Does the massage therapist take away the patient's illness? Professional masseur - skillful, experienced masseur hands: care, illness. How to take care of the masseur's hands. Approximate duration of treatment

A question for fellow masseurs. How do you recover from the massage sessions? Do finger joints bother you? How do you prepare for work? The masseur's hands are one of the vulnerable parts. How do you take care of your hands?

Hand joints: there is such a problem. But the tendon problems are worse: the joints of the phalanges of the fingers "snap", with pain on extension. But these are trifles, and insignificant. And most importantly: Do not work with your hands, but with your whole body. Here's the trick. And everyone can master it. You can also do yourself a light hand massage, every massage therapist can master this. Especially important after anti-cellulite or sculpting massage.

I read about the technique of performing hand massage, not everything turns out right away, most likely I only partially understand the method of work and the technique of execution, although I have read it more than once. Reading is one thing, practice is another. In terms of movements, I always try to adapt to the movement of the body, clients are sometimes surprised at how you work in this mode. A long time ago I watched a video about the hands of a massage therapist - professional advice on how to help yourself. I advise beginners!

It is interesting that at one time the development of massage techniques to facilitate their work coincided with a rethinking of the technique of performing exercises in the gym, we came across a wonderful trainer (now, however, we are in different gyms) and so, he also discovered a lot about the technique of performing exercises. Showed what to do when the masseur's hands hurt. I agree that legs and priests are the most difficult thing (by the way, when customers ask about the price).

I will explain very simply, "on the fingers". How to relax the skillful hands of a masseur.
Performing the technique: either with the thumb or with a clenched fist.
Nuances:
- if the thumb, then you need to imagine the edge of the thumb as the edge of the cutting surface (knife, razor, everything will go), and move with a shearing motion (you can watch the video on YouTube or download a movie)
- a clenched fist - that's completely different. If in boxing the fist is correctly clenched from the index finger to the little finger, which rests directly on the flesh of the palm, then the opposite must be done.
In massage with a fist, it is necessary to clench the fingers, starting with the little finger, and it is imperative that the pad of the little finger lies on top of the eminence of the little finger, right on it (on the hypotenar, specifically)
And the ring finger also fits on top of the hypotenar (but does not rest against it in any way!)
Thus, both the middle finger and the index finger are completely turned off from work (and we do not need them). The entire load falls on the phalanges (joints) of the ring finger and little finger
Why?
Because the release of force to the place of application goes along the elbow of the forearm and hand (bequeathed to Jack Dempsey)
And this is justified in practical work.
The energy of movement comes from treading on the spot ("clubfoot bear", according to AE Syromyatnikov). And that's it! This is how the experienced hands of the masseur remain healthy after decades of anti-cellulite and sculpting massage.

Massage theses:
1. At the first stage, the main thing is to understand the technique of performing the technique. Then you need to try on different faces, constitutions, body types, temperaments, etc. Gain some experience.
The biggest helpers at this stage: fatigue, exhaustion, pain in the working muscles of the arms.
Exhaustion is a great guide and teacher. In this state, all unnecessary unnecessary movements are turned off, the movements become economical, without unnecessary movements. First, the muscles of the hands and arms begin to turn off from work, they relax - and then the whole body begins to work. This is the key to mastering.
2. Now we need to develop the automatism of movements. So that the performance of techniques began to be carried out in a reflex automatic mode. This will take a lot of time.
But when it works out, the head will be freed and will be able to perform more important functions: assessing the state, prospects and direction of work, how to build work, and other important promising things.
Somehow like this. And do not forget - the treatment of the masseur's hands is necessary for your own good!

I once saw the hands of a masseur in a photo - all in knots and gout. On a side note - he did lymphatic drainage massage. Is the prevailing massage technique somehow related to diseases of the musculoskeletal system of the hands?

This means that this pro did not do special exercises for the masseur's hands. There is a whole complex. It is especially favored by specialists in the field of beauty massage, where special sensitivity and precision of massage movements are needed.

I will tell you - strong hands of a massage therapist are needed both in the fight against cellulite and in terms of relaxation. Once I did a relaxation massage for one client for two and a half hours. Mom brought a girl with depression and severe body ossification. Pulled out. But this relaxation massage was the most exhausting one in my more than twenty years of massage practice!

The masseur's hands should be sensitive. I do both general wellness and manual massage. It has been noticed that manual workers more accurately determine the nuances of cellulite tissue and work better with orange peels. Personally, my opinion.

Oh, colleagues, a sore subject - diseases of the hands of massage therapists! I work out with an expander, a colleague gives me a hand massage, but I still have pain and tunnel syndrome. Although I try to turn on the body as much as possible in the massage, turn off the brushes.

Take care of yourself! The masseur's golden hands restored my health! Give yourself a massage and arrange a weekend, God grant health and long years, and healthy hands to all masseurs!

The work of a massage therapist is associated with a large number of harmful effects: heavy physical exertion, emotional contact, energy contact, contact with oils and other drugs, psychological stress. Therefore, massage therapists often leave the profession, get sick, and experience emotional suffering.

Training by Margarita Levchenko, a practicing massage therapist with more than 25 years of experience, provides a complete system for maintaining health and professional longevity for a massage therapist.

Hello dear colleagues!

My name is Margarita Levchenko, I am a practicing massage therapist with over 25 years of experience. I have been teaching massage for over 20 years.

Needless to say that our profession is not the simplest and easiest one?

Great physical and emotional stress has a serious impact on our health and psychological state.

Many do not survive in the profession for more than 5 years, "burnout" occurs and people leave. Often with acquired sores and phobias.

I also had such a period, I also wanted to leave, I felt bad in the profession.

I managed to find my own system of maintaining health for a massage therapist, protection from harmful influences in this profession, and now I feel great, work at full strength and get great pleasure from our really wonderful profession.

I have prepared a complete training for you, in which I fully transfer my system of maintaining the health and professional longevity of the massage therapist.

Practical training, we will practice. Therefore, take suitable clothing.

I will be glad to see you!

Training program:

1. Occupational diseases. Analysis, nature, causes of occurrence
   • The most problematic area is the thumb (for example, tendonitis).
   • Arthritis of the wrist, hands. The main load during the massage falls on the hands.
   • Spontaneous contraction of the forearms.
   • Varicose veins in the legs.
   • Due to the fact that work often takes place in a half-turn of the body, the kidneys, the cardiovascular system, and the spine suffer.
   • And last but not least, the occupational disease of massage therapists - "burnout" or, more precisely, the emotional burnout syndrome (EBS) is a reaction of the body that occurs as a result of prolonged exposure to occupational stresses of moderate intensity.
2. Prevention of occupational diseases
   • Rehabilitative gymnastics for the musculoskeletal system of the masseur, aimed at reducing the risks when loading the joints and the entire apparatus; exercise that reduces the risk of illness, which can be used before work, during work and when coming home.
   • A complex of medical gymnastics aimed at preventing varicose veins of the lower extremities.
   • Activities that can be done between patients, taking 1-2 minutes in time and improving blood circulation not only in the lower limbs, but throughout the body.
3. Hygiene measures to keep the masseur's organs healthy.
   • Disinfection procedures to restore the health of the massage therapist due to the constant rubbing of various oils, preparations and massage products into oneself.
   • Cleansing the liver, kidneys, lymphatic system.
   • Training in procedures for cleansing the capillary system, which is responsible for the health of the massage therapist as a whole.
   • The author's gymnastics complex, developed and tested for 15 years to strengthen, maintain flexibility and improve the body.
4. Maintaining the emotional health of the massage therapist
   • Burnout is an acute crisis.
   • It is characteristic of people who constantly face negative experiences of other people and find themselves more or less personally involved in them.
     • The burnout phenomenon is characterized by such phenomena as:
       • Mental and physical fatigue, loss of faith in oneself.
       • Mental and physical fatigue.
       • Feelings of helplessness and failure.
       • Reluctance to go to work.
       • Irritability and aggressiveness during a conversation, the desire to complete it faster.
       • Feeling of low importance of the problems being solved.
       • Transfer of negative emotions to others.
       • The desire to leave and realize oneself in another area.
       • Why does burnout happen?
       • How to determine if you have it.
       • What are the options for getting out of the syndrome.
       • What can be done right now.
5. Methods of energy protection of the masseur:
   • Each patient takes energy, because in order for the procedure to be sensible, you need to give everything to the end. There is much more contact (both physical and spiritual) in massage than in a dentist or therapist. As a result, at the end of the day, a person may remain emotionally devastated, since there is no strength and emotion left for any activity. There are techniques for this, both for protection and for the quick recovery of the massage therapist after difficult patients and recovery from work in general.

