Robin's Massage Blog

Using the Evidence to Promote Your Practice

2011-11-29T20:03:00.009-07:00

These days it's not difficult to find sources for massage therapy (MT) research information. Pop in on FaceBook and many practices have their own page. Several of them post research articles as a way to promote MT and don't mind sharing (like mine). Maybe we should define what a research article is. A research article has been peer reviewed and published in a scientific journal. It's usually based on an investigation of a subject the authors were interesting in learning more about and they want to communicate their findings to other interested parties. Here are some great FaceBook evidence resource pages:

Often, you'll hear someone say, off hand, they're doing research on something they're interested in learning more about. This is a form of expanding one's knowledge but it is different than the research we're talking about here. Research in MT uses the scientific method. Additionally, many students are required to write a "term paper", not usually a research paper. A term paper is most often a review of the scientific literature (referred to as a lit. review). There's not usually any actual, hands on research being conducted (although, sometimes there is).

Here is a link from Columbia University that explains the research article format. It's pretty standard and helpful for reading through a research article. Let me just say, it takes a while to fully comprehend what you're reading in a research article. How could you, unless you've been on a research project or gone through graduate school? For the time being, just read through the abstract. The abstract is a summary of the research article. Read the background (AKA the intro) and then skip down to the conclusion. If you're still interested, then see what methods they've used in this study. After the methods, check out the results. Then, it's good to read the intro and the conclusion again (because by now the 'ole brain is clicking). If you're still interested, now's the time to read the entire article.

Why should we care about research anyway; we just want to practice, right? Lots of reasons including:

Other health care practitioners will take us seriously;
(because it puts us all on the same page).
Research helps us understand our work;
(at a deeper level and it WILL make you a better practitioner).
You can use research to promote your practice;
(which is what this blog is getting to).

Research articles provide evidence of the effects of an intervention; in this case, the intervention is massage therapy. Because of the evidence, we can now safely say massage therapy is effective for decreasing anxiety, blood pressure, and heart rate. We also know there is evidence that MT is effective for non-specific lower back pain. There is evidence, as well, that relaxation massage is just as effective as deep tissue massage for low back pain. Massage has also been found to increase the weight of pre-mature infants. You can use this information to support and promote a modality you provide. Potential clients like this data, the bio-medical community respects it and you will gain confidence in your work as a result of knowing the evidence exists (that's how it's most often referred to in science, as evidence, not so much as research).

A few tangible ways of providing the evidence that I've heard other MTs say they've found success with:

A. Printing off the article and providing it to clients in the reception area of your practice;

B. Sending abstracts to clients via e-mail;

C. Taking several abstracts along to doc visits, fitness centers, networking events or where ever else you are trying to establish a MT referral source;

D. Posting it on your FP page, LinkedIn, Twitter, or any other social media site.

Here are two of the top online sources to finding MT research articles:

You might find the Massage Therapy Foundation site easier to navigate the first time around. It has a wealth of other valuable research information too. Both links ultimately end up at PubMed, which has many science journals and is a good place to get to know if you're really interested in the MT evidence. When you do a search on PubMed, clear the search box (click on the tiny x at the right), type in the area of interest, and massage. For example, you could start by typing: "non-specific lower back pain AND massage." This search results in 15 articles. If you look to the right hand corner of the page, you'll see you can filter your results further. Click on reviews and you will get the consensus of evidence for the effectiveness of MT on non-specific lower back pain (when I looked today there were three).

Clicking on the link for the reviews, I see one of the three articles that came up has free access to the full article. Click on this link and then look again to the right corner. There you'll see the journal, in this case, Medicina. Follow the link and you'll find the connection to the PDF. This article is written in Lithuanian; yikes, I don't read Lithuanian, do you? To avoid this, go back to the main search page and look for limits at the top of the page under the search box. Here you can narrow your search. I usually do this in the beginning of a search and narrow mine to the last five years of publication, English, and abstracts with free full texts.

You can do as much or as little as you like with your research education to promote your MT practice. Just keep at it, a little at a time, and be patient with yourself; it will come. If you have any questions, shoot me an e-mail, I'll do my best to find you an answer. If you're really gong ho, here are a few more reputable links you can check out:

a. The Cochrane Review

b. Poem

c. Research Methods for Massage and Holistic Therapies

Marketing...

