This document provides an overview of massage therapy and hydrotherapy. It discusses the history and techniques of massage therapy, as well as how massage impacts various body systems like the muscular, skeletal, nervous and cardiovascular systems. It also covers hydrotherapy modalities like hot/cold applications and whirlpools. Vescent dry hydrotherapy is introduced as a modality that combines the benefits of massage, heat and hydrotherapy through water movement without getting the body wet.

1. Massage Therapy & Hydrotherapy
An Overview

2. Purpose
The purpose of this module is to provide
you with a basic knowledge and
understanding of the methodology,
science, technique and effects of massage
therapy and the industry as a whole.

3. Learning Objectives
Upon completion of this module you will be able to:
• Comprehend how and why massage therapy, in
conjunction with heat and hydrotherapy, effects the body.
• Communicate with massage therapists and clinicians with a
shared understanding of the industry, using the appropriate
terminology.
• Demonstrate the correlation between the effects of
massage, heat and hydrotherapy and how Vescent
equipment incorporates these elements into an all-
inclusive modality.

4. What is Massage Therapy?
• By Definition:
– a variety of techniques using the hands, mechanical or
electrical apparatus to manipulate muscles and other soft
tissue with the intent of improving well-being or health.
• This is a general term for a range of therapeutic
approaches with roots in both Eastern and
Western cultures.

5. History of Massage
• Massage Therapy is one of the oldest healthcare
methods.
• References to massage are found in Chinese
medical texts 4,000 years old.
• In 4th
century B.C., Hippocrates (“father of
medicine”) wrote:
– “The physician must be acquainted with many things and
assuredly with rubbing”

6. History of Massage
• 1817: The father of massage therapy in the
United States, Cornelius E. De Puy, MD,
published the first journal on the subject in 1817.
• Early 1900’s: physician’s began prescribing
massage as the healthcare system in the U.S.
became more influenced by biomedicine.

7. History of Massage
• 1930-1940: massage therapy virtually
abandoned by medical professionals due to
its labor-intensive nature.
• 1970: New interest surges in massage
therapy in the realm of alternative health
care, thereby revitalizing the field.

8. What is the Minimum Schooling
Required for a Massage Therapist?
• No national standard for regulating massage.
• Only 30 states and Washington D.C. regulate massage.
• Massage therapists are licensed (LMT) or registered
(RMT).
• Many massage therapists have also been "certified"
(CMT) by specific school, bodywork organization, or
national regulating body.
• Training hours required vary from state to state

9. Massage Practice Requirements in
Florida
• Regulated by the Florida Dept. of Health
• 500 hours from state board approved school or
completed 1,453 hours apprentice program.
• 3 hours HIV / Aids education
• CEU: 12 hours every two years and 3 hours
HIV/AIDS update classes

10. National Certification
• National Certification Board for Therapeutic
Massage and Bodywork (NCBTMB):
– administers the National Certification Examination
– certifies massage therapists who pass the exam
– maintains their status through continuing education.
• Certification represents the highest professional
credentials in the field.

11. Where Do Massage Therapists Work?
• Top Five:
– Private Practice :35.2%
– Freelance/Home: 23.8%
– Chiropractic Clinics: 6.5%
– Health Clubs 5.8%
– Beauty Salons/Spas: 2.4%
• Other:
– Physical Therapy Clinics
– Sports Teams
– Wellness Clinics

12. The Massage Industry Today
• Growth! Within the last eight years:
– The number of massage therapists in the
United States has increased approximately
41%.
– The number of adult Americans who say they
have had a massage in the previous 12 months
has more than doubled.

13. Why is the Industry Growing?
• 1992: Touch Research Institute (TRI)
established by Director Tiffany Field, Ph.D. at
the University of Miami School of Medicine
(http://www.miami.edu/touch-research)
• Increased Awareness of the Benefits of
massage:
– within the medical field
– by insurance companies
– among consumers (primarily ‘Baby Boomers’)

14. Why People Get Massages
• To get relief from injuries and certain
chronic and acute conditions
• To help them deal with the stresses of
daily life
• To maintain good health
• IT FEELS GOOD!

