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. 2.

Punctuality Regularity

Personal hygiene/ appearance: Apron should be clean Hair tied Hands cleaned with trimmed nails Other accessories should be discarded 4. Loyalty
3.

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  General relaxation  Insomnia  Constipation  Scar  Tendinitis 

Sprains  Oedema  Mastectomy  Lymphadenopathy  Head ache  Distended abdomen 

Contraindication: 
    

Haemorrhage Haemoptysis Haemophilia Hairy skin Acute infections: septicemia carcinoma hyperpyrexia Hypotension 

    

Burns Pressure sores Open wounds fractures Osteoporosis Vascular diseases ulcers

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:

SubSub- classification
Kneading:  Circular  Squeeze  Stationary  Spiral finger  Ironing Hacking  Longitudinal  Convergent and divergent Friction:  Circular  Transverse

Massage manipulations

Stroking Technique
Effleurage (distal to proximal) 
 

Stroking (proximal to distal)

Effleurage
Effleurage means- to stroke meansUnidirectional 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 capillarycapillary- 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 position: Therapist arm position: arm slight abducted position: 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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