The History of Medical Massage

It goes back to the 19th century, when British Physician Dr. Head published, his, what we now call, Head’s zones. During a very long time, observing hundreds of patients, Dr. Head paid attention that in many cases of chronic internal organs diseases, skin within somatic distal components, develop changes in a form of higher skin density, a local low threshold of pain, etc. The great clinical value of his observation soon became apparent. When he performed skin massage in these areas he not only eliminated these abnormalities in the skin but also have had a tremendous healing impact on diseased internal organs. As far as I know, Dr. Head was the first one who has established visceral somatic reflex concept as well as somatovisceral reflex concept, which allowed to professor Sherback in 1937 to go further and to develop the concept and hands-on techniques of segment reflex massage as we practice it today. There is no doubt that Professor Zabludovsly (1913) remarkably advanced massage therapy as a powerful clinical tool and, I would say, that in many cases, it became the most powerful methodology for treatment.
Professor Zabludovsly (1913) was the first one who explained the reflex effect on arterial circulation in non-massaged extremity. The phenomenon was confirmed later by many experimental and clinical studies (Guthberson, 1933; Ebel and Wisham, 1952; Belaya, 1974; Shtergertz, 1985, etc.)

In 2003, at Beverly laboratory of Vascular Studies, I repeated Professor Zabludovsly’s protocol. In Medical Massage Vol.2 text, Dr.Ross Turchaninov extended on this experiment. We have provided him with all post-experimental data. In fact, a qualified massage therapist can reproduce the same outcome every time. To study this 15-25 minute protocol is simpler than studying many other simple step-by-step hands-on medical massage protocols.

The Beverly laboratory of Vascular Studies in California examined the effect of medical massage therapy on arterial blood circulation in lower extremities of healthy adults by using Pulse Volume Recording (PVR), Photoplethysmology (PPG) and Thermography (TMG). All these tests measured blood circulation on the opposite lower extremity, i.e. practitioners worked on the left extremity while circulation was measured on the right extremity. Peripheral circulation was measured before the experiment and after application of medical massage. Major changes were registered in PVR, which is a pulsate volume of perfusion through the extremity.

Let’s briefly review the results of this study. Initial PVR registered on the right lower extremity was 0.81. After this parameter was registered, a medical massage practitioner applied the treatment of the lower extremity for 15 minutes. After 15 minutes of medical massage, PVR increased to 1.22 and continued to climb during the next 2 hours after the medical massage was over. At the end of the second hour, PVR value was 1.63, i.e. blood perfusion through the contralateral lower extremity showed a double increase even after the medical massage was over.

This study is a great example of the valuable effect of medical massage on the peripheral blood circulation (Prilutsky, 2003). This is why patients with arterial circulation disturbances respond so well to medical massage.

It’s hard to overestimate the importance of contralateral extremities massage, in cases of fractures, surgeries, and significant other types of injuries when we cannot apply massage technique directly to the injured area. More than that, at the time of the experiment described above, my models agreed to wait only two hours in order, to allow us to perform PVR measurements. Two hours after the stopping treatment, it continued to increase PVR.

Back in the Soviet Union, we have repeated described protocols many times, and the reflex of increasing blood supply is sustained for an average of 15-18 hours. Isn’t this exciting? The stimulation by massage is already stopped, but during 15-18 hours after it is stopped, the body continues intensive healing! Remember after significant blood supply increase, abnormalities never come back to initial conditions, but after every treatment continues to improve.

The importance of tension build-up in the connective tissue/fascia and its impact on chronic somatic and visceral abnormalities, initially, was made known to the medical community through the work of Austrian physical therapist Elizabeth Dickle in 1929. As with many important discoveries, Dickle’s discovery was an accidental find. For several years, she suffered a failure of arterial circulation in her lower extremities as a result of Thromboangiitis Obliterans. The disease had progressed to the stage when amputation became a real possibility. Dickle also experienced chronic, lower-back pain caused by her limping. While rubbing her lower back in trying to relieve tension, she noticed sensations of warmth and weak pulsations in her feet. Intrigued by her finding, she started using various techniques on her lower back. She noticed that the most intense warm sensations in her feet were triggered when she pulled the skin on her lower back. After several months of self-therapy, she was able to restore circulation through her lower extremities and prevented double amputation. Powerful stuff.

