Foundations of Massage 2

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2 SUBJECT 4 Foundations of Massage 2 studymassage.com.au HLT52015 Diploma of Remedial Massage HLT42015 Certificate IV in Massage Therapy National Office: 98 York Street South Melbourne Victoria 3205 Subject 04 Foundations of Massage 2 V16.03

3 Evolve College Pty Ltd, 2016 This document is copyright. This document may not, in whole or in part, and in any form or by any means (electronic, mechanical, micro copying, photocopying, recording or otherwise) be reproduced, stored in a retrieval system or transmitted without prior written permission. Page 2 Subject 04 Foundations of Massage 2 v16.03 Evolve College 2016

4 Contents Subject Details... 4 General Information... 4 Suggested Lesson sequence... 4 Suggested Equipment for Practical Component... 4 Practical Lessons... 5 Content Outline... 5 Lesson 1 Abdominal Massage... 6 Objectives... 6 Abdominal Massage... 7 Lesson 2 Chest and Neck Massage Objectives Lesson 3 & 4 Front of Leg Massage Objectives Lesson 5 Pregnancy Massage Objectives Positioning Massage sequence Getting off the table Cautions Lesson 6 Oedema Massage Objectives Supine Position Prone Position Lesson 7 & 8 Part 1: Full Body Massage Objectives Order of body parts Things to avoid Lesson 7 & 8 Part 2: Full Body Massage Self Evaluation Objectives Subject 04 Foundations of Massage 2 v16.03 Evolve College 2016 Page 3

5 Subject Details Welcome to training with Evolve College. Evolve College aims to bring massage awareness, education and recognition to the community as a valued means of health care. Massage is perhaps one of the most popular forms of complimentary health care. In recent times massage has become much more formalised and massage associations have been formed to promote the science of massage as well as to safeguard the interests of the public and the profession. Evolve College is a Nationally Accredited course provider and as such is listed on the National Register of Providers. This is your assurance that the College is a nationally recognised educator offering approved courses and administration services. General Information Suggested Lesson sequence In order to gain the most from each lesson it is suggested that you work through them in the order they are presented. Suggested Equipment for Practical Component Equipment required for this subject includes: Two large size towels (Beach Towel size) or two cotton sheets Two smaller towels One pillow or footroll Massage oil (cold pressed vegetable oil) - do not use baby oil A massage table (you do not need to bring your massage table to class) Isowipes, viraclean or any equivalent hospital grade disinfectant Page 4 Subject 04 Foundations of Massage 2 v16.03 Evolve College 2016

6 Practical Lessons This section of Foundations of Massage 2 continues with the practical application of relaxation massage from Foundations of Massage 1. Additional massage sequences to the front of the body are provided and the theory and practice of giving a full body massage is covered with particular emphasis on correct draping techniques. Content Outline Lesson 1 Lesson 2 Lesson 3 & 4 Lesson 5 Lesson 6 Abdominal Massage Chest and Neck Massage Front of Leg Massage Pregnancy Massage Oedema Massage Lesson 7 & 8 Part 1: Full Body Massage Lesson 7 & 8 Part 2: Full Body Massage Self Evaluation Subject 04 Foundations of Massage 2 v16.03 Evolve College 2016 Page 5

7 Lesson 1 Abdominal Massage Objectives Using the information in this lesson, the student will be able to do the following: 1. Perform the appropriate draping techniques for an abdominal massage. 2. Perform the massage sequence for an abdominal massage. To encourage peristalsis and the mechanical emptying of the colon, all massage techniques must be directed clockwise. It is best to still do small anticlockwise circles but let the overall direction of your massage routine work in a clockwise direction around the abdomen. To avoid any chance of impaction of faecal material, the stroking should begin in the lower right hand quadrant. The person is positioned in supine and a pillow under the knees is essential to relax the abdominal area as well as take the pressure off the lower back. Transverse Colon Ascending Colon Descending Colon Rectum ý Work in an overall clockwise direction. Start at the ascending colon, go across the transverse colon and down the descending colon, with small anti-clockwise circles. Page 6 Subject 04 Foundations of Massage 2 v16.03 Evolve College 2016

8 Abdominal Massage Always work Start Check COMFORT Client positioned in supine with arms by side. Slight flexion of knees will help relax abdominals. Make CONTACT Sequence 1. Single Handed STROKING clockwise direction A work in a clockwise direction right hand stays on the abdomen ensure the circle made by the hands is as wide as possible DEFINE the area B Remove DRAPING C Apply OIL Subject 04 Foundations of Massage 2 v16.03 Evolve College 2016 Page 7

