Massage For Supportive Cancer Care

Kathleen Dzubur, MS; Francine Manuel, RPT; Gary Abrams, MD; Lee Erman, NCTMB; Ernest H. Rosenbaum, MD

Massage
Giving a Massage
Massage and Compassionate Touch
Types of Massage
Basic Strokes of Swedish/Western Massage


Massage
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One of the most soothing treatments for a bedridden person is massage. In Europe and elsewhere, it is used frequently to promote relaxation, decrease pain and speed healing. It may also help reduce or eliminate the need for certain medications. If you have a willing family member or friend, massage can be a pleasant way for others to participate in your recovery and gain satisfaction from being able to help. Massage therapy can help prevent bedsores. By turning over, you release pressure on the areas on which you have been lying. Massaging the pressured areas encourages more blood to flow into the tissue. If massage is done frequently, it will prevent skin breakdown. The buttocks, tail bone (coccyx), wings of the shoulder blades (scapulae), hips, heels, elbows and bumps (malleoli) around the ankles are susceptible spots for pressure sores.

Giving a Massage
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The following instructions can be used by a friend or family member to give you a massage. It is very important that you find a comfortable position at the start; no matter how soothing the stroke, an uncomfortable patient will not be able to tolerate the massage for very long.

There are four basic massage strokes: II. Massage and Compassionate Touch
Kathleen Dzubur, MS; Francine Manuel, RPT; Gary Abrams, MD; Lee Erman, NCTMB; Ernest H. Rosenbaum, MD
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One of the most relaxing and enjoyable experiences for a person with cancer (or for any other human being, for that matter) is to receive gentle, compassionate, accepting touch from another person. This can range from a from a 1 or 2-hour massage from a trained massage therapist to something as simple as having your hand stroked by a friend. Touch is fundamental. It is the first sense to develop indeed, all infant mammals require touch to survive and thrive. It may also be one of the last senses to be lost in the dying process.

Here are some of the values you might derive from compassionate touch:

Although for effective focused therapeutic massage, a skilled and experienced massage therapist is needed, all humans are capable of providing loving and beneficial compassionate touch. We all have innate touching skills; however, many of us have not practiced those in our often touch-deprived culture. To help, here are some hints for anyone to provide effective compassionate touch:

In addition to the benefits for the recipient, studies have also shown that the person providing the touch also benefits. So, turn the tables on your friend, caregiver, or another person with cancer and provide them with some loving compassionate touch- you'll both love it!

Types of Massage:
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Swedish/Western Massage:
Based on the Western concepts of anatomy and physiology, Swedish massage employs the traditional strokes of effleurage, petrissage, vibration, friction, and tapotement (percussion). Swedish/Western is the most widely used system in the west. (See below for a description of these strokes.) However, most massage therapists are trained in and utilize a wide variety of other techniques, blending them with Swedish/Western into a treatment tailored to your needs. Here are descriptions of a number of the most commonly used other techniques, in alphabetical order.

Cross-fiber Friction Massage:
Friction massage applied in a transverse direction across the muscle, tendon, or ligament fibers. The stroke is only long enough to cover the intended tissues. The fingers do notmove over the skin but move the skin and superficial tissues across the target tissue.

Myofascial Release (also called Connective Tissue Massage):
Slow, focused stretching through one or more body planes. This can also include ischemic compression (the application of progressively stronger pressure) to release the tenderness of trigger points. A trigger point is a hyper-irritable spot, usually within a taut band of skeletal muscle or within the muscle's fascia, thatis painful on compression and that can give rise to characteristic referred pain, tenderness, and autonomic dysfunction.

CranioSacral Therapy (CST):
A gentle, hands-on method of evaluating and enhancing the function of the craniosacral system - the physiological body system comprised of the membranes and cerebrospinal fluid that surrounds and protects the brain and spinal cord.

Deep Tissue Massage:
The term refers to various massage styles that are directed toward the deeper tissue structures of the muscle and fascia.Most deep-tissue massage techniques aim to affect particular areas within the various layers of fascia that support muscle tissues and loosen bonds between the layers of connective tissues. Various styles of deep tissue massage include Rolfing and structural integration.

