effects & therapeutic uses of massage

Question 1

what are the ‘mechanical’ effects of massage?

Answer 1

1. movement of lymph, blood, oedema (swelling)
2. mobilisation of muscle fibres, muscle belly, tendons, scar tissue, tissue layers etc

Question 2

in response to massage, what happens to the flow of lymph and blood in the body?

Answer 2

• there is an increase in blood and lymph flow
  -blood vessels dilate
  -removal of metabolic waste products

Question 3

what is diffusion?

Answer 3

fluid flows down the conc gradient from high pressure to low pressure

Question 4

what is osmosis?

Answer 4

water flows up gradient from less concentrated to higher concentrated

Question 5

what are the 3 main phases of the healing process ?

Answer 5

• acute inflammatory phase
  -proliferative phase
  -remodelling phase

Question 6

what does the acute inflammatory phase involve?

Answer 6

• immediate vasoconstriction of BV’s to reduce blood loss
• then vasodilation to recruit blood cells
  -phagocytosis occurs
• for 72 hours - there is heat, swelling and redness
  -tissue sensitivity - protective mechanisms

Question 7

what does the proliferative phase of the healing process involve?

Answer 7

• fibroblasts are recruited (note fibroblasts secrete collagen)
• collagen formation producing granulation and scar tissue to replace the damaged tissue
• can take 48 hours - 6 weeks

Question 8

what does the remodelling stage of the healing process involve?

Answer 8

• contraction of scar
  -tensile strength of collagen increases
• starts at the end of the second week and can last for up to 1 year

Question 9

what are the 4 basic types of connective tissue?

Answer 9

• connective tissue proper
  -cartilage
  -bone
  -blood

Question 10

what is the main supportive protein of connective tissue?

Answer 10

collagen

Question 11

what can happen to connective tissue as a result of being immobilised in shortened position or only being moved through limited ROM?

Answer 11

it can become shortened

Question 12

what needs to occur in order to return the soft tissue to original length?

Answer 12

-it needs to be stretched
- should be stretched when it is at its most extensible - eg once heated

Question 13

what is tensile strength of soft tissue?

Answer 13

the ability of the soft tissue to withstand a pulling force along its length or resistance to tear

Question 14

what is muscle tone?

Answer 14

the amount of tension (force produced0 in our muscles

Question 15

in response to certain massages eg effleurage, should our muscle tone be increased or reduced?

Answer 15

it should be reduced

Question 16

what is an example of a massage technique that may cause an increase in muscle tone?

Answer 16

tapotement

Question 17

In what ways does massage cause local analgesia (pain relief)?

Answer 17

• fluid exchange between cells increases and circulation improves
  -decrease in fluid pressure in nerve endings
  -increase in soft tissue extensibility
  -decrease in muscle spasm

Question 18

what is the pain gate theory?

Answer 18

-this is a theory that suggests that the central nervous system has a neurological gate that controls pain signals to the brain
- the gate is the different fibre types

Question 19

what kind of nerve fibre do noxious stimuli eg hot flame, cut, puncture travel in?

Answer 19

small peripheral nerve fibres

Question 20

what role do the small peripheral nerve fibres play in the gate theory of pain mechanism?

Answer 20

• the small fibres inhibit the inhibitory fibres, which allows pain information to travel to the brain
• ie they allow pain perception

Question 21

what role do the large peripheral nerve fibres play in the gate theory of pain mech?

Answer 21

-the large peripheral nerve fibres excite the inhibitory neuron, which diminishes the pain transmission to the brain and less pain is perceived

Question 22

what kind of stimuli do the large peripheral nerve fibres carry ?

Answer 22

distractive stimuli - rubbing, massaging, application of heat etc

Question 23

in terms of the immune system, what can high intensity exercise lead to?

Answer 23

• temporary immunosuppression

Question 24

why does temporary immunosuppression occur after high intensity exercise?

Answer 24

• there is reduced IgA - which increases the chance of infection

Question 25

how can massage help with the temporary immunosuppression after intense exercise?

Answer 25

• massage can facilitate the recovery of IgA
  -decreases the presence of pro-inflammatory mediators generated by high intensity exercise

Question 26

what psychological effects does massage have?

Answer 26

• relaxation
  -relief of anxiety, stress and tension - by increasing levels of serotonin and dopamine
  -analgesia - a decrease in anxiety may be better able to cope with pain
  -increase in general well being