Strokes
Strokes
- Effleurage
- Tapotement
- Guide to treatments provided by graduates of B.Sc. in Health & Leisure with Massage
Effleurage
EFFLEURAGE is a gliding movement over the skin and is a sedative stroke. It initiates each treatment, can aid relaxation and helps in diagnosis of the state of a client’s soft tissue. It is used more than any other stroke.
Description: All of the hand makes contact with the body and contours to the surface it is stroking. The two hands are intertwined at the thumbs and all fingers remain close together as the two hands, in unison, glide up the body. It is used
• To spread the oil
• To accustom the client to the operator's hands.
• It helps you to discover tenderness or tightness in areas of the body.
• If the area you are massaging is extremely sore, effleurage may be the only stroke you can employ.
• It provides a passive stretch to the muscles when performed slowly and deeply.
• It is always employed upwards in the direction of the heart and aids venous return.
Wringling
WRINGING is an effleurage stroke across the fibres of the muscle and is used mainly on the thighs and can be used also on the calves if they are quite muscular.
Description: The hands are flat on the muscle with thumbs beside the fingers. They then work in opposite directions surrounding the limb and slightly lifting the limb at the beginning of the ‘up’ part of the stroke. It is used to loosen the muscle fibres.
Petrissage
PETRISSAGE is a kneading stroke. This stroke presses and rolls the muscles under the hands. The two hands can be used on larger areas. One hand can be used or where an area is quite small as between the scapula and spine two fingers can be used in a thumb rolling stroke. Care must be taken not to pinch or bruise by working on the one site for too long.
Description: The hand is laid on the area to be worked and the heel of the hand applies the pressure as it works/rolls across the fibres of the muscle. It is a deep stroke and used:
(a) to 'milk' the muscles of waste products that collect due to abnormal activity.
(b) to assist venous return.
(c) to help free adhesions in some instances.
Friction
FRICTION Is perfomed in small circular movements with the tips of the fingers, the thumb or the heel of the hand. These movements are performed by moving the tissue under the skin - not the tissues on the skin. When using this stroke it is important to increase and decrease the depth of the stroke gradually.
Description: Place pad of finger or thumb on the point to be worked. Apply pressure slowly and hold for 10 seconds prior to rotating on the spot. The skin and finger rotate to friction the tissues underneath. Decrease pressure slowly, wait and repeat.
Friction is useful
(a) for massaging deeply into the joints or around bony prominences
(b) around a well healed scar to break down adhesion between the skin and the tissues beneath (muscle layers)
(c) in achieving absorption of the local effusion and breaking down of some inflammatory conditions.
(d) It is beneficial to the spine to increase nerve activity and stimulate the nervous system.
(e) It is beneficial to the abdomen to aid in the total expulsion of faecal matter.
Pinch
TAPOTEMENT strokes are used when stimulation is required. They are wake up strokes that send vibrations into the cells. They stimulate circulation of blood with oxygen and nutrients into all the cells of the body. Any series of brisk blows following each other in rapid, alternating fashion come under the broad term of tapotement. All of these strokes make varying amounts of noise if performed correctly. They are beneficial when stimulation and waking up is required in the massage. They can never be considered soothing and would therefore be detrimental to the highly nervous, exhausted persons and people with certain heart complaints. The blows are always given from the wrist, not from the shoulder and they are short and brisk. The wrist, elbow and shoulder joints are relaxed. Allow time and space for the vibrations to work after you have completed the stroke. Do not touch muscles you have worked until the tingling has eased in your own hands. Hacking, pounding and cupping send vibrations deep into the tissues while tapping, slapping and pinching provide surface stimulation.
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TAPOTEMENT strokes are used when stimulation is required. They are wake up strokes that send vibrations into the cells. They stimulate circulation of blood with oxygen and nutrients into all the cells of the body. Any series of brisk blows following each other in rapid, alternating fashion come under the broad term of tapotement. All of these strokes make varying amounts of noise if performed correctly. They are beneficial when stimulation and waking up is required in the massage. They can never be considered soothing and would therefore be detrimental to the highly nervous, exhausted persons and people with certain heart complaints. The blows are always given from the wrist, not from the shoulder and they are short and brisk. The wrist, elbow and shoulder joints are relaxed. Allow time and space for the vibrations to work after you have completed the stroke. Do not touch muscles you have worked until the tingling has eased in your own hands. Hacking, pounding and cupping send vibrations deep into the tissues while tapping, slapping and pinching provide surface stimulation.
2
HACKING: The ulnar surfaces of the hands are used. This is done by each hand in rapid succession, in such a way that as soon as the hand touches the surface it is lifting off again. Light stimulating strokes - not painful. Used over the fleshy areas of the body, the thighs and buttocks at the back and the front of the thighs also. It can also be used over the shoulders if the area is very muscular.
