I can’t really comment on this module as it is a very basic assessment of the hip. I do like the technique of just circling the femur instead of the whole leg. That sure makes it easier on the practitioner. I’ve always circled the whole leg and it took several tries to get the rhythm down especially switching sides 😂
Love the rocking techniques! This is something that was never discussed during my diploma program. I’m not sure why. I get the impression since much of Western style massage focuses on calming and relaxation, jostling the body around doesn’t fit that classic idea of smooth effleurage type work. For me, though, movement is the key! Any time I can move tissues and structures all the better. A few of my favourite techniques are active isolated stretching and active soft tissue release. The body is built to move and people need a lot more of it especially as we age.
I saw a 67 year old lady yesterday morning for sciatic symptoms and she REALLY appreciated the fact that I generally treat with people clothed. Being able to move her around going from assessment to treatment and back to assessment and also have her be an active participant without working around draping is so unbelievably helpful.
"The body is built to move and people need a lot more of it especially as we age." - So true, and this is where Thai Massage really shines. Being able to work on fully dressed people is an added bonus that some really appreciate, as you found out. Doing Thai Massage on undressed people with sheets would be seriously impractical and less effective.
Some nice techniques in this module for larger people. I’m all thumbs when it comes to using knees and feet! It is so difficult to sense what is going on when using those tools. I can see myself using my knees eventually but I don’t have a lot of large clients so I’ll just have to “force” myself to use them so I can get used to having more control. I had a personal trainer friend come over so I could practice…he didn’t tell me that he trained his legs the other day and where very sore from the workout. We had to go very gentle…that was fun with my lack of control especially with the feet 😆 It’s so funny how awkward using body parts in an unfamiliar way can be 😂
Knees and feet do take practice and time to feel something with. What I recommend is that you don't worry about using the techniques on large people. Instead try to use knees and feet in a very gentle way. If you get good at using them in a gentle way, it is very easy to add pressure later on. But if you start out using them as power tools, it is actually much harder to feel with them in that way. It is possible to use knees and feet in a very gentle way, and that's what teaches you best how to use them.
Once you develop more sensitivity and control in them, then you can use them as power tools as well, but don't start out that way.
I really like the hip pie concept. It makes it very easy to remember to work the hip in multiple positions without really having to think about the positions themselves. I already have enough things rattling around in my head to keep track of so any tricks like the hip pie are very welcome 😂
Pretty straight forward stuff in this module. I already do similar work for the adductor group as it is very often needed in most people. It’s quite common for me to find adductors short and over active and the glutes under active with the TFL and piriformis compensating for the under active glutes. Finding ways to effectively work on the adductor group without the client being naked and in a vulnerable position was one of the factors that lead me to Thai massage.
I went for my first Thai massage last week and the therapist performed the blood flow restriction technique but I didn’t experience much. I have pretty muscular legs so I’m guessing she didn’t apply the technique quite correctly to get deep enough pressure. She was definitely not an aggressive therapist…the whole session didn’t feel like a lot 😂 It did reveal some movement asymmetries in my body that I wasn’t aware of that I can now address!
I really liked the anterior hip work to help relieve that common pinch people get when flexing the hip. We just need to be careful that we aren’t detailing with an impingement issue at the rim of the acetabulum and the neck of the femur. Some people have bony defects or labral issues that will make hip flexion and adduction a very painful experience that is not soft tissue related. I used many of these techniques this morning after a personal training session and my client needed some work in her glute area. The stretches compliment the neuromuscular therapy work so well. Such good tips for dealing with larger legs…I don’t know how I’ll ever keep these nuggets in my head 😂
With regular practice, those nuggets will become part of you. I know that from my own experience.
It sounds like you had a fairly bland Thai Massage session. If the blood stop technique is not done correctly, it feels like nothing is happening at all, and it leaves the client wondering what this is all about. I have received my share of such sessions.
