Note: This section contains instructions that demonstrate Key

how to perform some of the strategies for preparation and Points:

positioning that were introduced in this chapter. Treatment Positions for
Various Muscles 6-1
POSITIONING AND DRAPING Prone Is an Excellent Treatment Position for
THE PATIENT DURING ■ Posterior cervical muscles
■ Latissimus dorsi
TREATMENT ■ Rhomboids
■ Mid and lower trapezius
Positioning ■ Spinal extensors
In selecting the position for massage, consider the ■ Gluteus maximus
aims of treatment, the areas you wish to access, and ■ Hamstrings
your patient’s preferences and comfort. Prone, supine, ■ Triceps surae
side-lying, seated, seated inclined, and long-sitting ■ Intrinsic foot muscles
are common options, each of which has its own spe-
cific requirements for pillow placement and support. Supine Is an Excellent Treatment Position for
■ All muscles of the head and neck
Key Points 6-1 summarizes which muscles, tissues, and
regions are readily accessible in the common positions ■ Pectorals

used for treatment. ■ All muscles of the arm

Once you have positioned the patient correctly on ■ Abdominals
the treatment table, adjust, add, or remove the pillows, ■ Quadriceps
bolsters, or rolled towels used for support to ensure that ■ Muscles of the anterior compartment
the patient is comfortable. Figures 6-39 to 6-45 illustrate
some common positions and how you can support them Side-Lying Is an Excellent Treatment Position for
with pillows. In practice, place pillows beneath the bot-
On Uppermost Side of the Patient’s Body
tom sheet so that you can reuse them without having to
■ Scalenes
recover them. Many other configurations are possible
■ Rotator cuff
and will be required if you work in a hospital, rehabilita-
■ Pectoralis minor
tion, sports, or office setting.

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 ■ Serratus anterior
■ Abdominals
■ Quadratus lumborum
■ Iliocostalis
■ Gluteus medius and minimus
■ Iliotibial tract
■ Peronei

On Lower Side of the Patient’s Body

■ Adductors of the hip
■ Triceps surae

Seated Upright Position Is an Excellent Treatment

Position for
■ Upper trapezius

Seated Inclined Position Is an Excellent Treatment

Position for
■ All muscles of the posterior aspect of the head and neck
■ All muscles of the upper back
■ All muscles of the posterior aspect of the upper arms FIGURE 640 Legs can be elevated for drainage with (A) a tilted
treatment table or (B) a mound of pillows.

Draping
Draping does more than place the patient in a safe, warm,
modest, and comfortable position in which to receive the
intended massage. Appropriate draping can also serve
to achieve and maintain appropriate patient–clinician
boundaries that clinicians need in all practice settings,
including the classroom. Because draping sets a symbolic
and an actual boundary between you and the patient dur-
ing treatment, you must make draping comfortable yet
precise and secure when exposing the patient’s body for
treatment purposes.

FIGURE 639 A. Typically therapists use one or two pillows

under the knees when a client is supine to reduce the strain on
the lower back. B. You may need an additional pillow or towel roll
under the cervical spine for the comfort of clients who have an FIGURE 641 In prone position, a single pillow under the ankles
anterior-head posture. takes pressure off the knees.

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 FIGURE 642 A, B. Prone, an additional small pillow placed
under the abdomen can raise the lumbar spine into a less lordotic
position. This may reduce the back pain of some clients with low
back pain such as those with acute facet derangement.

FIGURE 644 A. In side-lying position, use pillows for the head

and legs. B. Place one or two pillows between the client’s knees
to enhance comfort. C. To access the medial tissues of the thigh
and leg nearest the table, flex the hip and knee of the upper leg
to 90°, and use pillows to support the upper leg so that the pelvis
does not rotate.

Your scope of practice, the professional code of con-

duct, and local laws will dictate what is permissible in
terms of exposing the patient’s body during treatment.
When undraping the patient, adhere to these rules:
1. Only undrape one body segment at a time.
FIGURE 643 A, B. Add another towel roll under the upper chest
2. Only undrape areas that are to be treated.
to improve comfort for large-breasted women or to take the 3. Do not undrape the gluteal cleft, perineum, genitals,
pressure off the thyroid cartilage. and female breast.

