(Name and certain personal details have been changed to protect privacy)

Jean came in at the encouragement of her daughter. At 84, she had a hip replacement surgery several months ago, and her hips, lower and upper back, and neck were all in excruciating pain.

She has developed many compensation patterns to avoid placing weight onto her right side, where the surgery was. She walked with a cane, taking very small steps, and needed my help to get up the one flight of stairs to my office. Every movement caused her to wince.

Jean told me that she has had many massage therapy treatments in the past, but did not find them helpful for any sustained length of time. Soon after a massage, the pain would inevitably come back.

I thanked her for giving it another try. I then described Thai Muscular Therapy. I explained that we will be working on the floor, that she can keep her clothes on, and that this technique involved a lot of passive joint movements, joint mobilization, and stretching, as well as point pressure work such as trigger points and acupressure points. Jean looked very doubtful. I assured her that she would feel better after the session and the effects usually lasted longer.

I helped her settle down on her back on the soft Thai Massage mat. Starting with some reflexology points on the feet, we discovered that a lot of the points leading to the spine and her digestive organs were very tender.

The surgery was on the right hip, so I worked the left side first to familiarize the body with the techniques and reduce any initial overprotective response. Range of motion was limited and many muscles were weak even on the ‘good’ side.

By the time I transitioned to the right side, Jean’s body was more receptive to the sensation of Thai Muscular Therapy. I was surprised to find how much range of motion was still available in the right hip. Her surgeon has done a great job.

Taking the hip joint through its various movements, I worked all the major points in the soft tissue around the hip. Sometimes, all that was possible was to place my fingers on the surface to induce an intense sensation.

Often, transformation and learning take place at the edge, such as the edge of the physical or emotional comfort, the edge of one’s flexibility, or the edge of a growth stage. At the edge, one can either take a step to the next stage or remain comfortable where they are and just breathe.

In bodywork, as in yoga, we work with edges to invite a transformation. As therapists, whether it’s Thai Massage, Neuromuscular therapy, or deep tissue massage, we take the body to its comfortable edge with the hope to advance that edge a little farther and a little deeper to create more range of motion and more comfort.

Keeping a gentle amount of pressure around the incision on Jean’s hip was indeed working at the edge. Jean reported that she could feel referred pain going from the hip joint all the way up her back as far as the neck. I followed these lines of referred sensation and discovered chronically contracted muscles and other tissues. We have discovered and explored many edges in terms of Jean’s comfort.

One session was not enough to address all of Jean’s concerns, but we started a journey. She felt better when she got up after the session, and seemed hopeful for the first time.

When she came back in a few days, she declared that she is stopping her physical therapy visits to allow more time for our sessions. She felt so much better that she decided to do the Thai muscular therapy work for a few weeks and to see what happens.

Several months later, Jean still comes in for her weekly appointments. She doesn’t use a cane anymore. Her back and neck feel a lot better, and her hip is much less tender with pressure.

The next two components in Jean’s healing journey are exercise and nutrition. Although our work is still continued, she is ready to find the next edge, to feel even stronger and healthier.

Slava Kolpakov, LMT, is the founder of East West Massage Boston and East West Massage Cambridge. He teaches yoga, sees weekly Thai Massage clients, and leads yoga retreats

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