Thursday, April 2, 2009

The effect of massage stroke
Touch is one of the most powerful senses we as humans have. It makes us feel accepted and included. It can also be used in negative violent situations, but as a caring form of communication it is every bit as powerful as words. In this blog I will address the effect of massage strokes on the autonomic nervous system, the effects of different massage strokes from gentle touching to vigorous tapotement. Effects on conditions such as muscle pain blood pressure and concentration will also be explored.

The effects of massage on the Autonomic Nervous system
The autonomic nervous system (ANS) is composed of two parts, the sympathetic nervous system and the parasympathetic nervous system. Both are regulated by the hypothalamus gland situated near the brain. These two systems are complimentary. The sympathetic nervous system serves all parts of the body and is our “fight and flight” system. It slows down some of our body systems like the digestive system, increases our heart rate and heightens our alertness ready for danger. This is an instinct to protect ourselves until we can confirm it is safe. The parasympathetic nervous system when activated decreases anxiety and depression. The release of cortisol (a stress hormone) relaxes us and keeps us calm. At the beginning of a relaxation massage with a new client who is not familiar with the therapist the sympathetic nervous system is likely to be triggered for the first 10-15 minutes until the body accepts there is no danger and with the correct massage the parasympathetic nervous system will then be triggered. Light massage and vigorous massage will stimulate the sympathetic nervous system whereas moderate massage will stimulate the parasympathetic nervous system (Diego,M. et al, 2004).

The effects of Massage Strokes
Different massage strokes have different effects on the body
Touching and holding is a gentle technique a massage therapist may use to introduce him/herself to a new client. It is a comforting soothing touch and would be suitable for the elderly and those with a life-limiting illness.
Effleurage is a gliding movement used to warm tissue and explore underlying muscles. It can be used to prepare the area for deeper massage. It is sometimes the only stroke needed to relax and alleviate discomfort.
Effleurage can be used as a transition stroke being used before deeper massage and then again as the massage on that area is coming to an end.
Petrissage is a kneading stroke that can increase the blood flow around the muscles,
reduce local swelling and rid the body of metabolic wastes. It can reduce muscle pain and stiffness and stimulate the nervous system. It can further stimulate the release of endorphins therefore helping in pain control.
Compression is the rhythmic pumping on a muscle. During compression the blood is pushed out of the area and when the muscle is released the blood quickly rushes back. This technique broadens the muscle and often encourages the muscle to relax.
This is my personal favourite as I have many trigger points on my back and shoulders from chronic Occupational Overuse Syndrome.
Tapotment has several variations:hacking cupping and pounding. Cupping is used on more sensitive areas like the calves. Tapotment increases local blood supply, tones loose muscles and can relieve pain. A hypersensitive area can be desensitised after a few minutes of tapotement. This technique is often used at the end of a relaxation massage when the client needs to return to a situation where mental alertness is required. Hacking and pounding can be used to loosen phlegm in the lungs in cases such as cystic fibrosis.
Vibration is a technique that can be used to observe the movement or stiffness of local tissue. Done before and after a relaxation massage the therapist can observe how much the muscle has relaxed due to the therapist's treatment.

Other effects of Massage
Effects of massage unfortunately are usually short-term. We need to be careful to not oversell the benefits. That said it is generally agreed the most people benefit from massage. Blood flow is increased due to pressure and long rhythmic strokes. Increased circulation aides in the delivery of nutrients and oxygen to cells and tissues. It also aides in the excretion of metabolic wastes Blood pressure is decreased. In the same way the lymph flow is increased, reducing swelling and increasing the lymphocyte count which supports the immune system. Muscle tension is decreased because of increased blood supply and muscle stretching. Massage on connective tissue can prevent excessive scar formation, decrease adhesion formation and can release fascial restrictions. It can promote fracture healing and improves connective tissue healing. As result of the relaxing effect of massage sleep patterns are improved and digestion maybe stimulated. My last client (personal communication, April 1, 2009) commented to me about how well she had slept immediately after her massage. Mood improves after massage and feelings of anger are decreased. Good concentration and mental alertness are recognised benefits of massage. Physical sensation of pain is reduced. Massage has been shown to affect the nervous system through stimulation of sensory receptors. The gate control theory refers to the idea that pain impulses pass through a “gate” to reach the nerve fibers leading from the spinal cord to the thalamus in the brain. Pain impulses are transmitted by large and small diameter nerve fibres. Massage stimulates the large diameter fibres, preventing the small diameter fibres from transmitting signals, suppressing the sensation of pain (Fritz 2000). The massage therapist, through touch can satisfy his/her clients needs for attention, acceptance, caring and nurturing .

Human touch and skin contact is an important basic need we all have to keep us healthy both physically and mentally. In his theory of Human Motivation Abraham Maslow, lists touch as number three of a list of 20 basic needs, being surpassed only by safety and shelter.“ Given that most diseases are exacerbated by stress and given that massage therapy alleviates stress, receiving massages should probably be high on the health priority list, along with diet and exercise.” (Field & Chaitow as cited in study notes, March, 2009)


Abraham Maslow 1962 Massage Therapy, 3rd edition Salvo, Louisiana.
Diego, M., Field ,T., Saunders, C., Hernandez-Reif, M. (2004). Massage therapy of moderate and light pressure and vibrator effects on EEG and heart rate. International Journal of Neuroscience, 114, 31-44
Field T, Chaitlow L (2000), Touch Therapy. Oxford, UK: Churchhill Livingston.
McQuillan,D. (2009) Study notes
Salvo, S.,(1999) Massage Therapy 3rd Ed., Louisiana, USA, Saunders Elsevier.