Massage Therapy

views updated Jun 27 2018

Massage therapy

Definition

Massage therapy is the scientific manipulation of the soft tissues of the body for the purpose of normalizing those tissues and consists of manual techniques that include applying fixed or movable pressure, holding, and/or causing movement of or to the body.

Origins

Massage therapy is one of the oldest health care practices known to history. References to massage are found in Chinese medical texts more than 4,000 years old. Massage has been advocated in Western health care practices at least since the time of Hippocrates, the "Father of Medicine." In the fourth century b.c. Hippocrates wrote, "The physician must be acquainted with many things and assuredly with rubbing" (the ancient Greek term for massage was rubbing).

The roots of modern, scientific massage therapy go back to Per Henrik Ling (17761839), a Swede, who developed an integrated system consisting of massage and active and passive exercises. Ling established the Royal Central Gymnastic Institute in Sweden in 1813 to teach his methods.

Modern, scientific massage therapy was introduced in the United States in the 1850s by two New York physicians, brothers George and Charles Taylor, who had studied in Sweden. The first clinics for massage therapy in the United States were opened by two Swedish physicians after the Civil War period. Doctor Baron Nils Posse operated the Posse Institute in Boston and Doctor Hartwig Nissen opened the Swedish Health Institute near the Capitol in Washington, D.C.

Although there were periods when massage fell out of favor, in the 1960s it made a comeback in a different way as a tool for relaxation , communication, and alternative healing. Today, massage is one of the most popular healing modalities. It is used by conventional, as well as alternative, medical communities and is now covered by some health insurance plans.

Benefits

Generally, massage is known to affect the circulation of blood and the flow of blood and lymph, reduce muscular tension or flaccidity, affect the nervous system through stimulation or sedation, and enhance tissue healing. These effects provide a number of benefits:

  • reduction of muscle tension and stiffness
  • relief of muscle spasms
  • greater flexibility and range of motion
  • increase of the ease and efficiency of movement
  • relief of stress and aide of relaxation
  • promotion of deeper and easier breathing
  • improvement of the circulation of blood and movement of lymph
  • relief of tension-related conditions, such as headaches and eyestrain
  • promotion of faster healing of soft tissue injuries, such as pulled muscles and sprained ligaments, and reduction in pain and swelling related to such injuries
  • reduction in the formation of excessive scar tissue following soft tissue injuries
  • enhancement in the health and nourishment of skin
  • improvement in posture through changing tension patterns that affect posture
  • reduction in stress and an excellent stress management tool
  • creation of a feeling of well-being
  • reduction in levels of anxiety
  • increase in awareness of the mind-body connection
  • promotion of a relaxed state of mental awareness

Massage therapy also has a number of documented clinical benefits. For example, massage can reduce anxiety, improve pulmonary function in young asthma patients, reduce psycho-emotional distress in persons suffering from chronic inflammatory bowel disease , increase weight and improve motor development in premature infants, and may enhance immune system functioning. Some medical conditions that massage therapy can help are: allergies , anxiety and stress, arthritis, asthma and bronchitis, carpal tunnel syndrome and other repetitive motion injuries, chronic and temporary pain, circulatory problems, depression , digestive disorders, tension headache, insomnia , myofascial pain, sports injuries, and temporomandibular joint dysfunction.

Description

Massage therapy is the scientific manipulation of the soft tissues of the body for the purpose of normalizing those tissues and consists of a group of manual techniques that include applying fixed or movable pressure, holding, and/or causing movement of or to the body. While massage therapy is applied primarily with the hands, sometimes the forearms or elbows are used. These techniques affect the muscular, skeletal, circulatory, lymphatic, nervous, and other systems of the body. The basic philosophy of massage therapy embraces the concept of vis Medicatrix naturae, which is aiding the ability of the body to heal itself, and is aimed at achieving or increasing health and well-being.

Touch is the fundamental medium of massage therapy. While massage can be described in terms of the type of techniques performed, touch is not used solely in a mechanistic way in massage therapy. One could look at a diagram or photo of a massage technique that depicts where to place one's hands and what direction the stroke should go, but this would not convey everything that is important for giving a good massage. Massage also has an artistic component.

Because massage usually involves applying touch with some degree of pressure and movement, the massage therapist must use touch with sensitivity in order to determine the optimal amount of pressure to use for each person. For example, using too much pressure may cause the body to tense up, while using too little may not have enough effect. Touch used with sensitivity also allows the massage therapist to receive useful information via his or her hands about the client's body, such as locating areas of muscle tension and other soft tissue problems. Because touch is also a form of communication, sensitive touch can convey a sense of caringan essential element in the therapeutic relationshipto the person receiving massage.

In practice, many massage therapists use more than one technique or method in their work and sometimes

combine several. Effective massage therapists ascertain each person's needs and then use the techniques that will meet those needs best.

Swedish massage uses a system of long gliding strokes, kneading, and friction techniques on the more superficial layers of muscles, generally in the direction of blood flow toward the heart, and sometimes combined with active and passive movements of the joints. It is used to promote general relaxation, improve circulation and range of motion, and relieve muscle tension. Swedish massage is the most commonly used form of massage.

Deep tissue massage is used to release chronic patterns of muscular tension using slow strokes, direct pressure, or friction directed across the grain of the muscles. It is applied with greater pressure and to deeper layers of muscle than Swedish, which is why it is called deep tissue and is effective for chronic muscular tension.

Sports massage uses techniques that are similar to Swedish and deep tissue, but are specially adapted to deal with the effects of athletic performance on the body and the needs of athletes regarding training, performing, and recovery from injury.

Neuromuscular massage is a form of deep massage that is applied to individual muscles. It is used primarily to release trigger points (intense knots of muscle tension that refer pain to other parts of the body), and also to increase blood flow. It is often used to reduce pain. Trigger point massage and myotherapy are similar forms.

Acupressure applies finger or thumb pressure to specific points located on the acupuncture meridians (channels of energy flow identified in Asian concepts of anatomy) in order to release blocked energy along these meridians that causes physical discomforts, and re-balance the energy flow. Shiatsu is a Japanese form of acupressure.

The cost of massage therapy varies according to geographic location, experience of the massage therapist, and length of the massage. In the United States, the average range is from $35-60 for a one hour session. Massage therapy sessions at a client's home or office may cost more due to travel time for the massage therapist. Most sessions are one hour. Frequency of massage sessions can vary widely. If a person is receiving massage for a specific problem, frequency can vary widely based on the condition, though it usually will be once a week. Some people incorporate massage into their regular personal health and fitness program. They will go for massage on a regular basis, varying from once a week to once a month.

The first appointment generally begins with information gathering, such as the reason for getting massage therapy, physical condition and medical history, and other areas. The client is asked to remove clothing to one's level of comfort. Undressing takes place in private, and a sheet or towel is provided for draping. The massage therapist will undrape only the part of the body being massaged. The client's modesty is respected at all times. The massage therapist may use an oil or cream, which will be absorbed into the skin in a short time.

To receive the most benefit from a massage, generally the person being massaged should give the therapist accurate health information, report discomfort of any kind (whether it's from the massage itself or due to the room temperature or any other distractions), and be as receptive and open to the process as possible.

Insurance coverage for massage therapy varies widely. There tends to be greater coverage in states that license massage therapy. In most cases, a physician's prescription for massage therapy is needed. Once massage therapy is prescribed, authorization from the insurer may be needed if coverage is not clearly spelled out in one's policy or plan.

Preparations

Going for a massage requires little in the way of preparation. Generally, one should be clean and should not eat just before a massage. One should not be under the influence of alcohol or non-medicinal drugs. Massage therapists generally work by appointment and usually will provide information about how to prepare for an appointment at the time of making the appointment.

Precautions

Massage is comparatively safe; however it is generally contraindicated, i.e., it should not be used, if a person has one of the following conditions: advanced heart diseases, hypertension (high blood pressure), phlebitis , thrombosis, embolism, kidney failure, cancer if massage would accelerate metastasis (i.e., spread a tumor) or damage tissue that is fragile due to chemotherapy or other treatment, infectious diseases, contagious skin conditions, acute inflammation, infected injuries, unhealed fractures , dislocations, frostbite, large hernias, torn ligaments, conditions prone to hemorrhage, and psychosis.

Massage should not be used locally on affected areas (i.e., avoid using massage on the specific areas of the body that are affected by the condition) for the following conditions: rheumatoid arthritis flare up, eczema , goiter, and open skin lesions. Massage may be used on the areas of the body that are not affected by these conditions.

In some cases, precautions should be taken before using massage for the following conditions: pregnancy , high fevers, osteoporosis , diabetes, recent postoperative cases in which pain and muscular splinting (i.e., tightening as a protective reaction) would be increased, apprehension, and mental conditions that may impair communication or perception. In such cases, massage may or may not be appropriate. The decision on whether to use massage must be based on whether it may cause harm. For example, if someone has osteoporosis, the concern is whether bones are strong enough to withstand the pressure applied. If one has a health condition and has any hesitation about whether massage therapy would be appropriate, a physician should be consulted.

Side effects

Massage therapy does not have side effects. Sometimes people are concerned that massage may leave them too relaxed or too mentally unfocused. To the contrary, massage tends to leave people feeling more relaxed and alert.

Research & general acceptance

Before 1939, more than 600 research studies on massage appeared in the main journals of medicine in English. However, the pace of research was slowed by medicine's disinterest in massage therapy.

Massage therapy research picked up again in the 1980s, as the growing popularity of massage paralleled the growing interest in complementary and alternative medicine. Well designed studies have documented the benefits of massage therapy for the treatment of acute and chronic pain, acute and chronic inflammation, chronic lymphedema, nausea , muscle spasm, various soft tissue dysfunctions, anxiety, depression, insomnia, and psycho-emotional stress, which may aggravate mental illness.

Premature infants treated with daily massage therapy gain more weight and have shorter hospital stays than infants who are not massaged. A study of 40 low-birth-weight babies found that the 20 massaged babies had a 47% greater weight gain per day and stayed in the hospital an average of six days less than 20 infants who did not receive massage, resulting a cost savings of approximately $3,000 per infant. Cocaine-exposed, preterm infants given massage three times daily for a 10 day period showed significant improvement. Results indicated that massaged infants had fewer postnatal complications and exhibited fewer stress behaviors during the 10 day period, had a 28% greater daily weight gain, and demonstrated more mature motor behaviors.

A study comparing 52 hospitalized depressed and adjustment disorder children and adolescents with a control group that viewed relaxation videotapes, found massage therapy subjects were less depressed and anxious, and had lower saliva cortisol levels (an indicator of less depression).

Another study showed massage therapy produced relaxation in 18 elderly subjects, demonstrated in measures such as decreased blood pressure and heart rate and increased skin temperature.

