It is nearly always possible to find a position that is comfortable for the client, and also allows you to maintain your body in as near to a neutral posture as possible as you work. Position your clients so that the part of their body you want to work on is directly in front of you, close to your body, and facing up toward you. A good rule of thumb is to work only on the parts of the client’s body that you can access directly, both visually and manually.
To maintain near-neutral posture with the client in supine position, work on the anterior aspect of the body. In prone position, concentrate on the posterior aspect of the body. For example, with your client lying supine, you would work on the front of the quadriceps, but then move the client into a side-lying position to work on the iliotibial band. Reposition your client as necessary to ensure that you can remain, as much as possible, upright, with your joints aligned, without bending forward, twisting or reaching out in front of you.
Following this logic, avoid techniques that require you to put your hands or arms under the client’s body (such as working on the erector spinae muscles with the client in supine position); this type of technique requires therapists to support the client’s weight on their fingertips, which is very stressful for the practitioner’s hands and arms.
—Reproduced with permission from Save Your Hands! The Complete Guide to Injury Prevention and Ergonomics for Manual Therapists, 2nd Edition , C.E.A.S., and Richard W. Goggins, C.P.E., L.M.P., © 2008 Gilded Age Press, www.saveyourhands.com.