15. Why People Don’t Get Massages
• Fear
– Disrobing (body image, modesty)
– Stranger touching them (distrust, embarrassment)
– Doesn’t feel good; hurts (stereotype of therapist)
• Myths
– It’s sexual (massage “parlors”)
– No real health benefits (superficial rub)
– Luxury Expense (nice if you’re rich; not associated
with maintaining wellness)

16. "Massage is to the human body what a tune up
is to a car. It provides a physical and mental
boost to the weary, sore, and stressed..."
— Chicago Tribune, April 6, 1995

17. Scientific Studies on the Effects of
Massage Therapy
• Increases lymph flow rate by seven to nine times.
• Reduces edema.
• Three studies show that massage increases activity level
of the body’s natural "killer cells.”
• Stimulates the brain to produce endorphins, the body’s
natural pain killer.
• Reduces acute and chronic pain and increases muscle
flexibility and tone.
• Reduces anxiety levels for employees.

18. Effects of Massage on the Body &
Systems
• Massage Therapy:
– improves functioning of the circulatory, lymphatic,
muscular, skeletal, and nervous systems.
– can help with a wide range of medical conditions
– “benefits” can bring about harm (contraindications)

19. Massage Strokes
• Effleurage – long, rhythmic stroke
• Petrissage – “milking” or kneading
• Friction – deep, narrow, non-gliding
stroke
• Tapotement – brief, brisk, rapid: light
striking
• Vibration – tremulous, somewhat gliding

20. Demonstration

21. Cells, Tissues, Organs
• Cells-the building blocks of the body
• Tissues-any group of cells that perform
specific functions
• Organs-any group of tissues that perform
specific functions

22. Fascia
• Complex, supportive web of tissue
• Covers, supports and separates muscles
and organs
• Unites skin with underlying tissue
• Retains tensions from physical and
emotional traumas; chronic pain

23. Connective Tissue:
“The Ties That Bind”
• Bone: "structural frame" for the human
skeleton that provides movement
• Tendons: connect muscles to bones.
• Ligaments: connect muscles to muscles.
• Fascia: covers and supports muscles and
organs

24. Meet ADAM!

25. Muscular System
• Muscle—tissues composed of fibers that
effect movement of organs and body parts.
• Acts as a lever to create movement:
– Shortens
– Contracts
– Relaxes
– Never lengthens

26. How Massage Impacts the
Muscular System
• Increases the blood supply and nutrition
to muscles without adding to their load of
toxic lactic acid, produced through
voluntary muscle contraction.
• Stretches connective tissue, improves its
circulation and nutrition.

27. Results Produced By Massage On
Muscular System
• Helps reduce the danger of fibrosis
– Scar tissue
– Collagen breaks down due to chemical
imbalance or injury
– Causes muscle tissue to harden and stick
together: adhesions

28. Results Produced By Massage On
Muscular System
• Improves muscle tone
• Helps prevent or delay muscular atrophy
– Weakening or loss of muscle tone/mass
– Due to inactivity; lack of use

29. Results Produced By Massage On
Muscular System
• Massage relieves tension and relaxes
muscle spasms
– Acute contraction of muscle
– Due to chemical imbalance or injury
– Causes sharp, deep, pervasive pain
– “Charlie Horse”

30. Effects of Massage:
Skeletal System
• Improves the circulation and nutrition of joints
and hastens the elimination of harmful particles.
• Helps lessen inflammation and swelling in joints
and so alleviates pain.
• Massage encourages the retention of nitrogen,
phosphorous and sulfur necessary for tissue
repair in persons convalescing from bone
fractures.

