Tag Archives: clients

Offering Reassurance and Hope to Your Clients

When will this get better? When will my pain be gone? When can I do what I want to do – when I want to?

Tough questions for us massage therapists to handle. Truth, we don’t usually know. Massage does marvelous things for the mind, body and soul – but what it does is often entirely up to the person receiving the massage – and the intent and skill of the person giving the massage.

The timeline? That may be set by many other things – perhaps even a higher authority.

When clients drop these questions on me I look them right in the eye and tell them all I can do is try to help them feel better. As pain drops, function returns. One can’t predict the time involved in healing.

It’s not a very satisfactory answer for some clients impatient to going back to doing the exact thing that brought them in feeling wounded. With as soft a tread as possible, as we develop a therapeutic relationship, I have a few ways to explain further. These come in handy with sticky troubles such as fibromyalgia or other conditions that vary day by day.

Answer # 1: You will turn the corner, but you may not realize it. Often you realize it afterward. You will discover that some pain or restriction has been gone for a while.

The body really heals itself in its own time. All we can do is try to make it easier to get there.

Is that fair to clients? I think so. I have rarely ever seen someone making no progress from massage. But I have often observed one factor in common with the impatient client: A chronic problem has often been ignored for so long it takes time to create an awareness of how to heal and avoid re-injury.

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Effleurage & the Flaming Snowplow

Most massage therapists make a habit of getting massages, as do I. A good massage is always appreciated, but at times it is hard not to be a “back-seat” massage therapist.

Recently I was looking forward to some relief for a strained deltoid when the effleurage began on my forearm. It started as a delicate, slow Swedish stroke. It treaded middle depth along the bicep and suddenly plunged head-on into a flaming snowplow of death over the coracoid process.

Oh my. My therapist made eye contact, I suspected to see if I was impressed. I writhed. Another effleurage. I cringed.

“Are you okay?”

“Well, no. The stroke feels really good on the arm, but then it feels like the pressure suddenly increases and it is very painful,” I said.

My therapist suggested skipping the area. As delicately as I could, I explained that shoulder soreness was what really brought me in for a massage.

My therapist looked perplexed. I offered that perhaps less pressure on the sorest area would work better. More perplexed look.

As a bad stroke, the flaming snowplow does double duty. First, it is very uncomfortable for the client. Second, as the therapist increases pressure away from his or her body, the stroke goes beyond the ergonomic zone. That places more strain on the therapist’s neck, back, wrist and arms. The pressure is produced from the upper body, instead of the feet, creating strain.

I don’t know where the flaming snowplow effleurage comes from. As a student I committed it once and got roundly screamed at by my instructor.

Effleurages feel best with constant, comfortable pressure along an effleurage. They are often the first stroke to be used and set the tone for other techniques such as MFR or trigger point. If I can effleurage without pain, I can usually treat the sore spot with other means. A win for the massage therapist, a win for the client.

Now, about the time I got the flaming snowplow effleurage up the arm followed by the Reverse Flaming Snowplow down the arm….

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The Bottom Line

Well, it wasn’t the most pleasant story I saw on TV news last night: A report about multiple incidents of women receiving massages from male therapists and complaining of sexual touch.

It’s tough to talk about what’s an ugly truth in the massage therapy field. Some people in our field may not be doing massages because they want to relieve pain and stress. They may be getting sexual satisfaction from massaging clients.

I don’t believe in bashing male therapists – Some of the best therapists I have met are men. But in 20 years all of the therapists I know whom have expressed sexual aggression in massage have been men.

Well, there it is.

What should we as a profession do? What should employers do? Not hire men? Not get massages from men? Prohibit cross-gender massage? (Some states do.) I’m not comfortable with any of those ideas. I don’t know.

But I do know if we are to have a public perception as the only healing profession that involves vulnerability and touch we have to be careful about who does massage.

The TV news story was a bit grim. The clinics where the men worked did fire them, but their statewide practice credentials were not affected. Technically, these men could find jobs at other massage clinics fairly easily. At least one did.

