Classic massage: how a treatment works and the techniques used

What classic massage is

Classic massage is the most widespread form of massage in Germany. It is also called Swedish massage, after the Swede Per Henrik Ling, who combined movement and hand techniques into a system in the 19th century. The French names of the techniques, still found in textbooks today, go back to the Dutch physician Johann Mezger. The work is done with the hands directly on the skin, usually with oil or lotion. How it differs from Thai, Shiatsu or hot stone massage is explained in Types of massage at a glance.

How a treatment works

1. Conversation: Where is the tension, since when, are there any pre-existing conditions or medications? In a clinic, a short palpation is part of it too.
2. Undressing: Only the area being massaged is uncovered. Your underwear stays on, and the rest of you lies under towels.
3. Positioning: Lying on your front, your face rests in an opening in the table, and a cushion under your ankles takes the strain off your lower back. Lying on your back, a roll goes under your knees.
4. Warming up: Large, calm strokes spread the oil and get the body used to the hands.
5. Main part: Kneading for the large muscles, small circular friction on tendon attachments and hard spots.
6. Winding down: Stroking again, slower and lighter than at the start.
7. Afterwards: Stay lying down for a moment and get up slowly. After lying down for a while, your circulation can lag briefly.

The five techniques and what they are for

Stroking (effleurage)

Flat hands glide over the skin with even pressure, usually towards the heart. Stroking opens and closes every massage and links the other techniques.

Kneading (petrissage)

The muscle is grasped, lifted slightly and shifted against itself. This is the core of classic massage and the technique most people associate with massage.

Friction

Fingertips or thumbs work in small circles on a narrowly defined spot. The technique is meant for hard points and attachments and can be clearly noticeable.

Tapping (tapotement)

Loose, springy strikes with the edge of the hand, a cupped hand or the fingertips. They have a stimulating effect and are used only briefly, and not at all over the kidneys and spine.

Vibration

The hand rests on the body and trembles finely and rapidly. The technique is tiring for the therapist and is therefore only used on individual spots.

How to use the techniques at home on a partner is described in Back massage at home. More on the origins and variations of the techniques is in Swedish massage: the five basic techniques.

Clinic, wellness or massage chair

On prescription, the treatment is called classic massage therapy and is provided by physiotherapists or by masseurs with medical training. According to the German catalogue of prescribed therapies, the standard treatment time is 15 to 20 minutes. Wellness massages last longer but follow the same order.

A massage chair mainly imitates kneading and tapping and works with fixed programmes. Fine friction on a single point is something hands do better. If you would like to try how the techniques feel in a chair, you can do so at the NAIPO Relax Lounge in Hamburg. For home use, there are smaller massagers for individual parts of the body.

What studies say about its effects

A meta-analysis of 37 studies found that even a single massage lowered momentary tension, blood pressure and heart rate, but not the stress hormone cortisol. A series of treatments reduced ongoing anxiety and low mood most clearly. In a small study with healthy adults, a 45-minute Swedish massage changed some hormone and immune values in the blood more than light touch did. The authors themselves call this preliminary.

For back pain, a Cochrane review reaches a cautious conclusion: massage eased the pain mainly in the short term, and the quality of the evidence is low to very low. The most common side effect was temporarily increased pain. So massage is a good addition to exercise, not a replacement.

When to skip it or ask first

No massage is given with a fever, acute inflammation, fresh injuries, a rash or open wounds in the treatment area. If a thrombosis is suspected, if you take blood-thinning medication, during pregnancy or with heart conditions, check with a doctor before having a massage. If pain radiates into an arm or leg and numbness or weakness are added, the cause needs to be looked at by a doctor.

Frequently asked questions

Does a classic massage hurt?

You may feel it, especially with friction on hard spots. It does not have to be painful. Speak up if the pressure is too strong.

How often should you have a classic massage?

That depends on your goal. On prescription, several appointments in quick succession are usual. For relaxation, many people find one appointment every few weeks is enough.

What is the difference from a sports massage?

A sports massage uses the same techniques but works more vigorously and specifically on the muscles a particular sport puts under strain.

Sources

• Moyer CA, Rounds J, Hannum JW (2004): A meta-analysis of massage therapy research. Psychological Bulletin. doi:10.1037/0033-2909.130.1.3
• Rapaport MH, Schettler P, Breese C (2010): A preliminary study of the effects of a single session of Swedish massage on hypothalamic-pituitary-adrenal and immune function in normal individuals. Journal of Alternative and Complementary Medicine. doi:10.1089/acm.2009.0634
• Furlan AD, Giraldo M, Baskwill A et al. (2015): Massage for low-back pain. Cochrane Database of Systematic Reviews. doi:10.1002/14651858.CD001929.pub3

This article does not replace medical advice.