ITEC HOLISTIC MASSAGE CASE STUDY 3

Holistic massage is one of my passions. Here is another case study from my portfolio, meant to be used for training purposes by aspiring therapists and students, or simply by amateurs who want to understand better how a professional massage session should work. Why not leave some feedback if you liked this lens or helped you achieve your massage goals...

CLIENT'S PROFILE:

Client I S P is a 26-year old female who lives in South West London with her boyfriend and two dogs.

She is a very active person, involved in volunteering for several associations, and she is often busy teaching children, looking after the house and her two dogs, while her boyfriend is away as he works full time as a chef.

She walks a lot and does plenty of physical activities, including going to the gym regularly, swimming and yoga. She is passionate about alternative therapies, especially the Alexander technique.

she used to travel often to faraway destinations to clear her mind, but now she's had two large dogs for a few months, she is not sure she will be able to keep on travelling that much.

She enjoys spending her weekend with her mother and sister who live in another part of London.

She does not have any ongoing health complaints, and she sought massage hoping to improve the condition of her skin, making it smooth and firmer, and to relax and find a quiet spot to hide and dedicate some time to herself..

CONSULTATION

CLIENT'S PERSONAL DETAILS:

Name Miss I S P

Address CONFIDENTIAL

Telephone (Home/Work) CONFIDENTIAL

Emergency Contact CONFIDENTIAL

Where did you find out about my practice? Word of mouth

MEDICAL DETAILS:

Doctor's name and address: CONFIDENTIAL

Have you visited your GP or the hospital within' the last 5 years? YES (Blood Test)

List any ongoing health complaints and any medication you are taking: sometimes client experiences localised backaches.

Do you suffer from any allergy? N

Do you wear contact lenses? N

Permission to contact doctor yes

CONTRAINDICATIONS TO MASSAGE

There are some contraindications to massage requiring medical referral or the client to indemnify their condition in writing prior to the treatment and some contraindications that restrict treatment

PLEASE UNDERLINE THOSE CONDITIONS WHICH APPLY TO YOU IF ANY. ¨ With medical, GP or specialist permission - In circumstances where written medical permission cannot be obtained clients must indemnify their condition in writing prior to treatment

¨*pregnancy *cardio vascular conditions such as thrombosis, phlebitis, hypertension, hypotension or any heart conditions *haemophilia *any condition already being treated by a GP or another complementary practitioner *medical oedema *osteoporosis *arthritis *nervous or psychotic conditions *epilepsy *recent operations *diabetes *asthma *any dysfunction of the nervous system as muscular sclerosis, Parkinson's disease, motor neuron disease, Bell's Palsy *trapped or pinched nerve like sciatica *inflamed nerve *cancer *postural deformities *spastic conditions *kidney infections *whiplash *slipped disc*undiagnosed pain *when taking prescribed medications *acute rheumatism.

Contraindications that restrict treatment

*Fever *contagious or infectious diseases *under the influence of recreational drugs or alcohol *diarrhoea and vomiting *skin diseases *undiagnosed lumps and bumps *localised swelling *inflammation *varicose veins *pregnancy-abdomen *cuts *bruises *abrasions *scar tissues- 2years for major operations,6 months for a small scar *sunburn *hormonal implants *abdomen-first few days of menstruation, depending how the client feels *haematoma *hernia *recent fractures-minimum 3 months *cervical spondylitis *gastric ulcers *after a heavy meal *conditions affecting the neck.

PLEASE NOTE THAT IT IS IN YOUR INTEREST ANSWERING HONESTLY TO ALL THE QUESTIONS IN ORDER TO TAILOR MAKE THE BEST TREATMENT SUITABLE FOR YOUR SPECIFIC NEEDS. ALL THE PERSONAL DETAILS PROVIDED ARE STRICTLY CONFIDENTIAL

ABOUT YOU AND YOUR LIFESTYLE

stress level at home 1 2 3 4 5 6 7 8 9 10

List the factors that make you feel stressed at home :looking after the dogs and keeping the flat clean.

Typical breakfast: granary bread or wholemeal with fruit jam and a green tea.

Food eaten more often? Favourite foods? : vegetables, fruits, soups, yoghurt.

Do you pay attention to your calorie intake? (Y) (N) If yes, state your average calories intake UNKNOWN

Would you say you have a well balanced and varied diet?

The diet is varied, the client aims to the 5 a day recommended intake of fruits and vegetables. The client does not eat any meat meat.

Are you vegan, vegetarian, or do you follow any particular diet? Please provide brief details Yes, vegetarian.

What do you drink on a typical day? Water, green tea.

THERAPIST'S NOTES although the client considers herself a vegetarian, her diet includes fish, therefore she is a semi-vegetarian or pescetarian.

