Avoid Being a “Chatty Kathy” While Giving Massage

So, here’s an interesting conundrum: we all know to keep our conversation with clients to a minimum so they can have the most relaxing session, and yet, reports from those on the table abound of overly talkative therapists. No one wants to be a “Chatty Kathy,” but it happens.

Years ago, before I even went to massage school, I had a pretty good massage therapist who happened to decide that she liked me. Over the course of four or five sessions, I ended up learning everything there was to know about her boyfriend, her living arrangements, the health condition she had experienced, and her personal opinion about many politicians. When I showed up the next time, she literally said, “oh, good! You’re my favorite client!” And she started talking at me just like in the previous sessions. I said nothing. I kept my end of the dialogue as best I could while trying to relax, but I made a mental note to make this my last appointment with this therapist.

Why does this happen?

Clients do sometimes ask us questions like: “Where are you from?” or “How long have you been practicing?” or “Where did you go to massage school?” Social norms dictate that the polite thing is to answer them. And hence, we are drawn into a dialogue, but it doesn’t need to get out of hand.

In order to know when to stop talking, try thinking of that dialogue as a dance. One person leads, and the other follows. The person with the lead shows interest and asks the questions. Always let the client be in the lead position. If they ask how long you have been practicing, you can answer politely that you’ve been practicing for two years—without going into the details of where and how and that one funny thing that happened that one time with that first coworker who drove you so crazy…

While in general conversation it’s polite to reciprocate with interest and questions of you own, it’s vital, with a client on the table, to take care to avoid taking the lead. If you find that you’ve been talking for several minutes, chances are you’re shifting into the “Chatty Kathy” mode, which can be a real risk. The average client is too polite to tell you to shut up. They might even acknowledge your comments. They’ll never tell you point-blank that you talked too much for their taste; they’ll simply opt to see another therapist.

If you’re lucky, the therapist will be one of your colleagues, but if you are in private practice, you’ll likely never see that client again.

Massage Clients Need Training, Too

Most massage therapists charge by their time spent in a session, so dealing with client cancellations and no-shows is a particularly dear subject.
Big massage businesses just put their policies out there: 24-hour cancellation or full charge for the missed session. No appointment without a credit card to “guarantee a reservation.” It is a survival tactic that keeps the bills paid.
But what happens when the massage is not part of a big edifice of business complete with a receptionist to state the policy? Massage is a client-based business, after all. Can you afford to alienate a client for a missed appointment? Can you nicely charge folks for services not rendered? Is a cancellation policy a must or a risk for the small massage practice or clinic?
Those questions are an excellent place to start when considering your practice and its future. But keep in mind that massage therapists tend to be quiet, healing people who do not like confrontations, especially with those people seeking relief from stress. If you don’t have any policy stated up front, you may be in the position none of us healing people like: broke and behind in the bills.doormat
Aaargh. Yes, boundaries. Those darn things hopefully they talked about a lot in massage school. Is there a middle ground? Can a therapist walk the fine line between impersonal business policy and caring personal service? And still pay the bills?
This is a tough subject. Why? Because out there in the universe, most people are honest and upfront and understand that you need to be paid for your time. Then there are others who feel every nickel saved on a cancel fee is a personal victory attesting to their ability to avoid paying for anything. Yes, these are the legendary “cheap clients” who will turn your book into a sea of red ink if you are not careful.
Airlines and other big shops generally don’t give money back or reverse charges. They have found out the hard way that when a big biz is involved, many people perceive lying to not be charged or to get your money back is okay fibbing. Hey, the airlines can afford it, right? Well, not really. Big shops have to defend themselves.
The most important thing here is that if you have a “cheap client” with a great excuse is to get rid of them. A cancellation policy will do that. Otherwise these folks will suck your energy dry with no regrets.
Sometimes, yes it happens, the client is actually using the no-show as a way of firing you. It says in a big way that the client does not value the service. It means “cya.” Whatever is going on, this is the client you will be relieved to remove from your book. If that client ever calls again, they pay the no-show fee before getting a massage for their “emergency.”
In the big and small picture of customer service, I think it is important to respect your skills enough to have a firm cancellation policy. It can be full charge, half charge, whatever you want, but have it. And when a regular client who appreciates your work has a true emergency, it is okay to say “no charge.” That will be appreciated. After all, small business is personal, eh?

