Welcome back to the last post in my series on Informed Consent Body Regions; this Massage Monday, we’re talking about Gluteal Massage!
The Glutes are considered a body region that requires Informed Consent because let’s face it: This is a region that is located adjacent to the genital region and other erogenous zones which may also include the rectum/anus. For this reason, the glutes can be highly sexualized by our culture or misinterpreted as inappropriate or suggestive without proper education on the benefits of therapeutic, non-sexual gluteal massage.
This is also a region that is located within the cultural boundary of undergarments which are highly personal and intimate for most people.
Some Clients may also feel an awkwardness or self-conscious about having their glute muscles touched. Other clients may not be aware of how gluteal massage would be performed or the secure draping procedures administered.
Speaking of which- about draping: The Client should be assured that their Center will always be covered! The gluteal cleft (commonly the crack including the anus/rectum) will NOT be undraped during a professional, legal, therapeutic massage session.
The drape should have the sheet tucked under the client's hip bone or top of their leg to secure the sheet in a "diaper drape". Therapists should never let their hands or fingers slide beneath a drape or waistband/hemlines of client’s undergarments.
The drape becomes the therapeutic boundary- a non-verbal contract between therapist and client. Therapists can re-adjust the drape and ask if the client still remains comfortable, but fingertips should never be allowed to slip under a drape.
I never ask a client to hold a drape. I also never tuck a drape into a client's clothes/hemline, its invasive and crosses a boundary the client set by wearing clothing during their session.
I primarily work and drape from the back region instead of from the legs… it requires only one drape instead of two, and the massage strokes can be extended into the client’s Back.
I like using my elbow/forearms over my palms/fists to me it doesn't feel as suggestive or intimate as using my hands- there is a sense of separation with the elbows/forearms). I am also in the practice of moving a stroke through the hips into the back region. Methods should slowly easy deeper into tissue.
In terms of anatomy, there are 5 muscles (including the piriformis & quadratus femoris)
And 4 bones; 2 coxal bones (which are made up of three bones themselves) and  2 femurs (one on each side)
The Bones and Joints in this region are larger compared to the rest of the body and can require more pressure and increased duration of treatment in order to relax the soft tissue.
Accompanying Vlog: https://www.tiktok.com/@kirbyclark.mmt/video/7313420518965742890
Peace and Healing,
Kirby Clark Ellis, MMT, BCTMB