FULL BODY RELAXATION MASSAGE HANDS ON...

2/12 © Blue Sky School of Professional Massage and Therapeutic Bodywork 1

CST 101 – Hands On Manual

BLUE SKY SCHOOL OF PROFESSIONAL MASSAGE AND

THERAPEUTIC BODYWORK

FULL BODY RELAXATION MASSAGE

HANDS ON MANUAL

Learning Objectives:

Demonstrate the correct way to carry a table in carrying case.

Long strap across shoulders.

Hold on to smaller strap at the side of the table.

Tables are not to be pushed or dragged.

Demonstrate the proper way to carry a table without a carrying case.

Hold the handle and lift.

Tables are not to be pushed or dragged.

Demonstrate the proper procedure for table set-up.

1. Remove table from carrying case.

2. Stand table on side with rubber feet down and handle side up.

3. Unlock table latches and flatten latches.

4. Open table to 90 degrees.

5. Straighten table legs-making sure no cables are twisted.

6. Open table to straight position/flat position/180 degrees.

7. Place your foot on a leg that is touching the floor, grab table handle and pull table toward you, allowing

the table to get to a standing position.

8. Lift one end (head or foot) of the table to be sure table is standing completely flat/secure/stable.

9. Adjust legs/table height as needed

10. Check the legs to insure they are set to the correct height and the leg knobs are tight.

11. Insert face cradle.

12. Place a sheet on the table for protection.

Demonstrate how to adjust the face cradle position for client comfort.

Demonstrate proper cleaning procedures for the massage table.

Direct students where cleaning bottles are kept.

Tables should ALWAYS be cleaned before they are put away.

Bring a towel or old t-shirt to wipe the table down after it has been sprayed off.



Demonstrate the proper procedure for table take down.

1. Spray table and face cradle down with disinfectant spray.

2. Reverse steps listed in “Table Set-up”.

3. Face cradle goes inside the table NOT in the pocket of the carrying case.

4. Table goes into carrying case when applicable.

Demonstrate proper draping techniques.

Demonstrate how to create a toga.

Wearing socks to and from the table (wipe the client’s feet before they get off the table).

Maintain a client’s comfort and modesty.

Cover the client for warmth.

Sheet turned length wise, as not to drag on the floor.

Demonstrate appropriate bolstering techniques.

Items that can be used for bolstering (bolsters, pillows, rolled up towels, and blankets)

Bolsters should always be offered.

When the client is supine/on their back there should be a bolster under the client’s knees for low back

support.

When the client is supine/on their back a bolster may be needed under their head and/or neck.

When the client is prone/on their stomach the bolster is placed under their ankles to protect their ankle

joint.

When the client is prone/on their stomach a pillow might need to be placed under the client’s hips and

stomach to help protect the client’s low back.

Place bolstering under the client’s shoulders to take the pressure off her breasts when she is prone/on her

stomach. This position also works for any client who has shoulder problems.

Demonstrate an initial contact that allows the client to become accustomed to you and your touch.

The first time you touch a client it is called the resting position.

This initial touch is done with respect and is client-centered.

Demonstrate a respectful and flowing end to the massage, allowing a respectful break in contact

and energy.

Demonstrate the proper application of oil/cream/gel/lotion.

Warm up lubrication in your hands before applying to client.

Keep contact with client.

Keep track of you lubricant.

Demonstrate the ability to maintain a physical and/or energetic contact with the client as you

perform a full body massage.



Demonstrate and explain the necessity for good client communication.

Introduce yourself.

Establish and clarify the goal for today’s massage.

Directions for disrobing and placement of the client’s clothes.

Directions for the client are starting position on the table.

Directions for how and what the client should do when the session has ended.

Directions for getting on/off the table.

Instructions for follow up care or home program (i.e. drink water).

Demonstrate a professional presence.

Appropriate dress.

Client centered sessions.

Appropriate massage related conversations.

Professional attitude.

Demonstrate good personal hygiene.

Clean hair that is tied back.

Body bathed and free of body odor.

Clean, short nails, free of nail polish.

No jewelry or watches.

Clothes comfortable and non-restricting, but do not drag on the client.

Body free of strong smells (smoke, foods, perfumes or essential oils.

Breath fresh.

Wear gloves as needed if the therapist has any broken skin.

Demonstrate safe and effortless body mechanics.

Shoulders down

Bent knees

Straight back

Relaxed shoulders, arms, forearms, wrists and hands

Feet in the direction of force

Bending from the hips, not waist

Head up

Power from the feet/core of the body/the legs

Breathe, relaxed and freely



RULES OF MASSAGE

Promote client comfort through a restful environment, appropriate bolstering and applicable use of a blanket.

The client should be in a comfortable position and able to breathe freely throughout the entire treatment.

Have good intentions.

Be present, be focused and respect the client.

Ground yourself so that sessions are client-centered. (Go to your “happy” place/be present for the client to

enhance the quality of your massage) (Be there for the client).

“A good massage therapist thinks less of the manner of moving his hands than of the tissues upon which he is

working” Mat Bullock, University of Illinois Athletic Trainer (1925). In other words, don’t get caught up in

the moves…keep the flow going. Allow your hands to work the tissue it is touching.

Be confident. Lack of confidence is transmitted through the therapist’s hands. (The client won’t know if

you’re doing it wrong anyway!!).

Use good body mechanics. The massage therapist should place themselves in comfortable and

relaxed positions for carrying out the massage session and should be able to breathe freely during the

entire massage session.

Care should be taken at all times to support the extremities while they are being moved, rotated, stretched or

massaged.

Avoid endangerment sites.

Learn indications and contraindications.

All movements should be performed rhythmically during relaxation massage.

The muscles being massaged should be relaxed.

The massage therapist’s hands should be warm and comfortable. This will allow the client’s entire body to

relax.

Begin with lighter pressure and work progressively deeper based on client’s tolerance to avoid guarding that

is counterproductive to massage.

Be thorough and complete. Always connect body parts to themselves and to one another.

Work deep enough to effect muscle and release tension, but not so deep that you cause tension and pain.

Depth of pressure is a result of leverage and leaning on the body. Pressure increases as the angle of the lean

increases. Increases in pressure are NOT achieved by pushing with muscle strength.

Practice personal hygiene and sanitation. Such as the therapist washing their hands before and after a

massage. If the therapist sneezes, coughs into their hands or wipes their nose during a session, hands must be

washed again.

Avoid scratching the skin of the client by having nails properly trimmed.

Avoid overly loose-fitting clothing that drags on the client during the session. Also very tight clothes that

will restrict therapist ability to move or may be suggestive in nature.

Hair should be pulled back:

Out of the eyes of the therapist, as it is not appropriate to touch your hair during a massage session.

To avoid dragging on or tickling the client.



Keep a towel handy to:

1. Remove excess lubrication from your hands and the client.

2. Provide additional draping as needed.

3. Wipe the sweat from your brow.

4. Cleaning the table at the end of the session.

KEY TERMS: (just a few to get started with) Bony Landmarks

PSIS—Posterior Superior Iliac Spine

ASIS—Anterior Superior Iliac Spine

AC joint—Acromioclavicular Joint

EOP—External Occipital Protuberance

Muscle/Muscle Groups Paraspinal muscles—Erector Spinae group

ITB—Iliotibial Band

SCM—Sternocleidomastoid

TFL—Tensor Fascia Latte

BASIC STROKES: Effleurage Friction

Petrissage ROM

*Compression Tapotement

Vibration

*Rocking

*Shaking

EFFLEURAGE: from the French word effleurer, which means to flow or glide.

Definition—gliding stroke whose result is determined by pressure, drag, speed, direction and rhythm; application is

horizontal in relation to the tissues.

Uses

To calm or sedate tissue.

To apply lubrication.

To warm or prepare tissue.

Precautions: Therapist should avoid hyperextension on their wrist, by keeping it between 100-180 degrees.



Techniques

One-handed

Two handed

Alternate hand

Circular

Nerve stroke

PETRISSAGE: from the French word petrir meaning to mash or to knead

(Including: Compression).

Definition—kneading; requires that soft tissue be lifted, roll and squeezed rhythmically; application is vertical in

relation to the tissues; main purpose is to lift tissue.

Uses

Good for decreasing muscle tension.

Good for mechanically softening superficial fascia (compare to breaking in new shoes).

Skin rolling is safe to use over the spine.

Stretches and broadens the tissue.

Precautions

Techniques

Skin rolling

Kneading

Wringing

One handed

Two handed

Alternate hand

COMPRESSION:

Definition—rhythmic, pumping action where the muscle is pressed at a 45 to 90 degree angle against bone to achieve

spreading action; stimulating to the muscles and nervous system.

Uses

Working over clothing or without lubricant.

Sports massage

Chair massage

Hairy clients

Acupressure points

Trigger points

Main method used in shiatsu and other Oriental approaches.

Compression bypasses the tickle response by activating deep touch receptors.

Client prefers more stimulating massage.



Precautions

Because of its stimulating effect, compression is less desirable for a relaxing or soothing massage.

If using the palm of the hand or heel of the hand be cautious of wrist position.

Techniques

1. Very specific pinpoint compression is called direct pressure or ischemic compression.

2. Fist

3. Knuckles

4. Thumb

5. Braced finger(s)

6. Forearm

7. Palm of hand

8. Heel of the hand

9. Fingertips

10. Heel squeeze

TAPOTEMENT (A.K.A. PERCUSSION):

Definition—Springy blows to the body at a fast rate to create rhythmic compression of the tissue; to rap, drum or pat.

Uses

Initiates or enhances sympathetic nervous activity.

Stimulates weak muscles.

Precautions

Do not use vibration or tapotement directly on the spine.

Use light pressure over the kidneys and floating rib and other endangerment sites.

Vary pressure with body area.

Not to be used after physical activity as it may set off spasms or cramps.

