When you massage the glutes....

[prusa1237]

Wow. This thread is awesome. Full of thoughtful responses and various options. Here are my variations on the suggestions mentioned above.

Asking client for permission prior to start of massage:
With new clients, as part of the intake process, I ask them a number of preference questions: 1.Would they like unscented or scented massage oil 2. Would they prefer to begin their massage face-up or face down. 3. What level of pressure do they prefer? 4. Are there any areas of the body more tense or sore than another, and therefore in need of special focus during the session? 5. Lastly, I mention that some clients like to have their hips and abs included as part of the massage and others don’t. I ask them their preference, stating that either way is fine with me. At this point, if they’ve never had their hips or abs massaged before, they’ll ask about the benefits. It’s a great opportunity to educate and relate it to any problems they noted on their intake form (i.e. low back pain, constipation , etc.) As part of a conversation on preferences, this question seems very natural. Also, there’s no pressure for the client to answer one way or the other. For those of you who might wonder why I say “hips” instead of “gluteals”, I find that to the layperson, “hips” and “gluteals” mean the same thing. Also, for some of my older clients, they don’t know what “gluteals” means.

Technique for working over the sheet:
If a client is wearing underwear, I choose to work the glutes through the sheet. My reason: I believe you can do equally effective work to these muscles through the sheet as you can directly on the skin. I begin with some compression/cat paw and gentle rocking to the gluteal muscles. I then move into specific trigger point therapy work around the greater trochanter, iliac crest, sacral border, and muscle belly. I follow up with some more compression/cat paw and rocking to soothe the muscles (trigger point therapy can be intense). I repeat this technique for the other side. I then stand on a footstool next to the table, beside the hips. Facing the feet, I place one hand on each glute, the heels of my hands along each side of the sacrum. I then do alternating deep compression to one glute and then the other. I move my hands outward toward the greater trochanter and then back again to the sacral border. Next, I place my hands (one on top of the other) directly on the sacrum and compress down. Holding the compression, I move my hands in a slow circle, first clockwise and then counterclockwise. This massages all the borders of the sacrum, warms the sacral fascia and stimulates the cranial-sacral fluid flow. You can experiment with various sacral compression techniques here – alternating pressure on one side of the sacrum and then the other. You can also hit the acupressure points (on either side of the sacrum and in the sacral fossa). Finish with steady pressure on the center of the sacrum again, and then lift your hand until there’s barely any pressure and gently begin rocking your hand. The rocking motion will first move the client's sacrum and hips and usually your whole client’s body will follow in a rocking motion. I use this technique at the end of the prone portion of the massage session. Clients love it! (If you want more training in techniques through the sheets for the whole body, take either a chair massage class or shiatsu. Both teach fully clothed techniques that can be adapted when necessary for table massage).

 

[forgetful]

Grat thread!

I don't ask to perform work on the gluts. I definitely don't ask the client to move their underware. I just do what is needed.

In the initial intake, I have found clients will let me know if they don't want something specific, but I do a pretty thorough intake.

The only time I don't do much glut work is when they are wearing jeans. I do have a few clients who only get upper body, and always leave their jeans on. However, I will work the sacrum through the jeans on these clients. For these particular clients I do not press the issue, as I feel they will eventually let me know when they are ready for more work.

I may perform glut work in a number of ways, but here are my most common:

Usually my clients are fully unclothed and draped. I do have a few that wear their undergarments though.

For those that wear their undergarments, I tuck into the waistband and pull the underware down specifically so that I can get low into the lower back. I then re-arrange the waistband to it's natural fall and re-drape the back working through the sheet into the gluts and sacral region.

Many clients who are unclothed will also recieve the over the sheet method, as I do usually get pretty deep in this region for a number of people.

For those who are not wearing undergarments and I am working directly on the skin: I usually undrape the leg and work up into the gluts. See comment here. Sometimes however, I will undrape the entire gluteal area and just cover the cleft. Other times I work from the lower back into the glut, by triangular draping of the sheet downward to expose the glut from the superior to inferior and keeping the cleft covered.

Hope that helps.

 

[Defense Devil]

I am sorry, but reading the post in regards to massaging the glutes, when you said that you face the feet and place your hands on the glutes..are you touching both sides at once,

We are learning in school here, that you do one side first and then move to the posterior leg, or go to the other side and redrape for glute works.

I just want to clarify the two hand glut thing, your not cupping the glutes are you???

 

[Sal B]

It's amazing how every school seems to teach their students so differently !

We are taught from day one that you NEVER ask permission to do glut, ab or pec work while your client is on the table...never. The reasoning is because when laying on a table in their underwear, or less, your client is in a position of vulnerability and you are in a position of authority over them. Not great conditions for asking anyone about sensitive areas or issues.
We are told to sit down, at eye level, with out clients BEFORE they get undressed or get onto the table and discuss every detail of what they expect, what areas they want done, what areas they prefer not to have done..and it is at that time that these specific areas should be brought up...when you and your client on are even ground.

As for draping and technique ( we have no choice in the matter in class...everything gets massaged on us if we're comfortable or not )....we are taught to always drape down to the gluteal cleft and to tuck the top of the sheet into the top of the underwear. If their underwear covers the top of the gluteal cleft, it is discreetly pulled down and tucked in so that just the top of the cleft is visible. The upper fibers of the glutes and top of the iliac crest are included in the back sequence.
The rest of the glutes are done while working on the leg...bringing your drape up, tucking it into the bottom of the underwear and pulling them high enough to expose the muscle ( wedgie ), then tucking it under the leg you are working on to completely cover the cleft and groin area. Thank god for those who wear thongs!

I have been lucky enough to be able to do most of my practice hours on our Jr hockey team...and since they over use their hip flexors and glutes so much they have no reservations at all about having their glutes done. Now...if I could convince them to wear thongs instead of boxers we'd be in business ! :wink:
The one drawback is that it is impossible to keep the sheet at the top of the gluteal cleft with the overdeveloped glute muscles these guys all have...gets very frustrating having to keep pulling the sheet and their underwear/shorts back down all the time. Since they are all 17-20 years old...they are a little uncomfortable with the idea of going without anything on under the drape.

 

[XEricac702X]

We are taught to get informed consent before the person is on the table and before we start to work on them. Basically we tell them the areas that we can work on them and ask them if there are any areas that they want skipped or are uncomfortable with us working. This is their chance to let us know their desires and comfort levels. What I have found is that if someone says that the gluts are okay they will typically remove their undergarments. If they do not then I personally just work over the undergarments and do not ask them to move them. My belief is that they left those on for a reason, and in my other work as a labor doula I have found that people do things for reasons and they keep that barrier up for a reason. In my eyes if they leave their underwear on they want the barrier and I would NEVER ask them to move them.