Unit 2 · Practical · New Routine · ~8 min
Anterior Legs & Feet
Learn the exact New Routine progression from the broad leg sweep through quadriceps, adductors, anterior lower leg, heel, plantar surface and toes.
The sequence is the anchor
The New Routine document gives this section an approximately 8-minute target and names eleven technique landmarks. Learn those names and their order. Anatomy and clinical reasoning should make the sequence easier to remember, not replace it.
Anatomy map
Quadriceps
Rectus femoris, vastus lateralis, vastus medialis and vastus intermedius extend the knee. Rectus femoris also crosses the hip and assists hip flexion.
Rectus femoris, vastus lateralis, vastus medialis and vastus intermedius extend the knee. Rectus femoris also crosses the hip and assists hip flexion.
Hip flexor region
Several muscles contribute to hip flexion. Don't assume every structure near the anterior hip is accessible or appropriate for routine massage.
Several muscles contribute to hip flexion. Don't assume every structure near the anterior hip is accessible or appropriate for routine massage.
Adductors
Adductor longus, brevis and magnus occupy the medial thigh. Their location makes draping, consent and treatment boundaries especially important.
Adductor longus, brevis and magnus occupy the medial thigh. Their location makes draping, consent and treatment boundaries especially important.
TFL / IT tract
Tensor fasciae latae lies near the anterolateral hip and blends into the iliotibial tract. The IT tract itself is dense connective tissue, not a muscle belly.
Tensor fasciae latae lies near the anterolateral hip and blends into the iliotibial tract. The IT tract itself is dense connective tissue, not a muscle belly.
Tibialis anterior
Runs lateral to the tibial crest and dorsiflexes and inverts the foot. Ask for dorsiflexion during palpation practice to make it easier to identify.
Runs lateral to the tibial crest and dorsiflexes and inverts the foot. Ask for dorsiflexion during palpation practice to make it easier to identify.
Anterior ankle & foot
Know the tibia, malleoli, calcaneus, metatarsals and arches so focused techniques stay in appropriate soft tissue.
Know the tibia, malleoli, calcaneus, metatarsals and arches so focused techniques stay in appropriate soft tissue.
New Routine sequence
Leg Sweep
Begin with broad effleurage from the foot toward the hip. Use the first passes to establish contact, distribute lubricant and assess general tissue tone and client comfort.
Begin with broad effleurage from the foot toward the hip. Use the first passes to establish contact, distribute lubricant and assess general tissue tone and client comfort.
Quad Glide
Use a forearm glide up the quadriceps / hip-flexor region. Keep the forearm broad, the shoulder relaxed and the elbow positioned so pressure comes from your stance.
Use a forearm glide up the quadriceps / hip-flexor region. Keep the forearm broad, the shoulder relaxed and the elbow positioned so pressure comes from your stance.
Adductor Wring
Use the taught fingertip wring along the medial thigh. Maintain the drape boundary and don't let the desire to follow anatomy override client consent or professional boundaries.
Use the taught fingertip wring along the medial thigh. Maintain the drape boundary and don't let the desire to follow anatomy override client consent or professional boundaries.
Quad Knead
Perform petrissage through the quadriceps belly. Lift, compress and mobilize the tissue without pinching skin or gripping with the fingertips.
Perform petrissage through the quadriceps belly. Lift, compress and mobilize the tissue without pinching skin or gripping with the fingertips.
Patella Line
Use the taught elbow glide just above the patella. Orient to the superior patellar border first so the contact stays in soft tissue rather than pressing onto the patella.
Use the taught elbow glide just above the patella. Orient to the superior patellar border first so the contact stays in soft tissue rather than pressing onto the patella.
IT/Quad Fist Flow
Use soft-fist strokes from the knee toward the ASIS through the lateral/anterior thigh pathway taught in class. Keep the fist relaxed and pressure broad.
Use soft-fist strokes from the knee toward the ASIS through the lateral/anterior thigh pathway taught in class. Keep the fist relaxed and pressure broad.
Shin Flow
Transition with effleurage into the tibialis-anterior / lower-leg region. Identify the tibial crest and keep direct pressure off the sharp bony border.
Transition with effleurage into the tibialis-anterior / lower-leg region. Identify the tibial crest and keep direct pressure off the sharp bony border.
Lobster Shin
Perform the class-specific cross-fiber friction to tibialis anterior. Use controlled movement across the fiber direction rather than dragging aggressively over the skin.
Perform the class-specific cross-fiber friction to tibialis anterior. Use controlled movement across the fiber direction rather than dragging aggressively over the skin.
Shin Strip
Use a knuckle or thumb strip through tibialis anterior. Follow the muscle lateral to the tibia and support your hand so the thumb isn't doing all the work.
Use a knuckle or thumb strip through tibialis anterior. Follow the muscle lateral to the tibia and support your hand so the thumb isn't doing all the work.
Heel Lift
Lift and glide the heel as demonstrated, supporting the ankle and allowing the movement to become the transition into foot work.
