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Theraputic Massage ?
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Permalink Reply by Gary W Addis, LMT on
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Although we are being taught to use that 10 scale (on soap notes we have to list client's assessment of before & after pain, I have never asked a client to rate his pain level. After all, one man's 8 is another's 3. It's their pain.
Yesterday I worked on one of my bodybuilding students, a teen trying to prepare for sports. He was tight as a drum and at the insistence of his older brother, asked for relief. Before we went to the table, I explained the procedure, that he must communicate with me, that although I can usually find a TP by feel alone, I needed his confirmation...that I need to find the most painful area of the TP, which can be large. So, we began to work. I'd find a trigger point, and ask for input. Nothing. I'd ask again, No, not tender, he'd finally say. I'd move on. This went on for a full hour, me not doing anything for him As a test I finally dug in quite hard in posterior scalene, forcing a reaction.
"Ow," he said.
"Now that is the response I need when I compress a tender spot," I said. "This ain't about proving how tough you are, this is about relieving your pain. This is just pressure," I said, demonstrating, "this is a trigger point," and hit the scalene TP again, with my normal pressure. Suddenly, using my normal pressure, TPS sprang up everywhere, in areas already covered five times. Thanks to Mr Macho, what should have been a 30 minute NMT treatment stretched into a 2 hour session.
So, in addition to different levels of pain tolerance, male (and female) determination not to be perceived as a wimp can distort a therapist's treatment.
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Permalink Reply by Daniel Cohen on
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I've had the same experience. I've also had guys who claim to have a very high pain threshold respond with barely a touch while some women have just felt that the level wasn't anything to complain about. We all have our own perceived reality. Part of assessment is trying to determine what reality the person on the table lives with.
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Permalink Reply by Gordon J. Wallis on
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I've had male clients come into the room, and I ask them if there is anything I need to know.. Then they fold their arms in front of me.. And tell me that they can take a lot of pain.. I tell them...Well in that case.. Just go stand over there in the corner and let me kick you in the nuts. Its a lot easier for me that way.. lol At that point they have a shocked look on their face... And I tell them... Look... Its not about taking pain...Its about removing pain .A good massage feels really freakin good....It can be really sore, but its gotta feel good.. I explain to them the hurt good...And if I come to a sore area during the massage. They have to tell me... Then we can approach their problem in a real way. In a way that hurts good.... If you want to do repair work...or free someone of pain...There has got to be efficient communication...But for a lot of males(females too) that are inexperienced with massage( or brainwashed by unknowledgeable therapists).. They think No Pain, No Gain.. So they take it...And of course they feel better after a massage like that...But its a very very inefficient way to do body work...if I have a new client...I usually talk to them for a while before I begin the massage..Just so we get on the right track...Clients will lay there... lay there and let you press too hard or not hard enough...A good massage, especially when dealing with pain... Should hurt good...You gotta explain what hurt good means.. Its not just a matter of taking pain..Like so many think. And the weird thing is..A lot of therapists dont realize that either... Ive even had clients tell me that they like it painful? lol I ask them.. Why do you like it painful.?. A good massage feels good.. Then they tell me.. Well Ive been told by other massage therapists that a feel good massage wont really do any good? There is a lot of unconsciousness out there. I always instruct my clients... When they say it hurts.. I stop what Im doing immediately...But if they say its sore, I keep focusing on that spot in the way Im doing it. Pain is a word..Sore is a word.. You have to define those.. Sore as hell is ok..But Hurt is not. A big difference.
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Permalink Reply by Mary Ann Foster on
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I've heard similar statements many times from clients who have gotten deep work that was not relaxing.
Effective deep tissue work, which this client seemed to be calling "therapeutic massage," requires working at an edge. The work needs to be deep enough to effect change (such as myofascial stretching) but not so deep that the client goes into a guarding response from the pain. If the client guards, muscles contract.Then, when a therapist applies deep pressure to a contracted muscles, the cross-bridges in the muscle fibers can tear, leaving the client with a beat up feeling.
Although I recognize the importance of working at this edge, that doesn't make it any easier. The pain threshold of individual client varies. I think working at this edge requires stellar client communication and client education skills, teaching the client how to relax under pressure, how to tell you when its too much, etc...
I imagine every therapist, no matter how poorly or well-educated, has those off sessions where the pressure is too much or too little to meets the client needs, leaving the client feeling beat up or uneffected.
Another question this discussion brings up- is a relaxation massage a therapeutic massage? I think it is. After all, relaxation provides many health benefits.
