MASSAGE COURSE

History of Massage

The history of massage is well documented in many historical texts, but it is really very difficult to
have a clear and precise conclusion. It has been practiced in all cultures and at all times, but the first
written records date back more than 5,000 years.

Massage is as old as man, probably even more so if we consider friction, rubbing, as techniques that
animals use to treat themselves, when faced with a blow we rub, we rub on a bruised area
unconsciously to reduce the pain, we know by science and by consciousness that massage heals, and
our ancestors also knew it.

In Egypt the priests treated the body and mind, papyri and hieroglyphs show manipulation and
massage techniques, which were applied along with other therapeutic measures.

In Greece, massage was used as a means to treat athletes and recover them after injuries. Even
Homer wrote in his texts the importance of massage in his time. Its use was very common in Gyms
along with therapeutic techniques for using water.

India and massage

The first data about the importance of massage in India come from Greek texts that related the
importance given to massage as a therapeutic means with a wide range of body treatment techniques,
in fact the aspects they covered were so broad that They could be related to techniques that are used
today in recovery treatments, from kinesitherapy to aromatherapy.

In ancient Indian texts, reference is also made to massage, which is part of the hygiene and health
measures that Indian medicine had for the treatment of the most diverse ailments.

China and massage

Massage seems to begin in China, there is extensive documentation about its use in Chinese
medicine, the emperors had masseuses of the highest categories to treat their ailments. Massage in
China was one of the most developed and widespread techniques for the treatment of the most
widespread pathologies along with acupuncture and medicinal herbs.

The massage in Rome

From Rome we widely know its thermal baths and the therapeutic applications that were carried out
in them, among them massages with all their possibilities: massages relaxing,
stimulants, therapeutic.
Massage in Rome was available to almost everyone, from commoners to the Emperor, and was used
both as a means to improve and recover health and to improve physical conditions after gymnastic
activities.
The word massage has various roots that lead to a clear purpose, which is to provide physical contact
between two individuals, “Massech” from Hebrew which means to touch or palpate, as well as
“Massein” from Greek which denotes the main action, which is friction, in addition to these two
towns there is the root of the Gallic people, “Masser” which in French is a verb that literally means
to knead or massage, France being one of the pioneers in the Western world in the use of manual
therapies.

According to this epistemology, it can be assured that Maso therapy is included within
kinesiotherapy, not only because it is a healing means, but also because it involves movement, a
movement of both the physiotherapist's hands and a synchrony in the friction that is generated in the
tissues underlying the manipulated area. This set of interventions forms one of the oldest therapeutic
means in the world, precisely because of the way it is applied, since it is a purely instinctive process,
it is not necessary to have advanced knowledge in this art. It is enough to see how a mother "rubs"
her child's knee when she sees that he has fallen or the simple touch of consolation on a person who
is going through difficult times, but it is the experience and apt knowledge of certain techniques that
catapults the massage therapy.

DEFINITION

It is a manual therapy designed to produce a series of controlled physiological reactions in the

musculoskeletal system and other systems of the body, which lead to therapeutic relief for the
individual to be treated, in addition to having the function of having an energy exchange between the
body and the body. therapist and patient.

In short, massage is a manual technique based on kneading, pressure, rolling, tapping, vibrations,
percussion, and more; performed at different rates and pressures depending on the person and the
problem to be treated for therapeutic purposes seeking pain relief when it exists and prevention when
one is in good condition.

CLASSIFICATION

Therapeutic massage

It is the massage that is applied with the purpose of recovering or helping the patient recover. In all
cases, the type of injury presented is assessed.
Therapeutic massage must produce healing action , as well as achieve the stability of the regulatory
systems and increase the functional capacity of the patients' body.
During the massage session the patient may experience various reactions, which is why it is
necessary to know how to correctly select the manipulations (maneuvers) and their varieties
(combinations) and determine the appropriate intensity of the irritating action. The sensitivity during
the massage action depends mainly on the individual 's constitution and their state of health , which
is why it is necessary for the masseuse to take into account the following aspects:

For the application of this type of massage there are general indications in various injuries, such as in
cases of:
Fractures, functional limitations of the joints, muscle atrophies, muscle contractures,
neuralgia, neuritis, radiculitis, paralysis in general, among others.

