Massage

The term "massage" comes from the Arab mass meaning "to touch" or "to feel," and this type of treatment is a basic to physical therapy. Physical therapy is a branch of rehabilitating medicine that makes use of all forms of mechanical, electrical, thermal, chemical, and radioactive energy for therapeutic purposes. In massage, a practitioner uses mechanical heat in particular on the body's tissues in order to trigger beneficial reactions in the body mainly through its reflex reactions. The extent and type of physiological reaction in the cells, tissues, and organs depends on the duration of the stimulus and on the degree of force, swiftness, and rhythm of the treatment.

Massage is an art that demands technical, physiological, and emotional involvement.
It must always be remembered that your partner on feeling the sensation of your touch, may assume a state of defense, a natural biological reaction caused by new stimuli. It is up to you to reassure your partner, encouraging a more relaxed state. Therefore a feeling of mutual sympathy must be established, one that will allow your partner to relax completely into your friendly hands. If you are not aware of your partners personal reaction to you, you will never make a good practitioner: The old adage "if it hurts it's doing good" has had its day. In fact, whoever provokes pain while massaging is not working correctly from a technical point of view. Massage can be applied even on sore areas without causing pain and should result in the patient's feeling rather like having awoken from refreshing sleep, with a deep sense of well-being.

The patient's reactions must be received and responded to in order for a massage to have its full therapeutic effect, because the treatment is more than a mechanical application of hands. In order to carry out a massage properly and satisfactorily, the following general suggestions should be followed:

• Adopt those manipulations that produce pleasant sensations and reject those not welcomed. You can perceive which these are through an unspoken or spoken dialogue with your partner. Remember, it is the agility and elasticity of the hands rather than muscular force that is important.
• Make sure your position is comfortable for you and that you are able to stay balanced for all the movements you need to make.
• Wear practical, uncluttered clothes. Converse with discretion in subdued tones, without exaggeration or confidential attitudes. The practitioner, while seen as a friend, must take on a more formal role.
• Start the treatment with light movements, suitable for the first approach with a new human personality. Introduce yourself by beginning each massage with stroking motions. Exit from a session in the same way.
• Carry out the massage with a calm, predictable rhythm, applying special care to sore areas, and avoiding possible areas of infection and bruises.
• End the massage with movements that become gradually slower, lighter and gentler, avoiding a sudden stop which could interrupt the state of relaxation.
• When possible, cover your partner at the end of the treatment and allow a resting period for a few minutes, as this allows the body to integrate the new physiological information.

Surroundings

The surroundings should be airy, spacious, hygienic, and welcoming, and give an impression of order and efficiency. Temperature should be kept around 23° C, and it is a good idea to have a light cotton sheet and perhaps a blanket handy to cover parts of the body not being massaged. Soft, suffused lighting is advisable and direct rays should never be trained on the face. A musical background is favored by many practitioners, while others opt for silence. The choice depends on you and your partners preference. The market offers numerous creams, oils, talcs, and so forth suitable for massage. Choose the ones you prefer, in agreement with your partner, and use just enough to limit friction.

Avoid spreading the product directly on the partners body, but warm and spread the substance first in your hands. Avoid mineral oils as they do not allow the skin to breathe. Also make sure you are not using a product to which your patient may be allergic: for example, some people react badly to almond and/or wheat germ oils.

Overall advice

Massage is advisable:

• in the presence of general, physical, and psychic fatigue, as it helps give tone to body and spirit alike. In fact, it stimulates that sense of well-being on which a healthy neurophysical condition depends.
• in cases of prolonged inactivity.
• in cases of reduced muscular tone and tropism.

Specific advice

Adopt one of the following methods according to need:

• relaxing massage: suitable for those interested in maintaining their physical appearance and a sense of well-being.
• therapeutic massage: suitable where there exists damage due to trauma or surgical operations, particularly orthopedic; degenerative disorders such as arthritis; damage to the peripheral nervous system.
• sport massage for athletes, practiced before a competition (stimulating) or after a competition (relaxing).

Swedish massage

Main areas of massage

There are five Swedish massage techniques: stroking, friction, kneading, percussion, and vibration. These techniques should follow in sequence and sometimes be taking into account the overall goal and the areas to be worked on. There are three such areas:

• The superficial level, consisting of the epidermis and the superficial dermis with their tactile corpuscles, nerve endings, and rich peripheral blood supply. Stroking, both light and sustained, friction, and vibration all access this level.
• The intermediate level, which consists of the middle and deep dermis and the subcutaneous cellular tissues. This is the classic connective tissue site, with its cells, in a matrix of elastic and collagen fibers. Massage can greatly affect the density and texture of this area. Friction and kneading access this level.
• The deepest level, which consists of the various muscular groups, the nerve plexus, veins, and certain organs with hormonal functions which may be influenced through reflex responses. Strong kneading, consisting of both kneading and squeezing movements, is suitable for this area as are percussion, deep friction and static pressure.

