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What are the implications??? or I don't understand?
I had a new client today. She told me that her right shoulder always hurts...She had surgery on it last year, but it still hurts, and that nothing changed sense the surgery. I said well where does it hurt.. She said they operated on the front of her shoulder but she always felt it was coming from the back of her shoulder... I palpated her infraspinatus and she had a huge nocioceptive response..she jumped and let out a loud OUCH...I asked her if she had any type of therapy prior to the surgery last year... She said that she had four and a half months of chiropractic and massage with no results..same pain..nothing changed... I asked her if any of the massage therapists or the chiropractor that worked on her ever touched her there... She said NO. I asked her if the Medical doctor touched her there..She said No. I asked her if after the surgery if she had any physical therapy..She said yes...I asked her if the physical therapist ever touched her on that spot...She said yes. I asked her if she jumped and screamed like she did when I touched that spot..She said yes. I said what did he do about it... She said he just gave her exercises to do. I released that infraspinatus trigger point in 30 seconds.. On firm re palpation it wasnt there any more...she didnt jump or flinch.. She said I feel no pain. Its gone. I will see her again next week. But its gone.
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Replies to This Discussion
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Permalink Reply by Linda LePelley, RN, NMT on
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Hi Therese!
I've never taken a class in LDT, but over the years I've worked on several people with edema who have had lymph nodes removed. Nobody ever told me I couldn't do it, LOL, and I helped them all! I remember the first one. She'd had her breast and lymph nodes removed. She wanted the therapy, I was fearful of working on her, made her get written permission, asked the doctor for any guidelines, etc. It gave her so much relief, I was glad I'd let her talk me into it.
Therese Schwartz said:I'm not sure exactly what they are doing with her but this won't be the first time I've had people show up with complications from PT. Thanks - I will definitely check serratus anterior!
Gary, you are so right. In my LDT 1 (Lymph Drainage Therapy) class they heavily stressed that to work on someone without an intact lymph system a therapist must be Lymphedema certified. It wasn't a question - you just don't do it.
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Permalink Reply by Therese Schwartz on
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Hi Linda, I think it must be one of those CYA things - in case things go wrong and a client ends up with lymphedema (a very dangerous and serious condition) they as an institute are covered because they've been very careful with their treatment advice.
I'm so glad you were able to help her!!
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Permalink Reply by Gary W Addis, LMT on
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Teena, I really like your nym.
Teena Johnson said:Great story-- I think the implications are that people need to be educated about what massage really CAN Do-- what it is capable of doing... preventing years of pain and billions of dollars of surgery. This will cause push back from the medical industry but it is for the good of the people.
ALSO We need to learn to develop better reporting tools and research protocols in order to better document experiences like this. WE know what we can do to help people but we often get into doing it and forget to document the before and after and exactly what was done. Measurements of pain, movement etc is important... I for one, would love to learn more about how to do this... from the initial assessment to the documentation of the successes.
The media paints massage as a relaxing luxury but for many it is the difference between scars and surgeries and months of rehabilitation-- with limitations in ROM at the end of all that anyway! Relaxation is a benefit too but ease from Pain is possibly the best aid to relaxation one can get!
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Permalink Reply by Gordon J. Wallis on
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Ive have a few female clients that have had mastectomies with lymph nodes removed...They come regularly, and no problem. And lymph nodes from one arm pit area are gone...Its never been any kind of problem.. So I dont know? Thats just my experience.
Linda LePelley, RN, NMT said:Hi Therese!
I've never taken a class in LDT, but over the years I've worked on several people with edema who have had lymph nodes removed. Nobody ever told me I couldn't do it, LOL, and I helped them all! I remember the first one. She'd had her breast and lymph nodes removed. She wanted the therapy, I was fearful of working on her, made her get written permission, asked the doctor for any guidelines, etc. It gave her so much relief, I was glad I'd let her talk me into it.
Therese Schwartz said:I'm not sure exactly what they are doing with her but this won't be the first time I've had people show up with complications from PT. Thanks - I will definitely check serratus anterior!
Gary, you are so right. In my LDT 1 (Lymph Drainage Therapy) class they heavily stressed that to work on someone without an intact lymph system a therapist must be Lymphedema certified. It wasn't a question - you just don't do it.
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Gordon, it's working specifically with the lymph system that's the potential problem. I have one client in the same situation, and I can do CST, MFR and massage on her all with no problems.
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Ok....I never have understood what the big deal was with lymphatic drainage massage in the first place? I figure lymph is moving with my regular massage anyway?
Therese Schwartz said:Gordon, it's working specifically with the lymph system that's the potential problem. I have one client in the same situation, and I can do CST, MFR and massage on her all with no problems.
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To a certain extent, yes it is. But LDT can do things that massage can't, and isolating the system and just working on it is really useful. In our workbook we got in LDT 1 there are 5 pages of benefits of LDT. Some of them are similar to massage but some of them are specific to LDT. I've done 4 1/2 years of massage on my Vietnam Vet but one session of LDT shut off his leg cramps...I've had lots of things happen for clients with LDT that I couldn't have accomplished with massage, CST or MFR. It's really good stuff! I wouldn't have believed it without experiencing it first-hand. I had no idea it was so useful.
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I just watched an interesting video by Doug Nelson.
He points out that, contrary to what most seem to believe, not all TPs cause pain when pressed--not local, not referred. These latent TPs instead create the super tightness that if worked with petrissage alone will wear you out PDQ. In the video he doesn't talk about treatments, but for months I've been treating that super-hypertonicity with TP therapy-- if I can't find an active TP, I dig in to the hardest part of the muscle and hold till it relaxes. And it does relax.
Other stuff the video talks about, the fact that these latent trigger points can create muscle weakness.
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Permalink Reply by Kathy Mackay on
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I've done LDT over the years. It has come in helpful for clients with sprained ankles or swelling from various injuries. While yes, you are moving lymph in regular massage work if you are looking to specifically address swelling knowing how to use the light, rapid, snapping motion during the massage simply does so more effectively. I have found it's super easy to show a client how to do the light and rapid movements so they can continue to work on it once their home. ...also works wonders for pregnant women who are dealing with swollen ankles/feet and/or wrists/hands.
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This Dorn method appears to be pretty much a rehash of methods used by Luchau and Erik Dalton. Dalton, especially, provides youtube videos of several of his techniques for opening spinal facets.
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Gary and Gordon - my client that I asked you about turned out to be a straight-forward case of a seized-up trap. The whole thing was so tight it felt like a rib was out because of the ridge of muscle along the border. She also had tension that crossed her spine at about L1 and continued down to her pelvis. She loved the massage - her first - and signed up for next week.
We've got ourselves a random thread going here! Kinda fun, actually.
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I use to get yelled at in here for getting off subject. Even though I never go off subject...lol Anyway..her first massage.. That can be eye opening for people...She obviously felt better... Well done.
Therese Schwartz said:Gary and Gordon - my client that I asked you about turned out to be a straight-forward case of a seized-up trap. The whole thing was so tight it felt like a rib was out because of the ridge of muscle along the border. She also had tension that crossed her spine at about L1 and continued down to her pelvis. She loved the massage - her first - and signed up for next week.
We've got ourselves a random thread going here! Kinda fun, actually.
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