Massage Styles: Shiatsu

Welcome to post #7 in my series of different types of massages. If you have a specific style you'd like to see covered or have a question about any style I cover, feel free to leave a comment and I will address it for you!

As I've been teaching a Shiatsu class at the local massage school where I work, it's naturally been on my mind a lot lately. Shiatsu (which literally translates to "finger pressure") is a holistic method of health care dating back thousands of years. It involves pressure and strokes applied to Oriental acupoints to balance the body's energy or chi, which promotes self-healing. It's a blend of traditional Chinese medicine and massotherapy (or massage therapy) that was brought to Japan from China in the year 552 A.D.

The basis for this massage lies in Traditional Chinese Medicine and meridians, or energy pathways, that link up and nourish the body's vital organs. Energy flow, just like blood flow, can become restricted, causing imbalances both physically and mentally. Shiatsu helps to rejuvenate this energy flow by massaging along the meridians and spending extra time on areas that feel tight, hot, or irritated as this indicates an energy blockage. It is traditionally done on a mat on the floor, with the client fully clothed. It can be very relaxing due to the constant rhythm of the practitioner's movements. 

Being such an ancient modality, naturally many different styles of Shiatsu have been developed. Some examples include Zen Shiatsu, which incorporates stretches and movement, Watsu, which is done in a pool to create a weightless sensation, and Ashiatsu, which is done with the feet as the practitioner supports themselves with overhead bars (see below picture) and many more styles.

 Whether you believe in energy work or just like to have your knots worked out, Shiatsu is a fun alternative to a traditional massage that leaves you feeling de-stressed, energized, and maybe even a few years younger!

Not gone, just working hard!

Ok, I'll admit that I lost my focus there for a while, but now I'm back on track and ready to go! I've been collaborating with my brother, creator of Unshoes Minimal Footwear, on a special blog post tailored for minimalist and barefoot runners. Check back soon for details!

Massage Styles: Russian Massage - Part 2

Welcome to part 2 of my post on Russian Sports massage, getting more into theory and technique.  As I mentioned in Part 1, Russian massage is a system of specialized and highly developed massage strokes that each have a specific purpose in affecting the central nervous system, skin, muscles, joints, and tendons and ligaments.

In this massage, the body is worked in segments. For instance, the back is worked separately on the left or right side, then the other side. The arms are worked from the forearm first, then the upper arm, and legs are worked from the lower leg, upper leg, then glutes (buttocks). All strokes are done on one segment before moving on to the next, and strokes usually begin at one joint and end at the next without crossing over.

Most of the strokes used are similar to Swedish massage, with one addition and with specific hand positions depending on what segment is being worked on (for instance, the back, the legs, the arms, and on the sides between ribs all have different hand placements). Read on to find a list of each stroke, its purpose, how it affects the body, and what makes it different from its Swedish counterpart.

• Effleurage- This stroke is generally the first stroke to be used on a body segment. It is a slow and light stroke always done toward the heart that prepares the muscles for the rest of the strokes and allows the therapist to spread their lotion/oil. 
• It is meant as a sedative (relaxing) stroke and does this by reducing the activity of the Central Nervous System (CNS). Since it is so light, it is only meant to affect the skin and very superficial blood vessels.
• Swedish effleurage is also meant to be sedating as well as to make connecting strokes that can be done all the way from the ankle to the hips, or from the wrist to the upper back, and the pressure can vary from light to firm.
• This stroke can be stimulating by increasing or varying the speed and pressure.

• Wringing- Similar to but deeper than effleurage, this gliding (glides across the skin) stroke is very slow and works superficial to deep muscles. The therapist should go as deep as they are able without causing pain.
• This stroke is stimulating to the CNS which increases muscle tone and reduces fatigue. It reduces swelling by moving blood and lymph fluid and decreases pain associated with swelling.
• This is not considered as one of the basic strokes in Swedish massage. Instead, it is grouped with effleurage. 
• If done long enough with constant speed and pressure, this stroke can become sedating.

• Petrissage- This is a non-gliding stroke that uses pulling and pressing to work on muscles. The majority of the massage will be using this stroke.
•  Stimulating to the CNS and works on the muscle to increase blood flow, size/strength/stamina of muscle, and decreases fatigue. The therapist uses light to medium pressure for pulling strokes and medium to deep pressure for pressing strokes.
• This stroke is exactly the same as the Swedish version except for the hand positions and a slightly faster speed.
• If constant speed and pressure are used, this stroke can become sedating.