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 the patient, identify the articles of clothing and jewelry
that she will need to remove and explain the rationale
for doing so. If the patient chooses to remain clothed or
partially clothed, you must explain the technical conse-
quences of this choice to the patient. Then give the patient
clear instructions on how to position herself on the table
and how to arrange the draping and supports that you
have provided. Once you are sure that you have answered
the patient’s questions, leave the room so that the patient
can undress in privacy.10 If the patient requires assistance
undressing or getting onto the table, you must clearly
explain which items of the patient’s clothing—if any—
you will be removing and where you will be touching or
moving her; you also need to obtain and record consent
for this assistance before assisting the patient. Clean your
hands and other contact surfaces thoroughly with soap
and hot water or alcohol-based hand sanitizer for at least
FIGURE 645 Several pillows support a relaxed seated position
that offers good access to the upper back, shoulders, and 10 seconds prior to beginning draping procedures and
posterior neck. subsequent massage.8,10
Students must practice the process of appropriate
draping repeatedly and extend appropriate respect to
each other during classroom practice. In addition, it is
There are three possible legitimate exceptions to these useful for students to perform initial classroom practice
rules.10,11 In each case, you must know whether your local with the practice partners clothed until they develop a
laws supersede the exception. reasonable level of skill in draping.
The draping sequences in Figures 6-46 to 6-59
1. You may expose the female breasts if breast massage
all use two single (twin) flat sheets and a few towels.
is clinically indicated and the patient has provided
Clinicians can also perform the sequences with sheets
voluntary informed consent to this exposure prior to
as narrow as 4 feet wide. When clinicians perform these
treatment.
draping sequences as described, the draping will be com-
2. You may undrape the pelvis if the patient has pro-
fortable and secure and will ensure privacy for unclothed
vided voluntary informed consent to massage for the
patients. You can easily modify the sequences for the
purposes of labor support and/or delivery. Clinicians
legs should the patient choose to wear her underwear.
who have the treatment of pelvic floor dysfunction in
In addition, you will need to modify the draping if you
their professional scope of practice should consult
are using massage as an adjunct to other modalities and
their professional organization for guidelines on
if the clinical setting or patient preference requires the
draping.
use of a gown.
3. You may treat infants undraped with parental
Following a clinical session, if there is sufficient
consent.
time, invite the patient to rest before rising. Then
Use the following steps for carrying out draping when instruct the patient on how to get off the table safely,
massage is a primary modality and you are in a clinical set- using statements such as “roll onto your side, let your
ting with individual treatment rooms and tables. You may legs drop off the table, and slowly come to a sitting posi-
modify these procedures if you use massage techniques as tion, using your arms to push up.” If the patient has
an adjunct to other manual or exercise techniques or if physical limitations, you may also be required to give
you practice in a hospital, rehabilitation, sports, or other the patient discreet assistance to sit up, stand, or dress
setting. Once you have negotiated the plan of care with after the session.

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 FIGURE 646 A. Starting position for undraping the female torso in supine. B. Place a folded towel on top of the sheet over the breasts.
The client holds the top edge of the towel while the therapist withdraws the sheet from under the towel. C. Tuck the towel under the
torso or arms, and then expose the abdomen. D. In the final position, the drape is securely tucked, and the client’s abdomen is exposed
from the xiphoid process to the anterior superior iliac spine.

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 FIGURE 647 For women, the chest towel can be folded back to
undrape one or both breasts if informed consent has been
obtained and massage of breast tissue or the pectoral muscles is
clinically indicated.

FIGURE 648 A. For men, the issue of consent to treat the anterior torso is less delicate. If you are to perform extensive work on a male
client’s torso, he can be undraped to the waist. If you only plan for abdominal massage, you should offer him a chest towel for warmth.
B. The final drape tucked at the level of the anterior superior iliac spine.

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 FIGURE 649 A. Undraping the anterior leg. You expose the client’s leg and gather the extra sheet between the legs. B. You then pull
the extra sheet underneath the exposed leg back toward the side of the table. Here, the weight of the leg securely anchors the sheet.
C. You can tuck the top edge of the drape under the gluteal at the level of the greater trochanter. D. Or you can roll the edge of the sheet
higher to expose the anterior superior iliac spine and tuck it under the client’s lower back.

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 FIGURE 650 A. Turning to prone. The basic procedure is similar for turning from supine to prone, from prone to supine, or from either
position to or from side-lying. Use the front of your thigh to pin the sheets against the near edge of the table while your hands secure
both sheets across the table. Instruct the client to turn. B. Throughout the turn, maintain control of both sheets at both sides of the
table. Failure to do this will result in exposure of the client or a migrating bottom sheet that bunches uncomfortably under the client.
Take care to minimize inadvertent touching of the client during the turn.

