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Read this report about four massage treatments performed on a female client

Case study number 2 from my portfolio, aimed to help students or simply people interested in holistic therapies.

This is an example of how an "Itec holistic massage case study" should look like. You will find a link on this page to case study one and three, plus links to my other massage lenses speaking about massage strokes and techniques, plus information about the history and origins of massage.

Good luck with your ITEC diploma!




Miss SDA is a female in her late thirties, and she works full time in a busy hotel bar in Mayfair, London. She is a bartender, and her job consists in welcoming the customers, preparing cocktails and keeping the bar clean and tidy. Also, because of the nature of the bar, which is very small, she needs to go several times a day to the ice-machine (located on another floor) with a trolley to collect ice. This process is difficult because the uniform provided at the bar (which is a Champagne bar) consists of a pair of high-heeled shoes and a designer's evening dress. This outfit is very uncomfortable according to Miss SDA.

She considers her job stressful as the bar is always busy and the customers very demanding. Another stressor is her work contract: as she is on a casual basis, she is often uncertain about her future.

She lives in South West London, sharing her accommodation with four friends.

During her time off she enjoys walking and shopping; she likes swimming and every time she has a few days off work she travels to the South of Spain.

She sought massage hoping to experience a reduction in the pain and muscular tension she feels in her back, arms, shoulders (especially right) and feet.

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Name Ms SDH


Telephone (Home/Work) CONFIDENTIAL

Emergency Contact CONFIDENTIAL

Where did you find out about my practice? Word of mouth


Doctor's name and address: CONFIDENTIAL

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Have you visited your GP or the hospital within' the last 5 years? YES

Reason: routine checks

List any ongoing health complaints and any medication you are taking: sometimes client experiences localised backaches.

Do you suffer from any allergy? N

Do you wear contact lenses? N

Permission to contact doctor yes


There are some contraindications to massage requiring medical referral or the client to indemnify their condition in writing prior to the treatment and some contraindications that restrict treatment

PLEASE UNDERLINE THOSE CONDITIONS WHICH APPLY TO YOU IF ANY. ¨ With medical, GP or specialist permission - In circumstances where written medical permission cannot be obtained clients must indemnify their condition in writing prior to treatment

¨*pregnancy *cardio vascular conditions such as thrombosis, phlebitis, hypertension, hypotension or any heart conditions *haemophilia *any condition already being treated by a GP or another complementary practitioner *medical oedema *osteoporosis *arthritis *nervous or psychotic conditions *epilepsy *recent operations *diabetes *asthma *any dysfunction of the nervous system as muscular sclerosis, Parkinson's disease, motor neuron disease, Bell's Palsy *trapped or pinched nerve like sciatica *inflamed nerve *cancer *postural deformities *spastic conditions *kidney infections *whiplash *slipped disc*undiagnosed pain *when taking prescribed medications *acute rheumatism.

Contraindications that restrict treatment

*Fever *contagious or infectious diseases *under the influence of recreational drugs or alcohol *diarrhoea and vomiting *skin diseases *undiagnosed lumps and bumps *localised swelling *inflammation *varicose veins *pregnancy-abdomen *cuts *bruises *abrasions *scar tissues- 2years for major operations,6 months for a small scar *sunburn *hormonal implants *abdomen-first few days of menstruation, depending how the client feels *haematoma *hernia *recent fractures-minimum 3 months *cervical spondylitis *gastric ulcers *after a heavy meal *conditions affecting the neck.



stress level at home 1 2 3 4 5 6 7 8 9 10

List the factors that make you feel stressed at home : no particular stressors at home, although sometimes sharing the accommodation can make the client feel stressed.

Typical breakfast: a black coffee with a croissant and jam or butter.

Food eaten more often? Favourite foods? : pasta, fish, Spanish and Chinese cuisine.

Do you pay attention to your calorie intake? (Y) (N) If yes, state your average calories intake UNKNOWN

Would you say you have a well balanced and varied diet?

