With your client lying face down on the massage table, fold the sheet to expose her back. Apply oil to your hands. Stand at the head of the table and use gliding and kneading strokes with light pressure to warm up the neck, shoulder and back muscles. Use long, flowing movements and massage from the shoulders to the lower back.
While at the head of the table, focus the massage on localized muscle tension in the neck and shoulders. Use your knuckles and slow strokes with increased pressure. Massage the back of the neck out toward the shoulders, following the upper trapezius muscle. When using the knuckles for deep tissue work, "it is imperative the fingers be extended in a straight line at the joint between the metacarpals and phalanges," reports MassageTherapy.com. Do not pressure the neck bones, which are delicate upper spinal column vertebrae.
Move to the side of the massage table to address muscle tension in your client's left shoulder blade. Massage the shoulder blade using slow knuckle strokes and moderate pressure. Focus on the edges of the shoulder blade. Communicate with your client to minimize discomfort. Repeat the deep tissue techniques on the right shoulder blade.
Move to your client's left side. Place your right hand on her hip and massage with your left knuckles using the slow, striping technique. Your thumb should face the client's feet. Focus on the muscles to the side of the backbone and massage from the hip toward the shoulder. Do not massage the back bones. Move to the right side and repeat the movements. This time, use your left hand to brace the hips.