Download Massage - Honda Wellness

Therapeutic Massage Therapy
Support for your health and
well-being
Mark J. Selmek, P.T.
Tia Lillard, L.M.T.
HealthPartners Physical Therapy
Overview of Presentation:
• Brief history of Massage
• What exactly is Massage?
• Effects of Massage
• Precautions for Massage
• Types of Massage
• Massage at Honda
• Finding “your” Massage Therapist
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Brief History of Massage
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Massage is one of the oldest forms of treatment for human ills. We have a natural instinct to “rub” a sore or
painful spot.
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Egypt BC 2330: The Tomb of Akmanthor [10] (also known as "The Tomb of the Physician") in Saqqara, Egypt
depicts two men having work done on their feet and hands, presumably massage.
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China BC 700: Bian Que, the earliest known Chinese physician uses massage in medical practice. Writings about
massage date back to 1400 BC, but it was certainly in use before then… Often discussed along with accupuncture.
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Greece BC 500: Aesculapius is reported to have treated patients with relaxation, diet, hydrotherapy, herbs,
massage, advice and tender loving care. Serpents were used at this stage as tools in curing patients; and it is the
Staff of Aesculapius, with a serpent knotted around it, that has become the symbol of medicine.
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Hippocrates BC 460-380: the founding father of medicine. He used friction in the treatment of sprains and
dislocations, and kneading to treat constipation. "A physician must be experienced in many things but assuredly
also in rubbing." He held that all disease results from natural causes and should be treated using natural methods
- incl massage - to restore the body to a healthy state, and that it essentially had the power to heal itself.
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India BC 300: Most records of Indian massage focus not on its medical qualities but on its sensual. The Kama
Sutra, and other documents bear testament to a culture that understands and uses these properties to change
peoples' moods, to arouse them and to calm them. Sanscrit records indicate that massage had been practiced in
India long before the beginning of recoded history.
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Rome: Galen was Greek but treated many Romans, who loved massage. Caesar himself was said to be “pinched”
every day!
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Middle East/Persia 980 AD: One of the greatest Persian medics was Avicenna, also known as Ibn Sina. He
excelled in the logical assessment of conditions and comparison of symptoms and took special note of analgesics
and their proper use as well as other methods of relieving pain, including massage.
• http://www.wischik.com/lu/massage/ljwhistory.html
• http://en.wikipedia.org/wiki/Massage
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Recent History of Massage
• United States: Massage started to become popular in the United States in the
middle part of the 19th century[8] and was introduced by two New York physicians
based on Henrik Ling's techniques developed in Sweden.[12] This is where the term
“swedish massage” comes from.
• During the 1930s and 1940s massage's influence decreased as a result of medical
advancements of the time, while in the 1970s massage's influence grew once again
with a notable rise among athletes.[8] Massage was used up until the 1960s and
1970s by nurses to help ease patients’ pain and help them sleep.[17]
• The 1996 Summer Olympics in Atlanta was the first time that massage was offered as
a core medical service to the US Olympic Team.[20] Massage has been employed by
businesses and organizations such as the U.S. Department of Justice, Boeing and
Reebok.[21] Notable athletes such as Michael Jordan and LeBron James have personal
massage therapists that at times even travel with them.
• http://www.wischik.com/lu/massage/ljwhistory.html
• http://en.wikipedia.org/wiki/Massage
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History of Massage
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What is Massage?
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Massage is the manipulating of superficial and deeper layers of muscle and connective tissue
using various techniques, to enhance function, aid in the healing process, decrease muscle reflex
activity, inhibits motor-neuron excitability[1] and promote relaxation and well-being.[2][3]
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Massage involves working and acting on the body with pressure – structured, unstructured,
stationary, or moving – tension, motion, or vibration, done manually or with mechanical aids.
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Target tissues may include muscles, tendons, ligaments, fascia, skin, joints, or other connective
tissue, as well as lymphatic vessels, or organs of the gastrointestinal system.
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Massage can be applied with the hands, fingers, elbows, knees, forearm, and feet. There are over
eighty different recognized massage modalities.[8]
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In professional settings massage involves the client being treated while lying on a massage table,
sitting in a massage chair, or lying on a mat on the floor. The massage subject may be fully or
partially clothed or unclothed.
