Swedish massage is the most popular type of massage in the United States. It involves the use of hands, forearms or elbows to manipulate the superficial layers of the muscles to improve mental and physical health. Active or passive movement of the joints may also be part of the massage. The benefits of Swedish massage include increased blood circulation, mental and physical relaxation , decreased stress and muscle tension, and improved range of motion.
Swedish massage was invented by a Swedish fencing instructor named Per Henrik Ling in the 1830s. When he was injured in the elbows, he reportedly cured himself using tapping (percussion) strokes around the affected area. He later developed the technique currently known as Swedish massage. This technique was brought to the United States from Sweden by two brothers, Dr. Charles and Dr. George Taylor in the 1850s. The specific techniques used in Swedish massage involve the application of long gliding strokes, friction, and kneading and tapping movements on the soft tissues of the body. Sometimes passive or active joint movements are also used.
Unlike drug therapy, which is often associated with many systemic and long-term side effects, massage therapy is relatively safe and has few contraindications. It also provides many benefits.
There are numerous physical benefits associated with the use of Swedish massage:
- loosening tight muscles and stretching connective tissues
- relieving cramps and muscle spasms and decreasing muscle fatigue
- loosening joints and improving range of motion
- increasing muscle strength
- calming the nervous system
- stimulating blood circulation
- firming up muscle and skin tone
- relieving symptoms of such disorders as asthma , arthritis, carpal tunnel syndrome , chronic and acute pain syndromes, myofacial pain, headache , temporomandibular joint (TMJ) dysfunction, and athletic injuries
- speeding up healing from injury and illness
- improving lymphatic drainage of metabolic wastes
Mental and emotional benefits
Mental benefits associated with massage therapy include the following:
- mental relaxation
- improvement in length and quality of sleep
- relief of stress, depression, anxiety and irritation
- increased ability to concentrate
- improved sense of well-being
In Swedish massage, the person to be massaged lies on a massage table and is draped with a towel or sheet. It is a full-body massage treatment, except in areas that are contraindicated or where the client requests not to be touched. Aromatic or unscented oil or lotion is used to facilitate the massage movements. Each session usually lasts 30-60 minutes. Depending on the client’s preferences, a massage session may involve the use of several or all of the following basic techniques: effleurage, petrissage, friction, vibration, and tapotement.
Effleurage is the most common stroke in Swedish massage. It is a free-flowing and gliding movement towards the heart, tracing the contours of the body using the palm of one or both hands. Oil is applied with this stroke to begin the first stage of massage. The therapist applies a light or medium constant pressure. This stroke is used to warm up the muscles, relax the body, calm the nerves, improve blood circulation and heart function, and improve lymphatic drainage.
This technique resembles kneading dough. It involves lifting, rolling, and squeezing the flesh under or between the hands. Pétrissage is designed to release muscle tension, improve blood flow, and increase lymphatic drainage.
Friction strokes work on deeper muscles than the techniques previously described. The friction technique is a pressure stroke and is the deepest that is used in Swedish massage. The massage therapist applies pressure by placing the weight of his or her body on the flat of the hand and the pads of the thumbs, knuckles, fingers, or the back of the forearms, and then releases the pressure slowly and gently. This movement should be a continuous sliding motion or a group of alternating circular motions.
To effect vibration, the massage therapist gently shakes or trembles the flesh with the hand or fingertips, then moves on to another spot and repeats this stroke. Vibration is designed to release muscle tension in small muscle areas, such as those on the face or along the spine.
Tapotement, or tapping and percussion, is a quick choppy rhythmic movement that has a stimulating or toning effect. The following are variations of tapotement:
- Cupping : The therapist forms the hands into a cup shape with fingers straight but bending only at the lower knuckles; the thumbs are kept close to the palms. The therapist strikes the flesh with the flat of the hands one after another in quick succession.
- Hacking: This technique is similar to cupping. The therapist uses the sides of the hands with palms facing one another to make a chopping movement.
- Pummeling: For this stroke, the therapist makes loose fists in both hands and applies them rapidly in succession over the thighs and buttocks.
