• Definitions of Massage

• Massage is manipulations of the soft tissues of the body

• most effectively performed with the hands
• administered from the purpose of producing effects on the
- nervous, muscular and respiratory systems
- local and general circulation of the blood and lymph
• According to (AMTA) defines massage as a manual soft tissue manipulation
that includes holding, causing movement and/or applying
pressure to the body
• Therapeutic massage involves the manipulation of the soft tissue structures of the body
- to prevent and alleviate pain, discomfort, muscle spasm and
stress;
- to promote health and wellness
 Historical Development of Massage
• It has been practiced throughout the centuries since the earliest civilizations.
• used medically as - a therapeutic healing treatment
- stimulating, soothing and beautifying the body
• an instinctive act for relieving pain and discomfort, and for soothing and calming
• origin - Arabic word mass or mass’h;- means ‘to press gently’
- Greek word massages means ‘to knead’
- French word masser means ‘to massage’
• earliest evidence of massage being used is found in the cave drawing and paintings of ancient
cave dwellers
• Various artefacts also found containing traces of fats and oils mixed with herbs
- perhaps for healing, soothing or beautifying purposes.
As early as 3000 BC, practiced massage to cure sicknesses and improve general
health
Chinese
• written on their book of the Cong Fau of Tao-Tse
• found that pressure techniques were very effective on specific points
• they developed special techniques called amma.
• This was the beginning for the development of acupressure and acupuncture

• Japan
• similar pressure techniques on specific points, which they called tsubo
• This form of massage has been practiced over the centuries;
• it has recently regained recognition and popularity and is now known as shiatsu
• practiced massage as part of their hygiene routines
Hindus
A sacred book called the Ayur-Veda (The Art of Life),
• written around 1800 BC,
- describes how shampooing and rubbing were used to
reduce fatigue and promote well-being and cleanliness
Egyptians and Persians
• used massage for cosmetic as well as therapeutic effects
• mixed fats, oils, herbs and resins for care of the skin and beautifying the body and face
• Cleopatra is said to have bathed in milk
- then to have been massaged with aromatic oils and creams
by her handmaidens
believed in the cultivation of a healthy mind and body
• Services of bathing, massage, exercise or dancing were practiced
by men and women.
Greeks
• encouraged the pursuit of physical fitness and organized
regular sporting, gymnastic and athletic competitions
• Massage was used - before events to improve performance
- after events to relieve fatigue and aid recovery.
• Gladiators and soldiers were massaged
- before battle to give vigor and promote fitness and health,
- afterwards to aid recovery, healing and relaxation
• Homer writes in the poem The Odyssey of Greek soldiers
- rubbed with oils and anointed by beautiful women to
aid their recovery and regain strength on return from battle
Cont’d …..

• 500 BC, the Greek physician Herodicus used massage with

oils and herbs to treat medical conditions and diseases.

• Hippocrates, who is now thought of as the father of medicine, was a learner of Herodicus
- began to study the effects of massage on his patients
- concluded and recorded that- ‘hard rubbing binds,
Soft rubbing loosens,
= much rubbing causes parts to waste

moderate rubbing makes them grow’

• also concluded that it was more beneficial to apply pressure in an
upward direction, i.e. towards the heart, as we practice today
• In Hippocrates’ day, the function of the heart and the circulation of the blood were not known
• conclusion only by observing the effect on the tissues of different strokes
Romans
The followed similar routines to the Greeks
• practiced bathing, exercise and massage for health and social relaxation
• Large private and public baths were built
- water baths and steam rooms, gymnasium and massage areas.
• baths were maintained at different temperatures and progress
was made from cold to hot baths
• Massage techniques recorded, include as squeezing, pinching or pummelling
(Striking)
- relate to the petrissage and percussion movements used today
• Dark Ages to the Renaissance

