1 - Massage - Unit 1 - Basics Flashcards
Touch
First technique in developing a therapeutic relationship.
Quality and sense of touch conveys intent and power of the movements.
7 factors to consider as components in application of massage:
- direction of movement
- amount of pressure
- rate and rhythm of the movements
- medium (type of lubricant)
- frequency and duration of the treatment
- position of the client
- position if the massage practitioner
Direction
Direction can move from the center of the body out (centrifugal) or from the extremities in toward the center of the body (centripetal)
Direction - Centrifugal
From center of the body out
Direction - Centripetal
Toward the center of the body
Depth of pressure
Compressible stress.
Can be: light, moderate, deep or variable
Depth of pressure - Drag
Amount of pull (stretch) on the tissue (tensile stress)
Light pressure movements
Applied over thin tissues or over bony parts
Heavy pressure movements
Indicated for thick tissues of fleshy parts of the body
Speed of manipulation
Fast, slow or variable mode
Rhythm
Regularity of application of the technique
Regular intervals = even or rythmic
Gentle movements
Slow rhythm
Soothing and relaxing
Vigorous movements
Quick rhythm
Stimulating
Frequency
Rate at which the method repeats itself in a given timeframe.
Generally how many times are each méthod repeated (frequency) before moving or switching to different approach?
3 times
Duration
Length of time that the method lasts or the manipulation stays in the same direction
Number of massages movements and possible combinations of strokes allow to…
… tailor the massage to specific needs of each client
The fundamental manipulation used in Swedish massage are
- Touch
- Effleurage (gliding stroke) - feather/nerve stroking
- Pétrissage (kneading ) - fulling, skin rolling, compression)
- Friction (rubbing strokes) - rolling, chucking, wringing
- Vibration (powerful stroke/shaking movements) - shaking, rocking
- Tapotement - hacking, cupping, slapping (splatting), tapping, beating + pounding
Effleurage
- aka gliding stroke/feather stroking/nerves stroke
- One of the most versatile manipulation
- Pressure become firmer as the hand glides over the surface of the body
Effleurage technique is accomplished with
Practitioner body parts?
- fingers
- thumbs
- palm of hand
- knuckles
- forearms
Effleurage - Varieties
- superficial (incl feather stroking?)
- deep
Effleurage - Superficial
- Very light touch
- Applied prior to any other movement
- Accustoms client to the practitioner’s contact
- Allows practitioner to assess the body area being massaged.
- Stays within the skin and subcutaneous layer
- Have a more reflexive effect
Effleurage - Deep gliding
- Have a mechanical effect
- Especially valuable when applied to muscles
- Most effective when part under treatment is in state of relaxation
- Practitioner must use good body mechanics (prevent strain & overuse syndrome injuries)
Effleurage - Deep gliding effects
- stretching and broadening of tissue and fascia
- enhance the venous blood and lymph flow
Effleurage - Deep gliding directions
- Follows the direction of the muscles fibers
- On the extremities: always directed from the end of the limb toward the center of the body.
Effleurage - Feather stroking
- aka nerve stroking
- very light pressure of the fingertips of hand with long flowing strokes
Effleurage - Feather stroking direction
Done from center outward
Effleurage - Feather stroking timing
Used as final stroke to individual areas of body
Effleurage - The 2 superficial strokes speed effects
Slow & superficial : very soothing
Fast & superficial: stimulating
Effleurage usually used after
Initial touch
Effleurage good when
- Applying lubricant
- evaluating for hard and soft tissues
- evaluating for hot and cold areas
- evaluating for areas that seem stuck
Effleurage preferred for
abdominal massage
Petrissage
card to be revised
Used to decrease muscle tone
Requires soft tissues to be lifted, rolled and squeezed
Fingers to be used as a unit along with thenar eminence of the thumb
Petrissage movements are
- Fulling
- Skin Rolling
- Compression
Petrissage - Reflexive relaxation
Card to review and confirm
Lifting, rolling and squeezing affect stretch receptors in the muscle and tendons resulting in the muscle to relax to avoid harm.
