Polio and whiplash

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packerfan

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I just started work on a new client today!  A 70 year old woman who has had polio since she was 16.  She was hit in the rear in an auto accident, last November and has whiplash.  Due to the polio her "traps" in the shoulder area are greatly diminished in size.  The rhomboids on the left  can not be palpated, the ones on the right are large and in spasm.  The "muscles" in the neck have also been effected by polio of over 50 years to the point that when she touches her chin to her chest, the neck muscles can not pull the head back up and she has to arch her back to move the head into position.  Your suggestions on how to treat her would be greatly appreciated.  If you need more info let me know.   THANKS....George
 
George, have you tried using bolstering to achieve any positional release?I had a client with post-polio syndrome while still in MT school, but she did not have the additional issue of having been in a recent MVA. Do you work often with MVA clients?  Is there still a lot of inflammation and guarding, or can't you tell?I thought I might also suggest you mention this problem over @ the http://www.massageresource.com forum as there is some crossover between the two boards. But some hang out there that do not visit often over here, and vice versa.
 
ok, that is a really hard client.  Primarily you have the major issue of dealing with the polio, the MVA is secondary unfortunately.  I am assuming that you have gotten her MD's approval for treatment, if not, you need to assertain what damage was caused by the whiplash, where she was sitting in the car and how the car was hit.  Unfortunately the stability of her posture and muscle control will greatly affect everything that you do, and due to the atrophy and the way she controls her movements it will be very hard.  As for the whiplash, if she was rear ended, and was sitting in a forward position her SCM's most likely have some degree of tear and the traps etc in the posterior were stretched, and from what you describe her anterior neck muscles are contracting due to the lack of tone in her posterior.  There are probably a ton of TPs in her anterior neck.  So getting back to the polio, use your spastic, flacid paralysis rules as it applies and do your best to help out with the damage that was done by the MVA, especially if I am assuming that this is a new client and you never saw them before the accident.  The best thing to do is to try and find out what events (posturally) have changed since the MVA, and do your best to help relieve whatever additional contractions, TP's and pain relief she has otherwise.
 
Polio and whiplash

I'm assuming you mean post-polio syndrome?

http://www.ninds.nih.gov/disorders/post_polio/post_polio.htm

If PPS sufferers are overweight or live an unhealthy lifestyle, it can progress quickly and leave them swollen and bedridden.  If they eat healthy and take good care of themselves, it can plateau and not progress further for years.

I would treat her just like any other client who's been involved in a MVA, but keep in mind that she may initially have more pain a day or two after the massage and she may have a much longer recovery time from her injuries.

Katykangaroo
 
Pandora,I have no knowledge base or experience with "spactic, flacid paralysis rules".  Would you please explain or perhaps cite a reference that I may go to.Thank you   GeorgeKaty K,The client states that the atrophy is from an earlier incident with polio,  she was recently evaluated for post-polio and was told that was not the problem...her age could be catching up with her and/or arthritis may be coming on and may be part of the problemat ..Plus the auto accident.  She also feels the whiplash and its related problems is getting worse.   She does not want to see a physical ther.  and stated that she was in more discomfort after her visits to the PTAlso, she is not overweight.   Thanks George
 
UP-DATEI have had 3 sessions with the 70 yr old polio/whiplash client...I am using a body cushion with her and she is on her back,  with the cut out section under her neck she is able to support her head and I am able to  work the back  and side of her neck in this fashion.  She states she feels supported, relaxed and quite comfortable in this position.  At the end of the sessions I have been using biofreeze.   So far it seems to be getting some results or at least some relief.George
 
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