Massage/ Soft Tissue Manipulative Techniques

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

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MASSAGE/ SOFT TISSUE

 It reduces mental and physical strain and

 To conserve energy in human body as a

muscles are relaxed

skin warmed & mind is blank

work of heart and lungs are reduced

Tense & rigid limbs after injury

 Relaxation of the body

 Room must be warmed and ventilated

 Noise should be kept minimum and light music

 Rhythmic limb movts

 It is important that every therapist /student

3. Personal hygiene/ appearance:

Position of the operator

Contact and continuity

Talcum powder , corn starch

 Soap and water:

 Hand contact –Firm contact with whole surface of

Both hands used together on opp aspects

 Therapist position – Walk standing

 Or stroking the hand back to start

 Indication: swelling , oedema

It reduces the pressure in venous end of capillary-

 Picking up – tissues compressed then lifted and

 Wringing – Tissues are lifted and squeezed by

 Therapist arm position: arm slight abducted

 Effect % uses: same as kneading

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