A combination of massage techniques for 52 subjects with traumatically induced spinal pain led to significant improvements in acute and chronic pain and increased muscle flexibility and tone. This study also found massage therapy to be extremely cost effective, with cost savings ranging from 15-50%. Massage has also been shown to stimulate the body's ability to naturally control pain by stimulating the brain to produce endorphins. Fibromyalgia is an example of a condition that may be favorably affected by this effect.

A pilot study of five subjects with symptoms of tension and anxiety found a significant response to massage therapy in one or more psycho-physiological parameters of heart rate, frontalis and forearm extensor electromyograms (EMGs) and skin resistance, which demonstrate relaxation of muscle tension and reduced anxiety.

Lymph drainage massage has been shown to be more effective than mechanized methods or diuretic drugs to control lymphedema secondary to radical mastectomy, consequently using massage to control lymphedema would significantly lower treatment costs. A study found that massage therapy can have a powerful effect upon psycho-emotional distress in persons suffering from chronic inflammatory bowel disease. Massage therapy was effective in reducing the frequency of episodes of pain and disability in these patients.

Massage may enhance the immune system. A study suggests an increase in cytotoxic capacity associated with massage. A study of chronic fatigue syndrome subjects found that a group receiving massage therapy had lower depression, emotional distress, and somatic symptom scores, more hours of sleep, and lower epinephrine and cortisol levels than a control group.

Training & certification

The generally accepted standard for training is a minimum of 500 classroom hours. Training should include anatomy, physiology, pathology, massage theory and technique, and supervised practice. Most massage therapists also take additional courses and workshops during their careers.

In the United States, massage therapists are currently licensed by 29 states, the District of Columbia, and a number of localities. Most states require 500 or more classroom hours of training from a recognized training program and passing an examination.

A national certification program was inaugurated in June 1992 by the National Certification Board for Therapeutic Massage and Bodywork (NCBTMB). The NCBTMB program is accredited by the National Commission for Certifying Agencies, the chief outside agency for evaluating certification programs. Those certified can use the title Nationally Certified in Therapeutic Massage and Bodywork (NCTMB). Most states use the NCBTMB exam for their licensing exams.

A national accreditation agency, the Commission on Massage Therapy Accreditation, designed according to the guidelines of the U.S. Department of Education, currently recognizes about 70 training programs. The Accrediting Commission of Career Schools and Colleges of Technology and the Accrediting Council for Continuing Education and Training also accredit massage training programs.

Resources

BOOKS

Beck, Mark F. Milady's Theory and Practice of Therapeutic Massage. Milady Publishing, 1994.

Capellini, Steve. Massage Therapy Career Guide for Hands-On Success. Milady Publishing, 1998.

Downing, George. The Massage Book. New York: Random House, 1998.

Loving, Jean E. Massage Therapy: Theory and Practice. Appleton & Lange, 1998.

PERIODICALS

Field, T., W. Sunshine, M. Hernandez-Reif, and O. Quintino. "Chronic fatigue syndrome: massage therapy effects on depression and somatic symptoms in chronic fatigue syndrome." J Chronic Fatigue Syndrome (1997):43-51.

Ironson, G., T. Field, F. Scafidi, and M. Hashimoto. "Massage therapy is associated with enhancement of the immune system's cytotoxic capacity." Int J Neuroscience (February 1996):205-217.

Joachim, G. "The effects of two stress management techniques on feelings of well-being in patients with inflammatory bowel disease." Nursing Papers (1983):4, 5-18.

Kaarda, B., and O. Tosteinbo. "Increase of plasma beta-endorphins in connective tissue massage." Gen pharmacology (1989): 487-489. Scafidi, F., T. Field, A. Wheeden, S. Schanberg, C. Kuhn, R.

Symanski, E. Zimmerman, and E.S. Bandstra. "Cocaine exposed preterm neonates show behavioral and hormonal differences." Pediatrics (June 1996):851-855.

Weintraub, M. "Shiatsu, Swedish muscle massage, and trigger point suppression in spinal pain syndrome." Am Massage Therapy J Summer 1992; 31:3; 99-1 09.

ORGANIZATIONS

American Massage Therapy Association. www.amtamassage.org.

Elliot Greene

Massage Therapy

views updated May 23 2018

Massage Therapy

Definition

Massage therapy is the scientific manipulation of the soft tissues of the body for the purpose of normalizing those tissues and consists of manual techniques that include applying fixed or movable pressure, holding, and/or causing movement of or to the body.

Origins

Massage therapy is one of the oldest health care practices known to history. References to massage are found in Chinese medical texts more than 4,000 years old. Massage has been advocated in Western health care practices at least since the time of Hippocrates, the “Father of Medicine.” In the fourth century B.C. Hippocrates wrote, “The physician must be acquainted with many things and assuredly with rubbing” (the ancient Greek term for massage was rubbing).

The roots of modern, scientific massage therapy go back to Per Henrik Ling (1776–1839), a Swede, who developed an integrated system consisting of massage and active and passive exercises. Ling established the Royal Central Gymnastic Institute in Sweden in 1813 to teach his methods.

Modern, scientific massage therapy was introduced in the United States in the 1850s by two New York physicians, brothers George and Charles Taylor, who had studied in Sweden. The first clinics for massage therapy in the United States were opened by two Swedish physicians after the Civil War period. Doctor Baron Nils Posse operated the Posse Institute in Boston and Doctor Hartwig Nissen opened the Swedish Health Institute near the Capitol in Washington, D.C.

Although there were periods when massage fell out of favor, in the 1960s it made a comeback in a different way as a tool for relaxation , communication, and alternative healing. Today, massage is one of the most popular healing modalities. It is used by conventional, as well as alternative, medical communities and is now covered by some health insurance plans.

Benefits

Generally, massage is known to affect the circulation of blood and the flow of blood and lymph, reduce muscular tension or flaccidity, affect the nervous system through stimulation or sedation, and enhance tissue healing. These effects provide a number of benefits:

  • reduction of muscle tension and stiffness l relief of muscle spasms
  • greater flexibility and range of motion
  • increase of the ease and efficiency of movement
  • relief of stress and aide of relaxation
  • promotion of deeper and easier breathing
  • improvement of the circulation of blood and movement of lymph
  • relief of tension-related conditions, such as headaches and eyestrain
  • promotion of faster healing of soft tissue injuries, such as pulled muscles and sprained ligaments, and reduction in pain and swelling related to such injuries
  • reduction in the formation of excessive scar tissue following soft tissue injuries
  • enhancement in the health and nourishment of skin
  • improvement in posture through changing tension patterns that affect posture
  • reduction in stress and an excellent stress management tool
  • creation of a feeling of well-being
  • reduction in levels of anxiety
  • increase in awareness of the mind-body connection
  • promotion of a relaxed state of mental awareness

Massage therapy also has a number of documented clinical benefits. For example, massage can reduce anxiety , improve pulmonary function in young asthma patients, reduce psycho-emotional distress in persons suffering from chronic inflammatory bowel disease, increase weight and improve motor development in premature infants, and may enhance immune system functioning. Some medical conditions that massage therapy can help are: allergies , anxiety and stress , arthritis, asthma and bronchitis , carpal tunnel syndrome and other repetitive motion injuries, chronic and temporary pain, circulatory problems, depression , digestive disorders, tension headache, insomnia , myofascial pain, sports injuries, and temporomandibular joint dysfunction.

Description

Massage therapy is the scientific manipulation of the soft tissues of the body for the purpose of normalizing those tissues and consists of a group of manual techniques that include applying fixed or movable pressure, holding, and/or causing movement of or to the body. While massage therapy is applied primarily with the hands, sometimes the forearms or elbows are used. These techniques affect the muscular, skeletal, circulatory, lymphatic, nervous, and other systems of the body. The basic philosophy of massage therapy embraces the concept of vis Medicatrix naturae, which is aiding the ability of the body to heal itself, and is aimed at achieving or increasing health and well-being.

Touch is the fundamental medium of massage therapy. While massage can be described in terms of the type of techniques performed, touch is not used solely in a mechanistic way in massage therapy. One could look at a diagram or photo of a massage technique that depicts where to place one's hands and what direction the stroke should go, but this would not convey everything that is important for giving a good massage. Massage also has an artistic component.

Because massage usually involves applying touch with some degree of pressure and movement, the massage therapist must use touch with sensitivity in order to determine the optimal amount of pressure to use for each person. For example, using too much pressure may cause the body to tense up, while using too little may not have enough effect. Touch used with sensitivity also allows the massage therapist to receive useful information via his or her hands about the client's body, such as locating areas of muscle tension and other soft tissue problems. Because touch is also a form of communication, sensitive touch can convey a sense of caring—an essential element in the therapeutic relationship—to the person receiving massage.

In practice, many massage therapists use more than one technique or method in their work and sometimes combine several. Effective massage therapists ascertain each person's needs and then use the techniques that will meet those needs best.

Swedish massage uses a system of long gliding strokes, kneading, and friction techniques on the more superficial layers of muscles, generally in the direction of blood flow toward the heart, and sometimes combined with active and passive movements of the joints. It is used to promote general relaxation, improve circulation and range of motion, and relieve muscle tension. Swedish massage is the most commonly used form of massage.

Deep tissue massage is used to release chronic patterns of muscular tension using slow strokes, direct pressure, or friction directed across the grain of the muscles. It is applied with greater pressure and to deeper layers of muscle than Swedish, which is why it is called deep tissue and is effective for chronic muscular tension.

Sports massage uses techniques that are similar to Swedish and deep tissue, but are specially adapted to deal with the effects of athletic performance on the body and the needs of athletes regarding training, performing, and recovery from injury.

Neuromuscular massage is a form of deep massage that is applied to individual muscles. It is used primarily to release trigger points (intense knots of muscle tension that refer pain to other parts of the body), and also to increase blood flow. It is often used to reduce pain. Trigger point massage and myotherapy are similar forms.

Acupressure applies finger or thumb pressure to specific points located on the acupuncture meridians (channels of energy flow identified in Asian concepts of anatomy) in order to release blocked energy along these meridians that causes physical discomforts, and re-balance the energy flow. Shiatsu is a Japanese form of acupressure.

The cost of massage therapy varies according to geographic location, experience of the massage therapist, and length of the massage. In the United States, the average range is from $35–60 for a one hour session. Massage therapy sessions at a client's home or office may cost more due to travel time for the massage therapist. Most sessions are one hour. Frequency of massage sessions can vary widely. If a person is receiving massage for a specific problem, frequency can vary widely based on the condition, though it usually will be once a week. Some people incorporate massage into their regular personal health and fitness program. They will go for massage on a regular basis, varying from once a week to once a month.

