performed on colorectal surgery patients reduced both anxiety and pain. Other similar studies of massage use after surgery have been reported over the years. In fact, TIME magazine ran an article on the subject in 2007. There are a number of ways in which massage is used both immediately after a surgical procedure and after some time has passed. Let’s take a look at a few primary functions of massage for the postoperative client. Massage has important general pain-relieving benefits. Some believe massage’s role in assisting pain relief is similar to how a TENS unit works, in that it creates competing signals that the body focuses on. Massage also reduces overall sensitivity in the nervous system and decreases anxiety associated with the surgical procedure as well. For this reason massage for postsurgical pain management does not have to be aimed at the surgical site, but could simply involve working a remote area, as in a foot-and-leg treatment. Treating a client who has just had surgery can lessen his pain, and help him move forward more effectively through the rehabilitation process. Another highly beneficial use of massage immediately after surgery is to encourage lymphatic drainage near the surgical site. Postsurgical swelling is most likely to occur close to the actual surgical site, so care should be taken with this type of treatment. Lymphatic drainage techniques reduce swelling and the pain associated with that swelling. You don’t want to apply lymphatic drainage techniques directly over a surgical site, but near the site to encourage removal of excess tissue fluid. It is important to have clear communication with the physician or rehabilitation professional about how lymphatic drainage techniques should be applied for different surgical procedures. Different surgeries have quite different applications for lymphatic drainage. For example, a rotator cuff repair may have swelling, but because of the surgical site location the swelling is not very evident. So techniques in this case are applied to the shoulder region to help superficial tissue swelling, but would not affect swelling deeper in the joint near the actual surgical repair. Patients who have had a mastectomy with lymphatic node removal, in contrast, are likely to have problems with tissue fluid accumulation. Consequently, lymphatic drainage massage is crucial for them. Massage is highly valuable in situations where lymphatic vessels have been damaged or removed by cancer surgeries. Rehabilitative massage There are other important goals of postsurgical massage that focus on benefits derived a period of time after the surgical procedure. One of the most beneficial roles of massage is management of scar tissue. Following some procedures, there may be a long period of immobilization to allow proper healing, which may result in fibrous adhesions and scar tissue that may bind or restrict movement. Massage is one of the most effective methods for improving mobility and reducing fibrous scarring in soft tissues. Methods such as skin rolling or friction massage are the most common applications used for scar tissue mobilization. These techniques reduce fibrous binding, and work best when used in conjunction with stretching to encourage full elasticity. Use caution with friction massage for postsurgical scarring because the area is likely to be tender and the Massage methods such as skin rolling or friction massage are effective methods for improving mobility and reducing fibrous scarring in soft tissues. 62 | MASSAGE Magazine | September 2015 | www.massagemag.com | tissues are usually somewhat fragile. Friction massage applied too vigorously could further damage the surgical site and impact tissue healing. There is an ideal balance of appropriate tissue stress and pressure, and of course, timing. For the best results, check in with the client frequently about pressure levels and pay close attention to what you are feeling under your treating fingers. Surgery, or injury that preceded it, often disrupts proper biomechanics. Biomechanical patterns of movement involve complex coordination of many tissues. These patterns may be disturbed prior to the surgery by a dysfunctional condition or injury, and are likely to be disturbed even further by the tissue damage caused by surgery. For example, shoulder mechanics may be altered from a rotator cuff tear. Following surgical repair of the tear, proper biomechanical patterns need to be restored. This treatment will include strengthening activities performed in physical therapy, but massage can also reduce tight muscles and help reestablish proper muscular tone. Massage is an excellent adjunct to other treatments after surgery. In certain surgeries, the patient is anesthetized and must stay in a static position for a long period of time. Patients in this situation cannot make comments about any pain or discomfort they are feeling. It is not uncommon for nerve compression pathologies to develop while a patient is lying on the surgical table for several hours. The nerve compression creates soft-tissue pain following the surgery that is not related to the surgical procedure itself. Myofascial trigger points and other soft-tissue dysfunction can also develop from long periods of bed rest following surgery. In general, massage helps improve circulation and tissue mobility when there has been a period of immobilization. When not to massage While