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Communication and The Perfect Massage

I know we have discussed this before

Communication is the KEY to the perfect massage! It begins the moment you bring your client back to the room and it starts with three simple questions:

What areas would you like to focus on?

They will begin with the areas that bother them the most and then talk about the areas that are also giving them some trouble and then maybe mention areas they enjoy such as feet or scalp, this is your starting point, remember these key focus areas, they are your main focus during this massage session, all other areas are side quests.

What level of pressure do you prefer?

Here they may tell you they prefer medium but you can do harder if you feel that you need to, key word, if you feel that you need to. They are honestly hoping to avoid pain, so try to use techniques that can achieve the most success with minimal discomfort.

Or they may tell you they like it as hard as you can go, which may not be accurate, sometimes they think they can handle that until you really apply some pressure, always check in with the pressure and ask them if they would like more or less pressure, especially if you notice any signs of discomfort.

Sometimes I get people who are there for a Deep Tissue massage, and this is where some of my coworkers have been getting the most complaints lately. One of them who is new in the field recently asked me how I avoid getting complaints on my deep tissues, so let me first explain some of the complaints my coworkers have been getting on their Deep Tissue techniques to explain the problem here:

Complaint #1 The therapist did not use enough lotion, the massage did not have enough glide. It sounds like the client wanted what we often refer to as a Firm Swedish/Deep Tissue, which is really Swedish just a bit deeper, so more flow, less focus on the deep tissue.

That client would have been right up my alley because that’s more my speed, The therapist actually did everything correctly Deep Tissue massage usually uses less lotion and is more targeted work with less glide, the client was booked for the wrong service and should have been booked for a Firm Swedish Deep Tissue.

Complaint #2 (And I laughed so hard when I heard this one!!!) The massage strokes were too sloooowwwwww! Deep Tissue strokes are slower and with purpose to sink deeper into the layers of muscle tissue, truth be told most of my massage strokes are slow. Fast is usually more of a Sports Massage modality. Again the therapist did nothing wrong and honestly I don’t know how she and this client could have come to some understanding in this situation.

Most of the time when it comes to complaints about Deep Tissue massage it is either that it was too deep or not deep enough, this is where getting a good idea of their expectations and communication is most important.

So when my coworker asked me how I communicate with my Deep Tissue clients I told her I simply ask them “How Deep do you like your Deep?” Deep Tissue means many things to people, for some people it can mean “Elbows in Deep” or it can mean “Firm Hands Deep” and from the start I want to know which deep this client is expecting before I touch them. If I know their base level of expectation I can adjust from there once we get started.

That brings us to my third and final question before the session begins, and most important.

“Do you have any medical conditions that I should be aware of?”

Now I know that some of you reading this are thinking that they have already filled out a medical waiver form, well in some places they don’t fill one out or don’t have to, or they failed to mention things that they thought were not important. You would be surprised how many things people will share with their massage therapists that they wont even tell their own doctor.

During this time they may tell me about a car accident several years ago or some hip pain, cervical spine issues, or other minor problems they may be having that could be important factors in how I will tailor the session to their individual needs.

Communication During the Session

It is important during the session to check in from time to time, for example, if I have been working on a stubborn area of muscle tension I may check in and ask if the pressure is still ok.

When changing to a different area of the body I often ask if they would like the same level of pressure on the legs that they wanted on the back, sometimes people have different sensitivities on the extremities.

After I turn the client over I ask them how they are doing and if the table heat is alright before I begin working on the other side.

You cant please all of the people all of the time, but with good communication you will be able to please most of the people most of the time.

Yours in Health and Wellness,

Kristeen Anne Smart (Formerly Kish) CAMTC CMT

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“Pump and Dump” Another Toxin Myth

About those Toxins again…

Not long ago I heard a coworker say that he instructed a lactating client to “pump and dump” following her massage in case any of the “toxins released during the massage” may have contaminated her milk supply.

This was the first time I had ever heard this toxin myth taken to such an extent. I did not try to explain to my coworker that there are no toxins released during massage, mostly due to the fact that people believe what they were taught in their massage schools as fact and often become defensive if you tell them it is not true and unfortunately it is repeated in almost every massage book ever written therefor it must be true, even if it is not.

Thankfully there are a few well known massage authors out there like Laura Allen who are trying to bring some sense and science back to the massage field and dispel some of these myths, but it will take some time before the massage schools get the memo and stop teaching this to their students.

