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Williams Massage Mastery: From Student to Professional Lesson Plans Chapter 13—Swedish Massage Techniques Goals of the Lesson: Cognitive: Students will understand the principles and applications of the six Swedish massage techniques. Motor: Students will be able to be able to perform the six Swedish massage techniques. Affective: Students will empathize with the client’s desire for a smooth and enjoyable massage experience. Learning Objectives: The lesson plan for each objective starts on the page shown below. 13-1 List two physiological effects from each of the six Swedish massage techniques described. ..................................... 13-2 Compare and contrast the effects of a friction stroke applied briskly and lightly with those of a friction stroke applied with slow, moderate pressure ............................................................................................................... 13-3 Explain the different effects of applying an effleurage stroke in different directions: away from the heart and toward the heart .................................................................................................................................................... 13-4 Briefly explain the effect of petrissage on Golgi tendon organs .................................................................................. 13-5 Briefly explain the effect of friction on adhesions ....................................................................................................... 13-6 Compare and contrast active, passive, and resisted range-of-motion techniques ........................................................ 13-7 Describe the effects of subtle factors such as rhythm, depth, and pacing on the client’s massage experience ............ Legend: SG: Study Guide; PPt: PowerPoint You Will Need: Gather the following materials and teaching aids for the following lessons: 13-1, 13-2, 13-6 Massage table, sheets Page 1 Copyright © 2013 Wolters Kluwer | Lippincott Williams & Wilkins Selected Key Terms Effleurage End feel Friction Joint movements Joint play Petrissage Range of motion Routines Sequencing Synovial joints Tapotement Vibration Williams Massage Mastery: From Student to Professional Chapter 13—Swedish Massage Techniques Objective 13-1 List two physiological effects from each of the six Swedish massage techniques described. Date: Lecture Outline Content Effleurage Term is from the French verb meaning “to skim” or “to touch lightly” Long, gliding stroke delivered with light, medium, or sometimes deep pressure Usually follows in the direction of the muscle fibers Usually toward the heart Main uses Applying lubricant Warming tissue Supporting venous return Activating the parasympathetic nervous system response Transition between strokes Text page 372403 PPt slide Topic 13-1: 2-10; Topic 13-2: 2-10; Topic 13-3: 2-10; Topic 13-4: 2-10; Topic 13-5: 2-10; Topic 13-6: 2-10 Figures, Tables, and Features Figures 13-1: Muscle spindles are a type of sensory receptor found in muscle tissue. These with primary endings monitor slow and fast changes in muscle length and deep pressure. When a muscle is stretched, the muscle spindle is also stretched and sends a signal causing the muscle to contract. Very rapid vibration can stimulate muscle spindles to cause muscle contractions that tone the muscle. p. 381 Term is from the French verb for “to knead” In-Class Activities Demonstrate, and allow students to practice, the following techniques: Technique 18: Effleurage pp. 373-374 Technique 19: Petrissage pp. 376-377 Technique 20: Friction pp. 379-380 Technique 21: Vibration pp. 382-383 13-2: Mind map: joint movements. p. 386 Technique 22: Tapotement pp. 384-385 Petrissage Resources and In-Class Activities 13-3: Structure of a synovial joint. Joint Page 2 Copyright © 2013 Wolters Kluwer | Lippincott Williams & Wilkins Joint movements are Outside Assignments Evaluation Outside Assignments As a research assignment that will be graded, have students summarize the history of Swedish massage in two pages. Instructor’s Notes Williams Massage Mastery: From Student to Professional Chapter 13—Swedish Massage Techniques Rhythmic stroke that lifts muscles off the bone and other muscles, compresses it between the fingers, and rolls the muscle fibers as the muscle falls back into position Often used after effleurage strokes have warmed the muscle tissue Main uses movement techniques focus predominantly on synovial joints, which are feely movable (diathrosis) joints where the bones do not touch each other. The ends of the bones are covered with an elastic, porous connective tissue called hyaline cartilage (or articular cartilage), which creates a smooth gliding surface for synovial articulations. Stimulates circulation in the muscles Increases soft-tissue pliability p. 387 Breaks up adhesions Tables Friction Term is from the Latin word “frictio,” which means to rub Heat-producing, chafing stroke Applied either with light, brisk strokes (superficial friction) or with depth (circular, linear, or crossfiber friction) Traditionally used after petrissage, and with little or no lubricant Main uses Heats tissue Breaks up adhesions Reorganizes collagen 13-1: Conditions, Contraindications, and Cautions for Joint Movement Techniques p. 389 13-2: Selected Joints That Might Be Moved during a Swedish Massage pp. 390-394 13-3: Overview of Swedish Massage Techniques p. 402 13-4: Overview