CHAPTER I

PRELIMINARY

1.1 Background

Healthy is an investment in the future that must be truly maintained. If you need to be

done as early as possible, even though mature and even old. Health is second to none for

those who love it, as a classic saying goes in coperasano or in a healthy body there is a

healthy soul too. In this modern era, many activities and work activities that we do by sitting

or standing, plus the gravitational attraction has caused toxins from the remnants of

metabolism buried in the soles of the feet. In addition, lack of exercise and food that is not

guarded causes many people to feel tired, lethargic, not excited and the emergence of various

diseases.

Based on studies conducted by the International Journal of Alternative and

Complementary Medicine, people who suffer from stress and depression feel an

improvement after undergoing massage therapy for at least 30 minutes every week. The word

massage comes from the Arabic mass which means to press, with an age affix from French.

Maybe it's also the word massage from the Jewish language Maschesch which means touch.

The use of the word massage is lepage, a French nation in 1813. In Indonesia massage is

known as a massage or massage, a massage consisting of gentle massages with fingers. How

to massage does not have a theoretical basis. So there needs to be a means to provide

guidance regarding the techniques in massage. More specifically in sports massage.

1.2 Problem formulation

1. What is the concept of massage?

2. What is the biophysiology of massage?

3. What about massage techniques?

4. What are the indications and contraindications of massage?

5. How to evaluate the massage action?

1.3 Purpose of writing

1. To find out how the concept of massage.

2. To find out how the biophysiology of massage.

3. To find out how massage techniques.

4. To find out how the indications and contraindications of massage.

5. To find out how to evaluate the massage action.

 CHAPTER II

DISCUSSION

2.1 The Concept of Massage

1. Definition

Massage is one of the complementary therapies that combines various techniques

in nursing such as touch, relaxation techniques and distraction techniques. Massage is

stimulation of the skin and underlying tissues by using various levels of hand pressure to

reduce pain, relax or improve circulation. Massage is part of a traditional healing method

that is classified as ancient. This method is believed to be carried out since ancient human

civilization until it lasted until the modern era. Modern massage methods were developed

in China and Japan as an alternative healing for non-medical and psychological therapy.

2. Types of Massage

a. Massage therapeutic goals: an attempt by massage, giving a good influence on the

state of postrauma pathology.

b. Beauty massage: channel skin blood better, to avoid the formation of wrinkles and

dryness of the skin.

c. Massage health: by way of massage to maintain health, normalize organ function, and

is useful in avoiding diseases and disorders.

d. Sports massage: a variety of grips, which are applied with bare hands to the skin that

is not covered by a healthy athlete passive, with the aim of maintaining the condition

of the body, repairing and or eliminating adverse sportsmen.

3. Types of massage

Massage techniques are also recognized by the people of Europe and America, even they

adopt Japanese-style massage techniques. The following are the types of massages

offered to the wider community.

a. Reflexology

Reflexology is a technique of massaging nerve points on both the soles of the feet

and palms. Every organ of the human body is connected to each other through nerve

pathways in the human body. The soles of the feet also have a neural network that

provides bioelectric stimulants to human organs. If our organs are disturbed, when the

nerve point in the leg is pressed, it will hurt. Reflexology is useful for healing various

mild and chronic diseases. The reflexologist can detect the disease from the patient's

foot massage. Initially the patient was massaged all over his legs. the next stage is to

find the points of meridian which are skaited. After that, press for ten minutes.

Biasnya when the nerve point is pressed, the patient will moan in pain, this is a sign

that the healing process is ongoing. The massage period lasts one hour and is repeated

again at the next opportunity on another day. The reflection massage technique

sometimes uses say blunt wood edges. Its function is to help suppress nerve points

that are located inside the skin. The second technique uses the tips of the fingers like

the thumb and index finger tips. The advantage of using a finger massage is a

massage expert can feel immediately the nerve contour being massaged.

b. Shiatsu massage

Shiatsu is a massage method originating from Japan. Shiatsu massage is

developed for various needs such as fitness and healing. Shiatsu massage techniques
 use the method of pressure on the fingers at the intended massage points. Shiatsu

massages rely on pressure on the palm of the hand with a constant groove so that the

patient's nerves and muscles relax. This method is so allocative that it is only aimed at

a certain point. If the pressure in the palm of the hand feels painful, then the patient

can ask to relax a little so that it no longer hurts. The benefits of shiatsu massage are

for healing insomnia, stress, back pain, rheumatism, soothing injured muscles,

headaches, and much more. This massage can only be done on a bed or flat floor and

the patient sleeps on his stomach. In order for a smooth massage, can use

aromatherapy oils and bath soaps. 9 After the massage process is complete, the

patient will be given a drink of water or green tea. The benefits of drinking water

after massage is to help improve blood circulation and digestion. While green tea has

antioxidant properties and is useful for removing toxins from the body.

c. Massage the baby

Baby massage is one method of massage that is applied specifically for toddlers.

