Many of us do not understand massage, what it does to our skin, muscles, blood flow, blood pressure and many other things. As a manual therapist we primarily work on the skin. Towels are used to keep a patient comfortable and the odd occasion they aid with grip. We may be looking for visual clues on the skin, areas of dysfunction, hypertrophy, atrophy, inflammation or swelling. We then look past that and look at the structure. I find the best way to do this is to asses a movement and then palpate (feel) the skin and the beneath structures. As a manual therapist it is very important to be able to touch your patient.
The first structure we touch is the skin. This allows us to asses muscles, fascia or bones. We then apply a knowledge of structure and function. Having knowledge of how these structures effect the skin and our skin receptors is key. Taking a history to find out any medical causes is vital. It also starts the process of getting to know your patient. If they have never had session before or have had bad experiences, we must know that.
When the skin is touched a flood of physiological reactions occurs in the body, most of which are unconscious. Skin receptors relay information to the cerebral cortex, this manages the here and now sense. The information is then relayed to the association cortex, this allows us to process memory of similar events.
Messages from both centres activate physiological and emotional responses. Touch can connect to past events. The sympathetic nervous system can activate the here and now physiological response. For those with a positive history this can be a warming, comforting or even helpful touch. With those with a history of abuse or trauma this can connect with distress. This is why the power of touch is not to be underestimated. Time should be taken with all patients to ask about past experiences, causes of an injury or issue. Massage as a whole can create a memory to similar events and even the current treatment may not be bad it can trigger information can be relayed this way.
We need to remember that emotions associated with touch are not all positive. My Mum is an Osteopath so growing up I have always had treatment from her. I have had plenty of good experience with colleagues and rarely feel the negative effects of treatment. I am relaxed around most therapists and even if something hurts, feels uncomfortable or is new I don’t become stressed. I usually trust the qualification and person. However many patients, especially new patients may not have this upbringing or openness. After all we are all individuals and the experiences are subjective. Some many may not understand the difference between good pain and pain. Some may associate touch in itself to be embarrassing, uncomfortable or create anxiety.
Overall it is important to make good connections with patients. Be friendly but professional. Have a calm and inviting practice room but show qualifications or skill. Make people feel safe and start to build the trust. Handle bodies well and give clear instructions when asking a patient to move or when you move them. This all builds up to allow a pleasant experience. I find that all of this allows patients to react positively to treatments. However, you do have to understand and inform that each experience is individual.
You are more than welcome to pop in to our Liverpool practice and see if Sports Massage can help you. Contact us today for more information.