• Friction- A gliding stroke that folds and stretches skin and soft tissue in different directions (think of a nicer version of an "Indian rug burn".)
• The only stroke that goes in all different directions instead of toward the heart only, this sedative stroke creates a lot of heat by increasing blood flow which speeds up metabolism. It also increases joint strength and flexibility of skin, muscles, tendons and ligaments while decreasing chronic pain, scar tissue, and muscle spasm.
• The only difference between Russian friction and Swedish friction are hand positions and that Swedish friction can be both gliding and non-gliding; Russian friction is always gliding.
• It's difficult to make this stroke stimulating. Usually it's done by combining friction with other strokes.

• Vibration- At 200-300 movements per minute, this is the fastest stroke that performs fine or course rhythmic movements (either horizontal or vertical) of a muscle, muscle group, or body segment.
• Vibration is mainly a rehabilitative stroke. It's sedative to the nervous system but stimulating to the muscular system by creating very fast contraction and relaxation of the muscles to help repair strains (muscle tears). It helps rebuild muscle reflexes, can affect internal organs if done long enough, and can even increase the production of bone calluses to speed up the healing process of a broken bone (read more about bone healing here.)
• Swedish vibration is usually done for a shorter time than Russian vibration and the movements are not as fast or constant, making it more stimulating whereas the Russian style is meant to be sedative. Russian vibration should also always be manual, not mechanical.
• See above.

• Percussion- Similar to vibration in making fast movements to the body, but the difference is that there is not constant contact with the body. Instead, it makes tapping or striking movements.
• This stroke is usually very stimulating to the nervous system. It increases muscle and skin tone, nerve signal strength, and blood flow. When used with wringing, it is very effective in regaining muscle strength after disuse from an injury.
• The same as a Swedish style massage except for hand placements.
• This stroke is easy to make sedating when constant speed and pressure are used, and the only stroke that is often meant to be used as both stimulating and sedating.

• Joint Movements- Joint movements are done to measure the range of motion in joints before and after a massage. 
• If a joint is not moving enough, the therapist can focus on flexibility in that area to increase performance.
• If a joint is moving too much, the therapist can focus on muscle tone and strength to prevent injury.
• Joint movements can be done when recovering from injury to prevent stiffness and loss of movement.

 After reading about all of these strokes, you can see how a Russian massage can accomplish many different goals. If a client wants a relaxing massage, the therapist will usually follow the same order of strokes as they are listed and make them mostly sedating strokes. If a client wants increased energy for their day or an upcoming sporting event, the therapist can modify the strokes to be stimulating.

I will typically give people a relaxing Russian massage and do very stimulating strokes for the last few minutes so my clients will be relaxed during the massage but feel refreshed afterwords so they don't go about their day feeling half-asleep. This massage is fun to give, versatile in the effects it causes and the people it can help, and has so much fascinating scientific research and history behind it. I hope everyone reading has to opportunity to receive it and fall in love with it like I have!

Massage Styles: Russian Massage - Part 1

Welcome to post #6 in my series of different types of massages. If you have a specific style you'd like to see covered or have a question about any style I cover, feel free to leave a comment and I will address it for you!

Since Russian massage is what I consider to be my main specialty, I feel that I would like to present more in-depth information on it - history as well as a description of how it works. In part 1 I'd like to recap the details of how Russian massage developed. I find it to be quite fascinating in conjunction with the history of Russia itself. I hope you do as well!

Russian massage is a series of specialized and highly developed massage strokes that have been researched and used in Russia as early as the 1800s. Massage was first used at the Navy Medical Academy in St. Petersburg for the recovery of warfare wounds and has since become mandatory training for physicians and nurses to aid their patients.

Not until 1882 did a Russian physician named Zabludovsky even start using massage on healthy people to prevent them from being patients. At the time, everyone thought it was a silly idea that massage should be used on people who are not sick. Zabludovsky was ostracized and moved to Germany to do more studies on the effects of massage. After combining sports massage with regular massage, he created the title of "Russian Massage."

