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The material presented here is partially from my article, first was published at 42 MASSAGE & BODYWORK • JUNE/JULY 2006
I concluded my article Remembering the uniqueness of massage therapy with the following words
I am of the opinion that massage therapists must remember about the great uniqueness of massage therapy when treating any disorders/dysfunctions. Our methods are not similar to painkillers that block pain impulses from reaching the brain but address the real causes that producing pain, and other dysfunctions.
For those who didn't have chance to read it, you're welcome to click this link.
In the current article, I will present a clinically oriented material. Its purpose is to understand the causes of dysfunctions and offer ways to treat them by means of massage in order to achieve results.
Biological science, which is the study of living organisms, is the base for the entire healthcare system and the utilizations of its clinical methods, including the methods of medical-massage. One of the subdisciplines of biology is microbiology. Microbiology also contains many subdisciplines such as virology, bacteriology, etc. Clinical medical fields such as Immunology, infectiology, and rheumatology emerge from the studies of virology and bacteriology. Mainly mentioned above medical specialties developed testing means and medications that are capable of diagnosing and treating detected infections.
Science of massage is also a part of biomedical science, but the goals of the research are to develop specific massage protocols to address particular disorders. To understand physiology and pathophysiology is to understand the causes of particular dysfunctions and find ways to address them by means of massage in order to achieve results.
This link is to “boosting the immune system” blog. Further in this article I will refer to this blog.
Especially, in massage therapy fields, we view the body and its dysfunction and disorders, holistically. That means that we cannot see any disorder, illness, dysfunctions, as an individual problem of organ or system. We view individually diagnosed disorders as an illness of the entire body. For example, stress leading to insufficient lymph drainage, excessive accumulation of toxic metabolic waste, decreasing immune power and much more. Of course, in turn, the immune system demonstrates insufficiency.
For example, people from the same age group and have the same health conditions, placed the same crowd, where many infected by a coronavirus. Some of them would get ill, some would die, while some other would experience insignificant symptoms and recover with ease, or maybe won't have symptoms at all. In this case, all depend on the individual’s ability of the immune system to defend her/him from this and other viruses as well as from other infections. Functions of all organs and systems depend on the normal function of other organs and systems. Massage therapy has the potential to address, improve and to balance these functions. The bottom line is that in order to empower/balance the immune system we must balance the functions of all organs and systems. First of all to keep a relative activity balance between sympathetic and parasympathetic subdivisions of the autonomic nervous system.
At the very end of this blog, you will find the link to the physiological effect of massage and other materials that support and explain the statement made above.
I would like to finish my introduction by saying that massage therapy is not a remedy for all diseases, but it is an extremely powerful methodology of treatment. One must integrate it in treatments of most of the skeletal muscular disorders, migraines and tension headaches, sciatica, thoracic outlet syndrome, rehabilitation from concussions/prevention of encephalopathies, prevention and treatments of other degenerative brain diseases, and more.
The immune system is a collection of billions of immune cells that move through lymph /bloodstream24 /7. They are “military defense forces” containing different specialized units. When the immune system works well, it maintains our bodies healthy. They use different strategies defending the body against foreign bodies /antigens such as bacteria, viruses, and cancerous cells. It is in constant dynamics, moving in and out of organs, and when detecting antigens, quickly destroying them.
We are born with some immune defenses. It's called “the innate immune system.” The rest is the acquired immune system, composed of specialized, systemic cells – “soldiers” that eliminate pathogens.
A more substantial defense comes from the acquired immune system or adaptive immune system. It develops antibodies, including and not limited to B cells and T cells which are memory/acquired immunity. White blood cells are known as lymphocytes B and T cells. B cells are activated into immunoglobulins, also known as antibodies. These acquired antibodies bind to the foreign antigens, killing them and not allowing the antigens to bind to the host cell.
Theoretical knowledge for a practical approach to successful hands-on procedures.
The main function of the lymphatic system is detoxification or disposal of toxic metabolic waste, but it also plays an important role in immunity, it's part of the immune system. Lymph is an extracellular fluid that enters the lymphatic vessels and is mixed with cellular elements. The lymphatic system starts at the lymphatic sacs in the extracellular spaces. These sacs have pores, allowing the passage of large proteins and other metabolic waste products. When the lymphatic sacs are filled, lymph enters the lymphatic vessels. These vessels also have large pores and carry a small number of smooth muscles. The walls of lymphatic vessels contain valves, directing the flow of the lymph one way only (toward the heart). Along the path of the lymphatic vessels are lymphatic nodes. When the fluid reaches these nodes, infections, alien proteins, and other foreign materials are destroyed. The drained lymph then continues its flow. Most of the lymphatic fluid reenters the circulation via the thoracic duct (a common drainage duct). Through this duct, the lymph enters the brachiocephalic vein. The right lymphatic duct drains lymph only from the right upper extremity and half of the face and head.