• Little is known about massage or health and beauty practices

• from the decline of the Roman Empire around 500 AD until the middle Ages around
1400 AD
• Little value was placed on education, the arts, physical health and fitness
• Renaissance (rebirth) in 1450 AD; Interest in the arts and sciences flourished
• renewed interest in health practices and massage advocated and practiced for
therapeutic purposes
• 16th century, the French surgeon Ambroise Paré (1517–1590) promoted and
developed the use of massage
- was the personal physician to four French kings
- have successfully treated Mary Queen of Scots with massage
- graded massage into gentle, medium and vigorous
 • modern massage
• evolved mainly from a system developed by a Swedish physiologist called Per Henrik Ling
(1776–1839)
• developed a system of passive and active exercises known as
- ‘Swedish Remedial Gymnastics’
- a system of massage movements
• used the terms ‘effleurage’, ‘petrissage’, ‘vibration’, ‘friction’,
‘rolling’ and ‘slapping’
• Dr. Johann Mezgner (1839–1909), a Dutch physician, developed massage for use in
rehabilitation
- used it successfully to treat many diseases and disorders
- adapted massage techniques in the light of his knowledge of
anatomy and physiology
• The work of Ling and Mezgner established massage as an effective therapeutic treatment
Cont..
• Techniques were taught in medical schools
• beneficial effects became widely recognized and accepted in the medical field
• In England, the eminent surgeon John Grosvenor (1742–1823)
used massage to treat joints
- recommended massage for the treatment of
stiffness of joints

• During WW I, the demand for massage to treat injury grew and many more massage therapists were

trained
- organization were formed
- institutions were built
- trained, qualified therapist were emerged
 • Unit two
• Effects of Massage on the Body
1. Skin
• improves the condition of the skin
- Metabolism is increased, which stimulates the cells of the
stratum basale and increases mitosis (cell division)
• aids desquamation (shedding of dead cells)
- Increased mitosis will increase the shedding of the flaky
dead cells of the stratum corneum
• color of the skin is improved
- produces dilation of surface capillaries:
- result in hyperaemia and erythema
• Sebaceous glands are stimulated to produce and release more sebum
• oil or cream used as a medium also lubricates and softens the skin
• Sweat glands are stimulated to produce more sweat
2. Adipose Tissue

is a connective tissue composed mainly of specialized cells called adipocytes, adapted to store
fat

• Fat is the body’s energy reserve

- stored when energy intake is greater than energy output

- utilized if energy intake is less than energy output

• the only way of losing fat is through sensible eating and increasing activity or exercise

• massage is thought to help the dispersal of fat because the deeper movements stimulate
blood flow to the area

- softens the area and speed up removal via the circulating blood
3. bone tissue and joints
• Bones are covered by a layer of connective tissue known as the ‘periosteum’.
- Blood vessels from the periosteum penetrate the bone
- Deep massage movements will stimulate blood flow to the
periosteum
- indirectly increase blood supply to the bone
• Massage increase circulation and nourish the structures surrounding the joint
• Massage is effective in loosening adhesions in structures around joints. For
example, frictions
• Massage with passive movements maintain full range of movement
4. muscle tissue
• aids the relaxation of muscles
- due to the warmth created, reflex response and removal of
accumulated waste
• pushes the blood along in the veins
- Deoxygenated blood and waste are removed
- fresh oxygenated blood and nutrients are brought to the
muscles
- metabolic rate is increased and the condition of the muscles
will improve
• will reduce pain, stiffness and muscle fatigue produced by the accumulation of waste following
anaerobic contraction
- removal of this metabolic waste, i.e. lactic acid and CO 2
- important following hard training, sport and athletic
performance
 • warms muscles due to the
Cont’d ……… - increased blood flow
- friction of the hands moving over the area
- friction of the tissues as they move over each other
# reduces tension and aids relaxation of the muscles
# Warm muscles contract more efficiently and are more
extensile than cold muscles
• elasticity of muscles is improved because manipulations stretch
the fibers and separate the bundles
- adhesions are broken down and tight fascia are stretched
• will break down adhesions and fibrositis nodules
- developed within the muscle as a result of tension, poor
posture or injury
5. blood circulation
• increase the blood flow through the area being treated
- produces hyperaemia (increased blood supply) and
erythema (reddening of the skin)
• speeds up the flow of blood through the veins
- Veins lie superficially (nearer the surface than arteries)
- deeper and faster the movements, the greater the flow
- venous blood carries away metabolic waste more quickly
# massage will relieve pain and stiffness by flushing out
metabolic waste
# relieving pressure on the capillaries, which restores free
flow of blood within the tissues
• increases the supply of fresh, oxygenated blood to the part
- nutrients and oxygen nourish the tissues and aid tissue
• Cont’d ……….
• dilates superficial arterioles and capillaries
- improves the exchange of substances in and out of cells via
tissue fluid
- will improve the metabolic rate, which, in turn, will improve
the condition of the tissues
• Warmth is produced in the area due to the
- increased blood flow and friction of the hands on the part
• reduce the viscosity of the blood, reducing its rate of coagulation
- Relaxing slow massage may reduce high blood pressure
6. lymphatic system