9 2. Oval Stroking Diamond STROKE abdomen A B D C Page 8 Subject 04 Foundations of Massage 2 v16.03 Evolve College 2016

10 3. ANTI-CLOCKWISE MOVEMENTS using fingers small anticlockwise circles in an overall clockwise direction 4. Single Handed STROKING clockwise direction 5. Lumbar LIFT Finish Replace DRAPING Remove OIL Make CONTACT Subject 04 Foundations of Massage 2 ACM 2013 Page 9

11 Lesson 2 Chest and Neck Massage Objectives Using the information in this lesson, the student will be able to do the following: 1. Perform the appropriate draping techniques for a chest and neck massage. 2. Perform the massage sequence for a chest and neck massage. 3. Adopt the correct body posture for the abdominal, chest and neck massages. Start Check COMFORT Make CONTACT (A) DEFINE the area (B) A B Sequence 1. Rowing STROKE Shoulders to occiput Remove DRAPING (C) Fold the horizontal towel back. Drape so the nipple area of the chest remains covered. 2. Circular KNEADING Shoulders C Apply OIL (D) D Page 10 Subject 04 Foundations of Massage 2 v16.03 Evolve College 2016

12 3. Thumb GLIDE inferior side of clavicle (collar bone) 6. Rowing STROKE to occiput 4. Rowing STROKE Shoulders to occiput 5. Alternate Single Handed STROKING neck Finish Replace DRAPING Remove OIL Make CONTACT Subject 04 Foundations of Massage 2 v16.03 Evolve College 2016 Page 11

13 Lesson 3 & 4 Front of Leg Massage Objectives Using the information in this lesson, the student will be able to do the following: 4. Perform the appropriate draping techniques for a leg massage in the supine position. 5. Perform the massage sequence for a relaxation massage of the front of the legs. 6. Adopt the correct body posture for massaging the front of legs. Start Check COMFORT Make CONTACT DEFINE the area Remove DRAPING Apply OIL Sequence 1. Rowing STROKE entire leg sandwich foot 2. Reverse Rowing STROKE thigh thigh to knee to thigh 2A emphasize upward drainage towards the heart 2C 3. Anticlockwise PETRISSAGE thigh 4. Knuckle FRICTIONS thigh 5. Circular STROKES knee 2B Page 12 Subject 04 Foundations of Massage 2 v16.03 Evolve College 2016

14 6. Circular V STROKING lower leg 7. Circular gentle thumb FRICTIONS lateral edge of tibia (shin bone) one thumb follows the other 11. CIRCLING ankles 8. FRICTIONS peroneus and tibialis anterior these are muscles of the outside of the lower leg A. Thumb FRICTIONS B. Knuckle FRICTIONS C. FRICTIONS with fingers A B C 9. BREAKING BREAD top of foot 12. Rowing STROKE entire leg Finish Replace DRAPING Remove OIL Make CONTACT Repeat on other leg ý Never just massage one leg, always repeat on the other leg. Otherwise the client may feel unbalanced. 10. Small Circles RAKING between tendons Subject 04 Foundations of Massage 2 v16.03 Evolve College 2016 Page 13

15 Lesson 5 Pregnancy Massage Objectives Using the information in this lesson, the student will be able to do the following: 1. Perform a pregnancy massage using the correct levels in the side lying position. 2. Perform a pregnancy massage using the correct levels in the seated position. 3. Perform a pregnancy massage using the correct levels in the supine position. 4. Identify the cautions and contraindications in massaging a pregnant woman. Prenatal care is very important for pregnant women. Pregnancy is not an illness; it is a natural event. A woman who is pregnant is undergoing extensive physical and emotional changes. Pregnancy is divided into three distinct segments: the first, second and third trimesters. ge hormonal changes that are likely to cause mood swings. The most common complaint is morning sickness or nausea, which results from the physical body adjusting to the growing baby. This is also a very vulnerable time for the developing baby. Massage given at this time is a general wellness massage, which may help to level out the not yet started to expand. Level one and two strokes are indicated while level three frictions should be avoided around the abdomen and pelvis area. The second trimester usually brings a levelling of the hormones and the woman feels better. Toward the end of the second trimester, the connective tissue begins to soften to allow the pelvis to spread. Over stretching must be avoided. Alternate positioning for side lying is important. Level three needs to be avoided. During the last trimester, the weight of the growing baby, the postural shifts and the movement of the internal organs may cause discomfort for the pregnant woman. The lower back may ache from the postural shift. Again side lying is the only way for the woman to lie at this stage of the pregnancy and deep massage should be avoided. Also at this stage fluid accumulation can occur causing the legs and feet to swell. An oedema massage using level one stroking only is indicated. If giving a foot massage use only stroking (level 1) technique, avoid using deep pressure on areas of the foot particularly near the ankle. Page 14 Subject 04 Foundations of Massage 2 v16.03 Evolve College 2016

