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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 Gordon J. Wallis on
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This is what I do when I have a clinical situation. How I measure the effectiveness of the massage session thats easily recognized by the client as well... I had a similar situation as the one in this thread, but fortunately caught earlier, before things got to carried away... This was yesterday... I asked her what she needed from the massage.. She told me that she has been suffering with pain in her right shoulder that runs from her upper back near her shoulder blade to the top of her shoulder and up her neck...all on the right side. I asked her how long she has had this pain..She said four months.. So I did my one minute palpatory exam from her hips to the base of her skull... I found one minor sore spot on the left of T12 on the spinal erectors. A really sore spot on her right rhomboid near the bottom of her shoulder blade. Another moderately sore spot on the top of her right Trap. And a smaller sore spot on the right side of her neck around C4. If you look at a trigger point chart the pain patterns fit her complaint. Anyway, so thats my goal.. To eliminate or down grade those sore areas...She had an hour massage scheduled. So whatever techniques or approach you use, you have something to measure the effectiveness or your massage treatment by rechecking those sore areas at the end of the session...And the client can feel and notice the effectiveness too. In her case I was able to eliminate all those sore areas within the hour session...She is coming in on Sunday for a 25 min. massage as a follow up.. where I will recheck with my one min. exam and go from there...I suspect she will be fine.. But lets say one of those sore areas came back... Then that would be noted, and that would be the goal for that 25min. session... But thats how I measure the effectiveness of what Im doing.. A brief one minute exam before and after the massage... And if there is no change in the clients condition after a couple of massage sessions .. Then I tell the client that I can always massage them, but that I wont be specifically effective for their problem.. Its like if I fail, I fail fast....Im not into ripping people off and massaging them twice a week for four months with no results. There should be a dramatic or noticalble reduction of their condition within four sessions in my opinion.. Thats my standard anyway.
Gordon J. Wallis said:Massage therapists need to be educated as to what massage can do. Once any underlying pathology is ruled out..There is no one better to see then a knowledgeable massage therapist.No one.. The massage therapists that worked on her gingerly worked around the area so as not to cause any further damage... Before I work on someone...I do a quick one minute exam...I palpate specific areas on the body where trigger points are common...If I get a nocioceptive response or the client indicates she is sore there...I take note...and then my goal is to eliminate those sore areas.. If Im able to do that, and often I can, more often then not all their presenting symptoms usually go away.... Its not rocket science...We work with muscles.. Trigger points or whatever you want to call them are involved in most peoples pain problems and often are solely responsible....So whatever approach you use, if the trigger point is still there, so is the problem. No one in that clinic knows what a trigger point is, or how to handle a sore muscle.(what a joke)... After the massage I re do that one minute exam..They notice the difference...Its measurable...you know if you are helping them or not by the results. And if someone isnt noticeably better after four sessions...You cant help them , and need to refer them on. Four or no more...Usually within two sessions you should know. Everyone can enjoy a good massage, but if you want to be specific for their problem. You should know very soon. In my opinion its our educational system.. Therapists are trained to fit in to a dysfunctional system.. In our text books is says to go to a medical doctor if you think you might have carpal tunnel... When in reality, massage is the best therapy possible for carpal tunnel... See what I mean? Most of the people diagnosed with carpal tunnel have what I call fake carpal tunnel anyway...I dont know everything about this kind of work...But I shake my head in disbelief every day...
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 Gary W Addis, LMT on
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Detailed SOAP notes would help to document--and when we absolutely have done well by the client, we should ask them to fill out a ratings form on the massage therapist, and specifically ask them to explain their situation before and after the great MT work. And I'd keep the SOAP and client's assessment of the result together, and in a separate folder. Might languish in the cabinet for a long while, but could one day be included in a published case research study.
