Methods of a Deep Tissue Massage
This is a two-part guide that you can check the Deep Tissue Massage Techniques Part I here if you haven’tYou can read the of Now that you understand how compression can be used in a deep tissue massage treatment, let’s add an additional component, the stretching of tissues.
In this part, you will learn the best ways to incorporate stretching into your massage, the parts of the body to which stretching is suited, and lots of tips to help you develop this skill effectivelyAs usual, there are also safety guidelines you need to be aware of.
Introduction to Stretching Techniques
Whenever you massage you stretch tissuesUnless you are using minimal pressure and large amounts of oil, even the gentlest of effleurage stretches the skinHere we are going to look at how stretching can be incorporated into your treatment.
This is not the kind of stretching you might do in the gym after a workout or the kind of stretching you might provide for a client as a specific treatment modality (e.g., gross passive stretching or specialized forms of stretching, such as muscle energy technique or proprioceptive neuromuscular facilitation, known as MET and PNF, respectively).
Nor does this stretching incorporate the kinds of active stretching you might provide for your client for use at home as part of an aftercare package.
The stretching you will learn here is stretching specific to the application of deep tissue massageIt is frequently performed passively, by the therapist, seamlessly incorporated into the massage treatment.
However, you will also learn how the client can help facilitate a stretch by contracting the muscle opposite (the antagonist) to the one you are working on, thus reducing tone in the muscle being treated (the agonist).
Stretching is inherent to almost all massageHowever, the techniques used in deep tissue massage can be broadly categorized as ‘without oil’, or dry stretching, and ‘with oil’ stretchingTo each of these categories, we can add two elements to enhance the stretch.
First, we can gently traction a limb, pulling it as we massageSecond, we can move the joint (affected by the muscles we are treating) in such a way that these muscles are stretchedMobilizing the joint like this is performed while continuing to massage.
Finally, we can add together these two elements of traction and joint mobilization, performing them at the same time, whether or not we are using oilIt is useful to note that with each subsequent additional technique.
First, dry stretching, and then with added traction, and then with added joint movement, and then with added traction plus joint movement the tissues are stretched to a greater degreeSimultaneously, the client is likely to sense the depth of massage increasing.
So, although performing most of these techniques without oil is possible and might benefit those clients who crave exceptionally deep tissue massage, most clients will find the techniques much less comfortable to receive than when oil is used.
Some therapists might also argue that without the use of oil these techniques are also harder to ‘link’, making it more challenging to provide comprehensive treatment.
Here we have described the use of dry stretching techniques only where they are most useful, with the majority of add-on techniques appearing in the ‘with oil’ section.
Without Oil (Dry Stretching)
Most clients prefer a particular massage stroke and a particular depth of pressure and might request that you spend more time on one part of the body than anotherAlthough we try to avoid overworking any one area, therapists instinctively gravitate to those tissues that require more focused treatment.
If you have ever found yourself doing this, you might have noticed that not only does the depth of your pressure sometimes increase but that the strokes you are using squeeze and stretch the tissues in a more concentrated wayIt is to these areas of the body that dry stretching can be particularly helpful.
Areas these depend on the needs of the client and where their fascia and muscles are most tightDry techniques can be incorporated with the oil at any of stage of the massage treatment by simply applying the stretch through a towel or facecloth placed over the area.
When used this way, dry techniques are compelling, so caution is called for; the techniques are not appropriate for clients with fragile skin or those who dislike deep tissue treatment.
Conversely, these techniques are ideal for enhancing the sensation of deep pressure and are particularly helpful when treating a muscle or area of tissue you have identified as being tight or shortened.
Used in their pure, dry form, they are useful when oil might not be appropriate or might be problematic when treating clients with psoriasis, for exampleThey are easy to apply, requiring little effort from the therapist, and easily modified to enhance the sensation of deep tissue massage.
In the next part, we will look at a couple of dry stretch techniques, as well as using traction with dry stretching.
A good example of an area in which dry stretching works well is the backThe technique is easy and safe to practice in this area, and by later adding oil and applying the technique through a towel, you will quickly learn how dry stretching helps facilitate the sensation of deep tissue massage without needing to apply deep pressure.
Many therapists learn to massage the back longitudinally, sweeping their effleurage from the neck to the sacrum or from the sacrum to the neck, depending on how they have been taught to stand with relation to the treatment couch.
