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Does anyone know the answer. I am currently training for my ITEC Holistic Massage therapist qualification and as you have all no doubt experienced, working like a headless chicken through my client case studies!!! Last week on the couch in college it became apparent to me that my client experienced some discomfort around the glutus minimus area on digitally fibrating the muscle, my tutor stated it was likely to be signs of siatic pain. As my client had not disclosed any lumbar pain in her consultation I became obviously concerned. My tutor had explained brefly to me that working around that area could help relieve pain. Have any of you experienced siatic pain clients and how do you continue with your massages? JACKIE
Dec 8 2008 11:59AM
From your description of the position almost certainly just a spasm in piriformis. A neat trick that releases that spasm 90% of the time is to bend the leg at the knee so the tibia is verticle, patient supine [face down], gentle steady thumb pressure on the tender point, and with no assistance from the patient [they really must not help] bring the foot sideways toward you 30 degrees [5 minutes on a clock face] and rotate the lower leg over the knee keeping the toes pointing to the centre of the circle, reverse the rotation still with the toes to the centre and lay the leg down. Magically the pain will have gone. As the leg goes round you will probably be able to feel the hip joint moving beneath your thumb. This is good.
This would be safe to do for someone with sciatica, it will not agrevate that problem unless the sciatic nerve is right over the joint here and caught in it, [only one in ten thousand] and if you are unfortunat enough to have found this one the pressure from the thumb will be extreemly painful, so if on pressing the point gently, your patient jumps out of their skin, leave alone. Otherwise you are safe to proceed.
Some Patients who have a chronic [long term] problem will armour not [be able to relax] and let you have the leg, if yours has this don't tell them to 'relax' it won't work, sometimes they can 'let me have the leg' and there are other forms of words that work better but the main point is this is not something the Patient has conscious control over and is indicative of a long term problem, [probably in excess of five years to learn this behaviour], I have seen therapists getting cross with a Patient who is unable to relax, a real NO NO.
Lots of luck with the examn, let me know how you get on with this, there is a direct connection on my web site http://www.muskelym.co.uk/
Yours aye Mike
Jan 24 2009 1:41AM
Just a pointer (which you should always discuss with your tutor) maybe the patient needs appropriate positioning. If they lay face down (which incidentally is prone, not supine) sometimes the natural inward curvature of the lumbar spine pulls the pelvis forwards. In the 1st instance I would offer a soft pillow to be positioned under the abdomen/anterior hip which will attempt to limit the 'lordosis' effect of the spine, so relieving pressure in the hips (and SCIATIC nerve root)
By the end of the massage (before you turn them supine) I would aim to remove the pillow so that the now RELAXED muscles can re-adjust and maybe not so aggravate the pelvis.
Keep it simple - once you qualify, you can attend workshops that will teach you various skills but in the meantime look at your clinet and see what suits them.
Apr 7 2009 9:15AM
I'm upsides down with my prones and spupines thanks Mark for the really good added advice