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Seeking advice on over treatment

I have a new client who receives deep tissue, NST, and ashiatsu massage 5 nights each week, by 5 different therapists (who specialize in DT, NST/NMT, etc). He has done this for many years. Therapists don't share charts, so I'm not really sure how long he's been experiencing certain pains. His verbal intake suggested he's had chronic low back pain, not acute. After my first treatment, I was left feeling as though it's unhealthy for the muscle fibers to receive such deep work 5 nights each week, and that his fibers cannot repair without rest, thus causing further inflammation and pain. Also, I think he should seek out other therapies such as PT or maybe acupuncture. I feel obligated to have this conversation with the client, and would like advise from this forum. Do you this this is a case of over-treatment?

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Permalink Reply by Jody C. Hutchinson on November 19, 2011 at 9:06am

Sarah,

I understand your concerns about this client. It is probably not best for healing to get five treatments per week. James Waslaski said every 72 hours is a good frequency. Also, most PT and Chiro plans are three times per week for about two months. I think the body will accomodate ( get used to and not have the same benefit) from massage delivered every day. So, my one question is-does the client think it is a problem?

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Permalink Reply by Sarah Witte on November 20, 2011 at 12:22pm

Thank you Jody. I don't believe the client thinks there is potential harm/lack of effectiveness in his current care plan, he didn't express concern, and based on his dedication to appoinments, I'm not sure it's crossed his mind. I want to discuss this in an educational mannor, and be very careful to not sound like what he's been doing is 'wrong'. Do you have advise on how to approach him? I need to speak with his assistant today, as they have requested I work on him again tomorrow.

Jody C. Hutchinson said:

Sarah,

I understand your concerns about this client. It is probably not best for healing to get five treatments per week. James Waslaski said every 72 hours is a good frequency. Also, most PT and Chiro plans are three times per week for about two months. I think the body will accomodate ( get used to and not have the same benefit) from massage delivered every day. So, my one question is-does the client think it is a problem?

JH

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Permalink Reply by Debbie Dehm on November 20, 2011 at 6:28pm

I would definately discourage this man from having so many massages per week. Suggest other modalities like accupuncture, new mattress, better shoes. I would want to know why he feels the need for so many treatments? Is he in constant pain? Does he like deep massage because he enjoys pain? Something fishy going on here. Why does he see so many different therapist? Most people stick to one. I find it a little unethical in my opinion to treat someone for years, doing the same things with no relief. I feel there is more going on here.

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Permalink Reply by David Villafana on November 20, 2011 at 7:21pm

Depending how old is your client I would evaluate the cause or causes of the low back pain. There are usually 4 or 5 causes that are typical and they can be treated to over 90% success. I do not know what is your training, but depending on your background you can treat your client. However, he will have to understand that he will have to stay with you so other treatments will not screw up your program.- If you are willing to share with me your approach to find the cause or causes of the low back pain I will be happy to discuss with you some of my experience in this area.

David

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Permalink Reply by Sean LeeChing on November 21, 2011 at 11:43am

Hello Sarah

You have not explain his career back ground to us and most of all in details the form and cause of his lower back injurys. I do believe you have the right to ask him if you can chat with his pimary doctor, just so you can ask his MD how better to approuch his wellness treatment, by doing this the MD will share what he can with you about your clients medical history. You as a LMT can also explain to his MD that his client gets "multiple Body Work Sessions by #5 Different LMT's/BodyWorkers a week" ...

I am sure his MD will tell you if thats too much and then you can move forward in what you should do from there on. Hope you have your insurnace handy for if he is further injured from anyone of those #5 different body workers within that week.. Which one of those body workers will he pointed out to be blaimed?

I hope this answers your question or helps in anyway.

Happy Massaging :)

Sean

LMT

NYC

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Permalink Reply by Daniel Cohen on December 13, 2011 at 10:29pm

Agreed, I would refuse to treat him unless he agrees to a plan of treatment discontinuing excessive (do they know he gets the other 4 days?) therapy.

Debbie Dehm said:

I would definately discourage this man from having so many massages per week. Suggest other modalities like accupuncture, new mattress, better shoes. I would want to know why he feels the need for so many treatments? Is he in constant pain? Does he like deep massage because he enjoys pain? Something fishy going on here. Why does he see so many different therapist? Most people stick to one. I find it a little unethical in my opinion to treat someone for years, doing the same things with no relief. I feel there is more going on here.

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Permalink Reply by Lucianna Johnston on December 30, 2011 at 1:37am

This is for anyone in this thread who is interested in discussion. ..I am genuinely curious what you all think...what is the difference between exercise (cardio, yoga etc..) 5+ nights a week and having bodywork 5+ nights per week? They both stimulate the soft tissues, they both increase tonicity, they both increase circulation......they both bring heat to the tissues........you follow? What do you think?

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Permalink Reply by Sheryl Matters on January 24, 2013 at 5:10pm

Did his body feel to you like it is receiving this much work? Do you have any way of knowing that he truly keeps this many appointments? Could he possibly be lying?

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Permalink Reply by Chuck Peck on January 27, 2013 at 9:37am

Maybe revisting his real massage goals would be in order. Maybe he just really likes to be massaged. He's using his back pain to support his desire to have massage often.

See if a different modality schedule that has less deep tissue and more therapeutic relaxation. If he can get his 5 days a week with less deep tissue, maybe it would be better for him.

Chuck Peck

AZ LMT

Cave Creek AZ

http://www.carefreeservices.org

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Permalink Reply by Chris Reynolds on February 23, 2013 at 2:54am

I agree with you 100%

Lucianna Johnston said:

This is for anyone in this thread who is interested in discussion. ..I am genuinely curious what you all think...what is the difference between exercise (cardio, yoga etc..) 5+ nights a week and having bodywork 5+ nights per week? They both stimulate the soft tissues, they both increase tonicity, they both increase circulation......they both bring heat to the tissues........you follow? What do you think?