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The larger muscles of your clients’ lower extremities, such as the gluteal muscles, quadriceps and hamstrings, are very strong, particularly when compared with the muscles of the upper extremities. Yet, many manual therapists work extensively on large muscles by applying pressure with their palms or grasping tissues with their open hands.

If your client has significant muscle guarding or hypertonic muscles, and you attempt to overcome this resistance using your hands, this is a battle you are likely to lose.

Your hands stand at least a fighting chance to get through the small muscles of your client’s neck or upper extremity, but you should not wear them out on large, guarded or hard muscles. When working on these large muscles, use your knuckles, fists, forearms and elbows rather than your fingers or thumbs, and avoid using your hands to apply pressure or grasp large muscles.

Keep in mind that it may be easier to loosen tight or guarded muscles with an ultrasound or vibrating massager (depending on the situation and scope of your practice) before going in with your hands.

Reproduced with permission from Save Your Hands! The Complete Guide to Injury Prevention and Ergonomics for Manual Therapists, Second Edition, , C.E.A.S., and Richard W. Goggins, C.P.E., L.M.P., © 2008 Gilded Age Press. For more information, visit www.saveyourhands.com. Read their blog here.

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