Tag Archives: massage jobs

A Degree from Massage University

My education in massage did not stop with graduation from a massage school. If anything, it intensified. Now a practicing therapist, I was learning every day from the most prolific of authors, the best logisticians, the brightest of the best.

It has been hard to keep up sometimes, but very rewarding. The classroom has been my therapy room, the teachers: my clients. Lessons learned go from the obvious to the subtle.

Some favorites:

Don’t smack your hands together like humpy honeymooners to warm your oil. (Can we get that one on a billboard?)

Don’t breathe on your clients face while doing neck stretches. (Again, billboard?)

Do listen to a client without distractions when they are speaking to you, even if you are getting a text.

Do ask every client to return. A genuine invitation goes a long way in a society where millions of people don’t mean what they say.

I was pondering some of the big lessons I garnered from clients the other day, after I heard that a former client, a very prominent man, had died at age 91.

Sad, yes, for I was thinking he would reach 100. But I remembered what he taught me about massage. He was a connoisseur, having had massages all over the world for many years.

He told me he liked me because I did “real” massages. He never told me how many therapists he had interviewed, but one day the house manager let it slip that a parade of therapists had come, once, and gone before he picked me.

That was good for my ego, of course.

So what did I learn? These were big lessons and small.

He always apologized if he was late. Always.

It’s important to take time for oneself.

And always buy the best seat at the ballpark that you can afford. Otherwise why go to the game?

Hmmm. Is it April yet?

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Providing Quadriceps Massage

My massage therapy client has been working very hard to lose weight. She is going to the gym four times a week, training under the watch of two very good kiniesiology trainers, and eating a diabetic diet. She has lost more than 70 pounds in the past year.

That is a little fast to lose weight, but she has been a trooper. This past holiday season she stayed on track, upping her workouts to make up for time spent traveling and enjoying a few extra carbs. I had not seen her for nearly more than 6 weeks when she limped into my office.

“It’s my knee,” she said. “My good knee!”

Sharp pain was curling around her kneecap. I recognized that look of dread. Try losing weight when you have knee surgery and you are going to spend a month on the couch. A few years ago she experienced that with her bad knee.

Knee pain can be anything, a testy sciatic nerve, nerve root impingement, a poorly tracking kneecap, and osteo-arthritis in the joint. But I do massage, so I follow my muse. Chances are, a sore knee is a sore, entrapped quadriceps – or more likely a sore, entrapped group of quadriceps.

It’s not the easiest massage, but opening the quads can bring a lot of relief. I have learned to start slow, with a lot of warming Swedish massage, to reduce the pain and agony of myofascial release and trigger point work on the most adhesed muscles of all.

Quadriceps that have become trapped in their fascia feel like stone. They lack the softness and rubbery bounce of muscle, feeling sharp and bumpy, almost lifeless.

Warming Swedish can get at the overlay of skin and adipose tissue but that will leave the quadriceps unchanged. Trigger point maps of the quads show so many “x” spots it is hard to see the anatomy. I have learned to start at the top of the muscle, near the trochanter and ISIS, using forearm rather than fingers. Both of these moves reduce the pain.

As trigger points fade, the muscles start to soften. Then add a layer of myofascial release, again using forearm to reduce the strain on the therapist and the client. I slowly move down each quadriceps in strips, starting with the medialis. As I work, I using overall Swedish strokes in between to structurally integrate and encourage circulation.

I am used to feeling the major changes in the quads as they soften. What is remarkable is that my client noticed this, too.

“They feel like they are getting softer and warmer,” she said.

The monster trigger points hide in the area of the vastus lateralis nearest to the knee. I work those last as they are the worst. On these points the knee pain finally subsided.

“Those ball squats you have been doing at the gym have been very effective,” I told my client. “We need to do the bad knee, too.”

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Massage Relief for Reflux and Indigestion

So many people work on computers and in hunched positions that massage therapists are seeing more clients for acid reflux and heartburn problems.

Recently I doctors have referred clients for massage to relieve reflux, and the results seem good. I wanted to offer some treatment tips.

First, reflux symptoms – burning in the throat, burping or stomach discomfort, especially at night, need to be evaluated by a doctor for other conditions. Clients I have seen for this problem have been to the doctor and had various tests to rule out other troubles. Most are taking medicine and avoiding certain foods to relieve their discomfort.

