Wildflowers

Wholed It Together – W.I.T
Blog entry 11 of many
Entry: Wildflowers

Glacier-National-Park-19.jpg

This past week I spent my time in Glacier National Park, Montana. Upon my ascent into the park I noticed the thick, gray clouds and the tall, woody trees. The fern, olive, and emerald greens of the grasses were shining against the smoky sky. There was a lot of smoke because wildfires stretching from British Columbia to Oregon had taken over the forests and hillsides. Turns out that there is some scientific debate as to whether we should be combating natural forest fires or allowing them to burn. Many ecosystems are dependent on the charred brush and yet with the rising temperatures we must be wary of what is ‘natural’ as opposed to human-made.

The juxtaposition of natural and human-made was very apparent as I sat in a line of cars waiting to pay the entrance fee while being surrounded by jutting mountains and rambling woodpeckers. I paid the thirty dollars, grabbed the brochure from the Park Ranger, and drove to the Fish Creek camping site.

The next morning, I set out on my first hike into Packer’s Roost on the Southwest side of the park. Some La Sportiva hiking boots, a Camelbak water reservoir, and a bear-deterring bell strapped to my Cotopaxi pack composed the framework of my 10-mile hiking gear. But none of that is what this story is about.

The Wildflowers. That’s what this story is about. The Glacier Lilies, Big Sky Balsamroot, and Monkeyflowers were bright and lush! Walking along the river with Fireweed up to my neck was so refreshing as I lost myself in the leaves and petals. My body seemed to meld into the flowers as I walked by and felt the coolness of the stems wisp against my ankles. Was that my hair brushing against my shoulder or a Forest Fern’s feathery leaves? It was difficult to tell. And in those moments, I became a part of the landscape.

The wildflowers were so abundant that I almost didn’t notice the 6,000-foot mountain faces with snow fields looming above. There was a moment as I was walking toward the suspension bridge that I remembered a quote on a silly magnet I read in the gift shop. The quote said: “Advice from a wildflower – show your true colors, delight in simple pleasures, spread seeds of joy, open up, be wild and wonderful!” Hiking with a 2,000-foot elevation gain and a 360-degree view of massive near-extinct glaciers, somehow the simplicity of that magnet quote resonated. Here I was, a tiny speck amongst these wildflowers which greatly outnumbered me and had a much deeper history with the park. I felt compelled to cherish every single drop of the park and take any advice the wildflowers would offer!

I found my way to the 7,600-foot packer’s camp spot, laid my pack on the turquoise rocks below me, and drank the thin, cold air. What an amazing experience. I sat and dangled my feet probably a little too close to the mountain’s edge. Looking down toward the direction of the trail head, which by now was completely invisible of course, I tried to make out the various wildflowers. From my vantage point the nuance was gone. I could still see some yellows, some pinks, some whites and oranges, but the subtle differences were also invisible. Now, the wildflowers created a painted smear across the valley below.

If we can all experience being enveloped by the wildflowers as well as viewing them from afar, maybe our ability to “…show your true colors, delight in simple pleasures, spread seeds of joy, open up, be wild and wonderful!” would increase and we could indulge in the wild beauty that abounds.

Sailing

Wholed It Together – W.I.T
Blog entry 10 of many
Entry: Sailing

This weekend I had my very first experience sailing. There were 8 of us, including the skipper who was a gregarious and knowledgeable guy. The 7-person crew was filled with complete neophytes, myself included. We jumped on board a J-105 racing sailboat with a colorful jib and boom that had a mainsheet long enough to tie us all up 3 times over.

Two days ago, I’d have read that paragraph and immediately tuned out. ‘Well, obviously, they are not talking to me. What the heck is a jib or a boom anyway!’ I’d have thought to myself. But fortunately, I had the experience to learn that a jib is a triangular sail used to help tack (recourse) a boat. A boom is a pole at the bottom edge of a sail that helps control the angle of the sail in the wind. 

 Now that we’re speaking the same language we can begin to sail together. And, wow, sailing is fun! Out on the San Francisco Bay on a warm Saturday with low winds and calm waters; couldn’t ask for better conditions. It was a great experience – both educational and relaxing.

 What I came to think about was how sailing was like using this body of ours. How we have various levers and mechanisms that have a function. A winch on the boat had a rusted part, and the rope wasn’t able to stay in place, which caused me to have to manually hold onto it until the skipper came over and pulled the rope across the boat to a different winch that held it in place. Now we had a crisscrossing of rope all along the deck to keep the sail open. This felt a lot like compensation in the body. For example, the ankles lock up to prevent full hip extension, if the glutes are inhibited, to create hip stability and prevent injury. There is a crisscrossing of muscular reactions aimed at protecting the body and allowing motion.

Our bodies are meant to move and just as the sails in the boat luff (or flutter) when they are not in line with the wind, so too our bodies have hiccups when we are maligned. We are meant to move in a state of ease with the wind at our backs. Anything outside of that is tantamount to a rusty winch. 

It’s so important to speak the language of the body so that we can use the vessel the way it is supposed to be used. Sailing requires a language, skill, and curiosity; so, does the body. The main difference is we don’t have to sail, but we do have to inhabit this body. For this reason, I’ve found it so important to learn the language of the body, practice the skills required to crew it, and maintain the curiosity necessary to take on the inevitable rough waters.

Our bodies are the greatest tools we’ve got and they require a lot of maintenance. Sailing reminded me that there is often a lot of preparation and work involved in getting us to a point of cruising on the waves. Using our bodies in the form of exercise and stretching helps to prep us for high winds. Resting, hydrating, and proper nutrition helps keep our machinery in full function. Bodywork helps to restore us systemically. 

