Massage & Bodywork

July/August 2013

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best practices BUSIneSS SIDe | Q & art | taBle lessons | SavvY Self-Care Quackery? Seriously? Turning Bodywork Skeptics Into Believers By douglas Nelson during advanced trainings conducted at my office, people who have specific soft-tissue problems are invited to receive treatment from me with a small number of my students present. Mr. V. was one of those lucky few on our schedule. (i turn away nearly 10 people for every client we accept. Knowing this, i was a little surprised at Mr. V.'s distant attitude.) "Can you tell me again how you were referred to me?" I asked. "Essentially, my wife encouraged me to come," Mr. V. replied. "This isn't something I would typically do, as I teach at the university." I thought to myself, "What a strange comment," but also believed that I may not have heard him correctly. "I have had knee pain for many years," Mr. V. continued, "probably dating back to when I played football in college. My left knee is much worse than my right. I had arthroscopic surgery for arthritic changes in my left knee about two years ago, but it did not help. Lately, I have been diagnosed with patellofemoral syndrome, but the quadriceps strengthening exercises given to me by the physical therapist haven't really helped either. My knee pain is seriously affecting my daily life." "Is there some action you can do that consistently initiates the pain?" I inquired. "That's easy," Mr. V. answered. "It hurts every single time I bend it." Sure enough, the pain on his face was obvious after bending his knee about 30 degrees. Mr. V. said his pain was only evident during weight bearing, and that passive motion of the knee was not typically painful. The pain was generally at the medial knee, but the distribution seemed fairly broad. Having just reviewed several tests for patellofemoral syndrome with my students, we went right to work. It was at this point that the assessment train began to derail. None of the standard tests for patellartracking issues showed positive, in direct confl ict with his diagnosis. That left me in an uncomfortable position, especially in front of my students. There were two possible explanations: either the tests did See what benefits await you. 37

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