Issue link: https://www.massageandbodyworkdigital.com/i/1417136
L i s te n to T h e A B M P Po d c a s t a t a b m p.co m /p o d c a s t s o r w h e reve r yo u a cce s s yo u r favo r i te p o d c a s t s 35 Communication Performing these techniques absolutely requires client/therapist communication. You can't just pick up a person's arm and start moving it around without giving the client forewarning and some explanation of what you are doing. "Clarissa, I'm going to take your shoulder joint through its range of motion to see if we can open up the tissues around it and provide some relief to the tingling you've been feeling down your arm. This will also help me explore what part of the joint and surrounding muscles are actually tight and causing the problem. Are you OK with me lifting your arm and moving it around slowly?" Wait for a response from the client. If yes, then, "Great. Now, as I do this, the best thing you can do is relax and surrender the weight of your arm into my hands. Be like a rag doll (or a noodle, or whatever other analogy works). I will completely support you throughout the movement. When I get to what feels like a maximum stretch for you, just say 'we're there'." This communication is not difficult. But it can cause some anxiety for therapists, especially those right out of school. Of course, when asking the client to participate, such as in active range of motion or resisted range of motion, there is more to the dialogue. Still, as you do it more frequently, it becomes as natural as any other massage skill you've learned. Coordination I should probably say more broadly "application" rather than simply coordination; however, the root of the fear is typically the act of moving someone's limp limb around and having some concerns you'll fumble. Allow me to outline some guidelines for how you can perform range of motion with a client in a safe manner. Communicate with your client. As previously mentioned, this includes telling them what you intend to do, why you are doing it, asking their permission, and verbally guiding them on how to "surrender." Warm up the joint. While joint movement techniques can be used as pre-session assessment, within the session itself they typically occur at the end of working a particular body part or region. This is because warming the tissue around the joint avoids injury or re-injury. Plus, it's when the tissue is warm that you safely get deeper stretches. When you do use these techniques for pre-session assessment, be mindful you are probably assessing cold tissue, so don't overdo it. Support the joint securely. When you lift a limb, place your hands on the joint or joints themselves so you avoid hyperextension. For example, if you are moving the hip joint, grasp the knee and the ankle. The knee is especially susceptible to hyperextension without support. Or, when you are moving the shoulder joint, grasp the elbow and wrist. Not only does this protect the joints themselves but it also communicates solid support to the client so they are most able to let go. Move slowly. This guideline speaks for itself. Go slow. Allow the surrender. Feel the "end" and honor it. Ideally, your client will tell you when you've hit the end of their range of a particular joint (especially because you have asked them to!). But also honor your felt sense. If you feel resistance, stop pushing and check in with your client. No one was born performing joint movement techniques, so give yourself a break as you learn or relearn. After some fumbling around followed by persistent practice, it becomes natural. Client communication and coordination is no different. All it takes is just doing it! LET'S BRING 'EM BACK! To support you in reviving your use of joint movement techniques, practice each guideline with a colleague, family member, or friend, and then see how adding this variety to your sessions keeps your work fresh and your clients breathing a sigh of relief. Since 2000, Cindy Williams, LMT, has been actively involved in the massage profession as a practitioner, school administrator, instructor, curriculum developer, and mentor. She maintains a private practice as a massage and yoga instructor. Contact her at cynthialynn@massagetherapy.com. BACK TO BASICS Hear Dr. Joe Muscolino talk about combining manual and movement therapies in Episode 49 of The ABMP Podcast, available at abmp.com/podcasts or wherever you listen to your favorite podcasts.