I loved being out on the water and meeting all those super cool people. There’s nothing quite like floating in an open bay on a gorgeous boat. I’ll never forget this experience and remember what it requires for smooth sailing.

Communication

Wholed It Together – W.I.T
Blog entry 9 of many
Entry: Communication

Recently, I was responsible for chairing a speech contest. This meant I helped organize, delegate, plan, and lead a bunch of people in producing a fun and inspiring event. This was my first time in such a position and I was both excited and nervous.

I began by asking my fellow speakers lots of questions and taking scantily coherent notes. Spending a lot of energy on creating a skeleton version of how I envisioned the event, left me with just that; a skeleton with no muscles, blood, or skin.

As a massage therapist, I couldn’t help but see this experience as a human body that needed the same type of care and nourishment. The skeleton was comprised of the rules, guidelines, and by-laws that created a foundational structure for the contest. Since it was my first time producing the event, I was very consumed by the skeleton and dug myself into the enamel and marrow. I wanted to understand and utilize the rules in a way that would not be depleting, but quickly I realized the structure was not healthy.

I printed documents, had contestants sign forms, read the laws, watched tutorials. I began to understand what was legal and what wasn’t. But, when I went to a meeting with the speakers and mentioned what I had been working on, they looked at me blankly. Oh yeah, I had been doing this all on my own and nobody really knew what was going on! Here lied the muscles. The people were what moved this body. Noticing that I had done it alone exposed the naked skeleton for what it was. I began the process of strength training. As a group, we met and collaborated; we began planning locations and whether we should have a potluck. It wasn’t just the talk of food that was nourishing, but the inclusion of others.

The body that was the speech contest began to come to life! With a strong skeleton and healthy muscles, we had a foundation and the movement required to forge ahead. The rules never changed, but just as with bones, sometimes nutrients are absorbed to create a hardier material. This was true as more senior speakers helped by adding their knowledge and expertise. The muscles required consistent training to prevent wasting. For over a month, there was not a dull moment. People needed questions answered, reassurance, tips, direction, and support. They needed to understand the rules and guidelines so they didn’t hang too loosely on the skeleton. Being responsible for directing the body can be intimidating. This is where I found the blood.

Blood is life. Blood carries nutrients and energy. Blood is passion and purpose. The life-blood of the speech contest turned out to be when I heard the speeches themselves. Wow! I was blown away by the speaker’s confidence, prowess, and powerful topics. The body was formed, had moved, and was flushed with healthy blood. The blood did not need direction from me because we had the container for it to course. All the hard work to create a fun an inspiring event had paid off. Our speakers could practice speaking with the support of all of us. And this was the skin. 

Skin is a vessel; it contains all the good stuff inside. It is permeable and strong allowing inside what needs to pass through and defending against that which doesn’t. Our contest was the skin and vessel that contained blood – passion, muscle – people power, and skeleton – foundational guidelines. We had a full body and an amazing contest!

Excitement and nervousness are two ends of the same spectrum. I have learned from chairing a speech contest so much about myself and others and it was worth facing the fear. Someone asked me why I was taking on this role, and I said because communication and leadership are keys to being able to provide excellent body work. Understanding how things work is a part of what we, as bodyworkers, do every day. I suggest we all apply our hands-on approach to other areas to help bring them to life!

Weaving

Wholed It Together – W.I.T
Blog entry 8 of many
Entry: Weaving

Fascia is connective tissue that encases and holds our entire body. It is a protein responsible for much of our embodied experience. As massage therapists, we work directly with fascia whether as our primary focus or indirectly. The fascia has a particular weave and density. Is it tight and dense? Loose and supple? There’s no judgment ascribed here, just an acknowledgement. The weave of the fascia may be weaved into the entire life experience you and your client have.

Our bodies are more than a vehicle of transport, rather, they are interwoven into how we move throughout the world physically and figuratively. Our fascia density has a way of guiding our thoughts and actions. Our breath, energy, stamina, comfort, pain, flexibility, range of motion, stability, strength, and general sense of being is at least partially determined by our fascia.

Listening to the podcast, Liberated Body EP61, Brooke Thomas was speaking about her childhood experience of having a tightly weaved fascia. She mentioned how trauma added to the tightness and disembodiment that ensued. It sparked my own memory of having tight fascia which led to a perceived inability to thrive in childhood avenues. It reminded me of my disempowerment felt by the disembodiment I used as a tool to distance myself from the painful physical experience. Tight fascia was not visible so it became a trapping of my own mind. I felt stuck, toxic, and different from others. I couldn’t do the same things other kids did. I had unexplained pain and often did poorly in school because the tightness was a distraction.

The very weave of my fascia effected specific choices in my life. Having a systemic tightness was both a painful and challenging aspect and, also, what led me into massage therapy which has been the single most important choice I’ve made.

I has been my mission to meet people where they are. To communicate with clients on a level they can relate to so their bodies release into a trusting space. Using myofascial release and trigger point therapy in a way that values fascia with the highest regard. Meeting the fascia where it is, too, and complementing a tight weave with a loose pressure and a loose weave with a firmer approach. This is more complex than just doing deep work on Gumby folks and using effleurage on body builders. It is a combination of presence and quality of touch. It is using tools – vaulted fingers, energy work, rocking and shaking, pointed elbows – that support the specific needs.

Continue to research fascia, learn about it on a scientific level. Dig into the spiritual significance of fascia and the psychological effects. Let us come together as massage therapists to learn and admire this beautiful connective tissue and recognize how it connects all of us to the universe in its intricate weave.

