CASE STUDY #1
**** is a thirty-four year old man who lives with his fiancée in the town centre of ******. He is the bar manager of a local venue and is a singer in a rock band. He is a very busy man and seldom has time for himself. He decided to come to massage to get some time to relax and get away from the worries of the world. His job is very stressful as his boss puts him under a lot of pressure. He also finds dealing with drunken customers very stressful and often ends the night with a headache. He doesn’t get much sleep ( about six hours a night at the most) because he finds it hard to switch his brain off when he is trying to sleep and doesn’t have a day off. He is a non-smoker but feels that the smokey working atmosphere is having a toll on his lungs.
On average he does at least one gig a week with his own band. They play all over the country so he spends a lot of time travelling at the weekend. Although he puts a lot of time into the band, organising bookings etc he finds this very enjoyable. He does find however those things can get on top of him and he gets a bit overwhelmed.
Because of the amount of time he spends at work he gets little time to exercise. He was once very fit, he use to work on a building site, but would see himself as been very unfit now. He has put on a bit of weight over the last couple of years and is finding it hard to lose it as he lose his sweet stuff and eats a lot of microwave meals.
TREATMENT PLAN
Because **** has no serious health problems, and I found no areas of tension or stiffness, I intend to make ****’s sessions as relaxing as possible. I will put more emphasis on effleurage and petrissage movements and stray away from frictions and percussion. This will also help him with his sleeping problems. I will try to make the session as relaxing as possible to help him get some time away from his stresses.
I will encourage him to try to eat more healthily and try to take some exercise. I will suggest that he cuts down on his caffeine intake and try to relax a bit more.
SESSION ONE
**** seemed to be a bit nervous at the beginning of the session so I asked him what his concerns where. He told me that he had never gone for a massage session before and wasn’t really sure what was going to happen. I explained that he would be covered with towels at all times apart from the area that I was working on. I explained that I would start on his legs, go to his abdomen, followed by his head shoulders and arms. I would then ask him to turn over and I would work on the back of his body. I told him that if at any time he was feeling uncomfortable, tender or in pain to let me know. He seemed a bit calmer and relaxed after this and so we proceeded with the session.
Judging by the amount of stress that **** is under form work I was expected to find areas of tension in his body. However over the entire message I found no area of significant stiffness or tension. All his muscles seemed quite relaxed.
For homecare advice I suggested that he cut down on his caffeine intake as this may be a factor in his sleeping patterns. I also encouraged him to drink plenty of water as he drinks very little to none at the moment. I also suggested that he cut down on his sweet and biscuit intake and try to eat a more balanced diet.
SESSION TWO
I asked **** how he had gotten on after his last session and he told me that he had a great and long sleep that night after the session but was back into his normal sleep pattern after that. He was still feeling very stressed about work as a lot was going on. There was work been done in the venue and it was behind schedule and his boss was putting a lot of pressure on him.
During the massage when **** turned over onto his abdomen he feel asleep nearly straight away. Again during the session I didn’t notice any areas of significant tension.
After the session **** told me that he felt really tired and a bit worn out. For home care advice I suggested that he should cut down on his caffeine especially before he goes to bed or late in the evening. I also suggested that he try not to think about work related stuff before he goes to sleep. He should try to put all thoughts of work out of his head until he is in work. Perhaps he should take a walk in the evenings to clear his head.
SESSION THREE
**** told me that he once again had a great nights sleep on the night of the previous session, but was still finding it hard to get a long night’s sleep after that. He also told me that he had headaches all week, they where mild and dull but nearly constant.
The whole way during the session **** was restless, and was constantly twitching, scratching and re-arranging himself on the couch. I asked him if he was uncomfortable or if the room was too hot or too cold but he told me he was fine. When I pointed out that he was moving about so much he told me that he couldn’t really relax as he had stuff on his mind. He had had an argument with his girlfriend earlier in the day and was finding it hard to put it out of his mind
I performed a lot of effleurage and petrissage movements on him and spent a lot of time on his back as he had told me that he enjoyed this area been worked on.
For homecare advice I suggested that he spend an hour or even half hour each day relaxing with no television, stereo or other distractions. During this time he should not think about work or his worries but just let his mind relax. He was still drinking a lot of coffee and told me he was finding it hard to cut down. He blamed the lack of coffee during the week for his headaches. He knew that it was withdrawal symptoms but felt that he just didn’t have the energy to go through them at the moment.
SESSION FOUR
**** told me that he had felt more relaxed this week. He had been taking time out each day to relax and not thinking about all his stresses. The pressure was calming at work and he was now walking to work each day to get exercise. He also told me that he had started listening to his favourite radio programme (The Goon Show) just before he went to sleep and this was putting him in good form and keeping his mind of things. He was sleeping better now.
He also informed me that he had bumped his left leg at work and now had a bruise that covered his left rectus femoris and Vastus Lateralis. I didn’t work on or around this area as he sore and tender.
I noticed that when I got to his left gastrocnemus muscle that there was a good deal of tension in it. I put this down to the fact that his upper leg was sore and that he was probably walking slightly irregularly because of this.
For homecare advice I suggested the same things as before. Cut down on his caffeine intake, cut down on his sweet/biscuit intake and try to drink more water.
CONCLUSION.
I was very surprised that **** didn’t have more areas of muscle tension in his body due to the amount of stress that he is under. He finds it very hard to get to sleep at night because he starts thinking about stuff when he gets into bed. His new idea of listening to a comedy show before he goes to sleep seems to be taken his mind off things and helping him to get to sleep. He is also spending some time each day to relax and take his mind of things.
He has also started to walk into work to get more exercise. He tried to cut down on his caffeine intake but started getting headaches from the withdrawal. This made his a bit agitated and in bad form so he went back to his normal daily amount.
I believe that if **** continues with his massage sessions and spend some time each day relaxing that his stress levels will be greatly reduced and his sleeping patterns will improve.
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