May 3rd, 2010
A well-executed effleurage technique can be a massage therapist’s bread and butter. If done skillfully, a full body Swedish massage session can be performed using only this stroke, and your client will come away feeling stress-free and eager to make another appointment. This is the first installment of the Institute’s four-part series of informative articles about massage stroke review.
by Linda Fehrs, LMT
The term effleurage is derived from the French word effleurer meaning “to touch lightly.” The first use of the word to describe effleurage as a massage stroke category is attributed to Dr. Johan Georg Mezger (1838-1909) of Amsterdam. One of the primary techniques of massage therapy, effleurage is very versatile and easy to perform.
Aside from a specific rehabilitative medical massage or a particular individualized overall technique, effleurage is a part of every massage routine and usually the first stroke a massage student learns how to do. Learning how to do effleurage with confidence and skill is very important, as the recipient can be sensitive to a therapist’s insecurity or lack of proficiency.
Effleurage is often used as an opening stroke in a massage routine. It helps spread the lubricant evenly and is invaluable as a hands-on assessment tool. It is also used as a transitional, or connecting, stroke between other techniques. It allows the massage therapist to maintain continuous contact with the client’s body throughout the session and gives the receiver a feeling of one continuous movement as the session progresses.
With effleurage, the massage therapist’s hands are relaxed and usually open-palmed, but variations of the stroke can also be done with the forearm, the knuckles or even just the fingers. Even pressure should be maintained from the tips of the fingers to the palms of the hands, with as much of the palmer aspect of the hand in contact with the client’s body as possible. The strokes should be long, steady and rhythmic. They should have an even flow to them with no jerky or abrupt movements.
Effleurage can be done very lightly, with the skin not moving or “buckling” as you glide over it. This is helpful for assessment as it allows for the evaluation of superficial tissue regarding temperature, muscle tone and edema. It can reveal possible inflammation, injury or stress in your client’s body. Light effleurage is also a gentle way for you to introduce your hands to the client, and induces a relaxation response via the parasympathetic (rest and digest) nervous system. (A version of extremely light effleurage would be lymph drainage massage, which uses almost no pressure at all and the strokes are very slow.)
Deeper effleurage can be as calming as lighter strokes. As you press deeper, the skin beneath your hands may ripple slightly ahead of the stroke. It has an inhibitory effect on muscles and their proprioceptors (nerves, muscle spindles, Golgi tendon organ). When first learning massage, students are often nervous about going too deep for fear of hurting the client. But, done correctly, you can put an enormous amount of pressure on a person’s body without injuring them. It is important to continuously check in with your client to make sure he or she is comfortable with the pressure depth.
Mechanical Effects of Effleurage
The mechanical, or physical, effects of effleurage include helping to move blood and lymph more efficiently. The general rule with effleurage is to perform the strokes centripetally, or toward the heart (along venous return). This helps to bring nutrients to, and remove toxins from, various organs and muscles. The exception would be in atypical circumstances where you might want to warm extremities and improve blood flow to the feet or hands. In those cases, moving blood along the arterial flow would be preferred.
Effleurage can be very effective in reducing pain. Pain is often produced by edema, or fluid buildup, that produces pressure within the tissues and causes a stimulation of pain receptors (nociceptors). The increased venous flow caused by massage can reduce this pressure by helping to drain the fluids. The reduction, or even elimination of pain, also comes from the fact that effleurage strokes stimulate the release of natural painkillers (endorphins) and help block pain impulses.
Effleurage strokes also stimulate nerve endings, which, in turn, have an indirect effect on other areas of the body. This is done through the autonomic nervous system, which in part, innervates the cardiac and smooth muscle, various glands and the gastrointestinal tract. This reflex effect can influence the release of chemicals and hormones into the system that induce relaxation, such as various neurotransmitters, vasopressin and oxitocin. This can also help to decrease blood pressure, lessen overall stress or even alleviate depression.
In general, effleurage is a safe technique that can be used in almost any situation, though there are a few precautions. You would not want to use it on someone with a recent injury, an open wound or over skin irritations such as a rash. The backs of knees, the areas over the kidneys and the front of the neck can receive a light touch, but no deep pressure, as these areas can easily be injured.
5 Things to Keep in Mind
- While contact between your hands and the client’s body is always maintained in effleurage strokes, pressure is only applied in strokes going toward the heart. The return stroke is lighter and should not affect the blood flow.
- Keep the pace of your strokes even and rhythmic. When done slowly (no more than 1-2 strokes per second), it produces a sedative reaction in the body much in the same way that rocking a cradle relaxes a baby.
- The longer the stroke, the better it feels to the client. Long, gliding strokes that go along the entire length of a muscle, or even the entire length of a limb, feel much more soothing than short, quick movements. With practice you will be able to perform quite long strokes and still maintain good body mechanics.
- If you try to do deeper effleurage strokes for an hour or more, you may become quite tired. Work using your own body’s center, your own body weight and gravity to achieve effective depth of pressure, and you should find that it is not as tiring.
- While an entire massage can be performed using only effleurage, you will usually want to include other strokes such as petrissage, friction, tapotement and vibration along with some range of motion.
Effleurage techniques are the ones clients are the most familiar and comfortable with. It is the primary tool in the massage trade and easy to perfect. Done well it will keep your clients relaxed and eager to return for more.
Beck, Mark F. Milady’s Theory and Practice of Therapeutic Massage. 3rd. Albany, NY: Milady Publishing, 1999.
Calvert, Robert Noah. The History of Massage: An Illustrated Survey From Around the World. Rochester, VT: Inner Traditions/Bear & Company, 2002.
Cassar, Mario-Paul, ND DO. Handbook of Clinical Massage: A Complete Guide for Students and Practitioners. 2nd. Philadelphia: Churchill Livingstone an imprint of Elsivier Ltd, 2004.
“Glossary – Effleurage.” Ivy Rose Holistic Health and the Human Body. 31 Jul 2008 www.ivy-rose.co.uk.
Mally, Dr. James. Swedish Massage with Dr. James Mally. Roseville, CA: Abundant Health Resources, 2000.
Uvnäs Moberg, MD, PhD, Kerstin. The Oxytocin Factor: Tapping the Hormone of Calm, Love, and Healing. Cambridge, MA: Da Capo Press, 2003.
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