16 Positioning Consideration needs to be given to each individual client and their particular needs, the ultimate aim being to ensure the client is comfortable. After the first trimester, the pregnant woman will need to be positioned differently. There are 3 choices with regard to positioning during pregnancy. These include: Side Lying Supine (face up) Seated Positioning - Side Lying Pillow under abdomen (optional) Pillow under head to ensure spine is kept straight Pillow folded in half then the draping placed over it Fully draped ready to commence the massage Rowing STROKE back Stay seated for at least 5 minutes before standing (massage shoulders while seated) Bottom leg straight, top leg flexed over 2 pillows Positioning Supine Only 5-10 minutes as blood supply to foetus is reduced Legs slightly elevated (as for the oedema massage) Page 15 Subject 04 Foundations of Massage 2 Evolve College 2015

17 Positioning Seated Ensure the top pillow is placed lengthways as this keeps the towel in place for the correct draping. Rowing STROKE back Massage sequence Finish Replace DRAPING Remove OIL Make CONTACT Getting off the table Slide legs off the table and sit up slowly Stay seated for at least 5 minutes before standing (massage shoulders while seated) Cautions ý Use of essential oils in massage blend. At this stage it would be best that you just use no essential oils or lavender until you learn which essential oils are contraindicated during pregnancy. Start Check COMFORT Make CONTACT DEFINE the area Remove DRAPING Apply OIL Sequence Level ONE Strokes Light Level TWO Strokes Finish with Level ONE Strokes ý Do not do any Level THREE Subject 04 Foundations of Massage 2 Evolve College 2015 Page 16

18 Lesson 6 Oedema Massage Objectives Using the information in this lesson, the student will be able to do the following: 1. Perform the appropriate draping techniques for an oedema massage. 2. Perform the massage sequence for an oedema massage. 3. Adopt the correct body posture for an oedema massage. 4. Position the limb correctly for an oedema massage. Oedema is the Greek word for swelling. It is basically fluid retention and it occurs when more fluid builds up in the tissues than the circulatory and lymph systems combined can accommodate. The purpose of oedema massage is to decrease that fluid accumulation. The oedema massage is one of the rare exceptions where we begin in supine and finish in prone. In the supine position 2 pillows are placed under the knees and 2 or 3 under the ankles to raise the legs for optimum venous and lymphatic flow. For the prone position, remove the pillows from under the knees and retain the 2 or 3 pillows under the ankles. Supine Position 5. Double Handed STROKING thigh Start Check COMFORT, Make CONTACT, DEFINE the area, Remove DRAPING, Apply OIL 6. Double Handed Fan STROKE thigh 1. Rowing STROKE entire leg 2. V STROKING entire leg 3. V STROKING thigh 4. Single Handed STROKING thigh Subject 04 Foundations of Massage 2 v16.03 Evolve College 2016 Page 17

19 7. V STROKING lower leg 8. Double Handed Fan STROKE lower leg Use outside hand with fingers pointing in, inside hand on top Fan over the knee Prone Position Start Check COMFORT, Make CONTACT, DEFINE the area, Remove DRAPING, Apply OIL 16. STROKING entire leg 17. Single Handed STROKING thigh 18. Double Handed Fan STROKE thigh 19. Double Handed V STROKING lower leg 9. STROKING lower leg into thigh 10. V STROKING ankle 11. STROKING ankle into lower leg 12. STROKING ankle into lower leg into thigh 13. STROKING foot 14. STROKING foot into ankle into lower leg 15. STROKING entire leg Finish Replace DRAPING, Remove OIL, Make CONTACT Repeat on other leg Turning Technique To perform the turning technique from supine to prone, your client will need to be wearing a T shirt. Prior to turning remove 3 fold towel from under their head and move pillow down to ankles. 20. STROKING lower leg into thigh 21. V STROKING foot 22. STROKING foot into lower leg 23. STROKING foot into lower leg into thigh Finish Replace DRAPING, Remove OIL, Make CONTACT Repeat on other leg Page 18 Subject 04 Foundations of Massage 2 v16.03 Evolve College 2016