After warming the muscles, therapists often work ‘up’ or ‘down’ the erector spinal muscles with more focused stripping-type techniques or using small circular movementsWorking transversely across the back without oil stretches the skin, fascia, and associated muscles away from the spine and is thus a useful addition to these techniques.
applying Dry-Stretch to erector Spinae Muscles Practice this technique before you have applied any oil to your clientFor this technique, you always work the erector spinal muscles on the opposite side of the client to which you are standing.
In other words, if you are standing to the right of the client (as in the Image), you will be working his or her left erector spinal musclesIt doesn’t matter which side of the client you treat first.
However, to help you grasp the technique, we start here with treatment to the client’s left erector spinal muscles.
1First, you need to stand at the right side of the treatment couch and identify the spinous processes of the client’s spineYou are going to avoid pressure on these.
2Locate the erector spinal muscles running longitudinally down the left side of the client’s backWith your hands positioned as shown, place your thenar and hypothenar eminences against the skin, over the muscles.
It doesn’t matter whether you start close to the cervical, thoracic, or lumbar spineHowever, when first learning the technique, a good place to start is around the upper thoracic region; you then work towards the sacrum.
Your aim is to gently push the erector spinal muscles (and the associated tissues) away from the spineLock onto the tissues and gently ease them away from the spine.
Keeping your elbows extended, avoid letting your hands slide across the skinYou want to stay locked to the skin and to stretch the tissue under your palms rather than gliding across it.
Sometimes using a gentle rocking motion as you push the muscles away from the spine helps the client relax.
3Work up and down the spine two or three times, always on the same side of the spineIt doesn’t matter if you start at the top of the thoracic spine and work your way down to the sacrum.
Stop and return to your start position before repeating, or if you start at the thorax, work down to the sacrum and then work back up to the thorax.
Notice that because of its natural lordosis and small area it is difficult to position the pads of your palms on the extensor muscles of the neckIf you want to apply the technique to this area, simply use the pads of your fingers instead of your palmsIn this very position (prone), it is difficult to fix these muscles in order to dry stretch themYou might find that treating them works better when you later add oil and apply this technique through a towel.
4Once you have worked along with the left erector spinae, move to the left side of the treatment couch and repeat the technique on the muscles of the client’s right side.
Four Modifications to Dry-Stretch the erector Spinae Muscles
There are four ways to enhance your understanding of how dry stretching might be a useful addition to your massage skillsFirst, practice the technique, paying particular attention to which areas of the back seem less pliable and stretch less.
Are there differences in the client’s left and right sides? Is one part of the lumbar region less pliable than another? Does the technique cause the client to report sensations of ‘stiffness’, ‘tension’ or ‘relief’ specific to a certain area?
One of the values of a dry stretching technique is that both you and your client become more aware of localized areas of tension, areas where there is less stretch in tissues.
A second thing you can do is notice what happens when you apply the technique through a towel, having added a small amount of oil to the clientTo do this, simply effleurage the client as you might normally, with perhaps a little less oil, and then repeat the above steps through a towel.
Notice that working through a towel allows you to get a better grip on the skin as the tiny fronds of the towel to soak up the oil, forming a lock between the towel and the client’s skinIn this manner you need to apply very little pressure at all and yet are able to stretch tissues easily.
Ask your client how this second method of application feelsMany clients report that it feels much more powerful, more ‘deep’.
If you are anxious about pressing onto the spinous processes of the spine, use one hand to locate the processes and keep that hand there as a guide; then use the other palm to stretch the tissues.
A third thing you can do is to practice the technique in different directions, all over the back, without oil on dry skin or through a towel following the application of a little oil.
However, you can work longitudinally over these muscles, or in any direction you chooseYou don’t have to stay on the erector spinae muscles but may choose to apply the technique to any part of the backUse the technique on those areas that require stretching, and avoid muscles that already feel pliable or are likely to be lengthened and weak because of the posture of your client.
Remember that erector spinae muscles are designed to keep us erect, and during daily activities they rarely get restThese muscles are naturally strong in healthy individuals, which does not mean they require stretching.
The middle fibres of the trapezius and the rhomboid muscles are also often long and weak, especially in clients with kyphotic posturesStretching these muscles (using any stretching technique) is not necessarily helpful.
Use of dry stretching to the erector spinae muscles has been described here simply because it is an easy way to learn the technique, and for the treatment of some clients it will certainly be valuable.
After learning the technique, modify it to suit your needsFinally, notice what happens when the client receives the technique with arms in varying positions.
