Hartvig Nissen.

Practical massage and corrective exercises online

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of the spine ; the pressure should be made a little
inward and upward, fimily, without jerking, in a
slow and quiet way. Repeated two to four times.

Relieves backache and is very soothing and
restful; if done with vibration of the fingers it is
stimulating- to nerve-centers.


49. Back percussion is applied with the edge of
both hands and fmg'ers aUcrnatcly and very (juickdy
from the neck downward on b<Jth sides of the spinal
column. On the upper part of the back, from the
shoulders to the lower end of the lungs, the per-
cussion may also be applied outward to the sides.
Repeated six to ten times. (Fig. 23.)

This has a very stimulating and strengthening
effect on the nerve-centers.

50. Long Friction Down the Back. — Place
lx)th hands, one on each shoulder, and make long,
slow, and lig'ht strokings down the whole back. Re-
peated ten to twenty times.

This should always follow and finish the other
manipulations of the back, as it has an exceedingly
soothing and quieting eft'ect.

In extreme nervous cases this friction downward
is often enough to put the patient tO' sleep.

The whole process of back massage — back fric-
tion, muscle kneading, muscle rolling, circular knead-
ing, znbrafion, spinal nerve compression, percussion,
and long friction donmicard — is considered the most
delightful and soothing of all manipulations. And
it is well worth while for a masseur, or masseuse, to
practise this to perfection.

Aft'ections of the heart, lungs, and stomach are
also reached and relieved through l)ack massage.
Many a mother has been able to quiet and put to
sleep her crying baby simply by patting and stroking
its back, whereby stomach-aches have been relieved.



51. Breech Beating (Standing). — The oper-
ator puts his left hand on the patient's abdomen for
support, the patient standing with his hands on a
table or bed, and with his right, moderately clenched
fist he applies the beating over the sacral bone

Fig. 24. — Breech Beating.

from hip to hip and down, all over the buttocks to
the thighs. The beating should be done with a
light wrist-movement, but firm, deep, and slowly.
(Fig. 24.)

Then put the right hand on the small of the back
and apply a quick vibration by making your arm
very tense.


If tlie patient is in bed a pillow shoiikl be put
under the abdomen, and spinal vibration, with the
right hand placed against the end of the spine may
be applied by shaking the hand very rapidly.

This acts on the sacral ner\-es and on the pelvic
organs, and draws the blood to the surface muscles ;
it is useful in weakness and congestions of the blad-
der and sexual organs, and also in constipation and
hemorrhoids, etc.

Head, Face, and Throat Massage.

When a boy of about 14 years I suffered a great
deal from headache over the forehead and temples,
and as Dr. Winge, of Christiania, Norway, had just
returned from his study with Dr. Mezger, I went
to him for massage, and after one month's daily
treatment I was completely cured. This treatment
lasted only five minutes each day and consisted of
hard percussion all over the forehead with a small
hammer on the end of which there was a layer of
rubber; after a couple of minutes of this pounding
my head was rested against the doctor's chest while
he nibbed my forehead with all his might with his
rig'ht hand, using some lard in order not to take the
skin off tog-ether with the headache. It was a heroic
treatment and did not "feel g'ood," especially when
I would sit down in the chair with a bursting head-
ache before the doctor began. But a few minutes
after the treatment I would walk away "light-
hearted" and "clear-headed." And I am still in
debt to this doctor for many reasons — he chased away
my headache, and ga\e me the first ideas about
Mezger massage, of which I later made a deeper

The Mezger method is pretty rough, and at times


it is necessarily so. hut in iiKist cases it is not, and the
masseur will, as a rule, find it much more Ixineficial.
both to himself and to his jxitients, to use a little
longer time and a little less roughness. Especially
in head, face, and throat massage it will be found of
great value ; so that the patient says : "Ah ! that is
good — it feels so nice! It rests me so!"

52. Head Percussion (Sitting). — The operator,
standing in front of the patient, first makes some
friction with lx)th his thumbs from the middle of the
forehead and over the temples, several times. Then
percussion is applied with the edges and tips of the
fingers of both hands simultaneously, beginning at
the middle of the forehead and going straight back-
ward to the base of the skull ; now begin again at the
forehead, but each hand a little farther out to the
temples, next still nearer, and at last over the temples
and backward down the neck — about thirty percus-
sions in ten seconds.

