Application of mechanical forces during massage. A, Compression. B, Tension. C, Bending. D,
Shear. E, Torsion. F, Combined loading: compression + tension. G, Combined loading:
tension + bend + torsion. H, Combined loading: compression + bend + torsion.
From Fritz: Clinical Massage in the Healthcare
In this second post in the series about Advanced Massage we will explore what
massage methods do to the body tissues.
At the foundational base massage introduces mechanical forces into the
tissues and then the body needs to figure out how to respond to the force . All massage methods regardless of name can be
described by the mechanical forces introduced and how the application is
modified by when it is applied, how long, what speed, what direction, the depth
of pressure, etc. I suggest you get some
modeling clay and observe what occurs when you apply the mechanical
forces. Does the clay get warmer, colder, stretchy, longer, shorter, etc.
Actions that involve pushing, pulling, friction, or sudden
loading (e.g., a direct blow) are examples of mechanical force. Mechanical
forces can act on the body in a variety of ways. The different types of
mechanical force and the ways they are applied therapeutically are important
aspects of massage.
The five kinds of force that can affect body tissues are
compression, tension, bending, shear, and torsion. Not all tissue is affected
the same way by each type of force. We will look at each of the five types of
force, the different ways they can cause tissue injuries, and the ways they
produce important therapeutic benefits when applied by a skilled massage
practitioner.
Compression
Compressive forces occur when two structures are pressed
together. Compressive force is a component of massage application and is
described as depth of pressure. This kind of force may be sudden and strong, as
with a direct blow (percussion), or it may be slow and gradual, as with gliding
strokes. The magnitude and duration of the force are important in determining
the outcome of the application of compression .
Some tissues are quite resilient to compressive forces, and
others are more susceptible. Nerve tissue is an interesting example. Nerve
tissue can withstand a moderately strong compressive force if the force does
not last long (e.g., a sudden blow to the back of your elbow that hits your
“funny bone”). However, even slight force applied for a long time, as occurs
with carpal tunnel syndrome, can cause severe nerve damage. The practitioner
must take this into account when determining the duration of a massage
application that involves compression over nerves. Compressive force should not
be maintained on a specific area for extended periods during massage.
Generally, a compressive force need not be sustained for longer than 15 seconds
to achieve results.
Ligaments and tendons are quite sturdy and resistant to
strong compressive loads. Muscle tissue, on the other hand, with its extensive
vascular structure, is not as resistant to compressive forces. Excess
compressive force can rupture or tear muscle tissue, causing bruising and
connective tissue damage. This is a concern when pressure is applied to deeper
layers of tissue. To prevent tissue damage, the practitioner must distribute
the compressive force of massage over a broad contact area on the body; the
more compressive force used, the broader the base of contact with the tissue.
Compressive force is used therapeutically to affect circulation,
sensory and autonomic nerve stimulation, nerve chemicals, and connective tissue
pliability.
Tension
Tension forces (also called tensile forces) occur when two
ends of a structure are pulled in opposite directions. This is different from
muscle tension. Muscle tension is created by excess muscular contraction, which
results from an increase in motor tone or an increase in tissue density caused
by fluid accumulation and connective tissue changes (muscle tone). Muscles that
are long as a result of being pulled apart are affected by tensile force.
Certain tissues, such as bone, are highly resistant to tensile forces. An
extreme amount of force is required to break or damage a bone by pulling its
two ends apart. Soft tissues, on the other hand, are very susceptible to
tension injuries. In fact, tensile stress injuries are the most common soft
tissue injuries. Such injuries include muscle strains, ligament sprains,
tendinitis, fascial pulling or tearing, and nerve traction injuries (i.e.,
sudden stretching of nerves, such as occurs in whiplash).
Tension force is used during massage with applications that
drag, glide, lengthen, and stretch tissue to elongate connective tissues and
lengthen short muscles .
Bending
Bending forces are a combination of compression and tension.
One side of a structure is exposed to compressive forces as the other side is
exposed to tensile forces. Bending occurs during many massage applications.
Force is applied across the fiber or across the direction of the muscles,
tendons or ligaments, and fascial sheaths. Bending forces rarely damage soft
tissues; however, they are a common cause of bone fractures. Bending force is
very effective in increasing connective tissue pliability and affecting
proprioceptors in the tendons and belly of muscles.
Shear
Shear is a sliding force, and significant friction often is
created between the structures that slide against each other. The massage
method of friction uses shear forces to generate physiologic change by
increasing connective tissue pliability and creating therapeutic inflammation.
However, excess friction (shearing force) may produce an inflammatory
irritation that causes many soft tissue problems .
Torsion
Torsion forces are best understood as twisting forces.
Massage methods that use kneading introduce torsion forces and target
connective tissue changes and fluid movement.
Application of torsion force to a single soft tissue
structure is not very common and is rarely the cause of significant tissue
injury. Torsion force applied to a group of structures (e.g., a joint) is much
more likely to be the cause of significant injury. For example, when the foot
is on the floor and the individual turns the body, the knee as a whole is
exposed to significant torsion force .
Massage Manipulations and Techniques (Mode of Application)
The methods of massage introduce one or a combination of the
five types of mechanical force into the body to achieve a therapeutic benefit .
As mentioned, this process is influenced
by the quality of touch, depth of pressure, drag, duration, speed, rhythm, and
frequency. Appropriate use of mechanical force is necessary. If insufficient
force or the wrong type of mechanical force is used, the application will not
be effective; conversely, excessive or inappropriate use of force can damage
tissues.
The variety of massage and bodywork modalities in the profession
can be clarified by describing what is
done during the application, using qualities of touch, mechanical forces, and
mode of application. For example, the method called active release is
compression applied by the massage therapist and tension force that occurs as the
client moves the area.
A trained massage therapist should be able to modify the
massage application from surface to deep, fast to slow, and long to short, as
appropriate, based on the client's individual needs. The intention and outcome
of the massage application appropriately influence fluid movement, nervous
system function, musculoskeletal function, and connective tissue pliability in
both acute and chronic conditions. Our attention to the client is based on an
intent to serve our clients in a focused and compassionate manner.
Advanced massage is skillful use of the basics.
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