The first appointment generally begins with information gathering, such as the reason for getting massage therapy, physical condition and medical history, and other areas. The client is asked to remove clothing to one's level of comfort. Undressing takes place in private, and a sheet or towel is provided for draping. The massage therapist will undrape only the part of the body being massaged. The client's modesty is respected at all times. The massage therapist may use an oil or cream, which will be absorbed into the skin in a short time.

To receive the most benefit from a massage, generally the person being massaged should give the therapist accurate health information, report discomfort of any kind (whether it's from the massage itself or due to the room temperature or any other distractions), and be as receptive and open to the process as possible.

Insurance coverage for massage therapy varies widely. There tends to be greater coverage in states that license massage therapy. In most cases, a physician's prescription for massage therapy is needed. Once massage therapy is prescribed, authorization from the insurer may be needed if coverage is not clearly spelled out in one's policy or plan.

Preparations

Going for a massage requires little in the way of preparation. Generally, one should be clean and should not eat just before a massage. One should not be under the influence of alcohol or non-medicinal drugs. Massage therapists generally work by appointment and usually will provide information about how to prepare for an appointment at the time of making the appointment.

Precautions

Massage is comparatively safe; however it is generally contraindicated, i.e., it should not be used, if a person has one of the following conditions: advanced heart diseases, hypertension (high blood pressure ), phlebitis, thrombosis, embolism, kidney failure, cancer if massage would accelerate metastasis (i.e., spread a tumor) or damage tissue that is fragile due to chemotherapy or other treatment, infectious diseases , contagious skin conditions, acute inflammation, infected injuries, unhealed fractures, dislocations , frostbite, large hernias, torn ligaments, conditions prone to hemorrhage, and psychosis.

Massage should not be used locally on affected areas (i.e., avoid using massage on the specific areas of the body that are affected by the condition) for the following conditions: rheumatoid arthritis flare up, eczema, goiter, and open skin lesions . Massage may be used on the areas of the body that are not affected by these conditions.

In some cases, precautions should be taken before using massage for the following conditions: pregnancy, high fevers, osteoporosis , diabetes, recent postoperative cases in which pain and muscular splinting (i.e., tightening as a protective reaction) would be increased, apprehension, and mental conditions that may impair communication or perception. In such cases, massage may or may not be appropriate. The decision on whether to use massage must be based on whether it may cause harm. For example, if someone has osteoporosis, the concern is whether bones are strong enough to withstand the pressure applied. If one has a health condition and has any hesitation about whether massage therapy would be appropriate, a physician should be consulted.

Side effects

Massage therapy does not have side effects. Sometimes people are concerned that massage may leave them too relaxed or too mentally unfocused. To the contrary, massage tends to leave people feeling more relaxed and alert.

Research & general acceptance

Before 1939, more than 600 research studies on massage appeared in the main journals of medicine in English. However, the pace of research was slowed by medicine's disinterest in massage therapy.

Massage therapy research picked up again in the 1980s, as the growing popularity of massage paralleled the growing interest in complementary and alternative medicine. Well designed studies have documented the benefits of massage therapy for the treatment of acute and chronic pain, acute and chronic inflammation, chronic lymphedema , nausea, muscle spasm, various soft tissue dysfunctions, anxiety, depression, insomnia, and psycho-emotional stress, which may aggravate mental illness.

Premature infants treated with daily massage therapy gain more weight and have shorter hospital stays than infants who are not massaged. A study of 40 low-birth-weight babies found that the 20 massaged babies had a 47% greater weight gain per day and stayed in the hospital an average of six days less than 20 infants who did not receive massage, resulting a cost savings of approximately $3,000 per infant. Cocaine-exposed, preterm infants given massage three times daily for a 10 day period showed significant improvement. Results indicated that massaged infants had fewer postnatal complications and exhibited fewer stress behaviors during the 10 day period, had a 28% greater daily weight gain, and demonstrated more mature motor behaviors.

A study comparing 52 hospitalized depressed and adjustment disorder children and adolescents with a control group that viewed relaxation videotapes, found massage therapy subjects were less depressed and anxious, and had lower saliva cortisol levels (an indicator of less depression).

Another study showed massage therapy produced relaxation in 18 elderly subjects, demonstrated in measures such as decreased blood pressure and heart rate and increased skin temperature.

A combination of massage techniques for 52 subjects with traumatically induced spinal pain led to significant improvements in acute and chronic pain and increased muscle flexibility and tone. This study also found massage therapy to be extremely cost effective, with cost savings ranging from 15–50%. Massage has also been shown to stimulate the body's ability to naturally control pain by stimulating the brain to produce endorphins. Fibromyalgia is an example of a condition that may be favorably affected by this effect.

A pilot study of five subjects with symptoms of tension and anxiety found a significant response to massage therapy in one or more psycho-physiological parameters of heart rate, frontalis and forearm extensor electromyograms (EMGs) and skin resistance, which demonstrate relaxation of muscle tension and reduced anxiety.

Lymph drainage massage has been shown to be more effective than mechanized methods or diuretic drugs to control lymphedema secondary to radical mastectomy , consequently using massage to control lymphedema would significantly lower treatment costs. A study found that massage therapy can have a powerful effect upon psycho-emotional distress in persons suffering from chronic inflammatory bowel disease. Massage therapywas effective in reducing the frequency of episodes of pain and disability in these patients.

Massage may enhance the immune system. A study suggests an increase in cytotoxic capacity associated with massage. A study of chronic fatigue syndrome subjects found that a group receiving massage therapy had lower depression, emotional distress, and somatic symptom scores, more hours of sleep, and lower epinephrine and cortisol levels than a control group.

Training & certification

The generally accepted standard for training is a minimum of 500 classroom hours. Training should include anatomy, physiology, pathology, massage theory and technique, and supervised practice. Most massage therapists also take additional courses and workshops during their careers.

In the United States, massage therapists are currently licensed by 29 states, the District of Columbia, and a number of localities. Most states require 500 or more classroom hours of training from a recognized training program and passing an examination.

A national certification program was inaugurated in June 1992 by the National Certification Board for Therapeutic Massage and Bodywork (NCBTMB). The NCBTMB program is accredited by the National Commission for Certifying Agencies, the chief outside agency for evaluating certification programs. Those certified can use the title Nationally Certified in Therapeutic Massage and Bodywork (NCTMB). Most states use the NCBTMB exam for their licensing exams.

A national accreditation agency, the Commission on Massage Therapy Accreditation, designed according to the guidelines of the U.S. Department of Education, currently recognizes about 70 training programs. The Accrediting Commission of Career Schools and Colleges of Technology and the Accrediting Council for Continuing Education and Training also accredit massage training programs.

Resources

BOOKS

Beck, Mark F. Milady's Theory and Practice of Therapeutic Massage. Milady Publishing, 1994.

Capellini, Steve. Massage Therapy Career Guide for Hands On Success. Milady Publishing, 1998.

Downing, George. The Massage Book. New York: Random House, 1998.

Loving, Jean E. Massage Therapy: Theory and Practice. Appleton & Lange, 1998.

PERIODICALS

Field, T., W. Sunshine, M. Hernandez-Reif, and O. Quintino. “Chronic fatigue syndrome: massage therapy effects on depression and somatic symptoms in chronic fatigue syndrome.” J Chronic Fatigue Syndrome (1997): 43–51.

Ironson, G., T. Field, F. Scafidi, and M. Hashimoto. “Massage therapy is associated with enhancement of the immune system's cytotoxic capacity.” Int J Neuroscience (February 1996):205–217.

Joachim, G. “The effects of two stress management techniques on feelings of well-being in patients with inflammatory bowel disease.” Nursing Papers (1983):4, 5–18.

Kaarda, B., and O. Tosteinbo. “Increase of plasma beta-endorphins in connective tissue massage.” Gen pharmacology (1989): 487–489.

Scafidi, F., T. Field, A. Wheeden, S. Schanberg, C. Kuhn, R.Symanski, E. Zimmerman, and E.S. Bandstra. “Cocaine exposed preterm neonates show behavioral and hormonal differences.” Pediatrics (June 1996): 851–855.

Weintraub, M. “Shiatsu, Swedish muscle massage, and trigger point suppression in spinal pain syndrome.” Am Massage Therapy J Summer 1992; 31:3; 99–1 09.

ORGANIZATIONS

American Massage Therapy Association. www.amta-massage.org.

Elliot Greene

Massage Therapy

views updated Jun 11 2018

Massage therapy

Definition

Massage therapy is the scientific manipulation of the soft tissues of the body for the purpose of normalizing those tissues and consists of manual techniques that include applying fixed or movable pressure, holding, and/or causing movement of or to the body.

Origins

Massage therapy is one of the oldest health care practices known to history. References to massage are found in Chinese medical texts more than 4,000 years old. Massage has been advocated in Western health care practices at least since the time of Hippocrates, the "Father of Medicine." In the fourth century b.c. Hippocrates wrote, "The physician must be acquainted with many things and assuredly with rubbing" (the ancient Greek term for massage was rubbing).

The roots of modern, scientific massage therapy go back to Per Henrik Ling (1776– 1839), a Swede, who developed an integrated system consisting of massage and active and passive exercises. Ling established the Royal Central Gymnastic Institute in Sweden in 1813 to teach his methods.

Modern, scientific massage therapy was introduced in the United States in the 1850s by two New York physicians, brothers George and Charles Taylor, who had studied in Sweden. The first clinics for massage therapy in the United States were opened by two Swedish physicians after the Civil War period. Doctor Baron Nils Posse operated the Posse Institute in Boston and Doctor Hartwig Nissen opened the Swedish Health Institute near the Capitol in Washington, D.C.

Although there were periods when massage fell out of favor, in the 1960s it made a comeback in a different way as a tool for relaxation , communication, and alternative healing. Today, massage is one of the most popular healing modalities. It is used by conventional, as well as alternative, medical communities and is now covered by some health insurance plans.

Benefits

Generally, massage is known to affect the circulation of blood and the flow of blood and lymph, reduce muscular tension or flaccidity, affect the nervous system through stimulation or sedation, and enhance tissue healing. These effects provide a number of benefits:

  • reduction of muscle tension and stiffness
  • relief of muscle spasms
  • greater flexibility and range of motion
  • increase of the ease and efficiency of movement
  • relief of stress and aide of relaxation
  • promotion of deeper and easier breathing
  • improvement of the circulation of blood and movement of lymph
  • relief of tension-related conditions, such as headaches and eyestrain
  • promotion of faster healing of soft tissue injuries, such as pulled muscles and sprained ligaments, and reduction in pain and swelling related to such injuries
  • reduction in the formation of excessive scar tissue following soft tissue injuries
  • enhancement in the health and nourishment of skin
  • improvement in posture through changing tension patterns that affect posture
  • reduction in stress and an excellent stress management tool
  • creation of a feeling of well-being
  • reduction in levels of anxiety
  • increase in awareness of the mind-body connection
  • promotion of a relaxed state of mental awareness

Massage therapy also has a number of documented clinical benefits. For example, massage can reduce anxiety, improve pulmonary function in young asthma patients, reduce psycho-emotional distress in persons suffering from chronic inflammatory bowel disease, increase weight and improve motor development in premature infants , and may enhance immune system functioning. Some medical conditions that massage therapy can help are: allergies , anxiety and stress, arthritis, asthma and bronchitis, carpal tunnel syndrome and other repetitive motion injuries, chronic and temporary pain, circulatory problems, depression, digestive disorders, tension headache , insomnia, myofascial pain, sports injuries , and temporomandibular joint dysfunction.