I have to say, I really enjoy your lectures, Shama. You explain the techniques so well. Module 7 had some tricky movements like the double forearm circling on the leg…that one is going to take a whole lot of practice! I already incorporate the large hip circle going through slices 6-3 to bring movement into the hip—it’s great. So many people have hypomobile hips! If the hips don’t move well, the lumbar spine and the knees have to make up for it and that causes all sorts of problems in those areas.
I’m familiar with most of the techniques in this module since I’ve had to figure out how to treat people’s glutes while they are clothed. Clothed people makes the side lying position so easily accessible I use it all the time! In fact, I used this very position and techniques with my personal training client this morning. I have moved away from my thumbs for deep pointed work and I use a wooden pressure tool. I palpate with my thumbs and then use the tool to apply the techniques. The thumb joints are simply not designed for that use and will eventually become damaged and arthritic—no good! Many a manual therapist’s career has been cut short from damaged thumbs. I’m really not sure why more therapists don’t treat hips this way. It is far better than treating a naked and draped client for so many reasons. Many therapists shy away from treating the glutes because in traditional western massage it is just too intimate and awkward for many to deal with.
"The thumb joints are simply not designed for that use and will eventually become damaged and arthritic—no good!" - My own Thai Massage career was almost ended very early on because I implemented tons of thumbing movements that we were taught in the Thai Massage schools. I learned from that experience with a severe thumb joint infection and made sure that I taught more therapist-friendly techniques in my school and skipped most of the intense thumbing ones - or at least provided alternatives.
So, I have been doing much of the side lying work you presented during this module. The rocking techniques are great and I have to remember to incorporate them! The thing I have never done is work the hip from the other side. It just never occurred to me LOL I’m not so sure about the technique where we scoot under the clients leg…my wife was fine with it but that is a pretty intimate position that I wonder if some people would not be very comfortable with. I do a very similar position on the table, however, and have never had an issue. I like it since it puts the glute max on a stretch which helps to intensify the work if needed. I’m glad you reinforce the idea that many of these techniques are going to feel awkward and uncomfortable at first and that is normal and OK. This is something I really struggle with. There is a saying and I’m paraphrasing, but it goes along the lines of you must be willing to be a fool in order to become and expert. Practice, practice, practice.
"...you must be willing to be a fool in order to become an expert." - I haven't heard that one, but I get it and I know similar sayings from various cultures. In my experience, the clients don't mind those more 'intimate' positions as long as they trust you and feel and know that you really care about their health and well-being.
Typically, the ones who are worried about this are almost always the therapists, not the clients.
Shama Kern said
Typically, the ones who are worried about this are almost always the therapists, not the clients.
In school, we were made to be so absolutely paranoid about anything that could be construed as sexual or could expose the client in any way. Many of my classmates would not work on glutes or pecs because of it and they would drape so conservatively around the legs that the upper half of the thigh would remain covered.
I know, that's a western paranoia. In Thailand they don't even mention anything about this in the massage schools, and as a result nobody is paranoid about this issue. That's quite refreshing, really. Neither the clients nor the therapists in Thailand are concerned about this 'private parts' or 'sexual area' issue. And it is not an issue anyway since the vast majority of therapists in Thailand are women.
The circular hip stretch at the beginning is amazing! This is a perfect technique for the many people I see who have pelvic out flares and/or up slip. This movement simultaneously gaps the SI joint by moving the leg into adduction and then the tractioning on the straightening component pulls the innominate down. I’ve used it twice on clients already. Amazing ❤️ Lots of good hip flexor stretches in this module, but I think my favourite one is the sitting on the client in prone. Getting a good, isolated hip flexor stretch is always a challenge because the restriction often ends up coming out in the lumbar spine. How best to well stabilize the lumbar spine while lifting a heavy leg into extension 🤔 Sit on the butt, lift the leg with both hands and lean back. Genius! Those two movements alone are almost worth the price of admission 😂
Another fabulous course, Shama. It is really helpful to see a session all put together as it offers a nice foundation to start putting things in place. Once a basic set of techniques can be strung together and practiced it can open the door to adding in other techniques and improving the flow. Lots to work on for sure but I’m confident my hip patients will appreciate this work. See you soon in the back course!