Yes I agree I am doing a few freebies and getting back into it gently
Hi Matt
I used to be a FE tutor myself, so I know about the nonsense from tutor's mouths.
There are many threads on Hp on contraindications. All I will say is that with experience "contraindications" often become "indications" for treatment. Initially tutors, colleges and exam boards do have a duty to make sure as a student that you don't bite off more than you can chew when it comes to case studies. But in real life situations, it's the client that often decides to have massage even with medical conditions. Most GP's won't give you letter to treat (they are exceptions to this, but not common on a national scale). Best you can often do is to get the client to ask if it is OK from the GP. Then the client takes some responsibility. (That doesn't mean you don't have responsibility for your actions - I have to say that as they can be nitpicky on here.)
To add some more advice, get to know some experienced therapists, attend local meetings, and do regular CPD courses. This way you develop the expertise to make better clinical judgements and not relie(sp) on the college spoon-feeding systems.
Best wishes
RP
Cheers for that RP- I will look around in the local area for some local contacts and events. Again, I really value your experience, I understand tutors need control systems in place and learning doesn't have to just be from the college!
Indications and cautions is a huge subject. Not going there just now.
But case history for many can easily be summed-up as a tick-box form - name, age, list any medical conditions, injuries, and medications, anything else you'd like to know about, and sign the bottom to say they consent to treatment as described. That can take 5 minutes for most and save a lot of effort.
If anything leaps out of that you can expand with a verbal grilling, you can even do it while you work. But the chances are there is always something you can do for them: if they have walked in they can cope with a degree of handling, and if they haven't, adapt accordingly. So yes - do feel free to go 'off-piste' so to speak in terms of adapting your methods to situations.
I repeat, routines are very useful tools, but they are there to help us, not the other way around. So I would agree that it need not be necessary, but I would completely disagree with those who think it is only for kindergarten. I personally find mine invaluable, and the more experienced I have become the more I find it to be incredibly useful, as it allows me to concentrate on the things that I really need to be aware of. None of my patients has complained that treatment is dull, irritating or ineffective.
Of course it's not the only way to do things. But if it leads to a robotic or unimaginative treatment, then that could also a reflection of the practitioner, they may well find a way to be boring regardless if they're really determined.
But case history for many can easily be summed-up as a tick-box form
One thing with a tick box form, make it tick boxES - a YES and a NO tick box. Too often people just skip over tick boxes. I've got YES and NO boxes, and it it often given to me with neither ticked, you can't tell if they mean it doesn't apply or if they missed the question. When I get them to tick the NO boxes, quite often suddenly YES boxes start being ticked. Many people just don't bother with the details. I am trained in aromatherapy and use customised blends in treatments (though hardly ever use the full Micheline Arcier aromatherapy routine that was part of the training) and there are quite a lot of additional considerations when using essential oils so the YES/NO answers are pretty important before they get on the massage table.
Oh yes cola, there's no substitute for sussing out your client. A tick-box makes that neither better nor worse if you're asleep on the job.
A verbal and painstakingly written case history can miss loads also. How many times do people tell us they're not on medication when they are?
Because people often think they are healthier than they are, I always spell out 'don't forget sprays, creams, inhalers, eye and ear drop, contraceptives and OTC meds'. Even so, some still say they're not on anything, and when asked about the packets of pills that just fell out of their handbag will reply 'oh, that's just for my heart'.
So I still stand by the point that the tools we use are not to blame, we can use them well or badly, we shouldn't blame them when things go wrong, nor should we throw them away just because some practitioners use them to become lazy.
I thought it was just me that had clients not declaring meds. I always say that if they forget anything, not a problem I'll write it in later. Then the client isn't under pressure and later into the treatment the real interesting things crop up that the client thought wasn't relative to the treatment but was. Typically things like an accident falling out of a tree when they were 12 years old and they completely forgot about the incident.
RP
Its even worse when they don't declare an operation and you discover a operation scar somewhere 😉
...and later into the treatment the real interesting things crop up that the client thought wasn't relative to the treatment but was. Typically things like an accident falling out of a tree when they were 12 years old and they completely forgot about the incident.
Amazing how once you begin to unravel the problem the relevant stuff seems to pop up to the surface all on its own!
