help needed w/ client

Poon Tang

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this gentleman is in his 60's. He states pain in upper back area. His back in the thoracic area is bowed out, sorta like pics of mild kyphosis (a medical diagnosis i'm not qualified to make). His whole upper back is very hard and dense..i cant palpitate anything. But his upper traps are flaccid.
I dont how to massage him. How do i address his upper back? I cannot feel his scaps or spine, let alone any muscle tissue.
Second question...i have moist heat pacs. His skin however pinks up quickly. Is it safe to use the heat pacs on someone like this?
I'd be so grateful for any suggestions, thanks.
 


His upper back muscles are WAY overstretched. I would work on chest and anterior shoulders more, especially stretching the pecs. You will find those quite hypertonic - that is what is pulling so hard on his back. His SCM & scalenes will probably be hypertonic, too. Start gently - it will hurt.
 


Rose of Sharon said:
His upper back muscles are WAY overstretched. I would work on chest and anterior shoulders more, especially stretching the pecs. You will find those quite hypertonic - that is what is pulling so hard on his back. His SCM & scalenes will probably be hypertonic, too. Start gently - it will hurt.

Yep - what she said. :-D

While the pain is felt in the back you need to be careful not to fall into that trap - you can actually worsen the condition.

Flip him over and work the pecs and other muscles in in the front of the chest, rib cage, neck and shoulders.

Blessings, Angela
 


he is coming back to see me. I didnt do any aggresive work, since it was his first massage, and he just wanted to relax mainly. He is a carpenter, his pecs are huge, but his upper traps across the tops of his shoulders are so flaccid. I did a little muscle stripping into the pecs with his arm raised, but they were so huge and tight i dont think it did much.

Any suggestions on how to work his pecs effectively? Should i start him supine and work the pecs first? I could warm them with moist heat pacs, do his legs for a bit, and then work on his pecs? Then turn him over and i dont know what with his back, everything was so taut...

thanks so much,
 


That sounds like a good plan. I'd do some lighter strokes, then gradually work a bit deeper, then stretch them really, really good. Stretching them can also be done, sometimes more effectively, when he's prone - just lift that shoulder and hold it. I sometimes loop my arm through the client's arm so I am holding his more with the inside of my elbow, straightening my legs as I lift. Then my legs are doing the work and I can hold the stretch much longer.
 


You can also do some resisted stretches to loosen the pecs without deep tissue work - I call it hold, release, stretch but I know there are fancier terms for it. :-)

When the client is positioned face up you can stretch the pecs by bring the arm up and back - I usually do it with a straight arm. Have him think about bringing his hand over to his opposite hip which will activate the pecs muscles. Resist the movement and hold for about a 10 count. Tell the client to full relax - this can be difficult for some to learn....they want to totally release. Wait for a moment and then stretch a bit further. Monitor the client's pain levels, stiffness and what they are feeling. If there is joint pain stop. Usually they'll just say it feels tight - you only want to stretch to that point of stiffness and then have them resist your pressure again. The arm never actually moves until you stretch it again.

I use this a lot with chronically tight pecs, hamstrings and psoas which can all be tender to work directly on when the muscles are hypertonic.

Angela
 


As mentioned above, some other stretching may be called PNF stretching, in case you want to do a google search on more info.

Here is an article that may be of help for an pectoral stretch.
Pectoral Stretch

This stretch can be easily performed without a partner by using a doorway or other stationary object for resistance. The stretcher begins by raising one arm to a 90 degree angle at the elbow, with the upper arm parallel to the ground and forearm perpendicular to the ground. Placing the forearm and open palm against the doorway, the stretcher will turn the body away from the arm until a comfortable stretch is felt through the chest and into the shoulder. Hold this stretch for 15 seconds. Then, isometrically contract the pectoral muscle, attempting to adduct the arm. Hold this contraction for six seconds. Relax the pectoral muscle and deepen the chest stretch by turning the body away from the arm for another count of 15 seconds.

And here's a picture: http://www.healthline.com/hlbook/art-pectoral-stretch

Just a little link while we're on the subject. I found this book while searching. It looks like it might be good. Facilitated Stretching-3rd Edition http://www.humankinetics.com/products/showproduct.cfm?isbn=0736062483
 


I was just going to suggest PNF - that should work great with him.

I agree with the advice you have gotten so far. Also encourage him to do some stretching on his own.
 


Yep - that's the term that was elluding my tired brain. :-)

If you've ever seen the Micheal Critz CD he does a really good job showing how to do this.

I often will show clients how to do the stretch in the doorway if this is an area impacted.