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May or may not include using topical agents, skin lubricants
May or may not include use of tools (stones) and mechanical devices (that mimic the use of the
hands)
•
http://en.wikipedia.org/wiki/Massage
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What is Massage?
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Terms Related to “Massage” have
EXPLODED
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Acupressure massage
Bowen therapy
Deep tissue massage
Myomassology
Postural integration (PI)
Relaxation Massage
Reflexology massage
Reiki
Rolfing
Self massage
Shiatsu
Stone massage
Structural integration
Swedish massage
Trager approach
Watsu
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• Augmented Soft Tissue Mobilization
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(ASTM)
Lymphatic drainage massage
Medical massage
Myofascial release massage
Trigger point therapy
Visceral manipulation
Energy work
Body work
Yoga massage
Polarity
Therapeutic Touch
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“INSTRUMENT ASSISTED” SOFT TISSUE MOBILIZATION…
IS NOT MASSAGE THERAPY, PER SE
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Principal Goals of
Treatment
Intention
Table 1: Proposed taxonomy of massage practice
RELAXATION
CLINICAL MASSAGE
MOVEMENT REMASSAGE
(Medical Massage)
EDUCATION
Relax muscles, move
Accomplish specific
Induce sense of
body fluids, promote
goals such as releasing freedom, ease and
wellness (reduce stress) muscle spasms
lightness in body
ENERGY WORK
Hypothesized to free
energy blockages
Commonly Used Styles
(examples*)
Swedish massage, Spa
massage, Sports
massage, Chair
massage, Stone
massage
Myofascial Trigger Point
Therapy, Myofascial
Release, Strain
Counterstrain,
Augmented Soft Tissue
Mobilization (ASTM),
Graston Technique,
Lymphatic Drainage,
Postural Drainage
Proprioceptive
Neuromuscular
Facilitation, Strain
counterstrain, Trager,
Active Release
Technique (ART),
Structural Integration
(Rolphing)
Acupressure, Reiki,
Polarity, Therapeutic
Touch, Tuina,
Reflexology, Postural
Integration
Commonly Used
Techniques
(examples**)
Gliding, Kneading,
Friction, Holding,
Percussion, Vibration
Direct pressure, Skin
rolling, Resistive
Stretching, Stretchingmanual, Cross-fiber
friction
Contract-relax, Passive
stretching, Resistive
stretching, Rocking
Direction of energy,
Smoothing, Direct
pressure, Holding,
Rocking, Traction,
Fascial-Myofascial
Unwinding
* While some styles of massage are commonly used in addressing one of the four principal treatment goals, some may be used
to address several distinct treatment goals.
** By varying the intent (or purpose) for a technique, many of them can be used in massages with different principal treatment
goals.
Sherman et al. BMC Complementary and Alternative Medicine 2006 6:24 doi:10.1186/1472-6882-6-24
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Why Massage?
There are 4 basic types of “tissues” in the human
body:
• Epithelial Tissue:
9%
includes skin
• Connective Tissue: 30%
includes bone & fat
• Muscle Tissue:
60%
40% is skeletal muscle
• Nervous Tissue:
1-2%
% of body weight
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Massage Therapy Continuum
LESS
SCIENTIFIC
EVIDENCE
Reiki, Reflexology,
Polarity,
Accupressure,
Magnets, Crystals?
MORE
SCIENTIFIC
EVIDENCE
Myofascial Release,
Proprioceptive
Neuromuscular
Facilitation, Strain
Counterstrain
Trigger Point
Therapy, ASTM,
“Eastern”, “Alternative”, “Holistic”…
does not necessarily make it bad or ineffective!
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Effects of Massage - Physical
• Blocking of pain thru afferent (sensory) nerve fibers
• Promotes release of opiates within the body
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(endorphins-natural painkillers that block pain)
Increases circulation of blood, vasodilatation, drop in BP
and HR.
Increase in lymphatic flow.
Sedative effect, autonomic reflex effect, increased
sympathetic activity.
In normal muscle, will not increase muscle strength,
tone or size :( sorry.
In injured muscle, fewer fibrous bands, adhesions, &
scarring.
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Effects of Massage- Physiological
• Loosen mucus and with postural drainage, can
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help remove excess fluid from lungs.
Increase in RBC count, Hgb, O2 capacity, and
even platelets.
