4.1 : Introduction
Now we get to the real meat: what methods there are to perform a massage.
This isn't really a 'how to' guide: by far the best
way to learn massage is by watching somebody else do it, and having them teach you in person.
That's why all the different massage technique module sin this course are accompanied by
a video tutorial.
A little experimentation can be no bad thing, but
attempting to teach yourself massage can be confusing
and potentially even dangerous. I've tried to indicate which strokes could
cause damage if performed incorrectly
contorting your body in unnatural ways, and if you're hurting somebody you're probably doing something wrong. With
that, on to the techniques
Effleurage
Effleurage
is the most common stroke used in massage. It is a gentle sliding of the hands
over the skin.
For the most part, effleurage strokes are pointed
towards the heart. Commonly, effleurage is used at the beginning of a session,
to enable the therapist to get a sense of the customer's body: its sensitivity, the placement of the muscles,
and so on. It is also used at the end of treatment as a
gentle 'wind-down', and as a filler to move between different strokes. Simple
as it is, effleurage increases blood
flow to the skin and to some muscles.
Variants on the basic pattern of effleurage include:
*Shingles. Otherwise known as 'alternating hand massage'. This uses the gliding of both
hands to massage an area of skin, one hand in front of the other
*Bilateral effleurage. This is a back-rub
technique, in which one hand is placed on either side of the back, and both are used
for effleurage
Tapotement
Tapotement is a massage
by hitting.
specific techniques – many of which are described in more detail elsewhere in this text. Tapotement is used
particularly heavily in warm-up massage for athletic events, but is generally an important part of Swedish
massage. It may draw some of its effects from the way in which air is compressed against
the skin by each blow.
make sure that the blows are made at equal strengths and intervals. It can be quite tricky
to get the level of force right.
Making the blows
too heavy can be uncomfortable, and hence cause a 'tensing
up' reaction which isn't ideal. However, a certain degree of force seems to be
beneficial.
Tapotement is best performed on areas of the skin
which do not have bones or particularly sensitive spots just underneath. Which
areas of the body this includes will depend on the person being massaged – if
you are skinny and bony, you may benefit less from tapotement.
Hacking
Hacking isn't
a very descriptive term for this technique – put away those images
of woodsmen with axes!
Hacking is a form of very light,
rapid tapotement, in which you hit somebody with the fingers of each hand
alternately. The force comes from the wrist rather than from the arm – not
least as a protection against accidentally hitting too hard.
Cupping
Cupping is something like slapping with a cupped
palm. If the hand is not kept bent enough, the result
will be as unpleasant as if you simply slapped the patient.
Beating
Beating lets you use your fists on the patient.
Make each hand into a fist and gently beat on the patient's skin with the bottom of
each fist alternately. As with other tapotement, the trick is to avoid getting over-enthusiastic and hurting the
patient. It may help not to concentrate fully on making contact with the patient. Instead,
imagine that you are tugging
on ropes or ringing a bell, and think
of the impact of your fists on the patient's skin almost as a side-effect.
Pummeling
Pummeling is a 'punching' type of action, done
rhythmically and evenly with both hands. Since it can feel more intensive than most massage strokes, it is generally
only performed on areas with a good covering
of flesh. For the same reason, pummeling isn't usually performed on
easily-harmed patients such as
children and pregnant women. It is supposedly good for breaking down fatty
deposits under the skin.
Petrissage
Petrissage techniques consist of short, circular
strokes that pick up and squeeze the muscles. This improves blood flow to the muscles, and can also help the muscles to eliminate their waste products.
Plucking
Plucking involves gently lifting a spot of skin,
and then letting it slowly slide back through the fingers. Think of your hand as being
like the beak of a bird, opening
and closing.
Raking
Raking is a way of massaging
the back and sides by following the contours of the ribcage
Nerve
Strokes
As I mentioned above, shiatsu massage
places great emphasis on the use of the fingertips. The counterpart to this
within Swedish massage is the 'nerve stroke', gently running the fingertips
across an area of skin.
C-Bowing
This stroke gets its name because an area of skin is bent into the shape of the letter C. You place your two thumbs next to each other
on a patch of skin, and grasp the skin with your fingers. Then you push the thumbs gently into the skin,
and pull back with the fingers. The result is that the skin gets distorted into a 'C' shape.
J Stroke
Another stroke named because it
makes a shape like a letter. With all these letters, there's a whole world of
massage poetry waiting to be explored! Anyway, this stroke is made with the
knuckles of a clenched fist, pressing quite deeply into the skin and moving in
a J shape.