No criminal charges resulted from the incidents, which, of course, means that these workers had no opportunity to defend themselves or be found not guilty or guilty. No convictions, no revoked credentials, no closure.

Is unwanted sexual touch a gender issue? I hope not. But many male therapists tell me how hard it is to get hired on at a spa or clinic. Many places seem to want one, only one, male therapist on staff.

And those men had better be thick-skinned. They have all had clients suddenly back out of a massage when they find out their therapist is male. When the front desk asks for gender preference when booking massages, the men lose income and feel discriminated against. And if the front desk does not ask, the spa loses money and suffers schedule nightmares as clients back out of appointments at the last minute.

I’m not offering solutions here, just a heads-up. I don’t want people to be afraid to get a massage at any spa or clinic. Ideas anyone?

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Seated and Ready

A regular table massage client loves to two-time this massage therapist every chance she gets. I do not mind at all. My client has fibromyalgia, travels frequently and loves to get chair massages.

The service she uses most often is at an airport near her employer’s national headquarters. She looks forward, especially on a day-hopper trip, to stopping in for 20 minutes of relief.

Initially I was scared to use them, she said, worried they might not understand someone like me. But I just did it one day when I was desperate – and it really was very good.

There are two therapists at the terminal chair massage shop she loves to get – and so far most of the ones she doesn’t know have been pretty good, too.

Given the opportunity, I’ll ask questions. Market research? Perhaps. So what’s good about a good chair massage?

I like that they look at me and talk to me before I sit down, checking in on what I want and don’t want, she said. My name is in their computer so they can check on what I’ve had done before.

Most of the time I need firm pressure, especially to relieve the burning spots in my shoulder. They know that too much pressure increases my pain, but just the right amount helps.

The good ones seem to know the pressure, but they always ask me if it’s right. I like being asked.

The only time I didn’t like the chair massage, I think it was this guy’s first day. Probably his last. He wouldn’t look me in the eye and didn’t ask me anything. I had to tell him I have fibro and pointed at my left shoulder burner. He just nailed me with the point of his elbow, no warm up or rocking in. My shoulder went off like a flare gun.

When I told him it was too painful, he switched to super-light and annoying. I finally just got up from the chair and left. The receptionist said I didn’t have to pay, which was good because it was a one-minute torture massage. Aargh.

I still go there, and I love my regular massage therapists. I make sure I give them good tips, so they will be there when I am in town, she said.

You can’t beat the relief after a bunch of meetings. I can tell them I want my arms, neck and back, or focus on neck and shoulders and less time on the other areas. It helps keep me sane, she said.

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Playground Moves

We massage therapists see a lot of people seeking relief. If it isn’t the upper back and neck, it is the lower back and legs. I’m a fan of giving people something they can do, on their own, to loosen up.

Most people go from doing a lot of movement in their salad days to increasingly stiffening marathons of driving, sitting or standing as they grow into their occupations. My loosen-up moves are an attempt to get some wiggle back into the muscles and joints we freeze up with age.

Like most massage therapists, I freely steal moves – giving credit of course – to multiple disciplines. My go-to sources range from Tai Chi Ch’uan, Yoga, Pilates and Hula to Islam. Give a girl credit for observation.

The ground rules are: everything in slow motion, no pain, exhale with effort and keep breathing normally. I practice with my clients so they get the rules in their head and can mirror me. This is also my secret way to get some stretches in for myself between massages.

For example, the hula roll-about allows people to balance abdominal, oblique and back muscles. Standing in neutral, use the tummy, then the side muscles and then back muscles to rotate the hips in a slow circle. The shoulders stay still and the breathing relaxed. If you can do the slow hula, you can swing a golf club.

I like to frame warming moves and stretches not as work, but an opportunity to revive our latent desire to play. Hula hip circles are a blast. When you get a bunch of serious golfers laughing while rotating their hips, you get a serious jolt of fun. And when those scores drop, the golf guys keep coming back….