Coconut

Wholed It Together – W.I.T
Blog entry 7 of many
Entry: Coconut

Coconut oil is fun to use for massage. It solidifies and turns into this chalky white that looks delicious and silky. When it’s heated up the solid white turns to liquid gold. It has a sweet and nutty scent and is healthy for the skin with its detoxification properties and is nourishing with vitamin E and lauric acid.

I don’t get any financial kickbacks for selling coconut oil, I know that sounded like a hard sell, but it’s not. What I realized today, while massaging a client with coconut oil, is that if you forget to melt the oil in hot water, it stays solid and can be impossible to use if it’s stuck in the bottle!

So here I am with this amazing oil that I can’t get to because of my own oversight. Quickly I became resentful of the oil. If only it wasn’t solid. If I just used crème or another oil this wouldn’t have happened. My client expected a Swedish massage and I didn’t have oil. All these “what-if’s”, “if only’s”, and “why now’s” were popping up. I felt frustrated and embarrassed and that made me unable to focus. There was no way to turn the oil into a liquid so I had to decide: do I panic or do I change course?

I decided the latter (after a couple minutes of panic). I communicated to my client that the oil was not heated and that I’d like to try a different modality with him if he was open to it. He seemed unsure at first, but then I assured him he could let me know if he needed something different at any time. He agreed and we began. I decided to use the coconut oil bottle as a roller for a type of myofascial release. The bottle was soft and warm and big enough that I could have good control while rolling his calves, hamstrings, shoulders, and erectors. I checked in with him regularly and he seemed to be enjoying the session. He mentioned that it felt very different but that he liked the new style. We ended up communicating much more than usual, as he usually fell asleep during sessions. This new exchange was fun and encouraging. He seemed to receive the bodywork differently and his energy was shifting in ways I hadn’t seen with him before.

About twenty minutes before the end of the session, the coconut oil had melted from the warmth of the body and the friction of the massage. So, I asked if he’d like to finish the session with a Swedish neck, scalp, and shoulder massage – using the oil – and he emphatically said, “Sure! Although this has felt wonderful.” I poured the coconut oil into my palms, rubbed them together, and let the warm liquid puddle up. I began some compression and skin rolling and did a little point work. The nutty scent steamed from my hands and I felt a sense of relief. I breathed into a fist compression of his upper traps and pushed the energy toward his feet.

It was then that I realized that good things remain good whether they are in our reach or not. We don’t have to rush. We don’t have to force. Mostly, we can still be appreciative for the vessel they are carried in and within time they will come to us. This is the wisdom of the coconut.

Unique

Wholed It Together – W.I.T
Blog entry 6 of many
Entry: Unique

Leonardo Di Vinci has been quoted to say, “learning never exhausts the mind.” He was a Renaissance Man with interests as diverse as cartography to sculpture and mathematics to botany. He is also known for intentionally using mirror writing when writing his personal notes. This is where you write in the opposite direction of what is considered normal and with inverted letters. Mirror writing is seen in people with dyslexia and neurological disorders. It also occurs with “normal” people and some who are simply left-handed.

Mirror writing is a supreme example of how what looks different can be a symptom of an ailment or just tell the story of a unique person with a different way of viewing the world. Farsi and Hebrew are written from right to left and Chinese and Japanese are written in vertical columns from right to left. So, to a non-native speaker of French or Italian (or Latin for that matter), he wasn’t writing backwards at all.

The more expansive our curiosity and interest in learning, the more open we tend to be to finding new stories to read. When we integrate those stories into how we operate in the world, be it writing backwards or something else, we can begin to see differently as well. There’s a phenomenon that comes from being able and willing to try things forward, backward, upside down, and right side up – it’s that we begin to understand that there really is no backward or forward, it’s all interpretation.

As massage therapists, what if we began our sessions with the client self-massaging their shoulders while we massaged their feet in a supine position? Perhaps we could change the dynamic of giver and receiver to a more fluid relationship that engages the client in their own healing. Each session is an opportunity to practice mirror writing and although it might seem off at first, it could be great to try something uniquely yours.  

Vuja De

Wholed It Together – W.I.T
Blog entry 5 of many
Entry: Vuja De

We’re all familiar with Déjà vu which is having the sensation that we’ve done this before. But if we flip that into Vuja De, we can take something familiar and bring a fresh newness to it.

Being a massage therapist has the common trappings of Déjà vu because we can get stuck in our routines, massage sequences, and interacting in repetitive ways. If another person tells me “I just hold tension in my shoulders” I might freak out because of the repetition of that statement. However, by bringing a Vuja De to the moment, perhaps we can find the newness.

Look them in the eyes, take a deep breath, and ask: “What does that tension feel like? When do you notice it most? If you could ascribe a color to the tension, what would it be? Have you ever named your shoulder tension?” Let’s be original. Allow our clients to feel their bodies in a new light.

Vuja De has the potential to get to the heart of tension in the body and produce profound insights. Find the uniqueness in every single interaction and bring in creative approaches. Just today a colleague was using a full-sized foam roller to kneed another massage therapist head to toe.  Looked like he was rolling pizza dough and from the outside it even looked a little too intense. However, the massage therapist receiving it was hailing its effects and saying how amazing it felt. It was creative, unique and he brought that Vuja De into what otherwise could have been just another typical massage.

When we commit to seeing things as if they are new, new things present themselves. Massage therapy has an endless degree of newness available to us if we just open our eyes and see. 

Jouissance

Wholed It Together – W.I.T
Blog entry 4 of many
Entry: Jouissance

Language says it all, doesn’t it? Really, though, it is language that dictates our first understanding of experience. If we have a word to describe our feelings, we can interpret it in our bodies and our minds.

