Massage for Special Needs: Communication Is Key

By Katie Meyer, LMT, CFT, Sans Souci Massage

Techniques the massage therapist might use with neurological impairments, geriatric and palliative care, and oncology massage include the following:

► Manual lymph drainage (MLD) indirectly stimulates circulation in the body, stimulates immune system, and stimulates parasympathetic system (relaxation, reducing pain, and muscles spasms). The lymphatic system basically acts as a waste drainage system with nodes that are filters for the body. The lymphatic system is not self-propelled; it relies on muscular contraction in order to keep it flowing.When muscles are inactive, this creates stagnation and therefore weakens the immune system. When the lymphatic system is not working correctly edema (swelling) can occur.

► Non-circulatory massage is to provide a massage that does not promote circulation of blood or lymph flow. This will be the choice if the individual is on strong medications (chemotherapy, cancer treatments, steroids), if there is a disruption in their fluid balance due to medication, or when an organ such as the spleen, liver, kidney, or heart are compromised. This can be a full-body massage with holding, light pressure massage (slight movement of the skin and superficial adipose tissue), limited compressions, passive movement of joints may be done gently, and hand/foot massage.

► Low-impact massage is usually a shorter session (thirty minutes maximum) with the client in a side-lying and/or supine (face up) position. Use bolsters helps make the client comfortable.  Light to gentle pressure is used for the strokes. Full hand contact is maintained with slow even rhythms.

► Oncology massage is safe if performed by a skilled therapist. Benefits include: decreased anxiety before surgery or chemotherapy treatment, and help with relaxation, which in turn promotes better sleep, decrease in pain, etc. Your therapist will develop a care plan that is designed specifically for you after learning what type of cancer you have or have had, the treatment you have received, and the state of health you are in that day. Things the therapist will take into consideration are: the tumor site, bone metastasis, risk of DVT (deep vein thrombosis), risk of lymphedema, if vital organs are involved, if the individual has any restrictions on activity, and how the individual feels typically and on the day of the session. Therapists trained in oncology massage will use precautions so they do no harm.  I recently attended a thirty-two-hour continuing education course on oncology massage. I was so surprised how therapeutic this massage was. I typically like deep tissue massage, and I was astonished at my enjoyment and the deep connection that was made between therapist and client during this training. I am grateful for learning these new techniques and look forward to helping special needs clients soon.

► Neurological Impairments such as spinal cord injuries require the client to communicate to the therapist about their impairment and if they have any complications due to the paralysis. Clients who are bedridden or wheelchair bound can still benefit from massage. Because of the loss of sensation, a therapist has to be very careful about using the right techniques with these individuals.

► Cerebral palsy (CP) describes an injury to the brain that occurred prenatally or in early infancy. Individuals with CP benefit most from indirectly affecting the muscle through low-impact massage, non-circulatory massage, gentle rocking, or energy or craniosacral work.  Massage will help this individual with better sleep, unbinding of postural distortions, ease with breathing, and increase of relaxation. Communication is key in finding the correct technique that will work with each case.  It is good to talk with the caregiver and the individual client to find out what the client is specifically looking for.

► Geriatric and palliative care clients might have different medical devices that the therapist must work around (feeding tubes, ventilators, tracheostomies, catheter bags, colostomy bags, etc.) Benefits include: increased circulation,stimulation of their parasympathetic system (rest and digest), decreased joint stiffness, decreased pain, decreased anxiety and depression, and more restful sleep. The techniques used can be performed in the side-lying or in the supine position to make it easier for them. The massage can be provided on a massage table or hospital bed, or they can sit in a recliner and still enjoy a full massage without the stress of trying to get on and off the table. I have worked on clients in homes, assisted living facilities, memory care facilities, and hospitals.

There are many reasons a therapist must change the normal massage routine for individuals. Everyone has special circumstances that require adjustments; so open communication between the client and the therapist is a must. However, each individual is different, and the stage of the condition they are in will dramatically change the care they receive at that particular time.

Katie is a co-owner of Sans Souci Massage. Visit Sans Souci Massage to set up an appointment. If you are interested in an out-call, then you will need to call 715-830-9890 to discuss this with Katie or email sanssoucimassage@yahoo.com the details of the appointment you are searching for.

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