Skin: increase sebaceous gland secretion,
sweating.
No effect on fat tissue :( sorry
No immediate or large effect on metabolism.
Increase peristalsis, emptying of the GI tract
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Effects of Massage - Psychological
• Soothing, relaxation effect
• Reduces anxiety
• Reduces stress, and effects of stress on
the body
• Can be used to teach and train heightened
sensory awareness and control of both
positive and negative body responses
(biofeedback?)
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Studies on Mind / Body Connection
• Researchers at Ohio State University have found that breast cancer patients
with the greatest anxiety about their medical condition had the lowest
levels of white blood cells (WBC normally attack cancer and combat
infection.) In blood of women with high degrees of stress, there were 20 to
30 percent fewer natural killer cells that play key roles in the body's
defenses. The study is the first part in a long-term project to test whether
controlling stress can play a role in fighting cancer.
• Another study at Ohio State University found that students examined during
final exams had weaker immune responses to hepatitis than unstressed
students.
• At Carnegie Mellon University, one researcher discovered that the more
stress or more negative emotional state a person has, the more likely that
person is to catch a cold when exposed to cold germs.
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Precautions for Massage
Contraindications?
• Diabetes
• Blood or clotting disorders
• Heart or circulation problems
• Pregnancy
• Sensory loss or nerve disorders
• Contraindicated for swollen tissues if
accompanied by redness and inflammation
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Types of Massage
• Relaxation: Swedish, La Stone, Chair
Massage
• Clinical: Myofascial Trigger Point Therapy,
Myofascial Release, Positional Release
• Movement Re-Education: Neuro-Muscular
Massage, Active Release Technique (ART)
• Energy Work: Cranio-sacral, Reflexology
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Swedish Massage
• Most common term you will hear associated with
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massage.
A Western-style massage that uses firm, yet
calming pressure to improve circulation, eases
tension, and improves flexibility.
Includes long, gliding strokes, kneading, and
vibration movements.
May be applied in the direction of the heart to
encourage circulation and waste removal.
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Swedish Massage
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La Stone Therapy
• La Stone therapy, also known as hot and cold stone therapy, is a type of massage
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that uses smooth, heated and cooled stones to relieve stiffness and soreness, and to
restore energy to aching muscles and joints.
Stones are applied by the massage therapist to balance a clients chakra. La Stone
practitioners also perform hand massage to assist with the unblocking of energy and
to direct blood and lymph flow throughout the body.
The stones are heated to varying temperatures - ranging from 0- to 140-degrees
Fahrenheit - to elicit physical healing, mental relaxation and a spiritual connection to
earth energy.
The theory behind La Stone massage is that warm stones will encourage the
exchange of blood and lymph circulation throughout the body, and provide soothing
and healing heat for deep-tissue work. Hot stones are used for encouraging
circulation and for easing stiffness; cold stones are applied to aid with inflammation,
to encourage blood to move away from a swollen areas. Benefits of alternating hot
and cold stones during a La Stone session have been known to encourage the
circulatory system and the self-healing process.
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La Stone Therapy
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Chair Massage
• Chair Massage is done in an ergonomically
designed portable chair.
• Chair Massage focuses on the head, neck,
shoulders, back, arms and hands.
• Clients do not need to disrobe to receive a
chair massage.
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Chair Massage
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Myofascial Release
• The term myofascial release is derived from the Latin
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words myo (or muscle) and fascia (or elastic band).
Gentle therapy, consisting of a mixture of light stretching
and massage work.
Therapist releases tension from the fibrous bands of the
muscles, bones, nerves and joints, by unblocking any
scar tissue or adhesions due to injury in the muscles and
surrounding tissues.
Therapist will use light to moderate traction and twisting
strokes to apply the appropriate tension on the soft
tissue, and to achieve a full reflex range of the muscle.
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Myofascial Release
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Neuromuscular Therapy
• Neuromuscular therapy (NMT) is a form of soft tissue manual
therapy in which static pressure is applied with the aim of
stimulating specific areas of skeletal muscle.
• Often these areas of muscle are myofascial trigger points. NMT aims
to balance the nervous system with the musculoskeletal system and
is based on neurological laws that explain how the central nervous
system maintains balance.
