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13.2 Physiological effects of Massage.pptx
- 1. Physiological effects of Massage By : Dr. Alpa J. Dhanani MPT(Musculoskeletal & Sports)
- 2. 1. Effects on the circulatory system a. on the venous and lymphatic flow b. on the arterial flow 2. Effects on the blood . 3. Effects on the exchange of nutritive elements. 4. Effects on the metabolism. 5. Effects on the nervous system. a. On sensory nervous system . b. On motor nervous system . c. On autonomic nervous system. 6. Effects on the mobility of the soft tissue. 7. Effects on the respiratory system. 8. Effects on the skin. 9. Effects on the adipose tissue. 10. Psychological effects. 11. Effect on immune system.
- 3. 1. Effects on the circulatory system • On the venous and lymphatic flow • When massage is applied to the skin it is quite often an observable change of colour in the area. • This change has been attributed most usually to the massage having an effect on the circulatory system. • Massage aids in the mechanical emptying of the veins and the lymphatics. • It facilitates the forward movement of the venous blood and the lymph. There by reduces the chances of stagnation of the blood and the lymph in the tissue space.
- 4. • The flow of the venous and the lymphatic channels from the extremities mainly depends on the activities of the smooth muscles present in the walls of the vessels. • The contraction of these small muscles acts as a strong pumping mechanism which keeps the tissue space clear from the free fluid. • The contraction of the skeletal muscle compresses the blood vessels and exerts a pressure on the fluid present inside which increase intravascular pressure and by that stimulates the contraction of smooth muscles present in the wall of the vessels will further increases the pressure inside the vessels. • When this pressure increases beyond the threshold the valves open up and the fluid moves onto the next segments. • As the valves provide only unidirectional flow the fluid cannot come back to the empty segment.
- 5. • When the muscles relax, the segment is refilled by the fluid from the distal segments. This way the venous and lymphatic fluids are allowed to move only in one direction. The mechanical action of massage stimulates the smooth muscles of the vein. • The different techniques of massage alternately compress and release the soft tissue facilitates the venous and lymphatic flow. • Effleurage, kneading and Petrissage squeeze the veins and the lymphatic vessels and force the venous blood and lymph towards the heart causing an increased drainage of the blood and lymph from the part to be treated. • In case of fluid stagnation due to mechanical factors the flow of venous and lymphatic fluid is obstructed. Massage facilitates the drainage and reduces the stagnation of fluid and also speeds up the removal of waste products.
- 6. On arterial flow • Massage improves the blood supply of the area being massaged. • A definite vasodilatation along with an increase in the peripheral blood flow is usually observed after massage. • Following events happening during massage to increase arterial blood flow. 1. Release of vasodilators 2. Activation of Axon reflex 3. Decrease of venous congestion
- 7. 1. Release of vasodilators: • Release of histamine and other substances by the stimulation of mast cells . (found in the connective tissues and brain but not in the blood) • Liberation of histamine increases the arterial diameter and are particularly responsible for the axon reflex. • The patent capillaries open up under the influence of these chemicals and bring about an increase in the blood flow to the part to be massaged.
- 8. 2. Activation of Axon reflex: • Massage activates the axon reflex leads to cutaneous vasodilatation • When the skin is firmly stroked the sensory nerve endings are stimulated and impulse is carried to the spinal cord by the peripheral nerves. • In the way itself a branch of nerves may be stimulated and instead of going to the spinal cord impulses return back to the periphery to produce its effects on the cutaneous vessels which are supplied by the branch of the same peripheral nerve.
- 10. 3. Decrease of venous congestion: • If any portion of the vessel is dilated than the neighboring vessels also become constricted (Avon reflex). • The arterioles become compressed if the venous congestion is increased. • The congested venous and lymphatic fluid exerts a compressive force on the arterioles, narrowing it so the blood supply to the part is reduced. • As a result of it the outflow from the veins exceeds the inflow to the constricted arterioles and congestion is decreases. • Massage promotes the forward movements of the lymph and blood and indirectly helps in restoring the arterial flow.
- 11. 2. Effects on the blood • Increase in RBC and WBC Platelets counts in circulating blood. • This increase may improve oxygen carrying capacity of blood and hemoglobin.
- 12. 3. Effects on the exchange of nutritive elements • Increases movements of liquids and gases. • Increase arterial blood flow with more oxygen and nutrients. • Increase nutritive exchange between blood and cells. • Rapid disposal of waste products.
- 13. 4. Effects on the metabolism • Increase of arterial blood flow and venous and lymphatic drainage massage may accelerate the various metabolic process of the body. • Increase output of urine, increase rate of excretion of nitrogen, inorganic phosphorus and sodium chloride. • This may overall improve the trophic condition of the part being massaged. • Traditionally massage has been applied for the purpose of promoting the general status of wellbeing.
