Post-Surgical Massage Post-Surgical

exploring today’s touch therapies

SEE PAGE 68 SEE PAGE

ISSUE 232 • SEPTEMBER 2015 • www.massagemag.com TIPS FOR WORKING 9IN A HOSPITAL PAIN-RELIEVING ESSENTIAL OILS

SPECIAL MARKET WITH VIDEO TO ATTRACT NEW CLIENTS

Post-SurgicalPost-Surgical

MassageMassage by Whitney Lowe SUPPLEMENTS FOR SELF-CARE SELL SESSION PACKAGES FOR GUARANTEED INCOME!

| Contents September 2015 Issue 232

44 56

Massage for the Frail and Dying: Communicate Cover Story Care through Touch The Postsurgical Client: Manage Pain While touch for the sick and dying is as unique as the & Enhance Recovery 38individual, its benefits are infinite and reciprocal. It can calm, comfort, relax, reduce pain, ease stress, relieve anxiety or depression, promote sleep and, most importantly, make people feel cared about. by Lindy Roussel, L.P.N., L.M.T., B.C.T.M.B. Read “Everyone Needs Touch to Thrive,” by Lindy Roussel, L.P.N., L.M.T., B.C.T.M.B., at massagemag.com/everyoneneedstouch.

Help in a Bottle: Anti-Inflammatory & Pain- Relieving Essential Oils Many essential oils have analgesic properties that can 44complement and enhance the massage therapy you provide. Clients dealing with chronic pain or inflammation may especially appreciate this natural, targeted approach. by Jimm Harrison Read “Best Application Methods for Essential Oils,” by Jimm Harrison, at massagemag.com/bestapplicationmethods.

Massage therapy can play a very important role in Market with Video: Attract New Clients & Raise 60the healing process clients face after undergoing Your Online Profile surgery, sometimes immediately after a procedure, other Content marketing is the present and future of a winning times as part of long-term follow-up care. By understanding promotional strategy—and one of the most captivating common surgical procedures and practicing the 56 formats you can use to gain the attention of potential new clients is appropriate precautions, you can become an outstanding online video. addition to your clients’ health care team. by Daniel Ruscigno by Whitney Lowe, L.M.T. Read “The Importance of Testimonials for Your Business,” by Daniel Ruscigno, at massagemag.com/businesstestimonials.

September 2015 Issue 232

30 Invest in the Best: High-Quality Tables & Chairs Support Your Massage You’ve put significant time and money into massage therapy training and continuing education—and that investment is worth enhancing by purchasing top-notch equipment you and your clients will enjoy for years to come. 30 by Brandi Schlossberg

48 Make Space in Your Body: Quick Self Fixes Improve Function While these simple strengthening sequences are designed to be self- treatments, many can be incorporated seamlessly into massage sessions, and taught to clients for at-home relief of muscle pain and weakness. by Barbara Sharp, L.M.T. Read “The Synergy of Quick Self Fixes and Targeted Muscle Testing: A Case History,” by Barbara Sharp, L.M.T., at massagemag.com/synergyqsf. Regular Features Departments

PRACTICE BUILDING 14 To Our Readers 22 Sell Session Packages: Better Client Care & Guaranteed Income In Our Mailbox by Karen Menehan 16 18 News & Current Events 26 EXPERT ADVICE Your questions answered by industry experts. Nichole L. Kucharek, 52 New Products P.A., L.M.T., B.C.T.M.B., addresses challenges therapists may face 74 Educational Resources and working in a spa environment. Development THE MASSAGE MAGAZINE LIST 76 Conventions & Events 36 The Top 9 Tips for Working in a Hospital Marketplace and Classifieds In the hospital, the massage therapist must work as part of a 78 team with other medical professionals—which brings unique 80 Display Ad Directory challenges and opportunities. by Karen Armstrong, L.M.T., N.C.T.M., and Laura Koch, L.M.T. 81 Reader Expressions Read more of your colleagues’ responses 66 LIVING IN BALANCE to this month’s featured question at A Foundation of Health: Supplements for Self-Care massagemag.com/readerexpressions. by Stacey Littlefield MASSAGE Magazine (ISSN1057-378X) (USPS 4596) Read “Pain-Relieving Herbs,” by Stacey Littlefield, at massagemag.com/painrelievingherbs. is published monthly by MASSAGE Magazine Inc., 820 A1A N, Ste. W18, Ponte Vedra Beach, FL 32082. RESEARCH REPORTS Subscriptions: USA surface $19.95/year; Canada surface $30/year; International air $47/year. Periodicals 72 Various Styles of Massage Benefit Fibromyalgia Patients; postage paid at Ponte Vedra Beach, Florida, and Acupressure Impacts Blood Flow, Heart Rate additional mailing offices. POSTMASTER: Send Visit massagemag.com/newresearch tto read this month’s online address changes to MASSAGE Magazine, P.O. Box Research Exclusive, “Oxytocin Affects Response to Social Touch.” 5027, Brentwood, TN 37024.

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www.massagemag.com SELF-CARE TIP Poll Question Are you massage research Feeling Overwhelmed? Massage literate? Your Inner Strength • Yes by Lesly Devereaux, J.D., D.Min. • No • No, but I plan to become You probably have times literate when hectic schedules and client interactions interfere Cast your vote at massagemag.com

with your productivity at work THINKSTOCK and leave you overwhelmed. Reader Expressions Instead of allowing these challenges to defeat you, you can MASSAGE Magazine asks you: Bookmark our Massage News page to harness your inner strength to face them. How do you use the Internet to keep current on the latest news about the In addition to practicing a healthy, consistent self-care find and retain clients? massage profession. routine, try these effective ways to channel your inner strength when you feel overwhelmed. Enter your response at Massage Modalities As a massage therapist, you spend the majority of massagemag.com your time helping other people relax; your session room’s Resource Center environment is great for massaging the body and mind— MASSAGE e-News both your clients’ and your own. Meditation involves a Our email newsletters deliver similar practice; it is a great way to clear your mind. While exclusive articles, tips, news and you may not have an hour to retreat from your busy work information directly to your inbox. Sponsored by Earthlite, this resource center schedule, a few minutes of deep, intentional breathing, provides massage therapists the latest news, away from distractions in the quietness of the room you information, articles and tools related to have prepared for your next client, will help alleviate stress. massage modalities, so they can read about Visit massagemag.com/overwhelmed and pursue training in those that best fit their to read the rest of this tip. practices and serve their clients’ needs. Visit Lesly Devereaux, J.D., D.Min. (leslydevereaux.com) is an massagemag.com/modalities. author, minister, wellness coach and speaker who specializes in training people to meet goals despite obstacles. She THINKSTOCK is the author of Breaking Codependency: How to Navigate Subscribe for free at Blogger the Traps That Sabotage Your Life. massagemag.com Spotlight Karen Ball, L.M.T., certified reflexologist and aromatherapist (academyofancientreflexology.com), Online Exclusives and author of massagemag.com’s • Best Application Methods for Essential Oils “Reflexology” blog, has been a manual • The Importance of Testimonials for Your therapist since 1983. She was trained and Business certified by the Reflexology Association of • Oxytocin Affects Response to Social Touch Canada as an instructor, and graduated from the Florida School of Massage in • The Synergy of Quick Self Fixes and Gainesville, Florida, where she currently Targeted Muscle Testing: A Case History teaches reflexology, professional • Pain-Relieving Herbs boundaries and ethics, and therapeutic • Everyone Needs Touch to Thrive communication skills. Ball is also creator of the Therapeutic Hand & Foot Reflexology See these and more under Current

THINKSTOCK Issue at massagemag.com. Professional Certification.

FAQs

Q: How do I subscribe? A: Order online, by mail or by phone. Order online at massagemag.com and click on our subscription link. Order by mail by MASSAGE Magazine’s mission is to provide to massage and touch therapists the tools, submitting a subscription card to: information and resources to help them succeed both in their businesses and their session MASSAGE Magazine rooms. We give readers the latest news affecting the massage field, in-depth feature articles, P.O. Box 5027 educational technique articles, accessible business advice, informative profiles, and inspiring Brentwood, TN 37024. stories of how touch promotes well-being on individual and global levels. We connect readers Order toll-free by calling (888) 883-3801. to each other, and to the organizations and manufacturers providing exceptional opportunities and products. We believe healthy touch has the power to create a better world, and that by Q: How much does a subscription supporting and educating massage and touch therapists, we are playing a role in that creation. cost? MASSAGE Magazine is dedicated to ongoing growth and improvement—both in editorial scope A: U.S. surface: $19.95/year; $29.95/two and content, and as a healthy business doing good work in the world. years or $39.95/three years. Canada/Mexico: $33.95/year; $57.95/two MASSAGE MAGAZINE years or $76.95/three years. International air: $48.95/year; $87.95/two Editor in Chief Sales Executives Office Personnel years or $111.95/three years (prices and Karen Menehan Donnell Curley payments in U.S. funds). [email protected] Director of Operations (904) 567-1549 Landon Calabello Associate Editor [email protected] Q: When will my subscription start? Allison Payne Controller A: Your subscription will start 4-6 weeks [email protected] Susan Nevins Arlette Keeley from the date you place your order. (904) 567-1554 Digital Editor Associate Publisher [email protected] Q: My address is changing—how do I Jenn Ruliffson Donnell Curley [email protected] Advertising Coordinator keep from missing an issue? Lorie J. McKown Founders A: Go online to massagemag.com and Art Director Robert and Judi Calvert click on the “Change your mailing address” Michael Lyons link found under Contact Us. Graphic Designer W. Kelley Lucas Q: How many issues are published each year? YOU CAN CONTRIBUTE TO MASSAGE MAGAZINE A: MASSAGE Magazine is published monthly.

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M | To Our Readers

underwent sinus surgery a few surgeries, the patient is anesthetized and must stay in years ago, and I remember being a static position for a long period of time,” Lowe notes. terrified beforehand—not so “Patients in this situation cannot make comments about much of the surgery itself, but of any pain or discomfort they are feeling.” Ithe story I told myself that I wouldn’t Lying on a surgical table for several hours can cause wake up from the anesthetic. Being put nerve compression pathologies to develop, he adds. “The under and cut into is a stressful thing, nerve compression creates soft-tissue pain following the whether the patient has time to get used surgery that is not related to the surgical procedure itself.”

PHOTO BY KELLY MENEHAN to the idea, as I did, or undergoes an You can see how massage therapy benefits this type of emergency procedure. clientele; however, advanced education focused on working I received massage prior to my surgery, and it went a long in a medical venue, along with the drive to market your way toward calming my nerves and helping me ground in services to patients and hospitals, and the confidence to my body. I was back on my massage therapist’s table a week network with physicians, are keys necessary to succeeding or so after surgery as well. in this niche area. More than 51 million procedures are performed each To learn more about the skills required to work in a year in the U.S., including surgeries and procedures such hospital, read this issue’s The MASSAGE Magazine List, as colonoscopies, according to the Centers for Disease “The Top 9 Tips for Working in a Hospital” (page 36). And Control and Prevention (CDC). More than 1 million people turn to page 38 for one nurse-massage therapist’s advice on undergo total hip or knee replacements in this country each massage for patients experiencing very serious challenges, year, and half a million people undergo hysterectomies, in “Massage for the Frail and Dying: Communicate Care according to the CDC. Those are just a few of the types of through Touch.” surgeries and other procedures carried out in hospitals and Many massage therapists possess the ability and desire to inpatient clinics. I would wager that for the vast majority of work in a medical venue. Perhaps for those of you who had patients, massage therapy would be a valuable addition to not considered doing so, this issue might open the door to a their care, pre- and post-surgery. new interest in medical massage. For this issue, Whitney Lowe, L.M.T., explains the Please contact me anytime with feedback and ideas. I’m benefits of massage postsurgery, in “The Post-Surgical at [email protected]. Client: Manage Pain & Enhance Recovery” (page 60). Stress, pain and restrictions may all be alleviated by massage following surgery, according to Lowe. “In certain

Meet some of the contributors who helped Contributors | create this month’s MASSAGE Magazine

Stacey Littlefield wrote Jimm Harrison wrote Lindy Roussel wrote Whitney Lowe wrote “The Nichole L. Kucharek “A Foundation of Health: “Help in a Bottle: “Massage for the Frail and Post-Surgical Client: answers the question, Supplements for Self-Care” Anti-Inflammatory and Dying: Communicate Care Manage Pain & Enhance “What challenges might for this issue. Stacey is Pain-Relieving Essential through Touch” for this Recovery” for this issue. I face when working in passionate about natural Oils” for this issue. Jimm, issue. Lindy works as a He directs the Academy a spa?” for this month’s medicines, and is product an essential oil, holistic nurse-massage therapist for of Clinical Massage, Expert Advice column. formulator and research wellness and scent branding hospice, has a private oncol- and offers an online Nichole offers workshops director at Redd Remedies, consultant, educator and ogy massage practice, and is certification program in for spa personnel a company in Bradley, author, teaches at Bastyr director of Sage Continuing orthopedic massage. through Sage Continuing Illinois, that manufactures University in Kenmore, Education for Massage Whitney lives in Sisters, Education, and practices herbal formulas designed to Washington, across the U.S., Therapy & the Healing Arts Oregon. massage therapy at improve health. and internationally. LLC in Lancaster and Easton, Elements to Wellness in Pennsylvania. Reading, Pennsylvania.

