I. INTRODUCTION:

Stress is a prevalent component in today’s fast paced world which can negatively impact on an individual health and well being. Massage therapy has been shown to be a means by which stress can be reduced significantly improved the physical and psychological level. One of the best things you can do for yourself when under stress is “to take a break and get a massage” says, Kristine Kaoveri weber in healing self massage.

Acute and long term care facilities are instituting massage therapy programs to support their patient health, healing and quality of life. Evaluation of the impact on these programs from the perspective of patients, providers and therapist is important for administrative decision making. The evaluation revealed that, hospital based massage therapy program has uncovered range of benefits for hospitalized patients.

The National Center for Complementary and Alternative Medicine (NCCAM) is sponsoring studies to identify the purpose for which massage may be most helpful. People use massage for a variety of health related purposes including to relieve pain, rehabilitate sports injuries, reduce stress, increase relaxation, address anxiety, depression, and aid general wellness.

II. What is Massage Therapy

Massage is a general term for pressing, rubbing and manipulating the skin, muscles, tendons and ligaments. Massage may range from tight stroking to deep pressure.

III. History of Massage Therapy

Massage therapy dates back thousands of years. References to massage appear in writing from ancient China, Japan, India, Arabic nations. Egypt, Greece (Hippocrates defined medicines as “the art of rubbing) and Rome.

Massage became widely used in Europe during the Renaissance. In the 1850s Two American Physician introduced massage- therapy 1930s and 1940s Massage Therapy was popular and was promoted for a variety of health purposes. From 1970s Interest in massage reviewed especially among athletes.

IV. Types of Massage

Swedish Massage

This is a gentle form of massage that uses long stroke, kneading, deep circular movements, vibration and tapping to help relax and energize you. This massage commonly used to reduce stress and improve well being.

Deep Massage

It is a massage, use slower more-forceful strokes to target the deeper layer of muscle and connective tissue. Commonly to help with muscle damage from injuries.

Sports Massage

This is similar to Swedish massage but its geared toward people involved in sport activities to prevent and treat injuries.

Trigger Point Massage

This massage focuses on areas of tight muscle fibers that can form in the muscles after injuries or over use.

Aroma Therapy Massage

It is the massage therapy with the addition of one or more scented plant oils called essential oil.

Hot Stone Massage

Heated stones are placed on certain points on the body to warm and loosen tight muscles and balance energy centers in the body.

Thai Massage

Thai massage aligns the energies of T6 body using gentle pressure on specific points and it also includes compression and stretches.

V. Benefits of Massage Therapy

(i) Relieves Stress:-

Stress relief is key to achieving a healthier life style. Even a single massage session can significantly lower heart rate, cortisol and insulin level- all of which help to reduce daily stress.

(ii) Encourage Relaxation

Relax, reset, repeat. Massage has been shown to help the body enter a relaxing rest- and recovery mode- an effect that lingers long after the massage is over.

(iii) Improve Posture

Massage helps to reinforce healthy and natural movement, which can get your posture back on track.

(iv) Improves Circulation

The pressure created by massage therapy moves blood through congested areas. This causes new blood to flow in, resulting improved body function.

(v) Lower Blood Pressure

High blood pressure has more misconceptions than nearly any other medical condition. Effective way to stave off high blood pressure naturally is massage therapy.

(vi) Relaxes Muscles

Massage gets to the root of persistent pain by relaxing tense muscles.

(vii) Improves flexibility and Range of Motion

Due to aging process joints tend to tighten, making range of motion more restricted. Massage helps keep joint more fluid, making more flexible and less prone to injury.

(viii) Promote Deeper and Easier Breathing

Massage can play an important role in relieving respiratory issues and training the body how to relax.

(ix) Strengthen the Immune System

Regular massage naturally increases the immune system’s cytotoxic capacity- the activity level of the body’s natural killer cells.

(x) Enhances Postoperative Rehabilitation

Massage helps the body to pump more oxygen and nutrients into tissues and vital organs. This makes massage therapy a great supplement to postoperative rehabilitation.

VI. Physiological Effect of Massage

Effects on the Skeletal System

· Massage can help to increase the joint mobility by reducing any thickening of the connective tissue and helping to release restriction in the facia.

· Massage helps in free adhesions breakdown scar tissue and decrease inflammation.

· Massage improves muscle tone and balance

Effects on the Muscular System

· Massage relieves muscular tightness, stiffness and spasm in the muscle tissue.

· Increases blood circulation bringing more oxygen and nutrients into the muscle. This reduces muscle fatigue and soreness.

Effects on the Cardiovascular System

· Improve circulation by mechanically assisting the venous flow of blood back to the heart.

· Dilate the blood vessels helping them to work more efficiently.

· Produce an enhanced blood flow: delivery of fresh oxygen and nutrients to the tissue is improved and the removal of waste products, toxins and carbon-dioxide is hastened via the venous system.

Effects on lymphatic system

· Massage help to reduce oedema by increasing lymphatic drainage and the removal of waste from the system.

· Regular massage may help to strengthen the immune system due to increase in white blood cells.

Effects on the Nervous System

· Stimulate and soothe nerves depending on the techniques used.

· Stimulate parasympathetic nervous system to promote relaxation and the reduction of stress.

· Massage help to reduce pain by release of endorphins

Effects on the Skin

· Improved circulation to the skin, increased nutrition to the cells and encouraging cell regeneration.

· Increased production of sweat from sweat glands, helping to excrete urea and waste products

· Improve elasticity of skin

· Increased sebum production

Effects on the Respiratory System

· Massage deepens respiration and improve lung capacity by relaxing any tightness in the respiratory muscle

· It slows down the rate of respiration due to the reduced stimulation of the sympathetic nervous system.

