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I have a few clients who have lost extreme amounts of weight and have loose/extra skin.  We have a comfortable working relationship.  Does anyone have any special techniques for working with this situation.  Compressions over the sheets feel good to the client, but I find the gliding, petrissage, or kneading strokes challenging.  Thanks for any guidance.

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Sorry, I don't think I understand. Are you massaging your clients while they are covered by the sheets, and if so, why?

No, I am only doing compressions while they are covered by the sheets, and then undraping to massage.

In an area where there is quite a lot of loose skin, I place my hand or forearm, depending on how large the loose area is, alongside, press in gently and pull away with a very gentle shearing movement so that the excess is out of the way while being supported at the same time. That leaves your other hand to provide the strokes. Have you massaged a dog with injured ribs? It's the same sort of procedure. If the dog has a luxurious pelt you need to pull it up and out of the way without hurting or tugging at the attachments to get to the flesh, much the same for people. Hope this helps. 
 
victoria said:

No, I am only doing compressions while they are covered by the sheets, and then undraping to massage.

Yes it does Linda.  Thanks for your input.


 
Linda LePelley, RN, NMT said:

In an area where there is quite a lot of loose skin, I place my hand or forearm, depending on how large the loose area is, alongside, press in gently and pull away with a very gentle shearing movement so that the excess is out of the way while being supported at the same time. That leaves your other hand to provide the strokes. Have you massaged a dog with injured ribs? It's the same sort of procedure. If the dog has a luxurious pelt you need to pull it up and out of the way without hurting or tugging at the attachments to get to the flesh, much the same for people. Hope this helps. 
 
victoria said:

No, I am only doing compressions while they are covered by the sheets, and then undraping to massage.

Great question Victoria, I've been struggling with this as well. I think Linda gave a solid reply, I have recently adjusted my technique to include pinning a static section and stroking away from the pin myself. Before that, I had been sticking to more acupressure and direct downward pressure, which worked but isn't the most flowing of all sequences. I find the pin and stroke is much better in this case. And you mentioned working over the sheet, which is a good work around as well. Thanks for bringing this up, it's a unique challenge that isn't always addressed in school.



Hallie C Patton said:

Check this page- https://en.wikipedia.org/wiki/Excess_skin

Thanks or sharing this link. 

I have heard one of my friends complaining about loose skin after weight loss. I think this is a very common problem after weight loss. Many people want to look great and attractive after losing weight. So, they can choose any of the effective way to get rid of this loose skin. I have seen many people going for the élastique sportif to shed pounds. They experienced quick weight loss and did not face the problem of loose skin after weight loss. It is better to go for the natural weight loss method that do not create the problem of loose skin.

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