Tag Archives: Acute Injury

When NOT to Massage

The following are examples of times in which we should NOT massage or at the very least modify the massage and inform the client as to why…

Client has not seen a doctor but believes he or she may have “torn” a muscle or “thrown out” their back lifting something:

As you begin to massage the area in question the pain becomes intolerable.  At this point STOP working on that area, we do not want to do anything that may make the condition worse.

We unfortunately do not have x-ray eyes and cannot see if a muscle is torn or a disc has been herniated or if there may be a bone spur pressing on a nerve or any of the many things that could possibly be going on.

This is when we really need to tell the client to see their doctor just to be sure that the injury is not worse than what the client believes it to be.

Many people are hesitant to see their doctors for a variety of reasons, I will admit that I seldom go to the doctor unless I am absolutely sure that I cannot manage whatever is wrong with me on my own so I understand this. Many people are more inclined to schedule a massage or stop by their local chiropractor before ever seeing a physician.

You are giving a massage and come across an area that is red, swollen, and hot to the touch:

Avoid that area, not only for their safety but for yours as well, there could be a staph infection or other condition that not only could you make worse but could contract and or spread to other clients.

I had this situation happen with a walk-in client, the first part of the massage, neck, shoulders, and back was uneventful, but when I exposed one leg to work on it that was when I saw the problem. I did not touch the area in question, I held my hand slightly above it and could feel the heat coming off of it, everything in me was telling me this man needs to see a doctor ASAP.

I told him that based on what I was seeing I cannot massage his legs and I strongly urged him to have it looked at by a doctor, his leg looked so bad that I added that he should not wait to have it checked out. I honestly hope that he did, because what I was seeing was very concerning.

Prenatal client states to avoid one of her legs:

As I was massaging her I noticed that the leg in question was more swollen than the other, she later tells me that she had recently had a blood clot in that leg but that it was gone now. She went on to tell me that in the past she had a blood clot that had gone to her lung when she was not pregnant. Later she tells me that she is on blood thinners.

I documented this in her chart and told the receptionist that she is very high risk and we cannot continue to massage her during this pregnancy for her safety and the safety of her baby.

Client Comes in Requesting a Deep Tissue but has a lot of bruises:

When you see a lot of bruises on a client that should caution you that deep tissue techniques should be avoid.

The client may be on blood thinners or an aspirin regimen to reduce potential blood clots. Often times the client will fail to disclose daily use of aspirin  because they do not consider over the counter medicines as being medications that we should be aware of.

When I see a lot of bruises on a client I ask them if they are on blood thinners or an aspirin regimen, if they are not on either of these things the bruising may be caused by anemia or a vitamin deficiency, but regardless of the cause of the busing  we need to avoid causing further damage.

Avoid suspicious skin rashes:

There are many skin conditions that are not contagious such as eczema, psoriasis, vitiligo, and ichthyosis. Such areas we can massage without concern, however, suspicious rashes, especially if red or itching should be avoided.

If you see redness or marks from fingernail scratching this should alert you that the area may be contagious. Any strange lesions or open sores should be avoided.

If a rash or other skin condition seems questionable you can choose to use gloves for the massage but make sure that the client does not have a latex allergy.

Do not be afraid to refer a client to their doctor:

Your clients trust you, if you see something that is concerning please don’t hesitate to suggest to the client that they may want to have their doctor take a look at something. It is better to be cautious than to let a potential condition worsen or go untreated.

Yours in Health and Wellness,
Kristeen Smart AKA Kristeen Kish
CAMTC Certified Massage Therapist
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MEAT vs RICE Treatment for Acute Injuries

When it comes to treating acute sprains the RICE (Rest, Ice, Compression, and Elevation) method is the most commonly repeated course of action, but what if I told you there has been a differing school of thought on this subject?

MEAT (Movement, Exercise, Analgesics, and Treatment) has been the buzz word in the sports therapy and physical therapy industry for a few years now.

Many studies on RICE therapy have failed to show any significant benefit to that method of treatment and suggest that the healing process may even be delayed by use of RICE therapy. (see link for full information)

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3396304/

Rest, ice, compression, and elevation therapy is an accessible and popular modality in the treatment of acute ankle sprains. Therefore, the objective of our study was to analyze the effectiveness of applying RICE therapy begun within 72 hours after trauma for patients in the initial period of ankle sprain. The specific null hypotheses included the following: (1) No differences existed in outcome measurements between using rest, immobilization, or no movement or mobilization and using early mobilization or movement for acute treatment of ankle sprains; (2) No differences existed in outcome measurements between using ice, cold, cold therapy, cryotherapy, or cooling and using no ice, no cold, or heat for acute treatment of ankle sprains; (3) No differences existed in outcome measurements between using compression and using no compression for acute treatment of ankle sprains; and (4) No differences existed in outcome measurements between using elevation and using no elevation for acute treatment of ankle sprains.

Recently studies on the  MEAT therapy has been showing more promising results for faster recovery.

In their published study, researchers at the University of Queensland in Australia found:

  • Mobilization increases blood flow and so reduces muscle atrophy, disuse osteoporosis, adhesions, and joint stiffness.
  • Early mobilization seems to decrease pain, swelling, and stiffness, and patients generally prefer it to immobilization.
  • Early mobilization results in earlier return to work, a greater range of motion, and fewer complications and residual symptoms. They concluded: “The best evidence at hand suggests the medical profession generally errs too conservatively on the side of immobilization.”

As time and knowledge progress we have learned that many of the old methods of treatments such as putting an arm in a sling have been counter productive to healing and even potentially cause more damage in the long term such as frozen shoulder syndrome.

I am sure that in time much of our old ways of treating acute injuries will be replaced with new and more effective strategies to promote a speedier and full recovery.
Yours in Health and Wellness,
Kristeen Smart AKA Kristeen Kish
CAMTC Certified Massage Therapist
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