Getting Started with Massage - PDF

30 G ET T I N G STA RT E D BEING PREPARED Aside from honing your massage techniques, there are other important ways to prepare for and develop your practice. Being properly equipped and spending some time on your mental and physical preparation (see pp.32–35) will ensure that when it comes to th...

30 G ET T I N G STA RT E D BEING PREPARED Aside from honing your massage techniques, there are other important ways to prepare for and develop your practice. Being properly equipped and spending some time on your mental and physical preparation (see pp.32–35) will ensure that when it comes to the actual massage, you will be able to place your focus solely on the receiver, knowing that all of the accompanying elements are in place to allow treatments to run as smoothly as possible. TOOLS OF THE TRADE Whether in a practice, a dedicated space in your home, or at the receiver’s home, a A padded face hole keeps the massage environment should be welcoming, body aligned, clean, and calm. In addition, being properly avoiding strain equipped will ensure the comfort of both you on the neck and the receiver, allowing you both to relax. ESSENTIALS A massage table or comfortable, supportive surface is key. A dedicated massage bed is ideal. For occasional massage, a well-padded, supportive floor-based futon can be used. Most beds are too soft for a massage and at an awkward height that puts pressure on the back. When choosing a massage table, look for the main features (see right) and make Table legs can be sure it is stable. Some tables state a weight adjusted manually limit, so check if this suits your needs. If you or by hydraulic or need to travel, a lighter, portable table is ideal. electronic control Clean towels and table covers are a must. A cover offers hygiene, while towels ensure comfort, warmth, and privacy and provide a safe boundary between practitioner and receiver. You will need the following: A protective cover, clean cotton sheet, or  B E I N G P R E PA R E D 31 large towels to cover the table. used (see p.26). These are easily absorbed, A disposable paper cover can be used on top skin-nourishing, and can be stored in a of the couch cover or towels; otherwise, pump bottle for quick, hygienic access. launder towels and cover after each client. A table that can They also warm up quickly. Two large towels to cover the receiver (see be raised at the Waxes are firmer and provide more grip if head to semi- p.81). Only one part of the body at a time— upright allows desired. They are often combined with oils the part about to be treated—is uncovered. you to adapt the for a semisolid texture. Extra towels to roll up or fold for support massage to a Powders may be used in reflexology, person’s needs and comfort. These can be placed under providing a nonslippery medium. the ankles when the receiver is face down (prone); under the knees when face EXTRAS up (supine) to alleviate pressure on In addition to the core items above, you may the hips and relax the lower back also want to include the following in your and stomach; and under the massage practice: head for support. Pillows to enhance comfort and offer Lubricants such as oils, lotions, waxes, additional support. They can be used in and powders help the hands to glide. place of rolled towels under the ankles Vegetable oils, such as grapeseed and knees. and sweet almond, are commonly A chair for a head and shoulder massage or for a back massage with the receiver sitting astride it if possible, using cushions as comfortable padding if needed. Essential oils to blend with base oils to enhance the massage (see pp.24–29). Meditative music, if welcome, to create a relaxing, peaceful environment and/or to block out background noise. Unscented candles may be used to create an inviting environment. COMFORT AND CARE Look for a well- cushioned table with a wipe-clean surface. 32 G ET T I N G STA RT E D PRACTICAL AND PHYSICAL Have at hand previous notes, a pen, any PREPARATION relevant reference material, and have a clock in view. As well as ensuring you have all the right equipment in place (see pp.30–31), consider practicalities, such as room temperature and MASSAGE POSTURE what you are wearing. During the massage, Body mechanics and posture are extremely your posture, balance, and how you move important for massage therapists to ensure around is key, both for facilitating the massage balance and fluid movement and to avoid and to ensure that you don’t injure yourself. injury. Depth of stroke should come from Check the list below to make sure you are using body weight and should be driven by prepped and take some time to practice the the lower limbs, not by tensing or pushing postures, opposite. from the hands, arms, or shoulders. When standing, both feet should be in BEFORE YOU START contact with the floor, the back should be A comfortable, warm, peaceful environment straight, the shoulders relaxed down, and the will help promote a relaxed atmosphere for chest open. Avoid overstretching, always face both you and the receiver. Make sure that you in the direction of the strokes, and don’t stay are both suitably prepared and that any in one position for too long. possible distractions have been removed. Adopt the positions, opposite, to suit Keep the room warm enough for the different techniques. Work on the head can receiver when he or she is undressed, but also be done while seated, with the legs not so warm that it is unbearable for you. spread wide and feet flat on the floor. Massage should be as relaxing and therapeutic to give as it is to receive. Turn your phones off and, ideally, make sure that these are out of sight. APPLYING OILS Don’t wear jewelry and ask the receiver to remove theirs. Rings, watches, and Just a small amount of oil is needed for a massage. Too much oil can be slippery and prevent good control, while too little can bracelets could catch on skin and irritate skin by pulling the hairs. Generally, long effleurage strokes potentially scratch one of you, while noisy (see p.40) require more oil to allow the hands to glide. Always oil jewelry can be a distraction. your hands rather than placing oil straight on the body, following Ask the receiver to remove glasses or, if the guide below: massaging the face, their contact lenses. Apply a small amount of oil hand, returning the Keep your nails short so they can’t dig into to the palm of one hand. Rub bottle to a safe, reachable the receiver’s skin. your hands together to warm place. Lay the other palm Wear comfortable, nonrestrictive clothing. the oil before using it. on the cupped one and Cotton is preferable to synthetic fibers to gently spread the oil Carry on adding small amounts stop you getting sweaty and overheated. between them. Turn of oil as needed. To avoid Adjust the table to suit your height. Stand both hands over to breaking contact when straight with your hands at your sides and resume strokes. Done reapplying oil, rest one cupped properly, the receiver make a fist. The table should be level with hand, palm up, on the back. may not even notice. your first set of knuckles. You may need to Squeeze a little oil into the lower the table for deeper tissue work.  