In this Post: A good upper body massage routine is critical to providing clients with the work they need. With so many complaints about neck and shoulder pain, it is important we master these areas of the body if we want to have a successful massage career.
What is the one area of complaint your clients most want addressed? I would be willing to bet “neck and shoulders” is the response you hear most often. With so much computer use, driving, and general “hunched overness” in today’s modern world, the number of clients who come in complaining about their neck and shoulders is astronomical! That is why I have put together this upper body massage routine.
Because so many people suffer from tightness in their upper bodies, we must learn routines that help address all of the muscles associated with these conditions. In the following sample routine, I make sure to have you address the muscles of the rotator cuff, neck, and the often neglected pecs.
Far too often, I see therapists neglect the pectoral region of the body. I get it. It is a little intimidating to massage around breast tissue. But the thing is when you avoid these muscles, you are doing your clients a huge disservice!
They Told Me I Needed Surgery
A few years back, I was struggling with severe pain in my neck, bicep, and rotator cuff. I began going to a physical therapist in my area. First, this PT thought I had bicep tendinitis, but after further evaluation, they determined that I had a tear in my bicep and informed me that I would most definitely need surgery.
I was devastated. How was I going to support myself financially if I couldn’t massage? How much recovery time would I require? I quickly began spiraling into a depression until I was given the advice to get a second opinion.
And so, before going to a surgeon, I went to a different PT. One who came highly recommended. This PT examined me and determined that he saw no evidence that I had a tear in my bicep, or that I had bicep tendinitis, or that I needed surgery. Instead, he spent an hour working on my pec muscles, opening up this neglected muscle group. By the time I left his office, the pain had decreased by about 90%, my range of motion was increased, and the depressive haze was lifted.
This experience was hugely educational for me. I had been taught the importance of pec work in school. That when clients complained about neck and shoulder pains, we should spend focused time on the front of the body. But never had this rang more true for me than at that moment, here I was thinking I needed surgery when all I needed was some gentle, yet effective pectoral attention. How simple.
Another lesson I learned through this experience was about staying within our scope of practice. The first PT I went to, never should have told me that I needed surgery. Not only were they wrong, but they sent me into a dark space. A space of fear and insecurity, one that could have easily been avoided if they had practiced a bit more sensitivity.
And, the last lesson I learned was to ALWAYS get a second opinion before panicking! There is no use in getting yourself worked up until you know for sure what your diagnosis is!
All that being said, I hope this sample neck, rotator cuff, and pec routine helps you fine-tune your upper body techniques. I hope you become more comfortable addressing muscles you tend to neglect!
Upper Body Massage Routine
- Start with the client in supine.
- Begin with broad BL strokes, moving from the lateral edge of the scapula towards the spine and then up to the occiput ridge. Repeat this step 2-3 times.
- On the last stroke, rest the client’s occiput on your fingertips. Point your fingertips towards the sky so that you create a shelf for the client’s occiput to rest. Hold this position for 1 minute.
- Utilize PROM and put your client’s head in lateral extension.
- With the palm of your hand, implement broad strokes from the base of the skull all the way down to the lateral edge of the clavicle.
- With fingertips begin striping the scalenes.
- While still focusing on the scalenes, stop when you feel restrictions. Apply firm but loose pressure on the restriction while you gently rotate the client’s head toward the restriction. Repeat process until you no longer feel restrictions.
- With the client’s head still in lateral rotation, pincher palpate the SCM, starting from the base of the skull and moving toward the clavicle.
- Repeat steps 4-8 on the opposite side of the body.
- End the neck sequence with the same broad BL strokes you utilized to open the neck sequence.
- With broad strokes, use the palm of your hand to open up the pectoral muscles on one side of the body. Slowly and steadily work medial to lateral.
- With fingertips, apply light friction on areas of the pectorals where you feel restrictions.
- On the lateral edge of the pectoral major muscle, grab the muscle and pincher palpate it.
- Place your hands under the client’s scapula and point your fingers toward the sky as you implement friction to the rhomboid muscles.
- Gently pull the scapula out laterally.
- Place your fingertips on the subscapularis as you have your client perform AROM, where, with their elbow in flexion, they rotate their arm medially.
- Apply steps 11-16 to the opposite side of the body.
- Have your client flip over to the prone position.
- Begin with some basic effleurage strokes across the entire back.
- Using your forearm apply pressure starting from the top of the rhomboids all the way down towards the iliac crest. Make sure to avoid boney landmarks such as the edge of the scapula and the spine. Repeat this step once on one side of the body.
- Starting inferiorly, use your elbow to follow the medial border of the scapula.
- Knead the infraspinatus, teres minor, and teres major.
- Apply cross-fiber friction to the infraspinatus and teres minor.
- Abduct the client’s arm to a 90-degree angle and allow the elbow to rest in flexion.
- Utilize broad strokes from the proximal edge of the humerus, down across teres minor and major, and across latissimus dorsi.
- Using your fingertips palpate along the lateral border of the scapula.
- Dig your fingers into the subscapularis and hold this position for one minute.
- Repeat step number 25, to “make nice” with the tissues.
- Return the client’s arm to an adducted position.
- Repeat steps 20-29 on the opposite side of the body.
- Finish with effleurage strokes across the entire back.
After completing this routine, your clients will walk away feeling more open and free of restrictions. There may be some areas that are a little sensitive to the touch, as this is deep work on muscle groups that are not used to being manipulated. That’s okay. It’s important work!
