Is massage innocent 3

Hi all,

I didn't finish my discussion: ”Is massage therapy an innocent procedure?”

Is massage therapy an innocent procedure? Part 2

To further illustrate my point I'll share with you something that just came up. Hopefully, that would prevent anyone from saying:” I wish you would share it earlier.”

Here is what has happened…

Recently I received a text message from my client from a long time ago, who requested me to treat his close friend.  Supposedly, he pulled his leg muscle while playing tennis.

At the initial evaluation, the fellow described 3 weeks old incident as follows. ”At the time when I tried to reach a tennis ball and was making a fast movement to the right, I heard a loud crack in my groin and felt a sharp pain. Since then I cannot walk normally and am feeling a strong pain. I saw an orthopedic surgeon, who said that I have nothing to worry about but a pulled muscle.  He prescribed ibuprofen 1200 mg a day, and physical therapy. Three weeks later, there were no changes. I only developed stomach aches.” In the end, he said: ”Perhaps I even have greater pain and more difficulties in walking.”

The client is a lawyer. He complained not to be able to appear in court or even to see clients. He described the pain as being destructive, disallowing him to focus and think.

I asked him about the quality of his sleep.

He responded that it was terrible. He was waking up, at least, five times a night because of pain, and any attempt to turn from side to side produced sharp pain. I commented that the most likely inability to focus is the results of sleepless nights. Three weeks of poor sleeping can exhaust a person.

I asked him to lay on the table. Numerous times, very gentle I slid my hand on the inner part of his thigh.  A little depression on his inner thigh suggested the possibility of muscular fibers' tears.

I would like to have your attention. I brought a piece of paper, and said, “Sir I will dictate and you please write down.” He couldn't understand what do I want, but said okay, whatever. My dictation was the following “while gently sliding his hand on my right inner thigh, Boris informed me, that he felt depressions. They could be the evidence of a few muscle fibers' tears. In such a case, we can suspect the formation of a hematoma, deep inside those that I cannot see. By reducing muscular tension within muscles, Boris informed me about the possibility of this hematoma showing on the surface, which as Boris explained, is a positive phenomenon that will stimulate the healing process. I understood that I cannot blame Boris' massage procedure, for this hematoma.”

He signed the paper. All this dictation process, he accepted as a game, like a joke. We laughed. I said that, at times, my clients forget my warnings. That is why I like them to sign a memorandum.

Little by little, starting as always from L/spine region, gluteus massage, general introductory massage on front thigh, increasing threshold of pain, little by little, I started focusing on, adductor brevis, adductor longus where I suspected the muscular tears were.

I was able to reduce severe protective muscular spasm successfully.

When he stood up from the table, he was happy, start walking, and told me that he barely felt the pain.

Of course, I was happy too and scheduled him the next appointment. The next day at noon, his friend texted me:” Boris that’s what has happened. After your treatment, my friend ended up in the emergency room. He had a huge bruise on his inner thigh.

If I wouldn't feel sorry for the fellow, I’d laugh. My answer was, can he walk better? One hour later, he texted, yes, when he walks with a much lesser pane. I said, “advise him not to miss the next appointment.”

Seconds after releasing this text, my patient/lawyer texted me,

“Hey Boris, after the treatment, a huge bruise appeared on my inner thigh, where you massaged. I was so scared that I referred myself to the ER. Any advice? I wrote:” my advice is not to panic, especially, in view of the fact that we discussed the possibility of having a big bruise. Most likely, after the treatment you couldn't see these bruise, usually, it appears a few hours after the treatment. Of course, I have included a picture of a signed declaration LOL.

He was not late for his next appointment, and for four more appointments.

He is doing well now. For some time I recommend withdraw from playing tennis.  He is walking and lifting weights.

ER doctors discharged him fast and referred him to a primary care physician.

How was I able to predict the appearance of a hematoma on the next day?

It was predictable since the hematoma was sitting deep and creating pressure, contributing to the pain, and fueling the muscular spasm. The muscular spasm prevented this hematoma from surfacing. Practically the entire goal of my massage therapy, at this point, was to release tensions within muscles and increase the blood supply. The moment I achieved the desired results, hematoma surfaced.

Guys, my advice when you hearing similar reports from your patients, please ask them to sign the acknowledgment document. As you can see, even though I informed him, the fellow rushed himself to the ER.

Best wishes,

Boris