Massage Of The Leg And The Arm

I. MASSAGE OF THE LEG.
Position. - The patient is lying or half lying on a bed or couch. The operator sitting at his side performs the following manipulations:
1. Stroking of the foot sole and dorsum ; quick stroking with the palm of the hand to the sole of the foot finishing with firm and quick clappings with one hand, the other grasping the ankle underneath, so as to elevate the limb.
2. Stroking with both hands from the ankle to the hip, the hand on the outside reaching up to the crest of the ilium, the thumb of the hand on the inside, with moderate pressure, going down toward the groin. (Avoid pressure upon the tibia.)
3. Friction with the thumb upon the outside of the leg from ankle to knee-joint, covering principally the flexors of the foot.

4. Stroking with one hand of the same part.
5. Friction with the thumb upon the inside and posterior part of the leg, covering principally the gastrocnemius and the soleus.
6. Stroking with one hand of the same part.
7. Friction with the thumb or hand upon the outside, inside and the back part of the thigh, dividing it into four distinct parts so as to thoroughly work upon all the different muscles.
8. Repeated strokings over the whole extremity, from ankle to hip.
9. Kneading with the two thumbs or both hands upon the different muscles of the whole extremity.
10. Hacking or clapping upon the whole extremity, avoiding the bones.

In certain cases (dropsy, rheumatism, etc.), it is well to have the limb elevated, thereby promoting the return of the venous blood.The limb should be frequently turned, so that the posterior part may receive proper attention.

II. MASSAGE OF THE ARM.
Position. - The patient is sitting or lying, with the semiflexed arm supported, if convenient. The operator sits at the side.
1. Stroking with one hand on the outside of the arm, from the wrist to the trapezius. The other hand should support around the wrist, but care should be taken that no pressure be used over the radial artery, as that checks circulation considerably.
2. Stroking with the other hand upon the inside of the arm, from wrist to shoulder-joint, the thumb going out toward the pectoral muscles. Support is given in a similar manner as described in 1.

3. Friction with the thumb upon the extensors of the hand and fingers with repeated strokings of the same part.
4. Friction with the thumb of the other hand upon the flexors of the hand and fingers, with repeated strokings upon the same part.
5. Friction with the hand upon the arm proper.
6. Stroking of the whole arm, as described in 1 and 2.

7. Kneading with the two thumbs or both hands upon different muscles, special attention being paid to reach the extensors and flexors in the forearm, the biceps, triceps, deltoid, supraspinatus and infraspinatus.
8. Hacking over the whole arm.

The most common mistakes in treating the arm are:
1. Too tight grasp around the wrist with the supporting hand.
2. The arm is kept too rigid, preventing the proper and necessary relaxation of the muscles.
3. The muscles of the upper part of the arm and shoulder are too often neglected.
4. Inefficient kneading.