Techniques

All are less invasive when applied parallel to muscle fibers.

1. Hacking

2. Pounding/Beating

3. Slapping

4. Cupping (good for chest/lung congestion; used for children with cystic fibrosis)

5. Star hands

6. Tapping



FRICTION:

Definition—vertical pressing down to apply movement to underlying tissues; skin moves with the fingers.

Uses

Creates therapeutic inflammation.

Prevents adhesions in connective tissue (ligaments; tendons) and scars.

Breaks up adhesions in connective tissue (ligaments; tendons) and scars.

Precautions

Not to be used over acute injury or fresh scars.

Friction burns may result if fingers are allowed to slide back and forth over the skin.

Tissue should be placed in a soft or slack position.

Creates a “good hurt”.

Client my have feeling of “mild exercise soreness” for up to 48 hours after treatment.

Creates increased circulation that results in mild puffiness/swelling.

The area should not bruise.

Techniques

1. Fingertip

2. Thumb

3. Braced finger

4. Fist

5. Palm of hand

6. Transverse

7. Circular

VIBRATION: ( includes shaking and rocking)

Definition—Fine or coarse tremulous movement that creates reflexive responses.

Uses

Used to “wake up” nerves (stimulates nerve endings).

Loosens connective tissues.

Encourages deeper lymphatic and venous circulation.

Precautions




Not useful on skin or superficial fascia.

Requires a lot of energy on the therapist’s part.



Techniques

1. Heel of hand

2. Side of hand/lamina groove

3. Thumb along side of spine

4. Fist

5. Motorized versions (i.e. the Thumper)

SHAKING:

Definition/Logic

Sometimes classified as rhythmic mobilization.

A technique in which the body area is grasped and shaken in a quick, loose movement.

Shaking manipulations confuse the positional proprioceptors because the sensory input is too unorganized for

the integrating systems of the brain to interpret and muscle relaxation is the natural response in such

situations.

Sometimes classified as vibration but the difference is that vibration begins with compression and shaking

begins with lifting.

Uses

Large muscle groups

Entire limbs

Performed on antagonist muscles (ex. Work on quads to relax hamstrings)

Stimulates weak muscles

Precautions




Not to be used anywhere there is pain or discomfort.

ROCKING:

Soothing and rhythmic to calm.

Works through the vestibular system of the inner ear and feeds directly to the brain to initiate parasympathetic

mechanisms (hint: parasympathetic = calming; sympathetic = fight or flight; Para = paramedics who come to

help);

One of the most productive methods to produce entrainment.

Used within the client’s natural body rhythm.



RELAXATION — Posterior Body In the informational boxes ‘Therapist position’ notations are guide lines, suggested starting points.

The exact placement will have to be adapted for the therapist – body type, framework, height and any

restrictions the therapist may have.

Posterior Body—Spine & Thorax

Therapist position: Standing at the level of the client’s gluteal region and facing superior/toward the head of the

client.

Client position: Prone; Ankles bolstered.

Draping: Sheet folded down just superior to the sacrum and sides of sheet tucked around hips of client at the

level of the PSIS.

Muscles/Tissue affected: Fascia

Common uses: Warm the tissue.

Definition of Fascia:

Fascia is a form of dense fibrous connective tissue that is found in abundance throughout the body. It not only wraps

the entire body (superficial fascia) but also surrounds each organ and muscle (deep fascia). “Pulling the skin off the

chicken” is fascia.

Definition of Connective Tissue:

It is the most abundant and widely distributed tissue in the body. It has various types with a variety of

functions

WARMING TECHNIQUES NOTE: These moves are performed without lubrication and can be performed on almost any part of the body.

MYOFASCIAL RELEASE WITH CROSSED HANDS (NO OIL IS USED AT THIS TIME)

Procedure:

a) Cross your hands your arms/hands in a “X” formation.

b) Place your flattened hands on the client’s back.

c) Apply a slight amount of down and outward pressure, use only enough pressure to prevent you from slipping.

(i.e., pushing your hands away from each other, yet your hands are stuck on the client’s skin)

d) Wait until you feel the tissue “give”/ “release”.

e) Slowly remove your hands to another starting position.

MYOFASCIAL RELEASE WITH OPPOSING THUMBS

Procedure:

a) Cross your hands your thumbs in a “X” formation.

b) Place your flattened thumb pad on the client’s back.

c) Apply a slight amount of down and outward pressure, use only enough pressure to prevent you from slipping.

(i.e., pushing your hands away from each other, yet your hands are stuck on the client’s skin)

d) Wait until you feel the tissue “give”/ “release.”

e) Slowly remove your thumbs to another starting position.



SKIN ROLLING

Procedure:

DO NOT PINCH THE CLIENT

Slowly picking the client’s skin up between the therapist thumbs and fingers gently, yet firmly lift and proceed to

roll the skin in a long continuous motion in varying directions. (Longitudinal, diagonal, transversely). Like

rolling a pencil between your fingers and thumbs.

POSTERIOR BODY—OPENING STROKES

Therapist position: Standing at the level of the client’s waist.


Draping: Draping to uncover back to PSIS. Therapist may want to use a folded towel on top of the draping at

the sacrum for added weight to secure the sheets. Remember to keep the person appropriately draped/covered at

all times.

Common uses: Warms the tissue.

NOTE: DO NOT put direct pressure on spinous processes of the vertebrae.

1. OPEN-HAND EFFLEURAGE:

Procedure:

a) Begin by placing open palms bilaterally/on either side of the spine on top of the erector spinae/paraspinal

muscles just superior to the iliac crest/hip bone.

b) With equal and firm pressure glide superiorly to the top of the thoracic spine (T1).

c) Once at the top of the thoracic spine, grasp the upper trapezius, and then glide straight down/inferiorly, with

open hands, to the inferior angle of the scapula.

d) Move out and around (lateral and superior) the axillary/lateral border of the scapula and continue superiorly to

the upper trapezius.

e) Once again, grasp the upper trapezius and glide inferiorly with firm pressure to the level of the iliac crests.

f) Repeat above series 3 times.

2. FISTS UP CENTER/EFFLEURAGE:

Use the flatten surface of the phalanges. Do not use the knuckles.

Procedure:

a) Begin by placing loosely clenched fists bilaterally on top of the erector spinae/paraspinal muscles just

superior to the iliac crests.

b) With equal and firm pressure glide superiorly to the top of the thoracic spine (T1)

c) Once at the top of the thoracic spine, allow your hands to open, grasp the upper trapezius, and then glide

straight down/inferiorly, with open hands, to the inferior angle of the scapula.




Allow your hands to gently fold into a loose fist.




3. CIRCULAR FISTS/EFFLEURAGE:

Procedure:

a) Begin by placing loosely-clenched fists bilaterally on top of the erector spinae/paraspinal muscles just

superior to the iliac crests.

b) With equal and firm pressure move fists in a circular motion (medial to lateral) superiorly to the top of the

thoracic spine (T1) NOTE: make 3-4 circles up the back, depending on the size of the client.

c) Once at the top of the thoracic spine, , allow your hands to open, grasp the upper trapezius, and then glide

straight down/inferiorly, with open hands, to the inferior angle of the scapula.




Allow your hands to gently fold into a loose fist.


Note: For steps 4, 5 & 6, use the spine as the mid-line and work on the half of the back opposite where you are

standing.

4. PUSH/PUSH, PULL/PULL/EFFLEURAGE

Therapist position

Working on the opposite side of the body from which you are standing and using open hands, glide from

mid-line to the lateral aspect of the trunk.

Begin at the level of the gluteal region and move superiorly to the shoulder region, and then move inferiorly

returning to the gluteal region.

Procedure:

a) With open, flat hands, move one hand from mid-line to the lateral aspect of the body (latissimus dorsi,

serratus anterior, and obliques) and keep that hand there. Move the second hand from mid-line to the

lateral aspect of the body next to the first hand (PUSH/PUSH).

b) Next, move you’re first hand from the lateral aspect of the body back to mid-line and keep that hand there.

c) Move the second hand from the lateral aspect of the body back to mid-line next to the first hand

(PULL/PULL).

d) Repeat steps a), b) & c) moving superiorly then inferiorly covering the entire thoracic and lumbar area.

5. PUSH/PULL, PUSH/PULL/PETRISSAGE

Procedure:

a) With open, flat hands, place one hand on at mid-line and the second hand on the lateral aspect of the trunk

(latissimus dorsi, serratus anterior, and obliques). Simultaneously, move first hand laterally and the

second hand medially (one hand pushes while the other hand pulls) and continue alternating movement of

hands laterally and medially (PUSH/PULL).

b) Repeat movements while moving superiorly then inferiorly covering the entire thoracic and lumbar area.

When working on a woman beware of the breast tissue that may move lateral (to the side of her body) when the

woman lays in a prone position. Do not massage the breast tissue. (if the table you are using has breast recesses you

do not need to be so concerned about this.)



6. PETRISSAGE/KNEADING/PAC-MAN FAMILY:

a) Daddy Pac - Large – petrissage covers large area (more open and flat handed)

b) Mommy Pac - Medium – petrissage covers a more specific area (using more of the full length of your fingers)

c) Baby Pac - small – petrissage is in quite a specific area (using more finger pad and tips of the fingers

Note: Strokes can be varied depending on surface area to be covered. The difference is determined by how wide

you spread your hands. This technique is great for transitioning to other moves.

Note: For steps 7-9, “Resting” hand/arm should not place any pressure on the sacrum.

7. FOREARM GLIDING/EFFLEURAGE

Therapist position:

Stand on the side of the client’s body that will be worked (work same side) at the level of the client’s waist.

Use the spine/spinous processes of the vertebral column as the mid-line and work just lateral to mid-line.

Start with the proximal portion/ulnar side of the forearm (thumb points to the ceiling).

Superior arm is the one closest to the client’s head; Inferior arm is the one closest to the client’s feet.

