching, tingling (forceps); vibration - puncturing ("finger shower"), labile continuous, point local (bai-hui, feng-fu, feng-chi, tian-yu), linear.
Indications. Diseases of the circulatory system, the consequences of injuries, skin diseases, mental fatigue, colds, cosmetic disorders, hair loss.
Guidelines
Alternate all massage techniques with stroking.
The duration of the procedure is from 3 to 10 minutes.
3. Before massaging the scalp, perform a light circular rubbing of the frontal, temporal, and occipital regions of the head to improve blood flow in the venous vessels.
4. After massaging the scalp, massage the collar area.
Massage of the scalp, with skin exposure, is done along the partings. The 1st parting is combed in the sagittal direction from the middle of the hairy border of the forehead to the back of the head, stroking is flat with fingers from front to back in 3-4 passes; rubbing - hatching, rectilinear, circular; kneading - pressing, shifting, stretching; vibration - puncture (terminal phalanges of the II-V fingers) along the parting, methods of acupressure linear, local.
Indications. Dry seborrhea, cicatricial skin changes after burns, injuries, premature hair loss.
Guidelines
1. After massaging one parting, comb the 2nd parting also in the sagittal direction at a distance of 2-3 cm.
2. In the transverse direction, make up to 10-12 partings.
3. In the sagittal direction, make up to 16-18 partings.
4. The duration of exposure to each parting is 1-2 minutes, the whole procedure takes up to 20 minutes, depending on the disease, as well as the tasks facing the massage specialist.
Facial massage. It is divided into massage of the forehead, eye sockets, nose, cheeks, nasolabial folds, auricles according to indications. Massaged more often sits, but may lie on his back. The massage therapist stands behind the patient or to the side of him (for more convenient work, put a mirror in front of the person being massaged).
Frontal massage. Planar stroking, stroking from the bottom up from the superciliary arches to the line of the beginning of hair growth, from the middle of the forehead to the temporal areas; rubbing - rectilinear, circular, spiral; hatching, techniques to carry out "stepping over" in all directions; kneading - intermittent, forceps-like pressure, pinching with fingers I-II over the entire surface of the frontal region; vibration - puncturing, "finger shower", local acupressure techniques (e-chung, yin-tang) and linear massage. Alternate all techniques with stroking, conducting 4-5 passes.
Massage of the eye area. Stroking in the upper part of the orbit towards the temporal regions, in the lower part of the orbit towards the bridge of the nose, towards the inner edge of the eye, flat, pincer-shaped; rubbing - rectilinear, circular, hatching - along the same lines; kneading - pressure, forceps in the upper part of the orbit, in the lower - towards the bridge of the nose; vibration - puncturing, tapping with fingers, acupressure techniques (qing-ming, tong-tzu-lyao, yu-yao).
Cheek area massage. Stroking towards the auricles, planar, forceps, ironing; rubbing circular, rectilinear, spiral, hatching, sawing; kneading - forceps, pressure, shifting, stretching; vibration - puncture, "finger shower", acupressure (xia-guan, chia-che).
Massage of the nose area. Stroking is planar, pincer-shaped; rubbing - rectilinear, circular, tongs, hatching; kneading - pressure, tongs; vibration - puncturing, shaking the terminal phalanges of the I-II fingers, acupressure techniques. All movements should be carried out from the tip of the nose to the bridge of the nose (ying-hsiang, chia-bi, bi-lu, su-lyao).
Massage of the mouth and chin area. Stroking from the midline along the lower edge of the jaw to the behind-the-ear areas, from the wings of the nose to the earlobe, from the corners of the mouth to the auricles, flat ironing, forceps; rubbing - circular, rectilinear, spiral, hatching, tongs; kneading - pressure, forceps, stretching, shifting; vibration - puncturing, "finger shower", patting, acupressure techniques (jen-zhong, cheng-jian, di-tsang, di-he). Alternate all techniques with stroking, when massaging the nasolabial fold, movements are needed from the lower part of the middle of the chin to the nasolabial folds to the wings of the nose.
Indications. Facial massage is prescribed for diseases and injuries of the trigeminal, facial nerve, injuries and injuries of soft tissues, as well as skull bones, diseases and injuries of the skin, after surgical interventions and for cosmetic, hygienic purposes, to prevent facial aging.
