Category Archives: Tools of the Trade

Massage and the Full Sixty…

When I was new to doing massage therapy, I had a habit of getting lost. Lost in the neck, lost on the back, lost in the space-time continuum. I’d glance up at my clock and see that I had spent 40 minutes massaging the back and I had 20 minutes to do the rest of the body. Or worse yet, 40 minutes just on the headache, and had 20 minutes to get hands on everything else!
And, learning point, most massage clients will be unhappy with that schedule. People will rarely complain, but they may decide not to come back. All my enthusiasm to erase that headache would cost me the opportunity to gain a client. Drat!
It happened often enough that I found a couple of solutions, which I will gladly share, and I timedeveloped some hacks – ways to get the client to forget that I had just given an uneven massage.
Fasten your seat belts.
Ask – Let the client decide – “Would you like me to spend all of our time today on your headache or do you also want a full-body massage?” Guess what the answer is 90 percent of the time…Full-body.
The clock – I drew a circle on an index card. The first 30 minutes was blocked in red, the next 10 in blue, the next 8 in yellow, etc. I hid the card behind my oil bottle, right next to my clock. The red zone was for the back and posterior arms. The next 10 minutes for posterior legs and feet. Eight minutes for anterior legs, eight for anterior arms. Four minutes for head and scalp.
Keep the card in view and practice, and you will run on time.
Okay, so what to do when space aliens have stolen your brain and you don’t have enough time to finish a full massage? When fudgsicles happen, make fudge!
Swoop – Big, long, slow, wasting Swedish effleurages. Three swoops to a limb will still trigger the parasympathetic nervous system. A timeless coma will result.
Hide – Stay in the room at the end of the massage and hold up the client’s robe in front of your face and conveniently stand in front of the clock. Offer to assist by holding the robe while they slip in arms and stumble out. “Let me help you with your robe.” It works.
I don’t recommend what one therapist did to me one day at an otherwise nice day spa. She carefully pointed out the clock to me to show that we were running on time. At the end of the session I got up and looked over at an empty space. She had removed the clock!

Adding Magnesium to Massage

Got Magnesium?
Turns out that might be a great slogan for massage therapists – if they look both ways and proceed with caution.
Magnesium as a topical aid, and along with ingested and intravenous magnesium, has been used for a very long time in the treatment of muscular cramps and spasms.
Magnesium is the other side of the calcium formula. The movement of calcium ions out of a cell make muscles contract, while magnesium ions make muscle fibers relax. For people in the relax biz, magnesium could come in very handy.
And many folks seeking a massage are likely deficient in magnesium, possibly because we don’t eat enough of the sources – green leafy veggies, beans and bananas.
Should you add magnesium to a massage?
Well, let’s look at what’s out there.spray
Epsom salt soaks are our most traditional way of introducing topical magnesium. Many therapists make their own retail packages for client to buy or take home after a massage. A few drops of lavender or eucalyptus added to the salts and an organza bag, and the massage therapist has a take-home item for you.
But how many times do you see clients who cannot physically get in or out of a bathtub? Or don’t have a bathtub?
Epsom salt compresses are the next step down – but we all know compliance with this advice may well be zero. What client wants to wrangle wet and dry towels and plastic sheets?
Epsom salt lotions now readily available in most drugstores are another good solution. These do, however, use some pretty synthetic petrochemicals to get the hardy Epsom salts to stay in solution. Some clients don’t want that.
Oh dear, leave it to the healthy marketplace to find solutions.
Now when I head off to the vitamin health food store there’s a little group of magnesium topicals at the ready. And here’s the rub. Some don’t feel real good when applied to the skin.
My favorite one is magnesium oil spray, which is magnesium chloride. Yup, a salt. After a nice vigorous deep tissue massage on my professional test body, my spouse, I added a spritz to a tight shoulder. Immediately producing a stinging feeling described to me as rubbing salt on a wound. Run for the wet towels.
I like to use the magnesium oil spray on myself right after the shower. I tell clients to avoid it after shaving, to avoid the ouch factor.
After that experience with my professional test body I have never sprayed magnesium oil on an area post massage. I notice the makers were suggesting it as a massage oil additive, but after my experience with my unhappy test body, I’m not putting it on freshly massaged skin anytime soon.
Other forms of magnesium abound. I don’t go there with magnesium pills or drinks, largely because that’s not what I do. I massage, and telling someone to take something internally seems a bit out of my expertise area.
But for people who might need it for night cramps or diet deficiency I let them know it is out there, and they need to read and follow directions. Magnesium isn’t good for weak kidneys and in large amounts ingested magnesium is a super-dooper laxative!

