Research article - The Professional Massage Mitts, evidence based article.

 

The university of UCLAN has completed an independent research report on the mitts, the article is available to download from the link below.

 download

 

pdfsoma-report-for-universities.pdf

 

'Patients gain a greater feeling of control over their musculoskeletal pain and post surgery rehabilitation'

 

 

Introduction
 
The Professional Massage Mitts are a pair of silicon massage mitts designed and patented GB2543361 by a qualified and chartered physiotherapist. They are for medical and sports use. They also reduce strain on the wrist and hands of the masseuse/user. 
 
The physiotherapist is Sandra Whittle and the company that holds all rights is Soma Therapies Ltd (Company registration No: 04988710).   At the time of conception Sandra was working long hours providing physio and various massage treatments in a very busy physiotherapy clinic. The Professional Massage Mitts were designed out of necessity; Sandra was suffering from repetitive strain injuries to the wrists and hands.  The Mitts have integral support to protect the therapist’s hands and external nodules for increased tactile surface to enhance sensory massage stimulation.  They can be used for self-massage or as an aid for rehabilitation from allied health professionals for more complex soft tissue mobilisation procedures.
 
Over time and after hundreds of patients’ feedback along with numerous testimonials, it was obvious that if the patient took control of their rehabilitation and used the Mitts on themselves they were able to improve their own outcomes and physically reduce their own symptoms. The Mitts empower patients to be able to do something constructive instead of relying on healthcare professionals to make the changes for them. This positive change in behaviours I’m sure would be welcome in the NHS. (Appendix 1, for advise on how to use the Mitts).
 
 
 

Clinic observations

• Reduced muscle soreness after exercise - several testimonials describe how after using the mitts they reduced the recovery time after exercise and resolved minor muscle strain after exercise.
• Scar tissue – post-operative scar tissue healed quickly with excellent recovery, reduced symptoms of localised pain and stiffness. Mastectomy patients report how their scar tissue feeling instantly softer and how their scar pain and       other symptoms reduced dramatically, and reduced localised swelling.
• Burns – skin reports feeling normal again with less pain and tension.
• Better results in less time – altered configurations of soft tissue take less time to soften.
• Longer lasting effects of massage – patients reported still feeling the effects of the massage mitts working 4-6 hours after.
• Reduced hand and joint fatigue – in this instance the physiotherapist no longer had RSI and worked all day without feeling tired.

 

 

SURVEY RESULTS
455 patients were surveyed: 98% (445 patients) stated a preference and benefit of using the massage mitts as opposed to bare hand massage (Appendix 2).

 

 


Why people seek massage

• Relaxation.
• Sports massage.
• Injury.
• Unexplained pain, alternative to the GP.
• Chronic conditions.
• Alternative to pain relief.

 

 

Professional Massage Mitts

The Professional Massage Mitts are a therapeutic, multi-directional massage tool designed to enhance self-massage. They can be used for rehabilitation and soft tissue mobilisation techniques for musculoskeletal (MSK) conditions.

They may be used as an aid for patient autonomous rehabilitation pre- and post-surgery, in an out-patient setting, and for allied health professionals to administer more intensive and complex procedures for the management of scar tissue.

Massage with the mitts provides a non-invasive, non-pharmaceutical alternative to reduce the symptoms of numerous musculoskeletal acute and chronic conditions, for rehabilitation pre- & post-surgery to reduce pain and restore function.

 

 

Design Feature of the mitts

• Surface nodules of various dimensions. The quality and consistency of the silicone nodules has encompassed features for optimum body conditioning and maximum contact. The nodules increase sensory stimulation and sensory feedback.
• Made with medical/food grade silicone. The flexibility of the mitts makes it easy to follow the contours of the body and keeps your hands relaxed for ease of movement.
• The Mitts unique shape and integral support protects the user from repetitive strain injuries and overuse of their wrist, hand and finger joints.

 

 

UK Patent number: GB2543361
(Appendix 2)


Time line for product development
(Appendix 3)

 

Benefits of using the massage mitts in the NHS

• Encourages and empowers patients to take control and responsibility for their own health and well-being.
• Reduce ‘days off sick’ with minor MSK ailments.
• Reduces the use of pain medication.
• Improves outcomes in musculoskeletal disorders.
• Improves self-care and preventative interventions in both primary and secondary care.
• Reduces recovery time and improve outcome post-surgery and improve scar tissue formation.
• Reduces the number of musculoskeletal and medical conditions that are being remedied or managed by surgery, they provide an alternative option before surgery.
• Improves oncology management and self-care.
• Could reduce the waiting list and demand for out-patient physiotherapy appointments.

 

 

Reduce NHS waiting times and improve patient outcomes for MSK conditions.

 

 

Scar tissue, pain, and reduced physical function are the most common physical conditions dealt with by MSK physiotherapists and GPs in primary care.

Reduce post-operative symptoms and increase patient satisfaction by giving the patient a tool to do for themselves.

The massage mitts are easy to use and provide far superior results than just hands alone, people prefer using them and feel the results last much longer. Patients feel more in control when using the mitts. They were able to reduce their own MSK symptoms.

 

See our survey of 455 patients (appendix 4), and Patient Testimonials (appendix 5).

 

'The Professional Massage Mitts provide a new concept for treating MSK conditions and Scars'.

 

How patients or allied health care professionals use the massage mitts

 

Patients –
With visual reminders either via an app or leaflets, patients are encouraged to gently massage the applicable area of their body either in the shower or massage with oil.

 

Treatment areas:

• Face, neck and shoulders.
• Upper back, neck and shoulders.
• Lower back, thighs and stomach.
• Lower limbs, Knees and feet.
• All joints.
• Healed scar tissue and adhesions.

Using the mitts, you initiate the body’s own processes by stimulating the soft tissue where you are massaging thus turning the stimulation into biochemical and neurophysiological responses, improving wellbeing and restoring function.

 

Professionals, or under supervision –

• Pre- and post-surgery.
• Oncology patients, (massage is no longer considered a contra indicated for cancer patients).
• Burns - including radiotherapy burn sites.
• Scar tissue.
• Chronic and acute pain.
• Diabetes to improve circulation and reduce tissue deterioration.
• Restricted movements, musculoskeletal conditions.