So I searched the web to see how common this new twist on the myth has gotten

These are a few of the posts about this subject that I found in various breast feeding forums from the web:

“She said I should dump the next two pump sessions because of all the toxins that come out after a massage. I barely produce enough for my lo and dumping anything makes me sad. Is this really necessary?”

“I got a 90 minute massage tonight. The massage therapist said that since I was breastfeeding, and she was massaging my lymph nodes, I should pump and dump at least for the next 12 hours, but 24 hours ideally. She said this is because the toxins now floating around my body can go into the breastmilk and cause DD to feel sick, not to mention I shouldn’t feed my baby BM with toxins in it.”

“Is it safe?? I’m getting my first massage today and I’m still breastfeeding. Just read that it could be dangerous because of the toxins that get released from your body and go into your breasts/milk — is this true? I’ve never heard of this. I will breastfeed right before my appointment but I’m I safe to breastfeed right after?”

“The masseuse informed me that I will have to drink a ton of water and dump at least 6 ounces from each breast until the toxins are removed. I Googled this to find that there is literally no research to back this up and that I CAN nurse her after all or pump and be able to use it. Does anyone have experience with this?”

“I had a massage today and the massage therapist told me to pump and dump for the next 24 hours because of the “toxins” that she released while massaging me. 24 HOURS??? Are you kidding? That’s over 40oz of breastmilk down the drain if it’s true. Does any one know for sure or know how I can find out? I would be bummed BIG TIME if I had to dump all the breastmilk down the drain. I will do it if I have to but a want a “second opinion”!”

I do not even know where to begin, other than to first apologize to these ladies for the misguided information they have been given, and especially to the one who was already struggling to produce enough milk to feed her infant.

I repeat NO Toxins are released by massage

None, zero, zip, zilch, nada! The only exception is that deep tissue massage might release some myoglobin which is not toxic but can become toxic if it builds up in the kidneys in large amounts, which is the real reason you should drink water after a massage.

I know that we all learned this toxin myth in massage school and many still believe it because they have not been educated otherwise,   this myth is harmful not only to our industry but clearly it is causing undo stress to these nursing mothers and may prevent other nursing mothers from getting massage treatments out of fear of these non existent toxins.

Lets spread the word, help educate other therapist and our clients that massage is safe for nursing mothers and their new born babies and that there is no need for them to sacrifice their precious milk over a silly myth about mystery toxins.

Yours in Health and Wellness,

Kristeen Anne Smart (formerly Kish)

CAMTC Certified Massage Therapist

 

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Migraine Journey Part 3: Update Feeling A Bit Better!

February was a challenge

The weather was unusual for Southern California, a lot of rain and overcast skies that often cause me a lot of light sensitivity and headaches.

My last entry detailed many of the ongoing days of struggle with the migraines and it was a bit chaotic but I decided to leave the entry exactly as it is because that is how my mind was working at the time.

I have been on the 100 mgs of Topamax for over a month now and using CBD oil daily along with Turmeric with Black Pepper and some Vitamin D (since I already know I am low on that) and drinking water.

I am trying to manage my migraines using as little over the counter or prescription pain relivers as possible due to the potential for rebound or over use headaches, this is a very real problem for many migraine sufferers.

Rebound or Overuse Headaches

Medication Overuse Headache

Medication overuse headaches have previously been termed “rebound headaches,” or drug-inducedheadache and medication misuse headaches. Medication overuse headaches are experienced more than 15 days a month for at least three months and have developed or markedly worsened during medication overuse.
And that brings us to the conundrum of the doctor saying “take this pill as soon as you feel the migraine coming on for full effectiveness.” If I were to take something every time I feel a migraine coming on I would run the risk of over use because there is not a day that goes by that my head is not threatening to turn on me, sometimes I can convince it to stay calm and work with me, but all it takes is a flash of light or a can of Axe deodorant spray and its on and popping!

I Promised You An Update….

So, I didn’t think the MRI would show up with anything strange, but you never know, so to rule things out before proceeding with treatment options it was best to have a look in there. Everything appears normal.

And since I have tried several Triptan’s I can be referred for the next treatment option after I try one more (because they have to say I at least gave them all a try) and then we can try Botox. The Doctor says many of his patients have good results with the Botox treatment.

As for March and my headaches, so far Zero ocular migraines and I have only turned to medication (not including the daily Topamax) three times this month, I have been able to manage it with the CBD oil most of the time… or, maybe the migraines have lessened due to the daily Topamax? That is very possible.

What Has Worsened? Photophobia! Oh Joy!