Today I offer you Jouissance, a French word meaning joy and pleasure at the tipping point. A teeter between pain and pleasure and a stimulation that brings you to the edge. It is said that jouissance can be experienced through the breakdown of barriers between self and others. This breakdown leads to a sense of wholeness and pure joy.

In our culture we are often taught the language of ‘otherness’ and that can lead to separation and despair. If our words truly conveyed the reality of our connectedness, we could experience jouissance in our daily lives.

However, because this feeling is almost too much as it has the tensions of pain and pleasure at their peaks, we are subdued into a realm of centrality and comfort. Less pain, and far less pleasure. It is human nature to avoid pain even at the cost of losing out on pleasure.

What if our boldness came through our hands and spoke to our clients, telling them that they had a safe place to experience pure joy? What if we offered a glimpse of containment where they could release their fears and pain and be enveloped in jouissance and bliss? Would we feel brave enough to create that space? Could we handle our own jouissance that may come of the breakdown of barriers and realm of wholeness?       

Reflecting

Wholed It Together – W.I.T
Blog entry 3 of many
Entry: Reflecting

Reflection can be a process of sitting back and thinking about something or mirroring to someone something that they said. We can reflect on our experiences. We can also reflect a statement that a friend made.

When we reflect on our own in terms of thinking, we often go in circles. We think of the experience, add an interpretation of it, create a story and potentially a judgment, and then come back to the experience itself.

When we are reflecting to others, it is much more dynamic. There is the parroting – repeating what they’ve said. Paraphrasing by putting it in our own words. Extrapolating by extending their idea into the future. And synergizing by combining ideas to create something better.

Massage therapy is a perfect culmination of both types of reflection. It is a personal journey of understanding and interpreting the experience of giving the massage as well as a reflection back to the client of what is felt, sensed, and spoken.

Bodywork is a synergistic experience where the interaction between massage therapist and client is greater than the sum of the individual parts. It is important to remember that what we say through our words and our hands is powerful. We are reflecting back to our client what their bodies are telling us and this can be frightening or difficult. It can also be invigorating and spiritual!

At the end of each day I reflect on my connections with those whom I’ve touched. I make a point to find the nuance in the experiences so that I have an openness when I am reflecting back to others.     

Change

A synonym for change is adapt. As external factors shift and change, the internal must adapt. The act of changing is a type of adaption to new events or circumstances. Two days after a monumental presidential election we are all called on to adapt to the many changes that have ensued.

Read more

Receiving

Wholed It Together – W.I.T
Blog entry 1 of many
Entry: Receiving

Massage therapy is an ever-expansive experience. It is an unraveling process both for the bodyworker and the recipient. What we, as MT’s, bring to the table today might be vastly different tomorrow. And, yet, somehow, that fact does not detract from today’s massage. We continue to grow and develop our sense of touch. We unearth new knowledge and greater insight. And, at this moment, the human on the table is at ease and in comfort releasing their armoring into a safe space that can hold it for them.

Many bodyworkers know this to be true inside our massage rooms. However, when we re-enter the world, somehow it is forgotten. We lose a part of our ability to receive. Every moment is an unraveling in all its imperfection and bounty. When we maintain our ability to receive this truth, we, too, can release our armoring into the Universe that will hold it for us. 

I received a Thai massage last week and it has altered the way I approach bodywork. I felt the shift in my body and my clients have taken note. I received one massage and have since been able to provide massage with some new twists – literally and figuratively, it is Thai massage after all. What we receive becomes a part of what and how we give.

Today I choose to receive equanimity and receptiveness.

Today I receive. Today I also feel the continuity between giving and receiving.

AMTA National Convention Recap November 6, 2016

Note: In the following blog entry there are (#'s) and they correspond to online resources. Please contact me if you'd like the resource document that it is referring to.

The American Massage Therapy Association (AMTA) is a non-profit serving massage therapists nation-wide. Their mission is to advance the art, science, and practice of massage therapy. The annual conventions are a way to bring practitioners together from all over the country to advance their knowledge and gain perspective. And, of course, to connect with one another. The first convention was in Chicago in 1943 – they met to pledge service to the ethical practice of massage therapy. In 1946 there were a whopping 68 members. Now – 71,000.

Next year’s convention will be here in California, just over in Pasadena. No excuses to miss it. One note about AMTA is they fund the Massage Therapy Foundation (MTF) to do research and there are many ways to get involved; more to follow.

AMTA created a constitution that said they’d “foster the spirit of cooperation, exchange of ideas and techniques, and advance the science of massage to merit respect and confidence of all people and benefit mankind.”

This is a huge statement and one that is just as relevant as ever before. In the 1950’s and beyond there were issues with the basic legitimization of massage through state law. We still struggle with separating massage from ‘illicit activities’ and keeping our practices in the realm of health, wellness, and medicine.

A beginning place is to know our industry; truly understand who we are so we can act together instead of separately. In January 2006, AMTA released its first summary overview of the industry and since then you can access it as an awesome resource. (1) Understanding who we are will help to know where we’re going and the best way to plug our own practices into the greater picture.

On that note, read the document on the 2015 Annual Position Statement of Portability as well as the resources for CA certification and licensing requirements. (2) & (3)

Licensing is mandatory. Certification is voluntary. There are laws governing massage therapy as an industry and then bylaws which are established by local agencies. California Massage Therapy Council (CMTC) is an agency that represents and establishes our bylaws.

