Special methods of segmental massage
Drilling reception. When drilling, two or three rotational and helical movements are used, strictly in the direction of the spinal column. The depth of the effect of reception should increase gradually to 5 kgf. Reception( one drilling) is performed within 3-4 seconds, after which the force of pressure gradually decreases and the performance of rotational and helical movements ceases. If necessary, the reception can be carried out by moving from one segment to another( from the periphery to the center) at the moment of least pressure on the massaged area. The brush of the masseur must have a support, mainly on the fingers, not directly involved in the reception.
Varieties of drilling: 1) I and II-IV fingers, 2) I fingers;3) middle phalanx;4) bar-drilling.
Technique of execution. Drilling I and II - IV with fingers is used to eliminate reflex changes in the muscles of the back and is combined with stroking. The position of the masseur is opposite to the massaged back area, most often to the left of the massaged lying on the abdomen. The right arm is placed on the sacrum so that the first finger is to the left of the vertebral column, and the remaining fingers are to the right, the vertebral column is between the I and the remaining fingers( Figure 62, a).After that, I use a finger to make a semicircular motion to the spine to the near-vertebral line, where they perform drilling with the distal phalanx, moving the tissues towards the vertebral column. During the
, two-five fingers are used to perform this movement and to drill the support. So massage the left region of the back from the bottom up from one segment to the other( Figure 62, b).
In the same way, but already the distal phalanges of II-V fingers are massaged to the right of the spine from the bottom up, with the first finger now serving as a support only.
To adjust the pressure, the left hand can be located on the right.
Drilling I with your fingers. The treatment is performed with a massage of the buttocks, waist, back, long muscles of the upper and lower extremities to selectively affect the limited hypertension( tension) of the muscles, myogelosis( muscular tightening) and in the region of the maximum pain points.
Fig.62. Drilling I and II - IV with your fingers.
and - first phase: the initial position of the massaging hand;b - the second phase: semicircle slip I of the finger to the spine and drilling with the distal phalanx.
Fig.63. Drilling I with a finger with the burden of the elbow of the wrist of the other hand.
When performing this type of reception, the pads and distal phalanges of the first fingers are positioned at an angle of 45-50 ° with respect to the tissue to be massaged, and the remaining fingers are the support. Rotatory and helical movements in the back area are performed strictly in the direction of the vertebral column. This type of reception can be performed with the 1st finger of one hand. The technique of reception is the same as in two-handed operation.
In order to enhance the effect of the effect, the reception is carried out with burdening. In this case, the elbow edge of the hand of one hand is superimposed on the base of the first finger of the other hand, and the reception is performed with much greater force( up to 4-5 kg), at a slow rate, for 4-5 s( Fig.
Drilling with middle phalanxes is used for massage of large muscle groups( gluteus, deltoid, hamstrings), fascia of the thigh and lumbar region. The back surface of the middle phalanges of the fingers is superimposed on symmetrically located massaged areas, and drilling is performed. Fingers are slightly compressed into a fist, I fingers are the support. This technique is most often performed by middle phalanges of the second and third fingers. The impact force is up to 4-5 kg, the tempo is within 4-5 s( Figure 64).
To increase the effect of the effect, the technique is used with weights, mainly in the area of the gluteal muscles. In this case, the palm of the free hand is superimposed on the back surface of the massage. The depth of the effect of the reception increases gradually to 5 kg and above. The rate of drilling is slow - within 5-6 s.
Bar-drilling. The position of the masseur is opposite to the massaged back area, most often to the left of the massaged one. In this position, the entire palm surface of the left hand of the masseur with the maximum finger set aside is placed on the lower part of the chest so that the finger lies 3-4 cm from the vertebral column strictly on the near near-vertebral line. The rest of the fingers are the support for the first finger and should be on the far field of the back( Figure 65, a).The right hand of the masseur is superimposed on the lateral surface of the massaged back. The distal phalange of the 1st finger, starting from the middle axillary line, performs a deep rectilinear movement( "stroke") along the eleventh intercostal space in the direction of the spine for 5-6 s( Fig. 65, b, c).When the first finger of the right hand is brought to the first finger of the left, the latter simultaneously perform 3-4 drilling clockwise( Figure 65, d, d).
Fig.64. Drilling with the back surface of the middle phalanges in the region of the gluteal muscles.
Fig.65. Reception of bar-drilling.
a - the first phase: the initial position of the massaging hands;b - second phase: the beginning of rectilinear motion( stroke) I of the finger;c - the second phase: the end of the stroke;d - the third phase: the beginning of drilling;d - the third phase: drilling;e - the fourth phase: the initial position of the massaging hands with the simultaneous movement of the finger of the left hand by 2-3 cm.
The pressure force for strokes and drilling is controlled by the appearance of distinct hyperemia of the skin. Then I finger of the left hand moves sliding 2-3 cm to the overlying vertebra( Figure 65, e), and the first finger of the left hand performs a stroke along the tenth intercostal space, etc., to the lower angle of the scapula.
When performing reception on another area of the back, the massage therapist moves to the opposite side of the couch. If the massage therapist does not change its position, the distal region of the back is massaged in a similar way, but the distal phalanges of the II and III fingers, and the first fingers are the support for them( Figure 66).
The "moving" is used to eliminate reflex changes in the muscles of the back and is always combined with stroking.