Then a rapid percussion is given alternately with
both hands, all over the forehead and temples, the
crown of the head, and the neck — four to eight

A znbration at the base of the skull is often applied
after the percussion, by placing one hand on the
patient's forehead for supix>rt, and with the ulnar
edge of the other hand or little finger, pressed on the
neck just l^elow the base of the skull, make a very
rapid vibration — three or four times at short in-


53. Kneading of the Head (Sitting). — The
patient's head rests against the operator's chest, he
standing behind. Begin at the comer of the nose and
make cirailar kneading with the index and middle
fingers of 'one hand, followed with stroking of the
other hand, working from the nose around the eye-
brows and to the temple; then begin a little higher
over the nose and work outward, next still higher, till
the line of the hair is reached. Now work the other
side of the forehead in the same manner.

Then give circular kneading with both hands, one
on each side of the nose, working outward to each
temple. After the whole of the forehead has been
well kneaded, spread all the fingers on the scalp and
let each finger make a small circular kneading, taking
care not to glide on the skin or pull the hair; raise
the hands and remove the fingers to other spots, and
so on until all of the scalp has been well treated.

In kneading the neck support the head with one
hand and knead — both muscle kneading and circular
kneading — with the other hand from the skull down
the neck 011 each side and over 011 the shoulders, fol-
lowed with a few strokings in the same direction.

54. Head Vibration. — After the kneading place
both hands around the patient's head and make a firm,
even pressure and rapid vibration, or trembling, of the

55. Friction of the forehead and temples and
back over the neck with both hands should finish the
head massage.


These manipulations of the licad are exceedingly
beneficial in cases of headache, weariness, insomnia,
etc., and always have a soothing- and (juieting effect on
nervous patients.

But aside from these general effects there is no
doubt, to my mind, that the circular kneading of the
scalp will produce new growth of hair. In fact, I have
seen several excellent proofs thereof. One, a lady of
65 years, who had worn a wig for more than twenty
years; she began after my advice to give herself scalp
massage twice every day for about ten or fifteen min-
utes each time, and when I saw the lady again, after a
couple of years, she had a good crop of hair all over
her head. The simple reason is that the massage will
bring nourishment to the roots of the hair and thereby
awaken Nature to new life.

56. Facial Massage. — Soon after I had opened
my Institute in Washington, in 1883, two ladies, who
had seen their best days of life, called and asked if
massage would take away wrinkles from the face. At
that time I had not thought of this and had never seen
any account of such treatment from other masseurs, so
I did not encourage the ladies and I never saw them
again. But the incident set me to thinking, and I do
not now hesitate to say that massage will prove itself
to 1>e the best agent in removing wrinkles and in mak-
ing a face younger and more beautiful if kept up
regularly for weeks and months at a time. This cer-
tainly is reason enough for the many offices and "par-
lors" for facial and scalp massage, or, as it is often


called, the "scientific" manipulation, which signs we
now see everywhere in the cities.

However, this kind of massage is often errone-
ously explained by certain waiters of "beauty and
health" in magazines and newspapers.

Fig. 25. — Veins of Head and Neck.

Let us take a look at Fig. 25, which shows the
veins leading from the head and face. The facial vein
(i) coming from the corner of the eye and nose,
crosses obliquely down the cheek, taking up the venous
blood from other parts of the face and finally emptying


its contents into the inlcnia! jii'^uhir I'cin (2) farther
down the neck. The external jiii^iilar z'ciii (3) re-
ceives the venous blood from the head, neck, and ears,
and carries it in an ahirost straight Hne to the superior
vena cava.

Now v^^ith this fact in view it is hard to understand
how persons who claim to know can advise making
strokings upward the cheek from the neck and chin.
This is in strict opposition to all laws for massage and
cannot produce any good effect. The strokings and
also circular kneading with the tips of one or more
fingers should follow the direction of the veins in order
to accelerate the circulation of the blood and to produce
quick absorption of waste material. If strokings are
directed from below and upward, congestion may set
in and impure matters may be more firmly imbedded
in* the walls of the blood-vessels and even rupture of
small vessels may occur.

