Example Massage Case Study No 1 Student Name: A Student Client Mrs MB Date: 5 th November

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1 Student Name: A Student Client Mrs MB Date: 5 th November Lifestyle/Profile (male/female, age, lifestyle, employment, manner) (this is actually my sister and I know her quite well obviously but nobody knows she is Mrs MB as her real name is Vera. Our tutor said to give a profile of our client I tried to think of how to describe her to someone who hadn t met her not easy but I even thought how I would describe her if she was going to a dating agency! They need a bit more than age and that she s a woman don t they? This does go on a bit, as I know her well, obviously) Mrs MB is 42 years old. She is married and has no children although she is stepmother to 4 grown up children. She lives with her husband who is an engineer. She is employed full time as a Management Accountant. Her office is based a short distance from her home so she is able to walk to work most days, depending on the weather. Last year was stressful for her as she was made redundant and had then had two job changes in four months. In the middle of all of the job moves, she got married organising the wedding completely by herself within a short space of time. This added to her stress levels. She has a very busy life both socially and professionally. She rates her stress levels as low now work 4/10 and home 2/10 and she has a positive, pro-active approach to life. Mrs MB is a keen amateur triathlete who had a regular training schedule. However, before her last event she developed severe back pain that resulted in a visit to a physiotherapist. She had to withdraw from her last two races completely. She did not visit her doctor, but the physiotherapist recommended remedial exercises that have helped. She has recently started to exercise again, swimming once a week and cycling occasionally but not at the same level as previously practised. Health and Lifestyle (I put in another headi ng here so that my tutor could find the bits she was really interested in!) She suffers no contraindications and is generally in very good health. She eats a healthy diet, mostly organic and is a non-smoker. She does suffer with occasional eczema on her hands and her skin is slightly dry but she feels that this is age related. Mrs MB feels that her back problems may be due to over training, particularly increased running and the change in her office environment. She thinks that massage may help to improve her circulation and relax her back muscles and prevent aches and pains. She has signed an informed consent form, and has been made fully aware of the treatment and its effects.

2 Reason for treatment Intermittent back ache/pain/stiffness back pain started in August due to an increased running programme and a change in work/office environment. It has now eased but Mrs MB is anxious that it may return. Treatment Plan A full body massage once a week for two weeks is proposed using the full range of classical massage movements with particular emphasis on the lower back/problem area to help prevent muscle stiffness. (this will go for all my clients who are my friends and family - I will just change the emphasis to where they need help I can just copy and paste this over to each case study for treatment 1) Treatment 1-05/11 Details of how the therapist conducted the treatment (massage undertaken, observations, areas of tension, muscles affected etc) (before I write in this section I have to ask myself what happened during the whole treatment from MY point of view i.e. how was it for me?) The room was a little cold so additional heating was necessary to ensure client comfort. (In November it was cold so it was obvious I needed heating, but if I don t tell them (whoever reads this) they won t know will they?) A full body massage was performed, with extra work/emphasis on the lower back, lumbar, sacral and gluteal regions. (this is going to go on all my case studies I shall just change the body part that needs work on and it will help me to remember my A&P) The massage medium chosen was grapeseed oil which is light and easily absorbed. (will use that sentence each time) Although the client does not suffer a nut allergy, she has a strong dislike of nuts and nut products so I felt it unwise to use sweet almond oil. It was necessary to adjust the pressure used on the back as the client was quite sensitive experiencing mild discomfort during petrissage on the sacral area. I used a lighter pressure for these movements that the client could tolerate. (I need to show the Examiner that I am always taking my client s needs into account and stating that I check/adjust the pressure is a good way to demonstrate my awareness) No additional support was required by the client. Some discomfort was felt in the sacral area, so pressure was applied within the client s tolerance to help with relaxation

3 Details of how the client felt during and after the treatment (before writing up this one I had to remind myself to answer the question what happened during the treatment from her (my client s) point of view how was it for her?) Mrs MB had come straight from work so she was very alert. She had experienced massage before so was not apprehensive about the treatment. However, as this was her first treatment with a different therapist, she talked throughout the treatment and was very interested in the different techniques experienced. (actually she came rushing in straight from work, really worried about having a massage and talked non stop asking what I was doing all the time I wished she would be quiet really, but tried to express it clearly and in a nice way to whoever reads this!) She felt relaxed and refreshed after the treatment, not sleepy and said that her back felt looser. Details of after-care advice given (this is advice given for the hours immediately following the massage to help get the best out of the treatment and avoid any sideeffects) I sat Mrs MB up slowly and she was given a glass of water immediately after the massage to help flush out any accumulated toxins. She was also advised to go home and relax for the rest of the evening if possible. (I ll be doing this each time, and will copy this sentence over each time too)_ Details of homecare advice given (this is specific to this client and based on information I have gained during her consultation to help long-term) She was advised to increase her water intake as she currently drinks no water in addition to her daily coffee, herbal tea and fruit juice. She could also try to cut down on her caffeine intake. She was given exercises to perform by her physiotherapist to improve the flexibility in her back so it is important that she continues with these daily and I gently reminded her about that. I also gave her the Session Diary to complete so that she can put down any changes in her health and well being from treatment to treatment (I will put this for each client now as they all should go and rest shouldn t they? And they will all get the Diary)

