Elbows applied to the Medial Borders of Scapular Region??!!?

[curious12345]

Alright, where is it being taught that it is pleasant or therapeutic for a therapist to apply their very blunt elbow into the medial borders of the scapuli??!!?? :shock:

I have now experienced myself - in one of the worst massages I have ever received - where without any warming of the tissue the therapist assumed I had trigger points and just dug in...

...and then today, a client comes to me after receiving their first massage last week at another spa, explaining that she didn't really like the massage. Sad, in that it was her first experience...we were in the midst of her first vichey body polish when she told me this.

She said she thought she might try again because she hears that massage is such a great way to take care of one's health.

I inquired to what she had not liked about the massage...she said too much pressure and that the therapist had bared down way to hard with elbows and pointed to the medial border of the scapula.

I went on to apply the second half of her body treatment with a bit of Swedish massage which she loved and subsequently booked a massage in the next couple weeks with one of us at the spa, I think me...

Anyway, I am just disheartened that people are practicing this way...maybe there is a good way to use the elbow in that region. When using forearms I do trace a bit with my elbow at a 45 degree angle in that region...but for a deep tissue client...and certainly not for a newbie to massage. As well, I always warm up the tissue before this.

What is the deal with this?!? Is it now cool to use elbows at 90 degree angles in client's scapular regions??? Is this the product of therapists trying to convince themselves that tissue is there to be tenderized like a grizzelly (sp?) steak??? :?

I wished they would stop it for my sake - when I get work and for those clients, especially those receiving their first massages....

Ok, sorry for the rant....

 

[Layman]

Ouch! :shock: My very first massage, the very first touch, was a fist suddenly buried deep in my gluts. It was SO painful I came off the table!!! For some dumb reason, I laid back down and took it. And she went over the hour by about 20 minutes.

It's a wonder I continued on with my plan to become a massage therapist. :shock:

I don't know if it is being taught, or if there will just always be people out there who LOVE to do deep work so much that they can't even slow down to warm the tissue first. :roll: But OUCH!!!!

 

[cookiesky]

Yikes Sharon! That would not have been fun...and in the glutes for your first massage

I guess this is the baptism by fire method of massage introduction...sure to not convert people...

Glad that you went on to practice despite your first bad experience...It sounds like you had a display of what not to do before you went to school from that experience.

 

[Jeff will come back!]

I think that the prolem here is not so much elbows or pressure but communication (and perhaps some common sense?)

Believe it or not, some clients like and expect elbows there or fists in the gluts. Personally, I would not have done the massage in either of the ways described above without proper warm-up, client communication and client desire.

If a client comes in for a nice relaxation massage (especially if it is their 1st massage) then elbows under the edge of the scapula would be inappropriate (in my opinion) but if someone came in for a deep tissue massage wanting work in that specific area, then it could be warranted.

There will always be therapists (I've known some who went to the same school I did, so the school did not teach them this) who believe the "no pain, no gain" philosophy. I'm certainly not one of them.

Again, good client communication skills are what's needed.

Angie

 

[ZEPPELIN OF LED]

More than one MT I've received from seemed stuck in a model where they dig in to the rhomboids because that's what makes most of their clients happy, and mysteriously forget to work the pecs to an equal (or any) degree.

 

[john313181]

Elbows

From what I have seen in the last 2 years, after interveiwing plenty of therapsits, is that the schools in the area that I live in teach mostly forearm and elbow work and not much neck work. I was taught in IL and were taught very little forearm and elbow work. I interviewed one girl and I don't think she used her hands at all anywhere.

 

[Yiati]

My experience is that the clients all think that massage must hurt to be effective. Frankly, I feel it necessary to re-educate them that even very deep work doesn't have to be painful. (except the piriformis! That's always a pain in the a$$!)

That conversation nothwithstanding, I still have one client who wanted me to really dig in. I believe she may be armoring, and I've told her that there is a point at which I will not compromise my own body in service to hers. I also gave her a referral to another local MT with a reputation for good deep work. She still comes to me--and I still go as deep as I can--but it's Ice ice baby when she's gone.

In defense of elbows and forearms, I have found that after tissue is properly warmed, I can get to the deeper layers of tissue with less discomfort to the client using a broader base of pressure than by using my thumbs. The key is, though, to use the other hand/fingers to monitor the depth of work that the elbow/forearm is doing. The other key is communication: observe the client's response to touch and check in.