In the early 1900s, Russia started integrating massage into their medical schools and began a lot of research on massage. In 1944, the Research Institute of Physical Education started to develop new strokes and specific protocols based on this research that were designed to give very specific results with muscle rehabilitation. This research enabled therapists to know exactly what the affects and outcome of a massage would be.

Massage is now considered a scientific practice in Russia and is required for every coach, physician, nurse, trainer, and physiotherapist (physical therapist) as part of their training and has been integrated into the medical field, working hand-in-hand with traditional medicine.

Massage Styles: Sports Massage

Welcome to post #5 in my series of different types of massages. If you have a specific style you'd like to see covered or have a question about any style I cover, feel free to leave a comment and I will address it for you!


When the term 'Sports Massage' is heard, people think of a very technical form of bodywork saved for elite athletes or Olympians. That's not entirely true- by definition Sports massage is the science of applying soft tissue manipulation to increase athletic performance and speed the recovery process from injury, so you can see it's not just for professional athletes.

A History
Although forms of massage and bodywork have been around for over 5,000 years, recordings have shown athletes in the first Olympics in Greece using bodywork to help them prepare for- and recover from- events. Sports massage gained popularity in America after the 1972 Summer Olympics in Munich. A Finnish runner named Lasse Viren (the 'Flying Finn') set a world record time in the 10k and it was discovered that he received daily massages to help his performance. Runners in the U.S. were immediately interested in using Sports massage in their own training, and pretty soon massage became a part of Olympic teams, professional and college teams, and many other marathons and sporting events.

Different types of Sports massage
Sports massage is broken down into two basic categories- Event massage and Maintenance massage. Event massage is used to assist the athlete prepare for competition, prevent potential injury, and recover from heavy exertion. Event massage can be done before, during, and after an event.

• Pre-event: assists a normal warm-up routine by increasing blood flow and literally warming up the muscles using basic massage strokes, range of motion, stretching, and joint mobilization. It can be non-specific (focusing on the entire body) or very specific (focusing on areas that are used during their sport.) Lasts 10-20 minutes and is fast-paced.
  
• Inter-event: used during or between events. Techniques used should focus on increasing blood flow to help with muscle fatigue and cramping. Lasts 5-15 minutes and is fairly gentle- no deep work is done.
  
• Post-event: usually done within 4 hours after the event for the greatest benefit. Focus is on assisting in recovery. This can also help identify any potential problems or injuries before they get worse and bring an early end to an athlete's season/career. A cool-down routine should be done to allow the body to relax before the massage or else the body can perceive it as a continuation of the workout. Techniques for relaxation are used and first aid such as ice, if needed. Lasts 10-20 minutes if done immediately after event, up to 30-90 minutes if done over an hour after event. Light to medium pressure.
  

Maintenance massage
This is routine maintenance performed on an athlete. It can also be referred to as rehabilitative or restorative massage. The focus of maintenance massage is helping the athlete maintain optimum performance. This could include recovering from injury, returning to pre-injury health, preventing further injury, and reducing pain and dysfunction. The goals of each session are dependent on the athlete's total health, the sport they compete in, and the time during the season. This massage typically lasts from 30-90 minutes and is moderate to firm pressure.

Sports massage is a much-needed type of therapy in this area with the Utah Summer Games, St. George Marathon, St. George Ironman, Huntsman Senior Games, and all the outdoor activities there are to enjoy. If you're looking for a way to increase your performance, gain a competitive edge, or recover or prevent an injury, I highly recommend finding a massage therapist who can do Sports massage.

Massage Styles: Hot Stone Massage

Welcome to post #4 in my series of different types of massages. If you have a specific style you'd like to see covered or have a question about any style I cover, feel free to leave a comment and I will address it for you!

Hot Stone Massage: Talk about heaven!! This is one of those things that is an absolute must for your Bucket List to do at least once before you kick it because of how awesome it is.

This is going to be a short post since most hot stone massages are just any type of massage (Swedish, trigger point therapy, reflexology, etc.) modified by using smooth, heated stones. Basalt rocks are the most popular to use because of their superior heat retention. The variety of strokes are reduced to mostly effleurage, compressions, and maybe a bit of friction since being pummeled with rocks isn't exactly relaxing. A review of the different types of massage strokes can be read here.

