Does everyone assess their clients?

[Angel M]

I am astounded when I have a massage from a therapist that I don't know, who gets me to fill in a medical questionnaire at the front desk, asks me to come into the room, disrobe and lay prone!! How can you assess the body and treat the person if you don't assess them whilst they are standing or sitting!! Is it just me or are these therapists incompetent and are you taught to assess your client before they lay down...and I just don't mean talk to them I mean visually assess themmmmmmmm.

 

[DavoJo]

i observe each client as i meet them. i don't need him or her to stand straight in front of me or remove any clothing.

 

[angel G]

i observe each client as i meet them. i don't need him or her to stand straight in front of me or remove any clothing.

Ditto.

I also do things such as observe how they get up out of the chair, their gait as they walk to the treatment room etc..... If there is something I'm unsure about at that point I might check to see the alignment of the hips but most of my assessment is done just by observing them.

Angie

 

[Jedimaster]

Depends on the person. But typical assessment for pain usually includes:

Ask where the pain is
Gait
Plumb Line and foot placement
Standing Assessment
Pelvic Level
Neurologicals (Herniated Disc, VBI assessment)
Check of the spine in flexed state for flat area, followed by TP assessment
Respiratory assessment of ribs
Active ROM for Cervical, Thoracic, Lumbar spine

Naturally, this is variable depending on the person. Often I do more specific testing as well.

 

[hockeybeast88]

Depends on the person for me too. Usually I've done a quick visual check as they come in and sit down. I watch how they move their upper body as we sit and chat, and as I come around to sit down. Then I watch how they move as they walk to treatment. Then I do a spot check ROM for minor complaints and ask them if they notice any tasks that are difficult to do in daily life.

This is for minor complaints. Major complaints/major injury, I do a detailed standing assessment, then prone and supine checks. Low back pain usually gets standing and sitting assessment.

I also do a respiration assessment, but I do this with nearly everyone as I'm working. If I notice any restrictions or abnormalities, I do a deep breathing check.

 

[Mommy of ~Andrew~ 8 mths]

Hee hee! Although I assess (observe as they move/sit/speak mostly), I just have to laugh because I have only ever been to ONE therapist who even had me fill out a form! (And she also did a detailed postural assessment, for routine wellness massage, which I disliked given the circumstances.) Most that I know here literally do not even ask a single health-related question, even the most basic ones.

For wellness massage, I feel like a formal "assessment" sets the wrong tone for the session. I try to keep it unobtrusive for that reason. I see quite a few people with body-image concerns too, for whom a full-on formal "observation" just totally sets them up for discomfort, making my job harder.

MVAs and injuries are a totally different story. To the OP: what kind of massage are you getting in these situations where you feel underassessed?

 

[Laura B]

I also do things such as observe their gait as they walk to the treatment room etc.....

I'm guilty of this at the mall, at WalMart, etc. Sometimes it irritates my wife.

If there is something I'm unsure about at that point I might check to see the alignment of the hips but most of my assessment is done just by observing them.

Seriously, though, in MFR we are supposed to do a through assessment, but often for the first visit it is too much.

 

[Osaka_L.A._Connect]

The first visit is the most important time to do the assessment so you can treat them and avoid them coming for a second treatment. I was receiving a remedial/sports massage as I was unbalanced, the therapist had no starting point or no ending point...Even in a 'wellness' massage you are making changes to the body which need to be quantified...of course 99/100 people feel better after their massage but are we making a difference in the long term...??

 

[As hatred sinks in]

The first visit is the most important time to do the assessment so you can treat them and avoid them coming for a second treatment.

Personally my goal is to have them come in again for another treatment! That way they can benefit more from massage. Prevention is so important in our line of work IMHO.

My school was very into assessments and the medical model of health care. I quickly learnt that patients who come in for a massage don't want an assesment...they want a massage.

 

[douglowesplace]

The first visit is the most important time to do the assessment so you can treat them and avoid them coming for a second treatment.

Personally my goal is to have them come in again for another treatment! That way they can benefit more from massage. Prevention is so important in our line of work IMHO.

My school was very into assessments and the medical model of health care. I quickly learnt that patients who come in for a massage don't want an assesment...they want a massage.

this is exactly what i was thinking. what client comes in and only needs one session? especially someone with issues? i don't do "clinical" assessments but i do observe, ask many questions and listen to every word of the client. typically, you'll know exactly (or almost anyway) what the client needs just from listening and watching.

 

[Michelle F]

LKM and terab..I think your goal should be to explain to this person what is happening to their body and your plan of treatment. If your first thought is to get them in for another massage then oops...people will not respect you. Do you want your time taken up by someone who has little benefit from your massage. I'd rather treat someone, get them to self manage and it maybe they don't need passive rehab rather active such as strength training..

 

[Froggy McFrogfeet]

I think your goal should be to explain to this person what is happening to their body and your plan of treatment.

I do this during the massage.

"If your first thought is to get them in for another massage then oops...people will not respect you."

Not my first thought at all, it's actually my last! I find the clients WANT to be told to come in again...they look to me for direction! I guess that is because they do respect me. I totally agree with homecare...and always give them something to work on.

 

[fishie]

LKM and terab..I think your goal should be to explain to this person what is happening to their body and your plan of treatment. If your first thought is to get them in for another massage then oops...people will not respect you. Do you want your time taken up by someone who has little benefit from your massage. I'd rather treat someone, get them to self manage and it maybe they don't need passive rehab rather active such as strength training..

