In honor of the completion of filming for the new DVD set with Paul Kelly about manual therapy and functional retraining strategies, here’s another treat from the archives. We’re back in 1916 with a Norwegian ‘masseur’ (self-described) making his fortune in the US. Going through this text is extremely refreshing, as Hartvig Nissen is a knowledgeable and humble educator offering his experience that it might not be lost. He served as an instructor for the Harvard University Summer School, teaching massage and corrective exercise in the form of Swedish Gymnastics for 24 years. The preface to the first edition indicates that this manual on practical massage is written exactly as he taught to his students at Harvard at the turn of the last century.

The revised edition available here adds a large section on corrective exercise. Hartvig Nissen recognized the necessity of functional home retraining for positive long term client outcomes. He shared his accumulated knowledge in this volume before passing away a few years later.

“As years roll by there are constantly new theories and methods coming up, and my own experience teaches me, more and more, one is never too old to learn; so I have found it necessary to enlarge and improve on my former books, and also to add the important ‘Corrective Exercises,’ with full description of their effect and muscles used in the different movements.

This new book, then, is what forty years of study and experience, practice, and teaching have taught me; and I earnestly hope it will be of value to those who wish to learn in a practical way to treat suffering humanity with Mechanotherapy.”

The purpose for this text is as straightforward as are its lessons. “A first class masseur must necessarily know gymnastics, and a medical gymnast surely knows massage.” Hartvig Nissen succinctly and directly puts responsibility on practicing manual therapists to understand movement and to treat their clients with directed exercise.
“In these lessons we will consider massage together with such gymnastic exercises as are necessary in order to do the most good for the patient. Let us, however, be frank and come to a full understanding of what we are trying to do.

It would be impossible for anyone to gain a thorough knowledge of this system, and how, understandingly, to give a full treatment, from a few lessons or a brief manual.

But there are hundreds of cases where massage, together with a few passive and resistive movements, and also active corrective exercises, will not only give a great relief, but even effect a cure when applied judiciously and according to physiological laws.

The object of these lessons is to describe, for the use of the doctor himself or for an operator under the doctor’s direction, such ‘movements’ as may be applied in the sick-room and without the use of apparatus, and also to outline some simple, active, corrective exercises which the patient may be taught to practice.”
He elucidates the physiological action of various manipulations and then categorizes each of the movements that can be made.

“The Movements May be Spoken of As:

‘Strengthening’ movements, such as flexion, extension, torsion, etc.
‘Stimulating’ movements, as percussion, vibration, etc.
‘Quieting’ movements, as rotation, friction, etc.
‘Derivative’ movements, with special movements of the extremities.
‘Purgative’ movements, as kneading, pressing, and active movements of the abdominal muscles.
Some movements have a special effect on the respiration, others on the circulation, etc.”

Nissen’s system of movement is heavily influenced by Ling’s Swedish Movement Cure and shares similar organizational structure. This book is a great opportunity to look into corrective exercise and gymnastics as practiced by a massage therapist and educator who was purportedly considered one of the strongest gymnasts in all of Norway in the 1870 and 1880s. His success in his home country begs the question of why he would leave for America. He responds:

“My idea was to stay in the United States a few years, make a fortune and go back to Norway as an experienced and rich man. I have got the experience and I am a rich man in many ways but not in gold. Often have I had my bitter hours and remonstrated with myself for being so hasty and foolish in my younger days. I have worked ten times harder here in this country, than I ever did in Norway and many a time felt tired out. And especially so when I noticed how my pupils, born Americans, would go ahead, take the honor and fat places, while I, the foreigner, who had taught them, was kept back.

But I am satisfied. I found an excellent, dear wife, and we raised four fine boys, who all are settled and have families.

And since I became the President of ‘Posse’ School I feel happy, these young people make me young, and I live and work for their interest. That fills my life now.”

Hopefully Hartvig Nissen can find a little more credit here for teaching and inspiring the earlier generations that have directly shaped our current understanding of the role of manual and movement therapies in healthcare.