M | In Our Mailbox Reader Feedback HOW’S BUSINESS? the market is doing right now I’m wondering if MASSAGE Maga- across the rest of the country. zine could run a survey on the current Are other therapists seeing fewer massage market to see how other clients than they were? Are others massage therapists around the country having to lower their rates to stay are doing financially. My business of afloat? Is there another economic 18-plus years has been steady up until downturn occurring? Thank you late this past fall, and for no apparent for your help! THANK YOU reason has seen a steady decline. Candace Thanks so much for letting me work I’m wondering if the market is Via email with your website on [my] article, “9 down for everyone, if it’s just regional, Ways an Outdoor Digital Sign Makes whether lowering my prices would EDITOR’S NOTE: Readers may weigh Massage Advertising Easy” (mas- bring clients back, or whether there is in on Candace’s questions by sending sagemag.com/outdoorsign). Your layout something else going on—such as a an email to edit@massagemag. and embedded hyperlinks really make new therapist that is providing better com—or by participating in our online this a first-class posting. I appreciate be- quality services or lower prices. discussions on LinkedIn (massagemag. ing associated with your organization. I have not had lulls like this for com/linkedingroup) or Facebook Sarah Robison well over a decade. I’m curious what (facebook.com/massagemagazine). Danville, Illinois MASSAGE Magazine Social Networking DISCUSSION: Do you see litigation around [the issue of massage enjoyable experience for both mother pregnant clients? during the first trimester] is truly and myself. I receive satisfaction in I love to give treatments to a shame. With proper training and knowing my clients feel relief and pregnant women. It is extremely experience, there really are very few relaxed when they leave. I see women useful for the typical low-back conditions that cannot be supported at all stages of pre- and postnatal, and pains, edema in the legs and feet, with bodywork. obviously vary the techniques and resilience of the abdominal muscles, Deane Juhan specifics depending on what stage of and general emotional well-being massagemag.com/linkedingroup pregnancy they are at. of the mother. I prefer the side-lying William Cornwill position for the mother’s comfort. Fear, Yes, I am trained in side-lying massagemag.com/linkedingroup misinformation and the prospect of pregnancy massage and find it a most

M | News & Current Events

New Report: 53 Million U.S. Adults Disabled

report from the Centers disability, the other disabilities A for Disease Control and highlighted in the CDC report, Prevention (CDC) released July Prevalence of Disability and 30 shows that 53 million, or 22 Disability Type Among Adults— percent, of American adults are United States, 2013 were related disabled. Among disabled peo- to cognition, vision, the ability ple, mobility problems—“defined to live independently, and the as serious difficulty walking ability to practice self-care such or climbing stairs,” the report as bathing and dressing. The noted, are most prevalent, and report and graphics may be such problems account for 13 viewed or downloaded at cdc. percent of all adult disabilities. gov/ncbddd/disabilityandhealth/ Disabled adults may be ideal features/key-findings- candidates for massage therapy, community-prevalence.html. as the flexibility and pain relief “I would never call massaging effected by massage could ben- a disabled person a challenge efit range of motion and mobility; so much, but an opportunity to however, disabled people are help a person in pain,” said Tyler, often not encouraged to visit who sees clients with conditions massage therapists, according including Parkinson’s disease, to massage therapist Gary Tyler, dementia, cancer, arthritis, fibro- Jr., who specializes in working myalgia and multiple sclerosis at with a disabled and geriatric his South Windsor, Connecticut, clientele. HOLLINGSWORTH/THINKSTOCK JACK practice, Total Touch Therapeutic “I feel the biggest obstacle so getting to an office can be “Often, when we work with Massage LLC. “Also, having that a disabled person very challenging for them.” people with disabilities, we experience and an understand- encounters, is that many times Because of that, a massage are working with them in a ing of disabled people helps to they are not getting the help therapist who wants to work wheelchair, a bed or other make them feel as comfortable they need because movement is with disabled clients must be device,” he said. “When as possible,” he added. “That is not always very easy for them,” flexible in terms of locale and you work on a person with my goal when working on any Tyler told MASSAGE Magazine. “I ways of working, Tyler said, a disability, you have to look client.” find many clients in wheelchairs and willing to provide massage outside the box.” that have to have 24-hour care, therapy on-site. In addition to mobility-related —Karen Menehan

Leaders Forge a Path for Massage Education

assage schools in the U.S. The Alliance for Massage July 23–25 in Minneapolis, some which held their board Mare facing challenges— Therapy Education (AFMTE) Minnesota. (MASSAGE Magazine meetings on-site, included diminished enrollments among and Commission on Massage was one of many congress the Massage Therapy them; however, commitment Therapy Accreditation co-hosted sponsors.) Organizations Foundation, Federation of State to creating top-notch school the 2015 Educational Congress represented at the congress, Massage Therapy Boards, curricula, first-rate educators National Certification Board and well-trained new therapists for Therapeutic Massage & is unwavering among the Bodywork, Society for Oncology profession’s leaders. This was Massage, Associated Bodywork evidenced at a recent gathering & Massage Professionals, of 215 massage school owners, American Massage Therapy educators, school directors and Association and American representatives from massage Organization for Bodywork organizations and businesses, Therapies of Asia. who met to discuss, and create Read the rest of this article at plans for, massage education.

THINKSTOCK massagemag.com/forgeapath

18 | MASSAGE Magazine | September 2015 | www.massagemag.com | AEROGONDO/THINKSTOCK Health Care Providers’ Sexual Biases Studied

he first study to look at health and medical education. She Tcare providers’ bias for or said future research could against gays and lesbians has be conducted to explore how found that just as in the general providers’ preferences toward population, health care providers sexual orientation might affect are biased toward people who health care delivery to gays, share their own sexuality. lesbians and bisexual people. Specifically, heterosexual “For health care organizations providers held moderate-to- that aim to serve these strong implicit preferences for populations, these data suggest straight people over lesbian and an opportunity to examine gay people, while lesbian and methods likely to mitigate implicit gay health providers expressed biases, such as eliminating implicit and explicit preferences discretion from decision-making, for lesbian and gay people use of clinical guidelines, over straight people. Bisexual awareness of personal bias providers were found to have as self-caution, organizational mixed preferences, according to policies that promote objective a press release from University of decision-making, and inclusion of Washington Health Sciences. counter-stereotypical experiences “Training for health care in educational programs,” the providers about treating sexual study’s authors stated in the minority patients is an area in press release. great need of attention,” said “Health care providers’ implicit lead researcher Janice Sabin, and explicit attitudes toward University of Washington lesbian women and gay men” research associate professor was published in the American in biomedical informatics Journal of Public Health.

Number of minutes per week of moderate- intensity exercise recommended to post menopausal women, to reduce total body fat. 300 Source: JAMA Oncology

| www.massagemag.com | September 2015 | MASSAGE Magazine | 19

M | News & Current Events

Diet Soda May Lead to More Belly Fat by Mary Purdy, R.D.N. although diet soda contains zero calories, the body may ou’ve probably heard still respond to the sugary Ythe buzz around the taste and produce the insulin it negative health effects of thinks is needed to do its job. sugar and high-fructose corn Diet soda also contains syrup. This news might have phosphoric acid, which can you reaching for the diet disrupt the balance of the version of your favorite soda beneficial bacteria that reside in hopes of avoiding excess in our digestive tract and sugar and staving off weight help metabolize nutrients. gain; however, diet soda may Mess with them, and you’re not actually be a healthier potentially messing with your choice. metabolism—which can also Recent research, including pack on the pounds. a 2015 study in Physiology If the fizz is what draws you & Behavior, showed an to soda, try some sparkling association between diet soda water with a twist of lemon or and increased abdominal fat. lime, a splash of juice or some Studies have also shown that fresh mint. If you want flavor,

some artificial sweeteners can BOARDING1NOW/THINKSTOCK brew up some iced tea with have a negative effect on our from several epidemiological the hormone insulin, which is the many tasty brands now ability to feel full, meaning that studies have found that meant to help shuttle energy to available. Your thirst can also even if we have consumed a consumption of NNSs, mainly the cells that need it. However, be quenched easily with a big sufficient amount of calories in diet sodas, is associated when insulin is consistently glass of ice water that requires for the day, after drinking diet with increased risk to develop and chronically elevated, the no money or packaging. soda our brain continues to obesity, metabolic syndrome, result is fat storage around the send out signals that we need and type 2 diabetes.” abdominal region. Mary Purdy, R.D.N., is a more. When hunger kicks in, Additionally, when the body registered dietitian nutritionist “Until recently, the general we often crave simple senses something sweet, with a master’s degree in belief was that non-nutritive carbohydrates—sweet drinks, it responds by producing clinical nutrition from Bastyr sweeteners (NNSs) were candy and other sugary insulin, even if the sweet- University (bastyr.edu) in healthy sugar substitutes snacks—since they tend to tasting substance is artificially Seattle, Washington, where because they provide give us the energy we seek manufactured and offers no she also recently served as sweet taste without calories with the least amount of real glucose to transport to an adjunct professor. She was or glycemic effects,” the digestive effort. Simple carbs cells, according to a 2013 also a clinical supervisor in the Physiology & Behavior article’s naturally raise blood sugar, Trends in Endocrinology graduate teaching clinic for five abstract noted. “However, data simultaneously raising levels of and Metabolism study. So years.

What Does It Take to Be Successful? massage association in Quebec, Canada, is conducting A research to identify the personal and professional traits that help lead to success in the massage therapy field. To take the survey sponsored by Alliance Québécoise des Thérapeutes Naturels, visit aqtn.ca/TypeSorter. TOPP_YIMGRIMM/THINKSTOCK

20 | MASSAGE Magazine | September 2015 | www.massagemag.com | Massage Therapist Acknowledged for Work with Veterans s a veteran of the U.S. military, Dahneke, CEO of Performance Health, Amassage therapist Jane Hyde when presenting the award at the Kordish understands firsthand the FSMTA’s annual convention in June in physical and mental challenges faced by Orlando, Florida. “Jane Kordish knows active duty personnel. This informed her that even greater healing comes from decision to volunteer seated massage serving our country’s ultimate servers: to service members at MacDill Air Force those in our military.” Base near Tampa, Florida, and provide When she was presented the award, massage therapy to participants in the Kordish said she’d like to see more U.S. Marines’ Wounded Warrior Athlete massage therapists work with members Reconditioning Program. of the military. She was quoted in a Her work with service members Performance Health press release as led to Kordish being awarded the saying, “We as massage therapists share 2015 Performance Health FSMTA many traits in common with our military Humanitarian Award. The award is service members, veterans, retirees co-presented by Performance Health, and their families, such as commitment, parent company to Biofreeze, Theraband dedication and a code of ethics. Let’s and additional therapeutic products, strengthen the ties between us at every and the Florida State Massage Therapy opportunity.” PHOTO COURTESY OF RUSSELL HAWORTH Association (FSMTA). Performance Health donated $500 Jane Hyde Kordish, L.M.T. (right), with Leiah J. “A key to being a true humanitarian in Kordish’s name to each of two Carr (left), president of the Florida State Massage is to know that the soul is healed by organizations: SOF Bionic Warriors and Therapy Association (FSMTA), at the FSMTA’s serving others in need,” said Marshall CAUSE USA. M national convention in June.

| www.massagemag.com | September 2015 | MASSAGE Magazine | 21

M | Practice Building Sell Session Packages Better Client Care & Guaranteed Income

by Karen Menehan

assage Michigan. “I find therapists them to be a wonderful understand feature for people who need, that regular see and feel the benefits of Mmassage sessions provide regular bodywork.” preventive care that keeps Offering session clients relaxed, flexible and packages also shows that pain-free—yet, the general the therapist is committed public still sometimes views to the client’s long-term massage as an occasional health, Cutlip said, and luxury or something to helps forge a professional turn to when pain becomes relationship based in trust. chronic. “I have many clients Session packages— with chronic pain or whereby therapists sell WOWOMNOM/THINKSTOCK fibromyalgia, [or who are] multiple sessions up front recovering from breast at a slight discount—create common ground Session cancer reconstruction surgery,” she where both therapist and client benefit said. “These clients receive such benefit financially. More importantly, when a client packages from regular massage [so] I’m happy purchases a session package, he or she is to do what I can to help increase their saying yes to regular massage therapy and allow therapist quality of life.” therefore making a commitment to ongoing Selling session packages, she added, health. and client to shows clients you are willing to work with them to create a regular regimen Commitment create a regular for better health. This results in a “My massage wellness packages are a stronger connection with clients, she big success at my studio,” said massage regimen for said. therapist Heather Cutlip, L.M.T., who owns That therapist-client connection Little Lotus Wellness Studio in Ferndale, better health. combined with an upfront financial

22 | MASSAGE Magazine | September 2015 | www.massagemag.com | investment keeps massage therapy front-and-center in the one-hour sessions per week for $50 per session, reflecting client’s consciousness, leading to better session outcomes, a total savings of $1,976—and regular income for Kelly. said Bard Williams, C.M.T., managing partner at Silicon His one-massage-a-week package costs $2,860 up front, Valley Massage Therapy Group in San Jose, California. costing the client $55 per massage. “When a client invests in his or her health, then they Cutlip books an initial session with a client, and are more likely to come in for regular treatments and afterward informs the client she has session packages routine maintenance,” he said. “This allows us to address available. She sells massage sessions in bundles of three, existing issues and prevent future injury.” five, 10, 15 or 20. “With these bundles, you receive a The need for regular massage sessions can be especially discount to make regular bodywork more affordable for true for people involved in sports and sporting events, those who need it on a regular basis,” she said. “With according to Alisha Pye, general manager of LA Sports each package, the bigger the commitment, the bigger the Massage in Los Angeles, California. “This is especially break.” true for professional athletes and anyone training for a At Silicon Valley Massage Therapy Group, clients may marathon or competitive event, as well as someone who pay for three Swedish massage sessions for $240, receiving requires routine body maintenance due to stress, work or $10 off each usual session price of $90; or they can pay frequent physical activities,” Pye said. $420 for six sessions, reflecting a per-session price of $70. Session packages are about more than money, though. Strategy The commitment and convenience aspects of packages are One benefit of offering session packages is guaranteed important to many clients as well, said Williams. income for the massage therapist. Since the therapist “Since our sessions are highly tailored to the client, receives a large amount of money up front, and won’t be we sell packages based on their needs,” Williams said. paid session-by-session by any client using the package “For some clients, it’s a money-saving path to maintain option, the therapist needs to budget accordingly. Cutlip said session packages actually create Types of session packages offered are up to the more reliable, steady income, even though she is not paid at therapist’s discretion. One massage therapist the time of every session, and promotes “mega massage packages”—one of making at least some income up front can help during less- which costs $5,200 up front. productive times. “Packages help level out the cash flow,” Williams added. “An infusion of cash from wellness, and to others, it’s [about] a finite number of packages helps us make up for times when we are less sessions recommended by a therapist who is working with busy.” the client on a specific issue—while to many, [packages Types of session packages offered are up to the offer] convenience designed to make getting bodywork therapist’s discretion. At Lotus Massage & Wellness anytime they need it easier.” Center, in Tucson, Arizona, a client who purchases a Cutlip and Williams both said that 40 to 50 percent of package of four sessions saves $5 per session. Purchase of their clients purchase session packages, and that once a an eight-session package results in $8 savings per visit. client has done so, he is much more liable to do so again A 12-session package provides savings of $10 per session. when his package expires. Meanwhile, the therapist who is paid for the 12 sessions “I have clients who purchase small packages every few up front receives $780 plus the confidence to know she months, and then those who buy their entire year at one will be able to assist the client’s health on a regular, time,” Cutlip said. ongoing basis. This in turn can benefit the outcome of Research on consumer psychology indicates it might massage and result in increased referrals from satisfied be beneficial to the sale to frame it in terms of the cost per clients. session, rather than focusing on the lump sum due at the One Las Vegas, Nevada, massage therapist, Kris Kelly, time of the sale, because seeing what might be considered for example, promotes “mega massage packages”—one a large sum activates the brain’s pain-processing center, of which costs $5,200 up front. This buys the client two according to neuroeconomics expert George Loewenstein,

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M | Practice Building

Offer session packages to convey the message that massage should be thought of as a wellness habit.