Angela
 
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  42. wilson holistic centre:
    new girl works at ๐Ÿ’‹535 Evans Ave today ๐Ÿ’•๐Ÿ’•๐Ÿ’•โ˜Ž๏ธโ˜Ž๏ธ416-531-6969โ˜Ž๏ธโ˜Ž๏ธ
  43. Spa in Markham:
    GOLDEN FS โ€“ 8380 Kennedy Rd ๐Ÿ“ž 905-258-0777 / 416-688-6886 ๐Ÿ‡ธ๐Ÿ‡ฌ CANDY, ๐Ÿ‡ญ๐Ÿ‡บ VANESSA, ๐Ÿ‡จ๐Ÿ‡ด MEGAN (2AM), ๐Ÿ‡ป๐Ÿ‡ณ JULIE (8PM) ๐Ÿ”Ž View Schedule: bit.ly/flowers_schedule ๐Ÿ›Ž๏ธ Booking Now: bit.ly/bookinggoldenlove
  44. FLOWER Spa - BLUEXADO | Thornhill | VAUGHAN:
    BLUEXADO FS โ€“ #06-1102 Centre St ๐Ÿ“ž 416-357-9797 / 416-678-8668 ๐Ÿ‡ป๐Ÿ‡ณ CICI, ๐Ÿ‡ป๐Ÿ‡ณ MY LINH, ๐Ÿ‡ป๐Ÿ‡ณ AMY, ๐Ÿ‡ป๐Ÿ‡ณ SHERRY ๐Ÿ”Ž View Schedule: bit.ly/flowers_schedule ๐Ÿ›Ž๏ธ Booking Now: bit.ly/bookingbluexadolove
  45. Red Rose Spa:
    ๐ŸŒธ We have 13 hot brown girls today ๐ŸŒธ MONICA, ASHA, MALIYA, MONIKA, ANGEL, MIMI, PREETI, ANGELINA, DIYA, PAYAL PEARL, KIRAN ๐ŸŒธ 2588 Birchmount ๐ŸŒธ 2 Invergordon ๐ŸŒธ 647-702-8800 ๐ŸŒธ Please visit for a great erotic massage
  46. FLOWER Spa โ€“ PINK | Scarborough | TORONTO:
    PINK FS โ€“ 3300 McNicoll Ave ๐Ÿ“ž 416-299-5515 / 416-817-3839 ๐Ÿ‡ฎ๐Ÿ‡ท ELINA, ๐Ÿ‡ป๐Ÿ‡ณ KELLY, ๐Ÿ‡ต๐Ÿ‡ญ MADY (1PM) ๐Ÿ”Ž View Schedule: bit.ly/flowers_schedule ๐Ÿ›Ž๏ธ Booking Now: bit.ly/bookingpinklove
  47. Jennyโ€™s Spa:
    ๐ŸŽ‰๐Ÿ’JENNYโ€™S SPA๐ŸŽ‰๐Ÿ’ โœ…5170 DUNDAS STREET WESTโœ… ๐Ÿ‘ŒETOBICOKE ONTARIO M9A 1C4๐Ÿ‘Œ โ˜Ž๏ธ( 647-893-5196)โ˜Ž๏ธCall or Text โ˜Ž๏ธ( 437-888-3759)โ˜Ž๏ธCall Only (ETOBICOKE) OPEN 10am to 9pm MONDAY to SUNDAY ๐Ÿ”ฅโœ…GRAND OPENING๐Ÿ’ฏNEW GIRLS EVERYDAY๐Ÿ”ฅEXCELLENT MASSAGE + SERVICE QUEENS NOW AVAILABLE AT JENNYโ€™S SPA FOR ALL YOUR MASSAGE AND SPECIAL EXTRA NEEDS๐Ÿ”ฅ๐Ÿ’ฏ๐Ÿ˜˜๐Ÿ”ฅโค๏ธ๐Ÿ‘Œ ๐Ÿ”ฅTWO BEAUTIFUL NEW YOUNG ASIAN GIRLS EVERYDAY๐Ÿ”ฅ ๐Ÿ’ฏREAL PICTURES OF ATTENDANTS๐Ÿ’ฏ ๐Ÿ”ฅ๐Ÿ’‹Limited Time Special Promotion๐Ÿ”ฅ๐Ÿ’‹ โœ…๐Ÿ’ฆ30 Minutes Nude Mass
  48. DareDevil:
    ARIA WELLNESS ๐Ÿฌ๐ŸญADDRESS: 360 HWY 7, UNIT #6, โ™ฅ๏ธRICHMOND HILL,647-222-5683 (PHONES CALL ONLY, NO TEXT'N AVAILABLE) โ™ฅ๏ธTODAY'S Schedule!โ™ฅ๏ธ Loaded lineup with Beautiful Girls : Yoga Lucy, Killer Kelly, Adorable Eva, Magical Mia and Work out๐Ÿ‹๐Ÿšด๐Ÿ’ช Babe Amy! BUY 10 HOURS (GET 11 HOURS) **TODAY'S PICK OF THE DAY ARE ๐Ÿฌ๐ŸญLUCY AND KELLY๐Ÿฌ๐Ÿญ**
  49. Soul Relax Spa:
    โœจ Looking for a relaxing escape? โœ… Click Here Meet๐ŸŒธNina๐ŸŒธAnna๐ŸŒธAmberCall us today for the best treatment and service experience. Click on our Username and FOLLOW US for updates ! Call now โ˜Ž 289 - 298 - 5662โ˜Ž๏ธ Your ultimate relaxation awaits! โœจ
  50. AliceSpa:
    TUESDAY at ๐—”๐—Ÿ๐—œ๐—–๐—˜ ๐—ฆ๐—ฃ๐—”, 4915 Steeles Ave. E, Scarborough ๐Ÿฐ๐Ÿญ๐Ÿฒ-๐Ÿฎ๐Ÿต๐Ÿด-๐Ÿฌ๐Ÿด๐Ÿต๐Ÿด. 3 Young Beauties Today at Alice Spa. Open 10am to 9pm: CLOUDIA (10am-9pm): is Vietnamese, young, petite 5'2" & 96 Lbs, B Cup, best rim deep bbbj cim. $40 Room Fee + $80 (incl bbbj & fs). +$20 for rim/cim. Excellent open minded services. KITTY (1pm-9pm) is a new Korean girl, super busty, small body, new
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