MOVEMENT

We are going to activate the corset muscles as Dr. Bruce Costello focused on at the convention. This includes the transverse abdominals which are directly under the internal obliques. They are responsible for compressing our abdominal contents – ‘minor details’. They also provide thoracic and pelvic stability. Also, included in the corset are the multifidus along the spine(iliocostalis, longissimus and spinalis), the diaphragm(lumbar, rib costals 7-12, xiphoid process), and the pelvic floor muscles.

To begin, let’s stand up, hands on hips, deep breath in and with full exhalation, let the chest expand which pulling the abdominals in toward the spine. Keep shoulders from rounding, look straight ahead. Repeat twice.

Okay, let’s sit. We’re going to take a deep breath and reach for stars. Expanding the ribcage, but keep it fixed. Activate the corset, lower the shoulders, extend the neck, look forward, feet flat on the ground. Let the arms drop down, but keep everything else in position. It might feel unnatural or difficult because it requires an engagement of the muscles. One note: If we don’t resist gravity, with muscle contraction, we’re literally hanging on our joints and that creates muscle tonicity.

Next, remaining seated, flex the hip, keeping a straight leg. Notice any restrictions, what happens to your spine. S.I. joint discomfort? Which is usually the result of a tight piriformis and weak glute maximus. Let’s clasp our hands behind of our heads and, keep a neutral spine, breathing, bring opposite elbows to opposite knee. Don’t compromise the neutral spine by reaching for the knees. If you can’t reach, stop where is comfortable. Remember a neutral spine is essentially when the PSIS and ASIS are in line. If you know you already have either a posterior or anterior pelvic tilt, take that into consideration when performing exercises.

Now we’re going to do a bridge with a straight leg raise. This will activate the transverse abdominals as well as the glutes. DO NOT perform if you know you have S.I. joint issues as this will increase the shearing effect placed on the joint.

  • Keep your hips level for the entire exercise.
  • Keep abdominals tight. o Slowly raise buttocks from the surface.
  • While keeping your hips raised, straighten out one leg.
  • Slowly return leg to start position, and repeat with the other leg.
  • Slowly lower hips to the surface.
  • Do not arch your back.
  • Do not raise your hips too far off the surface.

Okay, we’re now going to re-measure ourselves and see if we’ve gained any length in our spines. These are basic exercises that we can use ourselves as well as teach our clients to integrate in their morning routines or even on lunch breaks during work.

REIMBURSEMENT

Imagine if your primary doctor didn’t accept insurance, but you seriously required treatment. The only thing standing between you and the treatment was the cost. Now replace doctor with MT. If we value our work as a healing modality and want others to, one good way is to make our work accessible by taking the financial burden off the table and getting more people on our table.

As massage therapists, we are on the cusp of multiple waves. ACA healthcare reform, preventative and wellness care trends, “self-actualization consumerism”, the experience economy, and chronic disease/sick-care paradigm shifts. Let’s not forget about the opiate epidemic and CAM therapies joining the mainstream. Worth looking into the following:

  • ACO’s and Physician-Owned entities (4)
  • Medicare Part B – PT/OT/referral (5)
  • Worker’s Comp, Personal Injury Protection (PIP) (6)

Also of importance to massage therapists is that insurance companies must offer a set of essential health benefits in the following 10 categories:

  1. ambulatory care
  2. emergency care
  3. hospitalization
  4. maternity and newborn care
  5. mental health and substance abuse
  6. prescription drugs
  7. rehabilitative and habilitative care
  8. laboratory services
  9. preventative and wellness services
  10. pediatric services

Imagine that we are like subcontractors to the insurance companies. Our job is to know these 7 guidelines:

  1. Which types of cases can or cannot be accepted
  2. Obtain authorization & verification of coverage
  3. Be prepared with forms
  4. Conduct an intake interview & get proper signatures
  5. Evaluate before and during sessions – SOAP notes
  6. Document & understand rules
  7. Prepare and submit accompanying documents

We need to get a physician’s prescription – this is a good opportunity to make connections and receive referrals.

Claims are reimbursed for a percentage of what they are billed for. There is a recommendation that there are not “different” prices for cash vs insurance clients, rather a “fee scale” that is based on particular services. The reimbursement is based on: patient eligibility, provider credentials, and medical necessity. It might be good to get a professional CMRS (certified medical reimbursement specialist) or RHIA (registered health information administrator) who is trained in medical billing to help enter the CPT and ICD codes and process the paperwork correctly. (7) ICD-10 - 14,000 codes within the International Statistical Classification of Diseases and Related Health Problem. (8) CPT - Current Procedural Terminology. These are some of the CPT codes commonly used by massage therapists: 

  • CPT Code 97124 Massage Therapy
  • CPT Code 97140 Manual Therapy
  • CPT Code 97112 Neuromuscular Re-education
  • CPT Codes 97010 Hot/Cold Packs
  • CPT Codes 97110 Therapeutic Exercise (9)

One key piece to becoming more integrated into the medical community and finding legitimacy in billing, reimbursement, research, and referrals is to act within our scope and know where we stand within the legal aspects of the industry. This is where industry ethics, guidelines, and Practice Acts come in. Practice Acts are based on mandatory licensing, not voluntary certification, however, Practice Acts for massage therapy are in the CAMTC guidelines. Begin to understand the SB731 and how it was revised to become AB1147 (here are the basic tenets: deals with local regulation, voluntary certification, ability to shut down human trafficking and illicit massage establishments). (10) & (11) AB2194 was recently agreed upon and as of 1/1/17 will help reduce redundant background checks, make it so only “reasonable and necessary fees can be imposed”, extends voluntary certification through the year 2020, prevents local ordinances from requiring showers in massage businesses (which can be costly), and gives local government ‘revocable establishment’ tools to help battle the illicit and trafficking issues*.

