Figure 7.26A Massage of pectoralis major. (From Fritz S 2004 Fundamentals of therapeutic massage, 3rd edn.Mosby, St Louis.)
Figure 7.26B Massage of pectoralis major. (From Fritz S 2004 Fundamentals of therapeutic massage, 3rd edn.Mosby, St Louis.)
Figure 7.27A (A) Kneading abdominal muscles, supine; (B) kneading
abdominal muscles, side-lying. (From Fritz S 2004 Fundamentals of
therapeutic massage, 3rd edn.Mosby, St Louis.)
Figure 7.27B (A) Kneading abdominal muscles, supine; (B) kneading
abdominal muscles, side-lying. (From Fritz S 2004 Fundamentals of
therapeutic massage, 3rd edn.Mosby, St Louis.)
TORSO POSTERIOR
This area can be addressed in the prone or side-lying position. It is appropriate to assess for hip extension and abduction firing patterns before actually beginning to massage the area and then correction can be incorporated as convenient during the massage. With the client positioned prone, SI joint assessments can be performed and then treatment would be included in the
massage as it is convenient.
This area becomes involved in breathing function difficulties as well as low back symptoms.
The muscles commonly problematic are:
serratus posterior superior and inferior levator scapulae
rhomboids latissimus dorsi
erector spinae and paravertebral especially the multifidi quadratus lumborum.
As described previously, massage begins superficially and progresses to deeper layers and then finishes off with superficial work.
Begin with skin drag palpation and scanning to assess for possible tissue changes related to low back issues
Use gliding (Fig. 7.28) with a compressive element beginning at the iliac crest and work diagonally along the fibers of the latissimus dorsi ending at the axilla
Repeat three or four times, each time increasing the drag and moving more slowly to address deeper tissue layers
Identify areas of tissue bind, heat, increased histamine response and muscle ‘knots’
Move up to the thoracolumbar junction and repeat the same sequence on the lower trapezius (Fig. 7.29)
Then begin near the tip of the shoulder and glide towards the middle thoracic area to address the middle trapezius
Repeat three or four times increasing drag (Fig. 7.30) and decreasing speed
Begin again near the acromion and address the upper trapezius with one or two gliding stokes to complete the surface area
Muscle energy methods and stretching (Fig. 7.31) can also be used to address short muscles that relate to the low back condition
Reverse the direction and work from distal to proximal applying tension force to stretch the areaKnead (Fig. 7.32) and glide across the muscle fibers, making sure that bending, shear and torsion forces are only sufficient to create a pleasurable sensation while assessing for changes in the tissue
Increase intensity of the kneading to further stretch the local tissue in the trigger point area and then again apply tension force this time by passively or actively using joint movement and stretching the area
Knead the area again to increase circulation to the area and shift nervous system responses
Skin roll (Fig 7.33) from the occipital base to the sacrum
Move the skin into multiple directions of ease, and holding the ease position for up to 30–
60 s. If appropriate use lymphatic drain methods in the area
Gentle rhythmic rocking within the ranges of motion of the area (oscillation) may be used to continue to relax the area
Identify rigidity in the ribs with the client prone bilaterally (on both sides of the spine) at the facet joints beginning near the seventh cervical vertebra and moving down towards the lower ribs maintaining compressive force near the facet joints
If an area identified relates to the low back issue,treat with various muscle energy techniques
Rhythmic compression to the area stimulates various aspects of fluid movement, supports relaxed breathing and finishes the massage of the area
Any areas or function that received specific intervention should be reassessed for changes.
Figure 7.28 Example of gliding with compressive force, prone. (From Fritz S 2004 Fundamentals of therapeutic massage, 3rd edn.Mosby, St Louis.)
Figure 7.29 Example of gliding with compression using forearm. (From Fritz S 2004 Fundamentals of therapeutic massage, 3rd edn.Mosby, St Louis.)
Figure 7.30 Example of gliding with drag on posterior torso. (From Fritz S 2004 Fundamentals of therapeutic massage, 3rd edn.Mosby, St Louis.)
Figure 7.31A (A) Positioning for muscle energy method. (B) Stretching using movement and gliding with drag to affect connective tissue. (Reproduced with kind permission from Mosby’s Massage Career Development Series 2006.)
Figure 7.31B (A) Positioning for muscle energy method. (B) Stretching using movement and gliding with drag to affect connective tissue. (Reproduced with kind permission from Mosby’s Massage Career Development Series 2006.)
Figure 7.32 Kneading posterior thorax.
(From Fritz S 2004 Fundamentals of therapeutic massage, 3rd edn.Mosby, St Louis.)
Figure 7.33 Skin rolling along spine.
(Reproduced with kind permission from Mosby’s Massage Career Development Series 2006.)
Figure 7.34A Positions for moving tissue of the shoulder and arm. (A) Supine. (B) Prone. (C) Side-lying. (D) Seated. (From Fritz S 2004
Fundamentals of therapeutic massage, 3rd edn.Mosby, St Louis.)
Figure 7.34B Positions for moving tissue of the shoulder and arm. (A) Supine. (B) Prone. (C) Side-lying. (D) Seated. (From Fritz S 2004
Fundamentals of therapeutic massage, 3rd edn.Mosby, St Louis.)
Figure 7.34C Positions for moving tissue of the shoulder and arm. (A) Supine. (B) Prone. (C) Side-lying. (D) Seated. (From Fritz S 2004
Fundamentals of therapeutic massage, 3rd edn.Mosby, St Louis.)
Figure 7.34D Positions for moving tissue of the shoulder and arm. (A) Supine. (B) Prone. (C) Side-lying. (D)
Seated. (From Fritz S 2004
Fundamentals of therapeutic massage, 3rd edn.Mosby, St Louis.)