[Critical Thinking] A conundrum, but not really......

**rkathryn** · 16-10-2011, 08:42 AM

So, this post by John Ware here really struck a chord with me as these days I'm increasingly experiencing this type of situation. So, I was in a conundrum about how I marketed my massage practice on my website b/c I did advertise that I did myofascial release and some other techniques that entailed postural evaluations and such that nowadays I neither subscribe to those ideas or use in my practice. I've since removed some of the stuff from my website, but did keep a few things for the very reason that John mentioned in his post.

There are so many clients I get who come to me with these notions about alignment, myofascial release, posture that they've learned elsewhere that I realized if I didn't include some of that stuff, these ppl wouldn't call for an appointment. So now I get them in and then figure out what they believe and work with them from their point of view.

For most of my clients, I've been able to discuss these new ideas about the nervous system and brain connection to pain and that stretching and foam rolling muscles doesn't work in the sense that they may think. And generally those clients seem to understand it pretty well. Granted, I don't get it all myself so I'm sure that's an issue. I just explain what I do understand and also let them know what I don't understand.

Diane's post here really helped me in that regard since (for example) there are those who aren't going to believe that regular stretching changes the mind's perception of what it can do in terms of movement and continue to choose to believe they are actually lengthening muscle tissue. Or that they need me to "get in there and dig out my knots". There are the clients who come in for pain relief and after a few sessions of DNM, they admit they're no longer in pain, but don't make the connection between the DNM and the reduced pain. Or the client who comes in for bulging disc pain that is relieved immediately by the DNM, only to have the pain return when she visits her PT who gives her exercises where she sits on a ball and extends her legs & while keeping them together, moves them left to right, left to right multiple times. There's where my struggle with keeping my ego out of the room is getting another once over. I just remember that they do indeed have a choice. Fortunately, only being a massage therapist, my scope of practice prevents me from ever suggesting the client does anything different from what another health care provider recommends-- both a blessing and a curse!

Both of those things were difficult to overcome. The ego thing, I'm still working on and definitely also finding out what it is the client believes and then finding that balance between giving them enough of what they expect and enough of what will be most effective without wasting their time and money. It's a fine balance and I seem to be just starting to finally understand a sense of how to proceed. I give thanks to both John Ware & Diane Jacobs for those posts which finally helped me to be able to verbalize what has been going on in my head for many months.

**John W** · 16-10-2011, 10:12 PM

You're certainly welcome, Rajam.

Sometimes, I envy massage therapists and other "non-traditional" care providers because they exist somewhat outside the current health care delivery system, which is startlingly ineffective and far to frequently harmful to patients with persistent pain problems. As a relative outsider, you can rely on your wits, determination and self-reliance more in getting patients to come your way. For those of us closely aligned with biomedicine, too often we have to play games, massage egos and navigate an increasingly irrational insurance authorization and reimbursement system in order to get patients in the door.

Only then can the "de-briefing" that you describe above begin.

TexasOrtho · 17-10-2011, 01:46 AM

Quote:

too often we have to play games, massage egos and navigate an increasingly irrational insurance authorization and reimbursement system in order to get patients in the door.

Thanks John. You just described 95% of my day.

Alice Sanvito · 17-10-2011, 02:28 AM

Rajam, wonderful post and wonderful words by Diane and Jon. All of you really hit the nail on the head.

Being an MT has got its advantages and disadvantages, but I do enjoy the great freedom that comes from being outside of the system. If I can convince a client to participate, I am free to proceed as I think is best within my scope of practice.

I wish I had a better memory. I want those words embedded in my brain so I can communicate more effectively (I hope) to clients.

Gosh, what a privilege to be among people who are thinking seriously, deeply, about how the body works, how we interact with clients. Thanks, all of you, for taking the time.

**caro** · 17-10-2011, 04:57 PM

Yeah Rajam, man do I hear you...