Ph.D. Also according to Loewenstein and colleagues’ Developing this wellness habit is “a win-win for research, “Brain Scans Predict Buying Behavior,” both therapist and client,” Williams said. “Packages published in the journal Neuron, consumers prefer to add options to the way you deliver services, help with make one large purchase rather than several small leveling cash flow over time, and are a great way to purchases, so the therapist could also focus on the ease encourage more frequent massage sessions. and convenience inherent in purchasing sessions in one “Once a client has purchased a package and seen the package, at one time. savings,” he added, “they’ll be back for more.”

Wellness Karen Menehan is MASSAGE Magazine’s editor in Offering session packages conveys to clientele chief. She wrote “Market to Millennials: Reach the Next the message that massage should be thought of as a Generation of Massage Clients” (February) and “Body wellness habit—something to be received on a regular Image: Massage Creates Healthy Self-Connection” basis rather than just a few times a year. Session (March) for MASSAGE Magazine. Menehan has edited packages provide the therapist with regular clientele, and written for additional publications and organizations, reliable income, and the opportunity to make a lasting including Imagine Magazine, the Sacramento Bee difference in each client’s levels of relaxation, flexibility newspaper and the LIVESTRONG Foundation. M and pain relief.

M | Expert Advice What challenges might I face when working in a spa?

Nichole L. Kucharek, P.A., L.M.T., B.C.T.M.B., responds

Ethical Easy PIXLAND/THINKSTOCK

roviding massage in a spa can have a unique set Spas’ challenges of challenges you may not have encountered There are many challenges in the spa industry that before. In a spa, employees have to work as a do not rear their heads in other places of employment. cohesive unit. Common obstacles can arise on a When the top priority of management is financial gain Pdaily basis, sometimes several times a day. and the top priority of staff massage therapists is client For example, imagine looking at your schedule for care, this combination can be a fiasco. the day and noticing you have seven sessions scheduled In spas, there can be many complications, in part back-to-back with no scheduled break. When you ask because the spa industry is growing quickly. Many new your spa manager about this, she says you have 10 spas offer cheap monthly rates and lower pay rates. I am minutes between each client to take a break. As you personally aware of spas that do not value continuing know, this buffer time can be lost by just one client education; or, where continuing education is required, running a little bit late. spa management will only pay for online classes. Some Now, not only have you started the day stressed spas even discourage proper note-taking. One lead mas- out, you also know that the quality of your work will sage therapist told me he was instructed to refrain from decline by the third or fourth massage. Burnout and note-taking as it “takes up time and causes arguments.” high turnover of spa massage therapists and clients are The lack of professionalism at some spas has created a result of situations like these. Welcome to the spa. a misperception on the part of the public that spa

26 | MASSAGE Magazine | September 2015 | www.massagemag.com | massage therapists may be untrained or undereducated. responsibility to be honest about our credentials and to I have met clients in the spa setting who were surprised only work on clients when it is deemed advantageous. I had gone to school for massage; a former spa coworker I have also been privy to new therapists coerced into told me, “When I was working in a particular spa, I felt thinking that learning to perform a hot stone massage in like there was a constant struggle of trying to prove I was the manner the workplace wants it done is equivalent to educated to my manager, [and] I know I was not alone. being trained in the modality. This created an environment of animosity and high Another area of concern is client confidentiality, which turnover for the spa, until that manager was no longer may be jeopardized in a spa. Client intake forms are employed there.” usually not massage-specific, and include questions for I have witnessed seasoned spa massage therapists estheticians and cosmetologists. (See “Are You Compliant? perform modalities they were not trained in, just to What the Latest HIPAA Rules Mean for Massage appease managers or out of fear of being ostracized Therapists,” MASSAGE Magazine, February 2015.) for refusing a client. Some spa managers tell massage Alcohol is yet another area of concern in spas. Many therapists to perform modalities they are not educated spas offer a complimentary glass of wine with the option in or to work on clients with contraindicated conditions to buy more. Many also have amenities such as hot tubs, because the company would “have their back.” This is saunas and heated pools. Although these are great selling uncalled for—and dangerous not only for clients, but points, combining alcohol with hot therapies makes for a spa massage therapist working as an independent clients vulnerable—and even more so when bodywork contractor, for the liability risk raised. We have a is added into the mix. Personally, I have been pushed

How to Respond to 5 Potential Spa Challenges

How to respond when asked to perform a ostracized for being mature when it comes to gossiping; 1technique you are not trained in: A positive however, do not allow yourself to be sucked into aspect of working in a spa is not every massage therapist negativity. Tell your supervisor that this type of behavior is educated in the same modalities. As a contained violates confidentiality, your professional standards group, we can play off of each other’s strengths and of practice and your personal code of ethics—not weaknesses; meaning, refer this client to a coworker. to mention the Health Insurance Portability and Accountability Act of 1996 (HIPAA). What to do when scheduled to perform 2seven massages back-to-back: If this is What to do when an inebriated client walks a common occurrence, become educated about 5into your session room: Decline to work on the classifications and labor laws so that you understand client. Again, consistency is key. The more you take your your rights as an employee. If you are an employee, livelihood seriously, the more you will be respected by contact your local National Labor Relations Board your colleagues. (nlrb.gov) for assistance. Still have questions? What to say to a manager when asked Remember, professional organizations, including 3to perform massage on a client with a associations, state massage therapy boards, the contraindicating condition: If you are trained in a National Certification Board for Therapeutic Massage modality that is not contraindicated for the client, such & Bodywork and various other entities, have codes of as reiki, inform your manager of this. If your suggestion ethics and standards of practice that do not waiver. does not appease your manager, decline to work on These codes and standards have been put in place to that client. Consistency is key to protecting yourself and provide a framework that protects us as professionals clients; meaning, always respond the same way in this and ensures the safety of our clients. This framework is type of situation. our reference point when it comes to any session-related situation we may be unsure of. How to respond when colleagues are 4gossiping about a client: You might be — Nichole L. Kucharek, P.A., L.M.T., B.C.T.M.B.

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M | Expert Advice

Ideally, spas should invest in continuing education for massage therapists, and also encourage in-person ethics training.

by management to give bodywork to clients who were of-practice considerations and be aware of absolute clearly inebriated, more than once. contraindications of modalities. Looking back, what I should have done was say no Ideally, spas should invest in continuing education for and be consistent every time I was put in that situation. massage therapists, and also encourage in-person ethics When I was a new massage therapist, I was afraid I would training. lose my job if I disagreed with the manager, who had no Working in a spa can be ethically challenging. To education in massage. protect your professional reputation, make sure to be As I’ve become a more seasoned massage therapist, I educated in all aspects of your code of ethics and scope have learned that the threat of losing a job for practicing and standards of practice. Stick to these principles and be within my code of ethics and scope and standards of consistent in the way you handle challenging situations; practice can be an eye-opening experience for both keep track of them and write them down if you need management and coworkers. to. Encourage coworkers to come up with protocols for handling common problems. Solutions If we, as professional massage therapists, do not Consistency in all departments of the spa is crucial. demand respect from coworkers and managing entities Spas should have their own ethical guidelines, and spa when it comes to adhering to the codes of our profession, management should have to adhere to those guidelines the obstacles to acceptance by the public and medical and be held accountable. Clear codes of conduct, professionals will remain. policies and protocol manuals should be established and available. Training in services should be based on a Nichole L. Kucharek, P.A., L.M.T., B.C.T.M.B., is a National protocol so that all services embody a uniform process. Certification Board for Therapeutic Massage & Bodywork- Management should have a clear policy of financial approved continuing education provider through Sage agreements and employee status. Management must Continuing Education (sagecontinuinged.com). She travels also be clear about who takes the cut with discounts, to bring her classes to you. She offers a workshop, Under- specials or coupons. Management also needs to ensure standing Massage Ethics and Integrity, for spa support that all support staff are knowledgeable in treatments staff and managers. She also practices massage therapy offered. Further, it is necessary for management to be at Elements to Wellness in Reading, Pennsylvania. M able to understand the ethical principles behind scope-

Invest in the Best

lients come to massage therapists seeking benefits High-Quality Tables that may range from a general sense of relaxation to relief from acute or chronic pain. If the skills and & Chairs Support knowledge of the massage therapist are considered Cthe driving force behind such benefits, then one might think Your Massage of the massage table or chair as the foundation of the service. After all, without proper equipment, even the most talented practitioner can be challenged to provide the best possible by Brandi Schlossberg massage. When it comes time to purchase a massage table or chair for your practice, it will help to remember the importance of a solid foundation. When you invest in a high-quality massage table or chair, you are paying for that solid founda tion and the benefits it can bring. These benefits are the return on your investment, and that return can be significant—more satisfied clients, increased income, greater energy, reduced injury risk, elevated professional status and more. Here, experts including the manufacturers of massage tables and chairs weigh in on what sets high-quality equipment apart, and the difference a top-notch table or chair can make for your clients, your body and your practice Custom as a whole. Craftworks’ Athena massage Defining quality table has a fully Before you pay a higher price for what is presented as a customizable higher-quality piece of equipment, you will want to know design, featuring a what may set this particular table or chair apart to merit the solid birch frame greater investment. According to Hagan Craft Suber, vice and dual-end president of Comfort Craft, it all begins with the materials accessory ports, used by the manufacturer. and can withstand “A higher-quality massage table is typically composed of up to 650 pounds higher-grade materials, providing a more durable piece of of pressure. equipment,” she said. “We have many customers who have had their tables for 20-plus years and are still going strong.” Suber said the foam in a quality piece of massage equipment tends to provide greater comfort to clients and

Custom Craftworks’ Melody massage chair adjusts at every point to ensure your client’s maximum comfort. Weighing only 18 pounds, it sets up in seconds and folds for portability.

30 | MASSAGE Magazine | September 2015 | www.massagemag.com | Stronglite’s newly redesigned Ergo Pro II™ was ergonomically designed with thicker, improved cushioning, replaceable pads and a sleek new endplate. Its new physique is more comfortable—and Invest in the Best more functional—than ever.

resists breaking down over time, and another hallmark of quality is a massage table that does not convey any lack of stability to the client. Earthlite’s DemiFit™ “When a client walks in and leans on a table and is designed for it moves, it might make them insecure that the table offering extra care to your clients, and won’t hold them,” she said. “When they walk in and comes equipped with see a solid-built table that does not move of its own our unique comfort accord, they can have ease of mind that the table cutout, providing will hold them and they are in quality hands.” additional breast According to Brian Paris, vice president of comfort to clients Earthlite, one of the hidden secrets to determining who require it. the quality of a massage table or chair is to look at its underside. He said you should be able to get a visual sense of how stable and well-made the equipment is when you inspect it from this angle. “Get down and peek under the table, inspecting the quality of the wood and any support structure. A well-designed table will look clean, joints will be tight, and the table will look like a complete product,” Paris said. “Poor-quality tables and chairs may have weak or sloppy connection points, including the wood joints, clumpy welding marks or a lack of conformity in the finishes—all leading to a weaker table.” Along with stability and durability, another Oakworks’ PortalPro® weighs 19 pounds, has aspect of a high-quality massage table or chair may built-in wheels, and features the patented be its “bells and whistles,” such as arm bolsters, QuickLock™ Face Rest. A carry case is included, making this chair super-portable and storable.

Oakworks’ ProLuxe with ABC System features the Adjustable Breast Comfort (ABC) System, the only design that allows therapists to discreetly customize the comfort level via a powered system without disturbing the client.

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A piece of equipment that’s uncomfortable in any way can work against the efforts of the massage therapist.

upgraded face cradle, electronic height adjustment and more. These added features can allow the equipment to adapt to the body types of different clients, as well as the positioning needs of the practitioner when it comes to applying specific techniques. Client comfort BRITTANY PASTERKIEWICZ A relaxed body is a cornerstone of massage therapy, and a high-quality massage table or chair may be able to help each client reach a relaxed state before the massage even begins. The NRG® VedaLux Massage Table On the other hand, a piece of equipment that’s uncomfortable provides a degree of luxury. Its 3.5-inch in any way can work against the efforts of the massage triple density foam and curved face rest therapist. with 3-inch memory foam pad allow a “There are many issues that will affect a client’s massage high level of comfort. experience, the biggest being comfort and support of the client,” Paris said. “A poor-quality foam system will not contain multiple layers and densities, eventually failing to provide enough give to allow a client to relax; not have a Made with high- bounce-back layer a therapist can use to work under the body; quality, aircraft-grade and will lack recovery to restore itself time and again after aluminum and a use.” simple design, the In addition to high-quality padding for optimal client NRG® Grasshopper comfort, the actual design of the massage chair or table may Massage Chair offers be able to effect greater relaxation as well. According to Jim professional massage Craft, founder and president of Comfort Craft, a basic, flat therapists a light, massage table will not allow the lower back to fully relax strong, easy-to-set- when a client is supine, as the natural arch of the back is up solution for on-site unsupported. massage. “We have a mid-split in all our tables, and the mid-split is what’s made us so famous,” Craft said. “The way the table works is, when you’re lying faceup, we raise it up nine or 10 degrees in the low-back area, where the arch is, and what happens is the arch will let go and rest—it no longer has to COURTESY OF MASSAGE WAREHOUSE MASSAGE OF COURTESY hold itself up.”

