Documenti di Didattica
Documenti di Professioni
Documenti di Cultura
Late 1980’s
◦ American Massage Therapy
1992
◦ National Certification Examination for Therapeutic
Massage and Bodywork
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
◦ On Pain
Gate control theory
Endogenous Opiates release
◦ On Circulation
Somatosympathetic reflex - probably does not occur
with massage, since massage is passive.
Axonal reflex occurs when cutaneous afferent
information travels antidromically and produces a local
vasodilation
◦ On Metabolism
Does not alter metabolism significantly
◦ On Motor Neuron Activity
There is an inhibition of the spinal motor neuron
excitability during a massage. It is specific to that
muscle with no lingering effects
◦ stretching and mobilizing tissues
◦ mechanically increase blood flow and venous return
of that muscle
Light exercise is more effective in increasing
blood flow than massage
Cellular metabolism
Increase ROM short-term, but no Long-term
effects
Massage appears to have no benefit on
recovery of muscle function in the following
situations:
◦ muscle damage caused by eccentric overload.
◦ recovery of post-exercise muscle strength.
◦ reduction of delayed onset muscle soreness (DOMS).
◦ rate of recovery of muscle function following
anaerobic work.
You communicate compassion, concern,
anger, sensual, or other emotions through
touch.
Basic Strokes: Myofascial Release:
Effleurage J-Strokes
Pétrissage Focused Stretching
Friction Skin Rolling
Tapotement Arm Pull / Leg Pull
Vibration Diagonal Release
Effleurage (stroking)
◦ Superficial or Deep
Petrissage (kneading)
Friction
◦ Transverse or Longitudinal
Vibration
Tapotement
◦ Percussion/slapping/hacking/beating
“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
“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
“Deep pressure”
Circular:
◦ 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
“Tapping or pounding” of the skin
Variations:
◦ Hacking
◦ Cupping
◦ Pincement (pinching)
◦ Rapping
◦ Tapping
Performed with a light, fast tempo
Promotes muscular and systemic
relaxation and desensitization of irritated
nerve endings
“Rapid Shaking”
Rolling a limb between hands (arm/leg)
Increases blood flow and provides systemic
invigoration of tissues
Mechanical devices available
Stroking and stretching of tissues:
◦ Relax tense tissues
◦ Release adhered tissues
◦ Restore tissue mobility
Clinician receives cues and feedback from
the patient’s tissue
◦ This indicates the appropriate strokes and
stretches
Specialized training in myofascial release
techniques is needed to become proficient
in these skills
One hand places the adhesion on stretch
Other hand’s 2nd and 3rd fingers stroke in
the opposite direction forming a ‘J’
Mobilize scar tissue
Heel of one hand in the area of restriction
Heel of other hand crossed in front
Stretch the tissue using slow, deep pressure
Reduces superficial or deep adhesions
Use fingers and thumb to lift and separate
the skin from the underlying tissue
◦ Similar to Pétrissage
Roll skin between fingers noting restriction
Lift skin and move it in the direction of the
restriction
Reduces superficial myofascial adhesions
Arm pull (example):
Grasp extremity proximal to wrist
Apply gentle traction that is in line with
anterior deltoid
Continue to abduct 10-15 degrees until full
abduction is reached
Stretches large areas of fascia
Cardiovascular
◦ Increase blood flow, histamine release, and temperature
◦ Decreased heart rate, respiratory rate, and blood pressure
Neuromuscular
◦ Increase flexibility, decrease neuromuscular excitability
(relaxation), edema reduction, and stretch muscle and
scar tissue
Pain
◦ Activate spinal gate and the release of endogenous
opiates
Psychological
◦ Reduces patient anxiety, depression, and mental stress
Increase blood flow
Facilitate healing
Increase range of motion
Remove edema
Alleviate muscle cramps
Stretch scar tissue/adhesions
Decrease pain
Acute inflammatory conditions
Severe varicose veins
Open wounds
Skin infections
Failed or incomplete fracture healing
Thrombophlebitis
Table
Linens and pillows
Massage lubricant
Patient position
Masseuse position
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
Elevate the body area
Apply massage lubricant to the skin
Clinician is positioned distal to the
extremity
Begin proximal to the edematous area
Long, slow, deep strokes towards the torso
Move starting point slightly distal every
fourth or fifth stroke
When the starting point moves distal to the
edema, begin working back towards the
starting point
Remove medium
If appropriate:
◦ Active range of motion exercises
◦ Compression wrap
Encourage patient to drink water to assist in
flushing metabolic waste
Soft Tissue Healing
◦ Injury
Protect
◦ Inflammatory Phase
Effleurage (Lymphatic) massage
Light petrissage
Avoid friction massage
◦ Fibroblastic-Repair Phase
Effleurage and petrissage to reduce edema
Friction to help tension the collagen for proper
alignment, thus preventing adhesions.
◦ Maturation-Remodeling Phase
Patient education
Pain Cycle
Inflammation
Physical Trauma
Dysfunction Pain
Psychological Trauma
ischaemia
Muscle Spasm
Chronic Injury
◦ Friction
◦ Petrissage
◦ Effleurage (lymphatic)
(Fritz, 1995)
(Fritz, 1995)
Indications
◦ Patients with adhesions, edema, muscle spasm,
bursitis, tendinitis, tenosynovitis, strains, and
sprains.
Contraindications
◦ Patients with myositis ossificans, thrombosis or
embolism, severe varicose veins (caution), acute
phlebitis, cellulitis, synovitis, abscesses, shin
injections, and massage of a cancerous site.