Abstract: Chinese massage is widely used in the treatment of dystonia, but it is difficult to quantify the change of muscle tension by massage in western medicine theory. In view of this problem, this paper expounds the therapeutic effect of TCM massage from the angle of the pathogenesis of muscle tension change and the therapeutic mechanism of TCM massage, and puts forward the author's experience on how to popularize TCM massage internationally.
Paper Keywords: TCM massage, muscle tension
1. Foreword:
Massage was also called guidance, shuttlecock pressing or massage at first. Massage therapy has a long history, which is recorded in Huangdi Neijing, the earliest existing medical monograph in China. According to the name, hold it with your hand, and the one you rub is to rub it slowly. ? ("Su Wen? The emergence of massage therapy in "Su Wen? It is also recorded in On Different Laws:? People in central China eat miscellaneous food without fatigue, so their diseases are mostly flaccidity, cold and heat, and the treatment should be guided by stilts. ? It can be seen that massage therapy was initially adapted to the cold and heat symptoms of flaccidity and syncope, and gradually expanded its scope of adaptation in the long-term medical practice. With the continuous improvement of TCM theory, the indications of massage therapy developed from paralysis, cold and heat at first to Qing Dynasty, and it can treat hundreds of diseases in internal medicine, gynecology, pediatrics, surgery, facial features and other disciplines. [1] However, Chinese massage is particularly effective in treating motor system diseases, such as muscle spasm, soft tissue injury and muscle atrophy. The above-mentioned motor system disorders are mostly manifested as changes in muscle tension. This article will discuss the influence of TCM massage on muscle tension.
2. Analysis of muscle tension change.
Muscle tension is the force produced by the mutual traction of muscle cells. The tension of muscles at rest and relaxation is called muscle tension. Muscle tension is the basis of maintaining various postures and normal movements of the body, and its manifestations are various. For example, when people are resting at rest, the tension of muscles in various parts of the body is called static muscle tension. When the body stands, although the muscles do not contract obviously, the muscles in the front and back of the body also maintain a certain tension to maintain the standing posture and the stability of the body, which is called postural muscle tension. Muscle tension during exercise, called exercise-induced muscle tension, is an important factor to ensure sustained and stable muscle movement (no trembling, convulsions and spasms). The generation and maintenance of muscle tension is a complex reflex activity, in which muscle tension reflex receptors (neuromuscular spindles and neuromuscular spindles) distributed in muscles receive signals, and then the A motor neurons in the anterior horn cells of the spinal cord and the motor nucleus of the brain stem dominate the outer spindle muscle, while the R motor neurons send out ar fibers to reach and dominate the inner spindle muscle. Pathological changes in any part of reflex arc will cause changes in muscle tension. There are two kinds of changes in muscle tension in clinic, namely, the decrease of muscle tension and the increase of muscle tension. Now discuss these two situations separately with massage.
2. 1 Decreased muscle tone
The decrease of muscle tension refers to the decrease of resistance encountered by the active body when the muscle relaxes, and the muscle relaxes due to the absence of swollen abdomen and normal toughness. The clinical manifestations may be different due to different injury sites. When the anterior horn of spinal cord is damaged, it is distributed by segments, accompanied by muscle weakness, atrophy, no sensory disturbance and muscle fiber tremor. Peripheral nerve injury is often accompanied by muscle weakness, atrophy, sensory disturbance and tendon reflex. Muscle tension of some muscles and nerve joints decreased, muscle weakness, with or without muscle atrophy, no muscle fiber tremor and sensory disturbance. The damage of proprioceptive fibers of spinal cord or peripheral nerves is often accompanied by the disappearance of sensation and deep reflex, and walking is characterized by sensory ataxia gait. When the cerebellar system is damaged, it is accompanied by exercise ataxia and staggered walking. Neostriatal lesions are accompanied by dance-like movements. In view of muscular atrophy caused by nervous system diseases, massage can enhance muscle tension and elasticity, and increase its contraction function and muscle strength. The principle is that massage can increase the number and diameter of capillaries in this part and greatly improve blood circulation. At the same time, it can promote the reconstruction of vascular network in muscle atrophy, restore the elasticity of vascular wall, improve the patency of pipeline and reduce the external friction of blood flow. All these can slow down the atrophy process of atrophic muscle tissue, thus improving the elasticity of muscle tendon and relieving the adhesion between muscle tendon and surrounding tissues. In the case of decreased muscle tension, we often use lighter techniques to retreat, which can stimulate motor nerves, improve muscle excitability and increase muscle tension elasticity.
2.2 Enhance muscle tension
Increased muscle tension can be divided into spasms and rigidity. Spastic muscular tension is increased with pyramidal tract damage, and spinal cord reflex is facilitated. When patients passively move their joints, they will feel impedance when muscle tension increases, which is related to the speed of being moved. Tension dystonia is seen in some special tension changes of extrapyramidal diseases, and its increase is selective, mainly in adductor, flexor, pronator of upper limbs and extensor of lower limbs. The resistance of passive exercise patients is generally smaller than that of spasticity patients, but it has nothing to do with the length of muscles at that time, that is, the contraction form, and there is no difference between extensor and flexor muscles. Regardless of the speed, amplitude and direction of the action, the same resistance is encountered. This increase in muscle tension is called lead tube rigidity, and if accompanied by tremor, it will produce alternating changes of looseness and tightness, which is called gear rigidity. In addition, muscle spasm, pain and fatigue will also occur after high-intensity exercise, because lactic acid, an intermediate product of metabolism, is produced in large quantities and deposited in muscle tissue. After clinical treatment, massage combined with drugs can reduce the tension of muscle tissue with strong tension. In addition, massage therapy for fatigue-induced muscle tension can promote the dissipation and discharge of lactic acid, relieve pain, eliminate fatigue and reduce muscle spasm. At the same time, massage therapy is beneficial to the expansion of capillaries in muscles and the opening of reserve capillaries. Traditional Chinese medicine believes that under the action of massage, there are 40 times more capillaries in the cross section of muscle than before, the blood flow velocity and flow pattern in microcirculation are improved, the transport and degradation of active substances in the body are accelerated, and the excretion of inflammatory substances is promoted [2], which is conducive to peeling adhesion, regulating tendons and promoting granulation, and promoting the repair of damaged muscle tissue; Therefore, it has a good effect on rapid functional recovery, short rehabilitation period and disappearance of sequelae. In addition, the increase of muscle tension is often accompanied by the limitation of joint activity. For example, ankle injury is the most common sports injury, mainly the injury of lateral collateral ligament. After the injury, the ankle is swollen and painful, and the tenderness is obvious. If you can't walk or can barely walk, you can use massage. Massage can promote local blood circulation, eliminate edema and stagnation, improve metabolism, help loosen adhesion, lubricate joints, correct tendon grooves and dislocations, and restore normal physiological functions of joints. [3]
3 Overview
Traditional Chinese medicine regards the human body as a unified whole, and at the same time thinks that man, nature and society are also an inseparable whole. This holistic concept runs through all fields of Chinese medicine, and massage clinic is no exception. [4] Under the guidance of western medicine, people are used to diagnosing and treating diseases simply from local anatomy and modern pathological knowledge, while western medicine has doubts about the accuracy and quantitative methods of Chinese medicine treatment, which makes it difficult for us to promote Chinese medicine internationally. How to guide the clinical practice of massage with the holistic concept of traditional Chinese medicine and quantify the pertinence and accuracy of its curative effect is an important topic worthy of serious and in-depth consideration.
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