Guidelines
1. Duration of massage - from 5 to 15 minutes.
2. The massage therapist must have special knowledge and experience.
3. The neck area should be exposed, as its massage is required.
4. A cold face must be pre-warmed with a compress, the massage therapist's hands must be warm.
Ear massage. Stroking the earlobe, planar, act sequentially, moving from the earlobe to the lower, middle, upper recesses, after which the back surface of the auricle is massaged; rubbing - rectilinear, circular, tongs; kneading - pincer-like pressure; vibration, mainly acupressure techniques using devices (sticks, rods, needles of various diameters with spherically rounded ends).
Indications. Unilateral effect in neuritis, sciatica. Auricular points are microzones of projections of individual organs, the impact on them is widely used in the treatment of diseases of the nervous system, to relieve pain syndromes.
Guidelines
1. To identify areas of pain on the auricle, use the compression technique between fingers I and II 8-10 times, fixing the response.
2. When choosing an impact, it must be remembered that the right ear corresponds to the right half of the body, the left - to the left.
3. To achieve a therapeutic effect, it is necessary to study in detail the structure and location of the points of influence (cartography of the outer ear) [Tabeeva D.M., Klimenko A.M. Ear acupuncture. M., 1976].
4. Having localized a point on the outer outer side of the auricle, it is "projected" onto the inner (facing the skull) side of the auricle. Massage is carried out with the fingers of the right hand, the auricle is supported with the left hand.
5. Massage in a clockwise direction enhances, excites functions, gives a tonic effect, and against it - a brake, calming effect.
6. In the process of massaging the auricle, local soreness of the ear first intensifies, then a feeling of warmth, burning sensation appears, soreness decreases, peripheral pain subsides, and a therapeutic effect occurs.
Neck massage. The skin of the anterior and lateral sections of the neck is tender and easily displaced. In the back of the head, the skin is thicker and less mobile. On palpation while turning the head, it is easy to determine the sternocleidomastoid muscle. Between this muscle and the trachea, one can feel the pulsation of the common carotid artery, and in the subclavian fossa, the pulsation of the subclavian artery. Lymphatic vessels passing in the neck flow into the lymph nodes located in groups at the border of the head and neck (occipital, behind the ear, parotid, mandibular, lingual, pharyngeal, buccal, chin).
Stroking is carried out (the patient sits or lies on his stomach, resting his forehead on his hands) flat, embracing, comb-shaped, forceps, the direction of all movements is from top to bottom; rubbing - rectilinear, circular, sawing, crossing, hatching; kneading - transverse, longitudinal, pressure, tongs, shearing, stretching; vibration - puncturing, tapping, patting, shaking with individual fingers, acupressure on the neck (fu-tu, i-men, tian-tu).
Indications. Diseases of the cardiovascular system, central and peripheral nervous system, respiratory organs, internal organs, injuries and diseases of the spine, skin diseases and damage, after surgery, as well as for cosmetic or hygienic purposes.
Guidelines
1. Duration of neck massage - from 3 to 10 minutes according to indications.
2. Alternate each massage technique with stroking.
3. Be careful when massaging the anterior surface of the neck, the region of the carotid arteries.
4. During the massage, the patient should not hold his breath.
The shoulder girdle (scapula and collarbone) and the free upper limb (humerus, bones of the forearm, hand) are interconnected during various movements. The blood supply to the upper limb is provided by the subclavian artery, and the venous outflow occurs through the subclavian vein. Lymphatic vessels on the fingers on the back side go transversely to the lateral and palmar surfaces, from here they go to the palm, to the forearm and further to the shoulder, to the axillary and subclavian lymph nodes. The innervation of the upper limb is carried out by the nerves of the brachial plexus.
Massage technique. The patient's posture is sitting or lying down. Massage is carried out with one or two hands. When massaging with one hand, the other limb is fixed and helps to capture the muscles that are affected. Movements are made along the lymphatic vessels towards the lymph nodes (the area of \u200b\u200bthe elbow, armpit). Along the radius, along the posterior surface of the shoulder and through the deltoid muscle - encircling stroking in the region of the supraclavicular lymph node, then encircling stroking along the ulna, along the anterior surface of the shoulder and complete the movement in the area of \u200b\u200bthe axillary lymph node.
