Massage Therapy Journal Spring 2024

Spring 2024 • 57

A common cross fiber friction protocol to use with your clients: 1. Do not use any oils, creams or lotions on the skin. 2. Warm the area with some petrissage or effleurage techniques. 3. Assess the area for tissue restrictions. 4. Apply pressure to immobile tissue. 5. The pressure must be enough to access the correct muscle or ligament layer, while working within the client’s pain threshold; the level of discomfort should not exceed more than a six or seven out of 10 on the numeric pain scale. 18 Use fingers or thumbs to move across the fibers of the muscle. 6. Continue to cross fiber the area for 10 to 30 seconds. 7. Reassess to see if there has been a change in the mobility of the tissue. Muscle Stripping. Muscle stripping is a focused technique that glides parallel with the fiber direction. This technique incorporates very slow, deep and specific gliding over the length of a muscle or tendon. The goal is to reduce trigger points, stretch fascial components of the associated muscle and restore muscle fibers to functional capacity. 19 Some common contraindications and cautions around muscle stripping include: • Anticoagulant or antiplatelet medications • Local bacterial infections • Bruises • Local skin diseases • Areas of decreased sensation • Fragile skin A common muscle stripping protocol to use with your clients: 1. Assess the tissue area for restrictions. 2. The depth of the strokes is dependent on the area and muscle layer. Lighter pressure will be used in areas where the target muscle is superficial, such as the wrist flexors; deeper pressure can be applied to muscles like the hamstrings. 3. Pressure is always to the client’s tolerance and should never elicit a pain level higher than that of a seven or eight out of 10 on the numeric pain scale.

4. Approximately three attempts should be made in the target area. Client should be checked for comfort and approval to continue. 5. Petrissage or a stretching technique should be used post stripping to separate contractile mechanisms of the target muscle. 6. Reassess to see if there has been a change to the tissue. Pin and Stretch Techniques. Pin and stretch techniques are soft tissue techniques that can be highly effective for treating muscle, tendon and fascia disorders. This technique focuses a stretch to a very specific region of a muscle, tendon or fascia. Thumbs, fingers, knuckles, forearms or elbows can be used to apply the focused force. The therapist “pins” a specific area and then takes the joint or tissue into a stretch. Some common contraindications and cautions around pin and stretch techniques include: • Anticoagulant or antiplatelet medications • Local bacterial infections • Bruises • Local skin diseases • Areas of decreased sensation • Fragile skin A common pin and stretch protocol to use with your clients: 1. Assess the area for tissue density and immobility. 2. Bring the jointed area into a passively contracted state. 3. Pin the tissue. 4. Maintaining the applied pressure or “pin,” take the jointed area into a stretch. 5. Remove pinned pressure. 6. Repeat the technique by again applying a pin pressure to an area close to the first application. 7. Repeat steps two, three and four between three and five times. 8. Reassess tissue for changes.

Muscle energy techniques (MET) is the name for a group of manual therapy techniques used by massage therapists, physical therapists, chiropractors and osteopathic doctors. The goal of these techniques is to improve joint mobility, reduce muscle tension and decrease musculoskeletal pain.

Positional Release. Positional release technique (PRT), also known as strain

counterstrain, is a manual therapy technique that is commonly used by massage therapists, physical therapists and orthopedic physicians alike. Strain

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