Post-massage cruds

[Lexie]

I have a client that chose me because I do more specific work than she is used to, and the massage is more aimed at pain relief. It accomplishes that but leaves her feeling cruddy afterwards. She sometimes goes to a more general therapist and does not feel cruddy afterwards. While on vacation, she got a basic Swedish and also didn't feel cruddy. Last time she was in, after she told me this, I did a more general and full-body 90 minute massage, but still focused quite a bit on her main area of complaint. Again, she felt less pain, but cruddy (lethargic.) Oddly, it hit a little later this time as opposed to right after the massage.

Suggestions?

 

[Pink Taco]

Post-massage cruds

Have you asked her how she eats? Sounds as if you are typically more thorough and may be assisting in the release of toxins stored in her tissue. She may just need to "ride it out" so to speak. Is she drinking enough water?

Maybe implement a bit more energizing massage at the end? Tapotement? Sports massage?

Are you grounded before your sessions? Is she breathing through the work?

Could there be some transference going on that you are not aware of as of yet?

Does she exercise?

 

[nejifan1234]

Post-massage cruds

Thank you for your response. We have talked about the other aspects that may be contributing.
I do ground and we do not chat. I have not tried tapotement yet.

 

[Farsea D]

Post-massage cruds

Suggestions?

My suggestion is to keep working with her until she gets well and it passes. I had a client like this, and it took about a year to get past it. Sometimes things are just "stuck".

 

[teebee]

Post-massage cruds

Have you asked her how she eats? Sounds as if you are typically more thorough and may be assisting in the release of toxins stored in her tissue. She may just need to "ride it out" so to speak. Is she drinking enough water?

Maybe implement a bit more energizing massage at the end? Tapotement? Sports massage?

Are you grounded before your sessions? Is she breathing through the work?

Could there be some transference going on that you are not aware of as of yet?

Does she exercise?

First, some mythbusting: Massage does NOT "release toxins" from any tissues. Drinking more water does NOT flush toxins from the body.

Some clients tend to have stronger reactions to specific therapeutic work than they do to more basic relaxation sessions. This is more common if the work is painful and/or includes "deep pressure" that might be significantly uncomfortable during the massage. Why? Because painful work tends to stimulate the sympathetic nervous system and may create elevated stress levels. As the client's CNS calms down after the session, she would feel more "cruddy" as her system downregulates to a more parasympathetic state.

On the other hand, this client tends to feel better after relaxation massage, which would stimulate the parasympathetic response. Therefore I recommend that you do gentle specific work blended with relaxation work. If you can do specific work pain-free, you might find that she is able to relax throughout the session and is much less likely to have any "cruddiness" afterward.

 

[FoulgeVossess]

Post-massage cruds

I would imagine if there's something she's doing outside of the massage that's affecting how she's feeling after, it would affect every massage she has to some extent, so my guess is that it's something to do with your work. I agree with pueppi since there was a little improvement after the last session so it could be that she just needs time in order to improve more.

 

[K T]

Post-massage cruds

Thanks for the responses. I plan to let her know about pueppi's experience and go lighter. Although I tell all my clients that pain is not okay, I think there is a loss of sensate ability and maybe my work is causing a bit more than a little discomfort, even if it is not registering with the client. I do Deep Tissue, not deep Swedish. It is not about push hard all over. Still, I may have to lighten up. Another thought is I think I am the only therapist working the anterior cervicals. I may also ask her if she normally starts prone.

Jason, if you believe that ischemia/hyperemia is occuring, what is your hypothesis on what Is happpening with increased circulation in particular areas? (perhaps in a different topic if you decide to answer and it's long?)

 

[OldPilot]

Post-massage cruds

jdcan,

I just went through my clients folder (the one I mentioned above). After about three months of bodywork, he showed minimal "ill" feelings after the massage. The next time it popped up was approximately 13 months after the initial session. I worked with him weekly between 2008 & 2011 (with a few months here and there where he was only seen once or so).

Throughout the years he continued to have intermittent bouts of "ill" feelings (and sometimes outright sickness) after a massage. But, pretty much after year one, it was random and occasional.

I wanted to update this with a few more specifics, in case it makes a difference for your talk with your client.

It should also be noted that he was a Gulf War soldier.

Despite some opinions that this is a myth, I must say I personally feel like this client was dealing with some sort of toxic load which was brought to the table, and the massage work had some part in accessing. I do not believe the neurological components (mentioned in a prior post) were significant enough to create stress on any level which could cause my client to be sick, post-massage.

 

[Kaleigh]

Post-massage cruds

Thanks for the responses. I plan to let her know about pueppi's experience and go lighter. Although I tell all my clients that pain is not okay, I think there is a loss of sensate ability and maybe my work is causing a bit more than a little discomfort, even if it is not registering with the client. I do Deep Tissue, not deep Swedish. It is not about push hard all over. Still, I may have to lighten up. Another thought is I think I am the only therapist working the anterior cervicals. I may also ask her if she normally starts prone.

Jason, if you believe that ischemia/hyperemia is occuring, what is your hypothesis on what Is happpening with increased circulation in particular areas? (perhaps in a different topic if you decide to answer and it's long?)

If you are the only MT doing anterior neck work on this client, you might have the answer as to why she feels "cruddy" after your sessions. For example, the SCM is most often associated with pain patterns in the occiput, forehead, and face, but has also been associated with nausea, tinnitus, vertigo, visual disturbances, etc. When you are working the anterior cervicals, whether you mean SCM, scalenes, omohyoid, etc... you have the potential to affect the lymphatic system and the cranial nerves, too. The more you know about the area you are working, the better. With repeated treatments, her undesirable symptoms should fade.

Ischemia and hyperemia are (generally) transient conditions that vary considerably depending on what is happening. This is probably better as a separate thread, especially since I don't think it is central to the issue at hand.