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Chapter 17: Therapeutic Massage

Kerry Gordon

Introduction

Massage is one of the oldest forms of healing techniques. Using therapeutic touch, the body's tissues are manipulated to reduce muscle spasm, promote relaxation, improve blood flow, and increase venous drainage. The scope of massage theories, techniques, and effects is broad. This chapter addresses massage techniques that are most frequently used in the treatment of musculoskeletal conditions.

• Massage, the systematic manipulation of the body's tissues, has been present in most cultures and can be traced back as far as the ancient Olympics. Regional variations have contributed to the different forms of massage used today. This diverse background leads to differences in application protocol and theory (Table 17-1).

TABLE 17-1Selected Methods of Manual Therapy Techniques
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TABLE 17-1 Selected Methods of Manual Therapy Techniques
TECHNIQUE DESCRIPTION
Acupressure Pressure is applied along acupuncture meridians, altering the body's energy pattern.
Craniosacral therapy Alters the flow of cerebrospinal fluid by lightly massaging points along the spinal column.
Deep tissue massage Targets individual deep muscle fibers and attempts to release adhesions and increase blood flow to restricted areas.
Lymphatic massage Targets the lymphatic system and attempts to remove edema, waste products, and toxins from the body using light, rhythmic strokes.127 This is one of few techniques that can be used for acute musculoskeletal injuries. Activation of the lymphatic system may limit acute inflammation.128
Myofascial release Breaks adhesions and other restrictions in the body's fascial network to restore normal function.
Neuromuscular therapy Focuses on reducing pain and muscle spasm by identifying trigger points and treating with ischemic compression.

Instrumented Assisted

Soft-Tissue

Mobilization

 Use of a tool other than one's hands to address myofascial dysfunction and soft-tissue adhesions.
Shiatsu Use of various forms of compression strokes and stretches based on physiology or traditional Chinese medicine.
Swedish massage Traditional massage techniques used for increasing muscle relaxation, decreasing pain and joint stiffness.

Massage and myofascial release are forms of soft tissue mobilization in which the tissues are manipulated to produce the desired effects. Joint mobilization, another form of manual therapy, is not discussed in this text.

Massage is an effective treatment method for promoting local and systemic relaxation or invigoration, increasing local blood flow, breaking down adhesions, and encouraging venous and lymphatic return. Because it is a time-consuming task that requires the full attention of the clinician, massage is infrequently used in multi-function health-care facilities. Still, massage has increased in popularity and massage therapy is a continually growing profession.

Massage is a skill- and knowledge-based technique, and because of the possibility for misuse, many states require licensure for massage therapists. Most other healing professions, including athletic training and physical therapy, incorporate massage techniques into their professional preparation. Massage therapists often work cooperatively with other health-care providers or may be dual credentialed.

Massage Strokes

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