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March 17, 2005

Homework

I had a new client this morning who was referred by a doctor. They presented with shoulder pain that has been building since Christmas (about 3 months). With a new gym membership, they noticed that the shoulders began to hurt and now they can't perform basic functions without discomfort in the left shoulder. As a stopgap measure, they had been getting their spouse to press on the knots in their neck and shoulders.

The client has a history of ruptured disks in the neck. They had surgery years ago and consider themselves healed of that. The muscles around their shoulders and neck were very sore and tender. We established good communication about their comfort level and I began using deep tissue techniques to lengthen connective tissue in the muscles.

The client reported feeling better after the massage. I assigned an light exercise to strengthen the rhomboid muscles to help with soreness. As an added benefit the exercise would help with posture which would help prevent neck and shoulder pain.

I advised the client to avoid exercise in the upper body for 48 hours to allow the muscles to recuperate from the massage and metabolize any soreness out of the muscles. After showing the client the exercise, we went over target reps and sets. And finally, as with any exercise or stretch, I advised that if the activity hurts, stop. To advise otherwise would be outside my scope of practice.

There is evidence that client involvement in their healing speeds recovery. But it is important not to overwhelm the client with too much homework. For this reason, I only assign one exercise or stretch or postural awareness activity per session or they won't be done at all.

Posted by linda at March 17, 2005 5:19 PM