Performing

Therapeutic
Massage
Xenia Grace E. Robles, RN, MAN
 Definition
Massage- a manual manipulation of tissues aimed at increasing circulation, promoting
relaxation and healing and restoring mobility.

Back Massage/ Back Rub- is a nursing measure done to promote relaxation or to act as a
stimulant or both which generally follows a client’s bath.

Effleurage- is a type of massage consisting low, slow, gliding strokes.

Petrissage or Pressure Manipulation- is a type of massage consisting of pinking the skin,

subcutaneous tissues, and muscles as the hands are moved up and down usually at the client’s
back.

Tapotement or Percussion Manipulation- is a type of massage consisting of alternate

stroking of the fleshy part of the hands on skin surface while moving the hands up and down
and allowing them to work alternatively.
Whoa!
Can you describe the lady in the
picture?
 Rationale
1. To relieve muscle tension
2. To promote physical and mental relaxation
3. To relieve insomnia
4. To improve the flow of blood and lymph, stretch joints,
relax muscles and relieve pain and congestion.
5. To evaluate excessive secretions from respiratory tract.
6. To stimulate the immune system, thereby help the
body combat disease.
7. To relieve anxiety and provide a sense of relaxation and
well- being.
8. To provide a sense of harmony and balance within the
body.
 Equipments
01 03
Lotion/
Powde
Cream
r/ Oils

Towels Drapes

02 04
 Special Considerations
The massagist must process the following
qualifications:
A basic knowledge of human
anatomy, physiology and
pathology Must be in good health.

Fingers must be soft and

pliant with fingernails cut Muscle must be firm and
short. strong

Attitude must be orderly,

pleasant and unhurried.
 Contraindicati
•
ons
Presence of skin disease
• Temperature above 100 F
• Presence of varicosities
• Nephritis (no back or abdominal
massage)
• Pregnancy (no back or abdominal
massage)
• Menstraution (no back or abdominal
massage)
• Recent injuries
• Tuberculosis of the lungs
• Burns
• Hypersensitive skin
Remember to:
1. Knock before entering the
persons room.
2. Address the person by name.
3. Introduce yourself by name
and title.
Pre-procedure
Set room temperature at approximately 75 F. Provide
low or indirect lighting, privacy and background
music.
Prepare the massage table or hospital bed by placing
a clean sheet on the surface. Adjust the surface light.
Remove rings and watch. Wash hands/ perform hand
hygiene.
Explain the procedure to client.
Assist the client to assume either a prone, Sim’s
supine or sitting position, depending on client’s
condition.
Loosen or remove clothing from the client’s back and
arms. Drape the client with a sheet to cover areas not
being treated directly.
To maintain clients body heat and provide privacy and
relaxation
To prevent back stain.
To avoid scratching the client and prevent
transmission of microorganisms.
To prepare the client for treatment and appropriate
position enables the nurse to apply the necessary
amount of pressure without causing discomfort.
To expose the affected body part and provide privacy.
Procedure
Squeeze a small amount of lotion or oil into the palm
of the hand to warm before applying to the client.

Begin with light to medium effleurage and other To prevent damage to internal structures. Stimulates
massage techniques. circulation and promote relaxation.

Effleurage
1. Mold hands to the part being treated.
2. Apply long, slow, gliding strokes with
maintaining an even pressure
3. Use the fingers or the thumb in small
areas as the hands, foot or face
Petrissage
1. Kneading
a. Alternately press the muscles and subcutaneous tissues inward and upward.
b. Squeeze, compress and release in a rhythmical manner.
c. Let the hands glide imperceptibly over the area during the relaxation phase.
d. Speed and depth can be varies.
e. Treat small areas with the tip of the fingers and thumb.
f. Modification can be applied such as:
- Squeezing Kneading – tissues are squeezed on the operators hands.
- Reinforced Kneading – one hand is placed on top of the other to
increase the depth of manipulation.
Petrissage
2. Picking-up
a. Use one or both hands.
b. Grasp the tissues, lift, squeeze and release
c. During the lift, the fingers and thumb should be controlled by the intrinsic
muscles of the hands.
d. Always keep the palm of your hands in contact with the clients skin.
Petrissage
3. Wringing
a. Using both hands, grasp the tissues and lift.
b. Move the hands alternately backward and forward across the long axis of the
muscles thus stretching the tissues.
Petrissage
4. Skin Rolling
a. Lay both hands flat on the surface of the clients skins.
b. Grasp the skin and subcutaneous tissues between your fingers and thumb.
c. Roll the tissues backward and forward against your fingers and thumb.
Friction
1. With the tip of the thumb, move the part treated in circular or transverse direction.
2. Vary the depth of localized penetrating movements depending on the affected
part.
3. When circular friction is applied, progressively increase the depth while in case of
a transverse friction; maintain an even pressure all throughout.
Tapotement
1. Hacking
- Strike the body with the use of the ulnar border of the little finger supplemented by
the other fingers.
- Extend the wrist and move in pronation and supination.

2. Clapping
- Cup the hands and pronate the forearm.
- Flex and extend the wrist alternately bringing the hands sharp into contact with the
body and resulting in a deep toned tapping sound.

3. Beating
- Similar to clapping, but loosely clutch the hands.
- Allow the dorsal aspect of the fingers and the base of the hands to come in contact
with the part treated.
Tapotement
4. Pounding
- Similar to hacking, but loosely clinch the fist.
- Strike the part treated with the ulnar border of the hands.

5. Shaking
- Hold the body part with one or both hands.
- Move it fully from side to side or up and down.

6. Vibration
- Using the hands or fingertips. Apply a fine of tremor to a body part.
Procedure
Finish treatment with effleurage
Wipe any excess lotion or oil from skin with towel, or
use a small amount of warm soap and water to clean
clients skin, taking care to dry completely.
Assist client into comfortable position for a period of
rest or sleep.
Document treatment, clients response and skin
assessment data.
Wash hands/ hand hygiene.
To assist with relaxation and provide a sense of
completion.
To promote and maintain skin integrity.
To allow client to fully experience therapeutic benefit
of massage.
To communicate pertinent data to other members of
treatment team; to promote continuity of care.
To reduce transmission of microorganisms.
After Care
1. Return lotion or cream or powder to its proper storage area.
2. Leave the client in a comfortable and safe position.
Evaluation and
Documentation
1. Clients comfort.
2. Reaction to treatment
3. Other significant observations.
 “ IF YOU ARE NOT WILLING TO
LEARN, NO ONE CAN HELP YOU.

IF YOU ARE DETERMINED TO

LEARN, NO ONE CAN STOP YOU”
- Zig Ziglar