contraindications to massage!!!!!!

Hi PP

Slipped disc is just a common term for a herniated or prolapsed disc. More info: http://en.wikipedia.org/wiki/Spinal_disc_herniation

If the client hasn't got pain in that region, I wouldn't say it's an contraindication, may be a precaution. Since the disc has been removed it can't be "slipped" anymore. The form and listings you have been given is to protect you as a student and make you think/reflect about your actions as a therapist. When you qualify you will find that a contraindication list isn't written it stone and is always debatable, and that a CI can be an indication for treatment, but that comes with experience. I only mention this as many tutors teach CI's as gospel, and the newly qualified get anxious about what they feel that they can do or not do.

My advise is: if it is not a painful condition and they are not taking pain killers, have the client sign the disclaimer form that they are happy to be treated by you, you should be fine.

Best wishes on your studies

RP

Hi
Not sure if i have put this in the correct forum, sorry.

I am currently doing my case studies for my ITEC massage therapy course.

I have a client that would like a massage, but they had a Discectomy in 2007. My form says i should get medical permission for slipped disk, but from what i can gather this operation was not for a slipped disc but for removal of herniated disc, are they the same thing????? my client had this operation following a car accident.
Im confused, can anyone with more medical knowledge help on this please.

HI PP,
my personal opinion is that as you are unsure about this , then it would be outside your remit, and for the record getting medical permission is about as common as hen's teeth. I am sure you will find enough case studies without stressing over things that you do not fully understand. Best of luck with your course

kind regards
BGFL

I would have thought that an operation in 2007 is long enough ago to not worry about. Whether it was successful or not is another matter - if your client still has pain in the area then treat THAT with caution, but the scar tissue etc will have long healed (and probably adhered, thus causing immobility, in which case massage is GOOD!) As BGFL says, getting med perm is rare - all you can really do is ask your client to run it past the GP next time they see him/her.

Slipped-disc and herniated disc are the same thing. You don't say if this is a lumbar or cervical disc, by the way (or even thoracic? it can happen).

I'd say this is a great case for a case study. The contraindications are relative and would depend on the exact circumstances. The point is to understand where strain may be coming from, and how the body is dealing with it.

Many of the symptomatic areas in a patient with this history are actually adaptations to 'shore-up' areas of vulnerability in the spine to limit further strain. We take down this support at peril. In other words, loosening all the tight bits can make matters worse.

On the other hand, many such areas will be part of the lingering adaptation to the problem, and will be maintaining problems. It can be hard to tell which areas are which (at least that's a degree course in itself).

But what else is feeding into the problem? In particular, what is happening in the legs? If the limbs have lost elasticity then forces are directed more strongly to the core - shock absorbtion has been lost. Or perhaps the muscles have shortened in response to a seated posture, say, in a car. So you might start your treatment there and see what happens.

If this is a lumbar problem, what is happening at the other end of the spine? The head is like a melon waving around on a stick, so the lower end of the stick has to cope with a lot. Is this patient adopting a hunched posture in front of a computer all day? In which case perhaps attempt to relax the anterior structures of the shoulder and neck - pecs, sternocleidomastoid etc.

What about the big bowstring of Latissimus dorsi? If this becomes tight it puts huge strain on everything and creates an exaggerated swayback.

Okay, these are conceptual points. But with any doubts about the history, a good general approach is to start as far away from the area of trouble as possible and work slowly inwards, checking the response as you go - perhaps over several treatments. Then you may often find by the time you reach the problem area, the problem has largely solved itself.

If the patient is asking for help with their actual recovery from this injury, then I would really push the boat out - see how far from the problem you can start and still find relevance. Nutrition? Hydration? Stress? Rest? Work environment etc. Politics?!?

Litigation? Believe it or not a good predictor of recovery is the expectation of a payout and whether or not the case is settled. In other words, people don't heal so well or so fast if they think the severity strengthens their case for payment. Good luck dealing with that one!