MEDICAL MASSage therapy information

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Some history  and facts about Medical Massage:

"The treatment of any chronic disorder of the human body has to include the appropriate method of massage therapy". Prof. A. M . Aksenova, MD Russia

Distinguishing between Russian Medical Massage and Swedish Massage

Quoting from "Therapeutic Massage A Scientific Approach" by Dr. Ross Turchaninov 2000

....some of the techniques are common in the USA but some were developed by Russian scientists and they are quite unique. 

...the main difference is their place in modern society and medicine.  In the USA and some other Western countries massage is considered mostly as a kind of art,spiritual and alternative healing.    

On the other hand in Russia and other East European countries massage is an important part of traditional medicine and the massage therapist sometimes plays a critical role in the final success of patient's treatments.

Many steps from there led to Russian Physician I.Z. Zabludovsky studies on Medical Massage and its clinical aspects.  He worked as the senior medical academy of the Russian Army.  In 1882 he published a dissertation titled "The impact of massage on the healthy human".  From his study, Prorfessor Zabludovsky moved to the clinical research on the medical benefits of massage.  The strong scientific approach of Professor Zabludovsky's works had a deep impact on the Russian and German medical communities.

Medical schools, scientific institutions and hospitals in St. Petersburg, Moscow, Kiev and other major cities were involved in the exploration and application of new methods and techniques of massage.  Today massage is still an important part of the curriculum in every medical school throughout Russia and other republics of the former Soviet Union.

I have obtained certification for Science of Massage Institute's Medical Massage program based on these historically proven clinical protocols.

Medical Massage: Principles, Techniques, and the Art of Precision in Therapy

Medical massage is more than the application of skilled hands to muscle tissue—it is a structured, science-based therapeutic approach grounded in neurophysiology, anatomy, and clinical reasoning. While numerous massage techniques exist, from effleurage to deep tissue pressure, their true effectiveness depends not merely on the manual skill of the therapist, but on the therapist’s clear understanding of the physiological target, the desired therapeutic effect, and the patient’s individual condition.

In other words: what the therapist is doing matters far more than the exact “how”—because different techniques can lead to the same therapeutic outcome when applied with the correct clinical rationale.

The Three Major Postulates of Medical Massage

At the heart of medical massage lies a framework of three postulates that define the therapist’s approach:

Pseudometamer Structure of the Human Body

The human body is organized in a way that often mirrors segmental structures, but not perfectly. This pseudometamer arrangement means that the distribution of soft tissue changes, vascular supply, and connective tissue patterns are influenced by—but not identical to—the segmental innervation pattern of the nervous system. Recognizing these overlaps and mismatches is essential for targeted work.

Segmental Structure of the Peripheral Nervous System

Every area of skin, muscle, and connective tissue receives sensory and motor innervation from specific spinal segments. An irritation or dysfunction at one level of the nervous system can manifest as muscle tension, altered skin sensitivity, or changes in vascular tone in its corresponding segmental zone.

Reflex Zones (Head’s Zones)

First described by Sir Henry Head in the late 19th century, these cutaneous zones reflect visceral pathology—meaning that dysfunction in an internal organ may produce pain, sensitivity, or trophic changes in a predictable area of the skin. Medical massage therapists use this knowledge both diagnostically and therapeutically, applying manual stimuli to modulate reflex arcs and support the healing process.

The Vital Role of the Medical Massage Therapist

A medical massage therapist is not simply a manual technician—they are a clinical decision-maker. Their task is to:

Assess: Identify the relevant pseudometamer and segmental patterns involved in the patient’s condition.

Select: Choose the combination of techniques that best influence the target structures and reflex zones.

Adapt: Modify the approach in real-time based on the patient’s tissue response, nervous system reactions, and feedback.

Here, the selection of a massage technique is always subjective. The same therapeutic aim—say, reducing segmental muscle hypertonus—can be achieved via multiple approaches: rhythmic petrissage, static compression, or slow deep stripping. The difference lies in the therapist’s reasoning and choice based on the patient’s unique presentation.

Basic Medical Massage Techniques and Their Combinations

Medical massage employs a range of techniques, which can be combined into protocols depending on the therapeutic aim:

Effleurage (stroking): Enhances circulation, initiates relaxation, and serves as an assessment tool for tissue tone and temperature.

Petrissage (kneading): Mobilizes soft tissues, promotes venous return, and helps break down adhesions.

Friction: Targets localized restrictions and scar tissue, influencing fibroblast activity and connective tissue remodeling.

