medication and pressure...

[Pompal 09.]

hi, i had a client yesterday that i think was out of my league...i think she should have seen a orthopedic/medical massage therapist....she had all sorts of issues....i work at a spa....she had a disk-ectomy, which went wrong and had been causing nerve damage to her leg.....and causing swollen joints...she also had all sorts of neck problems...and she was on all sorts of meds which some of the were anti depressants...anyways, she had signed up for a swedish and kept asking me for deeper pressure, i kept giving her more and more pressure, but i dont think she had any sensation, because of meds????anyone else encounter this...i also didnt want her to be in pain when her meds wore off...or next time i think i should refer her to the appropriate therapist which is not at our establishment, most people that come there, come for relaxation and pampering, not a overhaul and repair....i probably wont see her again but i might see similar people....

 

[lovechild]

You know I was just thinking about making a thread along these lines after a massage I did a few days ago.

I have a number of clients on things like Lyrica, Neurontin, painpills, muscle relaxants, and you can move on down into the not so strong meds.

I also have clients who take things like meds to lower the cholesterol, and that sort of thing.

Then there are those who I figure do illicit drugs.

The interesting thing in all of these cases is that many of these people don't feel the pressue like a "regular" client. It can make working with them difficult. Then, sometimes I notice they do need deeper work because the muscle tissue doesn't like a lighter touch.

Now, the Myofascial Realease guys and the CST guys here may be able to give some feedback as to how their clients in this realm react, too. Which I think would be great.

I mainly do deep work, so I can basically comment on what I see. But, I think the tissue does act funky when too many meds are floating in the system, and in my case, I have noticed that I have to add a lot of pressure.

Which brings me back to my thought:

I have a client who has "cleaned up" some-- and I can tell by his tissue. A year ago, I had to do a full 10/10 on my pressue depth. That's kind of like, pegging my foot against the wall so there is no slippage, table height around 23" and only about 20" from the wall, and full on pointy elbows compressing the rhomboids just to get this guy to say, "Oh, that feels nice". And, working on him weekly for two, maybe three years for 2 hour massages. ~~~ This week, I saw him after 9 months of having a lot of other things going on in his life.

I could do some very firm deeper work with some deep swedish combined with trigger point and elbow movement and compressions on about a 7/10 scale and got wonderful results in two hours.

It's amazing what a little less stress and a little less heavy partying will do for a guy.

 

[Pompal 09.]

My sweet baboo has chronic cervical pain from 2 ruptured disks at C4-5 and C5-6 on opposite side of the spine. He is on Percocet [down from being on methadone, thank god] every 4 hours for the rest of forever since he won't subject himself to the surgery that may or may not fix the disks.

His sensitivity to touch is mitigated by the fact that he also has Asperger's syndrome. He is a really "interesting" person to work on. Because of the Asperger's he can barely stand to be touched with any pressure. Because of the meds, he has less accurate "pinpointing' skills than are optimal to tell me where he wants me to try to work.

Having laid out that background for you all, I do a lot of CST on his neck and upper thoracic region as well as CST pelvic diaphragm release for hips and low back issues. Have even developed a cst-like way of working with the shoulder girdles to release them for him. Regular massage for him is way to much stimulation and is frustrating for me, because, even at my lightest kneading and gliding, he is wincing and complaining that I am being rough.

With others in my practice who are on heavy meds, it just depends on them individually, and, on where there body is at the moment they show up in the office.

One older female client came for 1/2 hour massage every week. Was on meds for cholesterol, diabetes, blood pressure, gout, and post-cancer treatment. She liked a gentle swedish massage [really quick whole body] with a bit of energy work thrown in at the end. After the first 6 1/2 years of her coming to see me, she went off bp meds, lowered the dosage of cholesterol and diabetes meds, didn't need the gout meds unless she didn't watch her diet. The doctor even removed the post-cancer meds because she was doing well.. With her, I used a "regular" pressure massage throughout the length of her association with my practice..... that's what really felt good to her.

FWIW

 

[Bossoli is back?]

When I do intake with people I always ask specifically if they are on pain meds. If they are, I explain that I will not be able to give them a very deep, or maximum amount of pressure because of their decreased ability to know if I am hurting them or not. I still work pretty deep and use the sensitivity of my hands to determine how deep I should go. If they urge me to go deeper and deeper, I will remind them about the pain meds and say no.

I once had a client who had recently had back surgery and didnt' tell me about the meds. He had me going SUPER deep, like how pueppi described with her client. When I found out later he was perhaps numb because of his meds, it scared me. So now I follow the above protocol.