B E I N G P R E PA R E D 33 TRAPEZIUS STRETCH SIDEWAYS LUNGE Turn from your hip rather than Ensure your back twisting the waist; is straight, and line keep hips aligned, your hip up with facing the stroke the table Angle your back foot to provide a stable base Draw your shoulders down while you make this stretch Try this arm stretch, alternating arms, before Use this position for gliding effleurage strokes (see p.40). Step back you start to open up the chest and stretch the with the leg closest to the table, then bend your front knee to lunge. trapezius to release tension and improve mobility. Lunge back and forth to work up and down the body. KNEELING STANCE SQUATTING SIDE ON Keep your back straight, Keep your hips aligned, neck straight, your leg not craned straight behind with the knee cushioned Facing the table and adopting a squatting position allows you to work across to the opposite side of the body, which is useful for deeper petrissage work (see p.56). Align your pelvis with the table and squat so that your arms can work across the body without Place your legs flexing the wrists. wide to balance and A kneeling stance at the top of the table can be help movement Sway your legs side used for head work. From kneeling, step a leg in to to side to work up and 90 degrees, keeping the knee aligned with the foot. down an area. 34 G ET T I N G STA RT E D MENTAL PREPARATION In addition to physical and practical preparation (see pp.32–33), preparing yourself mentally—“getting into the zone”—is an essential part of the practice. Being grounded, calm, and focused will allow you to give the massage your undivided attention and in turn help the receiver to let go and completely relax. Before you begin a massage, your mind needs to feel calm and free from distractions. Different techniques and lifestyle practices can help you master the stillness and focus you need to optimize your practice. GIVE YOURSELF ENOUGH TIME Building in sufficient time so you can take stock before a session will ensure that you don’t feel rushed and out of sync and that you are in a calm state of mind. Create a schedule that gives you a quiet interval between appointments so you have time to carry out any relaxation or stretching techniques (see opposite and p.33) if you wish to do so; too many back-to-back appointments should be avoided. If you need to travel to a practice or client, arrive early so that you don’t feel rushed and you have time to prepare—checking that the room is clean and warm and that everything you need is at hand. Making sure that the environment is restful, welcoming, and comfortable will be mentally soothing for both you and the receiver. STAYING GROUNDED As a massage therapist, your calm demeanor is an important element. Being grounded and feeling mentally “still” will set the receiver at ease from the outset, helping him or her to step back from the emotional state they arrived in. Maintaining this stillness throughout the massage will enhance the feeling of relaxation. The ability to stay grounded will also help you not to take on  B E I N G P R E PA R E D 35 the emotions of the receiver or carry these treatment if the receiver is happy for you through the day into other appointments. to do so, which can also help relax them You may want to try some of the following and ensure that he or she doesn’t feel the techniques and practices: need to make conversation. Practice meditative breathing exercises (see below) to calm the mind. Breathe from LOOKING AFTER YOURSELF the diaphragm and focus on your breath, Massage can be physically and emotionally letting go of any intrusive thoughts. Breathing demanding, so to ensure that you feel into any areas of tension also helps you to mentally resilient and able to relax during release physical stress. As you relax with the treatment, you need to look after yourself. your breaths, you will feel tension ebb away. Staying fit and agile, eating healthily, avoiding Try the following yoga breathing exercise. alcohol, and getting sufficient sleep will all 1 Sit in a comfortable position, close your enhance your ability to massage. Part of eyes, and breathe quietly through your looking after yourself is learning how to nostrils, observing the sound of your manage everyday stress. Try to make time breath as you breathe in and out. for activities that energize, revitalize, and, in 2 After a minute or so, lengthen your turn, relax you, such as being out in nature. inhalation slightly, followed by a Try to limit screen time, too, perhaps usual exhalation. Do this for allocating a set time of the day to five breaths, then breathe catch up on news or social GIVING AND normally for a few breaths. RECEIVING media. Also be aware of your 3 Next, lengthen your body’s natural rhythms and Massage is a reciprocal exhalation, followed by try to schedule appointments practice. Your deeply a normal inhalation, for relaxed state influences a for when your energy levels five breaths. treatment; likewise, sensing are optimal. 