Each half of the body will be divided into thirds the long way and worked for each technique.

Client’s sacrum

Client’s head

Client’s spine

Client’s trunk/thorax divided in half by the

spine and then in thirds

Procedure: a) Gently place/rest inferior arm on client’s sacrum and place superior arm at just superior to the iliac crest.

Begin moving/gliding superior arm firmly toward the client’s shoulder (superiorly) and stop stroke just

inferior to cervical region. (Erector spinae, rhomboids, trapezius).

b) Lighten pressure of superior arm circling laterally glide inferiorly to starting position.

c) Repeat steps a) and b) 2 to 4 times beginning more laterally each time. The number of times of repeating this

stroke will depend on the size of the person’s back.

d) When the most lateral portion of the trunk/thorax has been reached, repeat above steps beginning laterally and

moving more medially each time. (latissimus dorsi, obliques).

Note 1: Be sure to adjust arm over inferior angle of the scapula to avoid inflicting discomfort to the client. The

number of times of repeating this stroke will depend on the size of the person’s back.

Note 2: One set for this move means working once from medial to lateral in thirds, then working lateral to medial

in thirds.

Note 3: Therapists shoulder should line-up with elbow; DO NOT use muscle strength—therapist weight shifting

will move the arm.

Note 4: The goal is to stretch the tissue.



8. FOREARM SKATING/EFFLEURAGE

Therapist position:





Each half of the body will be divided into thirds the long way and worked for each technique

Procedure:

a) Gently place/rest inferior arm on client’s sacrum and place superior arm at just superior to the iliac crest.

Begin moving/gliding superior arm firmly toward the client’s shoulder (superiorly) and stop stroke just

inferior to cervical region. (erector spinae, rhomboids, trapezius).

b) Gently “rest” superior arm at the level of T1, lift inferior arm and place next to superior “resting” arm.

c) Glide inferior arm toward iliac crest (inferiorly) and “rest” inferior arm just superior to the iliac crest.

d) Lift superior arm, place superior arm next to inferior arm at the iliac crest. As in ‘a’ above.

e) Repeat steps a) to d) (skating inferiorly and superiorly) moving laterally with each set of moves.

f) When the most lateral portion of the trunk/thorax has been reached, repeat above steps beginning laterally and

moving more medially each time. (latissimus dorsi, obliques).

SEE NOTES 1-4 in section 7

9. BUTTERFLY/EFFLEURAGE

Therapist position:





Each half of the body will be divided into thirds the long way and worked for each technique

Procedure:

a) Place arms approximately halfway between T1 and the iliac crest on the lateral aspect of the ribs.

b) Firmly glide slightly medially with both arms and then spread the arms superiorly and inferiorly (inferior arm

moves inferiorly and superior arm moves superiorly) (erector spinae, trapezius).

c) When superior arm reaches T1 and inferior arm reaches the iliac crest, lighten pressure of both arms but

remaining in contact with client’s skin, move both arms laterally and then toward each other.

d) Place arms approximately halfway between T1 and the iliac crest further laterally on the ribs than placement

in step a).

e) Repeat above steps until the last “third” of the trunk has been worked. (Obliques, latissimus dorsi).

f) Repeat above steps again beginning step a) as far laterally as possible and move medially with each

successive stroke.



g) Repeat all the forearm strokes on other side of the client’s body.

***The movement is like making 2 ovals circling away from each other across the client’s back. Moving more

lateral with each oval (2-4 times depending on the size of the client’s back) then medial 2-4 times back to the

starting point .

SEE NOTES 1-4 in section 7

Posterior body—Shoulders/Cervical region

Therapist position: Standing at the side of the table, at the level of the client’s mid thoracic.


Draping: Draping to uncover back to PSIS. Therapist may want to use a folded towel on top of the draping at the

sacrum for added weight to secure the sheets. Remember to keep the person appropriately draped/covered at all

times.

Muscles/Tissue Affected: Rhomboids, subscapularis, and upper trapezius.

Palpation hints: The acromioclavicular (AC) joint is the “V” on the superior-lateral aspect of the shoulder.

Common uses: Tight scapula/shoulder blades, sore “rhomboid area and decreased shoulder range of motion.

NOTE: A hair clip, hair tie or towel may be used to keep client’s hair out of the way and minimize lubrication in

the client’s hair.

SHOULDER DANCE

a) The therapist inferior hand is open and palm down, starts just superior to the ilium and just lateral to the

spinous processes.

b) That hand followed by its forearm glides superiorly along the erector spinae until the shoulder has been

reached.

c) At the same time the superior forearm followed by its hand starts at the neck/shoulder area just lateral to the

spinous process. It moves along the top of the shoulder to the deltoid.

d) Gently pick up the superior arm and reposition that arm to repeat this stroke several times. At the same time

the inferior arm continues, lightens its pressure and makes a gentle oval down the lateral side of the client’s

body back to the starting point in ‘a’.

e) Continue this stroke several times.

f) Each time working more and more under scapula to loosen it up.

MONEY ROLL/PINCER COMPRESSION WITH A TWIST THE UPPER TRAPEZIUS ALONG SHOULDER AND NECK

( WATCH DEMO CLOSELY)

PETRISSAGE AROUND THE SHOULDER

PETRISSAGE THE SUPRA AND INFRA SPINATUS



Posterior Body—Neck & Shoulders/Cervical region

Therapist position: Standing or sitting at the head of the client.


Draping: Client exposed to axillary/arm pit area, client covered from axillary/arm pit region to feet.

Palpation hints: The acromioclavicular (AC) joint is the “V” on the superior-lateral aspect of the shoulder.

Common uses: Headaches, whiplash, neck restrictions, general neck soreness, TMJ dysfunction

NOTE: A hair clip, hair tie or towel may be used to keep client’s hair out of the way and minimize lubrication in

the client’s hair.

1. DRY SHAMPOO

Muscles/Tissue affected: epicranial/ cranial fascia, occipitals; temporalis

Procedure:

a) Perform circular friction with both hands on client’s scalp/cranium.

Note: Pressure can be light or deep, depending on client’s preference. Remember to ask client’s permission and

goal is to work scalp NOT hair.

2. SCOOPING

Muscles/Tissue affected: upper trapezius, levator scapula, and cervical paraspinals

Procedure:

a) Open hand scoop along the upper trapezius on both sides of the neck (from AC/acromioclavicular joint to

occiput) with your hands alternating from one side of the neck to the other.

NOTE: This move can be used as a transitional move.

3. LET YOUR FINGERS DO THE WALKING/EFFLEURAGE

Muscles/Tissue affected: upper trapezius; levator scapula; cervical paraspinals

Procedure:

a) Gently place the therapist’s thenar eminences/heel of the hands on the client’s occiput and place fingers on

posterior cervical musculature.

b) Rhythmically flex fingers one at a time superiorly from the base of the neck to the occiput, working superior

onto the nuchal line of the occiput. Working the whole back (posterior)portion of the neck

Note: This move can be used as a transitional move.

4. NEIGHBORING THUMBS/EFFLEURAGE

Muscles/Tissue affected: upper trapezius; levator scapula; cervical paraspinals; supraspinatus

Procedure:

a) Place thumbs together (next to each other or one on top of the other for more depth, you can vary the

technique) and glide from occiput to AC joint, following the upper trapezius. Moving inferior and lateral

working one side of the neck at a time.

b) Repeat at least 3 times moving slightly lateral each time.

c) Repeat on other side of the neck

Note: Do not work directly on the cervical vertebrae



5. THUMB-ROLLING/EFFLEURAGE

Muscles/Tissue affected: upper trapezius; levator scapula; cervical paraspinals; supraspinatus

Procedure:

a) Place one thumb at the occiput and begin glide from occiput toward AC joint moving inferior and lateral

working one side of the neck at a time. Place second thumb at occiput after first thumb has begun movement.

Alternate thumbs, using thumb-over-thumb movement until the AC joint has been reached.

b) Repeat entire movement from occiput to AC joint at least 3 times.

c) Repeat on other side of the neck.

Note: Do not work directly on the cervical vertebrae

6. THREE (3) PRESSURE POINTS ALONG THE SHOULDERS

Muscles/Tissue affected: upper trapezius; supraspinatus (deep to the upper trapezius)

Procedure:

a) Place thumbs at occiput on both sides of the client’s neck (not on the cervical vertebrae). Glide down to base

of the neck until upper trapezius stops the inferior movement of your thumbs.

b) Gently but firmly press into upper trapezius at the base of the neck and hold for a count of three to five

seconds.

c) Glide thumbs laterally approximately halfway between the base of the neck and the AC joint and press gently

but firmly into the upper trapezius holding for a count of three to five seconds.

d) Once again, glide thumbs laterally stopping just medial to the AC joint (in the “V” of the AC joint) and gently

but firmly press into the upper trapezius holding for a count of three to five seconds.

7. INTERLACED FINGERS

Muscles/Tissue affected: posterior suboccipitals

Procedure:

a) Interlace fingers and place hypothenar eminences (medial/pinkie side) at the base of the client’s neck and the

pads of the thumbs at the base of the occiput.

b) Apply static pressure with thumbs on the superior and inferior nuchal line of the occiput

c) Move thumbs in small circular friction movements from mastoid process to EOP and return back to mastoid.

8. FINGERS AT BASE OF SKULL (NUCHAL LINE OF THE OCCIPUT)

STATIC PRESSURE


Procedure:

a) Place pad of index, middle or both fingers of each hand on occipital ridge just lateral to EOP. Do both sides

of the occipital ridge at the same time

b) Gently but firmly press into the occipital ridge just lateral to EOP.

c) Move finger(s) laterally and press again.

d) Continue lateral movement until mastoid process has been reached.

e) Repeat movements moving medially back to the EOP.



