The Importance of Touch: A Guide for Parental Massage
Cynthia Karlson, B.S., L.M.T.
University of Kansas
2006

Massage therapy has been around for thousands of years and has recently been used to treat symptoms of disorders ranging from HIV and cancer to back pain and depression. Numerous studies show that massage therapy reduces muscle tension, decreases feelings of anxiety and depression, and increases positive mood. Thus, massage may be an ideal intervention for children with scleroderma.

As with many complementary therapies, massage appears to offer a wide range of benefits to both adults and children. Massage may be particularly helpful for children who suffer from chronic pain because massage relaxes tired and sore muscles and promotes long-term relaxation. Clinical research suggests that relaxation is one of the most effective complementary interventions for managing children’s pain. In fact, thirty five percent of pediatric pain centers that offer complementary and alternative therapies offer massage therapy to promote relaxation and help reduce and control chronic pain.

Massage may also have specific benefits for children with autoimmune illnesses such as scleroderma. In a recent study of children with juvenile rheumatoid arthritis, parental massage was found to decrease pain and morning stiffness, and increase joint mobility. Although it is not known exactly how massage affects the immune system, it is likely that massage reduces stress, tension, and anxiety; all of which have been shown to increase autoimmune disease activity. Because of these types of benefits, massage therapy may be able to help children with scleroderma feel better and lead more active lives.

Although regular professional massage can be quite expensive, massage therapy need not be financially out of reach for children with scleroderma. Parents can be trained to give their children massages! Parental massage has repeatedly been found to be effective for a number of pediatric conditions. One disease that has skin symptoms similar to those of scleroderma is dermatitis. Parental massage was found to improve all measured symptoms of dermatitis in children, including redness, thickening, scaling, abrasions, and itching. Thus, massage therapy may offer many benefits to children with scleroderma and can be easily and effectively performed by parents for little or no cost. Here are some of the potential benefits that you can offer your child with parental massage.

Benefits of Massage

1. Increasing Joint Motion: Massage can help increase joint mobility by increasing blood flow to the tendons and muscles that surround the joint. Additionally, manual manipulation helps to break up adhesions in the connective tissue and increase tissue dexterity.
    

2. Decreasing Pain: Touch and pressure sensations travel to the brain faster than pain sensation. So, when an individual receives massage, the pain message is interrupted and the sensation of pain is reduced.
   

3. Decreasing Swelling and Inflammation: Performing massage using the following technique will push old blood out of a swollen area and bring new blood in to the area; thereby decreasing swelling and inflammation. Technique: Massage the area above the swollen area, next very lightly massage the swollen area, lastly massage the area below the swelling. Always stroke upwards towards the heart to push excess fluid out of the swollen area.
   

4. Soften Scar Tissue: Massage can be performed with skin creams and lotions that contain ingredients, such as Methylsulfonylmethane (MSM), that help soften the skin.
   

5. Decreasing Stress: Massage promotes relaxation, improves sleep quality and decreases the release of stress hormones, such as cortisol. All of these mechanisms help individuals who receive massage to feel less anxious and to reduce stress. 

Another benefit of massage therapy is the experience of positive touch.  Because scleroderma can affect children’s physical appearance, children with scleroderma may receive a limited amount of positive touch from peers, teachers, and other adults. Animal studies and studies with infants show that positive touch is extremely important in normal growth and development. In fact, massage has repeatedly been found to significantly increase premature infants’ growth and ability to thrive. Massage can also help children with scleroderma view their bodies in a more positive manner, as a companion rather than the enemy.

Massaging Your Child

Different kinds of massage can be used to achieve different goals. In general, 15 to 20 minutes of massage is recommended for each massage session.

If you want to promote more restful sleep, massage should be given right before bedtime using slow, soft strokes. Alternatively, sports massage (quick, brisk stokes) can be used prior to stretching or physical therapy to help warm up the muscles and tendons; thereby decreasing the pain associated with stretching and physical therapy sessions. Massage therapy can also be used as light anaerobic exercise to help combat the muscle atrophy that sometimes occurs in scleroderma with the use of moderately quick and medium depth strokes.

Like any other therapeutic treatment, there are times that massage is not recommended. You should not massage your child if he or she has a cold or fever. It is thought that the increased circulation may speed up the cold process, making your child feel worse rather than better. Always avoid massaging directly on the spine, as this can be painful and cause bruising. Also, avoid any cuts, bruises or open wounds to prevent further tissue damage.

Massage Strokes

1) Neck

1. clasp neck directly above shoulders and gently stroke upwards

2. circular strokes on either side of spine with flats of fingers

3. circular strokes across base of head

4. upward strokes along neck

2) Face

1. strokes along both sides of the face

2. flat fingers across the forehead

3. circular strokes over the temple and the hinge of the jaw

4. flat finger strokes over the nose

3) Arms

1. stroking from shoulders to the hands

2. squeezing and twisting in a wringing motion from shoulder to hand

3. massaging hand and fingers

4. stretching wrists

5. stroking the arms upwards towards the heart

4) Legs

1. stokes from hip to foot

2. squeezing and twisting in a wringing motion from hip to foot

3. massaging foot and toes

4. stretching the Achilles tendon

5. stroking the legs upwards toward the heart

5) Back

1. downward strokes along the back

2. hand-over-hand movements from the upper back to the hips

3. hands from side to side across the back, including the sides

4. circular motion from head to hips along, but not touching, the spine

5. simultaneous strokes over the sides of the back from the middle to the sides

6. rubbing and kneading shoulder muscles

7. rubbing the neck

8. stroking the length of the back

9. stroking from head to feet

There are many useful instructional books and videos on massage therapy for adults, children and infants. These resources often give step by step instructions on how to give massage and are usually easy to follow. Such books and videos can be found at your local bookstore or ordered online. Listed below are some helpful websites for more information about massage therapy. As always, consult your child’s physician before beginning any alternative or complementary therapies for the symptoms of scleroderma.

Helpful Resources:

American Massage Therapy Association: http://www.amtamassage.org

National Center for Alternative and Complementary Medicine: http://nccam.nih.gov

Touch Institute of the University of Miami: http://www.miami.edu/touch-research/

In summary, massage is a safe and effective complimentary therapy that has been found to help the symptoms of many childhood diseases. It can increase positive parent-child interactions, and can be good way to bond with your child. Give massage a try and see if it works for you!

Please keep in mind, this webpage is for your information only.
Please check with your child's physician for any treatments.

For more information on Juvenile Scleroderma, contact:

Juvenile Scleroderma Network, Inc.
1204 W. 13th Street, San Pedro, CA 90731

Tel: (310)519-9511 (Pacific Time)
Speak to another JSD parent for emotional and logistical support provided by home-based JSD volunteers. For medical advice, please contact your child's physician.