Addressing Thoracic Outlet with seated massage?

jlyn

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Any advice on how to do this? The client has been diagnosed by an MD and I only see her in a corporate massage setting. Help!
 


The best results I have had with TOS has been with MFR to the pecs, which is very easily done during chair massage. Do you do pec stretches at all?
 


Hello Sharon,

I don't do many stretches because I am a little uncomfortable with them. Some of the seated pec stretches seem to require some leaning into the chest area (mine) and I am concerned that this might give some clients the wrong idea. (Can't be too careful I think.) I would be more than happy to learn some if you know of some good ones. I am sometimes concerned about doing more harm than good as well. Any thoughts?
 


I do a lot of pec stretches during chair massage and have never had that problem....I'll try to explain how.

The first one is not a great stretch, but it's a good start. I stand behind the client, one leg back to brace myself, reach over both shoulders and pull back, leaning my weight into my back leg. That stretches both at once and is helpful in warming the muscles for further stretching.

Another, very effective pec stretch, is to stand facing the client with my right arm to his/her right arm, so that I am sort of off to the side. With my right hand, hold the anterior shoulder and with my left hand hold the right lat. Lean into the shoulder and hold the stretch. The key is to feel the muscle and not go past the first barrier. Stretch TO the resistance, not beyond, and then hold there. Let the client know to communicate with you if there is any discomfort.

While you are doing this pec stretch, it is easy to get the other hand underneath the scapula and work out any TPs in the subscap. That will help free up the TO.
 


Do you have them hold anything to keep their body steady? The main stretch I am thinking of is where you have the client clasp their hands behind their head and you pull back on the elbows. I saw it on a chair massage training DVD. If you want that to be a stretch, you need to brace with your own body. That's where I have been running into issues. If I could get my knee up that high, I might use that! :) There is another stretch that may focus a bit on the pecs, but seems to be more geared toward the shoulder... you pull the arms up from behind simultaneously and hold/pull. Do you think that is more of a shoulder stretch? That's why I haven't been using that one. Wish I had some pics!
 


I have them sitting in the massage chair normally - relaxed, with their arms on the arm rest. I've seen but haven't ever used the one with their hands behind their heads.

If you are not comfortable stretching the client, why not teach them how to stretch themselves? One hand behind the head, hook that elbow in a doorway and walk forward. Change the angle of the elbow, do again. I have them stretch it at several different angles and they can really feel the different muscle fibers stretching. You could take just one minute of their massage time to show and have them try it out. Have them do that several times a day.

Pictures would be really nice!!
 


Thanks for your quick replies! I have shown a few of the people some stretches. Seems like you can do a lot with a chair, but there sure are some limitations! :irked:
 


When doing the hands behind the head stretch, try turning your body perpendicular to the client so that their back and head rest back onto your thigh and sidebody rather than your chest.

Make sure that when you are assisting the stretch you maintain a pulling lateral as much as posterior. Have someone do it on you both ways (pulling straight back versus pulling out and back) to feel the difference.

You can also work directly on pec minor fairly easily even in a seated position. I've done it in offices before :-) Don't forget SCM and the scalenes, etc.
 
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