Second, I assess the client’s posture and ask questions about their body mechanics at work. Hunched shoulders and thoracic kyphosis are common. Some have had car accidents where their chest was compressed by seat belts. Many work on computers for long hours or have jobs where bending and lifting are frequent, for example, nurses or bartenders. I have also observed some cyclists who use racing-style bikes requiring bent posture.

These observations tell me that when I do the massage, chances are their backs and shoulders will be very sore from overstretching and the abdominals will be flaccid and shortened. Often the shoulder girdle is quite high and forward, the thoracic flexed, creating shallow, upper-chest breathing.

Lying flat on a table is often very difficult, so I like to start with the client prone. A back and neck massage comes first to relieve back and neck soreness and also to assess the stiffness in ribs and spine and specifically the scalenes and serrati. After massage I like to gently mobilize the shoulders toward their anatomical positions.

Many clients have had doubts about getting any massage on their abdomen, fearing tickling or invasive techniques. I assure them that as a ticklish person myself; I use slow, firm touch to avoid triggering tickle reactions. I also assure them that the techniques are not invasive and I can lighten them at any time without tickling.

If a client is still averse to tummy massage, I will suggest that they allow it over the sheet as a demonstration. If the answer is still no, I move on to breath work and ask them to let me know if they feel comfortable getting tummy massage later.

As you may infer, permission to treat is important. If the client is defensive, the massage will not work.

The actual massage for reflux is fairly simple. Slow Swedish-circles in the direction of the colon (counter-clock-wise) followed by slow half-circles over the solar plexus just under the rib cage. The stomach is on the client’s left side of the abdomen, immediately under and to the left of the xyphoid process. Gentle effluerage away from the rib cage; this encourages the stomach to drop down into its anatomical position.

Then I suggest they fill the area under their navel with air as they breathe in. This encourages diaphragm breath and releases the thoracic area from paradoxical chest breathing.

Let me emphasize that a doctor’s exam and diagnosis are important before starting this work. Some very serious illnesses such as cancers and heart disease can masquerade as heartburn.

With the occasional client who refuses to get medical exams, I ask them to write in their own hand a release for massage, in which they specifically state that they understand they could have serious medical conditions. Not seeing a doctor could cause death or disability. They should specifically state they do not hold the massage therapist liable. (I have never seen a client finish such a note.)

The joy of massage for reflux is that as the clients unwind and practice diaphragm breath, their reflux lessens and often disappears. If it does not, I refer to an osteopathic who practices visceral manipulation.

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Yearly Goals, Triumphs, and Mulligans

Right about the end of the year, or sometimes the beginning of the year, I do an audit of my massage therapy practice.

Years ago I started doing because I found it was easy to slip into a groove – also called a rut – and because I usually take at least a few days off during Christmas and New Year’s.

My list includes things I think went well, things that sucked and things I need to take more seriously, as well as look toward some goals for the next calendar year.

By setting these things down on paper, I was able to take some mega-steps in my massage therapy career. My status as a spa employee helped me buy a home, but once that was done – and I had two years of spa experience learning about massage, people, management, etc. – it was time to move on.

Picking up the skills I needed to move on took some practice. All the while I had minor and major goals to help me along – how to book a private client was a mini-goal. Once I could book one private client, I learned enough to give myself a goal of three private clients a week, and so on.

I like big goals for the end of the year, but little chunks at a time to avoid discouragement. Making the goals is not so important as learning how to get there. If I am off by five massages, who cares? At least I figured out how to get a few clients.

As you may notice, lots of these goals are not the purview of massage schools. They have a hard enough time teaching people the basics of techniques and body mechanics without turning themselves into business schools as well. We had a class or two on basic business skills and that was it.

The odds are probably good, too, that most massage students would not need business skills because few go into business for themselves. What they needed were skills at getting jobs working for others, and learning how to survive in the environments of places such as spas, clinics and chiropractic offices. Some of those skills could not be taught they had to be earned. One of my classmates was great at interviewing, but couldn’t show up for work. Another gave a terrible interview, but was rock solid and loved by the clients.

A spa manager I liked a lot confessed to me once that she often hired people solely based on whether they were on time for the interview. She had long ago given up on the idea of figuring massage therapists out.

Now, in my 20^th year of massage, I’m looking at the nuts and bolts of what I am doing and asking myself: Is this where I want to be? Am I working enough, too much? Going in the right direction? Are my clients benefiting from my work? Where do I want to go from here?