The Comfort Craft Model 800’s mid-split bend puts clients in a relaxed position so therapists can open the back area with less effort. The smooth, electric- powered design improves treatment because the client’s back is taken out of compression.

32 | MASSAGE Magazine | September 2015 | www.massagemag.com | In the prone position, a well-designed face cradle can optimal support during the session may not be the only be a crucial component of a high-quality massage table requirement for comfort. Such clients may also need or chair, supporting the client’s head and neck in a way access to a massage table that can lower down and raise that will lead to tension release and enhanced relaxation. up automatically in order to get on and off the table in a For this reason, Paris said he highly recommends that safe and comfortable manner. Come tax time, the cost of massage therapists upgrade their face cradles. investing in one of these tables may be substantially offset “We’ve developed a new FacePillow system that simply by the Disabled Access Credit. changes the entire massage experience by eliminating pressure points and using our proprietary cushioning Practitioner benefits system,” he said. A piece of equipment that can make your clients According to Craft, too many standard face cradles more comfortable and improve their overall massage cause the head to be supported by the forehead, experience has the potential to help bring more people dropping the client’s chin and putting the neck in a less through the door and keep them coming back as repeat comfortable position. To remove this barrier to client clients. This is an obvious benefit for your bottom line, relaxation, Comfort Craft focused on designing a face but it’s not the only reason to consider investing in a high- pillow that offers proper head support. quality massage table or chair. Among the other potential “There are more options with a high-quality product, perks of investing in top-notch equipment is reduced such as an adjustable headrest, which places the client’s strain and increased energy for the practitioner. head in the correct position and alignment to the body,” “A therapist with high-quality equipment will not said Suber, Comfort Craft’s vice president. “Our tables only have a more comfortable product, but if the therapist have the sliding headrest, which takes comfort one step invests in an electric table, they can, with a push of the further by allowing the head to move independently of button, be able to put the client in the position they need the body, which helps let the neck elongate and relax.” without putting strain on themselves,” Suber said. “This, For clients with disabilities and conditions that in turn, reduces the effort placed by the therapist, which prevent certain movements, a massage table that provides keeps him or her more energized by the end of the day.”

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Even if one does not choose to invest in an automated which owns Custom Craftworks. “Your equipment and table, the padding and design of a higher-quality product office is going to say more to the client than you ever will. may decrease practitioner strain by enhancing client A high-quality massage table or chair sends the message relaxation and giving the massage therapist easier access that you’re here to stay and you took the time to build a to certain areas of the body, as well as the ability to superior practice.” perform specific techniques without exerting as much energy. A valuable investment “A product made at the highest quality is designed to From increased client comfort and decreased be a tool to help extend the career of the therapist, since practitioner strain to a more professional image and it helps in lessening the strain the therapist goes through the ability to save money by keeping one massage table during massage sessions,” Suber said. “Therefore, a higher- or chair for a longer period of time, there’s a long list of quality table and chair are worth the expenses.” benefits that can come from investing in a high-quality Purchasing a top-quality product can also mean saving foundation for your massage services. money in the end, due to the fact such equipment tends to “I teach continuing ed workshops for table and chair be built to last. Also, high-end massage tables and chairs massage, and I’ve seen a lot of equipment over the years,” can help practitioners develop a more professional image said Dale Wheeler, L.M.T., B.C.T.M.B., owner of Education and better compete with other massage therapists, spas Destinations and The Massage Professionals. “I think it and franchises in the area. boils down to the old adage: You get what you pay for.” “If you’re in an area where massage therapists are charging $50 an hour and you want to charge $60, your Brandi Schlossberg is an avid bodywork client and full-time equipment better portray that you’re professional and journalist based in Reno, Nevada. She has written on many you’re worth that,” said Bryan Hawley, D.C., who teaches topics for MASSAGE Magazine. She wrote the articles “Every continuing education classes for massage therapists and Massage Therapist Needs Liability Insurance” (May 2015) serves as medical advisor for Pivotal Health Solutions, and “Build a CAM Network” (May 2014). M

Hospital-based massage could involve giving chair massages to physicians and nurses during breaks; providing massage to outpatients; bringing soothing touch to the elderly or dying; or providing massage to inpatients in one of many inpatient areas, including pre- or postsurgery, oncology, pregnancy or pediatric wards.

No matter what form massage takes in a hospital, it has several key differences from massage practiced in other locations. In the hospital, the massage therapist must work as part of a team with other medical professionals—which brings unique challenges and opportunities. IMAGES: THINKSTOCK IMAGES:

Have an eye for details. For massage therapists who love to follow the rules, a hospital is a great place to work. As a hospital employee, you will be expected to 1 2 meet the same compliance policies as all other hospital staff, including but not limited to health screenings, such as tuberculosis testing, annual flu shots, mandatory 8 epidemiology training and dress codes.

Know the main contraindications to massage. It is always best to ask the nurse or doctor what contraindications might be of concern. Some common contraindications, according to the book Exploring Hospital-Based Work with focus. A massage Massage, include hemophilia, coagulopathy, low platelet count, bone therapist’s scope of practice in a metastasis, an unstable spine or other posture limitations, osteoporosis, hospital is often more narrow than it is neutropenia, phlebitis, thrombophlebitis or deep vein thrombosis. Care in other environments. For instance, range should also be taken to avoid wounds, bedsores, broken bones, tumor of motion is left to physical therapists. sites, injection sites, surgical sites and inflamed areas. When treating inpatients, often the massage therapist’s focus is comfort care. Hospital- Be a team player. In some cases, hospital-based massage therapists based massage allows a clinical approach, may join rounds with physicians and other members of the health care while some modalities are prohibited. team. In this setting, you must have outstanding communication skills— For example, you may be an expert in you may be asked the benefits of massage for a specific patient or aromatherapy, but the hospital diagnosis—be an excellent listener, have a basic knowledge of medical may not allow you conditions and terminology, and have a full understanding of your scope to practice it. of practice. 3 4

36 | MASSAGE Magazine | September 2015 | www.massagemag.com | Understand you won’t have Know your patient population. You will see control over the environment. In a wide range of conditions and diagnoses in private practice you can lower lights, a hospital. You need to be willing to research turn on soft music and know no each patient’s diagnosis, understand how one will interrupt. In a hospital, the massage will affect the patient, and be willing to room may be ever-changing. The ask questions of nurses and physicians. Many patient may hear conversations from hospitals require advanced training to work with the patient in the next bed; family special populations such as oncology patients. members may watch the massage; the patient may be eating lunch; a phlebotomist may be waiting to take blood; a physician may be giving test results. Create the most relaxed atmosphere you can, but understand 5 it is not a private session room. 7 6

Keep up with massage research. Be prepared to provide evidence-based research when speaking to hospital staff. You’ll need to 8 understand the physiological effects and benefits of massage so you can explain why hospital-based massage should be recommended. 8 9

Be gentle. Gentle massage to scalp, neck, back, feet and hands, with a focus on being palliative, soothing and calming rather than on addressing sore or tight muscles, Maintain clear boundaries. In a hospital, you often deal meets patients where with people in crisis, so working in this venue can be more they are—a critical, scary, challenging emotionally than a private practice setting. You stressful, painful point in have to be more grounded, more able to let go of your work their lives. when you get home, and more able to have boundaries.

Karen P. Armstrong, L.M.T., N.C.T.M., is manager of clinical massage at Beaumont Health, which For more information about providing has several locations in Michigan, and teaches oncology and hospital massage continuing education through Beaumont’s Schools of Allied Health (beaumont.edu). Laura Koch, L.M.T., founded the massage in various environments, visit the Hospital-Based Massage Network (hbmn.com) in 1995, for the purpose of helping massage therapists ] Massage Careers Resource Center section provide soothing and humanizing touch to hospital inpatients throughout the U.S. and abroad. of massagemag.com.

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Massage for the Frail and Dying Communicate Care through Touch by Lindy Roussel, L.P.N., L.M.T., B.C.T.M.B.

s a young just one week prior to our student clinical rotation and were nurse at a supposed to practice on local hospital our patients, after lunch or Ain my hometown before they went to sleep many years ago, I was at night. She told me no, he introduced to my first was not a candidate for the patient: a 23-year-old backrub because he was man who was actively dying. And die he did, just a dying from terminal lung few hours later. cancer. I had never known Alone. In pain. Scared. or been in the same room Untouched. with a very sick or dying I cried all the way person before, and was through, but was grateful scared out of my wits. for the postmortem care, My orders were to when I finally did get to stay out of his room and touch him and say goodbye. leave him alone except to I think I cried for an entire give him his medication, week, and questioned why and take his vital signs I wanted to be a nurse. If we every hour to make sure couldn’t touch or connect he was still alive. Since in some way with someone he was my only patient who was suffering, what on an eight-hour shift, was the point? and was responsive, in pain, alone and, I assume, Stay away very scared, I asked my In the 1980s, in the area instructor if I could sit of Pennsylvania where I with him and talk, read grew up, most people didn’t and listen, and give him like to talk openly about the backrub that we suffering and dying, and students had learned early in my nursing career I

KATARZYNABIALASIEWICZ/THINKSTOCK

38 | MASSAGE Magazine | September 2015 | www.massagemag.com | noticed that once someone was sick and got to the point able to do this one thing for my friend whose dying wish of suffering and was told he or she was going to die, was to be touched by someone who knew what they were family and friends didn’t want to see him like that or doing, wouldn’t be upset if she cried and who didn’t wear wanted to remember her like she was before she got sick, gloves to touch her like the hospice people did. and drifted away. A few days before Sue passed away, she looked at me We young nurses, fresh out of school and ready to and said, “You should learn to be a massage therapist and save the world, wanted to help everyone, but never work for hospice. You give great backrubs and you care.” seemed to have enough time to spend with our patients So I did. in need of our time, and the senior nurses warned us not to get too close to our patients. No age limits Because many people were afraid of sickness—some Who am I to go against a dying woman’s last wish? I cancers were still thought of as contagious and AIDS had took this as an opportunity to rectify myself for failing come to town—death was thought of as a Bad Thing. Not miserably on her second-to-last wish; I got a nursing only should we not touch someone who was very sick, job at a new, local hospice, where I learned that death we should stay away. is actually not a Bad Thing, went to massage therapy The fact that death was a part of life was not taught school, and when I graduated at the age of 41, secured a in our schools, growing up, or talked about within our family units. Animals that passed away “went to a farm,” and relatives “went A few weeks before my friend Sue to heaven.” And because of that, there was a whole lot more suffering going on. passed away, she asked me to set up Although I knew it was wrong, and didn’t feel good about it, I too found myself fearing a professional massage for her. and avoiding human suffering and death, and eventually worked at jobs such as the Visiting Nurse Association and a mental health facility, job with another hospice as a nurse-massage therapist, hoping I wouldn’t have to witness death or dying. and immersed myself in learning how to touch the It worked out pretty well until my dear friend Sue medically frail and dying. found out she had cancer in 2003, and died six months At Sue’s funeral, I heard many people commenting later. that Sue was too young to get sick and pass away. As children and young adults, many of us think of people Sue’s advice who are medically frail as the elderly, weak with old-age Sue asked me to help take care of her, and of course maladies such as heart disease, breathing difficulties I did, but watching her and her family suffer made me and brittle bones; possibly with some dementia, lying hate and fear death and dying even more. When I look in bed or sitting in a wheelchair. Dying is for the old, as back on that time, I realize Sue did me a great favor. She well—grandparents, elderly aunts and uncles, possibly a challenged me by teaching me things I didn’t want to friend of our parents. know, and asking me to do difficult tasks that eventually Then we learn, as we age, that sickness and death re-routed my life’s path and put me where I am today. have no age limits. One thing I remember was the time, a few weeks before she passed away, when she asked me to set up a Aging America professional massage for her. I was doing my best with The oldest baby boomers, born between 1946 and my nursing backrubs and such, but she wanted the 1964, will begin turning 70 in 2016. The youngest are whole experience, because she never had one before, and in their 50s. There are a lot of us: more than 75 million, wanted to before she died. I called every spa, clinic and according to the U.S. Census Bureau. By 2030, “more independent massage therapist within 25 miles, and not than 20 percent of U.S. residents are projected to be one would touch her. aged 65 and over, compared with 13 percent in 2010 and I don’t blame them a bit. Back then we didn’t know 9.8 percent in 1970,” according to the Census Bureau’s what we know now about cancer and touch, and nobody report, The Baby Boom Cohort in the United States: 2012 to wanted to hurt her—but I was devastated that I wasn’t 2060.

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Touch for the sick and dying can mean a slow, light touch; full-body massage; reiki; or a hand on a shoulder or stroking of the hair.

Even though some say the the 48-year-old ex-Marine dying from early- baby boomers are the most active Percent of U.S. onset dementia. It can be reiki, Therapeutic and physically fit generation, one residents projected to Touch or Swedish massage. It can be a hand that smokes and drinks less than be over age 65 on a shoulder or stroking of the hair. Touch generations that came before, statistics 20 means meeting the person where he is and indicate that cancer and diabetes are 15 listening to what he wants. more prevalent than ever, and obesity The benefits of touch are infinite and and stress look out of control. These 10 reciprocal. I’ve learned this from the people and other issues can lead a person to who have graciously allowed me into 5 severe illness and sometimes death. their sacred space, whether they were sick, Touch can help, and in my 0 distraught or at death’s door. experience, most baby boomers want it. 1970 2013 2030 Because loving touch makes people feel —U.S. Census Bureau cared about, it has the potential to, but is Share love not limited to, calm, comfort, relax and Touch for those who are sick and dying is as unique as help reduce pain and discomfort, help people breathe the individual. It can mean a slow, light, skilled touch for easier, ease stress, help with insomnia, ease anxiety, ease a person who has cancer. It can be a full-body massage for depression, and make a person feel good.