 

The professional massage mitts are made from food grade silicone for the low thermal conductivity (reduced friction), low chemical reactivity and low toxicity properties that does not support microbiological growth, making them suitable for patient use in the NHS. (https://en.wikipedia.org/wiki/Silicone)

 

What is different about using the Massage Mitts and how do they work?

The University of Central Lancashire (UCLAN) has already obtained funding from the European Union Development Fund and is writing a report on the Massage Mitts. Early results indicate that massaging with the Mitts increased localised tissue oxygenation significantly greater than massaging with hands.

We are still waiting for the completed report from UCLAN.

 

Background

The Mitts harness the knowledge of decades of physiotherapy and complementary therapies to create a highly functional and time saving pair of massage mitts. They have numerous therapeutic applications. They reduce the impact of hours of massage and soft tissue mobilising techniques on the therapists’ hands and encompass years of scientific research.

After using the Mitts on your skin even for a couple of minutes the tension of the tissue and fascia changes and soften. Dysfunctions of the fascia have been recognised as an indication of various symptoms, including scar tissue, musculoskeletal pain and altered soft tissue configurations that reduce functional movement [1].

Sports massage has long been used to reduce or resolve pain and dysfunction and to use as part of a rehabilitation programme between training and after events. The soft tissue massage techniques of remedial sport massage help restore function and aid the recovery process. Sports massage is considered important in rehabilitation; it is used to optimise the athlete’s health to stimulate biomechanical and physiological processes necessary to optimise performance, conditioning, maintenance support [2]. It is indicated that using the mitts post sporting events reduce the effects of the delayed onset of muscle soreness (DOMS), but we are at present collecting data to confirm their effect post 10K running events compared to massage with hands alone. We hope to engage with universities that have the facilities to undertake a research project that would proficiently demonstrate the precise benefits to our athletes.

Injury and scars tissue are also indicative for using the massage mitts, on both acute and chronic conditions; there are numerous testimonials to suggest that further investigations are valid.
Scars can be cosmetically, psychologically, and physically incapacitating for patients, having a massage aid for home use that enhances the healing process would positively impact both the physical and emotional scars. The initial injuries may be caused by trauma, surgery, burns, or a skin disease [2] [3] [4], having a practical tool to support the process of tissue healing that a patient can use would reduce some elements of strain on the NHS funding.
 

Stages of healing [5]
• Stage 1: Acute inflammatory reaction - the massage mitts can be used to decrease inflammation, increase lymphatic draining and influence early fibroblastic activity to promote healing and prevent compensation patterns.
• Stage 2: Subacute repair and healing - this is when collagen and scar tissue formation can be influenced by using the massage mitts. Post injury/operation when the wound has healed (approximately after two weeks), using the massage mitts will reduce recovery times and improve outcomes without overstressing the tissue and maintain, or increase flexibility within the tissue.
• Stage 3: Remodelling - reduce tissue and scar contraction with continued frequent gentle massage techniques with the mitts to return to full function and mobility.
• Stage 4: The Maturation Phase can last between 21 days and two years Macrophages re-organise the collagen within the newly healed wound to form a scar. This scar tissue will fade from red to white over time. Using the massage mitts will ensure that the scar remain flexible and reduce the risk of scar tissue complications.

The components of scar tissue formed in subacute phase two is quite different from the functional chronic healing stage [6]. It will slightly vary also depending on the pathology of the wound, injury site, and if the wound is from trauma, elective surgery, or from a burn. There is evidence that suggests scar massage is effective to improve scar tissue appearance, but more extensive clinical trials are needed to develop evidence-based guidelines for scar massage [7].

There are several studies that highlight the positive effects of massage to reduce pain in various chronic conditions such as rheumatoid arthritis and fibromyalgia [8], and studies that highlight the benefits of massage to positively reduced symptoms of depression and anxiety amongst patients. Massage physically reduces heart rate, and there is evidence of improved immune function [8] by reducing stress levels through massage. Recent studies link inflammation and fascia dysfunction to the increased pain levels in fibromyalgia [9] and suggest the use of manual therapies such as the massage and myofascial release techniques would be extremely effective [10].
 

Massage is used for various reasons, we know that it increases localised blood circulation, lowers blood pressure, improves flexibility and joint mobility, induces relaxation to reduce stress,  lowers blood pressure, boosts your energy levels, releases endorphins and enhances mood, increases the flow of lymph and enhances the immune system [11], improving health in general. It also relieves chronic low back pain symptoms and increases functional movements patterns, it provides general pain relief, and increases range of joint movements, plus improves psychological functions [12].  I believe we should be discussing self-massage as an option for our patients.

Massage is useful to reduce back pain in pregnancy, postpartum and intrapartum on the maternity wards. Health care professionals report how massage can decrease pain, shortening delivery time, and increase the satisfaction of a woman’s birthing experience while in hospital [13].  After unplanned Caesarean sections women would also benefit from massage to decrease their stress levels, reduce their pain levels, and reduce pain medication [14]. Using the massage mitts for self-massage or massage by another family member in these scenarios with benefit the patient and improve post-operative scar healing, reduce symptoms of pain and increase flexibility and movement. Interventions that are designed to promote family participation for a loved ones admitted to hospital in acute care wards could improve patient outcomes  and recovery [15], relative could become a part of their loved ones care.

Times are changing, we must be conscious of  the definitions used by therapists especially when describing deep tissue massage which has become increasingly popular over the years as a therapeutic tool [16].  Deep tissue massage may be described as the intention of the therapist to work deep into the tissue layers within the body to encourage them to relax, lengthen, and release holding patterns. Massage treatments must be comfortable for the patient, effective, and energy efficient which does not always necessarily mean that the massage is deep and hard to have a deep effect. The  fascia system is effectively engaged with slowly and gentle pressure and just holding the tissue until the fascia relaxes under the therapists hands and treatments can be profoundly deep [17].

An increase of skin surface temperature has been indicated in massage due to the increase in blood circulation from the massage [11].  There are few studies that have investigated the long term improvements on vascular dilation responses from massage [18], or how this would affect performance in sport or in tissue regeneration and scar formation. Using the Massage Mitts daily for massage with oil or in the shower will improve skin and sub dermal tissue blood circulation, oxygenation and chemical responses for overall tissue health and function. 