20 Lesson 7 & 8 Part 1: Full Body Massage Objectives Using the information in this lesson, the student will be able to do the following: 1. Take a client history and complete Client history and treatment form 2. Perform a full body massage treatment in 1 hour using relaxation tempo. 3. Perform the appropriate draping techniques for each body part being massaged, i.e. back (including upper buttocks), back of legs, face, chest, abdominals, arms and front of legs. 4. Set the massage table up correctly prior to starting the massage. 5. Perform the turning technique. 6. Position the client correctly in the prone position. 7. Position the client correctly in the supine position. 8. Adopt the correct body posture throughout the full body massage. Use your notes for sequences for each body part as a guide. You do not have to perform the exact same strokes as in the manual. The important thing to remember is that you must attempt level one on a body area before level two and then perform level three before finishing off with a repeat of level one. How many strokes in each level is not a priority, the difficulty is in getting the full body massage in one hour. Normally two or three of each type of stroke is sufficient - any more and you are likely to go over time. Order of body parts Some options for you to consider: Option One 1. Back (including upper buttocks) 2. Back of legs Turn over 3. Chest and Neck 4. Abdominals 5. Face 6. Arms 7. Front of legs Subject 04 Foundations of Massage 2 Evolve College 2015 Page 19

21 8. Feet Option Two 1. Back (including upper buttocks) 2. Back of legs Turn over 3. Face 4. Arms 5. Chest and Neck 6. Abdominals 7. Front of legs 8. Feet In Option 1 and 2 the feet are left until last due to hygiene reasons. This means that when doing the back of the legs, the feet are not included. Option Three 1. Back (including upper buttocks) 2. Back of legs and feet Turn over 3. Chest and neck 4. Abdominals 5. Face 6. Arms 7. Front of legs and feet Option Four 1. Back (including upper buttocks) 2. Back of Legs and feet Turn over 3. Front of Legs and feet 4. Abdominals Page 20 Subject 04 Foundations of Massage 2 v16.03 Evolve College 2016

22 5. Arms 6. Chest and Neck 7. Face Option Five 1. Back (including upper buttocks) 2. Back of Legs and feet Turn over 3. Front of Legs and feet 4. Arms 5. Abdominals 6. Chest and Neck 7. Face Full Body Massage is always completed in the prone position followed by turning over and finishing in the supine position. The back can be a safer area to begin the massage and is also the area that may need the most time and treatment. Completing the back and back of legs first allows the client to relax before the more sensitive areas of the body, the chest and neck, face and abdominal regions are massaged in supine. The following times can be used as a guide. Please keep in mind that the full body massage treatment must be completed in 1 hour. This is an approximate guide only: ý ý Back - 15 minutes Back of legs & feet - 5 minutes each Turning and positioning in supine - 3 minutes Chest and neck - 4 minutes Face - 4 minutes Abdominals - 4 minutes Arms - 5 minutes each Front of legs & feet - 5 minutes each Total Time: 60 minutes Variations can be made on the order and times for a full body massage. The main aims are: keep a flow complete in 1 hour slow tempo Subject 04 Foundations of Massage 2 v16.03 Evolve College 2016 Page 21

23 ý Checklist for the massage therapist: body stance draping techniques hand skills use of correct levels of massage. Things to avoid Below are some things to avoid when doing a full body massage for relaxation purposes. Chatting to the client Try to keep the dialogue to a minimum within the treatment, especially after the first 10 to 15 minutes. Allow the person then to have quiet time to themselves. The only communication you need to have with the client is to check pressure when in level three. Remember, the aim of relaxation massage is for the client to fully relax with their attention on themselves. Keeping the dialogue going distracts this process. Lifting or changing the position of any of the body parts Repeated applications of oil on the one body area This disrupts the flow of the massage. For example, one application of oil should be sufficient on the back, it would be a rare exception to have to apply more oil to the back half way through the back massage. Page 22 Subject 04 Foundations of Massage 2 v16.03 Evolve College 2016

24 Lesson 7 & 8 Part 2: Full Body Massage Self Evaluation Objectives Using the information in this lesson, the student will be able to do the following: 1. Assess their own level of competency with regard to: a. draping the client for each body part b. positioning the client c. hand skills for level one, two and three d. communication with the client before during and after treatment e. stance at the side and the top of the table 2. Complete a full body massage in one hour using relaxation tempo practicing at least two different options. After completing the full body massage treatment give yourself a rating using the table below. 1. History Taking 2. Draping 3. Positioning - supine/prone 4. Checking for comfort 5. Level 1 6. Level 2 7. Level 3 8. Communication with client 9. Use of oil 10. Posture and stance Comments: Subject 04 Foundations of Massage 2 v16.03 Evolve College 2016 Page 23

25 Grading Key A Excellent 5 B Above Average 4 C Average 3 D Below Average 2 Total Score 50 Pass Score 30 Your Score E Unsatisfactory 1 Page 24 Subject 04 Foundations of Massage 2 v16.03 Evolve College 2016