I Got Rhythm – Tapotement Massage

Have you ever experienced the relaxation of rocking in a rocking chair or a hammock? How about  jumping on a trampoline? Yeah? It’s because these all deal with rhythm, and rhythm is relaxing. Massage therapists can help produce relief for their clients via rhythm in percussion techniques.

Means: light blow. It is a repetitive staccato, striking movement of the hands simultaneously or alternately. It may be delivered with:

• The ulnar side of the hands
• Fingertips
• Open palms
• Cupped palms
• Striking the back of one hand with a closed  fist of the other hand

If performed well, tapotment has a stimulating but relaxing effect. It is used by respiratory therapists and nurses to loosen phlegm and congestion in the lungs.

There are many variations including:

• Hacking
• Cupping
• Tapping
• Pincement
• Pounding
• Clapping

Tapotement may be applied directly to the skin or through a drape or clothing. You should begin with light pressure and a moderate striking speed, then gradually increase the speed with a crescendo. Finish by diminishing the speed and depth. Your hand should spring back after contact.

Cautions:

1. You want to avoid doing tapotement immediately after exercise and do not do it heavily over the kidneys.
2. Tapotement is a great help to release tension and cramping from muscles in spasm.

Practice Session # 1

View the following video sequences.  Follow along and watch a few times before attempting on your own.

Testing Session # 1

View the above videos again if necessary and try tapotement on someone’s back and legs as shown in the videos or grab a pillow.

1. Describe technique
2. Repeat

Things to Notice:

Notice how the tissues change and become easier to work with. If you need to, close your eyes to focus and concentrate. Compare the tissues with the first and last applications of tapotement and describe how the tissues feel different.

Techniques:

Hacking

1. Use ulnar edge of one or both hands
2. Hold hands loosely with fingers slightly spread
3. The momentum of stroke causes each finger to contact the one below it
4. Produces slight vibratory action coupled with percussion
5. Hacking along fibers with fingers parallel produces relaxation

Cupping

1. Cup hands and strike the skin, it should make a muffled, horse-hoof sound.
2. A vacuum is created when lifting the palm from the skin’s surface.
3. Cupping is the stroke of choice for loosening mucus and phlegm in the chest.
4. It is a very vigorous stroke that may induce coughing.
5. If you orient the client with their head lower and/or bolstered it will help induce drainage.
6. End with several soothing strokes.

Tapping

1. Done with the fingertips of one or both hands
2. Modifying time and speed of tap reproduces several varieties
3. Rapid/consistent—punctuation tapotement
4. One-handed with alternate deep or light tap—pulsing tapotement (like a full note followed by a ½ note—like a heart beat)
5. Each fingertip striking lightly at a different time—raindrop tapotement used on face/scalp

Pincement

1. Plucking tapotement lifts skin much like skin rolling, but in a grasping/striking, lifting/releasing motion.
2. Resembles petrissage because of lifting, but it is tapotement.

Pounding

1. Performed with the ulnar side of one or both loose fists.
2. Done rhythmically with moderate pressure.
3. Used on large muscles (posterior legs and hips).
4. You may use fist palm down (like knocking on a door) “rapping.”

Clapping

1. Also called slapping.
2. Use palmar surface of hands and fingers striking skin alternately.
3. Hold fingers together.
4. Loud smacking sound if done right.

Cautions:

Do not use on survivors of abuse.  It has been known to trigger past episodes of abuse.

Diffused

1. Lay palmar surface of relaxed hand on client.
2. Strike the back of that hand with the other hand using a loose fist and dragging the bottom hand across the surface.
3. Most usually performed on the abdomen.
4. It has an ultrasound effect.

Practice Session # 2

Review all of the techniques mentioned above, and practice on a pillow.

Testing Session # 2

Try the variations of tapotement on someone or a pillow without breaking stride. This may take work and lots of practice. Be sure to keep relaxed and don’t tense up.

1. With client (or pillow) face down starting at their back practice the hacking variation for 30 seconds
2. Finish with several soothing strokes
3. Now begin tapotement’s cupping variation for 30 seconds
4. Finish with several soothing strokes
5. Move to the glutes and begin the beating variation for 30 seconds
6. Keeping the tapotement rhythm going, move to the hams and calves and perform one or all of the below for 30 seconds
   1. Hacking
   2. Cupping
   3. Slapping
7. Move to the soles of the feet
8. Compare the 1st and last stroke and describe how the tissues feel different.

Tapotement or Percussion massage is very beneficial. It stimulates nerve endings, aids in decongestion and increases local blood flow. It also tones the atrophied muscles and relieves pain. This form or massage gives you access to deeper structures, such as the hip rotators.

What is your favorite variation of tapotement or percussion?  Do you think it sounds relaxing? Now that you’ve learned about tapotement, who could ask for anything more?