• flow of lymph in the lymphatic vessels is speeded up

- direction of lymph drainage to the nearest group of lymphatic

nodes

• facilitate the transfer of fluid across vessel walls, fluids

- pass into the lymphatic vessels and drain away more quickly

* prevent or reduce oedema (swelling of the tissues)

• movements of petrissage are the most effective

- part is elevated while being massaged, as gravity will assist

7. Respiratory System

• air passages are lined with a mucous membrane; secrets mucus

- moistens the tubes and traps any organisms in the inspired air

• irritation of membrane result in an increase production of mucus

- mucus may thicken and become difficult to remove through

coughing

• Shaking and vibration manipulations performed over the chest to

loosen these secretions

• Deep breathing exercises will also help to move the mucus

• Digestive System

• stimulates peristalsis; movement of digested food through colon

• relieve constipation and flatulence
Nervous System
• Slow, rhythmical massage produces a soothing, sedative effect on
sensory nerve endings

- promoting general relaxation.

• Vigorous brisk massage will have a stimulating effect,

- producing feelings of vigor and glow

• Too poor or heavy manipulation techniques

• Urinary System

• improve the circulation to the kidney

• increase the output of urine and the elimination of toxins

Precautions

• Heavy percussion should not be performed over the area

• too heavy a pressure over the bladder area can be uncomfortable.

• Pain in the lower thoracic and lumbar region may indicate a kidney problem

• client empties the bladder before treatment, as it is impossible to relax if the

bladder is full
Quiz 1
Benefits of Massage

• Physical benefit
• Mental benefits
• Emotional benefits

•
 Physical benefits

• relives stress and aids relaxation

• relive muscle tension and stiffness

• Alleviates discomfort during pregnancy

Benefits
of • Foster faster healing of strained muscle and sprained ligaments;
Massage
• reduces pain and swelling;

• reduce formation of excessive scar tissue

• Reduce muscle spasms

• Provide greater joint flexibility and range of motion

 • Improves circulation of blood and movement of lymph fluids
Cont’d… • Reduces blood pressure
• Enhance the health and nourishment of skin
• improves posture
• strengthens the immune system
Mental benefits
• foster peace of mind
• promotes a relaxed state of mental alertness
• relive mental stress
• improves ability to monitor stress signals
• enhance capacity for calm thinking and creativity
 Emotional benefits
Cont’d …..
• satisfies needs for caring, nurturing touch

• fosters a feeling of well-being

• reduces levels of anxiety

• creates body awareness

• increase awareness of mind-body connection

 chap.3 preparation for massage

Massage Room

• Preparation for massage involves

- the physical and mental preparation; i.e. hygiene, safety, health

- the preparation of the working area or room

Preparation of working area

• Ensure the client total privacy, without being overlooked by others

• Ensure enough space to move around

• The area should be warm, well-ventilated and draught free

• It should be quiet, peaceful and free from distracting noise

• The lighting should be soft and diffuse

• The color scheme should be pale(light color) but warming

Cont’d…… Factors encourage relaxation
• The area must be Perfectly clean and tidy area

• Items gracefully arranged

• A plentiful supply of clean laundered towels and linen

• Extra pillows, small support pillows or rolled towels

• Shower and toilet facilities

• A hand basin or sink to wash hands

• A lined bin for disposal of waste

 Selection is often based on the cost of the couch,

• wide enough for the clients to turn over easily

• long enough to support the length of the body

Selection of
massage couch • healthy, protected and secure; not move or rock

• be at the correct height for working

• smooth, washable covering material

The most useful couches are the adjustable height

Some couches have a hole for the nose and mouth; to make positioning
and breathing easier when lying prone.
 • Cover the entire surface with a toweling or cotton sheet

• Next cover this with a large bath towel or cotton sheet

Preparation of
massage couch • Use one or two pillows for the head

• Fold two large towels and place them at the foot of the bed

• Place extra pillows, large and small, and a rolled towel

 Lubricants used for massage
 Lubricants used fo

 Manufacturers produce a wide variety of oils, creams, lotions, gels and powders suitable for massage.