Going a bit OT now:D
I repeat, routines are very useful tools, but they are there to help us, not the other way around. So I would agree that it need not be necessary, but I would completely disagree with those who think it is only for kindergarten. I personally find mine invaluable, and the more experienced I have become the more I find it to be incredibly useful, as it allows me to concentrate on the things that I really need to be aware of. None of my patients has complained that treatment is dull, irritating or ineffective.
I agree with you. I know there are people here who say no two massages are alike, and up to a point they are right. Colleges teach you "three strokes of this, three strokes of that", and of course, in the real world, that is nonsense. But a routine makes good sense from both the therapist's and the client's point of view. If I were to leap around the client's body (left leg, then face, then right arm, then over to the back, then over again and back to the right leg...), I might miss something out that could turn out to be crucial. But probably more importantly, it will make no sense to the client - there is a reason why you might be taught, for example, to begin with the legs, then move up to the abdomen, the arms, shoulder etc. The reason is that it feels natural to the client and doesn't give them any unnecessary surprises.
Of course, if the client wants something special, then that is different (and the most important thing is to satisfy the client), but otherwise, what is wrong with a natural progression around the body - wherever you happen to start it?
i suppose then, the difference is not in someone doing a routine or not, but in an intuitive therapist performing a routine versus a 'paint by numbers' therapist doing a routine, because there is a difference.
Of course you have to have some sort of plan, ie where to start etc, but the frustrating thing is, when someone does 2 of this and 3 of that, because that is how they are trained, and then when you ask for say, extra time on lower back, they go to pieces because they dont know what to do....and yes, I have experienced this with therapists, on more than one occasion.
Hi Guys
I've developed routines for FBM & chair massage combining moves from assorted courses & learned from other therapists. I know these work well as a sequence & come in on time & I'll use these with a new client with no particular issues or someone who pops in occasionally for a tune up.
Would hate to use them all the time though so I bring in different moves from time to time to keep it fresh. Also, more importantly, it doesn't work for clients who have particular issues or preferences in their massage.
One of the benefits of lots of training & learning from other therapists is that we develop the confidence & enough techniques to respond to what the client wants/needs and adjust or even abandon any routine without going to pieces as ST outlines above.
i suppose then, the difference is not in someone doing a routine or not, but in an intuitive therapist performing a routine versus a 'paint by numbers' therapist doing a routine, because there is a difference.
Of course you have to have some sort of plan, ie where to start etc, but the frustrating thing is, when someone does 2 of this and 3 of that, because that is how they are trained, and then when you ask for say, extra time on lower back, they go to pieces because they dont know what to do....and yes, I have experienced this with therapists, on more than one occasion.
This strikes a chord with me!
I once decided to treat myself to a two hour massage and wondered why the time had flown quite so quickly as she neared the end of completing the whole body massage whereupon I was asked to turn over again and she did the same 'paint by numbers' massage again for the next hour.
It became like walking home along the same old route, predictable and boring. She only knew how to do a one hour massage sequence and that was it. Lucky I didn't ask for a 3 hour massage or I would have thought I was in some kind of deja vu nightmare.
I've also on occasion asked for extra work on an area and then found that it was at the expense of other areas normally included being missed out completely even though it was a 'full body' massage because the hour was up. Should be possible to still do the other areas even if less than normal due to time spent elsewhere.
I notice there are courses teaching 'intuitive massage'.
Maybe massage therapists should adopt comedians names to indicate their massage approach?! An hour of Eddie Izzard ;)please or a Miranda:D.
Or for the one hour repeated twice a Jim Davidson 😮
A Jim Davidson, what a nightmare!
Well I have to admit that I have many mini-routines that can be cut, pasted and linked to suit the need of the client. Gets the timing right as well - I have to admit that this takes confidence and experience.
"Amazing how once you begin to unravel the problem the relevant stuff seems to pop up to the surface all on its own!" Yes K, it is amazing and thank goodness it does happen!
RP
I once decided to treat myself to a two hour massage and wondered why the time had flown quite so quickly as she neared the end of completing the whole body massage whereupon I was asked to turn over again and she did the same 'paint by numbers' massage again for the next hour.
That's terrible!!