Massage & Bodywork

January | February 2014

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One of the tricky things about identifying adverse effects of massage is that events could be linked to lots of other triggers as well. We don't hear about it often, but this sort of thing can happen with massage, too. Here is an excerpt from a letter I received: "A healthy, active older woman who was on vacation in my town came to me for a massage. She was complaining about a lot of neck pain, so I did some focused work on her sternocleidomastoid muscles. She seemed happy with the session, and went home. Later I heard that she had had a massive stroke that night. Now I'm worried: was that my fault?" One of the tricky things about identifying adverse effects of massage is that events could be linked to lots of other triggers as well. When something unexpected happens—especially something bad—people tend to attribute it to an activity that was out of the ordinary. This makes sense, but linking the effect to massage as a cause is not always accurate. In the case described in the letter, it is possible that the massage fragmented a clot in the client's carotid artery. It is also possible that the act of climbing the stairs to her house, or taking a hot shower, or holding a phone to her ear with her shoulder did the same thing. SOME ANECDOTAL EXAMPLES In preparation for writing this article, I put out a call among my associates to share— anonymously—their experiences with adverse effects. Some of them were mild; others much more disturbing. Here are a few responses: • "I worked on a client who was about five months pregnant with her first child. She'd been having pain in her shoulders and chest. The obstetrician attributed it to her job, and gave an OK for her to receive massage. I did a standard, safe treatment with some attention to her pecs, traps, and whole upper back; nothing fancy. She woke up the next day in excruciating pain, and it hurt to breathe. It turns out she had costochondritis, and the massage had kicked it into overdrive. She treated it with ice and ultrasound, and continued to receive careful massage through the rest of her pregnancy." • "I was performing a scapula pull/retraction on a client when my hand slipped and I caught a mole with my fingernail. It came off, bleeding and all! I had to dress the wound on the spot." • "I had a client who requested deep tissue work. I asked her lots of questions about her health, and she denied any pathologies. Fifteen minutes into working around her low back, I noticed that she seemed highly congested in that area. She still denied any problems, but I stopped the massage anyway. I sent her on her way, with a request that she let me know if she developed any problems. The next day, her daughter called, saying I had 'screwed her mother up.' Her mother's low back and abdomen were swollen and she was having trouble urinating. Finally, she told me that her mother had severe lupus. I advised that she get to the ER as quickly as possible. My client spent four days in the ICU, and I had to explain to three different medical specialists what triggered her symptoms; they didn't believe that a massage could lead to this potentially lethal inflammation." • "I had a client with very tight neck and shoulder muscles that caused a lot of pain. She wanted me to help her resolve it. I worked gently, but she was much worse after the first session and the second session It pays to be ABMP Certified: www.abmp.com/go/certifiedcentral 45

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