Brush massage. Stroking is flat, forceps-like along the back surface 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 - on the palmar and lateral surfaces of each finger and hand is circular, rectilinear, hatching, sawing, comb-shaped; kneading - forceps, pressure, shifting, stretching; vibration - puncturing, tapping, shaking, acupressure techniques (he-gu, lao-gong, shao-chun, shao-shan, shi-xuan, e-men), passive and active movements.
Forearm massage. Stroking the area of the elbow bend, planar, encircling, comb-like, forceps-like, rake-like, ironing; rubbing - rectilinear, circular, spiral, sawing, crossing, hatching, planing; kneading - longitudinal, transverse, felting, pressing, shifting, stretching; vibration - tapping, patting, chopping, shaking, continuous labile, stable, acupressure techniques (nei-guan, wai-guan, da-lin, yang-chi, yang-si, yang-gu, yang-lao, show-san -li, kung-tsui), as well as linear acupressure.
Elbow massage. Stroking is circular, planar; rubbing - rectilinear, circular, spiral, hatching, pressure; vibration - point, puncture; kneading - forceps, shifting, stretching, pressure; acupressure (qu-chi, shao-hai, xiao-hai); passive and active movements.
Shoulder massage. Stroking in the direction of the axillary fossa - planar, encircling, forceps; rubbing - rectilinear, circular, spiral, crossing, sawing, hatching, planing; kneading - felting, transverse, longitudinal (flexors and extensors are kneaded separately), stretching, shifting, forceps, pressure; vibration - shaking, puncturing, tapping, patting, chopping, shaking, acupressure (bi-nao, tian-fu, xiao-le, tian-jing).
Shoulder massage. Stroking - planar, encircling, tong-like, ironing, rake-like; rubbing - circular, rectilinear, spiral, hatching; kneading - pressure; vibration - point (jian-yu), puncture; movements - passive, active and other types of reception.
The deltoid muscle is massaged first, and then the shoulder joint. If the massage therapist is in front of the patient, then for better access, the massaged person is offered to lay his hand behind his back; if behind - then the patient puts his hand on the other shoulder. The lower surface of the articular bag becomes more accessible to the masseur when the hand is moved to the side or placed on the masseur's shoulder (Fig. 41).
Indications. Diseases and injuries of soft tissues, bones, joints; diseases of vessels, peripheral nerves; skin diseases.
Guidelines
1. Before the massage, relax the patient's muscles as much as possible.
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 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.
In the lower limb, a pelvic girdle and a free lower limb are distinguished. The blood supply to the lower extremity is provided by the iliac artery system. Lymphatic vessels are located along the course of the blood vessels; starting from the rear of the foot and sole, they go from the distal to the proximal limbs.
Massage technique. The position of the patient - lying on his stomach, on his back. Massage movements are carried out along the lymphatic vessels towards the popliteal and inguinal lymph nodes.
Foot massage. Stroking - from the fingers along the dorsum of the foot, along the front surface of the lower leg to the popliteal lymph nodes, planar, encircling, along the plantar surface, comb-like, stroking from the fingers to the heel; rubbing - circular, rectilinear, comb-like, hatching; kneading - tongs, pressure on the sole; vibration - puncturing, tapping, patting, shaking, point (push, gun-sun, zhao-hai, zhan-gu, yung-quan, xia-si); passive and active movements.
Ankle massage. Stroking - circular, planar; rubbing - rectilinear, circular, spiral, hatching; kneading - pressure; vibration - point (kun-lun, tse-si, chun-yang); passive and active movements.
Leg massage. Stroking - planar, embracing, along the front and back surfaces, comb-like; rubbing - rectilinear, circular, spiral, sawing, crossing, planing, hatching; kneading - longitudinal, transverse, pressure, felting, stretching, shifting; vibration - shaking, puncturing, tapping, patting, chopping, point (zu-san-li, xia-ju-xu, cheng-jin, cheng-shan).
Massage of the knee joint. Stroking - circular, planar; rubbing - rectilinear, circular, shifting of the patella; kneading - pressing; point vibration (du-bi, he-din, he-yang), passive and active movements.
