Therapeutic massage

Massage is a manual therapeutic modality that produce physiological effect through different types of mode and technique. it is a systematic manual manipulation of the body’s tissues to restore normal function. it is the manipulation of superficial and deeper layer of muscle and connective tissue , using various techniques to enhance the healing process.


A) The effleurage/ stroking manipulation

B) Petrissage manipulation-

  1. Kneading
  2. Picking up
  3. Wringing
  4. Rolling
  5. Shaking

C) Friction manipulation

  1. Circular friction
  2. Transverse friction

D) Percussive  manipulation- performed either to assist evacuation from hollow organ or to stimulate either skin or muscles.

  1. claping
  2. Hacking
  3. Vibration
  4. Beating
  5. Pounding
  6. Tapping


  • Unidirectional manipulation
  • Operator’s hand passes from distal to proximal with a depth .
  • Depth should be such as to push fluid onwards in the superficial vessels .
  • Performed with the whole hand softly curved and relaxed to fit the part .
  • Both hand may be used  together
  • Spreading and moving the hand with pressure and speed to gain relaxation and lymph drainage
  • Effleurage is frequently used at the beginning and end of massage treatment to soothing and relaxing
  • The word effleurage is derived from French, meaning “to skim”.
  • it is always the first and last technique (as well as being used between other techniques) applied in a massage session.
  • Effleurage may be used with varying tempo and pressure according to the stage of the condition and whatever the desired effect of the massage is.


  • Unidirectional manipulation
  • Direction -proximal to distal
  • Stroke should start with firm contact and finish with a smooth lift off of your hands  and performed with whole hand or finger.

types- two types of stroking

1)slow stroking→

  • more sedative,
  • speed-one stroke/5 sec,
  • greater depth can be achieved at the slower rate.

2) fast stroking→

  • more stimulating
  • speed-four stroke/5 sec
  • faster stroke is often used to complete a more stimulating massage.

It comprises the usage of relaxed hand over the patient skin with a rhythm and pressure that produce a relaxing effect.


  •  Petrissage is derived from a French word, meaning “to knead”.
  • The basic movement is to compress, pick up and then release the soft tissues.
  • It is generally used when a deeper effect than effleurage is desired, and it’s techniques include:
  1. Kneading
  2. picking up
  3. wringing
  4. rolling`
  5. shaking


  • When the tissue are compressed against the underlying structure.
  • it is a circular manipulation, so that the skin and subcutaneous tissue moved in circular manner on the underlying structure.

Types of kneading-

  1. Whole hand kneading
  2. Palm kneading
  3. The finger only-a) flat finger kneading, b) finger pad kneading, c) finger tip kneading.
  4. The thumb kneading-a) thumb pad kneading, b) thumb tip kneading.
  5. both hand kneading when one is superimposed on other.
  6. Elbow kneading
  7. heel of hand kneading.


  • When the tissue are compressed against the underlying structure.
  • Picking up is manipulation in which tissue are compressed against underlying bone, then lifted, and squeezed and released.
  • Usually performed single hand with the thumb  and thenar eminence and the middle two or there finger and hypothenar eminence as the other components of the grasp.
  • C- shaped grasp→on wider or larger area.
  • V- shaped grasp→on narrower or lesser bulk area.
  • Picking up begins slowly and progress to deep, firmer pickup.


  • When the tissue are lifter and squeezed by alternating pressure.
  • the manipulation may also be performed as skin wringing, an alternative to skin rolling, when only the superficial tissue are lifted and wring .


When the tissue are lifted and rolled between the finger thumbs as in skin rolling or muscle rolling.

  • Skin rolling- skin lifted and rolled between the thumbs fingers of the two hands. the manipulation most often performed on the back, abdomen, and thigh.
  • Muscle rolling –performed by working across the muscle fibers and along the long axis of the muscle.



  • When the tissue are lifted and shacked from side to side.
  • This manipulation performed on the→ biceps, triceps, quadriceps, small muscle of thenar and hypothenar eminence.
  • For longer muscle the length of your thumb should be placed on one side of the muscle belly and all your finger placed on other side of the muscle belly, your palm should be contact, your hand is then rapidly shaken from side to side.


Friction are small range, deep manipulation, performed on specific anatomical structures, with the tips of the finger or thumb.

Two types of friction-

1)Circular friction-

  • performed with the finger tip
  • pressure is applied and a small, stationary manipulation is performed, in a circular manner and at gradually increase depth for 3 or 4 circles.
  • used→over ligaments and myofascial junction.

2) Transverse friction-

  • It is a transverse connective tissue therapy applied directly by the fingers.
  • Transverse frictions use an oscillating pressure applied across the direction of the tissue fibers.
  • This technique is used mainly on tendon or ligament injuries to help break down thickened, pain-producing scar tissue.
  • If these lesions are not reduced then they are likely to cause further irritation, and degenerate more quickly than they should.

friction is a small movement applied with thumb or finger where pressure is applied from superficial to depth of the tissue. its performed when tissue is in relaxed neutral position and the thumb or fingers are used to compress the tissue over the lesion site. no oil or lotion is used.

What Conditions Benefit from a Therapeutic Massage?

Massage therapy helps your body in numerous ways. Massage can relax muscle tissue, which may lead to decreased joint and nerve compression, increased joint and muscle range of motion. This commonly results in less pain and improved function.

Therapeutic massage benefits the following conditions:

  • Stress
  • Anxiety
  • General Well-being
  • High Blood Pressure
  • Arthritis
  • Low Immunity
  • Minor injuries


  1. Relieving tension
  2. promoting blood flow
  3. loosening muscle
  4. removal of metabolic wastes
  5. decrease muscle atrophy
  6. facilitate healing
  7. reduction of edema
  8. relaxation


  • Pain
  • Reduced ROM
  • Edema
  • adhesion
  • muscle spasm and cramping
  • scar tissue
  • bursitis
  • lactic acid accumulation


  • Large open wound
  • burns
  • skin ulcers
  • gross edema
  • extremely hairy areas
  • sensitive skin
  • bacterial infection
  • skin disease
  • malignant tumour





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