“The aim of medicine is to prevent disease and prolong life, the ideal of medicine is to eliminate the need for a physician.”
William J. Mayo (1861 1939), American surgeon and co-founder of the Mayo Clinic
“The doctor of the future will give no medicine but will interest his patients in the care of the human frame, in diet, and in the cause and prevention of disease.”
Thomas A. Edison
What is the difference between a therapeutic (Swedish) massage and a medical massage?
Swedish or therapeutic massage is intended to improve health and well-being by reducing stress and soothing tight, aching muscles. This type of massage generally utilizes a conventional, set configuration for a relaxing full body treatment for every client. This form of bodywork is widely recognized as therapeutic for its restorative and rejuvenating capacity.
When massage becomes more specific in application and intention to rehabilitate chronic or acute soft tissue impairment, it transcends the benefits of relaxation to a true corrective therapy. Therapeutic massage that employs advanced techniques and protocols to treat conditions diagnosed by a doctor or chiropractor is now becoming known as “medical massage.” Medical massage therapy is a specialized system of rehabilitation based on the theories and research of connective tissue healing.
Medical massage has been well researched and accepted in the major clinics of Europe and Russia since the 20’s and 30’s, and has continued to evolve into a widely employed and respected treatment, despite being relatively unknown in the American medical community. Since World War II, our medical profession has focused on the use of technologically advanced equipment and pharmaceuticals, with little attention paid to simpler and more effective, non-invasive treatments.
In medical massage, the focus is on relieving musculoskeletal pain and limitation by addressing dysfunction in the connective and soft tissues. The session is customized to treat the specific areas of complaint and associated structures with the intention to achieve clinical results. Treatments of up to one hour would be repeated twice or so weekly for an estimated total of 15 sessions or until a degree of normality is achieved.
What are the connective and soft tissues and how does medical massage help the body heal?
To answer that, we need to understand some structures of the body and what can happen to them to cause us to receive pain messages.
Whether from a single trauma such as a turned ankle or from repetitive strain where micro-traumas accumulate through movement and postural over-load, most soft tissue pain and dysfunction involve tearing of the fibers in the muscles, tendons, or ligaments and damage to the fascia. The fascia is a specialized sheet of connective tissue that differentiates, supports, and covers muscles (myofascial) and almost all other internal structures.
When there is significant tissue damage or accumulating stresses, the body may respond with fibrosis and scarring. The result can be recurring pain, compromised range of movement, frequent re-injury, and an increased probability of developing osteoarthritis later in life.
Scarring and fibrosis result in part from the inherent limitations of the human healing process. When injury damages structures in the soft tissues, a type of collagen fiber will form a “patch” to repair the breakdown of the tissues. It does so in an indiscriminate fashion with fibers possibly “gluing” together previously independent surrounding structures, forming adhesions. The fibers in the forming scar are randomly oriented and not bundled efficiently along lines of pull for maximum strength. The repair fibers may not have the same elasticity or the ability to perform the specialized functions of the original tissues.
Fibrosis is the excess production of collagen fibers that proliferate when there is decreased blood flow due to chronic muscle constrictions or inflammation. Muscles may also become fibrotic through postural or functional misuse; the body adapts to long-term strain (and weakness) with increased fibrous tissues adapting to take up new lines of tension instead of the muscle fibers. The fascial structures can become misshapen, thickened, adhered, or fibrotic under abnormal conditions.
Scar tissue, adhesions, and fibrosis can lead to future trouble, as there is reduced functionality, integrity, independence, and uniformity of structure. What was once a part of our resilient motive system with parts gliding past each other like silk scarves can become congested, stiff, and bound-up.
In my practice of medical massage, I use neuromuscular therapy, deep tissue massage, passive and active stretching, myofascial release, and cross-fiber frictioning, combined with more conventional therapeutic massage procedures. These techniques enhance the healing process by breaking down excess scar tissue, and by treating or preventing adhesions and fibrosis. They also increase blood supply to congested tissues and to areas that normally have very little circulation, such as tendons and ligaments.
This improves the supply of oxygen and nutrients to the injury or dysfunctional sites and speeds the removal of toxic metabolic by-products. Therapy is applied to muscles that are chronically tight or in spasm to decompress joints and ligaments and to relieve constrictions of normal circulation and painful movement. Passive and active stretches are added to ensure that normal healing occurs with properly aligned and mobile tissues.
“While release of muscular restrictions and shortening could be seen to be a desirable step in the restoration of normality, it is worth emphasizing that once adaptive, fibrotic changes have taken place in the soft tissues (whether in response to emotional stress or anything else) these changes are no longer under neurological control and therefore cannot simply be ‘released’ (by exercise or anything else) but require a physical input which alters, stretches, and effectively breaks down concretions such as fibrotic issues.”
Leon Chaitow ND, DO
Medical massage is a thorough program of recovery from acute and chronic pain syndromes and prevention of future occurrences. Much advanced training and practice is required to perform this type of massage effectively. It is a full-time vocation, and few medical practitioners or physical therapists have the time or the inclination to master it.
However, this procedure of hands-on muscular therapy can provide relief for many people, as it directly addresses soft tissue pain and dysfunction. It can be part of a comprehensive program, complementing all other health care modalities, but we should always look first for the simplest solution. Medical massage delivers the least risk of side effects and complications as a non-invasive, cost-effective therapy for the musculoskeletal system.
This can be an intense massage experience with powerful results, but it is always applied in such a manner as to encourage the body not to react defensively. The depth and pressure are kept within the comfort range of the client. After all, if the therapist’s toolbox only contains a hammer, everything looks like a nail. In my practice, many tools are available and every effort is made to facilitate the therapeutic benefit in the manner most relaxing and beneficial for the client.
“ A muscle is one of those everyday things which seems simple unless looked at closely. The closer the look, the more complex muscle and its function become. There is no other tissue whose functions involve such sweeping changes in chemistry, physical state, energy and dimensions. In their contractions and relaxations, muscles control the very pulse of life in man and animal.”
Albert Szent-Gyorgyi, Nobel Laureate
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