Touch has the potential to form a profound connection that is more meaningful than words.

Touch can be a way to communicate, to show a person Most people want to be listened to and cared about. he is important and to share love. For sick or dying individuals, touch has the potential to form a profound connection that is stronger and more Just be meaningful than words can ever hope to say. In order to offer a sick or dying person the full benefits of touch, to show her you really care, and to make a Lindy Roussel, L.P.N., L.M.T., B.C.T.M.B., works as a nurse- difference in her life, it is important to be present and massage therapist for hospice, and has a private oncology know how to listen. massage practice. She is director of Sage Continuing Being fully present, to me, means I can be with a person Education for Massage Therapy & the Healing Arts LLC physically, emotionally and spiritually, and not distracted (sagecontinuinged.com), located in Lancaster and Easton, by my own stuff or surroundings. I can just be. It means Pennsylvania. She is a National Certification Board for I am open and aware of whatever the person I am with Therapeutic Massage & Bodywork Approved Provider, wants me to know. A person knows when another person and is a preferred provider for the Society for Oncology is present or not. Listening means I’m hearing and seeing Massage. M what the individual’s entire body is saying to me, paying attention, being present and not scrambling for a response, and being OK with emotion or silence. Being able to be Read “Everyone Needs Touch to Thrive,” by Lindy present and listen is one of the best gifts you can give and Roussel, L.P.N., L.M.T., B.C.T.M.B., at massagemag. receive. And it makes touch all the better. com/everyoneneedstouch.

Help in a Bottle Anti-Inflammatory & Pain- Relieving Essential Oils

by Jimm Harrison

he massage therapy and other bodywork of compounds related to the inflammatory response methods you offer clients can go a long way are histamines, kinins, prostaglandins, leukotrienes toward helping ease their pain—but if their and complement plasma proteins. Pain is a protective pain is related to chronic inflammation, response alerting us to tissue-damaging stimuli or injury Tyou can step up the therapeutic value of your sessions channeled through free nerve endings called nociceptors. by offering topical products infused with appropriate Both pain and inflammation are necessary to essential oils. maintain the health of the individual. Chronic pain and inflammation are signs that the body is diseased or out of Understanding inflammation balance, states often caused by stress, dietary, lifestyle and and pain environmental factors, along with disease. Inflammation is a physiological response to Essential oils have demonstrated their effectiveness in infection, chemical agents or injury—and it plays a reducing pain and inflammation, and can assist the body critical role in fighting disease and sustaining good in finding relief from the conditions that may cause the health. The inflammatory response is one of the body’s inflammatory response. internal defense systems; its combined effect involves vasodilation, increased permeability of the blood vessels, Properties of essential oils and a host of other responses intended to protect the body Essential oils have a long history of use for reduction of from injury and parasitic invasion. pain and inflammation. For example, menthol, camphor The four fundamental symptoms of inflammation and methyl salicylate, all compounds found in essential are redness, pain, heat and swelling. The main group oils such as peppermint, rosemary camphor type, and

44 | MASSAGE Magazine | September 2015 | www.massagemag.com | wintergreen, are widely used in pain-relieving lotions, in action and fragrance. Geranial, an aldehyde compound rubs and creams; these oils are responsible for the familiar with a distinct lemon fragrance, is an effective anti-inflam- sharp odors of many topical over-the-counter remedies matory; the essential oil of lemongrass, high in geranial for sports injuries and pain. Clove is a familiar odor in content, is an excellent anti-inflammatory oil. Another dentistry due to its use as an analgesic. lemony aldehyde, citronellal, provides anti-inflammatory Research studies, such as “Citral, a component of and pain-relieving properties to Eucalyptus citriodora and lemongrass oil, citronella. activates PPARα and γ Methyl salicylate, and suppresses COX-2 Formulas a well-known pain expression” (Biochimica reliever, is used in et Biophysica Acta, 2010), The following blends are calculated, by drops, for use in a many over-the-coun- have found that essen- 1-ounce (30-milliliter) carrier base. ter lotions and balms. tial oils and their com- Sore Muscle Relief Inflammation Wintergreen and ponents have an ability 4 drops birch 4 drops Eucalyptus globulus birch are good essen- to inhibit compounds 11 drops katrafay 6 drops German chamomile tial oil sources of this triggered by the body to 4 drops rosemary ct. 4 drops ginger CO2 extract compound. Spearmint induce inflammation camphor 3 drops peppermint is a fragrantly uplift- and pain. 11 drops spearmint 7 drops copaiba ing, pain-relieving It’s been suggested oil due to its carvone that analgesic essential Arthritis and Joint Pain Soothing Bath content. oils, eucalyptus as an 5 drops Eucalyptus citriodora Add drops to unscented example, can affect 6 drops black pepper soap or vodka carrier Choosing both peripheral and 5 drops kunzea 8 drops frankincense essential central neural path- 4 drops Melaleuca 8 drops lavender oils ways. In several studies quinquenervia viridiflora 4 drops lemongrass There is a long list the action of essential 6 drops vetiver 5 drops myrrh of ideal essential oils oils was shown to effect 3 drops wintergreen —Jimm Harrison in therapeutic practice the production of nitric for treatment of pain oxide and prostaglandin and inflammation. E2, as well as expres- The criteria for sion of inducible NO synthase, cyclooxygenase-2, tumor choosing essential oils may be based on several necrosis factor-α and interleukin-1β, thus inhibiting the parameters, including desired fragrance, availability expression or formation production of these pro-inflamma- and cost. Common essential oils used for pain are clove, tory mediators. lavender, lemongrass, peppermint and wintergreen. Here is a list of essential oils with proven anti- Chemistry of essential oils inflammatory properties: Methyleugenol—found in clove, cinnamon leaf and bay • B alsam poplar: deep resiny, sweet and balsamic laurel—and alpha-terpineol, found in ravensare, fir and • B lack pepper: spicy with a resinous, woody undertone Melaleuca quinquenervia viridiflora, have been reported, via research on rodents, to be central and peripheral neural • C opaiba: light, resinous, woody depressants, respectively, which suggests they might act • Eucalyptus citriodora: lemongrassy and sweet green as anti-nociceptive (pain-blocking) agents. (There are, • Eucalyptus globulus: eucalyptus-like with fruity, leafy unfortunately, very few human studies that view the notes biological activity of essential oils.) • G erman chamomile: herbaceous, hay-like with light, Two compounds found in many anti-inflammatory fruity notes essential oils are the sesquiterpene hydrocarbons • K atrafay: green-woody and mossy humulene and caryophyllene. Some essential oils that contain one or both of these compounds are Helichrysum • Kunzea ambigua: fresh, with balsamic and spice italicum, copaiba, black pepper and kunzea. undertones The list of available anti-inflammatory and pain-reliev- • Lemongrass: lemony and herbaceous ing essential oils is extensive and allows for some diversity • M yrrh: warm, sweet, resiny and balsamic

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Single essential oils or blends may be used during massage sessions, as spot treatments applied to areas of pain and inflammation, in body lotion or in a bath.

• Patchouli: rich-earthy, woody and balsamic with and effective for dealing with pain and inflammation. slight animalistic notes Single essential oils or blends may be used during • Tanacetum annuum: slightly sweet and fruity, with hay- massage sessions, as spot treatments applied to areas of like undertones pain and inflammation, in body lotion or in a bath. • V etiver: earthy and smoky For example, as noted in “Essential plant oils and Several oils may be added to this list. Along with the headache mechanisms” (Phytomedicine, 1995), peppermint essential oils, there are supercritical carbon dioxide (CO2) essential oil induces a significant increase of blood flow to extracts, an alternate extraction of plant oils offering the skin of the forehead after local application and exerts increased anti-inflammatory benefit; these include significant effects on mechanisms associated with the turmeric CO2 extract and ginger CO2 extract. These pathophysiology of clinical headache syndromes. Local extracts contain compounds not available in essential oils, application of peppermint oil generates a long-lasting such as curcumin in turmeric CO2 extract and gingerol in cooling effect on the skin, caused by an alteration of ginger CO2 extract. the calcium channels of the cold-receptors. Peppermint also inhibits non-competitively 5-hydroxytryptamine Essential oils used topically (serotonin) and substance-P-induced smooth muscle Essential oils have a variety of application methods. contraction. This explains how peppermint works to A number of topical application options are appropriate relieve a headache. There are many more studies that

46 | MASSAGE Magazine | September 2015 | www.massagemag.com | support the use of essential oils for pain and inflammation, client. Personalized blends give exclusivity to your both in therapeutic practice and self-care. treatments, which can enhance your services’ value and For topical application, essential oils are added to a support client retention. You can also offer self-care home carrier, such as a vegetable fixed oil, cream or lotion base. treatment products for retail sale to your clients, which can The area of application, oils used and therapeutic purpose increase your profits. will determine the total amount, or percentage, of essential As a massage therapist you are constantly adding to oil used in the base carrier. An essential oil dilution can your array of tools; paired with your skilled hands and be anywhere from 0.5 – 50 percent in the carrier. In a close attention to clients’ needs, essential oils can provide 30-milliliter container, 2 percent will equal approximately you another effective way to help your clients find relief 12 drops of essential oil. Ten percent is approximately 60 from inflammation and pain. drops. Jimm Harrison (jimmharrison.com) is an essential oil, Essential oils in massage practice holistic wellness and scent branding consultant, educator The diversity and holistic properties of essential oils and author with more than 20 years’ experience. He is provide great opportunities for the massage therapist and the author of Aromatherapy: Therapeutic Use of Essential other practitioners. Used topically, oils’ analgesic and anti- Oils for Esthetics (Milady) and teaches his Aromatherapy inflammatory properties synergize and enhance the work and Essential Oil Certificate CCCE Program at Bastyr of the practitioner, increasing therapeutic results. Also, University in Kenmore, Washington, across the U.S. and the inhalation of essential oils may more quickly bring the internationally. M client into a state of relaxation, decreasing the initial time you would normally spend getting the body prepared for Read “Best Application Methods for Essential deeper work. Oils,” by Jimm Harrison, at massagemag.com/ Essential oils can be personalized with focus on the bestapplicationmethods. specialized needs, including fragrance, of the individual

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Make Space in Your Body Quick Self Fixes Improve Function

by Barbara Sharp, L.M.T.

he only way to gain strength is by it needs to protect itself from injury or pain, the muscle exercising.” I saw that line again just the action will reflexively collapse even under the light other day in a LinkedIn discussion panel. pressure of a muscle test, keeping it from full activation We’ve all heard it, and there is some truth and full strength. “Tto it: Exercise does build strength—but that assertion So, I’m not referring to the kind of weakness that doesn’t tell the whole story. Our bodies constantly exercise is designed to combat. I’m talking about specific perform a balancing act to create functional movement, muscle weaknesses where the body feels fixated or specializing at helping us maintain whatever posture we inhibited somewhere in the complex of muscle, fascia, choose to inhabit the most. nerve or joint. However, small fixations and inhibitions in muscles, Because every person’s body mechanics suffer when joints and fascia can keep a muscle, or section of muscle, muscles stay weakened, it is in each person’s self-interest weak to prevent further injury. When the body signals to find and resolve these fixations. Massage, chiropractic,

trapezius and deltoid muscles, but skull bones: frontal bone, parietal Quick Self Fixes can often strengthen many muscle bone, temporal bone, sphenoid 5to Try Now tests body-wide. bone and occipital bone. The first It is a very light touch—no more four bones meet in front of and 1. Cranial Fix. This fix stems than a nickel’s weight—of splayed slightly above the ear; that meeting from craniosacral and osteopathic fingers on both sides of the head, point is a powerful healing point techniques. It targets the upper bymaking Mark contact Volkmann to the skin over five (often active in migraines).