If you apply the technique with the client prone, with arms at the sides, this feels quite different (both to give and to receive) compared to what clients feel when they abduct their arms to 90 degrees, allowing their arms to hang over the treatment couch, or even when they take their arms above their heads.
Changing the position of the arms changes the position of the scapulae, which in turn affects the tension in the tissues of the backYou might discover that areas that felt relatively slack are suddenly subject to more tensionFor example, if you position the client prone with arms above the head, you stretch the thoracolumbar fascia slightly.
Dry stretching the lumbar area in this position aids those clients whose lumbar erector spinae or quadratus lumborum muscles are tightHowever, in this position, fascia of the upper trapezius is shortened, making it harder for you to access this area with the dry stretch technique.
Treating clients with tight upper trapezial fibres might be more effective when their arms are at their sidesHaving the option to change the position of the client’s arms in this way is useful for enhancing dry stretching.
Safety guidelines for Dry Stretching the Back
Always work away from or parallel to the spinous processes of the spine, avoiding pressure towards or directly on the processes themselvesSimilarly, avoid stretches that require you to press up and on to the sharp bony ridges, such as the medial border of the shoulder bone (scapula).
Remember that ribs curve outwards and what some therapists perceive to be hardened muscles or ‘knots’ in muscles might actually be underlying boneAvoid all forms of dry stretching when treating clients with fragile skin.
Finally, note that dry stretching is not limited to use on the backYou can use the technique on any part of the body, remembering to avoid pressure into bony areas and focusing the stretch to those areas you have identified as feeling most tightadvantages.
Disadvantages and uses of Dry Stretching
1) A stretch might be localized to a particular area of tissue.
2) Dry stretching can be useful when the use of oil is not appropriate or is problematic.
3) It is easy to apply.
4) It can be used anywhere on the body.
5) It requires little effort from the therapist.
6) Dry stretching is ideal for clients who require the sensation of exceptionally deep tissue massage.
1) Dry stretching can be difficult to link to other techniques without the use of oil.
2) It might be uncomfortable for some clients to receive.
3) It is not appropriate for clients with fragile skinSituations When Dry Stretching Is Indicated.
4) When treating a muscle or area of tissue you have identified as being tight or shortened(usually used when you need to stretch a localized area of tissue)
5) When treating a client who requires or values the sensation of exceptionally deep tissue massage.
The use of gentle traction is an invaluable component of deep tissue massageTraction involves gently pulling on a limb, distracting a joint and thus stretching the associated tissues.
Although traction can be incorporated into an oil massage, it is best performed when the skin is dry and the limb can be easily gripped without slippingPerformed slowly, safely and with minimal effort, this stretching technique is easy to apply, although it might require a different working posture than the one you are used to.
Not only does traction enhance the sensation of deep tissue massage, therapeutically it can significantly improve the range of movement in a joint? For this reason, it should not be used on clients with joint laxity—those who are hypermobile, have had dislocations or who have unstable joints.
You should also avoid using traction on clients with fragile skin because it localizes the stretch in tissues around a joint, including the skinOne of the best places to practice traction is on the back of the armpit, over the latissimus dorsi, teres major and teres minor muscles.
This is often an area much neglected by massageHere you can traction the glenohumeral joint of the shoulder to stretch many of the associated muscles.
which is particularly useful if clients regularly use these muscles as part of a sport or hobby (such as rock climbing or rowing); if they have been using crutches (which requires adduction of the glenohumeral joint); or if tissues have been shortened following surgery in which the arm has been deliberately but temporarily immobilized in an adducted position.
Tractioning the glenohumeral Joint in Prone
This technique is ideal for improving joint range, which is particularly useful for clients who have limited abduction.
Although we have chosen to illustrate the technique with the shoulder abducted to 90 degrees, you can start tractioning at any degree of abduction, providing that you are able to get a hold of the elbow in a comfortable manner.
1) With your client prone, carefully abduct his shoulder to around 90 degrees or less.
2) Kneeling down if necessary, place one hand against the back of the client’s armpit and use the other to support his elbow.
3) Keeping your own elbow extended, gently press into the back of the armpit while simultaneously tractioning the glenohumeral joint with your other handAvoid pressure into the armpit itself, where there are important neural, vascular, and lymphatic structures.
Avoid gripping the elbow too tightlyVery little force is required to traction the shoulder in this wayRemember that you are trying to distract the glenohumeral joint, not the elbow joint.