I am blessed to work in a dim lit environment, right? Well that has its disadvantages too! Coming out of the dim lighting and into the brighter hallway and then looking onto the computer screens for information on my next client can be painfully blinding, but not only that I have developed a new and even more entertaining migraine side effect, PHOTOPHOBIA!

I was fully aware that the light sensitivity and the way the headlights of oncoming cars and even the street lights and stop lights flare and hurt my eyes was a form of photophobia but now I have gotten to a point where the cell phone and computer screen are also painfully bright to me as well.

Walking down the hallway at work after coming out of a dark room I am now seeing the trim boards move like waves as I walk past them and returning to the dim lit room I now see not one but two massage tables briefly. I am able to adjust to the lighting in a few minutes with some time to focus but I feel as if I am becoming a vampire, suddenly preferring to come out of the building once the sun has completely set.

So, my obvious next step will be to see an optometrist, which is something I had been putting off since the migraines tend to effect my vision and it can change from day to day based on the migraine attacks. I will look into that this coming week.

In a Nut Shell

What seems to be working, the CBD oil and the Topamax, what does not seem to be working for me, the Triptans seem to help with the headaches about 50% of the time but really make me feel terrible, muscle pain and weakness and just an overall feeling that I do not like at all.

Another simple thing that I found on migraine forums is that in the UK the first line of treatment is 900 to 1,000mg of Aspirin taken with a Sugar Cola (sugar, not fructose corn syrup, so something like a Jones Soda or a Mexican Coke) and I have tried that twice now and both times it has stopped a migraine in its tracks.

I have since looked up the studies on Aspirin for migraines and there have been several peer reviewed studies where they compared 900 to 1,000 mgs of Aspirin to the Triptans and Placebo and found the Aspirin to be as effective as the Triptans, my Neurologist disagrees with that but the many studies shows this to be the case.

Last night I tried another in the Triptan family, within 30 minutes I felt my body get weak, I began to feel sick to my stomach, the pain in my head did not go away, in fact it got worse. I took some CBD oil and went to bed. I felt better this morning, but if the pain continues today I will simply use the Aspirin because I do need to function at work, I do not need to have my muscles effected by a my migraine medication.

I do hope that something along the way here may be of help to someone else that may be going through this or even to my daughter who is struggling with the migraines along with me. It turns out that there is indeed a genetic component to the condition and it unfortunately effects more women than men.

Most migraine studies have been largely conducted on men in the past but that trend is changing and I look forward to more research studies being done on women and more specifically on the hormonal triggers as that is often a very common trigger for many women.

Yours Always, In Health and Wellness!

Kristeen Anne Smart (formerly Kish)

CAMTC Certified Massage Therapist

 

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The Polaris Report vs the FSMTB Report on Human Trafficking

Human Trafficking and Illicit Massage Businesses

A few months ago the Federation of State Massage Therapy Boards (FSBM)  put out a task force report on Human Trafficking in illicit massage establishments (IM’s for short), however, there was some controversy within the massage community that some of their proposed solutions included regulations that would impact legitimate massage establishments.

You can read their full report here: https://www.fsmtb.org/media/1606/httf-report-final-web.pdf

The proposed suggestions that concerned various massage agencies include the following statements:

Evaluate the possibilities of a uniform, national accrediting body for massage therapy schools and programs.

Create a work group to study the efficacy of massage establishment regulation and serve as an informational resource for state boards on this subject.

Continue to develop its Massage Therapy Licensing Database (MTLD).

Amend the Model Practice Act to include a representative with a background in human trafficking to the composition of member boards.

Regularly report as much information as possible to the FSMTB Massage Therapy Licensing Database (MTLD) and query MTLD for every applicant and licensee as frequently as necessary for regulatory purposes.

Advocate to ensure its state school oversight mechanism includes programmatic or specialized approval review and a capacity to conduct follow up audits on the performance of massage therapy and/or massage and bodywork schools to ensure each school is meeting standards.

Encourage or require training of their massage board members and staff, in human trafficking, and familiarize themselves with human trafficking initiatives within their jurisdiction, state and federal laws, any current legislation on human trafficking, and other available resources.

Discuss the possibility of implementing massage establishment regulation, after the recommended Federation work group studying the efficacy of massage establishment regulations issues a report.

As you can see the FSMTB’s suggestions contain enacting changes to massage education and regulation in the hopes of stopping a problem that has absolutely nothing to do with legitimate massage establishments and could place an unintended burden upon our industry.

