September 19, 2011

Good Intentions and Messy Manifestations

Working with clients who have had early interventions for muscle-skeletal problems has proven quite interesting. Along with all the reasons to have a massage, these clients have an extra agenda: They want to feel good about areas of their bodies that have been identified early on as not being quite right.

For some people the area that has not been right has a special meaning to their whole. If knock-kneed or pigeon-toed, legs are often restricted by braces, leaving the child locked down while others their age are learning to run and play. A good amount of senescence, the sense that the body is in balance and harmonious with gravity, is lost unlearned and unavailable.

One response to bracing is the good-sport carry-on persistence that leads the child to ignore pain and awkwardness in an attempt to keep up and fit in. In adults, I have noticed this is big trouble when it comes to recognizing the difference between signs of injury and simple fatigue. The attitude is that no matter what, they will finish the task – even if it is an impossible distance for someone with rotated hips.

Iron Man had managed to complete nine of the Hawaiian endurance races, despite having pigeon-toes corrected forcibly with heavy braces when he was an infant. During his last run season he had developed a deep joint infection and inflammation in his hip, yet he had pulled off the training and races.

I met him five years later, when he was long past his Iron Man ambitions and found himself limping and in pain. I had hopes it was soft tissue hardening, but a visit to the orthopedist showed a fully necrotic trochanter and femoral shaft, leading to the conclusion he must have run with a massive infection. During that infection, the vein supplying blood to the bone had been destroyed.

Part of his recovery included a hip implant and a new attitude toward pain. Yet how do you establish pain boundaries when a person is used to ignoring the pain? I found that massage helped him somewhat with his recovery from surgery, but the big issues really were the purview of another type of therapy.

Another client had struggled with sciatica for several years. As a youngster her pigeoned toes had been over-corrected with braces. I was able to suggest early on that she avoid walking through pain, and her hip responded to massage therapy.

As she recovered, however, she kept firing her personal trainers for not being challenging enough. About a year later she had another bout of sciatica. I asked how she would handle hip pain in the midst of one of her favorite activities, walking the dog.

“Just keep going until the pain goes away,” she said.

I fought the urge to bang my head on the massage table.

1 comment:

Heather said...

I think that we live in a society that teaches us not to listen to our bodies. When someone is accustomed to pain that lack of listening is even stronger. While we are trained to help with muscular problems, we are not trained to help clients change their attitudes. That is the most important change that many clients need to make.