The massage [ masaːʒə ] (of . Fr. masser "massaging" originated 1755-1771 from arab. مس ( mas ) "touch; touch" or . Greek μάσσω "chew knead") is used for mechanical manipulation of skin, connective tissue and muscles through stretching, pulling and pressure stimuli. The effect of the massage extends from the treated area of the body over the entire organism and also includes the psyche.
Massage in the broadest sense is one of the oldest remedies known to man. Franz Kirchberg put it this way in his book:
"Just as every person instinctively rubs or presses a swollen and therefore painful or bumped area of his body and tries to alleviate the pain caused by the tension, this instinctive remedy will probably have been used as a remedy at all times."
The targeted application of massages for healing has its origins in East Africa and Asia (Egypt, China, Persia). The first mentions can be found with the Chinese Huáng Dì , who lived as early as 2600 BC. Describes massage movements and gymnastic exercises. In connection with essential oils and herbs there is also early evidence in the Indian health teaching and healing art, Ayurveda . Indian monks between the 15th and 17th centuries also performed massage ( udvartana or mardanā ) as part of their wrestling matches , mainly to remove doshas that caused illness . The massage finally came to Europe through the Greek doctor Hippocrates (approx. 460-370 BC) and his medical school. Here she later played an essential role in the rehabilitation of gladiators in the Roman Empire. Hippocrates explored and deepened the secrets of massage and wrote down his findings and recommendations for use. The second important physician of antiquity, the Greek Galenus (129–199), also took on manual therapy and wrote countless treatises on the forms he designed and for which diseases they were to be used. Despite its influence, which extended well into the Middle Ages, in later times European society lost interest in massages and other preventive and therapeutic measures.
Probably the oldest pictorial representation of a massage comes from Butkara in what is now West Pakistan and was created in the second century AD.
It was not until the end of the Middle Ages, in the 16th century, that massage by the doctor and alchemist Paracelsus (1493–1541) became the subject of European medicine again. However, he resisted the teachings of Galenus, especially against the humoral pathology , and made many enemies among his colleagues. It took another doctor, the French Ambroise Paré (1510–1590), to establish massage in modern medicine. He used massage as rehabilitation therapy after surgery.
Hahnemann's recommendation of massage
Samuel Hahnemann (1755–1843) integrated massages into homeopathy as a therapeutic addition to his medicinal treatments . In paragraph 290 of the Organon der rationellen Heilkunde (1810), headed “massaging” , he recommended “ the so-called massaging by a strong, good-natured person, who and who has been chronically ill, who has healed but is still slowly recovering Suffering from emaciation, indigestion and lack of sleep, grasping the muscles of the limbs, chest and back, pressing them moderately and, as it were, kneading them. This stimulates the life principle to restore the tone of the muscles and their blood and lymph vessels in its counteraction. "
Advancement and present
The so-called “Swedish era” in the field of manual therapy began with Pehr Henrik Ling (1776–1839). Ling initially worked as a gymnastics and fencing teacher and later founded the “Central Institute for Therapeutic Gymnastics and Massage” in Stockholm in 1813, where he taught his ideas about massage and gymnastics. The handles he developed were referred to as “rubbing, pressing, walking, chopping and poking”.
The Dutch doctor Johann Georg Mezger (1838–1909) was also significantly involved in the further development of classic massage . His work in Amsterdam opened the gateway to science and medicine for massage. From then on, its effect could no longer be denied.
The Swedish massage technique was adopted by the Americans and only introduced in Germany by the Berlin orthopedic surgeon Albert Hoffa (1859–1907) at the end of the 19th century. It was also Hoffa who fine-tuned the massage and spread it in the form we know today. He used the massage specifically for the musculoskeletal system and combined it with a joint-specific exercise treatment. In his opinion, only doctors could “palpate and massage pathological products of the muscles”. Each of his interns therefore had to learn and practice massage.