Other Physiological Effects

· Reduce stress and anxiety by relaxing both mind and body.

· Create a feeling of well being and enhanced self esteem.

· Promote positive body awareness and an improved body image through relaxation.

· Ease emotional trauma through relaxation

VII. Equipment needed for a back massage

· A warm and quiet environment

· A firm and comfortable surface Such as a bed, floor mat or massage table

· Massage oil

· A set of towels to lie on and cover the body

· A couple of cushions and pillows

VIII. Techniques of Back Massage

Technique 1

Effleurage (Smooth rhythmic stroking): Using the Whole Hand

Before you begin the massage, warm the oil in your hands and apply a small amount with the whole hand using smooth rhythmic strokes. It is important to use the whole surface of both hands. Use firm movements to stroke upwards, i.e. from the lower back right up to the neck, using gentle pressure circle around and slowly move to the lower back region. Follow this procedure for 5 to 10 minutes.

Technique 2

Effleurage: Using the Heel of the Hand

In this technique there is a smaller area of contact because of which the pressure is deeper. Start at the lower back using both the hands and working in circles. Using the same circular movement, move outward first and then upward. Return to the center gradually and then progress to the upper back. This procedure should be followed for 5 minutes.

Technique 3

Effleurage: Using Reinforced Fingers

Like the previous technique, this one too concentrates on a smaller area of contact. Stand on the right hand side of the area that you are working on. Place one hand on top of another and push with the flats of your hand away from the centerline, and then glide back towards the spine. Begin this procedure at the lower back and work up to the upper back. Follow this procedure for 5 minutes.

Technique 4

Stripping: Using the Reinforced Thumb

Use deep continuous pressure up to the full length of the muscles that are located at either side of the spine. As you move to the neck, lessen the pressure a little. Move slowly and intentionally feeling for sensitive spots and knots. You glide from the lower to the upper back. Continue this three times each side, alternating it with a couple of minutes of effleurage (Smooth rhythmic stroking) and then repeat the stripping.

Technique 5

Friction: Using the Reinforced Middle Finger

In this technique firm deep movements need to be applied on each side of the spine. Begin the massage at the lower side of the spine and move upward. 5 frictions need to be applied on each spot with a few more in case of a sore spot.

Technique 6

Effleurage: Using Forearms

Begin the massage by applying firm downwards pressure and then move the arm that is closest to the head up to just below the shoulder blade. Follow the procedure with 6 strokes taking into consideration the possibility of lower back pain.

Technique 7

Trigger Point Release: Using sustained pressure of the Reinforced Thumb

For this massage you need to depend on the patient’s pain. To begin with place your thumb on tender knots or spots that your patient has told you about. Press down on those points; increasing the pressure gradually till the pain reaches 6 or 7 on a scale of I to 10. Hold the pressure till the pain lowers to about 4 on a 1 to 10 scale. Repeat the steps. Muscle and back pain may miraculously disappear using this technique.

Technique 8

Using Effleurage to finish the massage routine

Apply effleurage with supported fingers, the heel of the hand and the full hand. Using these techniques will increase the good that you have done with the trigger and stripping point release. After this is done, leave the patient quiet for a few minutes.

IX. Cautions about Massage Therapy

· Vigorous massage to be avoided by people with bleeding disorders.

· Massage should not be done in any area of body with blood clots or fractures and open wounds.

· Don’t massage the area where there has been a recent surgery

· Patients with cancer should consult their oncologist before having a massage.

· Pregnant women should be consulted before any massage.

X. Contraindications to Massage Therapy

The contraindications to massage therapy are as follows,

1. Total contraindication

2. Local contraindication

3. Medical contraindication

1. Total contra indication

· Fever

· Contagious diseases like cold or flu

· Under the influence of drugs or alcohol including prescription of pain medication

· Recent operations

· Neuritis

· Skin disease

2. Local Contra Indication

The therapist can massage but not over any areas affected by

· Varicose veins

· Undiagnosed lumps

· Pregnancy

· Bruising

· Abrasions

· Undiagnosed pain

3. Medical Contra Indications

· CVS conditions (Thrombosis, phlebitis)

· Edema

· Psoriasis or eczema

· Osteoporosis

· Angina with pacemakers

· Epilepsy

· Diabetes

· Bell’s palsy trapped or pinched nerves.

XI. CONCLUSION:

There are tremendous benefits to be achieved through regular massage therapy treatment. A therapeutic massage can enhance overall sense of emotional and physical well being as well as the quality of life. Central to the development of a sound evidence base for music therapy are the use of valid reliable and relevant outcome measures in research and practice in evaluating massage therapy intervention. Currently the outcome measures in research and practice and evaluating massage used in both the health and the social sciences are many and varied.

XII. REFERENCE:

1. Adams R. Massage Therapy. International Journal of Therapeutic Massage and Body work: Research, Education and Practice. Vol.3; 2010: 4-11.

2. Lori Newel. How does massage therapy reduce stress? A review. Available from: http://www.livestrong.come/article/124957- massage therapy.

3. Martin and Zipser. Massage therapy as complementary and alternative medicine. A review. Available from: http://www. medi cinenet.com/massage therapy, 1-3.

4. Aniakania and Marja J Verhoef. The Massage Bodywork. International Journal of Research. 2 (1); 2009: 8-16.

5. Jolie Haun and MK Brennan. Massage can relieve work place pain and stress. Massage Total. 13 (9); 2013: 1-3.

6. James Mulcahy. Massage therapy contra indications. A review. Available from: http://www.livestrong.com/article/129484,2013, 1-3.

Received on 28.05.2014 Modified on 07.07.2014

Asian J. Nur. Edu. and Research 4(4): Oct.- Dec., 2014; Page 516-519