List any vitamin or mineral supplements or herbs you take NONE

Average hours of sleep 8

Smoker? NO If yes, state how many a day N/A

Do you drink tea/coffee? If yes, how many a day? 3a day (green tea, no coffee)

Do you drink alcohol? Never

If yes, how many drinks/glasses a week? N/A

Hobbies/leisure Alexander Technique, yoga, travels.

Do you do any sport? Workout at a gym, yoga

How many hours a week? 4

stress level at work 1 2 3 4 5 6 7 8 9 10

Work pattern: day

Different day shifts: according to the business/when required.

List the factors that make you feel stressed at work:

Unruly and badly behaved children.

PERSONALISED TREATMENT PLAN

To provide four full body massage sessions lasting approximately 1 hour each 1 week apart, to promote relaxation and relief from stress, tension or pain, searching through the tissues for abnormalities or areas of increased tension and manipulating them, in order to lose adhesion and realign tissue fibres, restore full function and improve muscle flexibility and skin elasticity. I will perform superficial manipulation and stretch release techniques, thumb stroking and trigger point pressure, combined with a more relaxing effleurage routine with long and soft strokes. I will include in the routine passive movements to joints of the upper and lower limbs, to prevent tightness and stiffness of the joints, to promote venous and lymphatic flows, to increase the production of synovial fluid and to promote a feeling of well being and relaxation through slow, soothing and rhythmical movements.

GREAT MASSAGE BOOKS TO IMPROVE YOUR MASTERY OF VARIOUS MASSAGE TECHNIQUES

TREATMENT ONE

DATE: 05/ 04/ 2008

Feelings before treatment: The client feels a moderate pain in the lumbar region, and also complains about a feeling of tiredness in her calves and ankles. She has been doing a lot of walking and running in the past few days.

Treatment given: Full body massage, with longer thumb stroking on the calves and petrissage around the ankles, including percussive movements to stimulate blood circulation and give a reinvigorating feeling.

Therapist's observations: I noticed areas of tension in the calves and in the lower back.

FEEDBACK FROM CLIENT:

Feelings during massage: the client was calm and still throughout the treatment.

Feelings after massage:

The client is pleased with the massage session she received today, and she declares that she feels energized and empowered. The massage also gave her the opportunity to relax and free her mind from persistent thoughts; in fact the client affirms that she is obsessed with planning and organizing her future days and weeks, and the massage helped to get rid of this thought, at least for the duration of the session.

The client felt good after the first treatment, and declared that her stress level has dropped.

HOME CARE ADVICE/REFERRALS:

As the client has a very healthy lifestyle, I only recommended she tries to use a refreshing gel or a spray to revitalize her legs and calves. Also, I recommended she avoids socks which are tight on the calves or on the ankles. Also, I recommended to drink plenty of fluids as she has a very hectic and busy schedule.

REFLECTIVE PRACTICE:

I performed a slow and rhythmical massage routine, starting with spinal stretches, then performing effleurage on the whole back and pressure points on the lower back, then moving to back of legs (to which I dedicated a longer amount of time as I felt this to be necessary in order to relieve the tension in the lower side of the gastrocnemius and the ankles), and a shorter amount of time to the front of the body.

TREATMENT TWO

DATE: 12/04/08

Feedback from last treatment: the client felt reinvigorated after the last treatment, and the feeling of well being lasted for several days after the massage session.

Feelings before treatment: the client feels tired today, as the session takes place in the evening and she just came back from a sightseeing tour with children to Legoland Windsor.

Treatment given: full body massage. This time I decided to perform a massage to promote total relaxation, therefore I avoided applying deep pressure and percussive strokes, and I dedicated a longer amount of time to the front of the body if compared to the previous session

Therapist's observations:even though the client was tired today, I noticed that her muscles were not contracted and I noticed less stiffness in the gastrocnemius. The client said that the use of a legs "spritz" lotion helped her legs to feel stronger throughout the day.

FEEDBACK FROM CLIENT:

Feelings during massage: the client deeply relaxed and felt in a state of semi-consciousness.

Feelings after massage: the client felt sleepy and relaxed after the treatment. She was thirsty and experienced increased micturition.

HOME CARE ADVICE/REFERRALS: I told the client to continue using the invigorating spray, try to vary the fruits and vegetables she eats and drink plenty of fluids.

REFLECTIVE PRACTICE: I noticed that the client felt in a state of total relaxation during the session. This is probably due to the fact that I performed a softer massage routine combined with an increased trust from the client, thanks to a positive and open body language and the elimination of all barriers.

