Parkinson's disease and how it changed my massage style

I graduated massage school in December of 2012.  As an enthusiastic student with a nearly 4.0 GPA, I was always eager to learn every new technique and work with every variety of client.

The school I attended in Arizona, Cortiva Institute, had a program called "Population Spectrum" in which experienced massage students could practice advanced-level techniques with specific members of the general population.  Some of the clients were battling cancer, or multiple sclerosis.  I was assigned a lovely elderly person who had severe head forward posture and Parkinson's.  They could barely look up, their head was so bent down.  They were in their 80's, practiced massage for over 20 years, and truly stole my heart with the compassion I felt for them.

The course allowed multiple treatments with each client, to allow us to see progress over time.  I attempted nearly every technique I could think of to treat this client.  I thought the head forward posture was all I could effect.  Parkinson's disease is in the brain, right?  How can I massage that?

Off to work I set, practicing my intercostal massage work, carefully working my large fingers between their tiny ribs, working around the collarbone, trying to loosen the subscapularis muscle with MET (muscle energy techniques).  It's not easy to dig into an armpit to reach the muscle on the inside of the shoulder blade, but I had more work to do than that.

We tried some work on the longus colli, a muscle on the inside of the cervical spine.  This requires moving the esophagus gently out of the way to get behind it to the muscles that were locking the client's chin into their chest.

I even learned more about releasing trigger points on my client's sternocleidomastoid.  Not everyone in massage has learned anterior neck techniques, so I am very glad I had the ability to learn what I did.

On my second session with this client, I began to realize that the tremor naturally associated with the Parkinson's disease would subside when I was performing the gentle effleurage strokes to warm up the tissues I was about to work.  As I worked nearer to the client's painful areas or a trigger point, the tremor would return.

For someone with Parkinson's disease, it was a welcome relief to not be shaking for even a little while.  Tremor is exhausting.  This was such a pivotal moment for how I treated my clients.  I learned to watch for cues.  The change in breathing, the smallest twitch of a finger or a wiggle of a toe were sometimes the only clue I had regarding a client's pain level.  I always tell my clients I can feel your problems but not your pain levels, so please let me know if you want less pressure.  

Fast forward to my early career, where clients wanting deep tissue really just wanted painful pressure because they believed that was the only way to get a therapeutic effect.  Finally one client prompted me to research neuromuscular techniques and I shifted my approach.  I went back to that moment in school, with the client with the stooped head, and I began to work with the body instead of against it.  

My style has evolved over all of these years, the techniques I've learned have grown, but those foundational moments in school truly shaped me as a therapist.  I'm forever grateful for that client, their tremor, and their feedback after all of the bodywork sessions were done.

After the three sessions, my client reported back to me that I was the first student who had performed intercostal work, despite that being the training module we had just learned, I was the first to attempt longus colli work, and I had created the most amount of change in my client's head and posture.  I will never forget them, their pain was my teacher.  

If you're ever in Las Vegas, feel free to look me up, I'm glad to treat people with the gift of massage, it has changed my life for the better.