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Feb 24, 2023

A client is an adult man with spastic cerebral palsy. He has a Baclofen pump and is preparing for Botox injections. He’s also found a massage therapist who has the experience and expertise to help him—that’s amazing!

Understandably, the MT has questions about the Botox—what are the guidelines for manual therapy when this is used to treat spasticity? Well, that assumes that such guidelines exist, which is not a safe assumption. Listen to this episode of “I Have a Client Who . . .” for some thoughts about what to do next.




Books of Discovery:  



The Massage Mentor Institute:



Host Bio:        


Ruth Werner is a former massage therapist, a writer, and an NCBTMB-approved continuing education provider. She wrote A Massage Therapist’s Guide to Pathology, now in its seventh edition, which is used in massage schools worldwide. Werner is also a long-time Massage & Bodywork columnist, most notably of the Pathology Perspectives column. Werner is also ABMP’s partner on Pocket Pathology, a web-based app and quick reference program that puts key information for nearly 200 common pathologies at your fingertips. Werner’s books are available at And more information about her is available at   



Recent Articles by Ruth:       


“Working with Invisible Pain,” Massage & Bodywork magazine, November/December 2022, page 36,


“Unpacking the Long Haul,” Massage & Bodywork magazine, January/February 2022, page 35,


“Chemotherapy-Induced Peripheral Neuropathy and Massage Therapy,” Massage & Bodywork magazine, September/October 2021, page 33,


“Pharmacology Basics for Massage Therapists,” Massage & Bodywork magazine, July/August 2021, page 32,    






Pocket Pathology:


Adult Cerebral Palsy: Symptoms, New Challenges, Progression (2018) Healthline. Available at: (Accessed: 22 February 2023).


Adults with Cerebral Palsy (no date). Available at: (Accessed: 22 February 2023).


Botox, Orthopedic Surgery, Posterior Rhizotomy and/or a Baclofen Pump? – KAREN PAPE, MD (no date). Available at: (Accessed: 21 February 2023).


Cerebral Palsy Massage Therapy (no date) Cerebral Palsy Guidance. Available at: (Accessed: 21 February 2023).


Prevalence of Cerebral Palsy (no date) Available at: (Accessed: 22 February 2023).


The Many Faces of Botox (no date). Available at: (Accessed: 22 February 2023).


‘What is Cerebral Palsy?’ (no date) Cerebral Palsy Research Network. Available at: (Accessed: 22 February 2023).


About our Sponsor:


Massage Mentor Institute


In 2019, Diane Matkowski, aka the Massage Mentor, began a closed Facebook page for hosting discussions with industry leaders. These interviews gave her an idea for The Massage Mentor Institute and Jam Series workshops.

The goal was to create various continuing education classes offered in one spot. The Institute is a space for massage therapists to learn different approaches and philosophies of bodywork and business classes. It’s also home to the Shoulder, Hip, Neck, and Back Jam workshops.

We believe that no one technique works for every human being. Our goal is to help you find your path. We have selected teachers we trust, admire, and believe will help you grow as a licensed massage therapist.




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Instagram: @massagementorinstitute