Are we really getting to the source of the client’s issues or are we only addressing the referred pain and giving a temporary solution to an ongoing issue. For example, if a client comes to you with stiff neck and shoulders, or reports numbness in the hand or lower leg. what would you do next? Pause for a moment and ask yourself , “what do I usually do in each of these situations?” Do you say to yourself, “I have seen this before. I know what to do.” Do you ask the client to go directly on the table or chair so you can test out your new modality.
Do you find yourself bypassing the fundamental and important pre and post assessment of the client which should be as natural to therapists as a reflex response. Void of assessment, how do you know you are actually helping and not adding fuel to the fire. I believe our assessment and palpation of client issues are fundamental which (we)therapists need to use each and every time a client come to see us. Implementation of these skills not only help to give you a base line from which to measure the efficacy of the treatment, but more importantly, the assessment will give you a better idea as to which structures to address. Assessment helps support your reasoning and rational behind the modalities and techniques used. Is the assessment part of your treatment?
June 15th, 2010 at 12:10 am
Yes assessments are a natural part of me being a MT. I can’t help but gather information in my mind as I see my clt sloughed over with eyes closed in the waiting room. I have to say, ” I hope you realize I am watching you walk, is that ok?” as they limp towards the tx room. And when they drop the heavy purse to the floor and rub their shoulder, how do you not notice and start adding up all the clues? But let’s be real! Gone on my days of PROPER assessment protocal as learned in school. First doing gait assessment, then postural assessment, ROM (active, passive, AND active resisted), standard orthopedic tests (S.O.Ts), then neurological tests. The very first day on the job I learned what RMT really stands for : Ridiculous Multi-tasking! as I learned to do health history, consent, assessment, tx all at the same time while my only focus was to jump out of the room as the clts start undressing before me!!!! Clts so eager to get on the table- they groan when I mention assessments- most have been through it all before with other practioners. And my tx room doesn’t have the space to do assessments properly, the table doesn’t even fit straight to get a proper visual! But you learn. you talk to other therapists, you take workshops, and you learn different ways of assessing regardless of the size of the tx room, regardless of your time constraints, regardless of the clt’s rush to ‘ ‘real massage’, you learn to ‘see’ with your hands, and ‘listen’ to your heart and assess all the information gathered ongoing (including health histories and the clt’s stories during tx) to formulate the safest, most effective tx plan for them. Regardless of the numbers on the ROM charts you didn’t have time to do, when your clt can now hold their baby in their arms without pain in their shoulder – you know you were effective. When a clt walks out of your tx room better than they limped in, you know you were effective..and when your clt joyfully exclaims, “my headache is gone”, you know you were effective!…. .etc
June 15th, 2010 at 6:11 am
Jayden, you are so right in saying that the assessment begins when contact is made with the client. And good on you to make the best of a not-so-ideal working environment, adapting and being able to continue giving high levels of client care.