Friction
Friction is one of the strokes aimed at the
muscles, and so the practitioner should ignore the skin itself as much as possible.
As well as the usual benefits of increased circulation, friction strokes can break
up knots of muscle. Variants
of friction can use different
parts of the hand, and they are mostly performed quite quickly.
Friction
can be performed:
*With
the palm
4.3 : Other techniques
Ice massage
The technical term for this is cryomassage – but
that doesn't mean anything more than 'cold massage'. The idea is to use ice packs on the body. Ice used in this way has the same effects
as it does when you put a bag of frozen peas onto a bruise:
it eases pain and reduces
inflammation.
The idea of using cold in this therapeutic way is hardly
new. We believe
some form of cryotherapy
was used in ancient Greece and Rome, although we would be stretching
definitions if we tried to call this a 'massage'. Ice baths came,
went, and came again as fads during
the nineteenth century.
Readers of classic children's book The Secret Garden
may remember a particularly unpleasant description
of such a treatment being given to an unwilling young boy – hardly the best
recommendation for a massage treatment.
But modern cryotherapy resists the temptation to
leap to extremes. Most therapists will try to avoid anything that feels
unpleasant, both for medical reasons and because hurting customers is bad for business!
Aquatic massage
Conducting a massage
in water opens up doors to methods
which would be impossible in other
circumstances. When we are immersed
in water, we are not subject to gravity in the same way2 , and a massage therapist can have access
to our entire body while we float gently.
Aquatic massage is particularly suitable for people
who have difficulty moving flexibly – people suffering from arthritis, for instance. It is also good for pregnant women.
Stone massage
In a stone massage, the therapist will heat basalt
stones in water, and then place them onto your
body. The warm (not painfully
hot!) sensation is pleasant, and can also relax muscles.
Acupressure
Acupressure is acupuncture without needles. That
is, it uses the same model as acupressure to
understand the body, imagining a network of key points with the power to
relieve tension.
Acupuncture tries to manipulate these points with
needles, whereas acupressure uses massage-like pressure from the hands.
Compared to other forms of massage, acupressure can be distinguished by its whole-body
approach. A problem experienced in one part of the body will not necessarily be cured by acupressure applied to that body part. Instead, the
therapist will use her knowledge of the acupressure network in the body to choose a part of the body to work
on to solve the problem experienced.
The theoretical basis of acupressure comes from the
Taoist idea that qi (life force) flows through the body in a set pattern of 'meridians'. Manipulating the body in
the right way can balance these meridians,
and thus relieve pain.
Cup massage
Cup massage needs to be distinguished from the
'cupping' massage technique, which simply involves cupping the hand. Cup massage,
by contrast, involves
placing vacuum cups on parts of the body.
The use of vacuum cups allows the masseur to 'pull
up' the skin, something which is very hard to do in other ways. The lower pressure may also improve the
circulation
Shiatsu
'Finger pressure' isn't a bad description of
massage, is it? That's what shiatsu. The technique, like the words, hails
from Japan, although
it is in part a synthesis of concepts from elsewhere.
Shiatsu was developed in the early part of the last
century, by individuals such as Tenpaku Temai
(whose 1915 book Shiatsu Ryoho brought us the word shiatsu) and Tokujiro
Namikoshi. It was Namikoshi who brought Shiatsu to the attention of the world,
giving treatments to people as well- known as Marilyn Monroe,
boxer Muhammed Ali, and Japanese
Prime Minister Shigeru
Yoshida.
century, by individuals such as Tenpaku Temai
(whose 1915 book Shiatsu Ryoho brought us the word shiatsu) and Tokujiro
Namikoshi. It was Namikoshi who brought Shiatsu to the attention of the world,
giving treatments to people as well- known as Marilyn Monroe,
boxer Muhammed Ali, and Japanese
Prime Minister Shigeru
Yoshida.
Shiatsu has spawned many
variations. In water shiatsu, often given the ungainly name watsu, the process
takes place underwater. This reduces the practical difficulties associated with
massage on dry land. One of its chief proponents (who holds a trademark on the
name 'watsu') was Harold Dull, a Californian Shiatsu practitioner of recent
years.
Ashiatsu
'Ashiatsu' means 'foot pressure': in ashiatsu, the therapist uses his or her feet to massage
the patient's back. Since
the full weight
of a masseur on one's
back would be neither pleasant
nor safe, the masseur
suspends herself from a bar. Hence the full name of the practice: 'Ashiatsu
oriental bar massage'.
Ashiatsu is one of the more recent additions to the
world of Western massage, arriving only in the
1990s.
