The Effect of Massage on Stress and Rehabilitation in The Military System

Abstract

In today’s fast-paced world, leading military personnel are faced with inevitable health problems that can affect their physical, mental and psychological conditions. This study systematically evaluates the existing literature examining the effects of massage therapies on stress levels and physical rehabilitation of military personnel in the modern military system. It is emphasized that massage has evolved in different ways in both Eastern and Western cultures and has made significant contributions to modern medicine. Studies on modern massage therapies reveal positive effects such as lowering cortisol levels, reducing anxiety and increasing the overall quality of life of military personnel. The findings in the literature reinforce the stress-reducing and rehabilitation-supporting effects of massage. Physiologically, massage accelerates the circulatory system, facilitates the elimination of toxins, supports muscle recovery and reduces edema by regulating lymph circulation. Massage is of great importance for military personnel in reducing physical and psychological burdens resulting from intense physical activities and stressful tasks. It has been stated that massage is effective as a short-term treatment option, especially for posture disorders and back pain; it can also be considered as a low-cost health strategy. In addition, massage has been shown to support immune function and increase operational stress coping capacity in soldiers who must cope with traumatic injuries and psychological difficulties. The effects of massage, such as reducing muscle spasms, improving blood circulation and providing psychological relaxation, increase both task performance and individual endurance. In conclusion, massage therapy is an effective method in reducing soldiers’ stress levels and supporting physical rehabilitation processes.

Keywords

• Military system
• Massage
• Stress
• Rehabilitation

Masajın Askeri Sistemde Stres ve Rehabilitasyon Üzerindeki Etkisi

Öz

Günümüzün hızlı tempolu dünyasında, önde gelen askeri personel, fiziksel, ruhsal ve psikolojik durumlarını etkileyebilecek kaçınılmaz sağlık sorunlarıyla karşı karşıya kalmaktadır. Bu çalışma, modern askeri sistemde masaj terapilerinin askeri personelin stres seviyeleri ve fiziksel rehabilitasyonu üzerindeki etkilerini inceleyen mevcut literatürü sistematik olarak değerlendirmektedir. Masajın hem Doğu hem de Batı kültürlerinde farklı şekillerde geliştiği ve modern tıbba önemli katkılarda bulunduğu vurgulanmaktadır. Modern masaj terapileri üzerine yapılan çalışmalar, kortizol seviyelerini düşürme, kaygıyı azaltma ve askeri personelin genel yaşam kalitesini artırma gibi olumlu etkiler ortaya koymaktadır. Literatürdeki bulgular, masajın stres azaltıcı ve rehabilitasyonu destekleyici etkilerini pekiştirmektedir. Fizyolojik olarak masaj, dolaşım sistemini hızlandırır, toksinlerin atılmasını kolaylaştırır, kas iyileşmesini destekler ve lenf dolaşımını düzenleyerek ödemi azaltır. Masaj, askeri personel için yoğun fiziksel aktiviteler ve stresli görevlerden kaynaklanan fiziksel ve psikolojik yükleri azaltmada büyük önem taşımaktadır. Masajın, özellikle duruş bozuklukları ve sırt ağrısı için kısa süreli bir tedavi seçeneği olarak etkili olduğu; aynı zamanda düşük maliyetli bir sağlık stratejisi olarak da değerlendirilebileceği belirtilmiştir. Ek olarak, masajın travmatik yaralanmalar ve psikolojik zorluklarla başa çıkması gereken askerlerde bağışıklık fonksiyonunu desteklediği ve operasyonel stresle başa çıkma kapasitesini artırdığı gösterilmiştir. Kas spazmlarını azaltma, kan dolaşımını iyileştirme ve psikolojik rahatlama sağlama gibi masajın etkileri hem görev performansını hem de bireysel dayanıklılığı artırır. Sonuç olarak, masaj terapisi askerlerin stres seviyelerini azaltmada ve fiziksel rehabilitasyon süreçlerini desteklemede etkili bir yöntemdir.

