Treatment/Therapy/Massage Session Can be a Stressor

[mary c]

I found this comment a few years ago and have been carrying it around in a pile of snippits and am finally getting it posted. That took a lot longer than I thought!

It is important to recognize that treatment is itself yet another "stress", making it imperative that we tailor treatment to the patient's (in MT's case - client's) ability to respond.

Treat symptoms in ways that do not add to the adaptive burden, while initiating comprehensive care that includes rehabilitation and preventative strategies.

If anyone has any comments or client observations to share regarding clients with specific situations where the adaptive burden had to be highly monitored, I think this might be a nice thread to park that information at.

 

[Pompal 09.]

Interesting! I have found that this is indeed the case, especially with my oldest clients. I learned the hard way - had a man (80 something) whose neck was so stiff that he had not turned his head in years. I released some massive TP's and within 30 minutes had his head turning both ways. Not just a tiny turn, but really turning it! We were both in awe. Then the nausea hit him. Then the dizziness. : He was ill for quite awhile. He didn't want any more massage. I don't know how long he had a massive headache.

I learned. Now when I have a client come in not turning his/her head, I work very superficially the first week. The second time, I try to get them so they can lie their heads flat on the table - they need quite a bit of pillow support when lying supine. When they see they can do that, they usually tell me to "just dig right in and DO it!", but I keep going slowly. It can take 6-8 weeks before they are moving their heads 30 degrees to either side. BUT they can keep moving it between massages and not lose any ground, without becoming sick from it.

Sometimes slow progress is faster. And doing in eight weeks what had been impossible for YEARS is incredible enough.

Edited for grammar: sounded like I have clients with two heads each! :shock:

 

[Red Sox 4 Life!]

Interesting! I have found that this is indeed the case, especially with my oldest clients. I learned the hard way - had a man (80 something) whose neck was so stiff that he had not turned his head in years. I released some massive TP's and within 30 minutes had his head turning both ways. Not just a tiny turn, but really turning it! We were both in awe. Then the nausea hit him. Then the dizziness. : He was ill for quite awhile. He didn't want any more massage. I don't know how long he had a massive headache.

I learned. Now when I have a client come in not turning his/her head, I work very superficially the first week. The second time, I try to get them so they can lie their heads flat on the table - they need quite a bit of pillow support when lying supine. When they see they can do that, they usually tell me to "just dig right in and DO it!", but I keep going slowly. It can take 6-8 weeks before they are moving their heads 30 degrees to either side. BUT they can keep moving it between massages and not lose any ground, without becoming sick from it.

Sometimes slow progress is faster. And doing in eight weeks what had been impossible for YEARS is incredible enough.

Edited for grammar: sounded like I have clients with two heads each! :shock:

Wow...I'm glad you posted this. I am just learning to back off. Most of my complaints come from working the QL area. They are staying sore there too long and it seems no matter how careful I am, it still gets them. I've decided to only do the MFR stretch there instead of working it when it's so tight. I've also had 2 clients call and say they felt as if they had the flu the next day, so I know I worked too many areas at once. It's hard for me to leave it alone when I feel it needs work, but I am going to have to learn how, or lose clients. And what is really odd about it is...when I graduated from school I had the lightest touch in the class. I guess my hands have gotten alot stronger and I've gained more confidence to get in there. Too much, for some...

 

[caseyyyy :D]

Hehe... welcome to the confessional booth. My "tendency to go overboard" area is the pecs. Probably because mine were so tight and sensitive when I first started massage school, and watching the area change was so exciting.

 

[The God of tickling]

As long as I've been a therapist, I have practiced my belief that the most effective strategy to release tissue is to gently coax it to release. However, I have to admit that I have experienced quite a few frustrating moments where it didn't seem that anything I did was working, and probably (most likely) went a bit too deep too quickly. I am learning to be more diligent about paying close attention to any signs that the tissue is starting to tense up, and back off or change techniques immediately.

One interesting case:
Had been seeing a client weekly, addressing a plethora of complaints including hip flexors, low back, mid-scap and traps. 4 months later, significant improvement everywhere except the scapular area. Tried everything I could think of including myofascial, TrP therapy, Thai stretching - I was approaching it from a relatively clinical perspective and much work was fairly aggressive and deep. So then, 4 months into it, the client informs me that he has PTSD due to tragic loss of a loved one. I realized than that my aggressive approach was very likely contributing to the trauma in that area, so I immediately switched gears and started treating his chest/heart area with much more subtle and nurturing techniques, including Reiki and acupressure. I am happy to say that the area is slowly but steadily responding by loosening up. The client feels less pain and discomfort, and posture has improved significantly. I continue to be amazed by the effectiveness of subtle energy work on the physical plane. (I'm thinking this one might be a good case study to write up.)