From this article you will learn: what to do massage after a stroke, and what therapeutic effect from it you can wait. General rules for the procedure, a description of the most important techniques.
How useful is the massage for recovery after a stroke
Massage is a type of restorative treatment after a stroke. Despite the auxiliary significance, it must be done by all patients. Rules and techniques depend on the characteristics of the disease in a particular person, taking into account the severity of neurological disorders. In any case, you need to combine a general massage for the whole body and special techniques for the hand or legs affected by paralysis.
Individual approach and strict adherence to recommendations will ensure the maximum possible rehabilitation effect of complex rehabilitation. It will pass much easier and faster with massage than without it - positive changes in the form of restoring general motor activity can be noticed 3-4 weeks earlier, and fine limb movements - for 2-3 months. But do not hope that only thanks to the massage the patient will be able to recover. It must necessarily be combined with exercise therapy and medication.
The rehabilitator together with the attending physician-neuropathologist is engaged in selection of massage. Do it on a professional level can both a rehabilitator, and an experienced masseur.
How useful is the massage for recovery after a stroke?
Therapeutic properties of massage:
- Improve blood supply and trophism( nutrition) of tissues in the area of paralyzed limbs.
- Normalization of impaired muscle tone( both increased and decreased).
- Restore sensitivity and movements.
- Prophylaxis and elimination of limb contractures( complete immobilization of muscles and joints as a result of paralysis and permanent fixation in one position).
- Psychoemotional relaxation( pleasant sensations and soothing effect on the nervous system).
- General strengthening effect and improvement of blood circulation throughout the body( prevention of decubitus, edema, stagnation in the lungs and infectious complications).
General rules
You can do restorative massage after a stroke both in medical institutions( hospitals, rehabilitation centers) and at home. For this, manual techniques( manipulations by the hands of the masseur) and various devices - massagers are used. In any case, it must initially be developed or approved by specialists( a rehabilitologist and a neuropathologist), they will determine the optimal volume of the procedure depending on the stage of recovery, teach relatives to do the procedure themselves and control the effectiveness.
Manual massage therapist 
Massagers for massage after a stroke To facilitate the procedure will help:
- Warm up the limbs with warmers or with a warm salt bath.
- Warm appliqués of paraffin on the massaged area.
- Applying to the hands of a masseur and a skin of sick substances on a fat basis( best of all is a children's cream or a special massage oil).
- Be sure to influence not only the sick, but also the healthy limbs.
- Each session should end with wrapping the patient with a warm blanket or towel.
Procedures that will facilitate a restorative massage When you can start
The first massage sessions can be started immediately after stabilization of the general condition of the patient, when:
- respiration and palpitation recover;
- normalizes pulse and pressure;
- will be the phenomena of cerebral edema.
Usually acute period takes from 2-3 days with ischemic stroke to 5-7 days with hemorrhagic. At this time, any massage techniques can adversely affect the course of the pathology. First, the body must adapt to pathological changes, restore the basic elements of vitality. Therefore, the first attempt at an easy massage can be done only 2-3 days after the onset of the disease, when all vital signs have stabilized.
If the condition is unstable or the first session has caused deterioration, it is better to wait up to 7 days. At this time, from 2-3 days of the patient, you can turn on one side, gently stroke the skin in places of redness( back, sacrum, hip joints, elbows, shoulders, heels) and rub it with camphor alcohol. These techniques prevent the formation of pressure sores. After a week, you can try again an active massage, after 2-3 weeks the volume of the procedure can be extended. Only 4-5 weeks after the stroke it is permissible to do a full restorative massage without restrictions.
Click on photo to enlarge Who can massage( specialist or native)
You can not know all the subtleties of massage after a stroke without being an expert. But to master simple rules under force to everyone. The first elementary techniques can be performed by any person caring for the patient. The main thing is to remember that there should not be unnecessarily exciting actions. Only light and smooth. The first restorative massage is best entrusted to an experienced specialist and under his guidance to learn to perform the necessary procedures.
If you master these techniques, you can do them yourself. Be sure to consult periodically with a rehabilitator or massage therapist( if there are any changes - improvement or deterioration).
Course duration
Adhere to the principle of course treatment. This means that massage, like any other treatment, should have a unique dose( rate).General techniques in bedridden patients can be performed continuously 2-3 times a day for 3-5 minutes as a component of care. Special manual actions to restore the movements of the paralyzed arm or leg are best organized in the form of daily courses of 20-30 procedures( once a day).
