Movement in massage

Physiological influence. The movements have a beneficial effect on the musculoskeletal system, affecting not only 3 muscles, ligaments and joints, but also the reactivity of the whole organism.

The physiological effect of reception is determined by four effects: tonic, compensation, trophic and normalization of functions.

During the intake, the impulse from, the proprioceptors and other nerve endings involved in the movements increases. The motor zone of the cerebral cortex is excited, and this reflex( motor-visceral reflex according to MR Mogendovich) causes an intensification of function and improves the trophic of the vegetative organs. Improves the function of the cardiovascular system, increases the function of external respiration, increase metabolism, the intensity of

digestion processes, the protective properties and resistance of the body as a whole.

In case of violation of the function of any system, the work of an undamaged part or another system is strengthened, that is, movements contribute to the acceleration of the formation of compensation.

Movement improves the secretion and circulation of synovial fluid, as well as blood and lymph circulation in the joint region, increase metabolic processes and accelerate regeneration processes in tissues. Under the influence of movements, the development of lterrophy caused by hypodynamia is delayed.

Movement gives a good effect in the treatment of joint stiffness, with wrinkling and shortening of the ligamentous apparatus, muscle contractures, adhesions and deposits of salts that form around the joint and limit its movement. Under the influence of movements, inflammatory exudates and hemorrhages quickly resolve, the contractility of muscle fibers and the elasticity of muscles and ligaments improve.

All this is of great importance not only with macro-, but also with microtraumas, sometimes occuring almost imperceptibly or causing a feeling of "awkwardness" in the joints.

Types of reception: 1) passive movement;2) active movement;3) movement with resistance.

Technique of execution. Passive movements of the are performed by the massage therapist most often at the end of the massage session with the position of a massaged supine lying on the back. Massed should be as relaxed as possible and do not take part in the performance of the reception. Movements in the joints are made on the natural axes of each joint slowly, gently, with a gradual adjustment of the amplitude to the maximum by the 4-5th time of their performance, and this maximum should not cause pain.

Passive movements in the joints of the brush are performed in the position of a mass lying on the back, with the arm bent 90 ° in the elbow joint and resting on the couch. When moving in those or other joints of the fingers of the hand( flexion-extension, lead-away, circular - for I fingers), the masseur fixes the phalanges with his fingers so that there are no movements in the other joints. With flexion and extension in the metacarpophalangeal joints, he must fix his fingers with one hand, and the other with a wrist joint( Figure 41).

In the wrist joint , flexion and extension, circular movements, reduction and retraction are performed. To do this, one hand of the masseur fixes the forearm closer to the wrist joint, and the other, clutching the fingers of the hand massaged, produces the indicated movements( Fig. 42)

Fig.42. Flexion of the wrist in the wrist joint.

Fig.41. Passive movements in metacarpophalangeal joints: a - flexion;b - extension of fingers.

Fig.43. Flexion-extension in the elbow joint.

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In the shoulder joint of the , flexion and extension, rotation, lead-out and rotation are performed. The masseur bent at the elbow joint arm fixes in the shoulder and forearm and, without removing the elbow, makes circular motions, involving a scapula in them. In this position, he leads the shoulder to the auricle( Figure 44).To increase the amplitude of flexion-extensor movements, the massed should lie on the edge of the couch like this( Figure 45), so that the shoulder joint and arm hang( without support).With the rotational movements of the entire upper limb, the masseur takes the brush massaged, as in the handshake, and makes movements along the maximum amplitude in both directions.

In the elbow joint flexion and extension, pronation and supination are performed. For flexion-extension, the masseur grasps the shoulder with one hand as close as possible to the elbow joint, and the forearm - with the other hand near the wrist itself and makes movements. For pronation-supination, the massage therapist takes a hand massaged, like with a handshake: the left hand - the left one, the right one - the right one. The other hand of the masseur keeps the bent massaged limb by the elbow joint( Figure 43).

If the passive movements are carried out in the sitting position, the massage therapist becomes behind the massaged one and puts one hand on the forearm in the acromion area, the other fixes the bent forearm massaged at the elbow joint( Figure 46).In this position, rotations, lead-outs, flexion-extension are performed. For the rotation of the shoulder, the hand of the massaged is bent in the elbow joint: the masseur, standing in front, fixes the shoulder in the lower third with both hands so that the forearm of the mass lies on his forearm and rotates.

Fig.44. Bringing the shoulder to the auricle.

Fig.45. Flexion-extensor movements in the shoulder joint.

Fig.46. ​​Leading-reduction in the shoulder joint in the position of massaged sitting.

Fig.47. Flexion-extension in the ankle joint.

Methodological requirements for performing movements in the joints of the foot are similar to those applied to the joints of the hand.

