Hey Everyone
Hope this is the correct place to post this!
So I recently passed my ITEC holistic massage diploma and aim to start practising as soon as I can.
The thing is, even before I've started I'm already incredibly nervous about it. I was wondering how everyone felt about contraindications which they came across and weren't sure about?
For example. One lady i got talking to on a train, was telling me all her ailments (when I told her what I was interested in :O)) She told me she had excruciating pain in her arm. the pain was located on the anterior upper arm, around the deltoid area I guess BUT she said it only hurt specifically when she reached out to get something of the shelf. Or, laying down horizontally in bed, from that position, she was physically unable to move that arm and had to use her other arm to move it
She asked me what was wrong with her and what could help it. I told her i was unable to diagnose as I wasnt sure and she would be better off seeing an osteopath or someone more trained.
I wondered what I would do if this was an actual client. Ive had a few people ask me whats wrong with them, and most of the time i obviously have no idea, as the contraindications and disorders we looked at on the course are quite general
I wondered
1) Can anyone have a guess at what they think this ladys injury is?! She doesnt work, doesnt do much excercise so can not think of what could have caused it.
2) When starting out as a therapist, does anyone have any advice as to how they handle clients whos ailments and illnesses are a mystery to them? I just always feel like I want to help more and I know we're not supposed to diagnose but I would like to do more than just tell them I dont know and send them on to someone else
A lady i was speaking to really recommended an a&p book full of massage contraindications and indepth knowledge on them, is anyone familiary with this as Ive forgottern the name?
I guess im just abit scared of practicing on the general public, even though Its what ive wanted to do for some time now 🙂
Hi ZJ
1) Anterior Deltoid problems are very common, and massage done appropraitely (sp) does help
2) Professionally is best to know your boundaries and not let clients take you into the land of imaginary diagnosis. Prehaps you need to take your studies further into remedial/advanced techniques.
As for contraindiactions, the list you learnt is for students to be careful of who they take on. But as experience develops you can make a more clinical discisions (sp) for yourself. Then you will find that what you thought was a contraindication can be an indication for treatment.
The only way to really develop is practice, practice and more practice. The massage diploma is the start of your practice and not an end to itself.
Best Wishes
RP
Hi is the book A Massage Therapists Guide To Pathology by Ruth Werner? Its a good book
So, this lady might have trigger points in her rotator cuff and need a jolly good rub to the shoulders and neck...
Or
might have a ruptured cervical disc, to which strong direct treatment could be catastophic!
Or
she might always carry her bag on that shoulder, and needs to be told to stop.
Or
she might have undiagnosed diabetes, and a frozen shoulder is the first sign that something is wrong.
Quite! This is the conundrum you are rightly aware of, so at least recklessness is not your problem.
On the other hand, what to do?
This is why we need to develop a method that is tolerant of uncertainty. Moving away from strict medical and/or tissue diagnosis is part of that. In the specific diagnosis model, we are confined to treating or not treating the part in trouble. This is not to reflect the true complex reality of your lady's problem - and how is a rub to a sore area supposed to cure inflammation anyway?
In a more general diagnostic model, it is better to treat anything BUT the bit that hurts. Look at the whole context of the problem, open your vision as wide as you like, the problem extends way beyond the limb and out beyond the body of the patient, right into their environment.
We aim to create a favourable environment for the inflammed tissues or dysfunctioning organs, this allows them a chance to recover, without risking further trauma; it reduces the body-wide reaction that may be exacerbating the problem, or even maintaining it.
And it is safe, because we do not need to overcome anyone's pain barriers or resistances to treatment. Such resistances are the body's innate intelligence saying 'leave it alone'. If we seek to overcome it, then we had jolly well better be 100% right or trouble will be the result.
We never force change, we invite change. That way if the body is not ready yet, then it does not have to adapt to our treatment as a further stressor.
And we do not cure any problem, we seek out obstacles to recovery, and understand what is needed for health.
Luckily, the more acute and desperate the situation, the less we generally need to do. In severe cases, tiny inputs can provide a huge benefit. So do not expect to muller your highly acute patient with an hour-long elbows, knees and needles treatment - light and quick and let them be on their way and come back soon. In very acute, they will seldom leave feeling better, so don't keep going until they do. It is when they wake up in a day or two's time they will appreciate the benefit.
If they are so acute that you can do nothing, you can't get into the problem in any way at all, then you cannot help and further information is needed. Luckily they came to you and you can point them in the right direction.
Beyond that, helping people does take courage to move a situation on. Our training is what stops this becoming recklessness, if you think you need more knowledge, then do go and get it. But our best teachers are our patients, without the feedback from helping them you will never get the confidence you require, and that would be a loss to the world.
Lastly, sometimes the best medicine is to leave well alone. The body is always doing something about the situation, even when we are not. As RP has rightly said, as we get more experienced we get better and better at navigating close to the line. But if you or your methods simply are unable to tolerate ever being wrong, making a mistake, being uncertain or confused, then your learning will be very limited.
So be as technically accurate as possible, and then you have to trust. Trust yourself, trust the process. Trust the resilience and healing ability of the human body - which is the sharpest tool in the box - and you will be amazed.
Thank you guys for your responses. Apologies for my late reply, I have been en route to Australia!
Susan - not sure if thats the book but i will check it out, especially if you recommend it.
kvdp - an interesting response, thanks very much 🙂 Actually, ive had a knee injury for some time now (torn meniscus) and the advice I was given from my osteopath was to wear sensible shoes and avoid excercise that made this injury worse and that the body would in turn, sort itself out. I have already noticed a difference after about two weeks or not wearing flip flops or ugg boots, and no more spinning or hula hooping!
So, with regards to this patient. I suggested she saw an osteopath too and in the meantime, I would give her and all over body massage but avoid too much petrissage around the affected area, would you suggest the same? From what i have gathered from her, she doesnt hold her bag on that arm, and hasnt done any extensive excercise to have caused this injury.