Anorexic client for massage

[cherriedlove]

Just had an anorexic client for massage. I was a little flabbergasted and one of the less confident therapists pawned her off to me. My client wanted deep tissue massage but I honestly didn't know what to do.

We did a thorough consultation but she didn't mention it to me. If I'm being politically or socially incorrect for saying she's anorexic because I'm not a doctor, I apologise. However there was no real fat or muscle to massage, only a layer on skin and protruding bones (scapula, spine, rib bones, tail and hip bones) and not just sticking out a little on some slim ladies. During the treatment, I could see skin just sliding over her bones.

I focused on mostly the shoulders and neck for about 30 minutes because it was literally the only place where I felt I could pick up muscle. The rest was made up of light to medium petrissage and effleurage movements all over the back, and some firm to medium pressure petrissage around the scapula (avoiding ribs).

I checked in with my client and obviously didn't put firm pressure on her bones and I've been taught only to use a lighter pressure on bony clients yet my client wanted 'very' firm. She loved the massage and asked for my name so she could ask for me for her rebook but I felt so uncomfortable.

She has been to the salon before with another therapist.

Should I have done the massage? What adjustments would you make to the treatment? I am wondering if there's a tactful way I could've said a firm pressure wasn't suitable.

Or am I stressing over nothing...

 

[little-miss-owl]

Just had an anorexic client for massage. I was a little flabbergasted and one of the less confident therapists pawned her off to me. My client wanted deep tissue massage but I honestly didn't know what to do.

We did a thorough consultation but she didn't mention it to me. If I'm being politically or socially incorrect for saying she's anorexic because I'm not a doctor, I apologise. However there was no real fat or muscle to massage, only a layer on skin and protruding bones (scapula, spine, rib bones, tail and hip bones) and not just sticking out a little on some slim ladies. During the treatment, I could see skin just sliding over her bones.

I focused on mostly the shoulders and neck for about 30 minutes because it was literally the only place where I felt I could pick up muscle. The rest was made up of light to medium petrissage and effleurage movements all over the back, and some firm to medium pressure petrissage around the scapula (avoiding ribs).

I checked in with my client and obviously didn't put firm pressure on her bones and I've been taught only to use a lighter pressure on bony clients yet my client wanted 'very' firm. She loved the massage and asked for my name so she could ask for me for her rebook but I felt so uncomfortable.

She has been to the salon before with another therapist.

Should I have done the massage? What adjustments would you make to the treatment? I am wondering if there's a tactful way I could've said a firm pressure wasn't suitable.

Or am I stressing over nothing...

I think you've done really well. I had a regular massage client who was so anorexic she had snapped her forearm by carrying a wire shopping basket on it :Scared: Seeing someone so thin you can see their tailbone is quite upsetting (for me anyway)

The other anorexic lady I did wanted the pressure really firm and I was like you, feeling like I was massaging a skeleton. I think as long as there is muscle there and not bone you can press firmer, but theres no way I'd dare use forearms or elbows on someone who might have brittle bones.

She obviously was happy with everything so it looks like you've picked up a client there which is great

 

[squidgernetball]

I don't think you're stressing over nothing. I think it can be really upsetting seeing someone so ill. I had very similar recently. She thanked me at the end and said she was feeling like she was on the mend and some treatments really helped her. All this without mentioning the A word! Nothing on her consultation, so what do you say? Nothing I think, just do your best for them and advise if you feel a treatment is totally inappropriate which clearly yours wasn't x

 

[Noodle]

Following edits, can we please keep this thread on topic and serious?

Personal opinions on such a sensitive subject should not discussed here.

Thanks.

 

[Kim Lawless]

Just wanted to say hats off to you for caring about her. Whether she's anorexic or just very slim, she will be aware of what people think and it must have taken a lot of courage for her to let you see her. Bless her and bless you!

 

[lynn amber]

Seems the comment has gone but wow to come across someone as ignorant as this is really makes me angry and sad at the same time, for someone to have absolutely no awareness or empathy for mental illness is disgusting, I currently have someone in my family suffering severely from anorexia, I also have someone who is bipolar, I my self have had unstable periods in my life, would you talk in the same manner if someone was diagnosed with diabetes or some other common illness!

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[sallyyummymummy]

A close friend of mine has suffered with anorexia which is heart breaking to see. She always says that it was so hard to actually go and treat herself with a massage as she had such low self esteem & still struggles now. Well done on providing what sounds like a professional treatment which probably made her feel wonderful.

