The Right Touch: Massage
- Oct 9, 2001
Editor's Note: This series on therapeutic options is meant to offer basic information on the history of the therapy, what the therapy is, and how it is being used in the equine industry. Information presented in this series is not intended to promote use of the therapy; simply offer an objective primer of how it is being applied to horses. Owners and managers always should discuss their animals' health problems with their veterinarians before using any therapies or medications.
A gentle massaging of tense and tight muscles in neck or back can be a pleasant experience, bringing with it relaxation and a release from stress for human or horse. There is, of course, more to massage than just loosening tight muscles and providing a feeling of well-being. Massage, say its proponents, has wide-ranging physiological benefits, ranging from increased blood flow to a positive effect on the skeletal system.
Massage is a very old remedy, with descriptions of its proper application appearing in Chinese literature some 3,000 years ago. There also is evidence that massage was practiced by early-day Egyptians, Romans, Japanese, Persians, Arabs, and Greeks.
The word massage is derived from two sources. One is the Arabic verb mass, "to touch," and the other is the Greek word massein, "to knead."
The founder of modern day massage appears to be Peter H. Ling, a Swede who incorporated some French massage techniques into his system. He lived from 1776 to 1839. Credited with continuing research and teaching of massage are Albert Hoffa (1859-1970), James B. Mennell (1880-1957), and Gertrude Beard (1887-1971). Positive changes in massage techniques and understanding have occurred over the past 50 years as science and research have broadened the boundaries of knowledge concerning the physiology of man and horse.
Massage is described as the systematic manipulation of the body's soft tissues, primarily the muscles, to benefit the nervous, muscular, and circulatory systems. Usually, this manipulation is performed with the hands, although some forms of massage also use the forearms, elbows, knees, and even the feet. There are also percussion tools and vibrators that are employed in massage therapy.
The use of massage as a healing modality likely originated from the reflexive reaction of rubbing an injury site. Over time, it is theorized, this rubbing approach was formalized into a number of different movements applied to specific parts of the body.
There are two basic approaches to massage--Western and Eastern--but increasingly, the line between the two methods is becoming blurred.
The Western approach arises from a European tradition that focuses on the body's musculoskeletal system. The most widely used Western method is Swedish massage, originally designed to duplicate the muscle movements of Swedish gymnastics through body manipulation.
Eastern forms of massage are described as being "energy-based." The theory is much like that for acupuncture--that a vital force circulates throughout the body. When this force is blocked by injury or tension, the result is illness or pain. The aim of the Eastern techniques is to remove these blockages so that there is once again a normal flow of energy. The most prominent Eastern school is shiatsu, which uses pressure on various vital points called tsubos to free blocked energy.
Relatively new on the scene when compared to the other two approaches is sports massage. It combines the strokes of Swedish massage, the Hoffa method, with the pressure-point techniques of Eastern massage. Sports massage focuses on specific muscles or muscle groups, and it is used not only to maintain healthy muscles, but also to rehabilitate injured tissue.
The book, Massage, Total Relaxation, which is the result of a group of practitioners pooling their knowledge and putting it on paper, provides this explanation concerning the benefits of massage:
"Massage does more than make you feel good--it has wide-ranging physiologic effects. Its initial benefits stem from the stimulation of nerve receptors in the skin. The nerve impulses, triggered by rhythmic massage motions, are relayed to the central nervous system (the brain and spinal cord), where they are translated into messages of relaxation that are sent back to the muscles.
"One type of massage stroke, the nerve stroke, calms and soothes peripheral nerve endings in the skin.
"Massage has an effect on the circulatory system. Studies have shown that various massage strokes cause capillaries beneath the skin to expand, thus increasing the flow of blood. Since many strokes are done in a centripetal direction--toward the heart--they speed the flow of deoxygenated blood from muscle cells to the heart and lungs, where the blood is replenished with oxygen.
"Furthermore, the increase in blood flow due to massage can produce a temporary decrease in blood pressure. Researchers have found that massage also slows the pulse rate and promotes relaxed breathing, two indicators of reduced stress.
"Massage also encourages the flow of lymph, a colorless fluid that transports proteins and other substances from the muscles and bones to the blood. The increased lymph flow helps prevent fluid accumulation that can lead to swollen tissues and joints.
"The muscular system can benefit from massage in several ways. First, massage stretches and relaxes muscles, promotes flexibility, and increases the range of motion.
Massage also helps tired or injured muscles recuperate by mechanically ridding them of lactic acid, a metabolic by-product.
"Some evidence suggests that massage affects the skeletal system. In one experiment, massaging the area around fractured bones significantly increased the retention of nitrogen, sulfur, and phosphorus, all of which are necessary for repair of injured tissue."
