not for everyone
I’m not going to lie. I’ve been hesitant to touch some of my incarcerated patients.
I should clarify. Shoulders, knees, hands, even feet are completely in the comfort zone.
But when it comes to backs and necks, it feels more personal. And more like something misconstrued as massage.
I don’t want my incarcerated male patients equating what I do as massage and thus see this as a reason to keep feigning pain so they continue to ask their doctors to refer them back to PT.
And yet, I know the benefits of human touch.
This is a population that would definitely benefit from a trusting human, therapeutic touch.
However, not everyone in prison wants to be touched. Some have been incarcerated so long, at institutions that don’t even allow females to be in a room alone with them, much less touch them. So, they feel uncomfortable being with me to begin with.
Additionally, their past experience with touch may not have been positive, so, as with anyone, asking permission is paramount.
Recently I felt it was time to try myofascial release on one of my older patients. It was about our 4th session in and he was doing ok with exercise but I recalled on assessment that his back muscles were very taught…..like years of built up tension. He moved and shifted incessantly like he had just been moving nonstop his entire life.
I asked if he was ok with being touched. Yes, he said. I worked on his mid to lower back while he lay face down. He was pretty quiet throughout so I had to keep checking on him.
When I was done, he said in his monotone, unemotional way, “that was about the best thing that’s happened to me in 30 years.” And not in a creepy manner, but in a tone of pure gratitude.
It felt a little heavy for me. I couldn’t help but feel a touch of sadness for him.
A similar thing occurred when I worked on the neck of another elder patient. He was from my Inmate #11 story. He shared that “it was much needed,” in a way only one could project if he had been down for 40 some years.
“I’ve never felt someone touch my feet that way, it feels so good.” He kept repeating throughout, with his eyes closed and his face full of relief, “it feels so good.” Again, this other patient commented, not in a suggestive way. It was literally the voice of someone that had literally never had his feet touched therapeutically. And I wasn’t even massaging his feet, but rather, I was mobilizing them.
And I will admit that touch is not always perceived in a positive way. I’ve had some patients that don’t feel comfortable at all (even though they consented to trying it) and I can pick up on those signs and sense it’s not going to be helpful in their recovery.
I often brush touch off as something passive that’s not going to carry over. Exercise and every day tools to use on their own will take one much farther over time.
But I’m starting to learn from this population of patients’ reactions to therapeutic touch….that even if it happens intermittently or even once, it can hit deeper than my intention of “mobilizing” the body.
And with the right person, it doesn’t have to feel suggestive or like massage. I know to keep my comfortable distance with certain individuals.
I’ve come a long way in a year and a half. I used to wonder how my fellow PT colleague could feel so comfortable around her patients. Now I know.
*just to note, I’ll be leaving out the name of the institution that I work at. It’s a state prison for reference. Images are not from the prison as no devices are allowed in.
Prison PT 
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