MASSAGE/ SOFT TISSUE
MANIPULATIVE
TECHNIQUES
RELAXATION
It is a state of complete slackness of mind
and body
It reduces mental and physical strain and
complete rest is possible.
To conserve energy in human body as a
periods of relaxation sleep.
During sleep
muscles are relaxed
limbs heavy
skin warmed & mind is blank
work of heart and lungs are reduced
Many patients require relaxation
INDICATIONS
Spastic
HTN
psychological cases
Tense & rigid limbs after injury
severe pain
Factors to be consider for relaxation:
Position of pt
Relaxation of the body
Breathing pattern
Room must be warmed and ventilated
Noise should be kept minimum and light music
Rhythmic limb movts
Massage
ETHICS OF MASSAGE
It is important that every therapist /student
should be aware of certain principles that
have vital important to practice massage
at a professional level.
PRINCIPLES
1. Punctuality
2. Regularity
3. Personal hygiene/ appearance:
Apron should be clean
Hair tied
Hands cleaned with trimmed nails
Other accessories should be discarded
4. Loyalty
5. Responsibility
Preparation for massage
Self preparation
Personal hygiene
Full ROM to all joints of forearm and hand
Relaxation
Full relaxation of the hand &arm
Resting position of hand
Reciprocal relaxation
Environment
Room should be warm and ventilated
Noise kept minimum and light music is kept
Treatment couch
Adjustable couch is imp
Padded treatment couch may be covered
with fresh linen.
Large and small washable blankets
Standard size pillows
Comfort and support of the patient
Complete relaxation of the body
couch should be comfortable
sufficient pillows
Blankets to cover exposed parts privacy
Position of the operator
Coordinated and integrated movts – prolonged
performance
Minor adjustment of foot and trunk
Time for treatment
Morning
Contact and continuity
Maintained through out the treatment
Change from one manipulation smoothly
and rhythmically without discomfort
Rhythm is maintained
Lubricants:
Powder:
Talcum powder , corn starch
Oils:
olive oil, liquid paraffin – fragile skin to
reduce excessive stretching ,hairy skin to
avoid pulling to reduce friction
Soap and water:
For scaly skin
Indications for massage:
Bells palsy
Facial palsy
Sprains
Oedema
General relaxation
Mastectomy
Insomnia
Lymphadenopathy
Constipation
Head ache
Scar
Distended
Tendinitis
abdomen
Contraindication:
Haemorrhage Burns
Haemoptysis Pressure sores
Haemophilia Open wounds
Hairy skin fractures
Acute infections: Osteoporosis
septicemia
carcinoma
Vascular diseases
hyperpyrexia ulcers
Hypotension
USES
Reduces pain, swelling and muscle spasm
Increase extensibility of tissue
Increase blood circulation
Reduces stress
Improves skin condition
Reduces hypersensitivity
Stretches adherent tissue
Removes metabolic waste products
Promotes lymphatic drainage
Promotes remodeling of tissue
Facilitates general relaxation
Increase tissue mobility
Increase sensory threshold
Massage manipulations
Classification of massage:
Stroking manipulation:
Stroking
Efflurrage
Petrissage manipulation:
kneading
Wringing
Rolling
Picking up
shaking
Percussive manipulation:
Clapping
Hacking
Beating
Pounding
Vibrations (shaking)
Tapping
Friction manipulation:
Sub- classification
Kneading: Hacking
Circular Longitudinal
Squeeze Convergent and divergent
Stationary
Spiral finger Friction:
Ironing Circular
Transverse
Massage manipulations
Stroking Technique
Effleurage Stroking
(distal to proximal) (proximal to distal)
Effleurage
Effleurage means- to stroke
Unidirectional from Distal to proximal
Draining towards – Finger tips to axilla
Toes to groin
Buttocks to axilla
Neck to supra clavicular glands
Depth - to push fluid in superficial vessels
Hand contact –Firm contact with whole surface of
hand and pressure will encourage drainage in
veins and lymphatics
Both hands used together on opp aspects
one hand follows another
Each hand used ,while opp hand supports
Therapist position – Walk standing
At the end of effleurage overpressure & pause given
Or stroking the hand back to start
Indication: swelling , oedema
Removal of chemical irritant
Stretch ms fibres
Increase ms tone
Keep skin soft & supple
Effects
It reduces the pressure in venous end of capillary-
reabsorption occurs
Stroking
Unidirectional
Direction of stroke varied ,full area covered
Start with firm contact and ends with smooth
lift
Speed : slow – sedative
Fast – stimulating
Can be done : One hand
Two hands simultaneosly
Rt &Lt hand following
Thumbs and fingers
Thousand hands
Effect: Cutaneous nerve ending
Relaxation
Preparation of pt to other manipulations
Indications: Relaxation
Muscle spasm
Petrissage Manipulation
Soft tissues are compressed against underlying
bone or against themselves
Divided into
Kneading – Tissues are compressed against the
underlying structures
Picking up – tissues compressed then lifted and
squeezed
Wringing – Tissues are lifted and squeezed by
alternative hands
Rolling - tissues are lifted and rolled
between the finger and thumbs as in skin
or ms rolling
Picking up
Tissues are compressed against the underlying
bone, then lifted , squeezed and released.
Single or double handed
Hand position:
Thumb & thenar eminence as 1 component
Medial 2or 3 fingers & hypothenar eninence
Thumb abducted – C shaped grasp
V shaped
Cleft must always contact with skin
Therapist position: Walk standing
Therapist arm position: arm slight abducted
semiflexed elbows
wrist extended
Body weight movement:
Forward on count 1
Backward 2
Hand: Compresses 1
Grasp & lift 2
Release 3
Moves 4
Contraindications: flaccidity
Effect % uses: same as kneading
Rolling
Skin Rolling
Muscle rolling