The techniques applied in therapeutic massage are analogous to those applied in sports massage.
Therapeutic massage does not have its own technique.
Any type of massage can be used in therapeutic massage, whether massages with devices, point
massage, segmental massage, etc.
The duration of a general therapeutic massage session is usually no more than 20 minutes. . In
healing practice, general massage is rarely recommended; without it only local massage is carried
out.
The first general massage sessions should be applied no less than 2 to 3 times a week and lasting 35
to 45 minutes. If during the treatment it is observed that the patient's general condition worsens
(weakness or other unpleasant sensations), the duration of the treatment must be reduced or the
massages must be temporarily stopped.
For therapeutic massage, especially general, it is recommended that the patient rest for 10 or 15
minutes.
People who suffer from diseases of the Cardiovascular System should have a rest of 10 to 15
minutes. before starting treatment.

General indications for therapeutic massage

Massage sessions are carried out by combining independent manipulations. To carry out the session
you must take into account: the clinical course of the disease, the general condition of the patient, the
activity carried out and the objective of the massage. First the superficial tissues must be worked on
and then the deep ones. To dose the massage, you must take into account the duration of the session
and the force to be applied, so it must be very clear that at the beginning of the treatment course it
should not be very intense or prolonged.

When there are chronic disorders, the massage can be performed more intensely than in cases of
acute illnesses. On the other hand, it must be done in such a way that the patient does not
experience a sensation of pain once the session is completed. Once the session is over, the
patient should remain lying down, to achieve a gradual decrease in reactions. The use of creams ,
oils or powders must be appropriate so as not to reduce the effect of the manipulations, taking
into account the condition of the patient's skin (sweating, hairiness, etc.) to apply these
substances.

- Helps edema and exudates disappear more quickly.

- Eliminates pain.
- Allows resorption of joint effusions.
- Prevents muscle atrophy.
- Improves joint functions .
- Accelerates the formation of bone callus in fractures.
- It contributes to the improvement of trophic processes in tissues.

It is good to clarify that the masseuse must know the particularities of therapeutic massage, as
well as the main characteristics and consequences of trauma.
The manipulations used in this type of massage are the same as sports massage, although they
are used with greater care and starting with the gentlest manipulations in the first sessions, but as
 the treatment progresses they intensify and get closer to the focus of the massage. trauma.
This type of massage should not be painful, that is why you should always start with the
preparation massage.

The effects on the body

Physiological effects of massage.

Effects on the skin

- It lightens it, freeing it from peeling cells and impurities that clog pores.
- Hyperthermia (increase in temperature), caused by a mechanical action (the therapist
rubbing against the patient's skin), with a reflex action (which would be superficial
vasodilation, which will be of greater or lesser intensity depending on the stimulus
applied) .
- Regarding the function of the skin, massage causes the release of histamine that
produces:

V Capillary vasodilation with local redness.

V Activates the nutrition of dermal cells .
V Increases local temperature.
V Promotes the elimination of waste substances from the skin.

> Effects on the nervous system .

It will depend on the application of the technique: If it is applied gently, the sensitivity
of the sensitive nerve endings decreases and there is sedation and analgesia. If applied
stronger or faster, it increases the excitability of the motor nerves, increasing tone and
facilitating muscle contraction. Also due to the hyperemia produced, the nutrition of the
peripheral nerves improves.

> Psychological effects.

> aa to produce analgesia and relaxation applied under conditions of adequate

temperature, relaxed environment , music. It is a gentle work that produces an analgesic
and relaxation effect, evading you from the problems of daily life.

Main indications and contraindications for the application of therapeutic massage

Indications

For the application of massage in cases of trauma in general, you must take into account the
following steps or indications.

• Ensure that the patient is in a comfortable position that allows the muscles to relax, without
straining to maintain a certain position.
• The application of the massage should not cause pain.
• Exclude frequent changes in the position of the patient's body
• Cover areas of the body that are not being worked on.
• Avoid the presence of other people, noise , strong light , drafts, etc.
• In the prone position, correct the lumbar region, especially in cases of pronounced lumbar
lordosis.

Contraindications

This type of massage is contraindicated in cases such as the following, so it can be said that they
are the main contraindications for its application:

• In cases of skin diseases.

• During acute febrile processes.
• When there are malignant tumors, lithiasis, etc.
• If there is or is prone to bleeding or in cases of wounds
• In acute inflammatory processes.
• In blood diseases
• In scurvy cases
• Diseases of peripheral vessels
• In cases of thrombosis, thromboangitis, atherosclerosis of peripheral vessels.
• Aortic aneurysm.
• When there is inflammation of the lymphatic and blood vessels.
• In cases of acute diseases of the Vegetative Nervous System.
• When extreme physical or mental fatigue occurs.
• In active tuberculosis , syphilis and other venereal diseases.
• In cases of chronic osteomyelitis.

