Clinical Evaluation of Client C, #1.1

Client C
6'1, male, 49
Diagnosis: no problems, no medications.

Subjective:
- piano player, music school teacher (elementary level)
- requested work on lower back, inner thighs, ankles, and calves

Observation:
- very stiff SCM
- relatively tight in both traps, but greater tightness in R trapezius
- tight levators
- tenderness in L inner thigh area (semimembranosous + gracilis, is that you guys?)

Assessment:
- focused on therapeutic techniques, some relaxation.
- relaxation: deep tissue on arms, lower back and hips (noticed some glut tightness afterwards). hearty hand massage for his piano hands.
- therapy: trigger point on SCM near mastoid process and trigger points in R trapezius. cross-fiber friction for levators, passive arm movement for pecs major/minor. passive rib cage movement, timed compressions to PSIS/sacrum. moved client to side-lying positions for tenderness in inner thigh area.

Plan:
- get up and stretch after piano lessons!
- do this stretch: sit on the ground and stretch legs apart as far as they can go without strain. drag knuckles along tender inner thigh areas in the direction towards/away from the pubic area. then try to touch toes in this position. *should help inner thigh muscles relax & activate lower back muscles*

---

One of my funnest clients to date. He actually let me do abdominal work on him, which is unusual for a first time client. He asked lots of great questions about what I was doing and what he could do to help. Next time I'd love to do more abdominal work on him and maybe some active stretches for his psoas musles.

For men it is especially important that I do side-lying massage when working the inner thighs. Not only is it important to get all that anatomy facing away from me, it's also a lot easier to reach the thighs, and clients feel less threatened when their top leg is in the way of all that "stuff". I really need to work on more men so I can get used to the anatomical differences, of which there are many!