Unit 2 · Practical · New Routine
Glutes & Posterior Legs
Continue the prone New Routine through the gluteal region, posterior thigh, calf and foot while connecting the taught sequence to anatomy, palpation, draping, boundaries and therapist mechanics.
Learn your instructor's sequence
This lesson is built from the New Routine materials. The exact demonstrated hand placement, draping and technique execution in class remain the standard. The material here explains the anatomy and reasoning underneath the routine so you understand it rather than memorizing motions.
Regional anatomy
Gluteus maximus
Large superficial hip extensor. It also contributes to external rotation and is best approached initially with broad contact.
Large superficial hip extensor. It also contributes to external rotation and is best approached initially with broad contact.
Gluteus medius & minimus
Lateral hip muscles important for abduction and pelvic stabilization. Their fiber orientation and depth differ from gluteus maximus.
Lateral hip muscles important for abduction and pelvic stabilization. Their fiber orientation and depth differ from gluteus maximus.
Piriformis
Deep lateral rotator extending from the sacral region toward the greater trochanter. It lies deep to gluteus maximus and near important neurovascular structures.
Deep lateral rotator extending from the sacral region toward the greater trochanter. It lies deep to gluteus maximus and near important neurovascular structures.
Hamstrings
Biceps femoris lies laterally. Semitendinosus and semimembranosus lie medially. Most hamstrings originate from the ischial tuberosity and cross both hip and knee.
Biceps femoris lies laterally. Semitendinosus and semimembranosus lie medially. Most hamstrings originate from the ischial tuberosity and cross both hip and knee.
Gastrocnemius
Superficial two-headed calf muscle crossing both knee and ankle. It contributes to plantarflexion and knee flexion.
Superficial two-headed calf muscle crossing both knee and ankle. It contributes to plantarflexion and knee flexion.
Soleus
Deep to gastrocnemius and primarily involved in plantarflexion. It doesn't cross the knee.
Deep to gastrocnemius and primarily involved in plantarflexion. It doesn't cross the knee.
Achilles tendon
Common calcaneal tendon formed largely by gastrocnemius and soleus. Distinguish tendon from muscle belly during palpation.
Common calcaneal tendon formed largely by gastrocnemius and soleus. Distinguish tendon from muscle belly during palpation.
Plantar fascia
Dense connective tissue on the sole extending from the calcaneal region toward the forefoot.
Dense connective tissue on the sole extending from the calcaneal region toward the forefoot.
New Routine sequence
Gluteal region
Secure the drape and establish broad contact
Prepare the gluteal region using the professional draping and consent procedure demonstrated in class. Begin broadly rather than immediately using focused pressure.
Prepare the gluteal region using the professional draping and consent procedure demonstrated in class. Begin broadly rather than immediately using focused pressure.
Palmar compression through the sheet
Use broad rhythmic compression over gluteus maximus and the lateral hip to warm the region and establish tissue response before deeper work.
Use broad rhythmic compression over gluteus maximus and the lateral hip to warm the region and establish tissue response before deeper work.
Forearm rocking / broad gluteal work
Use the forearm with relaxed shoulders and body-weight transfer. Let the movement come from your stance rather than repeatedly pressing with the arm.
Use the forearm with relaxed shoulders and body-weight transfer. Let the movement come from your stance rather than repeatedly pressing with the arm.
Piriformis elbow melt
Locate the taught piriformis region using the sacrum and greater trochanter as orientation landmarks. Sink gradually with sustained pressure rather than jabbing or searching aggressively.
Locate the taught piriformis region using the sacrum and greater trochanter as orientation landmarks. Sink gradually with sustained pressure rather than jabbing or searching aggressively.
Reinforced-thumb / focused gluteal work
Use the reinforced contact taught in class where appropriate, then return to broad contact before transitioning into the thigh.
Use the reinforced contact taught in class where appropriate, then return to broad contact before transitioning into the thigh.
Posterior thigh
Connect into the hamstrings
Use broad gliding to transition from the gluteal region down the posterior thigh.
Use broad gliding to transition from the gluteal region down the posterior thigh.