Hip massage. Stroking - on the front, side, back surfaces, planar, encircling, comb-like, ironing; rubbing - rectilinear, circular, spiral, sawing, crossing, planing, hatching; kneading - stretching, felting, longitudinal, transverse, pressure, shifting (carry out separately in the area of the anterior, external and internal muscle groups); vibration - shaking of individual muscle groups, puncturing, tapping, patting, chopping, shaking, point (bi-guan, fu-tu, yin-men, yin-bao), shaking.
Massage of the gluteal muscles. Stroking - from the sacrum, coccyx and iliac crests to the inguinal lymph nodes, planar, embracing, with weights; rubbing - rectilinear, circular, spiral, comb-shaped, hatching, planing, sawing, crossing; kneading - longitudinal, transverse, pressing, shifting, stretching; vibration - shaking, puncturing, patting, chopping, tapping, point (huan-tiao, cheng-fu, ba-lyao).
Massage of the hip joint. First, stroking in the pelvic area, and then in the area between the ischial tuberosity and the greater trochanter - circular stroking and rubbing, shading; passive movements (Fig. 42); point influences (xin-jian).
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.
Guidelines
1. The massage of individual segments of the limb must be preceded by a preparatory massage of the entire limb.
2. Massage the foot or lower leg separately should not be.
3. When massaging the thigh, it is necessary to massage the muscles of the pelvis.
4. When massaging in the area of the popliteal cavity, the movements should not be vigorous.
5. On the inner surface of the thigh, especially in the inguinal region, exclude shock techniques and intermittent vibration.
6. The duration of the massage - from 3 to 15 minutes when massaging individual segments and from 5 to 20 minutes when massaging the entire limb.
During examination and palpation of the back, the spinous process of the VII cervical vertebra, the ribs, the scapular spine with the acromion, the medial edge of the scapulae and their lower angle, protruding under the skin, are well defined. Lymph from the vessels located in the back area is taken by the axillary and inguinal lymph nodes.
Massage technique. The position of the patient is lying on his stomach, his arms are slightly bent at the elbow joints and are located along the body. Rollers or pillows are placed under the frontal area, chest and abdomen.
Massage begins with superficial stroking, then flat, deep and embracing - with both hands. The direction of movement is from the sacrum and iliac crests up to the supraclavicular fossae, at first parallel to the spinous processes of the vertebrae, and then, stepping back from the spine, they move upward from the iliac crests to the armpit.
During massage in the pelvic area, stroking, rubbing from the bottom up, auxiliary techniques - stroking with weights, comb-like, ironing; further rubbing - circular, with weights, comb-like, sawing; kneading - with both hands, longitudinal and transverse, ascending and descending; vibration - chopping, tapping, intermittent, patting, point (da-zhui, fu-fen, gao-huang, ge-guan, min-men - Fig. 43).
Guidelines
1. When rubbing in the region of the C4-D2 segment, weaken the force.
2. Perform vibration in the interscapular region, reducing the impact force.
3. Spare the projection of the area of the kidneys, lungs, heart on
back.
4. End the back massage with stroking.
The anterior chest wall is supplied with blood through the internal artery of the mammary gland and its branches, the side walls are supplied through the branches of the axillary artery. Innervation is carried out by spinal nerves from the subclavian part of the brachial plexus. The lymphatic vessels of the chest, accompanying the superficial veins, are sent to the supraclavicular and axillary lymph nodes.
Massage technique. The massaged position is lying on the back or on the side, as well as sitting.
First, a preparatory massage is performed - stroking (superficial, planar, then covering from the bottom up and outward to the armpits), then selective massage - the pectoralis major, anterior serratus, external intercostal muscles are massaged, at the level of the diaphragm. Massage movements are carried out in the direction from the collarbone and sternum to the armpits and shoulder joint (Fig. 44). Apply stroking, circular rubbing, transverse kneading, chopping in the region of the pectoralis major muscle; vibration - concussion, point - according to indications (zhong-fu, zi-gun, jiu-wei).
Massage of the external intercostal muscles. Stroking, rubbing, intermittent vibration in the direction from the sternum along the intercostal spaces to the spine,
Diaphragm massage. First, the vibration is stable, uninterrupted, then the fingers from II to V are inserted into the right and left hypochondrium and they carry out vibration; the impact is only indirect. Completing the massage, perform (with the patient lying on his back) stroking planar, embracing, from the bottom up, shaking, squeezing; movements should be rhythmic and painless.