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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That would be smart...and perhaps the notes would be good for study, as to what worked and didn't. But for me, treatment notes are out of the question. Working in a busy spa.. There is just no time.. I instruct all my return clients to remind me as to what we are working on and what I did... However with my one minute exam I find where they need work anyway...but yea....treatment notes would be ideal...in all situations....But we live in an imperfect world...lol I had three clients for clinical work yesterday.. I was able to dramatically help two of them...They will return for follow up sessions in a few days..However I failed with one client.. She had pain in her left shoulder that went up her neck. I thought for sure I could help her...But I couldnt.. So I told her that I couldnt help her.. I mean I used all my massage armimentation, everything in my bag of tricks so to speak. However..she was no better.. So no need for her to come back.. Im not going to rip anyone off by having her come back twice a weak for four months telling her I can help her.....It cost her $55.00 for me not to help her...There are too many con artists in the health care industry already.
Gary W Addis said:Detailed SOAP notes would help to document--and when we absolutely have done well by the client, we should ask them to fill out a ratings form on the massage therapist, and specifically ask them to explain their situation before and after the great MT work. And I'd keep the SOAP and client's assessment of the result together, and in a separate folder. Might languish in the cabinet for a long while, but could one day be included in a published case research study.
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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The spas here don't do SOAPS either.
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Yea there is just no time.. But I dont need them.. My clinical return clients are educated as to what Im doing, and let me know... I love my work...I gotta get ready for work now...Yea I work on Sundays..its a busy day for spas.....
Gary W Addis said:The spas here don't do SOAPS either.
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Ok it happened again... Im really angry...I thought I might wait a few days before I typed this...but Im tired of it...Its pretty much a normal occurrence....It was only only a few weeks ago that I wrote this origianal post...Now it happened again...I had a client today that has been diagnosed with a rotator cuff injury. She told me that they are talking about surgery.. She has been going to physical therapy twice a week for six months.. ok.. She told me that she still hurts, and she is going to have to talk to the docs about surgery. One of her friends said you have go to see Gordon.. She heard that four months ago.. But continued to go to physical therapy. Her husband made her stop a month ago because it wasnt getting better...Well she saw me today...She told me that when she lifts her arm, it hurts like hell..So I immediately palpated her infraspinatus, on the shoulder blade, and found Two Huge trigger points.. Of course no one touched her there? I dont know what kind of exam those idiots did... But I would love to read it...It would be pure Bull poop. In five minutes her rotator cuff injury was gone.. GONE.. NO MORE... FIVE MINUTES..GONE. She had six months twice a week of physical therapy billed to the insurance company.!!!!.. Two infraspinatus trigger points.!!.. She was extatic...she couldnt believe it... It was like a dream for her. She was raving all the way out of the spa... She told me she is the happiest women in Alaska.. She was freaked out....I didnt do very much to make her happy...I have fancy release techniques, but if anyone would of just rubbed those sore spots.. They would of had dramatic results....There is no excuse for that incompetence.. NONE.. What kind of exam could they have possibly done?? I found her problem in freakin in seconds , before she even got on the table.. Look in any trigger point book or keinisiology book as to what muscles are involved if someone cant lift their arm(abduct). And I just checked where she told me she was sore...This is what pisses me off.. Massage therapists are educated and looked at as third tier providers..Like a freakin hot pack in the Conner of some clinic... Those people she saw are not ever qualified to work with me..thats why I work in a spa.. They arnt good enough...The thing is.. Its not my skill level thats amazing....its their incompetence thats amazing...That was so simple..SIMPLE... Massage therapists should be trained to dominate this whole chiropractic and Pt industry.Instead we are trained to grovel to work for them????..Think about it... Six months twice a week.. compared to freakin seconds.!!.. Think of the cost and suffering and stress she went through...She thinks Im Jesus..You should of seen how happy this women was... When she came out of the room.. She said I cant believe this is true...But i dont feel any pain... I cant believe this is true.. She was shocked... So was I, yet again for the millionth time... She rescheduled to see me for 15 min.session three days from now for a follow up...but its over. Six months twice a week !!!!! WTF??? If I cant help someone dramatically withing four sessions...I tell them anyone can enjoy a good massage..But Im not going to be specific for your problem.. Im honest... If I fail.. I fail FAST... Im not ripping anyone off... I told another client today that had pain in her back after seeing her two time that.I couldnt help her...She told me that she really respects my honesty..and that other health care providers had her coming in three times a week for months before she stopped seeing them.. She said because Im the only one that talked to her honestly...she is going to see me as a regular client at least once a month..And she scheduled to see me next week.. We need a new organization to take over this common ache an pain industry.. Right now its full of incompetence and con artists....Thats the truth. I should of waited to type this after my anger dissipated.Maybe I would state things more calmly.. I cant imagine working for any of those clinics...Id rather shovel poop to the moon. There is NO EXCUSE..