Cause and Effect
While anyone can learn massage techniques, one must become skilled in the modality to be effective. Ongoing research has provided equine therapists with a much better understanding of cause and effect relationships in a number of modalities. At the same time, modern science has produced equipment powered by electricity that can carry out a number of treatment procedures.
However, there is one thing that this sophisticated equipment can't do that massage can--provide a close, hands-on relationship between the horse and the person whose hands are performing massage.
Massage can be a beneficial diagnostic tool. Practitioners are able to feel with their hands any abnormalities or problems, either via changes in soft tissue structure or the way in which a horse reacts when certain areas are massaged.
It can also serve as a preventative for injury, by assuring that the horse's muscles are loose and stretched before it is asked to perform.
Elaine Winter, ESMT, LMT, LCSW, a massage therapist in Salt Lake City, Utah, puts it this way:
"When massage is employed with knowledge and skill, it not only treats specific health problems in horses, but also improves their general health. After massage treatment, the 'feel-good' sensation derived erases much of the nervous tension and anxiety. That sensation will convey a sense of satisfaction and reconnection with life that subconsciously promotes recovery and improvement."
Winter says that there are at least four sensations that the massage therapist perceives with the hands. They are called the four Ts:
* Temperature--The normal body temperature of a horse is 99-100.5° Fahrenheit. Any change in the temperature of a horse suggests that certain problems exist.
* Texture--The density and elasticity of the skin and the muscle fibers.
* Tenderness--The degree to which the animal responds to your touch is proportional to the severity and stressfulness of the condition.
* Tension--Too much tightness means less blood circulation, fewer nutrients, less oxygen. Tension will increase toxin buildup, creating an underlying inflammation--trigger points, stress points, or scar tissue buildup after trauma.
"The key to a successful massage," says Winter, "lies in the heightened perception of the practitioner's fingers and mastering of the four Ts and of pressure, contact, rhythm, timing, and sequencing."
She describes those as follows:
* Pressure--There is a variety of pressures used, depending upon the intent. In general, light pressure means 5-10 pounds of pressure; moderate pressure is 10-15 pounds of pressure, and deep pressure is more than 15-25 pounds of pressure or more.
* Contact--The hands must remain flexible, molding to the body parts. Weaving one move into the other and keeping constant contact make the difference between an "okay" massage and one that produces better results.
* Rhythm--Rhythm is the frequency with which the movement is applied. Rhythm plays a strong role in the effectiveness of the massage.
* Timing--The amount of time spent on the problem area and the appropriate time for using a specific technique.
* Sequencing--When and where to use a specific combination of movements to achieve maximum results.
There are nine essential classes of basic massage moves in the sports massage approach, says Winter. They are stroking, effleurage, direct pressure, petrissage, shaking, vibration, friction, nerve manipulation, and tapotement, plus a multitude of combinations of the nine.
"Each individual category," she says, "has several moves, and each move can be performed in either a soothing or stimulating manner. Some of the moves appear to be similar, but they have different effects."
She describes each of the nine moves as follows:
* Stroking is used for its soothing, relaxing, and calming effect on the body, directly affecting the central nervous system.
* Effleurage is a gliding movement done to emphasize proper draining and the venous blood and lymphatic circulation. Effleurage is always performed toward the heart.
* Direct pressure is pressure varying in depth and intensity over a trigger point or acupressure point to relieve a spasm.
* Petrissage is the foundation movement of massage. It consists of kneading, compression, muscle squeezing, picking up, wringing up, and skin rolling.
* Shaking is a very strong mechanical movement used in sports massage to increase circulation.
* Vibration is mostly used to have an effect on the deeper structure of muscles and joints that are below the superficial tissues. It is a quivering type of movement done with the hand.
* Friction is the movement that breaks down adhesions and scar tissue over muscular fibers.
* Nerve manipulation is the movement that consists of stroking, pressure, friction, and stretching. One has to be very careful in applying this technique. These movements are concerned with nerve maintenance and therapy.
* Tapotement consists of a series of soft blows to the body, done rhythmically. It increases circulation and energizes the body.
How Massage Can Help
Massage, contends Winter, can benefit horses in a number of disciplines, although the problems they exhibit can vary widely.
In a discussion of the various disciplines and the effect on horses involved, she gives this analysis:
School Horses--These horses are used to teach any number of people how to ride. They spend hours each day moving in circles at all gaits with inexperienced riders on their backs. New riders tend to ride with a heavy hand, which can cause a horse to become tense in the neck and back.
Pleasure Horses--Sometimes an irregular schedule can cause extreme stress. For example, little riding in the winter followed by a lot of riding in the spring and summer; little exercise during the week and a lot of exercise on weekends.
Hunters, Jumpers--Stadium jumping tests a horse's ability to jump a challenging course. A lot of stress is put on the flexor and extensor muscles, tendons, and ligaments of the hind quarters. Landing puts stress on the flexor muscles, tendons, and ligaments of the foreleg and also the hind quarters. Also affected are the entire shoulder, chest, back, and neck areas.