16-10-2011, 08:42 AM	#1
rkathryn Senior Member Join Date: Jul 2009 Location: San Diego, CA by way of Huntsville, AL Age: 39 Posts: 190 Thanks: 56 Thanked 43 Times in 14 Posts	A conundrum, but not really...... So, this post by John Ware here really struck a chord with me as these days I'm increasingly experiencing this type of situation. So, I was in a conundrum about how I marketed my massage practice on my website b/c I did advertise that I did myofascial release and some other techniques that entailed postural evaluations and such that nowadays I neither subscribe to those ideas or use in my practice. I've since removed some of the stuff from my website, but did keep a few things for the very reason that John mentioned in his post. There are so many clients I get who come to me with these notions about alignment, myofascial release, posture that they've learned elsewhere that I realized if I didn't include some of that stuff, these ppl wouldn't call for an appointment. So now I get them in and then figure out what they believe and work with them from their point of view. For most of my clients, I've been able to discuss these new ideas about the nervous system and brain connection to pain and that stretching and foam rolling muscles doesn't work in the sense that they may think. And generally those clients seem to understand it pretty well. Granted, I don't get it all myself so I'm sure that's an issue. I just explain what I do understand and also let them know what I don't understand. Diane's post here really helped me in that regard since (for example) there are those who aren't going to believe that regular stretching changes the mind's perception of what it can do in terms of movement and continue to choose to believe they are actually lengthening muscle tissue. Or that they need me to "get in there and dig out my knots". There are the clients who come in for pain relief and after a few sessions of DNM, they admit they're no longer in pain, but don't make the connection between the DNM and the reduced pain. Or the client who comes in for bulging disc pain that is relieved immediately by the DNM, only to have the pain return when she visits her PT who gives her exercises where she sits on a ball and extends her legs & while keeping them together, moves them left to right, left to right multiple times. There's where my struggle with keeping my ego out of the room is getting another once over. I just remember that they do indeed have a choice. Fortunately, only being a massage therapist, my scope of practice prevents me from ever suggesting the client does anything different from what another health care provider recommends-- both a blessing and a curse! Both of those things were difficult to overcome. The ego thing, I'm still working on and definitely also finding out what it is the client believes and then finding that balance between giving them enough of what they expect and enough of what will be most effective without wasting their time and money. It's a fine balance and I seem to be just starting to finally understand a sense of how to proceed. I give thanks to both John Ware & Diane Jacobs for those posts which finally helped me to be able to verbalize what has been going on in my head for many months. __________________ Rajam K. Roose, HHP "The danger is not that the soul should doubt whether there is any bread, but that, by a lie, it should persuade itself that it is not hungry" (Simone Weil)

16-10-2011, 10:12 PM	#2
John W Harmless creampuff Join Date: Sep 2006 Location: New Orleans, LA Age: 48 Posts: 4,643 Thanks: 617 Thanked 966 Times in 436 Posts	You're certainly welcome, Rajam. Sometimes, I envy massage therapists and other "non-traditional" care providers because they exist somewhat outside the current health care delivery system, which is startlingly ineffective and far to frequently harmful to patients with persistent pain problems. As a relative outsider, you can rely on your wits, determination and self-reliance more in getting patients to come your way. For those of us closely aligned with biomedicine, too often we have to play games, massage egos and navigate an increasingly irrational insurance authorization and reimbursement system in order to get patients in the door. Only then can the "de-briefing" that you describe above begin. __________________ John Ware, PT Fellow of the American Academy of Orthopedic Manual Physical Therapists "Nothing can bring a man peace but the triumph of principles." -R.W. Emerson “If names be not correct, language is not in accordance with the truth of things. If language be not in accordance with the truth of things, affairs cannot be carried on to success.” -The Analects of Confucius, Book 13, Verse 3

17-10-2011, 04:57 PM	#5
caro Arbiter Join Date: Jan 2011 Age: 43 Posts: 679 Thanks: 1,167 Thanked 437 Times in 174 Posts	Yeah Rajam, man do I hear you... __________________ Carol Lynn Chevrier LMT "Beaucoup d'entre nous mourront ainsi sans jamais être nés à leur humanité, ayant confiné leurs systèmes associatifs à l'innovation marchande, en couvrant de mots la nudité simpliste de leur inconscient dominateur." Henri Laborit - 1914-1995 .

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17-10-2011, 02:28 AM	#4
Alice Sanvito Continually Curious Massage Therapist Join Date: Apr 2011 Location: St. Louis, MO USA Age: 60 Posts: 243 Thanks: 190 Thanked 152 Times in 56 Posts	Rajam, wonderful post and wonderful words by Diane and Jon. All of you really hit the nail on the head. Being an MT has got its advantages and disadvantages, but I do enjoy the great freedom that comes from being outside of the system. If I can convince a client to participate, I am free to proceed as I think is best within my scope of practice. I wish I had a better memory. I want those words embedded in my brain so I can communicate more effectively (I hope) to clients. Gosh, what a privilege to be among people who are thinking seriously, deeply, about how the body works, how we interact with clients. Thanks, all of you, for taking the time.