Blood supply is an important aspect in the development of pathological scars, but the correlation between blood supply and tissue hypoxia is controversial [19], but is does appear that pathological scars have unique characteristics of blood supply that are closely associated with tissue hypoxia.

 

Tissue oxygenation

To evaluate the effect of the massage mitts on tissue oxygenation levels when using the Mitts to reduce the delayed onset of muscle soreness (DOMS) post exercise, ideally blood serum samples could be taken, but these are advanced techniques and require a dedicated team of experts.  Samples at different moments post exercise would determine serum blood markers of muscle damage, oxidative stress and antioxidant status [20]. Regulation of tissue or muscle oxygenation is essential in order to continuously provide cells with energy, in the form of ATP during the process of oxygenation phosphorylation.

There is a close relationship to blood flow and tissue oxygenation [21],  but the question here is whether the increased tissue oxygenation generated by using the Massage Mitts is directly from the increased blood flow or from biochemical responses  within the tissue structure, cells, and tissue matrix.

At a cellular level the mucopolysaccharide ground substance within the tissue matrix is critical for tissue mobility and changes in the fascial system. Any blockage or reduced function from injury or inactivity will hinder self-healing and self-regulation homeostatic activity [22].  So using the mitts could reduce the congestion in the tissue, enhance cellular activity and communication.

Normally gloves are only used to provide a protection barrier against infection and disease and wound depend on the protocol for the type of massage treatment to be administered and the patient’s symptoms.  The main area for consideration is with oncology patients where patients need to be protected from infection [23]. Cancer is no longer considered a contraindication for massage [24]. Patients receiving massage therapy during and after their chemotherapy show a significant decrease in anxiety levels [25]. Cancer patients can experience high levels of pain [26], but if they had a safe massaging tool to use at home where they need it most would have a profound impact on their quality of life.

No literature was cited on the use of Mitts with nodules as a tool for massage or myofascial treatments because they are a unique product, but there were various references on the short term use of foam rollers [27] and very limited research on other fascial massage tools. 

There are numerous research studies based on the clinical experience and successful outcomes for myofascial pain treatments  [28], but they do not effectively monitor the short- and long-term outcome on myofascial pain to enable us to assess the true outcome  and efficiency of traditional and more modern therapies. We should gather more information on patient centred treatments, the massage mitts are a fabulous tool for patients to work on their own body’s, including massage on scar tissue, for oncology patients, and for our elite athletes to enhance performance.

High intensity sports performance and eccentric exercises induce muscle fibre damage and impair the muscles ability to generate voluntary for after exercise, this is associated with delayed onset of muscle soreness (DOMS) [29] . It is a common occurrence that limits the sporting performance of elite athletes and stiffens the novices’ muscles hindering their fitness regimes.  Sports professionals search for ways to reduce and prevent soreness (the onset of DOMS), and explore treatment modalities which have frequently included massage treatments [30]. However, we are unable to conclude which treatment technique is more effective [31] at elevating symptoms.  Foam rolling has some effect on DOMS and increase fascial tension, but it still need to be determined the long term effects of using the rollers [31]. 

Research that is evolving on fascia in functional anatomy has highlighted the effects of restriction and pain on the human body when the fascia system is compromised or restricted.  Numerous therapeutic approaches affect the fascia at a molecular level [32] and have a direct impact on sport performance, soft tissue pathologies, exercise, and movement patterns.  The nodules on the Mitts provide a brief mechanical stretch to the superficial fascia that influences the fascia tensegrity, tissue matrix, and cellular activity.

Many studies investigate the homeostatic functions and underlying processes that can potentially influence manual and movement therapies [17]. During movement and hands on therapies the mechanosensitive cells will respond to different mechanical loading of the fascial system [33]. Both physical and chemical communication processes are involved between the specialised cells in the extracellular matrix [34]. Fibroblasts and telocytes are embedded in this mesh-like matrix and are mechanosensitive playing a vital part of cellular behaviour and physiological adaptation for more efficient repair and remodelling of the tissue  [33].  The mechanical stretch the nodules on the mitts produce could potentially assist the body with gene expression, protein synthesis, and modulate the inflammatory response.

Myofascial Trigger Points are a known cause of pain, discomfort and dysfunction of the facical system [10].  They are present in fascia dysfunction and are associated with several chronic diseases and are recognised as  a post-operative symptom [35]. When the fascial system is not working efficiently, the collagen fibres are not effectively gliding over each other, this stresses the tissue resulting in local and referred pain plus altered configurations of movement patterns. Myofascial trigger points can cause acute and chronic symptoms in MSK, studies have indicated that by increasing the blood flow locally using myofascial release techniques to the affected area will help normalise function and motor activation of the muscle [36].  This indicates that in theory if the Massage Mitts increase blood flow and tissue oxygenation they should reduce symptoms of myofascial dysfunction. Obviously further investigation is needed.

The professional massage mitts are design for self-massage, for patient use to promote self-awareness and for them to take an autonomous approach to improving their health.  NICE Guidelines recommend we encourage behavioural changes and provide services that encourage patients help themselves more.  According to the World Health Organisation 60% of all deaths are related to chronic disease (World Health Organization, 2017), perhaps self-treatments would promote more change to patient behaviour and make them less reliant on health care professionals.  Any product that can promote and improve our well-being will impact our quality of life is one worth investigating. Promoting healthier choices to increase our  physical activity and quality of life is difficult [37],  but it can have a major impact on disease outcomes, and would significantly contribute in the area of chronic disease management [38].

 

Therapist feedback

Therapists with less favourable attitudes about providing health promotion reported more barriers to providing the messages to their patients. Barriers to providing health promotion included a lack of guidelines, knowledge, and skills. The greatest barrier for health promotion in massage therapy practice is lack of guidelines [38].

Seventeen therapists were chosen at random to evaluate the Massage Mitts, without prior instruction or advice. Initial first glance impressions of the Mitts were not favourable.

Those who tried to apply the same old bare hands techniques with the Mitts gave little positive feedback. However, after being shown correct massage technique with the mitts many the therapists instantly saw how the Mitts would benefit their patients. There is an instant increase is blood circulation on the skin surface, this is observed by the linear and circular patterns of erythema from the nodules of the Mitts. This is a good indication of an increased pattern of circulation, tissue oxygenation and increased cellular activity.

