Massage

Massage is the practice of applying structured pressure, tension, motion, or vibration — manually or with mechanical aids — to the soft tissues of the body, including muscles, connective tissue, tendons, ligaments, joints and lymphatic vessels, to achieve a beneficial response. A form of therapy, massage can be applied to parts of the body or successively to the whole body, to heal injury, relieve psychological stress, manage pain, and improve circulation.

Unquestionably, massage is widely accepted as pleasurable. Massage is widely accepted as a physical therapy technique, both medically and in athletic training. When the massage is based on biofield therapy, however, and manipulates purported energies, the efficacy becomes far less well-defined.

Where massage is used for its physical and psychological benefits, it may be termed massage therapy. Massage can also be a part of lovemaking (see erotic massage, tantramassage), and often takes place in the context of sex work. As massage is a lightly regulated industry, clients are advised to get references, ask questions and judge for themselves.

Massage Basics

Good communication is essential to effective massage. In a commercial setting, the client is encouraged to communicate the type of treatment expected, for example relaxation or pain relief, full body massage, avoidance of, or focus on a specific area, the amount of pressure that is comfortable, preferred techniques, and past medical history and current physical condition.

There are a variety of massage techniques, which may be combined in various forms of massage. The first three forms were defined by Henry Ling, in a 19th century model of massage:

• Effleurage (stroking): Soothing, long, gliding strokes made with the entire flat surface of the hands that may be deep or superficial
• Petrissage (kneading): Firmly but gently grasping the skin and surface muscles with thumb and fingers, and rolling, squeezing, or wringing them, and dropping them back into place.
• Percussion: Stimulating, rapid alternate movements using both hands in:
  • tapping - using fingertips
  • Hacking –using chop movements with stretched fingers
  • Cupping - using cupped hand movements
  • Slapping - using flat, open palms
  • Pounding - using both fists
  • Tapotement- the lightest percussion-using drumming movements with fingertips .It is stimulating to the muscles and may be stimulating or calming to the nerves.
• Friction: May be long, slow, firm stroking movements or rolling circular movement in which the hand is kept in contact with the skin and the superficial tissues are moved over the deeper underlying ones. Used in treatment of joints and around bony prominences to break down adhesions, clear out congestion and toxic waste build-up. It raises local temperature and should be followed by effleurage.
• Vibration: Very rapid back and forth shaking or trembling movements performed by the whole hand or the fingers; used on the upper back, buttocks and thighs. Has a stimulating effect upon the nervous system by acting on the nerve centers or terminal nerve branches.

In commercial settings, massage techniques involve the client being treated lying down on a massage table or in a massage chair, or on a mattress on the floor. Except for modalities such as Thai Massage or Barefoot Deep Tissue, the massage subject is generally unclothed, and the body may be "draped" with towels or sheets. This also helps keep the client warm. In some jurisdictions it is required that certain areas such as the genitals on both genders and the breast/nipple area on women be draped at all times. Due to the necessary physical contact between the practitioner and the client, sexual arousal (or signs of it) is possible, but rarely intentional. In many forms of massage, the treatment may start with the client face up or down for the first part of the session: the client then rolls over for the second half of the session. Relaxation is necessary for maximum therapeutic benefits to be achieved.

Efficacy of massage therapy

A meta-analysis of its role in palliative care for cancer suggested it may have promise but more rigorous trials are needed. Some studies indicate that combining massage and aromatic oils may be more effective than inhaled aromatherapy alone or massage alone, as in short-term knee pain (N=59), double-blinded. In another study, it showed benefit in sleep quality for postoperative coronary artery bypass graft patients, with 40 total patients in two arms. Effleurage (from the French effleurer, 'to skim over') consists of long, flowing or gliding strokes, performed with open hands. In many massage sessions, effleurage is used as the initial type of stroking, as it has a calming effect when performed slowly. Effleurage is usually performed in the direction of the heart to promote circulation and lymphatic drainage.

Types of massage

There are well over 150 types of massage therapy. Various styles of massage have developed from a number of sources.

Basic methods

Petrissage

Petrissage (from the French petrir, 'to knead') is one of the five basic strokes of a Swedish massage. It is performed with kneading movement with the whole palm or finger tips, wringing, skin rolling, compress and lifting. Petrissage is usually applied vertically to the muscle tissue.