 The massage standard should be selected to suit the client’s skin type

 Oils:- offer the highest level of lubrication - suitable for thin skin or hairy areas

 Lotions and creams:- more nourishing and may have flavors - beneficial for dry skin.
 Gels and powders:- more suitable for oily skins because powder
helps to absorb sebum and sweat
 Massage can be performed without lubrication
- tissues are grasped and lifted; picking up, wringing
- Neuro-muscular techniques; friction
Reasons for using lubricants
• reduce friction by improving gliding movement
• increase client comfort
• prevent dragging and pulling hairy skin
• prevent stretching loose, fragile skin
• nourish dry, scaly skin
Cont’d…  Gels and powders:- more suitable for oily skins because powder
helps to absorb sebum and sweat
 Massage can be performed without lubrication
- tissues are grasped and lifted; picking up, wringing
- Neuro-muscular techniques; friction
Reasons for using lubricants
• reduce friction by improving gliding movement
• increase client comfort
• prevent dragging and pulling hairy skin
• prevent stretching loose, fragile skin
• nourish dry, scaly skin
• produce psychological and therapeutic benefits
 • Vegetable oils:- are the most widely used
Types of - include almond oil, grape seed oil, olive oil, corn
massage oil, sunflower oil, wheat germ oil, avocado oil,
lubricants
coconut oil, peanut (arachis) oil
• Mineral oils:- include baby oil, liquid paraffin, and cold cream
• Essential oils:- are oil extracts of aromatic plants
- massage oils, candles, perfumes, shampoo, and
other beauty and health products
- have varying uses – to uplift, heal and relax

Sunflower Oil Olive Oil Apricot oil

Avocado Oil Cocoa butter Grape seed oil

Jojoba oil Hazelnut oil Sesame oil
  Lubricants produce an allergic reaction in some clients
range from abnormal reddening of the skin, to very serious shock
Precautions with fatal consequences
- allergic to peanut oils; produce anaphylactic shock, result in:
* rapid pulse, difficulty in breathing, profuse sweating, collapse
 essential oils have different properties and different effects
- harmful; e.g. oil of bergamot not used; exposed to sunlight

increases skin sensitivity to ultraviolet rays

Manufacture products
Read the manufacturers’ instructions and list of ingredients
 Some vegetable oils can turn rancid and have a short shelf life
 stored in containers with small apertures to prevent contamination
by micro-organisms
Cont’d…..  Wash your hands before pouring the lubricant
 do not pour too much and take care not to spill any
 Spread lubricant between the palms of both hands to warm it
Psychological preparation
 enhances concentration and co-ordination
contributes to expertise and effectiveness of the massage
 Develop a calm, tranquil but positive attitude
 Develop co-ordination between mind and body
 Develop sensory awareness; ability to sense and visualize structures
 Learn to synchronize speed, rhythm and depth; to remain consistent
 Positioning and Draping
Lying
Positioning and • Ensure the client’s safe at all times
Draping • Help and Position the client correctly onto the couch
- well-supported position ensure comfortable, aid muscle
relaxation; if not
- muscle be tense, restless, unable to relax and ineffective
• Ensure the client’s body is straight and lie centrally
supine
 lying on the back
offer one or two pillows under the head for support
Another pillow placed under the knees- to flatten the lumbar
spine
- This pillow must be fairly small and firm; does not
Cont’d….. Prone
 lying on the face down
 head usually turned to one side with without pillow
 A pillow placed under the abdomen - round out the lumbar spine
 small firm pad or tightly rolled towel placed under the ankles
- to avoid over-stretch of anterior tibial tendons
 Cover the client with two towels
Sitting
 done massage of the neck and upper back and low back pain
• Place a stool to the side or end of a couch or table; Cover with a
towel.
• Place one or two pillows on the couch and cover with a towel.
• Ask to undress, sit on the stool and lean forward onto the pillows.
Cont’d…… • Ensure that the client is comfortable and well supported,
- arms and head resting on the pillow
• Cover with a towel until the massage begins
 • Unit four
• Basic techniques of massage
• Type of massage
Types • Remedial massage:- to restore function to injured ‘soft tissue’
of • Relaxation massage:- promotes general relaxation, improves circulation and range of motion
and relives muscular tension
Massa
ge • Reflexology:- applying pressure to using thumb and finger on the reflex points of the foot
that corresponds to organs and systems in the body (which corresponds to all areas of the
body).
• Sports massage:- to prevent and treat athletic performance
• Hot stone massage:-applied gentle pressure with heated smooth stones to warm and loosen
tight muscle and balance energy centers in the body.
• Deep tissue massage:- deeper layers of muscle and connective tissue used for chronically
tight or pain full muscles, repetitive strain postural problems or recovery from injury.
• Swedish massage:- long smooth stokes, kneading and circular movements
• Shiatsu:- uses localized finger pressure in a rhythmic sequence on acupuncture meridians -
held for two – eight seconds
Cont’d… • Thai massage:- adjust the energies of the body using gentle pressure on specific points
… • Aromatherapy massage:- addition of one or more essential oil - conditions This type of massage is
most suited to stress related conditions or conditions with emotional components.
==============================================
There are differences in terminology from country to country and from school to school. The
terminology used today is based on the Swedish remedial massage devised in Sweden by the
physiologist Per Henrik Ling, and Dr Johann Mezgner of Holland. This has been modified over the
years with input from French, German and British physicians and practitioners.
The names of the groups describe the action of the hands on the tissues. The four main groups
are:
Basic
• Effleurage: hands skim over the surface of the tissues
Techniq
ues of • Petrissage: hands press down or lift and squeeze the tissues
Massag
e • Percussion or Tappotement: hands strike the tissues

