If we look at medicine honestly, we see it’s based on trial and error. Even when the board-certified specialist prescribes a drug that’s been studied for decades, she won’t know how it affects one particular patient.
We often don’t know why a treatment works, we just hope that it will.
As therapists, we should be well aware of how hard it is to really determine cause and effect, and how much our own brains trick us into seeing causality where there is none.
No matter how great our palpation skills, how finely tuned our hands. We can’t know whether the “knot” is just a tight spot after sleeping in a hotel bed or whether the hypertension is protecting a small injury. Go after the former with your neuromuscular skills and yay! problem solved. Try the same on injured tissue, and you make everything worse.
So should we just admit to clients that we don’t know what’s wrong, and we can’t be sure whether we’ll be able to help?
As massage therapists, we’re not allowed to diagnose anyway. As patients, we’re all sick and tired of cocky diagnoses that turn out to be completely wrong. Our clients come to us often after being misdiagnosed several times. They don’t need us to point to trigger point charts while mumbling in Latin.
- Tell your clients what you think about their pain, but make it clear that it’s a theory, you can’t know what exactly is happening in the tissue.
- Just do a short tryout treatment as the first session. Approach the problem how it makes the most sense to you, explain why, and say openly “Now, if this responds like in similar cases I’ve had, you should feel much better tomorrow, you might just be a little sore, but that should pass by the next day. Please let me know how you’re feeling, and we’ll make a plan from there.”
- In the next session you can build on the results–if the tryout helped, do similar work, but make it a full session. Otherwise find a different approach. For example lymphatic drainage can help with healing an injury without irritating the inflamed tissue any further.