Figure this one out!
Popular in the world of advanced massage is the concept of
targeted populations. This approach comes in the form of geriatric massage,
prenatal massage, infant massage, oncology massage, sports massage, massage for
fibromyalgia, massage for anxiety, and the list goes on and on. I think this approach is more logical than
method systems such as the myriad of
connective tissue methods or the huge variety of trigger point methods however
in this day of massage confusion both fall short.
Previous posts in this series describe the fundamentals of
massage therapy. Massage is the skilled
application of methods that introduce 5 basic mechanical forces into the soft
tissue. The effect of the mechanical
forces is modified by direction, drag, location which includes where on the
body and what tissue layer or depth and duration.
Adaptation then involves choices and changes in the type and
combination of mechanical forces introduced and the modification i.e. What direction,
how much drag, where or where not to apply massage and so forth. Adaptation also involve positioning of the
client, where the client is located (hospital, home, office), alteration of the
environment such as barrier free access, massage table, mat or chair etc.
Now we all know that every client is unique therefor a
recipe approach to massage will not work.
For example geriatric massage: yes there is a commonality to the
physiology of the aging process but each person ages in their own unique way. There is great variety in those individuals
with a cancer diagnosis, however there is commonality in the treatment. There is commonality in joint replacement procedures
however there is huge variety in those receiving a joint replacement. There is actually a great deal of commonality
in all forms of acute care but a huge variation in how to approach chronic conditions.
When an “advanced” massage therapist begins to work with any
individual the history and assessment process determines, among other things,
the process of adapting the massage to best achieve the determined outcomes in
a safe way.
There are in the massage profession excellent educators who
are teaching adaptive approaches to various populations- again examples include
oncology, infant, sport and so forth.
What you get when you take their courses or read the books is the cumulative
adaptive experience which in turn shortens your trial and error learning. This is a good thing. You can to some extent increase your
individual level of experience by incorporating the cumulative experience of
others. However, even the very best
teachers can only offer what they have learned and it will never be
enough.
AN ADVANCED MASSAGE THERAPIST KNOWS HOW TO BE THEIR OWN
TEACHER.
So how do we do that?
I know a lot about a lot of different adaptive changes during
massage. Most I learned in the trial and
error method. That is what happens when
you do many, many massage sessions over many years.
I learned best when a client challenged me with a problem to
solve. I have learned a huge amount
about knee injury for example because I have had many clients with knee
injuries. I have learned a lot about
pain in all its many forms because I have had many clients that deal with
pain. And let’s not forget our own
personal experiences and how they influence our learning. A year ago I blew out my left knee-torn ACL,
MCL, meniscus, quad. Ugh it was bad. So
I had an idea about what had occurred but still needed the doctors to perform
the necessary tests to provide an accurate diagnosis. I needed a brace and needed to going through
the healing process. I really get knee
injury now in my gut as well as in my head.
I also had open heart surgery 6 years ago and that entire process was an
invaluable learning experience as you can imagine.
When encountering a client needing adaption during the
massage-(AND GUESS WHAT ALL CLIENTS NEED ADAPTATION)- they are your first and
most important source of information and your greatest teacher. Then
you need to research. You need to learn about the anatomy, physiology
pathology, and treatments including adverse effects of treatment. You need to determine how the individual is
manifesting the condition or responding to the circumstance. You have to look up all the treatments and learn
about them including surgery, medication, herbs, counseling, physical therapy
and so forth. You need to gather information
about how massage has been used in the circumstance through research studies
such as found on PubMed and those with extensive clinical experience. YOU HAVE TO DO THIS. You can take all the classes offered and read
all the books and this is a good start but to be “ADVANCED” you have to do the
work because your client is unique.
You also have to adapt based on the limits of your own
skills including body mechanics. There
are many different ways to apply a mechanical force to a specific
location. Begin with what you intent to accomplish and
then experiment with how you can best perform the method for your most efficiency
and clients comfort and benefit. You can start by doing something the way the
teacher does but you will have to modify how you do it somewhat because your body
is different.
Massage is actually very basic and fundamental. The ability to adapt is the mark of
excellence.
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