massage Archives - Body Mechanics Orthopedic Massage : Sports Massage and Massage Therapy New York City

Massage at our location during COVID-19

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Massage at our location during COVID-19

Welcome to your local Massage Therapy information page for Body Mechanics Orthopedic Massage!

If you are reading this blog, you probably have some questions about whether or not it is safe to receive a massage in the time of Covid-19, and what our practice and our cleaning regimen looks like since opening. If you have been directed here by reception or management, it is so that we can put all the information you need in one place.

** UPDATE as of September 3rd, NYS allows services where you need to touch the face to take off their masks provided the practitioner has had a Covid test….we are NOT taking masks off in treatment. It is unnecessary and creates undue risk. However, we feel that the ruling is an EXCELLENT indication of how safe it is to have a massage at this point. We look forward to breathing a little more deeply with you all when the risk is over. 

In July, Phase 3 allowed massage therapy to open in New York City. You can see our initial announcement about that at the bottom of this page. We were given specific guidelines to follow in a multiple page document from Forward New York that included a summary, as well as a detailed explanation of how a business is supposed to operate to prevent the spread of Covid-19. The instructions provide a comprehensive outline of required cleaning, safety, and operations. If you want to see the full document, you can follow the links here.

Fortunately, we have always operated as a medical practice, so most of what was in the document was already being used by our facility in the routine care of universal and standard precautions ( the accepted standard for cleaning and disease prevention). Each of our rooms has always been equipped with 70% alcohol which is the CDC/OSHA standard for cleaning and disinfecting. We have also always had 30 minutes between appointments because I was used to hospital-based care and I did not think 10-15 minute breaks between patients was a reasonable time to clean, disinfect and do a full assessment. On a similar note, when we designed our space, all of the treatment room furniture was chosen to be able to be disinfected by chemical means. The chairs and tables may look nice, but we picked plastic for a reason. Now, of course, we are paying extra attention to cleaning things like light switches and buttons in addition to wiping down all of our tables and chairs. Rest assured, however, that we have and will always strive towards a medical level of clean, as that was how we were built.

So what are we doing, and what will you find to be different? 

  • All staff is masked, and you will be too, for the entirety of your treatment. Not to worry, we have multiple ways of making this very comfortable and have extra masks on hand if you need a spare.
  • Our staff is wearing scrubs/smocks so that they are not bringing outside transportation yuckies in.
  • We upgraded our booking platform to a new one that is completely paper-free and HIPAA compliant. No passing forms back and forth, no touching clipboards.  All of your notes are now online (if you are an old customer, we kindly ask you to start with a new health history and consent form- but do not worry, we have access to all of our old information as well).
  • You might also notice that our linens are a little brighter. Previously we used a local laundry company. We have switched to a hospital laundry service. Everything is packaged and handled for medical care. Our laundry was clean….now it is pristine.
  • Your temperature will be taken on arrival.
  • There is hand sanitizer provided in the rooms, not just at the desk, as it was pre-COVID.

There have also been some changes you may not see:

  • Reception is disinfecting the desk on a regular schedule
  • We now have tap and go EMV payments
  • The waiting room is technically closed so most people go directly to their rooms after a brief pause to have their temperature checked. Our office has always been low traffic, but you may not even see another customer now or just see them briefly. You can help us by showing up promptly 5 minutes before your appointment so we can keep that happening.
  • Our staff is testing regularly.
  • Each room and the lobby has a discreetly placed HEPA filter device
  • Reception is tracking visitors to our office who do not have appointments such as mailmen and pest inspection.
  • All of our bedding/extra pillows/pregnancy supports have been modified to allow for disinfecting, not just regular laundering. * For example, our pregnancy pillows for side-lying used to be double covered in pillowcases to protect you. Now the pregnancy pillow itself is made from vinyl and that is covered with a pillowcase. We had custom pillows made for this

We are happy to answer any specific questions you have…please ask!

Our Clean Routine and Your Health

We are currently open for business, but on a limited schedule with strict health care precautions in place. We are checking in daily with our therapists and clients. If you or someone you know is sick, please stay home. Please wash before entering our space. This is a challenging time for everyone. We understand. Luckily we buy sterilization products in bulk:)

Please reach out if you have any questions.

