Stroke is clinically characterized by sudden fainting, hemiplegia, facial and ocular deviation, or aphasia, with numbness of one side of the body as the main symptom. Massage therapy for stroke can dilate blood vessels, promote the circulation of qi and blood, and accelerate the absorption of therapeutic drugs, which helps facilitate stroke recovery. So, what is the procedure for stroke massage?
Principles of Stroke Massage Therapy
Stroke massage therapy is mainly suitable for meridians and collaterals and sequelae after stroke, with the principle of dredging meridians, regulating qi and blood, and promoting functional recovery. Patients with visceral organ disorders should receive comprehensive rescue treatment. Stroke massage focuses on acupoints in the head and face, upper limbs, waist and back, and lower limbs.
Massage Techniques for the Head and Face
1. The patient lies supine, and the masseur kneads and massages from the Yintang acupoint (the midpoint of the line connecting the eyebrows) to the Shenting acupoint.
2. Sequentially press the Yintang acupoint to Jingming (depression above the inner canthus of the face), Yangbai (1 inch above the forehead, above the midpoint between the eyebrows and the line connecting the pupils), Yuyao (midpoint between the pupils and the eyebrows), Taiyang (horizontal line from the outer end of the eyebrows to the midpoint of the outer canthus), Sibai (depression below the pupils, at the lower orbital foramen), Yingxiang (beside the midpoint of the outer edge of the nasal wing), Xiaguan (depression in front of the ear in the face, when the mouth is opened, it bulges), Cheche (1 inch above the front of the jaw angle in the cheek, where the masseter muscle bulges when chewing), Dicang (outside the corner of the mouth in the face, on the line directly opposite the pupils), Renzhong (1/3 above the philtrum), and other acupoints. Perform 1-2 rounds, then press the Baihui acupoint for 1 minute, and massage from Baihui to the side of the head, back and forth several times, with strong intensity, to achieve a slight distending pain. Knead the Fengchi acupoint for 1 minute, and gently spasm the facial muscles on one side with the base of the palm.
Benefits of Massage: According to traditional Chinese medicine, "the head is the residence of wisdom and the gathering place of all yang." Head and face massage can directly stimulate the vascular system connected to the cerebral cortex, promote blood circulation in the brain, dredge meridians, and enhance the ascending and clearing yang qi.
Massage Techniques for the Upper Limbs
1. Relax the muscles of the shoulders and neck.
2. Point pressure on Jianzhu (between the shoulder peak and the greater tubercle of the humerus), Jianyu (at the midpoint between Jianzhu and Quchi), Quchi (at the midpoint between the outer side of the elbow and the outer upper tubercle of the humerus), and Hand Sanli (2 inches below the transverse crease of the elbow on the back of the forearm).
Jianzhu: At the upper part of the trapezius muscle, between the shoulder peak and the greater tubercle of the humerus, when the arm is extended outwards or forwards, there are two depressions below the shoulder peak, and the depression in front and below the shoulder peak is the Jianzhu acupoint.
Jianyu: On the outer side of the arm, at the midpoint between Quchi and Jianzhu, 7 inches above Quchi.
Quchi: At the midpoint of the line connecting the outer edge of the elbow crease and the outer upper tubercle of the humerus when the elbow is flexed at 90°.
Hand Sanli: On the back of the forearm on the radial side, at the midpoint between Yangxi and Quchi, 2 inches below the transverse crease of the elbow.
3. Shake the shoulder joint.
4. Rub from the shoulder to the forearm, and twitch the affected limb.
5. Twist and stretch each finger.
Benefits of Massage: During the relaxation phase of stroke, there is qi deficiency and blood stasis, resulting in poor blood circulation and blockage of channels and collaterals. Qi deficiency hinders blood circulation, and stagnant qi and blood hinder the transport of qi and blood. By pressing the root acupoints, the purpose is to stimulate the flow of qi, promote unobstructed qi and blood in the affected upper limb, and restore its function.
Massage Techniques for the Waist, Back, and Lower Limbs
1. Knead the back.
2. Press the Jiaji acupoints (0.5 inches on both sides of the midline of the back) from top to bottom. Massage the pressure points on the back (1.5 inches on both sides of the midline of the back).
3. Massage and press the acupoints on the lower limbs, such as Huantiao (outer lower part of the buttocks, 1/3 outside the line connecting the most prominent point of the femoral trochanter and the sacral hiatus), Chengfu (middle point of the horizontal line below the buttocks), Weizhong (middle point of the popliteal crease, between the tendons of the biceps femoris and the semitendinosus), Chengshan (middle point of the line connecting the middle point of the popliteal crease and the tip of the lateral malleolus, when the calf or heel is raised, a sharp depression appears below the gastrocnemius), Taixi (depression between the tip of the medial malleolus and the Achilles tendon), and Kunlun (depression between the tip of the lateral malleolus and the Achilles tendon).
4. Knead and rub the anterior side of the lower limbs.
5. Press the acupoints on the anterior side of the lower limbs, such as Xuehai (bend the knee, grasp the knee cap with the palm of the hand facing upwards, and the fingertip of the thumb is the acupoint), Yanglingquan (at the front and below the head of the fibula), Yinlingquan (push along the inner edge of the tibia with the thumb until resistance is encountered, and the depression below the bone is the acupoint), Sanyinjiao (four fingers together, with the little finger touching the acupoint above the tip of the medial malleolus, the intersection of a parallel line above the upper edge of the tibia), and Taixi (depression between the tip of the medial malleolus and the Achilles tendon).
Benefits of Massage: Through massage techniques, tendons and collaterals can be relaxed and activated, meridians can be unblocked, qi and blood can be invigorated, and muscles can be nourished, thereby improving the motor function of the affected lower limb and promoting the circulation of qi and blood in the lower limb, which helps relax joints, ligaments, and joint capsules, and relieve spasms.
Appropriate Time for Stroke Massage
The duration of stroke directly affects recovery. Therefore, it is important to treat the disease as early as possible. Generally, massage therapy is mainly used during the recovery and sequelae stages of stroke. After the stroke, when the condition is relatively stable, massage therapy can be administered.
During the first six months, the focus is on promoting blood circulation and resolving stasis. After six months, the focus shifts to replenishing qi and blood, in order to support the body and strengthen tendons and bones. At the same time, passive movement of the affected limb joints should be strengthened. If the disease has lasted for more than one year, the effectiveness of massage therapy is limited.
Appropriate Symptoms for Massage: Hemiplegia, limb paralysis, facial and ocular deviation, speech disorders, swallowing difficulties, accompanied by facial numbness, limb numbness, heaviness, hand tremors, and pain.
Precautions for Stroke Massage
1. Stroke treatment takes a long time, and the stimulation intensity, duration, and focus areas of the massage should be adjusted according to changes in the condition.
2. It can be appropriately combined with traditional Chinese medicine, acupuncture, physiotherapy, and dietary therapy.
3. During the recovery period, the patient should engage in whole-body exercise and simple activities, strengthen functional exercises of the affected limb, but avoid excessive exercise or excessive fatigue.
4. During treatment, the patient should maintain stable emotions, live a regular life, avoid stimulating foods such as tobacco, alcohol, and spicy foods, as well as excessive intake of fatty foods.
5. Massage therapy should not be used for patients with severe liver or kidney dysfunction, congestive heart failure, respiratory failure, electrolyte imbalance, severe malnutrition, new infarction or bleeding, recurrent condition, severe consciousness, mental or functional disorders, dementia, unclear speech, and inability to communicate.
