Body Part - Hips/Pelvis/Glutes - Techniques

[molloyboy3]

Hi.

I envision a sticky for this thread in the future (and the other body part threads I'll start!), if this goes well.

We could utilize this sort of like the "Massage Pearls" thread. Anything you find interesting within the MassagePlanetL forums regarding a specific part body and the work surrounding it, could be parked in this thread. Obviously we may end up with some thoughts duplicated from the Massage Pearls, but who cares!!!! The more, the merrier!

In addition, if you'd just be interested in posting some neat techniques you do for this particular body part, that would be wonderful too!

Consider items like:

• Amount of time you generally spend on this body part.
• Amount of time you can spend on this body part.
• Techniques you may use to stretch out a massage while working this body part (example: you need to pass a few minutes to get back on track -- swedish therapists may really appreciate this info).
• How you incorporate other bodyparts at the same time when you are working this area (example: long strokes in working the hip with one hand and the posterior calf with the other -- in unison).
• Techniques for specific problems or patterns.
• Draping/loose draping/non-draping information - the why & why-nots associated with this area.
• Tell us something that just feels good!
• Types of lotions/oils you would use for the technique and why.
• How to perform deeper work or lighter work in the region.
• Case Study Examples from your practice.
• Bonus thoughts that you may have that would be helpful to new and old therapists alike!

Without further ado .... it's all about the hips/pelvis/glutes!!!!

 

[Top answers]

Regarding work with hot stones around into the glutes:

The advaneforum.xxxe to bigger stones is they stay warmer longer so you can do more work before you have to change them, and they do have the extra weight. (by big I mean about 3-4inches across, not 6inches across, THOSE big stones are more for placement) I do use the edge of a BIG 6" one getting into the glutes around the greater trochanter, and I will use it on the back of the thighs going up into the glutes.

 

[bluareochick8]

Client lying supine...pick up leg flex knee and hip then stretch by rotating at the hip. Support leg by holding the heel and on the thigh just above the knee.

So the picture on the right is how to hold it then circle that sucker and stretch those rotators!

 

[. otto.saxo .]

So I have this new client who is suffering from sciatic pain and has lumbar compression.

Of course in the beginning of the session as I'm familiarizing myself with his muscles, the tightness, the soreness...yada...yada...yada...and I'm asking him about pressure and depth he says certain areas around his SI joint are incredibly tender.

So...I'm working along on the surrounding tissue for release and going back periodically to work around the SI joint...asking about intensity to see if he notices any changes. As I'm working through the quadratus lumborum and into the erectors he, of course, is surprised at how sore these areas are throughout his body.

Being the diligent practitioner I keep working...and working into an ever widening circle around the SI joint, as well as, mixing in work that addresses his back and legs in general.

Zoom to the end of the session -- as I revisit the SI joint and the specifically sore areas he became aware of at the beginning of the massage...asking him about intensity -- lo and behold it's not sore anymore.

LOL The surprise in his voice is considerable!! LOL

I laughed and said, "Ahh, you sound so surprised!" at which point he laughed and acknowledged that indeed he was surprised and grateful that he's not sore anymore!

 

[ebonyqueen]

For akb:
Nice photos showing the work you're doing -

but one caution:
With the client in the supine position:
If you're working with someone who has knee issues it is better to hold behind the knee (just above the joint) rather than closing up the joint as shown. We learned in the AIS classes, with Aaron Mattes, to stand to the side of the table & allow about a 45 degree angle bend in the knee while doing the rotations, then do the stretch slightly to the side & up toward the armpit - holding the stretch there for approx. 2 seconds. The other way to do this if your client is experiencing a knee problem is to allow them keep the leg straighter while you stretch the entire leg up toward the shoulder.

The other way in which I address the hip/glute area is this:
For the left hip - stand on that side - with the client laying prone - bring the leg up to a 45 degree angle (and again watching out for problem knees may require other adjustments) I will place my left hand along the outer hip/glute region feeling for tension in the attachment points then proceed to compress & release - rocking the entire hip as I use my right hand to hold just above the ankle - then gently but firmly stretch & rock the lower leg medially than laterally - back & forth a few times as I work the hip. Then I frog the leg out to the side & continue compressing & releasing the entire joint - finishing the side by doing acupressure compressions down the entire leg. Once I straighten the leg & recheck the hip and points north up into the waistline I generally find that the whole lower back has opened up.