Description

Massage therapy is the scientific manipulation of the soft tissues of the body for the purpose of normalizing those tissues and consists of a group of manual techniques that include applying fixed or movable pressure, holding, and/or causing movement of or to the body. While massage therapy is applied primarily with the hands, sometimes the forearms or elbows are used. These techniques affect the muscular, skeletal, circulatory, lymphatic, nervous, and other systems of the body. The basic philosophy of massage therapy embraces the concept of vis Medicatrix naturae, which is aiding the ability of the body to heal itself, and is aimed at achieving or increasing health and well-being.

Touch is the fundamental medium of massage therapy. While massage can be described in terms of the type of techniques performed, touch is not used solely in a mechanistic way in massage therapy. One could look at a diagram or photo of a massage technique that depicts where to place one's hands and what direction the stroke should go, but this would not convey everything that is important for giving a good massage. Massage also has an artistic component.

Because massage usually involves applying touch with some degree of pressure and movement, the massage therapist must use touch with sensitivity in order to determine the optimal amount of pressure to use for each person. For example, using too much pressure may cause the body to tense up, while using too little may not have enough effect. Touch used with sensitivity also allows the massage therapist to receive useful information via his or her hands about the client's body, such as locating areas of muscle tension and other soft tissue problems. Because touch is also a form of communication, sensitive touch can convey a sense of caring—an essential element in the therapeutic relationship—to the person receiving massage.

In practice, many massage therapists use more than one technique or method in their work and sometimes combine several. Effective massage therapists ascertain each person's needs and then use the techniques that will meet those needs best.

Swedish massage uses a system of long gliding strokes, kneading, and friction techniques on the more superficial layers of muscles, generally in the direction of blood flow toward the heart , and sometimes combined with active and passive movements of the joints. It is used to promote general relaxation, improve circulation and range of motion, and relieve muscle tension. Swedish massage is the most commonly used form of massage.

Deep tissue massage is used to release chronic patterns of muscular tension using slow strokes, direct pressure, or friction directed across the grain of the muscles. It is applied with greater pressure and to deeper layers of muscle than Swedish, which is why it is called deep tissue and is effective for chronic muscular tension.

Sports massage uses techniques that are similar to Swedish and deep tissue, but are specially adapted to deal with the effects of athletic performance on the body and

the needs of athletes regarding training, performing, and recovery from injury.

Neuromuscular massage is a form of deep massage that is applied to individual muscles. It is used primarily to release trigger points (intense knots of muscle tension that refer pain to other parts of the body), and also to increase blood flow. It is often used to reduce pain. Trigger point massage and myotherapy are similar forms.

Acupressure applies finger or thumb pressure to specific points located on the acupuncture meridians (channels of energy flow identified in Asian concepts of anatomy) in order to release blocked energy along these meridians that causes physical discomforts, and re-balance the energy flow. Shiatsu is a Japanese form of acupressure.

The cost of massage therapy varies according to geographic location, experience of the massage therapist, and length of the massage. In the United States, the average range is from $35–60 for a one hour session. Massage therapy sessions at a client's home or office may cost more due to travel time for the massage therapist. Most sessions are one hour. Frequency of massage sessions can vary widely. If a person is receiving massage for a specific problem, frequency can vary widely based on the condition, though it usually will be once a week. Some people incorporate massage into their regular personal health and fitness program. They will go for massage on a regular basis, varying from once a week to once a month.

The first appointment generally begins with information gathering, such as the reason for getting massage therapy, physical condition and medical history, and other areas. The client is asked to remove clothing to one's level of comfort. Undressing takes place in private, and a sheet or towel is provided for draping. The massage therapist will undrape only the part of the body being massaged. The client's modesty is respected at all times. The massage therapist may use an oil or cream, which will be absorbed into the skin in a short time.

To receive the most benefit from a massage, generally the person being massaged should give the therapist accurate health information, report discomfort of any kind (whether it's from the massage itself or due to the room temperature or any other distractions), and be as receptive and open to the process as possible.

Insurance coverage for massage therapy varies widely. There tends to be greater coverage in states that license massage therapy. In most cases, a physician's prescription for massage therapy is needed. Once massage therapy is prescribed, authorization from the insurer may be needed if coverage is not clearly spelled out in one's policy or plan.

Preparations

Going for a massage requires little in the way of preparation. Generally, one should be clean and should not eat just before a massage. One should not be under the influence of alcohol or non-medicinal drugs. Massage therapists generally work by appointment and usually will provide information about how to prepare for an appointment at the time of making the appointment.

Precautions

Massage is comparatively safe. However, it is generally contraindicated, i.e., it should not be used if a person has one of the following conditions: advanced heart diseases, hypertension (high blood pressure ), phlebitis, thrombosis, embolism, kidney failure, cancer if massage would accelerate metastasis (i.e., spread a tumor) or damage tissue that is fragile due to chemotherapy or other treatment, infectious diseases, contagious skin conditions, acute inflammation, infected injuries, unhealed fractures , dislocations, frostbite, large hernias, torn ligaments, conditions prone to hemorrhage, and psychosis.

Massage should not be used locally on affected areas for the following conditions: rheumatoid arthritis flare up, eczema, goiter, and open skin lesions. Massage may be used on the areas of the body that are not affected by these conditions.

In some cases, precautions should be taken before using massage for the following conditions: pregnancy , high fevers, osteoporosis , diabetes, recent postoperative cases in which pain and muscular splinting (i.e., tightening as a protective reaction) would be increased, apprehension, and mental conditions that may impair communication or perception. In such cases, massage may or may not be appropriate. The decision on whether to use massage must be based on whether it may cause harm. For example, if someone has osteoporosis, the concern is whether bones are strong enough to withstand the pressure applied. If one has a health condition and has any hesitation about whether massage therapy would be appropriate, a physician should be consulted.

Side effects

Massage therapy does not have side effects. Sometimes people are concerned that massage may leave them too relaxed or too mentally unfocused. To the contrary, massage tends to leave people feeling more relaxed and alert.

Research and general acceptance

Before 1939, more than 600 research studies on massage appeared in the main journals of medicine in English. However, the pace of research was slowed by medicine's disinterest in massage therapy.

Massage therapy research picked up again in the 1980s, as the growing popularity of massage paralleled the growing interest in complementary and alternative medicine. Well designed studies have documented the benefits of massage therapy for the treatment of acute and chronic pain, acute and chronic inflammation, chronic lymphedema, nausea, muscle spasm, various soft tissue dysfunctions, anxiety, depression, insomnia, and psycho-emotional stress, which may aggravate mental illness.

Premature infants treated with daily massage therapy gain more weight and have shorter hospital stays than infants who are not massaged. A study of 40 low-birth-weight babies found that the 20 massaged babies had a 47% greater weight gain per day and stayed in the hospital an average of six days less than 20 infants who did not receive massage, resulting a cost savings of approximately $3,000 per infant. Cocaine-exposed, preterm infants given massage three times daily for a 10 day period showed significant improvement. Results indicated that massaged infants had fewer postnatal complications and exhibited fewer stress behaviors during the 10 day period, had a 28% greater daily weight gain, and demonstrated more mature motor behaviors.

A study comparing 52 hospitalized depressed and adjustment disorder children and adolescents with a control group that viewed relaxation videotapes, found massage therapy subjects were less depressed and anxious, and had lower saliva cortisol levels (an indicator of less depression).

Another study showed massage therapy produced relaxation in 18 elderly subjects, demonstrated in measures such as decreased blood pressure and heart rate and increased skin temperature.

A combination of massage techniques for 52 subjects with traumatically induced spinal pain led to significant improvements in acute and chronic pain and increased muscle flexibility and tone. This study also found massage therapy to be extremely cost effective, with cost savings ranging from 15–50%. Massage has also been shown to stimulate the body's ability to naturally control pain by stimulating the brain to produce endorphins. Fibromyalgia is an example of a condition that may be favorably affected by this effect.

A pilot study of five subjects with symptoms of tension and anxiety found a significant response to massage therapy in one or more psycho-physiological parameters of heart rate, frontalis and forearm extensor electromyograms (EMGs) and skin resistance, which demonstrate relaxation of muscle tension and reduced anxiety.

Lymph drainage massage has been shown to be more effective than mechanized methods or diuretic drugs to control lymphedema secondary to radical mastectomy, consequently using massage to control lymphedema would significantly lower treatment costs. A study found that massage therapy can have a powerful effect upon psycho-emotional distress in persons suffering from chronic inflammatory bowel disease. Massage therapy was effective in reducing the frequency of episodes of pain and disability in these patients.

Massage may enhance the immune system. A study suggests an increase in cytotoxic capacity associated with massage. A study of chronic fatigue syndrome subjects found that a group receiving massage therapy had lower depression, emotional distress, and somatic symptom scores, more hours of sleep, and lower epinephrine and cortisol levels than a control group.

Training and certification

The generally accepted standard for training is a minimum of 500 classroom hours. Training should include anatomy, physiology, pathology, massage theory and technique, and supervised practice. Most massage therapists also take additional courses and workshops during their careers.

In the United States, massage therapists are currently licensed by 29 states, the District of Columbia, and a number of localities. Most states require 500 or more classroom hours of training from a recognized training program and passing an examination.

A national certification program was inaugurated in June 1992 by the National Certification Board for Therapeutic Massage and Bodywork (NCBTMB). The NCBTMB program is accredited by the National Commission for Certifying Agencies, the chief outside agency for evaluating certification programs. Those certified can use the title Nationally Certified in Therapeutic Massage and Bodywork (NCTMB). Most states use the NCBTMB exam for their licensing exams.

A national accreditation agency, the Commission on Massage Therapy Accreditation, designed according to the guidelines of the U.S. Department of Education, currently recognizes about 70 training programs. The Accrediting Commission of Career Schools and Colleges of Technology and the Accrediting Council for Continuing Education and Training also accredit massage training programs.

