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Many clients come in for a massage and wonder why we ask so many questions, or give a brief assessment before we begin treatment. As health professionals, we are trained sleuths. Our first priority is to figure out what underlying health conditions may be present. We are obligated and regulated to ensure our treatments are not contraindicated. Some health conditions we may treat for shorter duration, such as those involve the heart or blood pressure, or perhaps there is a fracture that we cannot treat directly, etc. Pregnant women need to be treated with different considerations, as do elderly clients with osteoporosis, or athletes before a big game, etc.


Some of our questions and tests also give us clues as to which structures are involved in how you are currently experiencing pain. You may present with pain in just one plane of movement, (such as pain turning your head to the left, but no pain looking right or down or up). This may indicate just a muscle strain in one or a few muscles. Or you may have pain in multiple directions, that may or may not indicate nerve, joint, ligament or multiple layers of muscle involvement.


We ask about activities that are contributing to your condition. For instance, most of us are aware how much desk postures and driving contributes to upper back and neck strain, but many forget that our pectoral muscles and arms are being overused in those forward movements. As massage therapists, we have to consider those muscles in our treatments. We cannot just loosen up the overstretched back muscles and allow the pectorals and deltoids to win that tug of war.


Some clients come in and say they are stressed, which for the most part would indicate relaxation focused massage. But, as healthcare providers, we have to figure out whether your neck and ribcage muscles are under strain due to upper chest breathing. We need to find out whether you are clenching your jaw, and thus contributing to headaches or neck strain. If your body is under an extreme amount of stress (triggering the fight or flight, sympathetic nerve system), we may back down from the deeper techniques because your body needs to get into the calmer rest and digest (parasympathetic nerve) state.


We hope that our questions also lead to your own line of inquiry with what postures you are using, or what activities may contribute to your pain, so that you can prevent or lessen the impacts. Hopefully, having a sleuth mindset will allow you to empathize and strategize more with those around you. Maybe your children’s aches and pains are due to track and field day, rather than just “growing pains”. Maybe Grandma thinks she needs a new bed because she “slept funny”.  Maybe she does need a new bed, try it out for yourself, but also don your deerstalker hat and see if there are a few more clues to her aches and pains.


Written by Sheree Kima, RMT

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