EFFECTS OF MASSAGE ON THE SKIN

The skin gains softness, elasticity and fineness, as well

as firmness and flexibility. It also increases perspiration
and facilitates sebum secretion from the skin glands.

EFFECTS OF MASSAGE ON SKELETAL MUSCLE

Massage becomes a substitute in any situation in

which the body is unable to perform physical
exercise.
It stimulates muscle action and increases the
propulsion of venous blood and lymph. The
muscles in their contraction and relaxation act as a
pump that facilitates blood circulation.
It is the best method to relieve muscle fatigue
caused by excessive exercise or
prolonged inactivity, as it promotes the rapid
elimination of waste elements
and improves nutrition.

EFFECTS OF MASSAGE ON CIRCULATION

Massage facilitates the mechanical emptying and forward movement of

blood and lymph, in addition to putting inactive capillaries into
operation. Regarding lymphatic flow, combining different techniques
results in a very marked increase in lymphatic flow, decreasing it if
edema exists. It is also beneficial in case there is chronic lymphatic
obstruction.
 EFFECTS OF MASSAGE ON THE DIGESTIVE SYSTEM

It activates the muscles by stimulating intestinal peristalsis, which in turn

facilitates the evacuation of feces. It acts at the level of the entire digestive
tract, facilitating the digestion process by muscular and circulatory
stimulation.

EFFECTS OF MASSAGE ON THE NERVOUS SYSTEM

It achieves a sedative effect at the central and peripheral

nervous system.

EFFECT OF MASSAGE ON THE RESPIRATORY

SYSTEM

Increases the work capacity of the respiratory muscles. The

result will be an increase in lung capacity, this benefits all
the cells in the body, which will receive a greater
contribution of O2.

The pressure stimulation associated with touch increases vagal activity, which in turn decreases
physiological arousal and stress hormones such as cortisol. The
decrease in this enhances immune function. Parasympathetic activity is
also associated with increased alertness and better performance of
cognitive tasks.
Since most diseases are exacerbated by stress and massage relieves it.

Fundamental Manipulations of Manual Massage

Manual massage is what the masseuse performs with his own hands
through the six fundamental manipulations that are:
• Outcrop
• Kneading
• Friction
• Percussion or tapping
• Sway
• Passive mobilizations
 Massage manipulations are divided into toning and relaxing, and some can even have both
effects on the body depending on the speed and depth with which they are carried out.

Outcrop

As it is a sliding manipulation on the surface of the skin, it will act on it, in the following way:

• Cleanses the skin of dead cells, waste from sweat and sebaceous glands, as well as
microorganisms and dirt.
• Activates the functioning of the skin's secretory glands.
• Increases the diameter of the capillaries, especially the superficial ones.
• Improves venous and lymphatic return circulation, due to the mechanical action of manipulation
and the secretion of histamines.
• Raises local skin temperature.
• Improves the nutrition of the skin, making it smoother and more elastic.

Kneading

• Promotes increased tissue mobility.

• Dilates and distends skin scars, as well as adhesions in deep tissues.
• Intensifies blood circulation, promoting the nourishment of tissues and processes
reabsorption of pathological products not only from the skin but also from joints, muscles, bones
, ligaments and joint capsules
• Increases local temperature up to 5 degrees Celsius.
Reduces muscle tone and pain caused by neuralgia, etc. If done quickly, it increases the
contraction capacity of the muscles and increases their muscle tone.

Friction

• It is intended primarily to improve the functions of the neuromuscular apparatus.

• Improves blood circulation, allowing energetic absorption of adipose tissues

• Improves tissue nutrition, intensifying the exchange of substances and elimination of metabolic
waste products (CO2 and lactic acid).
• It partially or totally reduces muscle fatigue, increasing the contraction capacity of muscles,
important in the development of elasticity.
• Accelerates breathing , increases body temperature and heart rate. Through this technique, an
increase in muscle strength after application has been demonstrated.
• Kneading is applied in case of functional insufficiency of the muscles, after a strong physical
load, to eliminate muscle tension and restore working capacity.
 Percussion or tapping

• It has a mechanical influence on the tissues, its effectiveness depends on the strength and
duration of the execution.
• It increases muscle tone, a very important aspect in sports practice, it increases the excitability of
the nervous system, by stimulating different receptors via afferent means, hence this
manipulation is widely used in preparatory massage.
• The tapping applied to different areas close to the spine through reflex pathways triggers
reactions that improve the functioning of internal organs, for example, a decrease in cardiac
activity, pressure and pulse, the motor and secretory activity of the stomach and small and large
intestine. , etc.
• It reinforces the action of vascular and secretory nerves, increasing their tone and therefore
improving metabolism.