Resources

BOOKS

Beck, Mark F. Milady's Theory and Practice of Therapeutic Massage. Milady Publishing, 1994.

Capellini, Steve. Massage Therapy Career Guide for Hands-On Success. Milady Publishing, 1998.

Downing, George. The Massage Book. New York: Random House, 1998.

Loving, Jean E. Massage Therapy: Theory and Practice. Appleton & Lange, 1998.

PERIODICALS

Field, T., W. Sunshine, M. Hernandez-Reif, and O. Quintino. "Chronic fatigue syndrome: massage therapy effects on depression and somatic symptoms in chronic fatigue syndrome." Journal of Chronic Fatigue Syndrome (1997): 43-51.

Ironson, G., T. Field, F. Scafidi, and M. Hashimoto. "Massage therapy is associated with enhancement of the immune system's cytotoxic capacity." International Journal of Neuroscience (February 1996): 205-217.

Joachim, G. "The effects of two stress management techniques on feelings of well-being in patients with inflammatory bowel disease." Nursing Papers (1983): 4, 5-18.

Kaarda, B., and O. Tosteinbo. "Increase of plasma beta-endorphins in connective tissue massage." General Pharmacology (1989): 487-489.

Scafidi, F., T. Field, A. Wheeden, S. Schanberg, C. Kuhn, R. Symanski, E. Zimmerman, and E. S. Bandstra. "Cocaine exposed preterm neonates show behavioral and hormonal differences." Pediatrics (June 1996): 851-855.

Weintraub, M. "Shiatsu, Swedish muscle massage, and trigger point suppression in spinal pain syndrome." American Massage Therapy Journal 31, Summer 1992:3; 99-109.

ORGANIZATIONS

American Massage Therapy Association. <http://www.amtamassage.org>.

Elliot Greene

Massage Therapy

views updated May 29 2018

Massage Therapy

Definition

Massage therapy is the scientific manipulation of the soft tissues of the body for the purpose of normalizing those tissues and consists of manual techniques that include applying fixed or movable pressure, holding, and/or causing movement of or to the body.

Origins

Massage therapy is one of the oldest health care practices known to history. References to massage are found in Chinese medical texts more than 4,000 years old. Massage has been advocated in Western health care practices at least since the time of Hippocrates, the "Father of Medicine." In the fourth century b.c. Hippocrates wrote, "The physician must be acquainted with many things and assuredly with rubbing" (the ancient Greek term for massage was rubbing).

The roots of modern, scientific massage therapy go back to Per Henrik Ling (1776–1839), a Swede, who developed an integrated system consisting of massage and active and passive exercises. Ling established the Royal Central Gymnastic Institute in Sweden in 1813 to teach his methods.

Modern, scientific massage therapy was introduced in the United States in the 1850s by two New York physicians, brothers George and Charles Taylor, who had studied in Sweden. The first clinics for massage therapy in the United States were opened by two Swedish physicians after the Civil War period. Doctor Baron Nils Posse operated the Posse Institute in Boston and Doctor Hartwig Nissen opened the Swedish Health Institute near the Capitol in Washington, D.C.

Although there were periods when massage fell out of favor, in the 1960s it made a comeback in a different way as a tool for relaxation, communication, and alternative healing. Today, massage is one of the most popular healing modalities. It is used by conventional, as well as alternative, medical communities and is now covered by some health insurance plans.

Benefits

Generally, massage is known to affect the circulation of blood and the flow of blood and lymph, reduce muscular tension or flaccidity, affect the nervous system through stimulation or sedation, and enhance tissue healing. These effects provide a number of benefits:

  • reduction of muscle tension and stiffness
  • relief of muscle spasms
  • greater flexibility and range of motion
  • increase of the ease and efficiency of movement
  • relief of stress and aide of relaxation
  • promotion of deeper and easier breathing
  • improvement of the circulation of blood and movement of lymph
  • relief of tension-related conditions, such as headaches and eyestrain
  • promotion of faster healing of soft tissue injuries, such as pulled muscles and sprained ligaments, and reduction in pain and swelling related to such injuries
  • reduction in the formation of excessive scar tissue following soft tissue injuries
  • enhancement in the health and nourishment of skin
  • improvement in posture through changing tension patterns that affect posture
  • reduction in stress and an excellent stress management tool
  • creation of a feeling of well-being
  • reduction in levels of anxiety
  • increase in awareness of the mind-body connection
  • promotion of a relaxed state of mental awareness

Massage therapy also has a number of documented clinical benefits. For example, massage can reduce anxiety, improve pulmonary function in young asthma patients, reduce psycho-emotional distress in persons suffering from chronic inflammatory bowel disease, increase weight and improve motor development in premature infants, and may enhance immune system functioning. Some medical conditions that massage therapy can help are: allergies, anxiety and stress, arthritis, asthma and bronchitis, carpal tunnel syndrome and other repetitive motion injuries, chronic and temporary pain, circulatory problems, depression, digestive disorders, tension headache, insomnia, myofascial pain, sports injuries, and temporomandibular joint dysfunction.

Description

Massage therapy is the scientific manipulation of the soft tissues of the body for the purpose of normalizing those tissues and consists of a group of manual techniques that include applying fixed or movable pressure, holding, and/or causing movement of or to the body. While massage therapy is applied primarily with the hands, sometimes the forearms or elbows are used. These techniques affect the muscular, skeletal, circulatory, lymphatic, nervous, and other systems of the body. The basic philosophy of massage therapy embraces the concept of vis Medicatrix naturae, which is aiding the ability of the body to heal itself, and is aimed at achieving or increasing health and well-being.

Touch is the fundamental medium of massage therapy. While massage can be described in terms of the type of techniques performed, touch is not used solely in a mechanistic way in massage therapy. One could look at a diagram or photo of a massage technique that depicts where to place one's hands and what direction the stroke should go, but this would not convey everything that is important for giving a good massage. Massage also has an artistic component.

Because massage usually involves applying touch with some degree of pressure and movement, the massage therapist must use touch with sensitivity in order to determine the optimal amount of pressure to use for each person. For example, using too much pressure may cause the body to tense up, while using too little may not have enough effect. Touch used with sensitivity also allows the massage therapist to receive useful information via his or her hands about the client's body, such as locating areas of muscle tension and other soft tissue problems. Because touch is also a form of communication, sensitive touch can convey a sense of caring—an essential element in the therapeutic relationship—to the person receiving massage.

In practice, many massage therapists use more than one technique or method in their work and sometimes combine several. Effective massage therapists ascertain each person's needs and then use the techniques that will meet those needs best.

Swedish massage uses a system of long gliding strokes, kneading, and friction techniques on the more superficial layers of muscles, generally in the direction of blood flow toward the heart, and sometimes combined with active and passive movements of the joints. It is used to promote general relaxation, improve circulation and range of motion, and relieve muscle tension. Swedish massage is the most commonly used form of massage.

Deep tissue massage is used to release chronic patterns of muscular tension using slow strokes, direct pressure, or friction directed across the grain of the muscles. It is applied with greater pressure and to deeper layers of muscle than Swedish, which is why it is called deep tissue and is effective for chronic muscular tension.

Sports massage uses techniques that are similar to Swedish and deep tissue, but are specially adapted to deal with the effects of athletic performance on the body and the needs of athletes regarding training, performing, and recovery from injury.

Neuromuscular massage is a form of deep massage that is applied to individual muscles. It is used primarily to release trigger points (intense knots of muscle tension that refer pain to other parts of the body), and also to increase blood flow. It is often used to reduce pain. Trigger point massage and myotherapy are similar forms.

Acupressure applies finger or thumb pressure to specific points located on the acupuncture meridians (channels of energy flow identified in Asian concepts of anatomy) in order to release blocked energy along these meridians that causes physical discomforts, and re-balance the energy flow. Shiatsu is a Japanese form of acupressure.

The cost of massage therapy varies according to geographic location, experience of the massage therapist, and length of the massage. In the United States, the average range is from $35-60 for a one hour session. Massage therapy sessions at a client's home or office may cost more due to travel time for the massage therapist. Most sessions are one hour. Frequency of massage sessions can vary widely. If a person is receiving massage for a specific problem, frequency can vary widely based on the condition, though it usually will be once a week. Some people incorporate massage into their regular personal health and fitness program. They will go for massage on a regular basis, varying from once a week to once a month.

The first appointment generally begins with information gathering, such as the reason for getting massage therapy, physical condition and medical history, and other areas. The client is asked to remove clothing to one's level of comfort. Undressing takes place in private, and a sheet or towel is provided for draping. The massage therapist will undrape only the part of the body being massaged. The client's modesty is respected at all times. The massage therapist may use an oil or cream, which will be absorbed into the skin in a short time.

To receive the most benefit from a massage, generally the person being massaged should give the therapist accurate health information, report discomfort of any kind (whether it's from the massage itself or due to the room temperature or any other distractions), and be as receptive and open to the process as possible.

Insurance coverage for massage therapy varies widely. There tends to be greater coverage in states that license massage therapy. In most cases, a physician's prescription for massage therapy is needed. Once massage therapy is prescribed, authorization from the insurer may be needed if coverage is not clearly spelled out in one's policy or plan.

Preparations

Going for a massage requires little in the way of preparation. Generally, one should be clean and should not eat just before a massage. One should not be under the influence of alcohol or non-medicinal drugs. Massage therapists generally work by appointment and usually will provide information about how to prepare for an appointment at the time of making the appointment.

Precautions

Massage is comparatively safe. However, it is generally contraindicated, (should not be used) if a person has one of the following conditions: advanced heart diseases, hypertension (high blood pressure ), phlebitis, thrombosis, embolism, kidney failure, cancer if massage would accelerate metastasis (i.e., spread a tumor) or damage tissue that is fragile due to chemotherapy or other treatment, infectious diseases, contagious skin conditions, acute inflammation, infected injuries, unhealed fractures, dislocations, frostbite, large hernias, torn ligaments, conditions prone to hemorrhage, and psychosis.

Massage should not be used locally on affected areas for the following conditions: rheumatoid arthritis flare up, eczema, goiter, and open skin lesions. Massage may be used on the areas of the body that are not affected by these conditions.

In some cases, precautions should be taken before using massage for the following conditions: pregnancy, high fevers, osteoporosis, diabetes, recent postoperative cases in which pain and muscular splinting (i.e., tightening as a protective reaction) would be increased, apprehension, and mental conditions that may impair communication or perception. In such cases, massage may or may not be appropriate. The decision on whether to use massage must be based on whether it may cause harm. For example, if someone has osteoporosis, the concern is whether bones are strong enough to withstand the pressure applied. If one has a health condition and has any hesitation about whether massage therapy would be appropriate, a physician should be consulted.