CIRCULAR PRESSURE MOVEMENTS


Procedure:

a) Repeat the moves as in ‘Static Pressure’, a-e, above except use circular friction movements with your fingers

instead of static pressure.

9. PALM-KNEADING SHOULDERS/KITTY MOVE


Procedure:

a) Place palms of hands on upper trapezius just lateral to the base of the neck.

b) With alternating movements, gently but firmly press palms (compression) into the upper trapezius moving

laterally to AC joint and then medially to the base of the neck.

c) Repeat several times

10. GLIDING FISTS


Procedure:

a) Place loosely clenched fists on upper trapezius just lateral to the base of the neck.

b) With firm pressure, glide laterally from the base of the neck to the AC joint and then medially back to the

base of the neck.

c) Repeat move at least three times, moving posteriorly and anteriorly (do not choke the client by moving too far

anteriorly onto the throat).

11. CIRCULAR FISTS

Muscles/Tissue affected: upper trapezius; levator scapula

Procedure:

a) Place loosely clenched fists on upper trapezius just lateral to the base of the neck.

b) Rotate your wrists in a circular motion several times remaining at the base of the neck.

c) With gentle, yet firm pressure, rotate your wrists laterally from the base of the neck to the AC joint and then

medially back to the base of the neck.

d) Repeat move at least three times, moving posteriorly and anteriorly (do not choke the client by moving too far

anteriorly onto the throat).

12. PETRISSAGE SHOULDERS & UPPER BACK

NOTE: This move can be used as a transitional move.

SMILE!! IT INCREASES YOUR FACE VALUE.



Posterior Body—Finishing Strokes

Therapist position: Standing or sitting at the head of the client

Client position: Prone; Ankles bolstered

Draping: Client exposed to sacrum; client covered from sacrum to feet.

Common uses: Closing, ending

1. EFFLEURAGE DOWN THE BACK/WAVE UP

Procedure:

a) Place open hands on the shoulders next to the neck.

b) Glide inferiorly from upper thoracic paraspinal region to ilium.

c) Glide laterally along ilium.

d) Glide superiorly along the lateral area of the rib cage and around the scapulas using a wave-like motion.

e) Repeat 3 times, using any of the following variations.

VARIATIONS: From the Procedure 1, (a-d) above, perform the strokes with the following variations

CONTOUR SHOULDER/NECK/OCCIPUT

Procedure:

a) Complete the stroke by scooping around the shoulders, up the neck to the base of the occiput.

A. CONTOUR ELBOW/ SHOULDER/NECK/OCCIPUT

Procedure:

a) Complete the stroke by gliding laterally around the shoulders, down the arms to the elbow gently

squeeze and hold the elbows, and move back up the arms, around the shoulders, up the neck to

the base of the occiput.

Note: Making sure not to hyperextend the elbow.

B. CONTOUR WRIST/ELBOW/ SHOULDER/NECK/OCCIPUT

Procedure:

a) Complete the stroke by gliding laterally around the shoulders, down the arms to the wrists, gently

squeeze and hold briefly at the wrists, and move back up the arms, around the shoulders, up the

neck to the base of the occiput.

Note: The above strokes can be performed one to several times time each for each stroke.



2. CIRCULAR OPEN HANDS

Procedure:

a) Start medially, moving in an inferior, and then laterally, returning superior motion (Making circles in a

downward and outward motion). All the way down (inferior) the back

3. CRAB WALK

Muscles/Tissue affected: erector spinae; mid and lower trapezius.

Procedure:

a) Place fingertips of each hand on both shoulders at the base of the neck.

b) Extend (spread open) fingers of each hand alternately while simultaneously moving inferiorly down the

back to the sacrum. (Opening fingers then bringing fingers back together)

c) You can do this movement with both hands at the same time

4. SEWING MACHINE / ZIGZAGS

Muscles/Tissue affected: rotatores; interspinales; multifidus

Procedure:

a) Place thumbs on either side of the spinous process of C7.

b) Glide thumbs in half circles around each spinous process in both directions, moving inferiorly toward the

sacrum.

Left thumb movement Right thumb movement

Left thumb movement Right thumb movement

Note: Movements can vary between slower/deeper strokes or quicker/lighter strokes.



POSTERIOR BACK - RIBS Therapist position: Standing at the client’s head, start on one side of the rib cage working in a continuous

motion flow to the other side of the rib cage


Draping: Draping to uncover back to PSIS. Therapist may want to tuck sheets under client’s hips or use a

folded towel on top of the draping at the sacrum for added weight to secure the sheets. Remember to keep

the person appropriately draped/covered at all times.

Muscles/Tissue affected: intercostals

Palpation hints:

Common uses: breathing problems

5. RIB RAKE

Procedure: Start inferior and move superior.

a) Place fingertips of one hand in the spaces between the ribs on the lateral (side) edge of the rib cage and pull

fingers medially (towards the spine) following the intercostals spaces.

b) As the first hand completes one stroke, the other hand is placed on the lateral edge of the rib cage and the

stroke is repeated alternating hands. Moving from inferior to superior and then back inferiorly.

c) Move from one side of the rib cage in a continuous motion flow to the other side of the rib cage and back

again.

d) In can add in the following stroke, Rocking Horse, as you move to the other side of the ribs

6. ROCKING HORSE/FEATHER STROKES

Procedure:

a) Place two fingertips of each hand (one hand more superior than the other) on both sides of the spine just

superior to the sacrum.

b) Lightly rake superiorly along the spine, one hand alternating to the other hand. Hand over hand in short

continuous rolling segments up the back to the upper thoracic/lower cervical regions.

Note: This move can be used to transition from one side of the body to the other while performing the rib rake.

7. VIBRATION

Heel of hand

Side of hand/lamina groove

Thumb along side of spine

Fist

Note: Reference your text book for explanation and procedures. Watch the demo very closely.

Vary the pressure depending on the area of the body.

Be careful of the endangerment zones of the body, light pressure in these areas



8. TAPOTEMENT

Hacking – alternating open hand, using 5th metacarpal side

Pounding - alternating closed fists using 5th metacarpal side

Slapping – alternating flat open hand

Cupping - alternating cupped hand

Star Hands – hands are placed together as if in prayer, spread your fingers apart, and use 5th metacarpal side

of your hands

Tapping – alternating tapping with the therapist’s finger tips varying pressure depending on the area of the

body being worked on.

Note: Reference your text book for explanation and procedures. Watch the demo very closely. Tapotement is

rapid striking motion; vary the pressure depending on the area of the body. Be careful of the endangerment zones

of the body, no or light pressure to these areas

Posterior Body—Gluteals

Therapist position: Standing at the level of the client’s gluteal region and working same side.


Draping: Draping to uncover ½ of buttocks keeping sacral sulcus covered. Therapist and/or client may want to

use a folded towel on top of the draping at the sacrum for added weight to secure the sheets. Remember to keep

the person appropriately draped/covered at all times.

Muscles/Tissue Affected: gluteals (gluteus medius, gluteus minimus and gluteus maximus)

Common uses: Sciatica, low back pain, gluteal pain, people who sit for long periods of time.

NOTE: To address the deep six/lateral hip rotators, a deeper pressure can be used if client can

tolerate it

1. ROCKING THE GLUTEAL REGION

a) Placing the therapist’s hands on top of the covered gluteals, gently rock back and forth at a rate that is

comfortable to the client.

NOTE: This step is performed through the sheets at the beginning and end of work in this area.

2. COMPRESSIONS OF THE GLUTEAL MUSCULATURE

a) Heel Squeeze.

b) Direct Compressions.

NOTE: This step can be performed through the sheets/before the client is draped.

3. PETRISSAGE GLUTEAL REGION

Note: This step can be performed through the sheets/before the client is draped.



4. GLUTEAL STRIPPING

Procedure: (Movement is superior to inferior)

a) Place the therapist’s superior hand (closest to the client’s head) on top of sheet at the sacrum with the rest of

the therapist’s forearm gently resting along the spine. This arm is used as an anchor for the sheet. There is

basically no weight on this arm; it’s a very light pressure.

b) With the therapist inferior arm, place the olecranon process/elbow of inferior arm at the iliac crest, just lateral

to the sacrum (to side of the sacrum). The hand of the therapist is in the direction of the client’s head.

c) With firm pressure, within the tolerance of the client, begin gliding the therapist’s inferior arm inferiorly

(downward towards the client’s feet) toward the gluteal tuberosity, follow through with the therapist’s

forearm to the upper part of the thigh (leg). Making an oval circle laterally, then superiorly lightly glide the

arm back to the starting position.

d) Repeat step b & c, 2-3 more times depending on the size of the client’s gluteal area. Working slightly more

laterally each stroke. Be careful not to run into the greater trochanter. Move around the greater trochanter to

avoid running into it.

Note: The whole gluteal area can be very tender for some clients, always work within the client’s tolerance. Ask

for feedback often.

Follow the contour of the client’s gluteal muscles. These are not just straight line strokes, they curve with the form

of the muscle.

5. SPOKES OF A WHEEL/PIE SLICES

Procedure: (Movement from medial to lateral)

a) Keeping the therapist’s superior arm in the same position as in “a” in the procedure above.

b) Using the sacrum as the hub or center part of a wheel. Place the elbow (olecranon process) of inferior arm

just lateral to the PSIS. With firm pressure, within the tolerance of the client, begin gliding therapist’s

inferior arm laterally toward the table. Lightly glide back to the starting position.

c) Repeat the stroke in “b” above. 2-3 more times depending on the size of the client’s gluteal area. The starting

point for the therapist’s elbow is the same. Though, each time moving the therapist’s elbow more on an angle

or diagonal towards the greater trochanter. Then, with following strokes, work the angle of the move, towards

the thigh (upper leg). Follow through on these moves with the therapist’s forearm.

Note: Use caution not to run into the greater trochanter.