In the period that followed, more and more specific massage techniques were found and a development took place that led away from the direct action of the user on the patient's skin and muscles. Henry Head discovered the first foundations of somatotopics . Building on this knowledge, Wolfgang Kohlrausch carried out research into influencing internal organs through targeted stimuli to the skin. Kohlrausch came across this form of therapy through the self-experiments of the physiotherapist Elisabeth Dicke (1884–1952), who then invented the connective tissue massage . At the same time, the doctor and physiotherapist Paul Vogler invented colon treatment and periosteal massage . A few years later, the Dane Emil Vodder developed lymphatic drainage together with his wife Estrid . Nowadays, besides classic massage, this is the most widely used treatment in the field of manual therapy.
Nowadays, massage and reflex zone therapy are no longer the responsibility of doctors, but are carried out by masseurs and physiotherapists . Almost every country in Europe has a corresponding training program that is protected by the law .
Since the theoretical principles of the individual types of massage differ greatly and are based on completely different treatment theories, the number of partially proven effects on the body is large. The following are the most important of these modes of action.
- Local increase in blood flow
- Lowering blood pressure and pulse rate
- Relaxation of the muscles
- Loosening of adhesions and scars
- Improved wound healing
- Pain relief
- Mental relaxation, reduction of stress
- Improvement of the cell metabolism in the tissue
Forms of massage
The different forms of massage try to cure or alleviate the patient in two different ways. The classic method is to treat the skin and muscles in the area that is being massaged.
This method is largely recognized by evidence-based medicine and can be found in textbooks and therapy guidelines.
Other forms of massage are based on the assumption, which has not been confirmed by evidence-based medicine, that ailments in the organs can also be treated via reflex arcs , "meridians" or influencing the " Qi ". Accordingly, only a few of these massages are covered by health insurance companies as a gesture of goodwill. The idea is not to treat the "sick place", but rather a "corresponding area" that should represent the sick organ. In order to give both methods a memorable name, the terms “direct massage” and “esoteric massage” are used here.
- classic massage (Swedish massage)
- Brush massage
- Esalen massage
- Lomi Lomi Nui (Romi, Kahuna Bodywork, Ma Uri, temple massage)
- Lymphatic drainage
- Rhythmic massage (based on Ita Wegman )
- Thai massage
- Underwater pressure jet massage (in swimming pools)
- Acupuncture massage according to Penzel
- Ayurveda massage ( Abhyanga )
- Connective tissue massage or segment massage
- Colon massage
- Sound massage
- Head crawl massage
- Periosteal massage
- Reflex zone massage (e.g. foot, hand reflex zone massage / therapy)
- Cupping massage
- Key zone massage (to Marnitz)
- Thai massage
- Warm stone massage (Hot stone)
The sensory effect is also used for erotic purposes. In Kamasutra different types of massage to promote sexual activity are recommended based on traditional medical traditions; there is no empirically verifiable scientific basis for an actual effect according to western methods.
Forms of erotic massages are:
The grip technique of Swedish massage has been used worldwide for decades, therefore also called "classic massage", by masseurs (in Germany the medical profession is now called masseur and medical lifeguard ), physiotherapists and alternative practitioners and has therefore become the most popular form of massage.
The indications of the classic massage include tension , hardening, diseases of the musculoskeletal system such as the spinal column syndromes or post-traumatic changes. The frequency of the massage plays a not insignificant role in the successful relief of chronic neck pain .
The reflex arcs can reveal diseases of the internal organs on the skin or muscles. Another area of application for massage is the field of neurology . Here especially let paresis , spasticity , neuralgia and sensory disturbances treat. In addition, there are the psychosomatic illnesses that can be traced back to stress , which mainly relate to the heart and blood circulation.
