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Medical massage in cases of bronchial asthma PDF Print E-mail

Bronchial asthma and bronchitis are very common disorders of the respiratory system. Various factors can cause bronchitis and asthma – viral infections, allergic reactions, etc. Massage therapy and bronchial drainage can play an important role in treatment and management of the aforementioned disorders. We can assume that in cases of bronchitis & bronchial asthma the activities of the sympathetic nervous system are diminished. Massage therapy has the capability to depress or stimulate the divisions of the autonomic nervous system and can be an invaluable tool in depressing the parasympathetic activities, thereby balancing the activities of the sympathetic and parasympathetic nervous system.


All of the body’s proprioreceptors have various levels of adaptation (their capability to produce action potentials). By deforming these receptors; touch receptors, pressure receptors, etc; we stimulate the creation of electric impulses. Massive stimulation of receptors allows us to affect the activities of different subdivisions of autonomic nervous system according to our needs.

Before treatment it is very important to perform the dermographism test to determine an imbalance between the activities of the sympathetic and parasympathetic nervous systems. This test is performed in a few strokes with a semi-sharp object (corners of the fingernails will do) on the paravertebral zones from approx L/S to the neck. The initial white dermographism changes to red dermographism which disappears in a short amount of time. The white dermographism should change to red within 30 seconds. When red dermographism stays for a prolonged time, sometimes even becoming raised lines with a kind of edema, this is evidence that the parasympathetic nervous system is in much more active tone. If it changes very quickly from red back to white, or stays white, it is a sign that the sympathetic nervous system is much more active. In cases of bronchial asthma and bronchitis we automatically assume that the parasympathetic activities are in domination.

In other cases we work in the inhibitory regime as an attempt to depress activities of the sympathetic nervous system. In the case of asthma, it should be opposite – the massage must be intensive, with the techniques mobile, not staying in one place like the inhibitory regime.

Steps

The strokes must be very intensive. No light touch, no effleurage

  1. Back of the fingers, 5-6 times on each side
  2. Back of the fingers cross-fiber direction on paravertebral zones
  3. Back of the fingers from the top of the trapezius to the middle back.
  4. Back of the fingers rotations for the top of the traps
  5. Fingertips petrissage bilaterally on the neck muscles.
  6. Power thumb strips for the upper back area.
  7. Petrissage #7 (with knuckles) for the upper back area (after massive connective tissue massage in reflex zones this is the way to intensify the
  8. Petrissage on neck, up and down.
  9. Comb the ribs
  10. Petrissage #3 for the neck
  11. Petrissage 1 and/or 2 for the upper trapezius
Paravertebral zones will not be in one place. We take a fold in towards us with our knuckles, only to be careful not to press on the spinal processes. The intensive part should be 1-15 minutes. Elbow can be utilized, or knuckles, but all techniques should be performed in an intensive manner. 

The approach is simple – intensive stimulation. Prolonged stimulation and creation of action potential under our hands, (the inhibitory regime) creates stimulation of the parasympathetic nervous system and will not contribute to therapeutic effect in, but oppositely, can even cause the person to have an asthma attack on the table. We want to depress the activities of the parasympathetic nervous system by doing this intensive massage for 20 minutes. Please don’t confuse “intensive massage” with aggressive massage. We must take care to not activate the protective muscular constriction.

It is very important to perform the vacuum/suction tapotement. In cases of bronchial asthma and bronchitis we perform this technique for a much more prolonged time than in cases of other treatments. Application of vacuum techniques should be focused on upper and middle back. It is very important to perform this technique correctly – when performed right, the hand makes a hollow sound as it strikes the skin.

After the massage we perform bronchial drainage. In cases of bronchitis and bronchial asthma, it’s not only mucous which obstructs the airways causing breathing difficulties, but also the higher tonus of the smooth muscles of the respiratory system. The bronchial drainage techniques are a kind of breathing exercise. When the patient exhales, we squeeze his diaphragm like a ball, squeezing as much air as possible from the capacity of lungs. At the point of maximum exhale, we ask the patient to start coughing. This causes a kind of stretching and exercise for the bronchi as well as allowing the drainage of mucous from bronchial structures. This kind of bronchi manipulation which cause removing- drainage of the mucous and thus help prevent bacterial infection and possible subsequent development of pneumonia. Additionally bronchial drainage techniques will also reduce the tension in the bronchial smooth muscles and contribute to restoration of normal metabolism in these tissues encouraging the swelling and inflammatory condition to go away little by little.

For the bronchial drainage procedure it is important to be prepared with napkins/ paper towels and a nearby wastebasket so that the client can spit up the sputum/mucous.

Client should be standing
Stand behind client and ask client to bend knees,
Wrap arms around client’s midsection slightly under ribs, clasp hands in front of diaphragm

Direct client to inhale, and simultaneous with his/her slow exhale begin to lean the client forward while constricting arms, compressing the client’s diaphragm.
When maximum compression/ expulsion of air is reached, instruct the client to cough. The client at this moment should be sort of draped forward over the clasped arms of the therapist. This leaning over position helps make the compression of the diaphragm more effective, especially considering the shaking during the client’s coughing.
*It is important to motivate the client to put effort into the cough to achieve maximum drainage of the bronchial airways.
Instruct the client to cough freely (no compression) to remove the mucous released during the compressed coughing. It is helpful to perform cupping techniques during this free coughing.
Encourage the client to spit up the mucous and not swallow it.
Repeat this procedure 5-7 times.

In general, the massage therapy and the bronchial drainage procedure should take approximately 35-40 minutes. Given the fact that bronchial asthma and/or bronchitis is a medical condition, the client must consult with the doctor to make sure that this kind of breathing exercise/ manipulation is acceptable.