Forearm glides through the hamstrings
Follow the muscle mass toward the knee while controlling depth. Use body weight and a long contact surface rather than exhausting the hands.
Follow the muscle mass toward the knee while controlling depth. Use body weight and a long contact surface rather than exhausting the hands.
Gluteal-fold / proximal hamstring work
Work the proximal hamstring region as taught while maintaining secure draping and awareness of the ischial tuberosity and sensitive boundaries.
Work the proximal hamstring region as taught while maintaining secure draping and awareness of the ischial tuberosity and sensitive boundaries.
Soft-fist thigh work
Use a relaxed soft fist for broad kneading or compression of the posterior thigh. The wrist stays neutral and the contact should feel broad, not knuckle-pointed.
Use a relaxed soft fist for broad kneading or compression of the posterior thigh. The wrist stays neutral and the contact should feel broad, not knuckle-pointed.
Differentiate medial and lateral hamstrings
As palpation skill develops, identify lateral biceps femoris and the more medial semitendinosus/semimembranosus region. Don't compress the popliteal fossa.
As palpation skill develops, identify lateral biceps femoris and the more medial semitendinosus/semimembranosus region. Don't compress the popliteal fossa.
Calf
Broad calf warm-up
Transition below the knee without pressing into the popliteal space. Warm gastrocnemius and soleus broadly before more focused techniques.
Transition below the knee without pressing into the popliteal space. Warm gastrocnemius and soleus broadly before more focused techniques.
Split the gastrocnemius
Use the thumb technique taught in class to distinguish the medial and lateral gastrocnemius heads. Follow muscle tissue rather than digging directly into the tibia or fibular head.
Use the thumb technique taught in class to distinguish the medial and lateral gastrocnemius heads. Follow muscle tissue rather than digging directly into the tibia or fibular head.
Lobster-claw calf technique
Perform the class-specific lobster-claw technique with controlled compression and release through the calf. Maintain a relaxed hand and adapt pressure to the receiver.
Perform the class-specific lobster-claw technique with controlled compression and release through the calf. Maintain a relaxed hand and adapt pressure to the receiver.
Deeper soleus awareness
Recognize that soleus lies deep to gastrocnemius. Deeper isn't automatically better. Use pressure appropriate to the tissue and client response.
Recognize that soleus lies deep to gastrocnemius. Deeper isn't automatically better. Use pressure appropriate to the tissue and client response.
Heel & plantar foot
Heel work
Use broad controlled contact around the calcaneal region, orienting to the Achilles tendon and heel rather than treating the foot as an undifferentiated structure.
Use broad controlled contact around the calcaneal region, orienting to the Achilles tendon and heel rather than treating the foot as an undifferentiated structure.
Plantar-fascia friction
Use the taught thumb or knuckle friction along the plantar surface with controlled depth. Work within tolerance and avoid turning every firm band into a diagnosis.
Use the taught thumb or knuckle friction along the plantar surface with controlled depth. Work within tolerance and avoid turning every firm band into a diagnosis.
Arch compression
Use broad compression through the arches and plantar surface to finish the foot work.
Use broad compression through the arches and plantar surface to finish the foot work.
Reconnect the whole leg
Use the connecting stroke taught in class to integrate the foot, calf and thigh before moving to the opposite side or next region.
Use the connecting stroke taught in class to integrate the foot, calf and thigh before moving to the opposite side or next region.
Palpation lab
Gluteus maximus
Use broad contact first. Compare resting tissue with gentle resisted hip extension if appropriate in the classroom palpation exercise.
Use broad contact first. Compare resting tissue with gentle resisted hip extension if appropriate in the classroom palpation exercise.
Piriformis region
Use the sacrum and greater trochanter as landmarks. The target is deep, so accuracy matters more than force.
Use the sacrum and greater trochanter as landmarks. The target is deep, so accuracy matters more than force.
Hamstrings
Near the posterior knee, palpate the lateral biceps femoris tendon and medial hamstring tendons while staying out of the central popliteal space.