Covering the Cradle

Some things about being a massage therapist are all about the details – the atmosphere, noise level, lighting, and yes the table linens.

Face cradle covers have always been problematic for massage therapists. The disposable covers are scratchy – and although no client has ever complained about them I have heard clients complain about other therapists who use them.
One fellow observed that he stopped using a therapist because of the scratchy covers. A comment I took note of.
Spas that have to worry about mounds of laundry at the end of the day – and costs – often use cotton hand towels. I have always found that kind of scratchy, too. I used pillowcases at first, and moved to soft paper/cotton towels for a time.
The fitted covers that come with sheet sets seem to be ill fitting for the larger, softer face cushions. After wrestling with the underwear-like elastic gathers on those cradle covers I finally threw in the towel.
Now I use a compromise on all fronts – soft, cotton flannel, flat cradle covers. These can slip around a bit but they do not have any seams to leave lines on the face and they are easier to fit over a face cushion. Less wrangling.
The cotton flats avoid the too-snug fit of elastic-edged covers and overcome the scratchy thing of disposables. At $5.99 apiece, the thought of stocking all flats has made me queasy, especially so because I suspect they will not be as durable as the undie-fit covers.
I found a site that would give me a wholesale discount and got 25 covers for about half. We will see if they measure up. So far, so good. The flats stack a lot neater and smaller. No more grappling in the linen closet for a good one.

Tools for Massage

As an “old hand” at massage, I am not too impressed with tools sometimes used in massage therapy. I have stayed away from knobbles and thumb covers and even hot stones in my practice, largely because they tend to create elbow and shoulder problems for therapists who are tempted to use too tight a grip.
One of my cohorts in a day spa had chronic extensor tendonitis from using hot stones, which eventually led to surgery on both forearms. It was a career-ending surgery. Rather than use the stones only in hot stone massages, she had begun using stones warmed in the towel cabby during every massage as an added treat.
I feel the pain, having had a 10-year bout with extensor tendonitis myself as a result of working an old computer keyboards at various newspapers. My flying fingers suddenly got stiff one day and the forearms had a toothache-like burn that never went away. It took years of therapy and ice to correct the problem.
Yet here I am feeling rather good about using a device in massages – conservatively – because I think it does some good for the client as well as the therapist.
I recently took a class with esteemed medical massage therapist Boris Prilutsky. He has been experimenting on using silicone cups as a negative pressure tool in massage.
What I like about this technique is that it is not the Chinese cupping. The Chinese method uses fire (scary to the clients) to create a vacuum and then leaves cups on an injured area or blocked meridian for several minutes. Skin is sucked into the cup, creating a bright red mark that can last for several days. Near as I can tell it treats by creating a secondary injury – inflammation and hyperemia – to draw healing factors to the region.
I have seen folks over the years with cupping marks and it has always struck me as not a therapy I would not enjoy doing or having done to me. But I have liked the effects of negative pressure when I have been treated with cups.
Prilutsky brought his massage skills to the table and presented a way of using soft cups made of silicone and very slight vacuum pressure over oiled skin. The technique lifts tissue over adhesed areas and seems to promote both lymphatic and blood movement.
And he advised us to use it slowly, sparingly, and with attention to not creating a tight grip and warring with the tissues.
Good advice, I think.
I’ve been trying the cups here and there on very “stuck” zones and I think it is a tool I will use. Carefully.

Travel Tips Redoux!

I love sharing travel tips with clients, as since they are classified top-secrets of the secret society Knights of the Massage Therapists, I want to share them with you.
Sciatica Roll: This can be a pillow, a rolled-up towel or jacket/coat. Use it for passive realignment in any airplane, car or train seat. Tuck it between your lateral quad and the armchair or seat console. It will reduce lateral rotation while sitting.
Instant Airplane Hot pack: I must credit one of my faithful clients for this one, and she learned it from an experienced flight attendant who deserves a medal. When you need a hot pack, fold over a dozen paper towels. Pour hot water from the tea dispenser over it. Put the folded towels in a barf bag, which is insulated from the inside. Warm moist heat for hours!
Headache Fixer Ice Pack: Even when traveling by yak, it is usually easy to find a cold soda can. Wrap in a paper towel or hanky or something, place at the back of the neck at the hairline. Try to keep it there for about two to five minutes. Also works on sore butts, smalls of the back, anywhere an icy pack is needed. Frozen bottled Guinness’s also work. Don’t ask about the story behind that. My memory is very fuzzy about that day.
Anywhere liniment: A tablespoon of Epsom salts in a couple of ounces of any clear cooking oil. Nuke for 10-second increments and stir until salts dissolve. I once made this in a 7-11. Can we be any more McGyver?