of Swedish Page 3 Copyright © 2013 Wolters Kluwer | Lippincott Williams & Wilkins covered in Objective 13-6. Williams Massage Mastery: From Student to Professional Chapter 13—Swedish Massage Techniques fibers into parallel patterns for greater ROM Massage Considerations p. 403 Vibration Term comes from the Latin word for “to shake” Pulsating, tremor-like or oscillating stroke Concept Briefs 13-1: Effleurage Stimulates or relaxes the body area or the whole body p. 373 Often used only in short bursts to a particular area, because it can be tiring for the therapist 13-2: Petrissage Main uses 13-3: Friction Stimulates the nervous system p. 378 Numbs the local area 13-4: Vibration Loosens muscles p. 381 Stimulates peristalsis Tapotement p. 376 13-5: Tapotement Term comes from the Old French for “a light blow” Rapid, rhythmic percussion stroke Uses the hands in various formations to drum on the client Main uses 13-7: ROM and End Feel Promotes circulation p. 390 Increases muscle tone Stimulates the nervous p. 383 13-6: Joint Structure and Function p. 388 13-8: Types of Joint Page 4 Copyright © 2013 Wolters Kluwer | Lippincott Williams & Wilkins Williams Massage Mastery: From Student to Professional Chapter 13—Swedish Massage Techniques system Movement Methods Loosens mucus for easier expulsion p. 400 Joint movements Involve brain, nerves, muscles, bones As part of Swedish massage, joint movement techniques are meant to improve joint flexibility. Originally called “gymnastics” Also known as range-ofmotion (ROM) techniques Joint structure Fibrous, cartilaginous, or synovial Immovable (synarthrosis), slightly movable (amphiarthrosis), or feely movable (diarthrosis) Pathological restrictions can limit a joint’s ROM There are many contraindications and cautions for using joint movement techniques Methods Active joint movements Active-assisted joint movements Page 5 Copyright © 2013 Wolters Kluwer | Lippincott Williams & Wilkins Williams Massage Mastery: From Student to Professional Chapter 13—Swedish Massage Techniques Active-resisted joint movements Passive joint movements Passive stretches Legend: SG: Study Guide; PPt: PowerPoint Page 6 Copyright © 2013 Wolters Kluwer | Lippincott Williams & Wilkins Williams Massage Mastery: From Student to Professional Chapter 13—Swedish Massage Techniques Objective 13-2 Compare and contrast the effects of a friction stroke applied briskly and lightly with those of a friction stroke applied with slow, moderate pressure. Date: Lecture Outline Content Brisk and light friction stroke Heats local tissue Increases circulation and lymph flow to local tissue Text page PPt slide 376378 Topic 13-3: 2-7 Figures, Tables, and Features Concept Briefs 13-3: Friction p. 378 Deep friction Applied with slow, moderate pressure Addresses connective tissue Applied parallel to muscle fibers, stretches and broadens miofascia, leading to better flexibility and muscular balance Transverse friction is applied across muscle fibers, to break up adhesions or scar tissue. Cyriax cross-fiber friction is an advanced technique. Legend: SG: Study Guide; PPt: PowerPoint Page 7 Copyright © 2013 Wolters Kluwer | Lippincott Williams & Wilkins Resources and In-Class Activities In-Class Activities Demonstrate the different ways to apply a friction stroke, following Technique 20: Friction, pp. 379-380. Outside Assignments Evaluation Instructor’s Notes Williams Massage Mastery: From Student to Professional Chapter 13—Swedish Massage Techniques Objective 13-3 Explain the different effects of applying an effleurage stroke in different directions: away from the heart and toward the heart. Date: Lecture Outline Content Applying an effleurage stroke toward the heart Most common method Assists venous return Enhances blood and lymph circulation Text page 372374 PPt slide Topic 13-1: 2 Figures, Tables, and Features Concept Briefs Used in Ayurveda Reenergizes the limbs Strokes should be applied lightly, to avoid damaging one-way valves contained in superficial veins. In-Class Activities 13-1: Effleurage Discussion p. 373 Why does Ayurvedic medicine apply effleurage strokes from proximal to distal? Applying an effleurage stroke away from the heart Resources and In-Class Activities Legend: SG: Study Guide; PPt: PowerPoint Page 8 Copyright © 2013 Wolters Kluwer | Lippincott Williams & Wilkins Outside Assignments Evaluation Evaluation Have students answer the short-answer question for topic 13-1 from the Study Guide: “Explain why effleurage is often the first stroke applied to a body area.” SG p. 5 Instructor’s Notes Williams Massage Mastery: From Student to Professional Chapter 13—Swedish Massage Techniques Objective 13-4 Briefly explain the effect of petrissage on Golgi tendon organs. Date: Lecture Outline Content Golgi tendon organs prevent muscle contractions from damaging tendons. Text page PPt slide Figures, Tables, and Features 375 When a Golgi tendon organ senses that a muscle contraction is excessive (as when lifting something that is too heavy), so that a muscle strain or tear is at hand, the organ signals to cause an instant reduction in muscle tension. According to current research, tiny muscle tension changes, like those caused by petrissage, activate Golgi tendon organs. The Golgi tendon organs then send signals through the nervous system to relax the muscle. Legend: SG: Study Guide; PPt: PowerPoint Page 9 Copyright © 2013 Wolters Kluwer | Lippincott Williams & Wilkins Resources and In-Class Activities In-Class