Monday, April 13, 2009

Head Cold Case Study


Read the following case study and answer the questions. Submit your answers in the Comments section. (Click on "Comments" below the blog. Type in your answer under "Leave your Comments". Be sure to include your initials and student number as part of your text. Click on Anonymous under "Choose an Identity", and then click on "Publish your comments").


It’s about 11am on Wednesday morning. The phone rings. Betty White would like to schedule a massage. She’d love to get in this afternoon if you can squeeze her in as she feels “achy all over.” One pm is available – that time works for her.


Betty enters your office with a facial tissue in hand. When you question her about it, she says that she began sneezing and having a runny nose yesterday – it must be allergies, but she doesn’t have a history of allergies, so she is unsure.


Looking at Betty’s face, her eyes were watery and she is so congested that she is breathing through her mouth. Prone position is off the table; Betty is already having trouble breathing normally, so you elect to massage her in a semi-reclining supine and side lying positions.


You begin asking Betty about other symptoms and she mentions a sore throat. After getting permission to palpate her neck for swollen lymph nodes (which you must avoid), you place your hands just beneath her ears and slide them under her jaw.


Betty’s skin feels warm. You suspect a slight fever. After explaining to Betty that it in her best interest to postpone massage, she seems upset and irritated.


  1. Are there other modalities you can offer Betty rather that Swedish or therapeutic massage? If so, which ones?

  2. Why are some massage modalities more appropriate than others in these cases? Be specific.

  3. When is Betty safe to receive a Swedish massage?

  4. Should she be referred to her doctor in the meantime?

  5. What are some home care suggestions to help her address her achiness, if any?

19 comments:

Anonymous said...

#14DH - Betty could be offered a foot massage. Maybe recommend she wait a week or so for a Swedish or Deep Tissue massage.

Anonymous said...

#25 CS
you could give her a foot, lower back , or hand massage. Because different massages work many other parts of the body. She would possibly be safe to go back in one or two weeks. I believe she should go to the doctor to make certain that the problem is allergies. At home she could drink more water, eat more healthy foods, and work out or walk every now and then.

Susan said...

How contagious is she? Do a little research about how common colds are acquired. DH and CS, join back in to the dicussion.

Anonymous said...

#8 DD
Since Betty has came to you with actual symptoms of a cold she probably has a virus infection in which she will have to let it run it's course. She is contagious and she will give it to you through skin contact and through her coughing/sneezing on you. I would explain to her she wouldn't be very comfortable laying on the table (expecially prone) because her nose would be running. In my opinion I would think it best to refer her to her doctor. I would do this in a very tactful way of course, because I would not wish to make one of the ladies from the Golden Girls mad at me.

Anonymous said...

#3 SB
I would say the same, you could offer her a foot massage. She should come back in a week or two and she should see her doctor for the sore throat it could be more then just a sore throat.

Anonymous said...

#13NH--Once the client walked in and I notice the symptoms I would suggest that she should postpone the massage and see a doctor instead. Her symptoms are flu like and could very possibly be contagious. No matter what massage methods I use, her coughing and sneezing can pass on what she has and jepordize me being sick and not able to work in the future.

Anonymous said...

#23LR- In case she is contagious you would not want to have much physical contact with her. You could do some energy work though, that way she would feel like she hasn't made a blank trip to see you. Let her know that she should see a physician if her symptoms get worse. Remind her to drink lots of water and possibly show her some self-massage techniques to hold her over until she is feeling 100%. Call her back in a week or so to check on her and see if she would like to reschedule.

Anonymous said...

#26 SV
She could get a foot massage or energy and just reschedule the Swedish or therapeutic massage for the following week or even the next week if she is still having pains.
Some modalities are more appropriate than others because you are protecting yourself from the sick area which keeps you from getting that sickness. If you are sick then you have to stay off of work until you are better.
It would be a good idea to see a doctor just to make sure it is or isn’t allergies.
Some home care suggestions would be drink lots of water to flush out the toxins, and take cold medicine

Anonymous said...

#10KF
If I would do any massage at all, it would probably be a foot massage or energy work. Most likely I would ask her if she would like to postpone and make an appointment with her regular physician. This way when she receives her massage she would get the full benefits from the massage. Also postponing the clients appointment would protect the therapist and other clients from getting sick. I would also suggest the client to take an epsom salt and baking soda bath to ease some of the aches and pain.

Anonymous said...

#10KF
I totally agree with #13NH.

#19JM said...

#19JM if i were determined to do SOMETHING with her, i might try some energy work or some reflexology to attempt to alleviate her symptoms. obviously, she shouldn't be lying prone because of her head/chest congestion. personally, i wouldn't work on her at all. i'd suggest she see her physician before trying to get a massage.
i'd briefly explain why i don't think it's a good idea for her to receive a massage today (i.e. can't lay prone, has a fever and flu-like symptoms, might be CONTAGIOUS). i might suggest vitamin C, echinacea, lotsa H2O and rest.
i would consider giving her a swedish massage about a week after she was completely well again...wouldn't wanna release more toxins into her already-ill body!

Anonymous said...

24 TS... If you know how to do energy work now would be a good time to use it. You could do back and foot massaging but I would try to reschedule. Betty would be safe to receive a massage when she in no longer sniffling. I would refer her to a doctor just to make sure that everything is ok. I could offer her some little massage methods at home to use, like using tennis balls to work out some areas in her back.

Anonymous said...

#9KF - If Betty came in with these symptoms, I would address her in a kind manner and let her know that since her symptoms may be contagious that we should postone her swedish or therapeutic massage until she is well. I could offer her a foot massage or energy massage. Because of body contact and her discomfort, some modalities are better than others. Betty's fever, sore throat, and achiness indicate the flu rather than a simple cold. I would suggest that she see her doctor. She should get plenty of rest, drink lots of fluids, and eat healthy until it runs its course. I might suggest self-massage techniques to help with the achiness in the meantime.

Anonymous said...

#5MC There's not much left to be said after reading everyone's comments. I would personally reschedule on a different day after the condition has been addressed by her PCP, if she were persist I may be willing to do lower body work maybe add a little aromatherapy to help with the sinus congestion...and offer some self help techniques for at home...

Anonymous said...

#18 AL
Since she doesn't know if it is allergies or a cold I would probabaly agree to some Reflexology which could help aleviate some of the symptoms, and Aromatherapy to help with the conjestion and open the sinuses. You could also possibly offer Theraputic Touch, Reikki Or Energy Work if the client were open to these modalities as these do not involve actual touch thus minimizing transmission of the cold if it is a cold.
I would suggest that she might want to see a Dr. just to be on the safe side in case it isn't allergies then he could possibly perscribe something to make her comfortable while she heals and that I would be happy to give her her swedish massage when she feels better and will enjoy and recieve the full benefit of it.
As for home care suggestions, I think she would benefit from the mineral bath we did with aromatherapy

Anonymous said...

#07CC
i would recamend that we not do the full body till shes better and just maybe work on legs feet and lower back

Anonymous said...

#11KG I probably would not do any massage work on her because she may be contagious. I would offer her to reschedule the massage for when she is feeling better after seeing her regular doctor.

Anonymous said...

#22JP i would not give betty a massage. you could be putting yourself at risk and getting your self sick putting your self out of work is the last thing you wanna do.
tell betty it would be better if you could reschedule her for next week. i would also suggest that she contact her regular doctor and seek medication if needed .

Anonymous said...

Betty has a fever. Can you massage someone with a fever? I don't think so. She's contagious and needs to be rescheduled. Recommend water and suggest seeing her doctor. The massage can be rescheduled after she is symptom free.
LB former student