Lift and glide the heel as demonstrated, supporting the ankle and allowing the movement to become the transition into foot work.
Plantar Path
Finish with thumb/knuckle work through the plantar fascia, arch and toes. Work methodically rather than randomly so the entire plantar surface feels addressed.
Finish with thumb/knuckle work through the plantar fascia, arch and toes. Work methodically rather than randomly so the entire plantar surface feels addressed.
How to palpate this region
Rectus femoris
Ask the client to gently extend the knee or flex the hip during a palpation exercise. Follow the central anterior-thigh muscle belly.
Ask the client to gently extend the knee or flex the hip during a palpation exercise. Follow the central anterior-thigh muscle belly.
Vastus medialis
Notice the distal medial quadriceps contour above the knee. Compare it with the larger lateral vastus lateralis.
Notice the distal medial quadriceps contour above the knee. Compare it with the larger lateral vastus lateralis.
Patella
Trace its borders before Patella Line practice. Your elbow glide belongs above the patella, not on the bone.
Trace its borders before Patella Line practice. Your elbow glide belongs above the patella, not on the bone.
Tibialis anterior
Find the tibial crest, move laterally into soft tissue, then ask for dorsiflexion. The contracting muscle should become obvious.
Find the tibial crest, move laterally into soft tissue, then ask for dorsiflexion. The contracting muscle should become obvious.
Calcaneus
Palpate the heel and Achilles relationship before Heel Lift so your hands understand what they're supporting.
Palpate the heel and Achilles relationship before Heel Lift so your hands understand what they're supporting.
Plantar surface
Identify medial and lateral arches, heel, metatarsal heads and toes. Pressure tolerance varies dramatically between clients.
Identify medial and lateral arches, heel, metatarsal heads and toes. Pressure tolerance varies dramatically between clients.
Body mechanics
Leg Sweep
Walk or transfer your weight toward the hip. Don't extend your arms farther and farther as the stroke travels.
Walk or transfer your weight toward the hip. Don't extend your arms farther and farther as the stroke travels.
Forearm Quad Glide
Keep the elbow below or near shoulder level and lean through your body rather than pushing down from the shoulder.
Keep the elbow below or near shoulder level and lean through your body rather than pushing down from the shoulder.
Adductor Wring
Move your whole hands rhythmically. Avoid overworking fingertips in a small, sensitive region.
Move your whole hands rhythmically. Avoid overworking fingertips in a small, sensitive region.
Soft Fist
Keep wrist neutral and MCP joints broad. A soft fist is a large contact tool, not a way to jab with knuckles.
Keep wrist neutral and MCP joints broad. A soft fist is a large contact tool, not a way to jab with knuckles.
Thumb / Knuckle Strip
Line the wrist behind the contact and move from the legs. If your thumb joint hurts, your mechanics or tool choice need to change.
Line the wrist behind the contact and move from the legs. If your thumb joint hurts, your mechanics or tool choice need to change.
Foot Work
Bring the foot to a comfortable working height/position rather than rounding your spine over the end of the table.
Bring the foot to a comfortable working height/position rather than rounding your spine over the end of the table.
Safety & boundaries
Medial/proximal thigh: maintain the exact draping and consent boundaries taught in class. Patella and tibial crest: don't apply concentrated pressure directly to superficial bone. Femoral triangle: recognize the proximal anterior-thigh/groin region as an endangerment area and don't casually extend routine work into it. Varicosities, wounds, acute inflammation, unusual swelling or suspected vascular problems: modify or avoid local massage as appropriate.
Practical checkoff
Perform all eleven named New Routine landmarks in order.
State the approximate 8-minute target for this region.
Demonstrate Leg Sweep from foot → hip using body-weight transfer.
Perform Quad Glide with a relaxed forearm and shoulder.
Maintain secure draping throughout Adductor Wring.
Locate the patella before performing Patella Line.
Use a genuinely soft fist for IT/Quad Fist Flow.
Identify tibialis anterior before Lobster Shin and Shin Strip.
Support the ankle/heel appropriately during Heel Lift.
Complete Plantar Path through fascia, arch and toes without rushing the foot.
MBLEx + clinical reasoning
Which quadriceps muscle crosses both the hip and knee?
Rectus femoris.
What is the primary action of tibialis anterior?
Dorsiflexion of the ankle, with inversion of the foot.
Why should Patella Line begin with landmark identification?
Because the technique is performed just superior to the patella. Knowing the bony border helps keep concentrated elbow pressure in the intended soft tissue.
Is the iliotibial tract a muscle?
No. It's dense connective tissue associated with structures including tensor fasciae latae and gluteus maximus.
Why is the medial proximal thigh treated as a sensitive boundary area?
It combines client privacy concerns with important anatomical structures. Consent, draping, scope and precise anatomical orientation matter.
What contraction makes tibialis anterior easier to palpate?
Dorsiflexion.
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