Massage Therapy Licensing Exam (MBLEx) Techniques, Strokes, and Modalities Summary

Petrissage is a kneading stroke. The hands lift, squeeze, and roll the muscle tissue.

Wrong choices

• Effleurage: Effleurage is a gliding stroke.
• Tapotement: Tapotement is rhythmic tapping.
• Vibration: Vibration is a fast shaking or trembling movement.

Tapotement is percussion. The hands tap, cup, or hack the body in a quick rhythm.

Wrong choices

• Vibration: Vibration is shaking or trembling, not striking.
• Petrissage: Petrissage is kneading.
• Effleurage: Effleurage is gliding.

Effleurage is a long, smooth, gliding stroke. It spreads lotion, warms the tissue, and is used to start and finish an area.

Wrong choices

• Petrissage: Petrissage is kneading, usually used after the tissue is warmed.
• Friction: Friction is a small, focused rubbing stroke.
• Tapotement: Tapotement is tapping, which is stimulating rather than smooth.

Cold makes blood vessels narrow (vasoconstriction). This slows blood flow and helps limit swelling.

Wrong choices

• It widens them: Heat, not cold, widens blood vessels.
• It has no effect on them: Cold clearly changes blood vessel size.
• It makes them permanently stiff: The narrowing from cold is short-term, not permanent.

A fresh injury is inflamed and swelling. Cold narrows blood vessels, which helps reduce swelling and pain.

Wrong choices

• A hot pack: Heat widens blood vessels and can increase swelling in a fresh injury.
• Deep kneading over the sprain: Deep work on a fresh injury can cause more damage.
• A hot paraffin dip: Hot paraffin is heat, which can increase swelling in a fresh injury.

Heat widens blood vessels (vasodilation) and brings more blood to the area. The warmth helps tight muscles relax.

Wrong choices

• Blood vessels narrow and swelling goes down: Narrowing vessels and reducing swelling are effects of cold.
• The area goes numb as it does with ice: Numbness is an effect of cold, not heat.
• Nerve signals to the muscle stop: Heat does not stop nerve signals.

Cross-fiber (transverse) friction rubs across the direction of the fibers. It is used on tendons, ligaments, and scars.

Wrong choices

• Effleurage: Effleurage glides along the length of the muscle.
• Tapotement: Tapotement is tapping, not rubbing across fibers.
• Nerve strokes: Nerve strokes are very light feathery strokes over the skin.

Pain felt in a different place from where pressure is applied is referred pain. Trigger points often send (refer) pain in a typical pattern.

Wrong choices

• Phantom pain: Phantom pain is pain felt in a body part that is gone, such as after an amputation.
• Muscle guarding: Muscle guarding is muscles tightening to protect an injured area.
• Local inflammation: Local inflammation causes pain at the same spot, not in another area.

The five basic Swedish strokes are effleurage, petrissage, friction, tapotement, and vibration. Myofascial release is a separate technique for connective tissue.

Wrong choices

• Effleurage: Effleurage (gliding) is a basic Swedish stroke.
• Petrissage: Petrissage (kneading) is a basic Swedish stroke.
• Tapotement: Tapotement (tapping) is a basic Swedish stroke.

Myofascial release works on fascia, the connective tissue that wraps muscles. The therapist uses slow, held pressure and stretch to let the tissue lengthen.

Wrong choices

• Lymphatic drainage: Lymphatic drainage is very light work to move lymph fluid.
• Tapotement: Tapotement is fast tapping, not slow held pressure.
• Vibration: Vibration is fast shaking, not slow held pressure.