The long-distance and general effects of classic massage are diverse. In the area of the microcirculation there is an improved blood circulation in the circulation, especially in the area of the lower extremities. The myocardial performance of the sufficient heart is increased by emptying the blood deposits. This means an increase in the stroke and minute volume of the compensated heart if there is a bradycardic tendency. A chemical effect is achieved by releasing denatured , alien protein from Gelotian areas in the sense of a general change of mood. A reflective, segmental effect is also possible by acting on dermatomes and / or myotomes via the lateral horn circuit and the intermediate zones to internal organs. A consensual response can e.g. B. in fracture treatment or in Sudeck's disease . This (also) happens in the untreated part of the body that belongs to the segment. An endocrine effect by acting on the pituitary and other endocrine glands is also possible. Massage has a vagotonic effect and improves blood pressure, pulse, breathing and sleep. In the psychological area there is usually relaxation.
For all acute inflammations, massages are contraindicated . These include febrile illnesses and diseases of the blood vessels, whereby the body is already heavily stressed and is additionally stressed by the massage. In the case of skin diseases, contact can worsen the disease, spread germs or infect the therapist. In the case of a traumatic injury, massage is absolutely contraindicated because of the pressure on the corresponding tissue (e.g. muscles, bones). The same applies to varicose veins, because the pressure on the extremities (arms and legs) can loosen thrombi .
The classic massage has five hand movements that are used due to their effect in the different phases of a massage.
- Effleurage (deletion; from French effleurer [ eflœˈʀe ] "to touch briefly")
Stroking is the most comfortable and relaxing part of the massage. It is mainly used at the beginning to distribute the oil (or cream ) and to get the patient's skin used to the therapist's hand. During the treatment, it serves as a break between the stronger grips. At the end of the massage, the stroke is used to relax the stressed muscles and relax the patient. After the massage, the patient's back can be rubbed with rubbing alcohol with quick strokes. This loosens the muscles and prevents inflammation of the hair roots .
- Petrissage (kneading, fulling ; from French pétrir [ peˈtʀiːʀ ] "kneading through")
The skin and muscles are either grasped between the thumb, index and middle finger or with the whole hand / both hands and kneaded or tumbled. When kneading, the effect on the muscles is produced by the therapist's hands; when flexing, this happens through the pressure of the muscle on the bones below. Both handles are mainly used to loosen tension. They act on the muscles and the subcutaneous connective tissue, and improve blood circulation.
- Friction (friction; from French friction [ fʀikˈsjɔ̃ ] "friction")
The fingertips or the balls of your hands make small, circular movements on the muscle. This grip is very effective for tension and hardening of the muscles, but must be used very carefully as it is very powerful and can cause severe pain and possible injuries.
- Tapotement (knocking; from French tapoter [ tapɔˈte ] "knocking against sth.; Patting")
With the edge of the hand, the flat of the hand or the fingers, short, striking movements are made. These promote the peripheral blood circulation and change the tone of the muscles. Tapping with the palm of the hand at the level of the lungs improves the mucus solution in the lungs. The latter is also known as tapping massage.
- Vibration (shock; from French vibration [ vibʀaˈsjɔ̃ ] "vibration; trembling")
Vibrations are generated by the therapist through what is known as muscle tremors. The fingertips or the flat of the hand are placed on it and the masseur creates the muscle tremors. The effect can reach deeper tissues and organs. This handle is loosening and thus has, among other things, an antispasmodic effect.
Full / partial body massage
A distinction is made between full and partial body treatments. One speaks of a full body massage when more or less all body regions are massaged. This usually includes feet, legs, arms, hands, back, shoulders, and neck. The massage can be extended to the chest, abdomen and face. Full body massage is rarely prescribed as medical therapy.
With the partial body massage, only one part of the body is massaged. Both legs or both arms count as one part of the body. This results in the following partial massage areas: legs, back (lying down and with a bare upper body), arms, chest, stomach, head, face. Each masseur has their own type of massage and will extend a partial body massage to the adjacent areas.
Electromechanical massage devices
Electromechanical massage devices are used to perform massages without a masseur.
There are different massage devices depending on the parts of the body to be massaged. There are massage beds or loungers on the market for massage while lying down. Massage chairs , seat covers and cushions are available for massaging the thighs, back or neck in a sitting or semi-lying position . Foot massagers are available for feet and calves.