Two Modifications for Tractioning the glenohumeral Joint in Prone
There are two ways to modify this technique to increase the stretch in the tissues you are working; with each of these, the client is likely to sense an increase in pressure.
First, you can add a small amount of oil to the back of the armpit and then apply the stretch and traction through a facecloth or small towelContinue to traction the shoulder in the same way, supporting the elbow.
Notice that just as the sensation of pressure increased when you applied a transverse stretch to the erector spinae through a cloth, so it does hereYou can increase this sensation, even more, should you want to: Instead of keeping your palm flat against the back of the armpit, rotate your palm so that you take up the slack in the underlying skin.
Notice that after applying a small amount of oil, you can press through the cloth to get a better grip on the skin and can really stretch the tissues on the back of the armpit.
To further facilitate abduction and stretch in latissimus dorsi, teres major, and trees minor muscles, you can passively move the shoulder joint while tractioning.
Keeping your palm pressed against the tissue of the armpit, simply increase the degree of abduction you are using as you continue to traction the jointWith your palm on the back of the armpit, as usual, direct your stretch inferiorly as you use your other hand to abduct the client’s shoulder.
Note that you can easily incorporate this posterior shoulder stretch into an oil massage, using the palm with which you will press to stroke down the client’s triceps and up and onto the back of the shoulder.
Safety guidelines for Tractioning
Providing you avoid pressure into the armpit itself, tractioning is a safe and effective technique, but it is not suitable for all clientsTraction should not be used on clients who are hypermobile or who have been diagnosed with having a hypermobile syndrome.
Although the technique can be used on other parts of the body, avoid applying it to previously dislocated joints or those likely to dislocate (e.g., if a client tells you he has a joint instability).
Use traction with medical advice when treating clients with known
inflammatory joint conditions, such as rheumatoid arthritis, because this could result in an aggravation of the conditionTraction is not possible to perform on some joints of clients with ankylosing spondylitis or when joints have been fused.
This technique also stretches the tissues around a joint, including the skin, so it should be avoided when treating clients with fragile skinThe use of gentle traction is a safe and comfortable adjunct to deep tissue massage for most clients, but if you have doubts it is appropriate for a particular client, consult his or her medical practitioner.
Advantages, Disadvantages and uses of Tractioning
1) Tractioning is ideal for improving the range of movement in a restricted joint.
2) It helps to localize a stretch to a particular area of tissue.
3) It is useful when the use of oil is not appropriate or might be problematic.
4) It is easy to apply.
5) It requires little effort on behalf of the therapist.
6) It enhances the sensation of deep tissue massage.
7) Tractioning is easily modified to increase the sensation of the stretch.
1) It takes practice to link tractioning into your massage.
2) Traction needs to be used selectively; it is not appropriate for all clients.
3) It often requires therapists to adopt a different working position to safeguard their postureSituations When Tractioning Is indicated
4) When you need to improve the range of movement in a restricted joint
5) When treating a muscle or area of tissue you have identified as being tight or shortened (usually used when you need to stretch a localized area of tissue)
6) When treating a client who requires or values the sensation of exceptionally deep tissue massage.
Dry Stretching for the Piriformis Muscle
Let’s complete this section on dry stretching by focusing on a specific muscleUnless our clients are actively engaged in sporting activity, they are unlikely to have a particularly tight gluteus maximus muscle, especially if they are in seated occupations,
in which this muscle remains lengthened and weak.
However, the gluteus minimus and gluteus medius muscles might be shortened, as might the piriformisThe piriformis muscle is believed to be particularly problematic in manual therapy because of its close proximity to the sciatic nerve.
Theoretically, the tension in this muscle can press on the nerve, leading to piriformis syndromeUntreated, the biomechanics of the hip are altered and muscular imbalance ensues.
Many therapists are thus keen to learn techniques to allow them to stretch this muscleOne of the best ways is with deep tissue dry stretching.
Using Dry Stretching on the Piriformis Muscle
With your client positioned in the prone position, thoroughly warm the buttocks using your regular massage techniques.
1Carefully locate the piriformis muscleOn most clients, this will be tender when deep pressure is applied, especially if it is tight.
2Relocate the muscle in the very center of the buttock.
3Lean onto the client using your elbow to ‘lock’ the piriformis muscle, taking care to support your own backIf the client reports pain, tingling, or numbness, use less pressure.
