Sequence- So many conflicting methods

[TonInhataWhob]

Hi,

I completed a course a few years ago and haven't been able to practice due to other commitments.

I am now trying to pick things up again and have been doing some studying from textbooks and a DVD and some practical practice.

In training, massage began on the front of the left leg. It seems that every book, textbook, and DVD I watch all say different things. They also include different techniques in different orders. My question is... do we have to stringently follow the prescribed sequences using prescribed techniques in exactly the same order. I know there are so many different schools from different accreditation but do you think it is ok to come up with what you think constitutes a good massage and stick with it?

Looking forward to your comments.

Best Wishes

Matt

 

[eclecticdoctor]

Hi Matt,
forget about sequences and routines, a good massage is intuitive, and your believe me you can tell the difference between a routine and an intuitive massage.

Enjoy it!

 

[zbefpufxiciiwuedx]

Hi Matt

Welcome to Hp

I agree with ST that good massage is intuitive.

Routines are taught to enable you to practice massage and pass the exams. But after a while you will soon discover your own methods and ways of doing things. Therapists all have their pet theories, whether to start supine or prone first, legs or back, feet or head, left side then right side and so forth.

You can ask the client what they need from the treatment, whether it's focusing on the back, shoulder & neck tension, or if they like a good firm foot massage etc. After all it's the client's treatment. Once you have got a "reference point" to work with, then it's good to go with your intuition. No textbook will ever teach this, after all in-tuition is listening to your inner teacher.

Best wishes

RP

 

[Shelly]

Hi Matt

Welcome to HP

I agree with ST and RP, you can certainly tell the difference between routine massage and intuitive massage. As a therapist and also a client, i never have a routine, my therapist does not either, it is all intuitive.

Enjoy what you do, and it will flow.

 

[Trickzta]

I agree with the others here, that intuitive therapy is the way to go. However, when we start out (or return to our practice after some absence) a routine can be very comforting because it is safe.

So my thoughts are to find a routine that you like and feel comfortable with, but remain open and listening as you practice it, allowing your intuitive nature to grow. Before you know it you'll be intuitive, intuitively!!

 

[Artemisc]

There may be many good reasons for a routine, and not just to help you, but clinical reasons also.

If you are making a cake, whether you mix the ingredients and then put them in the oven, or do it the other way around, makes a big difference. On the other hand, when mixing the ingredients, it may not matter whether you add one before another.

The point is - what is your vision of the treatment, its rationale, how it is supposed to affect the patient etc etc? What you do and the order in which you do it should arise from that.

So ask yourself - is there a reason for doing things in a particular way? If you don't think there is a reason, or you don't agree with it, then you are at liberty to choose another way.

However, if somebody else appears to have a reason for their approach, and you don't know what that is, then you can't possibly evaluate their method until you have first tried to understand their thinking process. Only then will you be able to choose.

 

[iojhyt675]

Hi K

I did consider such points before initially replying in post#3. Many in the massage field do consider "intuitive" massage to be very important and not an intellectual persuit - easy to point to the moon and look at the finger than looking at the moon itself. But I do get the point of where do you start. There are so many paradigms in massage that I think MattABC has to consider what type of direction he wishes to go and develop his own "vision".

Best wishes

RP

 

[Lindobarap]

Hi RP, far be it from me to suggest we should be robotic and formulaic in our approach. Treatment should be infinitely variable according to situation.

Even without a routine the risk remains of cold, sterile, robotic treatment. A routine can enable us to stop worrying about what to do when, and instead focus on the signals and feedback our patient is sending. So there is plenty of room for intuition, even with a routine.

 

[Emerald]

Having taught massage, I can say a large part of any 'routine' is so you can have everyone in the class doing the same thing at roughly the same time, any class structure would quickly fall apart if someone intuitively thought that the person they are working on needed a foot massage while most of the other people were working on the neck while the client was supine, and some people felt the need to work on the neck with the client prone. In a classroom situation there is a need for a structure and for massage, that structure comes in the form of a 'stroke sheet'.
I've done courses where you work supine first, some prone first, some legs first, then back/arms, some where you work one side (left leg, then left arm, right arm then right leg, some the other way round) followed by the other, some where you work under and on the body at the same time, some where you don't ever have the client face down, and almost all of them have a reason for what they do, but on all the courses, it was presented as a 'routine'. There have been only a couple of courses I worried about following the routine afterwards, and both of those were because I didn't feel quite confident with the techniques straight out of the course, the routine allowed me to get more confident.

The important thing is what the client needs, a variety of routines to draw from means you can customise what you do to what the client needs.

 

[insomzar]

Hi K

Of course form creates function, and the routine can always be fall back upon when in doubt. Since Matt says "do you think it is ok to come up with what you think constitutes a good massage and stick with it?", I look forward to what he comes up with.

Glad this is not a Reiki discussion, as it would be very hot topic!

Best wishes

RP

 

[michal]

routines and sequences are fine for when you are learning 'massage', but not for when you are practising surely, as everyone is different?

Of course if you are doing 'remedial' type massage, then clinical reasoning comes in as KVDP says, but I dont think the poster was meaning 'clinical or remedial massage'?