4 Return to normal the receiver’s relaxation breathing once more, helps ground you. STARTING THE SESSION then finally lengthen both Starting the session off inhalation and exhalation for with a friendly yet professional five breaths before returning to conversation will help build a normal breathing to end the exercise. relationship based on trust. Introduce Try visualizations to calm your mind. yourself and ask how the receiver is feeling Imagine a warm light enveloping your body and why they have booked a treatment. This to help you relax. Or imagine that your feet friendly introduction and inquiry, followed have roots deep in the ground while your by a discussion of your treatment plan spine and neck float up like the top of a (see pp.176–177), will relax both you and the tree to help you embody spaciousness receiver. Tell the receiver to give you feedback and feel grounded. Or try your own if they wish, letting you know where pressure visualizations to help you feel present, is too soft or hard and any areas that need calm, and responsive. more attention. Listen to calming, meditative music to prepare and focus before a treatment. You may wish to play this throughout a 36 G ET T I N G STA RT E D A SAFE PRACTICE Massage should always be a positive and therapeutic experience for both giver and receiver. To ensure that this is the case, it’s essential to be aware of contraindications that mean massage should be avoided. Also think about how you can maintain professional boundaries between yourself and the receiver to make sure that you both feel completely comfortable and safe. CONTRAINDICATIONS possibly contagious condition, such as Massage should be avoided where it could athlete’s foot, a wart, or a cold sore. aggravate a complaint or impact health. Also, If there are areas of major inflammation never try to diagnose a health problem; instead, with heat, redness, or a burn. advise the recipient to visit a qualified medical Where there is swelling caused by arthritis. practitioner. Avoid massage in these situations: If someone has epilepsy—refer for medical If either you or the receiver has a fever or advice before a massage. is in pain, or if you feel unwell or very tired. You may wish to avoid massage until the PERSONAL If someone has thrombosis. second trimester of pregnancy, when the PRESENTATION With open wounds, broken bones, bruises, risk of miscarriage is reduced. Maintaining personal joint dislocation, or soft tissue ruptures. Avoid aromatherapy on breastfeeding hygiene is crucial; If you have broken or damaged skin (even women unless supervised by a professional. keep nails neatly minor damage) on your hands or forearms. If someone is under the influence of trimmed and hands On local areas where the receiver has a alcohol or recreational drugs. scrupulously clean. MASSAGE HYGIENE A crucial part of providing a safe treatment is ensuring hygiene. Be clean and presentable. Wash Keep your nails short. your hands before and after a Avoid wearing strong-smelling treatment and before touching perfume or cologne. the face. Make sure the towels do not Tie long hair back and, if you touch the floor at any point are likely to sweat, wear a head before or during a treatment. band to create a barrier.  A S A F E P RAC T I C E 37 THINKING ABOUT personal, this is known as transference. This BOUNDARIES may be happening if he or she suggests a Establishing boundaries between yourself and meal, contacts you outside working hours, the receiver helps avoid confusion and ensure asks for a reduced price, or brings you gifts. a safe practice. Some practices are down to Being aware of this means you can steer the personal choice—for example, how much you relationship back to a professional level. talk to each other, what you wear, the Countertransference is when the therapist products you use, whether to exchange gifts, offloads problems or finds it hard to separate and how you communicate when arranging a personal feelings from a therapeutic massage. There are also physical, emotional, relationship. A therapist may think excessively and social boundaries to be aware of. about someone after a treatment or believe that they can remove all of their pain. If this PHYSICAL BOUNDARIES occurs, it’s important to check these feelings. Setting physical boundaries is very important. Practitioners may find that committing The receiver is in a vulnerable position during to periodic professional supervision or a treatment, so proceeding with care and mentoring will help maintain and refine their sensitivity ensures trust. Using towels own best practice. correctly, covering the body and uncovering just the part you SOCIAL BOUNDARIES CARE AND need access to, maintains the SENSITIVITY These are most commonly modesty of the receiver and crossed. Talking is a normal Properly applied, massage helps them to feel secure interaction, but as a therapist, is unlikely to cause an and comfortable. adverse reaction, but too you should control the urge Tell the receiver to let you much pressure or over- to ask about work, home life, know if they are not happy treating an area could or vacations. Likewise, if the with anything and explain what cause inflammation. receiver drifts toward you are going to do before conversation, this may be a sign moving a towel. Never expose the of nervousness, so you need to bring genitals, breasts, or buttocks and adapt the receiver back to a relaxing, therapeutic techniques around the upper thigh to avoid the environment where silence is comfortable genital area. Tell the receiver if you need to and the focus is on the massage only. move the towel lower to work on the gluteals. If someone is a colleague, family member, Just as the practitioner should not touch or acquaintance, it can be hard to maintain the receiver inappropriately, the receiver also boundaries. You may feel obliged to offer a should not touch the therapist inappropriately. discount or greater flexibility, which can be If this happens, make it clear that this demotivating. You may wish to limit or avoid behavior is undesired and, if necessary, end such relationships, perhaps recommending the session and do not reschedule the person. a fellow therapist to avoid any awkwardness. EMOTIONAL BOUNDARIES Emotional boundaries help keep massage relationships on a professional footing. If a receiver tries to make the relationship GETTING STARTED Massage is so much more than a set of techniques. To appreciate the complexity of the practice and put your massage into context, a knowledge of key body structures and systems and consideration of how to prepare will give your practice depth and purpose. Here, a brief introduction to anatomy and physiology provides a handy starting reference, while an overview of aromatherapy shows the therapeutic possibilities for combining this holistic art with massage. Tips and checklists ensure you are equipped and physically and mentally ready. Most importantly, a guide to safe practice provides essential advice to protect both you and the receiver and ensure you practice with integrity. 