When performing passive movements in the ankle joint , the masseur takes the heel tendon with one hand and the other for the arch of the foot. In this joint, flexion and extension, pronation and supination are performed, as well as circular movements of the foot in both directions( Figure 47).

Passive movements in the knee and hip joints are produced most often as follows: the masseur with one hand grasps the ankle area, puts the other hand on top of the thigh just above the knee joint and brings the heel to the gluteal region( Figure 48);then one hand of the masseur fixes the heel tendon, the other - the tendon of the quadriceps muscle, and it produces a very slow extension in the knee joint, while the

Fig.48. Flexion of the lower limb in the knee joint and bringing the heel to the gluteus muscle.

Fig.49. Extension in the knee joint.

The limit of the amplitude of flexion in the hip joint is determined by the moment of the beginning of the flexion in the knee joint of the other leg lying on the couch( Figure 50);when performing rotational movements, the leg bent at the knee and hip joints is brought, then straightened, bent again, retracted and unbent, etc.( Figure 51);when rotated, the masseur leans against the iliac crura with one hand, the other fixes the shin above the ankle and turns the leg either inward or outward( Figure 52).

the leg goes up( Figure 49), after which the masseur again bends the leg in the knee joint, and the hand that lies on the hip translates to the knee and lowers the leg on the table;Further the masseur leads a heel to a buttock, then the hand lying on a thigh, transfers on a shin and starts to lead slowly a knee to a thorax.

Fig.50. Bringing the knee to the chest.

Fig.51. Hip removal and circular movements in the hip joint.

Fig.52. Rotation in the hip joint.

Fig.53. Flexion-extension in the ankle joint with the position of a mass lying on the back.

Passive movements in the joints of the lower limbs can be performed in the position of a massage lying on the stomach. When carrying out movements in the ankle joint, the masseur fixes the foot with one hand, and the other - the shin in the lower third, while the leg should be bent by 90 °( Figure 53).When bending at the knee joint, the masseur clasps the ankle with one hand and places the other on top of the lower back( Figure 54).The extension, retraction and reduction in the hip joint are performed as follows: one hand of the masseur is brought under the shin from the inside, the other fixes the lower back, the more the amplitude of the movements being performed, the stronger the lumbar spine is pressed against the massage couch( Figure 55).

Passive movements in the cervical intervertebral joints are performed in the position of massaged sitting. The masseur, standing behind, puts his hands on the head of the above-massed auricles on both sides and makes the head tilt to the right and left( Figure 56) and circular movements in both directions. Putting one hand on the forehead, the other on the back of the head, the masseur tilts his head back and forth.

Fig.54. Flexion in the knee joint and bringing the heel to the buttock muscle with the position of a massage lying on the abdomen.

Fig.55. Retraction in the hip joint with the position of a mass lying on the abdomen.

Fig.56. Head inclinations to the right and to the left.

Passive movements in the intervertebral joints of the

trunk are performed in two positions.

Massed sits. The masseur stands behind, puts his hands on his shoulder joints and bends the trunk forward, then unbends back. After this, by shifting his hands to the deltoid muscles, he turns the body of the massaged right-to-left( Figure 57).

Massaged lies on the stomach. The masseur brings one hand under the neck that is massaged below and performs extension of the trunk( Figure 58).At the same time, the other hand fixes the interscapular area, and after each movement it gradually shifts to the sacrum. Then the masseur brings one hand under the shoulder joint of the person being massaged, passing it between the extremity and the trunk, with the other hand fixes the nearby blade or lumbar region and performs the twisting of the spinal column( Figure 59).

Fig.57. Turns the trunk to the right and left.

Fig.59. Twisting of the spinal column with the position of a mass lying on the abdomen.

Fig.58. Extension of the trunk.

In addition to the above-described types of reception, there are a number of others that actually belong to the eastern( Uzbek) massage and are called stretching and twisting of the upper and lower extremities.

Motion with resistance. This method has the following varieties: 1) the masseur performs movements, and the massaged provides resistance;2) massaged performs movements, and the masseur provides resistance.

Methodical requirements for the technique of receiving are the same as for passive movements.

Movement with resistance allows selective action on any muscle group or joint-ligament apparatus, which is of great importance in the practice of therapeutic massage, especially to maintain muscle tone, strengthen muscles, increase their elasticity, stimulate healing processes of soft and bone tissues,etc. Instead of movements with resistance in recent years, widely began to use a variety of simulators, produced serially and allowing to render on the muscular system and ligament apparatferior, overcoming and static effects.

Active movement. Performed only massaged by the order of the masseur in order to check the effect of the massage techniques performed on the tone and elasticity of these or other muscle groups. Classification of active movements is described in detail in any section of curative physical culture.

The most common errors when performing movements:

1) a sharp increase in the amplitude of the movements to the maximum without sufficient preparation;

2) rough( jerk) execution of movements;

3) the performance of reception is not according to the natural axes characteristic of the joint.