Issue link: https://www.massageandbodyworkdigital.com/i/68165
DEVELOPMENTALLY DISABLED CLIENTS Beth's story is remarkable because she wouldn't sit still for any kind of touch nearly five years ago when we started treatments. Through patience, understanding, and a willingness to walk outside the comfort zone, massage therapists can experience similar results when working with the developmentally disabled. EARLY SESSIONS Beth was one of the mentally challenged clients I inherited from another massage therapist who discovered early on that working with this clientele was not a good fit for her. To say I had no idea what I was getting myself into is a huge understatement. My initial contact with some of these clients was unnerving: One older man pushed me away saying, "Leave me alone." Another client gagged and spit up. Then, there was Beth. I was told by Beth's caregivers that it might work best to go to her room and shut the door for our time together. Beth got out of her wheelchair and sat in the middle of the room on the floor. I knelt and put my hands on her shoulders. She moved two feet forward. I followed. As soon as I touched her, she moved again. This action went on for a couple of minutes. Then, Beth moved toward the closet and began pulling clothes off hangers. I closed the door and remained in front of it. It was my hope to get some shoulder work done when she returned to try opening the door. She tried. I tried. Beth turned away from me and went to the center of the room. She began taking off her clothes and I was unable to stop her. I checked the clock; 15 minutes had passed since we entered her room. My frustration was at a peak. I left the room wondering if I too would give up. I returned to the facility two weeks later. It wasn't Beth's turn for a massage, but I made a point of connecting with her and touching her. I never imaged that such a rocky start would lead to a successful and growing part of my massage practice. Twenty-nine developmentally disabled people are now regular clients, and referrals from nursing staff are coming from greater and greater distances. Working with this population is a continual reminder of why I became a massage therapist. Why massage them? Because massaging the developmentally disabled can make a huge difference in their lives. The following are examples of successful sessions. Practitioner Linda Maher has more than 29 clients with a range of disabilities. I never imaged that such a rocky start would lead to a successful and growing part of my massage practice. RANGE OF MOTION Encouraged by touch, range of motion (ROM) improvements can be made to long-held contractures, as evidenced by Carol, who came to me four years ago. All her limbs exhibited varying degrees of contraction. Her legs were capable of active extension and flexion, but her elbows were in flexion contraction. Her right elbow could be passively moved 60°–80° of extension; her left elbow opened passively to 120°. Carol responded well to verbal and visual prompts. Requests for a high five with an extended arm became part of her treatment. Carol responded by extending her right arm at both shoulder and elbow. Sports massage techniques were later integrated into her treatments. This included palpation of both agonist and antagonist muscles in her upper arm and forearm, plus soft-tissue release and modified proprioceptive neuromuscular facilitation (PNF) stretches used to release tension. More active ROM was the result immediately following each treatment. After two years of monthly, half-hour sessions, results were increasingly measurable. Today, Carol passively moves her right elbow into neutral position. Her right elbow 56 massage & bodywork january/february 2010