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Permalink Reply by Teena Johnson on
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Gosh- I think we have a choir!
This is why we need to make ourselves better at record keeping, research AND get confident enough in our data that we PUBLISH articles about our work.
Good Job!
You are right about the anger--- get it under control and put the passion to good use.
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You have to wonder why do some of these people enter the medical field--but not for long.
There are lots of very dedicated, sincere medical doctors, but a percentage of them enter the field in order to become rich. They endure 8-10 years of college plus internship to earn their right to earn the big bucks. Physical therapists spend four or more years in the classroom, and earn their daily bread. Education is expensive. For an MD, the debt can be more than $200,000. So, we can understand why even the good ones begin to look for ways to increase profits.
My massage therapy schooling took two years, and has saddled me with $32,000 in student debt. To pay it off within the 10 year limit I'll have to do a minimum of two massages per week for the bankers, double that number at the percentage rate paid to therapists by the spas and clinics.
Education is expensive. All healthcare practitioners have to support themselves and families. So, none of us can afford to treat people for free. But there's no excuse for manipulating the treatments solely to increase profits. Doctors swear to the Hippocratic Oath; chiropractors probably have a similar oath; physical therapists and massage therapists are expected to uphold similar ethical standards. For all of us, the rule is, first, do no harm. Unnecessarily extending treatment by even one session does harm to the patient/client. At the very least doing so is a violation of oaths and ethical standards.
But, the devil is in the details. PTs who work within their scope of practice work trigger points only incidentally to their work; surgeons would rather remove the 1st rib than release a scalene trigger point. This creates a doughnut hole within which massage therapists like Daniel and Gordon and a few highly skilled others do their magic.... When they come to us.
Leaves us with the question, do MDs and PTs and DCs (and some MTs) purposely prolong the treatment process in order to put more money in the bank, or is it because they just don't know any better? Probably both.
Good on you, brother Gordon. Good on all who do all they can to relieve pain and restore ROM as quickly as they can.