The Associated Body work and Massage Professional and The American Massage Therapy Association responded…

A link to the full response: ABMP & AMTA Response to FSMTB’s Report

The FSMTB is straying far from its mission in this report. It ignores readily available data from law enforcement and implies, wrongly in our opinion, that the massage therapy profession is responsible for ending human trafficking. AMTA and ABMP oppose the premise of the report. We reject both the misinformation it conveys and its perceptions about the responsibilities of the massage therapy profession.

Polaris, “A leader in the global fight to eradicate modern slavery” has issued its full report…

You can read the full report here: Human Trafficking in Illicit Massage Business

I encourage you to read the full report to get a better understanding of how wide spread this issue is and how the problem with human trafficking does not simply begin and end with the massage establishments but include an entire network  of organized deception and cohesion.

The following is a brief summary of the solutions proposed by Polaris (please read the full report for details on these suggestions.)

SOLUTION: Require transparency in business registration

Supporting Effective, Survivor-Centered Law Enforcement

Adopt an organized-crime approach, shift to increasing pressure on buyers by doing demand stings

Build networks of anti-trafficking law enforcement, code enforcement, and prosecutorial professionals

Closing Loopholes In The Commercial Real Estate Industry

Landlords can take responsibility to ensure human trafficking is not happening on their rental properties, and cities can leverage nuisance abatement laws to address those who do not.

Ending Online Practices That Legitimize Illicit Massage Businesses

Online review and “deal” sites should screen for IMBs

Shifting the Media Narrative to Increase Public Understanding, Decrease Public Tolerance

Media outlets must create policies to protect potential victims, and law enforcement must carefully frame press releases

Working Together to Ensure Victims Receive Robust, Culturally-Competent Services

Nationwide safety net: Key pieces of this coalition safety net include: • Culturally humble, trauma-informed interpreters• Attorneys• Job training

Polaris offers a more inclusive solution

Instead of focusing only on how the massage establishment can enact changes to help regulate IM’s by putting further regulations on the massage industry alone Polaris offers solutions that offer a focus ranging from public awareness, business compliance, a shifting of the media focus, as well as victim support and job training.

There is so much more that I would like to discuss about the Polaris report. Once again I highly encourage you to read the full report.

 

Yours in Health and Wellness,

Kristeen Smart aka Kristeen Kish
CAMTC Certified Massage Therapist

 

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What is Firm Swedish?

The other night at work an Esthetician asked me “What is Firm Swedish?”

One of my massage therapist coworkers was in the break room with us at the time and turned to hear my response…

I began to try and explain that it is a Swedish Massage with a firmer pressure, then I said “ok, realistically it is a gentle  Deep Tissue because Deep Tissues by definition is accessing the deeper layers of the muscles instead of just the superficial ones and I have no idea why we even bother muddying the waters with all the various terms we use.”

My coworkers eyes widened and she said “You are right, Swedish is gentle and relaxing, its not supposed to be firm pressure.”

Firm Swedish is for people wanting more of a Deep Tissue therapeutic effect without the pain or discomfort often associated with Deep Tissue massage

In all honestly there is not a lot of difference between the stokes, moves, and methods that I would use during a Firm Swedish Massage and the ones that I would use for someone asking for Deep Tissue.

In fact many of the Firm Swedish massages that I do end up being Deep Tissue work and some of the Deep Tissue work that I do ends up being more of a Firm Swedish depending on the need and tolerance level of my client.

Pressure is subjective!

We then discussed how all these words “Firm” “Deep” “Light” and “Medium”  are all subjective and vary widely  from not only the clients but the therapists as well.

One client’s idea of medium pressure is another client’s idea of deep, some say light when they really want medium, and some say light when they want feather light pressure.

My idea of light may be too light for some or too heavy handed for others, each persons perception of pressure is different and each therapists idea of pressure is different.

I find its easier if the client says something like “I want results but I don’t want to be put in pain” or “really go to town on those shoulders” or “please no elbows” to give me a better idea of what it is they are seeking. Communication is always the key to getting the massage experience that you desire.

Deep Tissue Massage Does not have to be painful!

If you search the internet about Deep Tissue massage you will find that page after page all state “Deep Tissue does not have to be painful to be effective.”

Unfortunately many people believe in the “no pain no gain” concept, this includes many Massage Therapists.

The idea that you have to tolerate a painful session because “you really need this” is not correct. If you are wincing, flinching, or tensing up then your muscles are not going to be able to relax and it may be counter productive to the goal of getting your muscles to loosen up.

Of course there will be people who will argue that point and say that the muscles will feel better after two or three days because of the painful deep pressure, that too is valid in the fact that eventually the muscle will tire and weaken and the result will be less tension due to the muscle exhaustion.