Training format:

Practical lesson lasting 4 hours + 30 minutes break.

A group of no more than 10 people. Practice, exercise.

Copied from the site "Samopoznanie.ru"

Massage for injuries and diseases of the nervous system

The basic concepts of the essence of the influence of various means of restorative treatment on various systems and organs of the patient are based on the following provisions (Naidin V.L.).

The stimulating effect of the means of restorative therapy on the patient is carried out by the main reflex mechanism; this influence consists of the trainer and the trophic.

Any reflex reaction begins with stimulation of the receptor; the main regulator in muscle work is proprioception (kinesthesia); the motor-visceral reflexes caused by it have both an unconditioned and a conditioned reflex nature.

The normalization of the activity of various organs and systems depends to a large extent on their neuroregulatory apparatus, i.e., autonomic nerve centers. However, the state of the latter is determined by the influence of the motor analyzer, which plays a dominant role in the regulation of autonomic functions during muscular activity.

The high plasticity of the patient's central nervous system makes it possible, through systematic exercises (physical exercises and massage), to develop a new dynamic stereotype, which determines the accuracy and coordination of the responses of the main body systems, as well as their significant economization.

Among the means of rehabilitation treatment, position correction, exercise and massage are mainly used. These funds are necessary both for disinhibition, true restoration of functions, and for compensation of movement disorders. Correction of position and massage (as simpler means) pursue mainly restorative goals, and physical exercises are used depending on the specific formulation of the problem (Naidin V.L.).

The task of massage is to stimulate lymph and blood circulation in order to improve trophic processes in tissues with flaccid and spastic paralysis, reparative processes and nerve conduction, strengthen paretic muscles, stretch muscles in a spastic state, prevent muscle wasting, reduce pain caused by irritation of nerves conductors, improving the general condition of the patient.

Massage for the consequences of cerebrovascular accident

Paralysis and paresis during strokes are caused by damage to the motor centers and pathways and are called central or spastic, characterized by increased muscle tone, involuntary friendly movements (synkinesis), high tendon reflexes and the presence of pathological reflexes. In the acute period after a stroke, the tone of the affected muscles is reduced, but then (from several days to 1.5–2 weeks) the muscle tone increases. Muscle spasticity is the result of increased reflex tone, which leads to typical contractures.

Appointment of massage. A number of authors advise, taking into account the patient's condition, to prescribe selectively massage, passive and active exercises with correction of the position of paretic limbs during the first week after a stroke (with thrombosis - on the 3rd day, with hemorrhages - on the 6-7th day).

Contraindications: increase in blood pressure hemiparesis, significant headaches, pain in the heart area, fever.

In the first week, when muscle tone is lowered, the use of vigorous massage effects is contraindicated.

Before starting the massage procedure, it is advisable to carry out relaxing activities on the affected side by means of special exercises. First, exercises should be carried out aimed at relaxing the muscles of a healthy limb, then the patient is taught to relax the muscles, starting with the distal sections. This leads to a decrease in muscle tone and a decrease in synkinesis.

To prevent stiffness or contractures in the joints of the affected limbs, it is recommended to combine the massage procedure with position correction.

In the initial period of the disease, in order not to cause an increase in hemiparesis, it is necessary to use the techniques of superficial stroking and non-intensive rubbing.

The massage starts from the lower limb, where reflex neuromuscular excitability is less pronounced than on the upper limb. It should be remembered that intensive massage can aggravate the pathological state of the muscles and negatively affect the normalization of the ratio of the tone of synergistic and antagonistic muscles.

Even to the slightest painful sensations, the patient can react with increased muscle spasticity and synkinesis.

Massage technique

The massage is carried out in a differentiated manner: a) muscles, in which the tone is increased, are massaged by stroking and rubbing (at a calm pace); b) stretched, hypotrophic, weakened muscles are massaged with the same techniques, but more intensively, without causing painful sensations.

In the first procedures, the techniques of grasping and gripping stroking, as well as rubbing, are applied only superficially.

If the procedure is well tolerated, light kneading is added - without displacing the muscles, the techniques of felting, longitudinal kneading and pressing are performed.

First, kneading is used on stretched muscles, and then on spastic ones.

Intermittent vibration techniques - patting, beating, chopping, etc. - are contraindicated.

Light continuous vibration, if it does not cause an increase in muscle tone and synkinesis phenomena, can be included in the massage procedure.

To reduce the excitability of the motor cells of the spinal cord and influence trophic processes, massage of the paravertebral spinal segments is performed in the area: S5-S1, L5-L1, Th12-Th10 (for affecting the lower limbs) and Th2-Th1, C7-C3 (for impact on the upper limbs).

In the stage of developed muscle tone, the following technique is most often used.

Paretic upper limb massage start from the distal sections: a) forceps-like stroking of the lateral, palmar and dorsal surfaces of the fingers; b) circular stroking and light rubbing of the interphalangeal and metacarpophalangeal joints; c) finger massage is completed with passive movements in each joint; d) massage of the back and palmar surfaces of the hand, using only the stroking technique; e) massage of the extensor muscles of the forearm and shoulder is carried out more vigorously, using stroking, rubbing and, with sufficient muscle mass, kneading; when massaging the extensor muscles, special attention should be paid to rubbing the tendons; f) the deltoid muscle, usually stretched and hypotrophic with central hemiplegia, is massaged with stroking and vigorous rubbing; g) for the prevention of adduction contracture of the shoulder joint, caused by an increase in the tone of the pectoralis major muscle, latissimus dorsi and subscapularis muscle, use stroking techniques and smooth (in a circular direction) rubbing.

Paretic lower limb massage they also start from the distal sections: a) spasmodically contracted muscles are massaged with light stroking, rubbing and kneading techniques; b) paretic antagonist muscles are affected by the same, but more energetic techniques; c) with a significantly pronounced edema of the limb, a suction massage is used.

Massage of the anterior and internal thigh muscle groups. The position of the patient is supine. The techniques are used - light superficial continuous, planar and embracing stroking, then - semicircular rubbing alternately with stroking, after that - they differentially affect the muscles: a) the front group - quadriceps and tailor; b) the internal group - stretching the broad fascia of the thigh and adductor muscles.

Massage of the back muscle of the thigh. The position of the patient is lying on his stomach. It should be remembered that with hemiparesis, the tone of these muscles is quite high, so the massage effects should be gentle. Use techniques - stroking and rubbing the gluteal region and the back of the thigh; the semitendinosus and semimembranosus muscles are massaged, starting the movement below the popliteal fossa to the inguinal fold. Stroking and rubbing is applied longitudinally and transversely using forceps-like stroking, but of low intensity and duration. After that, without massage of the knee joint area, they proceed to massage the muscles of the lower leg.

Calf muscle massage. The position of the patient is lying on his back (when massaging the front surface of the lower leg) and on his stomach (when massaging the back surface of the lower leg). They use techniques - stroking, rubbing and kneading. Carefully massage the heel tendon, since proprioceptive irritation of this area can intensify pathological signs (a significant expansion of the Achilles reflex induction zone, the appearance or increase in the tone of the muscles of the foot).

Massage the muscles of the foot. The position of the patient is the same. Apply the techniques of stroking, rubbing and kneading.

Due to the significant fatigue of the paretic muscles, the duration of the massage should be increased gradually - at first from 5 to 10 minutes and then from 15 to 20 minutes. The course of treatment is at least 25-30 procedures. Massage should be applied for a long time with breaks between courses for at least 10-12 days (Kunichev L. A.).

