February 25, 2013

Finding the Right Touch…


Recently a prospective client quizzed me on the phone about my massage therapy services. This is the type of call I used to be frustrated with – some people only ask about price and hang up.
          
I’ve never found a great way to turn the price-callers into appointments – I try to get a question in before they hang up after a pregnant pause that seems to indicate unhappiness with the bottom line – but they seem to be on a mission to find a price they like, not a service they need.
           
Money can be a source of consternation for massage therapists – we have to make a living but we also want to help people. Lots of my friends, including myself, have gone through periods of price accommodations that have left us very tired and unhappy with our income.

Price, it turns out, is a boundary, not a barrier.

People who ask questions about the massage, rather than the price, are the most likely to make an appointment. I try to answer as simply as I can and coax enough information to find out if I can be of help. That helps the prospective client understand and appreciate the value of the service.

The odd thing about price-shoppers, too, is the ones who have issues about price rarely have a true need for a lower rate. They are savvy shoppers.

Well, I’m a savvy shopper, too. But I know when I look at a shirt on the rack at a mega-discount store that I can see what I am buying, and I have to be OK with the presumed source of that wonderful discount – someone’s cheap, hard labor.

Massage, it turns out, can be like that too. I feel no “guilt” not booking a price-shopper because I know they will get what they pay for.

I find if I can communicate the value of my service – and there are ears to listen to that message, I can turn that call into an appointment.

Massage therapy is not a shirt.


February 18, 2013

Tools for Massage

As an “old hand” at massage, I am not too impressed with tools sometimes used in massage therapy. I have stayed away from knobbles and thumb covers and even hot stones in my practice, largely because they tend to create elbow and shoulder problems for therapists who are tempted to use too tight a grip.
         
One of my cohorts in a day spa had chronic extensor tendonitis from using hot stones, which eventually led to surgery on both forearms. It was a career-ending surgery. Rather than use the stones only in hot stone massages, she had begun using stones warmed in the towel cabby during every massage as an added treat.
         
I feel the pain, having had a 10-year bout with extensor tendonitis myself as a result of working an old computer keyboards at various newspapers. My flying fingers suddenly got stiff one day and the forearms had a toothache-like burn that never went away. It took years of therapy and ice to correct the problem.
         
Yet here I am feeling rather good about using a device in massages – conservatively – because I think it does some good for the client as well as the therapist.
         
I recently took a class with esteemed medical massage therapist Boris Prilutsky. He has been experimenting on using silicone cups as a negative pressure tool in massage.

What I like about this technique is that it is not the Chinese cupping. The Chinese method uses fire (scary to the clients) to create a vacuum and then leaves cups on an injured area or blocked meridian for several minutes. Skin is sucked into the cup, creating a bright red mark that can last for several days. Near as I can tell it treats by creating a secondary injury – inflammation and hyperemia – to draw healing factors to the region.

I have seen folks over the years with cupping marks and it has always struck me as not a therapy I would not enjoy doing or having done to me. But I have liked the effects of negative pressure when I have been treated with cups.

Prilutsky brought his massage skills to the table and presented a way of using soft cups made of silicone and very slight vacuum pressure over oiled skin. The technique lifts tissue over adhesed areas and seems to promote both lymphatic and blood movement.

And he advised us to use it slowly, sparingly, and with attention to not creating a tight grip and warring with the tissues.

Good advice, I think.

I’ve been trying the cups here and there on very “stuck” zones and I think it is a tool I will use. Carefully.

February 15, 2013

Class Struggles


At a recent continuing education class, our instructor went around and asked us to introduce ourselves and talk about how we are doing with our massage therapy practices.
           
Our first participant said she is doing a few house calls and working for a chiropractor two days a week. Her practice is slow. Renting a space is out because her house call clients will not come to an office once they are used to home service.
          
Our second participant has an office 30 miles away from her home, and is hampered by chronic health issues. Her practice is sporadic at best. She has to turn away business, mostly because many clients want simultaneous couples massages. She is thinking about recruiting another therapist.
           
Our third therapist networks with friends, family and networking groups constantly. She is looking for more clients all the time and finds many do not want to pay $75 an hour for a massage. She does a lot of showers, spa parties, etc. and is struggling.

