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21.8 • Kneading of lateral soft tissues side-

lying Stand at the head of the table and stabilize the patient's head with the front hand. Use the thumb and thenar eminence of the kneading hand to work on the tissues on the side of the neck to produce the kneading force.

Tips: This hold allows the anterior tissues to be worked as well as the lateral ones. Try varying the rotation of the head with the stabilizing hand to direct the effect of the technique to different layers and parts of the muscles.

21.10 • Kneading of soft tissues sidelying

Stand at the corner of the table slightly behind the patient and stabilize the head with the upper hand. Use the thumb and thenar eminence of the lower hand to work on the soft tissues of the neck.

Tips: Try using a rotation force at the same time with the head hand to emphasize the effect of the force applied with the kneading hand.

21.11 • Kneading of soft tissues sitting The patient sits with her legs over the side of the table. Stand in front of her and stabilize her head on your chest; use a suitable pad if necessary. Reach round her neck and use the fingertips to pull the soft tissues away from the spine on both sides simultaneously.

Tips: Try adding a sidebending movement at the same time to aid the muscle stretch effect.

21.12 • Kneading of soft tissues sitting The patient sits with her legs over the side of the table and her head is stabilized against your chest, suitably padded if necessary. Control her head with one hand and use the fingertips of the other to knead the soft tissues on the lateral and posterior parts of the neck.

Tips: This hold allows movements to be combined with the kneading as the head hand can control the directions more easily than if two hands are performing the kneading.

21.13 • Kneading of anterior tissues supine

Stand at the head of the table and fix the head into the pillow with one hand. Reach carefully round the anterior part of the neck to the scaleni muscle group and push toward the table with the thumb and thenar eminence. When the barrier has been engaged, keep the thumb still and roll the head away with the other hand to bow the muscles over the thumb.

Tips: If kneading is applied directly to the scaleni, it is extremely uncomfortable. Working on the muscles using this method allows quite strong stretch with far fewer problems.

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