Curious experience with elderly client.

[Nathan C]

I had a new client come in yesterday - really nice older lady, about 62 years old. She was in fantastic shape. Now she was either untruthful on her intake form - or she's got no health problems and is on no medications, or at least none relative to massage.

She came for a massage mostly for a firm relaxation massage. She complained of general aches and stiffness as she'd been washing windows and doing some heavy house cleaning and had maybe over done herself. Aside from that she had no specific problem areas. I found some tension in her shoulders, but other than that nothing stood out.

However, during several points during the session, she had some very odd body movement. When I got to her feet - she had twitches, but only one toe on each foot, and it was a different toe on each foot. And her feet seemed to contract. It was completely different than usual ticklish twitches - she was alert and talking to me and never mentioned any discomfort or odd sensations.

Once she was supine and I got to her arms, I once again noticed off movements. I lifted her arm and cradled it with my other as I always do, and as I was working on it with my free hand, I noticed it twisting and turning, back and forth. It wasn't jerky movements, but they didn't seem all that controlled either. It continued as I worked on her forearm as well as her hand, almost a rocking back and forth motion, with some contractions in her hand. The movement was identical in the other arm as well.

When I got to her neck, and turned her head with my hand supporting it, her head began to sway slightly, it almost seemed if I let go, her head would just bobble back and forth. I had to quite firmly grasp her to keep her from rolling out of my hand, and eventually ended up just doing what I could with her head on the table to avoid the motion.

The odd thing is that I never noticed any movement like this from her during her intake, our conversation, while she was on the table - until I actively touched her in those places. When I put her arms back down, she stopped the movement. When I was working on her neck and scalp with her head on the table, she was still.

The motions reminded me of slow, smoother Parkinson's like movements. Nothing else about the movements or her gait or anything seemed to suggest Parkinson's from what I know of the disease - however, I'm not familiar with it first hand, so it could be.

Has anyone exerperienced anything like this with any sort of illness?? Or have any idea what it could have been if not related to an illness? And, lastly anything I can do to help still her while I work on her?? She was alert and carrying on a conversation with me the entire session, and the movement did not seem deliberate at all, to me.

Thanks for any ideas - she has rebooked for next month and I'd like to figure this out before then!

 

[Sooo Happy]

Curious experience with elderly client.

When I got to her neck, and turned her head with my hand supporting it, her head began to sway slightly, it almost seemed if I let go, her head would just bobble back and forth. I had to quite firmly grasp her to keep her from rolling out of my hand, and eventually ended up just doing what I could with her head on the table to avoid the motion.

I have had clients with Cervical Dystonia have more of a head sway and slight shake, but the head does not particulary "move out of my hand" while working on the client.

I have only had 2 of these clients over the years though, so it may not be an uncommon etiology, just something I haven't experienced.

As for the other items you mentioned... maybe it was a "release" of some sort. t017

Regarding the neck, it may also be that you just put her in a trance-like enough state that she completely let go, even though she sounded coherant.

Dunno... those are my thoughts right now. t001

 

[Brit]

Curious experience with elderly client.

My thoughts, being one who works with a lot of elderly.... though I wouldn't consider 62 to be "elderly", actually. I'm guessing she was perfectly honest about not having any illnesses or medications. My guess is that the head movements were from a very relaxed "let it go" state. The twitching....many people just get twitches, especially after having exerted oneself. Heavy duty cleaning is over-exertion unless it's the daily routine. But twitches happen to many people at different times for no known reason and they just come and go. I wouldn't think anything of it. If it was an illness, it would generally occur when she is walking and talking. Parkinsons, as you noted, is not smooth movements. Cervical Dystonia, in my fairly frequent experience, is also not very smooth - and doesn't come with toe twitches. As far as working on her, I wouldn't be concerned with keeping her still. It takes a little practice, but you can often just coordinate the massage to the movements - make it a kind of "dance", without drawing any attention at all to the fact that her body is participating. Support the head carefully if you are concerned about dropping it, but don't try to force it to be still - that might hurt her neck.

