Touch and massage

8 Touch and massage

Touch and massage

Massage begins with touch, which all of us need; it conveys a feeling of warmth, relaxation and security all beneficial to good health. There are many empirical examples of massage therapy effects, including reduction of pain during childbirth and lower back pain (Field 2000 p. 45), even without essential oils. The addition of essential oils with analgesic properties enhances the relief obtained by massage alone.

Massaging babies and infants can reduce pain associated with teething, constipation and colic, as well as inducing sleep (Auckett 1981). Studies carried out on preterm infants showed without doubt that massage was beneficial to their growth and development (Field et al. 1987). The babies were massaged for 15 minutes three times a day for 10 days in an incubator. Compared with the control group, 47% of the treated infants gained more weight and were hospitalized for 6 days less.

Patient benefits

Whether the causes of ill-health are biomechanical, psychosocial, biochemical or a combination of these, massage seems to be able to exert a beneficial influence (Chaitow 2000). Touch itself is a basic human behavioural need (Sanderson, Harrison & Price 1991) and ‘may be the only therapy which is instinctive; we hold and caress those we wish to comfort; when we hurt ourselves, our first reaction is to touch and rub the painful part’ (Vickers 1996).

As research and scientific developments in the efficacy of drugs forged ahead, close patient contact diminished and by the 1960s massage had more or less lost its therapeutic status in medical care. However, in the late 1980s and 1990s there was renewed interest by nurses in the value of touch, and now many hospitals and hospices are using massage to benefit their patients; during this time massage has been enhanced by the addition of essential oils, transforming the treatment into aromatherapy (Buckle 1997) (see Box 8.1). The benefits are further enhanced by the choice of essential oils used (Wilkinson 1995) increased energy levels, reduced side effects from drugs, symptoms not treated by the hospital relieved and emotional problems eased. The effects can last longer than those of massage alone, owing to the therapeutic action of the essential oil components (see Chs 1015).

Box 8.1 The Experiences and Meaning of Touch among Parents of Children with Autism attending a Touch Therapy Programme

Barlow and Cullen (2002) instigated a touch therapy programme aiming to enhance parents’ perceptions of closeness with their children and provide them with an alternative to verbal communication to promote the latter. Parents of children with autism were taught simple massage techniques over 8 weeks. Having practised massage with their children, parents reported that the children tolerated the massage and not only were routine tasks such as dressing tolerated more easily, but the children appeared generally more relaxed. Parents reported feeling closer to their children and that touch therapy had opened a communication channel between them.

Patients can benefit from a massage (simple or involved) given by any of the following:

The most important thing to remember is that nothing can replace hands-on, when the giver (whether or not a qualified masseur/se) is caring and works within his/her capabilities, combining gentle touch with a loving attitude. With the right approach, beginning with a small non-intrusive movement, both the giver and the receiver can come to enjoy the care they are sharing, making it easier for the receiver to open up and become more relaxed in body and happier in mind (Worrell 1997). Authors agree that it is not necessary to spend an hour on a massage for it to be effective – people also benefit from a short period of dedicated time.

Massage and aromatherapy therapies in their own right

Professional massage

Several colleges run short courses that are not sufficiently comprehensive to confer a recognized massage qualification. To meet professional standards and be competent to give a full, professional massage,

Case study 8.1 Anxiety


Because of the amount of anxiety she was experiencing she was taken through some breathing exercises before a full body massage, which was carried out using:

Kay opted for treatment twice a week and after the first treatment said she felt much calmer and more relaxed. She was standing upright rather than being bent over with the shoulder tension, and said that her head felt much clearer.

She was given a blend of the following neat essential oils to use at home in the bath, and as an inhalant if required:

1 mL Valeriana officinalis [valerian] – sedative, tranquillizing

1 mL Chamaemelum nobile – properties as above

2 mL Lavandula angustifolia [lavender] – analgesic, balancing, calming and sedative, tonic

2 mL Origanum majorana – properties as above

3 mL Cananga odorata [ylang ylang] – balancing, calming, sedative

On her next visit Kay reported that she found inhaling the oils when particularly anxious had relieved the hyperventilation and helped her to relax; she had also started to incorporate breathing exercises into her routine.

After six treatments over 3 weeks, Kay felt sufficiently confident to go shopping without anxiety. She had also been able to resolve some of the problems at work. She was beginning to put weight back on and her appetite had returned to normal.

