Patients reported outcome: "In the beginning it helped, but then..."

Massage procedure is about rapid but sustained results. Lately too often I hear from people and healthcare providers who are a source for referrals, statements similar to this: "In the beginning massage therapy helped me and/or to my patient, but then it didn't work and therefore I continue consume/or prescribe painkillers, steroids injections, etc.”

What do massage therapist needs to do in order to achieve sustain results? In order to attain this goal a therapist should view the human body in a holistic way in general, and from massage therapy stand point. For example, to reach sustained results in cases of thoracic outlet syndrome, it isn't enough to adequately address Anterior Scalene Muscle (ASM), trigger points within ASM, cervical and upper back neighboring muscles, but also it is extremely important to address pectoralis minor because pectoralis minor syndrome produces the same symptoms as thoracic outlet syndrome.  In fact, this syndrome can be developed in parallel with thoracic outlet syndrome, as a main contributor to initiation of thoracic outlet syndrome, or as a contributor to clinical picture similar to thoracic outlet syndrome symptoms.

Similarly, when treating rotator cuff syndrome, if  in addition to rotator cuff muscles, latitissimus dorsi, teres minor, deltoid muscles and pectoralis major muscle are not addressed, sometimes, it is difficult to achieve sustain results.

A few years ago I received a client by the name of Dennis Tinerino. Dennis used to be World famous bodybuilder and power lifter. To view Denis' testimonial please click here.

He had a chronic pain in the shoulder joint area. Doctors using radiological examination and in accordance with his symptoms diagnosed his condition as severe case of rotator cuff syndrome. Pain was significant at any movement along any axes and plains. Especially significant sharp pain appeared when he tried to abduct or extend the arm in the shoulder joint. During three years, Dennis have received many physical therapy treatments, corticosteroids injections within rotator cuff muscles, other non-steroids oral drugs, all providing temporary relief of pain.

Three weeks prior to visiting my office, he was scheduled for rotator cuff reconstructive surgery. MRI showed some partial tears within rotator cuff muscles and tendons; therefore doctors decided that severe pain is the result, of this partial tears and surgery was the only option.

I asked why corticosteroid injections as well as physical therapy treatment provided temporary relive? His surgeon replied, because corticosteroids used to reduce inflammation. Kind of makes sense, isn't it?

Surely, in addition to other movement in shoulder joint, rotator cuff muscles flex, adduct and medially rotate arm. But all these movements are also the function of pectoralis major. If rotator cuff muscles would be successfully addressed, it would provide relief.  However, if pectoralis major muscle will retain high muscular resting tone, it will be the only question of time when all rotator cuff muscles will re-accumulate tensions, and full painful clinical picture will return.

I have implemented full protocol for rotator cuff syndrome, but additionally performed protocol for pectoralis major muscle. After 4 treatments, we found signs of improvement and surgery was canceled. The results sustained for four years. Altogether I provided Dennis with 15 treatments. He could work out, and arm was fully functional. To get familiar with the medical massage educational video description featuring the full rotator cuff protocol please follow this link.

Incidentally, as part of the comprehensive approach to massage therapy it is extremely important to discover all trigger points, as well as to address them adequately. To read scientific review on the subject please follow this link.

So if one reporting that infamous ”in the beginning it helped, but then...” does it really mean that massage didn't work?

Many people take medications all their life while expecting miracles after receiving a few massage treatments.

Return of the symptoms could be not only because not all the components were properly addressed. Many times, people receive too few treatments, and even if they were helpful and changed the clinical picture, it isn't enough to sustain results.

My professor Dembo believed that in order to sustain results, one must receive 15 treatments. Then after one week break, even if no dysfunction or pain will be reported, one have to come back for 15 more treatments.

Having worked with the Soviet Olympic teams, I remember that Olympian athletes, who were in perfectly good health, after rehabilitation, used to receive 15 additional treatments, to sustain results, and to prevent re-injuries. Of course, this is difficult to implement in America considering costs involved. Also this might not be necessary unless your client is a professional competitive athlete. Yet three or five treatments surely are not enough to sustain results.

So we shall educate our clients on the necessity to receive at least 10 to 15 treatments. If the cost involved is too high then clients have to be recommended to do self-massage.  To get familiar with the self-massage please follow this link for free self-massage lessons

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