Understanding and Releasing the Big 4: Psoas, Piriformis, QL and Subscap
Master the Big 4 Muscles That Cause the Most Pain in Your Clients
Learn powerful release techniques for the Psoas, Piriformis, QL, and Subscapularis to deliver deeper results in every session
You already know how frustrating it is when a client keeps coming back with the same pain patterns. These muscles are often involved in stubborn discomfort, compensation, and restricted movement. When you understand the deeper anatomy, your sessions become more precise and effective.
Common pain points therapists often run into with clients:
Chronic pain with no specific source
Unremitting back pain no matter how much therapy they receive
Shoulder pain that hasn’t been solved with PT or other modalities
Sciatic pain running down the glutes into the legs
Uneven gait patterns leading to knee and back pain
Transform Your Ability to Help Heal
In this course, you’ll learn how to identify, assess, and work with the Big 4 in a way that supports better outcomes for your clients.
You’ll gain more confidence, more clarity, and more precision in your hands-on work.
Benefits:
Understand what each muscle does.
Recognize common compensation patterns.
Apply more effective release strategies.
Improve the quality of each session.
Tie it all together so your bodywork flows.
This course is for:
Massage therapists.
Bodyworkers
Manual therapists.
Students who want deeper anatomy knowledge.
Practitioners who want more confidence working with stubborn pain patterns.
What you’ll learn
How the psoas contributes to pain and compensation..
How piriformis tension may affect movement and comfort.
How to understand the subscapularis in a treatment context.
How to approach the QL with more precision.
How to integrate the Big 4 into full-session strategy.
What’s in the course:
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The beginning of the class will focus on:
Introductions, level of experience and any pre-existing conditions within the class
anatomy of each muscle
why these muscles are a challenge for so many,
the emotional component that may be tied to each muscle
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What physical problems/assessments will indicate this muscle may be the problem?
Shoulder Restriction
Anatomy Review
Safe access
Manual Muscle Testing and Orthopedic Assessment
Contraindications
Release techniques
Mobility restoration
Emotional components
Client homework, stretches, treatment plan
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The Psoas
What physical problems/assessments will indicate this muscle may be the problem?
Anatomy Review
Manual Muscle Testing and Orthopedic Assessment
Contraindications
Release techniques, hands on demo and student practice
Emotional components
Client homework, stretches, treatment plan
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What problems may be showing up to indicate this muscle is involved?
Identifying sciatic involvement
Review anatomy
Muscle testing and orthopedic assessment
Proper release techniques
Client positioning
Demo and hands on practice
Emotional components
Client homework, stretches, treatment plan
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What physical problems/assessments will indicate this muscle may be the problem?
Anatomy Review
Manual Muscle Testing and Orthopedic Assessment
Low back pain patterns
Contraindications
Release techniques
Emotional components
Client homework, stretches, treatment plan
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Integrating the deeper therapeutic work into the flow of a full body massage.
Flow sequence
Full treatment strategy
Creating the “Best Massage Ever”
Feedback on Body Mechanics
This course is designed to help you move beyond memorizing anatomy and into practical, hands-on application. You’ll not only learn where these muscles are but also how to think about them in the context of pain, compensation, and release work.
What makes it different:
Focused on clinically relevant application.
Built for massage and bodywork professionals.
Designed to improve confidence in real sessions.
Meet the Instructor
Hi, I’m Dr. Gretchen Rivas, and I created this course to help massage therapists develop a deeper understanding of the muscles that most often present with pain and restriction.
My goal is to make anatomy practical, clear, and usable in your work.
Background History
1986 Bachelor of Science in Business Administration with minors in Marketing and Small Business Development from the University of South Carolina.
2001 Certificate of Massage Therapy from Coastal Carolina Institute of Massage Therapy
2002 LMBT #3153 Started Relax to the Max Massage Therapy, which became Relax! Massage Therapy, then Relax! Massage Therapy and Skin Care
2005-2012 Instructor at MMC in the Massage Department
Somatics
Spa
Energy Work (Included instruction in TCM, polarity therapy, craniosacral therapy, shiatsu, etc.)
Special Populations (*included massage instruction in Geriatric, Pregnancy, Pediatric, and Infant, and High-Risk populations)
Supervisor at the Massage Clinic
2008-2011 LAc #633 Master's in Acupuncture from Jung Tao School of Classical Chinese Medicine in Boone, NC.
2011 Infinity Acupuncture, Wilmington, opened
2018 Infinity Acupuncture, Hampstead, opened
2017-2019 Doctor of Acupuncture: Pacific College of Health and Science
2021-2023 Certified Sports Medicine Acupuncturist
2023 Relax! Massage Therapy and Skin Care sold
2025 Nationally Certified Massage Therapy Provider #1002561
2026 Infinity Acupuncture, Wilmington clinic sold
Areas of Expertise
Massage Therapy
Sports Medicine
Body mechanics
Massage Flow
Business Development
Professional Development
Pregnancy Massage
Somatics
Special Populations
Meridian Therapy
What People Are Saying
Communication was top-notch and the final outcome was even better than I expected. A great experience all around.
— Michael M., Former Student
Dr. G's attention to detail and commitment to quality instruction truly stood out. I’ve already recommended this class to others.
— Kat, Former Student
The details about each muscle were thoughtfully explained. I'm thrilled with my learning outcomes.
— John C. Former Student
Your Questions, Answered
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Click on the Course Link and sign up! There are early bird discounts and a way to pay as you go to help you reserve your space if you can’t afford to pay it all this minute.
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With a passion for helping people heal, 24+ years of experience in the massage world, years of teaching and public speaking, plus the additional training as a Doctor of Acupuncture and Certified Sports Medicine Acupuncturist, Dr. Gretchen brings her scope of experience to the classroom to make your time worth it.
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You can reach us anytime via our contact page or email. We aim to respond quickly—usually within one business day.
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Serious information in a fun, engaging format. I use a PowerPoint but only to help you see what I’m talking about and for demonstration purposes. I can’t stand a CE class where the instructor reads from the PP. I won’t torture you like that! We will do lots of hands-on work that you will be able to utilize the day you get home.