The diet is varied but the client feels his diet is not well-balanced, as some days she eats regularly (breakfast, lunch and dinner), but this often does not happen when the client is at work, as she only has a few minutes break, or, when she is on her own, no break at all.

Are you vegan, vegetarian, or do you follow any particular diet? Please provide brief details N/A

What do you drink on a typical day? Water, wine, coffee.

List any vitamin or mineral supplements or herbs you take NONE

Average hours of sleep 7

Smoker? If yes, state how many a day 10

Do you drink tea/coffee? If yes, how many a day? occasionally

Do you drink alcohol? Occasionally

If yes, how many drinks/glasses a week? 2 to 4

Hobbies/leisure Shopping, travels

Do you do any sport? Swimming. How many hours a week? 2

stress level at work 1 2 3 4 5 6 7 8 9 10

Work pattern: day/night, shifts. Different day shifts. (14.00 to 22.00; 18.00 to 02.00)

List the factors that make you feel stressed at work:

Uniform, difficult customers, walking with high heels, fear of breaking bar furniture as tables and chairs are made of glass.

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To provide four full body massage sessions lasting approximately 1 hour each 1 week apart, to promote relaxation and relief from muscular stiffness, paying particular attention to the neck, back and shoulders. Also, I will include a longer foot massage, as the client states her feet and legs hurt.

The massage will be smooth and slow, superficial to start with, then increasing the pressure applied, to improve the elasticity of the skin, help decreasing tension between the muscles, reduce pain and restore flexibility; the movements performed will be deep and rhythmical, and the transition between strokes will be barely perceptible. The strokes used will be mainly effleurage, petrissage and kneading, combined with acupressure points, performed at a constant and unhurried tempo avoiding percussive movements on the painful areas, to help reduce stress and tension, and to promote a feeling of physical and mental well-being. I will then provide some practical advices about lifestyle and diet.

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Treatment Record


DATE: 07/ 03/ 2008

Feelings before treatment: the client feels a moderate pain in her right shoulder area and in the neck. Also, she complains about her back and feet. However she feels very positive about the massage and she believes the session will help her release unwanted tension.

Treatment given: Full body massage with light percussive movements, in order to promote total relaxation and well being, stimulate the blood and lymph flow. Petrissage on the neck and shoulders 10-minute foot massage with foot acupressure. I performed a slow and rhythmical massage routine, starting from the back, performing a longer petrissage routine in the neck and right shoulder area, then going to the back of legs, and a larger amount of time to the feet and ankles.

Therapist's observations: tension is perceivable in the client's right shoulder, where the muscles are tight and stiff.


Feelings during massage: the client felt pampered and relaxed throughout the treatment.

Feelings after massage: feeling of well being and relaxation. Increased micturition. The client says she feels lighter but empowered, as if a burden had been taken off her body.

The client feels positive after the first treatment, and declares that her stress level dramatically dropped. She feels relaxed and self-contented, and she tells me she is sorry the massage is over and she is looking forward to her next session.


I recommended the client to wear flat and comfortable shoes whenever possible, and clothes she feels at ease with. I also suggested her to use hand cream and body lotion on a daily basis, as her skin is very dry and needs to be constantly hydrated.


Ms SDH skin looked very dry and flaky. A larger amount of oil was necessary in order to perform the massage.


DATE: 14/03/08

Feedback from last treatment: the client felt relaxed and enjoyed her week-end off. During the week her stress level went back to normal, but her shoulder was less painful and she managed to sleep better since she had the massage.

Feelings before treatment: The client feels stressed and very tired after 5 consecutive days of work. She is happy to receive a massage and in a good mood because she will now have the weekend off work.

Treatment given: full body massage. Once again petrissage strokes in the cervical area.

Therapist's observations: I noticed less stiffness in the cervical area, and the client said that the pain in the shoulder had been milder since the last massage session. The condition of her skin had not improved, it was still dry and flaky.


Feelings during massage: the client deeply relaxed during the course of the whole session, drifting asleep and drifting back to consciousness

Feelings after massage: the client was happy as said that she felt less anxious at the end of the session, and her shoulder was not painful.