4With your other hand, hold the client’s ankle and slowly rotate the hip joint back and forth while maintaining pressure with your elbowNotice where the client reports the sensation of a stretch, and repeat these movements for a few minutes only.
5Remove the towel and soothe the area.
6Repeat if necessary, but avoid overworking this area.
Safety guidelines for Dry Stretching Piriformis
Having thoroughly warmed the area first, always work cautiously, avoiding too much pressure too earlyIf pressure elicits pain, numbness, or tingling in the lower limbs, stop because this indicates you are compressing the sciatic nerveAlways avoid the
Advantages, Disadvantages and uses of Piriformis Stretching
1) Dry stretching is reportedly very effective for stretching the piriformis muscle and thus overcoming problems associated with a tight piriformis.
2) The stretch is relatively easy to apply.
1) Because the piriformis lies close to the sciatic nerve, extra caution is needed when performing this technique.
2) Not all clients appreciate receiving elbow pressure to the buttock region.
Situations When Dry Stretching to Piriformis Is Indicated
1) When you have identified this muscle to be tight and contributing to muscle imbalance in your client
2) When a client suffers from piriformis syndromeA condition in which the piriformis muscle impinges the sciatic nerve (apply stretch with extra caution in this situation)
With Oil Stretching
Now let’s look at applying stretching techniques with oil, working directly on the skinIn each of the examples described you will see how the elements of tractioning and joint movement may be combined to further enhance the stretch and sensations of pressure.
To begin, we’ll consider how stretch naturally occurs during the application of compressive techniquesTake a look at this photo of the adductor muscles being treated in supine.
Would you agree that during this compressive effleurage, the fact that the therapist has considerable leverage with respect to the muscles being treated means that these tissues are likely to be stretched during the application of the stroke?
In this particular example, the therapist is pushing the skin and fascia proximally, working away from the knee, towards the hipWould you say that using less oil there is likely to be more drag against the skin, and the tissues are likely to be stretched even more?
When you intend to stretch muscles during a massage, the effect is quite different from when you intend to compress themWhen your intention is to compress tissues, you ask yourself such questions as, ‘How can I employ more or less pressure?’ and ‘What is the effect of adding more pressure in this way?’ Once you start to try and stretch tissues, you notice that the direction of your strokes is paramountYou will notice that moving in one direction increases the stretch, whereas working in another reduces it.
Although our intention might be to compress muscles, whenever we work this way stretch occursSo, if your intention is to incorporate stretching techniques with oil, you could start simply by positioning yourself to apply some of the compressive techniques just mentioned and, using less oil, intend to stretch tissues as you apply the compressive strokes.
Stretching With Oil Plus a Passive Joint Movement
To further enhance a stretch you can move the joint associated with the muscles on which you are workingYou can do this passively or ask the client to move the jointBoth methods are described here.
A good way to explore the technique of stretch and joint movement is treating the calf with the client proneThe advantage of this scenario is that you can perform the stretch passively or ask the client to perform the stretch.
Using Stretching With Oil Plus a Passive Joint Movement
The technique of stretching with oil and passive joint movement is described here using the calf as an exampleFollowing the steps, you should easily be able to adapt this technique to most limb joints.
1Passively shorten the muscleIn the case of the calf, this means either flexing the knee or plantar flexing the ankle, or bothIn the photo, the therapist has flexed the client’s knee but left the client’s ankle in a neutral position (that is, neither overly plantarflexed nor dorsiflexed).
2Starting at the distal end of the muscle, use a little oil to apply a compressive effleurage type stroke, working proximallyIn this case, you are working from the ankle towards the knee, avoiding pressure into the popliteal space at the back of the knee.
The key here is to maintain pressure in the effleurage stroke during movement of the jointIf you are passively stretching the muscles, this requires you to be ambidextrous, applying forearm effleurage with one arm while dorsiflexing the client’s ankle with the other.
3Repeat this stroke, but this time stretch the muscle on which you are workingIn the case of the calf, this means dorsiflexing the ankleYou can do this passively or ask your client to do it.
Active dorsiflexion of the ankle by the client results in a greater relaxation in ankle plantar flexors (such as the gastrocnemius and soleus) as the client engages the tibialis anterior, the antagonist to these musclesRemember that muscles work in pairs, so contracting one muscle produces relaxation in its oppositehowever, the disadvantage of repeated use of active movements is that this could fatigue the muscles being contracted in this example, the tibialis anterior muscle.
