There are a huge number of massage or soft tissue mobilization (STM) techniques offering a variety of therapeutic option. Many are discussed in detail in our texts Muscle Manual or Physical Medicine (below are some videos showing the more common techniques)
Uses, Indications & Effects of Massage Therapy
A USE is the purpose of the technique(s) that is employed for a given situation or condition in which this known physiological response would be most beneficial. For example, if we know that effleurage increases blood flow to an area, it would be appropriate if we applied or “used” effleurage when a patient presents with a condition of poor or sluggish circulation.
An INDICATION is the condition that dictates the appropriate technique(s) to be employed. For example, if a patient presents with a condition of inefficient circulation, effleurage would be indicated to increase local blood flow.
An EFFECT is primarily the physiological response to a technique(s). For example, effleurage (the stimulus) increases blood flow through an area (the physiological response).
Mechanical effects are those that result from a direct physical stimulus such as pressure or movement. Example: compression causes a draining & refilling of vascular vessels
Reflex effects are those that result from a neurological response to a mechanical stimulus. Example: relaxation of muscle tissue is a result of a neural response
Chemical effects are those that result from a chemical response to a mechanical stimulus. Example: deep pressure on the skin causes a release of histamine, which in turn, causes an increase in capillary permeability & local blood flow. (If you run your nail down your forearm the skin will turn red.)
Contraindications
Contraindications (CIs) exist when certain therapeutic techniques are NOT indicated for a given condition or situation. When a physical medicine modality is contraindicated, a clinician must modify or omit the type of treatment given. Common sense should be applied in the treatment of all conditions. The value of the treatment must be considered with respect to the risk to the patient & to the clinician. Contraindications guidelines exist to protect the patient from further exacerbation of a condition & to help avoid legal action being taken against the clinician.
If a practitioner is in doubt as to whether a condition or situation is contraindicated, it is best to omit the involved area or the treatment altogether until you are sure you can safely treat the patient. As clinicians gain experience & knowledge in clinical sciences & pathologies, some of the absolute contraindications may become relative contraindications.
Types of contraindications
General or systemic contraindication exists when the situation or condition affects the whole body
Local contraindication is when the situation or condition affects a particular region or body part
Absolute contraindication: pathological conditions or symptoms that cannot be treated under any circumstances. Absolute contraindications can be systemic or local.
Relative contraindication: pathological conditions or symptoms that are generally less acute or in a state of remission may be treated with caution and/or modification of technique(s). Relative contraindications can be systemic or local.
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Systemic (General) Contraindications |
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Absolute |
Relative |
| Contagious infections
Temperature of two or more degrees above normal (99°F/37°C) Severe, active cardiovascular disease (arteriosclerosis, congestive heart failure, high blood pressure (160/115) Cancer (if metastatic)Acute inflammatory disease (RA) Any condition that requires immediate first aid or medical attention (fracture) Patient under influence of alcohol/drugs (decreased mental function) |
A mildly contagious infection
Temperature of less than two degrees above normal (99°F/37°C) History of cardiovascular diseases Cancer if in remission or terminal (palliative care may be approved by attending physician) Rheumatoid arthritis if in remission or managed by medication Neurologic conditions that alter a patient’s perception of touch or pain (quadriplegic, multiple sclerosis) Medication that alters pain perception or circulatory responses |
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Local Contraindications |
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Absolute |
Relative |
| Undiagnosed lump (possibly cancerous)
Infectious & contagious diseases of the skin Recent wounds, burns &/or scars Severe varicose veins (elevated & painful) Thrombosis (blood clot within vascular system)Phlebitis (inflammation of a vein) Abdominal Massage: high blood pressure (160/115); acute colitis; diarrhea, nausea &/or vomiting, undiagnosed or malignant tumor |
Benign tumor/cyst – dependent on condition
Sprain/fracture – modify treatment Healing wounds, burns, scars Visible but not elevated or painful varicose veins Muscle contusion (depends on stage of healing) Abdominal Massage: high blood pressure; chronic colitis; abdominal hernia; benign tumor/cyst; dysmenorrhea (difficult or painful menstruation); 2nd/3rd Trimester (placenta previa) |
Reference: Vizniak, NA. Muscle Manual or Physical Medicine. Professional Health Systems Inc. 2015
Explore Massage Technique Videos
Click here for our youtube playlist (40+ techniques)
Effleurage, Swedish, petrissage, kneading, jostling, rolling, shearing, skin rolling, picking up, light and deep stroking, percussion (digital & ulnar)