The back flexion warm-up borrows from Yoga and Islam – start out on your knees on a soft surface like a bed or mat. Lean forward and extend your arms on the surface in front of you, slowly lowering your upper body into a stretch. Just like the Moslem prayer position, and a bit like the yoga child pose. To stretch the QLs, move one hand to the left, while aiming the hips back to the right. Then reverse hands and hips to stretch the other QL.

Heck, that’s a very good thing to do three times a day for your back. Funny how a move associated with a religious ritual can be so good for the body.

What about Tai Chi? My go-to is “Wave Hands Like Clouds.” This move helps people with balance and fluidity as well as peripheral vision and coordination. All you do is hold your palm in front of your face and look at it as you turn from center to one side. As you turn to reverse, you raise your other palm and look at it as you turn back to center and to the opposite side.

Simple yet complex, this move builds core and balance. Hmmmm. Who thought goofing around and playing could be so liberating and healthy?

Please send me some of your go-to play moves in the blog comments section. I’ll steal it, and give you credit, of course. Hula!

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Practice Punts

Massage therapists are not all alike when it comes to their understanding of how to build a practice. I have heard lots of explanations as to why bookings stay low, very few explanations of why they are full.

How to develop a practice is an art just as much as massage. It requires some close self-observation and sometimes an outside hand to help therapists along. Often when I catch an episode of some show like Salon Take-over or Bar Rescue or Hotel Impossible, I am reminded very quickly of what it takes to have a consistent practice.

If you catch one of these shows the clichés are numerous. The owner wants help to make their business pay, but they don’t want to hear anything critical of their skills. The help is interested in making money, but stymied and discouraged by unsolved problems. Often there is a sacred cow: a lazy staffer or manager whom the owner wants to avoid confronting – or an unworkable idea that the manager/owner won’t drop. The bottom line is that the bank wants its money, not excuses.

I enjoy these shows as a kind of self-therapy even though the environments are very different. Most massage therapists work alone. They are the owner, staff, manager and investor. The outlay to start a massage practice tends to be small, and there are very few therapists who make anywhere near “six-figures” when it comes to gross income.

In common, though, are some basic universal truths. The formula for success is not a secret requiring an expensive marketing class or a practice coach. It is, just like the roaches in the kitchen of a failing restaurant, right in front of a person with eyes to see.

Yes, darn it, arrive on time. Be clean. Do not wear jeans. Listen to the client. If it is a return client, go over your notes before they arrive. No notes? Where are they? Why be paid professionally if you don’t practice like a professional? Do you report your cash? And yes, a warm room and a clean heart.

No shortcuts.

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Therapist Notes from a Low-Slung Sports Car

Sometimes when I am square in between someone’s shoulder blades, I find myself thinking about how some of these knots got there.

Most are whiplashes and hard work – a traffic encounter followed by running a lathe at the machine shop, or writing some intensely detailed thesis. No fun involved.

Once in a while somebody has a different combination.

This gentleman had back pain. He told me he had a brand new promotion and lots of extra stress with it. As I worked on massaging his muscles, he told me the one fun thing about the promotion. He celebrated by getting the dream car. Not that I know that much about cars, he was clearly having a ball driving his super-charged, T-topped Corvette.

“Have any trouble getting in and out of the car?“ I asked.

There followed a long pause. His back stiffened. “Some.”

Never mess with a dream.

“Tell you what, I bet you will love that car even more when I show you a couple of tricks on getting in and out that will help your back.”

“Um. OK.” He started to relax. After his massage, we went out to the car and I demonstrated how to sit first and then swing both legs in at the same time, eliminating the sciatic effects of one-legged entry. Once in, I showed how to get the car seat to drop back and up before exiting. The slinky bucket seats? Umm. “Sometimes it helps to adjust the seat up a little,” I said, trying to be tactful.

Should this client be driving a roller skate with jet packs? Heck no.

But oh heck, when I stood looking at the Cherry-red (never maroon) super-finish of this slinky corvette I had to say: “Some people have all the toys!”

“Want a ride?” he asked.

“You bet!”

Hair flying in the wind, I had to wonder: How am I going to get out of this car?

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