Wringing Petrissage Stroke – How to Where to & Effects

Wringing is what is termed a medium depth stroke. These are deeper strokes than effleurage that stimulate muscle tissue under the epidermis and dermis. It is done using 2 hands, pulling flesh and then pushing it together. Therapists may look like they are dancing as they use this rythmic technique. There are many benefits to using this stroke including, aiding circulation, stimulating the filtering of toxins and relaxing muscles.

Wringing is a medium depth stroke used in a full body Swedish massage routine. This means the pressure applied by the hands when doing it is more pressure than superficial (light) and less pressure than deep (hard) strokes. It will affect the skin itself, the myofascial layer just under the skin and 1^st layer of muscles. There might also be some effect a bit deeper but, generally this won’t be great. Medium depth strokes are generally the second type of stroke used, after effleurage.

How to Do Wringing Massage

The stroke is done using 2 hands. Hands are placed on muscle as though to grasp (not pinch) flesh between fingers and thumbs. The flesh is lifted and pulled away from the bones. Then the flesh is wrung or squeezed, as you would wring a cloth but, in a slightly gentler motion, to be comfortable. You should be pushing one hands flesh toward the others. This side to side and up and down motion will free up the muscles you are working on. You must be in good communication with your client to make sure you are not using too much or too little pressure with this technique.

Done With the Aid of Rocking to Conserve Energy

Wringing must be used at the right time, that being after effleurage. Using this stroke to spread oil might be difficult or even painful. The strokes can be quite tiring to do. A tired therapist will not be as helpful as a lively, fresh one. So as your therapist does them, they should rock back and forward. This means body weight is used in addition to arm muscles. If seen from fly on the wall camera view, it can look like your therapist is dancing.

Where to do it

Good fleshy area where lots of muscles an be grasped are the place to do this. Examples include the back (trapezius), thighs (quadriceps), calves (gastrocnemius). on the ribs and back and upper arms (triceps and biceps). It can also be useful on the shoulders, sides of the lower back, buttocks (gluteus maximus) and across the stomach. (R Hull 2013)

Effects of Wringing

• Aids the circulation of skin and underlying muscle tissues.
• Forces deoxygenated blood into capillaries and out into veins.
• Stimulates the interstitial fluid (the liquid that muscle cells are bathed in) to be taken up by lymphatic capillaries, vessels and then filtered in lymph nodes.
• Improves extensibility or elasticity of tissues. (Rosser 2016)
• Stimulates filtering of toxins, bacteria and damaged cells.
• Raises flesh temperature aiding relaxation.
• Releases tension in muscles while relaxing them.

 

References:

Rosser, M. (1996) Body Massage Therapy Basics, London, Hodder & Stoughton

Hull R (2013) Anatomy & Physiology for therapists and healthcare professionals, Cambridge, The Write Idea

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Massage for Osteoarthritic Knee Pain Can Help

There are many painful complications that come with Knee Osteoarthritis. There are also a number of different recommended treatments giving relief from the symptoms. One of these that has proven to be beneficial through many studies is massage therapy. Our guide to self-massage below can help you but, a professional massage therapist will likely help much more.

Symptoms of Osteoarthritis are Common 

Osteoarthritis is the most common form of arthritis in the UK according to the NHS (2019). Its symptoms range from severe pain in joints to them just being slightly stiff. This pain and stiffness can come and go on one person and be constant source of discomfort for others. Any joint in your body can be affected but, it is very common in the knee. As you can imagine this joint bears a lot of wear and tear from constantly being under pressure when we move.

There are many simple treatments for osteoarthritis. For milder symptoms these include;

• massage therapy
• regular exercise
• not staying in 1 position too long, getting up and moving regularly
• stretching regimes taught by a therapist
• considering what footwear you use regularly and perhaps changing it
• loosing some weight if your BMI is above average

Doing it Yourself is OK but, a Professional’s Touch Will be Better

Self-massage can help but, allowing a professional massage therapist to manipulate the tissues in and around the knee would be far better. Self-massage requires some knowledge of the knee and leg to ensure you are massaging the right tissues and not going to hurt yourself. A professional will be able to do this for you while you are laid out comfortably on as massage table. Non-the-less if you are gentle with yourself the guide to self-massage below may help, just do it carefully.