The function of baby massage is to relax, stimulate body growth, and maintain baby's

health. Only certain people who have the expertise to massage the baby. Proved

massage in infants has a number of benefits for the baby itself, including increasing

body weight, launching motor muscle movement, and causing a sense of calm.
2.2 Biophysiology of Massage

1. Benefits of massage

The benefits of massage include creating a relaxation response, increasing

metabolic processes, improving lympatic tissue function, accelerating muscle healing and

relaxation, reducing muscle tension, and stress levels. The massage therapy is useful for

improving blood circulation, and lymph, by increasing the delivery of oxygen and

nutrients into the body's cells, while also increasing metabolic waste expenditure from the

body. Sorting and squeezing stimulates local circulation and soft tissue mobilization.

Psychological benefits that are related to the reciprocal touch and relaxation processes

associated with massage. Case is useful for improving individual well-being as a separate

or complementary therapy in orthodox medicine. Clinical massage can be used to reduce

stress and improve tissue repair and muscle damage. This therapy can be included in

routine activities such as bathing in the bed and treating pressure areas. Massage can be

used as a separate technique or it can be combined with essential oils that provide

therapeutic scope.

2. The mechanism of massage work

In reflexology or massage techniques, an illness is usually characterized by pain

at a certain point in the body when the point is pressed or massaged. And when a patient

for a disease is declared cured, it is also marked by the disappearance of the pain even

though the body part is massaged. Actually the way the reflection massage works is when

a point on the body is massaged and feels painful, then the body will automatically emit a

kind of morphine or that known as a neurotransmitter that aims to relieve pain. One of the

most important substances is endogenous encephalin or endorphins. These substances

 play a role to raise the threshold of pain in humans. Endorphins which are substances

such as morphine, are different from morphine, known as psychotropic substances or

drugs. The effect is not addictive, but instead gives good effects for health. With the

massage, the body continues to produce these substances until the pain disappears and the

disease heals.

3. Effectiveness of massage

A recent study showed that patients of all ages, reduced symptoms of anxiety by

half in 3 months after undergoing a series of massage therapy for 10 hours. This study is

the first study to examine the effectiveness of massage therapy as a therapy for patients

who experience anxiety. The researchers randomly gave 68 patients who had anxiety

problems to undergo 1 of 3 therapies namely massage therapy for 10 hours while

listening to music, lying down & breathing slowly while listening to music and in the

third group patients wrapped arms & legs with heating pads & warm towels while

listening to music. The three groups did not show different results after 3 months. This

discovery has been published recently in the journal Depression and Anxiety. This

massage therapy has a high enough effectiveness, in addition to launching mechanistic

has the ability to train the nerves and muscles of the body so that the body is more fit, and

can ward off various diseases. Many diseases can be cured ranging from minor illnesses

such as fatigue - dizziness, dizziness, flatulence to severe diseases of diabetes, heart

disease, cancer, degeneration / hernia, impotence, nerve nerves, etc.

2.3 Massage techniques

1. Effleurage

Effleurage is rhythmic / rhythmic rubbing sequence movements that are carried

out and successively upward. The meaning of stroking movements, namely light and

continuous movements carried out with the tip of the lower finger, especially on the

narrow face such as the nose and chin. And with palms on the wide face such as forehead

and cheeks. Do it slowly and rhythmically without pressure. Effleurage massage has a

seudative effect that is a calming effect, therefore this movement is always done at the

beginning and end of the massage. To do massage, the muscles of the hands and fingers

are relaxed. In the effleurage motion the palm or finger must cling and adjust to the part

being ordered while pressing slowly on each part that is being ordered, and should not be

removed from the skin being sorted before the whole section is finished. At each

effleurage motion the pressure should be mild at the beginning and then harden and

decrease again at the end of the movement. Effleurage is often used for face, neck, scalp,

back, chest, arms and legs.

The efficacy of this movement such as:

a. Mechanical removal of exfoliated epithelial cells. Rubbing can be facilitated using

cream or oil. As a result of exposure to blood circulation and lymph is the following:

1) Speed up transportation of waste and blood substances containing carbon dioxide

also facilitates the flow of new lymph and blood that contains lots of nutrients and

oxygen.

2) Exchange of substances (metabolism) in all tissues increases and the provision of

food to the skin from the body is more secure.

2. Friction

This movement puts pressure on the skin to facilitate blood circulation, activate

skin glands, eliminate wrinkles and strengthen skin muscles.