The Benefits of Manual Therapy- An Interview from the Knowledge Exchange

Benefits of massage therapyOur Massage Therapist, Matt Danziger sits down with the Knowledge Exchange to talk Manual Therapy or rather what manual therapy is NOT in this blog/podcast

One of the things we pride ourselves over here at Body Mechanics Orthopedic Massage is our devotion to science and giving people a real outlook on what massage can and cannot do. We are for the most part, for what its worth science based-ish with the understanding that minds do not change over night and therapists need room and time to grow. When Matt told us that this podcast blog post was coming out we immediately asked him if we could re-post it for the Knowledge Exchange.

If you have never heard of the Knowledge Exchange, they are a professional education group that runs courses and mentor ships on the BPS model of pain (that’s Biopsychosocial if your not up on your acronym’s).  They have some wonderful online resources and blogs you can check out and they specifically define what they do as:

“We don’t see our selves as educators but rather facilitators of ideas, discussion and critical appraisal. We do this because we aren’t satisfied with the status quo of health care and believe we can all do far better for our patients.”

I do not want to give too much away in what this podcast covers but it gives some great insight into how Matt sees the role of massage in terms of fitting into the BPS framework. Frequently, a massage therapist who uses this model is viewed as anti-manual therapy and that is not the case.

You are also going to get a great look into Matt’s personal journey as a massage therapist as well as his journey with pain.

Want to check it out? Go ahead and read their post by following this link to listen to the podcast.

You can check out this blog with Adam Meakins  by the Knowledge Exchange if you want to go further into the manual therapy rabbit hole.

If you want to book with Matt and his talented mind, you can read more about Matt’s Massage therapy her or book here.

To connect to Matt’s blog follow this. 

Body Mechanics NYC

1 W 34th St
#204,
New York, NY 10001
United States (US)
Phone: 212-600-4808
Email: info@bodymechanicsnyc.com

Six easy ways to get the most out of your massage therapy

Want to get a great massage?  We put together a list of six super easy ways to make sure you are getting the most out of your massage therapy experience.

 

Massage can be great…it can also be miserable. Just browse through Google reviews or Yelp reviews and you will see experiences that run the gamut between amazing and horrific. In between the lines of those reviews there are frequently experiences that did not have to be bad, but were created by a series of misunderstandings or misinformation. Sure you might get a dud of a massage therapist now and again, or someone on a bad day but the majority of Massage Therapists are professionals who want to give you what you want. We put together this list of easy ways to get the most out of your massage experience to help paitents and clients navigate how to avoid some of the common problems that come up on review sites.

 

1. Arrive on time: Actually arrive 10-15 minutes early, especially if it is your first time. Frequently customers think they have purchased an hour of time. What they do not realize is that that hour of time is very specific to it’s time slot. If you booked a 5pm for one hour, your hour starts at 5 pm. Arriving at 5pm and then needing to use the restroom, fill out paper work and check in, will cut into that time. Paper work is a big time suck. Even at a gym or salon there might be some liability forms to fill out, so err on the 15 minute side of early if it is your first time at a location. Additionally you might consider asking have them send you the paper work in advance or if it can be done online. One of the big complaints we see online is that the appointment was cut short. Generally this will not happen so long as the customer has arrived with time to spare, this is literally getting the most ‘time’ out of your massage. (if it does then see suggestion number 6)

 

2.  Advocate for yourself: There are MANY different depths and styles of massage. Before most sessions your therapist will either take a medical history, ask your likes or dislikes, and what you want to focus on. Some processes are more thorough than others…but whereever you are, this is your time to speak up and make your needs known. You do NOT want someone else’s massage. You want the massage you want. If you like a head massage, let the therapist know. If you do not want your new blowout touched, let the therapist know. Asking a questions about what will be massaged and what will not be is another good way to go. “Full body” does not mean the same things to all people, so try instead to say things like “I would really like I would really like a massage that focuses on my back, legs, calves, arms and neck, I do not care so much about my hands and feet”. Clarity of words can go a long way to clearing up any misunderstandings and having an experience where your legs were mysteriously left out.

Come in with a plan. Knowing what you want ahead of time will save you time and money. If your goal is to relax, that is totally valid, but a ‘full body’ can be made very un-relaxing by your therapist chatting away. Stating what you came in for can be really helpful to both you and for your therapist in order to get what you want. Same things goes for sports massage and medical work. Let your therapist know both your long and short term goals so that they are not guessing at what you want. Some people are terrible guessers.

