Get Disability Insurance; and Beware of Falling Pianos

In early November of last year, I was asked to take on a sixth shift due to an emergency. "What emergency?" I asked. "Sandra [another massage therapist] broke her foot in thirteen or fourteen places; it's practically crushed," was the reply. "WHAT? How did that happen?" "Well, she dropped a piano on it."

WHAT? And so what sounded like the plot of a Looney Tunes cartoon (I could practically see Wile E. Coyote with a mouth full of piano keys) was the beginning of a six-week unplanned hiatus for poor Sandra and a really screwy schedule for the rest of us. Undoubtably, though, Sandra suffered most. Her foot was so swollen, she couldn't really even stand on it for at least two weeks. When the swelling when down, a cast was put on, almost up to her knee, and she still couldn't work due to pain. Finally, at about a month into the whole mess, she was almost forced to return to work due to financial needs, and she returned on a knee scooter, which she had to leave outside the room, then hop over to her stool for the session. And after several weeks of that, it was a boot and crutches. Only now in mid-January is she finally limping around in regular shoes on two feet.

The scariest part of Sandra's story is how easily something like this could happen to any of this. I love what I do, but this is the most unsecure profession I've ever worked in in terms of stable finances in the face of health issues. Most massage therapists are not salaried and are paid by the session. Most of us do not have sick days or paid vacation or health benefits, even when we are employees, not independent contractors. Which really sucks. Because unlike someone who does data entry, we cannot work easily with a broken foot. Break a hand or finger or dislocate a shoulder, etc., and we are REALLY in trouble. This potential for financial disaster has really worried me at times, especially since short term/long term disability insurance is not always affordable, and some of us aren't even sure where to start looking for it.

This is why I was glad that our employer at least brought in an AFLAC representative after Sandra's accident. At 40, I know I am no longer ten feet tall and bullet proof, so I was very happy to have the opportunity to get disability insurance. Most of us have heard of AFLAC insurance; it's the one with the annoying duck that pays the suffering policy holders directly so that they can have money for whatever they need most during their trying times. A six-month disability policy for me, I believe, will pay a little over half of my typical monthly salary should I lose a month due to illness/injury. Because we got a group rate I'm paying in the $30 range per paycheck, not the $50 range.

I highly suggest all massage therapists consider getting disability insurance, no matter how young and strong they are, because accidents happen. People slip on ice, get Shingles, have babies (yes, birth and several weeks post-labor constitutes disabililty at AFLAC), and even (YIKES!) drop pianos on their feet. I have a little more peace of mind knowing that if something were to happen, my income might suffer . . . but at least it won't disappear. Best of all, if you leave your massage business, you can take your policy with you at no rate change. And all it takes is a call to an AFLAC representative who will come in, bring lunch, give a staff presentation, and hopefully give you your own extra dose of peace of mind.

Scrunches, Wobbles, and Breathless Sumo

The hamstrings tell the tale.

These hamstrings, normally smooth and strong, were developing bumps I associate with adhesions. The bellies of the muscle were like a bit of bad road, dipping up and down with jellied clumps of static muscle tissue even though they were supposed to be at rest.

A monument to adhesions myself, I asked about the workout. The new exercise was feet on the ball, back on the floor, with the butt up and slow knee flexions to work the hamstrings.

A great exercise, for sure, but this had been done with much wobbling and too many reps. The hamstrings had kicked in to provide the stability my client’s spinal column was missing. Now, a few days later, I was feeling the results.

These muscles had overloaded and paid the price. As I worked out the adhesions, hoping to prevent or derail future trigger points, I was trying to figure out how to address what might well turn into body armor – a perimeter of static, overloaded long muscles helping someone work through exercises despite a wobbly, sleeping core.

We tried some pelvic tilts, scrunching the rectus abdominus while breathing out, holding the scrunch while using the diaphragm for three breaths. Rested for three diaphragm breaths, then scrunch. Rested and scrunched. The posterior spinal muscles relaxed and the core woke up.

