This modern form of massage, also known as connective tissue massage, bears many similarities to Chinese medicine, reflexology, shiatsu massage, and other non-invasive treatments that work on the nervous system to promote internal healing.

Practitioners use this bodywork approach to provide pain relief, increase circulation, and improve nervous system function in clients.

What Is Bindegewebsmassage?

Bindegewebsmassage, German for “connective tissue massage,” was developed by Elizabeth Dickie, a German physical therapist who suffered from intense lumbosacral pain. The lumbosacral spine, or the area where the lumbar spine (small of the back) connects with the sacral spine (the lowest part of the spine), is particularly vulnerable, as it carries three times more weight when we stand than when we sit. Many people strain this area when participating in athletic activities such as ballet. Injuries to this area can cause both lower back pain and sciatica (shooting nerve pain in the buttocks and legs).

In addition to lower back pain, Dickie had endarteritis obliterans, an inflammation of the blood vessels in her legs. This condition shrinks the arteries and eventually blocks them, leading to gangrene. Dickie experimented with self-care techniques such as rubbing and stretching to manage her lower back pain and noticed a warm, tingling sensation in her legs in the process. By continuing these treatments, she was able to further increase circulation in her legs and avoid amputation.

In 1928, Dickie created Bindegewebsmassage in order to share her findings with the world. Massage therapists who practice this type of bodywork do not simply manipulate soft tissues but use light pressure to manipulate their clients’ nervous systems, indirectly affecting underlying tissues and organs. The use of other, related body parts to treat pain and dysfunction is one area of commonality between Bindegewebsmassage massage therapists and reflexologists, acupressurists, acupuncturists, and shiatsu practitioners.

How Does Bindegewebsmassage Work?

In the Bindegewebsmassage/CTM approach, practitioners move subcutaneous fascia (connective tissue underneath the skin) in patterns that relate to the distribution of neurologic dermatomes. Dermatomes are areas of the body that correspond with the individual nerves that exit the spinal cord between the vertebrae. If the soft discs between the vertebrae are damaged or compressed, they can pinch the nerves that pass through them. When this happens, people feel pain in the areas served by those particular nerves.

Bindegewebsmassage therapists work on subcutaneous tissues to relieve this pain. They massage the superficial layer of connective tissue underneath the skin and above the muscles, applying just enough pressure to move the fascia across the underlying muscles. In Rolfing and Hellerwork massage, connective tissue is also manipulated, but massage therapists who practice these approaches access the fascia surrounding the muscles deep within the body.

Typically, the technique is primarily applied to the back, where it can help influence relaxation and increase circulation throughout the body, particularly to the abdominal and pelvic areas.

How Can Bindegewebsmassage Help? 

Bindegewebsmassage therapists and other proponents of this type of bodywork support its use for the treatment of a number of physical and neurological conditions. Most notably, connective tissue massage can help those experiencing spinal and/or joint pain, osteoarthritis, and circulation issues. It can also help provide migraine relief, reduce digestive and urinary tract symptoms, and improve symptoms of respiratory conditions such as asthma. Bindegewebsmassage therapy has also been shown to be helpful in improving symptoms of dysmennorhea, such as severe cramps.

Other conditions it may be beneficial in the treatment of include:

  • Cardiac Disease
  • Neurological Dysfunction
  • Rheumatoid Disease
  • Sciatica
  • Nerve Root Pain
  • Neuralgia

What to Expect from A Bindegewebsmassage Session

The Bindegewebsmassage therapist will begin by making a number of small strokes across the client’s lumbar spine (the small of the back) and sacrum (slightly lower, where the spine engages with the hipbones). Eventually, they will lengthen these movements to work under the ribs and parallel to the spine.

Therapists use light, pulling strokes to actively and vigorously mobilize and stimulate the tissues. They do not use massage oils during treatment. Massage clients will feel a firm pressure during the massage, and this pressure may feel uncomfortable on sore and injured areas. Some clients may feel a cutting or scratching sensation during the session, though they are not actually being cut or scratched.

Once treatments begin to return the subcutaneous tissues to a healthy state, the Bindegewebsmassage practitioner will likely begin working on other parts of the spine and might also massage the client’s arms, legs, neck, and head, using short strokes near the spine and lengthening and expanding their movements as they move outward and the client begins to relax. Typical movements in connective tissue massage follow this pattern, starting at the spine, radiating across the back, and fanning out to the extremities.

During the massage, a client should feel free and comfortable to talk with the therapist about the treatment and raise any questions or concerns, especially if they feel any tingling or dizziness. In some rare cases, people may shake—or even pass out—during Bindegewebsmassage sessions. However, practitioners of this type of massage are trained to understand and handle a client’s reactions, regardless of what they experience.

Bindegewebsmassage Precautions

Though connective tissue massage has many health benefits, the approach may not be right for everyone. Those who have been diagnosed with cancer, are in the late stages of pregnancy, or are experiencing severe inflammation and abscesses may want to avoid Bindegewebsmassage. People with deep-vein thrombosis (blood clots) should avoid all styles of massage. Heart patients and people with high blood pressure may benefit greatly from Bindegewebsmassage; however, it is always advised they first consult their physician first. This style of massage is not indicated for people with some circulatory conditions.

Those interested in including massage therapy as a complementary treatment to their medical care may wish to seek the advice of their primary care physician. Many physicians provide lists of preferred massage therapists who have special training in working with patients also receiving medical care.


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