Massage therapy, which physiotherapists commonly refer to as soft tissue therapy, is a popular treatment choice in many clinical settings. Massage therapy at a physiotherapy clinic is often called remedial massage therapy, which means that is practised by a qualified health care professional to help in the healing of muscle dysfunction rather than a massage given purely for general relaxation purposes such as with a beautician.
Where there is increased tension in muscles and tightness of the surrounding soft tissue structures (including connective tissues such as tendons and ligaments), quality of movement can be disturbed, body alignment can be distorted and pain and stiffness may be the result, By restoring muscles and connective tissues to a relaxed and flexible state through massage therapy, this helps optimum pain-free movement to resume.
Massage therapy is used by physiotherapists to:
- Increase blood supply to an area
- Release tension in muscles and connective tissues
- Release specific areas of spasm (trigger points)
- Relax the patient to help ease muscle tension caused by stress and anxiety
- Prepare muscles for stretching and sport
- Warm and relax an area of the body before treating it with passive mobilisation and manipulation
Physiotherapists use massage therapy during their treatment regimen for an enormous variety of conditions including:
- Sports injuries
- Neck and low back pain
- Post-surgery or immobilisation of a limb
- Tension headaches and migraines
- Tendinopathies such as Achilles tendinopathy, Tennis elbow and Golfers’ elbow
- Muscle strains and joint sprains
- Thickened connective tissue such as Plantar Fasciitis
and that’s just to name a few!
There are several types of massage therapy used in physiotherapy settings. The two most commonly used massage techniques amongst physiotherapists are effleurage and digital ischaemic pressure. Here they are explained in some detail:
Effleurage – This is a light touch massage technique. It is usually the way a physiotherapist begins a massage treatment to help the patient relax and also to relax the specific body area involved. The physiotherapist uses steady, slow and long strokes with flat palms of the hands and flat fingers. Effleurage performed with strokes towards the heart helps stimulate better blood flow which brings nutrients to and removes toxins from the muscles. This increased circulation also helps with the reduction of swelling and inflammation. Effleurage is a very effective form of pain relief in that it stimulates the release of pain-relieving hormones called endorphins into the body. Endorphins also help the patient relax and this helps ease muscle tension.
Digital Ischaemic Pressure (trigger point therapy) – this is a more aggressive massage technique. The physiotherapist uses their thumbs or sometimes their elbows to apply direct pressure to a specific area of muscle spasm referred to as a trigger point. The pressure is maintained until there is an ischaemic effect, meaning the flow of blood to that trigger point is interrupted. The physiotherapist then stops applying force to the muscle after a minute or so of maintaining the pressure. The reasoning behind digital ischaemic pressure is that once blood flow resumes when pressure is released, the incoming rush of blood will remove pain-causing toxins that were in the area and bring in pain relieving nutrients. (To imagine this, picture putting a kink in a hose to stop the flow of water then releasing the kink and the rush of water that ensues). Like effleurage, digital ischaemic pressure also stimulates the release of the pain-relieving chemicals called endorphins which, as well as providing pain relief, help the muscle to relax and the trigger point to ease away. In addition to this, another effect digital ischaemic pressure has on the body is that it stimulates the nerves that are in the trigger point whose role it is to release muscle tension. When these nerves are activated the muscle tone created by the trigger point decreases and the muscle relaxes.
Although massage therapy is appropriate for the treatment of many conditions, there are some cases where it is contraindicated including over open wounds and malignancies. If you would like to benefit from a therapeutic physiotherapy massage, come and see us.