• Vibrations: hands vibrate or shake the tissues

 Classification of massage movements/techniques

Effleurage Percussion/ Vibration

Petrissage Tappotement

1. Hacking
1. Effleurage 2. Cupping or
1. Kneading
2. Stroking
2. Wringing clapping 1. Vibrations
3. Picking up
4. Skin rolling or 3. 2. Shaking
muscle rolling
Beating
5. Frictions; circular
transverse 4. Pounding
 • The word ‘effleurage’ comes from the French verb effleurer, which means ‘to skim over’
• There are two manipulations within this group - effleurage and Stroking
Effleurage
• the two manipulations are similar, in that the relaxed hands move over the surface of the body
Effleurage Stroke

Direction must always follow the direction of venous

return back to the heart - may be performed in any
the direction of lymphatic drainage towards the direction
nearest group of lymphatic nodes

Pressure may be light, moderate or heavy, but always - selected at the beginning and
increases at the end of the stroke towards the is maintained throughout
lymphatic nodes - It also may be light,
moderate or heavy

Hand continued during the return of the stroke, - may maintain contact or may
contact although little pressure is applied lift off the part on return
 • is a manipulation where one or both hands moves over the
surface of the body
A. Effleurage • applying varying degrees of pressure according to the type of
massage being given

• produce superficial effects when the pressure is light to

moderate, but will produce deeper effects if the pressure is heavy
Adapting effleurage
• must be adjusted to suit the client and the objectives of the treatment;
• example, older thin client with poor muscle tone, the pressure will be light
to moderate, younger or fitter and well-toned client, the pressure can be
deeper
Cont’d…… • Relaxing massage, the effleurage will be rhythmical, slow and medium depth
For a stimulating or vigorous massage, the effleurage will be rhythmical but
faster and deeper

• When treating edema, effleurage will follow kneading and squeezing

movements – not precede them as is usual

• The effleurage performed at the end, to complete the treatment, should

become progressively slower

• When treating areas of fatty deposits the heavier movements of kneading and
percussion are combined with effleurage, and the treatment ends with
effleurage to increase drainage
Cont’d…… Deep effleurage
• Heavier pressure is sometimes required to affect the deeper tissue and muscles

• This does not mean the use of greater force but rather the more effective use of body
weight.

• Deep effleurage is used for promoting relaxation in deep muscles and improving the
local circulation

• Effleurage with the forearm is another deep technique that is particularly effective over
the large sheet-like muscles of the back.
• Effleurage uses the clenched fist to apply short stroking movements to particularly
dense areas.
=========================================================

• Stroking is very similar to effleurage in that one or both hands moves over
Cont’d…….
Soothing stroking

• performed slowly with light pressure

* to soothe and relax a tense, nervous client

* to help insomnia and promote sleep

* to produce vasoconstriction on a hot, edematous area.

