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Routine15 minsupineChestTrunkDraft

Abdomen and chest — 15 min

A gentle supine routine for the upper chest and abdomen, with specific consent, secure draping and clockwise abdominal strokes.

Steps

  1. 012 min

    Consent and draping

    Explain what the chest and abdominal work involves and get the client's specific consent; they can decline or stop at any time. Bolster under the knees, and a towel over the chest under the sheet so breast tissue stays covered.

    Body mechanics

  2. 022 min · Chest

    Upper chest effleurage

    Glide from the breastbone out under the collarbones to the front of the shoulders, staying above the breast tissue. Keep pressure light to moderate and check it.

    Effleurage · Pectoralis major

  3. 032 min · Chest

    Chest and shoulder petrissage

    Gently knead the upper chest near the shoulder and the front of the shoulder, one side at a time. Ask about pressure: this area is often tender.

    Petrissage · Pectoralis major · Deltoid

  4. 041 min

    Move the drape to the abdomen

    Keep the chest towel in place and fold the sheet down to just above the pubic bone, tucking it in. Rest a warm hand on the abdomen for a few breaths before you start.

    Body mechanics

  5. 053 min · Trunk

    Clockwise circles

    Standing at the client's right, circle the navel clockwise with flat hands: up the client's right side, across under the ribs, and down their left side. Keep the pressure light and slow with the breath.

    Effleurage · Rectus abdominis · External oblique

  6. 062 min · Trunk

    Side pull-ups

    Reach across and draw the hands alternately up the far side of the waist towards the navel, then do the near side. Keep it light and stop if it tickles.

    Petrissage · External oblique · Internal oblique

  7. 072 min · Trunk

    Clockwise colon strokes

    Follow the line of the large bowel: up from the client's lower right, across under the ribs, and down the left side. Use soft, slow strokes and stop if the client feels any discomfort.

    Effleurage · Rectus abdominis

  8. 081 min

    Closing hold

    Rest one hand still on the abdomen for a few breaths, then cover the client fully and tell them you have finished.

    Body mechanics

Set-up

Chest and abdominal massage needs specific, informed consent each time: explain what you will do and where your hands will go, and make clear the client can decline or stop at any point. Draping follows Draping and room set-up: a bolster under the knees, a towel across the chest under the sheet so breast tissue is never exposed or touched, and the sheet folded down to just above the pubic bone for abdominal work. Ask the client to empty their bladder first, and skip the abdomen after a large meal.

Order

  1. Consent and draping (2 min).
  2. Upper chest (4 min): Effleurage out under the collarbones and gentle Petrissage of Pectoralis major near the shoulder.
  3. Move the drape (1 min).
  4. Abdomen (7 min): clockwise circles, side pull-ups over the External oblique, then clockwise strokes along the line of the large bowel.
  5. Closing hold (1 min).

Abdominal strokes always go clockwise as you look down at the client (up their right side, across, and down their left), following the course of the large bowel. Keep pressure light (see Pressure scale and check-ins), move slowly with the breath, and never press into the soft area below the ribs or over the bladder.

Closing

Finish with a still hand on the abdomen, cover the client fully and give them time to get up.

Sources

  1. Large intestine (Wikipedia) (Course of the colon (ascending on the right, transverse, descending on the left), which is why abdominal strokes run clockwise.)
  2. Durga, G. et al. (2025). Scientific Evidence-based Effects of Abdominal Massage in People with Constipation: A Narrative Review. International Journal of Therapeutic Massage & Bodywork (Describes abdominal massage applied in a clockwise pattern. Cited for stroke direction only, not for any treatment claim.)
  3. General Cert IV (HLT42021) relaxation massage practice (Region order, timings, draping and transitions follow common Cert IV teaching; check them against your RTO's course notes.)