2. What is massage?
• Massage is a mechanical stimulation of
the tissues by means of rhythmically applied pressure and
stretching
Massage is a systematic manual application of pressure and
movement to the soft tissue of the body--the skin, muscles,
tendons, ligaments, and fascia (the membrane surrounding
muscles and muscle groups).
• The most important tools in massage are:
– The clinicians hands
– The setting
– The patient’s comfort
– Knowing which type of massage to use
2011
Dr: Mosab
3. Why massage is used
• To increase flexibility, coordination, venous
return , and blood flow
• to decrease neuromuscular excitability and pain
• To stimulate circulation
• To facilitate healing and restore joint mobility
• To remove lactic acid and edema
• To treat pursitis, tendonitis, muscle spasm
Dr- mosab-2011
5. physiological effects of
massage
The physiological effects of Massage include:
1- Mechanical
2- physiological
- on the circulatory system
- on the nervous system
- on the musculoskeletal system
3- psychological
6. Mechanical effects of
massage
• Mechanical effects are always accompanied by some
reflexive effects
• Mechanical techniques stretch a muscle, elongate fascia, or
mobilize soft tissue adhesions
• Effects muscle and skin
2011
7. The Muscular System
• Relieves , tension, and stiffness
• Improves muscle tone
• Increases flexibility and range of motion of joints
• Improves the flow of nutrients to muscles and joints
• Reduces scar tissue
• Breaks down or prevents adhesions
• Enhances freedom of movement
• Prevents muscular atrophy, resulting from inactivity caused by
injury, age, surgery, or illness
• Increases physical confidence
• Relieves cramps and muscle spasms
• Reduces pain and swelling
8. The Skeletal System
• Improves posture/body alignment
• Relieve stiff joints
• Decreases inflammation
• Restores range of motion (increasing joint movement)
• Releases joint strain (releasing tight muscles and tendons)
• Releases restrictions in the fascia (connected tissues)
• Improves the circulation and nutrients of your joints
9. The Circulatory System
• Increases blood flow (to tissues and organs), which can relieve
much muscular and joint pain (especially associated with
swelling)
• Increases the flow of oxygen and nutrients (to cells and tissues),
improving and relieving congestion throughout the body
• Increases the number of red blood cells, especially in cases of
anemia
• Lower blood pressure
• Reduces heart rate (helps develop a stronger heart)
• Elimination of metabolic waste
10. The Nervous System
• Stimulates Nervous System = boosting energy
• Calms the Nervous System = relaxing
-- Massage may have a sedative, stimulating or an
exhausting effect on the nervous system depending on the
type and length of massage treatment given
• Relieves restlessness and insomnia
• Relieves pain due to pinched nerves
• Decreases chronic pain
• Stimulates the release of endorphins (the body's natural
painkiller)
11. psychological effects of massage
• Increases awareness of mind-body connection!
• Massage can help you become more aware of where you are
holding tension, as well as where you have tight muscles or
painful areas
• Massage reduces mental stress and Decreases angry feelings
• Promotes better sleep and sleep patterns
• Massage induces mental relaxation
• Fosters peace of mind
• Massage helps improve concentration
• Provides mental clarity
• Revitalizes your mind
13. Contraindications
• Acute inflammatory conditions
• Severe varicose veins
• Open wounds
• Skin infections
• Failed or incomplete fracture healing
• Thrombophlebitis , Thrombosis
• Pregnant women
• Immediately after surgery
2011
14. Treatment Considerations & Guidelines
• Need to know underlying pathology
• Need to know basic massage principles (must have manual
dexterity, coordination, & concentration).
• Hands must be clean, warm, dry & soft. Nails must be short
and smooth. Hands should be warm.
• Must obtain correct positioning that will allow for relaxation,
prevent fatigue & permit free movement of arms, hands, &
body.
• Must obtain good posture to prevent fatigue & backache.
• Weight should be evenly distributed on both feet.
• You must be able to fit your hands to the contour of the area
being treated.
