NMK part 2

1. Induction - Considerations for Treatment Framework whilst
Massaging at No More Knots

2.  Introduce yourself in a friendly manner – tell them what your name is when you are looking at them and
smiling!!
 Show them through to the cubicle and tell them to make themselves comfortable while you run through
their chart with them

3. Don’t be rushed! You only get one initial consultation, so make it thorough!! Find quantitative
measures that you can retest.
Do as many tests as you need to, to establish a treatment regime, based on the complaints listed on
their chart.
Establish if what they are complaining of, they actually want treated – ask them “So what is it
that you would like me to work on today?” This may be entirely different to what you are assessing
them for – your assessment has not been wasted though!!!!
Summarize your treatment regime with them, and the things that you are going to try to cover
during the massage, LIST THEM OUT and ask them if they are happy with this. Suggestion: “OK,
so today I’ll work through your….,
 is there anything else that you would like me to look at?” (or)
 “How does that sound?”
Give them clear instructions when you ask them to get onto the table about
where you would like them to lay eg. “If you could please lay face down with
your head in the hole, I’ll give you a chance to hop onto the table, and I’ll
just pass your chart on to the girls at the front desk”

4. Be task orientated when you leave the room so that the person feels that they have enough
time to get onto the table without rushing, or making you wait for them. Other things to
tell them when you are out of the room are:
“I’ll just put a heat pack in for you. Take your time.”
“I’ll just go and wash my hands, take your time.”
“I’ll go and give your chart to the girls at the front desk”
DO NOT LEAVE THEM THERE TOO LONG. This is not a time to SMS or read the paper.
When returning to the cubicle, begin speaking to them before getting to the cubicle so that
they know that you are on your way back.
Suggestion: “Let me know when you are right, (patient’s name)”.
If they are not ready: “I’ll be out here stretching, so just let me know when you are ready!”

5. How is the pressure? Too hard/ too soft? – Often they will not tell you if your pressure is
inadequate. Give them complete permission to let you know what they want!
Suggestion: “Often people don’t let us know if they aren’t happy with the pressure, because
they don’t want to hurt our feelings or complain… but fortunately I’ve got big shoulders! I
want you to be completely happy with what I’m doing with you, so let me know at ANY
stage, if you want me to adjust the pressure or how I’m working. OK?”
 Are you too hot/too cold?
 Are you comfortable?
 Would you like a pillow?

6.  Consider if you would start them on their back or front – starting them lying on their
back allows you to establish eye contact and build a rapport. Consider if they will have
bad towel marks on their face prior to returning to work – perhaps ask them as they will
be grateful to have the option!!
 Tell them what you are feeling in their body and what you think it means!! Start to
problem solve with them reasons for their muscle tightness or dissymmetry! Discuss
things like work related jobs that may contribute and how they might modify or stop
them. Talk about postural awareness and what they should be concentrating on, and
base your exercises and stretching around this. If their complaint is being primarily
driven by something you are unable to treat, then REFER them with confidence to other
HCP’s with a letter or phone call or fax!
 Retest throughout the treatment. If you retest throughout you have the ability to alter
you treatment if it is ineffective. If effective, you have the option to pinpoint which area
responded in what way and refine your treatment for the next session with clarity

7. OUTCOME: Within the last 10 minutes of the end of their session,
begin to outline your findings during the session. i.e.
 What was tight
 What felt good
 What needs further attention next session
 What their program of treatment you think should be from here.
 What they can do for homework to help them help themselves
 How long you think it will take to get them on to the path of
recovery etc.
Summation: “OK, I’ll go and wash my hands, and I will let you hop
up slowly. You can get changed, and then I’ll show/give you some
exercises/stretches to take with you. Take your time.”