The whole gluteal area can be very tender for some clients, always work within the client’s tolerance. Ask for

feedback often

6. NO SAGGY BUTTS

Procedure: (Movement from inferior to superior)

a) Now switch anchoring arms. Place the therapist’s inferior hand on top of sheet at the sacrum to secure the

sheet from moving. There is basically no weight on this arm, it’s a very light pressure.

b) Place the elbow (olecranon process) of the therapist’s superior arm, inferior (below) the gluteal tuberosity

moving superiorly toward the iliac crest, following through with therapist’s forearm, being careful not to run

into the greater trochanter. Follow the contour of the client’s gluteals. Lightly glide back to the starting

position.

c) Repeat the stroke in “b” above, 2-3 more times depending on the size of the client’s gluteal area. Moving

more medially (towards the sacrum) each time, to the original starting positions in movement #4 above.

Note: The whole gluteal area can be very tender for some clients, always work within the client’s tolerance. Ask

for feedback often.



Follow the contour of the client’s gluteal muscles. These are not just straight line strokes, they curve with the form

of the muscle.

7. SHORTENED GLUTEAL MUSCLE

Procedure:

a) Bend the hip and the knee, so the knee is flexed/bent and the hip is laterally rotated (as if they are going over

a hurdle) Circular motion around the greater trochanter, using the flat of your hand or a loosely closed fist.

b) Gradually increase the size of the circle, until all of the gluteal area has been worked.

c) Work very deliberately along the sacrum with the fibers and cross fiber.

d) Straighten the leg.

Note: Use proper draping, make sure the client feels secure with the draping.

8. ROCKING THE GLUTEAL REGION

a) Placing the therapist’s hands on top of the covered gluteals, gently rock back and forth at a rate that is

comfortable to the client.

Note: This step is performed through the sheets at the beginning and end of work in this area.

9. REPEAT THE ABOVE STEPS ON THE CLIENT’S OTHER SIDE OF THEIR BODY

POSTERIOR BODY—Thigh

Therapist position: Standing on the same side of the client that the massage will be performed on. Standing

approximately between the client’s knee and ankle, modify as needed.


Draping: One leg draped securely from hip to ankle. No diaper draping necessary. Remember to keep the

person appropriately draped/covered at all times.

Common uses: knee problems; edema; people who stand a lot.

NOTE: The edema drain should be performed first if edema is present or to increase circulation to the legs.

Always clear upper leg first and then clear lower leg. Always apply pressure centripetally, or WORK TOWARD

THE HEART/CENTER.

1. EDEMA DRAIN

Procedure:

a) Using effleurage strokes, starting several inches inferior of the gluteal area. Moving from distal to proximal,

elongating your movement with each stroke (using strokes towards the heart.) Continue to do the whole

posterior thigh. Moving onto the calf continue the same distal to proximal movement.

Note: Beneficial for reducing in the fluid in the ankle.



2. UPWARD RAKING

Muscles/Tissue affected: hamstrings

Therapist position: Standing on the same side of the client that the massage will be performed on, at the

level of the client’s knee, facing the client’s head.

Procedure:

a) Place fingertips of both hands just superior to the crease of the client’s knee and at the midline of the client’s

thigh.

b) Keeping fingers straight and alternating hands, begin moving hands just superior from the knee crease

working your way just slightly inferior to the gluteal region.

c) Repeat this stroke several times moving slightly medial and lateral from the midline of the thigh. Covering

the whole back of the thigh with this move.

Note: Do not do the medial aspect (inner) thigh on this move, it can feel invasive

3. STRAIGHT FISTS




Procedure:

a) Place loosely clenched fists just superior to the crease of the client’s knee and at the midline of the client’s

thigh.

b) Moving from the therapist’s hips, begin gliding one or alternating one fist then the other or both (next to each

other) fists superiorly. The therapist can vary the strokes.

c) Begin moving fists just superior from the knee crease working your way just slightly inferior to the gluteal

region.

d) Repeat this stroke several times moving slightly medial and lateral from the midline of the thigh. Covering

the whole back of the thigh with this move.

4. CIRCULAR FISTS




Procedure:

a) These strokes are the same as above except the therapist fists are moving in a circular motion. If the

therapist is using only one fist the therapist should stabilize lightly with their other hand on the client’s leg.



5. FOREARM STROKES (optional for muscular legs)


Therapist position: Standing on the same side of client to be worked at the level of the client’s knee, facing

the client’s knees.

a) Place the therapist’s forearm just superior to the crease of the client’s knee.

b) Therapist moving from their hips, begin gliding forearm superiorly toward the gluteal region.

c) Repeat this move several times, moving medial and laterally across the client’s thighs

6. LONG STROKES ALONG ITB/VASTUS LATERALIS

Muscles/Tissue affected: ITB; vastus lateralis

Therapist position: Standing on the same side of client to be worked at the level of the client’s knee, facing

the client’s head.

Procedure:

a) Place loosely clenched fist or open hand just superior to the lateral side of the client’s knee. (The outer aspect

of the client’s thigh)

b) Moving from the therapist’s hips, begin gliding fist or open hand, superiorly and in a long gliding stroke or

circular motion toward the greater trochanter region. Repeat several times

Note: This can be a very sensitive area of the body on some people. Be sure to check with your client on pressure

and use only open hand for more sensitive people. For deeper pressure you can then move on to fist if client can

tolerate more specific/deeper work.

7. PUSH-PULL MEDIAL THIGH

Muscles/Tissue affected: hamstrings; adductors; sartorius; gracilis

Therapist position: Standing on the same side of client to be worked at the level of the greater trochanter and

facing the client’s opposite foot.

Procedure:

a) Place both hands on medial thigh just superior to the crease of the knee.

b) Begin by moving hands in a 45 degree angle and in opposite motions toward the knee (Similar to the Push-

Pull move done on the back)

c) Be sure to work the medial thigh from knee to gluteal region and back down to the knee without being

invasive to the groin area.

medial thigh

gluteal foot

Hand movement direction lateral thigh



8. CIRCLES ON SIDES OF KNEE

Muscles/Tissue affected: hamstrings; gastrocnemius

Therapist position: Standing on the same side of client to be worked at the level of the client’s calf, facing

the client’s heads.

Procedure:

a) Place fingertips on both sides of the client’s knee just superior to the crease of the knee

b) Perform small circles with the therapist fingertips moving superiorly and inferiorly around the sides of the

knee

9. PETRISSAGE/SCOOPING ENTIRE THIGH INCLUDING THE KNEE

BREATHE!! IT HELPS BOTH YOU AND YOUR CLIENT RELAX.

Posterior Body—Lower Leg/Calf

Therapist position: Standing on the same side of client to be worked.




Common uses: calf cramps; knee problems

NOTE: All applications should be inferior to superior or TOWARD THE HEART

Note: The following techniques can be mixed and matched and done in any order you choose to create

your own personal massage routine.

1. THUMB/FINGER STRIPPING

Muscles/Tissue affected: gastrocnemius; soleus

Therapist position: Standing on the same side of client to be worked, at the level of the client’s ankle facing


Procedure:

a) Place thumbs/fingertips on the center of the client’s calf just superior to the ankle.

b) Glide superiorly up the center of the calf and stop just inferior to the crease of the knee (popliteal fossa).

c) Repeat steps a & b gliding up the lateral and medial sides of the calf until the entire calf has been treated.



2. THUMB/FINGER CIRCLES

Muscles/Tissue affected: gastrocnemius; soleus



Procedure:

a) These strokes are the same as above except the therapist’s thumbs/fingertips are moving in a circular motion

over the whole calf.

3. PETRISSAGE/SCOOPING ENTIRE CALF

4. PUSH-PULL/SNAKE BITE

Muscles/Tissue affected: gastrocnemius

Therapist position Standing on the same side of client to be worked, at the level of the client’s mid-calf

facing the client’s opposite leg.

Procedure:

a) Place both hands on calf.

b) Begin by moving hands in a 90 degree angle to the calf and in opposite motions (Similar to the Push-Pull

move done on the back)

c) Be sure to work calf from ankle to knee without working in the popliteal fossa.

Gluteal foot

Hand movements

on posterior lower leg

5. CALF LIFT/VIBRATE

Muscles/Tissue affected: gastrocnemius

Therapist position Standing on the same side of client to be worked, at the level of the client’s mid-calf

facing the client’s opposite leg.

Procedure:

a) Grasp calf musculature with both hands.

b) Gently lift musculature posteriorly (up towards the ceiling) and vibrate.



6. EFFLEURAGE UP ENTIRE LEG/FEATHER STROKE DOWN



NOTE: Ending stroke for leg.

Procedure:

a) Place open hands on the client’s ankle and glide superiorly to the gluteal region. Remember to be glide gently

over the crease of the knee/popliteal fossa.

b) Just inferior to the gluteal region, lightly place fingertips and glide inferiorly (downard) to the ankle

alternating hands.

c) Repeat a) & b) 3 times.

Note: Remember to use proper draping as the client turns over. Secure the sheet with your thighs against

the table (on the side closest to you) and tent the sheet above the client as they roll over. Lower the sheet

making sure client is still covered. Watch the demonstration closely

RELAXATION / ANTERIOR BODY

Anterior Body—Lower Extremity (Bent Leg)

Therapist position (bent leg work): Standing or sitting on the same side of the client that is to be worked on.

Therapist will either gently sit or kneel on client’s covered foot to stabilize the leg. (Make sure the foot is covered

with the sheet, so the client will not feel intruded upon and to prevent the lubricant from getting on therapist’s

clothes). Support leg laterally or medially depending on stroke so client does not have to support their own leg.

Client position (bent leg work): Supine; Bolster under opposite knee, if client would like.



The edema drain should be performed first if edema is present or to increase circulation to the legs,

(similar to the back of the leg as previously demonstrated)

Leg is straight during edema drain

All applications should be inferior to superior or TOWARD THE HEART.