2011-09-22T19:24:00.000-07:00

...is not an easy task. After finishing my full time research training, the past two years, I've found it necessary to practice build once again (my client base had dwindled from lack of attention to marketing). After reviewing what other MTs had to say on the Massage Professionals website last year I considered running a Groupon ad. Turns out one must have a number of positive reviews on Yelp to be eligible to run a Groupon ad. Now I have positive reviews all over the web, because I've been running my business for a number of years; not to mention a whole page of testimonials on my website. But if you are in practice rebuild mode you must stay current and that means going along with Yelp for the time being. So, I asked several clients to post reviews (some old, some new) and they did; only to have them filtered within a few days. That's five reviews down the drain friends! I've decided not to worry about it and just run an ad on Yelp anyway; I'll get to Groupon, or Living Social, at another time. I also have an ad with Google (who did post my reviews); I appear to be breaking even with them so far.

Here's a crazy idea I've liked better than running ads: handing out cards for half priced sessions to various folks I know socially who won't allow themselves massage with their current finances; like students and young moms. I've also e-mailed clients who aren't regulars anymore and offered them the same deal for specific times and dates. For example, I sent out an e-mail a day or two before at a time I knew was good for them on a day that was slow in my schedule (a last minute fill the slots special). One week I targeted seniors, the next teachers, etc. So far, about one third of these folks have responded and we're both happy. Keep in mind, at half off my regular rates I'm still making double what I would with a Groupon ad. I'm also not undercutting other MTs because these are my clients who haven't been getting massage because of the economy.

I've also followed through with old clients who can afford full price but have gotten out of the habit of wellness massage for one reason or the other (usually they just got too busy). For the past month this has worked out about 90% of the time and they are all happy to be back. These are follow-up things I should have been doing all along but did not make time for while going to school in addition to seeing clients. Any who, I've doubled my clientele over the summer with considerate and respectful folks who are a great fit for my practice. Yes, most of them were my old clients, so they knew me already, but it still counts. I also know that most of the friends I've offered the half off sessions to aren't going to become regulars, but I don't care. They're people I know and like, and they'll tell other people AND it creates momentum in the meantime (it's as good as comping a session). I'm also in the process of joining a site called Hands for Heroes which offers veterans free massage. Hands for Heroes is meaningful to me as I'm a veteran and am happy to support their efforts.

Then of course there are all the social networking groups. I've done this a lot over the years and decided to start with the online groups I'm a member of already. So for me it has been a matter of updating sites and getting back into regular communication with places like LinkedIn and Face Book. This has resulted in a couple bookings and I pay nothing for these memberships. There are also a few local on-line groups; I just haven't made time to re-connect with them yet.

The next step for me is to physically attend a couple local networking events. I plan to soon but first wanted to re-connect with old friends and several practitioners I know over coffee, lunch, or an after hour drink. Supporting each other through cross referral is a great source of increasing both our businesses. I even refer to other massage therapists. It might be the client is closer to the other MT's office, they offer a service I don't provide or a time when I'm not available. I have found however, you must be clear, direct and realistic with how they can help you too, for example, pointing out a modality you provide that they don't. Then it's important to stay in touch with your network so they don't forget you!

Marketing never ends. It's not just new MTs that have to deal with marketing, as you can see, it's us long timers too. If your business needs a pick me up, you know what you have to do, some of the old and some of the new, some tried and some true (not so much a poet and I know it). That reminds me, there are many successful MTs out there who are happy to provide ideas and advise about marketing; Laura Allen for one. She's a business dynamo and among the best; check out some of her videos if you haven't already for more marketing ideas. Yes, that may mean pushing outside your comfort zone as you did when you first started out; big deal, just do it.

Next up: Using research to promote your business.

Next Up

2011-08-01T18:04:00.000-07:00

Well, I've completed one additional year of CAM (complementary and alternative medicine) research training through the NIH fellowship. I learned CAM theory and methods of research, along with studies in medical anthropology, ethno-medicine, and bio-statistics. I was also involved with another service learning project that worked with several inter-city resource organizations. My participation with Project Reach continues, as well, as we close out our first year of collaboration with local chiropractors and they begin the second with acupuncturists.