Stimulating stroking is used

• performed vigorously with pressure:

* to stimulate a tired client and stimulate a tired one

* to produce an erythema and warm up an area

 • The word ‘petrissage’ comes from the French verb pétrir meaning ‘to knead’
• There are five manipulations in this group, but some can be further subdivided:
1. kneading 2. wringing 3. picking up
4. skin and muscle rolling 5. frictions
• All the manipulations in this group apply pressure to the tissues, but each manipulation
Petrissage differs in technique
Kneading
• The true kneading manipulations apply pressure to the tissue and move them over underlying
bone in a circular movement
• There are many forms of kneading
• Palmar kneading: this is kneading with the palmar surface of the hand. There are different
forms of kneading.
• ➛ Digital kneading: this is kneading with the digits (i.e. the fingers) – the index, middle and ring
fingers are usually used.
• ➛ Thumb kneading: this is kneading with the thumbs.
• ➛ Ulnar border kneading: this is kneading with the ulnar border of the hand (ulnar bone or
little finger side).
Cont’d…… a. Palmar kneading

• applies pressure to the tissues through the palmar surface of the hands
and fingers, moves the superficial tissues over deep tissues
Single-handed kneading: one hand performs the kneading while the other
supports the tissues on the other side
* useful on smaller muscles such as triceps and biceps
Alternate palmar kneading: one hand works slightly before the other,
resulting in alternate upward pressure
• The hands are placed on either side of a limb
e.g. - one on the abductors and one on the adductors of the leg
- placed on the right and left side of the spine
Cont’d…….
Reinforced palmar kneading: one hand lies directly on top of the other,
reinforcing its movement

• produces very deep pressure, which is useful on large muscle groups

such as the quadriceps, hamstrings, posterior tibial,
• on areas of dense adipose tissue over the hips, waist and sides of the
trunk

Double-handed kneading: the hands work side by side, moving the

tissues in a large circle with the pressure upwards

• useful when covering large areas,

e.g. - from one side of the back to the other

Cont’d……..
b. Digital and thumb kneading
• Small circular movements are performed over small areas or small muscles
using
* the pad of the thumb
* the pads on palmar surface of first, second and third fingers
• These digital movements are useful over
- the upper and middle fibers of the trapezius muscle
- the flexors and extensors of the forearm,
- down the erector spinae, around the colon
- the pectoral muscles
• Thumb movements are useful around
- patella, over the anterior tibias
- over the dorsum and sole of the foot,
Cont’d…….
c. Ulnar border kneading

• the ulnar border of the hand is used to obtain greater depth

• The ulnar border of the hand is placed on the part and moved in circles

• used mainly over the soles of the feet and around the colon in abdominal
massage

• similar in technique, effects and uses to digital kneading

• When performed around the colon the pressure changes:

* upwards over the ascending colon (on the right side);

* across over the transverse colon;

* downwards over the descending colon (on the left side)

Cont’d….. Wringing

• is a manipulation where the tissues are lifted away from the bone,
and pushed and wrung from side to side as the hands move up and
down
• It must not be used on over-stretched muscles or those with poor
tone

• the fingers of the right hand work with the thumb of the left hand to
press the flesh diagonally, then the fingers of the left hand move
towards the thumb of the right hand

• Wringing can only be performed over areas of loose or supple tissue

Cont’d……. Picking up

• is a manipulation where the tissues are lifted away from the bone, squeezed
and released

• performed with one hand or with both hands

• must not be used on stretched muscles or those with poor tone

Single-handed picking up

• is performed with one hand grasping the muscle

Reinforced picking up: technique

• one hand is placed on the area as in single-handed work, but the other hand
is placed over it
Cont’d…….
Double-handed picking up
• performed by two hands working in a synchronized manner up and down
usually on
- the large muscle groups of the leg
- adipose tissue at the sides of the trunk and hips

Skin rolling

• This manipulation presses and rolls the skin and subcutaneous tissues against
underlying bone

• only performed where there is a bony framework underneath to work against

• particularly effective when used transversely across the back, over the ribs or
across the limbs
Cont’d……. Muscle rolling

• This manipulation lifts the muscle away from the bone and moves it from
side to side in a rocking manner

• particularly useful when muscles are very painful and sore and unable to
tolerate any other pressure manipulations
Frictions