That being said there have been cases of injuries from Deep Tissue massage, there is a point where too much is too much. There is  also a condition called Rhabdomyolysis or Rhabdo for short that can result from muscle crush injuries.

Muscles store myoglobin, when too much myoglobin is released into the body it can become toxic when it reaches the kidneys. This is one of the main reasons why you should drink plenty of water following a massage to help flush that away.

Release of Myoglobin from massage has been found in a study to reduce the pain and discomfort of myofascial pain syndromes with surprisingly positive results:

https://www.ncbi.nlm.nih.gov/pubmed/3462906

A positive correlation was found between the degree of muscle tension and pain, and the increase in plasma myoglobin concentration. After repeated massage treatment a gradual decline in the increase in plasma myoglobin concentration could be demonstrated parallel to a reduction in the muscle tension and pain.

So  there is definitely benefit to getting Deep Tissue massage for people with muscle pain, the same can be said for Firm Swedish which is simply another form of Deep Tissue therapy.

We can honestly only go so deep

There are times when we get a client who wants the deepest, hardest, and most painful massage that we can possibly give them.

For whatever reason that client feels the need to have it hurt, whether it is because they believe it will be more effective or because they cannot quite feel how much pressure is actually being given I am not sure.

When a client is clearly seeking a sensation of pain we do our best to try and use pressure points to provide them the sensation they seek without causing damage to the muscles  tissues and bony structure, however, there are times when we simply cannot go any harder or any deeper.

In closing, to sum things up…

Firm Swedish is simply a more gentle form of Deep Tissue Massage. Deep Tissue Massage does not have to be painful to be effective.  Areas that are more tense may be a bit painful but it should be a “good hurt” and not a “bad hurt” or overly painful experience.

Whatever it is you are seeking from your massage experience it is best to communicate your needs, concerns, and areas that you want to address as well as areas that are more sensitive to you so that we can offer you the massage experience and effect that you are seeking.

Yours in Health and Wellness,

Kristeen Smart aka Kristeen Kish

CAMTC Certified Massage Therapist

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Should You Get a Massage When You Are Sick? NO!

Tis the Season, the Cold and Flu Season

Should you get a massage when you are sick, NO absolutely NOT, for oh so many reasons…

Risk of spreading the illness to others

Many people who are seeking massage treatments often have other health concerns. When you come  into the treatment area please be aware that some of the clients have autoimmune conditions and cannot easily fight off infections or illnesses, some are elderly, others are recovering from cancer treatments or other serious medical conditions. Please keep this in mind.

Risk of getting your therapist sick

Your massage therapist will be stuck in a room in close proximity to you, your sneezing and coughing will disperse germs into the massage room, the bedding your therapist will be changing, and the massage equipment.

Your therapist will then be exposing all of the other clients to the illness.

Risk of making yourself feel worse

Your body is already busy trying to recover from the illness, you need rest and fluids. A massage may feel comforting but it may actually increase some of your symptoms by overstimulating your autonomic nervous system.

This has been a tough cold and flu season

You can help prevent the spread of illness by limiting the exposure to others around you. Please do not hesitate to reschedule your appointment if you believe that you may be sick.

Get well soon!

 

Yours in Health and Wellness,

Kristeen Smart AKA Kristeen Kish
CAMTC Certified Massage Therapist
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When in Doubt Refer Them Out

At the college that I attended it was impressed upon us not to be afraid to refer a client to a doctor.

We are not allowed to diagnose, even if we know exactly what it is we are seeing it is out of our scope of practice to tell them what we suspect, but we are well within our scope to suggest or even encourage them to see a doctor or specialist.

Years ago I had a co-worker who told me she would never refer or suggest that someone should see a doctor

She did not believe that referring clients to a doctor is our responsibility as Massage Therapists, I said to her “but we are in a unique position to see areas of their body that they cannot see and conditions they may not be aware they have.” We have a responsibility to our clients to make them aware when something needs to be addressed by a doctor.

Depending on the situation or condition I might say something to the effect of  “you should have a dermatologist check this out” or “it might not be a bad idea to have a doctor take a look at that.”  They may ask you what you suspect or why you have made that suggestion, be careful not to cross the line into diagnosis, try not to sound alarming while at the same time let them know that it is a good idea to have it looked at to rule out any issues.

If it is something so concerning that you do not feel comfortable massaging the area or continuing the session then explain to them that you do not feel comfortable working on that area until it has been seen by a doctor, this could be anything from a suspicious rash to a suspected muscle tear or injury. You are well within your scope of practice to refuse to treat any area that you believe may cause further damage or injury to the client.