3 1

4 2

The circle 5 highlights the Fingers touch on the meeting point five numbers. of the four skull bones. PHOTOS BY CHRIS SAVAS

48 | MASSAGE Magazine | September 2015 | www.massagemag.com | osteopathy and various forms of stretching and yoga motion, increased balance and an improved ability to are some of the most common bodywork methods. But perform a movement. When all the fixes are practiced, sometimes we need something quick, painless and not many people report a renewed sense of flow. dependent on another practitioner. Quick Self Fixes are “This work helps integrate mind-body connections as self-treatments developed to answer this need. we become consciously aware of how differently we hold our bodies after muscles are newly made strong,” said Target weak muscle areas Maggie Alfieri, massage program director at the Atlanta Quick Self Fixes are a series of self-care techniques School of Massage in Atlanta, Georgia, where Quick Self that exactly target the muscle areas that are most commonly weak in most adults, as determined by clinical experience. I practice Person after person has reported that Quick Self Fixes on myself, and I teach them to clients and other therapists. They enable an area feels more secure internally me to use better body mechanics, enhance my strength in places I might need a little extra after it tests stronger. help, and empower me to take care of small issues before they become large problems. Fixes are part of the training program. “That is especially For example, I have personally experienced how one noticeable when starting with massive, quadrant-wide pectoralis major fix stretched my acromioclavicular joint weakness, such as all the hip flexors or all the shoulder and instantly both eased my ability to perform push-ups muscles.” and doubled my count. Other health professionals see similar results. Make space many ways “Using these fixes allows for more balanced movement It’s all about making space. Different fixes create space and better and more complete muscle recruitment,” said in different ways. We don’t always know exactly how this Lyndzey Dare, a CrossFit, gymnastics and weightlifting happens—case studies are being conducted on Quick Self instructor, who has evaluated her clients before and after Fixes, but large-scale studies have not been—however, Quick Self Fixes. person after person has reported that an area feels more Common results of practicing Quick Self Fixes include secure internally after it tests stronger. It feels like Quick increased strength, dissipated pain, increased range of Self Fixes restore the body’s neural communication and

The fix is simple: Hold your relaxed thigh. Using the thumb 3. Latissimus Dorsi Fix. This fix stems fingers lightly against both sides of your of your left hand, firmly from the Touch for Health Kinesiology head with one finger over each of the but not painfully pin Association’s neurolymphatic point for bones for about 10 seconds. People will the bicipital tendon just the latissimus muscle. However, these often sway slightly as this fix takes effect. below the humeral head reflex points are located between ribs 5 medially toward your and 6 and ribs 6 2. Biceps Brachii Fix. chest. and 7, just below This pin-and-stretch Hold this firm pin, the pectoralis fix targets the long and gently flip your arm major muscle head tendon of the and shoulder joint into and in line with biceps brachii muscle, external rotation. Your the nipple. On whose origin tendon hand will end behind your women, it is under the bra strap, medial to can become fixated body, thumb pointing back. the Spleen 17 acupressure point. within the acromial As you flip the arm, you will Look for one or two sore points on and bicipital groove feel the tendon move under either side of the anterior rib cage and areas of the anterior your thumb. It is also helpful massage each point between the ribs in shoulder. to feel your scapula drop as a small circular motion for 10 seconds. It Let the target arm hang loosely at the latissimus muscle exerts a downward should become less sore in that time. Do your side, hand touching your anterior pull on the humerus. not massage directly on the rib bone. Continued on page 50

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While the fixes are designed to be self-treatments, many can be incorporated seamlessly into a massage session, where they increase therapeutic results and client satisfaction.

innate fluids—blood, lymph, interstitial and cerebral Clay on a weekly basis, learning first the assessment spinal—to the area. technique now called Targeted Muscle Testing. (See Stretching joints and muscles certainly feels like “Targeted Muscle Testing: A Kinesthetic Approach making space, but making space might also mean to Address Muscle Weakness,” MASSAGE Magazine, decompressing a fascial restriction, encouraging December 2014.) Quick Self Fixes evolved from the fluid back into an area, taking pressure off a nerve, or desire to find self-sustaining ways to strengthen the perhaps changing the responses of mechanoreceptors, weak muscle tests found via Targeted Muscle Testing. proprioreceptors and Golgi tendon organs to reactivate a more positive link between brain and body. Use fixes with clients Cassius Camden Clay, D.C., an Atlanta-area While the fixes are designed to be self-treatments, chiropractor, developed Quick Self Fixes from the many can be incorporated seamlessly into a massage practitioner-based disciplines mentioned above. He session, where they increase therapeutic results and has been in practice more than 35 years, incorporating client satisfaction. Quick Self Fixes that are rooted in kinesiology, muscle testing and Thai massage-style massage, stretching, proprioceptive neuromuscular stretches into his private practice. He has also taught facilitation or craniosacral techniques are well within more than 265 continuing education workshops on the massage therapist’s scope of practice, as are those assisted yoga postures, including Thai massage for the rooted in reflex, acupressure and neurolymphatic massage profession, which is how I first met him in points. Sometimes a muscle will need more than one 2007. fix, so multiple fixes overlap areas. Often fixes will need I started studying this functional and structural frequent repeating over time for the body to learn how approach to muscle testing and assisted yoga with to stay strong.

Continued from page 49 targeted shoulder close by your ribs There is very little actual movement Strengthening latissimus dorsi and use the other hand to hold under in that final lift, yet it can relieve a lot of is a great, quick fix for combating the elbow. The targeted arm’s hand shoulder dysfunction. Some people hunched-over postures, and it is very may rest on your chest or opposite may even hear a click. If the lift is both important for maintaining good body shoulder. Use the hand holding the needed and successful, the shoulder mechanics. Sometimes I use it mid- elbow to softly push the targeted will immediately feel a lot freer and session to re-enable strength. I also (passive) humerus up into the acromial show increased range of motion. find it can temporarily relieve some joint, taking out all slack in the rotator upper trapezius discomfort. cuff. Hold in that 5. Liver Fix. This fix stems from place to make visceral massage and osteopathic 4. Shoulder Fix. This fix stems sure there is no techniques. Manual stimulation of the from a chiropractic adjust- pain, then use liver may stimulate its detoxification ment and is not in the scope of the hand on the activity, and particularly strengthens massage therapy to perform on elbow to make a pectoralis major and middle trapezius someone else, but it is a safe self- very small, extra muscle tests. Because of its body- stretch of the rotator cuff insertion lift of the targeted wide function, the Liver Fix often tendons. It strengthens muscle humerus straight strengthens other muscles, too. tests for supraspinatus, infraspina- up into the If you have fragile ribs, osteoporosis tus, subscapularis and teres minor. glenohumeral or osteopenia, do not do this fix. While Hold the fully bent arm of the joint. standing or lying down, use the left

50 | MASSAGE Magazine | September 2015 | www.massagemag.com | I often tell clients, “Your body may need 100 fixes to hold this new strength, but only one from me and the rest from yourself.” Because Quick Self Fixes are both quick and portable, the client is more likely to perform them herself. Muscle testing clients before and after the fix shows clients whether the fix works for them. The one caveat is that no fix (or test) should be done to the point of pain or in cases of acute trauma. If all the possible fixes fail to strengthen the area, have the client consult a doctor.

Barbara Sharp, L.M.T., is a licensed massage therapist in Marietta, Georgia, with 21 years of experience. She found Targeted Muscle Testing, Quick Self Fixes (quickselffixes. com) and assisted yoga postures from Thai massage so helpful that she expanded her class note-taking skills into writing three full curriculums to help others have a written resource to learn from and reference. Quick Self Fixes and Targeted Muscle Testing are approved by the National Certification Board for Therapeutic Massage & Bodywork for continuing education. M

Read “The Synergy of Quick Self Fixes and Targeted Muscle Testing: A Case History,” by Barbara Sharp, L.M.T., at massagemag.com/synergyqsf.

hand to pin up and under the right rib cage to hold the liver stationary. Curl the fingers of your right hand to make a soft air pocket over your palm. From a height of about 6 inches, rhythmically tap your right hand over your lower right rib cage and liver in a diagonal approach for 10 to 15 taps. Each tap should create a resonating vibration in your liver. Be gentle and do not cause pain.

—Barbara Sharp, L.M.T.

A free e-book and video of these five fixes and their associated muscle tests targeting the shoulder are available at quickselffixes.com.

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M | New Products & Services new on the scene

RED JADE HEALING BODY PILLOW Jadience Herbal Formulas The blend of jade powder combined with a special formulation of herbal grains stimulates acupressure points on the body to strengthen chi (energy). Use in massage sessions to relax muscles and joints, relieve low-back pain and ease cramps. Red Jade Healing Body Pillow costs $26.46. Contact Jadience Herbal Formulas, (858) 373-1830 or jadespacollection.com.

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52 | MASSAGE Magazine | September 2015 | www.massagemag.com | the scene MIGRAINE MIRACLE Kelly Lott’s Migraine Miracle Massage therapist Kelly Lott created this holistic, natural, self-administered home therapeutic treatment to provide soothing relief for migraine headaches. The kit includes 12 custom marble stones, four aromatherapy blends, step-by-step instructions and a mesh carrying bag. Migraine Miracle costs $99. Contact Kelly Lott’s Migraine Miracle, (800) 705-7037 or migrainemiracle.com.

LENGTH TENSION TESTING BOOK 1, LOWER INTELLIGENT QUADRANT: A WORKBOOK OF MANUAL SKIN MD THERAPY TECHNIQUES Wall Street Brush Education Inc. Dermatology This book provides clear, This app, designed by comprehensive descriptions and color dermatologist Julia Tzu, photos of techniques for assessing M.D., combines real-time flexibility and length tension in the environmental data with muscles of the lower quadrant. It your personal information includes techniques for the lumbar to generate customized spine and pelvis, hip, knee, and foot and responsive skin care and ankle, and also shows alternative recommendations. Test positions to accommodate clients’ yourself on the adequacy of comfort and needs. your current routine, or create Length Tension Testing Book 1, your ideal skin regimen based Lower Quadrant: A Workbook of on your environment. Manual Therapy Techniques costs Intelligent Skin MD costs $34.95 for a printed version or $1.99 for iPhone, iPad and $24.99 for an e-book. Contact Brush Education Inc., iPod Touch. Contact Wall Street Dermatology, (855) 283-0900 or brusheducation.ca. (212) 931-0538 or wallstreetdermatology.com.

HAWAII BODYWORKERS RETREAT Hawaii Bodyworkers Retreat This retreat combines a six-day, five-night educational experience with a Hawaiian vacation. Earn continuing education hours in Integrative Modalities Technique; huna, a traditional Hawaiian energy system; and marketing and social media. You’ll enjoy delicious, healthy meals and activities such as hiking, sailing and going to the beach. The Hawaii Bodyworkers Retreat costs $2,495. Contact Hawaii Bodyworkers Retreat, (808) 386-6763 or hawaiibodyworkersretreat.com.

PAIN POTION PLUS The Aromatherapy Factory Pain Potion Plus is an organic, vegan lotion for muscle and joint pain relief. The smooth, silky, all-natural ingredients smell clean, fresh and slightly lemony. All essential oils used are therapeutic grade. Formulated and created by a licensed massage therapist and a clinically certified aromatherapist. Pain Potion Plus costs $19.95 for an 8-ounce jar. Contact The Aromatherapy Factory, (252) 222-3805 or thearomatherapyfactory.com.

| www.massagemag.com | September 2015 | MASSAGE Magazine | 53

NOERIZKI/THINKSTOCK Market with Video Attract New Clients & Raise Your Online Profile

by Daniel Ruscigno

f you are up-to-date on your marketing jargon, Combat consumers’ you have heard the term content marketing being overexposure thrown around a lot lately. Content marketing The reason for content marketing’s popularity largely is any strategy that involves creating valuable has to do with the trend of society becoming unrespon- Iand interesting media in order to attract the attention sive to traditional marketing channels. For instance, of potential new customers. This media can take any many people will now DVR a television show and fast- of several forms, including blog posts, articles, photos, forward through the commercials, post a “no junk mail” infographics and videos. sign on the mailbox, and have become desensitized to online advertisements due to constant exposure. Read “The Importance of Testimonials for As consumer trends and behaviors change, it’s Your Business,” by Daniel Ruscigno, at important that your business’ marketing strategy massagemag.com/businesstestimonials. changes along with them. And with consumers

56 | MASSAGE Magazine | September 2015 | www.massagemag.com | generally no longer interested in a sales-pitch approach, amount of shares compared to an average, non-video content marketing changes the game by instead post on social media. That networking effect can be very delivering value to your customers and building powerful for your business. relationships that will ultimately lead to winning their business and their loyalty. Where you’ll post Research compiled by JBH and Smart Insights indicates The first place to share your video is YouTube. The that content marketing is the most commercially benefit of YouTube is you don’t have to host the video important digital marketing trend for 2015, with social on your website’s server and you may gain a few extra media, email newsletters, articles on your website, viewers based on people browsing videos. Once uploaded, illustrations and videos as the top five most popular you can then use the YouTube link to your video to share content marketing tactics. it on your Facebook page, in Facebook groups, on Twitter Including content marketing is the present and the or on your blog. future of a winning marketing strategy—and one of the If you send out an email newsletter to your clients, most captivating media formats you can use to gain the include a link to your latest video. Your clients will be attention of potential new clients is video. impressed that you go above and beyond by providing Why video works extra value between appointments. Because many email Why should you start using video in your clients do not support video in email, or many email content marketing strategy? There are several reasons. It’s OK to post your video more First, it’s more fun than text. YouTube plays over 1 billion videos per day for a good reason. than once, such as on Facebook Videos are easier to consume than text, appeal to both the audio and visual senses, allow you one morning and on Instagram the to convey personality, hold attention spans for longer, and can play on emotions that inspire next evening. people to share. Also, video is quick, in terms of time to create it and time in which it shares your clients will block video in emails, a common technique message. Sitting down to write an article can take quite is to create a picture with a play button on it. When a bit of time, but shooting a two-minute video can be pressed, clients are taken to your blog, where they can done very quickly. And since a picture is worth 1,000 watch the video. words, imagine the impact a video message will have on It’s OK to post your video more than once. You might potential clients. post to Facebook in the morning on one day and on Next, video shows off your expertise. Using video is Instagram the next evening. This allows you to capture a great way to show that you are an expert in your field. the attention of people who are online during different When potential new clients see you talking in depth times of day. And if the content is still relevant, you can about types of massage, what to expect in a session, spa resurrect an old video that people may not have seen the add-ons and massage research, they will feel confident first time around—especially since you’ll have a bunch of about booking an appointment with you. new followers now compared to then. Video also creates a connection. It’s difficult to develop a relationship with a potential new client through a Web Finally, don’t be afraid to get creative. Since it only page. When new clients visit your website, you will have takes a few minutes to shoot a video, consider different a big advantage if you can create a connection with them options like a video reply to a Twitter question, or engage so they feel comfortable booking an appointment with your clients on Instagram with quick tips via their you. A video allows them to see your personality, have 15-second-videos option. a glimpse of your office, and get an introduction to your staff. Reach many people Finally, videos are shared. People love to share valuable A viral video may be out of reach for a local business, and interesting content. Videos receive over twice the but the point is that with even just a few shares, there is

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an opportunity for your videos to reach hundreds of potential new clients. Keys to Successful Video Marketing Just like building your social media following, content 5 marketing is a long-term strategy. In the early days, you may get only one or two shares of your video, but each time your 1 Make it worthwhile. The most important video is shared it reaches a brand-new audience of potentially part of using video in your marketing strategy is to hundreds of people. If your content is valuable and interesting, make sure your content is valuable and interesting. the new viewers may choose to like your Facebook page, follow Valuable and interesting has purposely been repeated you on Twitter, or even book an appointment with you. And as a few times in this article because people simply do you gain more followers, you gain new opportunities for your not share dull content. videos to be shared, and you start to see a snowball effect. But how do you know what your clients and potential new clients will find interesting? Gain new clients Simple: Ask them. After all, your existing clients Video is emerging as one of the most popular items in a are the extent of your network when you are first content marketing strategy. By using equipment you already getting started, so you want to know what they are have, and with only a few minutes per week, you can easily be interested in so that they will potentially share a part of this growing trend and expand your online presence your video with their friends and family. while gaining new clients. 2 Ask and deliver. At the end of each appointment mention to your clients that you Daniel Ruscigno is one of the founders of ClinicSense are starting a video blog and you’d like to know if (clinicsense.com), clinic management software that helps they have any questions about massage they’d be massage therapists with SOAP notes, intake forms, scheduling, interested in having answered. Post this question to billing and promoting their business. Ruscigno has also recently your social networking pages as well. published his book, 15 Practical & Proven Ways To Grow Your Massage Business.