Near the posterior knee, palpate the lateral biceps femoris tendon and medial hamstring tendons while staying out of the central popliteal space.
Gastrocnemius
Identify medial and lateral heads. The medial head is commonly larger and extends more distally.
Identify medial and lateral heads. The medial head is commonly larger and extends more distally.
Soleus
Palpate along the sides of gastrocnemius where deeper soleus tissue is more accessible.
Palpate along the sides of gastrocnemius where deeper soleus tissue is more accessible.
Plantar fascia
Trace from the calcaneal region toward the forefoot and notice the difference between fascia, intrinsic musculature and bony landmarks.
Trace from the calcaneal region toward the forefoot and notice the difference between fascia, intrinsic musculature and bony landmarks.
Body mechanics & draping
Archer stance
Use smooth forward/back weight transfer for long glides. Step with the technique rather than reaching.
Use smooth forward/back weight transfer for long glides. Step with the technique rather than reaching.
Elbow & forearm
Keep the shoulder relaxed and use your center of mass. Depth should increase by leaning, not by forcefully extending the shoulder.
Keep the shoulder relaxed and use your center of mass. Depth should increase by leaning, not by forcefully extending the shoulder.
Soft fist
The fist remains relaxed enough to create broad contact. Don't drive individual knuckles into the thigh.
The fist remains relaxed enough to create broad contact. Don't drive individual knuckles into the thigh.
Thumbs
Support the thumb during gastroc splitting and plantar work. Reposition if the wrist or thumb joint begins carrying the load.
Support the thumb during gastroc splitting and plantar work. Reposition if the wrist or thumb joint begins carrying the load.
Draping
Secure the pelvic drape and expose only the leg/region being treated. Gluteal work requires clear consent and adherence to the exact draping boundaries taught in class.
Secure the pelvic drape and expose only the leg/region being treated. Gluteal work requires clear consent and adherence to the exact draping boundaries taught in class.
Flow
Maintain intentional contact during transitions. A good routine feels continuous even when your stance, tool and target change.
Maintain intentional contact during transitions. A good routine feels continuous even when your stance, tool and target change.
Safety & boundaries
Popliteal fossa: don't apply deep direct pressure into the central space behind the knee. Gluteal region: obtain clear consent, maintain secure draping and work only within professional scope and classroom protocol. Varicosities, acute injury, inflammation, suspected DVT, altered sensation, wounds or skin lesions: require appropriate modification, avoidance or referral according to the situation.
Sharp pain, neurological symptoms, unusual swelling, heat/redness, guarding or a response that doesn't fit normal massage discomfort are reasons to stop and reassess rather than “work through it.”
Practical checkoff
Secure the gluteal/leg drape correctly before beginning.
Perform broad gluteal compression and forearm rocking with relaxed mechanics.
Locate the piriformis region using anatomical landmarks before the elbow melt.
Transition from glute to hamstrings without losing flow.
Demonstrate posterior-thigh forearm glides and soft-fist work.
Identify medial versus lateral hamstring structures near the knee and protect the popliteal fossa.
Split the gastrocnemius heads using the taught technique.
Demonstrate the lobster-claw calf technique with appropriate pressure.
Perform heel, plantar-fascia and arch work while supporting the foot comfortably.
Reconnect the entire leg before transitioning.
MBLEx + clinical reasoning
Which hamstring lies on the lateral posterior thigh?
Biceps femoris. Semitendinosus and semimembranosus are medial.
Which major calf muscle crosses both the knee and ankle?
Gastrocnemius. Soleus crosses the ankle but not the knee.
Why avoid deep direct pressure in the popliteal fossa?
It's an endangerment site containing important neurovascular structures.
Where is piriformis located relative to gluteus maximus?
Deep to gluteus maximus.
A client develops unusual unilateral calf warmth, swelling and tenderness. Should you perform the calf sequence?
No. Stop local massage and follow appropriate referral/emergency procedures because those findings can indicate a vascular problem such as DVT.
Why does the routine begin gluteal work broadly before using an elbow melt?
Broad contact establishes tolerance and tissue response before a more focused, mechanically concentrated technique.
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