When working the leg, be sure to work all sides: lateral (ITB, vastus lateralis); anterior (quadriceps: rectus

femoris, vastus lateralis, vastus intermedius, vastus medialis), sartorius; medial (adductors, gracilis, sartorius).

ITB, sartorius, rectus femoris & gracilis cross over the knee joint.

1. EDEMA DRAIN

Procedure:

a) Using effleurage strokes, starting on the upper thigh. Moving from distal to proximal, elongating your

movement with each stroke (using strokes towards the heart.) Continue to do the whole anterior thigh.

Moving onto the lower leg continue the same distal to proximal movement, until the whole leg has been done.

Note: Beneficial for reducing fluid in the ankle.



EDEMA DRAIN/CLIENT’S LEG ON THERAPIST’S SHOULDER (variation)

Procedure:

a) Elevate the client’s leg by placing their leg on the therapist’s shoulder or a large stack of pillows making sure

to support the knee.

b) Repeat the movements from Edema Drain “a” from above.

2. SCOOP CALF

Muscles/Tissue affected: gastrocnemius and soleus

Procedure:

a) With open hands scoop the calf using the area between the therapist’s extended thumb to index finger.

b) Move from the client’s ankle area to just inferior to the knee. Using hand over hand movement as the

therapist glides up the calf.

c) Repeat this movement several times

3. CALF BROADENING/RAKING

Muscles/Tissue affected: gastrocnemius and soleus

Procedure:

a) Begin by interlacing bent fingers of both the therapists’ hands on posterior lower leg/calf, gently pull - -

separating the hands, from medial to lateral around leg.

b) Continuing anteriorly towards the front of the lower leg.

c) Repeat several times moving up and down the client’s calf.

4. THUMB/FINGER STRIPPING UP CENTER & SIDES OF TIBIA & FIBULA

Muscles/Tissue affected: tibialis anterior; extensor hallucis longus; extensor digitorum longus; peroneus

brevis; peroneus longus

Procedure:

a) Place thumbs/fingers on anterior ankle and glide with both hands superiorly (ankle to knee) up the center of

lower leg

b) Repeat step a) working laterally and medially, working the entire lower leg. Be sure to support the leg as you

do this.

5. THUMB/FINGER CIRCLES UP CENTER & SIDES OF TIBIA & FIBULA



Procedure:

a) Place thumbs/fingers on anterior ankle and glide using both hands superiorly (ankle to knee) using circular

movement up the center of lower leg

b) Repeat step a) working laterally and medially, working the entire lower leg in circular motion. Be sure to

support the leg as you do this.



6. THUMB CIRCLES AND PETRISSAGE AROUND KNEE

7. FIST/OPEN HAND CIRCLES ALONG ITB

Therapist Position: Sitting on edge of table support the medial (inside) of the knee with arm closest to client

and allow the leg to comfortably fall medially.

Muscles/Tissue affected: vastus lateralis (the ITB is NOT a muscle)

Procedure:

a) Perform closed fist and/or open hand circles along the lateral leg/ITB from the knee to the greater trochanter

area.

b) Repeat several times working entire lateral thigh.

c) This is very tender for most clients, proceed slowly and gently

8. FIST/OPEN HAND STRIPPING ALONG ITB

Therapist Position: Support the medial (inside) of the knee and allow the leg to comfortably fall medially.


Procedure:

a) Perform a closed fist and/or open hand glide along the lateral leg/ITB from the knee to the greater trochanter

area.



9. OPEN HAND/PALM GLIDING ON THIGH

Muscles/Tissue affected: quadriceps

Procedure:

a) Place open hand/palm on anterior thigh just superior to knee and firmly glide, hand over hand, superiorly on

thigh moving distal to proximal (knee to hip).

b) Repeat this move several times moving medial and lateral. Stabilizing the leg with the therapist’s hands.

10. PETRISSAGE THIGH WITH BOTH HANDS

11. RAKING FROM KNEE TO HIP


Procedure:

a) Place fingertips just superior to knee and with straight fingers glide hand over hand, superiorly along thigh

(distal to proximal).

b) Repeat movement several times working entire anterior thigh.



12. WAVE/PUSH-PULL THIGH


Procedure:

a) Interlace fingers and place on top of thigh.

b) Using a figure-8 motion, perform deep movements from distal to proximal (knee to hip).

c) Repeat several times working entire anterior thigh.

13. LONG STROKES ALONG MEDIAL THIGH

Therapist Position: Support the lateral (outside) leg with a pillow, bolster or the therapist’s bent knee or arm

allowing the leg to fall laterally.

Muscles/Tissue affected: vastus medialis; adductors

NOTE: Make sure the client is covered while the leg is being moved laterally.

Angle moves anteriorly/laterally along draping line at the end of the stroke to avoid the “no fly zone”.

Procedure:

a) Perform long effleurage strokes distal to proximal (knee to thigh) on the medial (inside) thigh.

b) Therapist should angle hand(s) anteriorly/laterally at the end of each stroke to avoid the “no fly” zone.

c) Repeat several times covering entire medial thigh.

d) Work within the client’s comfort zone as this area can be quite tender.

Anterior Body—Lower Extremity (straight leg)

Note: Remember to use proper draping as the client turns over. Secure the sheet with your thighs against

the table (on the side closest to you) and tent the sheet above the client as they roll over. Lower the sheet

making sure client is still covered. Watch the demonstration closely

Therapist position (straight leg work): Standing on the same side of the client that is to be worked on..

Client position (straight leg work): Supine; Bolster under the client’s knees to remove pressure from their lower

back. Some client’s prefer no bolster. ASK

Draping: One leg draped securely from hip to ankle. Drape top sheet so it is held in place by non-treated leg. No

diaper draping necessary. Remember to keep the person appropriately draped/covered at all times.

All applications should be inferior to superior or TOWARD THE HEART.

When working the leg, be sure to work all sides: lateral (ITB, vastus lateralis); anterior quadriceps: rectus femoris,

vastus lateralis, vastus intermedius, vastus medialis, sartorius); medial (adductors, gracilis, sartorius).

ITB, sartorius, rectus femoris & gracilis cross over the knee joint.

Apply oil using long effleurage strokes up the leg.



1. EDEMA DRAIN/CLEAR THE LEG

Procedure:

a) Using effleurage strokes, starting on the upper thigh. Moving from distal to proximal, elongating your

movement with each stroke (using strokes towards the heart). Continue to do the whole anterior thigh.

Moving onto the lower leg continue the same distal to proximal movement, until the whole leg has been done.

Note: Beneficial for reducing fluid in the ankle.

EDEMA DRAIN/CLIENT’S LEG ON THERAPIST’S SHOULDER (VARIATION)

Procedure:

a) Elevate the client’s leg by placing their leg on the therapist’s shoulder or a large stack of pillows making sure

to support the knee

b) Repeat the movements from Edema Drain a) from above.

2. EFFLEURAGE ENTIRE LEG

Procedure:

a) Starting at the ankle, glide superiorly with both hands working the entire leg (distal to proximal).

b) Repeat at least 3 times.

3. THUMB/FINGER STRIPPING UP CENTER & SIDES OF TIBIA & FIBULA



Procedure:

a) Place thumbs/fingers on anterior ankle and glide with both hands superiorly (ankle to knee) up the center of

lower leg

b) Repeat step a) working laterally and medially. Working the entire lower leg.

4. THUMB/FINGER CIRCLES UP CENTER & SIDES OF TIBIA & FIBULA



Procedure:

a) Place thumbs/fingers on anterior ankle and glide with both hands superiorly (ankle to knee) using circular

movement up the center of lower leg

b) Repeat step a) working laterally and medially, working the entire lower leg in circular motion.

5. PETRISSAGE AROUND KNEE AND THIGH

6. THUMB CIRCLES AROUND KNEE



7. OPEN HAND/PALM GLIDING ON THIGH


Procedure:

a) Place open hand/palm on anterior thigh just superior to knee and firmly glide with both hands together or

hand over hand, superiorly on thigh moving distal to proximal (knee to hip).

b) Repeat this move several times moving medial and lateral. Stabilizing the leg with the therapist’s hands

during the move.

8. OPEN HAND/PALM CIRCLES ON THIGH


Procedure:

a) This move is same as above but using a circular motion, use both hands at the same time or alternating

hands.

9. FIST/OPEN HAND STRIPPING ALONG ITB

Therapist Position: Support the medial (inside) of the knee.


Procedure:

a) Use a closed fist and/or open hand glide along the lateral leg/ITB from the knee to the greater trochanter area



10. FIST/OPEN HAND CIRCLES ALONG ITB

Therapist Position: Support the medial (inside) of the knee and allow the leg to comfortably fall medially.


Procedure:

a) Use a closed fist and/or open hand circles along the lateral leg/ITB from the knee to the greater trochanter

area.



11. PETRISSAGE THE THIGH AGAIN AS THE THERAPIST TRANSITIONS INTO THE NEXT

MOVE.

This move can be done between other moves.



12. PUSH/PULL MEDIAL THIGH

Muscles/Tissue affected: vastus medialis; adductors; sartorius; gracilis

Therapist position: Standing on the same side of the client that is to be worked on at the level of the greater

trochanter and facing the client’s opposite foot.

Procedure:

a) Place both hands on the medial thigh just above the knee.

b) Begin by moving hands in a 45-degree angle and in opposite motions toward the knee (push one hand

posteriorly and pull other hand anteriorly, reverse hand movements. This is similar to the back’s push/pull

move).

c) Work medial thigh from knee to just below the draping, without being invasive and within the comfort level

of the client.

d) Repeat several times covering entire medial thigh.

Medial thigh

Foot

Hand movements

on anterior thigh/ lateral thigh

therapist position

13. RAKING FROM KNEE TO HIP


Procedure:

a) Place fingertips just superior to knee and with straight fingers, glide superiorly along thigh (distal to

proximal).

b) Repeat movement several times working entire anterior thigh.