Core stability is not breathless Sumo. It's an ability to balance one’s weight in the pelvic bowl without sloshing about and tightening the posterior spinal muscles, all the while using the diaphragm to breathe.

When I went home that night I did my tilts and ball squats. It’s always good to practice what my clients teach me.

Great Moments in Customer Service

The rain was coming down hard and sideways, an event very unusual for Southern California. After a sticky freeway ride, my 18-minute drive to work took 30 minutes; I pulled into the driveway at my office two minutes late and saw my client huddled in her car.

"Sorry I’m late. What’s with this rain? Where’s my California? And why do people insist on tailgating in the fast lane - with no lights on - in hard rain?"

We were standing on the doorstep with the rain swirling around the brick steps. I put my keys to work. First the deadbolt, then the regular lock. I grasped the handle and felt solid alder wood. No give at all. I was standing with my bag of laundry, phone and my Louis Vuitton bag (a paper bag from the LV store at the mall, Recession chic, which I use as a briefcase.)

“Could you hold my bag? It’s too wet to put down.”

I tried both keys again, and then gave the door a shove. Nothing.

“Could you hold my laundry?”

I gave it another shove, this with a good foot and shoulder into it like an episode of Law & Order. Nothing.

“This is a first for me!” I said cheerfully.

I gave up on the door and asked the client to return to her car while I called the landlord. I shoved my stuff back into my car and sprinted to the next office.

Shivering in the cold, I thought about all my good intentions when I left early from the house. My landlord doesn’t have a key to my office. We went into the adjacent office of the vacationing acupuncturist, and I made my way into the back, through the bathroom we share and to the inside of my office. The deadbolt was stuck on the last bit of the jam. I remedied that and with enough force to pull a Buick uphill, finally swung the door open

After my very understanding client had her massage, I realized I had left the hall light on the acupuncturist’s office. I was going to have to call the landlord again.

It is, at times like these, when I think of my list of “Great Moments in Customer Service”. I think we massage therapists all have them. The double-booked. The forgotten appointment. The wedding party that had booked every room in my spa just before the computer went down and all the appointments disappeared into computer ether, along with the call-back number.

The day I was in the midst of a soothing, relaxing massage and I bumped into the towel caddy table, causing the lamp to fall, loudly, breaking the glass shade and then the bulb popping like a gun.

Or the day I tried a wheat grass shooters at the juice bar just before a 2-hour massage appointment. Shooters indeed. I have never run so fast with my knees stuck together.

Thank heaven people are kind, understanding and in search of relief enough to put up with an ordinary human like me.

As Homer Simpson would say: “D’oh!”

WWTD - What Would Travell Do?

That darn knot was driving me crazy.

It was embedded in the rib cage, just below and under the lower vertebral border of the right scapula. It seemed to ease with heat, but no amount of myofascial release, Swedish, cross-fiber, trigger point or lymphatic or any of another half-dozen styles of massage I had tried would budge it.

Every week that darn thing was there. Everything else had budged, and my client, whose principal complaint was major migraines on the right side, had been getting better gradually as I worked to erase the right-sided pain pattern. This client is hyper mobile and thus negative on most of the muscle tests such as range of motion.

I had hunted down a huge serratus anterior knot and it bit the dust. A mondo masseter knot was opening up. I even felt the scalenes starting to slip back into the matrix.

Except for that darn knot. Instinct and experience told me it was a progenitor of the migraines. It must go. I was close to naming it – Jethro? – And I wanted it out. Bad.

I followed it as if it was from the multifidus, progressing up and down the spinal points trying to balance the tension on both sides. I followed the lines of the rhomboids, the serratus and the latissimus choo-chooing with the anatomy trains.

I must be missing something. I must be chasing the wrong thing. I can do this. And when in doubt, look it up.

Years ago, at relatively great expense given that I was a humble massage student, I had invested about $450 in a set of Travell and Simons, “Myofascial Pain and Dysfunction: The Trigger Point Manual” (it's a good deal on Amazon now - $215). I use the Travell flip charts of trigger points pretty much daily. It is, for the manual therapist, the reference books for what we know, what we don’t know and why.