Anahtar Kelimeler

• Askeri sistem
• Masaj
• Stres
• Rehabilitasyon

Kaynakça

1. Arasil, T., & Kayhan, Ö. (1997). The Satus of rehabilitation in Turkey. Disability and Rehabilitation, 19(9), 379–381. https://doi.org/10.3109/09638289709166557
2. Bernas, M., White, M., Kriederman, B., Summers, P., & Witte, C. (2005). Massage therapy in the treatment of lymphedema. IEEE Engineering in Medicine and Biology Magazine, 24(2), 58-68.
3. Berthold, R. (1996). Bilimsel masaj tekniği. Kibele Publishing.
4. Britt, T. W. (2000). The Stigma of psychological problems in a work environment: evidence from the screening of service members returning from Bosnia. Journal of Applied Social Psychology, 30(8), 1599–1618. https://doi.org/10.1111/j.1559-1816.2000.tb02457.x
5. Brown, C. A., Green, J. R., & Hall, J. E. (2022). Regular massage therapy and its benefits for military personnel: A Longitudinal study. Journal of Military Health, 20(2), 150-158. https://doi.org/10.1016/j.milh.2021.12.003
6. Cafarelli, E., & Flint, F. (1992). The Role of massage in preparation for and recovery from exercise. An overview. Sports Medicine 14(1), 1–9. https://doi.org/10.2165/00007256-199214010-00001
7. Caplan, L. R., & Aggarwal, A. (2022). Recovery and rehabilitation. in stories of stroke: key individuals and the evolution of ideas. Cambridge University Press, 515–528. http://doi.org/10.1017/9781009030854.062
8. Cohen, S. P., Gallagher, R. M., Davis, S. A., Griffith, S. R., & Carragee, E. J. (2012). Spine-area pain in military personnel: a review of epidemiology, etiology, diagnosis, and treatment. The Spine Journal, 12(9), 833–842. https://doi.org/10.1016/j.spinee.2011.10.010