The High Costs (and High Benefits) of Hands

I see these huge automatic water massage machines on E-bay all the time. Discounted to about $20,000. Maybe on a bad day, discounted to $10,000.

The ads say wonderful things about how great they are and how much money you will save by not having to have a massage therapist do the massage.

I read between the lines: Please, please, someone buy this huge thing and get it out of my office.

One always wonders if the future is going to be automated by something robotic and unfeeling. Something that will never develop carpal tunnel, come in late for a full day of appointments or forget to order oil.

There are plenty of massage gizmos, and the water massage tables were the only ones I feel come close to doing what we therapists do.

Only they are humongous,  take 220 electric current, and are about as heavy as my car. They look like tanning beds on steroids and the lid closes down like a coffin.

Take heart, we haven’t been replaced yet. One electric bill, one repair bill and people want to get rid of these things.

Will swirling electric mitts, water jets or robots ever replace us? I don’t see it ever being possible to program the TLC of our chi into a machine.

Our humble little hands are safe. For now….

Wrapping Up a Massage with Tape

Lots of athletes showed up with their sticky strips showing at the London Olympics this year, giving the wide world of kinesio-tape a swift punch in the deltoid.
I do occasionally use the tape I dealing with massage clients, generally to encourage sluggish lymph, although I find it also helps with muscles that keep slipping back into spastic patterns. More sports stores are carrying the tape, making it readily available to all of us weakened warriors.
Neat stuff, really, although I warn other therapists to clearly think through their tapings to make sure they are following lymphatic vessels and major muscle groups. I have seen about 30 U-Tube versions of taping, some of them I swear seemed to be taping backwards or across lymph channels. The goal for these tapes may be more to create an awareness of synergy and balances in troubled muscle groups rather than enhance drainage. Or they are just wrong.

Also fun in the kinesio world, no one is really sure how it works. Lots of people are doing lots of studies, and thus far the best clues say that the tape pulls skin up and away from lymphatic vessels. That drains more lymph fluid than usual – as long as the person is moving the area actively by themselves or passively with the help of a therapist.

We therapists, of course, are at risk for some lymph related problems as we are often on our feet, moving but not doing full steps or cardio. A little tape up the calves or on the lumbar/QL works wonders for me. I have also used the hand stretch tape at night to improve drainage of the hand at the carpal area.

It would be nice to know how or why tape seems to help with muscle spasticity. Surely some silly hamstring or soleus should by oblivious to a strip of kinesio-tape. Yet there it is. Preventing spasms and cramps. Hmmm. It would be nice to know those answers….

Bottled Nerve-Amma

This massage therapist has long searched for the magnum of massage oils. Somewhere, somehow, there is an oil out there that will take inflammation, anxiety and tension out of clients.
Oils are not the only source of relief in massage, but I figure if there is oil out there, a certain blend, that will send people out to never-never land, I am going to find it.
My candidates:
·       Clear, cold pressed sesame oil blended with a touch of neroli, an essential oil made from citrus leaves. This is subtle, wafting, not-too-sweet and shifts people from drive to neutral. Fantastic scalp and face massage.
·       A tiny drop of sweet birch essential oil added to clear and cold-pressed castor oil. This is very thick oil for scruffy feet and elbows. The birch adds something refreshing between a mint-y and, oddly, an earthy aroma.
·       Myrrh, rose and sandalwood oils added to plain, uncooked avocado or rice bran oil. These pretty much lead to a coma, but I use these sparingly. As great as they are, these scents are often used for funerals. I don’t want any crossover.
·       Magnesium sulfate lotions added on the worst zone – at the last pass of a Swedish massage for fibro or workout soreness. I’ve also seen other therapists using magnesium and sulphers in moderation.
Do I seek the mythological fountain of relax? Yes. I could have a less noble hobby.
Now spill, so to speak. What is your favorite curare blow-dart oil for the highly stressed?