Gordon J. Wallis said:Ok it happened again... Im really angry...I thought I might wait a few days before I typed this...but Im tired of it...Its pretty much a normal occurrence....It was only only a few weeks ago that I wrote this origianal post...Now it happened again...I had a client today that has been diagnosed with a rotator cuff injury. She told me that they are talking about surgery.. She has been going to physical therapy twice a week for six months.. ok.. She told me that she still hurts, and she is going to have to talk to the docs about surgery. One of her friends said you have go to see Gordon.. She heard that four months ago.. But continued to go to physical therapy. Her husband made her stop a month ago because it wasnt getting better...Well she saw me today...She told me that when she lifts her arm, it hurts like hell..So I immediately palpated her infraspinatus, on the shoulder blade, and found Two Huge trigger points.. Of course no one touched her there? I dont know what kind of exam those idiots did... But I would love to read it...It would be pure Bull poop. In five minutes her rotator cuff injury was gone.. GONE.. NO MORE... FIVE MINUTES..GONE. She had six months twice a week of physical therapy billed to the insurance company.!!!!.. Two infraspinatus trigger points.!!.. She was extatic...she couldnt believe it... It was like a dream for her. She was raving all the way out of the spa... She told me she is the happiest women in Alaska.. She was freaked out....I didnt do very much to make her happy...I have fancy release techniques, but if anyone would of just rubbed those sore spots.. They would of had dramatic results....There is no excuse for that incompetence.. NONE.. What kind of exam could they have possibly done?? I found her problem in freakin in seconds , before she even got on the table.. Look in any trigger point book or keinisiology book as to what muscles are involved if someone cant lift their arm(abduct). And I just checked where she told me she was sore...This is what pisses me off.. Massage therapists are educated and looked at as third tier providers..Like a freakin hot pack in the Conner of some clinic... Those people she saw are not ever qualified to work with me..thats why I work in a spa.. They arnt good enough...The thing is.. Its not my skill level thats amazing....its their incompetence thats amazing...That was so simple..SIMPLE... Massage therapists should be trained to dominate this whole chiropractic and Pt industry.Instead we are trained to grovel to work for them????..Think about it... Six months twice a week.. compared to freakin seconds.!!.. Think of the cost and suffering and stress she went through...She thinks Im Jesus..You should of seen how happy this women was... When she came out of the room.. She said I cant believe this is true...But i dont feel any pain... I cant believe this is true.. She was shocked... So was I, yet again for the millionth time... She rescheduled to see me for 15 min.session three days from now for a follow up...but its over. Six months twice a week !!!!! WTF??? If I cant help someone dramatically withing four sessions...I tell them anyone can enjoy a good massage..But Im not going to be specific for your problem.. Im honest... If I fail.. I fail FAST... Im not ripping anyone off... I told another client today that had pain in her back after seeing her two time that.I couldnt help her...She told me that she really respects my honesty..and that other health care providers had her coming in three times a week for months before she stopped seeing them.. She said because Im the only one that talked to her honestly...she is going to see me as a regular client at least once a month..And she scheduled to see me next week.. We need a new organization to take over this common ache an pain industry.. Right now its full of incompetence and con artists....Thats the truth. I should of waited to type this after my anger dissipated.Maybe I would state things more calmly.. I cant imagine working for any of those clinics...Id rather shovel poop to the moon. There is NO EXCUSE..
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Permalink Reply by Daniel Cohen on
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There is security in creating treatment dependency. Everyone haas bills to pay and the larger they are the more tempting to have permanent patients rather than expect new ones to walk in. I think you will find it to a certaain extent inn all fields. Some are more notorious for it than others. I often find from patients going to Chiro & Acu that they are afraid to miss their weekly appointment because they are convinced they will be worse without it.
Gary W Addis said:You have to wonder why do some of these people enter the medical field--but not for long.
There are lots of very dedicated, sincere medical doctors, but a percentage of them enter the field in order to become rich. They endure 8-10 years of college plus internship to earn their right to earn the big bucks. Physical therapists spend four or more years in the classroom, and earn their daily bread. Education is expensive. For an MD, the debt can be more than $200,000. So, we can understand why even the good ones begin to look for ways to increase profits.
My massage therapy schooling took two years, and has saddled me with $32,000 in student debt. To pay it off within the 10 year limit I'll have to do a minimum of two massages per week for the bankers, double that number at the percentage rate paid to therapists by the spas and clinics.
Education is expensive. All healthcare practitioners have to support themselves and families. So, none of us can afford to treat people for free. But there's no excuse for manipulating the treatments solely to increase profits. Doctors swear to the Hippocratic Oath; chiropractors probably have a similar oath; physical therapists and massage therapists are expected to uphold similar ethical standards. For all of us, the rule is, first, do no harm. Unnecessarily extending treatment by even one session does harm to the patient/client. At the very least doing so is a violation of oaths and ethical standards.
But, the devil is in the details. PTs who work within their scope of practice work trigger points only incidentally to their work; surgeons would rather remove the 1st rib than release a scalene trigger point. This creates a doughnut hole within which massage therapists like Daniel and Gordon and a few highly skilled others do their magic.... When they come to us.
