• Segmental massage

    Development of segmental massage is associated with the name of one of the founders of physiotherapy AE Shcherbak( 1863-1934).The physiological basis of this type of massage is the unity of the human body, all its components are interrelated;consequently, every disease is not just a local process, but a disease of the whole organism. Therefore, the local pathological focus causes reflex changes in functionally related organs and tissues( skin, connective tissue, muscles, periosteum, etc.), mostly innervated by the same segments of the spinal cord - the Zakharyin-Ged zone( Fig.).

    Fig. Zakharyin-Ged zones on the trunk and their relationship with segments of the spinal cord and viscerosensory reflexes in diseases of internal organs.

    C - neck segments;T - thoracic; L - lumbar; S - sacral;1 - light;2 - liver( capsule);3 - stomach( pancreas);4 - liver;5 - the kidney;6 - small intestine;7 - bladder;8 - ureters;9 - heart;10 - lungs, bronchi;11 - intestines;12 - genito-urinary organs;13 - the uterus.

    Depending on the nature and location of the pathological process, as well as the reflex changes in various tissues, many subspecies of massage have been created. Currently, segmental and point massages are widely recognized.

    In clinical practice, the technique of segmental massage has been carefully developed by O. Glezer and A. V. Dalicho( 1965, 1972) and is a generalization of such types of reflex massage as deep friction according to Tsiriaks( 1944), tactile according to Rumans( 1933), periostealFogler and Kraus( 1953), Lang's Gelotripsy( 1931), Leibe connective tissue and Dick( 1948), Cornelius nerve-point( 1933), etc.

    In the segmental massage , the main goal is to find and then influence the reflexchanges in the surface tissues of the bodythe Lamb. Discover these Zakharin-Ged zones is one of the essential tasks of segmental massage. The study is done layer by layer starting with the skin and moving to deeper tissues. In the area of ​​the corresponding segment, the sensitivity of the skin is often so high that even a gentle touch is felt as acute and painful. Identification of such zones during palpation, the so-called diagnostic massage , is a valuable clinical sign indicating an increase in reflex excitability - when the skin is caught in the fold, a thickening is felt, the mobility of the skin is limited. With palpation, pain and tension in the connective tissue and muscles can also be determined. When trying to stretch the connective tissue in this case, pain occurs. The elimination by massage of such changes in the skin, connective tissue, muscles and periosteum facilitates the elimination of the primary pathological focus.

    With segmental massage lasting an average of 20-25 minutes, it is mainly intended to affect the Zakharyin-Ged zones. Techniques used in classical massage are used: stroking, grinding, kneading, migratory, as well as special - drilling, moving, receiving a saw, stretching, rolling, shaking. Particular attention is paid to stretching painful areas of skin and tissues. Fingers try to penetrate into a tight area of ​​connective tissue and produce a long and slow stretching of it in longitudinal, transverse and zigzag directions. In this case, the massage finger should feel gradually weakening the tension of the tissue. Mening and vibration are used to eliminate reflex changes in muscle tone. It is advisable to begin massage with segmental roots at the point of their exit from the spine, then massage techniques are performed towards the spine( Fig.).

    Fig. Sequence( according to the figures) of segmental massage in the regions of the back( according to O. Glaser and A. V. Da-liho, 1965).

    As the reflex changes in the skin, muscles and connective tissue are eliminated, the state of in of the affected organs is rapidly improving, so the main task of segmental massage is to relieve tension in the tissues of the affected lesions. Accurate knowledge of the relevant segments is mandatory for the masseur.