June 30, 2009

All good things come from plants.. right?

I was sitting in my office, with its organic cotton sheets, organic, crystal-clear oil and a drawer full of matrix-shifting essential oils and root extracts when a new client came in. She plopped a bottle of paraffin massage oil on my desk.

"I can’t have any plant oils or products on my skin. Is that going to be a problem?"

Of course, not a problem, I explained, I could use whatever oil she wanted. The prospect of using mineral-based oils was something new to me. If anything, I would hear the occasional horror story about people reacting to heavy massage oils, petroleum-based oils or ones with lots of preservatives, and her request made me curious.

Healthy stuff comes from plants - fabulous foods, great oils, therapeutic smells, anti-inflammatory substances, organic materials, and all kinds of stuff things that make us feel better, cope better and love better.

Well, fudge crumpets. At least I thought so.

The client - a very nice lady with a very tight neck and a classroom full of first-graders - was on a protocol for fibromyalgia that included taking the drug guafinesin. Guafinesin is a mucus-thinning drug that helps break up thick secretions. It is something I have taken occasionally in a cough syrup. I also had a client, years ago, who went on the drug to help with fibro, but it had not helped her much.

Turns out her doctor, a fibromyalgia specialist in Santa Monica had found a link between lack of response to the drug and use of plant products on the skin. To keep the drug active, no arnica, veggie oil, essential oils or anything else on the skin.

I used the paraffin oil, and despite its sort-of weird lube feel and clear thin-ness to my hands, it seemed to work quite well. After she left, I sat at my desk wondering if all these years searching for the best, most fab oil of all time, if I had missed the boat, the dock and the mainland.

I mentioned my new client’s request to my office-mate when she came in later that day. She made a sound that I can spell only as "AAGH!" But plants are so healing, so good for you, so good for everyone, etc. It took a few minutes to sink in; while I watched, her head shook in disbelief.

As a few weeks went by, my client became at ease enough to tell me about her troubles finding massage with paraffin. One therapist had promised to use her paraffin oil and after going to her for a month she found out the therapist just thought she was crazy and was really using her safflower oil. The client had understandably gotten quite indignant, and that is why she came in my door she addressed the question head-on.

I used my standard answer for commenting on what I think of as "great moments in customer service."

"She must have gone to a different school than I did."

June 27, 2009

A Rose by Any Other Name?: Massage and the Word Masseuse

About six weeks ago, the American Massage Therapy Association sent out an email with an attached press release about a recent Craigslist.com decision. The decision involved the Craigslist.com “Erotic Services” section and the use of the word masseuse in that section as a “cover” word for prostitutes. Although the document’s wording was a bit difficult for me to unravel, what I took away from it was that the AMTA does not support the use of the word masseuse not only because prostitutes often use the word as an attempted legitimate cover for illicit activities, but also because some licensed massage practitioners still use the word as a legitimate title. Clear as mud? Okay, let’s try this instead: “Hookers cannot call themselves masseuses because everyone knows they are not really giving massage, and even though we don’t generally use the word anymore because it makes us sound like hookers, a few of us either still use it or might want to use it in the future, so it should be off-limits to... hookers.” Hmmm... well, I tried.

In any case, I have to wonder if the massage community as whole can ever really use the word masseuse again in any lasting legitimate fashion. Shakespeare said, “A rose by any other name would smell as sweet,” but that’s not quite true when you’re dealing with language and connotation. Anyone who got uncomfortable at my use of the word “hooker” knows on a gut-level what connotation is. It’s a word plus any associated ideas and baggage that word has picked up through cultural use. Which is why, no doubt, the author(s) of the AMTA press release used the word prostitute, not hooker or whore. The first is cleaner and more objective; the others are... not. The word masseuse has fewer negative connotations for me personally, probably because I grew up in the rural Bible Belt where there were almost no massage practitioners, legitimate or otherwise, and masseuse (and masseur for that matter) was a word I encountered only in fantasy romance novels where rich people go to fancy hotels and spas and get pampered. However, it no doubt has extremely negative connotations for some people.

Language is a funny thing. And I don’t mean funny/humorous, although it can be. Such as the time my grandmother was gossiping in shock about a distant cousin of mine who had “gotten mixed up” with someone paralyzed from the neck down—in her words, “a quadra-pubic.” I confess, I still can’t drink carbonated beverages and recount that conversation at the same time. But when it comes to the word masseuse, language can be a bit more funny/strange and far more politically and socially complex.

June 21, 2009

The Mana of Lomi Lomi

When I began massage school, I had never heard of Lomi Lomi. Later, having been introduced to the few odd strokes, I became very enthusiastic about learning more, given that I have a tendency to want to listen with and use my whole body in massage, and Lomi Lomi seemed as much like dancing as massaging. On the other hand, I was leery of the spiritual aspect. Though I am a very spiritual person, all things Hawaiian in my upbringing were tainted with shameless tourism, plastic hula girls, and the kind of plinky music that sounds like the background advertising for a Girls Gone Wild video.

