Therapeutic Massage

Purpose Manipulates the the body’s tissues to: Reduce muscle spasm Promote relaxation Improve blood flow Increase venous drainage Broad range of massage theories, techniques, and effects

Contraindications Acute inflammatory conditions Severe varicose veins Open wounds Skin infections Failed or incomplete fracture healing Thrombophlebitis

Preparation Table Linens and pillows Massage medium Patient position Masseuse position

(Fritz, 1995)

(Fritz, 1995)

Preparation Elevate the body area Apply massage medium to the skin

Types of Massage Basic Strokes: Effleurage Pétrissage Friction Tapotement Vibration

Different types of strokes Effleurage (stroking) Superficial or Deep Petrissage (kneading) Friction Transverse or Longitudinal Vibration Tapotement Percussion/slapping/hacking/beating

Effleurage “Stroking of the skin” Spread massage lubricant Use at the beginning and end of the massage Superficial: slow strokes for relaxation Deep: Elongates muscle fibers Stretches fascia Forces fluids in the direction of the stroke towards the heart

Pétrissage “Lifting and kneading” Frees adhesions: Stretches and separates muscle fiber, fascia, and scar tissue If only technique used, it may be performed without the use of lubricant

Friction “Deep pressure” Circular: Transverse Friction: Use a circular motion with thumbs, elbow, or a commercial device Transverse Friction: The thumbs or fingertips stroke in opposite directions Effects muscle mobilization, tissue separation, and trigger points

Tapotement “Tapping or pounding” of the skin Variations: Hacking Cupping Tapping Performed with a light, fast tempo Promotes muscular and systemic relaxation and desensitization of irritated nerve endings

Vibration “Rapid Shaking” Rolling a limb between hands (arm/leg) Increases blood flow and provides systemic invigoration of tissues Mechanical devices available

Traditional Massage Sequence Apply massage medium with light, slow Build to deeper effleurage Pétrissage Wipe medium before applying deep friction (if applicable) Reapply pétrissage and deep effleurage End with light effleurage

Termination Remove medium If appropriate: Active range of motion exercises Compression wrap Encourage patient to drink water to assist in flushing metabolic waste