Rebar and the Concrete Floor

This massage client had survived a long list of honey-dos last weekend and he came in Monday night with a particularly nasty knot in his scapula area.

I thought I would be dealing with a knot in the rhomboid or serratus but this seemed to be less of a problem than the very defined set of longissimus “rods” either side of his thoracic and lumbar spine. Tough, adhesed, stuck in their fascial sheaths these muscles were screaming for massage.

“What did you do this weekend?” I asked, impressed with these muscles.

“You name it,” he said. “Landscaping. I moved the couch five times. Lots of lifting.”

Hmmmn, I thought. These erectors felt like they had done more than that. They felt like they had been hard-marched across the longest concrete floor in the world. Tough, stuck and over-used in their fascia, these muscles felt like rebar.

“What are you doing all day at work? Are you walking around on concrete a lot?”

“You could say that. I’m a commercial broker. Selling leases on empty offices and warehouse space. And it has been brutal.”

“I can feel it,” I said. “Let me guess, You are gussied up in a suit and dress shoes and walking on concrete all day.”

At this point I felt more like Psychic Sue than Fascia Girl. Have other therapists ever had the experience where it seems like the muscles themselves have told you what they have been doing? I know it sounds weird, but it was like these guys were telling me they had enough of tough, long days and bare concrete.

With a lot of myofascial release and stretching, I sent this client home with directions to get some supportive inserts or better dress shoes. Perhaps I should buy a lottery ticket this week.

Point Well Taken and Massaged

Holistic is the massage therapist’s mantra. Treat the person as a whole, all connected parts and a complete person. The entire massage helps.

This is the kind of thinking that goes into most of my massages. But then I get the occasional clients who want just one body part massaged.

“Just do my feet.” “Just do my scalp.” “Massage my hands only.” “I just want massage on my back. It makes my whole body relax.”

Well, I’m the expert on massage but clients are the expert on their bodies. I dutifully will do hands, feet, back, whatever for an hour or so. But I pitch before I putt.

“I love to have just my hands rubbed,” I’ll say. “But you know, the massage tends to last longer and work better when it is a full-body massage. Let me know if you ever want to try it.”

That last bit is key, I find. Often clients asking for a focused massage have issues with another person touching them. They will get a massage because they know it makes them relax, but they are not comfortable with the loss of control that lying on the table brings. Give them that control, and they may just come along after a while.

The Purpose-Driven Massage

In the action of performing massages daily, I've often had to step back before starting a session, take a Zen breath and get grounded. Why? Because I operate on the belief, as I suspect many therapists do, that my intent affects how well the massage will proceed.

My thoughts need to be in a calm, subdued and peaceful state when doing the massage. Not thinking about bills, problems or arguments, but thinking of the client’s areas of tension and envisioning those areas as clear and calm as the summer sea.
Managing my moods and thoughts translates directly into my intent, and my intent should reflect my desire that the person on the table feel better. As an operating belief, I think it works for me. But it does raise the question: If my intent is clouded with other unrelated or stressful thoughts, does that negatively affect the outcome of the massage?

I suppose I can speculate all day, but the truth is in the result. I think people know when they have had a good massage, so they probably know when they have had a bad one. But if the massage is technically good, can simple thoughts interfere with those results?

I can relate, but only through experience. I’ve had massages that seemed perfectly normal, but they didn’t turn out well. One was too fast and the therapist seemed to be on automatic. It left me feeling nervous. Another time I felt the therapist would much rather be doing something else other than massage. I can’t say I didn't feel well after the massages, but I did not get that feel-good-for-a-few-days bump I associate with a good massage.

Is there a bottom line to intent? I think so. But don’t ask me to quantify that. I wonder how massage therapists rate their intent versus technique. Is intent the most important thing? Is intent the only thing? Or just an operating belief that keeps the therapist in the Zen zone?

Stalking the Ultimate Face Cradle Cover

Time to face the facts: most cradle covers remind me of some grandma’s underwear.

The covers do not fit very well, leaving lots of extra cotton. The little stretchy elastic edge seems like undies to me. I’ve noticed clients tend to get itchy noses while prone because the lower seam covers their airway a bit. And the side seams leave a wrinkle line on faces that reminds me of the nuns who taught at my grade school.

Can’t someone make a giant leap for humankind and massage and come up with a better design?

OK – I have tried alternatives. Once, I bought a box of nurse hats recommended by a chair massage company. In the field, I found that the holes I made in the middle left the clients breathing little polyester fibers. A client asked me if it is the same stuff they make insulation from. Plus: they are cheap. Minus: Very scratchy, Home-Depot feel.

I tried a firm cotton and paper towel once only to find it is so absorbent it sticks to makeup – and the faces wearing makeup. Great idea, too many sticky cheeks out there. Clients are supposed to laugh at my jokes, not the linens.

At some point someone came up with the idea to add Velcro to the upper and lower seams to gather up the extra cotton and make the covers snug, but on my thick cradle cushion, the Velcro tends to be too close to the face and scratches the forehead a bit.

Now every time I open up a web page, magazine or browse an exhibit hall, I go on a hunt for a new design. No more thin paper, as in toilet seat covers, for me or my clients.

At an AMTA convention last year I picked up some flat, double flannel covers. No seams along the face line, no drooping over the nose. Perfect. I wore them out. Now can I find that lady’s card? Please, if you know someone who makes these....

The Light in the Eyes

Sad Sack-like, this client came in not expecting much. After a hellacious car accident a decade ago, she had developed pain throughout the left shoulder girdle and felt restricted and unable to do much. She had cut down work to two days a week. Her husband drove her in to the office because she hasn’t driven a car since the accident. She looked a bit down-and-out in sweats, no makeup and expression-less.