Petrissage mechanical effect
Soften and create space around the actual muscles fibers and making tendons more pliable
Tension on the pulled tendon deforms the connective tissue and mechanically warms it
Petrissage - Skin Rolling
- Lifting only the skin from underlying muscle layer
- Warming and softening effect on the superficial facia
- Reflexive stimulation to the spinal nerve
- Excellent assessment method
- One the rare method safely used directly over the spine
Petrissage - Compression (& effects)
- Main method used in shiatsu & other oriental approches
- Effect results from pressing the tissue against the underlying bone, causing it to spread and squeezed from two sides
- stimulates muscles and nerve tissues - less desirable for relaxation and soothing
Petrissage - Ischemic Compression
Aka direct pressure
Very specific pinpoint compression
Used on acupuncture points (motors points) and trigger points
Petrissage - Deeper compression
More mechanical effects
Petrissage - Lighter compression
More reflexive effect
Friction
Prevents and breaks up local adhesion in connective tissue, especially over tendons, ligaments and scars.
Do not use over acute injury or fresh scars
Modified use: on stabilized scares or acute phase passed, to prevent adhesions development and promote more normal healing process
Friction direction
Usually transverse to the fiber direction
Friction duration
Usually for 30sec to 10min, some suggest 20min
Results of friction
- Initiation of small, controlled inflammatory response.
Chemicals released during this type of manipulation causes reorganization of the connective tissues in a way that can be controlled by the practitioner. - Increase the water-binding capacity of the connective tissue ground substance.
Connective tissue had a high water content and must remain hydrated to maintain their pliability.
Friction is best for
High connective tissue concentration such as musculotendinous junction.
Friction can be combined with compression to
add a small stretch component.
It has a mechanical, chemical and reflexive effect.
Most common approach.
Friction has 3 basic variations
- Longitudinal
- Circular
- Deep
Friction has additional variations (out of 3 basics)
- Rolling
- Chucking
- Wringing
Friction - Rolling
Rapid back & forth hands movement
Flesh is shaken and rolled around it’s axis or the imaginary center line of the body part
Friction - Chucking
Grasping the flesh firmly in one or both hands and moving it up and down along the bone.
Series of quick movement along axis of the limb
Friction - Wringing
Back & forth movement with both hands placed a short distance apart n either side of the limb.
Hands work on opposing directions, stretching and twisting the flesh against the bones in opposite directions.
Effleurage - Deep slow stroke effect
card to check
Mechanical effect
Vibration
review card
Very powerful stroke if done long enough and at an intensity sufficient to produce reflexive physiologic effects.
Vibration effects
- Tone muscles by applying the technique at the muscle tendons for up to thirty seconds
- Wake up nerves, stimulate nerve activity
- Shift joint pain perception
Variation - 2 variations
- Shaking
- Rocking
Variation - Shaking
Relax muscle groups or an entire limb
Variation - Shaking effects
- Confuses the positional sensors and causes the muscles to relax by going limp (natural response)
- warms and prepares body for deeper bodywork
Vibration - Shaking begins with…
… lift and pull components.
A muscle group or limp is grasped, lifted and shaken.
Vibration begins with…
… compression
Variation - Shaking - Do not use shaking on…
… the skin or superficial fascia, nor is it effective to use on the entire body.
Variation - Shaking is best applied on…
… any large muscle groups that can be grasped and to synovial joints
Variation - Shaking - Good areas for application
- Upper trapezius & shoulder area
- Biceps & triceps groups
- Hamstrings
- Quadriceps
- Gastrocnemius
- in some instances the abdominals & pectoralis muscles close the axilla.
- Joints of shoulders, hips and extremities
Variation - Shaking to be used when…
… muscles seem extremely tight
Vibration - Rocking
Soothing and rhythmic form of shaking
One of the most effective relaxation techniques of the massage therapist
Vibration - Rocking works through…
… the vestibular system of the inner ear and feeds sensory input directly into the cerebellum.
For effective rocking the body must move so that the fluid in the semi-circular canals of the inner ear is affected, initiating reflex nervous system mechanisms.
Vibration - Rocking - Action…
Action moves the body as far as it will go, then allows it to return to the original position.