- 14. 5. Effects on the nervous system • The nervous system consists of 1. Sensory system , 2. Motor system & a. Fascilitory effect b. Inhibitory effect 1. Autonomic nervous system.
- 15. 1. Sensory system Massage helps to stimulate the peripheral sensory receptor, mainly touch and pressure receptors, present in the skin and soft tissue. These sensations are carried out by the large diameter A beta fibers which play an important role in inhibition of the perception of pain, carried by A delta and C fibers. Block pain signals by a process of presynaptic inhibition at the level of substantia gelatinosa of spinal cord and may reduce or prevent transmission to conscious level. Reduce or remove noxious substances. Decreasing pain. Sedative effect on the CNS if applied monotonously with slow rhythm.
- 16. 2. Motor system a. Facilitatory effects of massage on motor system: • Massage can reflexely increase the muscle tone by stimulation of the skin receptor or stretch receptors( muscle spindle). • Following are the facilitation techniques helps in massage therapy. • Touch: facilitate the activities in the motoneuron pool. • Pressure: creating stretch stimulus. • Cutaneous stimulation: by quick light brushing, stroking. -Increase the excitability of motoneuron. • For the skin supplied by anterior primary rami, the excitatory effect is local and is mainly confined to superficial muscles. • For the skin supplied by posterior primary rami, the excitatory effect is on deep muscles.
- 17. b. Inhibitory effects of massage on motor system: Activation of tension dependent Golgi tendon organ has an inhibitory effect on the stretch reflex mechanism reduces the tone of muscle which helps in the treatment of spasm, Associated increase of tone in psychological stress, anxiety in neurologically healthy person.
- 18. c.On autonomic nervous system • Massage has reflex effect and it can influence the functioning of visceral organ by modulating the autonomic nervous system through peripheral sensory stimulation.
- 19. 6. Effects on the mobility of the soft tissue • Massage has significant effect on properties of the soft tissues like elasticity, plasticity and mobility. • The tissues affected are muscles, sheath, ligaments, tendons, aponeurosis, joint capsules and superficial and deep fascia. • Different types of massage stretch the constituent collagen fibers of these tissues in different directions. • The adhesions present between fibers are broken and maximum mobility between fibers and adjacent structure is ensured. • This way massage maintains and restores the mobility of soft tissues as well as prevents adhesion formation, joint stiffness, and contracture.
- 20. 7. Effects on the respiratory system • Percussion and vibration techniques of massage assist the removal of secretion from the larger airways. • After chest physiotherapy both in adult and in paedia group increased secretion clearance combine with percussion and vibration which helps to loosen the secretion. • After the removal of secretion gas exchange becomes more efficient. • Efficacy of these techniques is dependent on the skill of the therapist and complications have been reported mostly due to poor technique administration like hypoxia, bronchospasm.
- 21. 8. Effects on the skin • Increases the temperature of skin, activates the sweat glands, improves the nutritive status of the skin and increases the skin conductance. • Facilitates the movement of the skin over the subcutaneous structures as a result skin becomes softer, supple and finer. • After prolonged massage the skin becomes tough, more flexible, elastic and its sensitivity is reduced so that it can be handled fairly roughly without causing much discomfort. • Increased sebaceous secretion from exocrine glands of skin improves lubrication and appearance of the skin.
- 22. 9. Effects on the adipose tissue • Massage was found responsible for activation of lipolysis.
- 23. 10. Psychological effect • Massage can lower the psycho emotional and somatic arousal such as anxiety and tension. • • During massage treatment close contact is established between therapist and patient who help to overcome the feeling of strangeness and anxiety. • The surrounding, equipments, treatment area and the assured way in which therapist handles the patient all exerts a strong placebo effect. • It helps to reduce tension and anxiety and induces relaxation. • This effect is used for the purpose of general relaxation.
- 24. 11. Effect on immune system • Decrease in stress ultimately increases over well being of individual.
- 25. Physiological effects at a glance: – Increase venous blood and lymphatic flow. – Increase arterial blood flow to the muscle and skin. – Decrease stagnation of fluid in tissue space. – Removal of waste products of metabolism. – Increase WBC,RBC and Platelets count in circulating blood. – Increase nutritive exchange between blood and cells. – Accelerate various metabolic processes. – Increase trophic status of the part to be massaged. – Induce sedation. – Reduce pain. – Facilitate contraction in hypotonic muscle.
- 26. – Decrease Excitability of motoneuron pool in neurologically healthy person. – Modulate autonomic response. – Increase electroderma response. – Break the soft tissue adhesions. – Mobilize soft tissues. – Promote lipolysis. – Increase removal of secretion from lungs. – Increase Gaseous exchange across pulmonary capillaries. – Increase removal of dead cells from skin. – Increase activity of sweat and sebaceous glands. – Modulate psychosomatic arousal.
- 27. • Book reference 1.Principles and practice of therapeutic massage , 2nd edition :Akhoury gourange sinha.