Submitted By Anonymous
I once worked on a woman who lied on her intake form. She had just been released the previous week from a hospital in a distant state for a “mystery illness” that she was still taking antibiotics for. She said no one ever figured out what she had. She did not think this was my business. As the room was dimly lit for relaxation, I did not notice anything unusual on her legs and took what appeared to be a slight discoloration as a birthmark. It was only towards the end of the massage when I worked on the front of her legs that I felt something very hard and ropey under the skin with an octopus-like impression. You could feel tentacle-like extensions, radiating out from a single lump, with slight spider veins and discoloration. Having worked on thousands of people, I had never ever felt anything like it before. I immediately asked questions. After a number of questions she told me that I was asking the same things the doctors had asked at the emergency room last week and was annoyed that I thought it needed to be checked out. I felt it was unsafe for her to be getting a massage while still under treatment for this condition. She thought it had “gone away” because at the time she originally sought treatment it was much worse and discolored and such. I informed her that it was not yet “gone” and clearly palpable and she needs to follow up with her physician ASAP. She got quite insulting at this point, and began claiming “Jesus will heal me.” I warned her that she should have disclosed she was under treatment as it might not have been the best time for a massage and that I was trying to protect her. I explained whatever was going on was still present, but just under the skin. She was in denial. I was also very angry with her as I had no idea what SHE had exposed me to. We stopped the massage.
If you were confronted with the same situation again, how might you handle things differently?
Response from Anonymous
I don’t know if there is much different that I could have done. Perhaps just stop it and explain that I found something that does not feel safe to massage and let it go. She seemed very upset when I suggested she needs to follow up with a doctor.
Response from Institute for Integrative Healthcare Studies
Whether you are in a private practice or working for someone else, when you have a first time client it is important to do a thorough intake. This can be difficult if you are working for a spa where there is a standard procedure and intake may be less than adequate for certain medical conditions. At the very least the massage therapist needs to know what medications are being taken and why, as well as allergies, recent surgeries and recent injuries.
It is also important to have the client sign a statement indicating he or she has answered all questions honestly and with the knowledge that, if incorrect information is given, it can affect the efficacy of the massage. This can be a short statement at the end or beginning of the intake form itself, or a separate statement.
It is then up to the massage therapist to determine prior to and during the massage session if there are any contraindications or precautions. If something raises a red flag, like varicose veins, excessive or unexplained bruising, unhealed surgical scars or a rash, then the massage should be stopped and the client asked about it or informed it is there. In some cases the massage should be stopped completely (if problem caused will be systemic); in others it may simply mean moving on to another area (if problem area is restricted locally).
Even if the client insists on continuing, but the massage therapist is in doubt, it is the massage therapist who must make the final decision. In some cases communication with the client’s physician may be necessary to get clearance, in other cases it may just mean that a rash needs to clear up or a scar needs more healing time.
As always safety for the massage therapist and the client is of utmost importance.
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