Twelve kneading / petrissage techniques

During a massage session, at least, 50% of time has to be spent on the petrissage-kneading techniques. Not only that each protocol, proposed in this book, offers its detailed mechanism, but also presents its purposes and goals in the overall scheme of treatment. In addition it’s important to discuss variety of kneading techniques. Medical massage recognizes twelve of them, five or six of which are used in daily practice. However, I believe that each massage therapist should know and perfectly administer each of these techniques. One of the greatest masters of conventional medical massage therapy, Sarazini, once said “if you want to assess the professional capabilities of a massage therapist, check how he performs kneading techniques.” There is some truth to this because the main power of massage therapy is a reflexive therapy. I don’t want to repeat myself because in chapters “Full Body Medical Stress Management Massage” and “Science of Massage and Energy Work” I explain the mechanisms of massage therapy in detail. Kneading techniques are mainly responsible for awakening the multiple therapeutic reflexes as a reaction to the original stimuli by our hands due to massive deformation of proprioreceptors caused by kneading. As you understand, the creation of electrical potentials is the result of deformation of proprioreceptors that are located in skin, fascia and muscles. Many research studies support the idea that for the best results, at least 50-60% of the massage therapy procedure must be spent on kneading. It doesn’t matter, which type of massage you are performing, whether it is full body stress management massage or sport massage or orthopedic massage or treatment for asthma. Unless otherwise indicated, all kneading techniques should be performed for at least 3 or 4 mobilization movements in one place before moving to a different area.

Petrissage/Kneading #1
Initial position; palms flat on human body, thumbs extended from fingers approximately 70 degrees. The first movement is initiated with both hands giving finger pressure against the tissue. Sustaining this pressure, we use the fingers of both hands, in sync, to shift the tissue towards the thumbs. Thumbs play the role of barriers. After shifting tissue to the thumbs, we continue circle motion of fingers, and this kind of kneading we performing 3-4 movements in each area. Amount of areas depend on the size of the part, which we are massaging as well as of our own hands. However, with Petrissage #1 we cover and stimulate all massage area.
Petrissage/Kneading #2

In principle, we perform this technique exactly like Petrissage #1, only instead of moving the hands synchronously, we move them one after the other.

Petrissage/Kneading #3

This technique is performed hand after hand, like Petrissage #2. However, whereas in Petrissage #2 it is the fingers that shift the tissue, in Petrissage #3 both the fingers and thumb of each hand works to shift the tissue, hand after hand, removing layer by layer, working deeper and deeper into the region. This makes the technique ideal for rounded areas such as the neck, knee, ankle, wrist/forearm, or shoulder.

Petrissage/Kneading #4

This technique is used for mobilization of the paravertebral tissue. Extend the thumb of one hand 90 degrees and place the web of this hand over the paravertebral region. With the 2nd-4th fingers of the other hand, applying pressure in a circular motion, shift-knead the tissue into the web of the first hand. The circular motion should be nonstop, in a manner that allows us to continuously shift the tissue into the barrier of the hand-web, resulting in massive mobilization.

Petrissage/Kneading #5

We can perform this technique over all areas of the back, as well as on the anterior and posterior thigh. In principle this technique is similar to #4, where the web between the fingers and extended thumb of one hand acts as the barrier. With the opposing forearm in a circular motion we shift the tissue to the barrier hand.

Petrissage/Kneading #6

In principles we perform this exactly like #5, but instead of the elbow, we use the fist to mobilize-knead the tissue towards the barrier of the other hand.

Petrissage/Kneading #7

This technique we perform on the lower part of the anterior leg and the forearm. One hand performs a kneading action like a single-handed Petrissage #3, traveling towards the heart. The other hand surrounds the lower leg or forearm and in a squeezing action follows after the kneading hand.

Petrissage/Kneading #8

This technique is performed with the knuckles, hands together in sync, with the thumbs creating a barrier and supporting the hands like a pole. Petrissage # 8 and 9 are typically used in treatment of people who suffer from asthma, or in pre-event sports massage treatment.

Petrissage/Kneading #9

Performed exactly like #8, but hand-after-hand.

Petrissage/Kneading #10

This technique utilizes the hypothenar region of both hands to shift and mobilize the tissues, hand after hand. When one hand does the circle motion the other hand has to create a barrier against the shifting in order to cause the deformation of proprioreceptors.

Petrissage/Kneading #11

Performed with both forearms, similar to how we utilize the hypothenars in #10.
Petrissage/Kneading #12

Mostly we administer the Petrissage #12 for calf muscles mobilization. With both hands grab the calf muscles, shift posterially as far as possible, squeeze between thumb and fingers and as it is being lifted, perform asynchronous kneading movement.



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