Massage

On a recent musculoskeletal placement I had a patient who presented with neck and shoulder pain. On assessment she was found to have poor posture with a lot of associated trigger points and tight muscles. I treated this patient with STM, trigger point release and a lot of postural education and training. She LOVED the ‘classic massage’ and was not so impressed with the postural education. I explained to her throughout the treatment that her pain is caused by her poor posture and that if she addresses the postural issues and does the exercises I prescribe to her the muscles will not be so tight and sore. By the end of the treatment I thought she understood and she was performing the exercises well.

The next time I saw her she had forgotten the exercises and said she had not done any of them and requested for me to do some ‘classic massage’ saying that was all she needed. This annoyed me a bit especially after I had spent so much time explaining posture to her at the previous session. The next time she came in exactly the same thing happened. This time I had a quick discussion with my supervisor and they told me not to do any massage and to advise the patient that we are going to provide physiotherapy which consists of what we determine is most appropriate for them on the day and may or may not include massage. I was told to tell the patient if she wants massage to seek a massage therapist. She decided to continue treatment and did not request massage again.

This patient reminded me that a lot of people present to physio expecting just to receive massage and I realise that for these patients it is important to explain that physiotherapy will only include massage if it is the most indicated treatment based on the assessment.