After completing both sides, I will then proceed to do a few full strokes of light into deeper pressure over the entire back before working the shoulders/scapula area, upper & mid back, then pulling it all together as I do the remainder of the whole back of the body sequence from the head to the feet.

 

[Pompal 09.]

I love working this area! Don't know exactly how it happened, but I went from feeling kinda ignorant about it to feeling it's now one of my strongest areas to work. The hip flexors especially are rewarding, as I often see dramatic changes in just one or two sessions.

Lately I've taught a few classes (CE provider approval pending) for MTs that focus solely upon the hip flexors. The course was originally intended to be just 3 hours... but I have a good 8-10 hours of material! : So we covered just the most critical pieces (assessment, anatomy, and palpatory skills) and surveyed a few basic treatment skills.

For simplicity, I roughly divide treatment skills into two broad categories that each have two broad subcategories:

A. Passive Techniques - basically anything you do where the client passively allows you to manipulate their tissues. These I divide into two categories: Indirect and Direct.

1. Indirect Techniques - basically techniques that don't require putting force directly into the tissue. These include fascia work, positional release, some forms of stretching, and so forth.

2. Direct Techniques - basically techniques that apply direct pressure to the tissues. These include trigger point, cross fiber friction, etc.

B. Active Techniques - basically anything you do in which the client actively participates in moving or manipulating their body. These I divide into two categories: Stretching and Exercising.

1. Stretching - Here I teach active stretching methods like Active Isolated Stretching and PNF stretching. There are others, but I prefer these for ease of use, effectiveness, and because clients learn them fairly easily.

2. Exercising - This could run the gamut of somatic education, personal training, etc... and it's far outside the scope of practice of most MTs. I limit my course material to emphasizing the importance of knowing practice limits and referring clients to the appropriate experts. MTs should not mess around with exercising clients or making recommendations regarding a client's exercise program unless they have real credentials and some actual training experience.

I believe MTs should have a good grasp of how to assess for hip flexor issues. This includes observation of posture and movement in addition to the verbal intake. It's also critical that the MT establish good solid boundaries and a connection of trust before working the area. Communication, in short, is key.

An MT should also really know what they are looking for, how to find it, and what to beware of. There's a lot of important stuff around the inguinal ligament, so you don't want to be aimlessly poking about. Even on very large clients, it's easy to figure out where you are once you find the ASIS and use it as a landmark.

I prefer to start with indirect techniques, especially if the client's anterior hip fascia is thick and doesn't move easily. Also, indirect techniques tend to be more easily tolerated if those areas are very tender and/or ticklish.

Direct techniques usually follow indirect ones, at which point the tissues should be well prepared. I teach a gentle approach to applying direct pressure, to make it easy on both client and MT. No sense in either one feeling real pain during or after the work!

Active stretching is something I would normally do last, to get the body to use the tissues we just released. This is critical for motor education, and clients can learn and practice these skills for faster progress between sessions.

Though the hip flexor course I've put together focuses on the psoas, iliacus, and pectineus, it's important to also look at them in relation to the glutes, TFL, quads, adductors, etc. The whole pelvic area is fascinating, and I hope to see more MTs take an active interest in working it!

 

[Jimmy Jazz]

Have you tried to make an enegetic connection between the pelvis and the sacrum? No pressure is needed, just a gentle hold of both of them for a minute or two may help to move them back in unison. Just a thought.

 

[SureThingBATMAN]

You Tube: Same gal I mentioned in Body Part - Abdomen/Psoas - Techniques with some glute work, and a different way to drape then many of us were taught in the US.

 

[LoNely GirL~]

Body Part - Hips/Pelvis/Glutes - Techniques

This You Tube video is a good example of what you can do with moderate sacral work. As she allows her hand to meld with the client, the trained therapists eye can easily see how she begins to achive deeper work even though it does not "look" deep on this video.
Massage Secrets for Sciatica by Athena Jezik, Low Back Pain, Techniques