16 G ET T I N G STA RT E D THE BENEFITS OF MASSAGE Touch is a basic and powerful human instinct that has the ability to reassure and comfort. Massage therapy uses touch not only to relax the whole body, but also to provide a range of therapeutic health benefits—primarily for the receiver, but also for the giver. Each treatment works holistically to bring relief and release to both the body and mind, promoting an overall sense of increased well-being. HOW MASSAGE HELPS THE BODY Massage therapy has a range of benefits for the body. On a physiological level, it helps improve the functioning of the body’s systems (see pp.18–23), and it is also used to target specific conditions and relieve their symptoms. One of the most notable benefits of massage is the stimulating effect that manipulating tissues has on the circulation of blood and lymph, which in turn helps oxygenate tissues all over the body, distribute nutrients to each cell, and support the efficient removal of waste. The increase in local circulation to the area that is being massaged also has a warming effect that relieves muscular tension and chronic pain. Overall, an improved circulation can have a profound impact on our health and well-being. The relaxing effects of massage also support healthy blood pressure, and the release of tension in the body stimulates and strengthens the immune system, helping build resistance to illness and increase its ability to ward off infections.  T H E B E N E F I TS O F M A SS AG E 17 Another key benefit of massage is its ability to A HOLISTIC PRACTICE increase mobility and flexibility. By improving Looking after our emotional health is muscle tone and body awareness and increasingly important in today’s hectic world. stretching tissues, massage improves Prioritizing time out to recharge both mind mobility; enhances athletic performance; and body and replenish our natural resources and improves posture, which in turn ensures is key for balancing energy throughout the that internal organs have sufficient space to body and managing stress. function optimally. Not only does massage have a naturally Massage can also be used to target specific uplifting effect—in part because touch boosts complaints. For example, certain techniques the body’s levels of oxytocin, serotonin, and DEEP RELAXATION can help reduce congestion in the lungs and dopamine, the feel-good hormones—but it Massage is a truly improve lung capacity by relaxing tightness can also improve self-esteem; promote a holistic treatment, in the respiratory muscles. Also, working on sense of balance and harmony in body and relaxing both the body and mind to the abdominal area can support digestion mind; and provide effective relief from help heal the body by improving the process of peristalsis— stress. All of these factors can ease the and improve the wavelike contractions that pass waste symptoms of anxiety and depression, in turn well-being. through the large intestine. This in turn helps promoting good-quality, restful sleep and relieve the symptoms of gas, constipation, providing a sense of comfort that leads to and also colic in babies. enhanced well-being. STAYING WELL Importantly, massage also acts as a BENEFITS FOR THE preventative tool. By easing muscular tension PRACTITIONER and aiding relaxation, massage can help The powerful effects of massage bring prevent physical pain and also release benefits to both giver and receiver. As a psychological tension and emotions that practitioner, massage can develop into a can manifest as physical symptoms. deeply meditative practice as you learn how to enter into a state of focused relaxation, both to enhance your own practice and to model the deep relaxation that you are “ encouraging in the receiver. In this way, using the power of touch in massage promotes a The holistic benefits feeling of inner calm and increased well- of massage can being that can carry over into everyday life. Massage is also mentally stimulating as a have a profound effect practitioner as you enjoy the fulfillment that is gained through learning and refining skills. on health and well- Physically, you need to learn how to improve posture, distribute weight correctly, and move ” being f! both giver around with fluidity to avoid damaging your own body, all of which will have an extremely and receiver. positive and lasting impact on your overall health and well-being. 18 G ET T I N G STA RT E D UNDERSTANDING THE BODY Sternocleidomastoid A basic knowledge of anatomy and physiology Pectoralis major Subscapularis puts massage in context. Understanding the musculoskeletal system—the location of muscles Deltoid and how these attach to bones and joints—is key. Also, an awareness of how other body systems Serratus anterior work, the structure of skin, and the positioning Biceps of major organs will help inform your practice. Abdominals Iliacus Wrist flexors MUSCULOSKELETAL SYSTEM The body has two types of muscle. Involuntary muscle, such as heart muscle, is not under our immediate conscious control. Voluntary, or skeletal, muscles—for example, in the legs—are the ones we move by will. Tensor fasciae latae Adductors Skeletal muscle is composed of muscle and nerve fibers, bound together by connective tissue, and is attached to bones by fibrous Sartorius tendons. Together with the skeleton, muscles Quadriceps give shape to the body and facilitate movement. Muscles work in pairs, responding to signals from the brain. Fibers slide over each other during a contraction as a muscle Anterior tibial Peroneus shortens; as the muscle contracts, providing movement, the opposing muscle relaxes, providing stability and balance. LOCATION OF MUSCLES THE EFFECT OF MASSAGE On the front view, the right side of the body shows the Muscles need oxygen and glucose to work superficial muscles, while efficiently and expel waste such as lactic the left side shows the acid, produced during vigorous or prolonged intermediate and deep exercise. If muscles aren’t relaxed sufficiently, muscles. On the back view, waste builds up, slowing the circulation and this is reversed. FRONT  U N D E R STA N D I N G T H E BO DY 19 the uptake of nutrients and leading to stiffness. Manipulating soft tissues relaxes them and increases blood flow so that oxygen Levator and nutrients reach all of the tissues and scapulae waste such as lactic acid is removed. This repairs and strengthens muscles, easing pain Trapezius Supraspinatus and stiffness to increase the range of motion in joints, improve flexibility, and reduce the Deltoid Infraspinatus risk of injury. Easing muscular tension also Teres minor improves alignment and, in turn, posture. Rhomboid Teres major JOINTS AND TENDONS Triceps Joints, the point where bones meet, give the skeleton flexibility. Tendons and ligaments Latissimus dorsi Sacrospinalis are attached to joint capsules, such as at the shoulder and hips, or directly to bones, such Wrist extensors Quadratus as at the knee and