So what's the benefit of the added stones? It's all in the heat. By utilizing heat, a massage therapist can relax outer layers of fascia and muscle more quickly and access very deep muscles with less effort. Heat draws blood to an area using vasodilation, or dilating/opening the blood vessels, and aiding in muscle relaxation, dissolving trigger points, and healing injuries.

Hot stone massages are not recommended for people with extreme high blood pressure, advanced stages of diabetes, and women who are pregnant. It's very important to tell your massage therapist if the stones are too hot since the last thing either of you want is for you to get burns or blisters! It's also important to note that stones should never be placed stationary directly on the skin without a towel or sheet protecting you. This is only done with warm or cool stones.

Massage styles: Trigger Point Therapy

Welcome to post #3 in my series of different types of massages. If you have a specific style you'd like to see covered or have a question about any style I cover, feel free to leave a comment and I will address it for you!

Note: terms marked with a * have a short explanation at the bottom for your information!

Trigger point therapy is another one of the most requested types of massage. It is highly effective in alleviating chronic pain and dysfunction and can either be integrated into full-body massage such as a Swedish massage or can be done on its own like what you would receive at a chiropractic clinic. Low back pain, sciatica, headaches, fibromyalgia, and headaches are just a few examples of the many conditions that can be treated with Trigger Point Therapy (or TrPT).

So what is a trigger point? Also known as Myofascial* Trigger Points, trigger points are firm, palpable*, highly irritable spots in a tight band of muscle fibers or fascia* characterized by exquisite tenderness, referred pain, and loss of range of motion. Commonly referred to as "knots", they resemble a callus on the muscle.

You might have felt the pain of a trigger point during a massage before. The most common symptoms can be one or a combination of the following:

• A deep, aching pain
• A more superficial aching
• "Pins and needles" sensation
• Numbness
• Inflammation
• Loss of range of motion (such as experiencing pain when turning your head to the side)
• Sudden weakness in a muscle or group of muscles
• Sharp, shooting pain

The way that these trigger points are treated is by using compression anywhere from 3 to 30 seconds directly on the knot. The reason this works is because the therapist pushes blood out of the area (you can see this when the skin turns white) then allows it to flood back by letting go (the skin will turn red very quickly). With the increased blood flow, the muscle can then heal itself more quickly with the additional nutrients the blood brings.

With all the different types of pain I described, this question often comes up: Does TrPT hurt? The short answer is yes, sometimes it hurts. However, this has been misunderstood by a lot of people, so I'm going to give a more in-depth answer. Yes, TrPT and other types of therapeutic massage can hurt a little, but it should never, ever be painful. A good indicator of what pressure is optimal is to use a pain scale from 1-10.

At level 1, you should feel no pain whatsoever. Level 10 is unbearable pain which might feel like you are getting a bruise and feel you must hold your breath to stand it. Around 7 to 8 is where you might feel slight discomfort but can still relax and breathe normally. Often described as a "hurts so good" feeling, this is where trigger points can be relaxed and healed without additional damage occurring.

A lot of clients have come to me asking for the absolute deepest pressure I can give and they like the pain; they have been told that pain is the only way to get any "real" work done. I use this pain scale with every massage that I give because I don't believe that a massage should be painful. Not only is it exhausting on me, but your body knows when too much is too much and will tense up to protect itself. Not only does this un-do any relaxing you've done, but forcing pressure beyond that point can cause damage to blood vessels and create a bruise or cause damage to the muscle itself, creating an even larger and more painful knot. You might be a little sore after a massage*, but it's just silly to be in more pain than before you came in.

Notes:
*Fascia and myo-fascia- Fascia is the tough connective tissue that holds our whole body together. Imagine a chicken breast; there's a layer of fascia that you must un-attach to get the skin off, and myo-fascia is what is between the meat (muscles) holding it together. Fascia also needs to be relaxed during a massage for optimal muscle function. In case you were wondering, massaging chicken or beef does make it more tender! ;)

*Palpable- this means that you can feel a knot when you touch- or palpate- it. Some knots are slightly moveable along with the entire muscle. Deeper ones in muscles that don't have much movement might not move and at times are hard to distinguish from bone.