Side effects

Massage therapy does not have side effects. Sometimes people are concerned that massage may leave them too relaxed or too mentally unfocused. To the contrary, massage tends to leave people feeling more relaxed and alert.

Research and general acceptance

Before 1939, more than 600 research studies on massage appeared in the main journals of medicine in English. However, the pace of research was slowed by medicine's disinterest in massage therapy.

Massage therapy research picked up again in the 1980s, as the growing popularity of massage paralleled the growing interest in complementary and alternative medicine. Well designed studies have documented the benefits of massage therapy for the treatment of acute and chronic pain, acute and chronic inflammation, chronic lymphedema, nausea, muscle spasm, various soft tissue dysfunctions, anxiety, depression, insomnia, and psycho-emotional stress, which may aggravate mental illness.

Premature infants treated with daily massage therapy gain more weight and have shorter hospital stays than infants who are not massaged. A study of 40 low-birth-weight babies found that the 20 massaged babies had a 47% greater weight gain per day and stayed in the hospital an average of six days less than 20 infants who did not receive massage, resulting a cost savings of approximately $3,000 per infant. Cocaine-exposed, preterm infants given massage three times daily for a 10 day period showed significant improvement. Results indicated that massaged infants had fewer postnatal complications and exhibited fewer stress behaviors during the 10 day period, had a 28% greater daily weight gain, and demonstrated more mature motor behaviors.

A study comparing 52 hospitalized depressed and adjustment disorder children and adolescents with a control group that viewed relaxation videotapes, found massage therapy subjects were less depressed and anxious, and had lower saliva cortisol levels (an indicator of less depression).

Another study showed massage therapy produced relaxation in 18 elderly subjects, demonstrated in measures such as decreased blood pressure and heart rate and increased skin temperature.

A combination of massage techniques for 52 subjects with traumatically induced spinal pain led to significant improvements in acute and chronic pain and increased muscle flexibility and tone. This study also found massage therapy to be extremely cost effective, with cost savings ranging from 15-50%. Massage has also been shown to stimulate the body's ability to naturally control pain by stimulating the brain to produce endorphins. Fibromyalgia is an example of a condition that may be favorably affected by this effect.

A pilot study of five subjects with symptoms of tension and anxiety found a significant response to massage therapy in one or more psycho-physiological parameters of heart rate, frontalis and forearm extensor electromyograms (EMGs) and skin resistance, which demonstrate relaxation of muscle tension and reduced anxiety.

Lymph drainage massage has been shown to be more effective than mechanized methods or diuretic drugs to control lymphedema secondary to radical mastectomy, consequently using massage to control lymphedema would significantly lower treatment costs. A study found that massage therapy can have a powerful effect upon psycho-emotional distress in persons suffering from chronic inflammatory bowel disease. Massage therapy was effective in reducing the frequency of episodes of pain and disability in these patients.

Massage may enhance the immune system. A study suggests an increase in cytotoxic capacity associated with massage. A study of chronic fatigue syndrome subjects found that a group receiving massage therapy had lower depression, emotional distress, and somatic symptom scores, more hours of sleep, and lower epinephrine and cortisol levels than a control group.

Training and certification

The generally accepted standard for training is a minimum of 500 classroom hours. Training should include anatomy, physiology, pathology, massage theory and technique, and supervised practice. Most massage therapists also take additional courses and workshops during their careers.

In the United States, massage therapists are currently licensed by 29 states, the District of Columbia, and a number of localities. Most states require 500 or more classroom hours of training from a recognized training program and passing an examination.

A national certification program was inaugurated in June 1992 by the National Certification Board for Therapeutic Massage and Bodywork (NCBTMB). The NCBTMB program is accredited by the National Commission for Certifying Agencies, the chief outside agency for evaluating certification programs. Those certified can use the title Nationally Certified in Therapeutic Massage and Bodywork (NCTMB). Most states use the NCBTMB exam for their licensing exams.

A national accreditation agency, the Commission on Massage Therapy Accreditation, designed according to the guidelines of the U.S. Department of Education, currently recognizes about 70 training programs. The Accrediting Commission of Career Schools and Colleges of Technology and the Accrediting Council for Continuing Education and Training also accredit massage training programs.

Resources

BOOKS

Beck, Mark F. Milady's Theory and Practice of Therapeutic Massage. Milady Publishing, 1994.

Capellini, Steve. Massage Therapy Career Guide for Hands-On Success. Milady Publishing, 1998.

Downing, George. The Massage Book. New York: Random House, 1998.

Loving, Jean E. Massage Therapy: Theory and Practice. Appleton & Lange, 1998.

PERIODICALS

Field, T., W. Sunshine, M. Hernandez-Reif, and O. Quintino. "Chronic fatigue syndrome: massage therapy effects on depression and somatic symptoms in chronic fatigue syndrome." Journal of Chronic Fatigue Syndrome (1997): 43-51.

Ironson, G., T. Field, F. Scafidi, and M. Hashimoto. "Massage therapy is associated with enhancement of the immune system's cytotoxic capacity." International Journal of Neuroscience (February 1996): 205-217.

Joachim, G. "The effects of two stress management techniques on feelings of well-being in patients with inflammatory bowel disease." Nursing Papers (1983): 4, 5-18.

Kaarda, B., and O. Tosteinbo. "Increase of plasma betaendorphins in connective tissue massage." General Pharmacology (1989): 487-489.

Scafidi, F., T. Field, A. Wheeden, S. Schanberg, C. Kuhn, R. Symanski, E. Zimmerman, and E.S. Bandstra. "Cocaine exposed preterm neonates show behavioral and hormonal differences." Pediatrics (June 1996): 851-855.

Weintraub, M. "Shiatsu, Swedish muscle massage, and trigger point suppression in spinal pain syndrome." American Massage Therapy Journal 31, no. 3(Summer 1992): 99-109.

ORGANIZATIONS

American Massage Therapy Association. 〈http://www.amtamassage.org〉.

Massage Therapy

views updated May 18 2018

Massage Therapy

Definition

Massage therapy is the scientific manipulation of the soft tissues of the body for the purpose of normalizing those tissues and consists of manual techniques that include applying fixed or movable pressure, holding, and/or causing movement of or to the body.

Purpose

Generally, massage is known to affect the circulation of blood and the flow of blood and lymph, reduce muscular tension or flaccidity, affect the nervous system through stimulation or sedation, and enhance tissue healing. These effects provide a number of benefits:

  • reduction of muscle tension and stiffness
  • relief of muscle spasms
  • greater flexibility and range of motion
  • increase of the ease and efficiency of movement
  • relief of stress and aide of relaxation
  • promotion of deeper and easier breathing
  • improvement of the circulation of blood and movement of lymph
  • relief of tension-related conditions, such as headaches and eyestrain
  • promotion of faster healing of soft tissue injuries, such as pulled muscles and sprained ligaments, and reduction in pain and swelling related to such injuries
  • reduction in the formation of excessive scar tissue following soft tissue injuries
  • enhancement in the health and nourishment of skin
  • improvement in posture through changing tension patterns that affect posture
  • reduction in stress and an excellent stress management tool
  • creation of a feeling of well-being
  • reduction in levels of anxiety
  • increase in awareness of the mind-body connection
  • promotion of a relaxed state of mental awareness

Massage therapy also has a number of documented clinical benefits. For example, massage can reduce anxiety, improve pulmonary function in young asthma patients, reduce psycho-emotional distress in persons suffering from chronic inflammatory bowel disease, increase weight and improve motor development in premature infants, and may enhance immune system functioning. Some medical conditions that massage therapy can help are: allergies, anxiety and stress, arthritis, asthma and bronchitis, carpal tunnel syndrome and other repetitive motion injuries, chronic and temporary pain, circulatory problems, depression, digestive disorders, tension headache, insomnia, myofascial pain, sports injuries, and temporomandibular joint dysfunction.

Description

Origins

Massage therapy is one of the oldest health care practices known to history. References to massage are found in Chinese medical texts more than 4,000 years old. Massage has been advocated in Western health care practices at least since the time of Hippocrates, the "Father of Medicine." In the fourth century b.c. Hippocrates wrote, "The physician must be acquainted with many things and assuredly with rubbing" (the ancient Greek term for massage was rubbing).

The roots of modern, scientific massage therapy go back to Per Henrik Ling (17761839), a Swede, who developed an integrated system consisting of massage and active and passive exercises. Ling established the Royal Central Gymnastic Institute in Sweden in 1813 to teach his methods.

Modern, scientific massage therapy was introduced in the United States in the 1850s by two New York physicians, brothers George and Charles Taylor, who had studied in Sweden. The first clinics for massage therapy in the United States were opened by two Swedish physicians after the Civil War period. Doctor Baron Nils Posse operated the Posse Institute in Boston and Doctor Hartwig Nissen opened the Swedish Health Institute near the Capitol in Washington, D.C.

Although there were periods when massage fell out of favor, in the 1960s it made a comeback in a different way as a tool for relaxation, communication, and alternative healing. Today, massage is one of the most popular healing modalities. It is used by conventional, as well as alternative, medical communities and is now covered by some health insurance plans.

Massage therapy is the scientific manipulation of the soft tissues of the body for the purpose of normalizing those tissues and consists of a group of manual techniques that include applying fixed or movable pressure, holding, and/or causing movement of or to the body. While massage therapy is applied primarily with the hands, sometimes the forearms or elbows are used. These techniques affect the muscular, skeletal, circulatory, lymphatic, nervous, and other systems of the body. The basic philosophy of massage therapy embraces the concept of vis Medicatrix naturae, which is aiding the ability of the body to heal itself, and is aimed at achieving or increasing health and well-being.

Touch is the fundamental medium of massage therapy. While massage can be described in terms of the type of techniques performed, touch is not used solely in a mechanistic way in massage therapy. One could look at a diagram or photo of a massage technique that depicts where to place one's hands and what direction the stroke should go, but this would not convey everything that is important for giving a good massage. Massage also has an artistic component.

Because massage usually involves applying touch with some degree of pressure and movement, the massage therapist must use touch with sensitivity in order to determine the optimal amount of pressure to use for each person. For example, using too much pressure may cause the body to tense up, while using too little may not have enough effect. Touch used with sensitivity also allows the massage therapist to receive useful information via his or her hands about the client's body, such as locating areas of muscle tension and other soft tissue problems. Because touch is also a form of communication, sensitive touch can convey a sense of caringan essential element in the therapeutic relationshipto the person receiving massage.

In practice, many massage therapists use more than one technique or method in their work and sometimes combine several. Effective massage therapists ascertain each person's needs and then use the techniques that will meet those needs best.