• are much localized manipulations performed with the fingers or thumb

• applied transversely across muscle fibers or in a circular movement

• are deep movements performed with much pressure

• performed on dry skin, free of oil or talcum powder, so that the fingers
Cont’d……. Circular frictions

• are small circular movements performed by the fingers or thumb

• pressure may be selected at the commencement and kept constant throughout

Transverse frictions
• are backward and forward transverse movements performed across ligaments
or joints

• the pressure may get progressively deeper

• used - to increase local circulation and promote healing

- to loosen adhesions and improve movement around joints
- to stretch and loosen old scar tissue
- to disperse tension nodules
 • all the manipulations of this group strike or tap the part

• hands are used alternately to strike the tissues with light, springy,
rhythmical movements

• When performing these manipulations, particular care must be

Percussion
(tapotement) taken to avoid bony reputations, ridges or areas where the bone is
not well covered

• must not be performed on old or very thin clients, or those with

loose, poorly toned muscles and little adipose tissue

• These manipulations are never used in a relaxing massage because

Cont’d…..
• There are four manipulations in this group, named according to the
position of the hands and the way in which they strike the part:
1. Hacking 2. Cupping 3. Beating 4. Pounding

Hacking

• uses the ulnar border of the hand and the little finger, ring and
middle fingers to strike the tissues in a light, springy, brisk manner

• The forearm must alternately pronate and supinate to allow the

fingers to strike the part

• avoid flexion and extension of the elbow joint as the resulting

‘chopping’ action is too heavy and powerful
Cont’d….. Cupping
• (also known as clapping)
• is performed using the cupped hands to strike the part alternately
• The movements are light and brisk, producing a hollow sound

Beating

• This is a heavier percussion movement that is useful on very large

heavy areas of adipose tissue,
- particularly over the buttocks and thighs

• is performed by striking the area with a loosely clenched fist

• The back of the fingers and heel of the hands strike the part as the
Cont’d…… Pounding

• is a heavy percussion movement, performed by the ulnar border (little

finger side) of the loosely clenched fist

• The side of the hands strikes the part alternately

========================================================

• There are two manipulations in this group: shaking and vibration

• Both produce vibrations or tremors within the tissues

Vibration
• Shaking is a much bigger, coarser movement and produces shaking of
the muscle
Cont’d… Shaking
…
• performed with one hand grasping and shaking the muscle while the other

supports the part

• performed with both hands working together, pushing in and out in a shaking
action
• particularly effective performed over the chest to loosen secretions and mucous in
the lungs
Vibration

• is usually performed with one hand, on large areas both hands can be used.
• The hand is placed over the area and vibrated either up and down or from side to
side
 • Comfort: always be comfortable; not hurt or injure the client

• Direction: towards the heart and to the nearest lymphatic nodes

• Order: begin with effleurage, petrissage then percussion; finish with effleurage

• Continuity: massage should be continuous

Basic rules
• Speed: slow for relaxing, moderate for a general massage, and faster for a vigorous,
and
guidelines stimulating massage

• Depth: moderate depth for a relaxing and general massage, deeper for a vigorous
massage

• Rhythm: is selected at the beginning of the massage and maintained throughout ;

slow rhythm for a relaxing massage, moderate for a general, and a faster rhythm for
a vigorous massage
• Stance: protect yourself from strain and injury by adopting the
correct posture
* Walk standing (i.e. with one foot in front of the other)

massaging up and down the length of the body

* Stride standing (i.e. with the feet apart)

working across the body

• Concentration: maintain your concentration throughout the

massage

• Coverage: cover the whole area thoroughly

- Do not neglect small areas as this will result in uneven

 • Chapter 5
• Sport Massage
• sport or athletic massage is highly specialized
• A qualification in massage is not enough; additional knowledge and practice is
required
- will enable the massage therapist to
Sport * carry out an assessment
Massage
* provide appropriate treatment

• The therapist must be part of the training team, giving advice and explaining the
effects and benefits of massage

• Athletes or sportspeople are highly trained the body to its limit, i.e. to the point of
breakdown
- train too hard and frequently in an effort to improve
Cont’d……
• Hard training with inadequate rest periods result in a decline in
performance and leave the body vulnerable to serious injury

* the athlete may suffer from any of the following symptoms:

- vague aches and pains - acute pain in muscles, bones or joints
- inflammation of tendons, ligaments, bursae resulting in pain and
swellings;