 

Patient feedback

Patients who were familiar with the Massage Mitts were able to use them confidently on their own - in line with a more autonomous approach to their health by addressing their own aches and pains.  They were able to use them very effectively and felt more in control of their condition.  Often post-operative patients would prefer to help themselves more - the Mitts may provide a safe option.

 

Moving forward

Therapist would need a greater understanding of the fascial system to gain an insight to our complex body systems before patients could be help with products like the Massage Mitts, and the concept of less could be more beneficial to initiate responses with in the fascial system. Also current attitudes, practices, and barriers toward our own health could possibly lie within the perception from patients that they need a health professional to make them well again.   Further research into the benefits of massage especially for certain defined patient groups needs and must be ongoing, but we still have limited knowledge and a true understanding of all the underlying neurophysiological and biochemical mechanisms associated with massage [8].  Research is constantly evolving, reviewing and defining the benefits of manual therapies and massage [11, 39].

Recently scientists have become intrigued with the function of the interstitium, inter and intra tissue spaces, the pre-lymphatic connective tissue [40], and the extracellular matrix as a method of communication [34].  It is now understood that fascia on multiple levels provides support for the whole of the body, rehydrates and supports all cellular activity, organs and whole body systems [41-45]. 

There is evidence that there are alteration to EEG patterns, vagal activity and cortisol levels during massage, and that massage has been represented in several brain activities during functional magnetic imaging  in the amygdala, hypothalamus and anterior cingulate cortex [8].  This may only be the tip of the iceberg - there may be endless possibilities still to be investigated and researched, especially within the fascial system and tissue matrix.  If the Massage Mitts are proven to be a valuable self-help aid for rehabilitation patients will gain more autonomy over their treatment and reduce pressure on the NHS.

There are various different types of massage, myofascial and fascia treatments [17, 46]. Some styles of massage will promote more relaxation, improve sleep, reduce stress and induce muscle relaxation and others will be more energising, stimulating [47], other body workers provide pain relieving and restore function [46],  but all massage treatments and soft tissue mobilisation techniques have something in common, we are encouraging our bodies to respond to the stimulation of their therapeutic intervention  to improve our health [48], reduce pain and restriction so we may continue to live life in optimum health.

Sports massage is usually performed deeper than remedial massage to get deep into the muscle and fascia structures, [2].  When sports massages were performed with the Massage Mitts by the same sports massage therapist patients reported the same deep sensation but without the pain of deep, bare hands massages. There was less strain on the therapists’ hands when using the Mitts. Further research products are required to evaluate the effectiveness of the mitts for –

  • Self-treatment between physiotherapy treatments.
  • Reduced post-match or exercise delayed onset of muscle fatigue.
  • Scar Tissue and altered configurations of connective tissue post injury.

Patient health promotions   education are essential for improving outcomes, self-management and self-massage provides a positive supportive approach to self-care and health maintenance [49].

There is evidence to suggest that massage can be effective to decrease symptoms of hypertrophic burn scarring [7].  More clinical trials are needed to develop the relevant evidence-based guidelines for scar massage in hypertrophic burns scarring, and the mitts would provide an excellent self-massage too for home care [50]. Patient centred research should include the Massage Mitts.

 

The Fascial System

The vital importance of the fascial system and its role in the normal functioning of many of our body’s systems is only becoming main stream in the last few years. The Fascial system [41, 51] [51]  has been defined as a whole body web, a network that the encompasses and surrounds all organs, muscles, bones and nerve fibres  from the top of our head to the tips of our toes.  It also provides a functional structure for support for movement.  It is a packing material that every structure and cell is embedded into providing an environment that enables all body systems to operate and for cell to cell  communicate to take place in an integral manner and to regulate homeostasis [42].

There are now many research studies that investigate the role of fascia in musculoskeletal pain and restricted movement patterns [17, 39] and the impact that it has on restricted movement and how fascia congestion effects  all our body functions [42]. 

Fascia can become congested through sustained poor postural habits, repetitive restricted movement patterns, and poor tissue hydration [41]. The dehydrated cells collapse and the bi-products from cellular reactions accumulate to cause inflammation to adding to the fascial constriction, pain, reduce movement patterns and all this has a negative impact on multiple homeostatic systems and pH within the body [52]. 

Increased whole body movements, localised pressure, and shear movements performed on the fascia, (or from the nodules oscillating effect on the skin) can assist rehydration of the ground substance [53] . This in turn unblocks the lymphatic and endocrine systems and also lubricates and hydrates the fascial increasing its ability to move and function [42].  The gel–like properties of the ground substance is considered thixotropic, which means that it can liquefy when agitated and return to a gel state as it stands, and become more viscous through lack of movement.  It is the Hyaluronic acid component of the ground substance which contributes significantly to fluid dynamics, cell proliferation, communication and migration in the constantly changing environment of the tissue matrix. The interstitium (inter and intra tissue spaces), the pre-lymphatic connective tissue and the extracellular matrix support the fluid dynamics of the fascia [40], and as discussed helps to rehydrate and supports all cellular activity, organs and whole body systems. 

The combination of massage and movement will relax and free the complex network of fascia and loosen muscle fascia to relieve common issues that manifest with in the fascial system [17]. The nodules the massage mitts provide a brief mechanical stretch to the soft tissue and the fascial and the extracellular matrix.  In theory this stimulation would increase localised tissue and cell oxygenation for ATP production, increase blood flow to clear metabolic by-products, and increase cellular activity in the extra cellular matrix turning the stimuli into biochemical and neurophysiological responses increasing lymphatic and endocrine function.

 ‘Altered configurations of the fascial system’ is now generally accepted as a key component for symptoms of chronic pain [33].  Adhesions and scar tissue symptoms can be reduced by using massage and myofascial techniques which can significantly improve the scar elasticity and appearance [54]. Massage with the Mitts two weeks post-operatively may help reduce symptoms of stiffness and pain and should be part of a post-operative protocol and guidelines.  Using the Mitts could enhance the standard physiotherapy protocols  [55] to improve range of motion, gait performance,  strength training and treatment outcomes.

