How Often Should I Come Back?

You’ve likely noticed something dramatic has changed after your first appointment and have asked, “How often should I come back?” I don't answer that question, because 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 did not get dramatic change, which is quite rare, there are insights within that will help you have a better understanding as to why, and what to do about it.

TL;DR - Default Protocol
If you don't want the details or don't have the time to figure out your own, unique return rate, then estimate an initial 1-5 visits spaced about 2-8 weeks apart before reaching peak maintenance of 1-4 times a year. 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 by the forthcoming details.

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

Density - of fascia
    Sensitivity - of neurological system
    Flow - of immune system fluids
    Lifestyle and Attitude <— this last entry often matters the most. 

Until Recently
I used to do the whole body in every session, no matter what. It was the healthiest, longest-lasting approach and also required for the kind of cleansing work I was doing then. It usually took a short series of sessions before people reached a “maintenance” state of 1-6 times a year. That type of work, while effective, also had a sometimes dramatic 72-hour, post-recovery time.

Today: More Concrete Answers and More Effective Techniques
Instead of the whole-body, layered approach, new methods allow me to zoom in and clear issues at their source, and the body does the rest. Our body's intelligence is superior, so I’m happy to let it do its job. And the 72-hours after? Goes much easier!
However, if the more modern approach doesn't get the usual results, which is quite rare, the original, full-body, full-cleansing approach is recommended.

The Goal
We should have one, mutual goal in common: Get to the point where you don’t need me except for preventive maintenance and injuries. And the preventive maintenance goal is as infrequent, yet consistent, as possible for your body's unique needs, something like quarterly or annually.

The Difficulty
Where you fall on the above four spectrums of density, sensitivity, flow, and attitude, 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: 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 “congestive” 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 clear before the underlying picture emerges.

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, contact me and let me know. In all my years of practice, I’ve seen this only a few times, and it deserves attention.
If I do bone work on you, the recovery period is 5-days. Bones are fascia, too, but due to their density and mineralization, the recovery period is longer. So, if you have any form of arthritis, figure on waiting 5-days before making any decisions.

The Next Few Visits
Most people require 1-3 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.

Symptom Tracking
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 longer 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.

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 be able to identify what your symptoms are so that you can track them. Examples might be: tension, range of motion, weakness, heaviness, asymmetry, or holding stress somewhere. Define it so that you can track it.

Pain Is Body's Last Resort
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 address the imbalance 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 or gentle lifestyle, for by the time pain sets in with these folks, reversing what is likely decades of buildup can be 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 as much or as often, or find it easier to make important decisions. Seriously. That's what my clients report.

Consistency
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 prioritize consistency.

Budgeting
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.

Reactive Types
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 proactive clients get.

Autoimmune Caveat
Autoimmune disorders throw a wrench into an otherwise stable healing system. There is no point in denying it. If you have an autoimmune disorder there is a cornucopia of reactivity going on, and almost all of it has to do with life history, lifestyle, diet, attitude, and coping mechanisms. A swift, blunt overview of tips can be found on an oldie-but-goody article about fibromyalgia that also applies to autoimmune disorders. As a sufferer of autoimmune disease, myself, I can often help in ways not found elsewhere. But the truth is this: Autoimmune sufferers have a "wolf in sheep's clothing" thing going on in their lives and in their bodies; healing for us requires mental and emotional strength and acuity that no one can do for us. And having someone who understands this, matters to our recovery. See also: Trauma Informed Care.
 
Prevention Motivator
Aging can be a potent motivating factor for shifting into prevention mode. Aging comes with too many surprises due to our culture's avoidance of talking about what's real. Whatever it takes to shift into prevention mode, be grateful, for prevention smooths out the harsher ripples of living!

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Originally published: 8/19/2014