14. EFFLEURAGE SUPERIOR/FEATHER STROKE INFERIOR

Procedure:

a) Starting at the ankle, firmly glide superiorly working entire leg (distal to proximal).

b) Lighten pressure at the hip and move inferiorly returning to ankle (proximal to distal)

c) Repeat steps a) & b).



Anterior Body—Hands & Arms

WATCH THE DEMOSTATIONS VERY CLOSELY

Therapist Position: Standing at the level of the client’s waist facing the head of the client.

Client Position: Supine with neck support (as needed) and knees bolstered as needed. The client’s arm is gently

bent at the elbow between a 45 degree to 90 degree angle, their arm/hand relaxed and is being supported by the

therapist. The client is relaxed so the therapist can freely move the client’s arm to comfortable positions, as the

different moves are performed.

Draping: Client covered with their arm and shoulder of treating side exposed. Sheet can be tucked under axillary

region (armpit) to insure coverage of breast tissue. Cover male’s chest as well.

Muscles/Tissue Affected: forearm flexor tendons; forearm extensor tendons

Forearm Extensors: extensor carpi ulnaris; extensor digiti minimi; extensor digitorum; extensor indicis;

extensor carpi radialis brevis; extensor carpi radialis longus; supinator; abductor pollicis longus; extensor

pollicis brevis; extensor pollicis longus

Forearm Flexors: flexor carpi ulnaris; palmaris longus; flexor carpi radialis; flexor digitorum superficialis;

flexor digitorum profundus; flexor pollicis longus; pronator teres; pronator quadratus

1. ROM FINGER JOINTS (lower arm at about 45 degree angle to the table)

Procedure:

a) Therapist applies gentle traction while rotating each joint of each finger 3-5 times both clockwise and

counterclockwise.

NOTE:

Be sure to stabilize above and below each joint during movement.

Isolate each joint of each finger.

2. BOX FINGERS (lower arm at about 45 -90 degree angle to the table)

Procedure:

a) Therapist places their thumb and index finger, at the base of the client’s finger, on the front and back aspects

and the therapist’s other thumb and index finger is placed on the sides at the base of the client’s finger.

Therefore boxing the finger of the client

b) Therapist shimmies up (proximally to distally) each finger, one at a time.

c) Repeat movements on each finger 3 times.

3. SHIMMY UP FINGERS (lower arm at about 45 -90 degree angle to the table)

Procedure:

a) Therapist places their thumb and index finger, at the base of the client’s finger, on the front and back

aspects gliding up (proximally to distally) to the fingertip.

b) Then therapist places thumb and index finger on the sides at the base of the client’s finger gliding up

(proximally to distally) to the fingertip.

c) Repeat on all the fingers



4. MASSAGE THE WEBBING BETWEEN EACH FINGER (lower arm at about 45 degree angle to the

table)

5. MASSAGE BETWEEN METACARPALS (lower arm at about 45 degree angle to the table)

Muscles/Tissue affected: palmar interossei; dorsal interossei; lumbricals

NOTE: Work between metacarpals on both the palmar and dorsal surface of the hand.

6. ISOLATE, STRIP AND ROCK METACARPALS (lower arm at about 45 degree angle to the table)

7. WORK WEB BETWEEN THUMB AND INDEX FINGER (lower arm at about 45 degree angle to the

table)

Caution with pregnancy this may create contractions

Muscles/Tissue affected: adductor pollicis; opponens pollicis; flexor pollicis brevis; abductor pollicis

brevis

8. MASSAGE THE BASE OF THE HAND & ENTIRE PALMAR SURFACE (lower arm at about 45

degree angle to the table)

Muscles/Tissue affected: abductor pollicis brevis; adductor pollicis; flexor pollicis brevis; flexor digiti

minimi; opponens pollicis; opponens digiti minimi; abductor digiti minimi; palmar interossei;

lumbricals

Procedure:

a) With client’s hand supinated (palm up), the therapist uses their thenar eminence, fingers, knuckles, thumbs, to

massage client’s palm. Work the whole area thoroughly

9. INTERLACED FINGERS (lower arm at about 45 degree angle to the table)

Muscles/Tissue affected: abductor pollicis brevis; adductor pollicis; flexor pollicis brevis; flexor digiti

minimi; opponens pollicis; opponens digiti minimi; abductor digiti minimi; palmar interossei;

lumbricals

Procedure:

a) With client’s hand supinated (palm up), therapist interlaces their fingers with the client’s fingers and

massages client’s palm using thumb circles, strips, broadening.

b) Be careful not to over stretch the fingers backwards or pinch the client’s fingers with your fingers when you

are holding their hand in position.

10. STRETCH AND WRING OUT HAND (lower arm at about 45 degree angle to the table)

Procedure:

a) With client’s hand supinated (palm up), the therapist places traction on client’s hand inferiorly (towards the

client’s feet) and wrings hand out proximally to distally (wrist to finger tips).

b) Turn the client’s hand over (pronate) and repeat above move



11. ROCK RADIUS AND ULNA (lower arm at about 90 degree angle to the table)

Tissue Affected: loosens up the interosseous membrane

Procedure:

a) Therapist grasps the distal (at wrist) ends of radius and ulna.

b) Therapist stabilizes the radius and gently moves the ulna anteriorly and posteriorly.

12. FOREARM STRIPPING

Therapist position: At the side of the table at the level of the client’s waist

Client position:

Supine (face up/laying on their back) with treating arm:

Pronated (palm down) to treat extensor compartment

Supinated (palm up) to treat flexor compartment

Muscles/Tissue affected: Forearm Extensors and Forearm Flexors

Forearm Extensor Compartment: extensor carpi ulnaris; extensor digiti minimi; extensor digitorum;

extensor indicis; extensor carpi radialis brevis; extensor carpi radialis longus; supinator; abductor

pollicis longus; extensor pollicis brevis; extensor pollicis longus

Forearm Flexor Compartment: flexor carpi ulnaris; palmaris longus; flexor carpi radialis; flexor

digitorum superficialis; flexor digitorum profundus; flexor pollicis longus; pronator teres; pronator

quadratus

NOTE:

Client may need to move over so that there is room for the client’s forearm to lie flat on the table.

If the client’s shoulder is shifted with placement of the forearm on the table, the client’s forearm may need to

be supported with a pillow or the therapist’s knee.

Procedure:

a) With client’s hand pronated (hand facing down towards table), therapist glides distal to proximal (wrist to

elbow) using fingers/thumbs/palm in a stripping motion up the client’s forearm through the extensor

compartment.

b) Repeat several times moving from one side to the other until entire extensor side of the arm has been treated.

c) Next, gently rotate the client’s arm so the hand is supinated (facing up) on the table, therapist glides distal to

proximal (wrist to elbow) using fingers/thumbs/palm in a stripping motion up the client’s forearm through the

flexors compartment.

d) Repeat several times moving from one side to the other until entire flexor side of the arm has been treated.



13. BEND AT ELBOW—WORK ELBOW AND UPPER ARM

Therapist position: Therapist will move up towards the client’s shoulder on the same side of the table.

Muscles/Tissue affected: deltoid; triceps brachii; biceps brachii; brachialis; anconeus; brachioradialis

Procedure:

a) Lift arm and bend at elbow.

b) Then horizontally adduct arm across the chest to the client’s opposite shoulder, allowing the client’s hand to

rest on their shoulder. (i.e. allowing the right hand to rest on the client’s left shoulder with their elbow in the

air)

c) Next, massage around elbow thoroughly and the upper arm all the way to the shoulder joint.

14. SCOOP/WRING OUT ENTIRE ARM—WRIST TO SHOULDER

Muscles/Tissue affected: all muscles of arm and forearm

Procedure:

a) Stabilize client’s hand either between therapist’s neck and shoulder or therapist’s waist and elbow.

b) Beginning at the wrist, glide distally to proximally (wrist to shoulder) up the arm using a wringing or alternate

hand scooping motion.

15. MASSAGE UPPER ARM

Therapist position: At the client’s shoulder facing the client’s feet.

Client position: Supine with elbow/arm in similar position as in #13 a&b above

Muscles/Tissue affected: deltoid; triceps brachii; biceps brachii; brachialis

Procedure:

a) Massage entire upper arm (If client’s right arm is being worked, therapist stands to right of client’s head,

supports client’s right arm with therapist’s left arm. Therapist uses right arm to work client’s right arm).

b) Work whole upper arm thoroughly with petrissage/stripping/wringing motions, be creative

16. WRING OUT ENTIRE ARM—SHOULDER TO WRIST

Muscles/Tissue affected: deltoid; triceps brachii; biceps brachii

NOTE: Use a towel to wrap the client’s hand and wrist to avoid getting lubrication on therapist’s skin and/or

clothing. Also to keep appropriate boundaries.

Procedure:

a) Stabilize client’s hand between therapist’s neck and shoulder.

b) Beginning at the shoulder, wring out/snake bite arm (using slight traction) proximally to distally (shoulder to

wrist) anteriorly (toward the ceiling).

c) A slight shaking motion can be done near the wrist.

d) Repeat 3 times. Place the client’s arm back on the table next to them.



17. MASSAGE CHEST AND SHOULDER REGION

Therapist Position: At the level of the client’s shoulder facing the client’s head.

Client Position: Supine with knees bolstered as needed.

Muscles/Tissue affected: pectoralis major; pectoralis minor; subclavius

NOTE: Check with your client to be sure not to intrude on breast tissue.

Procedure:

a) Massage into the pectoral region and inferior to clavicle using compression, effleurage, petrissage and

stripping. Keeping the client properly draped.

b) With a continuous motion move into the shoulder area using circular motions, covering the whole shoulder

joint area.

c) Scooping up into the posterior neck area connecting areas together.