This summer has been about healing for me. I worked really hard this past year and felt like my health needed attention. So, I've been slowly decompressing by getting back to a decent sleep schedule, eating right, and getting enough exercise. Time with family and friends has been of top priority too and I've enjoyed catching up with them. I've even had time for fun, and much needed mindless, activities like NetFlix, badly written memoirs of interesting people, and a trip to the coast.

My next focus will be on my practice. I haven't spent time marketing, networking, or promoting it in any way. Thank goodness for a strong client base that has sustained me through this rough economy. I've learned so much from my clients and my practice has always been my real passion. It is through our connection that I continue to grow and why I've pursued higher education in the first place. It is time, however, to practice build once again. There are so many resources out there to help me and I've got a couple methods I'll dust off and reuse. If you have any ideas you're willing to share, let me know, I'd love to hear them; stay tuned.

Exciting Ecuador

2010-07-14T15:58:00.000-07:00

Just back from 18 days in Ecuador. A much needed break from school and the Tucson heat where we are losing patience waiting for our monsoons. Lots of rain in Ecuador. Wonderful people and climate. It must be the fruit capital of the world too; avocado and banana trees everywhere; not too mention the sugar cane, papaya, kiwi, and mango's. Obesity is not an issue in Ecuador; neither is smoking. I also noticed a public health campaign targeting litter awareness. Garbage cans with clown faces, garbage trucks with what sounded like Christmas carols resonating from within, and little "no littering" logos on all the food packaging.

I learned as much about their traditional healing as I could while in Ecuador. The first week I was given Guayusa leaves, to drink as tea, for some menstrual irregularity I was experiencing; fixed me right up. Looking it up online I find it is used by the Amazonian Jivaro Indians for a number of issues; including to promote dreams during healing rituals. It supposedly contains caffeine and acts as a stimulant. It had the opposite effect on me and settled me down.

The following week my partner and I got really sick after eating in a local cafe and recovered from a blend of boiled onion mixed with fresh orange juice and honey. It soothed my stomach and opened up my sinuses. The Amazon rain forest has so many medicinal plants, orchids, and other flowers, fruits, and vegetables. What a wonderful place to explore the culture and learn from the Ecuadorian indigenous tribes.

Massage therapy is readily available in many towns and cities in Ecuador. They have skilled therapists, many of whom are certified from other countries. I do not know about Ecuador's MT regulation or requirements. Massage therapy does seem to be appreciated and acknowledged in Ecuador as part of a health maintenance routine. I've noticed that same awareness when in Mexico too; much more than in the US. Just my observations...

Indigenous Healing Practices

2010-05-26T21:06:00.000-07:00

Last week was incredible; thrilled to spend so much time in the northern AZ tribal communities. Traditional healing approaches with the Navajo and Hopi are similar to CIM practices; holistic and client centered. I found them to be respectful, gentle, and unassuming people who honor their heritage, are spiritually dialed in, and speak simply and with meaning. I met two massage therapists (Navajo and Hopi), worked on one elderly Navajo women who had recently suffered a fall injury, and found people receptive to massage therapy in general.

At the swap meet in Gallup, New Mexico (which is held every Saturday) I spoke with Pueblo Indians, Ute', and Paiute'; all from Utah. There I found pow wow music, various medicinal plants and herbs, fresh green chilies, and juicy red cherries.

I also got to see some incredible country including the Grand Canyon, Colorado River, Ship Rock, the Hopi Terrace Gardens, Window Rock, and Canyon de Chelly. I learned to sheer sheep too!

Check out the Peach, the Hualapai kids radio station sponsored by Kidstar; they rock! Also, here's a video I made of our trip; complete with peyote songs from a couple navajo locals in the area. Their personal statement on the back of the CD I purchased says "through these songs, we learn to live strong, support one another and have faith thru the Native American Church ways."

CIM Therapies and LBP

2010-05-13T20:58:00.000-07:00

Check out this study that considers the unanticipated benefits of CIM therapies on lower back pain. Our work gives people hope and hope heals....you knew that already, but it nice to affect the science guys (oh yea, I'm a science guy too).

Speaking of healing...I'm spending next week in northern Arizona tribal country on a service learning field project. I hope to observe traditional healing and learn some about their use of herbs and other medicinal plants. Details later.

Glad my friends are having fun at the CIM conference in Seattle; go Jan, Jolie, and Rosemary!