Massage of the intercostal nerves. Stroking, raking, vibration.
Painful points: 1) at the spine, outward from the spinous processes at the exit points of the nerves; 2) along the axillary line - in places where perforating branches come to the surface; 3) in front on the line of connection of the sternum with the costal cartilages - the points correspond to the place of exit to the surface of the perforating anterior branches.
Massage of the mammary glands (according to indications). Stroking, rubbing, intermittent vibration, puncturing; with a sluggish and stretched mammary gland - movements from the nipple to the base of the gland, with insufficient secretory activity - from the base of the gland to the nipple.
Guidelines
1. When massaging the skin of the chest wall, do not touch the mammary glands, nipple.
2. Avoid vigorous techniques at the points of attachment of the ribs to the sternum.
3. Supplement massage movements with special physical exercises.
The abdominal wall is supplied with blood from parietal branches of the external and internal iliac arteries. The outflow of venous blood is carried out through the veins of the same name of the system of the inferior and superior vena cava.
The lymphatic vessels of the upper half of the anterior abdominal wall carry lymph to the axillary lymph nodes, and the lower half to the inguinal nodes. From the deep layers of the epigastric region, lymph enters the intercostal space, from the celiac to the lumbar, from the hypogastric to the iliac lymph nodes.
Abdominal massage includes massage of the anterior abdominal wall, abdominal organs and celiac (solar) plexus.
Massage of the anterior abdominal wall. The position of the patient is on the back with a raised head, a roller under the knees. Techniques: stroking - gentle circular, planar, starting from the navel and then the entire surface of the abdomen in a clockwise direction; rubbing - sawing, hatching, crossing (grinding); kneading - longitudinal, transverse, felting, rolling - according to indications (Fig. 44), vibration techniques.
Selective massage of the rectus abdominis muscles. First, pincer-like stroking, ironing, kneading from top to bottom and from bottom to top, shaking; complete the procedure with gentle stroking.
Stomach massage. The position of the patient is on the back, and then on the right side. Massage without selective action. After relaxing the abdominal muscles, they act on the stomach. The bottom of the stomach reaches the 5th rib along the left mid-clavicular line, and the lower border - in the region of the anterior abdominal wall 1-2 cm above the navel in women and 3-4 cm in men. Techniques: intermittent vibration - rake-like placed fingers in the epigastric region on the left and outside and inside, concussion. Techniques of reflex influence.
Massage of the small intestine. It is carried out reflexively by stroking with fingers, intermittent vibration with the ends of bent fingers and pressing with the palm or fingertips from right to left in a clockwise direction of the entire surface of the abdomen.
Colon massage. The movement should begin in the right iliac region, lead to the right hypochondrium, bypassing it, descending to the left iliac region. First, stroking is used, then circular or spiral rubbing with weights, intermittent pressure, shaking. Finish with circular stroking, vibration. You can resort to hardware massage.
Liver massage. Movement from the bottom left and right up. The ends of the fingers penetrate under the right costal edge and produce spiral rubbing, vibration, shaking.
Gallbladder massage(located on the lower surface of the right lobe of the liver). It is massaged according to indications with light, planar stroking, semicircular rubbing and continuous vibration.
Kidney massage. The position of the patient is on the back. Massage with the right hand in the projection area of the right kidney, and the left hand performs the same reception from the right lumbar region. The same on the left. Direction of movement - front to back; apply circular rubbing, pushing, shaking, stroking.
Massage of the epigastric (solar) plexus. Its projection is on the line between the xiphoid process and the navel. Massage with one hand with fingers, making circular stroking, rubbing, intermittent vibration (Fig. 44), acupressure (chi-hai, shi-men).
Guidelines
1. Massage of the abdomen in the absence of contraindications for the patient 30 minutes after a light breakfast and 1-1.5 hours after lunch.
2. Duration of the first procedures - no more than 8-10 minutes. rest after massage - 20-30 min.
3. Massage is carried out differentially, taking into account indications (see Fig. 8).
Vibration is a mechanical oscillatory movement in which the physical body periodically passes through a stable position, deviating from it in one direction or the other. Oscillatory movements have kinetic and dynamic indicators: 1) the amplitude of the oscillation is the amount of deviation of the body from a stable position; 2) oscillation frequency is the number of deviations of the body from a stable position per unit time (measured in hertz).
