Massage techniques: effleurage and petrissage

Effleurage and petrissage are essential tools in the arsenal of every massage therapist. While there are generally recognised ways of applying them, one’s imagination is the only limiting factor.

​Effleurage is an umbrella term for massage strokes of varying length that are applied longitudinally or transversely to the fibres. It is usually the first technique that a massage therapist learns. Effleurage us used at the beginning of the session to warm the tissue, as a transition between other techniques, as well as at the end of the session to provide gradual and rewarding conclusion. The pressure and speed can of the strokes can be modified to according to the goals and stage of the massage. The word ‘effleurage’ comes from the French word, effleurer, which means to skim.
 
Effleurage can be applied with two hands, a hand fist or forearm when a broader stroke is needed. Using the fingers, thumbs, elbow or knuckles affords a more targeted approach. It should be performed in a smooth and rhythmical manner starting with a light and gentle touch. A slower movement with deeper pressure to increase circulation and stretch the tissues can follow. Ideally, the hands follow the contours of the client’s body and are relaxed. It is important to apply this technique slowly at the early stages of massage to start sensing the condition of the tissues underneath and help the client relax.
 
Older sources, recommend applying effleurage only centripetally (towards the centre of the body) as it was considered that its most prominent role is to accelerate the circulation of blood and lymph. This is still a very good general recommendation to follow especially when massaging the hands and legs. In some instances, this ‘rule’ does not apply.
 
Effleurage can be applied to most body parts with sufficient inventiveness on the part of the therapist. Some of the more common areas include the arms, lower and upper back, and the legs.  

Purpose and benefits of effleurage

• Introduction and warm up – effleurage is the ideal technique to introduce the therapist’s touch to the client’s body and bring heat to the superficial tissues. Attention and care to this first stage are essential as they leave a strong impression on the client’s attitude toward the practitioner and on the client’s body and nervous system.

• Investigation – the slow and usually long strokes of effleurage allow the practitioner to focus on sensing and palpating the condition of the underlying tissues. This can inform the subsequent stages of the treatment.

• Relaxation – with its slow, gentle, rhythmic movements effleurage stimulates the parasympathetic nervous system. This system promotes relaxation and growth, increases body temperature, lowers the hart rate and releases hormones producing a feeling of well-being. If relaxation is the primary objective of the client, effleurage can be used as the sole technique delivering a complete and enjoyable experience.

• Post-injury – when performed centripetally, effleurage encourages lymph flow, which is essential for the immune system and the body’s ability to drain waste products. This helps to reduce swelling and fight infections by promoting the flow of white blood cells to the area. In the aftermath of an injury, effleurage may well be the only technique that is gentle enough to bring benefit to the client with minimal risks.

• Post-surgery – if the medical intervention has damaged or removed lymph nodes this can have a systemic effect on the whole lymphatic system. In such cases, effleurage would be essential in promoting and maintaining the flow of lymph. This reduces the risk of lymphedema (built up of excess fluid) and supports the body’s recovery in a holistic way by increasing circulation.

• Circulation – as already alluded, effleurage increases venous return (flow of deoxygenated blood back to the heart) and promotes the flow of the lymphatic system. This exerts a systemic effect on the body and can lower blood pressure, improve the immune function and accelerate healing.

• Affect mood and mental performance – the release of hormones that promote well-being mentioned earlier is a very important effect of effleurage. Effleurage promotes the release of endorphins (pain-relievers) and dopamine (an important neurotransmitter) and the synthesis of serotonin (powerful influencer of mood and social behaviour, appetite and digestion, sleep, memory and sex drive). There are many clinically documented cases where symptoms of depression have been reduced or totally eliminated with massage.

• Healing and recovery – effleurage improves healing and recovery with its systemic and local effects respectively. By promoting circulation across the body, it has a beneficial effect on the body’s healing ability as a whole. Effleurage speeds up recovery by increasing blood flow in the local area, thus enhancing the delivery of fresh blood, oxygen, nutrients, and antibodies if needed. 

 
Petrissage
 
Petrissage is probably the second most often used massage category following effleurage. It includes a variety of movements including lifting, squeezing and compression with both hands in a rhythmical manner. It can be applied either more broadly with the whole hand or in a more targeted way using the fingers.
 
