Posterior: Hand, Arm & Back

POSTERIOR TECHNIQUE:
Hand, Arm & Back (Right Side Only)

1. Palm of the Hand:

Practitioner Position:

Stand at S3. Use both your feet on recipient’s palm.

Sarga Wrapping Technique:

Double or Single Shoulder Wrap.

Stroke Direction & Foot Mechanics:

Use your big toe and pad of the foot on recipient’s palm with pressure moving down and out, opening tissue of the palm like a book. If able, you may slide the recipient’s thumb between your big toe and second toe to work on the thenar eminence.

Target Tissue:

Palm of the hand, thenar eminence, hypo-thenar eminence.

Considerations & Contraindications:

Do not apply direct pressure on the wrist joint or stand with full weight on the fingers. Be careful not to direct pressure towards the wrist, causing it to bend.

2. Forearm:

Practitioner Position:

Stand at S3 facing the head of the table. Standing foot left, working foot right. Stabilize the recipient’s hand by lightly pinning the fingers with your toes/ball of your standing foot while using your right foot to work on the forearm.

Sarga Wrapping Technique:

Double or Single Shoulder Wrap.

Stroke Direction & Foot mechanics:

Begin slightly above the recipient’s wrist with the pad of the foot, work up towards the elbow and pivot (heel out) around the middle of the recipient’s forearm, ending with your lateral arch before the elbow. To come back down, pivot back and forth on the lateral arch of your foot, working towards the wrist, or simply pick up and begin again above the wrist.

Target Tissue:

Forearm flexors.

Considerations & Contraindications:

Do not apply pressure directly on the wrist or the elbow joint!

3. Upper Arm:

Practitioner Position:

Stand at S2 in the space between the torso and the upper arm of the recipient. Standing foot left, working foot right.

Sarga Wrapping Technique:

Double or Single Shoulder Wrap.

Stroke Direction & Foot Mechanics:

With your working foot externally rotated at a 45 degree angle, contact recipient’s superior deltoid with your heel and gently roll the deltoid tissue up and over the head of the humerus, always staying lateral to the scapula. When you begin to contact the posterior deltoid, turn your foot parallel with the recipient's spine. Continue this stroke with the full plantar surface of your foot down towards the foot of the table.

Target Tissue:

Posterior deltoid, triceps.

Considerations & Contraindications:

Watch the spine of the recipient’s scapula to make sure that you are not taking tissue laterally. Work gently in this sensitive area. Do not let the heel drop down to the nerve plexus of the medial upper arm.

4. Back:

Practitioner Position:

Stand at S1 facing the foot of the table at an angle with your standing foot against the recipient’s shoulder/upper arm. Standing foot right, working foot left.

Sarga Wrapping Technique:

Harness / Double or Single Shoulder Wrap.

Stroke Direction & Foot Mechanics:

Begin at the lower angle of the recipient’s scapula. Working transversely, take tissue laterally to medially, working towards the spine with the leading edge of your heel, completing a half-chevron (See "Chevroning" in terminology). Your forefoot will cross the spine with little to no pressure. This is a very slow, oblique, high friction stroke! Repeat 4-6 times moving inferiorly towards the sacrum. At the lower ribs, begin to target lateral iliocostalis and quadratus lumborum. Continue over the top of the sacrum and finish with slight traction. Do not compress the lumbar spine with downward pressure; it is important to target this area with oblique contacts.

Target Tissue:

Erector group, latissimus dorsi, thoracolumbar fascia.

Considerations & Contraindications:

Do not apply direct downward pressure on the secondary curve of the lumbar spine, especially when the recipient has lower back considerations (See Bolstering & Recipient Body Positioning). Bolster appropriately if the recipient has large breasts or breast implants.