manual skills petrissage/kneading/wringing

Question 1

petrissage

Answer 1

Petrissage comes from the French word, “petrir” meaning “to knead.” This group of techniques are used
after the tissue is warmed up, mainly because of the pressure and focus of Petrissage. Petrissage makes
up a key group of techniques used in treatment. These techniques are applied to muscle groups,
individual muscles or a specific portion of the muscle itself.
All types of Petrissage will affect local circulation while they are being applied. Different techniques may
achieve varying effects depending on the degree of pressure or compression and the amount of drag
applied to tissues. Muscle fibre and connective tissue adhesions may be loosened if increased drag is
applied to the tissue. If only the superficial, skin layer of tissue is engaged, only the supefical fascia is
addressed, and therefore, deep structures will not be affected.
Petrissage can be used for several conditions. These conditions include, but are not limited to,
hypertoned muscles, poor or sluggish circulation, edema, post-event sports massage, adhered fascia
and anxiety.
Some precautions include, all general and local CIs, severely atrophied or atonic muscles
and severe varicosities.
K

Question 2

kneading defenition
(is always circular)

Answer 2

A petrissage technique that may use the thumb, fingertips, palmar surface or knuckles.
The therapist performs short, rhythmical, unidirectional circular movements. The
pressure peaks in the middle of the technique. When increased pressure is required,
the therapist can use the their other hand for reinforecement and support.

Question 3

components

Answer 3

Palmar, thumb, fingertip, knuckle and open C techniques
Single, single reinforced, double simultaneous, double alternating
Pressure can be superficial (Palmar/Open C) to deep (thumb/fingertip)
Can be applied general (palmar/open C) to specific (thumb, fingertip)
Rate and rhythm can vary but is usually moderate
Contact is always maintained
Pressure applied on upward stroke of circle/movement and released on the return
aspect of stroke
Size of stroke is dependant on the size of body part being treatment and the treatment
goals
When being applied to the extremities, the stroke progression is from distal to
proximal, with increased pressure towards venous return
Knuckle Kneading – keep your hands soft and relaxed in a loose fist, with fingers tucked
in (not including the thumb). The dorsal aspect of the metacarophalangeal and
proximal interphalangeal joints are in contact with the tissue at all times.
Palmar Kneading - position your legs, torso and upper extremities as you would for
effleurage techniques when working on larger surface
s of body
When working locally, hip positioning should be either parallel (Symmetrical) or
perpendicular (Asymmetrical) to the treatment area with hands out in front of you
during technique application.
Thumb Kneading – Thumbs should be maintained in a slightly flexed position, avoiding
hyperextension and hyper-abduction (bridging) of your thumbs by using the pads of
the thumbs while maintaining palmar contact.
** thumbs should move WITH your hand, NOT independently of them

Question 4

wringing definition

Answer 4

A petrissage technique, with the application of
equal pressure on opposite sides of the part of the
body being treated. The tissues are compressed in
opposing directions, lifted and then released.

Question 5

biomechanics

Answer 5

Use a Symmetrical Stance perpendicular (facing)
the treatment area.
- Feet shoulder width apart for balance with knees
slightly bent – hips forward.
- The weight or “load” being as close to your
midline as possible.
- The lifting movement comes from the legs and
arms, NOT from your shoulders

Question 6

technique

Answer 6

Pressure, Lift, Release, Glide
Place hands on opposing sides of the treatment
area with equal pressure being applied by the
palmar aspect of the hands.
Soft hands mould to the contours of the treatment
area with firm contact.
Thumbs normally should be in a “neutral” position,
but may be adducted or abducted (avoiding
hyperabduction) to accommodate the following
factors:
The size and shape of the treatment area.
The size and strength of the therapists’ hands.
The opposing pressure of the hands lift the tissue
up and the tissues are gradually released when
tissues are lifted to their apex.
As pressure releases, the hands glide past each
other towards the opposite side of the treatment
area.
Proximal to distal application on the extremities,
does not apply when treating the torso.