 

3.  If you are sick or have a possibility of a schedule change, let reception know ASAP. Most places have cancelation policy’s. Those policies are often more lenient the earlier reception knows there might be an issue. If you wake up with the sniffles or your boss throws a curve ball,  give the reception a shout as soon as you know…they might be able to do you a solid. When you wait till an hour or two before your massage because you waited to see if you could really come, you are not going to find much flexibility.

 

4.  Be forthcoming in your injury history and health history:Things that may not seem like a big deal to you, such as that trick shoulder that separates when you put your arm over head, might cause a serious problem if your therapist does not know. Sure you have had it all your life, but this is your massage therapists first time seeing it. Medications are equally important. There is no judgment, but some medications can leave you at risk for bruising, blood pressure complications, and injury. Most complications are easily avoided just by knowing the medication, so please be honest.

 

5.  Do not come in medicated, drunk or high: Massage therapists are supposed to legally send you home if you are altered in any way…and you will probably be charged a fee. Even if your therapist does take you after a few boozy lunch drinks, it may be because they are not exactly sure if you are or are not altered. The likely outcome is, they are not going to give you the massage you want, instead they are wondering if they should be sending you home and giving you the most conservative massage possible. If you have medications you’re taking for an injury and that is what your coming in to be seen for, then call ahead and ask about them. Any medicine that alters your sense of touch or judgment, is a no-go for massage because it may increase your ability to be injured.

 

6.  Complain…but start at the right place first. Businesses are not perfect. No one wants you to have a bad time. Seriously, a business is only as good as their customer service. If you had a bad experience or feel you were somehow wronged, reach out to a manager. Frequently I hear stories where a customer might have mentioned something to reception…and you should totally do that since they are sitting there, but know that not all reception knows that means you needed help. Receptions job is to take payments and greet, often they will be overtasked and not realize you complained at all, or that that complaint should be passed on. Politely asking for a managers email is totally ok, and it will get you the fastest resolution. For small businesses, they are often grateful for this approach as they WANT to find out about problems before they hit the fan. With larger businesses you may indeed have to go to social media to get someone’s attention….but this is rarely the case with self run businesses or businesses that are not chains.

Every massage is going to be a little different. It is important to keep in mind, we do this every day as massage therapists but it may be a special day for you…Hopefully this guide helps you navigate our world of massage therapy a little better.

To book an appointment, or ask us a question about our practice find us here on our Contact and booking page.

Body Mechanics NYC

1 W 34th St
#204,
New York, NY 10001
United States (US)
Phone: 212-600-4808
Email: info@bodymechanicsnyc.com

Five Things Your New York State Massage Therapist Should be Doing for You

We have put together the top 5 things your New York State Massage Therapist, should be doing for you but may not be….

This blog post is specific to New York State Massage Therapy, but in any state that see’s massage therapy as a licensed medical profession, these may apply. We put together this list of important bullet points in order to educate the public about their rights. Massage therapist undergo training in order to become professionals, but the public is often unaware of what that training is or what their rights are. So here it goes, here are our top five things your New York State licensed Massage Therapist should be doing for you.

1. Giving you a full consent before you are treated or assessed

What is consent you ask? It is your agreement to the treatment, assessment, or procedure that is about to be performed. It can be both verbal and written. Consent can cover the type of treatment for massage (for example: trigger point therapy, stretching, or Swedish massage), how it is performed, what products or tools may be used (for example lotions or graston tools), and even as far as what smells you might encounter. The bottom line is, you have full control over what happens to you, even if you have not been made aware of it. What does this mean for you in real time? At the very least you should be looking for a Massage Therapist who gives you a rundown of what they are going to do before they do it, a little snapshot so to speak. This rundown, not only keeps you safe but also ends up in making you happier over all with your massage because you can actually relax.

2. Protecting your right to privacy

In New York state, Massage Therapists are considered Medical Professionals. They are required by law to protect your privacy. If you find your therapist is particularly chatty about their other patients, it may be time to move on.

The New York State Massage law reads as follows:Massage therapists will safeguard the confidentiality of all patient/client information, including patient/client records, unless disclosure is required by law or court order. Any situation which requires the revelation of confidential information should be clearly delineated in records of massage therapists.