Nothing is abrupt, there is an even ebb ad flow to the methods.
Vibration - Rocking Effects
Reflexive and chemical.
Vibration - Rocking focuses on…
What part of the patient body
… the joint receptors
Vibration - Shaking focuses more on…
… the soft tissue
Tapotement
- aka percussion
- stimulating manipulation
- Springy blows to the body at a fast rate that create a rhythmic compression of the tissue.
Tapotement - 2 classifications
- Light
- Heavy
Tapotement - Effects
- Reflexive effects except for the mechanical results of tapotement in loosening and moving mucus in the chest.
- Strongest effects due to tendon reflexes
Tapotement - Practitioner actions
… 2 hands alternately.
To tap motor point: 1 or 2 fingers can be used alone
Tapotement - Heavy tapotement shouldn’t be done…
… over kidney area
or anywhere there is pain or discomfort
Tapotement - 5 methods
- Hacking - loose karate chops
- Cupping - upside down drinking cups
- Beating and pounding - loose fists
- Slapping (spalling) - flat open hand
- Tapping - finger print surface
Tapotement - Hacking application
Practitioner actions
Applied with both wrists relaxed and the fingers spread
Only little finger or ulnar side of the hand strikes the surface
Tapotement - Hacking used with whole hand on…
… the larger soft tissue areas such as the upper back and shoulders, quads, hamstrings, gastros
Tapotement - Cupping
Practitioners actions
Fingers and thumbs are places as if making a cup
Tapotement - Cupping Use
Patient body part?
used on the anterior and posterior thorax, cupping is good for stimulation of the respiratory system and for loosening mucus
Tapotement - Beating & pounding
Done with soft fist (withe knuckles down) or vertically with ulnar side of the palm.
Tapotement - Beating & pounding use
Over large muscles such as the buttocks and heavy leg muscles (gluts, large quads, hamstrings)
Tapotement - Slapping (splatting)
Palm of the flattened hand makes contact with the body
Tapotement - Slapping (splatting) use
Good to use on bottom of the feet
Tapotement - Tapping
Palmar surface of the fingers alternately taps the body area with light to medium pressure.
Tapotement - Tapping use
Good around joint, on the tendons, on the face and head, and along the spine.
Joint movements involve…
… moving the jointed area within the physiologic limits of range of motion of the client
3 types of joint movements
- Active
- Active assisted
- Passive
Joint movements - Active
The client moves the joint by active contraction of muscle groups
Joint movements - Active assisted
Both the client and the therapist move the area
Joint movements - Passive
The massage therapist moves the joint with no assistance from the client
Joint movements are always done…
… within the comfortable limits of range of motion of the client.
Joint movements - Anatomic barriers …
… are determined by the shape and fit of the bones at the joint.
Joint movements - Physiologic barriers …
… are caused by the limits of range of motion imposed by protective nerve and sensory function.
Often displays as stiffness, pain or “catch”
Joint movements - Soft end-feel
When a normal joint is taken it its limit, there is usually still a bit more movement possible, a sort of springiness in the joint.
Joint movements - Hard end-feel
When there is an abnormal restriction and the joint is fixed at the barrier, no spring effect it is distinctly “binding” or jamming.
Joint movements - 3 basic suggestions
- Start with active joint movement to assess range of motion & then have client move are against your stabilizing force to increase intensity of signals and so discharge nervous system
- Incorporate massage methods
- Once tissues are warm and nervous system relaxed: passive range of motion/joint movements
Massage techniques through the skin to the underlying tissue
are more mechanical and stimulate localized chemical response
Massage techniques within the skin and superficial fascial layer
are more direct effect on the nervous system and stimulate the release of hormonal and other body chemicals that provide for a general systemic (whole body) effect.
Massage techniques that move the body (muscles contraction & joint position to change)
deliver sensory input to the proprioceptors and are more flexible in nature.
Massage techniques that stretch (pull on) soft tisues
have reflexive, mechanical and chemical effects
While applying movements, the practitioner must
- pay close attention to the overall response of the client
- pay close attention to the response of the tissue or body part which the manipulation is being applied
- adjust the application accordingly
