Muscle Groups

[This is insanity!]

I just started at a new place and it is more clinical then the last place I worked. What I mean is that it is run by a Doctor that is a MD and they have a Chirporactor on staff. I had to go thru a two week training program which I found very useful and did learn some new things and areas I could improve. But I was instructed that I need to work on a clients Adductors and Glutes if they requested it, the owner said that many of the clients that come in are athletes and have ligitiment tension in these muscle groups. I have never worked these areas as they have always seemed to be out of bounds. I don't really have any hang ups working these areas but a little uncomfortable with the Adductor Brevis, Longus and Magnus group due to their proxcimity to the genital area. Any advise on how to handle this and how many of you work comfortably with these muscle groups?

 

[bigestpimpin]

I would do a diaper drape on the client and rotate the hip. Is there another massage therapist in the office with you?  You could ask them to mentor you.

 

[STEVEN F]

Glutes are even easier to work than adductors - whether or not client leaves underwear on, they can be worked through a thin drape (this is where sheet-and-blanket comes in handy as you can pull back the blanket and leave the sheet on).  Glutes can be worked as part of the back and/or part of the leg - I usually include them in both.

 

[knucles]

I agree that glutes are really easy to work on over a sheet, unless you are looking to get deep and specific.  It's still easy enough by draping the leg while the client is prone.  I tuck the sheet in above the hip on the "outside" and at the inner thigh on the "inside".  It's hard to explain without visuals.  As for the adductors, I work on them with the client laying supine.  I bend the knee out and rest the leg on my leg.  It's easy to drape by wrapping the sheet around the top of the leg.  Try not to feel too uncomfortable doing it because your client will sense it and it will make them uncomfortable.  If you're having trouble, ask a coworker to pratice it with you.  Good Luck!

 

[ikeman155]

Muscle Groups

...Adductors and Glutes...Any advise on how to handle this and how many of you work comfortably with these muscle groups?

Hi.  I work the adductors - face up ... and the gluts - face down.  Here are examples, but it can be modified to whatever you actually have to do.  Hope it helps.   For the upper leg, start by warming up the tissue and making the client feel a little more comfortable by "rolling the leg like bread - back and forth under the sheet", then undrape professionally and warm up some more with some long, deep palmar and finger strokes, just so they get comfortable to your touch.  Next "frog-leg" the client, with the drape in professional postion and begin to work into the internal thigh.  I find this just gives the body a bit more of what it needs to accept the work which is coming next.  Usually the above proceedures should only take a few mins.  Next you can begin to get high into the adductors and work with thumbs or fingers at the insertions.  The client can have underware on or off - usually off.  You can cross-fiber effectively this way, and you can have the client cover their "private regions" with a hand if need be.  I suggest making sure that the back side of your hads is the only thing that touches any unsuspecting regions and never the palmar surface.  And of course, the plan is that nothing touches at all.  The main thing is positioning yourself so that you can do the work without being too uncomfortable.  As for the gluts, I will work them according to how I feel the client accepts it.  That's one of those "you just have to get the feel of the client" things.  Most of the adductor clients in my past have just needed the work and don't really complain about it.  Many actually asked for it, and would state it was hard to find someone besides a Physical Therapist to "do the work".  Usually they appreciate it if they are athletes in need.  So -- gluts.  I usually prepare the region, if the client is not someone I am used to working on, by kneading through a sheet first.  Something along the line of: closed fists pressing alternately on the gluteal region.  And you might want to throw in some gentle to agressive rocking from the side of the table with one hand on the lower back and the other starting on an ankle and moving up the leg with that "rolling proceedure" I mentioned a second ago.  You can do that on both legs, one at a time, while rocking the lower back.  It can get them a little more relaxed, as well as yourself.  Then, onto the "kneading" and then you can add in elbow/forearm work of the gluts through the sheet.If you decide to undrape, you just keep the gluteal cleft covered and drape the leg professionally.  I just do a little tuck under the thigh while they are *obviously*   face down.  Now the one glut is uncovered and you can proceede to work flat handed up the leg over the glut and into the lower back -- you can do this with the knuckles and you can do this with the elbow/forearm combination.  Sometimes, (let's say I am working the clients right) I will stand with a quite wide stance facing into the table from the side, so that I am pretty short to the ground, and will lean onto the client  moderately with my left forearm over the gluteal cleft (forearm actually parallel with the spine - pretty much right in line with it *tries to give you a visual*), while working the clients right side with my right forearm/lebow combination.  This does a few things that work with my body type.  It braces me for deeper or lighter work, gives me more depth perception and allows the sacrum to "give a little", as well as locking that sheet in place so it doesn't slide away.Hope those give you a few things to work with.  I like aralia's side lying position -- that's something new for me, and think I'm gonna try it sometime.Oh, and I also generally work with a sheet and blanket, like BJB-LMP, and pull the blanket across, so it bunches a bit over the clients "privates", especially when male, just to give them a little more "at ease with something covering them".  However, working with a sheet really is fine to, you just bunch it some to give the feeling of "more coverage".  You are working with athletes, so they may be hot natured and not like the blanket, so keep that in mind too.speters idea of finding a mentor is a great idea.  If you don't have one, consider grabbing a massage student from a school in the area and working on them.  They'll love it, because they are learning something new and getting some much needed work.terab gives some excellent advice. "Try not to feel too uncomfortable doing it because your client will sense it and it will make them uncomfortable."Good massage!