3. You have the full right to refuse, modify, or change the treatment at any time. 

Ever have the feeling you have made a terrible mistake, part way through something? It happens, even with massage. It is totally ok to stop once you start. Individual clinics may have policy’s on if you will pay or not based on stopping treatment so you may want to check, but generally if you encounter a medical problem, such as feeling dizzy, we waive all fees at our clinic. Fee aside, you can always simply stop regardless of the situation. If you just think that it is not working out, you can always change the plan too. If your therapists pressure is not right, tell them…or redirect the treatment entirely so it works on what you just figured out you want. A 30 minute back massage can easily become a 25 minute foot massage. Do it, it is your right.

New York State Massage law reads as follows: Massage therapists will respect the patient’s/client’s right to refuse, modify or terminate treatment, regardless of prior consent for such treatment.

4. Referring you out

Is your therapist Mr/Ms fix it? It is fantastic that you found a great therapist. Massage Therapists cannot wear all health care hats however. As a Massage Therapist we cannot diagnose or treat disease, so if you genuinely have a medical issue no one has seen you for, your therapist should refer you out. Vibrant clinical practices are loaded with referrals, we send people out and they send other people to us. We just cannot be all things at all times. It may totally be appropriate for your massage therapist to work alongside another professionals work though, just because they refer you out does not mean you necessarily have to stop going to your therapist.

New York State Massage law reads as follows: Massage therapists may provide services that lead to improved health and muscle function, but they do not diagnose medical diseases or disorders. They evaluate patients/clients in terms of health and disease in order to know what massage technique should be used and when to make referrals to other health care practitioners.

5. Maintaining your personal health records

Records are an essential part of making sure you get a good treatment. If you are seeing one person, they help them remember the details of the last treatment. If you are at a clinic that shares files, they help keep your heath care consistent and make sure your health information travels to the practitioner you are seeing next. Beyond that, your health care records may be needed if you have been in an accident, or are claiming to certain kinds of insurance. Beware of the therapist without files, they may not serve you best long term. New York State Massage Therapists have to maintain records for 6 years.

New York State Massage law reads as follows: therapists must keep a record of client evaluations and treatments for six years or until the client turns 22, whichever is longer.

If you want more information on New York State Massage Therapy, you can find it at the New York State Government website. If you want to verify that your massage therapist is in good standing you can do so here.

Body Mechanics NYC

1 W 34th St
#204,
New York, NY 10001
United States (US)
Phone: 212-600-4808
Email: info@bodymechanicsnyc.com

 

 

Review of Walt Fritz Myofascial Release Seminar

Walt Fritz’s Myofascial Release Seminar for Neck/Voice/Swallowing disorders

Before I get into the meat of this, there are a few things to note.  This class, ‘Myofascial Release Seminar for neck/voice/swallowing disorders,‘ is named for the conditions that may occur in the area being treated, as well as how the touching is done. While the title is ‘neck/voice/swallowing’  you can use many of the cervical techniques with any patient who has neck discomfort.  To further the point about the course name, it also is named for Myofascial release.  However Walt is not suggesting that this modality is meant to replace whatever intervention you are already using or that you should just go pulling on skin.  We frequently have a description problem when it comes to manual therapy and courses that operate within the realm of scientific reality.  The question becomes, what do you call things when your tag is “this may help some people, some times, in some way, with some things…but it also may not”.  So if you are fine with the spirit of this, keep reading.

Two other staff members (Tommy and Sylvia) and I attended this course in April of 2019.  It is a two day seminar.  This particular one was at the Grabscheid Voice and Swallowing Center of Mount Sinai near Union Square.  The attendees were mostly speech pathologists, with a smattering of other professions, including massage therapy.  I will get back to who is in the course, but one of the reasons I have admired Walt’s classes is that he has taken the time to get his classes approved for New York State Massage Therapy continuing education credits.  In New York State, it is super hard to level up your skill set when the same information is being taught and re-taught by the same professionals, over and over again.

Walt’s class was well attended and well organized.  He utilizes helpers to make sure you get real feedback ,even though you are in a large group.  Snacks and coffee were provided, although we did not need the coffee to keep us awake.