Another therapist, a male, had gone broke renting a therapy room for $500 a month while struggling to get two to three clients in that time. He gave up the office and has been going to the local swap meet, doing chair massages. Most people do not want to pay his fee for a full massage, preferring the cheaper joints around town, many of which do not use credentialed therapists. He is also often rejected because of his gender.

I wasn’t feeling the confidence or success in this room. And people who bother to take c.e.u.s tend to be the go-getters. How can therapists develop practices when confronted with people who won’t pay or do not want the services offered?

I also felt like the oddball. My practice is going well, I have been too busy and I am working at my office and at homes. I can’t fit in all my clients.

A small sampling, but does it represent the struggles all massage therapists face?

Our instructor, an experienced and very smart therapist asked another question. “How many of you use social media?”

My hand went up. No others.

For folks trying to build a practice, remember much of social media is free. Cover the basics such as having proper credentials and licensing and you can list your availability on a number of sites. People looking for massage will find you.

Having your clients recommend your services to others often works very slowly. Their online review of your work makes that referral work for everyone who reads your information.

During the break, I was waiting for questions. No questions. Before class adjourned, I told my practice mate to stop going to swap meets. “Don’t chase people who do not want or value your services,” I said. Loudly enough for the rest of the class to hear, I hope.

February 8, 2013

Practice Punts

Massage therapists are not all alike when it comes to their understanding of how to build a practice. I have heard lots of explanations as to why bookings stay low, very few explanations of why they are full.
            
How to develop a practice is an art just as much as massage. It requires some close self-observation and sometimes an outside hand to help therapists along. Often when I catch an episode of some show like Salon Take-over or Bar Rescue or Hotel Impossible, I am reminded very quickly of what it takes to have a consistent practice.
 If you catch one of these shows the clich├ęs are numerous. The owner wants help to make their business pay, but they don’t want to hear anything critical of their skills. The help is interested in making money, but stymied and discouraged by unsolved problems. Often there is a sacred cow: a lazy staffer or manager whom the owner wants to avoid confronting - or an unworkable idea that the manager/owner won’t drop. The bottom line is that the bank wants its money, not excuses. 

I enjoy these shows as a kind of self-therapy even though the environments are very different. Most massage therapists work alone. They are the owner, staff, manager and investor. The outlay to start a massage practice tends to be small, and there are very few therapists who make anywhere near “six-figures” when it comes to gross income. 

In common, though, are some basic universal truths. The formula for success is not a secret requiring an expensive marketing class or a practice coach. It is, just like the roaches in the kitchen of a failing restaurant, right in front of a person with eyes to see. 

Yes, darn it, arrive on time. Be clean. Do not wear jeans. Listen to the client. If it is a return client, go over your notes before they arrive. No notes? Where are they? Why be paid professionally if you don’t practice like a professional? Do you report your cash? And yes, a warm room and a clean heart. 

Argh. 

No shortcuts.



February 1, 2013

Steamrolling the QL



   
The tough part of massage therapy long-term back pain is chasing trigger points in the quadratus lumborem.  This is one of those muscles that not only keep clients awake at night; it keeps the therapist up, too.
           
I have done prone QL massage, prone with approximation, prone with stretch.
          
I have massaged the QL sideline with the olecranon. Sideline with directed relaxation. Sideline with directed breathing. Sideline with heat and a tennis ball.
          
It feels sometimes, that I have done everything except roller-skate to get those pesky points.
           
Does some massage therapist, somewhere, have a quick and easy method for releasing the QL?
           
Not to pick on the QL. The multifidus and the longissimuss and iliocostalis contribute to the problems of repeating lumbar pain. I find that if those muscles are skipped, they can recruit the QL back to tension and TrP.
           
And the opposing muscle, the psoas, can be just as equally weak as the QL is knotted. Bilateral weakness of the psoas and I will definitely have to roll my sleeves up. It is going to be a bumpy ride.
           
It is some consolation to know that QL problems tend to fester, painless and subclinical for years. The massages are unwinding years of QL spasticity making up for a lack of core strength.
           
That is a little comforting, I guess. Time to sharpen my elbow.