Stretching for the MassageTherapist
Redesigning Movement
By Jill Bielawski and Jerry Weinert
Originally published in Massage & Bodywork magazine, December/January 2000.
Copyright 2003. Associated Bodywork and Massage Professionals. All rights reserved.
In this installment of "Redesigning Movement" we will discuss how important our positioning of the lower body affects our performance when delivering a massage and during daily activities. Foot, leg and hip postures ultimately affect overall comfort level throughout the therapist's body.
Many massage therapists and bodyworkers focus on the satisfaction and needs of their clients at the expense of their own somatic well-being. They are so client-oriented that they tend to ignore the warning signals from their own body. Often we hear, "I can't deliver enough pressure" or "It hurts when I do," does "I have a chronic low backache" have a familiar ring to it? This scenario can simply be ameliorated by paying attention to proper body mechanics.
It is very important that our feet and pelvis face the direction in which we are delivering pressure. Pelvic and foot movement must follow our hands and thus are integral to providing deeper (not harder) pressure and more effective control of specific strokes. It's inevitable that there will be some low back and hip torsion when reaching across the client. This torsion, though, can be minimized through proper hip and foot placement and by keeping a dynamic flow throughout the treatment session and throughout the day.
Often as the day progresses, many practitioners begin to fatigue and tend to become more static in their own bodies without realizing the consequences. They feel this lack of movement may be conserving energy when, in reality, it consumes vast amounts. In the same light, if the practitioner's body is relatively static, it can produce a hard, unyielding quality of touch for the client and the client may subconsciously resist relaxation. Movement not only increases your comfort level, but it decreases strain on your joints and musculature and ultimately increases your treatment effectiveness.
Repetitive activities of daily living are also contributors to aggravating improper body mechanics of a massage and bodywork practitioner. Sitting for extended periods of time in an improper position (i.e. slouching to one side, crossing legs, feet not flat on floor, standing with weight on one leg) all contribute to misalignment of the pelvis and ensuing discomfort. Certain physical fitness activities, such as jogging and cycling, could factor into this scenario and exacerbate an existing condition. We're not suggesting you quit any physical fitness regimen, but rather modify your activities if you experience pain or discomfort. Consideration must also be given to the work environment, such as floor surface and proper shoe wear. The floor needs to have adequate padding, like carpet padding or a rubber mat. The therapist's shoes should be supportive and well-cushioned. Sore calves or knees are good indicators that it is time for a new pair.
Some common conditions which arise from a fixed posture, improper foot and hip positioning, and contributing factors from daily activities may include the following: low back pain, sciatica, knee pain, and subsequent ankle and foot pain.
In the last article we covered several stretches which not only help the trunk, but are beneficial for low back and hip discomfort. These include pelvic tilt, hip hiker, iliopsoas and side bends. The following stretches are useful for the kinetic chain of the low back, hips, legs and feet.
Remember the tenets of active-isolated stretching: identify and isolate the muscle to be stretched and contract its opposite, stretch only to the point of light irritation (not pain), hold for two seconds and exhale during the stretch.
HIP AND LEG STRETCHES
Straight Leg Hamstring
Starting Position: Lie flat on your back, legs straight, with a rope around the foot of the leg you will stretch. If you don't have a rope, you can use your hands to assist in this stretch. Keep your other leg flat. If you have a back problem, you will want to use a cushion under the knee you aren't stretching. Take a breath.
Action: While exhaling, bring your straight leg toward your head until you feel tension. Use the rope to assist a further stretch to light irritation and hold for two seconds. Inhale while you are returning to the starting position. Repeat 4-10 times depending on fitness level. Repeat for other leg.
Quadriceps Stretch
Starting Position: Lie on your side and bring the bottom knee close to your chest by holding the knee or foot. This will stabilize the low back to avoid strain. The top leg is your exercising leg. Bend the knee, keeping the leg level with the hip. Take a breath.
Action: While exhaling, bring your foot back toward your buttock. Use your hand or a rope on top of the foot and ankle of your upper leg to assist the movement. Stretch to light irritation and hold for two seconds. To increase the stretch, move the knee behind your body. Inhale while you are returning to the starting position. Repeat 4-10 times depending on fitness level. Repeat for other leg.