 

[Stella]

Curious experience with elderly client.

This sounds like ideomotor movement activity. The neurocentric folks at SomaSimple.com work with it all the time and can explain it better than anyone else I know. If you search their forum, you'll find TONS of discussion on this very topic.

 

[itsme6922]

Curious experience with elderly client.

I work with a woman who also has these movements and twitches. Massage, specifically in certain places, triggers the twitch response. The difference is that she does feel and comment on it and says she can not control it and her movements are more like reflexive jerking movements. She also twitches when she is just talking to you, not on the table but it is more in her face and hands.

 

[unibumps]

Curious experience with elderly client.

Thank you guys!

I wasn't sure if there was maybe an illness she and I were unaware of, or if it's nothing to be concerned about. I just want to make sure I'm not missing anything and risking putting her in danger. I guess when I asked if there is anything I can do to 'still' the movement, I should've said 'calm' the movement. I certainly don't want to force her to be still - just wondering if there was a technique or anything in specific that I should use to help calm the movement.

I still feel something is off - her movements were very out of the ordinary. She also did mention how she has trouble fully relaxing during massage and it is something she has been working on - so I don't think it was a release, as on top of that I didn't get the sense that she was fully letting go, either.

But, either way, I do feel better about just going with it since it doesn't seem to be anything to be concerned about. So thanks again!

 

[Chorus (City 4-2 Chelsea)]

Curious experience with elderly client.

I find your observations regarding her response to working on her toes interesting in relation to her head movements. In reflexology, each toe is related to a different part of the head - so I would be inclined to investigate her head and neck muscles further during her next session. Twitch response can sometimes be in relation to latent trigger points in the area - points that often don't cause any noticeably unusual sensation in the client until they are activated through touch. I agree with your assessment that the client was not fully letting go, esp. since she said so!, and I would approach the next session with a focus on breathing, calm steady strokework, and cessation of talking during the session, except when necessary to share pain info, by trying to turn her attention back into her body whenever she speaks. Sometimes a hot pack can work wonders to still and quiet the system - across back and on the feet in prone, and lying gently across the belly in supine.

 

[Pompal 09.]

Curious experience with elderly client.

Sorry -
I just have to say that 62 is not "elderly". Unless someone is physically decrepit then it is better to just accept everyone the same and not lump them into age categories. I never,ever think about my clients' age...let alone mention it to them or others.

Since twitches were not present until you were working on an area I suspect that they were forms of release - or a dissipation of "excess" energy or tension.
If she has not had bodywork before or not for a long time this could be her body's way of adapting to the experience.
With Somato-Emotional Release (SER) this kind of thing is normal especially when you are supporting a limb or body part.

Just a thought...

 

[Jisha]

Curious experience with elderly client.

Sorry if I offended anyone or struck a nerve with the use of the word 'elderly'. Guess it depends on your definition of elderly. Definitely didn't mean it in a "Wow, she's old" sense.

And I do take my clients age into consideration. Disease or disorder is a possibility at any age, but that possibility goes up as we age. That's just something I'm mindful of. Just like I am mindful that my young clients are more likely to be self-conscious and uncomfortable at first, and I may have to focus more on making them comfortable than I would with someone else. Neither are absolutes, I don't assume all my older clients are ill, and all my young clients are self conscious, just that it's more likely.

I don't judge or treat my clients differently based on their age - they all receive the same treatment and level of care.

Anyways, the only reason I ever mentioned her age was to basically say "She's not super young, so the possibility of it being due to a medical problem is a bit higher" in not so many words.

Again, thanks for the ideas, I will look into them - and sorry again if I offended anyone or came off as disrespectful, wasn't my intent.

 

[Aijaz]

Curious experience with elderly client.

- and sorry again if I offended anyone or came off as disrespectful, wasn't my intent.

:
Oh - I totally KNOW that - I would never think that of you.
It just hits a little close to home when you're a bit older yourself.
And I just hate that I'm a "ma'am" now...makes me feel like an old hag. :altwink: