Monthly Archives: May 2017

Massage Video: 8 tips for working with low back pain

I hope I’m not alone when I say that I’ve had more than one client stand up with more low back pain than they started with. I reduced the frequency of this over the years, but it took a lot of fiddling and small changes. More importantly, I found that some clients would respond well to a change, while it would do nothing for others.

So, I kept expanding my toolbox!  Here are my 8 tips for working with clients with low back pain:

I’ve got the pillow-under-the-abdomen trick in there (along with a playlet about how to explain it to the client), along with my favorite new toy: The unbelievably huge bolster for under the knees while the client is supine. Both prone and supine positions can exaggerate the normal lumbar lordosis; add in some pressure, and it can create an unpleasant environment for the low back. Both the abdomen pillow and the giganti-bolster bring the client into slight trunk flexion, which seems to be less provocative over the course of an hour. ... continue reading.

Massage video: How to keep clients from helping with limb movement

It can be hard to work with a massage client’s limbs if they’re trying to help you move them, or if they’re unconsciously holding them in place. Here are a few strategies for dealing with this phenomenon:

I think that communication is key, which brings me to an important point: The word “relax.” This is something that I’ve been commanded to do on more than one occasion as a massage client, and… there’s nothing relaxing about it. It can actually make me feel a little indignant, because I thought I was relaxed!

Instead, I like to focus on the body part, and acknowledge that tension is often unconscious. “See if you can let this shoulder be loose. You might not even know that your muscles here are contracting, and that’s normal.” If it’s impeding your massage, you can try having them consciously contract those muscles before releasing them, allowing your hands to sink in as they do. “Did you feel those muscles let go?” Over time, you can help your clients become more aware of their own chronic contraction. ... continue reading.

Massage Video: Working with Shoulder Pain After Surgery

Here’s a new video about how I work with postsurgical shoulder pain. I talk about my strategy, and I demonstrate specific techniques for working gently from a myofascial perspective:

I’d like to highlight something that’s changed for me in my practice: While I do explore the client’s range of motion, I do my best to avoid those painful end-points. Over the course of my career, I’ve found that mobilization can work just as well (or better!) when it’s done painlessly. If done patiently and with good communication, it can be a way of demonstrating to the client that safe movement is possible. I’ve frequently had clients stand up with a greater comfortable range of motion despite the fact that I didn’t try to increase that ROM on the table!

I’ve also started erring on the side of less specific work during that first session, especially in areas that are prone to guarding or spasm. That specific stripping and trigger point work can still be incorporated in future sessions, but by working broadly at first, I can help the client gradually get used to movement and contact without provoking spasm or next-day tightness. ... continue reading.