Massage for peripheral nerve injuries

Damage to the nerve trunk leads to paralysis or paresis of the innervated muscles, impaired sensitivity, trophism, secretion and vasomotor function of the innervated area, and the disappearance of the corresponding tendon and muscle reflexes.

Appointment. Massage is prescribed during the period of anatomical recovery, when acute events are smoothed out, the risk of bleeding and infection has passed.

The challenge of massage are: stimulation of nerve regeneration processes, prevention of denervated muscle hypotrophy, reduction of pain.

Massage technique

In the preoperative period, to strengthen the muscles innervated by the nerve to be operated on, the following massage techniques are used: deep stroking, longitudinal and transverse kneading, felting, muscle stimulation techniques; massage that reduces the tone of antagonistic muscles (superficial stroking, rubbing, light longitudinal kneading); with contractures - active or active-passive movements in the joints, stretching, displacement, intermittent pressure of the paretic muscles; joint massage - stroking, rubbing, passive movements. Procedure time: 10-12 minutes daily

On the 2-3rd day after the surgical intervention, the segmental reflex massage is started.

In case of damage to: a) the radial, median and ulnar nerves, the upper thoracic and cervical paravertebral zones of innervation of the spinal segments Th6-Th1, C7-C3 are massaged; b) sciatic, large and peroneal nerves - lumbosacral and lower thoracic paravertebral zones of innervation and spinal segments S3-S1, L5-L1, Th12-Th11.

All massage techniques are carried out without effort and at a calm pace - superficial planar and embracing stroking, semicircular (with fingertips) rubbing, pressing, squeezing.

ATTENTION!

Gross massage movements will help rather than inhibit the formation of scar tissue. Vigorous massage can also cause vascular paralysis due to their sharp expansion, since the loss of muscle tone in the event of nerve damage deprives the blood vessels of their protective layer.

With prolonged rest after stitching the nerve, scar tissue in the area of ​​the nerve suture is deposited randomly, forming often tangled bundles of nerve fibers, which adversely affects the direction of the regenerating nerve fibers.

Massage should be combined with exercise as early as possible. The earlier they start physical exercises, the more actively the process of nerve regeneration goes on in the future, the faster its correlations are restored.

Massage at this stage should precede physical exercise in order to better prepare the muscles for movement. When active movements appear, especially when an additional load on weakened muscles is given, massage is recommended after exercise in order to quickly relieve possible fatigue of paretic muscles.

In the classroom they use: a) passive, active-passive, active exercises; b) isometric muscle tension (exposure 5–7 sec) followed by their relaxation; c) sending impulses (ideomotor exercises) to contract the muscles innervated by the stitched nerve. The duration of the procedure is 3-5 minutes.

Correction by a position that ensures rest in the area of ​​operation.

When the postoperative scar gets stronger enough, the following massage techniques are prescribed: deep stroking, rubbing, kneading, shifting, felting, stretching, puncturing, tapping, vibration along the nerve trunk, shaking. The duration of the procedure is 15–20 minutes.

Massage for neuritis of the facial nerve

The mimic muscles determine the configuration of the lips, partly the nostrils, eyelids, the shape and direction of natural and individually acquired furrows and folds of the skin (nasolabial fold, chin-labial groove, wrinkled forehead, cheeks, etc.). The mobility and expressiveness of the face depend on the function of the mimic muscles (Fig. 11).

Rice. eleven. The layout of the muscles of the face and neck: 1 - the broad subcutaneous muscle of the neck; 2 - the muscle that lowers the corner of the mouth; 3 - chin muscle; 4 - the muscle that lowers the lower lip; 5 - the circular muscle of the mouth; 6 - zygomatic muscles; 7 - muscle that lifts the upper lip; 8 - the circular muscle of the eye; 9 - muscle wrinkling the eyebrow; 10 - frontal muscle; 11 - temporal muscle; 12 - chewing muscle; 13 - muscle of laughter; 14 - sternocleidomastoid muscle

Features of facial muscles significantly affect the formation and clinical manifestations of painful muscle seals (tight cord, trigger points) and are as follows.

They are located subcutaneously and constitute an anatomical structure of the symplast type, without having fascial intermuscular septa (somewhat reminiscent of the myocardium).

Do not perform static functions.

The coefficient of efferent innervation of facial muscles is high, they are precise and dexterous.

They are highly sensitive to acetylcholine.

The functional features of the facial muscles are presented in table. 4.

Table 4

Functions of facial muscles

With neuritis of the facial nerve, paresis or paralysis of the facial muscles comes first, which most often develops on one side of the face, as a result of which a characteristic asymmetry is created. Contracture of facial muscles is the most common complication of facial nerve neuritis, characterized by persistent tension of the paretic muscles and clonic-tonic or tic spasms in certain muscle groups. From synkinesis in the clinic are often found:

Eyelid-frontal-labial synkinesis - when the eyes are closed, the forehead wrinkles and the corner of the mouth rises;

Eyelid-plethysm synkinesis - closing the eyes leads to contraction of the subcutaneous muscle of the neck;

Eyelid-nasal synkinesis, or Hue's synkinesis, - lifting the wing of the nose up and outward when closing the eyes;

Eyelid-ear synkinesis - closing the eyes is accompanied by raising the auricle;

Lipo-palcebral synkinesis - narrowing of the palpebral fissure when the cheeks are swollen;

Frontal-labial synkinesis - raising the corner of the mouth with wrinkling of the forehead.

Tasks of massage: improve blood circulation to the face area (especially on the affected side), as well as the neck, shoulder girdle; restore the impaired function of facial muscles, prevent the occurrence of contractures and friendly movements (synkinesis), and, if any, help to reduce their manifestations. Restore the correct pronunciation.

In the first week of illness, all attention should be paid to the healthy side of the face. The patient is taught to relax the healthy half of the face at rest, after a conversation, and later at the moment of speaking.

It is imperative to limit the amplitude of mimic movements of the healthy side.

When you try to perform a mimic movement, friendly movements appear due to muscle dysfunction. In the absence of active movements, the masseur performs them with his hand, the patient simultaneously performs the movement with the healthy side, and the masseur provides metered resistance to this movement on the healthy side, limiting its amplitude, ensuring that the movements are carried out symmetrically (Fig. 12).

As movement is restored, the therapist begins to resist movement on the affected side to increase the strength of the paretic muscles, and limits the range of movement on the healthy side.

The restoration of nerve function is uneven, so movements are not restored at the same time. Such uneven muscle function can lead to contractures, so you should not force the restoration of one of the branches of the nerve with exercises and massage techniques.

To eliminate the asymmetry of the face, adhesive tape is applied from the healthy side to the affected one. The technique is directed against the traction of the muscles of the healthy side and is carried out by firmly fixing the other free end of the patch to a special helmet-mask (Fig. 13).

Massage plan: impact on the reflexogenic zones of the skin, head and neck, ears, massage of the mimic muscles of the healthy side of the face and affected muscles.

Patient position- while sitting, the head rests on the headrest of the chair, the muscles of the arms, shoulder girdle and upper limbs are as relaxed as possible.

Massage technique

The massage technique is differentiated taking into account the clinical forms of the lesion: in the acute stage of the disease and in its further course, not complicated by contractures and synkinesis, the following is necessary: ​​a) in the first procedure, relaxation of the facial muscles is taught; b) position correction, consisting in the following: 1) sleep on the side (on the affected side); 2) chew food on both the affected and the healthy side; 3) sit for 10-15 minutes 3-4 times a day with the head bowed to the side of the lesion, supporting it with the back of the hand and leaning on the table with the elbow; 4) putting on a headscarf (for women), tie it up, pulling the muscles from the healthy side to the side of the lesion (from the bottom up), while trying to restore the symmetry of the face (Belaya N.A.).

Rice. 12. Correction of facial movements. Application of metered resistance (b, d, e, g, h) and pre-stretching (a, c, e) muscles to restore facial movements

Rice. 13. Position correction: stretching the muscles of the left (healthy) side of the face and the right circular muscle of the eye with an adhesive plaster (Naidin V.L.)

