Number one on my list of top 10 things to be a successful massage therapist is: It’s all about applying the right treatment at the right time and in the right way. A lot of people ask me “What was it that made you successful in making this patient better? Did you do myofascial release, trigger point release, craniosacral therapy, energy work, range of motion, or myoskeletal alignment?” I have learned that if I start telling people, “Yes I used X method, and it was successful,” then they want to apply that method to every situation.
That’s just not how it works. A treatment can be good in one situation but bad in another. For example, stretching is an extremely beneficial proactive aid, but it is not suitable as a corrective aid when someone is hyperacute. Treatment is never black and white. It’s often not a case of all stretching is bad or all stretching is good. There are different levels of stretching that are beneficial in different situations. You have to match the treatment to where your patient is at. Light slow stretching is going to be very different than an advanced yoga class.
The same goes for exercise and strength training. Having a patient lift their arm up and down with no weight is way different than having them use 25-pound free weights. One of these treatments can be very beneficial while another can be very damaging. The threshold of what is best for each patient will be different for each person and can also change throughout the individual’s treatment.
As an orthopedic massage therapist, it’s essential that you are able to determine where a patient is at so you can use the right tools at the right time. It’s not only about the right treatment at the right time, but it’s also about applying it in the right way. Think of a contractor. Contractors have tons of tools in their toolbox. You can’t imagine a contractor working with only a hammer, but it’s also hard to imagine them being effective at their job without one.
In situations where the hammer is appropriate, it’s vital that it is used correctly. If you use your hammer but miss the nail, you get nothing done. If you hit the nail at the wrong angle, you may make a bad situation worse. Just having the right tool does not guarantee you will get the results you need and the same goes for orthopedic massage therapy.
If I have a patient with a trigger point, I will determine which type of trigger point release therapy to use and then decide how much pressure to use and modify that pressure based on the feedback that I get from their body. I will also choose and be ready to adjust the angle I address the trigger point from as well as how long to spend holding the trigger point.
I might even move the patient’s body. For example, for a trigger point in the upper trap, I might hold the same trigger point at the same pressure but passively move the arm around so I can get access to the trigger point differently.
This is critical, and in my opinion, a significant reason why other body workers either don’t get the results they are looking for and unfortunately in some cases make matters worse. Make sure you are applying the right treatment at the right time, in the right way.
In future posts, I will be going over specific types of modalities and treatments. It’s incredible to have your necessary tools and then fill the gaps in your toolbox with specialized methods for unique situations. You want to have as many tools as possible but for now, keep using the tools you have and make sure you are using them in a way that is going to get the results you want to achieve.
There is no magic equation for deciding which treatment is best. There is a lot of intuition involved. You have to work with the feedback that the body is giving you. Developing your intuition is a critical aspect of being a successful orthopedic massage therapist. Practice reading the feedback from the body, and you will get better and better and better.
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