Stubborn knots during massage

[MermaidsSecret]

Hi there!!

I'm a massage therapist and I have a regular client coming to me for either 30min or 60min depending on her timing. She is mainly coming to me to improve her mental well-being but she has a lot of knots in the scapula and trapezius area. She has been coming to me once a week for about 8 weeks now and I have tried a various range techniques from friction to using my elbows etc. but the knots will just not disperse or change in any way from week to week.
Luckily this client is also a friend, but still need to know in case I get another client with the same issue.

Do any of you have any ideas what I can recommend to my client? Or any techniques that I could use to help?

Thankyou in advance!
MS xxx

 

[sanilulu]

Hi
Do you do Hot stones massage / lava shells ... ??

One of my clients is the same, with the Hotstones it takes all the hard work out of it rather than my hands/wrists ...
The heat from the stones starts breaking them down before i even get to work on them manually ...
She comes every month for maintenance now ... Shes said that no-one else has ever been able to break them down...

Xxxxx




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[MisstyB]

Hi,
I think that one of the problems that you face as a massage therapist is that if you have a client with long term muscle problems they need to be addressing the underlying problem, poor posture, sitting at a computer for long hours, massively overloaded handbag, etc, but there could also be a trapped/compressed nerve which is causing knots (particularly in the areas that you mentioned) but may be situated in the neck, for me when I have clients with problems that I am unable to rectify then I always refer them to a phisiotherapist, I have one that actually does my back for me and is amazing so when I hit a wall with someone I refer them on, she can normally sort them out in a few sessions, I always stress to them the benefit of regular massage sessions to help stop the problem returning.
xxxx

 

[smallandcute]

I have a knot which starts from my right shoulder and lower neck and runs all the way down to under my right scapula. It is incredibly painful and after about ten mins of massaging someone im in agony. For as long as i can remember i have had this knot and for love nor money i can not get rid of it. Mum took me to an osteopath as a child and said the lady did something to my back and shoulder which caused the entire right side to bruise badly but it didnt hurt and for a few years never had any problems but i havent been able to get rid of it since.

I think some of us are just prone to having knots that cannot be got rid of tbh and may need to see an osteopath to really work deep down to get rid of them. I feel as beauty and spa therapists we are only ever given basic massage training but osteos work on a much deeper level.

Also i was taught that if there are big knots around the scapula place the clients hand on their back to create a chicken wing effect with the scapula then slowly using your forearm slide into the scapula, this lifts any knots away form the scapula and makes it easier to reduce the knots.
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[Min]

Have you tried audio sonic or g5?
I was told a stroke of hot stone has 5 times a greater effect then manual massage.

 

[laurakate]

You can't always get all of the knots and that's ok as long as you get a good amount out because this alone will make the massage worthwhile

 

[gillian w]

How does she feel.You may still be feeling knots but she may well feel quite loose and comfortable.If she doesn't then she may well need an osteopath,chiropractor or physiotherapist.

 

[jcpark]

I agree with others. Swedish massage is simply a relaxing treatment it does not give you enough knowledge to treat problems. You need to refer her to a remedial/sports therapist.

 

[jcpark]

Have you tried audio sonic or g5?
I was told a stroke of hot stone has 5 times a greater effect then manual massage.

I disagree with that although I think it depends on what sort of massage you are referring to. Hot stones again, is a relaxing treatment, not a remedial one.

 

[jcpark]

Hi there!!

I'm a massage therapist and I have a regular client coming to me for either 30min or 60min depending on her timing. She is mainly coming to me to improve her mental well-being but she has a lot of knots in the scapula and trapezius area. She has been coming to me once a week for about 8 weeks now and I have tried a various range techniques from friction to using my elbows etc. but the knots will just not disperse or change in any way from week to week.
Luckily this client is also a friend, but still need to know in case I get another client with the same issue.

Do any of you have any ideas what I can recommend to my client? Or any techniques that I could use to help?

Thankyou in advance!
MS xxx

In all honesty, I think you need to refer her. If she's been coming to see you for 8 weeks without change, it really is a professional responsibility for you to refer. TBH, you are providing her with a relaxation treatment, which is great, but she needs remedial massage for her problems, a relaxation massage will not sort her out.

 

[megaone]

Maybe aromatherapy oils, refer to an aromatherapist as some essential oils can help with muscle tension.

 

[sanilulu]

I disagree with that although I think it depends on what sort of massage you are referring to. Hot stones again, is a relaxing treatment, not a remedial one.

Sorry completely disagree ... !!!

Hot stones breaks down nodules more effectively than any manual massage ...

And Any massage you give should be prescriptive from the consultation ...

Do we not ask about pressure ??
Soft / medium or firm
What massage they are after .. Ie .relaxing, uplifting, stress release ?
Any problem areas?
... is the massage movements not then prescriptive to the clients needs ...
effleurage - long movements- (relaxes/ draining) /
Petrissage ( knuckling / kneading- stimulates)
Tapotement / percussion (cupping pounding beating hacking tapping - toning effect / dispersal of fatty deposits / improve cellulite ....