58 | MASSAGE Magazine | September 2015 | www.massagemag.com | Keys to Successful Video Marketing by Daniel Ruscigno

People love to watch informational videos, how-to the end of your video with a call to action of booking an videos, do-it-yourself videos, healthy living videos, and appointment. even video testimonials from clients. Keep a list of their Start filming. Many people are mistaken that requests handy for when you are ready to film a new video. 5 they need high-quality production for their videos to be 3 Get involved. You can also use social media to find posted to their website and social media pages. The truth interesting topics. Get involved in groups and forums to see is, an iPhone or webcam, you and a simple, uncluttered what people are talking about and interested in. Don’t be background is all it takes. Pretty much all devices these afraid to tackle a sensitive topic or to express a new opinion. days shoot in high definition, so don’t worry about having Original thoughts and comments on controversial topics high production quality or creating visual effects—and can draw a lot of attention. focus on content, content, content. As with every aspect of your marketing strategy, it’s Call them to action. Successful videos also include a 4 important to create a production schedule so that you stay call to action. A call to action is what you want the viewer on track. If you have enough content to produce, you may to do after watching your video. This will change based on be able to shoot a video once per week. At a minimum, the content of your video. Examples of calls to action are: aim to mix in a video once per month—and don’t be afraid “Share this video”; “Visit my blog for more details”; “Follow to break up your video into segments. Short videos are me on Twitter”; “Sign up via email for special promotions”; favorable for keeping viewers’ attention, and a variety of and “Like my Facebook page.” You can also reward the segments give them a reason to come back to your website viewer for watching by mentioning a coupon code at or Facebook page. M

| www.massagemag.com | September 2015 | MASSAGE Magazine | 59

SIRI STAFFORD/THINKSTOCK SIRI The Post- Surgical Client Manage Pain & Enhance Recovery

by Whitney Lowe, L.M.T.

assage therapists know the beneficial In some circumstances massage is beneficial effects of a relaxation massage are immediately after surgery, while in other types of fundamentally therapeutic. Yet the interventions more recovery time is required prior most common reason for people to to soft-tissue work. Making the distinction about Mseek the care of a massage therapist is to address a pain what type of postsurgical massage, if any, would be or injury complaint. In massage school, students are in the client’s best interest is a highly valuable skill sometimes told to stay away from recent surgeries. that can enhance your practice success and help However, there is a very important role for massage in generate referrals from other health care managing pain and enhancing recovery after surgery. providers.

60 | MASSAGE Magazine | September 2015 | www.massagemag.com | Let’s take a look at why postsurgical massage might be taken with this type of treatment. Lymphatic drainage used and the most effective ways to work with clients in techniques reduce swelling and the pain associated with this special population. that swelling. You don’t want to apply lymphatic drainage techniques directly over a surgical site, but near the site to Key uses encourage removal of excess tissue fluid. Pain management is perhaps the most common use of It is important to have clear communication with massage in the postsurgical environment. Patients often the physician or rehabilitation professional about how experience pain and anxiety after a surgical procedure; lymphatic drainage techniques should be applied for this pain can be short-lived or persist. Continued different surgical procedures. Different surgeries have management of the condition, as in physical therapy or quite different applications for lymphatic drainage. For extended nursing care, can also extend the patient’s pain. example, a rotator cuff repair may have swelling, but Not only is pain, well, painful, it can seriously impede the because of the surgical site location the swelling is not patient’s improvement by limiting her compliance with very evident. So techniques in this case are applied to rehabilitation protocols, and suppressing the immune the shoulder region to help superficial tissue swelling, system. but would not affect swelling deeper in the joint near the There is no debate that touch lowers anxiety levels actual surgical repair. generally; this is true for patients having just undergone Patients who have had a mastectomy with lymphatic a surgical procedure as well. However, current research node removal, in contrast, are likely to have problems shows massage can also reduce the overall pain experience. with tissue fluid accumulation. Consequently, lymphatic For example, a study published in BMC Complementary drainage massage is crucial for them. Massage is highly & Alternative Medicine in 2012, “Symptom management with massage in postoperative colorectal Massage methods such as skin rolling or patients: a randomized controlled trial,” showed that massage friction massage are effective methods for performed on colorectal surgery improving mobility and reducing fibrous patients reduced both anxiety and pain. Other similar studies of scarring in soft tissues. massage use after surgery have been reported over the years. In fact, TIME magazine ran an article on the subject in 2007. valuable in situations where lymphatic vessels have been There are a number of ways in which massage is used damaged or removed by cancer surgeries. both immediately after a surgical procedure and after some time has passed. Let’s take a look at a few primary Rehabilitative massage functions of massage for the postoperative client. There are other important goals of postsurgical massage Massage has important general pain-relieving benefits. that focus on benefits derived a period of time after the Some believe massage’s role in assisting pain relief is surgical procedure. One of the most beneficial roles of similar to how a TENS unit works, in that it creates massage is management of scar tissue. Following some competing signals that the body focuses on. Massage also procedures, there may be a long period of immobilization reduces overall sensitivity in the nervous system and to allow proper healing, which may result in fibrous decreases anxiety associated with the surgical procedure adhesions and scar tissue that may bind or restrict as well. For this reason massage for postsurgical pain movement. management does not have to be aimed at the surgical site, Massage is one of the most effective methods for but could simply involve working a remote area, as in a improving mobility and reducing fibrous scarring in soft foot-and-leg treatment. Treating a client who has just had tissues. Methods such as skin rolling or friction massage surgery can lessen his pain, and help him move forward are the most common applications used for scar tissue more effectively through the rehabilitation process. mobilization. These techniques reduce fibrous binding, Another highly beneficial use of massage immediately and work best when used in conjunction with stretching to after surgery is to encourage lymphatic drainage near encourage full elasticity. the surgical site. Postsurgical swelling is most likely to Use caution with friction massage for postsurgical occur close to the actual surgical site, so care should be scarring because the area is likely to be tender and the

| www.massagemag.com | September 2015 | MASSAGE Magazine | 61

tissues are usually somewhat fragile. Friction massage applied too vigorously could further damage the surgical site and impact tissue healing. There is an ideal balance of appropriate tissue stress and pressure, and of course, timing. For the best results, check in with the client frequently about pressure levels and pay close attention to what you are feeling under your treating fingers. Surgery, or injury that preceded it, often disrupts proper biomechanics. Biomechanical patterns of movement involve complex coordination of many tissues. These patterns may be disturbed prior to the surgery by a dysfunctional condition or injury, and are likely to be disturbed even further by the tissue damage caused by surgery. For example, shoulder mechanics may be altered from a rotator cuff tear. Following surgical repair of the tear, proper biomechanical patterns need to be restored. This treatment will include strengthening activities performed in physical therapy, but massage can also reduce tight muscles and help reestablish proper muscular tone. Massage is an excellent adjunct to other treatments after surgery. In certain surgeries, the patient is anesthetized and must stay in a static position for a long period of time. Patients in this situation cannot make comments about any pain or discomfort they are feeling. It is not uncommon for nerve compression pathologies to develop while a patient is lying on the surgical table for several hours. The nerve compression creates soft-tissue pain following the surgery that is not related to the surgical procedure itself. Myofascial trigger points and other soft-tissue dysfunction can also develop from long periods of bed rest following surgery. In general, massage helps improve circulation and tissue mobility when there has been a period of immobilization. When not to massage While massage is often highly beneficial in the postsurgical environment, there are important precautions as well. These precautions may require some knowledge of the surgery, and also an understanding of how the body is compensating for the surgical intervention. Here are a few general rules. Do not treat fresh surgical sites; it usually takes some amount of time—sometimes several weeks—before massage close to an incision is appropriate depending on the rate of tissue healing, which can be unique to each individual. Be careful working over any area that has implants or any other instrumentation inserted. For example, screws, pins or rods may be used for serious fractures or to straighten bone deformities in orthopedic surgeries. You should not apply pressure over instrumentation that could damage the soft tissues. Most practitioners also understand that movement of the region should be limited and only performed within

pain limitations. Keep in mind that when joint regions are unstable, as is the case in an ACL repair surgery, a certain degree of muscle tightness is beneficial to make up for the ligament impairment. In cases like this, be cautious about working extensively on muscles near the treatment site because hypertonic muscles may be serving a purpose. As another example, massage can be very helpful for restoring proper biomechanical patterns in the hip region after a hip replacement surgery. However, for at least six weeks postsurgery, certain motions, including hip flexion past 90 degrees, adduction or internal rotation—which might be performed during range-of-motion or stretching activities—should be avoided. Artificial hip joints are, in general, less stable. Techniques One of the common questions that comes up about postsurgical massage is what type of techniques should be used. The technique is highly dependent on the nature of the surgery, the patient’s condition, primary goals of treatment, and the physiological effects of the treatment. The most effective way to properly choose treatments for postsurgical massage is to consider all of these factors and use good clinical reasoning to determine a proper course of action. While the general guideline about not treating recent surgeries has some merit, massage appropriateness really depends more on the type of massage and where it is applied. It is very important to communicate with the client’s physician or rehabilitation professional to determine effective and safe treatment strategies, and to pay attention to the precautions to avoid adverse effects. Consulting with the client’s other health care practitioners is particularly important if you are working immediately after a surgical procedure. When a length of time has passed, be sure your understanding and knowledge of this type of work is up to par. If other health care practitioners are involved in the client’s care, reach out to them or have your client consult with them. You will be far more effective in addressing postsurgical massage if you have a good understanding of the surgical procedure itself. Arm yourself with greater knowledge and understanding of common medical interventions, and the types of massage that are most effective, and you can be an outstanding addition to the health care team.

Whitney Lowe, L.M.T., directs the Academy of Clinical Massage (academyofclinicalmassage.com), and is the author of Orthopedic Assessment in Massage Therapy and Orthopedic Massage: Theory and Technique. He teaches continuing education in advanced clinical massage through the academy, and offers an online certification program in orthopedic massage. M

M | Living in Balance A Foundation of Health KAMOLMEK/THINKSTOCK

Supplements for Self-Care

by Stacey Littlefield

assage therapists give so much—both role in your self-care routine. Incorporating some key physically and emotionally—to every supplements into that routine will create and maintain client, every day. With so much of your physical and mental balance within so you can keep focus placed on your clients, it can be easy giving to help create balance within your clients. Mto push self-care to the sidelines. You might notice you are focused on clients’ health, but experiencing gaps—in the Protect against stress form of pain, stiffness, fatigue—in your own health. Stress can wreak havoc on the body, and it comes in Dietary supplements can fill the gaps and provide many forms. It is involved in nearly every activity you targeted support where you need it most. They can nourish take on during the day; it involves physical, psychosocial and protect your emotional and mental self by helping the and environmental challenges. The stress response is mind adapt to the repeated, daily stresses of your work. primarily mediated by adrenal hormones, such as cortisol From simple nutritional needs to plant-based and epinephrine, and these mediators are associated with medicines, dietary supplements can play an important both adaptation and disease.

66 | MASSAGE Magazine | September 2015 | www.massagemag.com | In the short-term, stress hormones act as essential As an agent of balance, Rhodiola rosea has specific messengers for adaptation, maintenance of homeostasis benefits for the female endocrine system. During times of and allostasis, or survival. In the long-term, they create a stress, the release of cortisol elevates levels of prolactin and cost known as the allostatic load, which can accelerate the increases androgen synthesis, which leads to an irregular disease process. Basically, the allostatic load is the price menstrual cycle. Rhodiola rosea has the ability to bring your body pays for constant adaptation. these levels back into line. There are ways, through dietary supplements, that you Ashwagandha (Withania somnifera) has its can manage all that stress and decrease the price your roots in ayurvedic medicine, where it is brain and body must pay. Plant-based medicines called used to prolong life, stimulate the mind adaptogens offer effective tools for stress management. and enhance vigor. In the Western This unique group of plants does just what their name world, ashwagandha is being studied implies—they help your brain and body adapt. for its fatigue-reducing and cancer-preventing In order to qualify as an adaptogen, plant medicines potential. In “Effect of Withania somnifera must meet three defining criteria: They must be nontoxic (Ashwagandha) on the development of and safe; they must have the capacity to normalize body chemotherapy-induced fatigue and quality of life functions and work nonspecifically over a broad range of in breast cancer patients,” a nonrandomized comparative issues; and they must reduce stress. trial on 100 patients published in 2013 in Integrative Cancer Adaptogens are ingenious in the ways they work to Therapy, the authors wrote, “Withania somnifera has fine-tune and protect your mind and body from the Ashwagandha is an adaptogen particularly negative effects of stress. After all, plants have evolved beneficial for women, as it is high in iron and to create compounds to protect themselves from can relieve perimenopausal symptoms. environmental stresses, and it turns out these compounds have the same effect on us. potential against cancer-related fatigue, in addition to Adaptogens are beneficial for women and men and work improving the quality of life. However, further study with on both the mind and body. Here, we’ll look at just a few a larger sample size in a randomized trial is warranted to adaptogenic superstars: Rhodiola rosea, ashwagandha and validate our findings.” Panax ginseng. Unlike most adaptogens, which have energizing effects, Also known as golden root, Rhodiola rosea has been ashwagandha is a calming adaptogen. Chronic, unchecked used as a traditional medicine for centuries. In Russia, stress can lead to episodes of anxiety and increased nervous Scandinavia and Asian tension. Ashwagandha is effective at addressing anxiety, countries, the roots of this stress-induced sleep problems and fatigue. The authors of plant have been used to review studies on ashwagandha published in 2014 in the increase physical endurance, Journal of Alternative and Complementary Medicine concluded, work capacity and “All five studies concluded that [withania somnifera] productivity, and to treat fatigue intervention resulted in greater score improvements and depression. Rhodiola rosea also (significantly in most cases) than placebo in outcomes increases mental performance, especially concentration, on anxiety or stress scales. Current evidence should be and prevents stress-induced burnout, a claim supported by received with caution because of an assortment of study research including “Rhodiola rosea for mental and physical methods and cases of potential bias.” fatigue in nursing students: a randomized controlled trial,” Ashwagandha is another adaptogen particularly featuring 48 subjects and published by PLOS ONE in 2014. beneficial for women, as it is high in iron and can relieve Rhodiola rosea exerts these effects by modulating perimenopausal symptoms. It also benefits thyroid cortisol, one of the adrenal hormones released during the function, and can re-regulate the thyroid, especially in stress response. Beyond preventing fatigue and increasing cases of hypothyroidism, as it enhances overall endocrine physical and mental energy, Rhodiola rosea also has function. cardioprotective benefits, as well as hepatoprotective and Panax ginseng is the grandmother of all adaptogens. Its anticancer properties. history of use as a tonic in traditional Chinese medicine