Tensor Fascia Latae (TFL)
Starting Position: Lie flat on your back with legs straight. Take a breath.
Action: While exhaling, bring one leg over the opposite leg with sole of foot facing outward (eversion). Keep your buttock close to the floor with the leg low and as close to the non-exercising leg as possible. Assist with a rope around your ankle for a further stretch. Stretch to light irritation and hold for two seconds. Inhale while you are returning to the starting position. Repeat 4-10 times depending on fitness level. Repeat for other leg. (Photo 6)
Adductors
Starting Position: Sit on the floor with the soles of your feet together and your hands on your knees (stomach tucked, sternum up). Take a breath.
Action: While exhaling, lower your knees toward the floor, hold for two seconds. Assist the stretch to light irritation by using your hands. Inhale while you are returning to the starting position. Repeat 4-10 times depending on fitness level.
LOW BACK STRETCHES
Knee to Opposite Shoulder
This stretches muscles of the hip and low back.
Starting Position: Lie flat on your back with legs straight. Take a breath.
Action: While exhaling, bring one knee toward the opposite shoulder. Assist with your hand on the knee for a further stretch. Keep your hip as close to the floor as possible. Imagine you are going to leave those buttocks behind on the floor as your knee moves toward your shoulder. Stretch to light irritation and hold for two seconds. Inhale while you are returning to the starting position. Repeat 4-10 times depending on fitness level. Repeat for other leg.
Thoracic Lift
This stretches the anterior body and strengthens the lumbar area.
Starting Position: Lie in prone position with arms at your sides and face to the floor. Take a breath.
Action: While exhaling, flatten your pelvis to the floor, contract your buttocks muscles and lift your shoulders and chest off the floor. Stretch to light irritation and hold for two seconds. Inhale while you are returning to the starting position. Repeat 4-10 times depending on fitness level. (Photo 12) Note: As with any exercise involving the spine, if you experience any active or acute discomfort or pain, or if you have a known disc problem, check with your health care provider before doing this stretch.
LOWER LEG STRETCHES
Calf Stretch-Gastrocnemius
Starting Position: Sit on the floor with both legs straight. Take a breath.
Action: While exhaling, keep the legs straight and bring your toes toward your knees to stretch the back of your calf. You can assist with hands or rope around foot to further the stretch. Stretch to light irritation and hold for two seconds. Inhale while you are returning to the starting position. Repeat 4-10 times depending on fitness level. Repeat for other leg.
Soleus
Starting Position: Sit on floor and bring one knee up into bent position. Take a breath.
Action: While exhaling, hold the ball of your foot with both hands and bring your toes toward you, assisting with your hands into a further stretch if necessary. Stretch to light irritation and hold for two seconds. Inhale while you are returning to the starting position. Repeat 4-10 times depending on fitness level. Repeat for other leg.
Tibialis Anterior
Starting Position: Sit on the floor with both legs straight. Take a breath. Action: While exhaling, point your toes away from your body to stretch the front of your lower leg. Stretch to light irritation and hold for two seconds. Inhale while you are returning to the starting position. Repeat 4-10 times depending on fitness level. Repeat for other leg.
Inversion
This stretches the evertors.
Starting Position: Sit on the floor and bring one knee up to a bent position. Take a breath.
Action: While exhaling, bring the sole of your foot to the inside. Assist with your hands for a further stretch. Stretch to light irritation and hold for two seconds. Inhale while you are returning to the starting position. Repeat 4-10 times depending on fitness level. Repeat for other leg.
Eversion
This stretches the invertors.
Starting Position: Sit on the floor and bring one knee up to bent position. Take a breath.
Action: While exhaling, bring the sole of your foot toward the outside and up. Assist with your hands for a further stretch. Stretch to light irritation and hold for two seconds. Inhale while you are returning to the starting position. Repeat 4-10 times depending on fitness level. Repeat for other leg.
Jill Bielawski and Jerry Weinert, both massage therapists, have been in the health and education professions for over 20 years. They conduct workshops on massage, body mechanics and flexibility and are co-authors of Head to Toe: A Manual of Wellness and Flexibility, published by Southwest Wellness Educators in Tucson, Ariz. They can be reached at 888/527-2200 or sweduc@aol.com.
