The therapeutic efficacy of connective tissue massage extends beyond mere fascial release and into a realm of holistic therapy.
Engaging both the autonomic and somatic body, the mechanical action of connective tissue massage has a direct effect on the tissues, increasing blood supply while regulating the ionic exchanges in the tissues.
Today’s Spa Menu
Today, most massage clients not only want to feel better, they want to look better — and to this end, connective tissue massage is showing up on more spa menus. Based on the theory of dermatome reflexes, connective tissue massage has proven remarkably effective in addressing circulatory problems such as cellulite, spider veins and fluid retention.
It also excels at promoting deep regenerative relaxation and dramatically rejuvenating results.
Popular throughout Europe, connective tissue massage (known as bindegewebsmassage in Germany) was developed by Elizabeth Dicke beginning in 1929. Suffering from an infection, the German-born physical therapist experienced a general toxemia that damaged the peripheral circulation in her right leg. Doctors advised Dicke to consider amputation.
Confined to bed with her back and leg in considerable pain, Dicke began to treat herself by gently stroking her lower back. In the process, she discovered painful areas of thickening and inflammation over the right iliac crest. Hypersensitive to touch but terrified by the prospect of losing her leg, Dicke persisted and over time the pain in her back and leg began to subside and the superficial venous circulation on the leg reappeared.
Buoyed by the success and under her direction, Dicke’s co-workers began treating her with this new technique, and Dicke enjoyed a complete recovery and returned to work.
Dicke’s groundbreaking and highly personalized case study served as the inspiration for many of the myofascial- and fascial-release techniques we are familiar with today.
A Linking System
With connective tissue massage, we are primarily focused on the connective tissue, the linking system of all our cells. Like a spider’s web, connective tissue runs throughout the body, binding us together.
Constantly changing its viscosity and integrity, it is a dynamic area that is responsive to messages from the external and internal receptors, and plays a vital role in the transportation, repair, adaptation and defense of our tissues. Connective tissue is often likened to the embryonic sac of the unborn infant and as such, is an essential component of life-conducting forces.
Changes in the connective tissue are often the result of an illness, a physical injury or emotional distress. For example, stress is capable of disturbing the mineral balance of the tissue and this imbalance leads to a gelatinous thickening of the tissue while compromising the vital flow of water, nutrients and nerve supply, thus impeding neuromuscular conduction.
According to Marie Ebner, author of Connective Tissue Manipulations (Krieger Publishing Company, 1985), “Suprarenal hormones also influence the salt balance of the tissue fluid, this in turn resulting in an alteration of osmotic pressure. Retention of sodium and the associated excretion of potassium will result in retention of water and interference with the neuro-muscular conducting mechanism.”
Inflammation, whether from injury or pathological causes, has much the same effect. This adaptation mechanism is known as thixotropy, a process where the tissues move from a solution to a gel-like consistency.
For practitioners dealing with muscular tension and related pain, it is important to understand that unless the organic connective tissue disorder is addressed, the desired result may not be achieved.
The Technique in Action
Characteristic of Dicke’s connective tissue massage techniques is the focus on not just the mechanical action but also the reflex action, which effectively accesses every part of the body, from derm to core. Serving as a linking system, connective tissue relays messages from the underlying organs to the dermis and the musculature, according to researcher G.W. Niebauer.
Connective tissue massage is a precise technique. Working on the skin and superficial fascia and often performed with the client in a seated position or lying on her side, the first order of business is for the therapist to observe, then palpate.
The mechanical aspect of connective tissue massage addresses the vascularity and integrity of the underlying tissue while enhancing the tone and elasticity of the skin. The skin acts as a mirror — and trained to recognize alterations in the dermis, the connective tissue massage therapist looks for shadowing, discoloration and constrictions.
The next step is palpation. Rather than probing and searching for tightness or constrictions, the connective tissue massage therapist evaluates the elasticity and movement of the dermis via a light-touch, skin-rolling technique. These two steps are key components of the treatment process. It is here that the connective tissue massage therapist identifies areas of concern.
Expansive in its range of applications, connective tissue massage’s effect on the autonomic nervous system is one of suppressing the sympathetic nervous system, thereby allowing the parasympathetic nervous system to become engaged. This, in turn, generates a lowered output of stress hormones.
According to Ebner in Connective Tissue Manipulation, “Connective Tissue treatments help to harmonize a relationship between the sympathetic and parasympathetic parts of the [autonomic nervous system] by increasing the blood supply to the parasympathetic nuclei in the pelvic region.”
Research on the Technique
As with many massage modalities, research on connective tissue massage is not conclusive at this point. Several research studies have been conducted to observe the effect of connective tissue massage on various aspects of human physiology.
• Results of “Investigation of the effects of connective tissue mobilisation on quality of life and emotional status in healthy subjects” (African Journal of Traditional, Complementary and Alternative medicines, 2014) indicate that Connective Tissue Massage might effect a “significant different in emotional status” related to depression, general health, social status, emotional well-being, pain and energy levels. For this study 50 subjects in a Connective Tissue Massage group received the modality, while 50 subjects were assigned to a control group.
• Results of “Cervical and scapulothoracic stabilization exercises with and without connective tissue massage for chronic mechanical neck pain: A prospective, randomised controlled trial” (Manual Therapy, 2016) showed a “significant difference” in nighttime pain intensity, pressure pain threshold, state anxiety and mental health, with the 30 subjects who received Connective Tissue Massage improving in all those areas compared with the 30 subjects in the control group.
• Results of “Connective tissue massage in the treatment of fibromyalgia” (European Journal of Pain, 1999) indicated that a series of 15 sessions of Connective Tissue Massage reduced subjects’ pain by 37%; lowered the rate of analgesic use; lessened depression; and improved quality of life. There were 23 subjects in the Connective Tissue Massage group and 25 in the control group.
A Healing Journey
The mechanical aspect of connective tissue massage addresses the balance and integrity of the underlying tissue, enhancing the tone and elasticity of the skin. As the primary protein fibers of the loose connective tissue, collagen and elastin serve as the spider’s web, providing shape and definition to the dermis.
In the treatment of early-stage cellulite, for example, connective tissue massage improves the texture of the underlying tissue, and we observe a decrease in fluid retention, as well as a marked improvement in skin tone and definition of musculature. Also, applying connective tissue massage techniques to the face produces a stunning and healthy looking natural face-lift.
One of the most gratifying aspects of connective tissue massage is observing how it affects clients. Most fall asleep or enter a state of deep relaxation. It is here the body comes home and begins its healing journey.
About the Author:
Ashley Jo is a traveling Advanced Spa Therapy Education Certification Council (ASTECC) instructor. She specializes in hydrotherapy, soft tissue therapies and client treatment plan development.