The word ‘petrissage’ comes from petrir, which in French means to knead. It was introduced in the late 1800s to define a certain type of bodywork by Dr. Johan Georg Mezger.
 
In petrissage, the therapist separates tissues from structures to loosen and stretch the muscle fibres. This also activates vascular and lymphatic responses in the skin and the treated area. The circulatory and lymphatic responses facilitate the draining of toxins and enhance blood circulation. Petrissage can also loosen up muscle fibres and help break down adhesions – thickenings of muscular tissue following surgery or injury.
 
Following a general warming up of the tissue with effleurage, the therapist can proceed with petrissage to help stretch and relax the muscles and bring fresh nutrients to the area via the blood. 

Usually, both hands are used alternately as a unit when performing petrissage. It may be hand over hand, hands moving towards one another or away but there is always rhythm and cooperation. The following techniques fall under the more general umbrella term, petrissage:

• Kneading is usually performed in a circular fashion and involves picking up and squeezing. The soft tissues and the skin are gently lifted and then rolled away from and back to the bone with a compressive stroke. By modifying the pressure, kneading can be either superficial or very deep.
• Lifting involves the lifting up, squeezing and release of tissue. Unlike kneading, it can easily be applied with a single hand and usually the thumb and the first two fingers are used rather than the whole palm.
• Rolling as the name suggests is the lifting up and rolling between the fingers of the either of the skin or the fascia and even the muscle fibres as well.
• Wringing refers to the pressing of tissue against the underlying structure and then gently lifting it away. It can be performed with the whole palms or alternatively the tissue is pulled with the fingers of one hand while pushing back with the thumb of the other hand. This technique applies equally well to both small and large areas.
• Milking is usually reserved for larger muscles like the legs, the shoulders, and the back. Like in kneading, the muscle is held with both hands and squeezing is applied in a rhythmic manner.

 
Purpose and benefits of petrissage

• Improve circulation – Like effleurage, petrissage also increases venous and lymphatic return. This is beneficial for the whole body as it accelerates the delivery of fresh blood and nutrients and the removal of waste products as well. This is a key reason why petrissage is a key feature of most massage sessions.
• Loosen and stretch – The squeezing and kneading strokes of petrissage help with lengthening the muscle fibres. This enhances muscle function, helps eliminate scar tissue and adhesions and reduces the risk of injuries.
• Increase range of motion – As muscle fibres are released, they can slide past each other more easily and a greater muscle length can be achieved. This naturally improves flexibility and results in a greater range of movement.
• Relax – With improved circulation, well-being hormones are distributed to the body more effectively. When this is coupled with the release of muscle tension there, relaxation is the expected outcome.
• Reduce DOMS – Locally, petrissage facilitates the healing and repair of muscle fibres following exercise. Systemically, by improving circulation, petrissage facilitates the removal of lactic acid from muscles which either eliminates or reduces delayed onset muscle soreness (the burning uncomfortable feeling in muscles starting 12 to 72 hours after exercise).
• Stimulate skin – Kneading movements effectively stimulate the skin and make it glow. Cell regeneration in the skin is identified thanks to minimising surface tension and improving circulation. Additionally, petrissage can help re-hydrate dry skin by increasing natural oil production.
• Mobilise fat – Petrissage can very effectively mobilise subcutaneous (located under the skin) fat. This can enhance weight loss and cleansing as body fat is often stored as a site for accumulated wastes in the body.

 
Considerations
 
In most cases, petrissage is safe and very effective technique, which often constitutes the bulk of a Swedish massage session. Still, it is essential to exercise caution in some cases.
 
Petrissage is inappropriate over inflamed areas, new scar tissue, swelling, damaged skin or in the aftermath of recent injuries. After a surgery, for example, it is important to allow sufficient time for recovery before applying petrissage anywhere near the area. The therapist must also be careful when applying petrissage to pregnant women. Because of the hormone relaxin released during pregnancy, their ligaments, tendons, and fascia become soft and vulnerable compromising joint stability.  
 
Effleurage and petrissage are versatile techniques that form the basis of most massage sessions. They can be used to deliver a complete massage experience even without frictions or tapotement. Mastering these two is a sure way of deepening one’s ability to benefit the client through massage.

Related articles:
Massage techniques: friction​
Massage techniques: tapotement