Massage area. The massage essentially consists of two procedures: a) massage of the neck muscles; b) collar area and face massage.

Massage of the sternocleidomastoid muscles: stroking, rubbing, kneading; vibrational stroking of the head and neck muscles, tapping with fingertips.

Massage of the temporal regions and auricles: stroking and rubbing; kneading the auricles.

The facial nerve is massaged 1 cm below the ear canal at the mastoid process using massage techniques: stroking, rubbing, short-term point vibration with the tip of the middle finger, tapping with a finger. Impact on the nerve is permissible when the acute process subsides, when movements appear and their volume increases.

Massage the mimic muscles of the healthy side of the face in the forehead, around the eye sockets, cheeks and neck muscles: stroking, rubbing, pressing and pinching, continuous vibration and patting with the palmar surface of the fingers.

Massage of the facial muscles of the affected side of the face: light planar stroking, kneading - pressing and pinching, tapping with fingertips.

Simultaneously with the massage procedures, classes are supplemented with physical exercises aimed at improving the function of facial muscles and articulation (Table 5)

Table 5

Sample exercises for facial muscles

Special exercises are performed in front of a mirror. Exercises are carried out simultaneously for the healthy and affected sides of the face. In mastering the absent movements, preliminary relaxation of the muscles with light relaxing massage movements and the performance of individual relaxing exercises (Belaya N.A .; Epifanov V.A.) significantly help.

Simultaneous and alternate inflating of the cheeks.

By snorting, pronouncing the sound "p" with a preliminary active delay at the initial phase of the movement.

The indication (pointing movement) performed by the masseur is a short stroke stroking of the facial skin in the area of ​​the paretic muscles. The direction of the display corresponds to the mimic movement. This technique gives the patient an idea of ​​the direction of movement and helps to carry it out.

Post-isometric muscle relaxation (preliminary stretching of the affected muscle, dosed resistance to the main movement, followed by isometric tension and muscle relaxation).

At all stages of rehabilitation treatment, control over the voluntary activity of the facial muscles is maintained. The range of motion should not exceed the size that helps to identify asymmetries, especially when crying, laughing, emotionally intense conversation.

The motor (trigger) points of the facial muscles usually coincide with the place of the greatest bulge of the muscle at its maximum tension.

In addition to the above exercises to inactivate motor points, the exercises should include post-isometric relaxation of the affected muscles.

Functional state of facial muscles are evaluated on a six-point scale (Ya. M. Balaban).

Assessment of the upper facial muscles

0 points - complete paralysis of the muscles (the patient cannot close his eyes, cannot frown and raise an eyebrow).

1 point - the patient does not close the eye completely, cannot frown and raise an eyebrow.

2 points - the patient closes his eye completely, but cannot close his eyes, slightly frowns or slightly wrinkles his forehead.

3 points - the patient blinks his eyes, frowns and raises an eyebrow, wrinkles his forehead, but to a lesser extent and with significantly less force (eyelash symptom) than on the healthy side (does not overcome the resistance of the masseur / exercise therapy methodologist).

4 points - the patient squints his eyes, frowns and raises an eyebrow, wrinkles his forehead in the same way as on the healthy side, but with slightly less force (overcomes the resistance of the hands of the masseur / exercise therapy methodist).

Assessment of the lower facial muscles

0 points - complete paralysis of the muscles - the patient cannot bared the dentition, the mouth slit tilts to the healthy side (“racket” symptom), cannot puff out his cheeks (the cheek “sail”), cannot fold his lips for a whistle.

1 point - when the dentition is bared, 1-2 teeth are visible on the affected side, the patient cannot puff out his cheeks and whistle.

2 points - when the teeth are bared, 1-2 teeth are visible, the patient puffs out his cheeks weakly (the cheek “sails”), cannot whistle.

3 points - when the teeth are bared, 3-4 teeth are visible, the patient folds his lips to whistle and can hardly whistle, puffs out his cheek, but to a lesser extent and with significantly less force than on the healthy side (does not overcome the resistance of the masseur / exercise therapy methodologist ).

4 points - when the teeth are bared, 4–5 teeth are visible, the mouth is noticeably pulled over to the healthy side, the patient can whistle and puff out his cheeks well, but with slightly less force than on the healthy side (overcomes the resistance of the masseur / exercise therapy methodologist).

5 points - facial musculature within normal limits.

Massage for osteochondrosis of the spine

Under the term osteocondritis of the spine understand the primary developing degenerative process in the intervertebral discs, which in turn leads to the secondary development of reactive and compensatory changes in the osteo-ligamentous apparatus of the spine.

Vertebral lesions of the musculoskeletal system, nervous and vascular systems, according to the topical principle, are divided into two large groups:

Vertebral - when the lesion is localized in various structures of the spinal motion segment (VMS);

Extravertebral with their localization in extravertebral tissues. The latter disorders include changes in the nervous, muscular and vascular systems.

All these syndromes are formed mainly by the reflex mechanism in response to irritation of the receptors of the tissues of the musculoskeletal system (Scheme 1). This is how myofascial, neuromyodystrophic and neurovascular syndromes arise (Veselovsky V.P .; Khabirov F.A.). All this leads to irritation of the receptors of the sinuvertebral nerve.

Scheme 1. Classification of vertebrogenic syndromes (Popelyansky Ya.Yu.)

There are four possible mechanisms of irritation of the sinuvertebral nerve.

Mechanical-dysfixation - due to the displacement of the vertebral bodies.

Mechanical compression - due to disc herniation, infringement of the capsule of the intervertebral joint, exostoses, yellow ligament hyperplasia, etc.

Dyshemic - due to edema, microcirculation disorders, venous stasis, etc.

Inflammatory - commonplace or aseptic (reactive, autoimmune).

Violations of biomechanical relationships in the kinematic chain of the spine in combination with other pathogenetic mechanisms contribute to the development of the myodiscoordinator process in the muscles of the vertebral-motor segment (VMS), spine and extremities. At the same time, complex synergistic reciprocal and other reflex processes develop with impaired statokinetics of the spine. First of all, its configuration changes in connection with changes in the tone of the muscles of the spine, striving to compensate for the insufficient function of the PDS, - lordosis is smoothed out or a kyphotic setting in the department develops, and in some cases, in connection with the transfer of support to the leg of the unaffected side, a scoliotic setting also arises. Both polyarticular muscles of the back and small intersegmental muscles are involved in the formation of these changes. At a certain stage, these compensatory mechanisms are sufficient. However, with the duration of tonic muscle tension, dystrophic changes develop in them. In addition, due to the formation of a pathological reflex ring, muscle tension from a sano-genetic mechanism turns into its opposite - a pathological contracture. As a result, the loads change not only on the muscles of the spine, but also on the muscles of the extremities functioning in new conditions, which leads to myoadaptive postural and vicarious myodystonic and myodystrophic changes in them (Veselovsky V.P .; Popelyansky Ya.Yu .; Ivanichev G.A. . and etc.). In connection with dystonic and dystrophic changes, the muscles become a source of pathological afferentation, addressed to the same segments of the spinal cord that innervate the affected SMS, as well as to the polysegmental interneuronal apparatus when the muscles of the entire spine and extremities are involved in the process (Fig. 14). In such muscles, then compacted cords appear, the so-called myofascial trigger points.

Rice. fourteen. The main mechanisms of the reflex musculo-tonic effect of receptors in the area of ​​the intervertebral disc on the muscles of the spine and muscles of the extremities: 1 - brain; 2 - spinal cord; 3 - muscles of the spine; 4 - muscles of the limb (Ya.Yu. Popelyansky)

Massage for osteochondrosis of the cervical spine

The severity of pain is of three degrees (Veselovsky V.P.):

I degree - pain occurs with the maximum volume and strength of movements in the spine.

II degree - the pain calms down only in a certain position of the spine.

III degree - constant pain.

In the patient's status, there is stiffness of the cervical spine, forced position of the head, soreness of the zones of neurofibrosis (with the age of the process).

