16.4.19 – Hour 40-41

My first patient today was a lacrosse player who plays for the university. He came complaining of pain in his chest moving into his shoulder when throwing the ball. Upon observation it was clear the patients shoulders were protracted, which I related to tight pectoral major muscles. For the treatment, I applied effleurage to the patients chest. I made sure when checking for contraindications to double check for any previous heart problems, as I was massaging in close proximity to the heart. I also applied effleruage and petrissage to the anterior head of the deltoid in case there was any tightness in this area which was contributing to the patients pain. I repeated the treatment on the other side. I finished the session by performing some PIR of the chest, to try and increase the patients ROM further. In order to improve I will try and find some different ways of applying massage to the chest so I do not repeat myself as much.

16.4.19 – Hour 41-42

For my second patient today I had a boxer who has been experiencing some pain when punching, particularly when extending his arm to make contact. Through a subjective assessment I managed to narrow it down to his rotator cuff muscles, primarily his subscapularis. I decided the best treatment to provide was effleurage to the patients chest, aiming to get deep into his subscapularis, into his pectoral major to release any tension which would have been contributing to his pain. Again, I also decided to apply effleurage and petrissage to both his anterior and medial head of the deltoid to remove any tension. To finish the session off I performed about 15 minutes of PIR, which involved lateral abduction of the shoulder, which put the pectoral major on stretch. I then did it with normal abduction of the arm to stretch the heads of the deltoid. Following the treatment, the patient performed a few light air punches, and said while there was still some pain, he felt looser and as though he had a greater range of movement. This suggests that while the treatment was effective to an extent, further treatment may be needed to try and solve the problem.

18.4.19 – Hour 42-43

Today, I had two patients who I have previously treated, and wanted a follow-up. The first patient was a semi-professional footballer who previously had been experiencing pain in his hamstrings during games. Since treatment began, and I advised him to perform some extra stretches, this pain had since stopped, and he just wanted to get a general massage seeing him through to the end of the football season. When palpated, there was still some tension in the patients hamstrings, however it was significantly less than the first time I had treated him. I proceeded to apply effleurage and petrissage to the patients hamstrings for roughly 15 minutes each as these are the main trouble areas, and also applied massage to the patients quadriceps and hamstrings for roughly 5 minutes each to fill out the hour time slot. The patient reported feeling a lot looser after and ready for his remaining games.

18.4.19 – Hour 43-44

My second patient today was an office worker who I have previously treated, and comes to me complaining of back problems due to working long hours at a computer desk for his job. In previous sessions, I have treated the patient with purely back and shoulder massage as well as some stretching. However, I today realised the reason for his shoulders protracting could be to do with a tight chest, which will then put a strain on his upper back. While I still massaged the patients back and traps to account for any tightness in this area, I primarily focused on the patients chest in this treatment. I applied effleurage to the pectoral major, and effleruage and petrissage to the patients anterior head of the deltoid. Straight away after the treatment, it was clear that the patients shoulders were no longer protracting, and a tight chest had been the cause of the pain and imbalance all along. This treatment was very effective as not only did it solve a patients problems, but it also shown progress in my ability to both diagnose and treat a problem a patient was having.

23.4.19 – Hour 44-45

My first patient today was my cousin who is a rugby player for a mens team. This presented a new task for me today as my cousin is roughly 6 foot 6 and 120kg, meaning he was by far the largest patient I have treated so far. Due to imbalances in how he walks, he has always experienced tight calfs, and sometimes hamstrings. He often pays for sports massage to solve this problem, but wanted to try me and see if the treatment was as good. Due to the large size of his calfs, I began to apply effleurage with the outside of my hand, and my forearm to cover as much surface area of the muscle as possible. The patient had very tight calfs due to pushing off his toes when he steps, rather than off the ball of his foot. I removed any adhesions using NMT. Due to the size of the calfs, it was difficult to perform petrissage, so incorporated tapotement periodically. Overall, he commented the treatment was of a good standard and feels no difference between myself and the services he has previously payed for. On a personal note, if i was to massage someone of this size again, I would set the bed height lower so that I am able to push down with more force, therefore creating greater massage depth.

