I have seen quite a few sciatic patients over the years. One of the things that I love most about Thai Massage Therapy is that it synergizes the whole body, which creates more space for them to self-correct. We don't heal anything; the body does.
If you take ten people on the street, 6-7 of them will show abnormal MRIs, despite no pain. This is why I believe so strongly in the mind-body connection. I like to learn as much as I can about recent challenges that a client may be facing so that I can possibly uncover a connection to injuries that fail to heal. It should be an easy fix if a person's sciatica is obviously due to postural or activity-related challenges. But, for those who seem to have pain that lingers for months and possibly years, I like to learn as much as possible about what they've been through emotionally.
Frequently, I'll discover that people have been through tremendous losses before their sciatica flared up.
This module touched on the preliminary tests that can be used to identify sciatica, although those patients typically come to me already diagnosed in my practice. I love your point about what the tests can't see and what hands can. That's a great reminder for my clients and patients.
Hi Anna, welcome to the Thai Massage For Sciatica certification program. Please take a moment to familiarize yourself with our certification checklist to make sure that it is all correctly organized:
Also, I cannot find a certification registration form from you. We need that for our records so that we are sure to issue the certificate correctly. You can find this form by clicking on the 'Certification Information' banner in the sidebar of your membership portal. This will take you to our Certification Tutorial page. If you scroll down, you will find a section for certification registration - highlighted in red. Please fill out the form and submit it.
Aside from these technicalities, it seems that you and I have a very compatible approach to Thai Massage. I hope that you will find this course useful.
You made an excellent point early in this module, which discusses how Sciatica is diagnosed and how we, as practitioners, can test for it.
Clinical testing is frequently limited on what it can show. I take a much more holistic approach with my clients, and not only look with my "hands" for what is happening in their body, but I like to assess posture, how they are moving, what they do to stay fit, how they eat, and what, if any, major emotional issues they might have recently faced are.
As you surely know, the hips are major places for storage of stress, particularly for my female clients. I will certainly palpate the surrounding areas for obvious structural issues. When needed, I will also give them homework for energetically releasing old stories and negative thought patterns to supplement their physical work. I offer that only to the level I am trained to, and will frequently refer out to trusted professionals who can handle deeper work with trauma.
The most important thing is to realize that the body functions as a whole and not as any singular body part. That whole includes chemistry, hormones, and emotional pieces...not just mechanical. That being said, it's not terribly frequent that I'll have to perform a F.A.I.R test on most clients who come in with sciatica, as they've usually been already diagnosed by the referring physical therapist. I also find that a lot of when can have weak pelvic muscles or pubic bone dysfunction that can lend to overstretching of the piriformis.
I take this exact approach when working with most physical conditions. I take 10 or so minutes to get their whole body relaxed before honing in on the complaint they are seeing me for. I find that frequently this helps to be able to move their injured places easier and with less distress than I might be able to otherwise. People can have a lot of anxiety around messing with their hurting body parts, lol, and I think it's critical to gain trust and try to remove that piece first. The rocking techniques are certainly deeply relaxing. I will go to the neck and feet first too, sometimes because that can help them to relax too, with the intention of working up to their problem spot. The "wavelike" motions are far better than pushing, and people in my yoga classes find this so wonderful.
I use all these techniques when working on my clients. I am careful with percussion, but find it very useful. I recently started adding ashiatsu techniques in with my thai bodywork, and there are cool percussion moves that can be done by beating the fists on my own thighs that will transmit down into the client's body.
The positional instruction is very helpful. It's actually been very helpful to review this more thoroughly a second time, as some things I had forgotten! For the most part, this mirrors what I do with people. I also do table massage, and find most of these techniques to be applicable in all modalities.
I recall this video being very helpful with body positioning while delivering techniques. Unless we focus carefully on this, we can screw our own backs and knees up! I have always loved how Thai Massage gives back to the practitioner. Since correcting many of my own postures and body positions, I've managed to take very good care of myself and can do a better job on my clients as a result.
All the elbow work, and the leaning in and out while using my own body's rocking motion not only helps the client, but also ME to relax as well.
I am 53, and am rarely in pain or sore. I think it's because this is like doing yoga for both parties.
This was a technique that I had completely forgotten and I was so glad I had an opportunity to review today! I will practice this one on my husband a little later, but I can see how this will be a powerful move to release the gluteal muscles. This was a great reminder as well to elevate the foot when working on the hamstrings. That happens naturally when I am working on a table client, but I had not consciously done this with my floor clients necessarily.
The elephant walking, and the circular movement is something I LOVE, and picked up from you, Shama! I use that frequently in my table massages and clients love the deep pressure it delivers when I go heavy.
The last move can feel a little tricky to me sometimes. It depends on the body size of the person I'm working with. I have short legs and arms, and can't always seem to get this one right where I feel like I've got great leverage. So, I find myself lunging over them instead. It seems to work.
I do most of these stretches with my clients and think that's such a huge advantage of the mat work when you can rock a body gently through the motions. I can push the envelope or not, depending on how much anxiety they have with their pain.
I find it interesting that the majority of my clients who struggle with especially painful sciatica are men. I see women with this condition less frequently and when I do, it's never excruciating. I would guess that may have more to do with the likelihood that men may be lifting heavier things, develop in while working, etc. Women have different hormonal profiles that can help the hips relax too. But, they definitely tend to store more anxiety in their hips than men do. It's a ton of neck and shoulders with men in my practice, lol.
One of the ways that I work very hard to differentiate myself from other local massage therapists is by offering assistance in the areas of fitness, recovery exercises, diet, yoga therapy, mindset, and stress management outside of the massage itself. I frequently send detailed client notes with instructions on what to do and how to do it to each client.
I do love that you offer so many great stretches to your clients to help them. I believe in stretching and strengthening. For those who's sciatica seems to keep returning again and again, I recommend that they read "The Mind Body Prescription" to see if any of it applies to them. Almost always, short of a serious mechanical injury, a hip that doesn't heal has something emotional behind it. Technically, even those should heal too!
I've never had a Thai Herbal compress treatment done. Is the primary efficacy in the heat it delivers to the body, or do the herbs do anything special? One thing I love to do is to add heat and lotion through towels and ashiatsu techniques. It is excellent advice to take these tools and to build more tailored and unique healing combinations to treat individuals as needed.
I have some hypnotherapy training, and will sometimes engage my clients in that while I'm doing the bodywork on them. I think this can be especially helpful for those who have difficulty relaxing or carry a great deal of excessive emotional charge. I also use your method of having clients "talk" to their body part. This is very much like Dr. Sarno's method of "defying" the pain by telling the body part that it's unnecessary anymore. If there isn't an actual injury, the body will respond to it.