9. Dakić, M., Toskić, L., Ilić, V., Đurić, S., Dopsaj, M., & Šimenko, J. (2023). The Effects of massage therapy on sport and exercise performance: a systematic review. Sports, 11(6), 110-110. http://doi.org/10.3390/sports11060110
10. Ditunno, J. F., (2017). Linking spinal cord injury rehabilitation between the World Wars: The R. Tait McKenzie legacy. Journal of Spinal Cord Medicine, 40(6), 641-648. http://doi.org/10.1080/10790268.2017.1370522
11. Easterbrook, J. A. (1959). The Effect of emotion on cue utilization and the organization of behaviour. Psychological Review, 66(3), 183–201. https://doi.org/10.1037/h0047707
12. Ernst, E. (1998). Does post-exercise massage treatment reduce delayed onset muscle soreness? A systematic review. British journal of sports medicine, 32(3), 212-214. Ernst, E. (2003). The Safety of massage therapy. Rheumatology, 42(9), 1101–1106. https://doi.org/10.1093/rheumatology/keg306
13. Feuerstein, M., Berkowitz, S. M., Haufler, A. J., Lopez, M. S., & Huang, G. D. (2001). Working with low back pain: Workplace and individual psychosocial determinants of limited duty and lost time. American Journal of Industrial Medicine, 40(6), 627–638. https://doi.org/10.1002/ajim.10000
14. Field, T., Quintino, O., Henteleff, T., Wells-Keife, L., & Delvecchio-Feinberg, G. (1997). Job stress reduction therapies. Alternative Therapies in Health and Medicine, 3(4), 54–56.
15. Furlan, A. D., Yazdi, F., Tsertsvadze, A., Gross, A., Van Tulder, M., Santaguida, L., Gagnier, J., Ammendolia, C., Dryden, T., Doucette, S., Skidmore, B., Daniel, R., Ostermann, T., & Tsouros, S. (2012). A Systematic review and meta-analysis of efficacy, cost-effectiveness, and safety of selected complementary and alternative medicine for neck and low-back pain. Evidence-Based Complementary and Alternative Medicine, 2012, Article 953139. https://doi.org/10.1155/2012/953139
16. Gore, M., Tai, K., Sadosky, A., Leslie, D., & Stacey, B. R. (2012). Use and costs of prescription medications and alternative treatments in patients with osteoarthritis and chronic low back pain in community‐based settings. Pain Practice, 12(7), 550–560. https://doi.org/10.1111/j.1533-2500.2012.00532.x
17. Govindu, N. K., & Babski-Reeves, K. (2014). Effects of personal, psychosocial and occupational factors on low back pain severity in workers. International Journal of Industrial Ergonomics, 44(2), 335–341. https://doi.org/10.1016/j.ergon.2012.11.007
18. Grant, D. J., Bishop-Miller, J., Winchester, D. M., Anderson, M., & Faulkner, S. (1999). A Randomized comparative trial of acupuncture versus transcutaneous electrical nerve stimulation for chronic back pain in the elderly. Pain, 82(1), 9–13. https://doi.org/10.1016/S0304-3959(99)00027-5
19. Greathouse, D. G., Sweeney, J., & Ritchie Hartwick, A. M. (1998). Chapter 2 Physical therapy in a wartime environment. Textbook of Military Medicine: Rehabilitation of the Injured Combatant, 1, 20-9.
20. Gubata, M. E., Piccirillo, A. L., Packnett, E. R., Niebuhr, D. W., Boivin, M. R., & Cowan, D. N. (2014). Risk factors for back-related disability in the US army and marine corps. Spine, 39(9), 745–753. https://doi.org/10.1097/BRS.0000000000000272
21. Gürkan, A. C., Dalbudak, İ., Bakır, B., Dinç, A., & Ali, K. G. (2018). Sports Massage. Igdir University Journal of Sports Sciences, 1(1), 24–28.
22. Halpin, S. (2012). Case report: The Effects of massage therapy on lumbar spondylolisthesis. Journal of Bodywork and Movement Therapies, 16(1), 115–123. https://doi.org/10.1016/j.jbmt.2011.04.003
23. Harbuzova, V., Y., Ulunova, A., & Mynenko, S., (2024). Assessment of professional life quality and resilience of medical staff working at military treatment and rehabilitation facilities in the conditions of war in Ukraine. Shìdnoukraïnsʹkij Medičnij Žurnal, 12(3), 492-504. http://doi.org/10.21272/eumj.2024;12(3):492-504
24. Hartwick, A. M. R. (1995). The Army medical specialist corps: The 45th anniversary, 85(2). Center of Military History, US Army.
25. Hertzman, C. A. (1968). Rehabilitation of casualties in a combat theatre. American Journal of Physical Medicine, 47(3), 113–117.
26. Hoge, C. W., Lesikar, S. E., Guevara, R., Lange, J., Brundage, J. F., Engel, C. C., Messer, S. C., & Orman, D. T. (2002). Mental disorders among U.S. military personnel in the 1990s: association with high levels of health care utilization and early military attrition. American Journal of Psychiatry, 159(9), 1576–1583. https://doi.org/10.1176/appi.ajp.159.9.1576
27. Johnson, M. H., Stewart, D. E., & Kosek, E. (2019). The Impact of massage therapy on psychological well-being in military personnel: A systematic review. Military Medicine, 184(3-4), 88-93. https://doi.org/10.1093/milmed/usy202
28. Kaçar, M. K., & Karaaziz, M. (2024). Systematic review on post-traumatic stress disorder and CBT Therapy. Academic Social Resources Journal, 8(53), 3783-3788.