elbow, allowing movement. Gluteus lumborus Cartilage lies between bones, with synovial medius fluid cushioning them to prevent friction. THE EFFECT OF MASSAGE By stimulating circulation, massage nourishes the joints, promoting healing and Piriformis preventing degenerative diseases. It also Gluteus maximus eases tension in tendons and ligaments to Gracilis improve mobility and the range of motion. Hamstrings FASCIA The fibrous connective tissue known as fascia is a densely woven, continuous mesh covering Gastrocnemius each body structure. With healthy tissues, fascia is relaxed and wavy, able to stretch and Posterior tibial move freely. After physical or mental trauma, scarring, inflammation, or repetitive actions, it Soleus thickens, losing pliability and tightening, which restricts movement and causes pain. THE EFFECT OF MASSAGE Deep tissue massage stretches the fascia, releasing adhesions that impede the flow of BACK energy throughout the body. 20 G ET T I N G STA RT E D NERVOUS SYSTEM The nervous system is the control center of Brain the body, sending and receiving signals to and from all parts of the body. Within the nervous system, there are divisions. The central Cranial nerves nervous system (CNS) comprises the brain and the spinal cord. From the spinal cord, Brachial plexus nerves branch out, forming the peripheral nervous system (PNS), which processes incoming sensory information. Spinal cord The autonomic nervous system (ANS), which overlaps partly with the CNS and PNS, Median has its own nerve chains and regulates nerve involuntary muscles, cardiac muscle, and certain glands, usually operating outside Lumbar plexus Ulnar of our conscious control. There are further nerve divisions within the autonomic nervous Sacral system. The sympathetic system is responsible plexus for activating our “fight or flight,” or stress response, while the parasympathetic division supports processes that conserve and restore energy during rest and recovery. The body is constantly working to balance these two responses in the nervous system. Femoral THE EFFECT OF MASSAGE nerve During a massage, nerves in the skin are stimulated, acting on the CNS. This in turn Sciatic nerve activates the parasympathetic system, which is responsible for promoting restorative actions. As a result, the stress response is subdued and the body undergoes restorative Tibial nerve processes, helping balance energy and encourage relaxation. This state of relaxation helps optimize the functioning of body systems, helping these to work effectively. For example, when the circulatory system (see opposite) is Digital branches supported and works smoothly, it nourishes of fibular nerve NERVOUS SYSTEM tissues efficiently; also the liver and the This system comprises lymphatic system (see p.22), unheeded by the the brain and spinal effects of stress, metabolize and transport cord, from which pairs waste materials out of the body effectively. of nerves branch out.  U N D E R STA N D I N G T H E BO DY 21 CIRCULATORY SYSTEM This is the body’s transport hub, taking oxygen and nutrients to tissues and cells Carotid artery Jugular vein all over the body and picking up toxins and waste products to expel. Superior vena cava Subclavian THE EFFECT OF MASSAGE artery Massage increases blood flow to an area. When a part of the body is massaged, this Aorta stimulates the circulation and blood rushes to the area, replenishing it with nutrients and Heart oxygen and removing toxins. This in turn Inferior vena cava stimulates the production of red and white blood cells, increasing their numbers, and Abdominal aorta encourages healing. A healthy circulation also helps lower high blood pressure and reduce the heart rate. Femoral Femoral vein “ artery Massaging a Popliteal artery particular part of Great saphenous vein the body increases the local circulation, bringing blood to the area along CIRCULATORY SYSTEM The heart pumps oxygenated blood ” (red) throughout the body; deoxygenated with nourishment blood (blue) returns to the heart. and oxygen. 22 G ET T I N G STA RT E D LYMPHATIC SYSTEM Tonsils This system of thin tubes—lymphatic vessels— and lymph nodes runs throughout the body Thoracic duct and is key to the immune system, playing a role in fighting infection, destroying abnormal or old cells, and helping remove waste. Like blood circulation, lymphatic vessels branch all over Axillary the body, but rather than carrying blood, they nodes carry a colorless liquid called lymph, which Spleen contains infection-fighting white blood cells. THE EFFECT OF MASSAGE The lymphatic system does not have a pump to circulate its fluids, so massage stimulates Cisterna its circulation, speeding up the removal of waste, chyli helping prevent swelling after injury or surgery, and strengthening the immune system. SKIN As the body’s largest organ, the skin has an important sensory role. In response to touch, thousands of tiny nerve receptors in the skin Inguinal nodes relay messages to the brain via the CNS (see p.20). The brain interprets these and returns them to the muscles. Lymph nodes THE SKIN This has two layers: the outer epidermis and deeper dermis. These contain blood Hair vessels to help control temperature, glands, Lymph The epidermis vessel has a protective follicle sweat ducts, and nerve endings. function Nerve sensor The deeper Sweat duct dermis is rich in nerve endings, Capillaries blood vessels, LYMPHATIC SYSTEM and glands Lymph fluid drained Arrector pili muscle Sebaceous gland from tissues is filtered in lymph nodes, then Sweat gland Subcutaneous returned to the fat layer circulatory system.  