Swedish Massage

Swedish chef, Swedish meatballs, Swedish fish, Ikea, and ABBA. Lots of good things are Swedish, and massage is on that list.

My Favourite Muppet

When you look at a brochure or a website for a massage clinic or day spa, there can be a huge range of different treatments available. Some of them can be baffling, some can sound scary or painful and some sound downright strange. To make things even more confusing, there are over arching categories, called modalities and there are specific techniques within a category. Just as every culinary tradition has some sort of unleavened or flatbread, massage has roots, one way or another, in most civilizations around the world. Often the same or similar techniques will have a variety of names simply because of the variety of cultures and languages.

3000 years ago in China, the “Yellow Emperor’s Classics of Internal Medicine” includes massage. Hippocrates also wrote about massage techniques for treating injuries.  Families in India have a cultural tradition of mothers massaging all their family members and passing this knowledge on to their daughters. Roman gladiators were massaged as part of their training regimen. Thai massage has its roots in yoga.

Modern massage, as a profession in the Western World, owes it’s beginnings to British nurses in 1895 who formed the first professional society for massage. There was no distinction between physiotherapy and massage in the beginning. When war time, large scale convalescent hospitals sprung up all over Europe, there was pressure on medical staff to patch up soldiers so they could go back to the front lines. Modern bureaucracy brought with it extensive filing systems and clinical note taking, which allowed for detailed observation of the healing process. Nurses noticed that patients who got out of bed and exercised their muscles and had their limbs massaged healed more quickly. When my mother took her nurses training and began her career in the ’60s (in a hospital, not a college), nightly massage of patients was routine. Can you imagine!

In Canada, when we say massage, chances are we are talking about Swedish massage. The Swedish therapist, Per Ling, developed these techniques in combination with movement therapy. Ironically, the techniques have French names, because of a Dutch therapist. Trying to follow the path of history is like a rabbit warren. There are so many different starting points and they merge and diverge constantly.

In addition to an extensive study of anatomy and physiology, massage students in Canada will start with Swedish massage. I am not overly fond of the term relaxation massage. Any massage that you get has therapeutic value. Even the lightest pressure will increase circulation and have an effect on your cortisol levels. A modality is a type of treatment (Swedish massage, reflexology, Thai massage, hot stone massage, etc.). Techniques are the specific and individual skills used during treatment (kneading, skin rolling, stripping, etc.).

There is sometimes a misconception that Swedish massage does not include deep tissue treatments. There is more to Swedish treatment than stroking. Stroking is the lightest technique and it is very soothing. In decreases sympathetic nervous system firing (flight or fight) and reduces the perception of pain. When we rub the back of a child to soothe them, or put sunscreen on someone's back, this is what we are doing. Direction doesn’t matter because the pressure is not deep enough to move fluid (blood or lymph) significantly.

Effleurage (means to glide). Effleurage is the warm up that the therapist uses to get the blood flowing and feel (palpate) for areas of tension, scarring, inflammation and edema. It has various levels of depth, but is characterized by long stokes. A key component of Swedish massage is that strokes go toward the heart to promote circulation and reduce edema (fluid build up).

Petrissage (meaning to knead) involves squeezing, wringing, picking up the tissue, skin rolling and muscle stripping. Sounds like doing laundry with a tub and washboard! When I “get in there” with my elbow, that’s petrissage—by no means is that relaxing! When someone kneads the top of your shoulders like bread dough, that’s petrissage.  These techniques search out restrictions, break up adhesions (knots) and scar tissue, they affect circulation and relax muscles. Depending on the speed and depth, they can be soothing or stimulating.

Vibrations are a technique that involves the therapist using rhythmic contractions of her own arm muscles to send oscillations through the tissue of the client. They are difficult to preform and exhausting and haven’t met a therapist who uses them. You are not likely to encounter them, but I include them for the sake of completeness.

Tapotement (meaning to tap) is the rhythmic drumming that is associated with massage. It has different effects depending on the speed and depth. It’s techniques are called tapping, pincement (plucking), hacking, clapping and beating. Doesn’t sound pleasant, does it. It’s a very stimulating techniques that temporarily increases muscle tone and promotes relaxation. One of it’s most useful applications is with respiratory conditions and dislodging mucus. Parents of children with cystic fibrosis are taught to do this to assist their children’s breathing.

Swedish massage is a core modality that Canadian massage therapists use as their base. We could make a whole career of Swedish massage, but that would be very boring. Professional associations, which we have to belong to in order to use the designation RMT and write receipts for benefits, usually require continued education. Massage therapists can tailor their path along any route that fits their personality and practice. Some therapists are also yoga instructors and focus on mobility and balance. Some are passionate about energy work or aromatherapy. It’s important to find a therapist who’s expectations about treatment align with your own. Don’t let a single or even a few disappointing treatments dissuade you from finding the right therapist.

The choices of courses to take are endless and this is one of my favourite aspects of my career. I love taking courses. If time and money weren't a factor, I would take classes every six months. My favorite things to treat are injuries and post surgeries, so most of the courses I take compliment that. The modalities I have studied include hot stone, joint mobilization, reflexology, sports massage, shiatsu, infant massage, myofascial cupping, and kinesio taping. Some of these were included as part of my initial diploma, some were continuing education. Some were fully certified courses and some were just a taste of a modality. Every course I take, and the treatments I receive all become part of my tool box. If I'm getting a massage and my RMT does something I like, I ask her to show me how to do it. I ask her questions about the courses she took and how she liked them. 

My knowledge becomes part of me. Once I know a useful technique, I can't not use it. In the course of an hour I may use shiatsu moves, reflexology moves, and sports massage techniques. No two massages are ever alike. I don't follow prescribed routines, even on the same client. What my client needs at the moment varies from appointment to appointment. Generally speaking, at the first appointment, I don't work very deeply and use a minimum of techniques. Everyone responds to massage differently and it takes time to get to know a client and their needs. 

For the next little while, I'm going to do a series of posts about different types of treatments.  When you find specific treatments work well for you, it's worth searching for a therapist who specializes in that. No RMT can take every course, and we don't always embrace every course we take. There are techniques that I'm fully trained in, but don't like doing, for a variety of reasons. Some things I have to use in moderation, because it has an effect on me (like aromatherapy or hot stone massage). 

If there is a specific technique or type of service that you want to know more about, leave it in the comments below.