MBLEx Mnemonics: 12 Memory Tricks for Massage Therapy Students

Rotator cuff muscles

“SITS”

1. SSupraspinatus: supraspinous fossa to the greater tubercle (top facet); abducts the arm with the deltoid, classically taught as starting the first ~15 degrees
2. IInfraspinatus: infraspinous fossa to the greater tubercle (middle facet); laterally rotates the arm
3. TTeres minor: lateral border of the scapula to the greater tubercle (lower facet); laterally rotates the arm
4. SSubscapularis: subscapular fossa (front of the scapula) to the lesser tubercle; medially rotates the arm

Use it when: When an item gives an attachment or a shoulder movement and asks which cuff muscle it is, or which one is most often torn (supraspinatus).

Careful: Three attach to the greater tubercle in S-I-T order from top to bottom; subscapularis is the odd one out - lesser tubercle, front of the scapula, the only medial rotator. Teres major is not a rotator cuff muscle.

Pes anserinus (goose foot)

“Say Grace before Tea”

1. SSartorius: from the anterior superior iliac spine (ASIS)
2. GGracilis: from the pubis
3. TsemiTendinosus: from the ischial tuberosity

Use it when: When an item asks which three tendons share the insertion on the proximal medial tibia, or what they have in common (knee flexion and medial rotation of the tibia).

Careful: The order runs front to back at the insertion. Semimembranosus is a hamstring but not part of the pes anserinus - it inserts on the posterior medial tibial condyle. The three come from three different compartments and nerves (femoral, obturator, sciatic/tibial).

Erector spinae columns

“I Love Spaghetti”

1. IIliocostalis: lateral column, attaching to the ribs
2. LLongissimus: intermediate column, the longest
3. SSpinalis: medial column, closest to the spinous processes

Use it when: When an item asks the order of the erector spinae from lateral to medial or which group extends the spine.

Careful: The mnemonic runs lateral to medial. Acting together they extend the spine; acting on one side they laterally flex to the same side. The deeper transversospinalis group (multifidus, rotatores, semispinalis) is a separate layer.

Cranial nerves, in order

“Oh Oh Oh To Touch And Feel Very Good Velvet, Such Heaven”

1. IOlfactory - smell
2. IIOptic - vision
3. IIIOculomotor - most eye movements, pupil constriction
4. IVTrochlear - superior oblique eye muscle
5. VTrigeminal - facial sensation, chewing muscles
6. VIAbducens - lateral rectus eye muscle
7. VIIFacial - facial expression, taste (front of tongue)
8. VIIIVestibulocochlear - hearing and balance
9. IXGlossopharyngeal - swallowing, taste (back of tongue)
10. XVagus - heart, lungs, digestive tract (parasympathetic)
11. XISpinal accessory - trapezius and sternocleidomastoid
12. XIIHypoglossal - tongue movement

Use it when: When an item names a function or a muscle and asks which cranial nerve supplies it.

Careful: The two massage-relevant ones are XI (spinal accessory runs through the posterior triangle of the neck to the trapezius and SCM - an area of caution) and VII (Bell's palsy affects the facial nerve). Vagus (X) carries most parasympathetic output, which relaxation massage is thought to favor.

Cranial nerve function: sensory, motor or both

“Some Say Marry Money But My Brother Says Big Brains Matter More”

1. ISome - Sensory
2. IISay - Sensory
3. IIIMarry - Motor
4. IVMoney - Motor
5. VBut - Both
6. VIMy - Motor
7. VIIBrother - Both
8. VIIISays - Sensory
9. IXBig - Both
10. XBrains - Both
11. XIMatter - Motor
12. XIIMore - Motor

Use it when: When an item asks whether a cranial nerve is sensory, motor or mixed.

Careful: Use it together with the names mnemonic - each word lines up with the same number. 'Both' nerves (V, VII, IX, X) are the ones with the most varied functions.

General vs local contraindications

“Whole body sick, no massage. One spot sick, work around it.”

General (systemic) contraindications rule out the whole session: fever, acute infectious or contagious illness, severe uncontrolled hypertension, shock or a medical emergency, and being under the influence of alcohol or drugs. Local contraindications rule out one area while the rest can be massaged: open wounds, local skin infection, recent burns or sunburn, acute sprains or strains, varicose veins, recent fractures, and inflamed or recently injected sites.

Use it when: When an item describes a client condition and asks whether to massage, adapt, or reschedule and refer.

Careful: Suspected deep vein thrombosis (warm, swollen, painful calf) is a 'stop and refer' finding - do not massage the limb, and the client needs medical evaluation before any session because a clot can embolize. When in doubt, get medical clearance; the exam rewards the cautious, referring answer.