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POUNDING: The ulnar surface of the closed fist is used. The fingers are not tight into the hand but held loosely. The force of the blows is light and bounding. Used mainly on the buttocks and the legs. It is of most value where muscle tone is present but deficient (flaccid muscle). It can be beneficial for treating sciatica and the blows can follow the line of the nerve. Do not use pounding is there is extreme tenderness or a muscle is extremely tight.
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CUPPING stimulates specific organs and stimulates the superficial nerves of the skin. Used mostly on the back it stimulates the organs within. It can also be used on the hips to stimulate any lack of life in the abdominal cavity. Cupping can also loosen broad flat areas of scar tissue. The open hands are used cupped to form a hollow. A slight vacuum is formed with each blow causing stimulation of the circulation around that area.
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TAPPING: is done with the tips of the fingers and is used mostly along the spine and along the sternum to encourage blood cell formation. It could be done all over the body but is usually used for the above function. It brings a surface focus to the area it is used on. It has been noted by some athletes that it benefits recovery from shin-splints once the soreness has receded.
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SLAPPING also has a surface focus and stimulates peripheral circulation. It is done with an open, floppy, hand and very loose wrists. The 'wet fish' hands strike the body in rapid succession, using mainly the finger area. It can be used all over the body but is usually used where there are skin conditions - rashes that require additional blood and nerve supply peripherally.
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PINCHING or PINCHMENT is used to break down skin/fat adhesion. While it can be used anywhere that you can pick up flesh, it is mostly used on the buttocks and thighs. The stroke requires a rapid, alternate, gentle pinching that picks up small portions of tissue between the thumb and first finger or fingers of the hand.
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CRUDE VIBRATION is performed by a gentle swaying and shaking motion of the limbs to encourage the client to relax when they find relaxing difficult. The performance of crude vibrations brings awareness of 'holding’ to both the patient and the practitioner and encourages the patient to relax and 'let go'. It can be used on legs, arms and head. Done well it can be extremely soothing, but done poorly it can cause frustrating and impatience to both the giver and the receiver. It needs to be given time and effort to be learnt well and performed well.
It is very effective at the beginning of a treatment if a client presents in a tense condition and can encourage the client to ‘let go’ of habitually held joints and muscles to the point that they can relax and benefit from the stroke work.
1
There are many variations on strokes and many textbooks have different names for similar strokes. Students from the Bachelor of Science degree in Health & Leisure with Massage at the Institute of Technology in Tralee, Co Kerry, Ireland will use many variations on the strokes described in the strokes section. The following guides to a variety of treatments endeavours to outline the techniques that may be included in the definition of different treatments that can be carried out by graduates
2
When graduates of the BSc in Health & Leisure with Massage from the Institute of Technology, Tralee states that they will perform back massage as part of treatment that back massage may include any combination of the following strokes. They will adhere to the general principles of layering from surface strokes to deeper work. They will individualize the use of strokes to suit the client’s case history/ condition on the day of treatment.
Effleurage:
Gliding/ flat-handed long strokes
Reverse side stroke
Reverse stroke down centre of back – up sides -around shoulders in along front of shoulders, up back of neck and hold base of scull
Fan stroke / Tree Branching / Shingling
Pull back on trapeziums
Crossover on trapeziums
Scoop on scapula
Wringing
Figure 8 along sides and neck to shoulder / V stroke on shoulders
Forearm stroke
Petrissage:
Wringing
Kneading horizontal strokes across Erector Spinae
Thumb Rolling
Bunching
Friction:
Compressions / reinforced compressions
Specific tender point and trigger point work – tip of thumb
Stripping
Tapotement:
Tapping
Cupping
Slapping
Hacking
Stretch
2 arms over head with traction
3
When graduates of the BSc in Health & Leisure with Massage from the Institute of Technology, Tralee states that they will perform leg/ hip/ buttock massage as part of treatment that leg/ hip/ buttock massage may include any combination of the following strokes. They will adhere to the general principles of layering from surface strokes to deeper work. They will individualize the use of strokes to suit the client’s case history/ condition on the day of treatment.
Crude Vibrations
Legs
Effleurage:
Gliding
Rolling effleurage
Reverse side stroke
Fan stroke / Tree Branching / Shingling
Wringing
Petrissage:
Kneading horizontal strokes from midpoint of leg
Thumb Rolling
Thumb circling
Stripping
Wringing
Bunching
Knuckling
Raking
Friction:
Compressions / reinforced compressions/
Specific tender point and trigger point work – tip of thumb/fingers around hip, knee, ankle
Tapotement:
Tapping
Cupping on hips
Hacking
Pounding
Pinchment
Stretches
Gluteus,
Hamstrings
Quadriceps
Adductors
Abductors
Gastrocnemius
4
When graduates of the BSc in Health & Leisure with Massage from the Institute of Technology, Tralee states that they will perform arm/shoulder massage as part of treatment that arm/shoulder massage may include any combination of the following strokes. They will adhere to the general principles of layering from surface strokes to deeper work. They will individualize the use of strokes to suit the client’s case history/ condition on the day of treatment.