BODY BREAK

Toe touch

Bird Dog

Superman and/or Plank

CURRENT RESEARCH

We accept that science requires research. Business requires research. Most things in life demand a depth of understanding in order to dig deep and find breadth. Massage is no different, on this level. This is what the MTF has to say:

Humans instinctively value the healing power of touch, and modern massage therapy comes from a long and venerable tradition reaching through time and across cultural boundaries. Rigorous research about massage can challenge tradition, but it strengthens our profession, and provides guidance for massage therapists to be as effective as possible. Since its inception, the Massage Therapy Foundation has funded 39 research projects, with a total of $720,366. Topics have ranged from massage for peripheral neuropathy related to chemotherapy, to postural control of elders, to migraines, cancer, and spinal cord injury. In addition, the Massage Therapy Foundation has consulted on numerous large-scale studies, funded two systematic reviews (one on stress, and one on sports massage), founded and published the International Journal of Therapeutic Massage & Bodywork (IJTMB), and hosted three international science conferences on massage therapy research.

Research and meta-analysis on the impact of massage therapy on pain (12)

In massage, there are ethics and guidelines as well. Here is the form for a research grant (13)

Case Studies are part of research (14)

For the Science Community

Adherence to the principles of good clinical practices (GCPs), including adequate human subject protection (HSP) is universally recognized as a critical requirement to the conduct of research involving human subjects. Many countries have adopted GCP principles as laws and/or regulations. The Food and Drug Administration’s (FDA’s) regulations for the conduct of clinical trials, which have been in effect since the 1970s, address both GCP and HSP.

For the Medical Community outside of Therapeutic Massage & Bodywork (TMB)

Title, keywords, abstract, introduction, client information, clinical findings, timeline, diagnostic assessment, therapeutic intervention, follow up and outcomes, discussion, client perspective, and informed consent.

TMB – that’s US!

Title, keywords, abstract, patient information, assessment measures, practitioner descriptors, therapeutic intervention (MASSAGE!), results, discussion Systematic Research Review Methods: Assemble a working group, develop a research question, search literature, screen literature, review methodology Data Extraction is where data is analyzed and crawled through to retrieve relevant information from data sources (like a database) in a specific pattern. Further data processing is done, which involves adding metadata and other data integration; another process is the data workflow. (15) Meta-analysis is a systematic review that answers a defined research question by collecting and summarizing all empirical evidence that fits pre-specified eligibility criteria. A meta-analysis is the use of statistical methods to summarize the results of these studies. PUBMED (16) – further research and data Sign 50 Checklist for validity in research and meta-analysis (17)

 

FUN THING

April 17, 2017 MTF will be sponsoring a team for the Boston Marathon – raise $10,000 and pay a $355 entry fee. “Running for Research”

PAIN – NOT AS FUN

Biopsychosocial cycle: 1977 George Engel called for a new medical model. Components: biology effects actions which effect interpretation of experience and symptoms. Social, environmental, religious, and economic status can all effect health. Well-being is based on medicine, psychology, and sociology which are all inextricable.

Pain is universal, how we experience it is unique. Pain is a riot. Acute pain = damage. Chronic pain ≠ damage = experience. Sensitivity = generalized experience, “oh, this again.”

Difficulty in measuring pain – scale might be taken out of E.R. admittance

1:5 report pain 1:10 report chronic pain – that’s 100+ million in chronic pain $560-$635 annual cost for pain management

military – 44% report being in pain 15% are on opiates

civilians – 26% report being in pain 4% are on opiates

>47,000 deaths/year from drug overdoses including opiate use – 2,000% increase since 2002.

Since 2014, CAM therapies for pain management include: yoga, tai chi, and music therapy -- hey, wait, why not massage??

Diana Thompson, works with the MTF – Author of the book: Massage, Movement, and Mindfulness Based Approaches

Douglas Nelson at the AMTA Convention reminds us that pain is a mystery not a puzzle and a process, not an event. This is to say that the experience of pain is not a single event, rather a compilation of many.

  • Primary pain – secondary gain *Do I identify with my pain??*
  • Nociceptors *Alarm System!*
  • Heterotopic pain *Is that pain in your arm or are you happy to see me?*
  • Spatial Summation *Brace for the instant; relax for the minute*
  • Placebo/Nocebo *Heal or Harm*
  • Amygdala Hijack (18) *I know what I was feeling, but what was I thinking?!*
  • Descending inhibitory system *Foot in mouth* (19)
  • Bi-directionality and avoidance *Relax?! I AM RELAXED!”
  • Alpha – C Fibers *I may be slow, but I’m not dumb*

Ice & Fire Massage Therapy

Taoist writing ~
When people see things as beautiful,
ugliness is created.
When people see things as good,
evil is created.

Being and non-being produce each other.
Difficult and easy complement each other.
Long and short define each other.
High and low oppose each other.
Fore and aft follow each other.

Background

Body, mind connection. I’m sure by now everyone has heard this concept and maybe even implemented techniques into their lives that serve both. An element I’d like to mention is the idea that the body and mind are circular. In Western culture we tend to think linearly and thus envision concepts more in a line or succession. There is no right or wrong here. Actually, that is the point. Right turns into wrong and wrong turns into right in a fluid, circular motion. Western culture and Eastern culture do not conflict, rather, they are two parts of a whole. And to come full circle (pun intended), the body nourishes the mind and the mind feeds the body.

Every aspect of this world has two opposites that create existence for either. The body cannot function without the mind to govern it. Nerves, muscles, blood flow, organ function, speech – all possible because of the mind. The mind is equally as connected to the body – when there is pain in the body, the mind changes course. When the body has pressing issues, the mind must use some of its resources to attend to it. When pleasure occurs, the mind is flooded with chemicals that then gush throughout the body.