The benefits include the warming of tissue for deeper work, increase circulation, increase the supply of nutrients and oxygen to muscle, softens superficial fascia, decreases muscle tension, and restoring mobility by decreasing adhesion.

No apparent therapeutic claims

Chair massage

Chair massage, also known as Corporate Massage, is by far the most convenient method of massage therapy. A chair massage session typically lasts 12-24 minutes, and is performed while fully clothed. Chair massage promotes better circulation, muscle stimulation and stress relief. This form of massage reduces tension in the back, neck, shoulders, head, arms, hands, legs or feet, providing a deep relaxation effect.

Chair massages are also advantageous because chair massage practitioners will frequently make work- or housecalls. Chair massage can also be done in hotels, airports and convention centers.

Swedish massage

This style utilizes long, flowing strokes, often but not necessarily in the direction of the heart.Swedish massage is designed to increase circulation and blood flow. There are six basic strokes:effleurage,petrissage,friction,tapotement,compression and vibration.Oil, cream, or lotion is applied on the skin to reduce friction and allow smooth strokes. This style of massage is generally attributed to the Swedish fencing master and gymnastics teacher Pehr Henrik Ling (1776-1839).However, it was in fact the Dutch practitioner Johan Georg Mezger (1838-1909) who adopted the French names to denote the basic strokes under which he systemized massage as we know it today, as Swedish or classic massage. Somehow, the term Swedish Movement System was transposed to Swedish Massage System sometime during the second half of the 19th century. Ling’s system was the Swedish Movement System or Swedish Gymnastic Movement System. This may be how he has become incorrectly associated for so long with Swedish massage (see [1]). In Sweden, the term "Swedish massage" is not used.

Scalp massage

In some barber shops in Hong Kong, scalp massage often lasts 30 minutes to 45 minutes during shampooing of the hair. It is also very common in India, after applying oil on the hair.

Therapeutic orientation

Deep muscle therapy

Deep muscle therapy (created by Therese Pfrimmer), is a massage technique that focuses on using a very specific set of movements applied to all muscles and concentrating on all layers of the muscle that have become depleted of their regular blood and lymphatic flow. This technique aims to restore the circulation with its healing properties to the cellular level. Deep muscle therapy is widely used to treat the following ailments: carpal tunnel syndrome, neck and back pain, headaches, poor circulation, whiplash, and more.

Deep tissue massage

Deep tissue techniques are generally designed for more focused massage work. Working a specific joint, muscle or muscle group, the practitioner can access deeper layers of the soft tissue. Starting superficially and easing into the depth of the muscle slowly often allows more movement. This is the recommended approach in this modality since each person experiences pressure differently. If the pressure is applied too deeply or too quickly, the muscle may tighten to protect that area, and unnecessary damage or inflammation can be induced. Very little lubricant is used as the pressure doesn't travel much over the skin.

The most commonly used 'tools' during deep tissue massage may include, 3 and 6 fingers, reinforced fingers, a flat elbow, opposing thumbs, the heel of the hand or foot, and the forearm.

Trigger point therapy

A trigger point is an area of a muscle (about 50 cells) that may refer pain sensations to other parts of the body. Trigger point therapy applies manual pressure, or CO₂ injections, to these points. With the proper pressure, duration and location, immediate release of tension and improved muscular functioning may occur. This therapy has been suggested for migraine pain, mock sciatica, mock carpal tunnel syndrome and other pain syndromes, and other symptoms that may have been misdiagnosed. This work is based upon the trigger point research and manuals of Dr. Janet Travell, President Kennedy's physician.

Sometimes this work is incorporated into other styles of massage therapy such as neuromuscular therapy (NMT) or even Swedish.

Myofascial Release

Myofascial Release refers to the manual massage technique for stretching the fascia and releasing bonds between fascia and integument, muscles, and bones, with the goal of eliminating pain, increasing range of motion and balancing the body. Injuries, stress, trauma, overuse and poor posture can cause restriction to fascia. Myofascial release frees fascial restrictions, and allow the muscles to move efficiently. This is usually done by applying shear, compression or tension in various directions, or by skin rolling. This is one of the techniques used by sports massage therapists and physical therapists.

Myofascial release originators come from physical therapy and from [[Rolfing]); its current developers include John Barnes from a Physical Therapy background, and from a rolfing background, Art Riggs, Michael Stanborough, Tom Myers, Til Luchau, and others.