After this, take a break for at least 3-4 weeks. During this time, the muscles of the limbs must regain their strength, so that the subsequent more intensive treatment course will produce the desired effect.
Duration of one session
The first massage session is the shortest - no more than 5 minutes. If after it there are no negative phenomena, the duration can be increased every day, bringing up to 15-20 minutes in the second week of treatment. A full restorative massage a month after the stroke, including general and special restorative techniques, takes 30-40 minutes, and in severe motor disorders - about an hour. Duration should increase gradually.
Any massage for strokes in duration and strength should be such that it can easily be carried by a specific patient. After all, this is a kind of load for the body. Therefore, after severe strokes with severe paralysis( bed patients), you need to start with the lightest and shortest massage( as described in the previous sections of the article).For minor violations after a stroke( weakness of the arm, legs, but kept walking and elementary movements), do not waste time on weak techniques.
Patients undergoing a full course of restorative massage should first massage the entire body and only then develop an arm and leg.
How to do general body massage
The sequence of neat surface effects by hands on the skin of the massaged area can be as follows:
- Stroke the skin with palms and fingers in the longitudinal, transverse and circular directions.
- Perform a series of rubbing movements in different directions with the palms and the rib( the soft part of the hand from the little finger) of the straightened hand or bent into a fist.
- Tap the left and right hands alternately on the entire surface to be massaged, creating a vibrating effect( intensive shots are excluded).
- With large, index and middle fingers, take the skin into a crease like a light, wide pinch.
- Massage ends with stroking.
Each of these actions is sufficient to perform for 1-2 minutes. It is best to massage the body first( thorax, back), passing to the shoulder girdle and arm, and then the pelvic region and the leg. Thus the patient should be in that position which will be safe:
- at a serious paralysis and disturbance of a swallowing - only on a back and on a healthy side;
- for mild forms - you can roll over on your stomach.
General relaxing body massage Doing massage with strokes, it is impossible to exert too energetic influences, especially point ones. This is associated with increased sensitivity and can cause severe pain or strong muscle tension. Most often this reaction occurs when massaging areas with a large congestion of receptors:
- Achilles tendon region on the posterior surface of the tibia;
- the anterior surface of the thigh is closer to the knee joint;
- area of the shoulder joint and its passage to the thorax;
- lower third of forearm and wrist.
General body massage is designed to relax and soothe the patient, improve the flow of blood and oxygen to the tissues. It is best to do it in the morning after hygienic procedures( shower, bath, rubbing the skin) before a special massage for the arm and leg.
How the hand massage is performed
Massaging your hands, it is important to observe the draining principle - improving the outflow of blood and lymph, reducing edema. Therefore, you need to start from the upper segment of the arm( forearm), but the direction of the massaging movements is from the bottom up. They are the same as with a general massage: stroking, rubbing-kneading, tapping( vibration) in the longitudinal, transverse, circular and circular directions. The patient may lie or sit with the hand fixed on the stand.
The massage sequence is as follows:
- The large pectoral muscle is from the sternum to the shoulder.
- The area of the shoulder joint, deltoid and trapezius muscle( shoulder-back-neck transition) - from the spine to the joint and from the shoulder to the neck.
- The back surface of the shoulder( triceps) and the front surface( biceps) - from the elbow to the humeral joint.
- The back, and then the foreface of the forearm - from the wrist to the elbow.
- Brush: massage each finger separately, kneading and pinpointing the fingers on the palm surface, which restores deep sensitivity.
Hand massage after a stroke The main goal of the massage of the arm and leg with stroke is relaxation of the strained muscles, which will facilitate the performance of therapeutic physical training.
How to massage the legs
The manual effects on the leg muscles are the same as on the hands. The position of the patient lying on the back - if the front and side surfaces are massed, on the side or on the stomach - if the back is massaged. To avoid premature cooling, it is better to cover the leg, leaving only the massaged area open.
Sequence of limb segments with massage:
- Buttocks - movements from the sacrum to the hip joint.
- Hip - stroking can be done from the bottom up or from the top down. Transverse, circular grinding and vibration only from the knee joint to the groin area.
- Shin - can be massaged more vigorously than the thigh in the direction from the ankle to the knee. Remember the accuracy of movements in the reflexogenic zone: in the Achilles tendon and below the patella.
- Stop - alternately every finger, acupressure of the sole and heel, kneading the back surface, rubbing the ankle.
Foot massage after a stroke Massage is a good complement to complex treatment after a stroke, which without harm to the body will allow you to recover faster.
