or enlarged breasts, anterior surgical or medical equipment sites, as well as gestating bellies. There is less pressing into the table or face cradle for those with delicate skin, and soft, stable support for the potentially fragile bones and inflexible joints of the aging, injured or those with considerable postural deviation.
Alignment. Fortunately, there are many options on how to get your client comfortably on their side: pillows, specially designed support systems or a combination of both. A few principles for achieving a jointneutral arrangement and some tried-and-true steps to follow to get there will have your clients happily side-lying in no time.
Proper client alignment includes the following:
- Spine paralleling table length and near the back edge
- Space for the pectoral girdle
- Support under the hip and belly, especially important with a gestating or obese belly
- Firm and high supports under the ceiling-side leg to level off that hip, knee and foot
- Often, too, you’ll use comfort supports under the arm, lumbar spine and rib cage, as well as custom provisions for medical equipment, extreme kyphosis or other postural deviations
Availabe equipment for practicing massage in side-lying equipment has both advantages and disadvantages, and client comfort varies with all. Experiment and identify what works for you and, if you use this position frequently, try to develop at least two reliable methods to get your clients to side-lying position.
For example, most clients find the firm stability of the Side Lying Positioning System comfortable and reassuring. Alternatively, the most petite or thin clients might prefer only softer pillows.
Whatever equipment you choose, be ready to make adjustments for individual client needs. For example, clients with pelvic instability at the symphysis pubis often are more comfortable with supports between their legs of sufficient height to level the hip with the entire leg.
Additionally, clients who are living with cancer may appreciate rolled towels to make soft channels of cushioning on top of pillows for maximum “float” and fine-tuning of limb comfort. Practitioners of structural integration, too, often adopt a less-is-more propping attitude.
Draping. Securing the covering sheet for working on the back is relatively straightforward. Maximize access to the entire back with an L-shaped arrangement along the underwear line and the lateral side of the torso.
Anchor this by tucking under the tableside gluteals and thigh. Gaining access to the entire leg and hip is a bit more complex, but I have refined a U-shaped drape and the steps to get there that you can count on:
- Reach across the table for the opposite corner of cover sheet
- Slip that corner between the ceiling-side knee and its supports, from posterior to anterior
- Alternate pulling a U-shape up the lateral thigh and sliding the sheet gently along the medial thigh
- Tuck the sheet end into the U at the lateral pelvis
- Secure the drape under gluteals and thigh against the table
Therapist comfort. Some therapists are discouraged from regularly side-laying their clients because the positioning hurts their body. You need to remember your own alignment and consider working with a table adjusted to a higher height so you can efficiently shift weight in the more horizontally directed line of force that side-lying requires.
Positioning Yourself to Open New Markets
Being able to position your clients in ways different than simply prone and supine can help bring a wider variety of clients to your practice or help you more clearly focus your marketing efforts so you can reach the clients you’re interested in working with regularly.
First, however, you need to equip yourself well and then practice repeatedly to develop ease and grace in the steps of side-lying set-up, draping and client turning on the table. One way to do that is to recognize your current clients who might benefi t from the fresh perspective and novel approach this additional position provides.
Most therapists, for example, have a long-term client whose progress has plateaued. Getting a new angle on your work with that client might solve those stagnations, and give you needed experience and confidence in lateral recumbent work.
Then, point out the unique benefi ts of your sidelying positioning option when marketing your practice’s services. Some potential employment sites and locations to market your side-lying advantage to include:
- Retirement and skilled care facilities
- Radiation and other out-patient oncology treatment facilities
- Oral and cosmetic surgical facilities
- Midwifery and obstetrical practices
- Health and athletic clubs
- Professional and school sports teams
- Chronic pain or back pain treatment centers
- Treatment centers for PTSD and other mental health conditions
When thinking of special populations you might reach, start from your own natural interests. As the population ages, do you fi nd yourself more interested in working with older clients? Are you an avid athlete who would like to reach more clients like yourself with the benefits of massage therapy? When you develop markets that naturally correspond with your own interests, finding and marketing to these client demographics becomes less difficult.
Learning and actively using side-lying positioning gives you one more way to work with a wide variety of clients, from maternity clients to clients facing health problems to athletes. Soon, you’ll find clients and health care providers are eager to schedule with you and you’ll quickly become the go-to therapist in your area!