Get Your Client Out of Pain: Put a Stake in the Ground

My wife, Lisa, and I were worried. Her sister, Patty, was dying of emphysema and she had one last request. She wanted to pet horses. The problem now was that Patty was very weak. A trip to the horse rescue farm might hasten her death if not do her in right there on the farm. The easy way out was to do nothing and let nature take its course. Instead, the family put a stake in the ground. We, and the nursing home staff, took Patty to the farm.

In the massage room, as in life, fully committing to a course of action without knowing the outcome can be scary, but when you do, you really start helping clients get out of pain.

Create a Plan

In massage committing to a course of action means having a treatment plan and then executing it. A treatment plan is important because it focuses your attention on the client’s problem. It also puts you in the crosshairs—in a positive way. You are saying to the client: I’m trying this, and if it doesn’t help you we’ll both know it.

The good thing about this is that if the plan works, you’ll have a template to use the next time your client comes in with the same pain condition. And if it doesn’t work, you’ll have a starting point to try something new.

Simple Can Be Effective

Your treatment plan doesn’t have to be complex to be effective. It could be something as simple as “for this person’s lower back pain, I’m going to address the spinal erectors and QL.” And it’s okay if your plan changes while you’re doing the massage—just remember what you did, then write it down.

More about complex treatment plans versus simple ones: if you have a complex plan and it doesn’t work, you’re going to have a lot more question marks about what you should adjust for the next time. Whereas, with a simple plan there will be less variables to adjust.

Complex Doesn’t Mean Better

Also, there can be a tendency to put too much stock in complexity. In other words, there’s a view that the more complex a system of analysis/treatment is, the more successful it will be. But if you look at the actual numbers, that’s not true. No one discipline or modality has cornered the market in providing pain relief. If they did, the rest of us would be out of business.

Lastly, if you’re actually feeling that your treatment plan “isn’t worthy”, you’re not alone. We’ve all been there at some time. Check out my post How to Stop Feeling Like an Imposter. It might help you get over the hump.

Explain Your Findings

After the massage, let the client know what you found, e.g., tightness in the trap, but not the levator scapulae. (It’s at this time that I also think about a plan B in case my plan A doesn’t work.) Also, find out if your client is in less pain, since reduced/no pain is the goal and the measuring stick for success. If she’s in less pain, you’re heading in the right direction.

I like to follow up 3 – 4 days after the massage. When I do, I ask again if the pain has decreased. If the answer is “a little”, then I often tweak my plan for next time. If the answer is the same or the pain has gotten worse, then I strongly consider my plan B.

When Nothing You Do Works

There may be a time that no matter what you try, nothing works. It’s important to recognize this. Once you do, you can then point the client in the direction you think she should go—e.g., orthopedist, chiropractor, etc. It’s the right thing to do for your client and there couldn’t be a better form of advertising than your integrity intact.

Clients Want a Plan

I used to think that firmly committing to a course of action was cocky. But I was wrong. It simply means that you’ve weighed the options as best as you can and you’re not going to let indecision make the decision for you.

From a therapy standpoint, a client wants to know that:

 1. you have a plan

 2. you’re going to work the plan

 3. and adjust/change the plan if need be.

Was it the Right Choice?

Fortunately, there are no life or death consequences when committing to a course of action in massage. But outside the massage room there are. Within 36 hours of the trip, Patty was dead. We were sad. But we also had the uplifting memory of a faint smile on Patty’s face as Tom Thumb chomped on a carrot she was helping to hold.

Did we make the right decision for Patty? Honestly, I’m not sure. For me, the memory of a faint smile on Patty’s face was a bonus. Putting a stake in the ground, and not letting indecision determine her fate, was what I could live with.

Patty Feeding A Carrot to a Horse

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