Anterior Body—Head/Face

Therapist Position: Seated at the head of the client.


Draping: Tops of shoulders are exposed. Arms can be tucked under sheet for warmth.

NOTE: Be sure to ask permission to work on head and face. Client may not want lubrication on their face,

makeup smeared or hair messed up.

1. DRY SHAMPOO

Muscles/Tissue affected: cranial fascia/epicranial; temporalis

Procedure:

a) Perform circular friction with both hands on client’s scalp/cranium. Vary the pressure to client’s preference.

Be careful; do not pull the client’s hair

2. SPREAD/WIPE FOREHEAD

Muscles/Tissue affected: frontalis

Procedure:

a) Place thumbs next to each other in the middle of the client’s forehead with pads of thumbs just superior to the

eyebrows.

b) Simultaneously move thumbs laterally and stop at the temples.

c) Repeat steps a & b moving more superiorly (from eyebrows to hairline) each time.



3. PINCH EYEBROWS

Muscles/Tissue affected: frontalis; orbicularis oculi

Procedure:

a) Grasp the eyebrows, (above and below the eyebrow hair), between thumb and index finger at the medial

aspect.

b) Gently, yet firmly, squeeze, release then move slightly lateral, repeat until you get to the outer edge of the

eyebrow line.

4. TMJ CIRCLES

Muscles/Tissue affected: zygomaticus major; temporalis; masseter; lateral pterygoid

Procedure:

a) Place fingertips just anterior to the external auditory meatus and just inferior to the zygomatic arch.

b) Perform circular friction.

NOTE: Be careful of pressure due to: 1) TMJ dysfunction 2) parotid gland and 3) lymph nodes.

5. PINCH MANDIBLE

Muscles/Tissue affected: platysma; orbicularis oris; masseter; suprahyoids

Procedure:

a) Starting at the chin/mid-line of the jaw, firmly squeeze along the mandible and move laterally.

b) The move is completed when you reach the ramus of the mandible.

c) Repeat 3 times.

Note: Do not work deeply in the submadibular fossa without advanced knowledge of anatomy.

6. NATURAL FACE LIFT

Muscles/Tissue affected: zygomaticus major; masseter; orbicularis oris; buccinator; lateral pterygoid

Procedure:

a) The therapist gently flexes fingers one at a time from the mandible to zygomatic arch, walking up the jaw and

cheek area. Let your fingers do the walking

b) Repeat several times.

7. ZYGOMA PRESS

Muscles/Tissue affected: zygomaticus major; masseter

Procedure:

a). Gently press along the inferior part of the zygoma bone (cheek bone), beginning near the nose and working

laterally.

b) Massage gently on the zygoma bone. (if these areas are tender, the client could have some sinus issues going

on.)

c) Repeat 3 times.

Note: If there is a painful nodule just inferior to the zygoma, refer client to a physician.



8. MASSAGE EARS

Procedure:

a) With the therapist finger tips gently massage in front of the whole ear, including the TMJ

b) Work towards the back on the ear, massaging the whole base of the ear where it attaches to the skull

c) Massage the whole ear now, including but not limited to the earlobe, up around all of the ear tissue, front and

back, very thoroughly.

Note: The ear reflexes the whole body of the person. It therefore is very important to massage the whole ear very

thoroughly

9. PALM EYES

Muscles/Tissue affected: orbicularis oculi

Procedure:

a) Vigorously rub hands together to create heat.

b) Gently place cupped palms over client’s eyes and hold for about 10 seconds or more.

10. GENTLE HAIR PULL

Muscles/Tissue affected: cranial fascia/epicranial aponeurosis; temporalis; occipitalis

Procedure: Ask permission first. Some clients do not like this move

a) Place open hands on either side of the client’s cranium.

b) Slide hands into client’s hair and gently traction hair

c) Move through out the entire scalp of the client

d) Shake hands toward the floor to disperse the energy.

Note: Make sure you turn your head to breathe so you do not breathe directly into your client’s face.

Anterior Body—Posterior Cervical Region & Shoulder Girdle

Therapist Position: Seated at the head of the client.


Draping: Tops of shoulders are exposed. Arms can be tucked under sheet for warmth.

1. SCOOPING

Muscles/Tissue affected: semispinalis capitis; splenius capitis; splenius cervicis; posterior

suboccipitals; upper trapezius

Procedure:

a) Scoop the neck with alternating one hand then the other hand from the base of the neck to the occiput.

b) Variation is to start at the shoulder and scoop all the way up to the occiput, following the contour of the

client’s shoulder and neck alternating one hand then the other hand.



2. FINGERS DO THE WALKING

Muscles/Tissue affected: semispinalis capitis; splenius capitis; splenius cervicis; posterior

suboccipitals; upper trapezius

NOTE: This move can be used as a transitional move as well.

Procedure:

a) Cradling the client’s head with both of the therapist’s hands. With the therapist’s fingers at the base of the

neck on posterior cervical musculature.

b) The therapist alternately flexing their fingers one at a time, in a rolling motion, moving superiorly from the

base of the neck to the occiput. Let your fingers do the walking up the back of the client’s neck

3. SEWING MACHINE/ZIG-ZAGS

Muscles/Tissue affected: rotatores; interspinales; multifidus

Procedure:

a) Place index finger on either side of the spinous process of C7.

b) Glide index finger in half circles around each spinous process in both directions, moving toward the base of

the occiput.

Left finger movement Right finger movement

Left finger movement Right finger movement

Note: Movements can vary between slower/deeper strokes or quicker/lighter strokes

4. SMALL CIRCLES

Muscles/Tissue affected: posterior suboccipitals; paravertebral muscles

Procedure:

a) Place pads of fingers of one hand on occipital ridge at EOP. Stabilize the client’s head with the therapist’s

other hand.

b) Move fingers in small circular friction movements laterally from EOP to mastoid process and then medially

back to EOP.

c) Switch hands and repeat on other side of EOP.

d) Variation is to use both hands at the same time.



5. COME TO JAMAICA

Muscles/Tissue affected: semispinalis capitis; splenius capitis; splenius cervicis; posterior suboccipitals;

upper trapezius

Procedure:

a) The therapist’s hands reach across the posterior neck muscle to massage the opposite side of the neck (i.e.

right hand reaches across the back of the neck to work the left neck muscle and visa versa).

b) The hand starts at the base of the neck or reach down onto the upper thoracic area.

c) Alternating the hands in a rolling motion using the fingers on the posterior neck muscles, grasp and glide

superiorly all the way to the occiput, apply slight traction.

d) Repeat alternating the therapist’s hands back and forth from one side to the other several times.

e) Variation of this move would be wave like motion of the fingers up the neck muscles.

Note: This move is exquisite when it is done right

6. HULA HANDS


upper trapezius

Procedure:

a) The therapist hands are placed on the same side of the client’s neck (i.e. right hand of the therapist on the right

side of the client’s neck, left hand on the left side of the client’s neck).

b) The therapist hands are slightly curved, using the sides of the therapist’s index fingers, the client’s neck rest

so that their spinous process is between the therapist curved index fingers.

c) Starting at the base of the neck or slightly lower on the upper thoracic area, if comfortable. Using both hands

simultaneously, in a continuous wave like motions, in a slight anterior, superior rolling traction, move up the

neck in small increments all the way to the base of the occiput.

d) Apply slight traction when you get to the base of the occiput

e) Repeat this move several time

7. ALTERNATE NECK SCOOPING /EFFLEURAGE


SCM; scalenes; upper trapezius

Procedure:

a) Cradle client’s head in your hands. Rotate the client’s head to the left and support client’s head with

therapist’s left hand.

NOTE: DO NOT cover client’s ear with therapist’s hand.

b) Therapist places open right hand at about the mastoid process and begin to glide inferiorly down the neck,

across the clavicle area towards the shoulder.

Note: Stay posterior to the SCM during the gliding motion.

c) Continue motion scooping laterally around shoulder cap to the posterior shoulder.

d) From posterior shoulder, move along the upper trapezius medially to the base of the neck.

e) Gliding superiorly along the posterior cervical region up to the occiput, complete the stroke with fingertip

traction at the base of the occiput.



f) Switch to the other side and repeat the same move.

g) Repeat several times on both sides.

8. CERVICAL TRACTION


upper trapezius

Procedure:

a) Cradle client’s head in both hands.

b) Hook fingertips at the base of the client’s cranium/occiput. Or grasp the client’s head with both hands.

c) Gently pull/traction cranium superiorly (toward the therapist).

Note: The therapists can straighten their arms and lean back with their upper body weight instead of using muscle

strength.

9. THORACIC GLIDE/TORSO STRETCH

Muscles/Tissue affected: trapezius; paraspinals; latissimus dorsi

Procedure:

a) Slide both of the therapist’s supinated hands under client’s posterior shoulders to mid-thoracic region. The

client may have to slightly roll from one side to the other to make it easy for the therapist’s hands to side

under.

b) Flex fingertips and pull/glide superiorly.

c) Complete stroke by hooking fingertips at the base of the client’s cranium/occiput.

d) Repeat 3 times.

Note: The therapists can straighten their arms and lean back with their upper body weight instead of using muscle

strength.

CONGRATULATIONS!!

YOU CAN NOW PERFORM A FULL-BODY MASSAGE!!!!

You have learned a number of different strokes and will continue to learn many more. Make them

your own. The most important skill to develop is to do your sessions with feeling, sensitivity, coming

from your heart, your intuitive self. Listening to what your client is saying verbally, more

importantly what they are saying non-verbally (observe their body reactions to the movements).

Trust your senses, develop them, and work with them.

May you have many years of joyfully helping all those you come in contact with. Remember it is an

honor and privilege to lay your hands on a person to help them. healing takes place with the first

smile, even if the person is not a client.

Be joyful and happy. Always continue to work on yourself.

With great excitement for you,

Karen

Date post:	19-Aug-2018
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