Tapotement techniques are invigorating to most people but may be too intense for some. When prolonged, tapotement leads to overstimulation and even exhaustion of the nerves and muscles. In addition, it should not be used over varicose veins or directly above bony structures.
Swedish massage requires the following equipment:
- Massage surface: This may be a professional massage table or any firm but well-padded surface.
- A clean sheet to cover the part of the body that is not massaged.
- Cushions: These may be needed, depending on the client’s wishes, to prevent lower back pain. The cushions may be placed under the head and the knees.
- Oils: The base oil should be a vegetable oil, cold pressed, unrefined, and free of additives. These oils contain such nutrients as vitamins and minerals in addition to fatty acids. They do not clog the pores as mineral oils often do. Essential (aromatic) oils may be added to provide additional relaxation or other therapeutic effects. Massage oil should be warmed in the therapist’s hands before it is applied to the client’s skin.
Swedish massage should not be given to patients with the following physical disorders or conditions:
- nausea, vomiting or diarrhea
- broken bones, fractures , dislocations, or severe sprains
- contagious diseases
- open or unhealed sores or wounds
- body areas that are inflamed, swollen or bruised
- varicose veins
- recent surgery
- severe pain
- kidney disease
- large hernias
- torn ligaments, tendons, or muscles
- high blood pressure or heart problems
- certain kinds of cancer
- history of phlebitis or thrombosis (These patients may have blood clots that may become dislodged and travel to the lungs, with potentially fatal results.)
- drug treatment with blood thinners (These medications increase the risk of bleeding under the skin.)
Some clients with histories of physical violence or abuse may feel uncomfortable about removing their clothing or other aspects of massage. A brief explanation of what happens in a massage session and how they can benefit from massage is usually helpful.
There have been few reported side effects associated with massage of low or moderate intensity. Intense massage, however, may increase the risk of injury to the body. Vigorous massage has been associated with muscle pain and such injuries as bleeding in the liver or other vital organs, and the dislodgment of blood clots.
Research & general acceptance
Swedish massage is now gaining acceptance from the medical community as a complementary treatment. Studies have shown that massage can relax the body, decrease blood pressure and heart rate, and reduce stress and depression. It may also provide symptomatic relief for many chronic diseases. Many doctors now prescribe massage therapy as symptomatic treatment for headache , facial pain, carpal tunnel syndrome, arthritis, other chronic and acute conditions, stress, and athletic injuries. Many insurance companies now reimburse patients for prescribed massage therapy. As of 2000, however, Medicare and Medicaid do not pay for this form of alternative treatment.
Training & certification
There are 58 training programs accredited by the Commission for Massage Therapy Accreditation/Approval in the United States. They provide a minimum of 500 hours of massage training. Certified therapists have graduated from these programs and passed the national certification examination for therapeutic massage. They are also required to participate in continuing education programs to keep their skills current.
There are several national associations for massage therapists in the United States, including the American Massage Therapy Association and the National Association of Nurse Massage Therapists. Persons interested in massage therapy should contact these organizations for referral to local certified therapists.
Beck, Mark F. Milady’s Theory and Practice of Therapeutic Massage, 3rd ed. Albany, NY: Milady Publishing, 1994.
Claire, Thomas. Bodywork: What Type of Massage to Get and, How to Make the Most of It. New York: William Morrow and Company, Inc., 1995.
Trotter, James F. “Hepatic Hematoma after Deep Tissue Massage.” New England Journal of Medicine 341 (1999): 2019-2020.
American Massage Therapy Association. 820 Davis St., Suite 100. Evanston, IL 60201. (847) 864-0123. Fax: (847) 864-1178. http://wwww.amtamassage.org.
National Association of Nurse Massage Therapists. 1710 East Linden St. Tucson, AZ 85719.
National Certification Board of Therapeutic Massage and Bodywork. 8201 Greensboro Dr., Suite 300. McLean, VA 22102. (703) 610-9015. (800) 296-0664.