2011
15. Points for Consideration
• Pressure regulation should be determined by the
type & amount of tissue present. Also, pressure is
governed by the condition & which tissues are
affected.
• Each stroke must have equal pressure & time
(rhythm present).
• Duration depends on pathology, size of area, speed
of motion, age, size, & condition of athlete.
– Some areas may take 30 minutes.
2011
16. • If swelling is present in an extremity, treatment
should begin proximally.
• Massage should never be painful, except possibly
for friction massage. It should not cause
ecchymosis.
• Direction of forces should be applied in the
direction of the muscle fibers.
• Each session should begin & end with effleurage.
2011
17. • Make sure the patient is warm and in a comfortable,
relaxed position.
• The body part may be elevated if necessary.
• Pressure should be in line with venous flow.
2011
18. Effects on skin
• Increase skin temperature
• Friction massage can loosen adhesions
and soften scars
• Toughens yet softens the skin
Effects on muscle(s)
• Increases blood flow to skeletal muscle.
• Retard muscle atrophy but does not increase strength or
bulk of muscle
• Increase range of motion
2011
20. Stroking - Stroking is performed with the whole hand or
fingers. It comprises the usage of relaxed hand over the
patient's skin with a rhythm and pressure that produce a
relaxing effect.
Effleurage - Effleurage is performed by spreading and
moving the hands with pressure and speed, to gain relaxation
and lymph drainage.
Kneading - Kneading involves alternate compression and
release of the part to be manipulated.
Picking up - Picking up involves lifting up of tissue from
underlying bone, releasing it after squeezing it.
2011
21. Wringing -Wringing technique lifts up the tissue and applies a
twist to enhance stretching effect.
Friction - Friction is a small movement applied with thumb
or finger where pressure is applied from superficial to depth
of the tissue.
Hacking - Hacking is performed with extended forearm and
striking the skin using the side of the hand .
Clapping -Clapping is done by striking the skin with cupped
hands.
Shaking and Vibration -Shaking and vibration involves
gentle strokes of shakes and vibrations respectively
23. Effleurage
• May be performed slowly for relaxation or rapidly to
encourage blood flow & stimulate the tissues
• Performed in rhythmic manner
• One hand should always be in contact w/ skin
• Light effleurage is performed at beginning & end of massage
or may be used between petrissage strokes
– At beginning – relaxes patient & indicates area to be
treated
– At end – calms down any irritated areas
2011
24. Technique/ Procedure
– Effleurage
• The therapist provides light
or deep strokes of the palms
and fingers
• Unidirectional circular motions
(Distal to proximal)
should be made moving
towards the heart
• Generous lubrication is
required
25. Petrissage
- Lifting & kneading of skin, subcutaneous tissue, & muscles
– Repeated grasping, pressure, lifting and rolling
of muscle tissue with the thumbs and fingers
– As if “kneading” the muscles
– Performed from the distal to proximal portion
of the muscle, Performed with fingers or hand
– Kneading performed either parallel or
perpindicular to the muscle fibers
– Little lubrication is required
26. Friction Massage
• Indications
– Loosen adhesions, aid in edema absorption, reduce local
muscular spasm
– Produce a reflex effect to remove “knots
• Contraindications
– Acute inflammation5,6,7
– *Refer to Hoffa contraindications5,6,7
2011
27. Friction Massage
• Superficial tissue manipulation over a small area
• Technique/ Procedure
– Uses the tips of the fingers, thumb, or heel of the hands
– A small circular motion of deep pressure is provided
– The skin is moved over the underlying tissues
– Lubrication is not recommended5,6,7
2011
28. Friction
• Transverse:
– Applied with thumbs or fingertips stroking the tissue
from opposite directions
– Can use elbow, end of rolling pin, etc. for larger areas
– Reaches deep tissues
– Begin lightly and then move to firmer strokes
– Muscle should be placed in relaxed position
– Should be avoided in acute conditions
– Effective in tendonitis or other joint adhesions
2011
29. Tapotement
• “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
2011