The Importance of Finding a Massage Mentor

One of the best pieces of advice that I’ve heard many times over the years is that if you want to excel at something, you need to find someone who’s already succeeding at it, connect with them, and try to learn from them. In other words, you need to find a mentor—someone who can help you see what in your practice or technique you might not know, notice, or even think to look out for, in order to help you improve.

Sometimes therapists can be reluctant to give (or receive) feedback because they don’t want to hurt anyone’s feelings (or get their own hurt). But if you look at it in perspective, you’ll see there’s nobody better-qualified to give you honest, actionable feedback, tips, and new techniques than someone who is already busy with a thriving practice.

How do you find a mentor when you are a massage therapist? Well, contact the most successful massage therapist that you already know and offer to give them massage in exchange for feedback. If you don’t happen to know someone like that already, then you could shop around at local spas or massage clinics until you find someone fabulous. You could also comb through online reviews on sites like Yelp, as well as your local newspapers’ annual “best of” lists to see who has built a strong following.

Once you get together with your mentor, put away your ego, mercilessly invite their honest feedback, and really open yourself up to it. Don’t worry; we all have blind spots. Asking to see yourself through their eyes only helps you to see more. Plus, when you go ahead and put yourself on the line to receive that feedback from a true pro, it gives you the chance to elevate your own practice and take it to the next level.

Find the Missing Piece to Your Perfect Massage Practice

There are some really great therapists who are super-effective at resolving the most complicated muscle conditions, and yet, they have trouble making a living. They struggle to keep their private practice going, or they end up going to work for an employer—possibly one who doesn’t pay them very well. So, how come that happens when their technique is so good?

In my experience, most massage therapists are focused on developing, honing, and refining their massage technique—which is not a bad thing. But, by having such exclusive focus on that, they end up overlooking the fact that almost 50% of the client’s experience comes from factors beyond their actual touch and technique. So, it’s important to step way out and look at the bigger picture remembering that Remembering that your client’s experience starts before they even enter your practice,

If you are struggling or it’s just not as busy as you’d like, do an audit of all those other things that go beyond your massage:

  •  Observe your practice’s outside experience
    • What’s nearby?
    • Is there graffiti?
    • Any smelly garbage?
    • Was it hard to find parking?
    • Is there a really loud noise next door?
    • Should you be looking for a different place to practice?
  • What does your client see upon entry into your practice?
    • How welcoming is your lobby?
    • Is there dog hair all over the couch?
    • What’s the temperature like?
    • Do you need some curtains because the view out the window is unpleasant?
    • Are they greeted with a friendly welcome?
  • In the Massage Room
    • Are you doing a thorough intake and discussing a massage plan?
    • Is the massage room clean?
    • How about your personal appearance?
    • Are there any unusual odors in the room?
    • Any odor issues from your body or breath?
    • What about your dialogue—are you communicating pleasantly and effectively?
    • Are you talking too much, or too little during the massage?
    • Have you been forgetting to let the client know at the end of a massage that you enjoyed working with them and would love to see them back and welcome any feedback?

There’s a myriad of things that could be working against you—or for you. How do you figure out what they are? Ask for feedback. Find a friend or long-time client and just ask them point-blank, “Is there anything that you think I could be doing better during our intake, during the massage, or afterward?” You may find a couple of things you could tweak that would begin to help you flourish.

It never hurts to look with fresh eyes.  You could even call in a Feng Shui expert. The fact is, when you focus on holding the intention of creating the most positive and welcoming environment, it pays.

Taking Chances with Your Massage Muse

Massage therapists are like musicians, athletes and dancers. We train, we practice, and yes, we ache.
Those of us who are in it for real are often playing despite pain. Therapists should be doing all kinds of things to stay in the game, from stretching icing and exercising. But like our musician and dancer friends we are often too busy doing lots of massages and working on our careers to do these things regularly.
Lately folks have wondered about the longevity of a massage therapist’s career based on body mechanics. The stats are kind of miserable: Some newbies are out in three months. The average career is five years. The longer-lasting folks seem invincible but are not really.cello
My long-timer buddies look fine but have complaints of tendonitis and numb appendages. In my observation, people who work out or do a cardio activity such as cycling seem to wear well. I will think that and then I see a friend out for six months after an accident on the bike.
I suspect there is no magic formula to surviving and thriving in a massage career, but I also suspect that some people leave their starting gates with their feet tied. Hyper-mobile thumbs, hips, shoulders don’t do that well in time. Too stiff people seem to get by but have a lot of osteoarthritis. A long-time therapist friend (25 years) says it all comes down to whether she can play racquetball twice a week.
Well, we all have our goals/expectations.
The older and wiser therapist, has, hopefully learned. My exercise ball is in my living room; another is at the office. My racquetball-crazed friend has her Pilates reformer in her living room. Another has her own cold laser on the nightstand by the bed. How many ice packs can fit in a side-by-side fridge?
We all know the best prevention of all is massage, of course, and when therapists get a massage once a week they seem to do well. How many of us do it? How many of us pay for it?
My master plan is to continue to enjoy doing massages for a good while longer. That takes dedication to prevention. I feel like the musician who has made it to the symphony. I’d better take care of what I have so I don’t have to retire before I am ready.
What is your strategy? Do you have one? Are you dedicated to prevention, the thing we tell all our clients about endlessly?