During inspiration, the diaphragm muscle contracts, creating negative intrapleural pressure. This is when both the thoracic and right lymphatic ducts release the largest amount of lymph into the circulatory system. It’s important to remember these points, our techniques contributing to negative intrapleural pressure, and accelerating lymphatic drainage/detoxification/immune response.
• Gravity is the main opposition to lymph flow. Most of the lymphatic vessels are between skeletal muscles. When muscles contract (during movement), a pumping action is created, thereby pushing the lymph along.
• Pulsations of large blood vessels also help the lymph to flow. • The peristaltic contractions produced by the walls of lymphatic vessels, however weak, contribute somewhat to the flow of lymph (though not significantly).
Attn: When we perform manual acceleration of lymph drainage we use the knowledge of the nature of lymph drainage and apply special techniques to accelerate lymphatic drainage.
Step 1. The client lies on her back. Place your hands on the upper part of the rib cage (mainly on the sternum). Ask your client to inhale and exhale. In the next inhalation, resist the expansion of the rib cage with moderate pressure. Release the pressure upon exhalation. With a resistance of rib cage expansion, we cause the diaphragm muscles to work harder. The degree of the diaphragm muscle contractions projects the level of negativity of intrapleural pressure. The more negative intrapleural pressure we create, the bigger the volume of lymph drains into the circulatory system. Repeat the rib cage expansion 5–6 times.
Step 2. Ask your client to turn her head to the right. Place your hand on the junction area of the thoracic duct and the brachiocephalic vein. Apply pressure (pumping action) upon exhalation. Repeat these techniques 5–6 times.
Step 3. Ask your client to turn her head to the left. Place your hand on the junction area of the right lymphatic duct and the superior vena cava. Apply pressure (pumping action) upon exhalation. Repeat these techniques 5–6 times.
Step 4. Place your fist on the client’s navel area. When the client exhales, perform pumping techniques under moderate pressure. Given the fact that the biggest lymphatic vessels including the cisterna chyli are on this level, this pumping effort is extremely important for the acceleration of lymphatic fluid progression to the thoracic duct. Repeat this technique 5–6 times. Lymphatic nodes are mechanical and chemical filters. As you understand, we are directing lymph drainage through lymphatic nodes, very often connective tissue within them becomes tense, which in turn reduces their drainage and filtering capability. Very often, this tension is a significant contributor to insufficient drainage. Therefore, it is very important to massage all lymphatic nodes gently to release this connective tissue tensions. If you palpate any swellings, enlargements, or tenderness in the lymphatic nodes, do not massage those nodes. You should recommend the client to see her physician.
Occasionally lymph drainage procedures cause nausea, dizziness, muscle pain, and decreased energy. This is a result of the massive release of toxic products into the circulatory system. Please inform your client that this kind of reaction is possible and should be seen as a positive occurrence as evidence of detoxification. During the procedure, if your client reports headaches, nausea, or dizziness, stop the procedure. Invite your client for a repeat session after two days. Usually, the reactions mentioned above do not reoccur the second time, because the earlier session that prompted the reaction removed enough toxins. Statistics show that only 10 percent of clients get an adverse reaction to lymphatic drainage. However, 90 percent experience a boost of energy, better mood, etc., after the first session. All contraindications to massage therapy apply to the manual acceleration of lymph drainage. However, people with specific medical conditions need to consult their physicians. Doctors must be instructed that manual acceleration of lymph drainage is a very gentle procedure that causes massive acceleration of lymph drainage to the circulatory system. At the time of direct, gentle massage of lymphatic nodes, if you palpate any swellings, enlargements, or tenderness of the lymphatic nodes, do not massage them.
You should recommend the client see her physician. There is no doubt that lymph drainage is a powerful method for lymphedema reduction.
Step 5. Place the tips of the fingers on the submandibular lymph nodes, and under moderate/light pressure, massage the nodes in a circular motion (5–6 times).
Step 6. Place the tips of the fingers on the submental lymph nodes, and under moderate pressure, massage the nodes in a circular motion (5–6 times).
Step 7. Place the tips of the fingers on the cervical lymph nodes, and under moderate/light pressure, massage the nodes in a circular motion (5–6 times).
Step 8. Place the tips of the fingers on the axillary lymph nodes, and under moderate/light pressure, massage the nodes in a circular motion (5–6 times).
Step 9. Place the tips of the fingers on the cubital lymph nodes, and under moderate/light pressure, massage the nodes in a circular motion (5–6 times).