Copyright 2003. Associated Bodywork and Massage Professionals. All rights reserved.
In this installment of "Redesigning Movement" we will discuss how important our positioning of the lower body affects our performance when delivering a massage and during daily activities. Foot, leg and hip postures ultimately affect overall comfort level throughout the therapist's body.
Many massage therapists and bodyworkers focus on the satisfaction and needs of their clients at the expense of their own somatic well-being. They are so client-oriented that they tend to ignore the warning signals from their own body. Often we hear, "I can't deliver enough pressure" or "It hurts when I do," does "I have a chronic low backache" have a familiar ring to it? This scenario can simply be ameliorated by paying attention to proper body mechanics.
It is very important that our feet and pelvis face the direction in which we are delivering pressure. Pelvic and foot movement must follow our hands and thus are integral to providing deeper (not harder) pressure and more effective control of specific strokes. It's inevitable that there will be some low back and hip torsion when reaching across the client. This torsion, though, can be minimized through proper hip and foot placement and by keeping a dynamic flow throughout the treatment session and throughout the day.
Often as the day progresses, many practitioners begin to fatigue and tend to become more static in their own bodies without realizing the consequences. They feel this lack of movement may be conserving energy when, in reality, it consumes vast amounts. In the same light, if the practitioner's body is relatively static, it can produce a hard, unyielding quality of touch for the client and the client may subconsciously resist relaxation. Movement not only increases your comfort level, but it decreases strain on your joints and musculature and ultimately increases your treatment effectiveness.
Repetitive activities of daily living are also contributors to aggravating improper body mechanics of a massage and bodywork practitioner. Sitting for extended periods of time in an improper position (i.e. slouching to one side, crossing legs, feet not flat on floor, standing with weight on one leg) all contribute to misalignment of the pelvis and ensuing discomfort. Certain physical fitness activities, such as jogging and cycling, could factor into this scenario and exacerbate an existing condition. We're not suggesting you quit any physical fitness regimen, but rather modify your activities if you experience pain or discomfort. Consideration must also be given to the work environment, such as floor surface and proper shoe wear. The floor needs to have adequate padding, like carpet padding or a rubber mat. The therapist's shoes should be supportive and well-cushioned. Sore calves or knees are good indicators that it is time for a new pair.
Some common conditions which arise from a fixed posture, improper foot and hip positioning, and contributing factors from daily activities may include the following: low back pain, sciatica, knee pain, and subsequent ankle and foot pain.
In the last article we covered several stretches which not only help the trunk, but are beneficial for low back and hip discomfort. These include pelvic tilt, hip hiker, iliopsoas and side bends. The following stretches are useful for the kinetic chain of the low back, hips, legs and feet.
Remember the tenets of active-isolated stretching: identify and isolate the muscle to be stretched and contract its opposite, stretch only to the point of light irritation (not pain), hold for two seconds and exhale during the stretch.
HIP AND LEG STRETCHES
Straight Leg Hamstring
Starting Position: Lie flat on your back, legs straight, with a rope around the foot of the leg you will stretch. If you don't have a rope, you can use your hands to assist in this stretch. Keep your other leg flat. If you have a back problem, you will want to use a cushion under the knee you aren't stretching. Take a breath.
Action: While exhaling, bring your straight leg toward your head until you feel tension. Use the rope to assist a further stretch to light irritation and hold for two seconds. Inhale while you are returning to the starting position. Repeat 4-10 times depending on fitness level. Repeat for other leg.
Quadriceps Stretch
Starting Position: Lie on your side and bring the bottom knee close to your chest by holding the knee or foot. This will stabilize the low back to avoid strain. The top leg is your exercising leg. Bend the knee, keeping the leg level with the hip. Take a breath.
Action: While exhaling, bring your foot back toward your buttock. Use your hand or a rope on top of the foot and ankle of your upper leg to assist the movement. Stretch to light irritation and hold for two seconds. To increase the stretch, move the knee behind your body. Inhale while you are returning to the starting position. Repeat 4-10 times depending on fitness level. Repeat for other leg.