In case of wrinkles put the index and middle finger
of one hand on each side of the groove and stretch it
out, while circular kneading is applied with one finger
of the other hand right on the groove ; this process to
follow the course of the wrinkle in the same direction
as the veins.

If the face is discolored, or there are pimples, the
circular kneading followed with strokings on the big
facial and jugular veins should l^e applied.

If the face is too fat or flabby, muscle kneading,
or, rather, a pinching, picking up the flesh with the
thumb and index and middle fingers, and letting each


finger squeeze and knead thq part before releasing" the
hold and removing to another spot near by. This
process may as well be given from the chin and up if
that seems desirable, as there is no stroking to be done.

If the face is poorly nourished apply circular knead-
ing and also pressure and light vibration on the twigs
of the fifth cranial nerv^es, where the stars are shown
on Fig. 25.

Always keep in nnnd that the circular kneadi)ig,
not too hard, brings nourishment and produces health
and growth, while muscle kneading reduces fatty sul>

57. Throat massage has proved itself of such
^'alue in cases of sore throat, tonsillitis, and catarrh of
the throat and nose, and against rushing of blood to
the head, that it ought to be a common remedy in
every family. If mothers would apply this method as
soon as the children complain of any soreness or pain
in the throat and ears, or they are troubled with
catarrh, much suffering would be spared the little ones
and many a wakeful night and big doctor and drug-
gist bills l^e spared the parents.

In applying throat massage, stand in front of the
patient, who sits or reclines, with his head well back ;
put your hands with the palms upon the side of the
patient's neck so as to let the edge of your right little
finger comei just under the left ear, and the edge of
your left little finger under the right ear of the patient;
now make a stroke down toward the chest and shoulder
over the course of the jugular vein, at the same time


turning your hands with the pahn full a,iL;ainst the
throat and neck, and continue the stroke down to the
chest. Keep this up for five to ten minutes.

In connection with the stroking- of the throat it is
often valuable to give circular kticadiii'^ in the same
direction and vibration of flic larynx by applying the
hand on the patient's larynx, the thumb on one side
and the fingers on the other, and, without squeezing,
give a rapid vibration, trembling, gradually sliding the
fingers forward. Stimulation of the nerves.

58. Head Rotation (Sitting). — The operator
places his one hand on the back of the patient's head,
and the other hand on his forehead, and slowly moves
the head in a circle, five to ten tinres one way, then as
many times the other way. Four to five times in ten

This acts on the blood-vessels and nerves ol the
neck and throat ; it is a derivative movement from the
brain, and has a quieting effect.

59. Head Flexion, Passive (Sitting). — In cases
of stiff neck it often becomes necessary to bend the
head in the opposite direction, so as to stretch out the
contracted muscles, and while they are under stretch
centripetal stroking (from head down) and also cir-
cular kneading should be applied.


Resistive Movements of the Arms.

60. Finger Flexion and Extension. — The pa-
tient's -hand rests either on the operator's knee or on
the edge of a table, while he bends and stretches all
the fingers, and the operator makes resistance.

61. Hand flexion and extension is done by tak-
ing hold of the patient's wrist with one hand, and with
the other hand resist, while the patient is bending and
stretching the wrist-joint.

These twO' exercises develop and strengthen the
muscles of the forearm, hand, and fingers, and increase
the flow of blood to them.

62. Arm Flexion and Extension. — Position as
in "forearm" rotation. (Fig. 11.) The patient bends
his arm in the elbow-joint as far up as possible, while
the operator resists, and gradually gives way, so as to
make the flexor muscles, the biceps, contract and shorten
to their utmost, whereby the extensor muscles, with
their nerves and blood-vessels, are passively extended.
Then the patient gradually stretches out the arm,
under resistance, so as to make the extensor muscles,
the triceps, contract and shorten, and thereby pas-
sively extend the flexor muscles, nerves, and vessels.

These exercises are "concentric-duplex" and de-
velop and strengthen the muscles and also act as an
excellent l>lood-propeller to and from' the heart.


If the muscles are rather contracted and stiff, the
"excentric-duplex" movements should be given in the
following way: Position as before, beginning with the
ami bent well up; the operator gradually stretches out
the armi, while the jxitient makes resistance; the con-
tracted flexor muscles are slowly elongated and ex-

Fig. 26. — Vertical Arm Flexion and Extension.

tended. Then the operator l>ends the arm, while the
patient resists, and the contracted extensor muscles are
slowly stretched out.

