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Massage and Your Body's Systems

 

Knowing the function of each body system is important when deciding what type of massage will be most beneficial. Understanding the various body systems helps when it comes to understanding client's pathologies, and can make your massage more specific and effective. Being able to speak intelligently and simply to your clients helps educate them and gets them involved in understanding how their body works. We'll briefly discuss three body systems; the circulatory, lymphatic and nervous system, and how massage relates to each system.

Circulatory system

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The circulatory system delivers blood and nutrients to every single cell in the entire body. (Figure 1) When there is a good blood flow, and every cell gets the nourishment it needs, there is health. Many diseases and disorders arise from lack of blood flow in the tissues. This is called ischemia (lack of blood flow). Massage powerfully affects how the blood flows through the tissues. This happens in one way simply by manual pressure. When the practitioner applies pressure to an area, it pushes the blood out of that area. When the practitioner releases the pressure, fresh blood rushes back into the tissues. This also can occur by stroking the tissues towards the heart, which will increase venous return of the blood.

On another level, massage induces a relaxation response in the nervous system, causing the walls of the arteries to relax, increasing blood flow to the area that the practitioner is working. This is called vasodilation. By encouraging vasodilation, fresh blood can nourish tissues that may have been ischemic, and initiate the healing process. When there is a strong flushing of blood into an area, it is called hyperemia. Hyperemia is visible on the skin as a reddening.

Usually massage therapists' focus on muscles, so it is strange to think that many of the benefits of Swedish massage come from an increased blood flow. Understanding how massage affects the blood supply can clarify the impact that massage has on various conditions. Massage is contraindicated in cases where increased blood flow would do more damage. Varicose veins, hematoma(bruising), edema, and viruses are all conditions where increased blood supply would be detrimental. Massage is contraindicated cases of varicose veins and hematoma, due to the weakened vein or capillary walls. In the case of edema, increased blood flow will only cause more fluid to fill the interstitial spaces, making the edema worse. In the case of viruses, the body is trying to isolate and destroy the virus, and pushing the blood around the body has a tendency to spread the virus throughout the body even more.

Lymphatic system

Massage also powerfully affects the lymphatic system. The job of the lymphatic system is to clear out excess fluids, large proteins, bacteria and debris from the interstitial spaces(the spaces between the cells), and to assist in the body's immune function by processing the lymph at the lymph nodes. Most of the lymph vessels are located in the skin. (Figure 2)These vessels have tiny muscles that rhythmically pump the lymph through the lymph vessels1. Breathing and muscular contraction also help to move the lymph.

All styles of massage affect the lymph system in one way or another. Deep pressure causes the lymph angions to temporarily cease pumping, causing a reduction in the flow of lymph. At the same time, Deep pressure powerfully increases blood flow. This combination of reduced lymph flow and increased circulation can leave clients feeling puffy after a deep session. In cases of edema, deep work is definitely contraindicated.

Medium pressure Swedish massage stimulates lymph flow and blood circulation, so the effect on fluid balance is negligible. But again, in a client with edema, this still will not help.

Light pressure with specific lymphatic drainage massage strokes will powerfully increase lymph flow by as much as ten times normal, while the light pressure has a minimal effect on blood flow2. In this situation, the interstitial fluid is decreased. This can help in cases of edema where the cause is a slow lymph system.

Understanding how massage affects these two systems can go a long way in helping the practitioner to vary their session to better match their client's needs. For example, in clients who get puffy after a deep massage session, 5 minutes of lymphatic drainage massage after the deep work can help to drain the interstitial spaces reducing any swelling. Understanding the role of the lymph system can also help to understand the effect of various pathologies.

Lymphangitis is an inflammation of the lymphatic vessels. The symptoms include a thin red streak extending from a wound, bite or infected region. Lymphatic drainage and massage in general is contraindicated, because it will help to spread the infection further through the lymph vessels3.

Another condition related to the lymph system is swollen lymph nodes. If a client has swollen nodes, it may mean that they are fighting an infection or virus, and the nodes are having a hard time processing the amount of toxins or bacteria coming through. Lymphatic massage proximal to the location of the swollen gland can be helpful to help open the space so that lymph can flow out of the node easier.

Nervous system

The nervous system is complex with many different divisions. For massage therapists, one of the most important aspects of the nervous system is the Autonomic nervous system (think automatic), which is responsible for running your organs and viscera. For the most part, autonomic nerves are not under conscious control; for instance, no one has to "try" to digest their food, or remember to keep their heart beating. Although we do have some control, you can slow your breathing if you try and with some practice of yoga or mediation, you can learn to slow your heart rate and other body functions. This control stems from the fact that this part of your nervous system has two sets of nerves that perform opposite functions. One grouping is called the sympathetic division, and the other is called the parasympathetic division.

