Pain Induction Part 3

By Rinalda,

When it comes to physically working with a client, the Therapist is obligated to being knowledgeable about:

·         Anatomy, Kinesiology, and Exercise Physiology – which facilitate understanding physical activity and movement and greatly assists with the processes identification and assessment.

·         Fitness Instruction – helps the Therapist to be totally attentive to details, and develop excellent communication and demonstration skills, which facilitate reaching the client at their point of need.

·         Sports Injuries and Rehabilitation – this helps the Therapist to properly advise the client on appropriate exercises that would facilitate the healing process.  First Aid comes in handy here.

·         Sports Psychology – this helps the Therapist to motivate and encourage the athletes and also examine the effects of stress on their performance so that they can make more informed decisions.

 

Some programmes squeeze in a bit of massage with as many as five persons working with one client on a table (overseas in recognised places).  The programmes usually entail much more than the points above, but I am unaware any curriculum including pain induction as a motivator, or the necessity of making the athletes cry.  We need to be mindful of a person’s pain threshold.  I got a new client recently who is into sports.  He had a ‘keyhole’ incision medially and inferior to the knee through which the knee was dealt with.  Gentle circular friction was done around the keyhole and though the surgery was done a month ago, I could feel heat radiating from the tissue.  What’s the difference between surgery and a sport-related injury?  

Should I have poked the keyhole and made him cry while telling him I’m doing deep tissue massage?  Soon after an injury we understand that there can be severe pain due to inflammation, along with nerve and other soft tissue damage (not considering hard tissue here).  In addition there may be swelling, heat, discoloration, etc.  How does a Therapist conduct an assessment, recognise any of the above symptoms, and still poke into the tissue?  Lymphatic drainage and vaso-constriction should be the main focus, and as time and healing progress the techniques used can be deepened being careful not to destroy the newly formulated fibrin, and later still, more depth can be added with the view to reduce scar tissue so as to maintain appropriate range of motion.  This process of working out the kinks from onset of injury to full recovery does incur some discomfort, but it is the deliberate induction of pain that I am concerned about.

 

If the use of pain as a motivator has merit (then children should be flogged at home and in school) like the use of reverse psychology, then it is for the Therapist to distinguish such among players.  If this is found to be the case, the Therapist is still obligated to monitoring the speed, skill, stamina, suppleness, and strength of the athlete and treating him/her with a view of maintaining fitness in all the areas.  I will agree with the Psychologists here and say that behaviour can be learned, and learned behaviour can be adjusted/changed, or improved upon, so that the athlete who gets his/her adrenaline rush from pain could be re-educated to source it in a more healthy way, as speed is not the only component for success.  

Getting back to massage…  It is a ‘tool’ of fitness that is often underestimated. Effleurage, for example, is the culprit that ‘pampers’ the athlete, but it is excellent for soothing the nerves to inducing relaxation, which is critical obtaining maximum results in healing and performance. Tension creates exhaustion.  Exhaustion and weakness go together. What does that do for motivation or performance?  But who cares? Let’s flex our arms, crack our knuckles and vie for the Petrissage/Percussion/Deep Tissue crown.  While we are showing off, the athletes are suffering.

 

So the question is, why am I not ‘involved’ in the Sports Industry? Firstly, the application of knowledge (which needs to evolve into understanding) gained under the banner of Sports Therapy, Medicine, Rehabilitation, Psychology, etc. is not limited to service in the Sports Industry.  But I have other excuses…  

2 Many athletes don’t know their self-worth so we find extremes of low and high self-esteem which affects their appreciation/perception of the attention given to facilitate their advancement.  

3 Training is sometimes an emotional thing (it has to be ‘fun’), which interferes with dedication and consistency.  Success only comes before work is in the dictionary.  

4 Payment is never a problem, yet is has to be ‘gotiated,’ negotiated, and renegotiated, which is tiresome.  

5 Working frequently with some athletes can degenerate the professional relationship, but that’s okay as evidence proves that coupling-up can be an invaluable form of support. 

6 As if this is not enough, among ourselves as ‘professional’ Therapists there are multiple standards and each one of us is right about our methods based on our training and/or experiences.  I dare say we are right not because we actually are, but because we have weak/sensitive egos that are afraid of censure.  We swat every fly that passes by looking like it knows what we know lest the pedestal on which we are ill at ease is ascended by another.  

And that’s good.  Life must be lived with some degree of passion…something to live for, or something to die for.  So, if the current methods are working, let’s fight tooth and nail to maintain them, but if they need adapting, we should fight with as much gusto for the change.  All in all I am glad that the exposure is helping students to see how drastically different perceptions can be, and they can use this information in deciding the arena in which we want to function after certification.

 

One of the new students who is a Muslim was remarking that she came to do the course because she wanted to be involved in ‘therapeutic’ massage so that she could work with athletes who have injuries as against clients who might be seeking a sensual massage.  We were discussing the Human Energy Field, and our connectivity to people and things as a result of energy, starting with our own aura and the therapeutic effect of our intentions being channelled through us, so that it is not merely our physical touch and how we bend our fingers and arms that alleviate distress, but energy through touch facilitating healing.  

She was fine with that and reiterated her desire to therapeutically touch athletes and maybe people who have stroke and the likes.  Another student remarked to her that while she desires to function ‘above board’ some men in sports suffer from groin injuries and she would have to massage them.  Whaaat?!  That’s true Miss?  I confirmed such and she panicked.  

We discussed it and she understood that as we build our practice we get a feel of what works for us and that specialization is always an option.  She mentioned a cousin of hers who does Chiropractic work and fills out insurance forms for her clients, and wanted to know if she would be able to do the same if she gets a Massage License.  I told her the Insurance companies will not be able to offer support for Massage Therapy until we sort of the legality of the license, which is also why Doctors could only suggest, but not prescribe massage treatments.  Almost exactly at 5pm her phone rang.  I permitted her to answer it.  It was the home-front reminding her that she had to be return home for prayers.