4Repeat the stroke three or four times, with dorsiflexion.
Notice This is particularly effective at treating the middle and lateral aspects of the calf because you can more easily access these areas with your effleurage stroke.
Notice too that you cannot easily traction this particular jointCompare the previous two photos with the following photo to see how the technique can easily be applied to the forearm, where it is useful in increasing wrist flexion.
When used on the forearm it is easier to also traction the joint by gently pulling on the wrist as you also passively flex itNotice that to apply the technique to the wrist you must position your client so that this joint can be flexed; to do this, his hand needs to be resting over the end of the treatment couch.
Stretching With Oil Plus an active Joint Movement
In some situations, movement of the joint is best performed by the client, enabling the therapist to focus on facilitating the stretchGood examples are when treating the iliotibial band on the lateral side of the thigh, and when treating the hamstrings in supine.
In both cases, the therapist has less leverage than in the examples previously described, so he or she has slightly less compressive force at disposal; plus, applying the stretch while also moving the associated joint would be difficult.
Stretching the ITB With Oil Plus Joint Movement
Follow these steps to safely stretch the ITB.
1Position your client in three-quarter lying so that her knee rests on the edge of the treatment couch.
2With loosely cupped fists and trying to keep your elbows extended, apply pressure to the distal end of the vastus lateralis muscle, just superior to the knee jointTake care not to press too deeply into the lateral epicondyle of the femur in this region.
3Using a little oil, slowly fist up the iliotibial band as your client slowly flexes and extends her knee.
4Repeat three or four times.
Stretching in this way is particularly helpful for targeting localized areas of tension around a jointStretching the iliotibial band is reported to be helpful in treating conditions such as runner’s knee (iliotibial band friction syndrome), in which tension in the lateral retinaculum of the knee might be a contributing factor.
The value of active stretching is the client is in control at all times over the severity of the stretchIf clients feel the stretch is too strong, they simply stop moving that limbAlternatively, the therapist could apply less pressure to the stretch, and together the client and therapist can work up to a tolerable level in order to meet the treatment outcomes.
The downsides to active stretching are that not all clients want to take part in treatment in this way, and that to move a joint the client must be in a position in which this is possible.
Adding Traction In some places, you can stretch tissues further by combining traction with your movement of the jointThis is easier than it sounds and works best on the upper limb.
Of all the techniques described in this section, this is the most advanced because it requires you to perform several movements at onceHowever, you might already be doing this instinctivelyHere you were learning to combine flexion of the wrist with deep stretching massage to the wrist extensor muscles.
Can you see how you could also gently traction the wrist as you do this, pulling the wrist towards you with one hand as you apply deep effleurage away from you with your other forearms?
Safety guidelines for ‘With Oil’ Stretching
Avoid pressing too deeply over bony points, such as the lateral epicondyles of the femur when treating the iliotibial bandRemember that when a client actively moves a joint,
this is beneficial for reducing tone in the muscle being stretched, but if he or she moves the joint too many times the muscle being contracted will fatigue.
Do not use deep tissue stretching on clients with fragile skin or on clients who are hypermobile or who have hypermobility syndromesAvoid deep tissue stretching when its use will increase mobility in an unstable jointIf you intend to incorporate tractioning with oil stretching, be sure to read the safety guidelines for this technique mentioned above this guide.
Advantages, Disadvantages and uses of Stretching with Oil
1) Stretching with oil is ideal for improving the range of movement in a restricted joint.
2) It helps localize a stretch to a particular area of tissue.
3) It requires little effort from the therapist once the technique has been mastered.
4) It enhances the sensation of deep tissue massage.
1) The client needs to be positioned in such a way that movement of the joint is possible.
2) The technique needs to be used selectively and is not appropriate for all clients.
3) The technique takes time to learn and master, especially when a joint is moved passively and the therapist is required to be ambidextrousSituations When ‘With Oil’ Stretching Is Indicated
4) When you need to improve the range of movement in a restricted joint
5) When treating a muscle or area of tissue you have identified as being tight or shortened
6) When treating a client who requires the sensation of exceptionally deep tissue massage
7) When you wish to apply deep tissue massage but do not have adequate leverage for pure compressive techniques
8) When the use of stretching might be more effective than massage alone
Now you have learned stretching techniques both with and without oil and can use these along with compressive techniques to deliver deep tissue massageIn the next Posts, you will learn to use these techniques for treating different parts of the body.