The sympathetic branch exits the thoracic vertebrae and the first two lumbar vertebrae. These sympathetic nerves innervate each organ and when activated increase the heart rate, speed breathing, secrete adrenaline and decrease digestion- all the signs of being nervous, frightened or angry. This is the fight or flight response. On a subtler level, perhaps you have experienced how when you are stressed, your food sits in your stomach. This is because the stomach is not very active if the sympathetic nervous system is dominant. Excessive sympathetic output is what causes many stress-related conditions such as headaches, high blood pressure and anxiety.

The balance to the sympathetic division are the parasympathetic nerves. When the parasympathetic fibers become active, the heart rate decreases, the breath rate decreases and digestion and peristalses increases. This is the rest and rejuvenation nervous system, and massage increases its activity. Amazingly, the parasympathetic nervous system exits the sacrum and the cranium, and travels from these exits to the same organs that the sympathetic nervous system reaches.

The sympathetic and the parasympathetic systems work in conjunction with each other to balance the body's needs. This internal balance is called homeostasis. We need the sympathetic activation to become energized, sharp and focused. Too much sympathetic activity makes us stressed. Long-term sympathetic activation depletes the body. The rhythmic quality of massage activates the parasympathetic nervous system. This activation causes vasodilation, muscle relaxation, and helps to bring balance, rest and rejuvenation to the body.

Massage's affect on the parasympathetic nervous system is general. On a more specific level there are two sensory receptors in the muscles that massage greatly influences. Located where the muscle turns into a tendon, golgi tendon organs are tension recorders that are designed to prevent a muscle from contracting too forcefully, and ripping itself from its tendon. If the tendon organ detects excessive overload, it may initiate a spinal reflex that inhibits that muscle, in effect "turning it off". Some massage techniques focus on applying pressure to the musculo-tendinous junction of the muscles, with the intention of activating the golgi tendon organs- thus relaxing the muscle. These techniques apply pressure at the musculo-tendinous junction, with force toward the muscle belly in short movements.

Muscle Spindle cells are another type of sensory receptor in the muscles, and are located in the muscle belly. Spindle cells are responsible for the stretch reflex: they initiate an excitatory reflex that causes the muscle to contract, thus preventing the muscle from over-stretching. They react to both the extent and velocity of the stretch. They are highly sensitive, and are important in maintaining posture.

The muscle spindles, with their capacity for initiating the stretch reflex, are responsible for the splinting that takes place when a muscle, tendon, or ligament is injured. The muscles surrounding the injury immediately tighten to immobilize the area. While this is an entirely natural and appropriate response of the body, without proper attention to rehabilitation it often backfires. The splinting reflex which has acted to protect that injury can actually "re-set" the proprioceptive resting length of the muscle, leading to lasting hyper-tonicity and limited range of motion.

One bodywork technique the resets the spindle cells is an isometric contraction. This is used in modalities such as muscle energy technique, strain-counter strain, Proprioseptive Neuromuscular Facilitation and others. An isometric contraction is where the client tightens the muscle without moving the joint. When they stop, an effect called post-isometric-relaxation takes place, meaning that the spindle cells resets and allows the muscle to lengthen even more.

Proprioceptive Neuromuscular Facilitation

Proprioceptive Neuromuscular Facilitation (PNF) is a type of flexibility exercise which combines muscle contraction and relaxation with passive and partner-assisted stretching. The technique has received considerable attention recently, since it is thought to improve range of motion in the skeletal joints to a greater extent than conventional static stretching.

A typical PNF stretch might start with an athlete lying on his back, with one leg raised and held straight; a partner then attempts to push the raised leg up and back, thus stretching the hamstring. The traditional approach would be to push the leg back until a stretch is felt, hold it for a time (maybe 10 seconds) and then push it a bit further, thus increasing the range of motion. By contrast, for PNF stretch, instead of holding for a few seconds, the athlete tries to push his leg back to the ground in opposition to his partner's efforts. Once this contraction is relaxed, the partner finds he can push the athlete's leg through a greater range of motion.

Reciprocal Inhibition

Another bodywork technique to loosen muscles is called reciprocal inhibition. This means that when a muscle contracts, it tells its opposing neighbor to relax- it inhibits it. To do this, have the client contract the opposite muscle from the one your trying to relax- without moving the joint. After a few seconds, have them relax, and you will notice that the other muscle has relaxed.

With these two neurological functions, you can see that doing any kind of isometric contraction around where you are working will help the all the muscles relax. Understanding the function of the nervous system can make you a better therapist, allowing you to work with the body, instead of against it.

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