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Sandakov massage is a proprietary manual technique that uses reflex (neurological) stimulation through massage movements to stimulate and develop righting reflexes in a child. It was developed by Moscow pediatrician and neurologist Dmitry Sandakov for the rehabilitation of children with cerebral palsy (CP).
Sandakov massage is a proprietary manual technique that uses reflex (neurological) stimulation through massage movements to stimulate and develop righting reflexes in a child. It was developed by Moscow pediatrician and neurologist Dmitry Sandakov for the rehabilitation of children with cerebral palsy (CP). When Sandakov massage is used, the rehabilitation physicians and manual therapists at CSM Clinic help children with special needs develop independent motor skills and a natural movement pattern.
Cerebral palsy remains one of the main pediatric conditions. In this diagnosis, a child may find it hard to move like other children, and movement may sometimes be accompanied by pain and involuntary tears.
However, according to statistical data cited by specialists, only about 10% of children with CP have irreversible brain damage. Most children with cerebral palsy retain cognitive functions: attention, speech, memory, intellectual abilities, and the perception and analysis of information. Many children with a CP diagnosis attend school alongside their peers. This means that such children are able to develop and communicate with the world and people around them.
By force of circumstance, in 1993 Sandakov, then an anesthesiologist-resuscitator, began working as a manual therapist and massage practitioner. Among the patients of the doctor, who had changed his specialty, there were soon children with CP. But he reached a technique that gives hope to parents and children only through trial and error. Delayed motor development, muscle dystonia, and pathological reflexes did not respond to the methods of classical rehabilitation. Having concluded from his own practice that, in his view, traditional therapeutic massage and orthopedic devices did not give children a positive result and could aggravate CP symptoms, Dr. Sandakov moved away from the classical approach and continued his search for a treatment.
The massage technique developed by Sandakov is based on knowledge of physiology and pathophysiology. Sandakov reflex massage includes technical elements of three independent therapy methods:
According to the author of the method, Sandakov massage for CP involves avoiding orthopedic devices with rigid fixation (splints, corsets, orthoses) and medications (except those the child takes for vital indications). Any such decision should be made only after consulting the treating physician.
Rehabilitation by the Sandakov method is based on point massage, gymnastic exercises, and therapeutic exercise. To work toward a positive result, we follow the main principles:
The author of the method emphasizes how important it is, during massage for CP, to cultivate normal movement responses in the child. A healthy child does not think about how to make a movement or hold the body upright, whereas a child with CP puts in more effort to hold up the head or roll over. During rehabilitation, such a child is encouraged to develop righting reflexes.
Righting reflexes are those that maintain and preserve body postures. The medulla oblongata and the midbrain take part in regulating this group of reflexes. When reflex responses are stimulated, massage for CP in children may support the functioning of the brain and central nervous system.
Sandakov positioning is performed in the presence of, or even with the participation of, the parents. A close family member holds the upper part of the body (shoulders) or the lower part (pelvis, legs), while the rehabilitation physician moves the limbs opposite to the fixed ones. When the shoulders are held, the legs move; when the pelvis and legs are held, the head, arms, and torso move. The child's body movements and static postures are performed by the doctor's hands, so the sessions resemble passive yoga.
As for the suitable age, Dr. Sandakov advises starting massage and therapeutic exercise for CP as early as possible. Early rehabilitation and cultivation of righting reflexes give a child more chances for a full life and social adaptation.
Rehabilitation tends to give noticeable results from birth to 8 years of age. At this age the child's brain develops rapidly, so impaired or lost functions may be compensated by healthy areas of the brain.
Children's massage, gymnastics, and therapeutic exercise by the Sandakov method require regular practice. It is important not only to avoid long breaks in the courses of sessions, but also to increase the physical load gradually.
By performing massage for CP in children in Kyiv and selecting exercises individually, we aim to work toward the following results:
In children with CP, massage may help relieve spastic tension in muscles that are in a state of hypertonia (spasms, cramps), and may tone muscles that are not working. Point massage for CP may help activate the transmission of nerve impulses and stimulate natural reflexes.
A child who learns to crawl only at 7 and at 10 first stands on their feet with the help of supports and a mother's hands is not a reason for complexes but a joy. It is a hope and a goal worth striving for. Even if every step comes with difficulty and pain, it is a step toward freedom of movement and a full life.