Step 10. Place the tips of the fingers on the inguinal lymph nodes, and under moderate/light pressure, massage the nodes in a circular motion (5–6 times).
Step 11. Place the tips of the fingers on the popliteal lymph nodes, and under moderate/light pressure, massage the nodes in a circular motion (5–6 times).
Step 12. Place the tips of the fingers on the malleolar lymph nodes, and under moderate/light pressure, massage the nodes in a circular motion (5–6 times). As stated previously, the pores of lymphatic vessels are large. Therefore, the proposed steps of pumping and direction of lymphatic fluid to the lymphatic nodes must be performed gently and with a lot of sense. If kneading techniques are performed instead of pumping/increasing drainage and increase flow through lymph nodes, lymphatic fluid will be removed from the lymphatic vessels to the extracellular space instead of being directed to the nodes, thoracic duct, and right lymphatic duct.
Step 13. With both hands, perform pumping techniques on the lateral sides of the lower leg with a combination of light strokes directed toward the lymph nodes. Proceed with the same technique on the front thighs.
Step 14. With the client lying in an anatomical position, perform pumping techniques on the forearm and arm, accompanied by light strokes directed toward the lymph nodes.
Step 15. Ask your client to lie on her stomach. Perform pumping techniques on the lower leg and back thigh, accompanied by strokes directed toward the lymph nodes.
Step 16. Place both hands on the lumbar region. Move your strokes toward the lateral part of the lower back and proceed in the direction of the axillary lymph nodes. Repeat 5–6 times. The total time of the session is approximately 45 minutes. Usually, the proposed protocol on the anterior and posterior are completed in 20–25 minutes. Repeat the proposed protocol twice.
The large pores of lymphatic vessels, under pressure, allow the lymph to move back into the extracellular spaces instead of proceeding through the lymphatic vessels to the lymphatic nodes and ducts. Therefore when performing described above techniques, pushing lymphatic fluid towards nodes, apply light / moderate pressure.
Simplicity and contribution of lymphatic drainage to well-being puts its contribution to detoxification in a unique position of value. For example, a person receives vaccination against the particular flu that initiates antibody production in the body. The existence of flu antibodies (the immune system warriors) means that this person has acquired resistance to the flu virus. However, at the same time, this person still has a considerable accumulation of toxins in their body. This means that her acquired immune system is significantly suppressed/insufficient and that her body has a lowered ability to defend against infection.
Referring to you to my blog ”boosting the immune system” accumulation of the excessive amount of toxins is the result of insufficient drainage or decreased quantities drainage through lymphatic nodes. Remember, when bacteria/virus enters lymphatic nodes, antibodies destroy them. “This insufficient immune system function can easily be restored by detoxifying this person’s body. Lymphatic drainage discipline causes significant detoxification, which in turn boosts/balancing the function of the already acquired immune capabilities.
The major question then becomes: ”Is an excessive amount of metabolic waste causes insufficiency of the immune system only?”
The categorical answer is NO. It has a negative effect on the functions of all organs and systems, including the central nervous system. It causes intracranial accumulations of excessive amount CSF, leads to neurotoxicity, functional reversible encephalopathies, has an adverse effect on the quality of sleep, muscular twitching, and foggy brain. To some degree, it exacerbates memory loss and diminishes the ability to focus. Can we view this insufficiency of brain function, as a brain the only dysfunction? As I stated in my article, in massage therapy fields we must view our body and its dysfunction in a holistic way.
1. In 1963, the professor of medicine, at the second Leningrad medical school, Alexander Dembo MD Ph.D., who has developed post-concussion rehabilitation medical massage protocol, realized that the cerebrospinal fluid drains into the lymphatic system. The resistance of rib cage expansion, accelerating the drainage of CSF, but as well, it contributes to the increase of lymphatic drainage. In the 1970s another Soviet scientist Vladimir Chernich MD Ph.D., who has researched lymph drainage and proposed the full-body acceleration of lymph drainage techniques, was positive that the brain contains lymphatic vessels. Today modern technological developments allowed scientists to detect in the brain the unknown earlier before Glymphatic System.
All the systems mentioned above, practically serve the same goal, the disposal of metabolic waste. Therefore techniques that I am proposing today, are scientifically but most importantly clinically proven as an effective massage protocol for disposing of metabolic waste, improve the body functions, and prevent brain dysfunction.
2. There is a negative chain reaction caused by stress, including but not limited to the buildup of tension in muscles, the increased secretion of stress hormones, and more. As you understood from my article, constrictions of muscles create pumping and thus support lymphatic drainage. Tense muscles do not provide sufficient support for lymph drainage. The increase in stress hormones secretion decreases the immune power by lowering the number of lymphocytes. Again, referring to my blog ”boosting the immune system” in the included video, I am stressing the importance of combining stress management massage with lymph drainage acceleration techniques.