Leaves us with the question, do MDs and PTs and DCs (and some MTs) purposely prolong the treatment process in order to put more money in the bank, or is it because they just don't know any better? Probably both.
Good on you, brother Gordon. Good on all who do all they can to relieve pain and restore ROM as quickly as they can.
Gordon J. Wallis said:Ok it happened again... Im really angry...I thought I might wait a few days before I typed this...but Im tired of it...Its pretty much a normal occurrence....It was only only a few weeks ago that I wrote this origianal post...Now it happened again...I had a client today that has been diagnosed with a rotator cuff injury. She told me that they are talking about surgery.. She has been going to physical therapy twice a week for six months.. ok.. She told me that she still hurts, and she is going to have to talk to the docs about surgery. One of her friends said you have go to see Gordon.. She heard that four months ago.. But continued to go to physical therapy. Her husband made her stop a month ago because it wasnt getting better...Well she saw me today...She told me that when she lifts her arm, it hurts like hell..So I immediately palpated her infraspinatus, on the shoulder blade, and found Two Huge trigger points.. Of course no one touched her there? I dont know what kind of exam those idiots did... But I would love to read it...It would be pure Bull poop. In five minutes her rotator cuff injury was gone.. GONE.. NO MORE... FIVE MINUTES..GONE. She had six months twice a week of physical therapy billed to the insurance company.!!!!.. Two infraspinatus trigger points.!!.. She was extatic...she couldnt believe it... It was like a dream for her. She was raving all the way out of the spa... She told me she is the happiest women in Alaska.. She was freaked out....I didnt do very much to make her happy...I have fancy release techniques, but if anyone would of just rubbed those sore spots.. They would of had dramatic results....There is no excuse for that incompetence.. NONE.. What kind of exam could they have possibly done?? I found her problem in freakin in seconds , before she even got on the table.. Look in any trigger point book or keinisiology book as to what muscles are involved if someone cant lift their arm(abduct). And I just checked where she told me she was sore...This is what pisses me off.. Massage therapists are educated and looked at as third tier providers..Like a freakin hot pack in the Conner of some clinic... Those people she saw are not ever qualified to work with me..thats why I work in a spa.. They arnt good enough...The thing is.. Its not my skill level thats amazing....its their incompetence thats amazing...That was so simple..SIMPLE... Massage therapists should be trained to dominate this whole chiropractic and Pt industry.Instead we are trained to grovel to work for them????..Think about it... Six months twice a week.. compared to freakin seconds.!!.. Think of the cost and suffering and stress she went through...She thinks Im Jesus..You should of seen how happy this women was... When she came out of the room.. She said I cant believe this is true...But i dont feel any pain... I cant believe this is true.. She was shocked... So was I, yet again for the millionth time... She rescheduled to see me for 15 min.session three days from now for a follow up...but its over. Six months twice a week !!!!! WTF??? If I cant help someone dramatically withing four sessions...I tell them anyone can enjoy a good massage..But Im not going to be specific for your problem.. Im honest... If I fail.. I fail FAST... Im not ripping anyone off... I told another client today that had pain in her back after seeing her two time that.I couldnt help her...She told me that she really respects my honesty..and that other health care providers had her coming in three times a week for months before she stopped seeing them.. She said because Im the only one that talked to her honestly...she is going to see me as a regular client at least once a month..And she scheduled to see me next week.. We need a new organization to take over this common ache an pain industry.. Right now its full of incompetence and con artists....Thats the truth. I should of waited to type this after my anger dissipated.Maybe I would state things more calmly.. I cant imagine working for any of those clinics...Id rather shovel poop to the moon. There is NO EXCUSE..
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If there were no insurance companies, and people had to pay out of pocket. Things would be very different in the Ache n Pain industry. Real effective and efficient therapies would take over.