If research is your thing, Walt does provide it with his materials, but

you are not going to go into a deep dive in this class.  He will give you an introduction and you are welcome to proof on your own.  The assumption is that you are a professional and as such, it is your job to review this information.  A small amount of time was spent on this.  In this way the class was pretty neutral in the “how we think this works” department.  It is not likely to radically change anyone’s mind on the function of manual therapy.  That being said, I am not really sure anyone’s mind can be changed unless they want to.  That is another topic entirely.

The same goes for anatomy in this course.  Walt provided some information in the form of his manual, but the goal is not to teach you anatomy.  If you are a little rough on what goes where in the head, face, neck and jaw, I would recommend flipping through your anatomy book before attending.  You will get a lot more out of the course by being able to connect the dots.  Keep in mind that he is not trying to reinvent the wheel, just showing you different ways you can roll it.  If you are struggling to find a touch that feels safe and appropriate due to anatomy, you might be slowed down.

This class follows the fairly typical pattern of  the presenter talking about what you are going to demo, then performing a demonstration on a willing subject, before you split off and practice on each other.

There are three things Walt does that I like:

  1. He utilizes technology to solve the issue of everyone standing around him, blocking the view of those behind them, while he demos.  One of his helpers was present at all times to get a live feed video on the manual actives that he is showing.  That video was then projected onto three screens so that everyone in the conference hall could access it as if they were in the front row.  The space we were in was well set up for that, and other spaces may not be, but I can only assume if he took the time to do it thoughtfully this time, he probably does in most spaces if there is need. (Maybe he will chime in on an answer for us post, post 🙂
  2. Walt gives his interview process with a patient equal weight to the hands on that he is doing.  In most classes, manual or otherwise, teachers often jump to new technique.  The format becomes ‘for this problem use this thing”.  Not so here.  Walt lets you sit in on his client/patient interview.  If you are a massage therapist, who wants to improve quality, booking, professionalism etc, this is 100% the area that you need to work on.  Sitting in on this is gold.  What he is showing is a conversational health care format of “ol’ dr fricara” interview (if you do not know what that is here is a link) and an adapted motivational interview strategy that continues on to the treatment in the form of feedback (remember consent is an ongoing process).
  3. He has a mixed profession class. For many of the speech path professionals manual therapy was new. They got to work with massage therapists. I think they learned a lot from them. For the massage therapists we got to work with speech pathologists….same story. Both sets came away with great referrals and a really good understanding of how we might work together to better care for people. Rather than pair off into our professions, we sought out the other for their expertise. It was a unique opportunity.

As to the things I did not like. To be honest I would have to be super nit-picky about this. It is a great class. I would say if you are really comfortable working cervical spine in multiple ways manually, or intra-oral treatment is in your wheel house already, it might be a little slow for you. Both Sylvia and I spend a fair amount of our days in working with TMD, so much of this was review. Even so, we managed to come away with some good take aways. Even if this is the case, there is HUGE value in watching how someone else problem solves the same problems. This course assisted us in the decision to add ‘dycem’ as a home care tool for our population, as they often struggle to figure out how to self treat at home in a way that feels good.

Walt also provides ongoing support in his facebook groups (invite only) and his YouTube channel for Myofascial Release.

So to wrap it up: If you are a speech pathologist, much of what he teaches will give you a fresh approach and more options, if you are a massage therapist, this is right up your alley, and will be a detailed course getting you comfortable with helping cervical/jaw/neck pain and problems.

Additionally, if you do find that you NEED more and this was basic, Walt also has an advanced MFR for Neck, Voice, Swallowing class you can check out.<—-I just found out about that from his mailing list.

Body Mechanics NYC

1 W 34th St
#204,
New York, NY 10001
United States (US)
Phone: 212-600-4808
Email: info@bodymechanicsnyc.com

Sports Massage Therapy Profile -Laura F.

Get to Know One of Our Sports Massage Therapists, Laura!

We are asking our sports massage therapists for a little extra information so that you can get to know them and their experience in sports massage.

 

So here it goes!

First off Laura, What is your background in Sports?

Laura: I have been working in the field of sports massage for 30 years.  I am not just a massage therapist but I am also a personal trainer, and I train myself.  I have played a number of sports… including boxing, running, and lifting.  If you are coming in for these things, I have a pretty good understanding of what is going on. 

