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Massage and Movement Incorporating Movement into Massage Part Two: Side-lying and Supine With Lee Stang, LMT NCBTMB #450217-06 1850 West Street Southington, CT 06489 860.747.6388 www.bridgestohealthseminars.com [email protected] 1 A bit of a Review The type of movement is: § Passive or active; § Concentric or eccentric contraction; § Concentric when broadening fibers; § Eccentric when lengthening fibers. Active Movements Concentric contraction: muscle shortens as it contracts broadening the fibers. These techniques facilitate further broadening of fibers Eccentric contraction: muscle lengthens as it contracts lengthening the fibers. These techniques facilitate further lengthening of fibers. Remember when asking for movement: § Be concise in how you ask for movement; § Demonstrate or guide them through the movement first § Use passive movement to demonstrate the action you want; § Make sure the client is doing the action you are looking for;; § Do not hesitate to ‘play’ with movement and create! 2 Working in Side-lying 1. Upper Trap: Lengthening § Client position: side-lying with shoulder elevated § Therapist position: head of table slightly behind client § Hand position: fingers/thumb resting on upper lateral edge of trapezius § Movement: depression of the shoulder while stripping muscle 2. Latisimus Dorsi: Lengthening § Client position: side-lying § Therapist position: head of table slightly behind client, supporting clients arm at 45º flexion. § Hand position: resting heel of hand on latisimus in axillary region § Movement: flexion of the shoulder while stripping muscle toward hip 3. 4. Serratus Anterior: Ribs § Client position: side-lying arm flexed 90º at the shoulder and protraction of scapula § Therapist position: posterior side of client at shoulder level facing hips § Hand position: resting on ribcage at lateral scapula border § Movement: retraction of scapula while stripping muscle along ribcage toward opposite hip. Serratus Anterior: Under Scapula § Client position: side-lying arm flexed at the shoulder and retraction of scapula § Therapist position: anterior side of client at shoulder level § Hand position: superior hand holding clients arm, inferior hand with fingers placed on ribcage under latisimus dorsi § Movement: protraction of the scapula 3 5. Erectors: Lengthening § Client position: side-lying; bottom leg bent; top leg straight; § Therapist position: behind client at waist/shoulder level, facing feet; § Hand position: fingers resting on erector group around T10-12 in direction of sacrum § Movement: hip flexion 6. Quadrates Lumborum: Lengthening § Client position: side-lying; bottom leg bent; top leg straight; body in a diagonal position on table § Therapist position: behind client at hip level § Hand position:1) supporting leg at the knee; 2) sink into QL pinning muscle toward head § Movement: leg slightly extended off table and adduct leg 7. TFL: Pin and Move § Client position: side-lying; bottom leg bent; top leg straight with knee flexed; body in a diagonal position on table § Therapist position: behind client at hip level § Hand position: forearm resting on TFL § Movement: abduction at the hip § Variation: 1)support knee while resting clients foot on therapists’ hip; 2) rest forearm/elbow on TFL § Movement: passive abduction/adduction of hip 4 When adding movement to your work: § Decide if you want active or passive movement; § Ask for movement first to see where restrictions are; § Begin with passive movement; § Ask for one movement at a time; Be concise about the movement you want; § Guide them through the movement if necessary; § Educate client on quality of movement; slow, slow, slow; § Engage the tissue at various times throughout the movement to determine which is most effective; Working anterior body: 1. Pec Major: Conductor § Client position: supine with arm abducted § Therapist position: side of table about waist level facing head § Hand position: grasp pec major muscle fingers on top, thumb underneath § Movement: client moves arm through range of motion at the shoulder while therapist holds muscle 2. Pec Major: Lengthening § Client position: supine arm flexed § Therapist position: side of table about waist level facing head § Hand position: holding arm at elbow; fingers, knuckles, fist at sternal attachment of pec major § Movement: flexion or horizontal abduction while stripping muscle 5 3. Pec Major: Sternum § Client position: supine § Therapist position: opposite side of table from muscle § Hand position: superior hand – fingers resting on opposite sternal attachments; inferior hand supporting client arm just above elbow § Movement: horizontal adduction as stretch sternal attachments of pec 4. Pec Minor: Lengthening § Client position: supine arm at side § Therapist position: head of table § Hand position: grasp arm at forearm; fingers on coracoid process § Movement: flexion at the shoulder while stripping muscle 5. Pec Minor: pin and stretch § Client position: supine arm at side § Therapist position: head of table § Hand position: grasp arm at forearm with one hand, fingers on coracoid process of other hand pinning attachment of pec minor at coracoid process § Movement: flexion at the shoulder while pinning muscle 6 6. Biceps: lengthening § Client position: Supine with arm resting on table, elbow flexed § Therapist position: same side of table as muscle worked § Hand position: fingers, fist, elbow placed at distal bicep just above the elbow § Movement: extension at the elbow while stripping muscle, lengthening fibers 7. Biceps: broadening § Client position: Supine with arm slightly abducted but resting on table § Therapist position: same side of table as muscle worked § Hand position: fingers, fist, elbow placed at distal bicep just above the elbow § Movement: flexion at the elbow while crossing the fibers of the muscle, broadening the fibers 8. Wrist Flexors: broadening § Client position: Supine with arm supinated on table, support at the wrist § Therapist position: same side of table as muscle worked § Hand position: fingers, fist, elbow placed at proximal wrist flexor group Movement: flexion at the wrist while crossing the fibers of the muscle, broadening the fibers 9. Wrist Flexors: lengthening § Client position: Supine with arm supinated on table, supported at the wrist § Therapist position: same side of table as muscle worked § Hand position: fingers, fist, elbow placed at distal wrist flexor group § Movement: extension at the wrist while stripping fibers of the muscle, lengthening the fibers 10. Wrist Extensor: broadening § Client position: Supine with arm pronated on table, supported at the wrist § Therapist position: same side of table as muscle worked § Hand position: fingers, fist, elbow placed at proximal wrist extensor group § Movement: extension at the wrist while crossing the fibers of the muscle, broadening the fibers 11. Wrist Extensor: lengthening § Client position: Supine with arm pronated on table, supported at the wrist § Therapist position: same side of table as muscle worked § Hand position: fingers, fist, elbow placed at distal wrist flexor group § Movement: flexion at the wrist while stripping fibers of the muscle, lengthening the fibers. 7 12. Psoas Release: § Client position: supine with knee and hip flexed § Therapist position: side of table, hip level § Hand position: one hand resting on iliacus just inside iliac crest; one hand on knee § Movement: flexion and extension at the hip while sinking into the iliopsoas § Variation: Therapist position: side of table with foot on table and client knee supported on therapist knee o Hand position: one hand sinking into iliopsoas; one hand on ankle o Movement: sink into psoas as us client ankle to create a “pump handle” like movement. 13. Quad Tendon: Lengthening § Client position: supine § Therapist position: side of table, waist level, facing feet § Hand position: grasp leg under knee; soft fist compressing quad tendon § Movement: flexion at the hip as compress tendon 14. § § § § Quads: Lengthening Client position: supine, leg off table with knee extended Therapist position: side of table, knee level, facing head Hand position: fingers, fist, forearm on thigh just above knee Movement: flexion at the knee while stripping muscle § § § § Quads: Broadening Client position: supine, leg off table with knee flexed Therapist position: side of table, knee level, facing head Hand position: either side of the quad just above knee Movement: extension at the knee while broadening muscle 15. 8