Massage after a stroke can be beneficial, but there are certainly some complications of which you should be aware. It is important to know the underlying cause of the stroke and your risk factors for another one occurring.
What is a Stroke?
A stroke is damage to the brain caused by internal bleeding or interruption of blood flow by a clot or other blockage. Strokes are also called “cerebral vascular accidents” (CVA).
Strokes are the third leading cause of death in the United States, behind heart disease and cancer. Approximately 700,000 people suffer a stroke each year in the US. That’s one every 45 seconds. Death by CVA happens to about 160,000 people each year; roughly one every three minutes.
Between 15 – 30% of stroke survivors become permanently disabled and around 20% of those require long-term nursing care.
The loss of blood flow to the brain reduces or completely blocks oxygen and nutrients reaching the brain. This can happen because of bleeding somewhere between the heart and the tiny blood vessels that reach deep in the brain. More commonly, strokes happen due to ischemia (mechanical blockage) in blood vessels.
There are two types of ischemic CVAs:
- Cerebral Thrombosis (blood clot) – This type of stroke occurs when a clot develops in the brain, blocking an artery.
- Sometimes caused by an injury, such as a car accident or other blow to the head that causes bleeding.
- Prolonged high blood pressure can weaken and tear small arteries, causing a clot to develop.
- Embolism – An embolus is a fragment of some material that breaks free in another area of the body and travels to the brain. Because these fragments are too large to pass through the small vessels in the brain, they get caught, shutting off blood flow.
- High cholesterol can cause plaque to develop in arteries, narrowing them. Fragments of this plaque can break loose and travel to the brain.
- Atrial fibrillation is an irregular heart rhythm that can form blood clots that travel to the brain.
- A complication of surgery or injury to another part of the body.
There are also two types of hemorrhagic (bleeding related) CVAs:
- Subarachnoid – A rupture of a blood vessel between the protective lining of the skull (arachnoid) and the surface of the brain. Blood pools in this space, which puts pressure on the brain and closes off blood vessels.
- Intracerebral – The rupture of a blood vessel somewhere in the brain, can be caused by:
- Aneurysm, a weakened area of an artery that can rupture with vigorous exercise or due to high blood pressure.
- Bleeding disorders
- Head trauma
- Birth defect.
The amount of damage caused by a stroke is determined mostly by three factors:
- the location of the CVA,
- the amount of time the brain is deprived of oxygen,
- swelling and inflammation of surrounding tissues.
Patients can control most of the underlying causes of a stroke.
- Hypertension (high blood pressure) is the single biggest risk factor. Chronic hypertension increases your risk of suffering a stroke 400-600%.
- Smoking constricts blood vessels, increasing blood pressure.
- Atrial fibrillation
- Drug use
- High cholesterol
- Sedentary lifestyle
- Use of high-estrogen birth control
- Hormone replacement therapy for menopause
- Untreated inflammatory disease
- Depression – one third of stroke patients are diagnosed with depression before their first CVA.
- High stress
Patients have no control over some risk factors, including:
- Age – 75% of stroke victims are over the age of 65.
- Race – African Americans are more likely to suffer from chronic high blood pressure and have strokes twice as often as Caucasians; African Americans are twice as likely to die from a stroke.
- Gender – Men have strokes 25% more often than women, but women are more likely to die from a stroke.
- Family history – Weak blood vessels can be genetic. High blood pressure and poor diets are often the result of behaviors learned from our parents.
Massage Reduces Stroke Risk
You may have noticed that a number of the controllable risk factors above are conditions that benefit from massage therapy. Stress reduction, improved circulation, stretching and range of motion exercises, and regulation of hormone levels are all benefits of massage.
Massage After You Have Suffered a Stroke
Regular massage therapy can play a vital role in recovery after a stroke. There are of course some important cautions that must be considered.
First, I should know about your overall cardiovascular health. If you have circulatory problems, especially any issues with the carotid arteries in your neck, care must be taken to avoid working near these easily accessible vessels.
Second, if you have suffered from any paralysis or loss of sensation due to a stroke, those areas must be massaged gently. It is easy to apply too much pressure to an area that you can not feel which can cause bruising and blood clots.
Massage can help restore function, control, and muscle tone over areas which have been affected by a stroke.
Recommended Massage Styles After a Stroke
Some recommended massage modalities for recovering after a stroke:
- Deep Tissue to improve movement and proprioception, or body awareness.
- Lymphatic Drainage after initial inflammation.
- Reflexology to reduce stress.
- Shiatsu to improve flexibility, reduce stress, and improve balance.
It is very important that you discuss your stroke history with me before your massage. I must be made aware of any clotting disorders or history of blood clots. You should also inform me of any paralysis, loss of sensation, or any other lingering effects you’ve suffered after a stroke.