Hypersensitivity and Involuntary Spasms??

[Lady Burps Alot]

I am completely baffled when it comes to this client's reaction on the table when he comes in. I have worked with him a handful of times and everytime it is the same thing.

#1: Complete hypersensitivity in hamstrings. Unable to work on them without putting him into spasms. Only providing light work now. However, even when I am working on his back, his legs and feet are constantly moving. He reviews 'you must be hitting some nerves there'. Now I know that I'm not grinding on his nervous system through his spine to cause such strong convulsions, but are these referral patterns?? Does he really have some nerve damage?

#2: He seems to also have extreme hypersensitivity in his scapular areas (areas of most stress on him). When working with MILD pressure, his breath rate increases, and becomes deeper.

Now, any one of these things would not be so strange, but the combination of these issues makes for a very interesting and challenging massage session. Although he enjoys his sessions completely, I feel that I'm making very little progress due to his hypersensitivity. (i'm assuming he's hypersensitive, but I don't know.)

Has anyone ever worked with clients like this? Between his hamstrings spasming on the table, his comments about 'hitting nerves' and the erratic deep breathing, I'm at a loss. He is not my typical client but I would like to provide him with my typically great results!

 

[2pac]

I've seen something like this in clients who have something weird going on neurologically. If this client has a "flat" affect, quirky personal habits, is fussy about the feel of clothes of the sheets, or responds unusually to pain, I'd suspect some kind of sensory integration issue. If that is the case, firm broad strokes can really settle the nervous system down. As if you were firmly petting a dog, with long, repetitive, moderately slow strokes. Broad static compression might be nice. Also a very heavy blanket (or multiple blankets) can be very calming, provided they don't get too hot.

If someone starts breathing faster or flinching when I work very gently on a tense area and it doesn't seem like I could possibly be hurting them, I usually suspect that on some level they are afraid I'm going to hurt them. In that case it is important not to do deeper work without warning them and preparing the area for it. Or maybe the deeper work isn't what the person needs. If someone is tense and flinchy, gentle work can sometimes release the tension more effectively than deep work.

There are two Trager techniques that can be really good for this sort of thing. They are a little hard to explain but I'll give it a try.

Rhythmic rocking - Put your hands on the body part in an encompassing way and make a good connection to the tissue. Moving from your center, push the tissue away from you to rock the body slightly. Maintain a connection to the tissue - you aren't letting go of them. Let the body rebound back into you and push again, establishing a rhythm that syncs with that natural speed of rebound.

Accepting weight - Look at whatever movement the tension is doing, firmly support the relevant body part, and hold it just a tiny bit further in that direction. (This works best if the person can be positioned so the tension is at least partially acting against gravity.) You are communicating to the tissue "I see the job you are doing. It is clearly an important job. Why don't you let me take over that job for a little bit?" Ask them to let you have the full weight of that body part. Gently moving the body part up and down can help them feel the weight of the limb and release it. When they release some of that weight to you, you can gently move the body part in the opposite direction from the tension. This will often give a very dramatic release, especially when the tension is emotionally or stress related.

-- Joshua

 

[Henry Spencer]

Wow, that is really helpful...... I understand the first Trager technique pretty well.... I already incorporate that effect into my sessions. The accepting weight, I'm not sure I will be able to try this one but it is worth a shot.

I am amazed at how well you may have described this client by saying 'flat', with quirky habits. That is so true. It is also true that the first broad strokes are most preferred.... I guess I will stick with that!

Thank you so much, Joshua..... I will remember this 'client profile' if I ever see it again.

 

[Killua]

Something else that you might find pretty helpful might be some really gentle passive stretches. When your Cl. is supine, pick up his leg and support it on your shoulder. Encourage him to keep his leg limp and heavy and slowly walk forward, lifting the leg towards a 90 degree angle. You may have to use your hands to keep his knee straight, that way the stretch targets his hamstrings, and maybe even his lower back. When he says he feels a comfortable stretch, hold the leg up and have him take some slow, deep breaths for 10-15 seconds, then slowly put it down.
Then, take the same leg and bend it at the knee, cross it over the other leg and plant the foot next to the other knee. Push the knee of the leg your working on medially, bringing it over the hip while holding the ASIS down with your other hand, spreading the ITB and eventually bringing the glutes into the stretch. Again, just wait for a comfortable, easy stretch and just hold it for 10-15 seconds.
Then (I swear this is the last part!) let go of the ASIS and let the him follow the stretch, and reach under the opposite shoulder, or just grab the forearm before it meets the elbow, and pull the client across the table while still pushing the knee in the other direction, like you were "wringing out the back". This can be a bit challenging if he is stiff or just plain holding himself, but the mild stretch can really open up the erecters and release tension.
Then just repeat on the other side. Overall, it takes five or so minutes. I do this to cl's with low back and hip pain frequently and it is almost always very effective.

Hope that helps.

 

[Ann O]

oooh! I would love to try this... I think some modifications might be necessary as the size ratio between myself and this client is rather large. Do you have any suggestions that would help me (as a smaller person) do that stretch?

Thanks,

 

[Lumidare]

stretches

Wow thanks josh. I use that stretch also but i always hold down the shoulder to do the wringing but im going to try the forarm

 

[charles_soler]

With larger clients, you might have to prompt them initially to lift their leg up, but once it's on your shoulder, they should be able to relax it without hurting you. In fact, sometimes this is easier with larger Cl's, because fat weighs less than muscle.