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  • Writer's pictureKirby Clark, MMT

Routines & Positions

Updated: Dec 19, 2023

Alright, let's start out face down, face in the cradle today. Have you ever wondered why your therapist has you start off in a specific position? Have you ever wondered if you are getting the same massage your therapist provides everyone?

When I started massage therapy school, at Blue Cliff College in 2013, routines were talked down about and discouraged. There was such an air of superiority for not having a routine and providing every client with a "cookie cutter" massage.

When I received my license and began my first job, I soon found that having a routine was supremely helpful. Granted, I've always worked in a spa setting- but my first massage job with Massage Envy in Fayetteville provided me experience working with all kinds of clients! Students, Athletes, Geriatrics, Bridal Parties, Office Workers, Manual Laborers, Doctors, Nurses- any type of person you can think of almost, I worked with in my five years with Massage Envy Fayetteville. I discovered that for me, developing a routine helped me have a standard plan of treatment that could easily be modified based on each client's needs. I was shocked (and a little ashamed) to learn that having a routine afforded me a plan of action while also allowing flexibility for customization. I spent a long time feeling bad about myself as a therapist and trying to reconcile why my instructors discouraged routines so much. I've since gained self confidence and stand by my routine.

Massage Positions

There are four major positions in Massage Therapy:

1) Prone Position (Face Down)

2)Supine Position (Face Up, "Supine, on your Spine)

3)Side Lying Position (Bolstered with pillowing on Left or Right side- typically used for Prenatal Massage or Hip/Gluteal work)

4) Seated Position (In a Massage Chair or less commonly, on a Massage Table, clothed with Legs dangling off the edge)

My Routine

So, I have a standard plan for a 60-minute massage (which can be altered and modified for any client). Body regions and techniques can be added or removed depending on client needs and length of session. I typically begin each session in Prone (face down) position and start working on the client's Right side. Then proceed as thus;

- Shoulder (forearm strokes & thumb compresses)

- Arm (top of Arm into Neck and bottom of Arm under Shoulder)

- Forearm (striping before positioning overhead to stretch out low Back)

- Back (right side alternating Tensile Force)

- Quadratus Lumborum (outlined with soft fists and open palms)

- Gluteals (clothing/client permitting, with elbow/forearm first, then soft fists & thumbs to address Piriformis)

- Lamina Groove/Erector Spinae Group (gentle rocking with fingertips to pull tissue off spine, followed by elbow/forearm)

- Arm & Hand/Fingers (after returned to client's side, soft fists & thumbs)

Then the same is repeated for the Left side (modifying for any asymmetrical presentations that might exist. Re-draping the upper body, I also like to place a heating pack on the back. And proceed to the lower body on the Left side;

- Calves (soft fists, forearm, thumbs, torsion force & petrissage)

- Hamstrings & IT Band (forearm & soft fists/knuckles)

And then the same is repeated for the Right Leg. And I finish out Prone work with;

- Feet (Right foot first, basic reflexology points, Plantar Fasciitis stripping, soft fists, & Acupressure holds)

Then I remove the Ankle bolster and heat pack & apply some quick Tapotament to both sides of the Back, before transitioning the client into Supine (face up) position.

- Scalp (fingertips & thumbs, acupressure points, palms)

- Face (forehead stripping, sinus release, TMJD stripping on jaws, temporal strokes)

- Pectorals (starting at sternum & working outward unilaterally)

- Neck (unilaterally, stripping Scalenes/Sternocleidomastoid-bilaterally, stroke along spineX3, tapotament upwardX2, occipital tractionX1)

If time allows (longer sessions or if certain regions weren't accessible for any reason), Feet, Legs, Abdominals, Arms, & Hands can also be added into the Supine portion.

So there we have it, my personal (and now unabashed) massage routine. What I love so much about it is it provides a variety of strokes, forces, touch modifiers- which we'll get deeper into at a later date.

Peace and Healing,

Kirby Clark, MMT, BCTMB

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