There is no better place to be a massage therapist than when you get a challenge. Could I help this lady feel better? After a decade of pain, stiffness, guarding and avoidance, what could I possibly do?

Well, off we went. Swedish, lots of Swedish, to warm up the area and get the blood and lymph flowing. Gently into deeper techniques, starting with the most irritated point in the trapezius and into the cave of forgotten TrPs, the lower traps.
Lymphatic spinal massage with moist heat. Manchurian acupressure. Russian sideline sports techniques adapted for fibromyalgia. Over the course of about four sessions, I pulled every little technique out of my hands that I thought would help.

So much and many that I was humming a song before her fifth appointment…."I’ve been working on the railroad.."

When she came in the office, she surprised me. She was wearing colors, a pretty blouse, makeup and had earrings on. She greeted me with enthusiasm, her eye lit up and shining. She skipped off to the ladies room. Actually skipped. I looked at her husband. We shrugged together and smiled.

In the therapy room I asked her how she was feeling. “The spot is still there, she said. “Better, but still there.” We started with some Swedish, and I asked her again if the main “spot” was better. She turned to her side, raised her left arm and did a perfect range of motion for the anterior serratus, a kind of a “locomotion” move drawing her arm back and forth across her midline.

Aha! Ask and the client will tell you! While she went through her range of motion, I added some active myofascial release to chase down the last bit of the “stuck” spot.
Yeppers, it is a blast to get a real live thank-you from a client. I’ll find out this week if the spot is finally “gone.”

Hearing and Understanding: Communicating with Deaf Clients

By the time he was a young man, my father was already hard-of-hearing, particularly on the left side. Being left-handed, he thinks that a lifetime of holding shotgun and rifle stocks to the left shoulder and firing without hearing protection was the largest culprit. In any case, by the time I was in my late teens, my interpreting services were more and more required in social situations. Very naturally, my father had become a face-watcher and a lip-reader, but if approached from behind (especially behind and left), he often could not hear (and appeared to be ignoring) the speaker. Speakers talking too fast or using a different dialect were also a problem, so I became very handy at restaurants and on vacation. If he couldn't understand something, he simply looked at me questioningly, and I repeated or translated the statement/question. My face and my dialect were easy for him: he'd been reading me for years. Now, I'm 40, and my father is pretty much deaf without his hearing aids. Upon getting them, he said it was nice to hear birds again, but not so nice to listen to my mother shuffle around in her bedroom slippers, which he said sounded more like a herd of elephants sliding around the kitchen.

I tell this story to illustrate that I am sensitive to hearing issues, or at least I always thought I was. In the last year, I worked at a clinic were I had a regular client who happened to be deaf. And I was rather horrified one day when another therapist friend pulled me aside after observing part of my post-session interview and teased, "For God's sake Lynna, he's deaf, not stupid!" Apparently, I was gesturing too much, and exaggerating by speech too much. I was mortified, largely because I was afraid that my attempts at being helpful had back-fired on me, and my client was probably going home after each session thinking, "What a wacko . . . "

So I did some research. I had been gesturing a lot to help clarify my message: was that wrong? Survey says: not necessarily. Gestures are welcome when communicating with deaf people. After all, people with "normal" hearing use gestures all the time in conversation. HOWEVER, gesturing should be precise and kept at minimum. For example, pointing at the gravy when asking, "Would you like some gravy on your biscuits?" Too much gesturing is just distracting and may confuse the issue instead of clarifying it.

Should I speak slowly and hyper-enunciate? Survey says: only to a degree. I had been worried because my dialect (South Eastern US, etc.) is very different to that spoken in the Seattle area, and that can change the way some words are framed. BUT, according to several sources, one should simply try to be as clear with a deaf person as one would be with a hearing speaker from another region/dialect. Which means, if a hearing person would think you sound condescending or strange, a deaf person could interpret that same speech behavior that way as well.

The only other universal suggestions I found for communicating effectively with deaf people were (1) write things down legibly if you cannot express concepts well enough through speech (which I do) and (2) be mindful that facial hair does not block your mouth/lips (I don't have any). And I might add, I guess, (3) give yourself a break. My mortification smacked of perfectionism, but I well know I can never be perfect. I believe my client knew my intentions were pure even if my approach was muddy.

Hands On and Ambitions

The last glowing ember of the Fourth of July fireworks had gone out and as we walked to the car, I ran into two old friends I had not seen since massage school – now a good 16 Fourth-of-July fireworks shows ago.

We compared hairstyles, and weights and marriage and divorce milestones. Then the question inevitably came up: Still doing massage?

Yes, I said proudly. I love doing massage. It's a very fulfilling career.

Ooh. That went over like a dud. Turns out my buddies from school were busy doing everything but massage and looking to open a more lucrative business. A domestic employment agency, for one, she explained. You don’t have to do any work. You just place people and collect money.

This discussion got my interest. Although both these folks still do massage, it seemed like they had long had ambitions to do anything but massage. They had a bunch of different activities: Teaching. Massage products like essential oils. Stints as lifestyle coaches.

I suddenly got the feeling that I must have missed something, being a massage therapist who likes to do massage.

I have to ask: Do massage therapists harbor ambitions to "stop using their hands?" Is hands-on not good enough? Are we stepping on stones to another profession? Do we want to be business people and not therapists?

Plus, if anyone knows a business where you do no work and collect money, my cell phone number is…

I wonder what the post-fireworks chat will be like in say, 10 years.