Circular and opposite. Yin/Yang – black/white, night/day, feminine/masculine, cold/hot. Can you imagine what the concept of cold would be to someone who has never experienced hot? There is an invigoration anytime we are presented with extremes, especially when they are enveloped by each other. For example, on a hot and sunny summer day, sitting under a cool, shady tree feels incredible. The body aims to find homeostasis (a stable physiological state) and the mind searches for an equilibrium.

Ice and heat are great examples of yin/yang. Ice has a lot of yin – cold, slow and heat is comprised of yang – warm and fast. When we bring them together in a fashion that celebrates both, we are part of facilitating that whole circular existence. When we intentionally apply this type of wholeness to the body, it is allowed to relax into the homeostatic equilibrium that it wants.

This is where “ice & fire” massage therapy is introduced. By applying cold ice in circular motions all across the muscles, we are waking up and revitalizing the soft tissue. The body may react with an initial tightness, holding, and shiver and will soon come to get comfortable with the cold and release into it. The metabolic breakdown of the muscle tissue will slow and this helps to preserve energy. After a full body coating of the icy glaze, the body will have adjusted – for the most part – to the cold and slowed to a steady, conservative pace. Slowly introducing heat to the muscles from head to toe, will result in a sluice of blood flow. The tissue will re-awaken and the molecules will speed up. The heat in contrast to the ice produces a flushing of blood and lymph as the body acclimates. The brain will also produce endorphins that are carried by arterial blood and as the heart speeds up, this blood is pumped faster and more frequently to the extremities and the core.

Utilizing external yin/yang tools to create a balance of yin/yang in the body is not a new concept; Traditional Chinese Medicine and Ayurvedic Medicine have their roots in this. Centuries of wisdom is stored in these modalities and we are more complete when we integrate science with ancient intuitive and empirical wisdom. Equal and opposite produces balance. “Ice and fire” can help facilitate this balance in the body and mind and a massage therapy session with this technique can encourage wholeness.  

Method

The upper body corresponds to the Yang, while the lower body roots into the Yin. The body’s center is where the Yin and Yang meet. We begin with a full body coating of ice followed by cold towels placed on the upper body and hot towels placed on the lower body to encourage opposites and balance. We end with a full body hot towel placed from head to toe. This is all performed face down and when you turn over, face up, a warm towel is placed at the core (the body’s center) while ice is applied to the back of the skull and bottom of the feet. The massage is finished with warm coconut oil therapeutically applied to the body – neck, shoulders, arms, legs, and feet. 

CLICK HERE TO SCHEDULE AN APPOINTMENT

The Hook

What do organic kale, massage therapy and entrepreneurship have in common?

A taste for adventure, that’s what! C’mon, admit it, your first frittata with kale tasted a little bitter. Eventually, the rich, earthy and vibrant kale flavour grew on you.

Massage therapy can take you into many worlds – the travelling resort massage therapist or the adventurous cruise massage work filled with novelty and excitement. Bodywork can bring you side by side with extreme athletes and devout meditators; it can be therapeutic, relaxing, luxurious or rehabilitative.

Entrepreneurship, the “E Word” as I call it (in this sentence). If that doesn’t send a surge of adrenaline through you, you might need some more kale. Really though, entrepreneurship is a powerful force in local economies and has the potential to transform lives from the inside out.

My question here is this: did I hook you? Did the question about commonality spark your interest in the blog? How about the idea of adventure? Maybe you were drawn toward hyperbolic droll humour and comparing kale to pretty much anything else was enough to keep you going.

Whatever it was, presupposing that you are still reading, I needed to hook you in a matter of seconds to capture you as an audience.  Once you were captivated, I get a little more time and flexibility to offer my services in depth.

Enter: Farmigo. The online, local marketplace. This startup company captured my attention by appearing in reading material I respected and trusted. They then offered me an irresistible first-time promotion and explained succinctly that if I joined their community I’d have access to an easy-to use online marketplace for all the local, organic food I could hope for while supporting small farmers. Quickly, I saw an opportunity to capture my own audience and build my client base by utilizing their offer to maximize my reach.

This is how it went: Farmigo has beautiful and seamless online tools including a database cloud, metrics that track everything from activity to preferences and e-blast client marketing. Since I named my Farmigo community the name of my business, when Farmigo customers searched for communities in or near my area, my business popped up as their option – now I had an audience exponentially greater than I’d have alone. And, this audience was prime because they were most likely health conscious, community-oriented and looking to integrate small startup services into their lives. Perfect!

My approach was to create a synergy that fed itself -- and it worked. Farmigo’s platform is what they sell to both the farmers and the consumers. That meant so long as my clients were purchasing food, I had free access to all these tools instead of having to create my own. Farmigo became my hook and a hook that was exactly in line with the values and mission of my company.

Hooking my new clients was much easier now that I had a mouth-watering product to entice an interest. Food sells. Almost as good as sex. Everyone eats, but not everyone has come to understand the benefits of massage therapy. Statistically speaking, however, those who are interested in local, organic food also have at least an awareness if not an interest in the healing nature of massage. So I knew I was accessing my niche market, but I was hooking them with a tasty promise.

Also, even those interested in massage, may not be willing to make the financial and time commitments at first. But with Farmigo, there were no strings attached and a customer could purchase a fresh loaf of sprouted, organic bread for five dollars and never look back. Making sure they didn’t leave my office without looking back was where the work came in. Now that they were hooked, I could take that in depth time to sell them my core services. They already trusted us enough to purchase something and they made the trip out to pick it up so why wouldn’t they at least see what else was being offered to them?

