In every issue of our journal, you will find a Case of the Month, which we will select from the submitted cases. Everyone who is using MEDICAL MASSAGE PROTOCOLS in their practice may submit their cases for review, and we will share the best one with our readers in every new issue.
If you would like to share your account of professional success with our readers and participate in the Case of the Month program, see Case of the Month Program.
I have worked with Samantha Avery, LMT, during several of our Medical Massage seminars in different parts of the country. What is striking about her is her professional curiosity and dedication to the profession and her patients. She is on a constant quest to help her patients by gathering as much knowledge and expertise as possible.
Samantha’s contribution to the Case of the Month section of JMS emphasizes a unique feature of Medical Massage: its simplicity. In many cases, it works where other modalities fail. As this Case of the Month illustrates, even one session of Medical Massage, when it is conducted correctly, may change the course of a chronic pathology a patient has suffered from for years.
ONE SESSION OF MEDICAL MASSAGE vs. YEARS OF CHRONIC PAIN
Client: Female
Age: 39
The client is a very good friend of mine who doesn’t live close enough to me to receive regular treatment. We communicate frequently, so I was aware of her problems. She has been complaining to me for years about a pinched nerve in her neck, pain down to her middle back and shoulder, headache, etc. All this time, she had been searching for a remedy, a therapy, a chiropractor or a doctor. She did pursue deep tissue massage, and either it made no difference whatsoever or she would feel great for a few hours, and in some cases even up to a day, but that was the extent of her relief. She had also seen a number of chiropractors with some results, but never any sustained relief from her symptoms.
Recently, she started seeing a new chiropractor who seemed to really want to help, but again the results were undependable. Finally, she planned to visit me, and I started to really think about her problem and the sketchy results from so many treatments from numerous sources of medicine.
I began by educating her on how it’s supposed to feel to receive a massage treatment without activating the pain-analyzing system and explaining that it isn’t always necessary for therapists to go so deep to get clinical results. I then examined her according to the evaluation process I had learned through the Medical Massage Training Seminar by Dr. Ross Turchaninov. I wanted to pinpoint the issue and give her the one treatment that we knew we could do during her short visit. I definitely wanted to give her chiropractor the evaluation and explain the prognosis. I also wanted him to understand where and why I worked on specific areas, and I suggested that perhaps he could help her find an informed, trained massage therapist in her area.
INITIAL COMPLAINTS
Chronic pain in the upper back, neck, and right upper shoulder. The pain intensified during deep inhalations and sneezing. She suffered from chronic headaches.
DIAGNOSTIC EVALUATION
While examining her, I found active connective tissue zones at the first and second levels on the right side of her posterior shoulder.
During the application of the Sensory Test, she reported a very sensitive, ticklish sensation on the skin over the trapezius muscle, especially on the right side. I considered that a sign of cutaneous reflex zones formed in the same area and a local imbalance between the sympathetic and parasympathetic nervous systems.
The evaluation of the skeletal muscles indicated the presence of active trigger points in the classical locations for the upper part of the trapezius muscle. She had cervical ROM pain at the end of the rotation to both sides, but more prominently to the left.
Finally, an examination of the occipital ridge at the insertion of the trapezius muscle revealed the presence of active periosteal trigger points.
After analyzing this clinical data, as well as the origin of innervation of the affected soft tissues, I concluded that my friend suffered from Chronic Trapezius Muscle Syndrome. Tension in the upper trapezius muscle irritates the greater occipital nerve at the insertion of the muscle into the occipital ridge, and in turn it triggers Chronic Headache. Also, the tense trapezius muscle exerted pressure on the cutaneous branches of the cervical spinal nerves, triggering the formation of reflex zones in the skin and fascia in the upper back.
TREATMENT PROTOCOL
I started with an inhibitory regimen of massage therapy to remove protective muscle tension. The next step was the application of Connective Tissue Massage strokes in the upper back and neck. After that, I worked at the insertion of the trapezius muscle into the occipital ridge, and then I used the step-by-step protocol of Trigger Point Therapy to address trigger points in the trapezius muscle. I finished the session with the application of PIR for the trapezius muscle.
After the session, I saw immediate visible results and she felt immediate pain relief. We were both absolutely thrilled. I discussed with her what she should and should not do during exercise. I showed her the stretches she needed to do as homework to support my therapy, and I told her how often she should get treatment for optimal results. The treatment held for the first time, and the next day she reported that she felt great, with more mobility and flexibility and with her shoulder not rounding as much. She had some minimal soreness in the soft tissues, but she didn’t have the sensation that someone had beaten her up.
She shared her experience with the chiropractor and gave him my notes. After reading them, the chiropractor said that everything I had done made perfect sense and that he could not believe that he had missed this! He did know of a great therapist for her to continue the therapy she had started with me. She continues to feel better even after one session!
ABOUT THE AUTHOR
Samantha Avery, LMT
Samantha Avery, LMT, graduated from Healing Arts College in 1994 and has always wanted to learn more to better serve her clients. She also attended other educational institutions, including Esalen, Upledger, and The Massage School of Santa Monica. These places offered some great training, but there was something missing.
She found the last piece of the puzzle four years ago when she took a Sports Injury Medical Massage class from Oleg Bouimer and Dr. Turchaninov. Since then, she has continued to take Medical Massage Seminars and finds this concept to be the most beneficial for her and her clients, with the best results. She has worked at a 5-star hotel and an acupuncture clinic. Now Samantha has her own practice in Beverly Hills. She has done volunteer work to provide healing massage for AIDS patients in hospice, and to provide educational information to HIV patients in Los Angeles shelters. Her website is Medical Massage & Skin Rejuvenation in Beverly Hills.
Category: Case Studies
Tags: JMS 2014 Issue #3
