The lower back massage routine is loved by clients. I have put quite a few clients to sleep and I always hate to wake them when I am through.

The above photo was sent to me without any story by Teka Robinson in Long Beach, California through a content 2.0 page on my prior website so thank you to her.

As a massage therapy student, you should learn a basic routine for the back from your instructor. While you are in school, you should use the routine your instructor teaches you so you will get a great grade.

After that, you can mix it up a bit. Add bits and pieces that you like from other routines and drop the things you don't care for. Each client may need something different, depending on the issues he/she is having.

Preferably, the client's clothes have been removed, including the bra for females so the massage therapist can really get to the muscles. Properly drape the client with the sheet. If the client's underpants are on, tuck the sheet into the waist band right above the buttocks so the client is covered.

The entire back should be exposed. Make sure the female client's breasts are covered by a sheet on the sides so she feels comfortable and not embarrassed. Proper draping should be taught in school. Make sure you practice it.

Apply massage cream to your hands and rub them together to warm the cream. Apply to the entire back.

Now we will start the back massage therapy. Make sure you are standing in the bow stance to one of the sides of the client. First, feather stroke up the back, starting at the lower back. Now we will start the effleurage portion of the back.

This will extend from the shoulders down to the lower back. Lower back massage can extend to the end of the tailbone. In some states, this will include the gluteal muscles. In Texas, this can be included, but at my massage school in my massage therapy class, it was not taught. However, some massage therapists in Texas have told me they were taught and it is okay to massage the glutes in Texas. In chair massage, it is okay for the massage therapist to include the portion of the hips above the chair massage seat. Some clients have asked if touching their hips/behind is okay in chair massage. It is perfectly okay as long as it is part of the lower back massage therapy.

Then do a drain stroke using the palms of both hands up the back to the shoulders. Follow this with a digital glide stroke up the back using the finger tips of both hands. Let your fingers sink into the back. Remember as you return your hands to the bottom of the back that you are not to break contact with the client.

Next, using the heels of your palms, do a palmar glide stroke up to the shoulders. Then do a knuckle glide, followed by a fist glide. After that, a sideways (ulnar portion) fist glide. Effleurage warms the tissue and gets the blood flowing. All of these strokes feel great to the client and some of them can resolve some of the pain issues by themselves. Remember that slow is the way to go on effleurage strokes. Slow and deep.

Next in the back massage therapy is petrissage. For petrissage, get in a horse stance facing the side of your client. Start doing J hook scoops to the neck, alternating hands. Hopefully, you learned this in massage class. If not, one hand grasps the skin at the bottom of the neck and in an upward motion, scoops it up. Then the other hand grasps the skin at the top of the neck and scoops it down.

Now perform large-handed palmar kneading across the back to the other side. Do not do this to the side of the back closest to you. Start from the opposite edge of the back over to the spine in zigzag form starting from the shoulder area down to the bottom of the back and all the way back up. Then, keeping your hands on the client, move to the other side of the table and repeat on the other side of the back.

During this portion, ask the client several times how your pressure is just to make sure that you are not being too rough for the client. Each client is different so make sure you ask, especially during the lower back massage portion.

Next on the back massage therapy is digital circular palmar kneading. Using your fingers and palms, make deep circles in zigzag form as above, moving from one side of the table to the other when the first side of the back is complete. Pay special attention as you perform lower back massage as this is where many clients have a lot of pain.

Next is digital palmar compressions. Then starting at the bottom of the spine, spider your knuckles up the spine on both sides. Then do the same thing back down to the bottom. Perform drain strokes up and down with your thumbs on the spine. Then give a relaxing palmar rub up and down the spine.

You can stop here or you can perform some tapotement strokes now. Tapotement strokes for back massage therapy include tapping, slapping, cupping, soft-fisted beating, hacking, and soft pinching. The pinching should never hurt.

Finish off the lower back massage therapy routine with a deep drain stroke and then some lighter drain strokes.