Anterior: Legs

ANTERIOR TECHNIQUE:
Leg (Right Side Only)

1. Lateral Lower Leg, Proximally & Distally:

Practitioner Position:

Stand at S5 facing the head of the table. Standing foot right, working foot left. Secure recipient’s plantar surface of the foot against the medial surface of your standing leg.

Sarga Wrapping Technique:

Double or Single Shoulder Wrap.

Stroke Direction & Foot Mechanics:

Start by working down the dorsal surface of the foot, ending around the lateral malleolus. Then work up the lateral lower leg to the lateral condyle of the tibia at the knee with your toes/pad of the foot working in a windshield wiper motion, pivoting at the heel. Switch to using your heel as the working surface as you come back down the leg, this time with the ball of your foot as the pivot point. Slowly move your standing leg forwards and backwards with the movement of the stroke, facilitating a pin-and-stretch as you work tissue down towards the table.

Target Tissue:

Tibialis anterior, fibularii, extensor digitorum longus.

Contraindications & Considerations:

Bolster beneath the knee, both to protect the knee from hyperextension and to neutralize the lower back. Be aware of any history of knee considerations.

2. Medial Lower Leg, Proximally & Distally:

Practitioner Position:

Stand at S5 facing the head of the table. Standing foot left, working foot right. Secure recipient’s plantar surface of the foot against the medial surface of your standing leg.

Sarga Wrapping Technique:

Double or Single Shoulder Wrap.

Stroke Direction & Foot Mechanics:

Work up the medial lower leg, from the medial malleolus to the medial condyle of the tibia and pes anserine with your toes/pad of the foot working in windshield wiper motion, pivoting at the heel. Switch to using your heel as the working surface as you come back down the leg, this time with the ball of your foot as the pivot point. Slowly move your standing leg forwards and backwards with the movement of the stroke, facilitating a pin-and-stretch as you work tissue down towards the table.

Target Tissue:

Anterior gastrocnemius, anterior soleus, crural fascia

Contraindications & Considerations:

Bolster beneath the knee, both to protect the knee from hyperextension and to neutralize the lower back. Be aware of any history of knee considerations.

3. Medial Upper Leg (Adductor Fan)

Practitioner Position:

Stand at S4, bracing the lateral side of recipient’s leg with the medial side of your left leg to keep it from externally rotating.

Sarga Wrapping Technique:

Double or Single Shoulder Wrap.

Stroke Direction & Foot Mechanics:

Begin above the medial epicondyle of the femur (around the midline of the anterior leg). Using a broad, flat forefoot, take the tissue medially and posteriorly down towards the table in a fan-shaped motion. Repeat this stroke as you work proximally, being sensitive to recipient’s privacy and comfort.

Target Tissue:

Quadriceps & adductor group.
Considerations & Contraindications:

Stay away from genital area. Do not use sustained compression on the femoral arterial compartment.

4. Top of Upper Leg (Quadriceps), Proximally:

Practitioner Position:

Stand at S4, bracing the lateral side of recipient’s leg with the medial side of your left leg to keep it from externally rotating.

Sarga Wrapping Technique:

Double or Single Shoulder Wrap.

Stroke Direction & Foot Mechanics:

Begin above the patella with the toes/pad of the foot. Work up the leg until the full plantar surface of your foot makes contact. When the heel makes contact with the medial edge of Vastus medialis, turn the heel slightly medially to create a torsion effect as you trace the tissue of the Quadricep group. Rotate your foot so that the lateral edge finishes below ASIS.

Target Tissue:

Quadriceps.

Considerations & Contraindications:

Bolster beneath the knee, both to protect the knee from hyperextension and to neutralize the lower back. Be aware of any history of knee considerations. Do not use sustained compression on the femoral arteries.

5. Lateral Upper Leg, Distally

Practitioner Position:

Take recipient’s forearm and place it on his/her abdomen. Stand at S3 facing the foot of the table. Standing foot left, working foot right.

Sarga Wrapping Technique:

Double or single shoulder wrap.

Stroke Direction & Foot Mechanics:

Begin at tensor fasciae latae, with the pad of your foot, working tissue medially and distally. Continue down the lateral upper leg with entire plantar surface of the foot affecting vastus lateralis and the IT band. Variation: A more lateral trajectory (with the heel of the working foot dragging on the surface of the table) will affect the IT band more directly.

Target Tissue:

Tensor fasciae latae, quadriceps, IT band, fascia lata.

Considerations & Contraindications:

Bolster beneath the knee, both to protect the knee from hyperextension and to neutralize the lower back.