Parts of the body to be avoided

In Swedish massage, there are parts of the body which should not be worked on because they are full of large, superficial nerves. Massaging these areas may cause irritation, sometimes with serious consequences. These areas are:

• the armpit
• the popliteal fossa (back of the knee)
• the front of the elbow
• the inner thigh
• the femoral triangle (the groin)

STROKING

Stroking (also called Effleurage) is simple and intuitive, and is something we all do on instinct when a part of our bodies has been traumatized.
The main purpose of stroking is to create a general sense of well-being.

The effects of stroking on the skin

Stroking helps shed old cells, accelerates the cell substitution process, and eliminates wax, thus making the skin softer and more elastic.
Cutaneous microcirculation may be stimulated both in a mechanical way, that is, by stroking the skin and pinching the capillaries, or by reflex, that is by activating the vegetative nervous system.
Vasoconstriction occurs if the stroking technique is carried out gently, whereas vasodilatation takes place if stroking is too strong. In each case, the tissue renewal process is set in motion in the areas massaged.

Technique

Stroking is carried out with open, relaxed hands gently resting on the part of the person's body needing to be worked upon. Hand and body contact must be total: the whole hand must be touching your partners body constantly, adapting to its every shape. Pressure must always be minimal and hand contact on the epidermis light. The rhythm is slow and constant; the movements are wide, circular, and enfolding.

FRICTION

Technically speaking, friction is similar to stroking, but it differs significantly in its intensity and in the effects it produces.

The effects of friction on the connective tissue and the skin

Friction produces an intense local skin vasodilation and directly causes the tissues to drain, disposing of waste products and letting good nutrients in. It affects the connective tissue positively, activating them and reducing adhesions caused by prolonged inactivity or following surgery. Friction acts directly on the skin because of the contact between the practitioner's hands and the patient's skin. As a consequence, heat is developed and blood flows to the surface of the treated area. By reflex, a series of reactions is triggered in the vegetative nervous system which causes the muscles and the organs linked to the dermatome to relax.

Technique

Friction is carried out on the larger surfaces (the back for example) with the palm of the hand and particularly with the tenar and hypotenar eminences (the most fleshy parts of the palm). On smaller surfaces, the fingertips or the side of the hand are used. Pressure is significantly stronger than with stroking. This is because the deepest levels, such as the connective levels are to be stimulated without involving the muscular tissue. The rhythm is slower and the direction is centripetal, semicircular, or transversal. In some cases friction must be fast and sustained. In this way, the local temperature is increased and circulation stimulated, with positive effects on muscle oxygenation.

KNEADING

Kneading is the most complex technique in Swedish massage and acts upon the muscular masses, the deepest dermis, and the connective tissue.

The effects of kneading on muscles and the connective tissue

Light kneading promotes drainage of the interstitial liquid and empties the glands found in the skin. It acts on the connective tissue causing adhesions; to break apart and the squeezing action on the muscles helps in the liquid renewal process, thereby increasing elasticity and tone. A further benefit is represented by improved circulation and deep vasodilatation.

Technique

Kneading is mainly carried out with the thumb in opposition to the index finger. With the "pliers" thus formed, grasp the muscle and with both hands squeeze alternatively, moving along the longitudinal axis of the muscle in a centripetal direction. If the muscular mass is large, the "pliers" are formed by all the fingers opposing the thumb and the tenar eminence. The movement is similar to that of kneading bread and the rhythm must be steady. There are several kneading variations, each used to obtain specific results:

• Fluffing is carried out by grasping the cutaneous fold and letting it fall again. This causes the separation of the subcutaneous connective tissue from the underlying tissues.
• Fanning is carried out with both thumbs held near each other and pushing the skin in a centripetal direction, raising it while the other fingers carry on "walking" on the skin and helping to raise it in the direction of the thumbs. Fanning causes the separation of the connective tissue on wide surfaces and, at the same time, brings about a positive vegetative reaction (relaxation) with hyperemia and vasodilation.

VIBRATION

Vibration is a movement carried out on the skin, which is transmitted from one part of the underlying muscular, fleshy body to the other. It is a tiring technique and a difficult one to put into practice.

The effects of vibration on nerve endings

Vibration works on the cutaneous, subcutaneous, and muscular nerve terminations. It has a sedative effect, but also acts upon the main substance of the connective tissue making it more malleable when flocculation or clotting (adhesions, healing processes, scars) occurs.

Technique

Vibration is produced with the practitioner's hand stretched out flat on the surface needing treatment. This hand exerts measured, intermittent, quivering pressures. It is similar to a wave which is transmitted in depth, and it affects the nerve endings. It may also be performed with the fingertips. Frequency and intensity may be varied in different ways.

