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Author Topic: Re the girl who got a massage and ended up paralysed.  (Read 6230 times)

Steve Lockhart

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Re the girl who got a massage and ended up paralysed.
« on: November 13, 2006, 05:39:41 AM »
Last week on Today Tonight, a current affair show in Australia, they covered the story of a 21 year old girl who got a chair massage at her work and approximately 3 days later suffered a stroke which paralysed most of her body. After being a normal, young women with a bright career and future one day, she is now faced with spending the rest of her life in a wheelchair being cared for. Not the sort of thing you would expect to be the result of an innocent massage at your desk at work.

It was a terrible story for the girl and one that has concerned all massage therapists who saw it including myself, who previously believed massage was a very safe modality that would at worst cause some tissue bruising if not carried out correctly.

The coverage of the story, being on a commercial station, sensationalised things as much as possible, as they do, putting the fear into everyone who like their regular massage with comments like, ?This could happen to you?, but there is no getting away from the fact that it was a terrible tragedy for this young women.

I wanted to make some comments about the incident to reassure both people who like their massage and therapists who chose this career to help people and would be horrified if they caused this sort of thing to happen to any of their clients.

The story was, that after the massage the girl felt sore then later that night suffered from dizzy spells. These continued for a few days then one night she went to sleep and during the night suffered a stroke. Apparently a blood vessel was ruptured in her neck and stopped the blood getting to a part of her brain.

I think for this to happen there must have been some negligence on the part of the remedial trained therapist in question, in that he must have been quite aggressive with his work. But I also believe there must have been some pre existing condition the girl had that he aggravated rather than the damage being the result of the massage alone.

That would be of little comfort to anyone though as many people getting a massage would have some pre existing condition.

The main mitigating factor I believe would have been the fact that it was a chair massage. I am not a fan of them because I don?t believe they achieve any real lasting benefit for one and are more of a gimmick that brings the massage to the person?s office when they don?t have time to go to the therapist. Also putting a suit back on an oily body is probably not really desirable for many people.

Massage was designed to be done with the patient lying down where they can properly relax and the therapist can accurately feel what muscles are tight and what if any problems are in the body. Whilst sitting in a chair a person can?t relax their muscles properly and so to the therapist everything would feel tight.

One of the things I teach is that you don?t force tight muscles to loosen up rather you use diet and exercises to make the muscles more treatable and responsive to the therapist techniques but to determine the true state of the muscles you do need the person to be lying down relaxed and sitting for a chair massage doesn?t allow this.

Another important consideration with a massage is that you be thorough and not leave the person with areas half done or still in a condition where they can be a source of irritation and cause a worse problem. I suspect this was probably the case with this girl. With a 15 minute chair massage it is virtually impossible to be thorough and do a complete job, there simply is not enough time.

Unfortunately just rubbing the muscles is the very one dimensional aspect of many massage courses. They don?t properly train a therapist to accurately read a body and pick up when something is not right, thereby requiring either further investigation or a more complete treatment of 1 full hour when things can be addressed properly and thoroughly. Even for therapists who have developed good skills that go beyond what they are taught in most courses, a chair massage makes doing the job properly near impossible because of the fact a person can?t relax properly and there is not enough time.

So what?s the answer for the therapists out there who make a living with chair massage and don?t want to ever be put in the situation the remedial therapist who treated this girl now finds himself in? I would say better to sell the chair and do a 15 min massage through a persons clothes without oil, under a towel whilst they lie relaxed on a massage table the way massage was always meant to be done. That way you can more accurately assess the body and pick up any problems you come across especially around the neck area that need the proper full attention of a therapist who is confident about what they are doing.

Alternatively build on your skills so you can get results that enable you to get sufficient work so that you don?t need to do 15 minute office massages, but rather work with the traditional way of massaging where you can do a more thorough and complete job in the 60 to 90 minutes it takes. I suspect that had the girl been treated this way she would not have ended up as she has, at least not from the massage treatment.

In closing I would ad that this is only my opinion, which I give because quite a few people emailed and asked for it. I may be wrong with some of the facts as I only took what the TV show said as being the case. That in itself is dangerous I know.

Does anyone else have an opinion or a comment on this or a similar case they would like to share?
« Last Edit: November 13, 2006, 05:54:55 AM by Steve Lockhart »

JYork

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Re: Re the girl who got a massage and ended up paralysed.
« Reply #1 on: November 14, 2006, 12:22:52 AM »
Hi, my understanding from the article was that the therapist may have also got his elbow right into her neck, which I believe is not part of what we are taught to do, but in giving the poor guy a break as we don't really know all the facts at this point and he is being crucified by media - I believe the general belief is that there was most likely a pre-existing condition.

As someone who has worked in the corporate world for many years and been the receipient of these 10 minute massages at the desk, knowing what I know now - my advice to any therapist would be:
Don't do anything remedial on the client.  You don't have time and you haven't taken any history to assess for contraindications.  You never get asked any questions in this situation, other than "would you like a ten minute relaxing massage?".

A 10 minute light swedish around head, neck, shoulders and upper back is probably the safest you can do and if the client wants you to work locally and remedially, a full 1 hour Remedial session in your rooms should be recommended.   I agree that a ten minute desk massage is pretty pointless and gimmicky - but if the organisation asks for it as part of a morale booster and the therapists get extra business as a result of this, then I don't have an issue with it..everyone wins.