23.4.19 – Hour 45-46

Today, I decided to invite another person on my course in for a massage, as another opportunity to try and receive some informal feedback so that I can progress further. The person who I got in does not play any sports, however has always struggled with lower back pain, but she does not know why. While I checked for contraindications and she was clear to be treated, I still advised her to get the problem checked in case of any underlying issues. The patient wanted a lower back massage, so I performed effleurage of the irector spinae, working into petrissage of the obliques. During the treatment I suspected the lower back pain may have been causing some strain on her glutes and hamstrings, which turned out to be the case, so I also performed effleurage of the hamstrings, particularly the semitendinosis up into the glutes. We finished by performing PIR, by getting the patient to perform maximal hip flexion while her leg was extended.

23.4.19 – Hour 46-47

My third and final patient today was a long distance runner who had the night before been for a 10k run. He is in training for the upcoming London Marathon this coming sunday. He wanted to clear any tightness or adhesions he had in his legs before he travelled to London in a few days time. I decided it was best to give him a general leg massage due to him not having any preferences. I applied 5-10 minutes of effleurage, petrissage and tapotement to each of the calfs, hamstrings and quadriceps, spending longer on any area which was slightly tighter. Due to the event on the weekend, I made the aftercare advice very clear advising him to drink lots of water and let his legs rest for roughly 24 hours.

25.4.19 – Hour 47-48

My patient today was a footballer who plays for a local team. Roughly 5-6 weeks ago, he torn his hamstring during a football game. Doctors at the time advised him he could play again in roughly 8 weeks. He came to me wanting a massage on his hamstrings to try and get him ready for when he returns to playing. I advised him that as the injury is still not fully recovered I wont be able to apply that much pressure so that I do not injure his hamstring again. I started by massaging the patients uninjured hamstring, relieving any tightness or adhesions that I found. When I went on to his injured hamstring, I started by applying a light pressure, gradually increasing it to a point where I was deep in the muscle, but the patient was comfortable. Following the treatment, the patient commented that although he was hesitant betting his injury massaged, he felt relaxed throughout and found the treatment to be very effective.

29.4.19 – Hour 48-49

My first patient today was a netball player who had a game the night before. She had a game the following evening and therefore wanted a massage to aid her recovery. She complained that she experiences particularly sore quadriceps after playing. I applied roughly 5 minutes of effleurage and petrissage to the patients hamstrings and calfs, pushing up into the glutes to ensure I massaged the entirety of the hamstring muscles. I then focused on the quadriceps, massaging for about 10 minutes on each quadricep which were particularly tight. I advised the patient that she could perform a warm down following her games, stretching her muscles which would start to redirect the blood flow away from the muscles, reducing the pain she experiences after games. I finished the session by performing PIR briefly on the various muscle bodies. The patient said her pain had diminished and she felt ready for her next game.

29.4.19 – Hour 49-50

My second patient today was a tennis player for a local club, who I have previously treated. He came to me today complaining of experiencing pain in his shoulder when serving. Upon observation it was clear that his right shoulder was elevated. I contributed the pain to an issue with his rotator cuff muscles, and due to where he was saying the pain was, I narrowed this down to his teres minor. I explained that I cannot directly treat the teres minor, however I did perform a massage of the patients upper back consisting of effleurage, working into petrissage of his trapezius to try and relieve the tightness that was causing his shoulder elevation. I finally worked around to his deltoids, where I performed effleurage and petrissage as these muscles are also heavily involved in the movements performed when serving in tennis. Following the treatment, the patient said he his right side of his upper back felt looser, despite not initially feeling any pain or issues in this area. Additionally, when abducting his right arm following the treatment, he said he was able to do so a lot easier.