Daniel Cohen said:There is security in creating treatment dependency. Everyone haas bills to pay and the larger they are the more tempting to have permanent patients rather than expect new ones to walk in. I think you will find it to a certaain extent inn all fields. Some are more notorious for it than others. I often find from patients going to Chiro & Acu that they are afraid to miss their weekly appointment because they are convinced they will be worse without it.
Gary W Addis said:You have to wonder why do some of these people enter the medical field--but not for long.
There are lots of very dedicated, sincere medical doctors, but a percentage of them enter the field in order to become rich. They endure 8-10 years of college plus internship to earn their right to earn the big bucks. Physical therapists spend four or more years in the classroom, and earn their daily bread. Education is expensive. For an MD, the debt can be more than $200,000. So, we can understand why even the good ones begin to look for ways to increase profits.
My massage therapy schooling took two years, and has saddled me with $32,000 in student debt. To pay it off within the 10 year limit I'll have to do a minimum of two massages per week for the bankers, double that number at the percentage rate paid to therapists by the spas and clinics.
Education is expensive. All healthcare practitioners have to support themselves and families. So, none of us can afford to treat people for free. But there's no excuse for manipulating the treatments solely to increase profits. Doctors swear to the Hippocratic Oath; chiropractors probably have a similar oath; physical therapists and massage therapists are expected to uphold similar ethical standards. For all of us, the rule is, first, do no harm. Unnecessarily extending treatment by even one session does harm to the patient/client. At the very least doing so is a violation of oaths and ethical standards.
But, the devil is in the details. PTs who work within their scope of practice work trigger points only incidentally to their work; surgeons would rather remove the 1st rib than release a scalene trigger point. This creates a doughnut hole within which massage therapists like Daniel and Gordon and a few highly skilled others do their magic.... When they come to us.
Leaves us with the question, do MDs and PTs and DCs (and some MTs) purposely prolong the treatment process in order to put more money in the bank, or is it because they just don't know any better? Probably both.
Good on you, brother Gordon. Good on all who do all they can to relieve pain and restore ROM as quickly as they can.
Gordon J. Wallis said:Ok it happened again... Im really angry...I thought I might wait a few days before I typed this...but Im tired of it...Its pretty much a normal occurrence....It was only only a few weeks ago that I wrote this origianal post...Now it happened again...I had a client today that has been diagnosed with a rotator cuff injury. She told me that they are talking about surgery.. She has been going to physical therapy twice a week for six months.. ok.. She told me that she still hurts, and she is going to have to talk to the docs about surgery. One of her friends said you have go to see Gordon.. She heard that four months ago.. But continued to go to physical therapy. Her husband made her stop a month ago because it wasnt getting better...Well she saw me today...She told me that when she lifts her arm, it hurts like hell..So I immediately palpated her infraspinatus, on the shoulder blade, and found Two Huge trigger points.. Of course no one touched her there? I dont know what kind of exam those idiots did... But I would love to read it...It would be pure Bull poop. In five minutes her rotator cuff injury was gone.. GONE.. NO MORE... FIVE MINUTES..GONE. She had six months twice a week of physical therapy billed to the insurance company.!!!!.. Two infraspinatus trigger points.!!.. She was extatic...she couldnt believe it... It was like a dream for her. She was raving all the way out of the spa... She told me she is the happiest women in Alaska.. She was freaked out....I didnt do very much to make her happy...I have fancy release techniques, but if anyone would of just rubbed those sore spots.. They would of had dramatic results....There is no excuse for that incompetence.. NONE.. What kind of exam could they have possibly done?? I found her problem in freakin in seconds , before she even got on the table.. Look in any trigger point book or keinisiology book as to what muscles are involved if someone cant lift their arm(abduct). And I just checked where she told me she was sore...This is what pisses me off.. Massage therapists are educated and looked at as third tier providers..Like a freakin hot pack in the Conner of some clinic... Those people she saw are not ever qualified to work with me..thats why I work in a spa.. They arnt good enough...The thing is.. Its not my skill level thats amazing....its