The massage takes place via vibrators, rotating rollers, cylinders, water nozzles or air cushions and thus acts on muscles and tissue. Depending on the version, this enables pressure, kneading and tapping massages and can stimulate blood circulation and relieve tension, thus relieving pain. In this way, for. B. the Shiatsu massage can be modeled. With the appropriate equipment, the devices can be adjusted in terms of speed or frequency, roller spacing and intensity. The setting is made by remote control or directly on the device. With armchairs, the seating position is usually adjustable.
The massage devices are mainly used for private use. Electric massage chairs are also used in massage institutes and in public facilities such as department stores. Payment is usually made by inserting coins for a given massage time. The massage guest can remain fully clothed.
Suppliers of corresponding devices advertise with terms such as feel-good, relaxation or Shiatsu massage.
Albert Hoffa : technique of massage. Enke Verlag, Stuttgart, 1893
- Ulrich Storck: Massage technique. Short textbook. 19th, corrected edition. Thieme, Stuttgart, 2004, ISBN 3-13-139599-0 (This is a new edition of the "classic" by Albert Hoffa).
- Franz Kirchberg: Handbook of massage and therapeutic gymnastics. Georg Thieme, Leipzig, 1926
- Heinrich Averbeck: The Medicinische Gymnastik. Enke, Stuttgart, 1882
- Bernard Kolster, Gisela Ebelt-Paprotny (ed.): Guide to Physiotherapy. Fourth, revised edition. Urban & Fischer, Munich, 2002, ISBN 3-437-45162-6 .
- Kerstin Uvnäs-Moberg: The Oxytocin Factor: Trapping the Hormone of Calm, Love and Healing. Da Capo Press, Cambridge / Massachusetts, 2003, ISBN 0-7382-0748-9 (especially the 13th chapter “Massage”).
- Bernard C. Kolster: Massage. Classic massage, transverse friction, functional massage. Second edition. Springer, Berlin, 2006, ISBN 3-540-34289-3 .
- Antje Hüter-Becker, Mechthild Dölken: Physical therapy, massage. Thieme, Stuttgart, 2006, ISBN 978-3-13-136871-3 .
- Bernd Muschinsky: Massage theory in theory and practice. Gustav Fischer, Stuttgart, 1984, ISBN 3-437-00415-8 .
- Markwart Michler : From the history of movement therapy. Würzburger medical history reports 24, 2005, pp. 195-221, in particular pp. 196 f., 200, 203 and 209 f.
- Physical Therapy Association (Germany)
- Swiss association of professional masseurs
- Austrian Federal Association of Medical Masseurs + Therapeutic Masseurs
- Elaboration on the history of Prof. Dr. med. Hans-Dieter Hentschel (Association of Physical Therapy)
- Hans-Dieter Hentschel: Where does the word "massage" come from? Würzburg medical history reports 21 (2012), pp. 338–348.
- Hans-Dieter Hentschel and Johannes Schneider: On the history of massage in the Indian way of life and healing. In: Würzburg medical history reports. 23, 2004, pp. 179-203.
- Hentschel / Schneider, p. 188 f.
- Hans-Dieter Hentschel and Johannes Schneider: On the history of massage in the Indian way of life and healing. In: Würzburg medical history reports. 23, 2004, pp. 179-203; here: p. 187.
- Samuel Hahnemann: Organon der Heilkunst. 4th edition. Haug-Verlag, Heidelberg, 1983, ISBN 3-7760-0699-4 .
- Antje Hüter-Becker; Mechthild Dölken: physical therapy, massage, electrotherapy and lymphatic drainage . 2nd Edition. Thieme, 2011, ISBN 978-3-13-136872-0 , p. 19-20 .
- Study: Only frequent massaging helps with neck pain , Spiegel online , on March 11, 2014.
- in the tantra full body massage , the female and male genitals are also included (see also yoni massage )