As I quickly found out, there was a lot more to Lomi than excuses for tropical debauchery. There are actually at least two main types of Lomi-Lomi: Temple Lomi and Clinical Lomi. Temple Lomi is quite energetic, and more like a dance: long flowing strokes, close to the body, and very spiritual. While Clinical Lomi is also spiritual, is it much slower and more focused to specific areas with specific thoughts. Mana Lomi™, the style I have been studying and practicing, is a form of Clinical Lomi. The Hawaiians believed the soul resides in the bones as much as anything else, so all types of Lomi massage reach into the bones as well as touch the muscle.

A little terminology goes a long way in better understanding Lomi. Lomi means to rub. Repetitions in this language often seem to amplify meaning so Lomi Lomi is roughly big rub or massage. Mana, as in Mana Lomi™, means life force or energy. Thus mana is similar to chi, prana, etc. Pule means to bless or pray. A Lomi session will typically begin with a spoken or silent pule to ask for permission or help or to express gratitude to the guiding forces. And finally, there is piko, which literally means navel, but also has an extended meaning similar to chakra. Hawaiians envisioned a triple piko: one on the head, connecting us to ancestors and the past; one at the navel, connecting us to our current generation of family; and the third at the genitals, connecting us to our descendants and the future. Between the three pikos runs the spine, a structural timeline connecting our past, present and future. Blockages in any piko can cause blockages and movement problems along the spine, in turn affecting parts of the whole body.

But Lomi Lomi is not just about words or even touch in general. It’s about deep, soft, loving spiritual touch. My first Lomi teacher, Barbara Helynn Heard, taught me once of the most useful things I know about massage. If I feel lost or unsure about what to do, or I can’t seem to focus, or some aspect of the client is resisting the massage, I silently say “I love you,” adding the client’s name, and I am always surprised how the message seems to go to the bone, and the muscle and other tissue opens up to me. There is indeed great mana in Lomi.

June 17, 2009

The Forgotten Muscle

My nominee for the most forgotten muscle is the tricep. Sight unseen on the back of the arm, it can create finger and arm tingles so gnarly even experienced therapists are convinced it is C6 compression in action.

How do we take it for granted? Many times the first basic Swedish massage we learn skips the tricep completely. Then on top of that, many therapists are so concerned with the bicep and its tendons the tricep is forgotten completely. Yet the tricep hides a somatic funhouse of trigger points that can not only affect the neck but also cause some darn interesting tingles in the hands.

Before I became a massage therapist, I worked – no slaved – at a computer for most of the day. They were the old computers with metal-to-metal contact keys that caused a lot of vibration echoing up the arms. The tricep, it turned out, keeps your average computer gnome in position to type away, which means it has a very static, isometric role in computer posture. Not knowing much about anatomy, and even less about somatics, the importance of the tricep completely eluded me. My tricep never really got a full contraction or stretch, and simply toiled in its isometric little crunch all day. Then when I drove the car, it continued to toil. Poor triceps, they got no respect.

I didn’t appreciate the role of the tricep in hand troubles, really, until well after massage school when I worked on another therapist who was having hand tingles – chiefly in the palm and fingers. This therapist did massage half-time and also worked on a computer doing accounting for small businesses. The therapist was convinced that the problem came from C6 compression, but I was not so sure. While in the prone position, I put the arms aside at 45 degrees from the body with a rolled towel supporting the acromium and humerus. I did some compressive effleurages. As I pushed up to the shoulder, the tingles got a little worse, then got a little better. I used the flat part of my forearm to clear out the big trigger points, my buddy therapist’s hands tingling away.

The tricep stretch felt like a door opening that you didn’t even know was closed. The palm and arm tingles cleared out. There was still plenty to do in the forearm and shoulder girdle, but the hand tingles left with the tricep trigger points.

Since then, the tricep is forgotten no more. Everyone uses a computer, drives, pretty much nailing the triceps to indentured servitude. Clearing the triceps has made a lot of seemingly carpal problems clear out.

I assume I have a lot to learn about hand and arm tingles, as well as cervical compression, but as a rule I now prop up the humerus and clear the triceps. Saves me a lot of work.

June 13, 2009

Don't You Love Me Anymore?: Referring Clients to Other Massage Practitioners

I have always been very comfortable referring clients to other health care practitioners, such as chiropractors and acupuncturists. I feel that many other forms of healing are complementary to massage, and most therapists I know feel the same way. Referring a client to a chiropractor for structural issues, for example, should never make a massage practitioner feel “less than.” After all, the goal is to get the patient out of pain in the most effective way possible.

However, feelings can sometimes change when it comes to referring to other MASSAGE practitioners. Then various issues have been known to emerge, such as:

1. The therapist can feel ashamed: “She wants Reiki? Stupid me, I only specialized in deep tissue, lomi lomi, cranial-sacral, and Rolfing . . . I completely forgot Reiki! Is that the energy thing or the foot thing? Stupid me . . .”

2. The therapist can feel hurt: “Reiki? We were doing just fine with deep tissue, and now she wants someone to wiggle their fingers at her or mash her toes or something?”

3. The therapist can feel fearful: “Am I becoming outdated? Will people stop coming to see me if I don’t do Reiki? Because I was never good with that kind of . . . thing.”