Ive had lots of massage performed, and can always tell when its a routine and it becomes very boring. You certainly get to know when the therapists have trained at the local colleges, because they all perform the same massage!

 

[ayrond A]

My wording of that question way maybe was not getting at what I wanted to express, but that is probably lack of experience.

Many thanks to all for replies, I agree with your comments. When I was trained they told us to do a consultation but it appeared to have just been a formality! There was no suggestion you could go off the beaten track of the routine.

I feel more relaxed that things can be changed and mixed up a bit, it will make me feel more relaxed and that will provide a better end result for the client. It means I don't have to worry about making mistakes, and instead just go with what feels right.

The best way will be through client feedback to improve and learn

 

[spider367]

Hi Matt

For general full body type massage treatment, long consultation forms from college are unnecassary. It's just another learning format. Anymore than one side of A4 is too much in the big wide world.

Best wishes

RP

 

[happygirl888]

I guess another real world difference is how contraindications requiring permission from the doctor are handled, I guess it is a contentious issue but do most insist on a letter from a doctor or advise that clients speak to the doctor and get them to sign a disclaimer to say they have? Again I think this must be an area requiring discretion otherwise I'm sure a lot of clients would not come back! I know this is off the beaten track but I think these are things that tutors seem to frighten you about!

 

[Marti]

Have a 'search' on this site (click on the search box at the top of the page) and put in - GP permission - you are unlikely to get it. In any case, if anyone came to you with a direct contraindication, you wouldn't treat them (I hope!).

I only write to GP's if I have a query about a client, when something crops up during the consultation, and I never ask for a reply - I simply touch base so that they know their patients are seeking help and advice elsewhere. Invariably, I ask the client to have a chat with their GP to make sure that massage therapy is OK - at least then you are seen as professional by the client. I have never been referred a client for massage therapy from a GP (been practising for 30+ years) - people come to me either through recommendation or when their doctor 'suggests' that massage may help. However, since working with lymphoedema patients, I do get calls from GP's. I have two close friends who are GP's - neither will refer patients for comp therapy, yet other doctors in their practice do (I'm still working on them!!).

If you have been out of the 'practical' loop for a while, why not do a refresher day or give some free treatments to some guinea pig friends - ask for feedback about what they did/didn't enjoy.

 

[ginger87]

Yes I agree I am doing a few freebies and getting back into it gently

 

[aejvryuc]

Hi Matt

I used to be a FE tutor myself, so I know about the nonsense from tutor's mouths.

There are many threads on Hp on contraindications. All I will say is that with experience "contraindications" often become "indications" for treatment. Initially tutors, colleges and exam boards do have a duty to make sure as a student that you don't bite off more than you can chew when it comes to case studies. But in real life situations, it's the client that often decides to have massage even with medical conditions. Most GP's won't give you letter to treat (they are exceptions to this, but not common on a national scale). Best you can often do is to get the client to ask if it is OK from the GP. Then the client takes some responsibility. (That doesn't mean you don't have responsibility for your actions - I have to say that as they can be nitpicky on here.)

To add some more advice, get to know some experienced therapists, attend local meetings, and do regular CPD courses. This way you develop the expertise to make better clinical judgements and not relie(sp) on the college spoon-feeding systems.

Best wishes

RP

 

[Tian]

Cheers for that RP- I will look around in the local area for some local contacts and events. Again, I really value your experience, I understand tutors need control systems in place and learning doesn't have to just be from the college!

 

[Kris, Cari and Elmo]

Indications and cautions is a huge subject. Not going there just now.

But case history for many can easily be summed-up as a tick-box form - name, age, list any medical conditions, injuries, and medications, anything else you'd like to know about, and sign the bottom to say they consent to treatment as described. That can take 5 minutes for most and save a lot of effort.

If anything leaps out of that you can expand with a verbal grilling, you can even do it while you work. But the chances are there is always something you can do for them: if they have walked in they can cope with a degree of handling, and if they haven't, adapt accordingly. So yes - do feel free to go 'off-piste' so to speak in terms of adapting your methods to situations.

I repeat, routines are very useful tools, but they are there to help us, not the other way around. So I would agree that it need not be necessary, but I would completely disagree with those who think it is only for kindergarten. I personally find mine invaluable, and the more experienced I have become the more I find it to be incredibly useful, as it allows me to concentrate on the things that I really need to be aware of. None of my patients has complained that treatment is dull, irritating or ineffective.

Of course it's not the only way to do things. But if it leads to a robotic or unimaginative treatment, then that could also a reflection of the practitioner, they may well find a way to be boring regardless if they're really determined.

 

[gpwoulux]

One thing with a tick box form, make it tick boxES - a YES and a NO tick box. Too often people just skip over tick boxes. I've got YES and NO boxes, and it it often given to me with neither ticked, you can't tell if they mean it doesn't apply or if they missed the question. When I get them to tick the NO boxes, quite often suddenly YES boxes start being ticked. Many people just don't bother with the details. I am trained in aromatherapy and use customised blends in treatments (though hardly ever use the full Micheline Arcier aromatherapy routine that was part of the training) and there are quite a lot of additional considerations when using essential oils so the YES/NO answers are pretty important before they get on the massage table.