 

[lawlman91]

So, I am one of those horrible therapists who does elbow work not only around the medial border of the scapula, but even up under it and around and under the lateral border on occasion.

A lot of it is technique, a lot of what I do is what the client prefers. I mainly have a deep tissue type practice, though I encourage straight relaxation work. I have DT clients who refer more DT clients. Therefore, I have a lot of DT in my practice. What can ya do? (rhetorical question there, that's all)

Each client is expecting something different and I do try to deliver.

That doesn't mean everyone gets this type of work, but it's not unheard of, if that makes sense.

I've been worked on by people who can do this effectively and although somewhat uncomfortable it does do the trick. I've also been worked on by people who have no idea how to work like this and it just feels like they are bruising the bone. There's a certain finesse to it, I think.

 

[cruz1850]

I also wonder where so many therapists have gotten the idea that digging and poking without warming is somehow therapeutic? This past weekend, I had the worst massage of my life, a 60 min massage that I had to end at less than 30 minutes. I went in for a relaxation massage and it was pokey, pokey, pokey! Initial touch was rock-hard palms in my traps and no ensuing warming whatsoever. Aggressive digging into medial scapula, axilla, levator and traps. I felt like I was being probed and picked at by alien fingers. The worst part is that I walked out of that session with injuries that I did not have when I walked in - SI joint pain and intense pain running from my right levator/traps down my spine to midback. I still can barely turn my head or lift my arm without pain. Not only was it a painful session, it was extremely anxiety-inducing. Since when are pain and anxiety relaxing?!?

What surprised me most was that this therapist has been in practice for something like 15 years, and she practices Reiki, and there was no mindfulness or softness to her touch at all, nor did she really listen to me. It was like she only heard what fit in with what she wanted to do - I felt a definite agenda there, and it certainly wasn't focused on making me feel good. I find it very disturbing when a massage therapist causes injury. The best I could think to do was talk to the owner about it and hope that no one in the future has as bad a massage experience with this woman as I did.

 

[[//anti * twilight//]]

At my school, Soma Institute in Chicago, we learned to use our elbows and forearms in both areas mentioned, but always w/ good communication and proper warming.

I personally prefer that DT work, but I'm sorry to hear that there are therapists out in the field who don't listen to their clients thereby causing them pain.

 

[my_huckelberry]

I am going to agree with what others have said. It all has to do with being judicious. Someone said here, I don't remember who, and I appologize for that, "it's not how deep you go, but how you go deep" It resonated with me, and has made me more aware of my techniques, and what I do.

I use my elbows, almost anywhere on the body, except the neck, hands only there. But not when the client asks me not to. I will frequently ask, how is the pressure, probably to the point to annoyance during certain massages (you ask for a deep/therapeutic massage, I keep in constant communication).

An elbow to the lateral/medial any border of the scapula, a fist in the glutes, a thumb to the subocciptials, can all be done, but done well is the question. Heck, when I do ART I have my thumb buried deep in people's armpits (with their consent) to work subscap, and pec minor. Is it for everyone? Absolutely NOT. I only do that kind of work, when it is indicated, and I have consent, and make sure things are warmed up and the client is okay with it.

There are a lot of new therapists out there, with schools pumping them out all the time. It is unfortunate that some of them don't quite have the right touch yet.

It can be done, you just have to know how to do it.

 

[[{ !shay! }]]

I agree with all of your posts.

I realize after reading my post you may I have felt that I implied that the elbow should never be used in this region (the way I worded my main line topic) ...I don't feel that way...but when it has not been warmed up and it is a first time client...no, I don't think it should be used.

I have never felt an affinity for using the elbow in that region because it is not full of large, deep muscles. I typically use my thumbs and fingers for exacting work and with fiber-stripping of the rhomboids (always a favourite). I saved my elbow only for piriformis...I am rethinking this.

I actually received a deep tissue massage last week that was comprised of mostly forearm and elbow and that was about it. We were just working back and glutes due to time.

It was an INCREDIBLE massage and the therapist used her elbows in my rhomboids and around the scaps...and it was lovely.

So, I have now experienced the huge influence finesse and technique do play in how we use our tools.

I do like deep tissue work, both giving it and receiving it,...but as you all have echoed in your replies it must be practiced judiciously. i also do not recommend it as someone's first massage experience.

So I have lived and learned in the past week and have found an elbow can feel good and can deliver therapeutic work in properly warmed up tissue in that region.

Thanks for the replies and thanks to those who do use their elbow in this region for replying.