Make a light circular massage with two fingertips that are pressed perpendicular to the

massage. This rubbing sequence has a great influence on the chewing connective fibers.

Because of the downward vertical pressure, the fibers are wrinkled and if the pressure is

released it will extend again like a gymnastic movement. Rotating friction is a movement

commonly used on the scalp, face, arms and hands. According to how the friction is done

on the scalp, resulting in hair drugs used will be absorbed more quickly because of the

heat that arises from rubbing. And rotating rubbing can also release the syntax or scales

on the scalp. Friction movements on the arms and hands that is by sliding, and squeezing

and turning. This movement is done by holding the arm or hand firmly, with one hand

and moving back and forth over the bone, and the other hand holding the arm so as not to

move.

The efficacy of friction movements are:

a. Influence healing of parts of the tissue that are sick or imperfect.

b. Production of pallid glands or fat by pressure and release of this rubbing sequence,

stimulated so that this method is useful especially for dry skin.

c. Friction has a noticeable influence on blood circulation and the activity of glands in

the skin.
3. Petrissage

This movement uses the tips of the fingers and palms to pinch some parts of the

skin. This type of massage needs a little pressure (pressure). The purpose of massage with

a little pinching or pressing is to provide deeper stimulation to the skin and facilitate

circulation. Pressure and tongs should be done lightly and rhythmically. In sorting the

body, pertisage is performed between the fingers and the palm of the hand. In sorting the

face and neck using only the thumb and index finger or pinkie. Fulling is a form of

petrisage that is mostly used to massage the arms. With the fingers of both hands, the

arms are held and a massaging motion is performed on the muscles.

Efficacy of petrisage movement is:

a. Streamlining the distribution of substances in the tissues into the blood vessels and

lymph, as if squeezed into them.

b. Blood and lymph deliver food essence to the tissues and carry the waste material

exchange from the tissues to the means of disposal. If blood flow and lymph are not

smooth, then there is a containment that can be avoided positively through

sequencing squeezing.

c. Chewy fibers of the connective tissue are first stimulated: the pulling or pressing

motion will increase the elasticity.

4. Tapotement

Tapotement is a successive and rapid tapping, which is done with the whole hand

or with the tips of fingers. The index finger in this movement must be held slightly

because its strength exceeds the strength of the other fingers. In this type of massage, the
 fingertips are emphasized with the aim of stimulating the skin. On tapotage, beats start at

the wrist and are touches to the skin. This knock shouldn't cause pain, and the punch

should always be flexed again. Movement on the tap of the fingertips is carried out on the

joint between the segment of one finger and the palm of the hand. The fingers on the

tapping movements of the hands, being passive but on tapping fingers being active.

Knocking is done if necessary to restore the loose muscle tone and also to stimulate nerve

endings. If the beat is done lightly, then each beat is a stimulus that causes muscle

contractions that will eventually relax again. Because of the repetitive contractions, the

muscles will be trained and become stronger. For ordering the face, only a very light and

slow knock is used, by touching the two finger joints. The chopping movement is a pat

that is done using the outer sides of both hands, which are tapped on the skin in

succession and alternately. Chopping and punching movements, mostly used for ordering

the back, shoulders and arms. Efficacy of tapotage movement is to refresh the muscles

and improve blood circulation and lymph in the sorted place.

5. Shaking

Shaking is a vibrating motion that serves to stimulate or to calm nerves and

eliminate wrinkles on the face. In this massage use your fingertips and palms to vibrate

the skin alternately. This massage can also use a device called a vibrator. The vibrating

motion to stimulate and performed by vibrating the fingertips over the nerves is called

static vibrations and vibrating movements that aim to calm are called dynamic vibrations

that are vibrations carried out along the course of nerves with the fingertips. To prevent

excessive stimulation, vibrational motion is only done occasionally and should not last
 more than a few seconds in one place. The efficacy of vibrational motion is to relax

tissues and eliminate tension.

6. Integrated Movement

Integrated movements, carried out limited to the ordering of arms, hands and legs. This

movement is a movement made to the joints, both movements forward, backward or

rotating.

Movement type:

a. Passive movements of the wrist which are done by way of bending the back of the

hand. Similar movements can be done on the toes or on the feet.

b. Passive movement towards the palm that is done from the wrist by bending the hand

down. Similar movements can be performed on the fingers and toes or on the feet

passively rotate the fingers.

c. Similar movements can be done for the forearm, toes or feet. Some things that need to

be considered when sorting are finger nails should be short, not cut down and well

maintained. And these sorting movements can be chosen according to the condition

of the person sorted, specifically for effleurage movements always used at the

beginning and end of the sequence.