31. Communication Systems:
Nervous and Endocrine
• Interface as the master communicators,
integrators and regulators of our bodies.
• Goal: maintain homeostasis (the
maintenance of the internal environment
within tolerable limits)

32. The Nervous System
• The body's information gatherer, storage center
and control system.
• Overall function: collect, analyze and initiate
appropriate responses in relation to the body's
external state.
• The nerves do not form one single system, but
several which are interrelated
• The brain and spinal cord make up the central
nervous system.

33. The Endocrine System
• Releases hormones and body chemicals into the
bloodstream, enabling them to circulate
throughout the body.
• Most body chemicals are specific in their actions,
and will therefore only affect specific targets.
– Cortisol: stress hormone
– Endorphins: ‘natural pain killers’
– Seratonin: induces feelings of well-being

34. How Massage Impacts
The Nervous & Endocrine Systems
• Massage may have a sedative, stimulating, or
even exhausting effect on the nervous system,
depending on the type and length of massage
treatment given.
• Increases serotonin.
• Decreases cortisol levels.
• Increases release of endorphins; analgesic effect
(gate theory.)

35. Demonstration

36. Transport Systems:
Cardiovascular, Lymphatic and Respiratory
• Transportation of fluids, cells and gases is a
crucial function of these three systems.
• The basic action of these systems enable:
– Proper gas exchange to take place
– Oxygenation of the cells to occur
– Cellular removal of wastes to take place

37. Blood
• Blood is the only fluid form of tissue in the body
• Blood is a form of connective tissue, consisting of
living cells and non-living fluid (plasma.)
• “Whole Blood” is a term used to describe both
the formed elements and the plasma.
– Formed elements: red blood cells (RBCs), white blood
cells (WBCs) and platelets.
– Functions involve transportation, regulation and
protection.

38. Functions of Whole Blood
Transportation Regulation Protection
•Transports oxygen from
the lungs and nutrients
from digestive tract to all
cells of body
•Absorbs and distributes
body heat, regulating core
body temperature
•Protects from blood loss
through clotting
mechanism
•Transports metabolic
waste products from cells
to elimination sites
•Regulates PH in body
tissues
•Protects from infection,
defending the body from
bacteria, virus and toxins
•Transports hormones
from endocrine organs
•Regulates adequate fluid
volume

39. How Massage Impacts
The Cardiovascular System
• Improves the general circulation and nutrition of
tissues.
• Increased interchange of substances between the
blood and tissue cells; heightens tissue
metabolism.
• Dilates or opens up blood vessels, improving the
circulation and relieving congestion.
• Increases the number of red blood cells.

40. The Lymphatic System
• Filters waste from tissues via lymph:
– Collects fluids not absorbed at capillary level
in tissues
– Returns these fluids back into the
bloodstream
• Defends against bacteria and disease

41. How Massage Impacts
The Lymphatic System
• Strengthens immune function by increasing
number of “natural killer” T-cells.
• Massage acts as a "mechanical cleanser“:
– open system vs. closed
– no barriers to function
• Reduces edema.

42. Demonstration

43. The Respiratory System
• Function:
– Supply cells in the body with oxygen
– Dispose of carbon dioxide cell waste
• Respiration= inhalation + exhalation
– Inhalation: breathing in, inhaling. Air is transported to
the lungs.
– Exhalation: breathing out, exhaling. Gases are leaving
the lungs.

44. How Massage Impacts
The Respiratory System
• Increases oxygenation via red blood cells.
• Stimulates expectoration of mucus from
lungs.

45. Demonstration

46. Contraindications
• Despite the many benefits of massage,
these “benefits” can also bring about harm
with certain medical conditions.
• See Contraindication handout

47. Thermal Therapy
• Deep Heat—penetrates tissues beyond the
superficial level.
– ultrasound
– electrical stimulation
• Superficial Heat—does not heat deep tissues.
– hot packs
– Whirlpool
– Paraffin
• See “Modalities” handout

48. When to Use Superficial Heat
• Chronic pain from muscle spasms
• Muscle adhesions
• Joint conditions
• Arthritis
• Before or after chiropractic adjustments
• Before or after exercise