 

[LouAnn]

Muscle Groups

Thanks for all the posts, Texas-gal for the in depth explanation of your method, that is quite similiar to how I received training my training. I have been doing this for a week now and I have done six massages involving the Adductors and I am feeling much more comfortable with it. I agree with you that the method that aralia has described would work well too. I do have another therapist in the office that works with me but she does not seem interested in exchanging massage treatments, I wanted to work witn someone else that can tell me if I am doing it right or add some suggestions. I think I am going to try the massage school I went to and see if I can get an interested partner.When I was in training at this office they instructed the diaper drape but I have found that to be difficulte to work around since there is a lot of bunching of the sheet near the area I need to work, so I have been experamenting and found that a double folded sheet laying diagonal accross the region pulle up tight against the opposite leg is working the best. All the clients I have had so far have been either swimmers or basketball players so they are used to being worked on and have told me that I have done as good as job as any therapist they had, two of them told me I was better paying more attention to there needs. That is what I want to hear since this is my profession and I want to be the best I can at it.Thanks again for the input guys.

 

[skymodog]

Muscle Groups

I too was not taught glutes in school and was very uncomfortable when asked to work them. Eventually I got over it and now I realize how tight they are on most everyone. You will get more comfortable with time and practice.

 

[Pringle]

When I receive a massage, if the therapist doesn't work on my glutes I feel cheated.  Very important muscles and the work feels so good.  Because of this I almost always work on a client's glutes.  Sometimes if it is their first pro massage I will just work through the sheet, or underwear if left on.  However on returning clients I explain that I can do a better job on their glutes if they remove their underwear and suggest they THINK ABOUT doing so the next session - IF they feel comfortable doing with that.  As a part of school practicums I worked on a local LMT for practice and experienced feedback.  He was surprised that I worked the adductors and was pleased - he is a runner. After the session he told me I did more work there than any other pro therapist and asked if would "practice" on him more during his marathon training.  Practicing on someone with a license was very valuable for me, great/educated feedback.

 

[Debie2000]

Muscle Groups

I've got nothing for ya' when it comes to getting over your glutophobia.  Glute work feels great to the client and provides some of the most rewarding releases for the therapist. (muscle releases that is, not so gratifying when gas is released). But I know where you're coming from when it comes to the adductors.  The first time I had to work on them was when I was doing my student internship.  I exposed the clients leg and draped it just about the same as I always had.  That's when I realized that I hadn't given myself access to the area I was going to work.  My first thought was that maybe I could work over the sheet.  Fortunately my brain was just starting into panic mode and moving very quickly.  I realized that this was one area where I had to be perfectly aware of exactly where my hands were. Missing my mark by a fraction of a centimeter could mean ruination; I thought "That's it, my career's over before it's begun."  Fortunately I was working with a client who had become a regular of mine, and had been a regular at the student clinic for several years. She was very patient with me as I re-draped, took a deep breath, re-draped again, took a deep breath,and got to work. I survived the ordeal without compromising my client's privacy and walked away from the experience with a very clear and specific to ask my instructor the next day in class. Since then I've gotten over the fear of draping there abouts. I can open up the area I need to work on without breaking into a cold sweat.  You can also gain greater access to the adductors if you lateraly rotate the femur.  Be careful to work from the centerline- out when stripping or making any longer flowing strokes. And if you are concerned about making incidental contact with male genetalia when workin that close to the danger zone, There's nothing at all wrong with asking the client to use his hand to move it out of the way and using his hand as a barrier.  You'll probably be more embarassed about asking than he will be about doing it. Good luck and good job landing a gig at the Dr.s office.

 

[Iliana G]

One of the most memorable school experiences was the day that our instructor made us all practice saying to the three males in the class  "Please use your hand to move your genitals to the (other side),  away from where I am working"   ;DAdductors can be tricky to get to and keep everyone's modesty intact, no doubt.... but as someone who has a body that benefits more from leg work all the way around than I will probably ever get from neck and shoulders, I can tell you that its quite noticable when you get your quads, hams and Abds worked well, and no work at all on the Adds. So, I explicitly ask for the work I want when i know its on the short list of often skipped muscles. That being said, though, I don't usually work the adductors all the way up on most folks unless they ask for it, or I feel it and explain to them what I'm doing and get their ok.  (its kinda like psoas work...you don't just "DO IT" without a little bit of prep.  but certainly some athletes both want and need the work...sometimes I utilize sidelying as has been already described, but more often I go at em with the client supine... if there is any uncomfortableness for the client, i find that being behind them (as I would be in sidelying) can add to their discomfort with the whole thing.  It's that whole power imbalance/comfort zone thing, I guess.  I prefer to be visible, and to be available to the client to pick up visual cues from me as we work in "sensitive" areas.  When working on (male) athletes, often times around events, this is actually easier to do than on the table in the office, as male "gear" tends to keep things gathered up and out of the way, especially if you can get a little bit of  lateral rotation.  Rob