Myoskeletal alignment technique

Myoskeletal Alignment Technique (MAT) identifies postural distortions to improve and prevent pain conditions. Proprioceptive Neuromuscular Facilitation (PNF) and myofacial techniques are used to lengthen tight/facilitated muscles while fiber activation techniques tone weak/inhibited muscles. MAT was developed by Erik Dalton.

Neuromuscular therapy

Neuromuscular Therapy (NMT) is used for pain relief and specific problems. Structural and postural imbalances are identified through an initial postural assessment. These are then addressed through systematic and site specific massage. NMT reduces pain, tension, postural imbalance, and lengthens and strengthens tissues. NMT was developed by Paul St. John.

Bowen therapy

Bowen Technique involves a rolling type movement over fascia, muscles, ligaments, tendons and joints. It is not strictly a massage technique, but a general healing method, "...a dynamic system of muscle and connective tissue therapy that was developed by the late Tom Bowen in Geelong, Australia. Sometimes called the “homeopathy of bodywork,” it utilizes subtle inputs to the body (known as “moves”), stimulating the body to heal itself, often profoundly.

Soft Tissue Therapy

Treatment techniques include:

• Trigger point therapy for the alleviation of trigger points.
• Myofascial (muscle and fascia) therapy for flexibility/mobility of the connective tissues of our body, or for alleviating fibrous adhesions and decreasing the severity of scars.
• Broad handed techniques for reducing swelling or inflammation
• Frictions for the ridding of adhesions between fascial layers, muscles, compartments and the like. Frictions also promote healing in tendon pathologies as well as decreasing pain perception.
• Sustained pressure (digital pressures) to alleviate hypertonic (tight)areas within muscle and fascia
• Other techniques such as Active Release Therapies, Myofascial Release and deep tissue massage are all derivatives of the techniques above. They are NOT unique techniques with unique results.
• Stretching - static, dynamic, and/or PNF stretches (proprioceptive neuromuscular facilitation)
• Muscle Energy Technique (MET)
• Exercise Prescription
• Advice

This is one of the techniques used by sports massage therapists.

Structural muscular balancing

A gentle and effective technique that releases chronic contraction in the muscles. The nervous system is triggered to release contractions through compression applied to muscles placed in a shortened position.

Biofield oriented

This is an approximate term, since many of the traditional methods speak in terms of field or energy manipulation.

Breema

Breema bodywork is performed on the floor with the recipient fully clothed. It consists of rhythmical and gentle leans and stretches which leads to deep relaxation, increased vitality, and stimulation of the self-healing processes of the body. Sessions can be any length of time, although 50 minutes is common. There are also self-Breema exercises. The essence of Breema is expressed in the Nine Principles of Harmony. The Breema Center is located in Oakland, California, and there are Breema practitioners and instructors in many locations around the world.

Esalen Massage

The basis of Esalen Massage is traditional massage, which works in a very precise manner on the muscle and circulation systems. This is combined with the bodywork approach developed by Charlotte Selver, which emphasizes the deeply relaxing and emotional responses of the body when a conscious, structured and pleasant touch is applied. In addition, gentle rocking of the body, passive joint exercises and deep structural work on the muscles and joints, together with an energetic balancing of the body, are all part of this Esalen Massage “experience”. See also Esalen Massage.

MA-URI massage

MA-URI is a new form of massage introduced by Hemi Hoani Fox in 1990, who cites as its roots Hawaiian Lomi-Lomi Nui dance, claiming increased so-called energy flow within the body and mind. Focus is internal, upon breathing, intent, and concentration. Claimed benefits include mental and physical health. Study and advocation is primarily carried out at the MA-URI Institute, headed by Hemi and Katja Fox. It is currently difficult to find practitioners, though this may change as it grows more popular.

Muscle Energy Technique (MET)

Reciprocal Inhibition (RI) is when the therapist uses a client’s muscle to stretch the opposing muscle. The therapist takes the muscle that they are wishing to stretch to its point of bind. The therapist then gets the client to use the opposing muscle by moving away from the therapist. When the client relaxes the therapist then moves the muscle to realign the muscle fibres therefore stretching the muscle.

As an example, Muscle Energy Technique (MET) Reciprocal Inhibition (RI) can be applied to the calf when the client is lying supine on the treatment couch. The masseur can place one hand on the tibia just below the knee to isolate the knee preventing it from moving. The other hand is placed around the heel so that the masseurs forearm can be used to dorsiflex the foot. This is one of the techniques used by sports massage therapists.

