Common Mistakes Made by the Clinical Massage Therapist Teacher

How do we teach to students about specific conditions, and what treatment protocols can be best used to resolve the problem?

We review the anatomy, the common causes, and discuss the associated conditions. We discuss the mechanism that can lead to the condition, and what are the common signs and symptoms. After all that is done formally, teachers will ask students, “So, let’s suppose you have determined the problem is Carpal Tunnel Syndrome. Now tell me, what is wrong with your client?” In most cases, the student will respond with things like, “They have numbness and tingling in their lateral 3 and a half fingers.”, or, “The pain wakes them up at night.”, or even still, “They lose grip strength, and in severe cases, the thenar eminence will start to atrophy.” They will go on to mention that the pain may move up the arm and sometimes reach the shoulder.

After I let them go on for a while, I have to tell them they are all wrong. You see, what the students have stated are the signs and symptoms of the problem, but they have not stated the actual problem. Yet, I have observed many teachers praise the students for their knowledge of the condition. The problem is, signs and symptoms are not the problem, but rather the result of the problem.

In the above mentioned situation, the problem is that the median nerve has undue pressure on it within the carpal tunnel, PERIOD. That is why it is called Carpal Tunnel Symptom. As teachers, we need to stress more on what is the source of the problem, rather than focusing on the symptoms. If we focus on the symptoms, the student will focus on getting rid of the symptoms.

Let me give you an analogy which may better describe what I am trying to get at. Let’s say you wake up in the morning, go to the garage, and find that the car’s tire is flat. You get out your air pump, inflate the tire, and drive to work. When you are done with work, you come out to find there is a little air out of the tire, but it is still near fully inflated. So you drive home and park in the garage. The next morning you come out to find the tire is again flat. So you fill it up, drive to work, and guess what…the same situation has happened again; some air has escaped during work, but the tire isn’t flat. You drive home, park the car again, but by morning, flat tire again. I can promise you that if you keep filling the tire in this manner, it will always be flat by morning.

Now, instead of just inflating the tire, you look for what is causing the tire to go flat, say a nail. You grab your trusty pliers, pull out the nail, and stick a plug in the hole, and Then inflate the tire. I promise, if the nail was the problem, and you pulled it out and you filled the hole correctly before filling in the tire, there will be air in the tire the next morning.

In much the same way, if you realize the problem is pressure on the median nerve, you treat with the intent of removing the pressure (pulling the nail out and plugging the hole), the symptoms should go away; but if all you do is treat the symptom, the symptoms will continue to return.

So teachers of clinical massage, always make sure the students are taught WHAT IS THE ACTUAL PROBLEM, then teach them the techniques to resolve the PROBLEM, and the chances are much better that the symptoms will stay away.

By Mike Hovi