What is your best “uh oh” story in regard to injury?

Laura: When I moved from LA to NYC, I (bleeping) fell on some black ice and I tore my left medial meniscus.  That was awful and it was a long recovery. 

If you could try any sport now, without limitations, what sport would it be? 

Laura: Krav Maga!

How did you get into sports massage?

Laura: When I was at Swedish Institute in NYC, I was bored with the relaxation massage and energy work I was learning.   I had an an instructor who taught sports massage and she was incredible.  That’s when I knew that was what I wanted to do. 

What are your favorite kinds of ‘sport’ people to work on now?

Laura: I love to work with dancers, but I also just love people who are active and want to take care of their bodies. 

Are there any athletes that you particularly admire?

Laura: Manny Pacquiao and Michael Jordan.  They are my favorites!

What sets your sports massage apart from everyone else’s sports massage?

Laura: (laughs) Honestly, I do not compare myself.  I just studied hard and took advanced courses.   I truly care about helping people in pain, and teaching them how to learn about their bodies.  As a trainer, I can also suggest some ways they might prevent hurting themselves. 

And last but not least, are there any other things we should know about you?

Laura: I am also a certified life coach.

To book with Laura, you can book online at this location, or you can read more about her Massage therapy and Sports massage there.

 

Body Mechanics NYC, 1 W 34th St, #204, , New York, NY 10001, United States (US) - Phone: 212-600-4808 Email: info@bodymechanicsnyc.com URL: https://www.bodymechanicsnyc.com/

 

 

We Have Moved to a New Location!

We Have a Fantastic New Location

Hello all! We just wanted to keep you updated to a few of the changes that have happened this year. The biggest of which of course is WE HAVE MOVED TO A NEW LOCATION!! It was a long time coming but after 5 years at our former location, near Grand Central Station, we have moved to a stunning location just near the Empire States Building! We traded one monument for another! Our new location address is 1 w. 34th Street. NY, NY, 10017. We are right across the street from the Empire States Building and across from Heartland Brewery. Our phone number and web contact information remains the same. We stay devoted to the same kinds of treatment: Sports Massage, Medical Massage, TMJ Massage, Breast Cancer Massage and Runners Massage.

There are a few things you should know about our new location 

  • Space! We have a lot of it! We went from 3 rooms to 4 room…and we have a staff room now with an extra large lobby. No more crowds and being on top of one another.

 

  • We have central air that is HEPA filtered. So this is pretty awesome…especially since our old space ran really hot and the dirty old outside air used to come in…but it also means there is 1 temp for everyone. If you are running hot or cold please let us know, there are fans and table heaters in each room but we can’t control the room temperature any more.

 

  • It is MUCH nicer. I mean really, its is totally an upgrade. We look a little more medical, as we are in a medical building, but we have kept with the same lux and plush stylings. We are just a little more streamlined now. The old space was cute, but the building was old and ill cared for. This building is brand spanking new!

 

  • Speaking of new, we have a few new things that may surprise you. Now on weekends we have to buzz you in. It takes a few seconds, but hey we have a buzzer, because we are fancy now.

 

  • We also have changed our pricing. You can find that information here: Pricing at Body Mechanics . Minimum wage is changing in NYC and we needed to adapt to reflect that. On the upside, yay for sustainable living! You will also find little perks like a new hot and cold water cooler, a better bathroom (no more keys), wifi for you, and a new charging station.  We also have some new therapists. You can check them out here: Massage Therapists 

Here are some pictures of our new space to help you get an idea of what we are doing. Scroll through and take a look!!
Our Space
 

Body Mechanics Orthopedic Massage

1 w. 34th Street #204. NY, NY 10017

212-600-4808

info@bodymechanicsnyc.com

Hands on Suggestions for Working with Trauma

Working with Trauma and Abuse

Before we go into what this post is, I want to touch quickly on what this post is NOT.hands on suggestions for working with abuse

It is not a substitute for an education course or training in working with victims of abuse/trauma. It is also not a suggestion to go beyond your scope or treat the abuse/trauma through massage therapy. You should follow your local law in reference to reporting abuse as a health care worker as it applies to you, and stay within your scope. I would also like to note that trauma takes many forms, it is not up to us to decide what is traumatic.

