Issue link: https://www.massageandbodyworkdigital.com/i/259468
I t p a y s t o b e A B M P C e r t i f i e d : w w w. a b m p . c o m / g o / c e r t i f i e d c e n t r a l 47 should know about working with implants or attached devices?" Here are some of their responses: "Other people on the client's team are also great sources of information. Occupational and physical therapist guidelines can provide a safe parameter for massage, so consult with them if your client gives you permission." Xerlan Deery, Pennsylvania educator and massage therapist "It comes down to three variables: pressure, site, and position. Many implants aren't fully 'locked in' by scar tissue for a few months after surgery. During this time, massage must be carefully gauged so as not to disrupt new scar tissue that is knitting the device into the body. Positioning and site-specific cautions also remain in play. Your client can guide you into what positions feel comfortable and what areas he or she wants you to avoid, but pressure on and around the device site must always be adjusted to respect the delicate connections that these devices require." Gayle MacDonald, author of Medicine Hands: Massage for People with Cancer (Findhorn Press, 3rd ed., 2014) and Massage for the Hospital Patient and the Medically Frail Patient (Lippincott Williams & Wilkins, 2004). "Did you accidentally step on your client's oxygen tube? Don't panic: they're very sturdy. But don't linger there. Treat any appliances as sort of extra appendages. Remember where things are when your client turns over so you can anticipate bolstering and draping issues." Tracy Walton, author of Medical Conditions and Massage Therapy: A Decision Tree Approach (Lippincott Williams & Wilkins, 2011). I've learned over the years that clients can give you lots of good information. If you're dealing with a new and unexpected situation, it is a simple thing to say, "I've never had a client with a ____ before. How can I make you comfortable?" OPTIONS AND OPPORTUNITIES Massage in hospital and rehabilitation settings continues to be a big growth area for the profession, but this requires a special skill set, along with compassion, scientific knowledge, and the ability to create a serene space in the middle of what can be a hectic, frantic venue. That is a remarkable ability, and we can celebrate those among us who have created this professional pathway. Author's note: I give great thanks to the people who so generously shared their insight and experience for this article. I am eternally grateful to be able to share their wisdom with a wider audience. Ruth Werner is a former massage therapist, a writer, and a continuing education provider approved by the NCTMB as a provider of continuing education. She wrote A Massage Therapist's Guide to Pathology (Lippincott Williams & Wilkins, 2013), now in its fifth edition, which is used in massage schools worldwide. Werner is available at www.ruthwerner.com or wernerworkshops@ruthwerner.com. "You can't know everything. It's not a realistic expectation. That said, if you know your new client has a device that is new to you, do your homework and look it up beforehand." Lauren Cates, Virginia massage therapist, Lighthold Massage Therapy