Water, Water and More Water

Telling clients that they should drink more water is almost so universal and ubiquitous that it feels like it shouldn’t even need to be said anymore, and yet it should—over and over again.

When we have sufficient water in our body this will help all the toxins that have been released during the massage to get comfortably flushed out rather than reabsorbed into the tissues.

Even though water is one of our most basic needs in life, a lot of clients are chronically dehydrated.   A client may walk in and you notice their lips are chapped and their skin is dry & flakey, or there are more or deeper wrinkles than normal.  Plus, you can feel it when they’re on the table, when you notice that their upper layers of fascia feel particularly tight or sticky.

Dehydration affects so much more than just their muscle soreness or stiffness. It can be the reason behind chronic headaches, irritability, or even poor posture. Should we remind our clients to hydrate? Absolutely. Dehydration in their bodies can limit the effectiveness of our work. So, keep bringing them water, and keep reminding them to drink it—even when they’re not in your massage room.

Medical Massage… not just for relaxation!

Our field of massage lives between two worlds. Historically, or at least over the last hundred years, massage was supposedly something that affluent people, primarily of the female gender, would allow themselves as a way of destressing and ‘getting away from it all. But massage is also increasingly recommended by doctors in situations where there is muscle injury, perhaps after a car accident or if there’s been surgery. So, luxury or legitimate treatment: which is it?

Sometimes, because I live in the world of massage and have embraced it so fully, I forget what the general perception is. When I am reminded, I’m always surprised how little the medical applications of massage are understood generally. So, for that reason I’m going to share them here—not because you don’t know them, but just as a reminder to continue to educate your clients.

Massage is, in addition to anything else, directly impactful to the musculoskeletal tissues of the body which include the muscles, ligaments, tendons, as well as the fascia that surrounds the muscle groups.

  • In the case of a micro-trauma, where part of the muscle, tendon, or ligament is torn, commonly called a sprain or a strain, the muscles surrounding the area might be very tense, compensating for the injured tissue. You could use some friction to help elongate the compensating muscles back into shape.
  • If there is a knot, you may find that trigger point work is super-useful.
  • Chronic adhesions that are tough and feel ropey benefit from cross-fiber friction techniques. While those aren’t gentle or relaxing, they are effective. If there’s anything that’ll get your muscle restored to full action, good old cross-fiber friction will.
  • Sometimes we use heat and ice, or hydrotherapy, and sometimes we’ll do stretches, either active or passive, and all of that is part of the work we do when we’re applying massage as a medical technique.

If I could, I’d like to make a clone of myself and go visit every surgeon in the country and ask them: “Did you operate on this person? Did your work create some scar tissue? Do you know that scar tissue can possibly be preventing full range of motion? Given how well it can improve outcomes, why haven’t you recommended massage to all your post-operative patients?” I know it sounds crazy, but that’s what I’d do. Why? Because massage is one of the absolute best methods for removing scar tissue and allowing patients a full recovery.

Trigger Me Mine

Massage therapists often enjoy showing clients something they can do on their own to relieve a chronic trigger point.
I do it too: “Here, try an old tennis ball and lean up against the wall. Just a little pressure, not your whole weight. Keep gentle pressure on the point for 10 to 15 seconds and then gradually lift.”
Most massage clients are surprised by what they can do one their own. But I am mindful of human nature. Like most therapists, I emphasize caution. “Avoid the urge to push too hard. You will be tempted. But too much pressure for too long can make the point come back much worse later. Always do this easy.”trp
But humanity has its nature. And unfortunately, the numerous videos and self-treatment trigger point therapy books can be the road to perdition.
In the last two years I have had two clients pop in with Olympian trigger points that don’t respond to usual treatment. These trigger points want to stay and drive the clients crazy. What do these two clients have in common? They learned from a book or video how to do their own trigger points.
I had the advantage of learning trigger point therapy in school. The instructors and the books all cautioned students not to go crazy doing trigger points. One by one, every student in my class learned the hard way why trigger point therapy rules are good to follow. I found an especially precious trigger point in my temporalis. I worked it like crazy. Sure that when I erased it I would get relief. Within a few days, I had blinding migraines.
Clients don’t have that experience to help them believe in under-treating trigger points. I am so much more cautious about giving out old tennis balls now.
So what do you do with runaway trigger points? With these clients I tried a few different tactics. The first responded to active release techniques, but the monolith trigger point tended to return after a week or two. The second came around with dedicated, repetitious Swedish massage. I had to get the relaxation system back up and running in the nervous system. Funny, huh?