their incompetence thats amazing...That was so simple..SIMPLE... Massage therapists should be trained to dominate this whole chiropractic and Pt industry.Instead we are trained to grovel to work for them????..Think about it... Six months twice a week.. compared to freakin seconds.!!.. Think of the cost and suffering and stress she went through...She thinks Im Jesus..You should of seen how happy this women was... When she came out of the room.. She said I cant believe this is true...But i dont feel any pain... I cant believe this is true.. She was shocked... So was I, yet again for the millionth time... She rescheduled to see me for 15 min.session three days from now for a follow up...but its over. Six months twice a week !!!!! WTF??? If I cant help someone dramatically withing four sessions...I tell them anyone can enjoy a good massage..But Im not going to be specific for your problem.. Im honest... If I fail.. I fail FAST... Im not ripping anyone off... I told another client today that had pain in her back after seeing her two time that.I couldnt help her...She told me that she really respects my honesty..and that other health care providers had her coming in three times a week for months before she stopped seeing them.. She said because Im the only one that talked to her honestly...she is going to see me as a regular client at least once a month..And she scheduled to see me next week.. We need a new organization to take over this common ache an pain industry.. Right now its full of incompetence and con artists....Thats the truth. I should of waited to type this after my anger dissipated.Maybe I would state things more calmly.. I cant imagine working for any of those clinics...Id rather shovel poop to the moon. There is NO EXCUSE..
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I have completed all my massage therapy training, including internship six weeks ago. I should have my license in hand already, but the State hasn't scheduled the licensing exam (which I could have passed a year ago!). But already I have a few regular clients that I treat usually once per month ( alas, they may not be so regular once I can begin to charge a fee). I do a good job for them; nevertheless, their issues recur regularly... due to lifestyle or work, which I can't change. So, it seems to me that an MD, DC, PT or MT who treats the condition successfully in a couple of sessions vs a couple of months will earn the client's loyalty, and will get the opportunity to treat them again and again and again anyway.
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Actually, if there were no insurance and people didn't have the money to pay for care, they'd suffer with the issue till it kills them--as it is, insurance co-pay of $20 keeps people from getting medical care till they can't stand the pain anymore
Gordon J. Wallis said:If there were no insurance companies, and people had to pay out of pocket. Things would be very different in the Ache n Pain industry. Real effective and efficient therapies would take over.
Daniel Cohen said:There is security in creating treatment dependency. Everyone haas bills to pay and the larger they are the more tempting to have permanent patients rather than expect new ones to walk in. I think you will find it to a certaain extent inn all fields. Some are more notorious for it than others. I often find from patients going to Chiro & Acu that they are afraid to miss their weekly appointment because they are convinced they will be worse without it.
Gary W Addis said:You have to wonder why do some of these people enter the medical field--but not for long.
There are lots of very dedicated, sincere medical doctors, but a percentage of them enter the field in order to become rich. They endure 8-10 years of college plus internship to earn their right to earn the big bucks. Physical therapists spend four or more years in the classroom, and earn their daily bread. Education is expensive. For an MD, the debt can be more than $200,000. So, we can understand why even the good ones begin to look for ways to increase profits.
My massage therapy schooling took two years, and has saddled me with $32,000 in student debt. To pay it off within the 10 year limit I'll have to do a minimum of two massages per week for the bankers, double that number at the percentage rate paid to therapists by the spas and clinics.
Education is expensive. All healthcare practitioners have to support themselves and families. So, none of us can afford to treat people for free. But there's no excuse for manipulating the treatments solely to increase profits. Doctors swear to the Hippocratic Oath; chiropractors probably have a similar oath; physical therapists and massage therapists are expected to uphold similar ethical standards. For all of us, the rule is, first, do no harm. Unnecessarily extending treatment by even one session does harm to the patient/client. At the very least doing so is a violation of oaths and ethical standards.