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[nailpod]

Seems the comment has gone but wow to come across someone as ignorant as this is really makes me angry and sad at the same time, for someone to have absolutely no awareness or empathy for mental illness is disgusting, I currently have someone in my family suffering severely from anorexia, I also have someone who is bipolar, I my self have had unstable periods in my life, would you talk in the same manner if someone was diagnosed with diabetes or some other common illness!

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Sorry if I upset everyone.
It was just my version of humour adding to the topic. And yes I am very aware of the sensitivity and severity of this condition. My friend is and has undergone therapy and she herself uses the comments I made in fact she was sitting next to me when I wrote that post.

But anyhow well done for handling the client with such professionalism and care. X




Beauty at your finger tips!

 

[lynn amber]

Sorry if I upset everyone.
It was just my version of humour adding to the topic. And yes I am very aware of the sensitivity and severity of this condition. My friend is and has undergone therapy and she herself uses the comments I made in fact she was sitting next to me when I wrote that post.

But anyhow well done for handling the client with such professionalism and care. X




Beauty at your finger tips!

Yes your friends has the right to make fun at her self if she wants, you do not until you have walked it those shoes

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[nailpod]

Yes your friends has the right to make fun at her self if she wants, you do not until you have walked it those shoes

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I have been myself actually so u can just calm down. I did apologise this isn't a forum to start fighting.


Beauty at your finger tips!

 

[gillian w]

If in doubt ask the client if the pressure is ok for them.She obviously thought it was fine otherwise she would not have rebooked.
You will come across a lot of different challenges in massage.Strange body parts,lumps and bumps,scars some self inflicted or inflicted by other people, obesity,anorexia etc etc but you do your consultations find out as much as you need to perform the treatment and then usually people will open up about the rest,especially if they become regulars and trust you.
Sometimes performing a massage on those most needy can be very special and rewarding and sometimes exhausting and worrying its best to not get too involved,but just listen if they start to tell you of any problems they have.It can be a bit like the Samaritans at times.

 

[Lucy'sBeauty]

I think it is an amazing feeling to make a client feel comfortable and happy within their body no matter what size or shape they are I fully hated my body and people seeing it for some personal reasons and since having regular massages it has made me feel really good about my self and I love thinking that people leave feeling that way as well x

 

[nicole333]

If she was suffering from Anorexia (nobody apart from the client can confirm this) how would the risks surrounding the cardiovascular system and circulatory system affect your treatment on her? Was this covered in your massage training? I am not trained in massage but am a psych nurse so have experience in EA's and am genuinely interested if this is covered or if it is felt to come under a general health consultation. Thanks

 

[cherriedlove]

Thanks for the replies ladies, makes me feel a lot better.

Nicole - that was my concern really. In college I have been prepared for a lot of situations, when a medical note is needed and when you can carry on with just adaptations. I wouldn't perform an electrical body treatment on her (except maybe viennese). In school we would've been told - use gentle pressure and avoid bony areas. But my client specifically came in for a firm massage. I started off with a medium pressure then checked with her, and she said wanted firmer (I did an internal sigh), I went firmer. But did I take a risk? Absolutely. Completely went on with it without knowing the medical consequences. I know massage is good for anorexic clients but mostly likely not firm, something just to possibly promote relaxation and use touch as healing.

Of course I want clients to feel amazing but at risk to their health, no. I guess all of a sudden a million questions ran through my mind (keep in mind, I am an over thinker/worry wort).

Is it my place to ask if she had anorexia or if she was just naturally bony? This would definitely make her feel uncomfortable.
What are the consequences on her body?
Is it my place to question the clients needs for the treatment? She came in for a firm massage and made it extremely clear.
If something were to happen due to the massage, would I be liable? It's not like my pressure is all that amazing, everyone says it's lovely and firm but I know it's a bit weak compared to other therapists out there so breaking a bone seemed unlikely to happen.

To me it's not just another body type. I massage male/female, all ages over 16 (have yet to have massage an elderly client), fat, skinny - whatever. No prejudice against body shapes. It's about whether my massage could possibly have negative consequences. I think the consensus is if she thought the pressure was fine then the treatment was fine, so will take that heart and let it rest.

Much love for the support xx

 

[lynn amber]

I have been myself actually so u can just calm down. I did apologise this isn't a forum to start fighting.


Beauty at your finger tips!

Im quite calm and not fighting with anyone just appalled at your first statement which has been removed

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[Noodle]

As the OP's questions have been asked and answered, I will now close this thread.