Dressage Horses--Dressage horses are trained to perform with elegance and finesse of execution. The nature of the work involved in this discipline requires great muscle control and coordination on the part of the horse. The entire body of the dressage horse has great demands placed upon it, especially the hind quarters. Then, stress can occur in the back, hips, and stifle. Lateral work contributes to stress buildup in the chest, shoulders, back, hips, legs, and inner thighs. Collection can make the horse tense in the jaw area and it can develop stress points in the neck.
Eventing Horses--Eventing is an extremely demanding equestrian activity, particularly since each phase is very different. This discipline requires an extraordinarily high level of fitness and competence from both horse and rider. All muscle groups incur a great deal of stress. Inflammation and contractions are common in the neck, shoulders, back, flexor and extensor muscles, tendons, ligaments, hind quarters, forelegs, and chest muscles.
Endurance Horses--Competitive trail riding and long distance riding test the endurance and stamina of both horse and rider. Exhaustion, dehydration, electrolyte imbalance, tying up, inflammation, and muscle contractions are the principal problems. Tension develops in the entire body, but especially in the muscles of the back, inner thigh, chest, and shoulders.
Another equine sports therapist who makes use of massage techniques is Mimi Porter of Lexington, Ky., author of the book, Equine Sports Therapy.
Porter sets the stage for massage, then describes how the therapy should proceed:
"Before beginning a massage, the therapist must examine the area for broken skin or areas of inflammation. The horse should be standing squarely and on good footing. It is best to work in his stall as horses are most apt to be at ease in their own stalls. The stall should be clean and dry. Lighting should be adequate and the surroundings should be quiet. The use of a lubricant is helpful when massage is performed on a human, but not necessary for horses. In fact, use of an oil or lubricant could cause the hand or fingers to slide, detracting from the pressure applied. If a lubricant is used, one might try baby powder as it is less messy than oil and can be easily brushed out of the coat.
"Massage should begin with stroking to accustom the animal to the therapist's touch and to allow the therapist to search for areas of spasm and tenderness. The strokes should be of even pressure and run longitudinally along the muscle following the direction in which the hair lies. The initial stroking should be superficial rather than deep to create a sedating effect and avoid creating protective muscle contractions.
"As the horse relaxes, the strokes can become deeper, stimulating blood vessels and lymph channels. Deeper stroking should be in the direction of venous flow, or toward the heart.
"It is usually recommended that one begins the massage away from the afflicted area. As the patient relaxes, the therapist can work gradually toward the affected area.
"The duration of the treatment should be determined by the severity of the condition. Usually, five to 15 minutes for a local area is sufficient. Massage should not be carried out so long that it becomes an irritant to the horse. Massage should feel good. The therapist should remain aware of the horse's level of comfort throughout treatment.
"It is often recommended that one use 15 pounds of pressure for compression type strokes. To become familiar with the various pressures, one can practice with a bathroom scale. Press down with the thumb, fingers, or palm of the hand onto the scale. Twenty pounds of pressure is the maximum one should apply in practice. It is important that every stroke has a purpose. Random movements of the hands can only diminish the effectiveness of massage."
There is another form of massage-type therapy that merits discussion. It is known as Rolfing. It is described as being a much deeper form of body work.
"The Rolfer applies pressure and manipulates the body's soft tissues ultimately to alter the body's structure, balancing it to allow for better integrated movement with the force of gravity." This description is provided by Michael Reams, a certified Rolfer based in Seattle, Wash., where he is a partner in the Rolfing facility Centerworks Northwest. He also has trained in Tuina therapy in China and cranial and visceral manipulation with the School of Etiopathy of Geneva, Switzerland.
The Rolfing Technique of Connective Tissue Manipulation was developed by Ida P. Rolf, PhD, a biochemist who graduated from Columbia University in 1919. As a young woman, Rolf became interested in the healing powers of physical manipulation when she was injured on a camping trip. Within 24 hours of the accident, she developed severe pneumonia and was rushed to a small-town hospital for treatment. A local osteopath performed spinal manipulation on her and her breathing immediately eased. She was able to return home, where she continued osteopathic treatments until she fully recovered.
During the next several decades, Rolf studied various forms of alternative health care. Working with family and friends, she discovered that the body's shape can be altered by applying pressure to its soft connective tissue, primarily the fascial system. (Fascia is the spiderweb-like wrapping that encases muscles, bones, and organs.)
The theory behind the Rolfing technique is that as a body suffers injuries or simply ages, the fascial tissue thickens, tightens, and adheres to itself to provide support for weakened areas. When the fascia tightens elsewhere to compensate for the changes, says Reams, the body can literally twist and warp over time.
