Issue link: https://www.massageandbodyworkdigital.com/i/230373
Although we didn't do full case histories with each client, we always took our clients through a systematic screening process before they sat in the chair. We did this to ensure we were massaging healthy individuals. Anyone with significant injuries or pathologies would have been referred to a clinic, so although we weren't sure of the exact cause of the fainting, it was evident that in these clients it was a problem with blood pressure regulation, not serious pathology. A HYPOTHESIS Why is this fainting reflex triggered with chair massage? I heard a number of possible explanations. I was told that hitting certain acupressure points in the hand could cause someone to pass out. But I had never heard of someone fainting while receiving hand massage when lying on a table, so it couldn't be the massage technique itself. I had also been told fainting was more likely if the client hadn't eaten. But we couldn't correlate all these fainting episodes with the timing of meals, and again, table massage clients don't faint when they haven't eaten first. We knew that massage would decrease a person's blood pressure to a certain extent. When you are relaxed, your heart doesn't pump as vigorously as it normally does and your blood pressure drops. With chair massage, the person remains upright and the heart must continue to pump blood against gravity toward the brain as the person relaxes. But blood pressure regulation systems in healthy people should be able to compensate for this. And of course, you never faint when you are just sitting upright in a normal chair, no matter how relaxed you are. If relaxation was, in fact, the mechanism behind the fainting, we would expect this to be a gradual process and for the person to report feeling lightheaded or dizzy. Sometimes this did occur. But these kinds of occurrences didn't seem that significant. What surprised my team was that almost every fainting episode happened very quickly and with very little warning. A relaxation-induced drop in blood pressure couldn't account for this sudden and dramatic effect. We began to interview chair massage clients who had experienced a fainting episode to find commonalities that we could include in a screening process. Much to our dismay, they seemed to have very little in common. Most were women. Their ages ranged from 10 years to about 60. The fainting occurred at no particular time during the massage session— within a couple of minutes of starting in one case, and at the end of a half-hour massage in another. There was absolutely no trend in what part of the body was being massaged when the fainting episode occurred, and it did not seem to be related to low blood pressure or menstruation. One day, the staff and I were discussing the issue when one of my senior trainers, Kam Toor, suggested the carotid sinus reflex might be the culprit. As we started to discuss this possibility, it made perfect sense. It pays to be ABMP Certified: www.abmp.com/go/certifiedcentral 61