Russian massage virtually was unknown in the U.S. until the 1980s. Upon my immigration to the U.S. in 1980 and during my occupational therapy internship at Riverside Hospital in Columbus, Ohio, I found out firsthand how little "hands-on" therapy was used by physical medicine in this country. It was a great surprise to me since massage has been a part of almost every treatment Russian patients receive during their inpatient or outpatient rehabilitation..

It took me a few years to realize, however, that Russian massage has been in the forefront of physical rehabilitation due to the extensive research that has been done in Russia and the Soviet countries for more than 130 years. To this day, Russian massage is still a virtual unknown in this country.

The main distinction of Russian massage is its 100 percent use by the Russian medical community since its inception in the late 1700s. Until the 1990s (perestroika), Russian massage was taught in medical and athletic establishments only. The only two ways someone could receive massage in Russia were to have a physician's prescription or to be a member of an athletic team. Massage for pampering and relaxation was only available as a part of a facial cleaning or for the super rich. Although practices and education have changed since that time, massage still is one of the most requested forms of physical rehabilitation in Russia to this day.

Russian massage has a long history, having been used by medicine women along with herbal preparations for centuries. The first recorded form of manual therapy done by the ancient Slovaks (later called Russians) at a bania (sauna) was called "twigging." It was done with branches of birch (Slovaks believed the birch had the best medicinal effects and properties). The leafed birch twigs were gathered in the late spring when the properties of the birch were supposed to be superior. They were then dried and used throughout the year. Russians, after bathing, would go to a very hot steam room (70 percent humidity - not quite as humid as the Turkish sauna), where a specially trained man or woman would hit the body with softened leaf-covered birch twigs and would follow by rubbing the body with the branches. After this part of the therapy was completed, the masseur would pour water - hot first, followed by cold - on the body.

This process of twigging, as some suggest, is nothing more than very deep friction. In fact, we do see a great amount of hyperemia in the skin due to both the twigging and the heat of the sauna.  This process was repeated several times during bathing (followed by rest), and concluded with the bather going for a dip in the snow or in a stream of running water. The severe amount of friction the bather received prevented the body from serious overcooling and helped them to adapt to the cold temperatures of Russian winters and strengthen their immune system. The bania still is in use today, and many Russians have their own outside saunas where they go to detoxify, usually once a week.

Although used as a part of folk medicine for centuries, manual therapy or massage was not studied or used scientifically in Russia until 1860. The catalyst came from the interest of French physicians in hands-on treatment protocols. Russian society, which was heavily influenced by the French at the time, found it easy to adapt new French practices which included physical rehabilitation. The massage done in Russia today is called classical massage, and it was first formulated in the middle of the 18th century. An internal medicine physician, Dr. M. Y. Mudrov, is responsible for bringing this classical form of massage to Russian medicine. He believed that in treatment of any illness, manual therapy and movement are necessary for getting well. At the end of the 19th century, pediatricians Drs. S. G. Zibelin and N.M. Ambodik thought it absolutely necessary to use manual therapy for the proper development of infants, so Russian infant massage was born.

Unlike other infant massages I have observed being done slowly and deliberately, Russian infant massage is very quick and light, involving fast and superficial brushing strokes over the skin using the fingers and no pressure. This is followed by swift and gentle spiral rubbing with the pads of the fingers. Each body part is massaged for one to two minutes, and the full procedure does not exceed 10 minutes. The goal of Russian infant massage is to increase blood circulation to the periphery, which in turn is believed to promote better physical and mental development of the child.

The main contention of Russian massage is that when the rest of the world started studying more "advanced" forms of rehabilitation therapy (electrical stimulation, ultrasound, infrasound and many others), Russian physical medicine did not stop its use of massage therapy in the treatment of patients or its research into the effects of massage. The research history of Russian massage begins with Russian internal medicine specialists Drs. S.P. Bodkin, A.A. Ostroumov and G. A. Zaharyin. These physicians saw manual therapy as one of the best clinical modalities for the treatment of many internal problems.

One of the most prominent Russian physiologists, V.A. Monassein, along with his students, conducted several studies to scientifically show how massage influences functions of the body. In 1886, Gopadze studied manual therapy influence on nitrogen metabolism in the body after the use of massage. I. Stabrovsky (1887) researched performance of the lungs after manual therapy and B.I. Kiyanovsky (1889) analyzed the influence of massage therapy on the metabolism of fats and nitrogen in healthy people.

At the end of the 19th century, centers for studies of massage were founded all over Russia and the Ukraine. These centers were located in a variety of medical schools - medical military academies taught massage and gymnastics (Dr. V.A. Monassein in 1876); obstetric centers taught their delivery nurses gynecological massage (Dr. D.O. Ott in St. Petersburg in 1888); and medical schools taught massage after surgical intervention (Dr. V.P. Dobrolubov in 1893). More than 20 different centers that taught, treated and researched the use of massage therapy were opened in Moscow and St. Petersburg alone from the 1860s - 1920s. Based on the research during this time, classical massage techniques were created, their performance was explained from the physiological perspective, and indications and contraindications in the use of massage were discussed.

Manual therapy was used extensively during World War II as a part of complex rehabilitation treatment of the wounded. After the war, such prominent Russian physicians as A.F. Verbov, V.N. Moshkov and L.A. Kunichev developed special methodology for manual therapy use in all dysfunctions.

In the 1960s, both major universities in Russia and specially formed Institutes of Resortology and Physiotherapy conducted in-depth research of manual therapy and its uses. Today there are hundreds of massage schools open all over Russia, but the fact still remains: Massage therapy is alive and well in the medical schools, hospitals, clinics, and sanatoriums (inpatient medical spas). Massage therapy continues to be heavily supported by the medical community and plays an important part in almost every physiotherapy treatment protocol for musculoskeletal, neurological, internal, cardiovascular and many other dysfunctions. Russia continues to be at the forefront of massage therapy research. Russian athletes still acknowledge the instrumental role massage plays in their performance and recovery, and most of them will tell you massage has prolonged their athletic ability. As massage assumes a more prominent place in the U.S., my hope is that it will gain the same prestige here that it has held in the Russian medical community. It definitely deserves it.