Two Year Pass

2010-05-06T20:53:00.000-07:00

I was awarded the pre-doc fellowship from the Department of Family and Community Medicine!

Time Flys.............

2010-05-02T07:37:00.000-07:00

My internship is over although I will continue working with the CIM Reach team as a paid research associate for the summer; woo hew! We've started recruiting our first wave of practitioners for the study; chiropractors. If you are a DC in the Tucson Metropolitan area and want to be a part of a University of Arizona Study; let me know. You will get free evidence based training, to include approved industry CEU's, and will contribute to making a significant impact on the health of the public by decreasing tobacco use.

Oh yea, I'm graduating from the masters in public health program too! The convocation is May 14th; who'd have thunk!

Massage Therapy Radio

2010-04-13T17:49:00.000-07:00

Check out Massage Therapy Radio, if you haven't already. They bill themselves as "the voice of the massage profession." A couple weeks ago, I listened to Diana Thompson and Ruth Werner as they talked about the upcoming CIM Conference in Seattle; Highlighting Massage Therapy (MT) in Research. Great discussion from the past and current presidents of the Massage Therapy Foundation.

Last week they had Tracy Walton on who specializes in MT for cancer clients. Tracy writes, teaches, and has completed research in her speciality area. Tonight they have Whitney Lowe discussing creative clinical applications of MT research. After their evening broadcast the MT Radio keeps the recordings available for you to listen to at your leisure. There's quite a list already, on other pretty interesting topics, including business, techniques, treatments, and technology.

CIM

2010-03-29T20:28:00.000-07:00

Last week I went to a breakfast meeting with the AZ Integrative Wellness Coalition. Great group of different complimentary and integrative practitioners (CIM; my new word for us instead of CAM). They have recently merged with the Holistic Chamber of Commerce so there were other business owners there selling their alternative products as well; for example supplements, dietary aides, etc.

A presentation was given by an MD and his wife who told us about their research trip to Cuba. They have a national health care system that includes CIM in a system that is based on egalitarian methods. Doctors make about $15 a month and citizens have their choice of medical approaches. The doc to patient ratio is better than ours, people are living longer, education is free (even to US students as long as they go back to their homes to practice afterwards) and they haven't the health care crisis we have in the US.

The fact is, we are out of control here for two main reasons; cost of hospitalization and physician referral for procedures (profit driven). No one with adequate insurance wants to hear this because it's our right. For example, the AMA came out with new guidelines this year about prevention testing that is a 180 from what we've come to know. Women are now told to start our baseline mammograms at age 50 with subsequent testings once every 3 years or so thereafter (instead of baseline at 40 and yearly testing). The creator of the PSA test recently told the NY Times his test has been abused as well. It was meant as a guideline but has been used to refer untold unnecessary procedures. The fact is the body most often will self regulate fibroid and prostate issues given the chance; a cautionary, watchful approach should take place, not a jump to medications and surgery. Yes, the mammogram and the PSA test have saved millions, however, twice that many have had unnecessary tests, procedures, and the associated trauma of fear and tissue invasion.

Integrative health care is happening folks; MT's, Ac's, DC's, MD's. It's all good.

Somatic Research

2010-03-08T13:10:00.000-07:00

Great article in the current Massage and Bodywork March/April issue. It's by Diana Thompson on Somatic Research and she does an excellent job of explaining research in our field; much like I've been promoting whole system research methods to investigate MT and other CIM (complimentary and integrative medicine).

I have to admit to becoming somewhat disillusioned by the recent discussion threads in Massage Professionals online and the Science Based Massage Therapy group on Ning. There are a few researchers who are narrowly focused on RCT's only for MT and ignore the value of qualitative research, pilot studies, and whole systems research. If we want MT's to become research literate and the public to appreciate the benefits of MT we have to give equal value to ALL research methods; many of which do an excellent job in TRANSLATING research.

The effectiveness of MT is realized in the whole experience of the session including it's context, the client/practitioner relationship, the values and beliefs each bring to the table, and the experience of the treatment by the client. A MT session is client centered and collaborative, so our research methods should not only reflect this but be inclusive as well.

Thanks Diana, for your hard work, AND for being a leader in our industry who's not afraid to say RCT's are not all that. Move over guys, think outside the box; don't be so attached to your own theories that you're not leaving room for the possibilities that could more fully capture our work as MT's.