What if it ends up being nothing serious?

Well great! Both you and your client will feel better knowing that it was nothing serious, but what if you said nothing and it was?

The other night a client that I last saw a few months ago came in for a massage and said to me:
“I wanted to thank you, you saved me!” he said “You suggested I should see a dermatologist, and you saved me, it was stage one aggressive malignant melanoma”

They were able to diagnose and remove the cancer before it had a chance to spread and he is now being monitored regularly to make sure that it does not return.

This was not the first time someone thanked me for suggesting they should see their doctor or specialist, but it is the one that will forever reinforce my position on referring clients to a doctor or specialist.

We are in a unique position to help others

That is what we do, it is who we are! Don’t be afraid to speak up if you feel that your client should see a doctor, if you are wrong then you both gain peace of mind, and if you are correct you might just save a life!

 

Yours in Health and Wellness,
Kristeen Smart AKA Kristeen Kish
CAMTC Certified Massage Therapist
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Massage Tools and Liability Insurance

A cautionary post for fellow Massage Therapists and Student

I research things as I become curious about certain subjects, one of my recent curiosities was about a product which got me searching for more information on tools and liability insurance because I know that not all tools are covered by all liability companies and I usually search mine to find out what is excluded, but new products raise the question of what actually is included.

Personally my advice to anyone using any tools or exotic modalities would be to contact your liability insurance and ask about coverage just to make sure. I know that some insurance companies do not cover hot stones while others do not cover cupping, and many insurance companies strictly exclude T-bar use.

In my opinion we need to be diligent in making sure that what we utilize in our practice is covered. That being said I did find this post and thought to share it with you.

https://www.ctha.com/Forums/?b=21206

Massage Tools and Insurance

Hi Everybody!

Do you use any supplemental tools when massaging and do your insurers know this? If so, what are their requirements for insuring you to use that tool: an accredited course, confirmation of reading all the instructional material, paying an extra ‘tool-use’ supplment or something else?

I have been asked to write an article about this relevant topic as an ‘expert’ on massage tools (I designed and sell a massage tool called ‘The Kneader’ for both general public and professional therapist use).

Recently, I gave a workshop on our new venture, which is Kneader On-Site Massage. Only Level 3 on-site therapists attended, as it was to gauge if they liked On-Site Massage with the Kneader as much as we do. Thankfully, they did and they all bought 1-2 Kneaders in preparation for our Kneader On-site Massage course, which is hopefully going to be this summer.

One of the therapists contacted her insurers at CThA to make sure she was covered to use the Kneader, in the meantime, as a supplemental tool. They said she was not insured until she took an accredited course on how to use the Kneader (again, even as a supplemental tool during a standard massage treatment). This was not good news as lots of therapists have been buying and using the Kneader as a supplemental tool for several years now! What ensued was nearly two months of deliberation on the Kneader – my argument being that the product comes with a comprehensive manual and DVD and there are loads of clips and instructional material on our website and YouTube.

Thankfully, the CThA insurers have been very thorough and accommodating and have now confirmed that all their therapists are insured to use the Kneader as long as they have reviewed the manual and DVD and use the tool in accordance with the product’s instructional material. It’s a start but this is only one insurer of many and they are all of the same view (I’ve checked around) – if you use a tool (any tool), you need to take an accredited course in it to be insured when using it. I have queried about ‘one move’ tools like Bongers, The Knobbler and Omni Ball – if a tool only does one thing, how can you warrant doing a course in it? Massage tool use is on the rise in the industry, because therapists are always looking at ways to improve their treatments and their working lives. Subsequently, how many therapists are using tools to save their hands or enhance their treatments without realising that they are not ensured to do so? It’s a question that I fear a lot of therapists have not even considered and run the risk (however small) of being caught out on.

I would be grateful for any input and will post the article once it is published for your consideration.

In the meantime, all the very best!

Una
Kneads Must

We love to provide our clients with the best that we can offer them but we also need to always remember to protect not only our clients but our practice as well by making sure that our insurance coverage meets our needs when it comes to our services and products.

Yours in Health and Wellness,

Kristeen Smart AKA Kristeen Kish
CAMTC Certified Massage Therapist
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Psoriasis And Massage

This is a topic that is near and dear to my heart

My Grandmother has psoriasis over 100% of her body and she suffered for many years with psoriatic arthritis which is the most painful and debilitating form of arthritis.

The following article discusses the benefits of massage for sufferers of psoriasis:

http://www.everydayhealth.com/psoriasis/living-with/massage-for-psoriasis-is-it-safe/

Massage for Psoriasis: Is It Safe?

