Tag Archives: massage jobs

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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History at Your Hands

We had a wonderful time picking out decorations for my mother-in-law’s 90^th birthday party.

Pink table-covers, birthday lawn signs, a banner and bubble-making bottles, clean fun for all of us youngin’s. We’ll also be running around next weekend picking up a vanilla cake with white and pink frosting, tamales, sandwiches and the “Happy 90^th” balloon. (Surprisingly popular, our cashier volunteered.)

All of which led me to ask Mom Mary the big question: To what to you attribute your long life?

Mom Mary looked at me quite surprised. “I have no idea. I’m just glad to be alive. I wish I felt better, though.”

Ooh-yaah. Hey, with a massage therapist in the family, many people would assume Mom Mary has the feel-good covered. Well, other than the occasional emergency neck or shoulder massage, Mom Mary has begged off the family discount. (Double for blood relatives and spouse, Mom Mary free.)

Yet thinking about it, I have had several older folks who come in for massage regularly. And I am impressed. My oldest client was 103, a World War I veteran. I have given massage services to many people aged 70s to upper 90s.

As a member of the second coddled generation, the lucky ones who grew up with food, dental care, schools and an expectation of college, I get a good sampling of how my elders got into their golden years.

Wars. Prison Camps. D-Day. Epidemics. No food, no heat. No air conditioning. Religious genocide. Ethnic genocide. Is longevity produced by adversity? Or, to put it another way, does that which does not kill you make you stronger?

It makes me wonder how my generation through the much-too-much millennials will fare. Will we prick our fingers on our computers and die? Could we ever be tough enough to skip a gluten-free meal?

I think a massage certificate for Mom Mary is in order, perhaps a pedicure as well. You should get some credit for living long, well and in good humor.

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Nail It!

We massage therapists pride ourselves on our abilities in touch – and that’s why I am so surprised when clients give me an earful about fingernails!

This is a touchy issue for massage therapists – we figure we’re doing things like avoiding perfumes and warming our oils so we can facilitate relaxation in our clients. And then they complain about fingernails?

Yup.

Actual Client Complaint Case #1: This guy must have been doing construction on the side or something. His fingernails were cracked and broken and his hands were covered with calluses. It was like being sanded!

Case #2: My massage started with a scrape-y hangnail across my feet. For the next hour, every time the masseuse did a stroke, I was dreading a re-appearance of The Claw!

Case #3: I’m slipping under the sheets and I hear the therapist out in the hallway clipping her nails. She comes in and jams these sharp edges in every time she works a knot. I expected to see little red half-moons all over my skin!

Case #4: Is it possible to do a massage with acrylic nails? These things were long – and she was more concerned with breaking one than doing a good job. It was the lightest massage of my life. I can put oil on myself, thank you.

Well, I am sure it was not these folks intention to make their fingernails the central memory of their massages. Most massage therapists know to keep nails trimmed, clean and gently filed and beveled to a soft edge. It perhaps slipped their minds those days…

…So I am off to check my manicure!

Predictions on Massage Therapy

I love the rag-mags when they have a page of psychic predictions, from the end of the world to when some celebrity will be married. But do we in massage therapy really need psychics to make spot-on predictions?

I’ve been working up my own list of the future of massage therapy – wink, wink. Here’s my crystal ball:

10. Studies will continue to show that massage is good for people’s health and wellness.

9. Massage is just as good whether done on a table, chair or porch swing.

8. No matter how sophisticated a machine is, it will not replace hands-on massage.

7. The more people use computers, the more work for massage therapists.

6. People will continue to train as massage therapists even though they don’t like people. It’s a learning experience.

5. The Industry will continue to lobby for short vocational training and minimal certification to keep labor costs down for storefront franchises.

4. Professional organizations will continue to press for making massage therapy a college degree, even though most therapists don’t want that.

3. Medical organizations will incorporate massage therapy as soon as they can bill insurance for it without hiring trained staff.

2. Someday we will use massage sheet s that are completely organic and will not stain.

And the Number ONE prediction:

Massage therapists who listen and care will always have work, joy and satisfaction, no matter where or how they practice.

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Dizzy Chair Massage

A client stopped in last week a bit worried about her neck. She had been on vacation, feeling very tight in the neck and shoulders and stopped for a chair massage.
Eager to get rid of the tension, she asked for a 30-minute massage. Toward the end of the massage, she started to feel faint and had an overall feeling of serious un-wellness.
“I thought I was going to die,” she said. “I felt terrible. It took several minutes of just sitting to feel like I was getting better.”
She wanted to know if I had any idea why she felt so bad.
Oh boy. Great. Just ask me. I have never seen anyone get sick from a chair massage. During classes the instructors have mentioned that rarely a few folks might experience a low blood sugar after a chair massage. But that’s really it.
And my client had eaten about a half-hour before her massage.
I suggested that if the massage was the cause of her spell, perhaps the headrest was in a tilted back or too far forward position, compressing her suboccipitals.
But the client said the position of the face cradle felt fine.
Another problem might have been if the therapist was using pressure directly into the neck, rather than at an oblique angle, and pressed on the vertebral artery. Stepping off the massage chair and sitting down in a chair for a few minutes would dissipate the feelings.
But heck, I really have no idea because I wasn’t there. Her experience was odd.
Her therapist, she said, was very attentive and very surprised that she didn’t feel well. She sat with her, gave her some water, and offered to call an ambulance. My client said no, she would be fine. And in a few minutes she was. But what happened?
I would like to know if any therapists have ever seen this sort of reaction from a chair massage. Or is it possible it was not related to the massage?
Here’s my very speculative guess as to what happened, barring other causes. This particular client has a very prominent bilateral knot at C2-C3, a souvenir of an old car accident. If pressure was placed directly into the neck from a standing position, it is possible the vertebral artery was compressed. Vaso-compression can cause a myriad of sickly feelings.
My only experience with this was with another therapist when I worked at a spa. Her client came out of her session and had to sit in the hallway for about 20 minutes to recover. She also had a knotty laminal groove near C-3.
After we both helped the client recover and she left, the other therapist and I went over the work done on the neck. My therapist co-worker had stood over the table and with her arms straight down had pressed directly down into the knot in an effort to release it, a method she used on other knots in the back and legs.
This stance is not only bad for the client; it also loads tension on the therapist at about C-6-C-7. Done often enough, it can create numb arms and hands in the therapist as well as unpleasant symptoms in the client.
My co-worker, of course, had just adapted a way of treating knots in one area to another and wasn’t very studied on neck release techniques. I showed her how to treat the neck with oblique angles, anywhere from 35 to 55 degrees to the prone client. This technique, of course, requires the therapist to bend knees and unlock joints in the arms and back.
The oblique approach is healthy body mechanics for the therapist and client as well, and it applies to chair or table treatments. Oblique pressure rises from the feet pushing on the floor, with the joints relaxed rather than locked. Basic? Yes.

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