4 Reflective practice I thought this was going to be a tough one as I couldn t think of anything at first! Then I realised that she had talked all the way through and how I wanted to get her to be quiet and couldn t think of how I was thinking about this and realised that reflective practice was really just thinking about what had happened and how I might have done it differently.) At the end of the first treatment I felt pleased with the outcome. I did feel that Mrs MB would have benefited from the treatment more if she had remained quiet throughout rather than talking, but this seems to be quite common for clients during their first few sessions. It is important to build a rapport with the client and many find it stressrelieving. It is also a good way of noting things that they might have forgotten to mention during the consultation. I need to work out a way to ask clients to be quiet in a polite way! (The reflective practice is really important; my tutor told me that this is the bit the Examiner checks carefully as s/he will want to see that I have grown as a therapist. I must always make sure it is about ME eg what I learned, what I could do differently or more of, less of Fortunately, my tutor saw my first draft of this case study and told that this part is NOT about the client and what they gained from the massage - that information goes in the Details of how the client felt during and after the treatment section above)

5 Treatment 2-12/11 Reaction to previous treatment and present health. Check for contra indications again. Although Mrs MB felt looser after the last massage, the back stiffness returned quite quickly within the next day. However, she felt that she slept better after the treatment. (Fortunately, she had made a note of this in the Session Diary I had given her). There have been no changes to Mrs MB s overall health this week Mrs MB arrived straight from work feeling slightly harassed. She then announced that she was on a tight deadline and had to leave in just over one hour. Details of how the therapist conducted the treatment. A full body massage was performed, again with emphasis on the lower back/sacral area, using a full range of massage movements. Although Mrs MB stated that she had cellulite on her legs during the initial consultation, I found that her legs were very well toned. As a result I needed to apply more pressure in order to work the tissues adequately, particularly with the wringing and finger rolling movements. The skin did feel quite cold to the touch in these areas though, perhaps indicating poor circulation. I sat Mrs MB up slowly and she was given a glass of water immediately after the massage to help flush out any accumulated toxins Details of how the client felt during and after the treatment She appeared quite tense throughout the massage and it was obvious that her mind was buzzing with thoughts of the rest of the evening. Whilst she may have experienced some of the physical benefits of massage, such as increased circulation, I was sure that the psychological effects this evening were poor as she seemed quite alert throughout the treatment. She experienced less discomfort this week in the lumbar/sacral area, so I was able to apply a little more pressure and work for longer. I still avoided the use of the tapotement movements on the gluteal region. I sat her up slowly, even though she needed to get going quickly. She said that she felt relaxed and comfortable but after her glass of water, she dressed and left quickly

6 . Details of aftercare advice given: Drink some more water and try not to undo the effects of the massage by rushing around too much today. Go to bed early if possible. Details of homecare advice given: Mrs MB was again advised to increase her water intake. She has been trying this week but kept forgetting. I suggested that she keep a bottle of water on her desk or have a glass of water each time she has a cup of coffee. She is continuing with the physiotherapist s recommended exercises. The next treatment will be in one week. Reflective practice I felt I rushed through the routine and I forgot some movements. I performed the massage too quickly as I was conscious throughout of the client s time limits. I completed the whole routine in approximately 50 minutes rather than just over an hour. She did not relax fully but appeared to enjoy the treatment nevertheless. I felt disappointed that I let the client s mood affect my performance and I need to be conscious of this for each client. I asked my tutor for advice on this and she said I could have done less movements to save time rather than doing them quickly simple when you know how!

7 Overall conclusion (Looking at the massages and how it has gone) Mrs MB has benefited from the massages, coping with a heavy workload and using the treatment sessions to unwind. She has become more aware of her posture and has changed her desk around to prevent further damage and feels that this is helping. She is more alert during the day and feels that drinking more water has helped. She will continue to drink decaffeinated coffee at work. I re-did the stress indicator test and she now feels work stress is now work 3/10 and home 6/10 (her daughter is now taking exams and it is impacting on the family! So I am happy to say she is coming for regular massages in the future and paying me. I will give her a voucher for a free massage when I qualify and also offer a discount for every person she recommends to me. Mrs MB is fit and body aware, but she must be careful not to over exert herself as she tries to regain her fitness levels. She has found that the massages have made her more aware of how she is feeling physically and hopes that this will guide and help her not to overdo her training when she starts properly. Not all clients undertake home/aftercare advice. It was very interesting to see how improvements in health could be made when the client takes advice and makes changes! CPD Requirements/Personal Plan: I would be very interested to learn more about nutrition, and will look for a course when I finish this one, although I would like to investigate learning sports massage for clients such as Mrs MB so I can do more to help them.