Surgery, whether planned or unexpected, marks a significant event in a person's life. While the surgery itself is a crucial step, the recovery period that follows is equally important. Post-operative care focuses on healing the surgical site, managing pain, and restoring function. An increasingly popular and effective component of post-operative care is massage therapy. This article explores the benefits of massage after surgery, how it works, different types of massage used, when it's safe to begin, and other important considerations.
Understanding Post-Surgical Scar Formation and Its Impact
Scar formation is a natural and essential part of the body's healing process after surgery. When the skin is cut during an operation, the body initiates a cascade of events to close the wound and repair the damaged tissue. This process involves the production of collagen, a protein that forms the structural framework of the skin. However, the resulting scar tissue can sometimes lead to a range of post-surgical issues, such as pain and reduced range of motion.
Jenice Mattek, LMT, notes that individuals may experience symptoms seemingly unrelated to their surgery or scar tissue. This highlights the complex nature of post-surgical recovery and the potential for scar tissue to affect various parts of the body.
The wound healing process typically progresses through three stages:
- Inflammation: This is the initial phase, characterized by redness, swelling, and pain.
- Proliferation: During this stage, new tissue is formed to close the wound.
- Remodeling: In the final stage, the scar tissue matures and becomes stronger.
The type and severity of scarring can vary depending on several factors, including the type of surgery, the location and technique of incisions, and individual characteristics. Rachel Richards, LMT, emphasizes that the effects of surgery depend not only on the body area involved but also on the invasiveness of the procedure.
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What is Post-Surgery Massage?
Post-surgery massage, or post-operative massage, is a specialized therapeutic treatment designed to aid recovery following surgery. Unlike traditional massages, which are more holistic, post-op massage focuses on the specific surgical area and surrounding tissues. It aims to alleviate discomfort, reduce swelling, and facilitate healing. These massages can be administered in a spa or at home using mobile massage services, where trained therapists tailor treatments to individual needs.
Post-Op Lymphatic Massage
One notable type is the post-op lymphatic massage. The lymphatic system eliminates toxins from the body, and surgery can cause lymphatic fluid buildup, leading to swelling and discomfort. A post-op lymphatic massage gently stimulates this system, aiding in the drainage of excess fluid, reducing inflammation, and accelerating healing. The techniques used in post-surgical massage differ from traditional methods, employing gentler strokes, careful pressure, and specific techniques to address post-surgical challenges.
Benefits of Massage After Surgery
Integrating post-surgery massage into the recovery protocol can offer a range of benefits:
Reduced Swelling: One of the primary benefits, particularly of lymphatic massage, is the reduction of post-surgical edema or swelling. By promoting lymphatic drainage, the body can more efficiently eliminate excess fluid from the surgical site. Occasional fluid buildup might not seem like a major issue, but persistent swelling in the arms, legs, or abdomen can be detrimental. It can cause limbs to feel heavy and tired, skin to feel tight and uncomfortable, and even affect the fit of clothing and jewelry.
Pain Management: The gentle manipulation of tissues around the surgical site can alleviate pain and discomfort. Massage also promotes the release of endorphins, the body's natural painkillers, further enhancing pain relief. A major review of 16 studies published in Pain Medicine indicated that massage therapy could effectively reduce pain severity in post-surgical patients.
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Enhanced Circulation: Improved blood flow is pivotal after surgery. Massage can help ensure that oxygen-rich blood reaches healing tissues, fostering quicker tissue repair and reducing the risk of complications.
Scar Tissue Management: Surgical incisions can lead to scar tissue formation. Skilled massage therapists can employ techniques to break down this tissue, resulting in softer, more pliable scars. Skin rolling can release the scar's attachment to deeper skin layers, while indirect myofascial release can ease the nervous system by easing the scar's pressure. The bowing technique can also help release more aggressive keloid scars.
Relaxation and Stress Reduction: The calming nature of massage can mitigate post-surgical anxiety, contributing to overall well-being and a positive recovery experience. Brent Bauer, MD, director of the Mayo Clinic Complementary and Integrative Medicine Program, notes that even the best surgical experience is stressful, both physically and emotionally. Massage can help manage stress, which may improve outcomes, as high-stress levels can reduce wound-healing abilities and dampen immune function.
Improved Flexibility and Range of Motion: By addressing the muscles affected by surgery, massage therapy techniques can relax muscle tissue and promote healing, leading to better range of motion.