Swedish massage uses a system of long gliding strokes, kneading, and friction techniques on the more superficial layers of muscles, generally in the direction of blood flow toward the heart, and sometimes combined with active and passive movements of the joints. It is used to promote general relaxation, improve circulation and range of motion, and relieve muscle tension. Swedish massage is the most commonly used form of massage.

Deep tissue massage is used to release chronic patterns of muscular tension using slow strokes, direct pressure, or friction directed across the grain of the muscles. It is applied with greater pressure and to deeper layers of muscle than Swedish, which is why it is called deep tissue and is effective for chronic muscular tension.

Sports massage uses techniques that are similar to Swedish and deep tissue, but are specially adapted to deal with the effects of athletic performance on the body and the needs of athletes regarding training, performing, and recovery from injury.

Neuromuscular massage is a form of deep massage that is applied to individual muscles. It is used primarily to release trigger points (intense knots of muscle tension that refer pain to other parts of the body), and also to increase blood flow. It is often used to reduce pain. Trigger point massage and myotherapy are similar forms.

Acupressure applies finger or thumb pressure to specific points located on the acupuncture meridians (channels of energy flow identified in Asian concepts of anatomy) in order to release blocked energy along these meridians that causes physical discomforts, and re-balance the energy flow. Shiatsu is a Japanese form of acupressure.

The cost of massage therapy varies according to geographic location, experience of the massage therapist, and length of the massage. In the United States, the average range is from $35-60 for a one hour session. Massage therapy sessions at a client's home or office may cost more due to travel time for the massage therapist. Most sessions are one hour. Frequency of massage sessions can vary widely. If a person is receiving massage for a specific problem, frequency can vary widely based on the condition, though it usually will be once a week. Some people incorporate massage into their regular personal health and fitness program. They will go for massage on a regular basis, varying from once a week to once a month.

The first appointment generally begins with information gathering, such as the reason for getting massage therapy, physical condition and medical history, and other areas. The client is asked to remove clothing to one's level of comfort. Undressing takes place in private, and a sheet or towel is provided for draping. The massage therapist will undrape only the part of the body being massaged. The client's modesty is respected at all times. The massage therapist may use an oil or cream, which will be absorbed into the skin in a short time.

To receive the most benefit from a massage, generally the person being massaged should give the therapist accurate health information, report discomfort of any kind (whether it is from the massage itself or due to the room temperature or any other distractions), and be as receptive and open to the process as possible.

Insurance coverage for massage therapy varies widely. There tends to be greater coverage in states that license massage therapy. In most cases, a physician's prescription for massage therapy is needed. Once massage therapy is prescribed, authorization from the insurer may be needed if coverage is not clearly spelled out in one's policy or plan.

Preparations

Going for a massage requires little in the way of preparation. Generally, one should be clean and should not eat just before a massage. One should not be under the influence of alcohol or non-medicinal drugs. Massage therapists generally work by appointment and usually will provide information about how to prepare for an appointment at the time of making the appointment.

Precautions

Massage is comparatively safe; however it is generally contraindicated, i.e., it should not be used, if a person has one of the following conditions: advanced heart diseases, hypertension (high blood pressure), phlebitis, thrombosis, embolism, kidney failure, cancer if massage would accelerate metastasis (i.e., spread a tumor) or damage tissue that is fragile due to chemotherapy or other treatment, infectious diseases, contagious skin conditions, acute inflammation, infected injuries, unhealed fractures, dislocations, frostbite, large hernias, torn ligaments, conditions prone to hemorrhage, and psychosis.

Massage should not be used locally on affected areas (i.e., avoid using massage on the specific areas of the body that are affected by the condition) for the following conditions: rheumatoid arthritis flare up, eczema, goiter, and open skin lesions. Massage may be used on the areas of the body that are not affected by these conditions.

In some cases, precautions should be taken before using massage for the following conditions: pregnancy, high fevers, osteoporosis, diabetes, recent postoperative cases in which pain and muscular splinting (i.e., tightening as a protective reaction) would be increased, apprehension, and mental conditions that may impair communication or perception. In such cases, massage may or may not be appropriate. The decision on whether to use massage must be based on whether it may cause harm. For example, if someone has osteoporosis, the concern is whether bones are strong enough to withstand the pressure applied. If one has a health condition and has any hesitation about whether massage therapy would be appropriate, a physician should be consulted.

Side effects

Massage therapy does not have side effects. Sometimes people are concerned that massage may leave them too relaxed or too mentally unfocused. To the contrary, massage tends to leave people feeling more relaxed and alert.

Research and general acceptance

Before 1939, more than 600 research studies on massage appeared in the main journals of medicine in English. However, the pace of research was slowed by medicine's disinterest in massage therapy.

Massage therapy research picked up again in the 1980s, as the growing popularity of massage paralleled the growing interest in complementary and alternative medicine. Well designed studies have documented the benefits of massage therapy for the treatment of acute and chronic pain, acute and chronic inflammation, chronic lymphedema, nausea, muscle spasm, various soft tissue dysfunctions, anxiety, depression, insomnia, and psycho-emotional stress, which may aggravate mental illness.

Premature infants treated with daily massage therapy gain more weight and have shorter hospital stays than infants who are not massaged. A study of 40 low-birth-weight babies found that the 20 massaged babies had a 47% greater weight gain per day and stayed in the hospital an average of six days less than 20 infants who did not receive massage, resulting a cost savings of approximately $3,000 per infant. Cocaine-exposed, preterm infants given massage three times daily for a 10 day period showed significant improvement. Results indicated that massaged infants had fewer postnatal complications and exhibited fewer stress behaviors during the 10 day period, had a 28% greater daily weight gain, and demonstrated more mature motor behaviors.

A study comparing 52 hospitalized depressed and adjustment disorder children and adolescents with a control group that viewed relaxation videotapes, found massage therapy subjects were less depressed and anxious, and had lower saliva cortisol levels (an indicator of less depression).

Another study showed massage therapy produced relaxation in 18 elderly subjects, demonstrated in measures such as decreased blood pressure and heart rate and increased skin temperature.

A combination of massage techniques for 52 subjects with traumatically induced spinal pain led to significant improvements in acute and chronic pain and increased muscle flexibility and tone. This study also found massage therapy to be extremely cost effective, with cost savings ranging from 15-50%. Massage has also been shown to stimulate the body's ability to naturally control pain by stimulating the brain to produce endorphins. Fibromyalgia is an example of a condition that may be favorably affected by this effect.

A pilot study of five subjects with symptoms of tension and anxiety found a significant response to massage therapy in one or more psycho-physiological parameters of heart rate, frontalis and forearm extensor electromyograms (EMGs) and skin resistance, which demonstrate relaxation of muscle tension and reduced anxiety.

Lymph drainage massage has been shown to be more effective than mechanized methods or diuretic drugs to control lymphedema secondary to radical mastectomy, consequently using massage to control lymphedema would significantly lower treatment costs. A study found that massage therapy can have a powerful effect upon psycho-emotional distress in persons suffering from chronic inflammatory bowel disease. Massage therapy was effective in reducing the frequency of episodes of pain and disability in these patients.

Massage may enhance the immune system. A study suggests an increase in cytotoxic capacity associated with massage. A study of chronic fatigue syndrome subjects found that a group receiving massage therapy had lower depression, emotional distress, and somatic symptom scores, more hours of sleep, and lower epinephrine and cortisol levels than a control group.

Resources

ORGANIZATIONS

American Massage Therapy Association. 820 Davis Street, Suite 100, Evanston, IL. http://www.amtamassage.org.

Massage Therapy

views updated May 18 2018

Massage therapy

Definition

Massage therapy is the scientific manipulation of the soft tissues of the body, consisting primarily of manual (hands-on) techniques such as applying fixed or movable pressure, holding, and moving muscles and body tissues.

Purpose

Generally, massage is delivered to improve the flow of blood and lymph (fluid in lymph glands, part of immune system), to reduce muscular tension or flaccidity, to affect the nervous system through stimulation or sedation, and to enhance tissue healing. Therapeutic massage may be recommended for children and adults to deliver benefits such as the following:

  • reducing muscle tension and stiffness
  • relieving muscle spasms
  • increasing joint and limb flexibility and range of motion
  • increasing ease and efficiency of movement
  • relieving points of tension and overall stress; inducing relaxation
  • promoting deeper and easier breathing
  • improving blood circulation and movement of lymph
  • relieving tension-related headaches and eyestrain
  • promoting faster healing of soft tissue injuries, such as pulled muscles and sprained ligaments
  • reducing pain and swelling related to injuries
  • reducing the formation of scar tissue following soft tissue injuries
  • enhancing health and nourishment of skin
  • improving posture by changing tension patterns that affect posture
  • reducing emotional or physical stress and reducing anxiety
  • promoting feelings of well-being
  • increasing awareness of the mind-body connection and improving mental awareness and alertness generally

Massage therapy may also be recommended for its documented clinical benefits such as improving pulmonary function in young asthma patients, reducing psychoemotional distress in individuals who suffer from chronic inflammatory bowel disease, helping with weight gain, improving motor development in premature infants, and enhancing immune system functioning.

Description

Massage therapy is one of the oldest healthcare practices known. References to massage are found in ancient Chinese medical texts written more than 4,000 years ago. Massage has been advocated in Western healthcare practices since the time of Hippocrates, the "father of medicine."

Massage therapy is the scientific manipulation of the soft tissues of the body for the purpose of normalizing those tissues and consists of a group of manual techniques that include applying fixed or movable pressure, holding, and/or causing movement to parts of the body. While massage therapy is applied primarily with the hands, sometimes the forearms or elbows are used. These techniques affect the muscular, skeletal, circulatory, lymphatic, nervous, and other systems of the body. The basic philosophy of massage therapy embraces the concept of vis Medicatrix naturae, which means "aiding the ability of the body to heal itself."

Touch is the fundamental medium of massage therapy. While massage can be described in terms of the type of techniques performed, touch is not used solely in a mechanistic way in massage therapy. Because massage usually involves applying touch with some degree of pressure and movement, the massage therapist must use touch with sensitivity in order to determine the optimal amount of pressure to use for each person. For example, using too much pressure may cause the body to tense up, while using too little may not have enough effect. Touch used with sensitivity also allows the massage therapist to receive useful information via his or her hands about the individual's body, such as locating areas of muscle tension and other soft tissue problems. Because touch is also a form of communication, sensitive touch can convey a sense of caring to the person receiving massage, enhancing the individual's sense of self and well being.

In practice, many massage therapists use more than one technique or method in their work and sometimes combine several. Effective massage therapists ascertain each person's needs and then use the techniques that will best meet those needs.

Swedish massage is the most commonly used form of massage. It uses a system of long gliding strokes, kneading, and friction techniques on the more superficial layers of muscles, generally in the direction of blood flow toward the heart, and sometimes combined with active and passive movements of the joints. It is used to promote general relaxation, improve circulation and range of motion, and relieve muscle tension.

