While seasoned massage therapists may take their sense of touch for granted, those newer to the profession quickly learn that palpating human tissue is no simple task. In addition to thoroughly comprehending anatomical structure, 13 exercises are suggested to help therapists recognize the tangible differences between body parts.

As healthcare professionals who navigate through their medium using touch, massage therapists are susceptible to the strengths and weaknesses of their own palpatory skills. A practitioner with a sensitive and responsive touch can adjust his or her applications accordingly, while one lacking these skills can make a faulty assessment, deliver a mediocre massage or even inflict accidental pain. While developing the ability to interpret what is felt underneath ones hands is a valued massage therapy skill, it is also one of the more obscure concepts to teach.

Although it is of major importance, memorizing a map of human anatomical structures is not enough preparation for learning how and where to apply bodywork. Because people come in all shapes and sizes, you can not simply superimpose any given diagram of anatomical landmarks on a client to locate the structure or muscle group being searched for. Most experts agree that there are several components to mastering palpation including combining the imaginative mind and drawing from the therapists knowledge of anatomy.

According to Leon Chaitow, ND, DO, Palpation cannot be learned by reading or listening; it can only be learned by palpation. He also says that an open mind is vital to the task of learning palpatory literacy practitioners with the greatest degree of rigidity, in terms of their training, often have the hardest time allowing themselves to feel new feelings and sense new sensations.

In accordance to John Upledger, DO, OMM, the developer of CranioSacral Therapy, Learning to trust your hands is not an easy task. You must learn to shut off your conscious, critical mind while you palpate for subtle changes in the body you are examining. You must adopt an attitude so that you may temporarily accept without question those perceptions which come into your brain from your hands. After you have developed your palpatory skill, you can criticize what you have felt with your hands. If you criticize before you learn to palpate, you will never learn to palpate.

Each tissue has a different tactile sensation. Since a practitioners fingers can literally only contact the skin, sensing the structures underneath is akin to trying to recognize types of food while blindfolded and wearing winter gloves. Below are some exercises devised by Mary Ann Foster, massage therapist and movement educator, to help develop a bodyworkers palpation skills of skin, superficial fascia, deep fascia, tendons, ligaments and muscle.

To explore the skin and superficial fascia:

To explore the deep fascia:

To explore tendons and ligaments:

To explore muscle tissue:

Although cognitive learning is essential, the ability to listen to what our hands are telling us is a vital component of delivering an effective massage. By developing palpation skills and carefully listening to a clients tissue with attentive hands, bodyworkers can transform into masters of their profession. As thinking and sensing merge together, the art and science of palpation takes full form leading to a stronger and more therapeutic connection for both practitioner and client.

Anatomy Review for ProfessionalsCranial-Sacral Fundamentals

References:

Adkins, Garry, NCTMB, Improving Palpation, Massage Today, May 2006.

Benjamin, Ben, PhD, Lets Talk About Palpation, Massage Today, February 2001.

Foster, Mary Ann, Listening Hands and Tissue Palpation, Massage & Bodywork, August/September 2006.

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