1. Massage Therapy: Principles and Practice, 3 rd ed.

2. Copyright © 2008 by Saunders, an imprint of Elsevier Inc. All rights reserved. 2 Chapter 27 Seated Massage _________________________________________________________________________________________ Ralph R. Stephens, BSEd, LMT, NCTMB

3. Copyright © 2008 by Saunders, an imprint of Elsevier Inc. All rights reserved. 3 Introduction Seated massage is also called chair massage David Palmer developed the first massage chair in 1986 and coined the phrase “on- site massage” still used today Palmer introduced seated massage to workplace in 1980s Palmer adapted Japanese system of amma to be performed on chair

4. Copyright © 2008 by Saunders, an imprint of Elsevier Inc. All rights reserved. 4 Introduction Seated techniques have made massage more accessible to general public Sessions typically short and affordable Client does not disrobe Lubricant not used

5. Copyright © 2008 by Saunders, an imprint of Elsevier Inc. All rights reserved. 5 Lesson 27.1 Objectives List major considerations when purchasing a massage chair Describe types of seated massage equipment State reasons that a massage therapist might choose to massage a client in the seated position Explain and demonstrate procedures of sanitation and hygiene unique to seated massage

6. Copyright © 2008 by Saunders, an imprint of Elsevier Inc. All rights reserved. 6 Lesson 27.1 Objectives Properly adjust the massage chair for the client Describe proper body mechanics and safety considerations for the massage therapist who uses a massage chair Use adaptive professional communication to communicate effectively with the client before and during the massage Perform a basic seated massage routine

7. Copyright © 2008 by Saunders, an imprint of Elsevier Inc. All rights reserved. 7 How to Select a Massage Chair Different features appeal to different people Should be lightweight and quick to set up and take down Should be able to adjust to variety of body styles

8. Copyright © 2008 by Saunders, an imprint of Elsevier Inc. All rights reserved. 8 Reasons for Using the Chair Seated massage can be used as promotional tool Can be done on-site or in therapist’s office Can be used for short treatments of upper body Often used as a “stress-buster” break

9. Copyright © 2008 by Saunders, an imprint of Elsevier Inc. All rights reserved. 9 Sanitization and Hygiene Clients notice and appreciate attention to clean equipment and environment Hand washing with water may not be possible; use antimicrobial towelettes

10. Copyright © 2008 by Saunders, an imprint of Elsevier Inc. All rights reserved. 10 Sanitization and Hygiene Wipe face support, arm rest, and chest pad of chair between clients Keep fingernails short and clean Use a cover on the face cradle –More comfortable for client –Keeps makeup off vinyl

11. Copyright © 2008 by Saunders, an imprint of Elsevier Inc. All rights reserved. 11 Safety Considerations and Body Mechanics Use proper body mechanics to prevent repetitive motion injuries Be sure you can move completely around chair during massage When using thumbs, “stack the bones” for proper alignment

12. Copyright © 2008 by Saunders, an imprint of Elsevier Inc. All rights reserved. 12 Before the Seated Massage Begins If client’s first time, explain and demonstrate how to sit in chair Before session begins, adjust the chair to each client After adjustments, ask if they are comfortable

13. Copyright © 2008 by Saunders, an imprint of Elsevier Inc. All rights reserved. 13 Massage Strokes Used for Seated Massage Compression, sustained pressure (acupressure) Deep and superficial friction Pétrissage Effleurage Tapotement

14. Copyright © 2008 by Saunders, an imprint of Elsevier Inc. All rights reserved. 14 Compression and Sustained Pressure Compression effective on forearm and back Apply firm pressure primarily with heel of hand or loosely clenched fists Sustained pressure used to relieve trigger and tender points Use finger or thumb, elbow, or handheld tool

15. Copyright © 2008 by Saunders, an imprint of Elsevier Inc. All rights reserved. 15 Deep and Superficial Friction Deep friction applied with thumb, finger, elbow, loosely clenched fist, palm, or heel of hand Superficial friction is warming, stimulating stroke applied with palms

16. Copyright © 2008 by Saunders, an imprint of Elsevier Inc. All rights reserved. 16 Pétrissage, Effleurage, Tapotement Pétrissage used primarily in neck and upper trapezius Effleurage applied over clothing for relaxation and sedation Tapotement used at end of massage

17. Copyright © 2008 by Saunders, an imprint of Elsevier Inc. All rights reserved. 17 Adaptive Professional Communication Important to talk to client to determine: –When it hurts –When it gets better –If the pain refers –If the therapist’s pressure is too hard Therapist should also “listen” for body language cues

18. Copyright © 2008 by Saunders, an imprint of Elsevier Inc. All rights reserved. 18 Adaptive Professional Communication If area is noisy ask the client to raise a hand to indicate pain Establish a pain-measuring system using fingers raised; 1 being no pain and 5 being excruciating pain Use more or less pressure accordingly