Tensor Fascia Latae (TFL)
Starting Position: Lie flat on your back with legs straight. Take a breath.
Action: While exhaling, bring one leg over the opposite leg with sole of foot facing outward (eversion). Keep your buttock close to the floor with the leg low and as close to the non-exercising leg as possible. Assist with a rope around your ankle for a further stretch. Stretch to light irritation and hold for two seconds. Inhale while you are returning to the starting position. Repeat 4-10 times depending on fitness level. Repeat for other leg. (Photo 6)
Adductors
Starting Position: Sit on the floor with the soles of your feet together and your hands on your knees (stomach tucked, sternum up). Take a breath.
Action: While exhaling, lower your knees toward the floor, hold for two seconds. Assist the stretch to light irritation by using your hands. Inhale while you are returning to the starting position. Repeat 4-10 times depending on fitness level.
LOW BACK STRETCHES
Knee to Opposite Shoulder
This stretches muscles of the hip and low back.
Starting Position: Lie flat on your back with legs straight. Take a breath.
Action: While exhaling, bring one knee toward the opposite shoulder. Assist with your hand on the knee for a further stretch. Keep your hip as close to the floor as possible. Imagine you are going to leave those buttocks behind on the floor as your knee moves toward your shoulder. Stretch to light irritation and hold for two seconds. Inhale while you are returning to the starting position. Repeat 4-10 times depending on fitness level. Repeat for other leg.
Thoracic Lift
This stretches the anterior body and strengthens the lumbar area.
Starting Position: Lie in prone position with arms at your sides and face to the floor. Take a breath.
Action: While exhaling, flatten your pelvis to the floor, contract your buttocks muscles and lift your shoulders and chest off the floor. Stretch to light irritation and hold for two seconds. Inhale while you are returning to the starting position. Repeat 4-10 times depending on fitness level. (Photo 12) Note: As with any exercise involving the spine, if you experience any active or acute discomfort or pain, or if you have a known disc problem, check with your health care provider before doing this stretch.
LOWER LEG STRETCHES
Calf Stretch-Gastrocnemius
Starting Position: Sit on the floor with both legs straight. Take a breath.
Action: While exhaling, keep the legs straight and bring your toes toward your knees to stretch the back of your calf. You can assist with hands or rope around foot to further the stretch. Stretch to light irritation and hold for two seconds. Inhale while you are returning to the starting position. Repeat 4-10 times depending on fitness level. Repeat for other leg.
Soleus
Starting Position: Sit on floor and bring one knee up into bent position. Take a breath.
Action: While exhaling, hold the ball of your foot with both hands and bring your toes toward you, assisting with your hands into a further stretch if necessary. Stretch to light irritation and hold for two seconds. Inhale while you are returning to the starting position. Repeat 4-10 times depending on fitness level. Repeat for other leg.
Tibialis Anterior
Starting Position: Sit on the floor with both legs straight. Take a breath. Action: While exhaling, point your toes away from your body to stretch the front of your lower leg. Stretch to light irritation and hold for two seconds. Inhale while you are returning to the starting position. Repeat 4-10 times depending on fitness level. Repeat for other leg.
Inversion
This stretches the evertors.
Starting Position: Sit on the floor and bring one knee up to a bent position. Take a breath.
Action: While exhaling, bring the sole of your foot to the inside. Assist with your hands for a further stretch. Stretch to light irritation and hold for two seconds. Inhale while you are returning to the starting position. Repeat 4-10 times depending on fitness level. Repeat for other leg.
Eversion
This stretches the invertors.
Starting Position: Sit on the floor and bring one knee up to bent position. Take a breath.
Action: While exhaling, bring the sole of your foot toward the outside and up. Assist with your hands for a further stretch. Stretch to light irritation and hold for two seconds. Inhale while you are returning to the starting position. Repeat 4-10 times depending on fitness level. Repeat for other leg.
Jill Bielawski and Jerry Weinert, both massage therapists, have been in the health and education professions for over 20 years. They conduct workshops on massage, body mechanics and flexibility and are co-authors of Head to Toe: A Manual of Wellness and Flexibility, published by Southwest Wellness Educators in Tucson, Ariz. They can be reached at 888/527-2200 or sweduc@aol.com.
