Issue link: https://www.massageandbodyworkdigital.com/i/72312
Alan M. Abromovitz, a Phoenix physician who uses massage, osteopathic manipulation, and acupuncture to treat his patients, says, "Chronic conditions require longer and more persistent treatment. Massage, moist heat, and healing oils such as olive oil and peanut oil improve local circulation and fluid mobilization. Most chronic conditions require treatment three to five times weekly for six to eight weeks initially. Ongoing maintenance ensures maximum continued benefits." To make massage pressure and stroking most effective, Abromovitz advocates positioning the areas being treated to maximize the benefit of gravity with elevation. This technique will assist fluid return toward the heart. Some of the more immobile clients might require special treatment. "If clients cannot come to me, I am happy to go to them," Wilson adds. "Avoid bodywork on infected areas," Jacobs says. "Same with limbs that have blood clots in the veins. People with immunosuppression issues, bleeding disorders, or low platelet counts—such as people undergoing chemotherapy— benefit from gentle and light bodywork." People with significant health challenges benefit greatly from positive feedback about what their bodies can do, rather than the limitations, Wilson says. "I have never thought of my clients with 'health concerns' or 'health issues' as such. And I never allow diseases or diagnoses to define my clients." When asked about communication between clients and therapists, Dr. Georgianna Donadio, founder and director of the National Institute of Whole Health in Wellesley, Massachusetts, quotes Maya Angelou: "People may not remember what you do or what you say, but they always remember how you made them feel." "Our whole program focuses on teaching healthcare professionals how to be mindfully and respectfully present for their clients," Donadio says. "Whenever clients speak, massage therapists should listen respectfully. Then, they should reflect back to the client their understanding of what was said. Therapists should do this, not only to gather important information relevant to their work, but to respond to the four most basic questions all clients have: (1) is anyone listening to me? (2) are my symptoms explainable? (3) does anyone care about my experience? (4) are my symptoms or condition controllable—not necessarily curable, but controllable?" When clients ask questions that enter the territory of health advice, therapists should be clear about their expertise. "Most massage therapists have no training as health educators, health practitioners, or health coaches," Donadio says. "So, as professionals, they need to be clear about their boundaries regarding discussions and comments on healthcare issues outside their scope of practice." Taking notes may be protocol in all cases but, when dealing with clients in health crises, these records become vital tools. Baker says her massage notes include trigger and tender points, areas of involvement, and observations of progress. "I maintain records on all clients," Wilson says. Whether done on loose-leaf paper or on sophisticated computer programs, whether elaborate and detailed or brief and focused, Wilson says she has found her comments essential components for success. "I take detailed histories, including a comprehensive list of medications my clients take," Dronet says. "If I don't know what a particular medication is, I ask. Most people will gladly educate you. Then, we decide together what will work best." When catering to challenged clients, clear and concise communication with other professionals is vital. "Some physicians like to be kept abreast of progress and will request copies of your records," Wilson says. "I never share any information without a client's express authorization." "I speak with physicians daily in my line of work and feel perfectly comfortable doing so when necessary," Dronet says. "I have also spoken with counselors to assist in developing care plans for several clients." Jacobs encourages therapists to maintain contact with clients' doctors for two reasons. "First, the client's quality of care improves," Jacobs says. All healthcare providers should be aware of treatments their patients receive, he adds. Better understanding leads to better care. Open communication sidesteps conflicting treatments, while conventional or alternative treatments can be adjusted for best possible outcomes. Second, Jacobs believes doctors need exposure to bodywork and bodywork therapists. So, the more contact, the better—whether by phone call or letter. Summaries of the client's progress or, lack thereof, keep massage therapy in the forefront of the physician's mind. Beyond the physical problems, clients bring their willingness or resistance for accepting help to the table with them, Abromovitz says. MTs with positive and open minds have the advantage. Dronet adds, "I find that clients tell me what they need. I let them guide me. Very often, they will tell me what is wrong and how to address it. Sometimes, they reveal their needs articulately. Sometimes, I have to read between the lines. Sometimes, body language does the talking." massagetherapy.com—for you and your clients 99