"I wouldn't thank anyone for a airy fairy massage-i want to feel mine - very firm "

Not everyone likes or gives relaxing massages only ... Not every client wants to sleep on my couch...

I know my clients with various needs wouldn't go anywhere else or have anything but a Hotstones
from deep knots and nodules to those who need a softer massage due to back problems but the heat breaks down their knots without any pressure ... !!!

Again I'd tell the OP to maybe look at these as an alternative massage or whether they have gone as firm as possible that the client can take ...
Or refer to maybe someone who does sports massage / deeper tissue ...

Xxxxx



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[skingeek78]

I disagree with that although I think it depends on what sort of massage you are referring to. Hot stones again, is a relaxing treatment, not a remedial one.

Oops I disagree too!

 

[jcpark]

Sorry completely disagree ... !!!

Hot stones breaks down nodules more effectively than any manual massage ...

And Any massage you give should be prescriptive from the consultation ...

Do we not ask about pressure ??
Soft / medium or firm
What massage they are after .. Ie .relaxing, uplifting, stress release ?
Any problem areas?
... is the massage movements not then prescriptive to the clients needs ...
effleurage - long movements- (relaxes/ draining) /
Petrissage ( knuckling / kneading- stimulates)
Tapotement / percussion (cupping pounding beating hacking tapping - toning effect / dispersal of fatty deposits / improve cellulite ....

"I wouldn't thank anyone for a airy fairy massage-i want to feel mine - very firm "

Not everyone likes or gives relaxing massages only ... Not every client wants to sleep on my couch...

I know my clients with various needs wouldn't go anywhere else or have anything but a Hotstones
from deep knots and nodules to those who need a softer massage due to back problems but the heat breaks down their knots without any pressure ... !!!

Again I'd tell the OP to maybe look at these as an alternative massage or whether they have gone as firm as possible that the client can take ...
Or refer to maybe someone who does sports massage / deeper tissue ...

Xxxxx



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As a sports/remedial massage therapist, I can assure you that hot stones do not work more effectively than any manual massage. There are many more effective techniques that a massage therapist uses than those you describe - soft tissue release, myofascial release, deep transverse frictions etc, however, in order to use these effectively, you need to not only know how to perform them, but also a deeper understanding of muscular skeletal function, ROM and PE tests. This is all beyond the scope of beauty therapy massage. That's not to say beauty therapy/spa massage does not have it's place and minor adhesions (knots) can be dispersed in a Swedish/deep tissue/hot stone massage.

Yes, it can take time, however, if I client of mine was not showing some improvement after one session, much less eight, I would be worried.

I think what many fail to realise is that there is a big difference between 'massage therapy' and providing beauty/holistic massage. They all have their place, but we should not be providing treatments that are beyond our range of skills and knowledge. If it is beyond our training then refer.

 

[hippy-chick]

How old is she? Say shes 28, and carried this problem with her for say 8 years, 8 x30 mins is not going to wipe out built up tension.
Is she enjoys her massages and says shes getting benefit continue with what you are doing.
If however she wants you to 'fix' her, refer her, shes in the wrong place.

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[skingeek78]

I agree with others. Swedish massage is simply a relaxing treatment it does not give you enough knowledge to treat problems. You need to refer her to a remedial/sports therapist.

Where has the op stated that she has only trained in Swedish massage technique? I agree that a referral to a Chiropractor/Osteopath or Physio would be agreeable, then depending on the underlying issue proceed with remedial massage, but I find from your comments that you are assuming that the OP is only trained in beauty therapy massage technique, instead I read in the original post that they are a massage therapist. I cant speak for anyone else but although I am a qualified beauty therapist I have also been trained in techniques other than Swedish. Using heat therapy I agree with several others will aid massage.

 

[MermaidsSecret]

Hi Everyone!
Sorry for the delay in replying but all that information is fabulous!
Luckily the said client has been a good friend of mine for 20 yrs and so it is easier being more honest with her. Her main objective of the massages was to relax and improve general well-being having been through and stressful time (purely psychological). I was also using aromatherapy oils to help with uplifting and depression.

In the first week on the massage, I told her that I could feel a lot of the knots and that it would be ideal to work on them to prevent them developing and to try release the areas. However by about week 4, when I noticed that knots were not changing, I then mentioned to her that I would start working a bit deeper to try to get at them better. I then started using muscle tension oils like Black Pepper and Rosemary to help but did not seem to make much difference.

In between the treatments I would always try and encourage here to be aware of how she is keeping and using her shoulders and back- eg handbags or slouching etc. She has now stopped using a shoulder bag and trying to make small changes her and there. I have said that it make be posture related and in which case it will be something to work on long-term as opposed to a quick fix.
She has also started going to see someone who is also helping with her posture and said I would be more than happy to continue with massages to help with relaxation and well being (and work on the knots little by little)- which we still do weekly and the reason she still comes to me as i'm still able to address the issue she originally started to come to me.

The ironic part of all of this is that she doesn't really feel them or have any trouble from the knots- and to be honest, didn't know they were there until I told her during her first treatment.
I think as the "owner" of my business- I feel I have to make sure I do all I can to make sure the client gets the treatment she wants and more.

Thankyou again for all your suggestions and advice!
MS
xxx