When analyzing a horse's structure prior to administering a Rolfing treatment, says Reams, he looks "not only for proper conformation and movement, but also for a lack of movement. Due to muscular and fascial compensations, manifestations of a problem often appear far from the site of the real problem. Owners might notice diagonal symptoms which occur when a horse has an injury in its front left leg, for example, but displays a problem in its right hind.
"The focus of Rolfing is to organize systematically the body's network of soft connective tissue to improve its form and balance, thereby enabling the client to function at successively higher levels of efficiency and ease.
"Horses, as well as humans, often find their physical performance inhibited by stress, by heavy training, or by tissue restriction from old injuries. Continued training results in further movement restrictions and often pain. Releasing restrictions in the fascia allows the muscles to re-establish a balanced relationship with each other.
"Although Rolfing can alter the balance and structure of a horse, it is a supplement--not a replacement--to good veterinary care and training. And, as with any kind of intensive body work, it's best not to Rolf a horse that is suffering from any inflammatory conditions or bacterial or viral infections. Rolfing won't help the condition and could possibly aggravate it."
In a typical session, the Rolfer starts with the horse's rear quarters and works his or her way up to the withers and neck. After a Rolfing session, says Reams, the horse needs several days to adjust to physical changes initiated by the Rolfing session and to "sort out the results."
Reams recommends light training for two or three days while the horse makes these adjustments. The full effects of a session, he says, generally are realized within two weeks, but he encourages a three- to four-week interval between sessions unless the horse has an acute problem that requires a more aggressive program of treatment.
Most horses, says Reams, not only allow Rolfing, but also facilitate it by directing him toward specific areas or by leaning their bodies into him, creating additional pressure that releases tightened tissue.
Still another form of massage is known as Tragering, named after the man who developed it--Milton Trager. Tragering combines mechanical soft tissue mobilization and neurophysiologic re-education. Unlike Rolfing, Tragering has no standardized procedures or protocols. The Trager system uses gentle, passive, rocking oscillations of a body part. This technique does not attempt to make mechanical changes in the soft tissues, but it attempts to establish neuromuscular control so that more normal movement patterns can be routinely performed. Essentially, it uses the nervous system to make changes rather than making mechanical changes in the tissues themselves.
Other Types of Massage
The list of massage techniques and approaches doesn't stop there. While
the sports massage approach is the classic form for most equine massage therapists, with its variety of strokes as described by Winter, there are these forms as well:
Friction Massage--Used to increase the inflammatory response, particularly in cases of chronic tendinitis or tenosynovitis, this technique is performed by making small circular movements using the tips of the fingers, the thumb, or the heel of the hand.
Connective Tissue Massage--This is a stroking technique carried out in the layers of connective tissue on the body surface. This stimulates the nerve endings of the autonomic nervous system. Afferent (bringing inward to a central part) impulses travel to the spinal cord and brain, causing a change in reaction susceptibility. This technique is used more widely in Europe than in the United States.
Acupressure Massage--This type of massage is based on the ancient Chinese art of acupuncture. The therapist will locate the key acupuncture points and massage them.
Myofascial Release Massage--This is essentially a form of stretching designed to relieve soft tissue from the abnormal grip of tight fascia.
As is the case with each and every modality, massage, in whatever form, is not a cure-all, and there are situations where it should not be used.
Porter provides these comments relative to inappropriate use of massage:
"There are a few cautions that must
be observed when making use of massage. Lesions caused by bacterial or viral infection must be avoided. The skin over the affected area must be intact. Massage should notbe applied to a torn muscle or to an area with internal bleeding, such as an acute hematoma. Massage should not be given when there is a possibility of dislodging a thrombus. The condition of phlebitis and inflammatory arthritis should not be massaged. Massaging areas of calcification in the soft tissues will increase the inflammation in these areas and should be avoided.
"Always apply massage before exercise, rather than after. Massage will help prepare the horse for exercise, but may aggravate an injury after exercise. One should have complete knowledge of the horse's state of health before ap-plying massage. Veterinary consultation is always required for effective treatment."
Porter even adds a word of advice for the massage therapist:
"Professional massage therapists often develop arthritis in the fingers and wrists. The therapist should prepare for the massage session with warmup and stretching exercises for the hands and wrists and maintain forearm strength to avoid injury."
Although it isn't a cure-all, massage can be beneficial in treating a variety of conditions, including chronic pain, and it can serve as an injury preventative.
About the Author
Les Sellnow is a free-lance writer based near Riverton, Wyo. He specializes in articles on equine research, and operates a ranch where he raises horses and livestock. He has authored several fiction and non-fiction books, including Understanding Equine Lameness and Understanding The Young Horse, published by Eclipse Press and available at www.exclusivelyequine.com or by calling 800/582-5604.
POLL: University Equine Hospitals