These are great questions to ask – in past years my questions would be how can I get more clients or make more money. Or how I could better use my energy – doing massage or managing or training those who do? Not easy questions or answers but this helps in my sense of satisfaction from work.

Wherever a massage therapist is on his/her career I urge this time of year for some self-reflection and goal setting. It really makes a difference in the long run.

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Practice Makes Perfect – Learn Your Craft

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Practice Makes Perfect – Learn Your Craft

Sometimes we massage therapists have to step up, as in try to pick up some massage skill fast because we have a looming assignment ahead of us. Hopefully we are at least leaning on our basic skills and quick-mindedness in developing a demanded specialty quickly.

One hopes.

A friends got stuck in “I do that” hell recently. The interviewer asked if she did myofascial release, and before she knew it, yes had popped out of her mouth. Yes, she really needed the job.

She went home and looked on You-Tube for some examples. An hour later she called me in a panic. She had lots of competing ideas off of the tube, and wanted a practice dummy. The web is a wonderful tool, yes, for massage therapists looking for ideas and starting points. But if you watch someone play the piano, do you think that your attempts to copy those moves on your own will result in the same music? kitties

I tried to stay off the table: “Well, all massage is myofascial release when you look at it. If someone has taken a formal class and been deemed certified by the teacher because of their attendance, they have probably learned something about special techniques, but we massage folks are all about moving muscle and connective tissue from stuck to unstuck.”

My friend was desperate. “I at least have to look like I know what I’m doing by tomorrow. I have a practical. And I know you will tell me straight.”

The ability to say “that sucked” has never been in short supply in my family, but some myth out there says that some family, even friends, might be afraid of hurting your feelings and discouraging you, so they get off the massage table with great deliberation and croak: “That was great.”

That leaves you to find out the awful truth on your own, from some less-inclined-to-kindness stranger, or your first boss, or your interviewer, or the dust gathering on your sheets….

I’ve seen that effect enough to know it is not so kind. “I’ll come over,” I said, “But can we practice on your cat?”

Stalking those Darn SCMs

The massage client who can’t turn the head, the headache that arcs over the ear to the ridge of the eyebrow, the sensation of steel cables squeezing the anterior neck: These are all signs of those darn sternal-cleido-mastoids.

We massage therapists see these symptoms frequently, and I have made a hobby of asking other therapists how they try to free the dreaded SCMs. There must be dozens of techniques, dozens of approaches, and yet I still seek one method that won’t make a client levitate.

Lucky for us, clients with taut SCMs are so miserable they will tolerate our fingers making an attempt to unwind these two-headed sticklers. They will try anything to get the eyebrow to stop pounding.

My first experience with unlocking SCMs was with a fairly invasive technique I learned in school: Lifting the sternal and clavicular heads of the SCMs together, on one side, and sifting the TrPs between thumb and forefinger, careful to exclude the pulsating nearby artery.

Well, that does work, but my experience with clients leaving skid marks led me to believe it might be better to learn a softer approach.

It does help to lift the head and shorten the side being palpated by turning the head to the opposite side. An MFR technique I tried to lengthen the SCM from short to long with pincing fingers also left me cold. If the client has any fear of neck constriction, this technique will make it a full-blown phobia.

One time I encountered a client who had survived an attempted strangulation. These SCMs had gone over the moon to protect her. There was no way in heck I was going to lift, sift or pince while twisting.

A class with Erik Dalton saved my hands on that one. He showed, with his usual complete relaxation, a non-threatening way to cross one hand over the front of the neck, palpating the anterior edges of the SCMs with soft finger-pads. The other hand, from behind the head, brought soft finger-pads to the posterior side. A few moments of light touch and patience, the SCMs unwound. No twisting necessary, and no skid marks.

Believe me, that client was able to enjoy a good night’s sleep for the first time in a long time.

What about the chronic phone holder? With today’s tiny phones, and with the old-timey, clodhopper phone handsets, many people have ground in one tight SCM. This pattern creates one-sided headaches and can persist for years. Enough stress and people come in looking like they are holding an invisible violin in their neck.

Well, when challenged, I look to topical magnesium lotions to help. Magnesium oil from seawater stings cut skin so it can be used only if the area has not been shaved. Otherwise, Epsom lotion. A light coating and then leave the client with that side in a light stretch while doing arms and legs.

By the time I return to the neck (20 or 30 minutes) the SCM at least knows it can stretch. If it lets me, I will do whisper-light TrP release on the surface followed by lymphatic circles toward the thoracic duct at the clavicular notch. You don’t have to get fancy, however, light Swedish in direction of the duct works also.

