Ep 559 - Skull Fractures and Failures in Communication: "I Have a Client Who . . ." Pathology Conversations with Ruth Werner

A client asks for a specific technique on their face. They have a bad reaction. Then they say they didn't want work in that area anyway, and by the way, they had a skull fracture four years ago. Now they're leaving because they feel a migraine coming on.

The therapist is left wondering what just happened.

In this episode of I Have a Client Who . . ., Ruth unpacks this interaction, what may have been going on for the client and their bones, and takes a closer look at where things started to break down.

Has this ever happened to you? You're not alone.

 

Resources:

 

Cheatham, S.W. et al. (2025) "International Expert Consensus on Instrument-Assisted Soft-Tissue Mobilization Precautions and Contraindications: A Modified Delphi Study," Healthcare, 13(6), p. 642. Available at: https://doi.org/10.3390/healthcare13060642.

 

Instrument Assisted Soft Tissue Mobilization (no date) Physiopedia. Available at: https://www.physio-pedia.com/Instrument_Assisted_Soft_Tissue_Mobilization (Accessed: March 13, 2026).

 

Skull Fractures: Types, Treatment and Prevention (no date) Cleveland Clinic. Available at: https://my.clevelandclinic.org/health/diseases/skull-fracture (Accessed: March 13, 2026).

 

Handling Head Trauma | ABMP (no date). Available at: https://www.abmp.com/massage-and-bodywork-magazine/issues/winter-2025/handling-head-trauma (Accessed: March 13, 2026).

 

Coiled telephone cord tied in a knot on gray background.

Episode Hosts

Meet our hosts

  • Ruth Werner Photo

    Ruth Werner

    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 (available at booksofdiscovery.com), now in its seventh edition, which is used in massage schools worldwide. Werner is available at ruthwerner.com or [email protected].