The Shakings

• The shaking of the tissues on different sensory, motor and secretory nervous receptors gently
inhibits the nervous system and, when done more strongly, causes its excitation.
• Increases muscle tone and lymph reflux.
• Through this manipulation you can check the state of the muscles, whether they are sufficiently
relaxed or still contracted.
• It is checked whether the massage session was effective or not

Mobilizations

• They stimulate locomotor activity and promote the elasticity of the joint and ligamentous
apparatus.

• Promotes muscle work in general.

• Promotes the flow and reflux of synovial fluid in the joints.
• It improves blood and lymph circulation, thereby helping to nourish the soft tissues around the
joints.
• They help reabsorb hemorrhages, exudates caused by trauma or training itself.
• This manipulation has a favorable action on the recovery of the joints.
• Increases the elasticity and flexibility of muscle and ligamentous tissues.

The following characteristics must be taken into account:

• Physical characteristics of the patient, given by muscle weakness, volume and type of clinical
variant.
• Pain, Age, Sex.
• Physical activity you perform.
• The pathology for which the massage is performed.
Given the specific characteristics of the cases presented, it is necessary to outline the techniques
or characteristics of special massages, which are specifically applied in the area of rehabilitation
massages.

Stump Massage : its precise purpose is to reduce the fat that accumulates at the distal end of the
stump, giving it the conical shape recommended for this type of massage; the use of very
repeated kneading, and tapping or percussion, keeping in mind the existence of pain when
applying the technique due to the existence of sensitive nerve terminals (in many literatures it is
contraindicated because it produces painful stumps). This massage is also combined with healing
due to the existence of a wound produced by the surgical technique.

Healing Massage: it is only used if there are scars, which may occur due to a surgical act or
trauma, this aims to provoke the elimination of existing adhesions on the skin and subcutaneous
tissue, this massage can be painful for the patient. patient because this adhesion can break.

Facial and Cranial Massage : they are extremely special because their manipulation, despite
being known by the technician and student, must be very precise and variable in turn both in the
position of the hands and in their path and especially the skill for their practice. They must be
soft so that they produce the desired reaction to the stimuli, tonic or stimulating.

Evacuative Massage : it is a modality whose objective is the rapid and dynamic transport of the
patients' fluids, the patient must be placed in a position in which the distal extremities are at an
angle of 45 degrees in relation to the most proximal part and the The therapist will apply
compressive manipulations to cause a selective and direct stimulus on the nerve endings that
accelerate the vasodilation process .

The technical and hygienic conditions of the massage are as follows:

To apply the massage, four important aspects must be taken into account:

• Local
• Furniture
• Massage therapist
• Patient

• The massage room must be well ventilated and if it is necessary to use air extraction devices,
air conditioning, large fans or large windows, but it must not be too cold, there must be an
adequate temperature , around 22 degrees C. It must be a dry location, where the relative
humidity must not exceed 60%. With adequate lighting .

• The furniture must have:

Table for applying the massage, covered in artificial leather (vinyl) with the headrest adjustable
to different heights and the following dimensions:
175-190cm long
 55cm wide
70cm high
Rollers adjustable to tables 60 cm long by 25 cm in diameter.
File for registration documents , sheets, towels, soap and talcum powder, oils or liniments, first
aid kit and supplies necessary for the application of the massage.
Two-step ladder for the masseuse, 50 cm wide by 20 or 22 cm high.

• THE masseuse.
The person who is going to perform the massage must have knowledge of anatomy and
physiology and perfectly master massage techniques, clean hands and short nails.
You should not wear clothing that could harm the patient.
You must wear appropriate clothing for the activity, preferably short sleeves. Save energy,
because the activity requires a lot of effort and you must maintain your work capacity
throughout the day.
You should plan your work to do the longest and most difficult sessions at the beginning of the
day, alternating them with the easier sessions.
It is recommended to take 2 or 3 breaks of between 5 and 10 minutes.
You must have extensive knowledge of the specific characteristics of the subject to be massaged,
that is, their functional status, the time of day that is most effective for the treatment, etc.

• The patient
You should not receive massage applications with dirty skin.
To guarantee the effectiveness of the massage, it is vitally important not to present
contraindications from the doctor. The clothing should be as light as possible, in the case of men,
a brief and for women, a blouse open at the back and without sleeves.
 massage
techniques