Plumb Out of Thumb

Body mechanics are important to massage therapists because they can make or break our careers We only have two forearms, two hands and ten fingers So why do many of us take such enormous risks with our thumbs?
When you go to classes for massage, you will hear some jaded tales. “I did this one thing and it took a year to heal.” “I knew it was trouble as soon as I did it.” Or the haughty brag: “I abuse my thumbs all the time and they are fine.” Well, just wait.
Thumb injuries are perhaps worse than the tennis elbow or carpal symptoms many massage therapists can develop because they are a long time healing, prone to immediate re-injury, and crippling for other life activities.
Most of us know better, but sometimes we do something without thinking. (Really?) The thumb can become a lightning rod when injured, because many of our techniques require the use of both pressure and specificity. The thumb provides both, but used recklessly can end your career.
I’m going to list the ‘rules of thumb’ for massage therapists.
Never hike out alone: When the thumb is split away from the fingers, you may think it gives a better sensation of pressure. Actually it does not. The client will feel a marked difference between thumb and finger pressure, not in a good way, while you are risking hyper-extension. At worst, your client will feel as if the thumb is digging while the fingers glide. Your hand, meanwhile, will be all set to resolve that hyper-extension by crimping into flexion while you sleep, compressing the radial nerve and carpal tunnel.
Stick Together: With nearly all massage moves, the thumb should be pressed against and supported by the fingers. This spreads the pressure evenly and results in a glide or effleurage that feels better to the client and to your hand. The entire palm, not just fingers, is used for these moves. What about wringing? Try it with the thumb stuck to the fingers. It will feel better to you and the client.wholehand
Thanar, not thumb: When the angle of a stroke tempts you to swing out the thumb, try using the thenar surface, the underside of the thumb, with the upper thumb pressed to the index finger. An example is in trying to shift the lateral quadriceps away from the ilio-tibial band. Using the thenar surface preserves the strength of the stroke without endangering the digit.
Two thumbs and eight fingers are better than one thumb: Depending on the shape and length of your phalanges, you can press two thumbs together to do a specific power glide – as long as the fingers are flexed at the second joint so you are using the thumbs with support on both sides. The second joint is the one just up from the knuckle.
No Lollygagging: Never drag the thumb behind a stroke. This is total thumb suicide.
Lucky for us all, good mechanics also feel much better to the client. If it hurts the client or will hurt you, why do it?

Temperature in the Massage Room

As a massage therapist, one of the most important considerations is to keep your client comfortable and relaxed. An integral part of that is the temperature of the room. In the Pacific Northwest, I would venture to say that the majority of temperature issues are not that your client is too warm, but rather that they’d like to be warmer. Being warm, of course, has the additional benefit of relaxing your client, which in turn helps to relax their muscles.

If your client expresses that they would like to be warmer, don’t take that as an affront. Everyone’s body temperature has a different thermostat. Here are some simple solutions to make sure your client is comfortable and the temperature is to their liking:

  • Blankets: The easiest one is to keep some blankets on hand, ones you can place over your client as needed.
  • Table warmer: Another good idea is to have a table warmer beneath the sheets that you can turn on for them.
  • Grain packs: Pillows stuffed with rice, buckwheat, or another grain can be microwaved and applied to your client’s body give a soothing, warm heat.
  • Space heater: In general, you want make sure that the actual air temperature in the room is at least at 70 degrees. A space heater can be perfect for that, especially in older or larger buildings where you can’t adjust the thermostat easily. Turn it on before your first client is there. Today there are many makes and models that work quietly and are energy efficient.

If your client is cold during the massage, simply turn to one of these options during the session for additional heat. I promise they’ll thank you later, and the reward will likely be a repeat customer and a referral.