A Little About Myself… Setting the Record Straight

Who is Kristeen Smart? aka Kristeen Kish aka Kristeen Narlock?

Hello, some of you already know me and know many things about me and about my life and have followed my journey from Nursing Assistant to Massage Therapist.

Due to an ongoing cyber stalking and harassment situation I feel the need to share a bit more about myself and state for the record my qualifications and address the lies that have been posted publicly about me.

I grew up in a small town in Washington State

I was born in a Naval Hospital and grew up not far from the Navy Base in a small town on the Bay over looking the mothball fleet of ships in the Puget Sound.

My birth name is Kristeen Anne Smart.

I am a beach bum at heart and spending hours searching the shores for trinkets and treasures of shells and rocks was my passion from an early age.

At a young age I was a member of the Medical Explorers Post on base where I was first introduced to health care and medicine as well as instructed in the use of CPR and First Aid.

As an adult my passion for helping others led me to become a Nursing Assistant in 1992 in Washington State, 1993 in the state of Wisconsin, and 1998 in the state of Oregon until the year 2012 when I allowed my license to expire after moving to California to peruse my career as a Massage Therapist.

Names I held licenses under as a Nursing Assistant  were Kristeen Anne Narlock (1st husbands last name) in the states of Washington and Wisconsin and in the state of Oregon Kristeen Anne Narlock until my second marriage when I became Kristeen Anne Kish. In 2017 I legally resumed the use of my maiden name Kristeen Anne Smart following my divorce.

During those years I worked in Nursing Homes, Assisted Living Facilities, a Group Home for Children with Developmental Disabilities, An Independent Living Apartment for Quadriplegics, a Senior Day Center, and Home Health Care.

Over the years I have had extensive background checks and have been fingerprinted, licensed and bonded in several states. I am currently on live scan.

I held Nurse Delegations as a Medication Aide in two Assisted Living Facilities, one Day Center, a Group Home, one Independent Living Apartment, and Home Health from the year 2000 until I left the state of Oregon in October of 2011.

My delegations included medication administration, medical records and documentation, diabetic testing and injections, epotin injections, wound care, catheter care including insertion and removal, bowel care, trach care and suction, and tube feedings.

My licenses and certifications are as follows:

1992 and 1993 Nursing Assistant Registered Washington State

1993 to 1999 Certified Nursing Assistant State of Wisconsin

1998 to 2012 Certified Nursing Assistant State of Oregon

2010 to 2012 Certified Chiropractic Assistant State of Oregon

2010 to 2012 Licensed Massage Therapists State of Oregon

2012 to Current California Certified Massage Therapist

My Stalker claims that I am unlicensed and uninsured, as you can see I am licensed and all of this can be verified. I have also maintained professional liability insurance since becoming a Massage Therapist with no lapse in coverage since graduating college in February 2010.

In 2009 I made the decision to go to school for Massage Therapy

In many of my jobs as a Nursing Assistant I worked in co-operation with Physical and Occupational Therapy departments where I was trained in Range of Motion Therapies and Ambulation to assist in recovery.

I enjoyed that aspect of helping others so much that I decided to peruse a career in Massage Therapy. It has always been my goal to remain in a field of health and wellness where I can continue to help others.

From 2010 to 2012 I held three licenses in the state of Oregon, Certified Nursing Assistant, Certified Chiropractic Assistant, and Licensed Massage Therapist.

From 2012 to current I have held and maintained Massage Therapy Certification through the California Massage Therapy Council in good standing.

In my many years in the field of Massage Therapy I have had the opportunity to work with people suffering from chronic pain disorders, skeletal defect, auto accidents, and work related injuries.

To me there is no greater satisfaction than helping others and the experiences that I have had both as a Nursing Assistant and as a Massage Therapist have been priceless to me.

As for the allegations being posted about me online…

First one must consider the source, a spiteful woman who poses as an “activist” online and has nothing but time on her hands.