PERCUSSION

Although an interesting to watch and well-known technique, percussion is not a particularly effective one. It is carried out with the flat or the edge of the hand or with the hand cupped. The technique must be gentle and needs to be well-tolerated in order to be helpful.

The effects of percussion

Percussion causes strong hyperemia and therefore improves local nutrition. It stimulates the elasticity of the muscular fibers and, if repeated for a sufficient amount of time, diminishes nervous excitability Slapping and cupping are techniques used almost exclusively for aesthetic massage, to produce a greater blood flow in the gluteal and hip regions when these have a lot of adipose tissue. This technique, carried out with the side of the hand and with relaxed fingers, especially if performed gently, is often used in the final phase of a therapeutic massage for muscle spasms and pains.

Technique

Percussion is made up of different techniques:

• Slapping is carried out with hands flat and gently "slapping" the region that needs treatment.
• Cupping is carried out with cupped hands, which on striking on the cutaneous surface, trap a volume of air which instantly compresses the underlying tissues.
  The correct performance of this technique generates a characteristic "popping" noise.
• Tapotement is carried out with open hands, the fingers being spread wide and relaxed. It is the ulnar on the little finger side which strikes the skin rhythmically.
  The relaxed fingers produce a string of repercussions as they rapidly strike one another from the little to the index finger.
• There is a stronger form of the hand technique which uses the hand's ulnar edge (from the little finger to the wrist), but as this is excessively sharp, it is not advised.

BACK MASSAGE

The back is the part of the body which most often enjoys the beneficial effects of massage. Massage in this area is advisable where there is cervical arthrosis, stiff neck, spasms, pain deriving from stress, or the aftereffects of traumatic events such as lesions or trauma to the soft tissues of the neck following car accidents (whiplash).

Back massage is not recommended in the presence of joint inflammation (arthrosis), inflammation of the peripheral nerves (neuritis), osteoporosis, bone cancer, all infectious or inflammatory diseases, or where there are skin diseases which carry the risk of contagion through contact.

All massage techniques are allowed and advised for the back. The movements should be made with the palm of the hand, using wide circular motions on the large muscles (dorsal, lumbar, and trapezius). Around the vertebral joints, the shoulders, and on the neck, you should use the fingertips and the pinch formed by the tenar and hypotenar eminences and the fingers.

The massage should begin with slow, gentle stroking, employing wide circular movements in order to overcome your partners natural defense reaction. Pressure is then increased to friction with slow, rhythmic movements which will produce superficial hyperemia.

Stroking and friction constitute the basic elements of massage and act as a lead-in to the other techniques. Avoid jarring movements and sudden changes in rhythm and keep in constant contact with your partners skin. Back massage is also excellent for physical fatigue, depression, and stress. In this regard, it is helpful to let your partner talk openly, should that person wish, as this can be freeing from psychological burdens. In this way, massage really becomes a compound therapy which can release latent psychosomatic energies. Sometimes this is expressed in dramatic ways, such as bursts of tears, explosions of laughter, or intense general shaking.

Always end back massage with light, diminishing movements, stroking slowly and delicately and, where possible, let your partner rest as long as necessary.

When massaging the shoulders and neck, it is advisable for your partner to sit on a backless chair with his arms and head leaning on a table. In this position the whole upper back area can be properly treated. It is also suitable for patients with a stiff neck, those suffering from cervical arthrosis, and for the specific treatment of headaches caused by arthrosis.

LEG MASSAGE

Massage of the legs can be helpful in two ways: it reduces overall tension in the lower body, producing an overall relaxation effect, and it is also of an aesthetic nature and is used to eliminate the signs of cellulite and to help mobilize areas where venous stasis exists, reducing swelling and edema in the lower limbs. Leg massage is particularly important for athletes and is recommended in the aftermath of traumatic events such as fractures, muscle strains, or ligament tears to the knee and/or the ankle. These pathologies force the patient into inactivity which can last for months, causing the muscles to shrink and lose tone, and causing the joints to become stiff. Leg massage should not be performed when there is acute inflammation, immediately after a trauma and in cases of thrombophlebitis, varicose veins, or fragile capillaries. The techniques are similar to the ones used for the back, except that the positions of the hands must be adapted to these shapes, which have smaller and more rounded surfaces. Therefore the fingertips and the arch formed by the space between the thumb and the index finger must be used more frequently. Massage behind the knee, on the inner thigh and on the groin is to be avoided. When massaging the back of the legs, place a rigid cushion under the ankles and while massaging the front put the cushion under the knees. Very often, and particularly during aesthetic massage, the patient is placed on his side, so as to treat the whole lateral part of the thigh and the flank more satisfactorily. In this case, a fairly large cushion, placed under the folded upper leg, may help. Leg massage is almost always preceded by that of the foot (which is the real peripheral pump and therefore very important for circulation).