The described cervical symptom complex refers to vertebral syndromes. Cerebral, spinal, pectoral, and brachial are defined as extravertebral syndromes. They can be compressional, reflexive, or myoadaptive (postural and vicarious).

Tasks of massage: improvement of lymph and blood circulation in the muscles of the neck, back and upper limb, reduction of pain, strengthening of hypotrophic muscles of the arm, increased tone in the muscles of the neck and back.

Rice. 15. Localization of 9 bilateral sensitive (trigger) points: 1 - lower cervical section; 2 - the second rib; 3 - lateral epicondyle; 4 - large spit; 5 - the area of ​​the knee joint; 6 - the suboccipital muscles; 7 - trapezius muscle; 8 - the supraspinatus muscle; 9 - gluteal muscles

Subject to massage: the upper limb on the side of the lesion, with a bilateral process - both hands (including the shoulder girdle) covering the muscles of the back of the neck. For severe chest pain, massage of the chest muscles is recommended.

Massage plan: impact on the paravertebral zones of the upper thoracic Th6-Th1 and lower cervical C7-C3 vertebrae and reflexogenic zones of the chest. Massage of the upper limb, interscapular regions, intercostal spaces, sternocleidomastoid muscles and pectoralis major muscles. Concussion of the chest. Selective massage in the zone of trigger points in the paravertebral region and interspinous spaces of the neck, interscapular region, in the region of the periarticular tissues of the shoulder joints, supraclavicular zones of the trapezius muscles (Fig. 15).

Patient position- lying on your stomach, on your back, sitting on a chair (head on a bolster, pillow).

Massage technique

Massage of a healthy upper limb. The following massage techniques are used: stroking, kneading, muscle shaking, shaking.

Massage of the affected upper limb. When symptoms of hyperesthesia are used: light shallow stroking, rubbing, felting of muscles; with muscle wasting - stroking superficial and deep, rubbing with fingertips, elbow edge of the palm, sawing, planing, crossing; kneading - longitudinal and transverse, shifting, felting and vibration - continuous, shaking, twitching, vibration stroking; for movement disorders (for example, paresis) - massage of the affected muscles and antagonistic muscles: stroking, rubbing, kneading and vibration techniques.

Deltoid muscle massage - planar and enveloping stroking, sawing, kneading, chopping, vibration stroking.

Massage of the sternoclavicular and clavicular-acromial joints - stroking and rubbing circularly, shading.

Back muscles massage. Stroking, rubbing, kneading the trapezius and latissimus muscles are carried out in wide strokes; deep rubbing and transverse kneading of the upper portions of the trapezius muscles, the back of the muscles of the neck and nape.

Massage of the paravertebral zones in the direction: from the underlying segments to the overlying ones. The following massage techniques are used: flat stroking, circular stretching with fingertips, hatching, sawing, kneading - longitudinal shift.

Massage of the interscapular region. The following massage techniques are used: rubbing with the fingertips and the elbow edge of the palm of the outer edge of the scapula, the angle of the scapula and the inner edge of the scapula; shifting of the scapula. Stroking and rubbing the intercostal spaces with a rake in the direction from the sternum to the spine.

Stroking and kneading the pectoralis major muscles. Compression and stretching of the chest muscles. Trigger points massage is carried out selectively (depending on their activity). After palpation in the areas of hyperesthesia, stroking and rubbing circularly with the fingertips, continuous vibration and puncturing are performed.

The massage procedure is completed by performing breathing exercises and exercises aimed at strengthening the muscles of the neck, shoulder girdle and upper extremities (see the manual by V. A. Epifanov and A. V. Epifanov "Osteochondrosis of the spine." M .: MEDpress-inform, 2005).

The duration of the procedure is 15–20 minutes. The course of treatment is 12 procedures daily or every other day.

Massage for osteochondrosis of the lumbosacral spine

In the case of a mechanical-compression version, irritation of the sinuvertebral nerve causes pain of two types:

a) with persistent compression, pain is deep, constant, aggravated by stress on the affected area;

b) direct compression is characterized by sharp, shooting pains that occur at the moment the load begins to act on the affected PDS.

With the mechanical-dysfixation variant, pain occurs in the process of static-dynamic loads; myofixation is almost always sanogenizing.

With the dysgemic variant, the pain is usually aching, stiff, arising after rest and decreasing with movement. They may be accompanied by a feeling of heat, burning, numbness in the affected area.

In the inflammatory variant, patients complain of chilling pain and a feeling of stiffness that occurs during sleep and passes after a warm-up. Patients feel better in the evening.

Tasks of massage: stimulation of lymph and blood circulation in the limbs and lumbar region, reduction of pain, strengthening of hypotrophic muscles of the posterior surface of the thigh and lower legs, gluteal muscles, reduction of the tone of tense paravertebral muscles.

Subject to massage: the lower limb on the side of the lesion (back and front surface) and the lumbar region with the capture of the gluteal muscles; with bilateral lesions - both lower limbs, lumbar region and pelvic girdle.

Massage plan: impact on the paravertebral zones of the sacral and lower thoracic spinal segments (S3-S1, L5-L1, Th12-Th11). Massage of the gluteal muscles, sacrum area, iliac crests. Concussion of the pelvis. Trigger point massage.

Patient position- lying on your stomach.

Massage technique

Massage of the paravertebral zones in the direction: from the underlying segments to the overlying ones from S3 to Th11. The following massage techniques are carried out: flat stroking in semicircular directions, semicircular rubbing with fingertips, rubbing with the elbow edge of the hand, sawing; kneading longitudinal. Stroking and rubbing the lower edges of the chest.

Massage the muscles of the pelvic girdle. The following massage techniques are carried out: stroking, rubbing, shifting in the lumbar region and sacrum, continuous vibration in the sacrum region with the supporting surface of the hand. Stroking and rubbing the iliac ridges.

Massage of the area of ​​the hip joints: stroking, rubbing the periarticular tissues of the capsule-ligamentous apparatus.

Massage of the gluteal muscles. The following massage techniques are carried out: stroking, rubbing, kneading; continuous vibration, slapping, chopping. Concussion of the pelvis.

Massage of overload sites of the spine (in the region of the V lumbar vertebra) - circular stroking, rubbing, continuous vibration, puncturing

Trigger point massage. The following massage techniques are carried out: after palpation of trigger points in the paravertebral zones, interspinous spaces, in the pelvic region (near the crests of the iliac bones) and on the thigh (along the sciatic nerve) - stroking, deep rubbing circularly with fingertips, continuous vibration, puncturing, tapping. Stroking the lower back and pelvic region with broad strokes.

The massage procedure is completed with active and passive movements in the joints of the lower extremities.

In the subacute stage with damage to the sciatic nerve, the following massage techniques are recommended: planar deep stroking with the palmar surface of the thumb along the nerve in the direction - from the middle of the popliteal cavity to the gluteal fold to the lower edge of the sciatic tubercle. Rubbing along the nerve with thumbs moving one after the other and describing semicircles in mutually opposite directions. Vibration - puncture with the terminal phalanx of the thumb.

Massage of pain points (trigger points) of the thigh surface in the gluteal fold, on the border of the upper and middle third of the thigh and on the border of the middle and lower thirds of the thigh: stroking and rubbing circularly, continuous vibration with fingertips, puncturing. Active and passive movements in the joints of the affected leg. Exercises aimed at stretching the posterior thigh muscle group. Concussion of the pelvis.

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Massage is an excellent tool for healing the body, relieving pain and tension in muscles, raising tone and restoring strength. But besides this, it also serves as a remedy for many pathological conditions. Massage is used for diseases of the nervous system, for the treatment of various neuroses and neuralgias, as well as for diseases of the spine, extremities, respiratory organs, digestion and hematopoiesis. Massage is also used in the treatment of infectious diseases.

Massage techniques can be different depending on the severity of the disease and the patient's condition. Contraindications that occur in some cases should not be neglected.

Massage is primarily an effect on nerve receptors, which are located in muscles, tissues and skin. These receptors are associated with the central and autonomic nervous system and transmit impulses resulting from massage techniques along sensitive pathways. The impulses reach the corresponding areas in the cerebral cortex, where a complex reaction is synthesized, which causes functional changes in the body.

