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Needing advice from any who have experience working with fibromyalgia clients
I have a new client who has fairly severe firbomyalgia. Most of her pain is in her calves, just above her knee, her hands, and upper back.
I've just completed the second session. I did tell her (based on what I've read) that she may feel more pain after the first few sessions, but that it would lessen and help overall after many more sessions.
The site I went to recommended starting out twice a week. I've been using very gentle swedish massage, along with myofascial release.
She experiences pain, not during the massage, but immediately afterward. Then it gets better, and then worse again. I'm not sure if this is normal or not. It's hard to find concrete details on what to expect.
Can anyone suggest a good site on firbo that is from a massage perspective? Or share your own experiences with me?
For the second session I tried working on each area less, in case I spent too much time there and thus, aggravated the muscles.
I appreciate any advice you all have to give me. ~ Jennifer Baker LMT
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Replies to This Discussion
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Permalink Reply by Gordon J. Wallis on
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Therese, thank you. Im not coming in here to tell any one what to do. Im just telling what I know based on my experience. The lady with the back pain came in today, my one appointemt. She is fine. Her pain is over. She is more then very happy. I explained what was wrong with her, and why her other therapy didnt work. She is healed now. I will see her a week from now just becuase she had this for a year..Then after that, I will see her in a month.. Then after that she may just want to be a regular massage client.. Maybe once a month. She already expressed that interest. In reality. Truth remains hidden. People that fail, are the ones that make the money in this Sixhundred billion dollar a year pain industry. Its a joke to me. lol
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Permalink Reply by Therese Schwartz on
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It just makes so much sense; I've even pulled up the attachments you include so that I can see them while I'm working on people (it's the nice thing about having my office and massage room be the same thing - my computer is right there). It really helps!
So glad to know about the lady with the back pain!
One of my clients broke her femur last November; she's 68 so this was no small recovery. She was almost healed and then went for more physical therapy. Something went wrong and she's spent the last 12 weeks in a lot of pain (it's a long story and she had to switch doctors). I've been able to help her a lot with the work I do. Last Thursday she found out that the rod was broken and her femur was roaming around inside her leg, unattached. I'm thinking that if I can do something to help her with that kind of situation, then I'm doing OK in the world!
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www.triggerpoints.net That's the website. You can also use it to show your clients . Nerve pain is much more rare.
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Permalink Reply by Gary W Addis, LMT on
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Therese, I'm betting the PT she was seeing was stretching the hell out of "tight muscles" in her thigh. They may have shredded ligament(s) if the femur is loose at hip or knee.. If so, you may find a bumper crop of trigger points. But in this instance it might be a mistake to release them: they may be serving a protective purpose, trying to keep the leg immobile (the muscles hyper tight) while the damage heals. Like Gordon says, sometimes trigger point pain is a symptom rather than the cause.
Good luck with the case.
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Thanks, Gary! I've been doing Lymph Drainage Therapy with her to help with the swelling, pain and muscle spasms, and really gentle MFR and massage. We've been super careful because we knew there was a big issue in there. After her next surgery (August 30th) which will involve replacing the rod and the hip joint and then tying the new rod and hip joint together, I think we'll find a way for me to work on her (LDT and other gentle work) at her house. I used to do outcalls all the time but I am too busy now; LDT I can do with her on her bed so that will be good.
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Thank YOU, Therese. I hope to one day become certified in MLD. A question though. I'm assuming that lymph channels permeate all tissue not just up near the surface. If so, how do you affect lymph flow inches below the skin? MLD's light stroking can't move fluid out of, say, deep in th adductors of thigh, can it? My understanding is that fluid draining into interstitial spaces between cells flows immediately into lymph channels-- I mean, don't all of the body's 7 trillion cells have access to the lymph watershed via lymph channels running through the interstitial spaces? How does that work, how does it get close to the surface where it can be aided by MLD therapy?
Therese Schwartz said:Thanks, Gary! I've been doing Lymph Drainage Therapy with her to help with the swelling, pain and muscle spasms, and really gentle MFR and massage. We've been super careful because we knew there was a big issue in there. After her next surgery (August 30th) which will involve replacing the rod and the hip joint and then tying the new rod and hip joint together, I think we'll find a way for me to work on her (LDT and other gentle work) at her house. I used to do outcalls all the time but I am too busy now; LDT I can do with her on her bed so that will be good.
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Gary, I'll answer your questions this weekend, to the best of my ability. :)
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It's just that everything I've read about lymph drainage therapies all stress light pressure ("about the pressure it would take to move a nickel across a table"). seems to me that you can't move lymph in psoas by lightly rubbing the skin. :-)
Therese Schwartz said:Gary, I'll answer your questions this weekend, to the best of my ability. :)
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Yea, I uhm, somehow couldn't get into it. I always thought I was moving lymph anyway, with my regular massage techniques? But I have not seriously studied it. So what do I know? I mean light touch has its benificial effects, and can even block pain. No doubt about it. But I don't know how it would move lymph?
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Permalink Reply by Kim-Andre Akselsen Ulvestad on
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I took a basic course in lymphatic massage in Thailand, there they used a deeper pressure. We were taught certain techniques, which were quite similar, if not the same, as regular Swedish, but they were to be used five times, and all moving towards the lymph nodes. I was quite surprised learning how different it was here in the US.
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Actually, with Chickly's LDT (I don't know about other forms of lymph work), you aren't rubbing at all. You make light contact (if you feel fascia you are too deep; the lymph layer is just under the skin), feel for the approx. 3 second wave of lymphatic fluid as it's pumped by the vessels, and enhance that wave with a gentle 3 second nudge. If there is no flow, you create it with the 3 second nudges.
It is very light pressure except for the abdomen and a couple of places on the legs, where you can work deeper. In the abdomen, you can work different layers of lymph flow.
Every cell in the body has access to the lymphatic system; the vessels are very simple deep in the tissue, just enough to collect the fluid. They increase in size and complexity as they get closer to the surface of the body. A great deal of the lymph system is just under the skin. But there are 100's of lymph nodes in the abdomen, and so it's good to get deeper there. (All of this I'm doing from memory and the class was last year so it's a bit hazy, but these are the basics as I remember them.)
The reason that LDT can affect the fluid deep in the body is because it's a water-based system and any time you move water in one part of the body it affects the whole body. It's just like dropping something into a swimming pool - the ripples extend through the whole pool.
Massage can affect lymph but only indirectly. Because massage is at the muscle level, the therapist necessarily pushes through the lymph layer to get to the muscles. Any modality that works on the fluid systems of the body will improve all of the fluid systems.
This is a bit stream-of-consciousness and I'm rushing a bit because I have a client on the way. I hope this helps answer some questions! If not, let me know.
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thanks, Kim. your version makes sense.
Kim-Andre Akselsen Ulvestad said:I took a basic course in lymphatic massage in Thailand, there they used a deeper pressure. We were taught certain techniques, which were quite similar, if not the same, as regular Swedish, but they were to be used five times, and all moving towards the lymph nodes. I was quite surprised learning how different it was here in the US.
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