ARM MASSAGE

Arm massage is used to treat specific problems such as arthrosis, tennis elbow, writer's cramp, and rheumatism. This massage is also recommended to complete the treatment for cervical arthrosis when this causes congestion of the brachial plexus, with painful reactions in arms and hands. This can sometimes manifest itself as carpal tunnel syndrome. Apart from those cases generally not advisable, remember that the arm is never treated during the acute, inflammatory phase of a frozen shoulder nor immediately after any traumatic event. When massaging the arm, avoid the armpits and the bend of the elbow. This technique is similar to that used for the legs, the only difference being that the surface is smaller and therefore the movements should be more refined and selective. Practice frequently on the arms as already suggested on the legs. During arm massage, it does not matter whether your partner is lying supine or prone, or is seated. Try out all these variations several times until you have mastered the techniques in the different positions. Remember always to massage the hand deeply during the arm massage.

FACE MASSAGE

Facial massage is a powerful type of treatment; not only can it smooth out wrinkles and cleanse the face, but also it helps to calm headaches and to balance energy excesses in the top part of the body (in this case massaging the scalp is very effective). The face and the neck are the "opening regions" for lymphatic drainage.

In theory, apart from the eyes, there are no areas that should not be massaged because energetic movements are replaced by very gentle movements of the fingertips: very light stroking, drainage from the center toward the temples and the neck, and light kneading of the few fleshy areas.

Do not massage using large quantities of cream; where possible, let your partner choose the cream from among those not causing allergic reactions. While carrying out a facial massage, avoid direct light on your partners face, and have a background of suitable music to induce maximum muscular relaxation.

Carry out the massage with your partner lying on the floor, a treatment table, or sitting on a comfortable armchair. At the end of the massage, gently rest your hands on your partners face and hold them there covering the eyes for a minute or so without exerting pressure.

ABDOMEN AND CHEST MASSAGE

Abdomen massage can cure blemishes caused by adipose deposits and may also help resolve intestinal problems such as constipation, but experience and great sensitivity is needed here to avoid causing disturbance to the internal organs of the abdomen which, in fact, is not protected by hard parts, but only by abdominal muscles which in themselves are not usually very resistant. Carry out circular stroking (clockwise so as to help peristalsis), drainage in the direction of the neck and of the armpits, light friction and superficial kneading of the skin and the subcutaneous area, and localized vibrations. Avoid all kinds of percussion. Do not massage the groin, and postpone the treatment should the internal organs be inflamed.

The abdomen is the center of the body and is the place where energy stores are produced and preserved; deep in the abdomen and toward the center is the solar plexus. It is a very important neuro-vegetative center which controls relations between the visceral metabolism and emotional displays. Bear in mind the fact that touching the abdomen is like intruding upon someone's privacy. Chest massage is a natural ending for body front massage. But contrary to what is generally believed, massaging the breast is not advisable because this organ is a gland.

A sagging breast or one prone to stretch marks benefits more from semi-cold showers than from massage, and the latter should be limited itself to gentle stroking while applying cosmetic creams. It is instead important to massage well the pectoral muscles, often so shortened and stiff as to cause the well-known posture of curved and hunched shoulders.

Connective tissue massage

The story of an intuition

Connective tissue massage was discovered casually in 1929 by Elisabeth Dike, thanks to a disease she had been suffering for years. Her lower right leg suffered from serious circulation problems and at that time amputation appeared to be the only therapy possible. Ms Dike also suffered from pains in the lumbar region and tried to alleviate the pain through digital tractions in the lumbosacral region. To her great surprise, she noticed that thanks to this treatment, the leg had begun to get better. Following this discovery, the technique of connective tissue massage was born and perfected, but it was not until later that its effects on the body were studied. At the beginning, in fact, the medical class, having failed to find a scientific reason for the results that were being obtained, was rather skeptical. It wasn't until further discoveries were made in the field of neurophysiology that the technique was approved by official medical authorities.

The deep and reflexive effect of connective massage

Neurological studies on the body's innervation system have revealed a division of zones of the body, in which each nerve corresponds to a segment of the spinal chord which innervates it. Each neurotome (nerve plexus along the spinal column) is connected to specific internal organs (enterotomes), to specific muscles (myotomes) and to a specific surface of the epidermis (dermatome). Any kind of functional alteration with one of these systems is reflected in the connecting systems through the neurotome. The result is that a muscular problem, or one concerning an internal organ, manifests itself in a specific area of the body. Furthermore, stimulation on the part of the skin concerned provokes a reflexive effect in the corresponding muscles and internal organs, thus positively influencing on the course of the illness.