Types of Massage Used in Post-Surgical Recovery
Two main types of massage can jump-start the recovery process post-surgery:
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- Lymphatic Drainage Massage: This gentle massage technique, developed in Germany, treats lymphedema, a post-operative accumulation of fluid. It stimulates the lymphatic system to help the body eliminate waste and toxins.
- Deep Tissue Massage: This type of massage relieves chronic pain experienced after surgery by targeting deeper layers of muscle and tissue.
When Can I Get a Massage After Surgery?
The timing of when it is safe to begin post-surgery massage varies based on the type of surgery, individual health status, and medical advice. Generally, massage is not recommended in the immediate days following surgery due to the body being in an acute healing phase. In the subacute phase (a few days to several weeks post-surgery), gentle lymphatic massages can be introduced, especially if swelling is a concern, ensuring the incision site is adequately healed. The chronic phase, starting several weeks after surgery, allows for deeper massage techniques to manage scar tissue and improve mobility, always ensuring no discomfort is experienced.
Daniel Hinshaw, MD, emphasizes that therapists should avoid massaging incision sites directly in the immediate post-operative period. Researchers at a Veterans Administration hospital found benefits in massage therapy used almost immediately after surgery, but they avoided the incision site.
Six weeks is the standard time massage therapists wait before working on or near post-operative incision sites. It’s essential to get clearance from a client’s doctor before working on a surgical site and to check in with clients thoroughly.
Specific Surgical Procedures and Massage Therapy
Massage therapy can be beneficial for a variety of surgical procedures, each with its own set of post-operative challenges:
Abdominal Surgery
Abdominal surgeries can be performed on various organs for reasons such as obstruction, infection, or tumors. Common post-surgery complaints include loss of control of abdominal muscles (muscle inhibition) and scar tissue development. More than 90% of people undergoing abdominal surgery develop some type of scarring or adhesions. Back pain often results from patients compensating for muscle inhibition and scarring. Massage therapy can help by changing alignment due to post-surgery complications and turning muscles back on. A February 2014 study in Scientific World Journal indicated that massage helped patients with chronic low back pain, with study authors suggesting massage therapy acted similarly to anti-inflammatory pain drugs.
Hip Replacement
Also known as hip arthroplasty, this procedure replaces a damaged hip joint. Post-surgery complaints and complications depend on the surgical approach. A 2017 study in the Journal of Orthopaedic Science showed that manual calf massage could lower the incidence of deep vein thromboembolism in hip replacement patients. Massage therapy also helps with troublesome scar tissue.
Open-Heart Surgery
After open-heart surgery, patients may experience discomfort, especially impaired movement in the shoulders, back, and neck. A research review in Heart & Lung found that patients receiving massage therapy with pain-relieving medications reported less pain than those who’d received "sham" massage or only pain medication.
General Surgery
General surgery can be performed on various body areas for reasons including cancer surgery. Resulting issues rely on the body area operated on. Minimally invasive surgery can still produce significant scar tissue. Massage benefits general surgery patients by reducing surrounding discomfort and re-aligning muscles and joints.
The Role of Lymphatic Massage in Specific Surgeries
Lymphatic massages are particularly beneficial for post-surgery recovery, promoting faster healing, and enhancing surgical results.
- Liposuction: Lymphatic massages speed up the formation of new lymphatic channels, aiding faster recovery since liposuction disrupts the skin’s lymphatic channels.
- Breast Surgery: Regular lymphatic massages after breast surgery enhance aesthetic results by speeding up the development of new lymphatic channels.
- Facial Procedures: Post-surgery lymphatic massages detoxify the body, moving fluids, toxins, and waste products to be filtered by lymph nodes and eliminated.
The timing of lymphatic massages post-surgery varies. Lymphatic drainage massages can typically begin 24 hours after surgery. For liposuction, patients can start the day after surgery, while those with tucks should begin a few days post-surgery.
Precautions and Considerations
Before integrating massage into post-surgical care, it's crucial to consider the following:
- Medical Clearance: Always seek medical clearance from a doctor before starting massage therapy, especially if less than six weeks post-procedure.
- Qualified Therapist: Work with a certified post-op massage therapist who understands post-surgical care intricacies. Seek a therapist with specific training in lymphatic drainage massage who understands the unique needs of post-surgical patients.
- Communication: Thoroughly check in with clients and ensure they are comfortable with the process. What may be OK with one client may not be OK with another.
- Contraindications: While lymphatic drainage massages are generally safe, they might not be suitable for everyone. Consult a doctor or certified lymphedema specialist if you have concerns.