U N D E R STA N D I N G T H E BO DY 23 The skin comprises a superficial layer: the epidermis, and thicker connective tissue: the The lungs are dermis. The tougher waterproof epidermis positioned in the The heart, located upper chest cavity protects skin and underlying tissues by to the left of the chest and are part of the producing pigment, providing immune cavity, is part of the respiratory system responses, and detecting touch sensations. The circulatory system dermis, a fibrous layer of connective tissue, contains collagen and elastin proteins to give strength and elasticity. The dermis is also rich The liver in tactile receptors, or microsensors, which forms part of the are sensitive to touch. digestive system The kidneys lie at the back THE EFFECT OF MASSAGE of the body Stomach Massage triggers the release of endorphins— our natural painkillers—sending messages to the nervous system to tell the body to relax. It Large intestine also improves blood flow to the skin and Bladder stimulates sweat glands, both of which help Small remove toxins. Sebaceous glands in the dermis intestine are also stimulated, aiding sebum production to lubricate skin. Also, by stimulating circulation, massage boosts the supply of nutrients to the skin via the blood, improving its texture and elasticity, and also supports the sloughing of dead cells, naturally exfoliating the skin. In addition, vegetable oils in massage provide their own nutrients and essential fatty acids that help nourish and feed the skin. MAJOR ORGANS Major organs such as the heart, lungs, liver, and stomach are controlled by the ANS (see p.20) and protected in the body by the ribcage. The organs are an integral part of the various body systems and are supplied with oxygen LOCATION OF and nutrients from the circulatory system. ORGANS A knowledge of where organs are positioned in the body aids understanding of the area of the body that is being worked on during a massage. BASIC TECHNIQUES The core set of techniques that make up Swedish massage (see p.110) form the foundation of massage practice in the West. These techniques make up the practitioner’s toolkit and are combined to create the ebb and flow of a massage, allowing the practitioner or giver to build pressure gradually. The techniques are also integrated into many massage specialties so that tissues can be softened and relaxed before applying more targeted pressure. Throughout a treatment, effleurage and petrissage soften the tissues and promote deep relaxation; lively percussions stimulate and wake the body up; and vibrations, static pressures, and passive movements loosen areas of resistance. KEY Light pressure Deep pressure Moderate pressure Hand placement 40 FAN STROKE WHEN TO USE GOOD FOR PRESSURE Start of Applying oil and Mostly moderate massage warming tissues to deep The T-shaped fan stroke is an oil-spreading stroke done on the back either from the base of the spine, as shown, or from the top of the BA SIC TEC H NI QUES back, with the T shape opening out across the EFFLEURAGE sacrum. The stroke can be done in stages, making mini-fans or fountains, as shown here, or, if oil has already been applied, you STROKES can make one large fan over the back. As you repeat the stroke, tissues gradually warm up and relax, allowing you to deepen the pressure. These flowing, rhythmic, smooth strokes form the basis of massage. As introductory strokes, they connect giver and receiver, beginning a dialogue through touch; practically, they spread oil so you can work without dragging the skin and they warm the tissues, boosting circulation. Effleurage is akin to a melody that you return to between other strokes, connecting different strokes together, as well as the receiver to their body. Each stroke should be done at least three times in a continuous action. The speed can vary, but the deeper you go, the more slowly you should work to sense if you are going too deeply and causing contraction rather than release. Generally, strokes are deeper toward the heart and lighter gliding back. Keep your whole palm in contact with the body Lean in, using the weight of your body to 2 help apply pressure, and fan your hands out in small fountainlike actions. Repeat this pattern up the back, reapplying oil at any point if needed (see p.32).  FA N ST RO K E 41 1 Oil your palms and keep your Keep your hands relaxed as you position thumbs lifted them at the base of the back. off the spine Place your hands on either side of the spine, making sure you aren’t touching the vertebrae. Crossing your thumbs helps you get close to the spine and avoids putting strain on them ALTERNATIVE METHOD If crossing your thumbs is awkward, keep them apart, avoiding the spine. Pressure can deepen over the shoulders Lighten pressure a little as you sweep your hands down the back As you reach the shoulders, fan out Slide your hands around to the sides of the 3 your hands simultaneously in a large T shape, keeping your fingers relaxed 4 ribcage and sweep back down the entire length of the back, making sure that your and increasing the pressure as you hands don’t lose contact with the back at any lean into the stroke. point as you prepare to repeat the stroke. 42 B A S I C T EC H N I Q U ES : E F F L E U RAG E ST RO K E S THOUSAND HANDS This smooth, flowing action is an oil-spreading technique done over large surface areas such as the back or limbs. As well as oiling the skin, it also warms your hands and introduces touch. As your WHEN TO USE GOOD FOR PRESSURE Start of massage Spreading oil; Light to hands alternate in small, gliding strokes, one or if skin dries warming hands moderate hand always in contact, the receiver has the sensation of lots of hands working on the body. OVER THE SKIN Place the whole palm of one hand on the body. Glide your hand up the body, then lift your hand and begin a new stroke with your other hand, alternating hands constantly to ensure that one hand is always in contact with the body. Keep your hands relaxed and avoid flexing at the wrists SMOOTH ACTION This stroke can be slow when you wish to soothe, or faster when you want to energize—but it should always be smooth and rhythmic. Pressure can deepen over fleshier areas  T H O U S A N D HA N D S 43 “ Constantly al!rnating the hands in this stroking action gives the ” impression that numerous hands are w"king on the body. Stroke over the spine lightly, ensuring you apply no pressure ALTERNATIVE METHOD Doing a thousand hands over a towel at the start of a session introduces touch gradually and helps reassure. 44 B A S I C T EC H N I Q U ES : E F F L E U RAG E ST RO K E S SLIDE AND GLIDE These fluid, oil-applying strokes, used at the start STROKES of massage to an area or if the skin dries out, also gently stretch and warm the underlying tissues to oxygenate the area and help you sense points of tension. Lightly oil your hands, then WHEN TO USE GOOD FOR PRESSURE repeat a stroke at least three times on each At the start of Applying oil; Build to moderate work to an area warming tissues with repetitions area, working progressively deeper each time. Keep your whole palm in contact with the skin OVER THE SHIN BONE This technique, called “dragon’s mouth,” cups your hand over the shin bone. It is unique to the shin, as it allows you to work on the lower limb without pressing on the bone, while the leg shape here prevents your The fleshy area Make a “V” shape over thumb joint overextending. between thumb the shin and gently press Glide up to the knee, then and index finger the muscle on either side sweep back down the calf rests on the bone side as your other hand starts a new stroke.  