I'M IN!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

2010-02-25T21:38:00.000-07:00

Last week I was admitted into the DrPH program at the University of Arizona; yayyyyyyyyyyyyyyy! Now to get the pre-doc fellowship that allows me to learn whole systems research in order to properly investigate massage therapy and CIM (complimentary and integrative medicine); fingers crossed.

Client Intake

2010-02-23T15:46:00.000-07:00

I was asked today, by another massage therapist, what I felt was the value of separating subjective and objective information from a client during the treatment assessment. My response to her question was subjective information is vital to the treatment assessment. The information gained from the client at the beginning of a treatment evaluation not only allows them to be heard it ensures we are listening and sets in motion the healing process. The client knows what their needs are (either consciously or subconsciously) and we help them best when they become aware of the message their body is sending and of their own innate healing potential. We further facilitate their wellness process through the use of our objective knowledge which is based on our education and experience. By taking their history, hearing their goals, and collaborating in a plan for their successful experience of massage therapy we guide them in a partnership towards better health.

MT Students Rock!

2010-02-13T19:42:00.000-07:00

I had the privilege of guest lecturing at Cortiva Institute of Massage Therapy a few weeks back, and enjoyed the experience immensely. The Research Applications class, part of an optional additional 4th quarter, invited me to share the current state of massage therapy research and to offer them guidance as they prepare for their required case report submissions.

I was prepared to present a power point of a recent literature review I'd completed and answer questions for an hour or so, but ended up staying three. It was wonderful to hear their bios, future plans, and to help them connect their interests to ongoing research; make it relateable, if you will.

Lots of interest in energy work; although we stayed on massage therapy and pain reduction for their case reports, for the most part. Many great questions and contributions to the discussion from students with a wide range of age, experience, and background.

Tucson Cortiva has impressed me with their leadership, direction, efforts to address research literacy in their curriculum, and support of their students. I look forward to addressing another class in the future.

Winter Break - Time to Catch My Breath....

2009-12-11T16:37:00.000-07:00

WOW, busy semester; but I'm done for the winter break. My internship is in place and is called CAM Reach. We will be investigating the practice patterns and health care approaches of local CAM health influencers (MT'S, LAc's and DC's) in order to develop an office system smoking cessation intervention tailored to their needs. Close as I could get so far to research in MT. It seems I must have a doctorate before I can do research in the area of my interest. So, I have applied to the DrPH program in Public Health here at the University of Arizona. I am also applying for a pre-doc fellowship, in the spring, that will allow me to do research in other areas of CAM study at the U of A. Never thought I'd go this far but I REALLY want to research MT, and so here I go. I better live a long time as I've gotten a late start in research; better late than never, don't you think?

Changing Gears

2009-10-03T07:47:00.000-07:00

Ok, PTSD MT intervention on the back burner, CAM Reach to the forefront. CAM Reach is part of a 10 year study of tobacco cessation and the public. I have joined a research team, at the University of Arizona, who is investigating getting the word out about tobacco education through CAM practitioners; ie MT's, Acupuncturists, and Chiropractors. We will be doing key informant interviews with 60 practitioners, here in Tucson, in a needs assessment effort. Then, based on what we learn from these interviews, we will develop a training tool for CAM practitioners about smoking and tobacco cessation. In other words, we hope to give them successful, evidence based methods of engaging smokers in a discussion around not smoking. That's as much as I know so far, and will post more later. Suffice it to say, the principle investigator on this project is a doc who recognizes the value of CAM, respects alternative practitioners, and thinks providers have failed in their attempts to educate their patients about smoking and tobacco use. She is reaching out to our industry for help in educating the public about smoking cessation. What are your thoughts about this plan?

Plodding along....

2009-08-28T08:18:00.000-07:00

The fall semester is back in session and I'm adjusting to a new schedule once again. I'm trying to get through my internship prep class ASAP in order to have IRB approval for next semester. This is an internal review board that has to approve any project working with human subjects. Still waiting for my professor and his VA contacts to come through as well. In the mean time I have anthropology and public health, and a research methods class that look quite promising for content and student discussion potential. One more semester to go; I can see the light.