What this post is about is providing some useful suggestions to practicing therapists  for the physical part of the treatment when the subject comes up with existing patients or someone with a history of abuse/trauma who wants to be part of a massage program.  At some point in a career it is likely that either an existing client or a new client will  disclose to you during intake that they have been the victim of abuse/trauma. If you are unprepared for how to appropriately handle that disclosure, managing it could be challenging. I suggest you take some time to think about it, but here is what works for me. Keep in mind, I follow generally the Canadian standard of practice and use a full medical consent.

My first steps are to determine in a professional way -is it safe and appropriate to continue. While you do not want to make anyone’s situation worse, it is very important that both parties (patient and therapist) understand their roles to be able to continue. Within the consent process this is usually a pause for me. A time to acknowledge a statement, by saying “I am sorry to hear that. Are you getting help if you need it?”. If the answer is no, I can open a conversation about referral and talk about the role of massage, making sure the patient understands our respective roles and the limits of what I can do for them. If the answer is yes, then we can move forward to discussing why they are here today and stay focused on that. Either way, an open dialogue is the way to go.  Keep focused on your role, and be careful not to ask questions that are out of your scope.

You may also be asked some questions about what massage can and cannot do, or about your role. Do not be surprised if, as a lay person, a patient does not necessarily know the boundaries of your treatment and wants something you cannot provide. There are many misunderstandings out there as well as hocus pocus treatments. It is perfectly acceptable to say “I am sorry but that is beyond my training”  or  “You know, that’s totally out of my wheel house” if you are asked to comment, give advice on, or suggest something you’re not qualified to discuss. I tend to say “I just don’t know enough about that” a lot. Training levels are something easily understood by most people, and while it might be scary to say ‘I do not know’ at first, people readily accept it.

A good consent process is essential in all treatments. I usually expand my consent to include a few extra things for this topic to discuss treatment as a whole,  as providing a safe, comfortable, relaxing place that they can control, where all information is private is essential. This is really just a re-wording of my usual consent speech which is that you have the right to stop and modify, and control your treatment. I also expand the consent to have a discussion on triggers. This may not be an issue, but you need to address it before it is. It is important for a patient to know they can stop but what happens then? If for some reason your patient should experience distress in the treatment you should have already asked the appropriate questions about your behavior: Do you A. take your hands off right away? B. Stop moving but stay in place and let the patient try to relax? C.Exit the room so they have privacy? or  D. would they prefer that you check in with them without stopping? Everyone will have a different definition of what will make them feel safe so it is important to discuss this before it happens. If everyone is on board and you have had a frank discussion about how you’re going to proceed with the treatment and what the goals are, you can continue.

Many of the hands-on components that I will use will be the same ones I use every day, just packaged a little differently.

So here are my suggestions, some of them are obvious, and some might not be so obvious, but all of them I have used more than once for one reason or another in this scenario.

 prepared to work clothed

-Be prepared to work through sheets

-Be prepared with a heavy blanket or extra blankets; being covered by weight can feel comforting.

-Some people love heat. Be prepared to work hot if that works for them.

-Perfect your draping to an art form of tight origami

-Think about sleep shapes rather than how someone normally lies on the table- aka let them hold something if they feel like it or lay side-lying.

-Be prepared to try outside-of-the-box activities to give the patient control:

    1.Use body weight rather than press down onto the person- if you know some positional release techniques they may be appropriate. I find this particularly useful in the cervical region.

    2.Let them move under you rather than you move over them

    3.Consider rhythmic activities.

    4.Demonstrate the technique first, let the person try it on themselves and then you perform it with them- The verbiage on this  would be “So I am going to show you a technique, then I am going to let you try it, then we are going to do it together.”

-Let the person choose their own music/sound environment

-Work in non-traditional time lengths if necessary.

-Create patterns within the treatment: creating a pattern creates predictability. If someone is nervous this can go a long way to soothing them. Examples would be:

    1. Always anchoring the drape of the fabric in the same way before you move it to signal change.

    2. Opening and closing all sections of the body in the same way.

    3. Before moving a body part, giving a gentle squeeze (explain it of course by saying , ‘Just before I stretch you I will always let you know we are going to move by….”Creating a system of patterns can be helpful in creating a predictable environment.