49. Thermal Therapy: Impacts
• “Superficial Heat”:
– Enlarges blood vessels just beneath skin.
– Increased blood flow causes a cooling reaction as it
removes the heat that is applied externally.
• Transfer of heat is classified into 3 general types:
– Conduction: direct contact between source and
tissues
– Conversion: heat transfers from source to body heat
– Convection: heat transferred by movement of source

50. Vescent Dry Hydrotherapy:
A Combination of Thermal Types
• Both conduction and convection:
– direct contact of source on body
– medium movement (water) transfers heat
• Not conversion or deep heat
• All-in-one modality

51. Shared Benefits of Massage and
Superficial Heat
• Helps increase circulation to speed healing
– Blood flow
– Vasodilation
• Encourages migration of “Killer T-Cells”
• Facilitates removal of waste from tissues
• Local analgesia (pain reliever)
• Relaxes muscles
• Reduces joint stiffness
• Increases flexibility and range of motion

52. Dry Heat vs. Moist Heat
• Dry heat pulls away your body’s natural
moisture and leaves your skin dehydrated
and prone to damage.
• Moist heat provides infusion of moisture
to the top layer of skin and prevents
moisture loss, thus maintaining improved
hydration of the skin and cells.

53. Vescent Dry Hydrotherapy:
A Heat Hybrid
• The barrier protects you from the water,
keeping users dry
• The moisture transferred via the water
provides the benefits of moist heat

54. Cryotherapy: Therapeutic Cold
• Primary effect: cools tissue to relieve acute
pain and swelling
• Common methods include cold packs, cold
immersion, ice massage (R.I.C.E.—Rest, Ice,
Elevation & Compression)
• Use the first 24 to 48 hours after injury;
immediately following trauma

55. Heat vs. Cold
• Cold treatments used for pain in the acute phase; heat
used for chronic pain.
• Heat treatments return muscle to normal temperature
more quickly than cold treatments.
• Increased tissue metabolism occurs with heat; decreases
with cold modalities.
• Blood flow increases with heat and decreases with cold.
• Heat increases blood/lymph flow to an area; cold
restricts.
• Joint stiffness is decreased with heating, increased with
cold.

56. Degrees
Fahrenheit
Description
of Sensation
Sensation
32 Ice Pain
32-34 Very Cold Pain and Numbness
55-70 Cold Sensation of cold
71-80 Cool Cool
81-92 Tepid Slightly Cooling
Body temp Neutral No Sensation
93-100 Warm Comfortably Warm
101-104 Hot Skin redness
105-110 Very Hot Tolerable for a short time
111-120 Painfully Hot Pain, possible tissue
damage
125+ Damaging Pain and tissue damage
Temperatures
For
Treatments

57. Hydrotherapy
• By definition:
– The use of water in any of its forms (solid,
liquid, vapor) for the treatment of disease or
the maintenance of health
– Mostly influencing:
• nervous system
• circulatory system
• skin.

58. Types of Hydrotherapy Treatments
• Whirlpool
• Baths
• Sauna
• Steam
• Local Heat/Cold
• Tonic Friction
• Showers

59. Vescent Dry Hydrotherapy
• The incorporation of medical and computer
technology that combines hydrotherapy,
massage therapy, soft tissue manipulation,
whirlpool therapy and heat in one modality.
• The combined benefits create a synergy effect
whereby the overall results exceed those
produced by each of these therapies separately.

60. Combined Effects of Vescent Dry
Hydrotherapy
• Simulates massage strokes:
– Effleurage (movement, contact)
– Petrissage (area massage)
– Tapotement (striking and vibration of water)
• Provides benefits of both massage and
thermal therapy.

61. Conclusion
• The benefits produced from Vescent Dry
Hydrotherapy incorporate multiple modalities
and therapies in a non-invasive manner.
• These benefits can greatly influence health and
help relieve pain associated with numerous
conditions.
• Just as the massage industry has progressed into
mainstream clinical and leisure environments, so
is Vescent Dry Hydrotherapy.