I send clients home with instruction not to turn quickly or whip their heads to either side. Use a little heat if sore. And hold the phone to an ear only looking straightforward and holding the phone in the opposite hand.

There are probably a many more good SCM secrets out there. Anyone?

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The Path to Progress

The footpath from the subway to my university led up the Boston Commons through the State House and down to the other side of Beacon Hill. I took the path often, going to the right side cut-through of the State House to avoid the somber figure sitting on a stone bench in front of the left wing.

It was just a statue: a pretty woman, dressed plainly, sitting on a bench. Sorrow and determination etched in her face; she leaned forward. The statue’s never-changing sadness gave me the creeps. Besides, when I took the right-wing entrance of the Massachusetts State House, I could grab a bagel before class.

Curiously, I never looked to see who the woman was. I was too busy getting an education and planning my career. For something that should have whetted my curiosity, I had none. It took me away from my goals.

I am a massage therapist now, and have been for almost 20 years. As such, I am a micro-business owner. I have dealt with snickers of people who viewed massage therapists as women offering something else. As my own boss, I am free to work plenty of overtime, nights, weekends, etc., if it takes that to be successful. Massage is largely an occupation of women, and it is one of the few businesses that can be started with little capital and much elbow grease.

Not that I took any of these things for granted, no, but I missed a few pieces of history along the way.

We took a trip to my hometown earlier this year. My spouse grew up in Los Angeles and was fascinated by the history and old buildings. We stayed a few nights in Salem, its damp streets dotted by witches museums and attractions. The lore of witchery in Salem is much more attractive than the reality. The local residents suspected devil’s work in everyday life. In the 1690s courts convicted several women of witchery and hanged them. The evidence? Friends and neighbors who claimed the witches flew through the air and cast spells.

At the home of author Nathaniel Hawthorne, we saw the family tree written on the wall. The Hawthorne’s surname was amended to avoid association with the hanging judge at the witches’ trials. The family was ashamed of that history.

In Boston, we took the open-air tourist trolley to avoid the stress of driving and parking. It stopped at the State House steps. Right in front of that darned statue.

Our tour guide/bus driver gave us the spiel: “That’s Mary Dyer, the Quaker hung from a tree near Boston Common for her heretical beliefs. The Pilgrims came here for religious freedom, but just for their own religious freedom. No one else was welcome. They wanted to make a Pilgrim Utopia so in 1660 they hung an innocent woman for being a Quaker.”

The state court had the statue erected in 1959 to remind lawmakers and judges of the folly of requiring every citizen to have the same beliefs. The early state of Massachusetts was a tyrannical state: Everyone had to support the ministers’ teachings or face court penalties. They were locked into stocks, whipped, had ears cut off, and banished. If they did not publicly repent, the government, one and the same as the church, took away rights to vote, own land, own businesses, and confiscated their weapons.

Mary Dyer had been sentenced to death a year before her hanging, and was saved from the gallows by her husband. He was still a Pilgrim, and though the family had moved to Rhode Island to get away from persecution he still had some influence with the court judge. He promised that she would stay away from Pilgrim settlements and took her home.

A year later Dyer returned and asked that the authorities reverse their unjust laws. Instead, they decided to enforce the sentence of death. She and two other Quakers who refused to be compliant with Pilgrim law were hanged on the same day. She held hands with the men as she walked to the hanging tree, and people in the crowd criticized her for touching unrelated men. Neither men nor women were free in the Utopian state of the New World.

Well, my education continues. I now see why Mary Dyer sits so sadly, and why so many of the Pilgrims descendants who crafted our Constitution vowed to separate church beliefs from state laws. I think those formative steps taken so many years ago have led to our freedoms today. To be free to touch others and to massage, to live, to educate our children and ourselves. Mary Dyer was a very brave woman, in deed.

(For more information about Mary Dyer’s life and death, and her influence in history, let me recommend Wikipedia’s listing. Also, “Mary Dyer: Biography of a Rebel Quaker” by Plimpton, Ruth, 1994.)

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Touching the Masses

Chair massage is a great way to deliver massage services – and it offers independence for many therapists who don’t want to be limited to table services.

This new era of chair massage is a big step forward. When it started more than 25 years ago, chair was seen by some traditional massage therapists as a Cinderella stepchild.