S L I D E A N D G L I D E ST RO K ES 45 OVER THE CHEST AND SHOULDERS Raise your 1 thumbs to avoid pressing Standing behind the on the throat head, knees slightly bent, place your palms on either side of the ALONG THE ARM chest, being careful with this delicate area. Fan your hands out to Gently hold the wrist cup the shoulders. to stabilize and slightly stretch the arm while you sweep up the length of the arm with your other hand. Circle the shoulder and glide back down in an 2 elongated “O” shape. Swap hands and Keeping the whole of repeat several times your palms in contact in a fluid, rhythmic with the body, sweep movement. Turn the down the shoulders arm to repeat on the and tops of the arms, inner arm. using your body weight to lean in as you deepen pressure over this fleshier area. SENSE OF TOUCH These introductory strokes 3 engage communication between the nerves and Curve your palms muscles and help the under the arms and receiver get a sense sweep back up, taking of your touch. your hands right under the shoulders. Repeat the steps several times in a continuous action, increasing the pressure in step 2 each time. 46 B A S I C T EC H N I Q U ES : E F F L E U RAG E ST RO K E S CIRCLE STROKES Working the tissues in a circular motion helps to warm them, boosting circulation to an area, and also releases stickiness in the superficial fascia that can cause tension and pain. Circle strokes are helpful in areas where tension WHEN TO USE GOOD FOR PRESSURE After initial Circulation boost; Moderate is typically held, such as the shoulders and back, or for warm-up strokes tension release to deep releasing tightness in muscly areas such as the thighs. Pressure can vary from moderate to deep; ensure that you slow the stroke the deeper you go. WHOLE-BODY ACTION Position yourself in a relaxed lunge and move your body with the action of your hands as you work over an area. Place a rolled towel under the leg for comfort if needed WITH FINGERS Using just the ends of the fingers, lifting the palm a little, lets you work into smaller areas such as the thigh. Circle up and down, sensing the texture of the tissue so you can detect areas of tightness—for example, in the quadriceps.  C I R C L E ST RO K ES 47 Keep your whole palm in contact with the body to help release tension Keep your wrist relaxed as you circle your hand WITH WHOLE HAND 1 Circle over large areas such as the shoulders and back using your entire palm. Begin with your hands at opposite sides of the circle and move them clockwise, avoiding bony areas such as the spine. Lift your hand briefly to cross over the opposite wrist Sweep your hand around, keeping the movement constant 2 Lift one hand to cross over the opposite wrist when it reaches it, keeping your other hand in contact with the body as you do so to ensure constant movement and contact. Do several repetitions on one shoulder before repeating the action on the opposite side. 48 B A S I C T EC H N I Q U ES : E F F L E U RAG E ST RO K E S CRISS-CROSS This linear push-and-pull action is a light, soothing effleurage stroke, though it can also be applied more deeply, as a kneading petrissage action. As the tissues are squeezed and stretched, blood flow to the area is boosted, WHEN TO USE GOOD FOR PRESSURE After oiling, or Warming and Moderate to making this a very relaxing and warming stroke that can deep strokes soothing deep be used as preparation for deeper strokes. It can also be done after vigorous deep tissue work to soothe the tissues. Criss-cross is typically done on larger areas, such as the back; thighs; and, more lightly, on the abdomen. HAND CRISS-CROSS Place the palm and fingers on the back so the whole hand is in contact Squeeze and slightly twist the tissues as your hands Work over the pass each other spine, but don’t press down on it With relaxed hands on either side of the area you’re working with, use your body weight to lean into the stroke, then push with the hand closest to you and pull with the hand farthest from you, squeezing tissues at the center as your hands cross over. Repeat back and forth.  C R I S S - C RO SS 49 “ Squeezing and compressing the tissues is extremely relaxing and warming. ” FOREARM CRISS-CROSS Keep your hand soft and relaxed Keep your whole forearm but not your elbow in contact with the body Slide one hand down as your opposite forearm glides over the back BEST POSITION Use your body to direct the Using your forearm in a criss- stroke. Squat, then lower cross stroke allows you to lean yourself as your hands into the body more for a deeper go down at each side stroke. This forearm pressure is and come up as effective for releasing tension in your hands rise. the fleshier muscles of the lower back, but avoid this deeper pressure higher up the back. 50 B A S I C T EC H N I Q U ES : E F F L E U RAG E ST RO K E S FIGURE-EIGHT This technique moves and stretches the tissues in different directions. It is best done after initial warm-up strokes, and the stretching action is helpful preparation for deeper tissue work. It can be done with reinforced WHEN TO USE GOOD FOR PRESSURE After effleurage, Stretching and Moderate to deep hands over fleshy areas, or your hands can work predeep strokes warming tissues (light on spine) separately to incorporate a crosswise stretch of tissues over the whole length of the back, shoulder, and hip. REINFORCED HANDS Ease off pressure as you travel over the spine Keep your fingers relaxed and together Layered hands can be used to trace a figure-eight pattern over the shoulder girdle and also over the lower back, pelvis, and gluteals. This reinforced action helps you deepen pressure over these fleshier areas.  