Massage is great for reducing inflammation and stress, two key benefits for people with psoriasis. Here’s how to get a massage that’s right for you and your psoriasis.

A therapeutic massage session can reduce inflammation and provide stress relief. Both are welcome benefits if you are one of the 7.5 million Americans who has psoriasis — a chronic skin condition that causes scaling and inflammation.

A study of male bicyclists in the February 2012 issue of Science Translational Medicine showed that massage helps reduce inflammation and promotes the growth of new mitochondria, the energy factories of the cells.

As many as 30 percent of people with psoriasis also have psoriatic arthritis, which causes persistent pain in the joints. Massage has been shown to relieve joint pain.

So you want a massage and you have psoriasis. Do you need to do anything special for bodywork with this condition? Not really, but here are a few ideas you might want to keep in mind:

Tell all up front. The National Psoriasis Foundation suggests that when you call for your massage appointment, you tell the receptionist you have psoriasis. “You can ask if they have a therapist who has worked on or is comfortable with people with psoriasis,” said Winona Bontrager, president of the Lancaster School of Massage in Lancaster, Pa., and president of the American Massage Therapy Association. You can find a qualified massage therapist in your area on the AMTA website.

“It’s not contagious.” Massage therapists should know that massage and psoriasis can be a good idea, as psoriasis is not contagious, Bontrager noted. “But it’s not a bad thing to make sure your therapist knows she can’t catch it from you.”

Go gently. Injuring your skin can cause your psoriasis to flare. Your therapist might want to avoid areas that are red and inflamed. “There’s nothing the therapist has to avoid per se,” Bontrager said, “but I tend to do something that’s less intense when someone wants a massage and has psoriasis.”

Ask for a Swedish massage. A Swedish massage includes long strokes and kneading. Swedish massage can increase circulation and stimulate the lymphatic system, a major part of the immune system. “A Swedish massage can help your immune system to make sure everything is moving,” explained Bontrager. Other types of massage that may work for people with psoriasis are deep tissue massage, reflexology, shiatsu, and acupressure. Talk with your massage therapist about which will work best for you.

Bring your own oils. Bontrager said she’s used many different kinds of lotions and oils and never had anyone say, “Oh, that’s not comfortable.” But if you have moisturizers and skin oils that help your psoriasis, you might want to bring them and ask your massage therapist to use them.

Avoid inflamed joints. If you have psoriatic arthritis and your joints are hot and inflamed, tell your massage therapist. The therapist should avoid the joints that are actively inflamed. Otherwise you may benefit from whole bodywork when you have psoriasis or psoriatic arthritis.

Paying for Bodywork for Psoriasis

On average, a massage costs about $60 an hour, though costs vary considerably depending on where you live. Will your insurance cover massage if it’s therapeutic? “That’s so individual,” Bontrager said. “If people are getting massages prescribed by their physician, the likelihood of getting them covered is greater.” You should check with your health insurance provider.

Massage Safety for Psoriasis

Massage is generally safe for people with psoriasis. Massage has the benefit of not only stimulating your circulation and reducing inflammation but also providing stress relief. “Lots of people fall asleep or doze off a little when they’re getting a massage,” Bontrager said. “That’s how relaxing it can be.” Massage is great for stress relief, and when it comes to massage and psoriasis, you may appreciate that.

Based on my personal experience with psoriasis I would like to further expand on this:

Having lived with my grandmother I came to understand more about just how fragile her skin was. With psoriasis the skin is frequently dying and regrowing which leaves it weak and prone to tearing, sometimes simply bumping into something was enough to tear my grandmothers skin open, conversely her skin regenerated so rapidly that her tears healed up very quickly as well.

The article pointed out that the massage should be Swedish and gentle, the article also states that “there is nothing a therapist has to avoid per se” but I would caution you to keep in mind that depending on the severity of the psoriasis certain techniques such as Myofascial Release where there is stretching and pulling of the skin could cause weakened areas of the skin to break open, so please treat effected areas with caution.

In most cases of psoriasis the client usually has only some effected areas to be cautious with, in my grandmothers case it was her entire body. The skin may be sensitive so check with the client about any products you may wish to use or have them bring in whatever they use.

My grandmother used Aquaphor to condition and repair her skin but coconut oil would also be a good choice to use for the massage as it is natural, conditioning, and antibacterial.

It is advised not to massage during an arthritis flareup as you may further irritate the already inflamed tissues, avoid areas that are red or hot to the touch.

