Connective Tissue Massage

Connective Tissue is the substance in the bodies of animals and people which fills in the spaces between organs and connects muscles and bones. It develops in the embryo from the mesoderm. All connective tissue consists of three main components: fibers (elastic and collagenous fibers), ground substance and cells. The section on connective tissue will provide the basics about this type of tissue.

All massage works with connective tissue of the body, but this article is about a specific type of massage called Connective Tissue Massage.

Connective Tissue Massage or Bindegewebs Massage

Connective tissue massage is a type of massage that was created by Elizabeth Dicke in Germany during the 1920s/1930s, and is also known as BINDEGEWEBSMASSAGE (Pronounced  “ bin-dah-ga-vebbs -massage”). The term itself was first mentioned by Johannes Peter Müller (14 July 1801 – 28 April 1858) was a German physiologist, comparative anatomist,  ichthyologist, and herpetologist according to Wikipedia.

She created it after having a circulation problem in her leg and was told that amputation was the only answer. She applied pulling strokes to the skin in the posterior pelvic region that she found created warmth in the affected leg. She did this consistently for 3 months and fixed the leg problem. After much research and refining of the technique, Dicke claimed that the reflex action of this stroke was the reason for the outcome in improving the function of the body and that it occurred due to the changes in the autonomic nervous system. She went on to create a complete system of treatment based on the zones she discovered applying soft tissue massage to induce reflex activity. The goal of this type of massage is to get an autonomic nervous system response that reduces pain and increases range of motion.

Early Zone therapy theories

Connective Tissue Massage is thought to be based on early zone therapy theories called Head zones after by Sir Henry Head (1861–1940) who described them in 1889. Today Head zones are thought to coincide to a large extent with dermatomes , that is, areas of skin innervated by one and the same spinal nerve. The most often cited theory for the mechanism of Head zones is that of viscerocutaneous reflexes: Viscero- and somatoafferent (nociceptive) neurons converge on the level of the spinal cord. 

Dicke collaborated with Professor Kohlrausch and Dr. Tierich H. Leube to lay a foundation for research and training in CTT/CTM.  They incorporated the work of J. MacKenzie who researched changes in muscle tone in relationship to organs.  In 1942 they published “Massage of Reflex Zones in the Connective Tissue in the presence of Rheumatic and Internal Diseases.” 

 The principles of CTM say that dysfunction of an internal organ is reflected in the superficial muscles that respond with an increased tone to the dysfunction. CTM works with the Loose Connective Tissue which forms the superficial and deep fascia, the inter-muscular septa (Fibrous connective-tissue sheets that partition muscle groups in the limbs) and surrounds blood vessels, nerves and forms the framework for many organs.

CTM predominantly effects the central nervous system, balancing the parasympathetic and sympathetic divisions of the autonomic nervous system. It seems to increase parasympathetic activity, blood vessel dilation, possibly because patients/clients have treatments/sessions when experiencing a pathological problem, stress and anxiety. It aids in blood circulation, increases oxygenation the tissues, encourages lymph drainage, elimination of waste and toxins, relieves arthritis and visceral disease. It is helpful with musculoskeletal injuries and in the prevention of scarring following surgery or injury. Because CTM has a profound effect upon the autonomic nervous system it may produce awareness and /or emotional changes.


Connective Tissue Reflex Massage for Type 2 Diabetic Patients with Peripheral Arterial Disease: Randomized Controlled Trial Adelaida María Castro-Sánchez
“Conclusion: CTM increases blood circulation in the lower limbs of type 2 diabetic patients at stage I and II-a (Leriche-Fontaine) of the disease, with improvements in differential segmental pressure in leg and greater skin blood flow. At 30 min after this massage, the heart rate lowered and oxygen saturation and temperature values rose, confirming the role of the parasympathetic nervous system in the effects of this treatment. CTM is a treatment option for asymptomatic patients suspected of being in Leriche-Fontaine stage I, that is, having the main risk factors for developing the disease. This type of massage may also be useful to improve symptoms and perhaps slow the progression of the disease in stage II-a PAD patients who have difficulties in taking part in any kind of exercise, including walking programs.”

Investigation of the Effects of Connective Tissue Mobilisation on Quality of Life and Emotional Status in Healthy Subjects Erdogan Kavlak
Conclusion: CTM is an interesting modality both to use and to study. It has been used in orthodox health care for a number of decades and within that setting has pioneered a holistic approach. It currently attracts a wider interest as it stands at the boundary between complementary and orthodox health-care provision. Its powerful clinical effects are undermined by a weak research base; however, empirical observation shows that it warrants a wide application for the benefit of patients. As a consequence, we thought that CTM can be use an alternative treatment method to decrease depressive symptoms and increase the quality of life in healthy subjects.