29. Kanbir, O. M. (2019). Classic massage: Relaxation - Treatment - Sports Massage. Ekin Press and Publication Distribution.
30. Kassolik, K., Andrzejewski, W., & Trzęsicka, E. (2007). Role of the tensegrity rule in theoretical basis of massage therapy. Journal of Back and Musculoskeletal Rehabilitation, 20(1), 15–20. https://doi.org/10.3233/BMR-2007-20103
31. Keinan, G. (1987). Decision making under stress: Scanning of alternatives under controllable and uncontrollable threats. Journal of Personality and Social Psychology, 52(3), 639–644. https://doi.org/10.1037/0022-3514.52.3.639
32. Keller, R. T., Greenberg, N., Bobo, W. V., Roberts, P., Jones, N., & Orman, D. T. (2005). Soldier peer mentoring care and support: bringing psychological awareness to the front. Military Medicine, 170(5), 355–361. https://doi.org/10.7205/MILMED.170.5.355
33. Kim, H. J., Park, S. H., & Choi, E. K. (2021). Effects of massage therapy on blood circulation and muscle recovery in military personnel. Journal of Bodywork and Movement Therapies, 25(1), 45-51. https://doi.org/10.1016/j.jbmt.2020.11.002
34. Klymenko, I., (2024). Innovative approaches in the rehabilitation of military prisoners of war and residents of temporarily occupied territories. Психіатрія, Неврологія Та Медична Психологія, 11(1 (23)), 50-56. http://doi.org/10.26565/2312-5675-2024-23-06
35. Koçer, M. (2019). Psychological aspects of military service and military environment. Turkiye Klinikleri Psychiatry, Special Issue, 7-12.
36. Koshtura, V. V., (2024). Etiopathogenetic mechanisms of immune dysfunction in combatants with lower limb soft tissue injuries under chronic stress. Aktualʹnì Problemi Sučasnoï Medicini, 24(3), 201-209. http://doi.org/10.31718/2077-1096.24.3.201
37. Kubsch, S. M., Neveau, T., & Vandertie, K. (2000). Effect of cutaneous stimulation on pain reduction in Emergency Department patients. Complementary Therapies in Nursing and Midwifery, 6(1), 25–32. https://doi.org/10.1054/ctnm.1999.0429
38. Kumar, S., Beaton, K., & Hughes, T. (2013). The effectiveness of massage therapy for the treatment of nonspecific low back pain: A systematic review of systematic reviews. International Journal of General Medicine, 4(6),733-741. https://doi.org/10.2147/IJGM.S5024
39. Lardry, J. M., (2023). Le massage dans la Grèce antique. III: Hygiène et bains. Kinesither Rev., 24(265), 53–58 http://doi.org/10.1016/j.kine.2023.07.007
40. Lee, Y. S., Kim, S. H., & Choi, J. H. (2023). The role of massage therapy in enhancing operational performance and stress resilience in military settings. International Journal of Stress Management, 30(1), 22-30. https://doi.org/10.1037/str0000217
41. Macgregor, R., Campbell, R., Gladden, M. H., Tennant, N., & Young, D. (2007). Effects of massage on the mechanical behaviour of muscles in adolescents with spastic diplegia: A pilot study. Developmental Medicine & Child Neurology, 49(3), 187–191. https://doi.org/10.1111/j.1469-8749.2007.00187
42. Martini, F. H., Ober, W. C., Nath, J. L., & Bartholomew, E. F. (2011). Fundamentals of Anatomy & Physiology. Pearson Education.
43. Marushchak, M., Golub, V., & Matviіenko, M., (2024). Massage, self-massage and other means of physical culture as ways of regulation and restoration of students'body in extreme conditions of war. Науковий Часопис Національного Педагогічного Університету Імені МП Драгоманова. Серія 15. Науково-Педагогічні Проблеми Фізичної Культури (фізична культура і спорт), (3K (176)), 308-312. https://doi.org/10.31392/udu-nc.series15.2024.3k(176).67
44. Mattila, V. M., Sillanpää, P., Visuri, T., & Pihlajamäki, H. (2009). Incidence and trends of low back pain hospitalisation during military service – an analysis of 387,070 Finnish young males. BMC Musculoskeletal Disorders, 10(1), Article 10. https://doi.org/10.1186/1471-2474-10-10
45. McDonald, M. V, Passik, S. D., Dugan, W., Rosenfeld, B., Theobald, D. E., & Edgerton, S. (1999). Nurses’ recognition of depression in their patients with cancer. Oncology Nursing Forum, 26(3), 593–599.
46. Merriam, S. B. (2015). Qualitative research: Designing, implementing, and publishing a study. In Handbook of research on scholarly publishing and research methods, 125-140. IGI Global. https://doi.org/10.4018/978-1-4666-7409-7.ch007
47. Monnier, A. (2016). Musculoskeletal disorders in the Swedish armed forces marines: back pain epidemiology and clinical tests. From Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy. Karolinska Institutet, Stockholm, Sweden.
48. Murodovich, A. B., (2023). A Cmparison of the effects of connective tissue massage and classical massage on chronic mechanical low back pain. Medicine, 102(15), Article 33516. http://doi.org/10.1097/MD.0000000000033516
