How Often Should I Come Back?

This entry needs to be updated to reflect the changes in my practice since the pandemic. Having said that, the points are still valid, although how they are carried out is still in the process of being reconfigured. Thank you for your understanding. ~ Paula

You’ve likely noticed something dramatic has changed after your first appointment and have asked, “How often should I come back?”
  When it comes to setting your ‘return rate’ - I'd rather you decide your health and wellness priorities. This article is my guidance gift to you; please use it to your fullest advantage.
  If you don't want to read further or figure it out on your own, then estimate an initial 1-5 visits spaced about 2-8 weeks apart before reaching peak maintenance. If your symptoms return sooner, come in sooner. If your symptoms return later, come in later.
 Healthy clients with no health or pain complaints would benefit from coming in annually or quarterly for maintenance and prevention.
  But I think you’d be best served if you read on...

No Protocol Fits All
​Every ‘body’ will respond differently, depending on where you fall on these spectrums :

Density - of fasciae
    Sensitivity - of neurological system
    Flow - of immune system fluids
    Lifestyle and mindset <— this often matters more than the others. 

Until Recently
I used to do the whole body in every session, no matter what. It was the healthiest approach and also required for the kind of deep work I was doing then. It usually took a short series of sessions before people reached a “maintenance” state of every 6-8 weeks. That type of work, while effective, also had a sometimes dramatic 72-hour, post-recovery time. In other words, it could be exhausting for both clinician and client.

Today: More Concrete Answers and More Effective Techniques
Instead of the whole-body, layered approach that got most, but not all, of the root level issues, I can now more quickly identify and clear issues at the roots, and the body does the rest. Our body is generally wiser than we are, so I’m happy to let it do its job. And the 72-hours after? Goes much easier!

The goal
We should both have one, mutual goal in common: Get to the point where we have taken care of the whole body, roots of the issues and all, so that you don’t even need me, except for a maintenance dose that is both consistent and yet infrequent, like quarterly or annually.

The Difficulty
Where you fall on the above four spectrums and how your body responds - not my opinion - are going to be the determining factors in how many sessions may be needed to reach your unique maintenance level. I’ll usually let people know if something is slowing the process down. One common example amongst many: If your fascia is super condensed (reactivity is slow) or your neurology is super sensitive (reactivity is high,) it’s going to slow the process down.

The first visit
The first visit is not necessarily the one to judge by. Most first-timers coming in for my brand of therapeutic bodywork have years of “catch up” needing done. In other words, there is generalized “congestion” buildup that can act either as a smoke screen for underlying problems or as the trigger for them. Once the congestion is cleared out, what is left can now be identified as a core issue and addressed. Sometimes, it takes a few 'first' visits to get the congestions cleared and for a clear picture to emerge.

The 72 hours following the first visit
How well you feel during this time is what matters most in the beginning, so please don’t make any decisions until after the 72-hour mark. If you didn’t feel well, that’s a sign of needing to return a bit sooner, not later, but almost never sooner than a week. If you don’t bounce back by the 72-hour mark (wait for it!), contact me and let me know. In all my years of practice, I’ve seen this only a few times, and it deserves attention.
  Note: Those clients whose issues are sprouting up 'from the bones' and who require bone-level work, may notice a 5-day recovery period. Bones are fascia, too, but due to their density and mineralization, the recovery period may take a little longer. For example: If you have any form of arthritis, figure 5-days.

The First Visit(s)
Most people require 1-5 visits before determining what symptoms have permanently left versus symptoms that come creeping back. These are the visits that occur before a maintenance level can be established, and are also what helps determine what maintenance level might be right for you. So, please keep track of how long it takes before symptoms return. If a discomfort returns within hours or within a few days, then you either have an acute issue that needs attention sooner rather than later, or your issue goes deeper and therefore requires deeper work then may have been done at the first visit out of caution. If a symptom takes longer to return, you can wait to return. However, waiting too long after a symptom has returned is like starting over! So, it is important to keep track of any returning symptoms, when they returned, and what might have triggered their return, if anything.
  In summary: The length of time it takes for a symptom to return is the best determining factor for the timing of the next visit or next few visits. In other words: Shortly after the return of unwanted symptoms is the best time to return. However, have no fear: At Paula's Body Shop, much effort is made to get to the root of your symptoms in order to reduce your need to return. Paula loves her clients, which means she'd rather not see you too often!

Regarding symptoms 
The things that bother “you” are the symptoms you want to watch out for. What bothers one person may have no impact on another, so first be able to identify what your symptoms are so that you can track them. Many clients are concerned about tension or range of motion or weakness or heaviness or stress or peace of mind. Just define it so that you can know it and track it.
  When possible, please don't define pain as the only symptom to care about. Excluding a sudden accident, pain is your body's last resort to get your attention after imbalance has been building, often for years. You want to get to it long before pain sets in. That's real prevention. Those who are neurologically more sensitive, will have no trouble not waiting for the pain to set in. Those who are neurologically less sensitive (or like me, are proud of being tough in spite of being hypersensitive) are cautioned to live a preventive lifestyle, for by the time pain sets in with these folks, reversing what is likely decades of buildup becomes a monumental task.

The cumulative factor
Therapeutic bodywork is usually cumulative, so over time, even the initial schedule may change: What might begin as a biweekly schedule may in just two visits morph into a bimonthly cycle! That's because when we succeed in giving the body what it needs, it's doing a lot of the work for us! By this time, don’t be surprised if you belatedly realize you don’t get sick much any more and find it easier to make important life and health decisions. Seriously. That's what my clients report.

The financials and schedules - Maintenance Level
Part of the reason for setting up a maintenance schedule, once we have attended to the root issues, is because the body appears to prefer consistency and responds accordingly. This is a pattern I've noted over the past two decades, so for your sake please put consistency up-front where priorities are concerned, whether pre-maintenance or after.
  After doing the work to determine your maintenance needs, you may discover that your body needs monthly sessions, but your pocketbook says otherwise. Fine. Decide what you can afford to put into your budget for therapeutic bodywork each year and then divide it evenly. Can only afford to go twice a year? Then go every six months.
  Consistency is best versus waiting until something happens. (For those who would like help with the financials, see The Fine Print for referral incentives.)
  Regardless of the importance of consistency, there are people, and I am often one of them, who are not going to make an appointment until there is something that needs fixing. That is fine, too. We all have our own priorities in life. This therapist is not going to judge you. However, please don't complain to your therapist if you aren't getting the results that most clients get.
  One thing I've noticed ... Aging can sometimes be the motivating factor behind shifting into prevention mode. Aging comes with too many surprises due to our culture's avoidance of talking about what's real with us. Yet, whatever it takes for a shift to prevention mode, be grateful, for prevention smooths out the harsher ripples of living!

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Originally published: 8/19/2014