Speed Bumps

[coopyey]

I have a friend taht recently had a massage(about 1 week ago) She has osteoporosis and informed the tehrapist.  The tehrapist went so deep in teh rhomboid area that she "jumped of the table" She told the tehrapist it was too hard, but the therapist said she had 2 knots that needed to be worked out.  The knots were in the same place on either side (medial border of teh scapula/rhomboid area)She is in so much pian taht she can't sleep unless she turns onto her stomach.  She also has pain in her right  pec major area.I suggested she should go to the Dr.  I remember something from a class about an area that feels like a knot, but it isn't, and teh teacher called it a speed bump.  I guess it is bone.  Anyway, any suggestions for her, besides going to the Dr.

 

[The Mad Hatter]

Well first of all, someone with any degree of osteoporosis, should not be getting a deep massage, the chance of the therapist actually breaking a bone or doing damage is very high.  What they are referring to with "speed bumps" are usually trigger points in her Rhomboids, Traps or Serratus posterior superior, they will be painful and so tight that they are hard to work on depending upon which muscle they are in... but all 3 have common TP's in that area.  If she is really thin, then yes it could be bone, so they have to be even more careful.  I honestly would not be continuing to see that therapist, and if the pain continues I would go to the doctor to make sure that the therapist didn't do any damage since Osteoporosis is a contraindication for deep massage, and a Definite no-no for trigger point work unless it is a very gentle vibrating technique or skin rolling.

 

[tracie]

Speed Bumps

I have to wonder if it is possible that your friend has Fibro.  The symetrical "knots" sound more like trigger points.  They aren't bone. They are reoccuring even if you coax them into leaving for a while. I have the same problem on the vertebral border of my scapulas.  Here is a good link with a diagram of the tenderpoints that are used to diagnose Fibro.  Fibro is nasty and debilitating.  I hope she doesn't have it.

http://www.plaidrabbit.com/fms/fibrom3.htm  

You can put pressure on these points to see if they cause her pain., but her Dr. should diagnose it.

As far as working knots out, a light touch and patience gets results. Trying to force knots out just causes unnecessary pain and guarding with no relief.   Her therapist should have known that.

Medicineman

 

[NobodyRoxas]

I have to wonder if it is possible that your friend has Fibro.  The symetrical "knots" sound more like trigger points. . .

Knots, fascial adhesions, or trigger points (which can all be the same thing), are often described as "speed bumps".  Taken directly out of my pathology book: Trigger points are NOT the same thing as Tender Points. Almost everyone has trigger points. Trigger points in the rhomboid area are extremely common. I'd say that about 80% of everyone I work on has trigger points in the Rhomboid/mid Traps area between the vertebral border of the scapula to the vertebrae.One of the defining symptoms which determines whether a physician will diagnose a patient with fibromyalgia or not is if they are tender in at least 11 out of 18 specific spots that are typical of fibro sufferers. These spots are called Tender Points. Although it is out of our scope of practice as MT's to diagnose, it's very important for us to know the difference between a Trigger point and a Tender Point as they are not treated the same way. I was taught incorrectly by one of my instructors and I treated the Tender Points on my first fibro client the same way that I would a Trigger Point. She had a major set back for the next week. After more research, and after taking a pathology class with a doctor, I learned that you DO NOT treat Tender Points on fibro clients the same that you would treat Trigger points. My clients respond considerably better now that I use more appropriate techniques.Trigger Points = usually refer pain, and are associated with a hypertonic band of muscle. These are often felt as knots or speed bumps, and they usually are tender to touch if they are currently active. Tender Points = do not refer pain, are not associated with a hypertonic muscle (though sometimes a Trigger Point and Tender Point might occur at the same spot such as the common rhomboids area which are a common problem for most people, certainly not just fibro clients), and they generally elicit pain with the same pressure that it takes to turn your thumbnail white if you were to press on it. It is also common for a tender point to hurt even by gentle touch with no pressure. Many of us may have Tender Points in a few places from time to time. Most of us have Trigger Points. Just having a few Tender Points doesn't mean we have fibro. According to the rheumatology association, you'd need to have many of the typical symptoms of fibro PLUS at least 11 of the 18 typical Tender Points for a minimum of 3 months in order to be diagnosed with fibromyalgia.

 

[Display]

Speed Bumps

Tender Points or Trigger points....in any case, your friend seems clearly worse off now than before...though, without knowing what happened in the session, one cannot really conclude anything other than if the intention was to feel better, apparently it didn't work. "She told the tehrapist it was too hard, but the therapist said she had 2 knots that needed to be worked out." JMHO, but any time a therapist "overrules" the client, a boundary has been crossed...whether it "works" or not. There is already enough of a power imbalance...if the bodyworker coerces consent, or ignores obvious indications that the client does not wish to continue, its really more significant issue than simply choosing appropriate treatment techniques or mistreating a tender point as a trigger point. Rob

 

[Elsabe]

lindad, have your friend call the therapist who hurt her to explain what happened.  this therapist could be doing this to other people, and she needs to know she crossed a line.  no therapist should EVER continue with something that is not within the pain tolerance of the client, EVER!  in this case, it would be good for the therapist to learn why your friend is not returning to her.

 

[Matthew. Aka_ No LiMitz]

Speed Bumps

I have to completely agree with jellybean. Sometimes I have clients that when I ask them how the pain level is (which I believe youshould always do)they say it hurts but they need it. After I tell them massage should not hurt, and I cn get the knot out while respecting their pain tolerance it just might take a little longer, they tell me that a different therapist they went to told them if they wanted it out it was going to hurt. Kinda like an ultimatum. I always wonder, "who are these therapists?" and "who taught them that?" Now Rolfing I know is painful, but if she is not getting that, the therapists needs to respect them. In reference to the lady who her shoulder still hurts, I have found that sometimes when a knot is tight for so long, it loses nerve sensation, so that it doesnt really hurt, but you still feel it is there. So, once the knot is released, you will be sore for a couple of days, but then feel great. I always show the client some stretches to continue to work it out at home and that usually does the trick.And yes, I know that I could break a bone on an elderly person with ostoeporosis quite easily, my instuctor told me that in school and to be careful. Your friend needs to be careful. Maybe she does not know her strength?