Typical Massage Session

Once the appointment has been set the next step is the actual appointment. I typically like to set the first appointment for a 2-hour session. This gives time for an introduction and a great opportunity to get filled in on your history of health, injuries, career, and daily activities as well as time to perform a detailed assessment. 

 

As a neuromuscular therapist, my first priority when you come in, is to "Ask why?". Why are you here today? Most clients come in because they are in pain and after about a half dozen sessions or so they begin to come in for relaxation or stress reduction purposes only. With occasional pain relief or pain management. Soreness, stiffness, and injury recovery or rehabilitation massages are mainly geared toward prevention or improvement in quality of life as well as controlling headaches & migraines.

 

Aside from relaxation or stress relief which just requires an excellent massage,  I now want to figure out why these conditions are taking place or what is their pathology. Let's say a client comes in with pain in the lower back for example. 

The first thing I need to know is where are they feeling pain. 
   • I need to know the region of the body. 
   • Does the pain refer anywhere else in the body?
   • What does the pain feel like?
       ○ Burning 
       ○ Stingy
       ○ Dull
       ○ Constant
When do they feel pain? 
       ○ Upon waking up.
       ○ At the end of a work day.
       ○ When exercising. 
       ○ Walking
       ○ Turning or twisting the arm. 

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I then ask When did they first become aware of the pain, what were they doing at the time, and the severity of it as well as what structures of the body are in pain and what type of tissue am I going to be working with. Joints, tendons, cartilage, fascia, nerves, or muscles? Maybe a combination of all of them, which is usually the norm in my sessions. It is also imperative that I know if this condition is something I can or should even be working on. 

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My sessions after the initial session are typically 90 minutes where I spend the first few minutes of the first third of the session focusing on a particular region or through a specific kinetic or fascial chain of the body. Assessing the neuromuscular, myofascial, and musculoskeletal health of the region affected by the injury or condition before I implement my plan of intention. If my intention is to relieve general tension then I transition from palpation to a type of myofascial therapy, where I work the tissue with no massage oil. This allows me to rapidly warm up the tissue, work the fascia, and focus specifically on muscle fibers that are in a steady state of contraction (tonus), either cause by guarding or overuse syndrome.

 

When I do come across these tonus muscle fibers I do a combination of things. I typically use a technique called transverse friction to see when and where the muscle fibers will let me run through them and where they make me roll over them and I do this technique from one end of the muscle attachment to the other or basically tendon to tendon. After determining where the muscle needs the most attention I then continue to perform some deep transverse friction on the tendons of the muscle just to say hello to the Golgi tendon organ and then continue on to those tonus muscle fibers.

 

After I am satisfied with the dry work I then begin to apply oil and switch to a combination of MFT, Swedish, and Deep Tissue. Continuing to work the same region with broader coverage of muscles and tendons before finishing up the session with a nice relaxing full-body Swedish massage. 

Each session and client is completely different yet still retaining a familiar feel and as a Neuromuscular Therapist, I am required to know everything about the human body; systems of the body, anatomical considerations, innervation and vascularization, functions, referred pain patterns, how to examine the patient, trigger points, differential diagnoses, associated pathologies, indications and contraindications, corrective actions, and home care techniques. 

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