. A manual of therapeutic exercise and massage, designed for the use of physicians, students and masseurs. Fig. 38.—Muscles of the right lower leg; seen from outside. If they need special attention, as they frequently do, thekneading between the thumbs or knuckle kneading will bemost useful (see Fig. 38). 106 APPLIED MASSAGE Abdomen.—For abdominal massage the patient lies on theback with the knees somewhat flexed and supported by apillow. The operator stands on the right side of the is wise to begin with \ery gentle movements becausemany patients are in the beginning rather sensitiv
. A manual of therapeutic exercise and massage, designed for the use of physicians, students and masseurs. Fig. 38.—Muscles of the right lower leg; seen from outside. If they need special attention, as they frequently do, thekneading between the thumbs or knuckle kneading will bemost useful (see Fig. 38). 106 APPLIED MASSAGE Abdomen.—For abdominal massage the patient lies on theback with the knees somewhat flexed and supported by apillow. The operator stands on the right side of the is wise to begin with \ery gentle movements becausemany patients are in the beginning rather sensitive and reactwith muscular spasm to any manipulations which are toostrong or quick. We begin frequently with MitcheHs intro-ductory massage: The operator puts both hands underthe patient until the fingers meet in the lumbar region, anddraws the hands forward, compressing and lifting at the. Fi(}. 39.—Effleurage of abdomen. same time till they meet in the middle line of the abdomen(Fig. 39). This movement is repeated several times andusually followed by a few gentle stroking manipulations overthe flanks and the middle abdomen. Then kneading is donein a systematic manner over the whole of the abdomen,beginning at the right lower quadrant. This is done for thelateral parts by the left hand pushing and lifting the flankingmuscles and viscera up and forward, while the right hand,especially the heel of the palm, describes kneading, rolling,and grinding movements. These manipulations are at firstsuperficial, but become gradually deeper, until one hand can ABDOMEN 107 distinctly feel the other through the abdominal wall when thepatient is not too fat (Figs. 40 and 41). In spite of the
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