TREATMENT THREE

DATE: 19/04/2008

Feedback from last treatment: the feeling of relaxation lasted for days. The client is very sensitive to each massage session, as the feeling after each treatment lasts for several days.

Feelings before treatment: the client feels well today, and considers the massage treatment she is going to receive as a personal treat and a little luxury for herself. She is not stressed because she has been volunteering in London this week, in familiar places and the children generally behaved well.

Treatment given: full body massage to improve relaxation of the muscular tissues and elimination of toxins from the skin, help the blood and lymph flow, improve the elasticity and the general condition of the skin, reduce cellulites around the waist through kneading

Therapist's observations: the muscles of the client were not contracted, and I did not notice any particular area of stiffness. I am surprised that the client is affected by cellulites around the waist, as her diet seems to be extremely healthy.

FEEDBACK FROM CLIENT:

Feelings during massage: the client relaxed throughout the session, but moved while I was kneading her back as she felt a little discomfort.

Feelings after massage: the affirmed that she was feeling better after the session, as lighter.

HOME CARE ADVICE/REFERRALS:

I recommended that she carries on with her diet and sport routine.

REFLECTIVE PRACTICE: I noticed the client was moving and readjusting her position on the couch while I was massaging those areas of her body affected by cellulites. Even though she brought this problem to my attention and she asked me to try to help the reduction of cellulites by kneading the areas affected, I felt this still represented a barrier as she was becoming nervous, shy or perhaps ashamed at times during the massage. I believe this problem could be overcome with time by knowing the client better and gain her complete trust.

TREATMENT FOUR

DATE: 26/04/2008

Feedback from last treatment: the client told me she had not enjoyed the previous session as much as the first two, and that she was looking forward to receive another massage, but she asked me to avoid the areas affected by cellulites this time. She also said she had continued with her diet trying to vary as much as possible the vegetables eaten and that she had drunk fluids and fruit juices.

Feelings before treatment: the client feels moderately tired as today she has been running with her dogs, cycling and she even went to the gym for a body workout (1hour).

Treatment given: I choose to perform a relaxing full body massage, incorporating percussive movement but avoiding deep thumb pressure. I performed some light percussive movements, thumb stroking especially on the erector spinae,the calves and I dedicated a generous amount of time to the face muscles, especially buccinators, masseter and nasalis, in order to promote total relaxation and vary the massage routine from the last treatments, trying to meet the client's needs and expectations.

Therapist's observations: the client was still and deeply relaxed during the course of the session. I believe she now trusts the therapist and she will no longer be shy about her body, as she understood that the massage is aimed to be beneficial for the client, and the therapist is a professional who works to help her clients and improve the quality of their lifestyle by improving their muscular condition, promote mental well being and provide practical home advice for a better health.

FEEDBACK FROM CLIENT:

Feelings during massage: the client particularly enjoyed today's massage routine and said it was beneficial and rewarding both for her body and her mind at the same time.

Feelings after massage: the client felt better, her muscles were free from tension and she felt purified from toxins. She was completely relaxed. She affirmed she greatly enjoyed the facial massage.

HOME CARE ADVICE/REFERRALS: I suggested she continues with her diet and sport routine, and that she applies a light body moisturiser to promote firmness and smoothness of the skin.

REFLECTIVE PRACTICE:

I need to improve my ability in gaining the client's trust, but I believe this will come with some more practice and experience, and I will be able to transmit a sense of security and reciprocity to the client starting from the first treatment thanks to the combination of a professional and adequate massage and a tailor made treatment. I tried to personalise Miss ISP's sessions as much as possible, also by finding out what her favourite type of music is and playing it during the massage. In fact she affirmed she enjoyed music with the sound of nature, therefore I played rainforest background music during the last session.

SUMMARY OF WHOLE TREATMENT

Miss ISP overall enjoyed her four full body massage sessions, and she asked me if I would be available for future treatments. This greatly pleased me as I felt extremely valued and helped me to gain confidence as a therapist. I also learnt the importance of performing a different massage routine to suit the situation according to various factors such as the client's feelings, mood and physical condition before each treatment, and it appears the last treatment was the one that perfectly suited the client. Miss ISP has a healthy diet and lifestyle, however receiving massage can help her improve the appearance of her skin (she declared she is often too lazy to apply body lotion or moisturizer, and she only applies the toning spray- however the effect of the spray is mainly refreshing and the hydrating sensation vanishes quickly), tone her muscles after sport performances and reduce cellulites in the areas affected. Massage can also help Miss ISP to diminish her stress levels and encourage a feeling of relaxation and optimism since she perceives the massage as a personal treat and something she deserves after a busy day, a retreat where she can temporarily escape from everyday's bustle and problems and a deserved reward.