Stone massage

Massage in which hot or cold stones, usually basalt or marble, are used to massage the body. Often the stones are placed on key energy points, such as Chakras or meridians, in order to improve energy flow and healing.

Traditional and tradition-derived

Tui Na (推拿) and Zhi Ya massage (指壓)

Zhi Ya is a form of Chinese massage based on acupressure. It is similar to Tui Na massage except it focuses more on pinching and pressing at acupressure points Tui Na is a form of Chinese massage (按摩) that is similar to Zhi Ya, but focusing more on pushing, stretching and kneading the muscle.

Tai Chi Massage

Tai Ji / Tai Chi Massage is massage using the natural principles of Tai Ji, Yin and Yang to achieve balance in the qi energies of the body, leading to a healthy mind body and spirit. Tai Ji / Tai Chi The traditional Chinese term refers to the Dao, which is the inexpressible oneness and connectedness of all things.

Tai Ji Massage is a Qi treatment and it makes a treatment in terms of Qi. The master practitioner can sense the Qi blockages inside the body and the relationship which they have to each other. Qi blockages gives the practitioner insight into causes of chronic sicknesses, recurring sicknesses, psychosomatic sicknesses, future sicknesses.

The main use of this techniques is, relaxation and self-exploration, and in a therapeutic way, functional organ problems, chronic sicknesses and psychosomatic sicknesses.

Tai Ji Massage was developed by Richard Wickes, Li Cun De.

Tantramassage (Tantric massage)

Original Tantramassage is a new form of massage developed in the early 1980s by Andro, Andreas Rothe an experienced Tantra and Bodywork Teacher in Berlin / Germany. The method includes various massage techniques, elements from Bioenergetic, Yoga and Sexualtherapy. The word "Tantra" emphasizes the connection with the old Indian cultural background where the body is seen as the temple of the soul. Clients are in a passive role, supported by breathing techniques they experience a very deep and intense journey through their own body. Every Massage session lasts 90 Minutes or longer. The Tantramassage movement is very popular in Germany and Switzerland, some practitioners are organized in the Association of Tantramassage in Germany.

Chinese foot massage

Foot massage, as practiced by the Chinese is performed in the context of chi, in that each spot on the sole of the foot corresponds to an internal organ, and the applied therapy is healing to one's overall well being. The theory supposes that an ailment of an internal organ will be associated with the nerve ending on the sole of the foot.

Before the massage, the patient's feet are soaked for about ten minutes in a foot bath, typically a dark colored solution of hot water and Chinese herbs. The massage therapist uses liberal amounts of medicated cream, to moisturize the foot and to provide lubrication. The knuckles on the therapist's hand are usually used to provide a hard and smooth implement for the massage. As pressure is applied to the sole, theory holds that a healthy patient should not feel any strong pain. Painful spots, reflexologists believe, reflect illnesses of other parts of the body. The practitioner rubs and massages the painful spots to break down rough spots and accumulated crystals and increase circulation.

The ailments are healed when the sore spots of the sole are treated and removed by massage. Based on this theory, some shoe liners are made with pressure points to stimulate the soles of the feet to promote better health of the overall body. The nature of these "crystals" has yet to be elucidated or demonstrated scientifically. Regardless of the actual correlation of reflexology to internal organs, many enjoy it for the mix of stimulation and relaxation.

Lomilomi — traditional Hawaiian massage

Lomilomi massage is a traditional Hawaiian method. They were taught their art over 20 years and received their last instructions from their master on his death bed. There are hundreds of styles of Lomilomi, the main ones being the style of Big Island which was passed on by Aunty Margaret Machado, and Maui style from Uncle Kalua Kaiahua. On the island of Kaua'i, Kahu Abraham passed on what is today called Kahuna Bodywork. It is not clear if other current practices - temple style, lomi lomi nui and others - are from Native Hawaiian practitioners or are modern adaptations.

Shiatsu (指圧)

Shiatsu is a form of Japanese massage that uses thumb pressure and works along the energy meridians in the body also with a lot of stretches the same meridians as acupressure. You are worked on fully clothed on a mat on the floor. It is uncertain whether it originated from Chinese Zhi Ya.