Vibration and Shaking: Modulates neural tone, particularly in hyperactive muscle segments.

Percussion (tapotement): Stimulates circulation and may enhance proprioceptive input to the central nervous system.

The Science of Combining Medical Massage Techniques

In medical massage, no single manual technique holds an absolute monopoly on therapeutic effectiveness. Instead, the therapist operates within a dynamic framework, combining methods in a way that best serves the patient’s neurophysiological needs. The process is neither random nor based solely on habit — it is a deliberate orchestration guided by anatomical knowledge, reflex patterns, and the three foundational postulates of medical massage.

From Isolated Actions to Integrated Effects

Every massage technique—whether light, deep, rhythmic, or static—produces a cascade of mechanical, vascular, and neurochemical responses. When combined with other techniques in a structured sequence, these effects can reinforce each other, broaden the therapeutic reach, or transition the patient’s tissues and nervous system through different stages of responsiveness.

The Role of Physiological Targets

Combination is dictated by what needs to be influenced:

A targeted effect on muscle tone may be followed by a vascular-stimulating technique to enhance nutrient delivery.

Nervous system modulation might precede connective tissue work to prepare reflex arcs for more adaptive responses.

The therapist’s task is to decide the sequence and interaction of these effects, rather than to adhere rigidly to any single modality.

Technique as a Variable, Not a Rule

One of the most important principles in this approach is that the choice of technique is subjective and situational. Multiple techniques can produce similar physiological changes. The deciding factor is the therapist’s understanding of the mechanism they wish to activate and their assessment of which method is most appropriate for the patient’s current state.

Adaptation Through Real-Time Feedback

As tissues and reflex zones respond to stimulation, the therapist continually adjusts pressure, rhythm, and method. The combination evolves in real time, shaped by the immediate changes in tone, sensitivity, and vascular response. In this way, combination is not a static “protocol” but a living therapeutic dialogue between therapist and patient’s body.

Why the Concept Outweighs the Technique

Understanding the segmental and reflex basis of dysfunction allows the therapist to choose the right approach for the right patient at the right time. This is why a technique in isolation is never the key—the intention and neurophysiological rationale behind it are paramount.

Two therapists might use entirely different sets of techniques, yet achieve the same result if their work is guided by a shared, clear understanding of the three postulates. Conversely, even technically perfect execution of a technique may fail if applied without an understanding of the underlying neural and reflex mechanisms.

Medical massage is both science and art—science in its reliance on anatomical and physiological laws, and art in the therapist’s ability to translate those principles into individualized, responsive care. The hands are merely the instruments; it is the therapist’s clinical vision, shaped by the three foundational postulates, that orchestrates recovery.

In medical massage, technique is the language—but the concept is the message.

LAUGHTER IS THE BEST MEDICINE

Every country in the world has the saying "Laughter is the best medicine". Now we know it's partly because when we laugh we increase respiration and pressure on the parasternal and paraspinal lymph nodes creating an instant cleansing and regulating effect.  Our natural state really is happiness and joy!

The Autonomic Nervous system consists of the Parasympathetic and Sympathetic Nervous System.  “Sympathetic On” makes the body react under stress producing the fight or flight response.  This response helps the body deal with emergencies by releasing hormones into the blood stream causing a number of physiological effects such as: increasing the heart rate, dilating the pupils, constricting blood vessels, and inhibiting digestion.  The fight or flight response initiated by the sympathetic nervous system is critical in our survival and is very effective in increasing our ability to defend ourselves or to escape from dangerous situation. However, in cases  of chronic “mental” stress or chronic illness, the sympathetic nervous system remains active, suppressing the parasympathetic nervous system which is the rest, relax and digestive system of the ANS.  The sympathetic mode creates an unhealthy state in the body and can lead to many disorders and symptoms associated with chronic stress or illness. 

A person can also be in an overly parasympathetic state as well with it's own set of health challenges.

The vast majority of chronic pain conditions have their roots in the emotional.  I recommend those with chronic pain learn about the work of Dr. John Sarno and the mind/body connection.

The following is a great explanation of Medical Massage vs. Stress Relief massage.

https://www.youtube.com/watch?v=8Q3W0LU_SWY&t=138s

https://www.scienceofmassage.com/meet-our-cmmps/

Here is a link to Dr. Sarno's work

TMS and the Mindbody syndrome

https://www.youtube.com/watch?v=cbF2HMXtfZ4