Procedure’s

Question 1

Table set-up steps

Answer 1

1. Sanitize table and pillows
2. Put on first sheet and tie knots at the ends to secure the sheet
3. Place a small towel at the head of the table
4. Place one pillow where the abdomen will be and one pillow where the feet will be.
5. Place second sheet on top. You can use a blanket as well if client is cold.
6. To check the height of the table, therapist should stand at the side of the table with arms at their side, and rolled knuckles. Knuckles should be able to rest on top of the table for correct height.
7. Ensure all sheets are neat and clean

*remember to remove these pillows when rotating a client

Question 2

Hand washing steps

Answer 2

1. Roll up sleeves and remove jewellery where the bacteria can be trapped behind
2. Adjust water for washing hands to warm not hot enough to remove oil and not cold enough for micro organisms to survive
3. Lather and foam soap really well
4. Clean under fingernails as needed do not use a brush. Nails should be cleaned once a day or as needed.
5. Wash up to your elbows adding more soap if needed. keep hands lower than elbows at all times. Briskly using frictions and rotary motions are more effective than back-and-forth rubbing. Rub in between fingers knuckles and the outside surface of the fifth digit as well as the ulnar border of the hand.
6. Rinse starting at the elbow
7. Dry arms and forearms thoroughly by blotting not rubbing to maintain skin health and avoid cracking
8. Use the used paper towel to shut off faucet and to open the door
9. Use hand lotion for your skins integrity
10. Wash lotion bottle as well. Keep exit pump clear so bacteria does not travel up into lotion
11. Keep gloves and finger cots handy to use if you have cuts or rash on hands or finger.

Question 3

Additional hygene steps

Answer 3

• Always use clean linens for each new client
• Store clean and used linens separately
• Used linens stored outside of room or in a container with a lid
• if you have a cold or contagious condition wear a mask when treating your client or reschedule. Dispose mask in sealed plastic bag.
• if you or the client needs to blow their nose the person who used the Kleenex should dispose of it
• use the same procedure if client has a nose bleed or any cut that bleeds.
• Open window and regularly air out the room to disperse airborne germs and dust
• regularly clean fans, air conditioners and anything else that moves the air

Question 4

Static holding steps

Answer 4

1. Undrape leg securing sheet under the leg and talking into inferior edge of the clients underwear
2. Palpate muscles of the thigh, then calf
3. Feel the Achilles tendon at the back of the heel
4. Palpate both legs for any differences in temperature, texture or tension

Question 5

Positioning client steps

Answer 5

1. It is important to carefully instruct your client on where to undress and how you would like them to position themselves on the table so they are correctly positioned and ready when you walk in the room.
2. Prone – position the client face down with a pillow under the abdomen and a pillow under the ankles. The face cradle should be positioned so that the neck is in neutral position. If there is no face cradle offer them a pillow. For large breasted women a towel can be rolled and placed under the clavicles and shoulders to relieve pressure.
3. To rotate the client from prone to supine you must first remove all the pillows. To ensure the client is not exposed hold the sheets to one side of the table with your thighs, make a tent with the sheet at the level of the upper back and lower leg. Then you can have the client turn over onto their back. Replace the pillows that have been removed.
4. Supine – position the client supine with a pillow under the knees and one pillow under the head.

Question 6

Back massage steps

Answer 6

1. Before on draping perform static holding over the sheet. This will establish touch. Place hands on both the sacrum and the posterior neck. The hand should conform to the shape of the client. No movement or additional pressure is applied to the body, only the weight of the hands.
2. Undrape.
3. Apply oil in the palm of the hand with back of hand touching client (do not lose contact with client from here on out). Spread oil all over back.
4.  Effleurage - remember your proper posture. Ask client if pressure is okay.
5. Palmar kneading - retain proper posture. Ask client if pressure is okay.
6. Open C kneading - proper posture. Ask client if pressure is okay.
7. Winging - proper posture. Ask client if pressure is okay.
8. Effleurage - always end with effleurage.
9. Soothing stroking
10. Re-drape the client
11. Static holding (repeat step #1)

Question 7

Posterior leg massage steps

Answer 7

1. “Rocking” (static holding of the leg) is done before undraping. Please both hands on the side of the clients leg. Gently push the clients leg mediately. Release and allow the client to passively fall back from the midline. Repeat this movement all the way down the leg.
2. Undrape

3. Effleurage

4. Palmar kneading.
5. Open C kneading
6. Wringing
7. Thumb kneading of the Achilles tendon
8. Effleurage
9. Soothing stroking
10. Re-drape

Question 8

Anterior leg massage steps

Answer 8

1. Rocking
2. Undrape
3. Effleurage
4. Palmar kneading
5. Open C kneading
6. Finger kneading around ankle
7. Wringing
8. Effleurage
9. Soothing stroking
10. Re-drape

Question 9

Foot massage steps

Answer 9

1. Effleurage
2. Thumb kneading around the ankle
3. Muscle squeezing
4. Breaking bread
5. Thumb kneading of metatarsals
6. Palmar kneading
7. Knucke kneading sole of foot
8. Knuckle kneading arch of foot
9. Knucke kneading heel of foot
10. Rotate ankle clockwise and then counter-clockwise
11. Rotate forefoot medially and then rotate it laterally
12. Toe kneading
13. Toe flexion
14. Effleurage

Question 10

Arm massage steps

Answer 10

1. Drape the client properly
2. Muscle squeezing before applying oil
3. Effleurage full arm
4. Supinate the arm and perform thumb kneading on inferior half of the arm
5. Pronate the arm and perform effleurage on inferior half of the arm
6. Muscle squeezing
7. Supinate the arm. Thumb kneading of the hypothenar eminences.
8. Thumb kneading to the palmar surface
9. Thumb kneading of the wrist.
10. Breaking bread
11. Pronate the arm and perform thumb kneading of the metatarsals.
12. Thumb kneading of the fingers
13. Thumb kneading of the dorsal surface of the wrist.
14. Finger stretching
15. Effleurage
16. Soothing stroking of the arm
17. Re-drape