Self-Massage of the Knee and Leg Step by Step

1. Please note you should always stop if you are in pain anywhere during this self-treatment. That includes your legs or any part of the rest of your body being in an uncomfortable position.
2. We will be massaging many tissues in the leg which are all connected to knee as well as tissues around the edge of the kneecap, but not over the top of it.
3. Warm up first. Move your arms and legs gently running on the spot for a few minutes. Do 20 gentle punches then, roll your shoulders back 10 times and forward 10 times to warm up your arms.
4. You may choose to sit on a bed, or on a carpeted floor and bend your legs slightly at the knee.
5. Warm up the calf with quick light pressure strokes from the ankle to the knee. Once up to just below the knee, release your hand and move back to your ankle. Stroke inside, outside, behind and the outside front of your shin bone too. When you feel your skin warming up, move to the next step.
6. Use the heel of your hand, or a fist or your knuckles to produce long gliding strokes in an upward motion along your calf muscles. Left side, right side, along the back and the muscle on the outside of your shin bone at the front (tibialis anterior) of the calf too. Press into your calf just above the ankle using medium pressure and move up to just below the knee. Next remove your hand and start again from the ankle. Do this 5 times.
7. Next use gentle pressure in quick long gliding strokes to warm up your front and back thigh muscles. Move from just above the knee to just below your hip, groinor buttock. Next remove the hand and return to just above the knee. Repeat this until you feel your skin becoming warm then move to the next step.
8. Use the heel of your hand, your fist or your forearm to produce slower long strokes, with deeper (more) pressure upwards along your thigh muscles. Start just above the knee and move up to just under your hip on the outside, groin if on the inside or buttock when around the back of the thigh. Release contact and return to start again. Do front inside thigh, central top of the thigh, front outside thigh and if you can reach easily, around the back both sides too. Do this 5 times on each area.
9. Now move to the knee, which is this self-massage all about. Start by warming up the tissues around the kneecap. Rub around the kneecap with your palms and fingers. Keep rubbing until your skin feels warm.
10. Next you want to release the facia, or in English lift the skin away from other tissues between your fingers and thumbs. You should be working skin around the kneecap not over the top of it. You can use a pinching motion all around the kneecap. You may also push the skin gently away from the kneecap with one hand, while pushing toward the kneecap with the other. Again, to be clear we want to lift the skin away from underlying tissues around the kneecap, not over it.
11. Now we want to work across the tendons and ligament that are all around the kneecap but, not on top of it. Using the edge of your hands move your hands in a sawing motion in opposite directions. Move both hand in and out quite quickly with medium pressure. Move all the way around the edge of the kneecap, not over it.
12. Next you can use the heel of your hand, your knuckles, a fist or your fingertips using medium pressure around not over the kneecap. Use small circular motions and move all around the knee. Then use circular movement in the other direction all around the knee. Do this 5 times each direction.
13. To finish gently stroke your leg from ankle, around the knee up to your thigh. Do this 2 times.
14. All done. Now just relax a moment before you get up slowly.
15. You may also find this video helpful. It is in French but, there are English subtitles. https://www.youtube.com/watch?v=ObrS30jA4gc                 

References:

Atkins D (2015) Self-Massage For Knee Pain [online] American Massage Therapy Association website available from https://www.amtamassage.org/publications/massage-therapy-journal/knee-self-massage/ accessed 10/05/2022

NHS (2019) Overview – Osteoarthritis [online] available from https://www.nhs.uk/conditions/osteoarthritis/ last accessed 09/05/2022

Pearlman A et al (2006) Massage Therapy for Osteoarthritis of the Knee A Randomized Controlled Trial available from https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/769544 last accessed 11/05/2022

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