Skills & Techniques

Here we will summarise the four most commonly recognised categories of technique that form sports nad many other forms of massage. They include effleurage, petrissage, frictions and tapotement.

What is effleurage?
The word effleurage derives from the French word, effleurer, which means ‘to skim’. It is a form of massage involving stroking movements with the hands sliding over the skin, and is always used at the beginning and end of as well as in between other techniques during a massage session. The stroking technique of effleurage may be used with varying pressure and speed according to the purpose and stage of the massage. Effleurage includes light stroking, firm stroking and deep stroking

How to do effleurage
The basis of effleurage is stroking with light to firm pressure, using a wide surface area of the palm of the hand and fingers. Pressure is sustained throughout the stroke and the direction of the stroke is always towards the heart to encourage venous return. This is opposed to the technique of petrissage, where although the stroke direction is still always being directed towards the heart, the overall movement is from proximal to distal. When you use strokes which pass over any bony prominences you must ease the pressure off since there is no benefit to massaging over bone, and it may be uncomfortable for the client, but still maintain contact. The movements may be performed using both hands simultaneously or by alternating hands. On the return stroke, the hands maintain light contact and avoid the path taken on the upward stroke. The position and direction of the movements will vary according to the technique and part of the body you are working on. For example, long stroking movements may be performed up the leg, whereas the movements may be more circular on the back.

Effleurage should be carried out in a smooth, rhythmical and relaxed manner, starting with a light touch at the start of a session and building up to deeper pressure with slower movements for increased circulation and stretching of the tissues later. The hands must be relaxed and follow the natural contours of the client’s body. The technique should not be rushed as you need time to identify and focus on any abnormalities in the tissue that may require further attention later in the session. Quick movements will not help the client relax, and if a tender area is missed it will almost certainly be more painful if discovered later when using deeper techniques such as petrissage.

What does effleurage achieve?
The aims of effleurage are to:

• introduce touch to the client
• put the client at ease
• warm the superficial tissues
• relax the muscles
• allow the practitioner to palpate and sense the condition of the tissue
• stimulate the peripheral nerves
• increase lymph and blood flow, and thus aid the removal of waste products
• stretch tissues
• relax a client before the end of the massage.

Not all of these aims may necessarily be achieved at once. The speed with which each technique is applied in relation to the circumstances will determine what you are aiming for. For example, lighter, brisk movements will be designed to stimulate and energise your client before exercise or competition while the same techniques applied more slowly after exercise may be aimed at helping the removal of waste products and relaxation.

It is essential, however, to achieve your aims using effleurage before moving on to deeper techniques. If the muscles have not relaxed sufficiently, deep tissue massage may be uncomfortable and even detrimental to the client. The more pliable the superficial tissue, the greater the opportunity for the massage to have an effect on the deep muscles.

To complete any massage, use light effleurage to relax the client, particularly if intense – and possibly even painful – movements have been used beforehand.

What is petrissage?
Petrissage comes from the French word, pétrir, which means ‘to knead’. The basic petrissage movement is to compress and then release the soft tissue, using either direct pressure or by picking up and squeezing the skin and muscle.
Petrissage is generally used to have a deeper effect on soft tissue than effleurage, and includes kneading, squeezing, picking up, shaking (and other techniques described as wringing and rolling, which achieve much the same results).
 

How to do petrissage
As with effleurage, the part of the technique applying pressure is usually directed towards the heart to encourage venous return. The surface of the practitioner’s hands often remain in almost static contact with the client’s skin while moving it over the underlying muscle.

However, with petrissage the overall direction is from proximal to distal, as opposed to effleurage, where the stroke and overall direction are both towards the heart. To achieve this, the practitioner first applies generally shorter strokes (towards the heart), but after one or more strokes deliberately slides the hands distally before commencing the technique again. The aim of this is to ‘push’ blood out of an area of soft tissue by applying pressure, then releasing the pressure before repeating the manoeuvre distally to force fresh blood and nutrients into the area just ‘vacated’.

What does petrissage achieve?
The aims of petrissage are to:

What are frictions?
Frictions are small forceful movements applied back and forth over isolated areas using the pads of the fingers or thumbs – utilising considerable pressure compared to the techniques described so far. They are applied adjacent to the direction of fibres and hence, are often referred to as ‘cross-fibre’ frictions. It is vital to understand that such techniques actually disrupt the tissues in order to realign new fibres and therefore must be used sparingly and only when the need arises – see below. Several benefits of frictions may be generated by using deep stroking instead; the subtle difference between the two techniques being slightly less pressure and therefore no disruption caused.

The pads of your fingers or thumbs move with your client’s skin in either a circular or transverse direction, and may be used on muscles, tendons and ligaments. Finger and thumb pads can be used with medium to firm pressure for exploratory purposes to feel small areas under the surface. Greater pressure is used for deeper and sometimes more painful movements aimed at separating muscle fibres and breaking down recent scar tissue.

The practitioner’s finger or thumb pads must remain in static contact with the skin, moving the subcutaneous tissue over the deeper tissue. When performing frictions for the purpose of separating muscle fibres and breaking down scar tissue, the client must be warned that these procedures may be painful or at the very least uncomfortable, although the pain will subside after a short while. This is an advanced massage technique and should only be used with when you are confident that:

• you can accurately locate a lesion (an injury or altered structure)
• you know how to place the affected tissue on full stretch – i.e. you are fully aware of where the origins and insertions are located
• you are confident that there will be an overall benefit.
  

To be successful in treating lesions, frictions should be repeated during massage two to three times a week. The purpose is to deliberately break down tissue, stimulate vaso-dilation (widening of the blood vessels), increase localised circulation, and restore elasticity.

Particular attention must be paid to how long and how vigorously frictions are applied. Applying frictions for a period of several minutes during a massage session to a very confined area is quite normal. Using frictions for longer can have a particularly detrimental effect by irritating or even damaging healthy muscle fibres and causing inflammation. It is far better to err on the side of caution and increase the amount of frictions applied during a subsequent massage session if necessary.

What do frictions do?
The aims of frictions are to:

• separate adhesions between fibres
• break down scar tissues
• restore elasticity
• stimulate vaso-dilation and blood flow
• stimulate the healing process
• realign new scar tissue.

Tapotement

Tapotement describes techniques such as hacking and cupping which have their place in massage aimed towards relaxation. Hacking is a technique in which both hands alternately strike the skin with the lateral borders of the fifth finger of each hand. As the other fingers close together on striking the skin, a characteristic sound is made. It is known to stimulate the skin and superficial muscle tissue, preparing the muscle for exercise and hence being an option for pre-competition massage. Cupping involves making an air-tight concave shape with the hand so that, as it strikes the surface, the air caught underneath is compressed, creating a vibration that penetrates the tissues. Char-acteristically, it also creates a vacuum as the hands are pulled away, and therefore by stimulating the superficial tissue can move blood away from deep tissue, a fact which may be considered counterproductive for sports massage. Other techniques achieve most of the same effects, together with additional benefits, more efficiently so tapotement is not widely used.

from The Complete Guide to Sports Massage