Visit my Web site - Become a FaceBook Fan

For more information, please visit my Web site: massage-stlouis.
Become a Face Book fan of Massage St. Louis and stay informed of classes, promotions, etc.


Thursday, January 22, 2009

A Reader's Question: Are Massage Therapists Fat Friendly?

A reader asks:
Are most massage therapists fat-friendly? Is it more difficult to do work on a fat person, and is it as effective for the client?

Thanks, Alice!

That's a good question and I'm glad you asked. I'm going to ask some massage therapists and see what they have to say about it. I can't speak for "most" massage therapists. Strangely, I don't recall it coming up in conversation so I don't know what other massage therapists would say. However, speaking for myself, I welcome anyone and everyone that I'm capable of accommodating. It pains me when I occasionally hear someone say that they'd like to get a massage but they are reluctant because of their weight. I want people to feel that my office is one place where they can feel good about themselves and accepted just at they are.

Please note: This article was written in January, 2009. Since that time I have learned some things about how massage works and about how the nervous system works that I didn't know then. My answer would be different now. I am keeping the article as it was originally written. However, I now know that we don't need to be able to palpate the muscles in order to treat pain. In fact, massage works through the nervous system. Receptors in the skin respond to our touch, send impulses to the brain, and it is the brain that makes the muscles relax or turns down the volume on pain. It is not direct pressure on the muscle. Therefore, it doesn't matter how much adipose tissue lies between our hand on the surface of the skin and the muscles below. This is good news.


I still welcome clients of all shapes and sizes and if I am unable to accommodate them for any reason, I am happy to help them find a therapist who can.  -
Updated 8/17/13 by Alice



It can present some challenges for the massage therapist and some of this depends on the type of massage that you are doing. If you are focusing on relaxation, there should not really be a problem since the work is more general rather than specific. However, if you are trying to work with a specific pain problem, can be more difficult for the therapist to palpate bony landmarks and to directly affect the muscles below. If the therapist knows their anatomy well, they can compensate for this diminished ability to feel the tissues by their understanding of anatomy. Further, since the nerves that serve the muscles also serve the skin directly over the muscles, we can have an effect on deeper tissues even if we cannot touch them directly. My personal experience is that if I focus, I can sometimes eventually palpate more than than I initially realized. So yes, can be more challenging but it is certainly possible.

As for the effectiveness, this is going to vary with the individual client and is hard to predict. My suggestion would be for a person to try it and see if they find it effective.

As long as my table can safely support a person, they are always welcome in my office. If my table could not support an interested client, I would find a therapist whose table could support them. I would hope that other therapists would feel the same. If they do not, then perhaps they should seek another profession.

Ask The Massage Therapist has moved to http://www.massage-stlouis.com
Please come and visit us there! You can follow us on Twitter at massagestl






6 comments:

Anonymous said...

Great answer! I look forward to seeing the other responses on FB, too. What is your table's weight limit?

Alice Sanvito said...

My table is supposed to be able to support a static weight of 500lbs. However, this does not mean it can support a person of that weight. When we sit on a table, our weight is not evenly distributed. When a client turns over, they will often push themselves on the table and so there is quite a bit of force behind that movement. I'd have to contact the manufacturer to find out realistically what it can support. I was provided that information when I bought the table but that was 18 years ago! I can testify that Earthlite tables stand up to 18 years of use.

After I posted that entry, the thought occurred to me that clients themselves would be the best ones to ask about what their experience has been. I've also posted the question in an online forum for massage therapists but since it's a very new forum, it's not very active yet. If I get any responses, I'll post them here.

Thanks so much for your comments. If you know anyone who has any questions, please invite them to Ask The Massage Therapist.

theotherlee said...

I am a former RMT, out of the state of Texas, but left the business to pursue other things. I have continued massaging friends and acquaintances over the years but am no longer "versed" in the techniques I learned/employed as a professional.

I am going to be visiting some friends for a few weeks, one of which is overweight, about 310 I believe.

In my practice previously I had not encountered many overweight clients and am sort of at a loss on how to perform the massage.

Are there any online resources that will help me figure out some good techniques for working on obese clients? I've done some searches, but nothing I have found has really given any direct 'instruction' that I could follow.

Any help or advice will be greatly appreciated.
Lee

Alice Sanvito said...

I have limited experience but I will share what experience I have. First of all, I don't see any reason to use any different techniques for general relaxation massage. They are non-specific and it's going to feel good to your client. It will feel different under your hands and that can be a little disorienting at first, but that's okay. Remember that it still feel very good to the client and that the receptors in their skin are just like anyone else's.

It gets tricky if you want to do more specific work and here is where you depend on your knowledge of anatomy. In my case, I had a client who needed work on their low back and hips. I could not feel their muscles directly as I usually could and barely could palpate bony prominences. However, I do know anatomy and knew where different structures should be. I used friction and some direct pressure over the affected areas, not sure if it would be effective. I reminded myself that the nerves in the skin over those areas affect the tissue underneath. When my client got up off the table, she could feel some improvement so it must have had some effect.

It's easy to feel nervous because you want to do something good for your client and you aren't sure if your usual approach will be effective. However, if you stay centered, remember your anatomy, remember that by touching the skin you are, through the nervous system, touching the tissues deep inside, all this will help you through an unfamiliar experience. Good luck and let us know how it turns out!

Alice Sanvito said...

By the way, I failed to answer your request about online resources. Sorry about that. I googled "massaging the obese client" and found some good comments. One pointed out that an obese client may not be comfortable on your table and she gives them the option of the floor. Photos are included. Another points out that you may need to lower your table in order to use good body mechanics. Check out the articles and you may find some very helpful ideas. Thanks so much for your question!

theotherlee said...

Thank you so much for the quick response.

As far as your google search, I think I found the same one prior to posting my question here, and you are correct, it does have some helpful information. I had actually already determined that working on the floor will be more beneficial to he and me both.

He does have a shoulder and upper back injury from an auto accident a few years ago, and that was the purpose for me initiating the massage in the first place.

My main concern was surrounding the amount of fat tissue and actually being able to affect the musculature underneath, but if you've had positive results from your clients then I'll take that and go with it.

I'll definitely post a follow up when I get back. Thanks again for the response!

Lee