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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.
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© Blue Sky School of Professional Massage and Therapeutic Bodywork
CST 101 – Hands On Manual
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
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.

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Demonstrate the ability to maintain a physical and/or energetic contact with the client as you
perform a full body massage.
© Blue Sky School of Professional Massage and Therapeutic Bodywork
CST 101 – Hands On Manual
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
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
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© Blue Sky School of Professional Massage and Therapeutic Bodywork
CST 101 – Hands On Manual
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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:
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
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.
© Blue Sky School of Professional Massage and Therapeutic Bodywork
CST 101 – Hands On Manual
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 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.
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© Blue Sky School of Professional Massage and Therapeutic Bodywork
CST 101 – Hands On Manual
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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.
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© Blue Sky School of Professional Massage and Therapeutic Bodywork
CST 101 – Hands On Manual
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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
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© Blue Sky School of Professional Massage and Therapeutic Bodywork
CST 101 – Hands On Manual
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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
 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 useful on skin or superficial fascia.
 Requires a lot of energy on the therapist’s part.
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© Blue Sky School of Professional Massage and Therapeutic Bodywork
CST 101 – Hands On Manual
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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
 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 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.
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© Blue Sky School of Professional Massage and Therapeutic Bodywork
CST 101 – Hands On Manual
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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.
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© Blue Sky School of Professional Massage and Therapeutic Bodywork
CST 101 – Hands On Manual
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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.
 Client position: Prone; Ankles bolstered.
 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.
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.
Allow your hands to gently fold into a loose fist.
f) Repeat above series 3 times.
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© Blue Sky School of Professional Massage and Therapeutic Bodywork
CST 101 – Hands On Manual
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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.
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.
Allow your hands to gently fold into a loose fist.
f) Repeat above series 3 times.
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.)
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© Blue Sky School of Professional Massage and Therapeutic Bodywork
CST 101 – Hands On Manual
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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.
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© Blue Sky School of Professional Massage and Therapeutic Bodywork
CST 101 – Hands On Manual
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8. FOREARM SKATING/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
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:
 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
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.
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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.
 Client position: Prone; Ankles bolstered.
 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
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Posterior Body—Neck & Shoulders/Cervical region
 Therapist position: Standing or sitting at the head of the client.
 Client position: Prone; Ankles bolstered.
 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
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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
Muscles/Tissue affected: posterior suboccipitals
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.
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CIRCULAR PRESSURE MOVEMENTS
Muscles/Tissue affected: posterior suboccipitals
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
Muscles/Tissue affected: upper trapezius; levator scapula; cervical paraspinals
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
Muscles/Tissue affected: upper trapezius; levator scapula; cervical paraspinals
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.
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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.
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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.
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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
 Client position: Prone; Ankles bolstered.
 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
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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.
 Client position: Prone; Ankles bolstered.
 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.
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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.
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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.
 Client position: Prone; Ankles bolstered.
 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.
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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
 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 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
 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) 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.
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5.
FOREARM STROKES (optional for muscular legs)
 Muscles/Tissue affected: hamstrings
 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
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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.
 Client position: Prone; Ankles bolstered.
 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: 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
the client’s head.
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.
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2.
THUMB/FINGER CIRCLES
 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
the client’s head.
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.
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6. EFFLEURAGE UP ENTIRE LEG/FEATHER STROKE DOWN
 Therapist position: Standing on the same side of client to be worked, at the level of the client’s ankle facing
the client’s head.
 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.
 Draping: One leg draped securely from hip to ankle. No diaper draping necessary. Remember to keep the
person appropriately draped/covered at all times.
 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.
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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
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 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.
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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.
 Muscles/Tissue affected: vastus lateralis (the ITB is NOT a muscle)
Procedure:
a) Perform a closed fist and/or open hand glide 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
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
Muscles/Tissue affected: quadriceps
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.
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12.
WAVE/PUSH-PULL THIGH
Muscles/Tissue affected: quadriceps
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.
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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
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.
4.
THUMB/FINGER CIRCLES 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) 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
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7.
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 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
Muscles/Tissue affected: quadriceps
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.
 Muscles/Tissue affected: vastus lateralis (the ITB is NOT a muscle)
Procedure:
a) Use a closed fist and/or open hand glide 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
10.
FIST/OPEN HAND CIRCLES ALONG ITB
 Therapist Position: Support the medial (inside) of the knee and allow the leg to comfortably fall medially.
 Muscles/Tissue affected: vastus lateralis (the ITB is NOT a muscle)
Procedure:
a) Use a 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
11.
PETRISSAGE THE THIGH AGAIN AS THE THERAPIST TRANSITIONS INTO THE NEXT
MOVE.
This move can be done between other moves.
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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/
therapist position
13.
lateral thigh
RAKING FROM KNEE TO HIP
Muscles/Tissue affected: quadriceps
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).
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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
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4. MASSAGE THE
table)
5.
WEBBING BETWEEN EACH FINGER (lower arm at about 45 degree angle to the
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
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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.
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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.
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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.
 Client Position: Supine with knees bolstered as needed.
 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.
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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.
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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.
 Client Position: Supine with knees bolstered as needed.
 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.
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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.
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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
 Muscles/Tissue affected: semispinalis capitis; splenius capitis; splenius cervicis; posterior suboccipitals;
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
 Muscles/Tissue affected: semispinalis capitis; splenius capitis; splenius cervicis; posterior suboccipitals;
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.
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f) Switch to the other side and repeat the same move.
g) Repeat several times on both sides.
8.
CERVICAL TRACTION
 Muscles/Tissue affected: semispinalis capitis; splenius capitis; splenius cervicis; posterior suboccipitals;
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
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