Areas of caution (endangerment sites)

“If you can feel a pulse or a nerve, ease off”

Areas of caution are where nerves, vessels or organs lie superficial and unprotected: the anterior triangle of the neck (carotid artery, jugular vein, vagus nerve), the posterior triangle of the neck (brachial plexus, subclavian vessels), the axilla, the medial epicondyle of the elbow (ulnar nerve), the upper abdomen and umbilical area (aorta, xiphoid process, liver edge), the femoral triangle, the popliteal fossa, the sciatic notch, the kidney area of the low back, and the eyes.

Use it when: When an item asks where to avoid deep or sustained pressure, or why a client felt tingling during work near the elbow or neck.

Careful: These are areas for light, careful pressure, not necessarily places to avoid touching entirely. Sustained deep pressure on the anterior neck can affect the carotid sinus and slow the heart. Tingling or numbness during work means you are on a nerve - move off it.

Medication classes that change a session

“A-B-C-D-E of meds”

1. AAnticoagulants and antiplatelets: bruise easily - lighter pressure, no deep or aggressive work
2. BBlood pressure drugs: dizziness on standing - have the client sit up and rise slowly
3. CCorticosteroids (long-term): thin, fragile skin and tissue - lighter pressure
4. DDiabetes drugs and insulin: avoid recent injection sites; watch for low blood sugar during or after the session
5. EEasing pain (analgesics, NSAIDs, muscle relaxants): dulled feedback, so the client may not report excess pressure

Use it when: When an intake lists a medication and the item asks what to adapt.

Careful: The 2023 outline added 'classes of medications' under Pathology, so expect these. You adapt the session and ask about effects - you do not advise the client to change, stop or time their medication, which is outside scope.

The five Swedish strokes

“Even People Feel Tension Vanish”

1. EEffleurage: gliding strokes; warms tissue, spreads lubricant, usually starts and ends a sequence
2. PPetrissage: kneading, lifting, wringing and squeezing muscle
3. FFriction: deep circular or cross-fiber strokes to address adhesions and scar tissue
4. TTapotement: rhythmic percussion - hacking, cupping, tapping, pounding; stimulating
5. VVibration: fine shaking or trembling movements

Use it when: When an item describes a stroke and asks its name, its effect (stimulating vs relaxing), or where it fits in the sequence.

Careful: On the limbs, effleurage is applied toward the heart (distal to proximal) to support venous and lymph return. Tapotement is stimulating, so it does not fit a relaxation goal and is avoided over the kidneys and bony areas. Some texts add touch, nerve strokes or joint movements, but these five are the core.

Cold application sensations

“CBAN”

1. CCold
2. BBurning
3. AAching
4. NNumbness - remove the cold

Use it when: When an item asks the expected sensations during ice application, when to stop, or whether to choose heat or cold.

Careful: Stop at numbness, usually within 10-20 minutes. Cold suits acute injury and inflammation (vasoconstriction, less swelling); heat suits chronic stiffness (vasodilation) and is never used on an acute injury. Avoid cold with Raynaud's or cold hypersensitivity, and use both with caution where sensation or circulation is impaired, such as diabetic neuropathy.

Scope of practice

“No diagnosing, no prescribing, no adjusting”

Massage therapists assess soft tissue to plan a session, but they do not diagnose medical conditions, prescribe or recommend medications, or perform spinal or joint manipulation (high-velocity adjustments). When a finding needs a diagnosis, the right move is to refer the client to an appropriate health care provider. What else falls inside scope - stretching advice, hydrotherapy, self-care education - is set by each state's law.

Use it when: When a client asks 'What is wrong with me?', 'Should I take this?' or 'Can you crack my back?' and the item asks for the best response.

Careful: Describing what you feel ('this area is tight and tender') is fine; naming a condition ('you have sciatica') is diagnosing. Recommending supplements or medication doses is prescribing. When scope varies by state, the exam's safe answer is to stay inside your license and refer.

Transference and countertransference

“Transference: the client transfers. Countertransference: the therapist counters.”

Transference is when the client projects feelings from another relationship onto the therapist - treating you like a parent, a friend or a romantic interest. Countertransference is the reverse: the therapist's own feelings and needs spill onto the client, such as wanting to rescue them or becoming personally attached. Both blur the therapeutic relationship, where the therapist holds more power and carries responsibility for the boundary.

Use it when: When a scenario describes a client (or therapist) acting out of a personal relationship and asks what it is called or how to respond.

Careful: The therapist is always responsible for maintaining boundaries, even if the client starts it. Dual relationships (treating a friend, employer or business partner) are not automatically unethical but need clear boundaries; any sexual relationship with a client is sexual misconduct, regardless of consent.