| www.massagemag.com | September 2015 | MASSAGE Magazine | 67

M | Living in Balance

dates back nearly 4,000 years. Throughout Asia, ginseng has enjoyed a reputation as one of the most valuable of all medicinal herbs. In China, Japan and Korea, people have used ginseng root to rejuvenate and revitalize the body and the mind, to increase strength and increase vigor. Ancient Chinese medicine texts describe ginseng as having the ability to “remove toxic substances, brighten the eyes, open the heart and improve thought.” Various research studies have looked at Panax ginseng and indicate it reduces tumor development and boosts cognitive function in mice. For massage therapists who may find themselves on their feet most days, Panax ginseng can enhance circulation and promote the free flow of blood. It’s also an herb that normalizes immune system function. Whether your immune system is depleted from long days or hypersensitive because of seasonal allergies, this adaptogen has what you’re looking for. Nourish muscles and joints Your hands are the tools of your trade, but the rest of your body also needs attention. Standing for long periods of time causes stress on many different muscles in the back and the legs. One of the best ways to nourish all the muscles of your body is with minerals, which are absolutely vital to their function and their ability to relax after contraction. The most important muscle mineral is magnesium. Most Americans don’t consume enough magnesium through diet alone, as many of us don’t eat nearly the amount of fresh veggies and fruits we should. Magnesium is also stripped from food during processing, especially from refined grains. While calcium interacts with actin and myosin, proteins found in muscle tissue, to shorten and contract muscles, magnesium works with the same proteins to lengthen or relax the muscle fibers. Any deficiency in magnesium will directly affect your muscles’ ability to contract and relax properly. There are many magnesium supplements out there; which one is the best fit for you? That depends on a variety of factors, from digestive sensitivity, your daily intake from food, and your like or dislike of taking tablets and capsules. My personal favorite is magnesium glycinate. It is highly bioavailable and tends to be much easier on the digestive system than magnesium oxide. All joints show signs of wear and tear as we age. It is an unfortunate fact of life. In addition to practicing sound massage techniques, joint-focused supplements can slow down or even repair worn-out joints. This is one category of dietary supplements that has been a little neglected on the innovation front.

M | Living in Balance

However, new supplements for joint health are slowly an exhaustive analysis of what dietary supplements are rising through the ranks and overpowering the very beneficial for massage therapists, but it can serve as a familiar glucosamine and chondroitin. One of these foundation for self-care with supplements. supplements is natural eggshell membrane, a food-based Of course, supplements can’t take the place of a supplement that neatly packages all the building blocks of healthy diet and exercise, but they can provide you a healthy joint. It naturally contains collagen, hyaluronic with very specific support for specific issues. Creating acid, amino acids, proteins and glycosaminoglycans such balance between mind and body takes many different as glucosamine and chondroitin. interventions. Consider using dietary supplements as part What’s great about this joint supplement is that of your daily self-care routine to preserve much-needed package. Not only does it have anti-inflammatory balance and create a foundation of health. properties, natural eggshell membrane also works far faster than isolated glucosamine and chondroitin. Those Stacey Littlefield is product formulator and research ingredients can take up to eight weeks to work. If the director at Redd Remedies (reddremedies.com), a joints in your hands are aching, you’re going to want relief company that specializes in herbal formulas focused on sooner than eight weeks. Natural eggshell membrane can delivering symptomatic relief today and core issue balance begin to work in as little as 10 days. for a healthy tomorrow. She is passionate about natural Another positive trait of natural eggshell membrane is medicines and a firm believer in utilizing nutritious food to the dose. It’s small: just 500 milligrams, usually contained improve health. M in one capsule, per day. Specific support Read “Pain-Relieving Herbs,” by From healthy stress management to nourishing Stacey Littlefield, at massagemag.com/ support for muscles and joints, dietary supplements offer painrelievingherbs. answers for a variety of issues. This article is by no means

70 | MASSAGE Magazine | September 2015 | www.massagemag.com | Special Insurance for not so special moments.

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M | Research Various Styles of Massage Benefit Fibromyalgia Patients A systematic review and meta-analysis of 10 studies on various forms of massage for fibromyalgia found most massage methods improve quality of life for people with fibromyalgia. For the alleviation of symptoms associated with fibromyalgia, myofascial release appeared to have the greatest effect.

he review, “Effectiveness of different styles of tissue massage, manual lymphatic drainage, shiatsu and Swed- T massage therapy in fibromyalgia: a systematic ish massage. The review aimed to assess the ability of each of review and meta-analysis,” included 10 randomized and these massage methods to improve pain, pressure pain thresh- nonrandomized controlled trials evaluating the effects of old, fatigue, stiffness, depression, sleep and health-related quality massage alone on symptoms and health-related quality of of life among adult fibromyalgia patients. life among people diagnosed with fibromyalgia. According Focusing on myofascial release, the researchers found this to the researchers, the search for studies to review was form of massage had large positive effects on pain and medium “limited to records published since 1990, when the effects on anxiety and depression. The relief from pain was American College of Rheumatology classification criteria maintained at medium-term follow-up, and the decrease in for fibromyalgia were first published.” depression was maintained at short-term follow-up. The studies selected for this meta-analysis used several A narrative analysis of the studies suggests myofascial forms of massage therapy: myofascial release, connective release also improves fatigue, stiffness and quality of life among fibromyalgia patients, and the researchers concluded there is “moderate evidence” myofascial release is beneficial for fibromyalgia symptoms. As far as the other forms of massage used in these studies, the results of this systematic review and meta-analysis revealed that, among fibromyalgia patients, connective tissue massage improves depression and quality of life, but manual lymphatic drainage is even more effective than connective tissue massage in terms of improving stiffness, depression and quality of life. The review and analysis also found shiatsu improves pain, pressure pain threshold, fatigue, sleep and quality of life among people with fibromyalgia. No improved outcomes were detected in connection with the use of Swedish massage for fibromyalgia. “There is moderate evidence that myofascial release is beneficial for fibromyalgia symptoms. Limited evidence supports the application of connective tissue massage and shiatsu,” stated the review’s authors. “Manual lymphatic drainage may be superior to connective tissue massage, and Swedish massage may have no effects. Overall, most styles of massage therapy consistently improved the quality of life of fibromyalgia patients.”

Authors: Susan Lee King Yuan, Luciana Akemi Matsutani and Amélia Pasqual Marques.

Sources: School of Medicine, Department of Physical Therapy, Occupational Therapy and Speech Therapy, University of Sao Paulo, Brazil. Originally published in April 2015 in Manual Therapy, 20(2), 257-264.

72 | MASSAGE Magazine | September 2015 | www.massagemag.com | Acupressure Impacts Blood Flow, Heart Rate Acupressure at three distal acupuncture points in the large intestinal meridian resulted in parasympathetic nervous system activation, along with increased blood flow and consistent oxygenation of the trapezius muscle, according to recent research.

he study, “Distal traditional acupuncture points of the women in the large intestinal meridian group did not tend T large intestinal meridian and the stomach meridian to increase, as it did in both the stomach meridian group differently affect heart rate variability and oxygenation and the control group. The study’s authors interpreted of the trapezius muscle,” involved 41 female participants these findings to mean that acupressure at the three without neck or shoulder pain. distal acupuncture points in the large intestinal meridian These subjects were randomly assigned to one of three triggered parasympathetic nervous activation. groups: the stomach meridian group, the large intestinal As for the oxygenation of the trapezius muscle, the meridian group or the control group. Those in the stomach researchers reported that total hemoglobin in the large meridian group received acupressure at three distal intestinal meridian group reached significantly higher acupuncture points: ST 34, ST 36 and ST 41. Subjects in the levels than the total hemoglobin in the stomach meridian large intestinal meridian group received acupressure at group. In addition, oxyhemoglobin in the stomach three distal acupuncture points: LI 4, LI 10 and LI 11. The meridian group significantly decreased temporarily women assigned to the control group did not receive any during acupressure, whereas the oxyhemoglobin in the intervention. large intestinal meridian and control groups did not The main outcome measures for this study were change. heart rate variability and oxygenation of the trapezius “These data indicate that these three distal muscle. Oxygenation of the trapezius muscle was acupuncture points in the stomach meridian did not measured bilaterally using near-infrared spectroscopy, influence blood flow of the trapezius muscle but rather which measures the concentration change in reduced oxygenation of the muscle,” stated the study’s oxyhemoglobin, deoxyhemoglobin and total hemoglobin. authors. “In contrast, these three distal acupuncture Heart rate variability was measured using a portable points in the large intestinal meridian increased blood electrocardiogram recorder. flow of the trapezius muscle and maintained oxygenation Subjects sat in a quiet room for 10 minutes before the of the muscle.” researcher began recording both outcome measures. As the recording continued, the women in the two meridian Authors: Yukiko Shiro, Young-Chang P. Arai, Tatsunori Ikemo- groups received acupressure on the right and then the to, Takashi Kawai, Masahiko Ikeuchi and Takahiro Ushida. left side of the assigned acupuncture points a total of three times. The three acupressure sets involved the use Sources: Department of Physical Therapy, Faculty of of the practitioner’s right thumb in a rotary fashion at 20 Rehabilitation Science, Nagoya Gakuin University, Japan; to 25 cycles per minute for 30 seconds on both the right and Multidisciplinary Pain Centre, School of Medicine, Aichi and left side of the assigned points. The acupressure Medical University, Japan. Originally published online in order was ST 34, ST 36 and ST 41 for those in the stomach 2014 in Evidence-Based Complementary and Alternative meridian group and LI 4, LI 10 and LI 11 for those in the Medicine. large intestinal meridian group. Once the three sets of acupressure were complete, the recording continued for Visit massagemag.com/newresearch to read this another 10 minutes. month’s online Research Exclusive, “Oxytocin Affects Results of the research revealed that, compared to the Response to Social Touch.” stomach meridian group, the high frequency component of heart rate variability among women in the large intestinal meridian group was higher. Also, the low- to-high frequency ratio of heart rate variability among

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M | Educational Resources and Development Improve Your Skills Build Your Business: At Home • Online • In Person

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M | Conventions & Events

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?may be in the minority, but I feel muscles work together in order to help how and where the pain manifests. I perfecting the art of massage, individuals with pain relief and under- Pain is complex and yet individual to learning how muscle imbalances stand pure and applied kinesiology, and the person experiencing it. cause the bulk of our aches and pains, to use assisted stretching as an aid to Julia Fettig is more beneficial than [learning] achieve this goal. Myrtle Beach, South Carolina other, what I call fad techniques. Eric Thomas When you create muscle balance, South Sioux City, Nebraska ull CDT [complete decongestive joints are more properly aligned and F therapy] certification, LANA [Lym- there is less nerve impingement, hence ’m more interested in an accurate phology Association of North America] less pain and better overall health. I understanding of how the body certification and medical massage— Dan Cetrulo works, how pain works, and how I, as everything else I want is gravy. Florence, Kentucky a manual therapist, can help clients Tina Rask with pain get out of pain. When one facebook.com/groups/massagemagazine ranialsacral [therapy], and hot has an understanding of how the body C stone … Technique may be highly works, technique will rise out of that … soteric healing, myofascial, valued, but the old childhood adage— you come to realize that the technique E neuromuscular therapy and stop, look and listen—has never made is secondary; the understanding comes teaching. There really aren’t teaching more sense. In regular daily practice first. Research (medbridgeeducation. classes to learn how to teach and this has made me a better therapist. In com/blog/tag/chronic-low-back-pain) guide others, but in our profession we this work we use all of our resources, has shown that the modality used is are always trying to help guide and but I’m learning that nothing fancy, less important than the quality of the educate our clients, even sometimes just being there and stepping aside can client-therapist relationship. our fellow colleagues. In my state, be the most useful thing I could offer Alice Sanvito teaching certification isn’t required, my clients. St. Louis, Missouri so anyone can teach a continuing Joseph Karp education class. Thus, it would be nice Virginia Beach, Virginia he more techniques in your reper- to offer continuing education courses T toire of skills to use intuitively, as to help us grow beyond just learning would like to learn Aston Kinetics. It you feel the pathways of pain and re- massage modalities or techniques. I seems it would be very beneficial to strictions, will only assist your clients Christina Stitt help repattern or retrain movements to understand their own bodies and Hendersonville, North Carolina in clients who have imbalances in their soft tissue. The classes are very expensive, but it seems like the next piece of the puzzle to help clients more Your New Question [in the] long term. How do you use the Internet to find Tracey Pritchett Santa Rosa, California and retain clients? Submit your response (up to 100 words) by September 15 via email to inesiology; movement of the [email protected] or visit massagemag.com/question. Responses may be edited for K muscle is fascinating. I would clarity and length, and must include your first and last name, city and state. Responses will be like to master the [knowledge] of how used for Reader Expressions only, and may appear in both magazine and online format. M

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