The operator is standing behind the patient and using the fingertips to work deep into the muscles. It is possible to get behind the quadriceps in this position, and right up to the adductor muscle origins to the pubis as the patient's other thigh 'protects' the groin area.
Tips: Most useful where it is necessary to reach deep into the muscles. Least useful where the muscles are extremely tender. Extra considerations: Find which works best in each case, either pushing or pulling.
Techniques for the thigh area 237 \
30.8 • Kneading thigh prone The operator is standing on the same side as the leg being worked on. The medial and posterior aspects of the thigh can be reached in this position. According to the needs of the case and the preference of the operator this can be made into a pulling technique or a pushing technique as desired. As in all such techniques, the more the work is shared between the hands, the less amplitude need be applied with each one as the conjoint effort produces the result.
Tips: Most useful where muscles are fairly slack as it is possible to work deeply into them. Least useful where muscles are extremely tight, as the technique will be very uncomfortable. Extra considerations: Vary the angle of knee flexion if necessary, with a pillow.
30.9 • Kneading thigh prone This position enables the operator to work on the posterior and lateral aspect of the thigh on the opposite side from where he is standing. As usual with this sort of technique, the hands are performing opposite actions so that the work is shared and this reduces the amplitude of the forces and the distortion of the tissues accordingly.
Tips: Most useful in smaller patients where leaning across the table is not too much of a stretch. Least useful in large subjects or where the patient finds lying prone difficult. Extra considerations: Vary the angle of flexion at the knee and abduction at the hip for best results.
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