FIGURE-EIGHT 51 SINGLE HANDS This hand always travels inward— toward the spine This hand always travels outward—away from the spine FINDING A RHYTHM It can take a little time to find a rhythm here. You may want to establish what one hand does first before bringing in the second hand. Squatting side-on, place one hand on the far shoulder, 1 the other at the base of the back on the far side. Move your hands together, pulling up tissues with the one near the shoulder, pushing them with your hand near the hip. Glide both hands toward each other, swinging Cross your arms and glide each hand to 2 them around so that the fingers face, until they meet in the midback. Lighten the pressure as 3 the opposite end of the back in a flowing figure-eight pattern. Swap sides to repeat you travel over the middle of the back. on the opposite side of the back. 52 B A S I C T EC H N I Q U ES : E F F L E U RAG E ST RO K E S DEEP STROKES WHEN TO USE GOOD FOR PRESSURE After warm-up Releasing Deep techniques chronic tension Working deeply into the tissues and fascia allows you to target areas that often carry tension, such as the back, trapezius, and leg muscles. Using different parts of your body or reinforced hands to apply the pressure helps protect your wrists and hands and allows you to lean in and use your body weight to intensify pressure. Warm and prepare the tissues first with lighter strokes and return to lighter strokes afterward to soothe the body. Deep strokes should always be done very slowly and sensitively. Work down both sides of the back, taking care Keep your not to press down elbow off on the spine the body REINFORCED HANDS Place one hand on top of Keep your fingers the other to deepen pressure together as you and also stabilize and protect press down across your wrist and fingers. This is the tissues a good technique for working across tissues—for example, over the trapezius muscles of the shoulders.  D E E P ST RO K ES 53 SIDE OF THE HAND NOTICE RESPONSES Follow the line of Be attuned to the receiver’s the shoulder blade responses. Check that the around the contour receiver is happy with the of the shoulder pressure and ease up or go deeper as needed. Lunge in to stabilize your body and help align your wrist The side of your hand can be used to access the small, tight area between the spine and scapula. Place your other FOREARM PRESSURE hand on the shoulder for support and to comfort the receiver and connect them to their body and your touch. Pressing down with your forearm helps you to apply deep pressure over large areas such as the back. Squat down and use your body weight to deepen the pressure, easing off over the kidney area in the midback and Loosely interlock going deeper over the gluteals your fingers and and trapezius muscles. press the heels of your hands into the muscle CUPPED HANDS This technique warms the calf muscle tissues and is a useful sports’ warm-up, though avoid it with conditions such as DVT. Work up the calf, pressing in with the heel of the hands, releasing, then moving along and repeating. Stop before the knee and glide back down. 54 B A S I C T EC H N I Q U ES : E F F L E U RAG E ST RO K E S FEATHERING This very light touch gently stimulates the nerves rather than acting on muscles, and can feel very relaxing. But it can also tickle, so it is best done on less sensitive areas such as the back, leg, forearm, and scalp, once the receiver is already WHEN TO USE GOOD FOR PRESSURE To finish an area Relaxing and Extremely relaxed. It signals the end of a massage to a particular area or whole session de-energizing light or the end of a complete session and draws energy down. FINGERTIP FEATHERING Use fingertips only to stroke very gently over the skin Work over the whole of an area, including bony regions such as the spine Keeping your wrists loose and hands soft, stroke your fingertips over the skin using a featherlike touch. Stroke one hand toward you; as this finishes a stroke, start a new one with the other hand so there is continual contact.  F E AT H E R I N G 55 BACKS OF THE HANDS Stroke the skin with the backs of your fingers Stroke away from your body, alternating your hands Feathering with the backs of your hands creates a slightly tingly sensation that can be used for a more sensual effect—for example, if massaging a partner. READING REACTIONS Be sensitive to how the receiver is feeling. For some, feathering simply irritates and tickles rather than soothes and is best avoided. ALTERNATIVE METHOD Feather over a towel to keep the receiver warm at the end of a session. 56 WRINGING WHEN TO USE GOOD FOR PRESSURE After warming Boosting Moderate effleurage circulation This is a compression “push–pull” movement incorporating a twist that should be done on lightly oiled skin to avoid an unpleasant stretch. The smooth, rhythmic action is done BA SIC TEC H NI QUES on fleshy areas such as the torso and thighs. PETRISSAGE If you feel a knot of tension, home in with some finger and thumb kneading (see p.60). Wringing can also be done with the forearms, working side-on as shown here, turning your body rhythmically first toward the head and Petrissage techniques are compression strokes to then toward the lower limbs to twist the flesh. the fleshy, muscular areas of the body that are done after the tissues have been warmed up with lighter effleurage strokes. Petrissage works along and across muscle fibers, engaging the deeper layer of muscles. The action of squeezing and twisting and then releasing works deeply into an area to release stickiness in the fascia; boosts circulation; and encourages the natural elimination of waste products from the tissues via the lymphatic system. The techniques should be carried out in a steady, continuous rhythm. Some effleurage movements, where tissues are worked into more deeply or squeezed against each other, can cross over into petrissage techniques. DEEP RELEASE This energetic action can feel very releasing. Ask the receiver how they feel and go deeper if they are enjoying the pressure.  WRINGING 57 Pull tissues toward you with your fingers and push away with your thumb, avoiding pressing on the spine Pass the grasped tissues between your hands to WITH THUMBS alternate the action SPLAYED Wringing the tissues with fingers and splayed thumbs creates a vigorous twisting and squeezing action. Move up and down an area, working on the opposite (contralateral) side of the back. Overusing this technique can strain your thumbs, so use it with caution. Work straight down, or stand Avoid flexing your wrists, diagonally to twist squatting down so they the tissues align with your hands WITH THUMBS TUCKED IN Keeping your thumbs next to your fingers achieves a gentler twist but protects your thumbs from strain. Sway from side to side to control the movement from your body rather than from your wrists and hands. 58 B A S I C T EC H N I Q U ES : P ET R I SS AG E ST RO K E S KNUCKLING This technique involves holding your hands in soft, relaxed fists, your fingers curled at the second joint as if holding something loosely, then massaging with your knuckles (using just a small amount of oil) to stimulate blood flow to an area. WHEN TO USE GOOD FOR PRESSURE Usually near the Relaxing and Light The action can be slow, rhythmic, and relaxing—as is the case end of a session revitalizing to deep with circular kn