Chair was viewed solely as a marketing introduction for table service. Interesting, some massage therapists felt the need to label chair massage as fluff, non-therapeutic, even gulp, recreational – and let me say this fuddy-duddy crowd gave the chair pioneers some grief.

All is forgiven now as chair massage has garnered respect as both therapeutic and a regular form of massage. Chair is found in airports, conventions, employee health fairs, malls and at my local car wash.

For the massage therapist, chair offers some freedoms. Most chair massage at workplaces has the advantage of being held during working hours. A chair therapist can get home in time to pick up the kids from school. They can take nights and weekends off!

Some of the barriers to male therapists melt on the chair squad. Male therapists often have to endure bruised egos in spas when men and women clients refuse them. But male therapists are very accepted in chair massage. They even have an advantage with a bit more upper-body strength, which helps in chair techniques.

Chair also lets therapists do more invigorating techniques such as tapotement. By the way, how many kinds of tapotement are there?

I’ve seen at least five, and there are probably more. I can do two of them without looking like an industrial accident.

Check out some of the leaders in this field: David Palmer, founder of TouchPro, offers many online and in person courses in chair massage, as does Boris Prilutsky. Another chair pioneer, Ralph Stephens, offers a medical chair massage class.

Sure, you can watch these folks and their video how-to chair massage, but you will not know how to do chair massage from a video any more than it will teach you to play the violin.

Take some classes.

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If This Bicep Could Sing….

When a massage therapist has been working for a while, it can seem as if some body parts are talking during the session. Well, not verbally, of course, but spinning a yarn, letting it hang, somehow bringing their troubles up on the table.

Hey, we touch folks know verbiage and the written word are not the only ways we communicate, and the muscles sometimes give me what almost sounds like a wail. Kind of like the people who can hear colors instead of just seeing them.

Well, sometimes a client is bliss-unaware of what the muscle is saying and in me finds an audience. Like a good therapist, I listen. Last week this bicep had a certain ring to it, like it had been overworked, wrung and pressed. It had a field of adhesions running the length right past the inner elbow. This muscle was hot, thread-y and tired.

I was doing my best to open up the circulation, which created some good faces on my client. I mentioned to my client that what I “heard” was almost like a song.

Hyperextension Blues, by Bi-Cep.

I woke up this morning,

Ba-da-da-dum (Muddy Waters?)

Elbow extended again.

Bad-da-da-dum

No hope of performing,

Ba-da-da-dum

Feeling totally un-Zen….

Now both my heads are twitchy,

Bad-da-da-dum

I don’t know how I can move.

Bad-da-da-dum

It makes my throws off pitchy,

Bad-da-da-dum

And my body hates to lose.

I got the hyperextension blues

Hyperextension blues

I got the hyperextension blues

Hyperextension blues.

Well, I fixed the rhymes a bit, but you get the idea. My client and I had a good laugh about the bicep blues, and she told me not to quit my day job. Isn’t it fun when the body tells its own story?

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Thumb Scrum

Massage therapists may think they are immune to injury, even though many of us came to do massage after recovering from injury. We’re helping people, after all, so that should be a win-win. We win, the clients win, all is right.

Oh, and then that little thumb screams tingle-tingle in the middle of the night.

The problem with bad thumbing is that it doesn’t tell you that it is hurting while you are doing the hurting thing. It tells you much later in the day, usually just before your deepest sleep cycle, by waking you up to a tingle party.

Oh, and it can take months of babying to get better. I know. I did it recently, as in earlier this year. Many soaks, rubs, deep cross-friction and MSM lotions later, I can say my thumb has returned as fit as ever. Of course, I know how not to hurt my thumb, I just suffered some sort of temporary delusional amnesia associated with getting that last knot out from under the cranial vault.

For the record, let’s go over thumb health. The thumb is a wimp, unable to go outside without his brothers and sisters. Thus the thumb is always stuck to its neighboring fingers when applying any pressure or other massage stroke.

Do not drag the thumb behind its family, keep it close – as in stuck – to its protectors.

Do not lead with the thumb unless it is stuck completely to the other thumb – that is both hands together at the thumb creating one seamless stroke.

If your thumb is able to bend backwards at the first joint, you will get away with disobeying all these thumb rules, but then the day will come when the thumb quits altogether. This is the curse of the hyper-mobile thumb.

As someone who occasionally forgets to practice safe thumb, I admit to being less than perfect while on trigger point hunts. But I know my thumb will remind me later of what I forgot earlier in the day. Zap!

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