Why do Massage Therapists need an in-depth health history?
By: Rachel Tice, LMT, 200RYT, Holistic Wellness Practitioner
Licensed Massage Therapists (LMT), like doctors, are recognized as licensed medical practitioners by the state that are allowed to provide the community with a wellness service. Like doctors, Massage Therapists need to know more about a person's health to provide a safe and effective massage. In the state of Michigan, LMTs are required by law to keep detailed information on their clients (SOAP Notes), like health history if a previous client deems that they were injured due to massage or to aid other health professionals provide a more informed view of a person's health. These notes also include information about the types of modalities that were performed, things that were found and the treatment plan in which was suggested by the practitioner. A detailed health history may include questions regarding accidents that you have been in, occupational information like what type of job you perform are you sitting at a desk, is the desk ergonomic, how often are you changing you adding movement into your workday. False teeth, joint replacements, different diseases you may have, as well as questions about your current health and areas of pain and what causes it to worsen or make it better. An extremely important thing for an LMT to know about is the current medications that the client is taking. Blood thinners for instance, thin the blood, causing the client to be more likely to bruise or bleed. Because of this, deep tissue massage is not recommended and only relaxation, light pressure massage is performed on someone taking blood thinners.
LMTs are trained in different relaxation and therapeutic massage techniques to aid in an array of different musculoskeletal dysfunctions, anatomy (structure of the body, like muscles and bones), physiology (the function of the organs), and pathology (disease). They are also trained in knowing when certain massage techniques are contraindicated (not advised to perform) for massage as they could cause harm to the person on the table. For instance, someone with a history of deep vein thrombosis is not advised to receive deep tissue massage as the increased fluid exchange can cause the clot to dislodge and move towards the heart, increasing risk for heart attack. Sprains, strains, fusions, rods, burns, old injuries and joint replacements also are extremely important to disclose to a massage practitioner. Many LMTs will perform stretching techniques to test for range of motion to aid in longevity of certain joints, to relieve pain or just to help relax the person on the table. If something like one of these is not disclosed, then your practitioner may try different techniques that could cause pain and discomfort to the client. Another example is one of the localized (pertaining to one area) pathologies that is very common, poison ivy. Poison ivy is known to be only contagious if the oils touch the skin or are ingested and that you are allergic to it. There are some people who are immune to poison ivy, but others are not so much. It is spread through contact with anything that has invisible oils on any surface, like clothes, skin, bags, coats, etc.! If you are scheduled to receive a massage and have poison ivy, poison sumac, or poison oak, to prevent spread to your practitioner or to their teammates, it is suggested to reschedule your appointment until it has cleared completely.
Not only do LMTs want to make sure they are not going to cause harm due to certain pathologies, but they also need a clear picture of what the tissue of the body may be like as they proceed with the massage. Burns are another important thing that needs to be disclosed as the skin is the largest organ of the body and the therapist will be in direct contact with the skin. Scarring from burn may be more sensitive to the touch, have no issues at all, or lack pain receptors to help you differentiate between pressure and pain. New tattoos, new piercings, and dermal piercings pose a risk of infection to the client and to the practitioner due to the potential for bloodborne pathogen (an infectious microorganism like Hep or HIV) and the risk of other viruses meeting this area. LMTs can typically avoid these areas but it is also suggested to wear some type of safe covering over the new tattoo or piercing during a massage.
Knowing about a client's lifestyle is also extremely important as this helps the LMT to tailor the massage to the client. If the client leads a sedentary lifestyle (not very active) the therapist may be more concerned with tension in muscles that are causing the upper spine, shoulders and head to round forward like the letter “C.” If the client is more active like a triathlete or a runner, the therapist will want to perform more stretching and to make sure to relax the muscles that are more commonly worked during exercises that the client is performing. Massage can directly affect a person's posture and suggest changes to make that will help relieve pain, and aid in longevity. Massage can also improve anyone's athletic performance, reduce injury time, reduce pain and overall health, but it is important to be transparent to the massage practitioner to keep your health safe as well as to get the most out of your massage!