Technique

This technique is performed with the tips of the third and fourth finger, which move the skin and lift it above the underlying connective tissue. The fingers may be either flat or perpendicular to the patients body surface, depending on whether superficial or deep stimulation is required. The patients health conditions and responsiveness determine the depth of stimulation practiced. The patient is usually seated on a stool, but it is also possible to perform the treatment on someone in a prone, supine, or side-lying position, should that person be unable to remain seated for long.

Different phases

Ms Dike's experience has shown that it is preferable, during treatment, to use certain techniques to achieve maximum results and avoid exaggerated and unpleasant neuro-vegetative reactions in the patient.
The first phase of the treatment deals with what is called the preparatory work. This first treatment sitting is needed in order to evaluate your partners reactions and to decide on a treatment program. Should there be excessive reactions at this phase, interrupt treatment for a week and then attempt a similar sitting.
Preparatory work is followed by a series of additional tractions, worked out on the basis of types of problems being faced. They are used to alleviate muscle tension in the regions to be treated. However, the treatment works progressively, gradually drawing closer to the area where the skin suffers most. Several sittings are often needed before the area concerned can be treated. Every sitting starts off with the basic preparation to which are added, at the following sittings, and according to the needs of the patient, the first, second or third therapeutic series, as well as accessory tractions. Should the patient have problems with his lower limbs, the practitioner should, after the initial preparation, pass directly to accessory tractions and the treatment specific to the lower limbs, gradually drawing closer to the area concerned.
It is good practice to repeat the initial preparation at intervals during a sitting and always end the treatment with it.

Manual lymphatic drainage

Manual lymphatic drainage was discovered in the 1930s by two Danish therapists, Astrid and Emil Vodder, who were the first to have the courage to massage the superficial lymphatic ganglia. Since then, thanks to in-depth studies on the lymphatic system, this technique has evolved, and there exist today many schools of massage which include lymph drainage in their curricula.

The effects of lymph drainage on lymphatic circulation

The aim of lymph drainage is to help the circulation of the lymph and its flow in the blood circulation. The lymph flows from the periphery to the center of the body, gathering in groups of small cisterns in specific points of the body, both deep and superficial. It then flows into the venous circulation where the internal jugular vein and the subclavian vein meet (this area is known as terminus). The lymph from the left chest, the left arm, and the left half of the head and face flows into the left terminus, while the remaining areas of the body flow into the right terminus.

Technique

In order to perform lymph drainage correctly, it is necessary to bear in mind two rules regarding lymphatic circulation:

• The lymph flows much slower than the blood, so it is therefore of the utmost importance to slow down the rhythm of the massage, performing the movements as if in slow motion. Not adhering to this one fundamental rule significantly compromises the effects of the treatment, and one risks causing the lymph to slow down further.
• Before draining the lymph in a region of the body, it is always necessary to empty the superficial lymphatic ganglion into which it flows. Drainage occurs in the direction of the lymphatic ganglion.

Anti-stress massage

The anti-stress massage differs completely from other techniques because it acts in greater depth, is more complex, and requires a greater effort on the part of the practitioner. The anti-stress massage demands involvement, concentration, and technical skill.

Technique

When performing anti-stress techniques, you must always observe the following fundamental rules:

• It is not enough to perform this type of massage with the palm of your hand alone, but you will have to use the whole forearm as far as the elbow.
• Constantly rock your partner, creating a steady, gentle swaying movement through rhythmic motions.
• Build up and maintain an atmosphere of trust and confidence with gentle but firm pressure.
• Your partner must be able to relax completely in your hands.
• Relax your partner through long rhythmic motions, that ebb and flow, then squeezing and draining in depth.

Performance massage

Performance massage is different from mainstream massage, which usually consists of a generalized relaxation sequence applied with a lubricant and long, slow, connecting strokes called "effleurage." Performance massage also differs from the specialized forms of medical massage, which are injury-specific and use deep (and sometimes painful), anatomically precise techniques.

Performance massage is the application of creative and intuitive touching skills to enhance expressive movement and athletic performance. Performance massage includes some of the technical variations of classical massage but directs them toward a human body that is engaged in regular physical activity, dance, or on-going athletic endeavors. In this way it is a skill system whose mission is to support, encourage, and complement integrative and expressive movement.

Ten features that make performance massage unique

Performance massage is characterized by the following unique features:

The fundamentals can be learned by anyone.

The actual skills employed in massage are not difficult, and they can be learned quickly by anyone who is willing to practice regularly. Touch is instinctive to all of us. However, it is also a skill that requires practice, good judgment, and creativity. Performance massage supports the development of a profound and positive sense of touch.

Clothing stays on.