Chair massage
A Chair massage is performed on somebody when they
are seated in a chair, rather than on a massage
table as usual.
to result in as satisfying a massage as is possible
using a table. Parts
of the body can be hard to reach, and those that can be reached will often be tensed in ways
that are hard to loosen
with massage. This is true even when the 'chair'
is really a stool.
With these disadvantages, why would anybody choose
a chair massage? The basic reason is convenience.
Chair massage can be conducted at your place of work, and some companies will arrange
for all or part of their workforce
to receive an occasional chair massage.
Chair massage is often conducted without removing
any clothing – again, something that is suboptimal
in terms of the massage itself, but which makes the massage much more
convenient. In short, chair massage
brings the possibility of massage to stressed, exhausted, overworked people, who might not otherwise find the time or
inclination to get a massage.
It isn't just for businessmen, though. The spread
of massage to unusual new locations has been
driven by chair massage. The 'massage bars' which have now colonized
airports across the United States
generally make use of chair massage. Some conferences and similar events
provide on-site massage, and you will
read occasional news reports of chair massage being set up in even more unusual places.
The techniques used in chair massage are
constrained by the awkward body position and the presence of clothing on the
patient.
Effleurage isn't a good technique in such
situations: it tends to move the clothing over the skin, rather than moving the clothing itself. Percussive techniques
are less affected, and so assume a slightly more
prominent role. But the real stars of the chair massage are the fingertip-heavy techniques, often derived from Shiatsu.
4.4 : Massage as part of other therapies
Many massage
therapists work within some wider theoretical context.
They understand the pressure and manipulation that they apply
not simply on the immediate practical level, but as fitting
into a wider framework of how the body works, and how to maximize its potential.
These theories come from the widest backgrounds
imaginable – Indian and Chinese mysticism, hard- nosed American science, and
everything in between. The following paragraphs summarize some of these schools of thought.
We will have to venture a little way
beyond massage itself in order to understand them, but the trip should
pay for itself
by explaining a lot of the background for massage.
4.5 : Massage vs. Bodywork
For the purposes of simplicity, we are mostly
avoiding the term 'bodywork', but if you read
elsewhere you'll probably find it cropping up an awful lot.
Essentially, you can think of bodywork being a slightly broader term than massage. Massage is understood by some people in a limited sense, to include only techniques similar to the basic Swedish massage: pressing and manipulating the skin, and so on.
Practices such as 'Rolfing' and 'Reik
Practices such as 'Rolfing' and 'Reiki', which are
closer to the New Age movement and further from the pragmatic, nineteenth-century origins of Swedish
massage, might not be included. So we have the term 'bodywork' to incorporate
this broader context.
The Alexander Technique
The Alexander Technique has its strongest following
among actors and dancers. It is named after its creator, Frederick Matthias
Alexander, who developed
it around the start of the twentieth
century as a systematic
process for increasing wellbeing by improving posture.
Alexander's insight was to concentrate on the
damage done to our bodies by unthinking physical habits. When we sit, we
slouch. When we lift objects, we exert muscles that are ill-equipped for the task, while we under-use muscles that
could do the job better. Practitioners of the Alexander Technique attempt
to be continually mindful of the effects
of their posture,
and to improve it through
this constant awareness.
The Feldenkrais Method
Like the Alexander Technique, the Feldenkrais
Method is named after its creator. The eponymous Dr. Moshe Feldenkrais began from a background in Judo. He wanted
to teach people to know their own bodies, and
hence to be able to move in a powerful, flexible way.
Structural Integration
Structural integration is the brainchild of Dr. Ida Pauline Rolf – hence it's alternate name of Rolfing. It is based around
the idea that muscles become
restricted by 'fascia'
(connective tissue), and that
this fascia can be loosened
through massage. Such treatment, which
takes place over ten sessions, is believed to 'unlock' the body
bodywork
From the Kurdish culture of southern Turkey comes
Breema bodywork. It takes its name from the village if Breemava, in which it was practiced
before being brought
to America by a certain
Jon
Schreiber
Turkish massage techniques were one of the original
sources for what has come to be known as 'Swedish
massage', so it is hardly surprising that Turkey has something to tell us about
massage. But the Kurdish culture, while connected to Turkey, is
quite distinct. The Kurds, who have their own
languages and live separately in mountainous regions, have produced a
form of massage which emphasizes
harmony with nature.
The 'Breema
center' (a Californian organization which claims trademark control over the
word Breema) lists nine principles of this harmony:
*Body
comfortable
*No extra
These gnomic phrases need some explanation from a
Breema teacher to be understood. But even just
reading them gives an idea of the Breema approach: emphasizing rhythm,
continuity, and balance.