Internship progress

2009-08-20T14:40:00.000-07:00

My meeting with the president of Cortiva, here in Tucson, went better than expected. She has offered up her students and clinic for my research design. Do I hear a hallelujah? My advisor has been out of town, but we were able to talk briefly twice while he was away, and he's still in. Next step, connecting with his UA contacts regarding our target population for our volunteer participants. I'm chomping at the bit here as I have a few contacts myself, but Pete says the VA has their own way of doing things and we have to play ball. I played volley ball for the army while serving years ago, does that count?

The Client Prospective

2009-08-13T08:38:00.000-07:00

One thing that has made me a better massage therapist (MT) is receiving regular massage treatment. It's like taking a class. Not only am I caring for myself and learning new techniques, I also experience the clients prospective. How comfortable is the table and face cradle, for example? If my sinuses are acting up I can only lay prone for a half hour. The bolster under my knees, when supine, affects my circulation and my legs fall asleep. I'm very healthy, so this may really affect someone who is less so. Is it time for new sheets, have I been too chatty lately with my regular clients, and have I really heard my clients response when asked how they're feeling or what needs focus this session? How does another MT handle client issues like no shows, tardiness, or raising rates? What CEU's are they taking and what has worked lately to gain new clients? Their room decor, office design, and location are always interesting to see in comparison as well. Having a massage session from another MT helps me to review and fine tune my own procedures, professionalism, and prospective.

As the world turns....

2009-08-10T09:19:00.001-07:00

Just back from a week's vacation and ready to go. This week I'm meeting with my advisers again at the University to discuss my internship plans. Next week I'm meeting with the president of Cortiva to see what their interest in collaboration with the U might be. Wish me luck everyone, as the process of creating a participation opportunity in MT research, completing my internship requirement for the MPH, and maintaining my business has been challenging (not to mention my family life). I feel like I'm stumbling around blindly while trying to get the right people interested. I'm determined to get my needs met while in this program and fighting frustration with the process. I keep telling myself that's always how it is when attempting to initiate something worthwhile; right?

Ergonomics

2009-07-26T09:25:00.000-07:00

Ergonomics, as I define it, is the science of making improvements to your work space and daily tasks, to more efficiently fit your body and routine. Its goal is to prevent pain and injury. The warning signs your body is communicating to you that can occur in the hands, wrists, arms, shoulders, neck, head, hips, back, legs, or feet include:

numbness
burning or tingling
soreness, aching, or tenderness
pain - throbbing or dull
swelling
tightness or stiffness
weakness or cold

Most of us these days, in the US, have computers and therein lie a lot of these issues. The computer is such a great resource, but what a time stealer. We become so involved we lose complete track of time. One should get up every half hour, while at the computer, to do something else; for example, stretch, do another task, or simply stand. Vary your position and tasks often; set a timer to make sure you do. I work from home, so when not with clients, I'm on the computer reading, typing, or networking. I'll start a load of wash, which takes about half an hour, and when the buzzer goes off, I get up and put it in the dryer. Unload the dish washer, make the bed, clean something (ugh), go for a walk, do your exercises, study; break up your tasks throughout the day so you are not in a static position. Those of you at an office, move your phone away from the desk, if sitting all day is an issue, then get up to answer it. Stand up to print documents, file, or even to read your computer screen for a while if you can get the monitor up higher (stack up books underneath). For more information (by HP) on setting up your computer work area ergonomically, click here. For an excellent free download, of stretch breaks you can do at your desk, with periodic pop up reminders, click here.

This week was a busy client week and I had to finish the remodeling work started in the client bathroom as well. So, I did extra repetitive motion tasks realizing it would probably compromise my wrists. The median nerve pain told me it was time to stop. I chose to finish up knowing it would hurt for a day but that I would not abuse it further for the rest of the week, and worked as efficiently as possible in the mean time to get the work done. This included using my other hand, as often as possible, to paint the walls and seal the floors. I then was extra careful of my body mechanics while with clients that day. In between, I dry skin brushed my forearms from wrist to elbow, front and back, until the circulation was greatly increased. Afterwards I did muscle releases, massaged my forearm, and rested my hands for the evening. The way to avoid carpal tunnel pain is prevention and that means prioritizing tasks. Usually when I have a busy client day, I will not use my hands for other tasks that include pulling weeds, carrying buckets, typing, writing, food prep, playing the piano, cross stitching, knitting, or in this case, painting. Those of us who use our hands to make a living know this is not always possible, so are sensible and cautious in situations like I had this week. My wrists feel much better today, the bathroom is done, and I'm receiving a massage tomorrow; ahhhhh...