Activities Discussion Why do we want to activate Golgi tendon organs with massage techniques like petrissage? (Answer: To relax the muscles) Outside Assignments Evaluation Instructor’s Notes Williams Massage Mastery: From Student to Professional Chapter 13—Swedish Massage Techniques Objective 13-5 Briefly explain the effect of friction on adhesions. Date: Lecture Outline Content Adhesions Feel like stuck tissue glued together Sometimes feel like obvious knots of bound-up tissue that the client may report as numb Can be assessed and addressed during application of friction strokes Text page 378 PPt slide Topic 13-3: 9-10 Figures, Tables, and Features Concept Briefs 13-3: Friction p. 378 Friction is used to break up adhesions Legend: SG: Study Guide; PPt: PowerPoint Page 10 Copyright © 2013 Wolters Kluwer | Lippincott Williams & Wilkins Resources and In-Class Activities In-Class Activities Share your experience with the feel of adhesions. The first paragraph under “Application of Friction” (p. 378) gives examples. Outside Assignments Evaluation Instructor’s Notes Williams Massage Mastery: From Student to Professional Chapter 13—Swedish Massage Techniques Objective 13-6 Compare and contrast active, passive, and resisted range-of-motion techniques. Date: Lecture Outline Content Active ROM techniques Text page PPt slide 390401 Topic 13-6: 10 Figures, Tables, and Features Tables In active ROM techniques, the client does the movement Active-assisted ROM 13-2: Selected Joints That Might Be Moved during a Swedish Massage pp. 390-394 Client starts movement and therapist helps finish Active-resisted ROM Therapist resists client’s movement, in order to build strength Passive ROM techniques Therapist moves the client Passive stretches Concept Briefs 13-8: Types of Joint Movement Methods p. 400 Therapist moves joint slightly past firm end feel Resources and In-Class Activities In-Class Activities Demonstrate, and give students the opportunity to practice, the following techniques: Technique 23: Active Joint Movements Paired With Massage pp. 395-396 Technique 24: ActiveAssisted Joint Movements pp. 396 Technique 25: ActiveResisted Joint Movements p. 397 Technique 26: Passive Joint Movement Techniques pp. 398-400 Page 11 Copyright © 2013 Wolters Kluwer | Lippincott Williams & Wilkins Outside Assignments Evaluation Outside Assignments Assign the short-answer question for topic 13-6 from the Study Guide. SG p. 7 Assign the case study for topic 13-6 from the Study Guide. SG p. 8 Instructor’s Notes Williams Massage Mastery: From Student to Professional Chapter 13—Swedish Massage Techniques Technique 27: Passive Stretches p. 401 Legend: SG: Study Guide; PPt: PowerPoint Page 12 Copyright © 2013 Wolters Kluwer | Lippincott Williams & Wilkins Williams Massage Mastery: From Student to Professional Chapter 13—Swedish Massage Techniques Objective 13-7 Describe the effects of subtle factors such as rhythm, depth, and pacing on the client’s massage experience. Date: Lecture Outline Content Once core skills are mastered, you can consider subtle factors. Therapist’s intention Use centering and grounding to calm your energy and focus your mind before a session Have everything ready for a session before the client undresses Maintain appropriate professional boundaries Be “present in the moment” Text page PPt slide 408412 Topic 13-7: 9-10 Figures, Tables, and Features Contact The quality of your touch is important. Warm, soft, dry, open, confident hands are good. Cool, damp, uncertain hands are not. Once you have established contact, avoid disrupting it. Page 13 Copyright © 2013 Wolters Kluwer | Lippincott Williams & Wilkins Resources and In-Class Activities Resources Chapter 11 describes the importance of centering and grounding before the start of a massage session. In-Class Activities Review the subtle factors that influence the massage experience. PPt Topic 13-7: 9-10 Discuss the importance of setting the therapist’s intention before a session, and of continuous contact during the session. Outside Assignments Evaluation Instructor’s Notes Williams Massage Mastery: From Student to Professional Chapter 13—Swedish Massage Techniques Use of lubricant Use in moderation With one hand turned over palm side up touching the client, pour lubricant into your palm and warm it by rubbing your other hand across it. Do not break contact with the client. Pacing and leading People have their individual pace or personal “rhythm.” Affects how fast they move, react, talk, etc. Match the first part of the massage to the client. As the massage progresses, “lead” the client into a more relaxing pace. Depth Superficial massage is sometimes called “fluff and buff.” Most clients do want the therapist to sink into the tissue and address problems. Rhythm A lot like dancing Page 14 Copyright © 2013 Wolters Kluwer | Lippincott Williams & Wilkins Williams Massage Mastery: From Student to Professional Chapter 13—Swedish Massage Techniques Strokes can be applied in a regular pattern at a regular pace or tempo. Clients relax to the rhythm. Use music to set the pace. Flow and continuity From one technique to another From one body area to another Should be one uninterrupted action Stroke length Long strokes tie body areas together. Cutting a stroke short leaves the client feeling oddly frustrated. These factors greatly affect the client’s massage experience. Legend: SG: Study Guide; PPt: PowerPoint Page 15 Copyright © 2013 Wolters Kluwer | Lippincott Williams & Wilkins