• symptoms of stress such as headaches, listlessness, tension, insomnia or

increased irritability

• hard training must be balanced with rest periods to allow adequate or full
recovery of the tissues and to restore homeostasis (body balance)

• The harder and longer the training, the longer the rest period should be
Cont’d…..
• Massage following training and performance will greatly hasten the
recovery of the tissues

• recovery is four to five times faster in tissues receiving massage than

in those simply allowed to rest

• A shorter recovery time allows for a greater number of training

sessions, which will improve performance

Sports Massage for Athletic Training

• Training massages are given throughout the training stage of athletic
performance
• Massages can be given before, or after a workout depending on the
Cont’d….. Benefits of Massage for Athletes in Training
• Faster recovery from micro damage and trauma from workouts
• Increase flexibility and range of motion
• Relieve fatigue and rejuvenate
• Reduces the strain of repetitive motions
• Reduces the healing time of injuries

Benefits of sports massage

• increases the blood flow through the area being massaged

• generates heat in the tissues through the friction of the hands

• increases the permeability of cell membranes

• speeds up venous and lymphatic drainage from the area; which removes
Cont’d…… • increases the flexibility of the tissues
• provides an early warning system to the risk of potential injury

• break down or stretch inflexible scar tissue found in muscles,

tendons or ligaments
• break down adhesions within the muscles

• Massage around joints will improve the circulation and generate

warmth
• Massage will promote local or general relaxation

Use of massage in sport

* pre-event massage * post-event massage
 • Aim:- to help the body respond to the demands of increased activity and
facilitate optimum performance

• The objectives are to:

- increase the delivery of nutrients & oxygen to the contracting muscles
- warm the muscles, thus improving contractility
- improve the flexibility and extensibility of muscles
Pre-event - maintain maximum range of joints movement
massage Treatment
• massage must be brisk and of fairly short duration,

e.g. 7–10 minutes for each area; to maintain balance

• athlete must have experienced massage during training; not receive the first
massage before performance
 Post-event massage

Aim:- to promote speedy and complete muscle recovery and to re-establish homeostasis

The objectives are to:

Post-event
massage * speed up venous and lymphatic drainage remove metabolic waste

* increase the delivery of nutrients and oxygen to combat fatigue and aid
muscle recovery

* prevent or relieve pain and stiffness

* relieve tension and promote relaxation

* prevent tightening of facial components and maintain flexibility

* identify areas of tenderness or soreness, which may indicate injury

* prevent the formation of adhesions and fibrosis

 • massage should be given as soon as possible after the event and
certainly within the first one to two hours
Treatment • Great care must be taken when giving post-event massage as the

muscles may be tender, sore and painful

• Very light pressure should be applied initially, becoming deeper as

muscle relaxation

• begin with light stroking and effleurage, gentle muscle lifting, rolling
and shaking

- Kneading, wringing and picking up should not be used until

 • Aim:- to help the athlete achieve and maintain peak condition, thus
maximizing performance

• is very similar to post-event massage, as its main aim is to clear out

the waste products and promote speedy recovery
Training
massage • The objectives are to:

- maintain an efficient circulation and delivery of nutrients and

oxygen for nourishing the tissues

- quickly remove metabolic waste after a training session

- promote fast recovery of the muscles, thus allowing greater

Cont’d….. - prevent any minor injuries becoming more serious and chronic
- prevent the formation of scar tissue and to stretch old scar tissue
- prevent the formation of adhesions and fibrosis
- maintain flexibility or elasticity of muscles, fascia, tendons and
ligaments
- maintain and improve the range of movement at joints
- relieve stress and promote relaxation

• Training massage is probably the most beneficial for the athlete

• given regularly as part of the training schedule

Treatment • may be a full body massage or half of the body, depending on the
areas of greater stress
Treatment massage

Aim:- to promote rapid healing and aid complete recovery of the tissues, thus
restoring normal function

The objectives are to:

- reduce the inflammatory response
- promote healing and reduce pain, swelling and stiffness
- gradually mobilize and stretch the affected tissues
- return the body to normal function.

Treatment
• R - Rest and immobilization to prevent further damage
• I - Ice, applied immediately for vasoconstriction
• C - Compression to reduce swelling
• E - Elevation, using gravity to assist drainage of exudate from the area