In addition to the nervous factor, which is the main one, there is also a mechanical effect on the human body, resulting in increased blood and lymph circulation, as well as the movement of interstitial fluid. When massaging, obsolete skin cells are removed, stagnant phenomena are eliminated, metabolism is enhanced. This is a very important factor, since with diseases the muscles lose their elasticity, blood, lymph, interstitial fluid stagnate, internal organs are compressed, the body does not fully fulfill its functions. Massage allows you to eliminate all these negative phenomena and helps the body to return to normal functioning.

From the history of massage

Massage as an excellent health and healing remedy has been known to man for a very long time. Several millennia ago, ancient healers used it to restore strength and raise the tone of the body. In Ancient Assyria and Babylon, Egypt and Mesopotamia, massage was regularly used for various bruises and injuries. This is evidenced by the drawings on the tomb of Pharaoh Ankamahor (c. 2230 BC), called the Tomb of the Healer.

But nevertheless, it should be noted that the Chinese used massage most effectively to heal the body. More than 4000 years ago, a treatise by the Chinese healer Tszhu-tzu appeared, which described in detail the benefits of massage and provided massage techniques. Subsequently, this treatise became the starting point for other works of Chinese healers. They have developed a set of massage techniques, which still form the basis of classical massage. But Chinese healers are constantly improving their techniques.

There were over 2,000 massage schools in ancient China. Several schools from each province participated in the annual competition held by the rulers. The masseur who showed the best skill was introduced to the court of the emperor. The most famous massage schools are in Guanch-Ruan, Shandong and Henan provinces.

It was the Chinese who considered massage an art that requires serious training and skills. In addition, massage in China has always been associated with reading poetry and pleasant music. According to Chinese healers, it helps a person to relax better and achieve harmony between body and spirit. It is known that once the Chinese emperor Lu-chi abolished the death penalty for a guilty dancer after the doctor Yi-Fui performed a massage. The emperor not only postponed the execution, but also forgave the girl. And I-Fui was appointed the chief court physician and remained in this position until his death. He penned about a dozen treatises, in which he compares the techniques of different schools and insists on the advantage of "simple" massage over "complex", that is, using various devices.

It was the Chinese who were the first to use various sticks, brushes, ropes with knots during massage. Yi-Fui rejected this, advocating the advantage of hand-touching over instruments. But devices still remained an integral part of Chinese massage and became the prototype of acupuncture.

The Japanese, who adopted massage from the Chinese, were followers of I-Fui. They developed their own techniques, which differed in many respects from the Chinese. Shiatsu acupressure has been developed on the basis of classic Japanese massage. The Japanese, accustomed to living in harmony with nature, rejected exquisite music and poetry reading during the session. But they opened sliding doors so that the massaged person could enjoy the scent of flowers from the garden, see the beautiful landscape and hear the murmur of water. The beauty of nature, according to the Japanese, is no less important than music or poetry. It also helps a person get rid of bad thoughts, forget about their worries, and massage brings the body and soul to harmony.

There were many massage schools in India, where massage also appeared several millennia ago. Indian healers have created numerous treatises that describe different techniques and massage techniques. And in each of them one or another school was glorified, representing all kinds of massage techniques. The Indians used massage to treat many ailments. Their methods differed in many ways from those that were known in China and Japan, and mainly in that in India they began to use wet wiping before massage, and also developed massage in a bath.

Before the massage sessions, they thoroughly cleansed the body, removing dust and sweat from it with the help of aromatic water. After the massage, water treatments were applied. This gave a good result not only in improving the health of the body, but also in its resistance to aging. This is what attracts modern scientists to the old methods. They are carefully studied, and many of them are currently used to rejuvenate the body.

But it was not only in India, China and Japan that massage techniques were developed. Ancient Egypt was also famous for its original methods. But here slightly different requirements were imposed on massage. The most effective was considered a "rough" massage. Instead of subtle, even gentle, touches (mainly stroking and rubbing), tougher techniques were practiced here - kneading and movements, and stroking and rubbing were not superficial, but deep.

The human body was first rubbed with oils, and then with a woolen cloth to achieve the desired elasticity of the skin, and only after that massage techniques were performed. This distinctive feature in the use of massage is due to the fact that the inhabitants of Egypt, to a greater extent than India, China or Japan, were exposed to the sun, wind and sand, which made their skin coarser. In order for massage techniques to achieve the desired effect, just such preparation was required before massaging. The warm oil softened the hardened skin, and the woolen cloth helped to rub it better into the upper layer of the epidermis. The effects of oil and woolen fabric have already preceded the main massage techniques. Then the masseur proceeded directly to rubbing and kneading.

The ancient Greeks also believed that water and oils were essential attributes for massage. They reached great heights in this art, as they specially trained slaves, trained in massaging. This is mentioned in the writings of Hippocrates. Ancient Greek doctors paid attention to how beneficial massage works in the treatment of various diseases and how it is necessary for a recovering person. They were the first to separate massage for healthy people and for sick people. It can be considered that it was in Ancient Greece that the methods of therapeutic massage were developed. The Romans also used these techniques, as well as the division in the massage. From the Greeks, they learned how to build public baths with massage rooms available there. And wealthy citizens often set up massage parlors in their villas. Guests could not only relax and take a bath, but also receive a refreshing and rejuvenating massage. The Romans, like the Greeks, paid much attention to the culture of the body.

But, as you know, the Roman civilization fell during the invasion of barbarian tribes. The barbarians who destroyed the Roman Empire did not adopt its culture, and the art of massage was gradually lost. The conquerors knew only its most primitive forms, which were used for bruises, injuries, dislocations. Gradually, the classical massage that existed among the Greeks and Romans was forgotten, in Europe this art has practically disappeared. But it continued to develop and improve in the East and reached its highest flowering in the Middle Ages.

The famous works of Avicenna (Ibn Sina) can testify to this. In particular, the talented scientist and doctor mentioned massage many times as an excellent remedy in the chapters of his famous works, and above all in the "Medical Canon". Avicenna was not alone in such judgments. His follower in this matter was Ibn Arabi (XII century), who left many medical treatises on massage. Ibn Arabi considered massage to be a very important tool in the treatment of various nervous and mental diseases. He developed his own massage techniques that helped heal unfounded fears and obsessions, as well as treat some forms of neuralgia. Later Western scientists of the Renaissance became interested in this. Interest in the techniques developed by Ibn Arabi has also revived.

The Renaissance era was the golden time for the return of the art of massage to Europe. It was during this period that interest in the culture of the human body and in all the classical things reappeared. Ancient Greek and Roman medical works were studied. Now they were being judged from a new perspective. The attitude towards massage also changed. His techniques began to be widely used. The treatises of oriental healers did not go unnoticed either. Avicenna's "Medical Canon", as well as medical treatises by Ibn Arabi made it possible to study the methods and techniques of oriental massage.

The works of Pietro Egilata, Bertuccio and Monde de Siuchi played a huge role in promoting massage. Also worth mentioning is Leonardo da Vinci, who believed that massage promotes the harmonious development of the human body. In the 16th century, many works were published in which various massage techniques were described in detail, as well as its beneficial effects on the body. Soon, doctors began to put massage into practice. They prescribed therapeutic massage sessions to patients, studied its effect on the body, and then described the most effective methods in their writings.

The first doctor who constantly prescribed therapeutic massage sessions was the Frenchman A. Paré. He applied his own techniques in practice and constantly emphasized the importance of using scented ointments and fragrant rubbing. Paré personally made several ointments based on honey, egg yolks and rose oil. In his opinion, these rubbing contributed to better preparation of the body for massage.

At that time, many doctors began to turn to massage as a therapeutic and prophylactic agent for many diseases. This is confirmed by the work of the German doctor Hoffmann "A radical indication of how a person should act in order to avoid early death and all kinds of diseases." This medical work contained various recommendations for the use of massage techniques, but particular attention was paid to rubbing in acute and chronic diseases.

