Chapter 22 Connective Tissue Massage (Bindegewebsmassage)
OVERVIEW.
Connective tissue massage (CTM, also called Bindegewebsmassage) is a deep massage technique of the fascia or connective tissue aimed at enhancing blood supply by affecting autonomic nervous system (ANS) activity. The technique attempts to affect ANS activity by targeting organs with associated dermatomal innervations.1,2
SUMMARY: CONTRAINDICATIONS AND PRECAUTIONS.
Four sources cited a total of 15 concerns for CTM. Concerns ranged from two to six per source, with a physical therapist citing the largest number. The largest proportion of concerns, cited by one source, were procedural (almost 40%) and related to undesirable autonomic responses attributed to excessive treatment.3 The most frequently cited concerns were the treatment of patients with TB and cancer (cited by two sources). Mental illness was also mentioned as a concern by two sources.
Note: Older guidelines from Dick’s manual of reflexive therapy viewed all mental illness and virulent tumors as strict contraindications for CTM. In a subsequent 1978 edition, the staging of illness had become an important consideration in selecting patients for CTM. More advanced stages or less acute forms of disease were being considered for CTM.4
A00-B99 CERTAIN INFECTIONS AND PARASITIC DISEASES
F00-F99 MENTAL AND BEHAVIORAL DISORDERS
I00-I99 DISEASES OF THE CIRCULATORY SYSTEM
L00-L99 DISEASES OF THE SKIN AND SUBCUTANEOUS
S00-T98 INJURY, POISONING, AND CERTAIN OTHER CONSEQUENCES OF EXTERNAL CAUSES
1 Geiringer SR, Kincaid CB, Rechtien JJ. Traction, manipulation, and massage. In: Delisa JA, editor. Rehabilitation medicine: principles and practices. Philadelphia: J.B. Lippincott, 1988.
2 De Domenico G, Wood EC. Beard’s massage, ed 4. Philadelphia: W.B. Saunders, 1997.
3 Ebner M. Connective tissue manipulations: Theory and therapeutic application. Malabar (FL): Krieger, 1985.
4 Schliack H. General indications, contraindications, and prescription. In: Dick E, Schliack H, Wolff A, editors. A manual of reflexive therapy of the connective tissue, “Bindegewebsmassage.”. Scarsdale (NY): Sidney Simon, 1978.
5 Prentice WE, Lehn C. Therapeutic massage. In: Prentice WE, editor. Therapeutic modalities for physical therapist. New York: McGraw-Hill, 2002.