But, the devil is in the details. PTs who work within their scope of practice work trigger points only incidentally to their work; surgeons would rather remove the 1st rib than release a scalene trigger point. This creates a doughnut hole within which massage therapists like Daniel and Gordon and a few highly skilled others do their magic.... When they come to us.
Leaves us with the question, do MDs and PTs and DCs (and some MTs) purposely prolong the treatment process in order to put more money in the bank, or is it because they just don't know any better? Probably both.
Good on you, brother Gordon. Good on all who do all they can to relieve pain and restore ROM as quickly as they can.
Gordon J. Wallis said:Ok it happened again... Im really angry...I thought I might wait a few days before I typed this...but Im tired of it...Its pretty much a normal occurrence....It was only only a few weeks ago that I wrote this origianal post...Now it happened again...I had a client today that has been diagnosed with a rotator cuff injury. She told me that they are talking about surgery.. She has been going to physical therapy twice a week for six months.. ok.. She told me that she still hurts, and she is going to have to talk to the docs about surgery. One of her friends said you have go to see Gordon.. She heard that four months ago.. But continued to go to physical therapy. Her husband made her stop a month ago because it wasnt getting better...Well she saw me today...She told me that when she lifts her arm, it hurts like hell..So I immediately palpated her infraspinatus, on the shoulder blade, and found Two Huge trigger points.. Of course no one touched her there? I dont know what kind of exam those idiots did... But I would love to read it...It would be pure Bull poop. In five minutes her rotator cuff injury was gone.. GONE.. NO MORE... FIVE MINUTES..GONE. She had six months twice a week of physical therapy billed to the insurance company.!!!!.. Two infraspinatus trigger points.!!.. She was extatic...she couldnt believe it... It was like a dream for her. She was raving all the way out of the spa... She told me she is the happiest women in Alaska.. She was freaked out....I didnt do very much to make her happy...I have fancy release techniques, but if anyone would of just rubbed those sore spots.. They would of had dramatic results....There is no excuse for that incompetence.. NONE.. What kind of exam could they have possibly done?? I found her problem in freakin in seconds , before she even got on the table.. Look in any trigger point book or keinisiology book as to what muscles are involved if someone cant lift their arm(abduct). And I just checked where she told me she was sore...This is what pisses me off.. Massage therapists are educated and looked at as third tier providers..Like a freakin hot pack in the Conner of some clinic... Those people she saw are not ever qualified to work with me..thats why I work in a spa.. They arnt good enough...The thing is.. Its not my skill level thats amazing....its their incompetence thats amazing...That was so simple..SIMPLE... Massage therapists should be trained to dominate this whole chiropractic and Pt industry.Instead we are trained to grovel to work for them????..Think about it... Six months twice a week.. compared to freakin seconds.!!.. Think of the cost and suffering and stress she went through...She thinks Im Jesus..You should of seen how happy this women was... When she came out of the room.. She said I cant believe this is true...But i dont feel any pain... I cant believe this is true.. She was shocked... So was I, yet again for the millionth time... She rescheduled to see me for 15 min.session three days from now for a follow up...but its over. Six months twice a week !!!!! WTF??? If I cant help someone dramatically withing four sessions...I tell them anyone can enjoy a good massage..But Im not going to be specific for your problem.. Im honest... If I fail.. I fail FAST... Im not ripping anyone off... I told another client today that had pain in her back after seeing her two time that.I couldnt help her...She told me that she really respects my honesty..and that other health care providers had her coming in three times a week for months before she stopped seeing them.. She said because Im the only one that talked to her honestly...she is going to see me as a regular client at least once a month..And she scheduled to see me next week.. We need a new organization to take over this common ache an pain industry.. Right now its full of incompetence and con artists....Thats the truth. I should of waited to type this after my anger dissipated.Maybe I would state things more calmly.. I cant imagine working for any of those clinics...Id rather shovel poop to the moon. There is NO EXCUSE..
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