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I'm currently in massage therapy school and I absolutely love it, but yesterday class was very frustrating because I had to work on two overweight classmates.

With the first girl I had to practice my Swedish techniques. Kneading and compression were fairly simple, but multiple clumps of adipose tissue made it difficult to properly grasping the tissue for other methods.

On the second girl I had to palpitate the spine to locate the projections of cervical, thoracic, and lumbar vertebrae. It was extremely difficult to locate the different processes of the vertebrae, and it caused pain when I pressed deep into the tissue.

I'm wondering if there are methods to use that can make it easier to work with bigger clients..

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Hi Barbara.

it was a pleasure to read your post.I have discovered it after posting my reply to Xach. Probably if would  see it wouldn't bother, but in any case more is better.

Best wishes.


Barbara Helynn Heard said:

Aloha Zach,


Thanks for asking this particular question.

In English we may call these people "fat".  In the Hawaiian language the word used is "momona".  Momona means "sweet and juicy like a peach".  In traditional Hawaiian culture momona was a good thing.  In my reply here I'll use the word momona rather than fat or overweight.

The "technique" (if you could call it that) that most helped me to work on momona people who have lots of soft tissue was to choose an attitute of compassion.  

Many momona folks feel self conscious about their bodies.  Many of us (myself included) who are somewhere between slim and obese at times feel self conscious and even negative about the fat that we do have.   I know so many women who look really good to me who want to loose weight. Years ago when I thought about all this I decided that part of my job in giving massage to momona folks was to help them love themselves by seeing them (fat and all) as beautiful and seeing them as having very special bodies.  Ever since I had that realization, whenever I give massage to momona folks I do so with loving attitude, and with the thought that I am touching a moon goddess, child of god, or other wonderful character. 

Secondly, I encourage you to seek to do trades with momona folks and to ask for their guidance.  Tell them you feel kinda lost and need their help to improve your work.  They are the experts!

In general, developing the ability to keep your hands soft allows you to go deep in a comfortable way.  When we tighten our hands we become aggressive.  Feel you fingers typing.  They stay soft but just strong enough to depress the keys.  Too much strength doesn't work.  Learning to use just enough strength and also jsut enough softness in our hands is a life long learning experience.

It's wonderful that you were willing to put this question on the table.



Barbara Helynn


It also helps me to be aware that people's fat layer makes hugging especially wonderful. In my experience momona folks often times give the best hugs.


I also encourage you to invite momona folks to do massage trades with you and to get their input on how to best do the work.  It's generally about softening your hands, and they can help you with that.  If you are upfront with them about the fact that you feel like you are groping about in the dark and could use their input, I bet they will be happy to help you.



Well, working with people who are obese may be a little frustrating or a cruel game with our skills. Usually in the office I put the massage table in a lower position so that the patient's body is at a height  for my optimal body mechanics. I also use a small step that allows me to raise myself a little more when I need compressions or depth at massage. Intuition helps a lot to define the precise place where to locate a muscle or bone, such as the vertebrae. In a matter of manipulative techniques use the forearms, wrists and "elbows" for more depth and quality manipulations. On the other hand manipulation using transverse instead of upward or downward, longitudinal or reverse. Working the muscle in transverse  gives you more comfort and client see that you manage to work with him or her and  is not "too fat for a massage."

When you know your muscular and skeletal anatomy you can massage any body type. Palpation works much better with a lighter touch so maybe you need to lighten up and listen more with your hands. Also, let go of your expectation of what it is going to be like to work on anyone. Approach each body type with fresh eyes, hands and heart. Fat (adipose tissue) typically is'll have to communicate with your client and just find out what areas are tender for each person. I have one obese client who loves deeper work on the lower back where most people her size would be flying off the just depends.

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