*Drinking a lot of water after your massage can prevent being sore! This is a big reason you will always get told to drink at least a few extra glasses of water when you get a massage.

Massage styles: Deep Tissue Massage

Welcome to post #2 in my series of different types of massages. If you have a specific style you'd like to see covered or have a question about any style I cover, feel free to leave a comment and I will address it for you!

Deep tissue massage can be a difficult topic to discuss. The reason is because in the recent surge in popularity of massages, the term "deep tissue" has not been very well defined. To some therapists, deep tissue means the same as a Swedish massage, using the same techniques only slightly modified to access deeper muscles. To others, deep tissue means accessing extremely deep muscles in a massage that is not meant for relaxation. One thing that's agreed upon, however is that deep tissue is generally more focused on pain relief rather than general stress and tension reduction.

There are more definitions as to what a deep tissue massage is that I won't list, but I think you get the point. Unfortunately, as I mentioned in my "To go green or not to go green; The organic question" post, much like the word "organic" has become a marketing word with little meaning in some cases, I feel like the same thing has happened with the term "deep tissue." Every (legitimate) massage establishment you will see offers deep tissue on their menu of services because that is what the public has come to expect. Because of this, I have drawn the conclusion that there is no such thing as a Deep Tissue Massage but instead a category in which massages can be put into. There are many types of massages that access deeper muscles and tissues and can be classified as as a deep tissue massage.

As for how I personally handle a request for a deep tissue massage, I ask my clients for clarification as to what they expect: deeper pressure with a full-body massage (Swedish) or if they want more targeted work on knots in specific areas and not full-body (Trigger Point Therapy, which I will cover next). I do not have a specific deep tissue massage on my menu although it's mentioned along with a Swedish massage.

Massage styles: Swedish Massage

Welcome to post #1 in my series of different types of massages. If you have a specific style you'd like to see covered or have a question about any style I cover, feel free to leave a comment and I will address it for you!

Whenever the word massage comes to mind, Swedish massage is probably what most people think of. It is the foundation on which most modern styles of massage are based and the very first type of massage that any massage student will learn.
Although records of massage have been found as far back as 3000 B.C., the art of Swedish massage was developed by a Swedish physiologist in the late 1700s. Only in the United States is the term Swedish massage used; in Sweden and most places in Europe it is called a traditional massage. In many spas, a traditional massage is often their Signature Massage.

The basic techniques used in a traditional massage are:

• Effleurage- this is a French term meaning to skim or to touch lightly on. The most frequently used stroke in massage, Effleurage is a repetition of long gliding strokes meant to relax and broaden soft tissue, increase blood circulation, and create a sensation of length and connection in the body.
• Petrissage- another French term, Petrissage means to knead. This is a non-gliding stroke that "milks" muscles by the therapist grasping tissue between their fingers and thumbs or between both hands and applying movement, typically circular. The milking effect encourages the movement of blood and lymph fluid from deeper tissue to promote health and elasticity of muscle. The stretching that occurs during these movements will also reduce muscle adhesions (knots).
• Friction- friction strokes can be either gliding or non-gliding. The main purpose of both strokes is to greatly increase blood flow in order to create heat, which in turn reduces muscle and soft tissue tension. Gliding friction will bring blood to the more superficial tissue such as your skin, and non-gliding friction (the therapist moves the skin along with their hands instead of gliding their hands along the skin) brings blood to deeper tissue such as muscles. Both techniques may be used for severe adhesions and scar tissue.
• Vibration- whether applied manually or mechanically, vibration is very effective for releasing tension in a muscle or group of muscles and due to the "confusing" effect on the nervous system, can break chronic pain cycles in the muscles (an example of this would be always clenching your jaw when you are annoyed or angry without realizing it). In general it is stimulating and invigorating but if done with consistent pressure and speed over a long period of time, it can be relaxing and sedating.
• Tapotement- also known as percussion, means to tap, drum, or pat. A prime example of tapotement is in many movies where a massage therapist uses a hacking or chopping motion with their hands. The effect is very stimulating on muscles and often causes muscle contraction. While this may seem to be the opposite of the relaxation a lot of people look for in a traditional massage, when this method is combined with the rest to create continuous muscle contraction then relaxation, this increases muscle tone and can prepare muscles for strenuous exertion such as a sporting event and thus prevents injuries.