FIGURE 651 A. Starting position for undraping the torso in prone position. B. For general back massage, the back is exposed to just
below the level of the posterior superior iliac spine. C. The drape is securely tucked. D. The client may choose to position her arms at her
sides. E. Or the client may position her arms overhead.

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 FIGURE 651 (Continued)

FIGURE 652 This angled draping unilaterally exposes the

superior gluteal insertions. Clinicians must work on these
extensively when treating many lumbar conditions.

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 FIGURE 653 A. The procedure for undraping the posterior leg is similar to that for the anterior leg. Expose the client’s limb and gather
the extra sheet between the legs. B. Pull the extra sheet underneath the exposed thigh back toward the side of the table. Here, the
weight of the leg securely anchors the sheet. C. For a low drape, tuck the upper edge of the sheet under the anterior thigh at the level
of the greater trochanter. D. A more common and much more useful technique is to roll the edge of the sheet toward the gluteal cleft
and securely tuck it above the anterior superior iliac spine, thus exposing the bulk of the gluteals.

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 FIGURE 654 A. To expose the back and the flank of a side-lying female client, first instruct the client to clasp a standard-sized pillow
in front. B. Undrape the back to the desired level. C. Then securely tuck the drape. The upper arm can be raised overhead, while the
lower arm maintains the pillow in position.

FIGURE 655 The side-lying position potentially offers unpara-

lleled access to the uppermost rotator cuff, serratus anterior,
quadratus lumborum, and portions of the pectorals and spinal
extensors.

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 FIGURE 656 A. To undrape the bottom leg in side-lying position (for work on the adductors, triceps surae, and tibialis posterior), first
flex the knee and hip of the top leg to 90° and use pillows to keep it forward and out of the way (see Figure 6-44C). Then expose the
bottom leg from behind and gather the extra sheet between the legs. B. Then pull the extra sheet underneath the exposed leg back
toward the posterior side of the table at the level of mid-thigh or slightly higher. Here, the weight of the leg securely anchors the sheet.
At this point, instruct a male client to move his genitals in a superior direction (e.g., “Adjust yourself.”). C. The top edge of the drape is
then rolled and pushed as close to the ischiopubic ramus as possible, and the posterior edge is tucked under the greater trochanter.
You may best perform techniques on the adductor attachments onto the ramus through the sheet, for reasons of discretion.

FIGURE 657 A. To expose the top leg in side-lying position, fold the posterior portion of the sheet forward. Move as much of the extra
sheet as possible out of the way in a superior direction. B. Pull the edge of the drape back under the leg. The drape now surrounds the
leg to be exposed, as in a pant leg. The other leg is not exposed at any time during the procedure. Again, move as much of the extra
sheet as possible out of the way in a superior direction. C. Keeping it tight to the leg, gradually work the “pant leg” drape up the thigh.
D. Finally, pull the superior edge of the drape toward the groin and toward the gluteal cleft and roll it over the iliac crest. It takes practice
to get this draping tight and secure. E. Gently lift the leg, and place a pillow under the knee for support.

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 FIGURE 657 (Continued)

FIGURE 658 The preferred position in which to work on the FIGURE 659 Wrap-around draping is useful for seated massage
piriformis is with the knee and hip both flexed to 90°. If you have of the head, neck, and shoulders in a seated inclined position.
applied the drape correctly, it will be possible for you to move the
leg without the drape loosening.

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 CLINICIANS’ POSTURE, The chapters on techniques use the postures and
movements described in this chapter8,9,12,13 during the
ALIGNMENT, AND BODY application of massage techniques. Ideally, practice them
MECHANICS DURING until they have become habitual before attempting to
learn the manual parts of massage techniques. These
TREATMENT exercises will assist you in developing the relaxation,
awareness, balance, coordination, flexibility, and strength
Efficient posture and movement constitute the physical that are required to perform massage. A lack of familiar-
foundation of effective execution of massage techniques. ity with these or comparable exercises can compromise
The outcomes and characteristic “feel” of well-performed the quality of your manual technique and increase risk
massage techniques depend as much on correct use of of injury. Furthermore, these exercises are worthwhile in
your feet, legs, pelvis, and respiratory apparatus as they their own right, and you can incorporate them into your
do on the motion of your upper limbs. Students and daily warm-up or cool-down.
clinicians who aspire to achieve expertise in performing
massage strokes may have postural habits that they must
systematically retrain. Furthermore, this retraining must Standing Aligned Posture
start before instruction in manual technique begins, since
This deceptively simple posture can actually be quite dif-
attention to your posture will decrease once you begin to
ficult to maintain because it often reveals and accentuates
learn manual technique. If you have habitually poor body
chronic patterns of tension in the body when you first
mechanics that are not corrected, then you will experi-
begin to use it. The steps for performing this posture fol-
ence fatigue and pain when performing massage strokes.
low (see Figures 6-60A and 6-60B).
For many, this unpleasant result can occur in as little as a
Stand with your feet positioned shoulder-width
few hours or weeks.
apart. Use the glenoid fossa as a landmark, rather than
The following general principles of body mechanics
the lateral surface of the deltoid.
apply during massage:
1. Breathe deeply and relax.
1. Keep your posture aligned and as upright as possible,
2. Let the weight settle down through your legs and into
except during controlled transfer of body weight.
your feet.
2. Keep both feet in contact with the floor.
3. Explore the manner in which your feet contact the
3. Reduce the vertical distance between yourself and the
ground by rocking from front to back, shifting from
patient by bending your knees, rather than by bend-
left to right, and shifting the inside to the outside.
ing at the waist.
4. Attempt to find the foot position in which you distrib-
4. Reduce the horizontal distance between yourself and
ute the weight of your body evenly through your feet.
the patient by repositioning your legs or shifting
5. Let the top of your head rise up gently. You may want to
your weight onto your forward leg, rather than by
have someone check whether you are incorrectly posi-
bending at the waist or reaching excessively.
tioning your head by flexing or extending your neck.
5. Point your navel area toward the body segment of the
6. Try to hold a standing aligned posture for 10 minutes,
patient that you are treating.
progressively refining both your foot contact with the
6. Increase pressure through the controlled use of body
ground and your sense of vertical alignment.
weight, rather than through muscle strength.
7. You may lean in a controlled way toward the point of
contact with the patient. When doing so, control
the amount of your body weight that you are trans-
Standing Aligned Posture with
ferring to the patient precisely and continuously. Diaphragmatic Breathing
8. Position your joints as close to neutral as possible and The following are the steps for performing this posture
do not load them when they are in a close-packed (Figure 6-60C):
position.
9. Change position (e.g., from sitting to kneeling) fre- 1. Assume a standing aligned posture until you feel very
quently to vary the mechanical stress that is being stable and relaxed.
placed on your body. 2. Focus your attention on your breathing.

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 FIGURE 660 A. Lateral view of standing posture shows a forward lean; a shortening in this therapist’s lumbar muscles, with an
accompanying anterior pelvic tilt; and an anterior-head posture. These may be due to postural habit or chronic fascial shortening. B.
The therapist’s lumbar spine is in a more neutral position, and the whole posture is better aligned after he balanced the weight on his
feet, softened his knees, let his sacrum drop, and let his head rise. Here, the therapist has overcompensated by bending his knees more
than necessary. C. Using the diaphragm to breathe produces a passive rise of the abdomen on inhalation. Use standing aligned posture
when you perform superficial reflex techniques that do not require application of pressure and that you need to sustain for some time.

3. Let your upper chest remain still, and breathe using

your diaphragm so that your abdomen passively
moves out during the inhalation and passively
moves back during the exhalation.
4. Remain in this position and continue to focus on the
passive movements of your abdomen. Gradually increase
both the duration and depth of the inhalation.
5. Sustain focused breathing for 10 minutes, and peri-
odically check the alignment of your body.

Standing Pelvic Tilt

The following are the steps for performing this posture
(Figure 6-61):
1. Assume a standing aligned posture until you feel very
stable and relaxed.
2. Ensure that your knees are not hyperextended.
3. Focus your attention on your pelvis.
FIGURE 661 During a standing slow pelvic tilt, the pelvis is
4. Keeping the legs and upper body motionless, perform
tucked under, while the thorax remains in the same position. This
a posterior pelvic tilt by letting your sacrum drop results in a lengthening of the lumbar region and a reduction of
and rolling your anterior superior iliac spine in a the normal lordosis. This movement is a prerequisite for later
posterior direction. movements that involve bending the knees.

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 5. Place a hand on your lumbar spine and note whether 2. First touch and then focus your attention on your
you feel it flatten slightly; this indicates that the ischial tuberosities.
posterior pelvic tilt has occurred. 3. Allow your spine to flex until you feel the weight of
6. Hold the pelvic tilt and breathe deeply using your your upper body resting on your ischial tuberosities.
diaphragm in the manner outlined in the previous 4. While maintaining your upper body in an upright
section. position, slowly roll the contact point of your pelvis
7. Relax. with the chair forward so that it shifts from being on
8. Perform this tilt and relax movement 10 to 20 times. the ischial tuberosities to being along the ischial rami
9. Vary your practice of this posture by making the in the direction of the symphysis pubis.
movement larger or subtler or by varying the amount 5. Since that movement should extend your lumbar
you bend your knees. spine, place your hand in the small of your back and
note whether you feel the erector spinae muscles
Proper performance of a posterior pelvic tilt in standing
tighten in your lumbar region.
requires some flexibility. If it is difficult to perform, prac-
6. Very slowly rock back and forward several times
tice this posture lying supine on a flat surface with your
and locate the point on your pelvis, between your
knees and hips flexed, progress to lying supine with your
ischial tuberosities and symphysis pubis, at which
knees and hips extended, and then attempt to perform it
your upper body feels upright and most comfort-
standing with your back against a wall before reattempt-
ably balanced over the pelvis (somewhere around
ing the posture in unsupported standing.
the perineum). The erector spinae muscles in your
lumbar region should not be engaged in that
Seated Aligned Posture position.
The following are the steps for performing this posture 7. Breathe deeply using your diaphragm.
(Figure 6-62): 8. Let the top of your head rise up gently. You may want to
have someone check whether you are incorrectly posi-
1. Sit upright on a level, firm, well-padded chair that tioning your head by flexing or extending your neck.
allows your knees and hips to rest at 90° of flexion. 9. Sit for 10 minutes, progressively refining both the
Place your feet on the floor, shoulder-width apart or contact of your pelvis with the chair and your sense
slightly wider. of vertical alignment.

Lunge
This position is also known as walk-standing, bow stance,
or archer stance. The following are the steps for perform-
ing this posture (Figures 6-63A and 6-63B):
1. Stand with your feet together.
2. Externally rotate your left hip to 20° to 45° so that
your left foot is turned out.
3. With your right foot, step forward and to the right of
the left foot a comfortable distance.
4. Maintaining an upright torso, slowly straighten your
left (back) leg without hyperextending your knee,
and bend your right (forward) leg as you move your
body over your forward foot.
5. Straighten your right (forward) leg and bend your left
(back) knee as you shift your weight onto your back
leg. Slowly shift your weight back and forth from your
FIGURE 662 Use seated aligned posture when applying many left to right foot, while keeping your torso perfectly
different techniques. Note the feet flat on the floor and the erect poised and upright. Your head should remain equidis-
upper body supported by the ischiopubic rami. tant from the floor throughout the movement.

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 FIGURE 663 A. Lunge position with the weight over the back leg. B. Lunge position, shifting the weight toward the front leg (the rear
leg can still be straightened some more). As you shift your weight back and forth, your torso remains balanced and motionless in relation
to the moving legs. This basic leg movement, used for many techniques, requires some quadriceps strength.

6. You may also synchronize your breathing with the which you flex your knees, by varying the level of your
movement by inhaling as you shift your weight in arms, and by using different breathing patterns.
the posterior direction and exhaling as you shift
your weight in the anterior direction. Lunge and Lean
7. Continue for 5 minutes, and then repeat the exercise
with the other foot forward. The following are the steps for performing this posture
8. Vary your practice of this posture and make it more (Figure 6-65):
challenging by gradually increasing the distance 1. Begin by performing the steps in the lunge movement
between your feet and the degree to which you flex previously described.
your knees. 2. Rather than keeping your torso upright throughout
the movement, incline it forward (lean) as you shift
your weight onto the forward leg. At the forward por-
Lunge and Reach tion of the motion, there should be a straight line from
The following are the steps for performing this posture the top of your head, through your torso, to the heel of
(Figures 6-64A and 6-64B): your back leg. The movement of this posture is from
upright with your weight on your back leg, to leaning
1. Begin by performing the steps in the lunge movement
with the weight on your front leg, and back again.
previously described.
3. Once you have mastered the performance of the lean
2. As you shift your weight onto your forward leg, extend
during the weight shift, add the arm movement pre-
both arms straight ahead at navel level without fully
viously described in the lunge and reach posture.
extending your elbows. As you shift your weight
onto your back leg, flex your elbows and shoulders
and bring your arms toward your body while keeping
Wide-Stance Knee Bend
them at waist level. This position is also known as the horse or warrior stance.
3. Vary your practice of this posture by increasing the The following are the steps for performing this posture
distance between your feet, by changing the degree to (Figures 6-66, 6-67A, and 6-67B):

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 FIGURE 664 A, B. Lunge and reach. Arms extend from an upright torso as you shift your weight to the forward leg. This exact
movement is used for superficial effleurage.