Deep tissue massage is used to release chronic patterns of muscular tension using slow strokes, direct pressure, or friction directed across the grain of the muscles. It is applied with greater pressure and to deeper layers of muscle than Swedish, which is why it is called deep tissue and is effective for chronic muscular tension.

Sports massage uses techniques that are similar to Swedish and deep tissue but are specially adapted to deal with the effects of athletic performance on the body and the needs of athletes regarding training, performing, and recovery from injury.

Neuromuscular massage is a form of deep massage that is applied to individual muscles. It is used primarily to release trigger points (intense knots of muscle tension that refer pain to other parts of the body) and also to increase blood flow. It is often used to reduce pain. Trigger point massage and myotherapy are similar forms.

Acupressure applies finger or thumb pressure to specific points located on the energy pathways or "meridians" in order to release blocked energy along these meridians that may be causing physical discomfort. The rebalance of energy flow releases tension and restores function of organs and muscles in the body. Shiatsu is a Japanese form of acupressure that applies these principles.

Massage therapy sessions can be at home or in a professional office. Most sessions are one hour. Frequency of massage sessions can vary widely as needed based on the condition being treated. The cost of massage therapy varies according to geographic location, experience of the massage therapist, and length of the massage. In the United States, as of 2004, the average range is from $35 to $60 for a one-hour session.

The first appointment generally begins with information gathering, such as the reason for getting massage therapy, physical condition and medical history, and other areas. The client is asked to remove clothing to one's level of comfort. Undressing takes place in private, and a sheet or towel is provided for draping. The massage therapist will undrape only the part of the body being massaged. The individual's modesty is respected at all times. The massage therapist may use an oil or cream, which is quickly absorbed into the skin.

Insurance coverage for massage therapy varies widely. There tends to be greater coverage in states that license massage therapy. In most cases, a physician's prescription for massage therapy is needed. Once massage therapy is prescribed, authorization from the insurer may be needed if coverage is not clearly spelled out in one's policy or plan.

Massage therapy may be recommended for children to help relieve conditions such as allergies , anxietyand stress, arthritis, asthma and bronchitis , joint or limb injuries, post-surgical muscle rehabilitation, chronic and temporary pain, circulatory problems, depression, digestive disorders, tension headaches, sleep problems or insomnia, myofascial pain, sports injuries , and eating problems associated with temporomandibular joint dysfunction.

Precautions

Massage is comparatively safe; however, it should not be used if the child has one of the following conditions.

If the child has cancer , massage is not advisable if the cancer is the kind that can spread to other organs (metastatic cancer) or if it involves tissue damage due tochemotherapy or other treatment. Massage may also not be advisable if the child has any of the following conditions.

  • a cold
  • an infectious disease
  • a contagious skin conditions
  • an acute inflammation
  • an infected injuries
  • an unhealed fractures
  • dislocations
  • is postoperative with a condition in which pain and muscular splinting are increased
  • has frostbite
  • has large hernias
  • has torn ligaments
  • has any condition prone to hemorrhage
  • has a psychosis
  • has any other psychological state that may impair communication or perception

Massage should not be used locally on affected areas (i.e., avoid using massage on the specific areas of the body that are affected by the condition) for the following conditions: eczema, goiter (thyroid dysfunction), and open skin lesions. Massage may be used on the areas of the body that are not affected by these conditions. The decision to use massage must be based on whether it may cause harm. A physician's recommendation is appropriate before a child with any health condition receives massage therapy.

Preparation

Going for a massage requires little in the way of preparation. Generally, one should be clean and should not eat just before a massage. Massage therapists generally work by appointment and usually provide information about how to prepare for an appointment. To receive the most benefit from a massage, parents should give the therapist accurate health information about the child and report discomfort of any kind (whether it is from the massage itself or due to the room temperature or any other distractions). The child can be encouraged to be as receptive to the process as possible.

Aftercare

There are no special recommendations for after a massage. A period of quiet activity or rest following the massage helps maintain full benefits from the procedure.

Risks

Massage therapy does not have notable side effects. Rather than feeling too relaxed or too mentally unfocused after a massage, a child may be both more relaxed and more alert.

Parental concerns

Parents who may not have experienced therapeutic massage themselves or who have doubts about its effectiveness may be interested in the results of research studies, particularly those conducted on groups of children. Well designed studies have documented the benefits of massage therapy for the treatment of acute and chronic pain, acute and chronic inflammation, chronic lymphedema, nausea , muscle spasm, various soft tissue dysfunctions, anxiety, depression, insomnia, and psychoemotional stress, which may aggravate mental illness.

KEY TERMS

Lymph Clear, slightly yellow fluid carried by a network of thin tubes to every part of the body. Cells that fight infection are carried in the lymph.

Manipulation Moving muscles or connective tissue to enhance function, ease tension, and reduce pain in those tissues as well as other beneficial effects.

Mind-body connection Rather than relying on an understanding of the term "psychosomatic," mind-body medicine acknowledges the influence of thinking and the cognitive process on the behavior of chemicals in the body, involving the mind in both creating the conditions for disease and helping to heal the effects of disease.

Psychoses Mental illness that interferes with an individual's ability to manage life's challenges and everyday activities. The impairment of cognitive ability that distorts reality.

Premature infants treated with daily massage therapy gain more weight and have shorter hospital stays than infants who are not massaged. A study of 40 low-birth-weight babies found that the 20 massaged babies had a 47 percent greater weight gain per day and stayed in the hospital an average of six fewer days than 20 infants who did not receive massage, resulting in a cost savings of approximately $3,000 per infant. Cocaine-exposed, preterm infants given massage three times daily for a 10-day period showed significant improvement. Results indicated that massaged infants had fewer postnatal complications and exhibited fewer stress behaviors during the 10-day period, had a 28 percent greater daily weight gain, and demonstrated more mature motor behaviors.

A study comparing 52 hospitalized depressed and adjustment disorder children and adolescents with a control group that viewed relaxation videotapes, found massage therapy subjects were less depressed and anxious and had lower saliva cortisol levels (an indicator of less depression).

Resources

BOOKS

Braun, Mary Beth, et al. Introduction to Massage Therapy. Baltimore, MD: Lippincott Williams & Wilkins, 2004.

Greene, Elliot, et al. The Psychology of the Body. Baltimore, MD: Lippincott Williams & Wilkins, 2003.

Hendrickson, Thomas G. Treating Soft Tissue Conditions with Orthopedic Massage. Baltimore, MD: Lippincott Williams & Wilkins, 2002.

Sinclair, Marybetts. Pediatric Massage Therapy. Baltimore, MD: Lippincott Williams & Wilkins, 2004.

ORGANIZATIONS

American Massage Therapy Association. 820 Davis Street, Suite 100, Evanston, IL 60201. Web site: <www.amtamassage.org>.

WEB SITES

National Certification Board for Therapeutic Massage and Bodywork. Available online at <www.ncbtmb.com> (accessed October 20, 2004).

L. Lee Culvert Elliot Greene

Massage Therapy

views updated May 23 2018

Massage Therapy

Massage therapy is the healing process by which the soft tissue of the body is manipulated by the hands of a trained therapist. Soft-tissue therapy includes the skin, muscles, tendons, ligaments, and the capsules that encase the various joints of the body.

Massage is a therapeutic technique that has been employed for many centuries in a number of cultures. Modern massage therapy has significant aspects in common with traditional Chinese medicines, including acupuncture and the use of various herbal remedies and the application of poultices, with the most important being that it is a proven aid to the enhancement of a number of physical functions.

Massage therapy is directed to a number of separate but related physical purposes. Injured muscles can be effectively manipulated to deliver pain relief in the affected areas; tight or contracted muscles can be relaxed through the application of various levels of manual pressure, especially when the muscles have been subjected to the stresses of athletic competition and training. The various massage techniques are effective in stimulating blood flow in the body. Massage is also useful in improving the function of the lymphatic system and the central nervous system.

Massage therapy is also employed for the purpose of relaxation. Stress is created in a number of circumstances for an athlete, both as a direct result of the production of the hormone adrenaline when the body perceives itself confronted by exciting circumstances, and indirectly through the accumulated effect of stressful circumstances. Diverse and critical functions such as heart rate, immune system, and the digestive tract are all adversely impacted by stress.

There are well over 50 different defined techniques used in the various applications of massage therapy. Many of these techniques are used in combination. Four common forms of massage therapy used to assist in the resolution of athletic injuries include:

  • Acupressure: This therapy is closely related to acupuncture procedures, which involve the utilization of the chi, the inherent healing energy believed to be present throughout the body, by manipulation of the tissues at defined pressure points. These pressure points are connected to the function of the internal organs and the circulation of blood throughout the body; their stimulation is designed to aid in the direction of healing power to an affected area. A technique similar to acupressure is that of shiatsu, a Japanese-derived system that involves the application of finger pressure to pre determined zones of the body.
  • Rolfing: This is a vigorous form of massage that involves a manipulation of the skin to effect a loosening of the underlying muscle structure. Rolfing is employed both as a preventative as well as a therapeutic treatment.
  • Swedish massage: This is a technique in which the basic direction of the hands in the course of the application is toward the heart of the person. The central object of a Swedish massage is improved circulation; it has also been employed as a technique to reduce scar tissue in muscle groups.
  • Sports massage: These techniques are often an amalgam of massage therapies designed to reduce injury and inflammation, to relax the athlete, and as use as both a warm up or a cool down ritual. A vigorous massage applied for up to 20 minutes, generally one hour in advance of competition, often prepares the athlete. Post-event, a massage will stimulate circulation, especially in the region of the working muscles, flushing out metabolic waste materials such as those related to lactic acid production.

Athletes seeking the benefit of massage therapy, no matter what type, will often receive the benefit of fascial techniques. These are manipulations that are intended to focus on the fascia, the general term for the connective tissues located at the joints throughout the body. In this context, the fascia may include cartilage, ligaments, tendons, and muscles in the vicinity of the joint. A well-known fascia problem experienced by athletes is plantar fasciitis, where the connective band between the heel and the forefoot under the arch of the foot becomes inflamed. The illiol band between the hip and the knee joint is another connective tissue that may become stressed in athletic activity.

It is a testament to the legitimacy of massage as a therapeutic technique that many elite-level athletic organizations and individual athletes regularly undergo massage therapy. Many teams have a full-time athletic therapist on their staff, whose focus is as much injury prevention as it is therapy. In many jurisdictions, massage therapists are a part of a larger regulated industry, where formalized training and licensing are mandatory.

see also Acupuncture and Eastern healing therapies; Exercise recovery; Musculoskeletal injuries; Sports medicine education.

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