Feldenkrais Method:
A form of somatic education that teaches through movement ? how we can improve our capabilities to function in our daily lives. It is an educational system that develops a functional awareness of the self in the environment.

Lymphatic Massage:
This method, a descendant of Swedish massage, was pioneered by Dr. Emil Vodder, Ph.D., of Denmark in the 1930s. Dr.Vodder's method of manual lymph drainage massages uses light, rhythmical, spiral-like movements to accelerate the movement of lymphatic fluids in the body.

Myofascial Release (MFR):
Helps restore fascial mobility with slow, focused stretching through one or more body planes.

Neuromuscular Therapy (NMT):
Identifies soft tissue abnormalities and manipulates the soft tissue to normalize its function. Addresses the neuromuscular dysfunctions created by trauma, improper body mechanics, poor posture, and other stressors.

Reflexology:
This method originated with the Chinese and is based on the idea that stimulation of particular points on the surface of the body has an effect on other areas or organs of the body. Today's techniques focus mainly on the hands and feet.

Rolfing:
A systematic program developed out of the technique of structural integration by Dr. Ida Rolf. Rolfing reshapes the body's physical posture and realigns the muscular and connective tissue through manipulation of the fascia (connective tissue).

Sports Massage:
A method of massage especially designed to prepare an athlete for an upcoming event and to aid in the body's regenerative and restorative capacities following a rigorous workout or competition. It is also designed to reduce the athlete's risk of injury.

Shiatsu:
A Japanese system of acupressure based on the Oriental concept of chi (life force energy) and tsubos (energy points). When pressure is properly applied to the energy points(via finger pressure), energy circulation is improved and the body is thought to be better able to heal itself.

The Trager method:
Developed by Dr. Milton Trager, this method uses movement exercises called "mentastics" along with massage-like, gentle shaking of different parts of the body to eliminate and prevent pent-up tensions.

Zero Balancing (ZB):
A hands-on body/mind system designed by Dr.Fritz Smith to align body energy with the body's physical structure. It represents the integration of Eastern views of energy with Western views of science and teaches how to use energy as a working tool in relation to body structure.

Basic Strokes Of Swedish/Western Massage:
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Touch: The stationary contact of the practitioner's hand and the client's body.
The pressure exerted may vary from very light to very deep depending on the intention. May be in the form of a hand shake or gentle hand on the shoulder.
* specific indications: Constitutes the first and last contact of the practitioner with the client. Touch is he primary communication tool used by the massage therapist. The main objective of light touch is to soothe and to provide a comforting connection that is calming. Light touch can be used as a complete treatment when basic massage is contraindicated.

Effleurage (gliding): The practice of gliding the hand over some portion of the client's body with varying amounts of pressure or contact according to desired results.
* specific indications: Generally applied prior to (and after) any other movement. Allows for practitioner assessment, distribution of lotion, and preparation of the area for other techniques. Often used to produce soothing effects.

Friction: Refers to a number of massage strokes designed to manipulate soft tissue in such a way that one layer of tissue is moved over or against another in order to flatten, broaden, or stretch the tissue.
* specific indications: Helps to separate the tissues and to breakdown adhesions and fibrosis, especially in muscle tissue and fascia. Friction has a marked influence on the circulation and glandular activity of the skin. Friction can also be used for increased circulation deep into the tissues.

Petrissage (kneading): Lifting, squeezing, and pressing the tissues.
* specific indications: Helps to reduce adhesions and stretch muscle tissue and fascia.

Vibration: A continuous trembling or shaking movement delivered by either the practitioner's hand or an electrical apparatus. Vibration may be classified as a type of friction.
* specific indications: This form of massage is soothing and brings about relaxation and release of tension when applied lightly. It is stimulating when applied with pressure. A numbing effect is experienced when vibrations are applied for a prolonged period of time.

Tapotement (percussion): A rapid striking motion of the practitioner's hands against the surface of the client's body, using varying amounts of force and hand positions.
* specific indications: To stimulate the body and tone the muscles. NOTE: Percussion movements should not be applied to muscles that are abnormally contracted or over any sensitive area.

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Supportive Cancer Care
by Ernest H. Rosenbaum, MD & Isadora R. Rosenbaum, MA
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