HOME CARE ADVICE/REFERRALS:I told the client to continue using a good skin moisturizer for her hands and body. I also recommended she uses a refreshing foot cream or gel, to soothe her feet and ankles.


As the client's skin is extremely dry, it was difficult at times not to interrupt the flow of the massage stokes, as I had to stop in order to apply oil. I find it hard to keep contact naturally when taking the bottle to apply oil, and I have to work on this and improve my performance.


DATE: 21/03/2008

Feedback from last treatment: the client felt relaxed after the session, however, after two days the pain in her shoulder returned. It was a mild pain.

Feelings before treatment: the client still experiences a mild pain in her right shoulder.

Treatment given: full body massage to improve relaxation of the muscular tissues and elimination of toxins and waste from the skin.

Therapist's observations: the condition of the client's skin had not improved yet. This is probably due to the fact that it is very dry and it requires time to become hydrated and lose its flaky appearance.


Feelings during massage: the client felt good and experienced a deep relaxation during the session. When the right shoulder was being petrissaged, the pain disappeared. She greatly enjoyed the foot acupressure and the back massage.

Feelings after massage: the client was deeply relaxed and took some time to get off the couch. She was thirsty, and once again, she wished the session could last longer.

HOME CARE ADVICE/REFERRALS:I suggested to apply body cream twice a day, morning and evening. Also, I recommended to use a delicate soap/batch cream or shower gel with ph5.5 not to alter the natural balance of the skin. The client must avoid any kind of brisk movement and must refrain from performing heavy duties. When she needs to lift heavy weights at work, I recommended she asks help to one of her male colleague, at least for the following few weeks.

REFLECTIVE PRACTICE: Once I started massaging the client I realised I was missing one small towel, however, I could not interrupt the therapy to go and look for one extra towel. I decided to use the towel I initially placed under the legs, to cover the client's breast at the end of the massage routine. It is imperative for a therapist to check that she/he has the entire equipment necessary to perform a professional holistic massage before the beginning of each session.


DATE: 28/03/2008

Feedback from last treatment: the client told me she had greatly enjoyed the previous session and that she was looking forward to receive another massage. She said that she had been trying to apply body cream regularly, and that she had drunk a lot of water during the previous week.

Feelings before treatment: the client is glad that she is going to receive a full body massage, and she believes she will feel even better at the end of the session.

Treatment given: Relaxing full body massage, to help the client free her mind from any unpleasant thoughts. I performed some light percussive movements; however, most of the massage routine I have chosen for this session consists of effleurage and petrissage.

Therapist's observations: I noticed that her skin condition had improved, as it was no longer dry and flaky.


Feelings during massage: the client enjoyed the massage and said it was beneficial. She entered a state of deep relaxation, falling asleep at times, then getting back to consciousness.

Feelings after massage: the client felt better, her muscles were more relaxed and the pain in the shoulder area had disappeared.

HOME CARE ADVICE/REFERRALS: I recommended she continues drinking plenty of fluids, apply body cream regularly and try to do moderate physical activity (e.g. walking to work or go to the gym), and avoid performing heavy duties.

REFLECTIVE PRACTICE: dedicating a larger amount of time to the back and the feet left me handful of minutes to work on the front of the body. I have to calculate better the time necessary to perform a full body massage in an acceptable amount of time ( 60 to 80 minutes).


Ms SDH greatly enjoyed her sessions, and from now on she intends to have regular massage treatments, at least once a month, as she is on a low budget. She feels that the massage sessions helped her to improve the condition of her right shoulder in a natural way, without taking medications or painkillers, which often upset the client's stomach.

The condition of Ms SDH's skin greatly improved over the past month, the combined effect of using body lotion, a mild soap and drinking more fluids helped keep her skin hydrated and smoother, and this was particularly visible during the course of the last session.

Reader Feedback

mfoot4u on March 12, 2012:

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mwater on March 10, 2012:

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viscri8 on March 21, 2011:

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