Popular Science Monthly/Volume 44/March 1894/The Action of Massage Upon the Muscles
By DOUGLAS GRAHAM, M. D.
THAT "science follows art with limping strides," as so well expressed by an able physician, is perhaps nowhere oftener seen than in the various branches of the practice of medicine. Experience has taught us from time immemorial the value of massage as a nerve and muscle tonic, and, like all good things, the possibility of its overuse. But the recent experiments of Prof. Arnaldo Maggiora, of the University of Turin, so clearly and beautifully detailed in the Archives Italiennes de Biologie (tome xii, page 225), have demonstrated that this matter can be brought into the sunny light of exact science and away from the somber shades of quackery, where it has been so long relegated by the vast majority of the medical profession. Zabludowski, it is true, had in part prepared the way for this by showing that when after fatigue from a definite amount of work a rest of fifteen minutes was insufficient to restore the tired muscles to their former vigor, after massage for five minutes they were capable of doing as much work as before, and after massage for fifteen minutes they could do twice as much work as at first.
Prof. Maggiora endeavored to ascertain:
1. The action of massage upon muscles in a state of repose. For this purpose the fatigue curves of the right and left middle fingers in maximum voluntary flexion every two seconds with a weight of three kilogrammes (6·6 pounds) were taken at 8 and 11 a. m., at 2 and 5 p. m., and the following day the fatigue curves of the same muscles with the same weight and rhythm were taken after mixed massage (friction, percussion, and kneading) for three minutes at the same hours of the day. The average result showed that the muscles did almost twice as much work after massage as they did before. The average of the work without massage was 4·352 kilogrammes for the left middle finger, but after massage of the finger and forearm the average was 8·019 kilogrammes before extreme fatigue stopped further contractions. An analogous series of experiments was next made in which the electrical current was employed to tire the muscles by applying it directly to them, and also to the median nerve. The results without and with massage were similar to the first series, and showed that it takes much longer to fatigue the muscles by contraction from electrical irritation after massage than before.
2. The next series of experiments were undertaken with a view to determine whether the beneficial effects of mixed massage (friction, percussion, and kneading) increased in proportion to the duration of its application. At 8 a. m. the normal fatigue curve was taken, then every two hours and a quarter after this the curve was taken, having been preceded by two, five, ten, and fifteen minutes of massage of the right and left middle fingers and their corresponding muscles in the forearm. Ten fatigue tracings were thus taken, and the result showed that with five minutes of massage all the useful effect that could be produced was obtained. When the massage was continued longer, for ten or fifteen minutes, there were but slight variations in the amount of work above and below that after five minutes. Similar experiments were made in which electricity was used to tire the muscles in place of voluntary flexion, and the same result was obtained.
3. The object of the next series of experiments was to ascertain the effects of the principal maneuvers of massage—friction, percussion, and pétrissage, or kneading. The mode of procedure was as before: first, the normal fatigue tracing was taken; then at regular intervals during the day, every two hours, the fatigue curve was inscribed after five minutes of friction or effleurage, after five minutes of percussion, after five minutes of pétrissage, and finally after five minutes of friction, percussion, and petrissage alternating. The results showed that there was very little difference in the work that could be accomplished after five minutes of friction as compared with five minutes of percussion. But there was a great increase in the number and strength of the contractions after pétrissage. The best effect, however, was obtained after the alternations of all three. (It would be interesting to reproduce the tables and tracings if space allowed.) Like results were obtained when the contractions were produced by electricity applied to the median nerve or to the muscles directly, and the friction, percussion, and pétrissage employed separately and alternately.
4. The effects of massage upon muscles weakened from various causes were also studied in the same exact manner by Dr. Maggiora. Upon muscles weakened from fasting the effect of massage was to restore them temporarily, so that they gave normal tracings of fatigue; and the same result was obtained when the electric current in place of the will was used to tire the muscles.