Your first thought SHOULD be getting them in for a second treatment. Never is an issue resolved after a single treatment. It's still basic sales. People will respect your opinion as a professional if you act as such. I have told many clients they HAVE to come back for follow up treatments. Many are suprised, but all respect me for it. You aren't selling a massage, you are selling a solution to the problem.

And if you are into rehab, you should definitly have them come back. How do you know they are:
a: doing the exercises
b: doing them properly
c: doing the right exercise for the dysfunction

Without closely monitoring, you will have zero feedback on the progress of the treatment. Yes, you don't want to have people wasting your time, but remember, if they are coming of their own free will and they are still paying for it, they obviously see a positive effect.

 

[Mariah]

This is a very interesting thread. In school they pushed assesment to the max. I often felt like how would I have anytime to actually give them a massage? I think in the end its what sort of clients you are working on that determines the whole PA thing. Personally now out in the real world for a few months no one has needed or wanted one of my in depth assesments. I also think you need to be intutive enough to know if that person wants/needs homework, assesments etc. They are paying for the time. I want them to come back again so I want them to feel comfortable and to feel like they are getting what THEY asked for. I am not a doctor. If I can make some physical change fantastic. If not I hope I made them feel good for an hour. Of course if you are working for a DC and have a perscription or specific medical issues my whole thing goes out the window.

 

[Melissa J]

If people come to you in pain, not addressing the problem and finding a possible cause is not doing them right. If you provide relief, are professional and caring, people will return to see you, not because they wanted another five minutes.

If time is the problem, book appointments with 15 minutes between, and give them 5 more minutes.

 

[sophiesmummy]

I'm in a salon, so most of my clients are there for relaxation. Not suprisingly, almost every person out there is nursing some kind of injury/illness so I am fortunate to have exposure to medical clients in my environment too. I do some assessment when the client presents a condition other than stress, but from what I'm reading here I don't do nearly the extensive assessment as some other MTs. My school training didn't seem to get into that as much as what I'm reading. We did visual assessments, and a little bit of muscle testing, but it wasn't extensive. Like everything else (I'm discovering) my school time was barely scratching the surface of what I will learn in practice.

Additionally, when doing trades with another MT I've never been assessed. I just explain my issues and we try a technique to work it out.

Personally my goal is to have them come in again for another treatment!

I don't see this as a bad thing. I certainly want people to get better, but I view massage as a health maintenence component, just like exercise or a vitamin regimen. You can't just quit exercising or eating nutritious foods and maintain good balance/health. Massage is just another way to maintain balance (in the body and in the mind) Most of the MTs on this forum receive regular massage to maintain good health and swear by its benefits, so how could we not encourage our clients to do the same? Especially in this society when we are chronically stressed and constantly view our health as something we have to "fit in" around jobs, family, obligations, etc., I see massage as a convenient tool for maintaining some good emotional and physical health. It doesn't replace exercise and good nutrition, but people seem to enjoy it alot more! I know I do, and look forward to my weekly massages very much! If I fit that niche and get some repeat business out of it, then I feel I'm helping them, which is all I ever wanted to do in this profession.

We all have different goals for our practices, and OffIce's practice obviously addresses a different segment of the population that I do, but I believe that we both are professionals and acheive beneficial outcomes for our clients no matter our different methods.

 

[angelcake]

I view massage as a health maintenence component, just like exercise or a vitamin regimen. You can't just quit exercising or eating nutritious foods and maintain good balance/health. Massage is just another way to maintain balance (in the body and in the mind) Most of the MTs on this forum receive regular massage to maintain good health and swear by its benefits, so how could we not encourage our clients to do the same?

:iagree:

Very well said.

t023

Angie

 

[jelainazareno]

Pookariah, you rock!
I couldn't have said it better myself!
:iagree:

 

[rosemary]

Pookariah, love the relaxation massage, but not for me to perform. I refer these people on. I feel that most relaxation therapists or 'spa' therapist don't do this. People who have a chronic or acute injury are bewildered with their massage and lack of progress and never come back for a massage again...or quote ' the massage was nice but I'm still in pain'.....

 

[Abbagail]

Pookariah, love the relaxation massage, but not for me to perform. I refer these people on.

I may have missed it, but I don't see anywhere that pookariah mentioned it has to be relaxation/spa work only. She mentioned maintenance work. In my office we do a lot of "deep tissue" maintenance-style work.

Now, of course when we get people well, we may not see them as often. Sometimes only when they get injured again, but working off of a maintenance care model, I do agree that regular work does maintain good health --- and it doesn't have to just be relaxational type work. I promote maintenance care for health.

I believe as therapists we do all practice differently and it makes sense not to bash each other for this. The original posts in this thread from you (OffIce) seemed to be leaning toward the bashing mode. I'd venture to say that 90% of the therapists who have made it to this forum aren't in the general "flake factors" people usually think of when talking about massage therapists. I bet you have a lot to share, so how about sharing with the group (on what you've learned and how you work) in a positive way that helps to build up others.

BTW, I do agree that when something comes into an office that we can't handle or don't feel comfortable with, it does make sense to refer it on or learn from the client if we are in a mental position to learn. On occasion a client arrives that we aren't happy about, but we can learn so much from them. It makes sense to be open sometimes.