Today I’d like to write about a topic that is very popular. The topic is: Writing about our experiences as a massage therapist; specifically, asking questions of other therapists or leader in our field about this situation with a client or that situation with a client.
An example of this would be: Asking assistance of other therapists when a client has limited ROM in their cervical area, an anterior pelvic tilt, etc., etc.
I also see discussion on specific techniques; myofascial release, neuromuscular therapy, trigger point therapy, etc., etc.
Please understand that I’m not ‘knocking’ any techniques or any experts, or discussion on how techniques are performed. I just find it curious and amusing as to how much value this really is.
We are in a ‘hands-on’ profession. It’s certainly true that if a question is asked, we can respond with, “perform this technique and it may assist,” yet I’m talking about when we get down to the ‘nitty-gritty’ of each technique, how to perform it, attempting to describe degrees of ROM, etc., etc.
My favorite example I’ve often used in other topics of discussion when it comes to practices of an experiential nature, is swimming. I use this example as almost everyone has been around a body of water and taken a crack at swimming.
Let’s say I’ve never learned to swim but would like too. Now I can read a book on learning how to swim. I can talk with my friends and listen to all their stories on swimming; the techniques they use to swim the length of the pool, tread water, etc., etc. I can join a discussion group and read posts about swimming.
Yet, until I get in the pool and experience swimming, how valuable is discussion about swimming??
Can you see how this relates to massage therapy? There is of course a bit of a difference, as we are all certified and licensed, or will be soon, and we have already experienced massage. We are just discussing tips and trick for this situation, etc., etc.
Yet, here’s my issue with any kind of deep discussion on ‘what to do or how to do it’ when it comes to (especially!) a client and their situation:
First, we as the ‘advice giver’ have zero medical history on this client. Oh, the therapist asking for help may offer up a little bit of background, but that’s about it. How, or should I say Why, would another therapist in their right mind offer Any sort of advice without knowing medical history?
Second, what is the current state of mind of the client? I refer to this as their ‘presence.’ This is seldom discussed by the therapist asking for assistance via some social medium. Are they (the client) currently in pain? Is their situation an acute one or a chronic one? Are they opened minded to receiving treatment from us? Have the visited their primary care giver? A chiropractor? Just got out of physical therapy? What happened in all of these discussions?
The next topic may be, and I’ve probably missed a bunch of other steps as I’m writing this off the top of my head but I’m sure you get the picture, is postural assessment and or structural analysis. Has this been performed by the therapist? If so, does the therapist even know how to perform this correctly? Has active, passive and resisted ROM been performed? What’s the end feel? Bone on bone or a leather-like feeling? How does the client re-act to this testing? Are they in pain? Once again, I don’t see this mentioned often enough when asking for advice.
I think I’ll cut this off here, because at least to me, what I mention above seems quite obvious. Don’t get me wrong, I love to write about massage! I’m just a little wary of doling out advice when I don’t have the complete picture. What’s even more important to me though, is that this client or whoever is not right here in front of me.
It may sound harmless to give out some advice on how to perform a specific technique, yet once again ask yourself, “How well do I know the therapist I’m giving advice too?” “Do they know how to perform this technique correctly?”
Here’s a quick example of what I’m referring too:
“I'm working with a client that has posterior pelvic tilt, almost no lordosis, and left SI pain. We have had some success with adductor release, and psoas strengthening exercises. What is you strategy for addressing posterior tilt?”
Now of course there are several replies from other therapists that were pretty generic and seemed harmless enough…yet let me ask….
Does this therapist know what posterior pelvic tilt is, or no lordosis? To what degree is the posterior pelvic tilt? What does ‘almost no lordosis’ even mean to this therapist compared to you? How long has the client been this way? Where are they at on the ‘pain scale’ when the therapist mentions that the client has SI pain? Acute pain or chronic pain? Have they seen or visited any medical professionals? If so, what did they say? What are the medical conditions of this client? Beyond that, are they contraindicated to even receive massage? Again, there’s a ton of other questions we can ask, yet I’m sure you can understand my point.
Also, I seriously doubt (my assumption of course and I hope I’m always right) that any advice given will actually harm the client. Yet, do you want to be the one who gives the advice when you don’t have a complete picture, and someone does have something occur negatively with said client?? I know I don’t….
What are your thoughts on this?
Am I being over sensitive or cautious in regards to this??