Communication with Your Massage Therapist

2009-07-21T13:39:00.000-07:00

I had a couple new clients this week. Most of my clients are regulars (monthly or bi-weekly) so a new client keeps me on my toes as I want them to return too. We have to get to know each other, so good communication is essential. After the intake and evaluation she asked me to spend time on specific areas of tension. I asked her what kind of pressure she preferred and to let me know if she needed more at times, or when to back off. Of course, the body communicates as well, with areas of sensitivity, misalignment, and tight muscles that aren't quite ready to let go. Gradual pressure to the clients level of comfort is my working process. This client had regular massage treatments in the past and knew to speak up and give feedback. Never lay quietly on the table, uncomfortable with techniques you aren't enjoying. Let the massage therapist (MT) know and they can change it up; MT's are trained in a lot of different modalities. Don't think only deep techniques are required to work out those knots either; it's an individual preference. There are many light touch therapies that are just as beneficial as deep tissue in releasing the muscles; an experienced professional will mix it up to get the desired effect. It's normal to feel a little sore, in the heavily worked areas, for a day or two. Any soreness after that means it was too much too soon, so let the therapist know next time you see her and she'll adjust. It's as easy as this dialog: "I prefer medium pressure," to start, and then, "you can go deeper here" or "that's a little too much." Communicating effectively with your MT can make all the difference in whether you get a good massage or not.

The Future of Massage Therapy

2009-07-19T10:49:00.000-07:00

Here's an exciting, well balanced, recent document, I came across yesterday, that suggests the direction MT research should take next; by a group of our industry proponents: Click here to read. It discusses evidence based MT effects, as well as, limitations in our research that need further attention. For example, we can say, based on our current research evidence, a well established effect of MT is its reduction in anxiety. Effects reported in other studies, such as pain reduction, are not yet as well understood and need more scientific analysis. Our profession is young, from a research point of view, and is subject to the same scrutiny every other established profession has endured. It's important to me, as a MT, we define and control our industry to the extent that some outside profession does not. To that end, we need to develop more rigorous study that can hold its own when compared to other health care professions. In any case, this article addresses all these points and more, in an easy to read, well organized and thought out manner, with the most up to date information I've seen summarizing the future in MT.

Innovations in Networking & Research Literacy

2009-07-17T09:01:00.000-07:00

Blogging, discussion boards, Linked In, Face book, Twitter; unbelievable how we network these days. Check out this wonderfully creative YouTube Video that has put it all to music and dance in an updated version of West Side Story called Web Site Story: http://www.collegehumor.com/video:1913584

I'm also reading a book my advisor suggested, when I was whining recently about massage therapy not being accepted by the medical community, called The Diffusion of Innovation by Everett M. Rogers; great book! When Pete first suggested it I thought, how can this apply to a practice that's been around for thousands of years? Lot's of reasons, it turns out, and there's a whole discipline of study around this subject that is subdivided into at least ten different major research traditions, including public health (which is my college at the university). The reasons behind MT's slow diffusion into current mainstream health practise include social and cultural explanations. That leads back to an oft debated discussion in our industry to evidence based practise. I'm only going to go there briefly as MT's debate this quite thoroughly through our associations discussion board: http://www.massageprofessionals.com/group/EBMT. It's just time for more and better research, plain and simple.

I don't want to change the fact that we get to spend an hour or more with our clients, we touch them in healthy ways, we listen to them, and encourage healthy behaviors. I do want to be able to answer their questions, to the best of my knowledge, and explore the mechanisms behind what we see works, with illness and injury, on the table each session. I also want to be able to look it up, when I have questions, to see what other MT's have tried and found successful; their outcomes. I want to be able to trust that their research has been reviewed by my knowledgeable peers and critiqued for bias, confounders, and limitations. I want to be able to review those studies with my well trained critical eye, and make up my own mind as I filter all the information that's out there. I want the research to include MT's because we know muscles best! Yes, our work is intuitive, and that's best mixed with experience and education.

