October 25, 2012

Parking Stones

Tailbone problems plague people – and massage therapists. The worst is the sideways curl, keeping hips, feet, lumbar vertebrae and cervical vertebrae all a-twist.

This massage therapist finds a lot of trouble in tailbones. They are really supposed to flex a bit when sitting, guide and balance while walking or running. Too may of my clients have stuckee tailbones, drifting off and away and leaving clients with everything from migraines to crabby personalities?
Oh my, I had a good one the other day. The rest of this client’s spine has been a challenge of momentous proportions. I have chased every symptom up and down the row and always been perplexed by this tailbone. It dips out and in. This tailbone defies gentle suggestion, firm guidance and repeated nudging.
It has been a full-court offense for this client. Weekly massages and regular adjustments, acupuncture and daily yoga. She has had coccyx cushions, ice packs, warm packs, you name it.

Funny thing happened the other day.
The client was doing the breathy hatha yoga, trying to open the diaphragm and get the energy moving. In the middle of the pose, her tailbone adjusted itself with a “POP!”
“It was really loud,” she said. “I didn’t move for a few minutes. I wasn’t sure what happened.”
Well the pop heard round the block didn’t hurt, and now she is walking a lot better. My turn to ask: Do you remember hurting the tailbone?
Well she did, and funny thing was, she didn’t remember it until she popped. She was in a parking lot, age 12, and had tripped backwards over a parking stone and landed squarely on her tailbone. She saw stars and couldn’t move. The area hurt for a really long time and she never had it looked at because she was embarrassed.
Somehow that tailbone wasn’t broken, but it had been in a bad way for a very long time. And probably it was annoying the heck out of her spine every time she sat down.
“I think that pop was a good sign,” I told her.


October 18, 2012

The High Costs (and High Benefits) of Hands

I see these huge automatic water massage machines on E-bay all the time. Discounted to about $20,000. Maybe on a bad day, discounted to $10,000.

The ads say wonderful things about how great they are and how much money you will save by not having to have a massage therapist do the massage.

I read between the lines: Please, please, someone buy this huge thing and get it out of my office.

One always wonders if the future is going to be automated by something robotic and unfeeling. Something that will never develop carpal tunnel, come in late for a full day of appointments or forget to order oil.

There are plenty of massage gizmos, and the water massage tables were the only ones I feel come close to doing what we therapists do.

Only they are humongous,  take 220 electric current, and are about as heavy as my car. They look like tanning beds on steroids and the lid closes down like a coffin.

Take heart, we haven’t been replaced yet. One electric bill, one repair bill and people want to get rid of these things.

Will swirling electric mitts, water jets or robots ever replace us? I don’t see it ever being possible to program the TLC of our chi into a machine.

Our humble little hands are safe. For now….

October 11, 2012

Adventures in Super-Mobile Massage

Nothing makes fear quake in many massage therapists than the entrance of the super, hyper-mobile client. I too, have experienced the fear, the trepidation and the surprise.

For the record, in Gumby folk symptoms of troubles are completely different than my true forte, people as stuck as me. What I would normally assess test with simple range of motion, these folks will cruise through with exceeding ranges. All orthopedic-based tests are useless. Symptoms are backwards, upside down and inside-out of normal trigger point problems.

The needle is not in the haystack. It may be on the next farm.

As much fun as working with ballerinas and gymnasts may be in terms of their fearlessness, I need a lie-down after they leave.

My latest venture involved a very athletic, very hyper-mobile volleyball player. Good heavens. The assessment symptom was a “cord” pulling the shoulder blade. Normally I would run to the rhomboids or the serratus, but oh no, here was a subscapularis that knew no bounds. She can do anything with these shoulders. They just hurt.

I figured out the problem by following my nose. What do volleyball players do a lot? Hit the ball. Hopefully with hands or forearms. It had to be subscap. Or I am going back to school to take auto mechanics.

And it was a subscapularis of epic proportions. Adhesed and anaerobic yet mobile. Gentle cross-fiber yielded whimpers, adding slow motion got a scream. Would I ever see this client again?

A week later she came back, admitting she wanted to kill me for the first two days and then she felt better. Oh good.

Then my next mobile-as-heck client came in. No sports, no exercise to speak of, just one horrible accident years ago with some seat belt bruising. “I feel like I have a cord pulling my shoulder,” she said.

Hey, it worked once. Gentle cross fiber. Motion added. “That hurts but it seems to be fixing it,” she said. Thank you, patron saint of the hyper mobile for the inspiration. I hope the ballet is not in town next week.

October 2, 2012

To Glute or not to Glute…

Hey, it happens. A humble massage therapist is massaging someone who has a freak-out during the session and leaves. Later, the client wails in an online review that the massage was unprofessional because…(drum roll please)...the therapist massaged her glutes.

This scenario happened to a friend of mine and believe me, it was not a fun day at that office. We are not in the business of triggering people’s fears. We want to help people feel better.

I talked with my friend about this the other day and she was still steaming about the review and the session. It is not the client’s fault, I said, because people have triggers and they often do not express them. They have trust issues, abuse issues, etc. and in many cases the expectation is that we will be mind readers and know what they do not like.

Clients may have had few or no massages, I explained, and the ones they had may have been at a spa that offers general massages and managers do not allow glutei massage. Schools are turning out therapists for these spas, so many are not teaching glute massage.

And here we are, my friend and I, old-school therapists who went to school in the therapy-driven ‘90s and we learned not only are glute massages beneficial; they are often the key to unlocking back pain.

The way I dealt with glute massage in a spa environment was to ask clients what they wanted from their massage that day. And I would ask if there are areas they did not want massaged.

Now in private practice, I have the question on the client intake. I read the intake and go over it with the client before the massage starts.

If there is some reason to massage glutes, such as lumbar pain, I will tell the client that glute massage will help resolve the problem – so if they ever want to try it, just let me know. That gives the client both the reason and the control.

And sometimes, after they develop some trust in me, they will say OK.

The bottom line is, as always, the client is always right. If a client feels glutes are off-limits, then they are. Find out first before you get a bad reaction in a massage, or even worse, in this net age, a bad review online.