Post Traumatic Stress Disorder & Massage Therapy

Post traumatic stress disorder (PTSD) is the after effects of stress from a traumatic event, situation or accident. Massage is beneficial to people with PTSD for several reasons.

Firstly, lets have a look at a client with PTSD. A middle aged woman is in a moderately severe car accident and comes in for massage due to neck and back pain. The scalenes, trapezius and latisimus dorsi are all very tense and it feels like there are two iron cables running down either side of the client’s spine. This is the physical trauma left from the accident. Trapped within the physical trauma is part of the emotional trauma. The reason for this is that emotions are, in the Western medicine tradition, nothing more than chemical reactions. What happened in the accident was that the rush of adrenaline and fear activating chemicals got trapped in the muscles when the muscles tensed. The muscles never released enough for the adrenaline and other chemicals to move on, so they got stuck there.

It is important to understand this because when you start working on releasing the muscles, you are releasing the pent up chemicals and allowing them to at last start to move and flow. Depending on the situation, this may elicit an emotional or physical response from the client. This is perfectly normal, and it is important to let the client know that, as they may not be certain of what’s going on or why they are experiencing certain emotions. Sometimes, the reaction may not come until later that day or within the next few days, and may leave the client a little shaken. This is also normal and varies case by case. In the case of the middle aged woman, if the car accident had been more recent, the faster the chemicals will be released from her muscles, therefore the quicker the reaction. If she had been in a car accident several year ago, the reaction may be slower and it may take more work to undo the physical trauma.

The other half of the PTSD is mental and emotional. Depending on the situation, the client may have a habit or unconscious reaction when either remembering or being faced with a similar situation. The woman may find that after the accident, she is extra cautious while turning left, or may not drive on icy roads. The muscles which are the most likely to hold tension at the end of the day are the ones that she tensed in the accident, or those in relationship to the muscle.

PTSD is not always related to an event that happened to the person physically. It could have been an emotionally or mentally traumatic experience, such as watching a pet or family member die, grade school trauma, or verbal abuse. While nothing physically happened to the body, it can still affect the body and by working on the affected areas, you can assist the client. In grief, the body folds in on itself, chest caved in, head bowed, hunched shoulders. Awkwardness may be shown in side effects from trying to fit in, such as sore feet and ankles from poor footwear, or anorexia or overweight problems. Anger shows itself by puffing out the chest, sharp and/or glaring eyes, firm jaw set, tight muscles or a rigid stance. These are very important signs for a massage therapist to read as you work on the client.

The client may start talking to the therapist about their trauma either before the session, while on the table, or after. It is often best at these times to just listen to what the client is telling you, and to watch what their body is doing while they talk, because often times that will tell you if they have other traumatized areas or how they feel about something, and either aren’t telling you or don’t know how to say. [It is appropriate for a massage therapist to listen, but not to try and resolve these issues. Many massage therapists are able to refer a client to a qualified counselor if needed.]

PTSD can have a wide range of levels, from minimal (general physical tension and subconscious actions, like flinching or tensing) to severe (outcomes vary from client to client). Some clients with PTSD may be on medication, in which case, precautions should be taken. It is highly important to know which medication it is, why they are taking it, and do research on what the drug is physiologically meant to do and its side effects [so that a massage may be safely modified]. Other clients may be using tools such as exercise, breathing techniques, meditation, or other recreational activities such as drugs or alcohol to deal with their trauma. It is important to watch for signs of such tools due to health precautions, which will change depending on the client.

Massage can offer safe, professional physical reassurance and pain relief for those suffering from PTSD, as well as coping techniques, and a safe, welcoming place for the client to release the trauma from their tissues without fear of embarrassment or pressuring.

By Tonia Curry-Ohlsen
Massage Therapy Student