Need some advice please...

[Jazmine N]

I have a client scheduled for my practicum next week who is very large lady. I have a couple questions. I am not sure how much different it will be as far as pressures , I mean, I know it's relative for all people but do extremly large clients need deeper pressure to get to the muscles? Also she will be hanging off the sides of my table, is there anything I can do to help her feel more secure so she is not feeling like she's gonna topple off? I'm concerned we will be putting major stress on the table and I am almost afraid to add the working wieght.Please note.... I am NOT being mean.... I am honestly not feeling like I know how to handle this situation. I have a love for all people , shapes and sizes...these are just honest things I have never encountered and I want to make her feel comfortable and to come back. Any advice on treating large clients would be appreciated. Thanks

 

[Like legitly legit]

Need some advice please...

If you are concerned that your table might not be able to withstand her weight and the working weight, I'd contact the client to ascertain how much she weighs. Additionally, I'd make sure there are NO contraindications involved (most specifically those associated with obesity or grossly obese people).As for strokes, if you have training in thermal therapies, you might consider using a heating treatment to warm up the tissues. And yes, your body is going to take a beating from the added work in order to provide an effective session.

 

[Maggiegirl]

First of all... has she been a client to the clinic before, and are all the tables the same?  I am assuming that she has been there before since you have the heads up on her size.  For your own sake, find out what weight the table can handle and just estimate.  If she has been there before, and everything went fine, I wouldn't worry about it unless she is on the fringe of the table weight.  I would drop my table a few notches that way you are comfortable and are not straining yourself through body mechanics.  Also, watch when she gets on the table, if it creaks and bows (common sense) is that she is too heavy and should not be worked on, and your added pressure can collapse the table, especially if it is a portable table.  Because the last thing you need is to get hurt before you are even out there, and you really don't want your client to get hurt.I definitely know what you mean, when I was in school, I convinced my shiatsu teacher to let us work on the tables, because I have had 2 knee surgeries and can't kneel down so working on the floor is extremely difficult.  Now I am not a small woman, I am very athletic, large framed and dense.  So I am not a lightweight, well my partner for the day was a woman who makes me look small... ok, so when we were working we had to sit on the table to get the connection and do the hara assessment... well oh boy did that table creak and shift when she sat down.  I know we were maxing out the weight and since it was a portable table, it isn't one flat slab of wood... I was so afraid that we were going to end up on the floor!!!  By the way this was a wooden aurora oakworks table.  So just take precautions and use common sense.  I know it will be hard to turn away a client, but safety should be your first concern.  But if she has been there before, she feels safe and has come back, and you will be ok.

 

[Princessofheart19]

Need some advice please...

And yes, your body is going to take a beating from the added work in order to provide an effective session.

Just a note that an effective session doesn't have to give your body a "beating" no matter what, if one pays attention to body mechanics and uses available tools.  Being a fat client is not an assault on the practitioner.

To the original poster:  I have many regular clients who are "morbidly obese" (one of my target markets) and their pressure requirements vary as much as do those of the very tiny client or clients of any other size and body composition.  Just as many extra-big people need very light pressure as need very heavy, so checking in with her can be exactly the same as it is for any other client you've ever seen.  You might consider setting your table a little lower than usual, for your comfort and hers.  If you don't have side extensions for her arms, you can always tuck the sheet in under the length of her arms while not working on her back or arms.  I do this for clients of all sizes (if they're not claustrophobic!) and many like the feeling of security.

There are few tables on the market that couldn't handle even a very heavy (500+ lb.) client.  I don't have a special heavy-duty table and it holds up great even with the largest of clients.  I'd be very very wary of asking her weight because my god how rude, but she also may be worried about the table herself so knowing your table's max will help you keep her safe.  To reassure yourself -- how many times have 4 or 5 students sat together on one table during a demonstration in class, and how many times has a table busted under the pressure?  (This used to happen all the time when I was a student and the number of table failures was zero.)

Your care and concern for your client will show.  It's up to her whether to come back but I have no doubt you'll provide a caring, quality session.

 

[Pompal 09.]

Thanks everyone. You have been helpful and reassuring.   I was so not wanting anyone to think I was being rude  . I will not ask her wieght, I would never do that . I hate it when people ask me mine ( I could stand to lose about 50 lbs myself idealy) So thanks for the tips.  ;D I really appreciate it.

 

[rocknrolltrekkie]

If you have purchased a decent table from one of the major manufacturers, you should be all set - they are made to to be sturdy.  Give them a quick call to dbl check (as mentioned above). I wouldn't bother with asking her weight, don't think it's necessary & agree that it could be considered rude. My other suggestion would be to double check all the nuts & bolts.  I know that my portable will work its way loose from time to time & it's just good common sense maintanence that should be checked often anyway.  

 

[10aila]

Being both obese and a student of massage, I can share experience from both sides of this issue.  When we studied people of size in the special populations units, there was a suggestion in our text (Mosby's Fundamentials of Therapeutic Massage) that if the table couldn't handle the client, give the session on the floor.  With all due respect to the MT/author, this is a terrible solution!  Not only would it be embarassing, but it is often difficult and sometimes painful to get down on and up from the floor.  Pressure: start LIGHT and work deeper at the client's request.  Use more whole-hand strokes; fingers pinch and poke and may cause bruising.  Adipose tissue is very fragile, containing one mile of capillaries for every pound of tissue.  Fascia adhesions are common, and painful as well.  My arms are especially sensitive, but my back can handle much firmer touch.    When you say hanging off the table, do you mean the sides of her body will? If so, try side-lying massage techniques like you'd do for a pregnant client.  Large arms do not lay flat on the table.  If you don't have a armrest on your table, roll your stool over and let her use it to rest her arms in a prone position.  In supine, she may choose put her arms up under her head, as one of my clients does. Be sure to tuck the drape well at her side.Our Earthlite tables creak under any weight (and frequently loose screws), but the Tatum, Oakworks {and ...I forget the other brand at the moment} are much more stable.I appreciate that you took the time to get some advice.  We all have hang ups about different issues with clients and this is a great place to discuss them "safely" w/o hurting feelings.  

 

[Tales]

Thanks for all the advise again. I felt SO bad having to ask but honestly wanted to know what was best to do so she will have a good experience and not because of any hang ups I have. I need to lose about 60 lbs as of this morning so I am last one to talk. I just was so concerned about how strict these table weights really are and it would make me feel AWFUL if I in anyway made this client feel insecure or worse yet get hurt.All your replies are appreciated I am feeling a bit less worried now. You all are great.  ;D