Crude Vibrations
Arms
Effleurage:
Gliding/ flat-handed long strokes
Fan stroke / Tree Branching / Shingling
Petrissage:
Wringing/ circular stroke from wrist to elbow and elbow to shoulder
Kneading horizontal strokes
Thumb Rolling
Friction:
Compressions / reinforced compressions
Specific trigger point work – tip of thumb around shoulder, elbow and wrist
Stripping
Stretches
Arms x 4 directions
Rotator cuff x 2
5
When graduates of the BSc in Health & Leisure with Massage from the Institute of Technology, Tralee states that they will perform head/ neck/ shoulder massage as part of treatment that head/ neck/ shoulder massage may include any combination of the following strokes depending on whether the client is seated or lying. They will adhere to the general principles of layering from surface strokes to deeper work. They will individualize the use of strokes to suit the client’s case history/ condition on the day of treatment.
Crude Vibrations
Head
Effleurage:
Gliding/ flat-handed long strokes
Fan stroke
Reverse stroke from front of shoulder
Pull back on trapeziums
Crossover on trapeziums
Figure 8 from neck to shoulder
Corkscrew stroke neck to shoulder
Effleurage with head twist
Effleurage from sternum - out over shoulder – in over trapezium, up back of neck to base of scull
Petrissage:
Pick up on the trapeziums
Kneading horizontal strokes across Erector Spinae
Thumb Rolling
Friction:
Thumb circling alongside spine, alongside scapula, from AC joint to neck and base of scull, on scull
Compressions / reinforced compressions
Specific trigger point work – tip of thumb
Stripping
Tapotement:
Hacking
Cupping
Tapping/ flicking on scalp
Stretches
Effleurage from sternum - out over shoulder – in over trapezium, up back of neck to base of scull – hook fingers under occiput and stretch (lean back to create neck and spine stretch)
Neck – ear to shoulder, chin to shoulder – look over shoulder
Chin to chest
6
When graduates of the BSc in Health & Leisure with Massage from the Institute of Technology, Tralee states that they will perform a full body massage as part of treatment - that full body massage may include any combination of the following strokes. They will adhere to the general principles of layering from surface strokes to deeper work. They will individualize the use of strokes to suit the client’s case history/ condition on the day of treatment.
Crude Vibrations
Legs
Arms
Head
Effleurage:
Gliding/ flat-handed long strokes
Reverse side strokes
Reverse stroke from front of shoulder
Reverse stroke down centre of back – up sides -around shoulders in along front of shoulders, up back of neck and hold base of scull
Fan stroke / Tree Branching / Shingling
Pull back on trapeziums
Crossover on trapeziums
Scoop on scapula
Wringing
Figure 8 along sides and neck to shoulder / V stroke on shoulders
Forearm stroke
Rolling effleurage
Corkscrew stroke neck to shoulder
Effleurage with head twist
Sternum - out over shoulder – in over trapezium, up back of neck to base of scull
Petrissage:
Wringing
Kneading horizontal strokes across Erector Spinae
Bunching
Kneading horizontal strokes from midpoint of leg
Thumb Rolling
Thumb circling
Stripping
Knuckling/ raking
Wringing/ circular stroke from wrist to elbow and elbow to shoulder
Pick up on the trapeziums
Friction:
Compressions / reinforced compressions
Specific trigger point work – tip of thumb/fingers around hip, knee, ankle
Specific trigger point work – tip of thumb around shoulder, elbow and wrist
Thumb circling alongside spine, alongside scapula, from AC joint to neck and base of scull, on scull
Stripping
Tapotement:
Tapping on spine
Cupping over chest cavity
Cupping on hips
Slapping
Hacking
Pounding
Pinchment
Tapping/ flicking on scalp
Stretches
2 arms over head with traction
Gluteus,
Hamstrings
Quadriceps
Adductors
Abductors
Gastrocnemius
Arms x 4 directions
Rotator cuff x 2
Effleurage from sternum - out over shoulder – in over trapezium, up back of neck to base of scull – hook fingers under occiput and stretch (lean back to create neck and spine stretch)
Neck – ear to shoulder, chin to shoulder – look over shoulder
Chin to chest
7
Full body relaxation massage –
Head, neck and shoulders - lying position
Head, Neck and shoulders - seated
Back massage with all known strokes and specific friction work
Hand/arm/shoulder with point work at wrist, elbow and shoulder
Hip point work
Intercostals work
Leg massage including knee and ankle point work
Incorporate crude Vibrations and stretching into each of the above treatments
Massage session Template
Part of body Sequence of strokes and techniques to be used Timing in minutes to total 50/55
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