-If home care is in your scope, working backwards from a home care first perspective might be helpful too. In this scenario, we would do home care together, and you would facilitate the process in office. As trust and comfort is gained you would add in more participation and possibly hands on. I use balls and body weight and do the exercises with them at first, then expand by adding hands on adjustments and then finally more hands on work.

 

These are just a few of the things that have worked for me in the past. It is important to remember that there is no one single way to treat and that clear communication is essential. I also want to take a moment as some of you might be asking ‘why would someone who has difficulty being touched seek out massage as a treatment and how did it get to this point?’. This is a little like asking ‘why did the chicken cross the road’. What it comes down to, is it does not matter how they got there, but it is your job to get them across the road safely.

 

Helpful links on Pain and the Body

You’re with your body all day, so it’s pretty important to you.

Let’s look at some places you can get more information on Pain and the Body

I wanted to put together a list of places to look for good information on subjects pertaining to massage, movement, pain, and the body. This is by no means comprehensive, but it is a place to start. Navigating the health care world as your own advocate can be hard. I could have a ticker tape parade with the number of times I have written key search words or links on the back of a napkin.  Without a background in science, it can be hard to tell plausible from implausible.

Soooo… that being said, I’ve compiled, all in one place, some links to some subjects that we end up sending out most. We  think these links are pretty helpful.

Why am I in pain?

Most people coming to see us are in pain. Pain can be scary…but what happens when you have been cleared by your doctor as healthy, and you still have pain? Or chronic pain? Or you have no pain but are diagnosed with a problem?

Do we advocate for those people to get checked again? Absolutely. But we also want them to know that pain is normal. That their body’s number one job is to protect them, and they can do a lot to manage that pain by understanding the basics of it. For that, we usually send them home with this video on pain by Lorimer Moseley. Not only can it be understood by professionals and lay people, it’s also really entertaining.

If you really want to learn and possibly change how your body feels about pain, take a look at this course by the ‘Retrain Pain Foundation’.  Each module takes just 2 or 3 minutes and can really make a difference in your life.

If you enjoyed the last one, and want more detail, we also recommend this handy video on pain. This is put out by the Hunter Integrated Health Service which delivers evidence-based pain care in Australia.

Is it my body posture?What to do about pain

The next question that inevitably comes up is, “Where did the pain come from? Since I don’t have an injury, is it my posture?”.  For various reasons, there is a LOT of misinformation out there on posture.  Posture certainly can affect you. For instance, we have all felt the pain of sitting in one position too long, but for the most part, your posture is probably fine. You could spend your whole life trying to whittle yourself into the perfect posture or way of moving. To help you understand the posture bunk we really like Paul Ingram’s blog pain and posture. It is very user-friendly and a really great place to start a search on a number of physical problems. Take a peek through the topics and you will see he touches a little on everything. A lot of the information he provides is the kind that can keep you from throwing good money after bad. So it is WELL worth reading through some of his work.

 

Do I need to foam roll or self treat?

People ask a LOT about foam rolling. Sometimes it’s in this hushed voice, like a secret, “You know I don’t foam roll…should I be?”. Look, it feels great to massage yourself. It also feels great to do something for yourself. But do you NEED to foam roll? A better question is, do want to?  The easiest thing is to probably do a little reading on what foam rolling actually does and to answer that, we usually provide Tom Hardgroves great blog piece on “How foam rolling worksand let you decide for yourself. His work is decidedly more technical but if you have a keen interest, it’s not out of reach. He also has a phenomenal book on movement you might check out. Sadly, we rarely have it in the office because we keep sending it home with patients.

 

What else can I do?

Well, it turns out you can do a lot. While doctors, physical therapists and massage therapists might help you with some aspects of your health and recovery, there is a lot you can do on your own to manage. Two videos by Dr. Mike Evans cover some of the excellent general things you can do for your physical and mental health to manage pain. Both are short, watchable and entertaining.

The first video talks about the research behind being active with your body and the health benefits that has. It is a great video on the benefits of moderate physical activity.

The other video that pairs nicely covers the topic of stress and your health.  Together, both of these topics are very important for helping you manage pain and function long-term. Do we recommend you see a doctor? Absolutely! But there is a lot you can do on your own too, without falling down the rabbit hole of unattainable results.

 

As more people ask questions we will add to this list. Good luck!