4. The client can feel hurt, ashamed, and/or fearful. “I like my therapist. I know she cares about me, and I don’t want to hurt her feelings, but I still want to try Reiki. What if she cries or gets mad and refuses to see me again and do that one thing with my foot that makes my whole leg feel good?”

Although most of us have “sensitive” days, and we can find ourselves forming close relationships with regular clients, the primary goal is STILL the client’s welfare and what is best for her. Frankly, sometimes a client’s healing journey requires that she try several things to find out what works best for her, and too much drama around this can be rather counter-productive. And intentionally or unintentionally sending the client on a guilt trip is definitely not healing and can even cause a client who would have come back decide to stay away after all. Besides, it’s often extremely beneficial for a client to have more than one therapist; for example, the client may have more than one special issue or need massage at a time when one therapist is unavailable.

So when it comes to referrals to other massage therapists, I find it useful to ground myself in my own strengths and not to take the process personally, even if my inner child occasionally wants to blurt out “Don’t you love me anymore?” Because I have found that if I open myself up to the universe in a giving way, even giving of income or clientele, etc.—then it DOES come back to ME as a blessing—in sometimes strange and wonderful ways.

June 10, 2009

How Many Massages Can You Do?

Sue Peterson, LMT, NCTMB, continues her series on our blog. Sue has a private practice in Orange County, California.

After a few years of practice, I thought I was quite the massage stud. I managed in a six-day week to do about 25 massages, sometimes 30. The AMTA polls showed most therapists reported full-time as 15 to 20 massages a week. Very few went to the 25 to 30 range.

Then a client came back from a three-week trip to a Swiss spa and popped the question: "How many massages can you do in a day?"

"Oh, I can do about five to six massages a day before I feel overworked," I said proudly. "My personal record is 13 in one day – the result of being accidentally put on for a double shift when I worked in a clinic for women with chronic pelvic pain. I don't ever want to do that many ever again."

My client's explained that his curiosity came through observation. The very expensive, very therapeutic spa he went to their therapists did eight massages a day, five days a week. Forty a week.

Suddenly I was the one asking questions.

"I really don't know how they could do so many massages..Are they real massages? Not quick-glide slides? Do you feel like the therapist was present?" "Yes, they were very good," he said.

I really had to ponder that one for a bit. Don't ask me what a quick-glide slide is, but you know it when you get one. "Perhaps they can do so many because of all the espresso and pastries," I speculated. As my client dozed back to waking sleep, I felt somewhat humbled. I looked at the view outside the window. Eight a day. Lots of deep tissue. Massages by prescription – to improve blood flow, alter structural problems, remedy deficits in flexibility and relieve pain. How could those folks do it?

I had never felt lazy before. Most of the time, no matter how many hours I work in a week, actual massage time doesn't exceed 30 hours. And those weeks can be tough.

That begs the question. In our area of the world, in our slice of the therapist community, how many massages are too many?

June 7, 2009

Swimming: Sweet Idea!

After an absurdly long stretch of gray, ugly rain, it seems that Seattle has finally decided that it will indeed join the rest of the civilized world in hosting Summer 2009. THE SUN IS OUT! Finally! It makes a Southern girl like me just want to sit on a porch swing and drink sunlight and sweet tea. And I do mean SIT. Not run, jog, or cycle. Okay, walking might be all right, but nothing faster than a brisk amble. Anything faster than that, and I’d miss the scenery, like all these gorgeous orange poppies blooming near my Northgate apartment. Anything faster, and one could be in serious danger of spilling one’s sweet tea, and that’s just wrong . . . unless the sweet tea is that nasty fake stuff from McDonald’s (which is no doubt making several past generations of Southern mothers and grandmothers spin in their graves).

Exercise doesn’t have to be intense to be effective. I’ve noticed that Seattleites almost seem to think that they must pay for the blessing of good weather by attempting to kill themselves reenacting Nike commercials while it’s here. Is it wrong to enjoy sitting on a sunny porch or taking a sunny walk, and right to enjoy sweating off half of one’s body weight climbing a sunny mountain? Well, no. Still, I’ve noticed that many of my out-of-shape clients, or those whose bodies have suffered injuries over the years, feel very guilty about not being able to get out and become Lance Armstrong on a bike or one of the Williams sisters on a tennis court. And what happens sometimes is that they injure or re-injure themselves trying to “exercise and be healthy.”

In response to this tragic phenomenon, I try to suggest to my clients forms of exercise that are gentler, kinder, and in my opinion, infinitely more fun and more easily accomplished with a tea glass nearby. Take swimming, for example. I have suggested it to a LOT of clients who have seen a LOT of benefits. You don’t have the impact issues you have with many activities, and you work about three times as hard doing it as you think you are due to the resistance factor. Furthermore, you don’t have to know special strokes or even do laps. I have clients who take Styrofoam boards like little kids and kick up and down the pool and who are now enjoying greater range of motion and have less pain than they’ve had in years. This is a very good thing, people! Seattle is blessed with a number of public pools, many of them indoors and most of them easily accessible. Swimming is beneficial and fun, so remember to go splash around this summer and encourage your clients to do the same—sweet tea optional :-)