I regularly get questions from massage graduates wondering how to massage clients who have a particular acute or chronic injury, and it’s impossible for me to say exactly what to do or not do without knowing the client’s history and injuries, however I can share a few important first tips:
- Know your scope of practice
- Don’t be afraid to say ‘I don’t know’
- Do keep up a communication during the massage
- Don’t be afraid to massage someone ‘unique’
- Make Metta and Meditation your mantra
I occasionally get calls from client who have just been injured and think that a massage is a great idea. However, if someone was just injured ie: had a minor car accident yesterday – massage is not recommended. What is recommended after a fall, sprain, or injury is to refer them to their doctor. Massaging undiagnosed and untreated bodies/minds that have just suffered an acute trauma is high risk, so best to get them to seek medical treatment first. Once someone is cleared for massage, then you an approach cautiously. Know your scope of practice and stay within your scope.
If a client has a chronic injury, illness, or musculoskeletal condition that is long-term, again it is a good idea to know if their doctor has cleared them for massage, yoga, or fitness. It’s also a great bonus if their medical practitioner, osteopath, physiotherapist etc can give some guidance on what areas to focus on, and most important what areas to avoid.
Keep in mind that sweeping, compressions (ie: palming), and light touch are less risky, and deep stretches and fancy postures and/or transitions are more risky. With a new client with medical/physical limitations – stick with ‘safe’ techniques.
Having said that, as long as a client is cleared for massage, it’s not necessarily the best thing to avoid areas of issue altogether. When we have chronic pain or injuries the muscles and tissues around it or compensatory muscles can often get very tight, tense and ‘protective’, and some light massage and/or sweeping can be of great benefit.
Tell the client that the first massage is a ‘get to know you’ session, that it will require a bit more talking than usual to make sure they are safe and comfortable, and make sure that each technique is beneficial. Go slow, start soft, and have the client tell you what feels good, what feels vulnerable, and what feels wrong. This will guide you in how to best massage this unique body. In the areas of issue, softer massage or sweeping is always a good idea. Light massage, if it feels safe, can help soothe areas of chronic tension/pain, and if massage feels too strong then sweeping is great to smooth out tension and generate relaxation in the area.
Discuss the process with the client, you might even call this first massage a ‘talking meditation’ – as you get to know their body, they will too – and you will both benefit from the insights into what feels good and what helps.
Use the mantra ‘how slow can you go’ as many people with chronic pain/injuries need lots of time to transition from pose to pose, and techniques practiced too quickly can sometimes cause us to tense, feel unsafe, or lose awareness of how things really feel.
Avoid deep stretches to the areas of issue. And when the body is in postures where those vulnerable bits are maybe a bit more vulnerable use lots of props ie: prop the head in Prayer, prop under the legs when lying on their back (if they can lie on their back). Do try to keep those areas fully supported throughout the massage.
The last thing I will say is that working with people with injuries or limitations is a great experience for you both as you will learn heaps about how to massage the client’s unique body (and bodies like it) and the client will learn lots about what their body needs, receive some much-needed compassionate touch, and perhaps gain some insight into self-care that can help on their healing journey.
If you are massaging people with injuries or special medical/physical issues we’d all love to hear about it, so please do share with us for our next Grad Update!