Tag Archives: self-care

All Thumbs Massage

Massage therapists have a few tricks for using specific pressure techniques without straining their thumbs. Whether light, firm or deep, these handy tips provide support for precious thumb during massage strokes.
These body mechanics require split legs, from 4 inches to shoulder width apart, one behind the other and slightly flexed at the knees and hips. Movement forward springs from the back leg. The visual cue is to imagine your foot pushing the floor away. As you push forward, the hands effleurage the client’s back. When this “fencing lunge” stops, the forward stroke stops. Return strokes should be glides rather than more forceful strokes to avoid activating the lats and rotators, which can lead to shoulder and neck pain.
With these mechanics the length of these strokes depends on the length of the therapist’s arms. Shorter-arm therapists tend to have smaller zones, for instance half the back rather than full length. Taller therapists can cover more territory but are at risk for using their neck and thoracic muscles if they do not take care to split and flex legs.
Here are some photos of thumb-saving stances that allow therapists to work as deeply or lightly as they like. The first is the main thumb saver: Pressing the straight thumb into the flexed index finger and using the other fingers for support. The fingers are flexed so the wrist must be slightly flexed or straight to avoid carpal injury. This allows for stripping along muscle fibers or for transverse friction without risk to the thumb. It also feels better to the client.thumb3
The second photo demonstrates the thumbs pressed against each other, but this time the fingers are spread so the massage therapist can knead with the second phalanges of the fingers. This kneading feels more broad and intense top the client than flat finger kneads. Think of it as a step between finger and forearm kneading.thumb1
The third photo shows some more thumb stabilization to avoid hyper extension and strain. This time both hands support both thumbs providing a wide and very stable effleurage. thumb2
These thumb tips have kept myself and colleagues out of danger while pursuing long careers in healing. One of my clients calls these strokes the teddy bear paws. Thumbs up!

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?

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?

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!

The Good Massage Therapist

Here’s my shortlist for what a good massage therapist needs to know:

Talk to the client first, not during a session. Get enough information to know what the client seeks, whether they want a complete massage or spot work, and if they have medical conditions that should not be massaged. This communication takes only a few seconds. A good massage therapist always has time to communicate.

Know Contra-indications: A client with a cold or kidney infection can develop much more serious infections if massaged. A good massage therapist knows the reasons not to massage and how to explain that so the client doesn’t get angry.goodtherapist

Practice Universal Precautions: Protect your clients and yourself. If you don’t know what universal precautions are, you are not practicing safely. Good massage therapists know how to practice without spreading disease – or going overboard and putting on gloves when there is no rational need.

Pressure: The point of an effluerage is to soothe, not startle. Pressure with a first effluerage should be mild and stay the same all the way up. Therapists who start light on less sensitive areas and then suddenly drill sensitive tissue at the end of an effleurage could be called grinders. Not a good rep.

Timing: Twenty minutes on the feet because you like foot massage is not a good opening if the client wants a full body treatment. A person with a headache usually wants their head rubbed first.

Encouragement: We don’t fix, we soothe. A positive word goes a long way in helping people feel better.

Goals: What you want to practice that day may not be what the client wants. They may just want to fall asleep. Check-in. Ask before doing unusual techniques For example: whiplash clients can be very afraid of having someone traction their neck by suddenly lifting their head with a towel. If they don’t understand or agree, they will tense up.

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.     university     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?



The Push

Massage therapists know that when a client has been pulling something – wire or cable, storage boxes, dogs, etc. that they will find a host of sore and overstretched muscles.

Ergonomically, it is not good to pull, but to push. Push we can do much more easily and with much less fatigue. Somehow the design of things and the human body makes push much better than pull.

This concept gets forgotten, here and there, by otherwise wise, experienced and intuitive massage therapists, in this case me.push

Oh my, something was up. I went for my weekly massage, which I hadn’t had for three weeks because my schedule got crazy, and felt what seemed like a loop of fatigued tissue running from my traps to posterior rotators to lats to triceps to forearms to my thumbs.

Funny I didn’t know that bad patch was there until the massage therapist starting rubbing there. How many times has a client told me that they had no idea something hurt until it was touched? It was especially bad on my left side. Lo, I am left-handed.

As my friend and massage therapist trade-partner tried to get the angst out of this area, I suddenly became aware that I had been doing something wrong. Oh so very wrong. Me? In the biz now for 20 years and I have found a new way to feel yucky?

Hey, it happens.

After three massages that week, I began to feel a lot better. The drilled-in fatigue dropped, I felt less looped in the shoulders and back.

But I needed to find out for myself what I had been doing that had run me off the boards.

I was working with a client who had a habit of clutching items – files, purses, children, and etc. when the dawn finally broke over Marblehead.

I had been working on rotator cuffs from the opposite side of the client, pulling up and back on trigger points in the lats / tereses / infraspinatus muscles. One can massage from the opposite side, on occasion, of course without ending up sore. But one must use the weight of the body, mainly one’s assets, to create the pull. Somehow in the frenzy of the past month I had forgotten this and started using my pulling muscles instead of leverage. What are the pulling muscles? Traps, lats, triceps, etc. Somehow I had forgotten to bend my knees and use weight instead of muscle.

Oh, I have been very good this week. Now I work trapped shoulder blades from the same side. I take care to move the arm into flexion to expose the shoulder. And I vow to never, ever, to pull again. Time for another Epsom soak.

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Effleurage & the Flaming Snowplow

ouchEffleurage & 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….

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 hulakidsdisciplines. 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!

History at Your Hands

We had a wonderful time picking out decorations for my mother-in-law’s 90th 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 90th” 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.”calm

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.