. A manual of therapeutic exercise and massage, designed for the use of physicians, students and masseurs. er opposite parts of the limb, as for instance, the flexorsand extensors of the elbow. In taking the axillary muscle groups, both these groupsmay be treated by having the one hand knead the pectoraland the other the scapular muscles (Fig. 21); or one hand isused as a pad over which the other hand is working (Fig. 22);whichever is most convenient. Often with muscles whichcannot be lifted up, as the long muscles lying beside thedorsal spine, petrissage is done more by rolling and pressingor
. A manual of therapeutic exercise and massage, designed for the use of physicians, students and masseurs. er opposite parts of the limb, as for instance, the flexorsand extensors of the elbow. In taking the axillary muscle groups, both these groupsmay be treated by having the one hand knead the pectoraland the other the scapular muscles (Fig. 21); or one hand isused as a pad over which the other hand is working (Fig. 22);whichever is most convenient. Often with muscles whichcannot be lifted up, as the long muscles lying beside thedorsal spine, petrissage is done more by rolling and pressingor describing small circles as in friction. As much as possibleof the surface of the hand or fingers is used, and is held THE KNEADING MANIPULATIONS 83 close to the skin; thus petrissage is never in any way hkerubbing. As in effleurage the anatomical outlines must be strictlyfollowed. Each single manipulation should be done in thedirection of the lymphatic flow, but as to the succession ofthe single manipulations, no rule exists. It may be centrif-ugal or centripetal. In case of edema or of an otherwise. Fui. 19.—Knoadiiifz: of upper arm. greatly disturbed circulation, it seems more rational to beginat the proximal end of long muscle groups and work graduallydown in order to clear the path for the venous and lym-phatic flow from the peripheral parts. Grasping alone is not much used, but more in combinationwith kneading, rolling, or pressing. These latter manipula- 84 TECHNIC OF MASSAGE tions are more often used where special attention is given tolimited parts of the muscle group. In rolling, one hand orboth grasp the muscle and roll it over its base. In pressing,one hand or both grasp the muscle and make a rhythmicalpressing manipulation.
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