The position of the masseur is opposite to the massaged back area, most often to the left of the massaged one. The right hand, fixing the pelvis massaged, is located on the right buttock and clasps the ileal crest with the fingers. The left palm produces spiral, circular movements to the vertebral column( clockwise), shifting all tissues from the lower left of the thorax, and gradually progressing to the left shoulder. At the same time, the right hand moves in the opposite direction( against the clockwise direction), all the while remaining in one place. With the correct execution of the reception, there is, as it were, twisting the spinal column with the muscles of the near-vertebral regions( Figure 67).After this, placing the massage hands on opposite sides of the back, the masseur makes a helical movement on the left buttock clockwise, with the palm of his right hand, and the palm of the left hand on the right side of the chest - against the clockwise direction( Figure 68).
Fig.66. Bar-drilling with distal phalanxes II and III of fingers on the back from the masseur of the back area
Fig.67. Movement( twisting) at the position of the massage therapist on the side near the thighs massed.
Fig.68. Movement( twisting) at the position of the masseur in front of the massaged back area.
If the massage therapist changes his position after the first part of the reception and accordingly performs twisting on the other side of the massaged one, then the massaging hands also change.
After each reception of "moving", the whole palmar surface of the hands is stroked, and during stroking, semicircular movements to the spine are made in the direction from the bottom up( Fig. 69).
The saw is used in the back area, acting primarily on the connective tissue.
The position of the masseuse is opposite to the massaged back area on either side. The radial edges of the brushes of both hands with the maximal allocated I and II fingers are placed on the back area in two ways: in the first variant, so that on one side of the spinal column there are I fingers, and on the other - II( Figure 70, a);in the second variant, the radial edges of the hands are superimposed on the paravertebral muscles parallel to the spinous processes of the spinal column( Fig. 70, b).Brushes are pierced, the distance between them is 3-4 cm, the fingers fit tightly to the massaged area and slightly converge so that a skin cushion appears between them. After that, both hands produce sawing movements in opposite directions, massaging the entire back surface from segment to segment from the bottom up, with the fingers having to move the captured skin more than sliding along it.
This technique can also be performed in the neck and limbs.
Admission "traction" ( shear) affects the reflex changes in the subcutaneous connective tissue( developed by E. Dicke in 1958).
Reception is performed most often by the palmar surface of the distal phalanges of II, III or IV fingers in the form of a stroke. On the chest and back, the movements are made in the direction of the spine( Figure 71);in the neck and forelegs - transversely;on the extremities - mainly along the course of the lymph flow.
Fig.69. Stroking the back area with segmental massage.
Fig.70. Reception of a saw.
a - the first option: a masseur brush across the spine; b - second option: brush the masseur along the spine.
Fig.71. Extension( shearing).
a - the first short and intermittent stroke in the back area;b-the second stroke.
The massaging finger, penetrating into the subcutaneous connective tissue layer and remaining in it, slowly slides, stretching the tight connective tissue. The amount of pressure depends on the desired depth of influence. The executed dashed motion can be short and intermittent or long and slow;the latter more intensively affects the tissues( Figure 72).
The intense subcutaneous connective tissue exerts a strong resistance to the massaging finger, the finger seems to get stuck in this tissue. When you repeat the reception, there is a gradual outgoing tension of the connective tissue. In addition, the patient may experience pain and a dermograph reaction( reddening) in the form of a broad band. Significant soreness and a broad, long-retained red streak, and sometimes the formation of the dermal cushion( bulging) in place of the stroke are characteristic for a more pronounced strain of the subcutaneous connective tissue.
Admission "rolling" is used to determine and eliminate local hypertension of muscles and tension of connective tissue.
Fig.72. Extension( shearing).
a - the beginning of a long and slow stroke in the hip area;b - the end of the movement.
Fig.73. Ripping in the back.
and - the beginning of the movement;b - in the middle of the movement.
I fingers of the masseur, touching each other with their pads, perform stroking with their side surface. Simultaneously, the other fingers, grasping the soft tissues, roll them onto the fingers that perform stroking( Figure 73, a, b).
Local hypertension of muscles and tension of connective tissue are felt by the fingers of the massage therapist as additional resistance.
Reception is performed with two or one hand and is often used for palpation examination of the massaged( see below).
The "shake" reception is used in the pelvic and thoracic region to eliminate muscle tension in these areas.
The position of the massaged - lying on the stomach, the masseur stands near the knee joints on either side, most convenient for him. Slightly perforated brushes cover the lumbar region massaged so that the fingers touch the
each other in the abdominal region( Figure 74, a).II fingers with a slight pressure deepen in the tissue between the lower ribs and iliac crests. Short and continuous lateral vibrational movements of the masseur's hand simultaneously or alternately perform concussion of the pelvis, with the hands gradually slipping to the lumbosacral spine( Fig. 74, b).
When performing the reception on the chest, the massage therapist grasps its lateral surfaces with palms, slightly squeezes and carries out jerky movements, sliding palms along the chest to the spine. Massaged at this time makes an extended exhalation through the mouth. Admission to the chest can be performed with the position of a massage lying on the back. Vibrational, jerky movements begin from the sternum in the direction of the spinal column at the same time as the exhaled mass( Figure 75).
Fig.74. Concussion in the pelvic and thoracic region, and - initial phase;b - final phase.
Fig.75. Concussion in the thorax at the position of a mass lying on the back, a - the initial phase;b - final phase.