49. Nissen, L. R., Marott, J. L., Gyntelberg, F., & Guldager, B. (2014). Deployment-related risk factors of low back pain: a study among Danish soldiers deployed to Iraq. Military Medicine, 179(4), 451–458. https://doi.org/10.7205/MILMED-D-13-00317
50. Pflanz, S., & Sonnek, S. (2002). Work stress in the military: Prevalence, causes, and relationship to emotional health. Military Medicine, 167(11), 877–882. https://doi.org/10.1093/milmed/167.11.877
51. Powell, J. M. (2022). Bodies of work. The gospel of rehabilitation. Cambridge University Press.
52. Robinson, S. L. (2006). The hidden toll of the war in Iraq. In R. Falk, I. Gendzier, & R. J. Lifton (Eds.), Crimes of war: Iraq (pp. 399–409). Nation Books.
53. Schaeffer, J., Culberson, J., Treloar, N., Knight, B., Lu, P., & Szafron, D. (1992). A World championship Caliber checkers program. Artificial Intelligence, 53(2–3), 273–289. https://doi.org/10.1016/0004-3702(92)90074-8
54. Schulze, B., Richter‐Werling, M., Matschinger, H., & Angermeyer, M. C. (2003). Crazy? So, what! Effects of a school project on students’ attitudes towards people with schizophrenia. Acta Psychiatrica Scandinavica, 107(2), 142–150. https://doi.org/10.1034/j.1600-0447.2003.02444.x
55. Shamsi, H., Okhovatian, F., & Kalantari, K. K. (2022). Physiological and neurophysiological effects of sports massage on the athletes’ performance: A review study. Rehabilitation Medicine, 11(5), 680-691. http://doi.org/10.32598/sjrm.11.5.12
56. Smith, L. L., Keating, M. N., Holbert, D., Spratt, D. J., McCammon, M. R., Smith, S. S., & Israel, R. G. (1994). The Effects of athletic massage on delayed onset muscle soreness, creatine kinase, and neutrophil count:A preliminary report. Journal of Orthopaedic & Sports Physical Therapy, 19(2), 93–99. https://doi.org/10.2519/jospt.1994.19.2.93
57. Spivak, L.V., Holovchenko, M.V., & Белоусова О. В. (2024). The inflence of stress on the state of the muscular system of patients with injuries of the musculoskeletal system. Shìdnoêvropejsʹkij Žurnal Vnutrìšnʹoï Ta Sìmejnoï Medicini, 2024(1):79-84. https://doi.org/10.15407/internalmed2024.01.079
58. Tarigan, C. U., Kushartanti, W., Sukarmm, Y., & Tarigan, W. P. L. (2024). Relationship of workload with fatigue and sleep quality in female exercisers. Fizjoterapia Polska, (4),304-312. http://doi.org/10.56984/8zg2ef8b3t
59. İlkin, S., & Tekeli, İ. (1980). İttihat ve terakki hareketinin oluşumunda Selânik’in toplumsal yapısının belirleyiciliği. Okyar, O., & İnalcık, H. (Eds.), Social and economic history of Turkey (1071-1920). Meteksan.
60. Tiidus, P., & Shoemaker, J. (1995). Effleurage massage, muscle blood flow and long-term post-exercise strength recovery. International Journal of Sports Medicine, 16(07), 478–483. https://doi.org/10.1055/s-2007-973041
61. Tortora, G. J., & Derrickson, B. H. (2018). Principles of anatomy and physiology 15th edition. Wiley.
62. Vahdati, S., Sarkhosh Khiavi, R., Rajei Ghafouri, R., & Adimi, I. (2014). Evaluation of prevalence of low back pain among residents of tabriz university of medical sciences in relation with their position in work. Turkish Journal of Emergency Medicine, 14(3), 125–129. https://doi.org/10.5505/1304.7361.2014.79106
63. Vickers, A. (1996). Massage and Aromatherapy (S. Van Toller & C. Stevensen, Eds.). Springer. https://doi.org/10.1007/978-1-4899-3130-6
64. Vickers, A., & Zollman, C. (1999). ABC of complementary medicine: Massage therapies. BMJ, 319(7219), 1254–1257.
65. Vos, T., Flaxman, A. D., Naghavi, M., Lozano, R., Michaud, C., Ezzati, M., Shibuya, K., Salomon, J. A., Abdalla, S., Aboyans, V., Abraham, J., Ackerman, I., Aggarwal, R., Ahn, S. Y., Ali, M. K., AlMazroa, M. A., Alvarado, M., Anderson, H. R., Anderson, L. M., & Murray, C. J. (2012). Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: A systematic analysis for the Global Burden of Disease Study 2010. The Lancet, 380(9859), 2163–2196. https://doi.org/10.1016/S0140-6736(12)61729-2
66. Wakim, K. G., & Martin, G. M. (1949). The effects of massage on the circulation in normal and paralyzed extremities. Archives of Physical Medicine and Rehabilitation, 30(3), 135–144.
67. Weerapong, P., Hume, P. A., & Kolt, G. S. (2005). The Mechanisms of massage and effects on performance, muscle recovery and injury prevention. Sports Medicine, 35(3), 235–256. https://doi.org/10.2165/00007256-200535030-00004
68. Yıldırım, A., & Şimşek, H. (2006). Qualitative research methods in social sciences. Journal of Theory and Practice in Education, 2(2), 113–118.
69. Yüksel, İ. (2018). Masaj teknikleri (İ. Yüksel & T. Akbayrak, Eds.; Vol. 4). Alp Publishing.
70. Yumusakhuylu, Y., Baklacıoglu, H. S., Haliloglu, S., Selimoglu, E., & İçağasıoğlu, A. (2018). The Economic cost of chronic low back pain. Bozok Tıp Dergisi, 8(1), 66-74.
71. Zincir, S. (2019). Mental disorders of significance in military psychiatry. Turkish Clinics, Psychiatry-Special Topics, 12(3), 34-41.