FIGURE 665 Lunge and lean. The therapist is shifting his weight
over the front leg as he leans forward; extending his back knee
slightly will complete the forward movement. Using exactly this
movement, the therapist transfers pressure to the client during FIGURE 666 First, practice the wide stance (horse stance)
various neuromuscular and connective tissue techniques. without movement (the “upper bent-knee position”).

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 FIGURE 667 A. Knee bend in the wide stance. As the therapist bends his knees, he simultaneously executes a posterior pelvic tilt so
that the lumbar region lengthens. Use this type of leg movement for some neuromuscular techniques like wringing. B. A common error
of movement is to increase the lumbar lordosis as the knees are bending.

1. Stand with your feet placed more than shoulder-width a. Change the distance (width) between your feet.
apart and your feet pointed straight forward or in a b. Flex your knees more.
small degree of external rotation. c. Rotate your upright torso in one direction as you
2. While keeping your upper body upright, flex your go down and rotate to the original position as
hips and knees a few degrees. Hold this position. you come up.
This is the “upper bent-knee position.” d. Perform the knee bend beside a massage table
3. Adjust the distance (width) between your feet until while transferring a portion of your upper body
you are in a position that you can comfortably hold weight to the table through your bent arms.
for 2 to 3 minutes.
4. Slowly increase the degree of knee flexion so that you
lower your body 6 to 8 in. This is the “lower bent- Standing Controlled Lean
knee position.”
The following are the steps for performing this posture
5. While keeping your torso upright, perform a poste-
(Figure 6-68):
rior pelvic tilt (using the steps previously described)
so that your lower spine lengthens as you lower your 1. You need a massage table or any other stable object
body. Place a hand on your lumbar spine to monitor against which you can lean to perform this. The
its position during this movement. table should be within reach of your partially
6. Slowly extend your knees and return to the upper extended arms.
bent-knee position without hyperextending your 2. Begin by performing the steps of the lunge and lean
lumbar spine or your knees. posture previously described.
7. Repeat. 3. As you shift weight onto your forward leg, lean for-
8. Gradually work up to 100 repetitions of this sequence ward and extend your arms. Allow your hands to
of movements from neutral to the upper and lower contact the table and slowly transfer some of your
bent-knee positions. weight to the table. As you do this, you should feel a
9. Vary your practice of this posture in one of several ways: shift of weight onto your extended back leg.

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 FIGURE 668 Use a standing controlled lean to apply pressure
during many neuromuscular and connective tissue techniques.

4. Slowly return your arms to their original position and

shift your upper body back over your back leg.
5. Repeat this back-and-forth movement and transfer
some of your body weight to the table at the appro-
priate point in each movement. The compression and
release should be slow and controlled.

Seated Controlled Lean

The following are the steps for performing this posture
(Figures 6-69 and 6-70): FIGURE 669 A. A seated controlled lean using a chair. This is
often used when treating the client’s shoulders. B. A seated
1. Begin in the seated aligned posture facing a massage
controlled lean sitting on the edge of the table. When treating
table or any other stable object against which you can clients, it is acceptable to sit on the edge of the table as long as
lean. the therapist only contacts the client with his hands or forearms,
2. Place your hands on the supporting surface. not his thigh or pelvis.
3. Gradually lean forward from your waist and apply
pressure to the supporting surface so that you feel
balanced as you do so.
4. Alternatively, sit upright on the edge of a firm bed or
massage table and face one end of it. If you are on a
massage table, the leg closest to the table will be off
the ground and the other foot will have a secure
contact with the floor.
5. Slowly lean forward to transfer your body weight in
the manner described above.
6. Vary your practice of this posture by changing the
amount of weight you transfer to the supporting sur- FIGURE 670 The therapist is obviously not using the client to
face, the height of contact, and the compression time support his body. He demonstrates flawless control of the
(without losing continuous control and relaxed amount of body weight that he could transfer to a client in this
shoulders). position.

30331_ch06_p143-185.indd 183 11/14/12 6:24 PM