I went back to the font.

There, hidden away in plain sight in the latissimus chapter, was a drawing of how to get that damn knot out. Approach from the lateral anterior, slip under the latissimus and locate the trigger point. Fix it with pressure from the hand under the lat to the exterior hand. Massage it and draw the point out laterally away from the body. Sweat was dripping down my face, and my client’s eyes rolled back, a bit like a shot of anesthetic.

I felt “Jethro” melt.

Janet Travell would have been 109 years old this past Dec.17 if she had not passed on at the tender age of 96. She got John F. Kennedy out of a wheelchair after WWII so he could run for president. She understood that people were people, even doctors, and worked to bring manual therapies back to orthopedics.

I hope all massage therapists and manual folks know her name and her books and charts. Shouldn’t we have some sort of Bodywork Hall of Fame?

The Twelve Days of Christmas (Massage-Style)

On the first day of Christmas, my true love gave to me,
A tub of rose-infused crème!

On the second day of Christmas, my true love gave to me,
Two eye-pillows, and a tub of rose-infused crème!

On the third day of Christmas, my true love gave to me,
Three salt lamps, Two eye-pillows, and a tub of rose-infused crème!

On the fourth day of Christmas, my true love gave to me,
Four finger cots, three salt lamps, two eye-pillows, and a tub of rose-infused crème!

On the fifth day of Christmas, my true love gave to me,
Five sets of sheeeeeets! Four finger cots, three salt lamps, two eye-pillows, and a tub of rose-infused crème!

On the sixth day of Christmas, my true love gave to me,
Six lumbar strains, five sets of sheeeeeets! Four finger cots, three salt lamps, two eye-pillows, and a tub of rose-infused crème!

On the seventh day of Christmas, my true love gave to me,
Seven chakra stones, six lumbar strains, five sets of sheeeeeets! Four finger cots, three salt lamps, two eye-pillows, and a tub of rose-infused crème!

On the eighth day of Christmas, my true love gave to me,
Eight sinus headaches, seven chakra stones, six lumbar strains, five sets of sheeeeeets! Four finger cots, three salt lamps, two eye-pillows, and a tub of rose-infused crème!

On the ninth day of Christmas, my true love gave to me,

Nine flute CDs, eight sinus headaches, seven chakra stones, six lumbar strains, five sets of sheeeeeets! Four finger cots, three salt lamps, two eye-pillows, and a tub of rose-infused crème!

On the tenth day of Christmas, my true love gave to me,
Ten breath mints, nine flute CDs, eight sinus headaches, seven chakra stones, six lumbar strains, five sets of sheeeeeets! Four finger cots, three salt lamps, two eye-pillows, and a tub of rose-infused crème!

On the eleventh day of Christmas, my true love gave to me,
Eleven face cradles, ten breath mints, nine flute CDs, eight sinus headaches, seven chakra stones, six lumbar strains, five sets of sheeeeeets! Four finger cots, three salt lamps, two eye-pillows, and a tub of rose-infused crème!

On the twelfth day of Christmas, my true love gave to meeeeeeee,
Twelve frozen shoulders, eleven face cradles, ten breath mints, nine flute CDs, eight sinus headaches, seven chakra stones, six lumbar strains, five sets of sheeeeeets! Four finger cots, three salt lamps, two eye-pillows, AND A TUB . . . OF . . . ROSE-INFUSED . . . CRÈME!

Is It a Muscle or?

Every so often in massage you see someone who you think might be having visceral rather than muscular pain. Since my X-ray vision is on the blink, and my psychic abilities have never worked when picking next week’s lottery numbers, I tell folks who have a symptom that might be something else to go see the doctor.

Come to think of it, I’m sure most therapists have some opinions and probably a few good stories, about when to say “have you had that checked?”

I sent my granite guy to the urgent care for chest pains not because I didn’t think he had pectoral problems from lifting heavy granite all day, but because he hadn’t been to a doctor for 20 years. He was fine, by the way, and his pec’s felt like rock.