• Therapist will locate the muscle spasm and apply continuous
pressure for about 30-seconds with their fingers, knuckles or
elbows, or other tool. The same pressure must be maintained by the
massage therapist for the entire 30-seconds in order to encourage
proper blood flow in the area. By applying this pressure, it disperses
the lactic acid, so the deficient muscle can begin to accept a clean
supply of oxygen and blood flow.
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Neuromuscular Therapy
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Active Release Techniques
• Active Release Techniques, or ART, is used to treat a wide variety of
soft tissue and repetitive-motion injuries that haven’t responded
well to other forms of therapy.
• The therapist shortens the tissue, applies a contact tension and
lengthens the tissue or make it slide relative to the adjacent tissue.
• The therapist uses an intensive series of massage techniques in
order to move the muscle through its full range of motion -this will
relieve the surrounding tissues of any adhesions or scar tissue,
which can form and block the injured muscle, and allow for the free
flow of blood, lymph fluid and nerve conduction so the muscle will
heal.
• These treatment protocols - over 500 specific moves - are unique to
ART. They allow providers to identify and correct the specific
problems that are affecting each individual patient.
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Early Intervention Program
• The medical department at Honda has instituted
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the EIP program for associates who may benefit
The nurse will do an assessment to determine if
the symptoms are likely to resolve with massage
therapy and other components of the program.
There are other requirements (entrance criteria)
to meet to be entered into the program.
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Early Intervention Program
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Cranio-Sacral Therapy
• Cranio-Sacral Therapy, or CST, is a gentle, hands-on
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manipulation of the cranio-sacral system - made of the
soft tissue and bones of the cranium (or head), the spine
and the pelvis.
Also target the membranes and cerebrospinal fluids that
surround and cushion the brain and spinal cord from
injury during a therapy session.
Uses a touch equivalent to the weight of a nickel.
Practitioners believe that until the spinal fluid is naturally
allowed to move freely around the body, the central
nervous system and the bodys other major organs and
muscles will be put off balance and put at risk of
sickness and injury.
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Reflexology
• Reflexology is promoted as an ancient healing art based
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on the principles that there are reflexes in the hands and
feet that correspond to every part, organ and gland in
the body.
Reflexology therapist will apply acupressure and
massage to the ears, hands and feet within zones. The
client is said to benefit from improved circulation,
detoxification, reduced tension and the body's ability to
heal itself.
According to some reflexologists, stimulating nerve
endings in these extremities has an effect on the whole
body's nervous system, which promotes healing.
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Massage Techniques
Some terms generally used for massage
techniques:
• Effleurage – long, flowing, gliding
strokes
• Petrissage – compression techniques
• Percussion – short, fast tapping
techniques
• Vibration – fast, stimulating techniques
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Effleurage
• The whole of the hand is used in this technique
to soothe and relax. It is also used to reduce
water retention and lymphatic build-up as it
encourages the removal of toxins from the
muscles being worked on.
• The pressure used in effleurage can vary. Use
lighter pressure at the beginning of the massage
and then work up progressively to firmer
pressure.
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Petrissage
• Petrissage is the name given to any of the compression techniques used in Swedish
massage; these are firm pressure techniques where the muscles or the skin is
compressed against the underlying tissue.
• Types of petrissage include:
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Kneading: This technique involves lifting the skin in one hand and transferring it to the
other hand, back and forth.
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Wringing: Similar to kneading, wringing involves more pressure and a squeezing action.
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Knuckling: Performed using the first and second phalanges of the fingers, this is a deeper
technique that helps to reduce tension in the larger muscles of the body. It is often used on
the upper legs and shoulders.
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Friction: Friction techniques are performed using either the fingers or the thumb on its own
and used on smaller areas of the body. Small circular friction movements are used to
encourage the elimination of toxins from the body and relieve tension in muscles that are
very tight or painful.
• Cross Friction Massage or Transverse
• Scar Massage
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Percussion
• Percussion techniques are used to stimulate and invigorate.
• Techniques include:
– Tapotement: Tapotement is a light, tapping technique performed using the
fingertips; it is used on delicate areas such as the face and neck.
– Hacking: Hacking is performed using a fast, chopping movement, where the
lateral sides of the little fingers make contact with the tissue, used to revitalize
the client.
– Cupping: This technique is carried out by gently curving the hands to create a
soft cup shape this, in turn, creates a slight vacuum, which encourages the flow
of blood to the area.