I would also like to point out that many PPO insurances DO cover medical massage with or without a prescription from your doctor, so if cost is a factor for you consider going to a Chiropractic or Wellness center that offers massage billing to insurance companies.

Yours in Health and Wellness,
Kristeen Smart AKA Kristeen Kish
CAMTC Certified Massage Therapist
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Cortisol, the “Evil” Stress Hormone

Cortisol and weight gain:

The other night I was having a conversation with a client who is struggling to lose weight and she stated that her cortisol levels are too high. This is a common problem for many of us.

As she and I were talking I realized that cortisol has its benefits

I got to thinking about why our cortisol rises, situations in which we might need what that hormone has to offer us. What is it about stress that would cause this need for a hormone that stores fat and keeps us awake at night? SURVIVAL!

I laughed and said to my client “Skinny people do not make it on Survivor” she laughed and agreed, yes that fat storage has its place in times of great physical stress such as famine, drought, and threat to our psychical survival.

Why does our body react to emotional stress the same way it would physical danger?

Our bodies cannot distinguish between a physical threat of harm and an emotional one, to the body it is all the same, your mind perceives ALL STRESS as if you are in danger and must prepare to survive, it really is that simple.

Lets take a look at the Pros and Cons of this “evil” hormone:

The following article has a lot of information on cortisol and its physical effects on the body http://www.fitness4her.com/the-pros-and-cons-of-cortisol-the-key-to-fighting-belly-fight/

Cortisol is a hormone in the body that is secreted by the adrenal glands and provides for the following functions:

  • Proper glucose metabolism

  • Regulation of blood pressure

  • Insulin release for blood sugar maintenance

  • Immune function

  • Inflammatory response

  • A quick burst of energy in times of fight or flight.

  • Heightened memory functions.

  • Boosts the immune system.

  • Lowers sensitivity to pain.

  • Helps to maintain homeostasis in the body.

Often referred to as the stress hormone because of the high levels of cortisol released in the bloodstream when the body is enduring a great amount of stress, too much cortisol can cause problems with your health such as:

  • Increased belly fat which is associated with a greater amount of health problems.

  • Impaired cognitive performance.

  • Suppressed thyroid function.

  • Blood sugar imbalances like hyperglycemia.

  • Decreased bone density.

  • Decreased muscle tissue.

  • High blood pressure.

  • A lowered immune system.

  • Higher levels of cholesterol.

In the first list you will see that it helps to maintain homeostasis, regulates blood sugar, improves immune response and other things that are beneficial to survival. The second list are the unfortunate side effects of cortisol when it is not needed for survival.

So how do we minimize cortisol resulting from stress?

The article goes on to describe several ways to help minimize the negative effects of cortisol:

The key to keeping cortisol production at a healthy level is relaxation.  As a matter of fact, proper rest is vital to the body’s well being. Getting 8 hours of sleep rather than 6 can mean a reduction in cortisol of up to 50%. Other ways of reducing cortisol are:

  1. Meditation and prayer can cut cortisol by as much as 20%.

  2. Listen to some of your favorite music to cut cortisol by nearly 65%. Fill your iPod with some new tunes and take a walk to lower stress and reduce belly fat.

  3. Sip black tea. As it turns out, enjoying an afternoon tea has many health benefits such as reducing cortisol by about 45%.

  4. Attend church or other religious service and reduce cortisol by 25%.

  5. Do something nice for someone to reduce cortisol levels by 20%.

  6. Go for a massage. Let a professional work out the kinks of built up stress and stiffening of the muscles. It can reduce cortisol levels by 30%.

  7. Hang out with a fun loving friend. Someone you can laugh with and enjoy your time with, you’ll reduce cortisol by up to 39%.

  8. Have a romp in the bed with your lover. Increased stress and cortisol can boost your sex drive, so why not take advantage and enjoy some love-making, you’ll reduce stress and cortisol levels, while burning about 70 calories in about 30 minutes.

  9. Exercise regularly. By maintaining your exercise program, you’ll regulate cortisol levels and reduce stress and help to lower blood pressure.

  10. Put stress in its place. Life’s challenges are sure to follow us but we can take charge of how we handle them and not let them control us. Enjoy life and preserve your health and happiness.

In Summary:

Cortisol is necessary for human survival, unfortunately stress can trick the body into believing it is under physical threat causing it to produce more cortisol than is needed. Meditation, massage, exercise, and learning to control your stress can help you to reduce cortisol naturally.

Yours in Health and Wellness,
Kristeen Smart AKA Kristeen Kish
CAMTC Certified Massage Therapist

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