Vibration affects human organs and systems. According to the degree of propagation, vibration is divided into local (local) and general.
The physiological effect of mechanical vibration on the body is associated with irritation of exteroreceptors (receptors located in the skin), interoreceptors (receptors located in internal organs) and proprioceptors (receptors located in muscles and tendons).
Mechanical vibrations are characterized by a frequency from fractions to hundreds of thousands of hertz, infrasonic - from 1 to 16 Hz, sound - from 16 to 20,000 Hz, ultrasonic - over 20,000 Hz.
It has been established that vibration massage has a pronounced analgesic effect, which is accompanied by separate response vasomotor reactions; at the same time, redox processes in the muscles are also activated, which makes it possible to quickly relieve fatigue and restore their performance. Vibration massage has a positive effect on neurohumoral processes, improves the functional state of the endocrine glands, autonomic and central parts of the nervous system.
Indications. Diseases and injuries of the peripheral nervous system; subacute and chronic forms of infectious nonspecific polyarthritis; bronchial asthma without exacerbation; chronic pneumonia in remission; chronic gastritis with secretory insufficiency; chronic diseases of the biliary tract, intestinal dyskinesia; eye diseases; gynecological diseases, etc.
Contraindications General infections; malignant neoplasms; active forms of tuberculosis; hypertension, starting from stage II B, cardiovascular insufficiency II-III degree, angina pectoris with frequent attacks; pronounced neuroses; pronounced dysfunction of the endocrine system; thrombophlebitis.
Temporary contraindications. Exacerbations of the underlying or concomitant disease; complaints of general weakness or fatigue.
METHOD AND TECHNIQUE OF MASSAGE WITH THE HELP OF DEVICES
General technical and methodological instructions
1. To conduct a vibration massage, you must first fix the desired vibratod in a special socket of the device.
2. Vibratodes come in various shapes, and their choice depends on the nature and area of the massaged body surface. On large areas, flat vibratodes with a large adjacent surface are used; on convex surfaces - concave; in the recesses of the body - spherical, bellied; on the scalp - with rubber spikes, processes. For a deep energetic impact, hard, plastic vibratodes are used, for a more superficial and soft one, rubber or sponge ones. Underwater massage is carried out in baths, semi-baths, local baths for individual limbs. The position of the patient in the bath - sitting, lying down. So, vibration in the neck, stomach, gallbladder, intestines, knee joints is performed in the supine position, vibration in the lumbar region - in the sitting position with legs bent at the hip and knee joints. Nozzles are selected depending on the nature of the procedure.
3. The choice of the place of influence depends on the nature of the pathological process and its localization. In some cases, they directly affect the affected area along the nerve trunks and blood vessels, on pain points (around the joints), in others - through various reflexogenic zones (vertebral and paravertebral regions, ganglia, endocrine glands).
4. Vibration massage can be performed with a labile and stable technique. In the first case, the vibratod is moved in a selected area with slow longitudinal or circular movements, stroking, rubbing, evenly pressing its surface to the skin. According to the stable method, the vibratode is installed in one place and the guide nozzle or vibratode is applied to the impact site without moving them. In both Cases, both continuous and intermittent vibration can be used.
5. In medical and sports practice, vibrations with a frequency of 10 to 200 Hz and an amplitude ranging from 0.1 to 3 mm are mainly used.
6. The duration of the procedures depends on the nature of the disease, the place of exposure, the general condition of the patient and the reaction of his body. At the beginning of the course, the exposure time is 8-10 minutes, it can be increased up to 15 minutes. long-term use of vibration of the same frequency and intensity after a while causes the patient's body to get used to it, and the procedure, which lasts more than 20 minutes, leads to patient fatigue.
7. At the beginning of the procedure, it is carried out every other day, then, depending on the general condition and response of the patient's body, they can be prescribed 2-3 times in a row, but with a subsequent break of 1 day. The number of procedures for each patient individually, depends on the nature of the pathological process, its stage, the age of the patient and ranges from 10 to 15 procedures.
8. Vibration massage in the bath, pool - hydromassage - should be prescribed after a light breakfast. Rest for 15-20 minutes is required before and after the procedure. After returning to the ward, the patient should rest for another 1-1.5 hours.