– Pounding: Pounding is performed by creating a light fist; it is useful for clients
that have good muscle tone but should be avoided when working on more frail
individuals. The lateral sides of the fists are used alternately in a pounding
movement to treat areas such as the calves, gluteals and gluteus maximus.
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Vibration
• Vibration is a light vibrating technique
used to relax the client and encourage the
release of tension and pain.
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What to look for in an LMT
• Are they licensed in the state where they are
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working?
Do they have professional liability insurance?
Are they a member of the American Massage
Therapy Association (AMTA)?
Do they have any additional training or hold any
specialist certifications?
Do they have a record of regularly pursuing
formal Continuing Education coursework?
Do their clients recommend them?
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Massage at Honda
• Massage is offered at Honda through the wellness
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centers.
Honda shares the cost of the massage program
overhead, therefore keeping the cost to associates
considerably lower than in the general community:
$16/25 min massage & $32/55 min massage
All therapists are Licensed by the State of Ohio
Must be a wellness center member to schedule an
appointment.
Days and times vary by location.
Massage therapists do not diagnose illness or disease,
nor do they prescribe medications or perform any bonejoint manipulations.
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Current Massage Availability
• ELP: Tuesdays 2p-5p.
• Call x65012 to schedule.
• AWC: Mondays 6p-10p, Tuesdays 5p-8p.
• Call x63682 to schedule.
• WWC: M 9a-7:30p, W 1:30p-7:30p, Th 9a•
7:30p, Sa 10a-2p, Su (3rd) 10:30a-2:30p.
Call x61729 to schedule.
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OTC Topical Analgesics
• Topical Analgesics include balms, ointments, rubs and PAIN PATCHES
that are applied to surface of body for pain relief.
• Most TAs work via method of counter-irritation.
• Counterirritants – Like stepping on your toe to take your mind off a
headache, counter-irritants stimulate or irritate the nerve endings to
distract the brain’s attention from musculoskeletal pain.
• Most TAs use menthol, oil of wintergreen, camphor, eucalyptus oil,
turpentine oil, or some other chemical agent to create a “warm” or
“tingly” sensation that helps block pain.
• Includes products such as ArthriCare, Eucalyptamint, and Therapeutic
Mineral Ice.
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OTC Topical Analgesics
• Capcaisan: A highly purified natural ingredient found in
cayenne peppers. Capsaicin works by depleting the
amount of a neurotransmitter called “Substance-P” that is
believed to send pain messages to the brain.
• For the first couple of weeks of use, the ingredient may
cause burning or stinging.
• Capsaicin is available under the product names Zostrix,
Zostrix HP, Capzasin-P and others. Menthacin includes
both capsaicin and counterirritants.
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Topical Analgesics
• A few TAs also include an anti-inflammatory pain medication called “Methyl
Salicylate” that is similar to aspirin, e.g. Icy Hot has the most
• May work by inhibiting prostaglandins
• Icy Hot, Aspercreme, Ben-Gay, Flex-all, Mobisyl and Sportscreme.
• If you want the Salicylate without the counter irritant, try Ben-Gay “Arthritis”
Formula.
Some of the benefit of TA comes from the massage
DO NOT use any TAs that contain silicone, eg BioFreeze
because it’s a damaging paint contaminant for Honda
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TA Guidelines
• Used correctly, topical analgesics can provide temporary
relief from minor aches and pains of muscles and joints
• As with all medications, misuse of these products can
cause harm.
• Products with methyl salicylate should not be used for
more than seven days and should not be applied to
wounds or damaged skin.
• FDA recommends they not be used under a tight
bandage, and contact with eyes should be avoided.
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When to seek help from a medical
professional?
• Pain that disturbs your sleep.
• Sensory changes (eg numbness OR tingling) that
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last > 3-5 min, or occur > 3x/day.
Color or temperature changes in hands or feet.
Weakness.
Swelling.
Difficulty performing the daily activities that you
normally can perform.
Fatigue that lasts > 1 hour, even with complete
rest.
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Remember:
• Massage is usually not a “cure” all by itself…
• But Massage it is an important complementary medical
treatment
• To find a Massage Therapist near you, call x80598, visit
the Honda Wellness Centers, or…
• Go to: http://www.amtamassage.org/findamassage/index.html
• Questions?
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