 

Localised Tissue Responses

Massage with the Mitts stimulates the skin, soft tissue, sub-dermal and deeper fascia structures to the area where you are massaging and the body turns the stimulus into biochemical and neurophysiological responses. There is  evidence  available to suggest that massage will reduce pain, muscle fatigue [56] and optimise metabolic tissue response [8] to improve wound and tissue repair, they are an excellent tool for patient to engage with their rehabilitation. 

Massage as a physical intervention has a positive effect on the reduction of musculoskeletal symptoms [57] and can reduce physical and psychological outcomes of scar tissue  [7].  The silicone mitts provide a soft non-frictional, non-invasive tactile surface area making it safe for the patient to administer self-massage.  The nodules on the mitts provide a brief mechanical stretch essential for the fascial system ‘well-being’ [33], and the mechanotransduction stimulation initiated by contact with skin will enhance the self-healing and self-regulating physiological body responses of the body and the fascial system [43].

 

Increased blood circulation

When using the Massage Mitts for massage it becomes apparent (immediately) that the Mitts stimulate blood flow greater than hands alone: lines of erythema become quickly evident on the skin.  A good blood supply is believed to be an important aspect in the development of pathological [19] and surgical scaring [3].  Massage and myofascial mobilisations affect the tension network of the human body [58], so promoting and advancing massage therapy practices into health care for self-treatment would appear to be an obvious progression [38]. 

Wound healing and tissue repair is a complex process [4], which ultimately leads to fibrosis [59] if not repaired well the condition could become chronic [6] and other symptoms of pain and restricted movement could manifest [10].  Massage is reported to have a positive effect on scar tissue and traumatic management for both acute and chronic conditions  [50].

During the healing process, the body forms new collagen fibres to repair the damaged tissue, the collagen fibre collectively form scar tissue, adhesions and may cause fascial restrictions [10].  There are four phases of wound healing; coagulation and haemostasis, inflammation, proliferation, and remodelling [60].  A scar is generally formed during the latter 2 phases of the process approximately two weeks after surgery or injury.  If there is an excessive inflammatory response this can impair the wound from healing, this could result in scarring and fascia dysfunction [61]. During proliferation phase, fibroblasts migrate towards the wound and to begin the process of making new collagen fibres, they will eventually become scar tissue. Remodelling is the last phase of wound healing, the collagen fibres within the tissue matrix  contract, this phase may last as long as 1 to 2 years [3]. Dermal fibroblasts are responsible for the synthesis and remodelling of extracellular matrix proteins (ECM), therefore we can presume the oscillation of the nodules on the mitts will also influence the tissue matrix and fibroblast production. 

The mechanical stretch responses that the nodules on the mitts induce have an impact on the ECM, tissue oxygenation, tissue hydration, lymphatic drainage and blood flow, but in-depth research. In the healing process the dermal fibroblasts regulate inflammation, cell proliferation, molecular function and cell to cell communication [61], making them an ideal modality as part of a rehabilitation protocol.  The pre and intra-operative tissue management, along with suture techniques are vital for optimising and minimising scarring [3, 62], but post-operative care protocols are paramount to improve post-surgical patient outcomes. The massage mitts can assist in the final overall scar appearance. They encourage the patient to take control of their homecare to reduce recovery time and improve physical outcomes.

Musculoskeletal (MSK) conditions are also impaired by excessive inflammatory responses, reduced blood and lymph flow, tissue oxygenation and the homeostatic functions of collagen that results from scaring, [61]. It is possible that manual therapies and massage could influence and improve outcomes to reduce scar formation, adhesions and tension within the fascial system [33]. By reducing the altered configurations and tension associated with fascial dysfunction you would reduce pain and increase tissue function and improve movement patterns of many MSK conditions.

The underlying processes and mechanisms that influence wound healing and MSK symptoms might potentially be influenced by enhancing the remodelling of the extracellular matrix (ECM), [63] as previously mentioned [5]. The ECM is the non-cellular component of tissues, it is a dynamic network of macromolecules that regulate cell function and tissue regeneration that is vital for tissue and organ function [64].

Not only does tissue oxygenation vital to optimize wound healing and minimize scarring [3], it improves tissue repair, and prevents tissue hypoxia which is a major cause for impaired healing [65].  Tissue oxygenation is also a major factor for consideration in muscle fatigue post exercise [56, 57].

Massage treatments that improve blood flow and increase tissue oxygenation are of particular interest for the treatment of chronic and acute conditions [11]. Introducing the Mitts two weeks post-surgery could impact and improve surgical wound outcomes [50] and in MSK the patient will be able to self-massage in-between outpatient appointments to improve recovery from trauma [62] and soft tissue injuries [16, 38].

Patients tissue oxygenation levels can respond differently after radiotherapy treatments [66]. Self-massage would increase tissue oxygenation early post-surgery and after chemo or radiotherapy treatment to benefit patients. Self-massage with the Mitts will also help patients to manage their depleted energy and fatigue [47], and could reduce their anxiety levels after their chemotherapy [25], or bring relief to their radiotherapy burns [54].

Many patients after breast conserving and mastectomy surgery suffer from myofascial pain which can also cause neck pain [35]. Myofascial pain in not uncommon in terminally ill patients [26]. Fascia is very resilient [42], being able to self-massage symptoms will bring a new perspectives for both patients, clinicians and researchers regarding the functional integration of fascia within the musculoskeletal system [67].

There are many areas within the NHS to consider for patient to use the Mitts, for Patient cantered rehabilitation.  In MSK rehabilitation, health researchers are only just beginning to understand the vital importance of the fascial system and its role in the normal functioning of many of our body’s systems. The fascial system [41, 51] has been defined as a whole body web, a network that encompasses and surrounds all organs, muscles, bones and nerve fibres from the top of our head to the tips of our toes.  It also provides a functional structure for support in movement and tissue repair.  Fascia is a packing material that every structure and cell is embedded into and provides the environment that enables all body systems to operate and communicate in an integral way to regulate homeostasis [42]. It has been established that fascia has a profound impact on wound healing and tissue repair.

There are now many research studies that investigate the role of fascia in MSK pain and restricted movement patterns [17, 39] and how fascia congestion effects  all our body functions [42] in MSK conditions.  Perhaps if patients had a pair of their own mitts they could be actively involved with their rehabilitation and recovery.