Reflexology
Some massage therapists will base their foot
massage on the theory of reflexology. Reflexology holds that there exists a connection between each area of the foot and a particular part of the body.
treat ailments of the body by manipulating the
appropriate part of the foot.
FACT
65% of patients reported that reflexology helped
with the symptoms of migraines & tension headachesBrendstrup & Launse (1997)
Reflexology was introduced to the West in the first half of the twentieth century,
primarily by William
Fitzgerald and Eunice Ingham. Here are some of the connections claimed by
reflexologists. Note that different reflexologists will propose
different links between the foot and the body. Also be aware that neither the
points on the foot nor the parts of the body correspond exactly to the common
understanding of them, but are tied in to mystical understandings of anatomy.
of the big toe
Manual lymphatic
drainage
Manual lymphatic drainage is an example of massage
tailored to the treatment of a specific group of medical
problems. It aims to improve the operation of the lymphatic system. This system
of ducts across the body is responsible for removing fluid from parts of the
body where it is not needed, for transporting fat around the body, and for
producing immune cells. In the 1930s Dr. Emil Vodder developed a massage-related technique to treat immune problems.
4.6 : Areas of the body
The following sections describe how massage can be applied to particular
parts of the body.
Massage techniques for different parts of the body
have much more in common than they have apart,
and much of the time it is enough to be guided by personal intuition as to
which techniques are best suited for
each person and for each situation.
Feet
The foot massage
has evolved its own style and foibles.
It is often performed as part of a manicure. The alternative treatment of
reflexology (see above) has attempted to expand foot massage into a therapy for the entire body. But foot massage can be very beneficial, without using reflexology at all.
It might include:
*Stretching the toes, by pressing them backwards or upwards
on the surface of the feet. This is best done by expanding the massage beyond
the foot itself, and incorporating the lower leg into the effleurage strokes.
the ankles. This can be particularly soothing after somebody has exhausted
their feet by walking, and can also
help with circulation problems
Face
A belavi facial massage combines a standard massage
with beauty treatments intended to improve the
health and appearance of the facial skin. The linkage between massage and
beauty is a sensible one in the case of the face.
When your face looks puffy and pale, the lymphatic system is likely to blame. If the lymph ducts do not remove waste
products from the face quickly enough, they will remain under the skin and give a puffy appearance. Facial
massage can stimulate the lymphatic system, enabling
it to remove this waste and make the face look much more vibrant.
Facial massage also can be a good way of relieving conditions such as a blocked nose, combining the usual
psychological benefits of massage with an unblocking effect.
Particular considerations when giving a facial massage are:
*The muscles in the face are particularly fragile and close to the surface, and they need to be treated with a delicate touch.
*Similarly, percussive massage is not generally a
good idea with the face. Concentrate on effleurage, and
on shiatsu-like finger work.
*Facial massage should usually be done mainly with
the fingers. The area of skin concerned is too small, and too crowded with other features,
to make much use of palms or fists
* Mind the eyes and the mouth. Be aware not just of
where you are putting your fingers, but of any massage
oil you are using. Use only oils and lotions
which are harmless
if they get into the eyes or the mouth. Use only limited
quantities, and apply them in such a way that they will not drip into the eyes or mouth.
Don't forget the neck! If you are giving a facial massage,
it is often best to combine it with a neck
massage. The neck is full of lymph
nodes, many of them connected to the face.
Therefore a massage which improves lymph circulation in the neck will
also improve lymph circulation in the face.
Head
A head massage
can build on a facial massage, combining
it with massage of the scalp. This can
relieve some of the symptoms of a headache. It can also be very soothing and
relaxing, especially when you are
tired. The scalp can be massaged somewhat more vigorously than the face itself,
but again effleurage should be the
main technique used.
The back is one of the easier parts of the body to massage, and is a good place for beginners to start
learning.
Here are some of the peculiarities of that part of the body, to watch for:
*It is generally
possible to press quite hard during a back massage,
as the back is fairly robust
and hard to damage
*If you are massaging
one side of the back, stand on the other side of the customer.
*Use effleurage at the start of a back massage,
both to get a feel for the locations of the
muscles and to ease your patient gently into the massage.
raking of the ribcage, but watch to see how your customer reacts. Some people
find raking an uncomfortable
experience.
Module Summary
Many clients will have different
needs and you can attract
a wider clientele if you know a good range of
different techniques. Massage
technique is the foundation of therapy and if you do not master it you will not be able to give clients
what they want.
This module has identified the different types of
therapies you can use to assist your massage techniques, you now also
understand how to treat different areas of the body with proper form.
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