Great Resources

2009-07-16T09:26:00.000-07:00

Yesterday morning I connected with Laura Key of Lotus Massage and Wellness Center. She has a beautiful place off of Grant and Country Club for any one needing MT's more central; check them out: http://www.lotustucson.com/. I've had a few other MT's express interest in support of research here at the U of A, so check here for updates to my progression with initiating this endeavor. I'm also spending a great deal of time reviewing the research that has been done actively since the '80's, some as early as the '30's. Here are the sources I use in finding MT research articles, or studies, in scientific journals that have been peer reviewed:

If you find something that interests you and can't get access to the free text, copy and paste the title of the article in your web browser, do a search and it will usually lead you to a free copy. If anyone needs help, let me know.

Local MT Resources

2009-07-15T09:20:00.000-07:00

So, I spent a good deal of yesterday following up on leads regarding a MT research collaboration between the MT schools and the U of A for my internship requirement. Mostly dead ends so far, from several well meaning interested parties. I did, however, enjoy tea with a new friend, Jan Schwartz, who's also in the MT industry and shares my belief in the need for evidence based practise. Jan's slaving away on her masters thesis this summer and hopes to be done by the end of this year. In the meantime her online business has taken off; you can check it out at: http://www.educationtrainingsolutions.com/. She also shared with me her contacts in the field and I joined a new local group, at her invitation, called Holistic Tucson Online. Thanks Jan.

Did I mention I received a massage on Monday? Thank you Donna, it was wonderful. If you are in need of a massage in the Marana Twin Peaks area, or have insurance that covers massage, Donna is an approved provider: donnabishop.massagetherapy.com. I receive at least two massages a month from different MT's, and they are so well worth it. Not only do I get to receive the benefits of relaxation, muscle work, and self-care, it's like taking a class. You get to experience another MT's techniques and are reminded of how a client feels and what they experience on the table. The benefit of self-care in receiving a massage refers to the notion you are doing something healthy towards illness and injury prevention. It also gives you a feeling of control knowing you have a tool you can rely on for maintaining optimum health. Exercise, good nutrition, and massage keeps me out of the doctors office and at my best.

Grinding My Wheels

2009-07-14T08:25:00.000-07:00

It's so nice in the desert early morning. Went for my 6:30 walk and saw several assorted sizes of lizards scurrying around; they are so interesting and we don't see them when it's cooler. The quail are scooting around as well, tooting like they do. All the critters are pretty active in the cool of the morning. Now to bring my temp down. Ever try freezing grapes for a quick cool down? Also, frozen bananas cut in half with peanut butter in the middle, on a stick? I have to be creative, in my household, to get my fellows to eat enough fruit.

I've been gathering info as I call it, in preparation for my internship prep class in the fall at the U of A; preparing to prepare. I'd like to do my internship on research in massage therapy (MT). So far, I have one professor who's showing some interest and a few contacts locally in the MT industry. I have lots of ideas and hope the MT schools are interested in collaborating; much begging to do. I've spent the past several weeks reviewing the completed studies in MT research. There have been over 9000 studies since the '60's. I'd say the U of A is behind the times here. A few CAM studies going on, but no MT specific research. These three women have contributed a great deal to MT studies over the years nationwide: Tiffany Fields, Janet Kahn, and Patricia Sharpe. All three are PhD's and LMT's; I'm impressed.

The Who, Why, & What For

2009-07-13T12:20:00.000-07:00

Welcome,

I am a licensed and nationally certified massage therapist with about 20 years experience. I specialize in stress and pain management, as well as, ergonomic intervention as a way to prevent illness and injury. For the past three years I have also been working part-time on a masters in public health at the University of Arizona here in Tucson. Why, many people ask? To gain further skills in promoting massage therapy to the public and changing our health model from one of disease focus to a model of wellness; it's all about prevention folks. I'm also very interested in massage therapy research because I like to get to the root of things and understand the outcomes and mechanisms of therapeutic massage.

I thought I'd share with you what I'm learning and my thoughts about health. A natural approach, that avoids medication and surgery, should be your first call to action when your body gets out of balance. Therapeutic massage increases your awareness while working out tight muscles and reduces your stress through relaxation; a valuable tool in your arsenal of defense. Pain should be your guide in making physical choices, not your enemy. Listening to pain helps you avoid injury by pacing yourself and knowing your limitations. We can still be active and listen to our bodies; that's awareness.