The correct combination of balneological and physiotherapeutic procedures with food intake and rest leads to the elimination of neurohumoral and hemodynamic changes caused by the procedure.
Equipment. In our country, the following types of devices are produced (Fig. 45).
1. Vibrating apparatus designed by P.L. Beresneva (1954). Equipped with an electric motor that rotates a flexible shaft with an eccentric; in this case, oscillatory movements appear, which are transmitted to the vibratode.
Rice. 45. Vibrating devices for massage: a - VMP-1: 1 - body, 2 - switch, 3 - vibration amplitude regulator, 4 - plastic semicircle, 5 - suction bell, 6 - spiked vibrator, 7 - sponge, 8 - ball ; b - AM-2 "Sport"
2. Vibrating device for massage (model VMP-1) and electrical device "Vibromassage" (model VM). Both devices are similar and are an electromagnetic device powered by an alternating current. The device has a vibration intensity regulator and nozzles in accordance with the purpose:
- suction bell - for massage of the chest, abdomen, neck, face;
- spike nozzle - for massage of the scalp, neck;
- sponge - for weak vibration massage of the face, neck, painful tissues along the lymphatic vessels;
- plastic nozzle - for vigorous vibration | when massaging the arms, legs, back, abdomen;
- various balls - for point vibration in places of nerve endings, in the area of tendons and periosteum.
3. Massage apparatus designed by M.G. Babia (1969). With its help, in addition to vibration, you can carry out various massage techniques. The device for mechanical massage consists of a stand, a hanging frame, an electric motor, a gearbox and a set of nozzles. Nozzle types:
- cuboid vibrogrinder - its lateral faces carry out rhythmic continuous vibration; the flat surface of the base of the cube - circular rubbing, with a light touch - planar stroking;
- cylindrical spongy rubbing - its base performs circular rubbing, side surfaces - rubbing longitudinal and transverse, as well as shading;
- pyramidal elastic kneader - when pressed, it rolls, displaces, kneads the muscles and makes a gentle continuous vibration;
- bladed vibrating kneader - when the blades rotate, they capture the muscles, move them, produce circular kneading and continuous vibration;
- forceps-shaped kneader - forceps infringes tissues, performs circular kneading;
- cone-shaped circular kneader - has radially located deep furrows, between which ridges are located. When the nozzle is rotated, the furrows capture soft tissues, displace them, and with the help of the combs, circular kneading is performed, with the help of the convex parts of the nozzle - circular rubbing;
- vibrating thumper - when two blades rotate, thumping occurs.
A good result is the use of hardware massage techniques in combination with manual ones.
When working with the above devices, stable vibration is used (3-5 s of exposure to one part of the body, a pause and a transition to other parts of the body) and labile vibration (they move in circular and rectilinear directions, taking into account the lymph flow in the limbs and torso - Fig. 46 ).
Rice. 46. Apparatus for mechanical massage designed by M. G. Babiy
VIBRATION-VACUUM MASSAGE (PNEUMO-VIBROMASSAGE)
With this type of massage, a combined effect of vibration and vacuum is carried out. Such devices are manufactured at the Vibrator plant. The vibration effect is achieved by creating a variable pressure.
Apparatus model EMA-1 in practice is often used in combination with manual techniques. The EMA-2M model, in contrast to the EMA-1, has 2 cylinders, which makes it possible to carry out the impact simultaneously with two vibratodes. Rubber cup nozzles are used for massage of joints, tendons, small muscle groups. Plastic vibratodes - for influencing large muscle groups. When massaging the back surface of the body, the main position of the patient is lying on his stomach; when massaging the anterior muscle group - lying on your back; when massaging the hands and neck, the patient sits (Fig. 47, a, b). With a sedative, calming effect, vibration with a frequency of 15 Hz is used, for toning, vibration with a frequency of 25-50 Hz is used.
Rice. 47. Pneumovibratory massage apparatus EMA-2M designed by N.N. Vasiliev: a - appearance: 1 - rubber hoses, 2 - vibration amplitude regulator, 3 - vibration frequency regulator, 4 - housing, 5 - impact vibrator, 6 - rubber vibrator; b - performing a massage technique
Movements with vibratodes are carried out along the lymph flow, changing their direction depending on therapeutic tasks.