The difference between Swedish massage and other types of massage is that even though it has very therapeutic effects, the main goal is for mental and physical relaxation. Therapeutic type massages use many of the same techniques and methods, but the therapist has a very clear intention of which technique or method to apply for specific conditions and complaints.

If you have never had a massage, I recommend starting out with a traditional or Swedish massage. Many people unfortunately don't have a good experience with their first massage, causing them to abandon the idea. If this has happened to you, I urge you to try a different therapist. We all develop our own personal style and if you didn't like a massage, that therapist simply might not be a fit for you. I think of it as finding a hair stylist you like; you might have to go to many different stylists and salons to find them instead of giving up on getting your hair cut after one bad experience!

Addendum: I'd like to add that most Swedish massages range from light, medium, or firm pressure and are usually full-body which, depending on your therapist's style, includes the back/neck/shoulders, arms, legs, hands/feet, and yes, the "buttocks" (gluteus muscles or "glutes"). Even the abdomen can be massaged if the situation calls for it although most therapists don't regularly include it. If you are uncomfortable with your therapist working on any area, just speak up and they will- or at least should- honor your request.

If you've never had your glutes worked on, you need to try it at least once! If you're still uncomfortable with having your legs uncovered that high, your therapist can still do compressions through the sheet. You will be amazed at how tight they are. After all, they do hold you upright all day!

An introduction to foot mapping and Reflexology

Reflexology:
The practice of manipulating reflex areas in the feet and hands. These reflex areas correspond to specific body parts and organs.

Reflexology is starting to gain popularity among Complimentary Alternative/Integrative Medicine (CAM & CIM) followers and practitioners. Here is a basic introduction for anyone curious about trying it or just wanting to know what it is.

Reflexology, as the name implies, uses the body's natural system of reflexes. There are reflexes such as our muscles tensing when we're startled, shivering when we're cold, sweating when we're hot, and other actions our body automatically takes to maintain a balanced state, called homeostasis. There are also less noticeable reflexes that our bodies have in order to protect itself and maintain homeostasis. All of these reactions are caused by information gathered by the brain from anything, internal or external, that affects the body. Any of these reflexes can cause distress and, as a result, cause reactions in unrelated parts of our bodies. This is often why if we have a headache, the cause can actually be in the neck, upper back, or shoulders.

Reflexology supports the premise of a relationship between areas of the hands and feet to specific parts of the body. Study results have indicated that manipulation of one part of the body definitely affects (or causes reflexes in) other body parts and functions. This concept is the basis for reflexology. Anyone who studies anatomy as a student will learn different systems of the body such as the bones, the muscles, the organs, etc. All of these systems communicate through the nervous system and, as a result, work together. This is the very basic how and why reflexology works.

The whole goal of reflexology, as mentioned above, is to induce reflexes in other parts of the body through the feet or hands in order to bring the body back to homeostasis through the following effects:

• Relaxation- Anyone who has had a foot rub can verify that it assists in relaxation of stress and tension. Stress is an abnormal state for the body to be in, both physically and mentally, and reducing stress will automatically balance out many processes happening in the body.
• Increases Circulation- Increased blood circulation means bringing more oxygen and nutrients to all the cells of the body, improving their function.
• Increases Nerve function- By stimulating the many nerve endings in the feet and hands, nerves send information faster.
• Increased Energy- Increases available energy by revitalizing organs and glands.

All of these benefits make reflexology an efficient, simple, and non-invasive form of preventative care by being able to address all systems of the body. Many people are self-conscious about getting a full body massage or have a condition for which massage is not recommended, and by increasing the body's function, it can fight off sickness and diseases more effectively.

Foot mapping
Here is a chart showing what parts of the feet correspond to the different parts of the body. If you simply imagine two feet together to make up a body, it's easy to see that the toes represent the head and brain, the balls of the feet represent the heart and lungs, the arches represent the digestive tract, and the very center where they come together represents the spine. (Please click on the picture for a larger view.)

If you have not tried reflexology, I highly recommend it simply because it feels amazing! The other benefits speak for themselves. I have been trained in reflexology but am not a certified Reflexologist. Keep in mind that Reflexologists should never diagnose a condition or prescribe anything.