At the end of the 18th century, the work of the French physician Joseph Tissot "Medical and Surgical Gymnastics" was published. In it, he described in detail the beneficial effects of rubbing on the human body, and also raised questions of the use of massage for medicinal purposes.

But the Swedish doctor Henrik Ling fully methodically substantiated the use of therapeutic massage in the 19th century. The work "General Foundations of Gymnastics" emphasized the great effectiveness of massage in relieving stress and fatigue, as well as its positive effect in the treatment of various injuries that led to the disorder of the body's motor functions.

Ling suggested prescribing a course of massage for the treatment of internal organs. He developed a new massage technique using techniques such as movement and vibration. This technique was later called "Swedish massage".

H. Ling's "General Foundations of Gymnastics", as well as his other works, met with a positive response from many doctors and contributed not only to the rapid spread of the theory of massage, but also to its widespread practical application. 10 years after the publication of Ling's first work, not a single European clinic, especially in the resort area, did not do without specially equipped massage rooms. Massage has become an integral part of medical and general health programs.

Now the beneficial effect of massage on the body and the resulting improvement in the condition in the treatment of many diseases did not raise any doubts. Massage began to be studied at departments in medical institutions. And many research institutes studying the culture of the human body have opened special departments that study massage techniques. At the end of the 19th century, there was a very strong interest in research on the effects of massage techniques on the human body. This can be confirmed by the numerous works of scientists who were able to reveal the huge effect of therapeutic massage. Nowadays, it is used everywhere and is included in the mandatory course of therapy for many diseases. It should also be noted that some nervous diseases are treated mainly with the help of massage and physiotherapy exercises.

In the twentieth century, new massage techniques continued to appear. Some of them arose on the basis of the system developed by Ling, others on the basis of Chinese or Japanese massage. But now doctors are trying to combine classical massage with specific techniques of Chinese and Japanese massage techniques. This massage is called mixed and has already proven its effectiveness. Indeed, when using it, a deeper effect on all organs is carried out, which contributes to normal blood flow, lymph circulation and the movement of interstitial fluid. Also, tense muscles relax well and the tone of weak muscles increases. The result is a beneficial effect on the entire body as a whole. That is why mixed massage is widely used in the treatment of various diseases.

Massage types

Experts identify several types of massage. This is a general health, therapeutic, segmental reflex, preventive, point, sports, children's, cosmetic, erotic, self-massage. Each of these types has its own variations and specificity in the execution techniques.

A general health massage can be used by anyone who wants to increase their vitality and improve their well-being. In this case, a certain execution technique is selected, there are no restrictions on the use of techniques.

Therapeutic massage is used for various diseases. In this case, painful areas and areas adjacent to them are clearly identified. Massage techniques are often performed sparingly so as not to cause pain. In this case, massage is carried out both on sick and healthy areas.

Segmental reflex massage by many refers to the varieties of therapeutic massage, since in this case, individual diseased areas are massaged. But the specificity of the use of techniques still allows it to be distinguished into an independent type of massaging.

Acupressure massage is quite difficult, because it is performed by acting on certain points of the body. To master it, you need to know well the human anatomy, as well as the location of the points of influence. This massage can be both general health and therapeutic. Acupressure self-massage must be performed very carefully, having previously consulted with a specialist.

Children's massage is also divided into general health and therapeutic. General health is recommended for any healthy child, and medical is prescribed by a doctor. This massage can be used for various diseases, and is also mandatory for children born as a result of a cesarean section. In the latter case, therapeutic massage is necessary, since the body of a child born in this way is not able to function normally. Such children lack the reflex of pinching the legs, and sometimes the grasping reflex.

During the massage, nerve receptors are stimulated, impulses from the skin and muscles enter the cerebral hemispheres, and the limbs begin to function. Massage for children is prescribed for a healthy child once a year, for children born as a result of a cesarean section - 3 times a year (up to 1 month, at 5-6 months, at 9-10 months). After a year, you can apply a general health massage on the advice of a specialist.

Self-massage can be general health and healing. The first one is recommended to be used by any person who considers it necessary for himself. In this case, self-massage can be both general and local. In the presence of a disease, self-massage is aimed at relieving pain and restoring the normal functioning of the body. In this situation, local massage is most often used.

Preventive massage is applied after recovery and is aimed at bringing the body back to normal as soon as possible. Preventive massage is less strong than general health, since the body after the disease is not strong enough, but more intense than the therapeutic one, since you can act on the areas without fear of causing pain.

Sports massage is well suited for people involved in sports. It is divided into several subspecies, each of which, in turn, has different execution techniques. Sports massage helps to relieve unnecessary stress before the start, or, on the contrary, to tone up. It also helps to relax well after doing a sporting task. Sports massage is also used for minor injuries that occur at the time of the competition.

Cosmetic massage is very important for women, as it helps to rejuvenate the skin of the face and neck, restore its elasticity and freshness, and eliminates wrinkles. Various methods of massage and self-massage have been developed, but one should not forget that the greatest effect is achieved in conjunction with cosmetics and various procedures.

Erotic massage is also important, especially if there are functional disorders of the genital area. Erotic massage helps healthy people to achieve harmony in relationships, get to know each other better, and deliver mutual pleasure.

All these types of massage can be applied as needed.

Using massage therapy

A special place among all types of massage, undoubtedly, belongs to therapeutic. For a person suffering from any disease, it helps relieve pain, get rid of discomfort and discomfort, and also brings the body to normal functioning.

Therapeutic massage is currently widely used for numerous diseases, mechanical damage to the skin, muscles, internal organs. When using therapeutic massage, the functioning of many systems improves and the activity of the body is normalized. This type of massage is an integral part of rehabilitation treatment programs after various types of operations, trauma to internal organs and childbirth.

Therapeutic massage has several subspecies: massage for diseases of the musculoskeletal system, diseases of the respiratory system, diseases of the digestive tract and blood-forming organs, as well as for injuries. A special place is occupied by therapeutic massage after infectious diseases. In turn, each of these subspecies has its own subsections. So, therapeutic massage for mononeuropathies is subdivided into massage for lesions of the ulnar, radial, tibial nerves, etc. This division is due to various techniques that are used in therapy.

The structure of massage therapy is actually a classic massage with the addition of some special techniques due to the specificity in the treatment of various diseases. For the greatest efficiency, various techniques are used to achieve the best effect in treatment. Such a division has proven itself well in the use of various techniques.

Massage techniques were developed for each specific pathological condition. But even now, the search for the optimal way to treat various diseases does not stop. Very often in recent years, universal techniques have been used that are suitable for the treatment of many disorders in the human body.

But even in this case, there remains a place for the use of special techniques, depending on the nature of the disease. This is primarily due to the nature of the onset of the disease, the course of the disease, clinical forms, various types of exacerbations and contraindications. Therefore, massage techniques are selected in accordance with the above factors. It should be noted that universal techniques are not always justified, sometimes the attending physician selects the techniques. So, the method of therapeutic massage of the extremities for polyneuropathies will be slightly different than for multiple sclerosis or various forms of mononeuropathies. The methods of massage of the extremities for Parkinson's disease will be very different from the methods of therapeutic massage for various types of neuroses. After all, what contributes to an excellent cure in one disease can be harmful if used thoughtlessly in another disease. Therefore, many doctors are very careful about the universal methods of therapeutic massage.

It should also be noted that massage techniques may vary depending on the course of the disease. Exacerbations and remissions cannot be ignored. When recovering, completely different techniques are used than during an illness. The use of various techniques also depends on the condition of each individual patient. What works well for one patient may not always work well for another. Therefore, massage techniques are selected taking into account all the characteristics of the state of the patient's body.

In case of diseases, both general and local massage can be used. This is due to the patient's condition and the nature of the disease. Sometimes it is useful to use both types of massage. And in some cases, only local massage is prescribed (for example, with mononeuropathies). Indeed, with a local massage, the emphasis is placed only on the zone of the disease, and with a general massage, the entire body is affected. Sometimes the latter is not necessary during illness, but after recovery, general massage is quite acceptable.