Dickle shared her findings with Prof. W. Kohlrausch. Their combined efforts, as well as the later works of Prof. N. Veil and Dr. Luebe in Austrian and German clinics, shaped a major method of somatic rehabilitation they called Bidegewebsmassage or connective tissue massage/fascia release and mobilization techniques as it is known by the rest of the world.

During the extensive research, they developed connective tissue massage/fascia release and mobilization hands-on protocols, including the stipulation regarding the direction of movement. This was presented in a straightforward way so that thousands of massage therapists could learn these techniques and, successfully, implement them on patients. Thousands were replicating outcomes when treating back and limp disorders, internal organ diseases, etc. for more information just Google Bidegewebsmassage.
The work of Prof. Sherback, which is an absolutely fundamental plateau for medical massage, is also a fundamental groundwork for any massage therapy. Today, the concepts that lay the foundation of his works were tested and massively utilized for many years, and thus proved their clinical viability.

After analyzing all the available data, and experiences of other scientists and clinicians, Prof. Sherback started checking somatic components of chronically unhealthy patients.
He figured out that regardless of the disorder type (being it skeletal muscular disorders or internal organs diseases) skin, fascia and muscles develop changes such as higher density of skin, tension in fascia and muscles.
The aforementioned changes produce pain when compressed and, in many cases, form localizations that are painful regardless of compression. Then a revelation come to him – “a simple revelation” as he put it that made massage a very powerful therapeutic tool.

All diseases of internal organs project pathological impulses on somatic parts that share the same level of innervations with a particular somatic part and trigger changes such as higher density of skin, tension within muscles, fascia, etc. forming reflex zones abnormalities/ somatovisceral reflex. The aforementioned changes in soft tissue can be painful and especially sensitive to touch or pressure.
The most important achievement of his and his students was that, by providing massage and eliminating these reflex zones abnormal changes, they improved the health of thousands of patients.
Another huge plateau was established by Drs. Glaser and Delixo after the tremendous work. In 1955, they published segments reflex massage text, including more than 30 maps of reflex zones abnormalities, for individual internal organs diseases, as well as for skeletal muscular diseases.

The contribution that prof. Sherback and Drs. Glezer and Delixo made to the development of massage science was indisputable and their influence is hard to overestimate. Similarly, it is impossible to overestimate the contribution of Dr. Sarkisov Serazini, who proposed comprehensive physiological effect of massage approach in 1938 and have established the concept of the physiological effect of massage as we know it today. This foundation allowed further generations of researchers to develop over 60 medical and sports massage hands-on protocols. Thus, the methodical research was done, and optimal step-by-step hands-on techniques were developed, all of which were standing on the foundation of the physiological effect of massage. Here is the link to a short description of the physiological effect of massage.

During his experimental clinical research Dr.Sarkisov Serazini said:
”…if you would like to assess the professional capability of a massage therapist, you must assess his capability to perform high-quality kneading techniques. Many different components are necessary in order to achieve rapid and sustainable results, and the quality of kneading techniques is one of this important components.”

Medical massage contains technical disciplines such as connective tissue massage/fascia release and mobilization, muscular mobilizations, trigger point therapy, circulatory massage, and more. This was my fundamental training in theoretical concepts as well as very intensive hands-on practice. As you can see no secrets what so ever.

Drs. Glezer and Delixo’s segment reflex massage text, have never been translated into English. Here comes a million-dollar question. If hasn’t been translated into English, can it still be scientific? Incidentally, it has been translated into Russian, German, Polish, and Hungarian.