The first kind — "concentric" movements — are used
alternately, bending and stretching for general exer-
cise: while the second — "excentric" movements —
should be used either for the elongating of the flexor


muscles or for the extensor muscles, whichever of them
are in need of such exercise.

63. Vertical Arm Flexion and Extension
(Sitting). — The operator stands behind the patient
and takes hold of both his hands, resisting the patient
when he bends the arms close down to the side and
stretches his arms to vertical position, "concentric-
duplex," in a slow movement alongside of his ears, the
elbows being- kept well out to the side. The operator's
knee should be pressed against the patient's back with
a small pillow between. Repeated from> five to four-
teen times. (Fig. 26.)

In the extension of the arms, the triceps, deltoid,
supraspinatus, trapezius, and serratus magnus are
principally at work, and a full passive extension of the
pectorals is effected. In flexion of the arms, by hold-
Hig the arms well to the side and not allowing them to
be pulled forward, the latissimus dorsi and teres major
are the chief workers, and the pectorals are kept in
a semi-neutral condition sO' as not to contract and de-
press the chest. The rhomboids and levator anguli
scapuLne draw the shoulders backward ; and the biceps
and brachialis anticus bend the forearm.

These exercises then are very valuable to strengthen
the miuscles, straighten the back, and to expand and
deepen the chest.

64. Horizontal Arm Flexion and Extension
(Sitting). — The patient's arms are raised horizon-
tally and kept well back, with the forearms sharply
l>ent upon them ; the operator, standing behind, press-


\ug liis chest against the ])riticnt's hack, takes hold of
both his wrists (Fig. 27) and resists, wlicn the patient
stretches and bends his arms at the ellxjw-joints, "con-
centric-duplex." Repeated from five to fourteen times.
By keeping the upper amis well back and not allow-
ing them to be moved forward, this exercise exerts a

Fig. 27. — Horizontal Arm Flexion and Extension.

powerful tension on the chest and contraction of the
muscles of the shoulder-blades, and neck (the trape-
zius, rhomboids, and levator anguli scapukne), and the
arms. It is therefore an excellent exercise to flatten
round shoulders and round out flat chests, and it is a
good respiratory and derivative movement.



65. Horizontal Arm Separation and Closing
(Sitting). — The operator, standing in front of the
patient, who holds his arms straight out tO' the sides,
takes hold of his wrists and pulls the arms forward
under resistance by the patient, "excentric-duplex."

Fig. 28. — Horizontal Arm Separation and Closing.

Then the patient brings his arms back to the former
position, resisted by the operator, "concentric-duplex."
Repeated from five to fourteen times. (Fig. 28.)

This is another form of strong contractive exercise
for the muscles of the back and shoulders, while it is
absolutely passive for the chest muscles, and is very


useful in stooping shoulders and many cases of lung
troubles, as it has a goo<l effect on the respiration and
the circulation. As a rule the pectoral muscles of pa-
tients do not need encouragement for contraction, but
once in a while it may be necessary, and in such a case

Fig. 29. — Lateral Arm Elevation and Depression.

the alx)A-e movement, while the operator resists both
forward and backward, making each move a "concen-
tric" exercise, will be very valuable.

66. Lateral Arm Elevation and Depression. —
The operator, standing behind the patient, takes hold
of his forearms, which are hanging down, and resists



when the patient raises his arms sideways, upward,
and when he brings them down again, "concentric."
The elbows should be kept straight. Repeated five to
ten times, (Fig. 29.)

This is a very effective movement to widen the chest
and to strengthen the muscles of the shoulders, back,
and upper arms, viz., the deltoid, supraspinatus, rhom-

Fig. 30. — Forward Arm Traction (Lying).

boids, levator anguli scapul?e, trapezius, and triceps m
upward motion ; and! latissimus dorsi, pectorals, teres
major and minor, and subscapularis going downward.
It is also effective on the respiration and circulation.

67. Forward Arm Traction (Lying). — The pa-
tient lying on a table or a couch with" his arms ex-
tended alongside the ears, gradually pulls his anns
upward, forward and downward, while the operator


makes resistance, ''concentric." (Fig". 30.) Now the
patient resists while the oi^^rator pulls the arms back-
ward again, "excentric." Repeated four to ten times.