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Well massage is therapeutic period if you ask me, and relaxing regardless ...Its just if they have a trigger point...It should feel a really good sore when you work it....And a lot of therapists go beyond that...Or don't even know what a trigger point is to begin with. To me..its all relaxing and good..And deep tissue is working specific instead of in general. The right pressure is important whatever kind of massage in my opinion. Hmm...I think I need a massage. Yea I do.
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Me too, Gordon-- heck, I'm still in massage school, surrounded by massage therapists of varying degree of skill, but I haven't had a full body massage in weeks. Lots of bodypart stuff. Ninety minutes of MFR one night on one posterior thigh? I walked kinda crooked till I got the other one worked the next day. :)
In my home clinic (no charge because I am a student) I start my sessions with a good warmup, then go directly into NMT and, when needed, MFR. Most then receive a full hour of Swedish. I live in a lower middle class area, in a low income state, so most of my home clients had never had any kind of massage, and probably won't continue coming to me more than once a year as a special treat once I get my license and begin to charge. But they are sure learning to appreciate massage.
Gordon J. Wallis said:Well massage is therapeutic period if you ask me, and relaxing regardless ...Its just if they have a trigger point...It should feel a really good sore when you work it....And a lot of therapists go beyond that...Or don't even know what a trigger point is to begin with. To me..its all relaxing and good..And deep tissue is working specific instead of in general. The right pressure is important whatever kind of massage in my opinion. Hmm...I think I need a massage. Yea I do.
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Permalink Reply by Joyce on
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This is kind of off topic, but wanted to share/recommend an experience I had a couple of days ago--a tandem massage! It came about because we had an uneven number of students in class that evening. I was the "client" and two other therapists synchronized a 90 minute total body massage for me and let me tell you...it was awesome, both on a physical and emotional level. My body had what my teacher calls a "happy healing". It's hard to describe the feeling, but my body almost felt like it was about to levitate, yet I felt very present. My teacher put a rock under the table which helped us all to stay grounded. I have been in a tremendously happy frame of mind since and have no kinks or pains. This experience was different than having one person massage me, I think because there was no place for the energy to be released or travel to other than up and out. :) It was a gentle healing..no drama..just a great sensation of peacefulness and joy. Amazing. So it gave me the idea that my fellow students and I could always team up after graduation with clients and the clients could experience this amazing massage for the same price as one person, but in about half the time. A win-win-win situation. :)
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Been there, done that. In class. Stranger still, you should lie on a table while receiving NMT from two fellow students! At the time, both were still new to the therapy, still rather insensitive, so they sometimes poked too hard and sometimes skirted over trigger points without noticing-- on the table I had to direct them both-- "No, not you...Ralph, you need to use more pressure...Joe, lighten up, you're killing me, buddy!" LOL. Needless to say, we never tried that one again.
Still a student myself, I can't comment on the professional aspects. However, couples massage is popular all over (ie, two therapists working in tandem on two clients).
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The mind can't follow 4 hands at once so you get lost in the sensations. Temple Style Lomi Lomi with 6 hands is an unimaginable experience. At the Hawaii-Festival in Bavaria they try to see how many hands they can get working on one body. The most I have heard of was 8.
http://www.youtube.com/watch?v=-sTeu0zJy7o&feature=related
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I've had one lomi lomi session. A fantastic experience. The therapist moved as if HE had eight hands--he was everywhere at once, moving down my back while the other arm moved down my front. I may never experience another massage by one so skilled, but I won't soon forget that one.
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It is a very different massage. For doing a relaxation massage I prefer Temple style Lomi Lomi to any other modality. Gary were you on an oiled table? That allows gliding the arm underneath with ease.
Gary W Addis said:
I've had one lomi lomi session. A fantastic experience. The therapist moved as if HE had eight hands--he was everywhere at once, moving down my back while the other arm moved down my front. I may never experience another massage by one so skilled, but I won't soon forget that one.
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The therapist was one of my instructors, in payment for my help building him a website. We used my table, bare--no sheets, and he lathered on the oil, a combination of walnut and regular ol' safflower cooking oil. He had received his certification just a few weeks before, and was proficient at it but still like an excited newlywed.
He's also a licensed counselor, this quarter he's teaching psychology. Doing a great job, getting into our heads and rearranging any bad thoughts that crop up. But what a waste. He doesn't much enjoy giving the deep stuff, but, man can he do a feel-good massage!
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