All fascia in the fascial system is made up of three main elements, collagen of which there are twelve different types in the body (depending on where in the body they are situated), elastin, and the extracellular matrix [5]. The ground substance within the extracellular matrix is a gel like substance that if it becomes dehydrated, restricted and congested will hinder cellular activity [68], the oscillating effect of the nodules of the Mitts on the skin (external fascia) bring about physiological change with in the tissue to rehydrate, enabling the mitochondria within the cell to convert the oxygen they need into ATP for cellular energy [44].

The mechanical forces that the Mitts stimulate enhance the tissue oxygenation process; increases blood flow, and provide extracellular matrix support. This influences the thixotropic state of the ground substance to reduce tissue viscosity and stiffness, therefore reducing tension in the tissue and increase intra and extra-cellular activity [63].

The gel–like properties of the ground substance means that it can liquefy when agitated and return to a gel state as it stands. And it will become more viscous through lack of movement.  It is the Hyaluronic acid component of the ground substance which contributes significantly to fluid dynamics, cell proliferation, communication and migration in the constantly changing environment of the tissue matrix. The interstitium (inter and intra tissue spaces), the pre-lymphatic connective tissue and the extracellular matrix support the fluid dynamics of the fascia [40] helping to rehydrate and supports all cellular activity, organs and whole body systems [34]. 

Localised massage movements performed on fascia can assist rehydration of the ground substance [53], which in turn unblocks the lymphatic and endocrine systems. This increase the ability for functional movement patterns and lubricates the fascial increasing its ability to move [42]. 

Fascia can become congested through sustained poor postural habits, repetitive restricted movement patterns and poor tissue hydration. The dehydrated cells collapse and the bi-products from cellular reactions accumulate to cause inflammation to adding to the fascial constriction. Pain, reduce movement patterns all have a negative impact on multiple homeostatic systems and pH within the body [52].  The nodules on the mitts provide a multiple, brief mechanical stretch to provide pressure, shear and hydrating effect to reduce tension, hydrate and increase nutrient to the tissue to reduce pain and increase movement for a multiple musculoskeletal conditions. 

In MSK conditions the combination of self-massage and exercises will relax and tone the complex network of fascia and muscle to relieve common issues that manifest with in the body. The nodules on the mitts provide a brief mechanical stretch to the soft tissue in the region affecting the fascial and extracellular matrix by increasing localised tissue and cell oxygenation for ATP production, increasing blood flow to clear metabolic by-products [62], and increase cellular activity in the extra cellular matrix turning the stimuli into biochemical and neurophysiological responses increasing lymphatic and endocrine function.

 

Conclusion

The scientific research is available to back up the theories for how these patented Professional Massage Mitts work. Further research is required for specific patient groups mentioned to validate them as a treatment modality to aid patient recovery, reduce the delayed onset of muscle soreness post exercise, save the NHS money, and improve treatment outcomes and patient satisfaction.

Training and guidelines for use of the massage mitts for healthcare professionals regarding health promotion and self-massage amongst various patient groups would be a reasonable next step for future research and protocol development. Utilizing self-massage could provide opportunities to deliver a more self-awareness messages to patients and make a positive impact on their own perceptions of who is responsible of looking after their health.

In future studies it may be found that increased tissue oxygenation and massage with the mitts may significantly improve surgical, scar tissue, and MSK symptoms.  Using the Mitts could enhance patient outcomes; an autonomous massage therapy strategy may increase patient satisfaction, giving them more control of their treatment and become more involved with their recovery for massage interventions using the Massage Mitts.

Depending on the patient groups chosen for evaluation/pilot study, which may include: chronic scar tissue or burns; two weeks post abdominal, total hip and knee replacement, or mastectomy surgery (there are many other post-surgery group appropriate for trials); MSK setting for self-treatment could include, delayed onset of muscle soreness DOMS or various regional studies including neck, shoulder and low back pain.

The benefits all patient experienced may or may not be attributed to the massage they received but the benefits of using the mitts in the early stages of post-operative recovery, wound healing, recovery need to be explored.

Advantage mentioned by patient is that they take control and become more aware of areas that need attention and are causing pain. 

The interest in human fascia will only increase, we are only just beginning to understand its’ important life sustaining role in musculoskeletal tensegrity, biochemical responses systems and chronic disease. Fascial dysfunction, pain and restriction are amongst the symptoms indicated.  The massage mitts could have an important role in the future of musculoskeletal rehabilitation providing patients with a self-treating tool providing a scientific practice solution for use within the NHS.

 

Funding

The University of Central Lancashire (UCLan) is wringing a report on the massage Mitts subsequent to Soma Therapies Ltd obtaining funding from the European Union Development Fund. Results indicate that massaging with the Mitts will increase tissue oxygenation much greater than hands alone.

 

Conflict of interest

The author declares that this product was designed and patented by the author but is actively looking for independent research to carry this project and research further to aid ‘self-care’ for the general population to reduce the strain on NHS resources.  The sample group is 455 and the results have been very positive.  A larger patient group research is welcomed to determine the full potential for patient benefits of using the Massage Mitts.

 

 

References:

    1. Griefahn, A., et al., Do exercises with the Foam Roller have a short-term impact on the thoracolumbar fascia? – A randomized controlled trial. Journal of Bodywork and Movement Therapies, 2017. 21(1): p. 186-193.
    2. Jelvéus, A., 14 - Soft tissue treatment techniques for maintenance and remedial sports massage, in Integrated Sports Massage Therapy2011, Churchill Livingstone: Edinburgh. p. 207-234.
    3. Welshhans, J.L. and D.B. Hom, Soft Tissue Principles to Minimize Scarring: An Overview. Facial Plastic Surgery Clinics of North America, 2017. 25(1): p. 1-13.
    4. Waibel, J.S. and A. Rudnick, Comprehensive Treatment of Scars and Other Abnormalities of Wound Healing. Advances in Cosmetic Surgery, 2018. 1(1): p. 151-162.
    5. Keane, T.J., C.-M. Horejs, and M.M. Stevens, Scarring vs. functional healing: Matrix-based strategies to regulate tissue repair. Advanced Drug Delivery Reviews, 2018. 129: p. 407-419. 
    6.  Li, X., et al., Comparison of subacute and chronic scar tissues after complete spinal cord transection. Experimental Neurology, 2018. 306: p. 132-137.
    7.  Ault, P., A. Plaza, and J. Paratz, Scar massage for hypertrophic burns scarring—A systematic review. Burns, 2018. 44(1): p. 24-38.
    8. Field, T., Massage therapy research review. Complementary Therapies in Clinical Practice, 2014. 20(4): p. 224-229.
    9. Liptan, G.L., Fascia: A missing link in our understanding of the pathology of fibromyalgia. Journal of Bodywork and Movement Therapies, 2010. 14(1): p. 3-12.
    10. Dommerholt, J., et al., A critical overview of the current myofascial pain literature – April 2018. Journal of Bodywork and Movement Therapies, 2018. 22(2): p. 402-410. 
    11.  Fritz, S., Mosby's Essential Science for Theraputic Massage. 4th ed. Anatomy, Physiology, Biomechanics, and pathology2013, 3251 Riverport Lane, Maryland Heights, MO 63043: Elsevier
    12. Netchanok, S., et al., The effectiveness of Swedish massage and traditional Thai massage in treating chronic low back pain: A review of the literature. Complementary Therapies in Clinical Practice, 2012. 18(4): p. 227-234.
    13. Unalmis Erdogan, S., E. Yanikkerem, and A. Goker, Effects of low back massage on perceived birth pain and satisfaction. Complementary Therapies in Clinical Practice, 2017. 28: p. 169-175.
    14. Simonelli, M.C., et al., Effects of Connective Tissue Massage on Pain in Primiparous Women After Cesarean Birth. Journal of Obstetric, Gynecologic & Neonatal Nursing, 2018. 47(5): p. 591-601.
    15. Mackie, B.R., M. Mitchell, and P.A. Marshall, The impact of interventions that promote family involvement in care on adult acute-care wards: An integrative review. Collegian, 2018. 25(1): p. 131-140.
    16. Koren, Y. and L. Kalichman, Deep tissue massage: What are we talking about? Journal of Bodywork and Movement Therapies, 2018. 22(2): p. 247-251.
    17. Chaitlow, L., Fascial Dysfunction -Manual therapy Approaches, ed. L. Chailow2014, Great Britian by Martins the Printers Ltd: Handspring Publishing Limited.
    18. Miyaji, A., K. Sugimori, and N. Hayashi, Short- and long-term effects of using a facial massage roller on facial skin blood flow and vascular reactivity. Complementary Therapies in Medicine, 2018.
    19. Li, Z., et al., The Characteristics of Blood Supply and Tissue Hypoxia in Pathological Scars. Chinese Medical Sciences Journal, 2017. 32(2): p. 113-118.
    20. da Silva, W., et al., Effect of green tea extract supplementation on exercise-induced delayed onset muscle soreness and muscular damage. Physiology & Behavior, 2018. 194: p. 77-82.
    21. Ikawa, M. and K. Karita, Relation between blood flow and tissue blood oxygenation in human fingertip skin. Microvascular Research, 2015. 101: p. 135-142.
    22. Davis, C.M., Chapter 71 - Complementary therapies for the aging patient, in A Comprehensive Guide to Geriatric Rehabilitation (Third Edition), T.L. Kauffman, et al., Editors. 2014, Churchill Livingstone: Oxford. p. 506-510.
    23. Wałaszek, M., et al., Practice of hand hygiene and use of protective gloves: Differences in the perception between patients and medical staff. American Journal of Infection Control, 2018. 46(9): p. 1074-1076.
    24. Schuster, L., Integrative Medicine in the Oncology Setting, What Does the Research Show? The Journal for Nurse Practitioners, 2018. 14(4): p. 276-282.
    25. Karagozoglu, S. and E. Kahve, Effects of back massage on chemotherapy-related fatigue and anxiety: Supportive care and therapeutic touch in cancer nursing. Applied Nursing Research, 2013. 26(4): p. 210-217.
    26. shiki, H., et al., Prevalence of myofascial pain syndrome in patients with incurable cancer. Journal of Bodywork and Movement Therapies, 2018. 22(2): p. 328-332.
    27. Cheatham, S.W. and K.R. Stull, Comparison of a foam rolling session with active joint motion and without joint motion: A randomized controlled trial. Journal of Bodywork and Movement Therapies, 2018. 22(3): p. 707-712.
    28. Nicol, A.L., et al., Chapter 25 - Myofascial Pain Syndrome, in Essentials of Pain Medicine (Fourth Edition), H.T. Benzon, et al., Editors. 2018, Elsevier. p. 207-212.e1.
    29. Craig, J.A., et al., Delayed onset muscle soreness: Lack of effect of therapeutic ultrasound in humans. Archives of Physical Medicine and Rehabilitation, 1999. 80(3): p. 318-323.
    30. Nelson, N., Delayed onset muscle soreness: Is massage effective? Journal of Bodywork and Movement Therapies, 2013. 17(4): p. 475-482.
    31. Lane, J., D. Kripaitis, and M. Spina, The effect of Foam Rolling (FR) on recovery from delayed onset muscle soreness. Physiotherapy, 2017. 103: p. e46.
    32. Avila Gonzalez, C.A., et al., Frontiers in fascia research. Journal of Bodywork and Movement Therapies, 2018.
    33. Chaitow, L., Fascial well-being: Mechanotransduction in manual and movement therapies. Journal of Bodywork and Movement Therapies, 2018. 22(2): p. 235-236.
    34. Marini, M., et al., Telocytes in human fetal skeletal muscle interstitium during early myogenesis. Acta Histochemica, 2018.
    35. Dibai-Filho, A.V., et al., Analysis of chronic myofascial pain in the upper trapezius muscle of breast cancer survivors and women with neck pain. Journal of Bodywork and Movement Therapies, 2018. 22(2): p. 237-241.