19. Copyright © 2008 by Saunders, an imprint of Elsevier Inc. All rights reserved. 19 Record Keeping Have each client fill out intake form Acquire informed consent Keep detailed treatment notes for clinical seated massage Provide receipts to clients

20. Copyright © 2008 by Saunders, an imprint of Elsevier Inc. All rights reserved. 20 Sample Seated Massage Routine Routine can be done in 15 minutes and includes: –Upper back and neck –Lower back –Arm –Face and scalp –Stretches

21. Copyright © 2008 by Saunders, an imprint of Elsevier Inc. All rights reserved. 21 The Upper Back and Neck Compression strokes to paraspinals with heels of hands or loosely clenched fists Client should breathe in rhythm Begin with scapulas and move inferiorly, one hand width at a time

22. Copyright © 2008 by Saunders, an imprint of Elsevier Inc. All rights reserved. 22 The Upper Back and Neck Use loose fists to repeat previous pattern Make circular deep frictioning stroke 4–8 times down and up spine Apply four friction strokes medially to laterally over paraspinals Ask how client is doing every few minutes

23. Copyright © 2008 by Saunders, an imprint of Elsevier Inc. All rights reserved. 23 The Upper Back and Neck Pétrissage the trapezius muscle Work laterally to the acromion process, then medially to base of neck

24. Copyright © 2008 by Saunders, an imprint of Elsevier Inc. All rights reserved. 24 The Upper Back and Neck Now move to side of client; grasp and pétrissage back of neck Work up to occipital bone, then back down to shoulder Tilt face cradle forward so head and neck are at 45 degrees flexion Apply deep frictioning to tissues between occiput and C2

25. Copyright © 2008 by Saunders, an imprint of Elsevier Inc. All rights reserved. 25 The Upper Back and Neck Examine rhomboids and posterior scapula with deep circular motion Can examine further with guided elbow Use circular friction below scapulas

26. Copyright © 2008 by Saunders, an imprint of Elsevier Inc. All rights reserved. 26 Lower Back Use circular friction to relax lower back Palpate client’s waistline, being careful to avoid tickle response, to locate lateral end of 12th rib Apply deep friction with thumbs in lateral to medial direction on inferior surface

27. Copyright © 2008 by Saunders, an imprint of Elsevier Inc. All rights reserved. 27 Lower Back Change directions of pressure to 45 degrees medial anterior Using circular friction, examine edge of lumbar spine Use deep circular friction to massage this area from L1 to the ilium bone Then change direction from inferior anterior and treat superior surface of ilium

28. Copyright © 2008 by Saunders, an imprint of Elsevier Inc. All rights reserved. 28 Lower Back Use fingertips, thumbs, or guided elbow to examine lower portion of paraspinals Use sustained pressure on tender areas and trigger points

29. Copyright © 2008 by Saunders, an imprint of Elsevier Inc. All rights reserved. 29 Arm Face front of chair, slightly to one side Place forearm with palm down on arm rest Treat forearm muscles with compression to the extensor muscle group, using heel of hand, working from wrist to elbow Repeat sequence three times

30. Copyright © 2008 by Saunders, an imprint of Elsevier Inc. All rights reserved. 30 Arm Rotate arm, palm up Apply three sets of compression to flexor muscles Roll hand over, palm down, and repeat using circular friction applied with heel of hand Repeat three times

31. Copyright © 2008 by Saunders, an imprint of Elsevier Inc. All rights reserved. 31 Arm Rotate arm, palm up Repeat circular friction moves on flexor muscles of forearm Use thumbs to apply circular friction to all sides of wrist Shake out arm before returning to arm rest

32. Copyright © 2008 by Saunders, an imprint of Elsevier Inc. All rights reserved. 32 Face and Scalp Ask before performing face or scalp massage Apply circular friction to temples, jaw, face, and forehead

33. Copyright © 2008 by Saunders, an imprint of Elsevier Inc. All rights reserved. 33 Stretches Stretches useful because most individuals spend a lot of time in flexed positions Passive and active-assisted stretches relax and lengthen habitually contracted tissues

34. Copyright © 2008 by Saunders, an imprint of Elsevier Inc. All rights reserved. 34 Final Procedure Finish with effleurage and slow downward nerve strokes if goal is relaxation Tapotement can be used if client needs to be alert to return to work Have client exit chair slowly Recommend another appointment Disinfect chair, clean hands, write notes

35. Copyright © 2008 by Saunders, an imprint of Elsevier Inc. All rights reserved. 35 Summary Seated massage in an important specialty area It usually employs a special portable chair and is performed through clothing without lubricants Sessions tend to be shorter, ranging from 5 to 30 minutes It is used to promote the therapist’s private practice or as a practice in itself