This is a very powerful movement on the anterior
muscles of the trunk; it raises the chest and inills all
upward. It produces a suction of the blood from the
abdomen and pelvic vessels to the chest, and is there-
fore of great value in reducing- congestions in those
organs, as well as to reduce obesity.

68. Arm Torsion. — The patient takes hold of the
middle of a stick with one hand and keeps his arm
straight out from the shoulder. The operator takes
hold of each end of the stick and resists the patient
when he izcists his ami outward and inward, "con-
centric." This movement may be changed by letting
the patient resist when the operator twists the arm,
"excentric." Repeated front six to ten times.

This brings into play the rotators of the arm, viz.,
inward rotation: subscapularis, pectoralis major, latis-
simus, teres major, and anterior deltoid ; outward
rotation : infraspinatus, teres minor, and posterior del-
toid, and is used in stiffness of the shoulder-joint and
in abnormal enervations of the muscles of the arm,
and as a derivative from the chest and head.


Resistive Leg Movements.

69. Foot Flexion and Extension: (A) Single
AND (B) Double (Fig. 15). — Positions as in foot
rotations. The patient bends and stretches his feet
during resistance by the operator, "concentric."

Fisr. 31. — Lesr Flexion and Extension.

These strengthen the anterior and posterior mus-
cles of the leg and foot, and strengthen and limber the
ankle-joint. It is a good derivative movement, and is
especially beneficial in cases of cold feet.

70. Leg Flexion and Extension (Reclining).

— The operator, standing by the side of the patient,

takes hold of his heel with one hand and of the ball of

the foot with the other hand. (Fig. 31.) The leg is




bent way up without resistance, and tlien the patient
stretches it out, while the operator resists by pressing
the leg- upward and slightly giving way till it is per-
fectly straight, "concentric." Repeated five to four-
teen times.

The first part O'f this movement puts the extensor
muscles of the thigh, viz., gluteus maxinms, gluteus
niedius, pyriformis, obturator internus, gemellus, etc.,

Fig. 32. — Upward Knee Traction.

and also the quadriceps muscles of the leg, with their
nerves and blood-vessels, on a perfect stretch, while
the second part makes them contract vigo-rously, and
thereby serves as an excellent movement to strengthen
the extensor muscles of the whole hinbi and also as a
derivative from diseases of the pelvis and alxKimen.

71. Upward Knee Traction (Reclining). —
The operator takes hold oi the back of the patient's
heel with one hand and on the front of his foot with



the other hand and resists, when the patient bends his
leg — piiHing his knee npward — 1)y holding it straight,
and slightly giving way till it is doubled up, "eoiicen-
tric;" now the patient resists while the operator pulls
the leg straight again, "excentric." Repeated four to
ten times. (Fig. 32.)

Fig. 33^ — Knee Flexion and Extension.

This movement strengthens the flexor niuscles of
the leg and the museles of the abdomen, viz., psoas
magnus, iliacus, sartorius, gracilis, gluteus minimus,
and biceps, and thus has a purgati\'e effect.

Leg flexion and extension and np-K'ord knee traction
are often used alternately as a good "general" exercise.


72. Knek Fi.exiOxNT and I'^xtkxsion (Sitting). —
The operat(M% sittint;- l)y the side oi the jjatienl, who.se
thigh is I'esting on the operator's knee ( hig. 2)3)^ fixes
the patient's knee with, one hand and takes hold with
the other hand around his ankle, resisting, when the
patient bends and stretches his knee, "concentric." Re-
Ideated five to ten times.

In this nio\'ement all the flexor and extens(M- mus-
cles of the leg are in vigorous action, wherehv the thigh
and the knee are developed and streng-thened ; it is also
a valuable exercise to break adhesions and overcome
stiffness of the knee-joint.

The exercise is still better when the patient is stand-
ing and rests his thigh — in a right angle with the body
— oil a bar.

/T,. Leg Elevation and Depression (Lying). —
The patient, keeping his knee straight, raises his leg
upward by bending the hip-joint, the operator making
slight resistance with his hand on the patient's knee,

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Online LibraryHartvig NissenPractical massage and corrective exercises → online text (page 4 of 11)