Most forms of massage are received in the nude while one is draped with sheets and towels. This is appropriate for Swedish massage and relaxation approaches, but performance massage is different. The clothing need not be removed, because the techniques involve direct pressure to the layering of muscle tissue beneath the skin. There is no need for superficial gliding over the surface of the skin. Also, the vast array of muscle-stretching techniques involved make it impractical for the recipient to be nude and covered with sheets and towels.
The fact that clothes stay on during performance massage makes massage more accessible. You can provide sessions in training rooms, on-site at some sporting events, in some locker rooms, backstage at a concert hall, or in an area that you and a training partner set aside. Performance massage can be performed through a bathing suit, running shorts, leotards, or even a sweat suit.
The fact that clothes stay on may also reassure those who are touch-sensitive or concerned about modesty. The recipient can more fully relax while you are performing the massage. As you can well imagine, it is often not practical to remove clothing before or after an athletic event, performance, or workout.

No skin lubricant is needed.

It is not necessary to apply oil or any other skin lubricant in the recipient-centered approach of performance massage. This is because the effleurage stroke is not employed.
Avoiding the use of oil makes the session more practical, for the recipient won't need to use astringents or shower afterward to remove a greasy or oily residue. Also, performance massage, by virtue of clothing being on, uses a series of grasps and techniques not dependent on effleurage or strokes requiring a lubricant.

Designed for athletes and active people.

Performance massage lengthens and decongests the muscles, tendons, and other connective tissues of the body by employing a creative combination of high-impact massage techniques along with muscle stretching. This approach encourages greater flexibility, enhanced motion, and overall body mobility, which are essential for peak performance.

Can be used before or after activity and as maintenance.

When the musculature is kept in an optimal physiological state, many common injuries and the all-too-familiar aches and pains of exertion can be minimized. A warm-up massage can be developed for use before physical exertion. A cool-down massage is also an effective therapeutic measure after exercise. Performed on an ongoing basis, maintenance massage can set the stage for activity at full capacity.

Shorter than most massage sessions

It can easily be performed in 30 minutes or less. This suits the temperament of active people, most of whom would find 60- or 90-minute sessions to be too long. By performing a 30-minute, up-tempo, and rhythmic massage, you can reach your objectives of muscle unwinding and circulatory stimulation without compromising quality.

Encourages intuition and creativity in its application

Very often traditional massage is learned and practiced as a generic sequence. Although this may be appropriate for some recipients, many others will find it to be a lethargic, mechanical hands-on experience. Performance massage is different.
Intuition is a capacity that we all possess. By using your hands intuitively, you will notice that your techniques blend with one another. Professional therapists often note that massage becomes an art form when these subtleties are blended into a comprehensive and creative session. Also, the specific techniques become much less intimidating when you feel confident that you already have a well-developed sense of touch.

Features therapeutic stretching

By incorporating muscle-stretching movements with your hands-on techniques, you can focus your attention on creating a uniquely therapeutic session. Specifically, you can lengthen the muscles that feel taut, thereby enhancing flexibility and range of motion. This can complement a warm-up, and it feels especially good after the strain and stress of physical exertion.

Encourages an integrative, whole-body experience

Much mainstream massage is performed technique by technique, sequence by sequence. This can give the recipient a feeling of being fragmented. Performance massage, particularly through its use of compression, allows you to work on two areas of the musculature at the same time. By applying leverage and pressure simultaneously, you can begin to unwind or unknot the musculature and create a sense of wholeness or totality. Soft tissues soften, lengthen, and assume more pliability from massage. Because movement is a total process, this is an important concept and one that will not be lost on the recipient.

It's user-friendly

Painful muscular aches, injuries, and soreness can produce a negative psychological disposition. It is important to experience the body in a positive and self-accepting fashion. Performance massage is the key in making this vital connection.

Precautions for performance massage

Touch, in and of itself, is healing. It has a positive effect on the skin, the circulation, and many vital organs and systems of the body. Because massage is a healing art, knowing what to do and what not to do is as important as knowing what you are capable of doing.

When the following conditions are present, do not use performance massage.