The main directions of movement of vibratodes when using the EMA-2M apparatus.
1. Vertical - the vibratodome oscillates perpendicular to the muscle surface.
2. Horizontal - vibratodes are located on one or both sides of the muscle.
3. Horizontal-vertical - vibratodes are placed at an angle of 90°.
4. Longitudinal vibrations - vibratodes move towards each other.
5. Transverse vibrations - vibratodes are located on the sides of the muscle in a horizontal plane and move towards each other.
6. Circular motions - one vibratode moves clockwise and the other counterclockwise.
7. Oscillations when the vibratodes are located at an angle to each other.
The vacuum apparatus for massage was proposed by V.I. Kulazhenko (1960) and A.A. Safonov (1967). In terms of its structure, it is simple: it consists of an air compressor and a double-acting pump, connected by a rubber hose with metal or rubber nozzles.
Vacuum-type massage is carried out in a labile or stable way. Technique: a suction jar (or an aspirator) is alternately applied to pain points for 30-40 seconds or slowly moved over the massaged area for 5-10 minutes. First apply a pressure of 500-600 mm Hg. Art., then lower it to 200 mm Hg. Art. The intervals between procedures are 1-2 days.
One of the types of pneumatic massage is syncardial. Massage is carried out by mechanical action on tissues of variable air pressure. The device for this massage is used in the treatment of vascular disorders. With its help, rhythmic compression of the limbs with affected peripheral vessels is performed, taking into account the frequency of heart contraction (Fig. 48).
Pressure chamber V.A. Kravchenko - is intended for the treatment of vascular and other diseases of the extremities. In it, with the help of a difference in air pressure, a mechanical effect on the tissues occurs, leading to their active hyperemia (Fig. 49).
In sports, 2 pressure chambers are used simultaneously for baromassage.
UNDERWATER SHOWER MASSAGE
For the first time the description of this type of massage was made by Horsch (Berlin, 1936) and Landa (1963). The main devices used in this massage are "Tangentor-8" and various modifications of hydromassage installations, which are produced in many countries of the world.
Systems of devices and methods of working with them are described by L.A. Kunichev (1979). Basically, the technique boils down to the fact that in special baths or pools from a flexible hose, on which nozzles of various shapes are put on for certain massage techniques, a jet of water is ejected under pressure of 2-3 atm. Massage techniques are performed in a certain sequence.
VORTEX UNDERWATER MASSAGE
One of the varieties of underwater massage is whirlpool. It is carried out in special cylindrical baths, in which a circular flow of water is created using a centrifugal pump. The whole body or part of it can be placed in the bath. The patient is affected by an elastic vibrating, mixed with air, vortex jet of water, which produces a deep and painless massage (Fig. 50).
The device "Volna" for vibration baths was proposed by A.Ya. Kramer (1972). With its help, dosed vibration is carried out (from 10 to 200 Hz). The device has a power supply and control unit, a vibrator and a tripod. This device allows you to direct water jets to the desired area of the body, to dose the sound pressure and frequency of vibrations within known limits.
Apparatus for general vibration massage can be in the form of a chair (firm "Sanitas"), a bicycle (Goff's cycle tube), a vibration bed (Hertz's bed), a platform. It should be noted that installations for general vibration are bulky, heavy and are rarely used at present. Apparatuses for local (local) vibration massage have become much more widespread.
Disadvantages when using hardware types of massage
1. The vibrations transmitted by vibratodes are not always well tolerated by patients (more often due to the impact on the body of a large impact force).
2. The area of contact with the patient's body is limited by the geometric dimensions of the vibratode. 3. Uneven transmission of vibrations to tissues due to improper contact of the vibratode with the skin, which is especially noticeable when exposed to small joints of the limbs (hands, feet).
4. Negative impact on the massage therapist, whose hand is constantly exposed to vibration, which is expressed in poor health, fatigue, up to the appearance of cramps in the hand.
Currently, equipment for some types of massage is mass-produced by the industry. Vibration, hydromassage, pneumovibromassage, ultrasonic massage, baromassage and other types of mechanical apparatus therapy, carried out with the help of massagers, rubber mats for feet, massage balls for hands, etc., are most widely used in practice. However, it should be noted that a single device cannot replace the heat and feel of the massage therapist's hands.