Steve Lockhart

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Re: Re the girl who got a massage and ended up paralysed.
« Reply #2 on: November 14, 2006, 02:41:20 AM »
In  the story the medie had a simulated vision of the massage as they told the story showing the guy working with his elbow and the client sitting in a normal chair back to front. I am sure this was just a re inactment and not an accurate demonstration of the way he actually worked.

Paul informed me that the ATMS journal will have an article on the subject in their next issue so I'll pass on the gyst of what thay say for those who don't get it.

Steve

NW

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Re: Re the girl who got a massage and ended up paralysed.
« Reply #3 on: November 14, 2006, 05:04:17 AM »
Hi and thanks to those who have shared their opinions about this sad situation. As someone who has worked for three years doing chair massage in office buildings I would like to add my thoughts. I certainly agree that therapists should refrain from doing remedial work in this situation as it is not necessarily clear exactly what state the body is in and also most therapists performing chair massage may not be qualified to do remedial work anyway.

I always do a health check before performing any massage. Clients are given a thorough screening and have to fill out a client information form. A follow up call is given with all new clients and if there are contraindications then the massage is not performed. On every new visit I ask if there have been any changes to their health and to refresh my understanding of any pre-existing conditions. When the client fills out the form initially there is a section which explains that they must tell me of any changes to their health including new medications and I explain this very clearly.

I do not perform massages in normal chairs, only in ergonomic massage chairs, which do support the weight of the body although admittedly they do not enable a person to relax as fully as if they are lying on a table. I refuse to do massages whilst people are still working I don't see the point. Also you have no way of gauging how the client is feeling if they are moving, and I won't do massages in normal chairs because it does not enable proper use of body mechanics and in the long term could easily end up damaging me.

I would dispute the idea that chair massages are gimmicky and ineffective. I feel it depends on the approach. Personally I spend extra time with clients discussing posture, work station setups and their general levels of stress. I strongly encourage them to seek extra treatment when they need it and provide the details of therapists I use personally.

Chair massage enables people who would not normally feel comfortable having a full table massage to try massage. I have massaged hundreds of first time massage recipients who have said that they wouldn't feel comfortable having a table massage. Six months to a year later many are having regular table sessions and loving the benefits. Chair massage provided a safe environment to become familiar with  the benefits of massage and the added benefit of bringing people's awareness back onto their health on a regular basis.

I think that people need to understand that chair massage is primarily for relaxation and that as a therapist you have an opportunity to encourage awareness and pursuit of extra treatment. I tell my clients clearly that I will not be able to sort our their problems in the chair, that the primary purpose is relaxation.

massagepoohbah

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Re: Re the girl who got a massage and ended up paralysed.
« Reply #4 on: November 14, 2006, 06:22:01 AM »
I truly feel for this woman and sympathize with her situation.

However, the reporting on the incident irresponsible and unfortunate. Notice that she only has symptoms two days after the massage and the acute stroke four days after, yet they tie it to the massage she had.

We all know that stroke is one of the leading causes of death, so it's not unusual for someone to have a stroke. And the causes is not always well defined. An idiopathic (no known cause) hemorrhagic stroke like this woman had is all to common. Even I was diagnosed with having a minor stroke a couple of years ago (at 40 years of age) with no known cause. 

Regarding the doctor's comment that they see serious injuries because of massage regularly is ludicrous. There are virtually no instances of harm mentioned in medical databases like Medline - anyone can search this database themselves online.

Here is an extensive review of reported cases of harm through massage:
http://rheumatology.oxfordjournals.org/cgi/content/full/42/9/1101#T2

Here it is in a table for easy reference:
http://rheumatology.oxfordjournals.org/cgi/content-nw/full/42/9/1101/T2

There are very few cases of reported harm. And you have to look at this in the context that there there are millions and millions of massages performed yearly by massage professionals around the world and likely millions of massage performed by lay people on their families or friends. Taken in context: More people are injured by falling coconuts than a massage.

If serious injury were to happen regularly or at all for that matter as the reporters paraphrase one doctor we'd be paying thousands or tens of thousands of dollars each year in malpractice insurance instead of the $200 per year most therapists pay now throughout North America.

The statement that "She [the association director] said more cases like this were inevitable unless national guidelines are set." is likely a loose interpretation of the woman's comments by this reporter and is not backed by data from the medial or legal research literature.

I'm certainly sympathetic to this woman's situation, but to tie the stroke to a short relaxation massage requires a huge stretch of the imagination. I'm sorry the media has to take a sensationalist approach like this.

Regarding other comments in this thread, chair massage is a very accessible form of structured touch. It works well as a relaxation modality, but there is no reason why rehab work can be done in the chair as well. Deep work to the neck including the use of the elbow is okay unless there are contraindications. It would be virtually impossible to cause a tear to the vetebral artery through manual work alone. There was clearly a pre-existing condition that caused the woman to have this stroke. The relationship to the massage is purely co-incidental.

I hope the media in an attempt to boost ratings has not discouraged people from using massage and I hope this does not affect anyone's ability to practice in Austrailia.

All the best,

Eric Brown, Director
http://www.bodyworkbiz.com


 

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