She therefore decided to reduce her treatments to once a week, and after 3 more weeks she felt able to resume some of her work duties, when she reduced her treatments to once a month. She had not ceased taking her medication during her aromatherapy treatment time, but 6 months after first commencing aromatherapy, her doctor felt he could reduce her medication over the next 3 months.

At this time, she found she was able to carry out her normal work schedule and once again enjoy social activities. … She now goes for aromatherapy treatments when she feels the need.

the therapist must know anatomy and physiology, understand the relationship between the structure and function of the tissues being treated, and be knowledgeable in pathology, as well as being skilled in the proper manipulation of tissues (Beard & Wood 1964 p.1).

Beneficial effects of massage

Massage is widely recognized as providing the following benefits; it:

These combined benefits not only result in increased body awareness, but also produce better overall health. Studies carried out in hospitals and private practice have shown that massage with essential oils greatly enhances and prolongs the health-giving effects.

Simple massage skills

The most easily acquired massage skills are:

Stroking, which comes under the heading of effleurage movements (perhaps the most important for hospital use), for which the whole of both hands from fingertips to wrist should be used. Stroking is simply an extension of touch and, as well as being one of the simplest, is one of the most important movements in massage.

Frictions, which come under the heading of petrissage (a deeper and more energetic series of movements than effleurage), and in which either the thumb or one or more fingers are employed. ‘Rubbing it better’ is a simple friction movement. The Hippocratic writings (from the Hippocratic collection 460357 BC) remarks that ‘the physician must be experienced in many things, but assuredly also in rubbing, for rubbing can bind a joint that is too loose and loosen a joint that is too hard’.

Case study 8.2 Depression

Everyone has an innate ability to perform these two movements correctly and safely without the need for long training; both are taught thoroughly on aromatherapy courses.

Three further techniques, requiring greater skill and best learned on an accredited massage course, are:

Other factors

Learning the different movements is only part of massage training. Equally important is the way in which these movements are performed. Essential factors to consider are contact, the direction of movement, the amount of pressure, the rate and rhythm of the movements, the medium used, the position of both patient and therapist, and the duration and frequency of the treatment (Beard & Wood 1964 pp. 3740). Further factors include the need for full contact with the patient and complete relaxation of the masseur’s own hands and arms because hard, tense hands transfer tension (and possibly pain) to the recipient. The mind should be cleared of any intruding, disruptive thoughts: the wellbeing of the client and how he/she can benefit must be uppermost.

The following principles need to be absorbed at the same time as the actual movements are learned.


No part of the human body is flat; nevertheless, when using effleurage (stroking movements) there should be full hand contact with every part of any large area to be massaged (Price 1999). Nothing breaks the relaxing effect of massage more than the repeated lifting off and replacing of hands. Fully relaxed hands and fingers maintain this contact by following the body’s contours closely, draping themselves over the body like silk. The hands should remain in contact with the body for both outward and return journeys of all movements made in sequence: lifting off disrupts the flow of the massage as a whole (Price 2000 p. 203).


In effleurage on a large area pressure should always be concentrated on the palm of the hand (Price 2000 p. 201). The fingers should be kept completely relaxed because pressure from fingers is not relaxing finger pressure should be used in friction movements only. Normally, palm pressure should be applied only when moving towards the heart, with none on the return journey. One of the aims of massage is to stimulate the circulation (the return of venous blood is not easily accomplished by the heart pressure towards the heart increases the rate of circulation. The lymphatic flow is also increased, ridding the body more quickly of any harmful substances.

Pressure in frictions using the thumb or finger pads needs to be firm, but care must be taken to use the whole finger pad and not to dig in with the tip.


Uneven or jerky movements are not conducive to relaxation and care should be taken to maintain a smooth, unbroken rhythm (Price 2000 p. 203). While massaging, relaxing music with a gentle rhythm can be of great help in sustaining continuous, fluent and flowing effleurage movements. Frictions also should be performed rhythmically (Beard & Wood 1964 pp. 1011).

Contraindications to massage

Contraindications to massage depend very much on the type of condition suffered. The lists below should be consulted to determine whether massage of any kind is appropriate or not.

Dec 12, 2016 | Posted by in GENERAL & FAMILY MEDICINE | Comments Off on Touch and massage
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