Barefoot Deep Tissue

Barefoot Deep Tissue is a blend of Eastern barefoot techniques with Western manual medicine. Clients are typically loosely clothed and lain on floor mat in supine, prone and side-lying positions with pillows or bolsters. No oil is used. Sessions may last 2 minutes or well over an hour. Because the therapist can apply a broad range of pressure with ease and does not have to strain, more effort and concentration can be used to sense and manipulate tissue, release fascia, as well as search for and attack trigger points and other problems, regardless of client's size or build. John Harris, the proceleusmatic mentor who worked in the 1984 Olympics and developed this modality, states that the combination offers a potent new tool for powerfully satisfying, effective deep tissue massage and Trigger Point work regardless of client's size or build. Mr. Harris and Fred Kenyon wrote Fix Pain in 2002.

Thai massage

Known in Thailand as นวดแผนโบราณ (Nuat phaen boran, IPA [nuɑt pʰɛn boraːn]), which correctly translates only as ancient massage or traditional massage, this form of massage is also known as Thai ancient massage, traditional Thai massage, Thai yoga massage, yoga massage, Thai classical massage, Thai bodywork, passive yoga or assisted yoga. It is usually soothing because of its emphasis on stretching and loosening the body. Its roots go back far into history, originating in India based on the Ayurveda, and then becoming popular in Thailand.

Originating in India and drawing from Ayurveda, it has inevitably incorporated modalities like yoga. The receiver is put into many yoga like positions during the course of the massage. In the northeren style there are a lot of stretching movements unlike the southern style where pressure is emphasised. It was believed that the massage art was brought over to Thailand by Shivago Komarpaj (Jivaka Kumarabhacca), a contemporary of Buddha almost about 2500 years ago.

The massage recipient changes into pajamas and lies on a mat or firm mattress on the floor. (It can be done solo or in a group of a dozen or so patients in the same large room). The massage giver leans on the recipient's body using hands and forearms to apply firm rhythmic pressure to almost every part of the taker's body. The massage generally follows the Sen lines on the body-somewhat analogous to Chinese Meridians and Indian nadis. In some gestures, legs and feet of the giver are used to fixate the body or limbs of the recipient. In other gestures, hands fixate the body, while the feet do the massaging action. Usually no oil is applied. A full course of Thai massage typically lasts two hours or more, and includes pulling fingers, toes, ears etc., cracking the knuckles, walking on the recipient's back, arching the recipient's back in a rolling action etc. There is a standard procedure and rhythm to the massage. Sometimes in a large group massage, the practitioners do the procedures in unison.

Note: The traditional therapeutic practice of Thai massage should not be confused with the sexual service of the same name that is available in some hotels and brothels.

Erotic massage

Erotic massage is a form of massage that includes the genitals and leads to sexual arousal and (sometimes) orgasm. Widely practiced by couples as part of lovemaking. Also sometimes practiced commercially, which may be illegal in some jurisdictions. See also Tantramassage.

Veterinary massage

Massage techniques can be a part of exchanging care and emotion with animals. It also has a therapeutic role, as a subset of veterinary physical therapy. although veterinary supervision is urged.

The position of the American Veterinary Medicine Association is

Veterinary massage therapy is a technique in which the person uses only their hands and body to massage soft tissues. Massage therapy on non-human animals should be performed by a licensed veterinarian with education in massage therapy or, where in accordance with the state veterinary practice acts, by a graduate of an accredited massage school who has been educated in non-human animal massage therapy. When performed by a nonveterinarian, massage therapy should be performed under the supervision of, or by referral from, a licensed veterinarian who is providing concurrent care.

Veterinary physical therapy is the use of noninvasive techniques, excluding veterinary chiropractic, for the rehabilitation of injuries in nonhuman animals. Veterinary physical therapy performed by non-veterinarians should be limited to the use of stretching; massage therapy; stimulation by use of a) low-level laser, b) electrical sources, c) magnetic fields, and d) ultrasound; rehabilitative exercises; hydro therapy and applications of heat and cold. Veterinary physical therapy should be performed by a licensed veterinarian or, where in accordance with the state practice acts, by 1) a licensed, certified or registered veterinary or animal health technician educated in veterinary physical therapy or 2) a licensed physical therapist educated in non-human animal anatomy and physiology. Veterinary physical therapy performed by a non-veterinarian should be performed under supervision of, or referral by, a licensed veterinarian who is providing concurrent care.