5. As the result of general fatigue, the muscles of the hand were also tried in an indirect manner. Prof. Maggiora, after a walk of ten miles, to which he was not accustomed, took a tracing of the fatigue curves of the right and left middle fingers as before, and found that they were only capable of doing one fourth as much work as when he was rested. After massage for ten minutes they were so much temporarily rested that they did nearly a normal amount of work and gave nearly a normal tracing. The work probably would have been equal to normal had it not been for the superadded fatigue of taking the fatigue tracing half an hour before the massage; for it has been found that the muscles of the middle finger when tired by contractions with three kilogrammes every two seconds require about two hours' rest in order to give normal fatigue tracings every two hours during the day.
6. The effect of massage upon muscles weakened by loss of sleep was also inspected. In muscular fatigue from fasting rest alone does not restore them, and in fatigue from wakefulness nourishment alone affords no appreciable relief. After the loss of a night's sleep the fatigue curve was taken and found to be very small, but after ten minutes of massage it was temporarily restored to a natural curve, which could not be obtained on previous occasions by rest nor by nerve tonics alone.
7. Intense and prolonged intellectual work produces a state of general lassitude. After the final examination of twenty medical students, which lasted for five hours. Prof. Maggiora was much exhausted. He then took a fatigue curve of flexion of the middle fingers of both hands. This was only about one fifth normal. Half an hour later, after ten minutes of massage, the number of contractions was little less than natural, and might have reached natural-but for the fatigue induced by the preceding experiment.
8. After a slight attack of fever of ten hours' duration the muscles were weak the whole of the following day, but after massage the aptitude for work was increased so that the contractions of the fingers gave almost a natural tracing of fatigue.
9. The effect of massage upon anæmic muscles was most interesting. Dr. Maggiora demonstrated that anemia for a short time—from three to five minutes—produces phenomena in muscles similar to fatigue; or, in other words, lessens their vigor and resistance to work. Compression of his brachial artery was made for three minutes, and at the end of this time, while the compression was still maintained, a fatigue tracing was taken and found to be very small, the finger contracting only eleven times. Two hours later the brachial artery was again compressed for three minutes, and at the same time the forearm was subjected to massage. At the end of three minutes, the anæmia being kept up, another tracing was taken, and the muscles contracted but nine times, when prevented by fatigue from doing more. Massage has, therefore, no effect upon muscles thus rendered so completely ansemic in the way of increasing their capability for work.
This experiment was made with a weight of one kilogramme (2·2 pounds) and contractions every two seconds. It was found that in a natural condition the middle finger could thus contract two hundred and sixty-five times without any fatigue.
In comparing this last experiment with the preceding ones it is found that the effect of massage consists essentially in reawakening the phenomena of the local circulation, in bringing to the muscles a greater quantity of material necessary for their contraction, and in removing the retrograde products of muscular work.
Résumé.—1. Massage, when applied upon a muscle in a state of repose, increases its resistance to work and modifies its fatigue curve by retarding the manifestation thereof.
2. The beneficial effect of massage is within certain limits in proportion to the duration of its application. Beyond these limits there is not obtained any further increase in the production of mechanical work.
3. Massage can hinder in muscles the accumulated effects of fatigue proceeding from the effects of work when not sufficient intervals of rest have been allowed.
4. The various manœuvers of massage act with different intensity upon the aptitude of muscles for work. Percussion and friction are inferior to pétrissage and to mixed massage.
5. In muscles weakened by fasting we can, by means of massage, notably ameliorate their resistance to work.
6. Upon muscles fatigued or weakened by a cause which acts upon the whole muscular system, such as prolonged walking, loss of sleep, loss of food, excessive intellectual work, etc., massage exerts a restorative influence which brings back to them their power of doing a natural amount of work.
7. The beneficial effects of massage upon the phenomena of muscular work are no longer produced when it is applied upon a muscle in which the circulation of blood has been suppressed.
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