Date: 25/04/19 – 0900

Location: Sports Therapy Clinic

Duration: 1 hour

Reflective Summary

I hadn’t carried out any sports massage during the Easter holiday period – nearly two weeks.  It took me a little while to get into the flow of things – remembering the correct height of the couch so that it was comfortable for me when massaging my client, and a routine of the massage techniques that I was going to use.  It is good to have a break but it clearly demonstrated to me how quickly you can forget your skills and lose a bit of confidence.  Regular practice is very important.

My client had been to the gym during the last 48 hours and completed weights resistance workout.  He hadn’t cycled for two weeks but just wanted a general sports massage of his legs.  We discussed whether there were any contraindications but my client was well and confirmed that he had no allergies.

I prepared the couch, washed my hands before beginning the sports massage. I asked my client lie on his front in the prone position so that I could massage the calf and hamstring muscles.  I placed a bolster under his feet and ensured that he was comfortable.  I covered him with a towel, but with the right leg exposed.  I warmed up the massage cream in my hands and warned my client that I was about to massage his left leg.  I began with effleurage along the complete length of the leg until erythema was present and checked with my client regarding the pressure applied.  I progressed onto petrissage and tapotement (hacking and beating).  I palpated the calf muscles and found trigger points on the lateral side of the calf.  There about two small trigger points. I applied the Neuromuscular technique (NMT) to breakdown the trigger points.  I communicated with my client regarding pressure (discomfort level ranging from 1-10) and he let me know when the discomfort eased (on average after 20 seconds).  I repeated the technique until each trigger point disappeared.

I palpated for trigger points on the hamstrings but the muscles felt good.  There was tension on the lateral side of the upper leg, so I turned my client onto his left side, with me positioned behind him to ensure that he did not fall off of the couch.  The under leg was bent resting on the couch and the top leg was straight, supported with a bolster underneath his knee.  I applied deeper effleurage strokes up the outside of the thigh along the ITB and Tensor Fascia Latae to stretch and ease out the tension.  When I finished I asked my client to return to lying in the prone position on the couch.  I pulled the right leg out and shook it to relax the leg and finished the massage with light effleurage strokes.

I repeated the same techniques on the left leg.  Again there were trigger points on the lateral side of the lower leg and these were eased out with NMT.  There was also tension on the lateral side of the upper leg, so I performed deeper effleurage strokes with the client laid on his side.  I finished massaging the upper leg with light effleurage strokes.

My client turned onto his back and I placed a bolster under his head support his neck and head and under his legs behind his knees to support his lower back.

I ensured that my client was comfortable and the towel was draped so that his left upper thigh was exposed.  I applied effleurage, petrissage and tapotement.  I could feel tension in the rectus femoris and vastus lateralis.  During palpation I found three trigger points and they were more sensitive than those found on the lateral side of the lower leg. I applied NMT and worked on each trigger point until they were smoothed out.  I applied deeper massage strokes up the upper thigh to lengthen and stretch the muscles and ease tension.  I finished the massage with slow, relaxing effleurage strokes.

I repeated the same routine of massage techniques on the right leg. The trigger points were more sensitive on the right thigh so I took care not to cause the client too much discomfort to the point that it was painful, communicating with him throughout the massage.  I completed the massage with light, relaxing effleurage strokes.

I had intended to apply and MET (PIR) technique, however I ran out of time.  The massage techniques used however adequately eased tight muscles and trigger points.

I helped my client off of the couch and advised him to drink plenty of water throughout the day and not to do any high intensity exercise the following day.

Areas for further improvement and action plan

Continue to improve my anatomy knowledge

Continue to practise all of the soft tissue techniques.

Returning to reflections at a later date