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Step 1
Begin compressions, starting with the left shoulder and arm. Ask whether the client wants more or less pressure. Use effleurage (always working towards the heart) to stimulate circulation and flush out toxins, and petrissage to loosen tight muscles.
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Step 2
Work the left arm, starting with the upper arm and working towards the heart. Effleurage is effective, along with petrissage and shaking. Move the client's arms around to promote mobility and range of motion. Repeat the sequence on the right shoulder and arm. This should take two to three minutes per shoulder and arm, no more than six minutes total.
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Step 3
Move to the back. Starting at the base of the neck, use your thumb to put some pressure along both sides of the spine. Work downward, working along the hips in the lower back. Knead the large muscle areas of the lower to mid-back, below the ribcage, working one side then the other. Move up the back between the shoulder blades, kneading and using your thumbs to put pressure along the spine. This section should take two minutes.
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Step 4
Work your hands into the neck, being careful not to apply too much pressure to the sensitive areas in the front. With your thumbs, apply light pressure upwards, stopping when you reach the occiput (the base of the skull). From here, work the small muscles of the occiput downward. You may have to move around to the front of the chair to do this easily.
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Step 5
Move down the neck, coming back to apply pressure down from the mastoid process (behind the ear) towards the clavicle. Be careful with pressure through here, as too much pressure can cut off circulation or cause a gag reflex in your client. Finally, use a light nerve stroke from the base of the skull down the back to the hips; repeat this several times as you close.