2.4 Indications and Cons Indications Masssage

1. Massage Indications

a. The use of massage is generally recommended after heavy work because it has

enormous benefits in helping to restore the body to a state of recovery. Massage helps

eliminate fatigue with all the symptoms that accompany it, such as aches, stiffness,
 pain, or feeling weak. Such massage is usually done to the entire body in a long time,

about one hour.

b. Light but continuous work such as sitting too long or standing or in work that causes

fatigue and burnout. In this case fatigue may be both mental and physical. Usually the

massage at the end of the task returns the body and the feeling back to be

comfortable.

c. In the world of sports today massage has become part of the effort to maintain the

condition of the sportsman during training, before the match, during the competition,

and after the match. In sending sports teams these days always include at least one

masseur.

d. To treat and restore bodily functions after an injury, help speed up the healing

process. Often massage is needed to continue the work of the doctor, for example

after recovering from surgery or treatment of broken bones. His job is to restore

muscle and joint functions that usually experience stiffness.

2. Counter Indications Massage

In certain circumstances massage should not be done and is a contra indication. This

usually involves the following circumstances:

a. On the advice of doctors not to do massage for patient safety.

b. In a state of contracting infectious diseases such as smallpox, measles, fever, liver,

and others.

c. Body temperature rises high due to infection.

d. In severe illness so it requires proper rest.

 e. Suffers from diseases related to blood vessels such as omaticmasis, omaticm and

others.

f. In each type of severe neurological disease such as patients with chorea and

omaticma.

g. Suffers from haemophilia, because it tends to bleed, although the cause is unclear.

h. Suffers from certain diseases which when massaged can cause widespread infections

such as ulcers, ulcers, etc.

i. Swelling due to a new injury that indicates internal bleeding. Capillaries that were

previously broken and closed can break again when massaged. Judga on wounds that

have not healed or recently healed.

j. Broken bones that have just healed. Massage can interfere with the location of the

connection.

k. Suffers from tumor or cancer.

l. Being omati month or in early pregnancy. Also in appendicitis, gastroenteritis,

coliyis, etc. Likewise, if there are stones in the gall bladder.

m. Suffers from high blood pressure, cerebral hemorrhage, heart and lung disease.

2.5 Evaluation of Massage

We drew an evaluation of massage based on a journal entitled "The Effect of Massage

Effleurage on Reducing the Intensity of First Stage Active Labor Pain in Primipara in Rsia

Bunda Arif Purwokerto 2011". The journal states that the process of giving birth to a child

and the pain during childbirth is a natural cycle in a woman. "Pain occurs due to contractions

during the process of cervical dilation and thinning. Increasing the frequency and duration of
contraction is more painful especially in primipara. This study is to determine the effect of

massage effleurage methods on reducing the intensity of labor pain in the first phase of active

phase in primipara before and after intervention. This used the pre-experimental design with

one group pretest-posttest design, the independent variable massage effleurage and the

dependent variable was the reduction in labor intensity of the active phase I. The data

collection used a numerical rating scale (NRS) instrument. The number of samples in this

study were 34 primipara. Analysis of the data used was pair t test, obtained pain intensity

before the massage effleurage method was on average 7.647. After the massage effleurage

method was obtained the average was 6.117. The value of the average difference before and

after the massage effleur method age is 1.53 (t-count: 8.260 and t-table: 1.960). With a value

of p (0,000) <α (0.050). There is a significant difference between pain intensity before and

after the effleurage massage method. The results of this study stated that the effleurage

massage method can be used as an intervention in midwifery care for maternity mothers.

"Based on the research conducted it was concluded that the measurement of pain intensity

before massage effleurage on the abdomen using the 0-10 pain scale obtained that most

experienced severe pain. The results of pain intensity measurements after effleurage massage

on the abdomen using the pain scale 0-10 obtained the results of most experienced moderate

pain. Thus after effleurage massage performed on the abdomen performed at the first stage of

maternity can reduce the intensity of labor pain in the first phase of the active phase in

primipara.
 CHAPTER III

COVER

3.1 Conclusions

Massage is stimulation of the skin and underlying tissues by using various levels of hand

pressure to reduce pain, relax or improve circulation. Massage is part of a traditional healing

method that is quite ancient. This method is believed to be carried out since ancient human

civilization until it lasted until the modern era. Modern massage methods were developed in

China and Japan as an alternative healing for non-medical and psychological therapy.

3.2 Suggestions

After understanding about massage as a complementary therapy, students, especially

readers and nurses, can take the essence of this paper so they can apply it in the world of

education or in the world of work because massage as a complementary therapy is very

beneficial for patients.

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Priyonoadi Bambang, 2008. Sport Massage.Yogyakarta: Fakultas Ilmu Keolahragaan.

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Desember 2019)

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3 Desember 2019)