Once I felt a little pebble in a client’s foot and sent him off to his doctor. It was some kind of benign but destructive tumor. He had it taken out.

I have no clue to what’s going on when I refer people for diagnostic work, but I do probe enough to at least find out if they have taken their symptom to the doctor at some point, especially if it has happened before.

That said, I’ve wondered sometimes if I’m playing Russian roulette. If someone who has aches and pains and never goes to the doctor okay? What if they’ve been through all that and been pronounced fine. Did they miss something? Who am I to say anything at all?

Plus the idea of mentioning the sawbones might just scare the fiddlesticks out of some clients. Some people don’t do well with the whole medical thing. Rather than scare the stuffing out of a client, I might say “it’s probably nothing, but you will be doing some good for the economy running up a bill.”

I’m careful not to mention what something might be, as that might be taken as diagnostic, which is doctor stuff.

On the other hand, if every time a client came in with a pain you sent the person away, we never get a massage done. There’s a balance somewhere, and I like to think I’m close to it.

A client who been dragged in by his wife said his “friend” told him that “you should never rub a sore muscle,” with a tone that suggested the Ten Commandments. I promptly told him that what I’ve been doing daily for the past 15 years. Massage therapists help people relax and let go of aches and pains. It’s just part of the landscape.

I added that I don’t rub fevers or road rash or hives, or something that looks red or swollen, but with good assessment before starting the massage I’ve managed to avoid killing people.

At the WAY other end of the spectrum referrals can be frustrating. I had a long talk with a client with a deep fear of doctors into taking the lump under her jaw line in to the clinic. She finally went to see a specialist and found out it was a benign salivary tumor. She started taking supplements to get rid of it.

As the tumor grew larger, I suggested that benign doesn’t mean it can’t do bad things by just getting bigger. She felt the tumor was getting smaller and would go away without surgery. Then she stopped getting massages from me. I saw her one day in the market. The tumor was the size of a grapefruit, and she had combed her hair, very unsuccessfully, over it.

Spa Olympics

Working at a spa is one of the most rewarding and challenging environments for a massage therapist – the pressures of running on time, keeping within guidelines and getting along with a bunch of other therapists – and their egos – all while trying to learn protocols and make a living.

I’ve always found spas a great learning laboratory when I worked in one and when I owned spas. What I found most interesting is how individual therapists perceive the spa environment as a challenge or an obstacle course. A case in point -

While operating a hotel day spa, one of the employees, a male therapist, showed great determination in developing a clientele. He worked mostly “slower” shifts and kept at it, despite the preference clients have for gender. After working a typically “slow” shift – Friday nights - for a good year, he had developed enough of a following that his Friday book was consistently full.

I, of course, was quite happy with this - it worked for him and for me to keep the books chubby and money rolling in. One of the other therapists saw the book and decided that the Friday night shift was rightfully hers. She called me to let me know that our male therapist didn’t want to work Fridays anymore and she would be happy to take that shift.

I thanked her for volunteering to take up the shift and told her I would think about it. Needless to mention, the moment I checked with the male therapist, I found out it was a ruse. After investing time and effort to build up that evening with steady clients, he was not interested in moving off it at all.

I was marveling about the chutzpah when I talked a confidant, the manager at the hotel’s restaurant.

Can you imagine someone just trying to shove somebody aside like that? I said.

“It happens in the restaurant all the time,” he said.

Really?

“Yes, I’ll have a new hire learning the restaurant and I’ll know if they will work out after the first full shift.”

OK I’ll bite. How?

“If they come up to me and complain that another server has all the best tables and they get the dregs, I know it’s not going to work. They’re just telling me that they don’t see how experience and focus pays off in tips. They assume there’s some magical reason why they are not doing as well as the server who has worked here for years.

“Now if they tell me they are going to work hard and try to emulate the good servers, until they get it, I know they’ll be fine.”

I must say that was a good lesson learned. Oh, and our “grabby” therapist didn’t work out.