3. I have a patient, who nationwide is one of the leading oncologists, a researcher, who was and is involved in the research and development of immunotherapy for different types of cancer, which is the most effective and side effects free, cancer treatments. In one of my private discussions, we talked about the lymphatic system and stress management massage, I said: “who knows how many times our treatment exposes cancer cells to the immune system, and as a result, prevents people from terrible suffering and death.” He responded that by reading my materials, he could not deny the possibility that massage therapists do extremely important work in preventing cancer. His concluding comment was “malignant cells use mechanisms to outsmart the immune system.”
I asked him whether it would be correct to say that malignant cells outsmart mostly those, with an insufficient immune system. He responded that logically I was correct.
Going back to the research of Dr.Chernich, he was able to prove that this method boasting Cytotoxic T lymphocytes and NK cells, cells are capable of eliminating the malignant tumor. He also proved, that the increase in stress hormone secretion lowers the number of lymphocytes, and therefore after massive observation, he concluded that excessively stressed people are at higher risk to develop cancer.
4. I don't believe, that we should, as well as can, help people who already develop difficult pneumonia secondary to coronavirus infection. These patients in this critical condition are in the intensive care units. At the same time, I can tell, that if prior to pandemics, these patients would undergo the treatment that I outlined in my article, their immune system would protect them from coronavirus and other infections.
5. ” Why do older people who suffer from preconditions such as cardiovascular diseases, diabetes, high blood pressure, and cancer are at the particularly high risk to contract coronavirus infection?”
Nowadays any instruction typically answers it in the following way: ”Their immune system is compromised.”However, this answer raises another question:“ Because of their life for many years, older people must have a very strong acquired immune system. Maybe the reason for their susceptibility is the buildup of additional metabolic waste secondary to the consumption of large amounts of medications suppresses their immune system. I believe so.
6. Much of the literature nowadays is devoted to boosting the immune system. I use this word too. Therefore, you could understand from this article that the methodology I describe is none else but the balancing of immune power.
It is impossible to overestimate the power of scientifically sounds, clinically proven massage therapy modalities I have presented in this article. In addition to all the presented theoretical concepts, I'm successfully practicing these modalities for many decades.
It took a while to write this article. Therefore I would appreciate the feedback. Everyone is welcome to share his or her thoughts about the subject matter discussed in this article.
PS
I received the criticism, as well as friendly advice, not to include advertising of my video hands-on educational materials in my posts.
Sorry, I strongly disagree. Why I am writing all of this? For sure not to enrich your knowledge in biomedical science, pathology, anatomy, pathophysiology only. You don't need me for this, and I don't see my mission as merely searching the Internet to present generally available data.
My goal in this undertaking is to provide theoretical information applicable to the successful application of certain massage protocols. Articles give me an opportunity, but the limited opportunity to share my knowledge and clinical experiences. At the same time, on my medical massage educational videos, I explain many in-depth concepts and offer practical guidance at the time of performing massage. By repeatedly watching and implementing the learned material on real people, allow massage therapists to learn to the level of successful hands-on application and that’s why I make them available. In such a case I achieve my goal.
Two factors define the physiological effect of massage on humans:
1. The local or mechanical factor is expressed by a mechanical acceleration of venous blood drainage, some degree of lymph drainage acceleration, passive exercise for soft tissues, breaking down deposits of calcium in soft tissue and stimulation of its removal from the body.
2. The main power of massage therapy is in reflexive therapy. By mobilizing skin, connective and muscular tissue, we deform the mechano-receptors, which in turn release action potentials/impulses. Through neurological pathways, these electrical impulses stimulate motor and vasomotor centers. As a reflex or involuntary reaction of organs and systems to original stimuli, the body responds by expressing positive changes such as muscular relaxation, vasodilation, reduction of blood pressure, reduction of stress hormones production, etc.
To ensure that we achieve the most profound physiological effect on the body of the client, massage should be performed as deep as possible. The deeper we massage, the more we stimulate the nervous centers, and the faster and to a greater degree the reflexive therapeutic effects occur, the greater would be awakened positive factors listed earlier.
Note that deep tissue mobilization does not require excessive pressure. Pressure should be significant but shouldn’t activate the pain analyzing system, which could be recognized by two different factors:
1. Muscular protective spasm as a response to excessive pressure.
2. The client reports “too much pressure” even in absence of the protective muscular spasm.
Note: In order to achieve successful results in any type of massage, 50 percent of the procedure time should be spent on kneading.
Please watch this presentation on how stress debilitating on our health, for better understanding of the importance to provide full-body medical massage.
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