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If you get a client whose back has "gone out," it can be a difficult situation. Too much direct interaction could worsen the spasm. Is there anything you can do to help?
In this video, we're going to address spasm in the lumbar/sacral region. I hope to address upper/mid back spasm in the future-just keep in mind that it can be difficult to deal with in the acute stage. With low back spasm, however, I find that I can prompt a reduction in symptoms pretty frequently. 60% of the time, it works every time.
Before you start, you may want to place a pillow under the client's hips, right at the level of the anterior superior iliac spines. This can be especially helpful for larger clients, and for those with a more pronounced lumbar lordosis. Ask the client to adjust the level of the pillow.
Once they're supine, an extra pillow under the knees can also increase comfort. Basically, we're trying to keep them closer to a fetal position during this massage. And yes, side-lying could definitely work well here!
The protocol for this massage is to start slow and broad, and to gently introduce more interesting stimuli as the nervous system acclimates to your contact. Because the area is likely "guarding," or recruiting other local muscles to protect the area of perceived danger, we need to soothe those as we gently start making contact with the area of greatest pain. Think of steam-rolling, or ironing the area out.
Check in with your client as time passes. Ask about pressure frequently, and make sure that the back isn't tightening up in response to your touch. If that's the case, it may be wise to discontinue work in the area for that session. It's just too reactive.
Other tips: Try pressure that goes superiorly toward the SI joint, starting from the posterior thigh. For some clients, this pressure will feel like more of a relief than the downward strokes that I demonstrate. Avoid rocking, especially at first. Pressure directed toward QL might be too much for this initial session, but it's something that could be addressed in the future.
Finally, consider working with the hip flexors in future sessions, and offering stretches for hip flexibility in all planes. I'll have a video on that soon.
Thanks for watching! Let me know if you have any tips, tricks, or protocols you'd like to share in the comments. Happy 2016 :)
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