• Do not massage when tissues are inflamed. Inflammation is part of the body's defense and healing process that takes place when tissue has been damaged or injured. It is the body's attempt to isolate damaged tissue and protect it from further injuries. These are the five signs of inflammation:
  • Redness from increased blood flow to the body part.
  • Heat, also resulting from increased blood flow to a localized area.
  • Swelling, due to increased cellular activity and blood engorgement.
  • Pain, due to the release of the chemical histamine and the increased pressure of cellular fluids on local nerves.
  • Loss of movement, resulting from excitation of the nervous system, contraction of the musculature, and increased fluid accumulation.
• Do not massage when severe pain is present in joints, bones, or muscles. These symptoms may indicate sprains, fractures, or other conditions well beyond the scope of your massage session.
• Never put pressure on swollen or painful joints. Conditions such as bursitis and arthritis can be exacerbated by inappropriate massage. Keep communication lines open with the recipient so that you are not inadvertently aggravating an arthritic or chronic joint condition.
• Be cautious with people in the advanced stages of diabetes. Advanced stages of diabetes often involve severe disturbances in circulation, which are characterized by edema and swelling of the joints. Deep pressure can cause tissue damage, so individuals should check with a physician prior to receiving a massage.
• Do not massage cancerous areas, tumors, or cysts. If you are in doubt about a particular lesion, play it safe and stay away from the area. Recipients should consult with a physician regarding any abnormal growth or tumor.
• Massage should not be applied if the recipient has a contagious illness or an elevated temperature. Flu, colds, and certain other viruses leave the person weak. Massage can often cause nausea at these times.
• Do not massage directly on open wounds or burns.
• Do not massage directly on any rashes or skin infections. A localized rash, however, in most cases will not prohibit you from working on other parts of the body.
• Do not apply direct pressure over varicose veins.
• Do not massage areas where blood clots or phlebitis (inflamed blood vessels) have occurred. A medical profile can assist in the exercise of good judgment.
• Use caution on people with some cardiac conditions, such as a recent heart attack or excessively high, untreated blood pressure. The heart may not tolerate the increased stimulation from deep massage. However, athletes and physically active people who control their blood pressure with medication may be massaged. Limiting the duration of a session to 15 minutes and utilizing light pressure are good precautions.
• Do not massage a person who is feeling physically ill. Anyone with symptoms such as nausea, shivering, or excess cramping due to hyper- or hypothermia should be referred to medical personnel. Such symptoms are common at the finish line of major marathons and triathlons, and the athlete should be referred to a primary care health provider.

Warm-up massage

Massage before exercise, performance, or competition is given as an adjunct to, but not a substitute for, the physical warm-up. Massaging before exercise or an athletic or artistic event has physiological and psychological benefits.

Warm-up performance massage creates a state of readiness within the muscles and tissues by stimulating circulation and generating a fresh, abundant supply of oxygenated blood to an area. This is known as hyperemia.

Massage also helps the muscles to work longer and become more efficient by reducing tension and increasing the flexibility of tight muscle groups. It can enhance the general state of well-being, thereby assisting in relaxation, focused concentration, centering, and visualization techniques.

Massage before an event or exercise should be light, of short duration, nonspecific, and warming. Emphasis should be placed on the muscles to be used for the particular activity. The pace is up-tempo and rhythmic, to simultaneously relax and energize. Be certain that your session does not include any painful or high-impact techniques. Deep cross-fiber friction would not be recommended just prior to exercising. Also take care that you do not overwork the muscle or relax the recipient to the point where he or she becomes sleepy or unfocused.

For these reasons it is best to apply a 15- to 20-minute warm-up massage prior to exercise or an event. Ideally this should be done 30 to 45 minutes before the event, as an adjunct to the actual warm-up.

If the individual is to perform to the best of her or his ability, it is essential that physical capacity and mental focusing become synchronized. Performance massage assists in experiencing a synchronized body-mind experience prior to exertion.

• It provides quality downtime in which to mentally focus on the impending event.
• It provides relaxation and anxiety reduction, allowing enhanced performance to occur naturally.
• It flushes-and oxygenates the muscles, creating the physiological environment for optimal performance.
• It initiates a powerful effect, enhancing the competitive edge.
• It provides an opportunity to practice meditation or visualization techniques conducive to excellence.

A highly anxious, hypertense person obviously needs to be calmed down or relaxed during the warm-up massage session. This allows the recipient to become more focused and avoid diffusing psychic energy through random nervousness. Your techniques need to be slow and rhythmic, creating a near-hypnotic effect on the high-strung person. You can also focus on breathing techniques and gentle stretching to facilitate the recipient's experience of weightless and free movement. The tenor and resonance of your voice is also important for guiding the recipient to the optimal performance state.

You have to remember these guidelines as you prepare for a warm-up performance massage.

• No deep pressure or highly specific work such as cross-fiber friction.
• Keep the session to 20 minutes or less.
• Keep a rhythmic and up-beat pace.
• Work lightly.

Be conservative in applying massage before exercise, so that you don't overdo it, and be sure to avoid working on areas of the body that are recovering from injury. This applies to massage not only right before an event or exercise but even a day or two prior to an event requiring maximum performance.

Cool-down massage

Performance massage is beneficial after athletic competition, artistic performance, or a challenging workout. It promotes a general state of relaxation, helps reduce lingering muscle tension, and can help eliminate subsequent muscular soreness. It will also help the muscles recover more quickly from fatigue. The length of recovery time from exertion can also be significantly reduced with a good post event session.

