L5 Effects of Massage

Question 1

mechanical effects of massage

Answer 1

movement of; lymph, venous blood, oedema, lung secretions

mobilisation of; muscle fibres, muscle belly, tendons, scar tissue tissue layers

Question 2

physiological effects of massage

Answer 2

increase blood + lymph flow - increase nutrient supply to tissue and decrease oedema
stimulation of healing process
increase mobility - extensibility if connective tissue
facilitate or reduce resting muscle activity
pain relief

Question 3

tissue fluid

Answer 3

filtered form of blood that bathes the body’s cells

Question 4

how does fluid movement occur

Answer 4

occurs by diffusion or osmosis along pressure / conc. gradients
from high pressure to low

Question 5

osmosis

Answer 5

– water flows up gradient from less concentrate to higher concentrate

Question 6

what can’t pass through capillary membrane and why?

Answer 6

Plasma proteins in capillary but not tissue space

Capillary membrane is permeable to water but not proteins

Question 7

lymph vessel properties

Answer 7

Lymph vessels are permeable to both  mop up extra proteins in tissue fluid particularly after injury
Lymph vessels have some valves < venous system

Question 8

how much tissue fluid returns to venous system and how much tissue fluid returns to lymph system

Answer 8

90% venous system

10% lymphatic system

Question 9

stages of inflammation and repair

Answer 9

acute inflammatory phase
proliferative phase
remodelling phase

Question 10

acute inflammatory phase

Answer 10

vasoconstriction
vasodilation
phagocytosis of neutrophil and monocytes
heat, swelling and redness in first 72 hrs
altered chemical state in tissue irritates nerve endings

Question 11

how is acute inflammatory phase characterised

Answer 11

by tissue sensitivity

Question 12

proliferative phase

Answer 12

fibroelastic infiltration
collagen formation - make and granulation and scar tissue to replace damaged tissue
48hrs

Question 13

remodelling phase

Answer 13

contraction of scar
-vascularity reduces
-tensile strength of collagen increase
-starts end of second  
 week – up to 1 year

Question 14

4 types of connective tissue

Answer 14

Connective tissue proper, cartilage, bone and blood.

Question 15

3 components of connective tissue

Answer 15

ground substance, fibres (collagen & elastin) and cells.

Question 16

name the main supportive protein of connective tissue

Answer 16

collagen

Question 17

how is connective tissue shortened and immobilised

Answer 17

as a result of being immobilised in shortened position or being moved only through limited ROM

Question 18

how does soft tissue/connective tissue return to its original length

Answer 18

must be stretched
Takes time (multiple sessions) to cause changes to collagen length

Question 19

where in the body does joint mobility get impacted by shortening of collagen

Answer 19

Joint capsule,
Ligament,
Tendon
Muscle

Question 20

how does muscle facilitation help

Answer 20

increase in fusimotor drive
tapotement
varies in depth, intensity and speed

Question 21

how does massage have LOCAL analgesia affect

Answer 21

Fluid exchange & increase in circulation improves local chemical environment
decrease fluid pressure on nerve endings
increase soft tissue extensibility
decrease muscle spasm

Question 22

how does massage have CENTRAL analgesia affect

Answer 22

Spinal segmental:
Pain gate theory
- Pressure impulses travel to dorsal horn of spinal cord via fast myelinated fibres
- Before pain impulses in slower unmyelinated fibres.
Bowsher (1988)

• Common mechanism in Manual Therapy e.g. Joint mobilisation

Question 23

who originated the pain gate theory and when

Answer 23

melzack and wall in 1965

Question 24

describe the gate theory

Answer 24

tiny neural networks distributed along the dorsal horn of the spinal cord are responsible for relieving the pain in a specific body location when an intense tactile stimulation is applied at the same place.

Question 25

why would there need to be an immunological impact of massage

Answer 25

High intensity exercise leads to temporary immunosuppression
reduced Immunoglobulin A (IgA) -> increased susceptibility to infection
High-quality but preliminary evidence ‘supports the possibility that massage exerts immunological effects

Question 26

explain how does evidence supports that massage has positive immunological effects

Answer 26

facilitating the recovery of immunoglobulin A

and ↓ presence of pro-inflammatory mediators generated by high intensity exercise.

Question 27

explain psychological response to massage

Answer 27

Relaxation
Relief of anxiety & tension / stress
Immune response and stress reduction
decrease anxiety may be better able to cope with pain
increase general well-being

Question 28

what hormones respond to massage

Answer 28

increase serotonin & dopamine

decrease cortisol levels (stress biomarker)