Massage for fixation, as well as scar contractures

When the stiffness of the joints as a result of shrinkage of capsular ligament complex is recommended primarily to combine massage with therapeutic physical culture.

The sooner movement therapy is used, the greater the chance of functional recovery.

This position was formulated very figuratively by A. P. Zelenkov back in 1889 city. "That, who wants to restore normal joint mobility, after he has already lost his mobility, resembles a sculptor, who would want to model clay after, how it hardened. He, May be, at the cost of incredible effort and loss of time will achieve this, what previously he could have achieved jokingly".

A combination of massage and balneotherapy is also recommended. (mineral baths), mud therapy, hardware physiotherapy, the order of use of which in combination with massage is determined in each case by special indications. So, for deep scars, myosclerosis and myofibrosis of supporting tissues, for peri-intraarticular adhesions, it is recommended to first use balneotherapy or mud therapy, or thermal treatments, then massage, which is combined with physical exercise.

With concomitant vascular disorders (phenomena of lymphostasis, disturbance of vascular tone due to capillary hypotension) suction massage is indicated first, then movement therapy, which should not cause pain, as well as increasing muscle tone on the injured side.

For joint stiffness due to periarticular adhesions, vigorous massage is used, first in the form of deep stroking, followed by deep rubbing in the form of sawing and shading above and below the affected joint. Massage combined with physical exercise, which are advisable to use during massage. Movements should be painless.

Along with the indicated movement disorders, one can often find pronounced changes of a trophic nature in almost all layers of soft tissue, both in the area of ​​damage, and at a considerable distance from it. So, on the affected side the skin loses its elasticity, becomes thinner or, on the contrary, becomes dense, rough and difficult to fold. When the skin moves, the patient feels a cutting pain.

Significant changes are also observed in subcutaneous fat tissue. In its thickness, upon palpation, individual lobular seals of spherical or almond shape of various sizes are very often determined (from millet grain to large pea), often painful when pressed (panniculitis). The consistency of the muscles also changes. They lose their softness, elasticity and become dense and tense in places. Muscle tone is usually unevenly altered. Most often, spastic contraction of individual muscle bundles is observed. (myofasciculitis), palpation of which can also be sharply painful.

With prolonged hypertonicity of muscle bundles, small areas of compaction appear as a result of physicochemical colloidal changes in muscle tissue, resembling cartilage tissue in consistency (myogelosis). A constant companion in case of damage to the musculoskeletal system, especially the lower extremities, are lymphatic disorders- and blood circulation due to disruption of the tonic and vasomotor functions of lymphatic and blood vessels, which leads to swelling, which, in conditions of impaired trophism of soft tissues, very slowly lends itself to reverse development.

Selection of massage techniques, as well as the method of their use depends on the presence and nature of the above soft tissue changes. That's why the attending physician, revealed these changes, must teach the massage therapist to recognize them so that he has the opportunity, in accordance with the presence and nature of these changes, to timely adjust the dosage of massage movements, and also observe the dynamics of these trophic disorders during massage.

To activate lymph flow, to improve the drainage function of deep vessels on the injured side, it is recommended to perform a suction massage in all these cases, in this case, first apply superficial continuous stroking, then grasping continuous stroking, combining it with spiral rubbing in different directions.

Massage movements are made with wide strokes over a long distance, without lingering near large lymph nodes and joints. For example, When massaging the upper limb, massage movements follow from the fingertips to the shoulder, reaching the axillary cavity.

After the preparatory suction massage, they move on to a detailed massage of individual segments, At the same time, first of all, great attention is paid to improving skin trophism, increasing its elasticity, elasticity. For this purpose, gentle stroking and kneading in the form of intermittent pressure are used alternately., compression, stretching and pinching.

In the presence of dermatofibrosis, dermosclerosis and cicatricial adhesions of soft tissues produce shifting, twitching, растяжение, tightening, combining these auxiliary massage techniques of kneading with the main ones - rubbing and subsequent grasping continuous stroking.

To improve skin nutrition, we recommend lubricating it with Satin cream at night., containing vitamin A, or cream "Delight", containing vitamins A, E, F. Reducing the resistance of subcutaneous connective tissue, improving its mobility is facilitated by slow shading according to Leube and Dicke (1948).

If there is a spasm of the muscle bundles, gentle mechanical vibration is applied using an electric vibrator. In places, where there are painful lumps (myogelosis), produced by the palmar surface of the ends of the II - III fingers
alternately stable circular rubbing in the longitudinal and transverse directions, intermittent pressure, kneading alternately with grasping continuous stroking.

Force, with which these massage techniques are performed, varies depending on the sensitivity of the tissues being massaged.

Talc and fatty substances are not used when massaging myogelosis to avoid weakening the sense of touch of the massaging fingers..

An excellent means of improving lymphatic- and circulatory, reduction of fascicular hypertonicity, as well as improving tissue metabolism on the damaged side is hydromassage.