    36. Gracovetsky, S., Yoga, fascia and the second law of thermodynamics. Journal of Bodywork and Movement Therapies, 2018. 22(2): p. 346-347.
    37. Crisford, P., et al., Factors associated with physical activity promotion by allied and other non-medical health professionals: A systematic review. Patient Education and Counseling, 2018. 101(10): p. 1775-1785.
    38. Kennedy, A.B., et al., Advancing health promotion through massage therapy practice: A cross-sectional survey study. Preventive Medicine Reports, 2018. 11: p. 49-55.
    39. Chaitow, L., Dosage and manual therapies – Can we translate science into practice? Journal of Bodywork and Movement Therapies, 2016. 20(2): p. 217-218.
    40. Benias, P., Wells, G., Sackey-Aboagye, B., Klavan, H., Reidy, J., Buonocore, D., Miranda, M., Kornacki, S., Wayne, M., Carr-Locke, D., & Theise, N., Structure and Distribution of an Unrecognized Interstitium in Human Tissues. Scientific Reports 2018. 8(4947).
    41. Adstrum, S., Hedley, G., Schleip, R,. Stecco, C., & Yucesoy, CA., Fascia Science And Clinical Applications: Fascia nomenclature sub-committee report 'Defining the Fascial System. Journal of Bodywork & Movement Therapies, 2017. 21: p. 173-177.
    42. Bordoni, B., et al., The indeterminable resilience of the fascial system. Journal of Integrative Medicine, 2017. 15(5): p. 337-343.
    43. Jansen, K.A., P. Atherton, and C. Ballestrem, Mechanotransduction at the cell-matrix interface. Seminars in Cell & Developmental Biology, 2017. 71: p. 75-83.
    44. Guimberteau, J.-C. and C. Armstrong, Architecture of Human Living Fascia. The extracellular matrix and celss revealed through endoscopy2015, Edinburgh: Handspring Publishing.
    45. Stecco, C., Functional Atlas of the Human Fascial System2015, Edinburgh: Churchill Livingstone.
    46. Bo, K., et al., Evidence-based Physical Therapy for the Pelvic Floor Bridging science and clinical practice. second edition ed2015, Croydon: Elsevier Churchill Livingstone.
    47. MacSween, A., et al., A randomised crossover trial comparing Thai and Swedish massage for fatigue and depleted energy. Journal of Bodywork and Movement Therapies, 2017.
    48. Rey-Matias, R.R., 16 - Manipulation, Traction, and Massage, in Braddom's Rehabilitation Care: A Clinical Handbook, D.X. Cifu and H.L. Lew, Editors. 2018, Elsevier. p. 111-118.e8.
    49. Kennedy, A., et al., Implementing, embedding and integrating self-management support tools for people with long-term conditions in primary care nursing: A qualitative study. International Journal of Nursing Studies, 2014. 51(8): p. 1103-1113.
    50. van Griensven, H., Traumatic scar tissue management. massage therapy principles, practice, and protocols. International Journal of Osteopathic Medicine, 2016. 21: p. 62-63.
    51. Adstrum, S., et al., Defining the fascial system. Journal of Bodywork and Movement Therapies, 2017. 21(1): p. 173-177.
    52. Thomas, J. and W. Klingler, 4.4 - The influence of pH and other metabolic factors on fascial properties A2 - Schleip, Robert, in Fascia: The Tensional Network of the Human Body, T.W. Findley, L. Chaitow, and P.A. Huijing, Editors. 2012, Churchill Livingstone: Oxford. p. 171-176.
    53.  Schleip, R. and D.G. Müller, Training principles for fascial connective tissues: Scientific foundation and suggested practical applications. Journal of Bodywork and Movement Therapies, 2013. 17(1): p. 103-115.
    54. Cho, Y.S., et al., The effect of burn rehabilitation massage therapy on hypertrophic scar after burn: A randomized controlled trial. Burns, 2014. 40(8): p. 1513-1520.
    55. Matheis, C. and T. Stöggl, Strength and mobilization training within the first week following total hip arthroplasty. Journal of Bodywork and Movement Therapies, 2018. 22(2): p. 519-527.
    56. Nunes, G.S., et al., Massage therapy decreases pain and perceived fatigue after long-distance Ironman triathlon: a randomised trial. Journal of Physiotherapy, 2016. 62(2): p. 83-87.
    57. Torres, R., et al., Evidence of the physiotherapeutic interventions used currently after exercise-induced muscle damage: Systematic review and meta-analysis. Physical Therapy in Sport, 2012. 13(2): p. 101-114.
    58. Stecco, C. and A. Stecco, 7.7 - Fascial manipulation A2 - Schleip, Robert, in Fascia: The Tensional Network of the Human Body, T.W. Findley, L. Chaitow, and P.A. Huijing, Editors. 2012, Churchill Livingstone: Oxford. p. 335-342.
    59. Schnittert, J., et al., Integrins in wound healing, fibrosis and tumor stroma: High potential targets for therapeutics and drug delivery. Advanced Drug Delivery Reviews, 2018. 129: p. 37-53.
    60. Korntner, S., et al., Limiting angiogenesis to modulate scar formation. Advanced Drug Delivery Reviews, 2018.
    61. Stunova, A. and L. Vistejnova, Dermal fibroblasts—A heterogeneous population with regulatory function in wound healing. Cytokine & Growth Factor Reviews, 2018. 39: p. 137-150.
    62. Han, A.A., et al., The impact of cytokine responses in the intra- and extracellular signaling network of a traumatic injury. Cytokine, 2018. 106: p. 136-147.
    63. Rilla, K., et al., Extracellular vesicles are integral and functional components of the extracellular matrix. Matrix Biology, 2017.
    64. Piperigkou, Z., et al., Insights into the key roles of epigenetics in matrix macromolecules-associated wound healing. Advanced Drug Delivery Reviews, 2018. 129: p. 16-36.
    65. Desmet, C.M., V. Préat, and B. Gallez, Nanomedicines and gene therapy for the delivery of growth factors to improve perfusion and oxygenation in wound healing. Advanced Drug Delivery Reviews, 2018. 129: p. 262-284.
    66. Dornfeld, K., et al., Differences in breast tissue oxygenation following radiotherapy. Radiotherapy and Oncology, 2011. 100(2): p. 289-292.
    67. Day, J.A., L. Copetti, and G. Rucli, From clinical experience to a model for the human fascial system. Journal of Bodywork and Movement Therapies, 2012. 16(3): p. 372-380.
    68. Schleip, R., et al., Strain hardening of fascia: Static stretching of dense fibrous connective tissues can induce a temporary stiffness increase accompanied by enhanced matrix hydration. Journal of Bodywork and Movement Therapies, 2012. 16(1): p. 94-100.

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