After exercise the muscles are in a state of congestion and fatigue, particularly following maximum exertion. The tissues and muscles are filled with metabolic wastes, and circulatory assistance is needed for the elimination of these wastes. Therefore the circulatory techniques of compression, flushing, and energy movements will be particularly effective in restoring balance and equilibrium.

When applying massage after exertion, be attentive to the tone and sensitivity of the recipient's muscles, which may differ greatly from their previous session. Be sure that your pressure does not cause any pain, and be aware that some muscles may be unduly sensitive to your touch. So gauge your pressure accordingly, and massage gradually, with the intent of loosening and decongesting the musculature.

Try to have water available for the recipient immediately after exercising. This will prevent dehydration, which can be extremely harmful. If for any reason you feel the recipient may have been injured or exceeded training and workout limitations, it is advisable to refer to a primary health care provider such as an athletic trainer, a dance coach, or a sports medicine specialist.

Here are symptoms of hyperthermia (excessive body temperature):

• excessive sweating,
• shivering or chilling,
• dry skin,
• nausea,
• a throbbing pressure in the head,
• an unsteady gait,
• lack of focus,
• extreme fatigue,
• excessive cramping.

If you observe any of these symptoms, have the recipient lie down, give fluids, and seek medical help. Do not apply massage, because this could add to unsteadiness, nausea, or fatigue.

During cold weather, have the recipient take a warm shower and thoroughly loosen and relax the body before you administer massage. Provided it is dry, sweat clothing should be kept on to prevent chilling or unnecessary stiffening of the muscles.

Keep your cool-down massage to 20 minutes or less. Keep your session balanced, but if there is an area of tension or stiffness, you may wish to devote extra attention to these problem areas. You can do this by applying compression variations and gentle muscle stretching.

Keep in mind that massage may be an important motivating factor for obtaining a new level of fitness or performance. Both physically and psychologically, the massage experience should be harmonious with maximum performance.

Remember these guidelines as you prepare for a cool-down performance massage:

• Be temperature-conscious in regard to overheating and chilling.
• Have water available.
• Realize that the recipient may be physically or emotionally exhausted, and keep your pressure light.
• Do not massage if symptoms of hyperthermia are present.

A benefit of massage after exercise is that it promotes relaxation from the strains and overuse that often occur with physical exertion. The recipient will feel better physically and psychologically. You can also help reduce those nagging aches and pains that often lead to major injuries.

Techniques of performance massage

Rocking

Rocking is a good way to start the session. Rhythmic rocking relaxes the individual while introducing gentle motion to the body. It is primarily used with the recipient in the prone position.
Place your hands on the back with your fingertips pointing away from you. Start by exerting a forward pressure with the heels of your hands, moving the body slightly away from you. Follow this with a pulling motion with your fingertips to return the body to its original position.
By slightly changing the position of your hands as you start a gentle back-and-forth movement, you will become familiar with the contours of the body. Be sensitive to the body's own natural rhythm, and keep the pace of your rocking in harmony with it.

Shaking

Shaking the arms and legs while exerting a gentle traction will help the recipient "let go." As the connective tissue is stretched, your partner will feel a sense of weightlessness in the limbs, which will help him or her relax.
To shake the legs, stand at the foot of the table, wrap the palm of your hand around the top of the foot while stabilizing the heel with your other hand. This grip will enable you to mobilize the leg without putting any pressure on the ankle.
While maintaining this grip, you can perform a limb pull by exerting a gentle traction on the leg, bending your knees, and leaning slightly backward. Combine the leg pull with a light shaking or bouncing, keeping in mind that the motion should come from the hip and not just the lower leg.
To shake the arms, stand at the side of the table, grasp the hand by placing both of your thumbs on the top of the hand and your fingers on the palm of the hand. Keep your grip well below the wrist so that the hand will not flop when you shake the arm.
As with the leg, perform a limb pull on the arm by exerting a gentle traction, bending your knees, and leaning slightly backward. Change your position slightly as you shake or bounce the arm to get mobility in the shoulder joint.

Abdominal sandwich

Stand perpendicular to your partner who is lying supine on the table. Place one hand under the lumbar curve of the lower back just above the sacrum and your other hand on the lower abdominal muscles just below the navel. Ask your partner to raise your top hand by slowly breathing into it. This technique allows for a three-dimensional diaphragmatic breath, which is relaxing and calming before exertion.

Other alternative therapies

• Acupressure
• Acupuncture
• Alexander Technique
• Ayurveda
• Biofeedback
• Chelation Therapy
• Hydrotherapy
• Kinesiology
• Magnetic Therapy
• Massage
• Meditation
• Naturopathy
• Reflexology
• Shiatsu
• Yoga