After building a client base that was accustomed to having autonomy in their food choices with the online marketplace, I integrated more choice into how I offered my services. They could choose the frequency of their sessions, which modalities would be used and how they wanted to use their progress data to make health plans. In addition, after they purchased a certain amount of Farmigo products, they would begin accumulating credits toward discounted massage therapy and donations to one of three of our affiliated non-profits. They were able to choose which non-profits their donation went toward and whether or not they wanted to roll over their massage discounts into more donations.

As a perk of being the community organizer, I received discounted food and referral bonuses so after a little while I reaped back the costs of giving discounts on the massages. And, as I mentioned, the whole system fed itself. Farmigo was branching out with new customers, my clients were very happy to have quality and convenient products and services and my company was growing while being rooted in the values I found indispensable.

We are currently in the expansion phase – working with the non-profits to make real, positive impact and selling some of our own nutritional products in the marketplace – and our porch looks divine covered in leafy greens, lush loaves of bread, creamy cheeses and seasonal fruit. As one of my clients said last week as they floated out of their massage room, “your hands make me feel like I’m on a cloud of fluffy yum and now I get to go home with a bag of yummy treats, too”.

Productivity and Self Care

Click on the image above to be taken to a post from the Freelancers Union community. Link will open in a separate window.  

Click on the image above to be taken to a post from the Freelancers Union community. Link will open in a separate window.  

As massage therapists and health practitioners we are in positions of great impact and also great responsibility. Loads of misinformation abound. Cheap cliches on how to be happy and healthy litter Facebook and Pinterest. There's no more important time than now to be in the wellness field. It is with our passion, knowledge and dedication to helping people that major strides can be taken toward creating improved quality of life on deep levels. The question is, are we currently living this? If not, why? 

Procrastination is not just about watching TV instead of finishing a project, it can become a lifestyle and mindset. 

The importance of our skill set is massive, but only if it is being utilized to the best of our abilities. Are you passionate about working with cancer patients but find yourself part time at a spa? Maybe you love sports massage but are too scared to give up that steady accounting paycheck. Are you giving 1 massage a day because 2 or more and you'd be so drained you'd live on the couch the next few days? 

There are endless scenarios where our bodywork skills are not being maximized and both ourselves and potential clients lose out. 

The solution is to assess what our procrastination style is, make small but effective changes and integrate self care into our lives. 

We suggest by starting out reading the infographic link above. The Freelancer's Union is a great source because, after all, a lot of us are wellness freelancers.

So, read the link, figure out your style and jot down a tip you'd like to work on. Then, think about what your ideal massage career would look like:

How often do you work?

Where?

Who's your client? 

What does work-life balance mean to you?

Write the answers to these questions followed by one step you need to take toward it. 

Now you know what you want, how to begin the process and, most importantly, what stops you. 

Onto the self care. Sit back, deep breath with lots of acceptance for where you are at this moment and gratitude for all your potential. Part of giving is being able to receive and unfortunately bodyworkers are known for skimping on receiving their own bodywork. Receiving regular, consistent massage is imperative to a healthy career. We all know it, but we procrastinate! Apply your new procrastination style knowledge to this same situation. Don't bury your head, wait until body meltdowns or expect someone else will tell you when and what you need. Self care is about longevity, inspiration, rejuvenation and general well-being.

The time is now. Click below to set up your next massage. Take another deep breath and consciously choose to make those strides toward making an impact as a massage therapist

Learn More About Texter's Thumb (De Quervain’s Syndrome)

Texting has become more prevalent than most types of communication. Add to that all the time spent using the cell for other things, those thumbs are going to take a beating. 

The thumb is meant for gripping, not necessarily performing the complicated, repetitive movements that texting demands. Essentially what happens when De Quervain’s Syndrome, or ‘texter’s thumb’, is present is that the tendons get compressed within the synovial sheath (the tendon’s housing unit) which has become inflamed from repetitive stress. Pollicis brevis and abductor pollicis longus are the muscles that are connected to the tendons of the thumb. These muscles extend into the forearm and can even be responsible for referred pain into the upper arm, shoulder, back near the shoulder blades and the chest area.


De Quervain’s Syndrome is a form of tendonitis which is an inflammation of a tendon. Because of the inflammation, some symptoms may include a “popping sound” at the base of the thumb where a tendon nodule is popping in and out of the sheath. Also, pain and tenderness on the outside of the thumb and wrist. 

Over time the loss of grip strength can be permanent as the tendons are damaged and corroded from the compression. 

Not all texting is created equally. Sitting hunched over with just the thumb doing all the work is a sure fire way to walk into De Quearvain’s world. However, sitting erect so the shoulders are not rounded and putting added tension on the arm muscles can help. In addition, texting with multiple fingers can help disperse the workload. This may not be as efficient so limiting the amount of time spent texting is another option. Even texting with a smaller screen can help because the further the thumb has to reach (or flex and extend), the more stress is put on the joint. 

Massage therapy is also fantastic as a preventative tool as well as a therapeutic solution after the fact. By releasing trigger points and tension in the forearm and thumb muscles, the joint can move more freely. This will release compression of the sheath and thus reduce the tendon inflammation. 

For Texter’s Thumb Trigger Point Therapy, book your appointment here! We specialize in assessing and treating your overworked digit. 

Our New Location at 9 Corners Sports & Holistic Health

We are so happy to be part of the 9 Corners team! Take a peak below at pictures of this wonderful location including the waiting area and massage studios. To book an appointment with us at 9 Corners simply click here to be redirected to our scheduling service. Hope to see you soon! 

Click the image below to cycle through the slideshow.