The duration of therapeutic massage sessions also depends on the patient's condition. A general massage takes about 30-40 minutes, and a local one - 20-25. Sometimes this time can be reduced to 3-5 minutes if the patient experiences pain or any other discomfort.

Also, one should not forget that massage has its beneficial and healing effect on the body only if there are no contraindications to it. Otherwise, massaging must be abandoned altogether. After all, such an effect on the body can not only greatly affect the well-being, but also worsen the patient's condition. Before starting massage sessions, you should consult with your doctor and get his approval.

What are the decisive contraindications? These are severe pains in any part of the body, high fever, acute inflammation, fever. They do not allow massaging blood diseases, bleeding and a tendency to them, as well as various purulent processes and all kinds of skin diseases, including wounds and other injuries - cracks, abrasions, burns, frostbite.

Skin diseases are a very important reason not to massage. Any inflammation and rash, fungus, warts, even flat ones, eczema, herpes, acne interfere with massage techniques and can spread from one focus to a wider area as a result of massage. This is due to the fact that during the massage there is a prolonged mechanical effect on the skin, which can increase the lesions.

Massage is completely excluded for diseases and conditions such as:

1) active form of tuberculosis;

2) allergic rashes;

3) angiitis;

4) atherosclerosis of peripheral vessels;

5) pain on palpation of the abdomen;

6) varicose veins;

7) inflammation of the lymph nodes and blood vessels;

8) benign tumors;

9) diseases of the autonomic nervous system during an exacerbation;

10) diseases of the abdominal organs with a tendency to bleeding;

11) malignant tumors;

12) myocardial ischemia;

13) hemorrhages;

14) general grave condition with various diseases and injuries;

15) acute inflammation of the veins;

16) acute respiratory diseases, as well as the period within 2-5 days after them;

17) acute period of hypertensive or hypotonic crisis;

19) cardiopulmonary insufficiency;

20) sclerosis of cerebral vessels with a tendency to thrombosis and hemorrhage;

21) nausea;

22) trophic ulcers;

23) thrombosis;

24) thromboangiitis in combination with cerebral atherosclerosis;

25) excessive physical fatigue;

26) excessive mental agitation.

In addition, there are some other diseases and conditions in which the use of massage is undesirable. For example, it cannot be prescribed after surgery if there are pulmonary edema and acute cardiovascular failure, renal and hepatic failure, acute allergic skin reactions.

But in the postoperative period, contraindications to massage may be temporary. As soon as the period of the acute inflammatory process ends, the temperature will drop, the febrile state will stop, the purulent process will disappear, there will be no bleeding, the exacerbation of diseases of the autonomic nervous system will pass, it will be possible to apply therapeutic massage again.

If there are no contraindications, then therapeutic massage should be applied after the removal of tumors, subsiding of the phenomena of hypertensive and hypotonic crises, after acute ischemia after 2-6 days, as well as after targeted drug treatment. In the latter case, this is very important, since massage enhances metabolism and promotes the fastest elimination of excess drug from the body.

For local massage, there are also limitations in application, but there are not so many of them, since the area for massage is smaller. In some cases, only segmental massage is allowed.

There are many different types of massage therapy. Rehabilitation massage is a very important and effective remedy. It can be either general or local. Its main task is to quickly return the body to normal functioning.

For various diseases and injuries, if there are no special contraindications for use, massage is prescribed as early as possible in order to relieve pain, normalize blood flow, lymph flow, movement of interstitial fluid, and also promote tissue restoration, resorption of hematomas, reduce edema and normalize metabolic processes ...

The first stage of this therapeutic massage is carried out together with the effects of cold, but then the massage is combined with thermal procedures. Ice massage is indicated for injuries. The cold acts on the affected areas as an analgesic and anti-inflammatory agent. It reduces the sensitivity of nerve endings, and this, in turn, improves the mobility of the massaged area and leads to a decrease in tissue edema. This type of massage significantly improves blood flow in the muscles, promotes the rapid elimination of decay products and accelerates the recovery process in the tissues.

The way to use it is quite simple: massage is performed using a bubble or a bag filled with ice or snow. Cold massage is performed in the first hours after injury. As you recover, cold massage gradually begins to alternate with thermal procedures, which helps the fastest healing.

For colds, cupping massage is used, and then percussion massage. At night we can-22

but apply a warming massage. In some cases, doctors prescribe it without fail.

Cupping massage is quite simple. To do this, you need to put medical banks for 7-10 minutes. The necessary effect is caused by mechanical irritation, which is produced by the vacuum created in the can.

For bronchitis and pneumonia, percussion massage is most often used. It serves to improve blood and lymph flow, as well as pulmonary ventilation. This type of massage is performed in the form of tapping a certain area of ​​the chest or back, followed by compression of the chest and dorsal region. Oblique chest massage helps better ventilation of the pulmonary tract. So that the patient does not hold his breath and the movements of the masseur are rhythmic, the commands "Inhale" or "Exhale" are used. The patient holds his breath or makes it quicker. At the right time, the masseur squeezes the chest or presses on the dorsal region, which leads to increased breathing. It should be noted that percussion massage is quite complicated and is performed only by specialists. It is not recommended to do it yourself, as improper actions can lead to a worsening of the condition.

But some methods of therapeutic massage are quite simple, and almost anyone can master them. The following massage techniques are not difficult and can help with nervous diseases.

Hello dear colleagues!

My name is Margarita Levchenko, I am a practicing massage therapist with over 25 years of experience. I have been teaching massage for over 20 years.

Needless to say that our profession is not the simplest and easiest one?

Great physical and emotional stress has a serious impact on our health and psychological state.

Many do not survive in the profession for more than 5 years, "burnout" occurs and people leave. Often with acquired sores and phobias.

I also had such a period, I also wanted to leave, I felt bad in the profession.

I managed to find my own system of maintaining health for a massage therapist, protection from harmful influences in this profession, and now I feel great, work at full strength and get great pleasure from our really wonderful profession.

I have prepared a complete training for you, in which I fully transfer my system of maintaining the health and professional longevity of the massage therapist.

Practical training, we will practice. Therefore, take suitable clothing.

I will be glad to see you!

Training program:

1. Occupational diseases. Analysis, nature, causes.

The most problematic area is the thumb (for example, tendonitis).
Arthritis of the wrist, hands. The main load during the massage falls on the hands.
Spontaneous contraction of the forearms.
Varicose veins in the legs.
Due to the fact that work often takes place in a half-turn of the body, the kidneys, the cardiovascular system, and the spine suffer.

And last but not least, the occupational disease of massage therapists - "burnout" or, more precisely, the emotional burnout syndrome (EBS) is a reaction of the body that occurs as a result of prolonged exposure to occupational stresses of moderate intensity.

2. Prevention of occupational diseases.

Rehabilitative gymnastics for the musculoskeletal system of the masseur, aimed at reducing the risks when loading the joints and the entire apparatus; exercise that reduces the risk of illness, which can be used before work, during work and when coming home.

A complex of medical gymnastics aimed at preventing varicose veins of the lower extremities.

Activities that can be done between patients, taking 1-2 minutes in time and improving blood circulation not only in the lower limbs, but throughout the body.

3. Hygiene measures to keep the masseur's organs healthy.

Disinfection procedures to restore the health of the massage therapist due to the constant rubbing of various oils, preparations and massage products into oneself.

Cleansing the liver, kidneys, lymphatic system.

Training in procedures for cleansing the capillary system, which is responsible for the health of the massage therapist as a whole.

4. Maintaining the emotional health of the massage therapist.

Burnout is an acute crisis.

It is characteristic of people who constantly face negative experiences of other people and find themselves more or less personally involved in them.

The burnout phenomenon is characterized by such phenomena as:

• mental and physical fatigue, loss of faith in oneself;
• mental and physical fatigue;
• feeling of helplessness and failure;
• unwillingness to go to work;
• irritability and aggressiveness during a conversation, the desire to complete it faster;
• feeling of low importance of the problems being solved;
• transfer of negative emotions to others;
• the desire to leave and realize oneself in another area.