My stalker has a history or court actions revolving around her ongoing stalking and harassing of people whom she has met on social media and has a list of victims of her harassment in several states across this nation and far more who have not come forward.

She once publicly announced on a talk radio show that she was being “stalked and harassed by 20 woman on facebook” when in reality she was the one who was stalking and harassing at least 20 women on facebook. I have court documents supporting this.

I have already faced this person and her wild accusations in a court of law and proved by “preponderance of the evidence” (as stated by the judge) that her allegations have absolutely no merit, yet she continues over a year later to make her accusations.

She claims that I lied about being CPR and AED certified

In the state of California it is not required of a Massage Therapist to obtain nor maintain their CPR certification, I do it because I want to and because it leaves open the possibility of working at other jobs that may require it.

In the state of Oregon it is a requirement for massage therapists, and while working in Oregon I always maintained my CPR/AED/ and First Aid certifications.

Recently an opportunity to take not only the CPR and AED certification but also First Aid literally fell into my lap through a city program for disaster readiness at a remarkable price, and it just happened to be on one of my rare days off! How could I possibly let that pass me by? So once again I am CPR/AED/First Aid Certified.

She claims I lied about my credentials

Now this one is seriously grasping at straws! In 2016 my cyber stalker found a listing online that erroneously listed my qualifications as a “nurse and nurse practitioner” (see link below.) This content was compiled without my knowledge or approval and had images and information obtained from my linkedin profile.

I have never professed to be either a Nurse or a Nurse Practitioner either online or in person and have always been honest about my credentials, licenses, certifications and professional delegations, once again all of my licenses can be verified by the issuing states.

40 Licensed Massage Therapists in Santa Ana, CA Directory

As you can see from the others listed there many have strangely exceptional credentials including Lawyers, Chiropractors, and Investment Bankers. Apparently we have some highly over qualified Massage Therapists in the area! All joking aside that listing is from a Radaris based search engine that takes information from your Linkedin profile and compiles it into a listing that you have absolutely no knowledge of or control over.

Not to mention the simple fact that no one in their right mind would be searching for a “Nurse” or “Nurse Practitioner” on a list of MASSAGE THERAPISTS, just stating the obvious here!

The listing about me stated my credentials as:

Massage Therapist Wellness and Fitness Licensed Massage Therapist Massage Therapy Nurse Nurse Practitioner Independent Contractor Contractor Independent Business Owners

Once again, just to be clear, this content was not created nor sanctioned by me in any way.

This woman then contacted my employer repeatedly in emails and via telephone claiming that I was advertising myself as a Nurse and Nurse Practitioner based on that listing and demanding that they fire me and threatening them with complaints to the better business bureau. They did not fire me so she then followed up with several phone calls harassing the company. This is exactly why I no longer state where I work anywhere online.

I contacted Radaris to have the listing removed. The profile in the listing has been removed at my request but the preview remains, they do not or will not remove the preview but they did as I requested and removed the profile in the link. Click on it and you can see for yourself the big bold words that read “NOT FOUND.”

Since then she has used this as her sole basis for all of her claims that I am passing myself off as a Nurse and Nurse Practitioner and she also claims that my participation in a Q&A site online called Quara is “practicing medicine without a license.”

Quoras Terms of Service CLEARLY state the following:

Content posted by Medical Contributors is not intended to be medical advice or instructions for medical diagnosis or treatment, and no physician-patient relationship is, or is intended to be, created by Content provided by Medical Contributors.

I hope that this clears up any misinformation being spread about me the internet. If you have any questions feel free to contact me!

Yours in Health and Wellness,

Kristeen Anne Smart aka Kristeen Kish

CMATC Certified Massage Therapist

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How To Get The Perfect Massage

Getting the perfect massage begins with communication

A good establishment will want to put the client with the right therapist. Every client has different needs and expectations and every therapist has a different specialty or approach to their massage style.

The receptionists get a lot of feed back from the clients and are happy to recommend the therapist who may be the best fit for you based on the information that you provide them about what you are seeking in your session.

Let them know if there are things you prefer, such as Deep Tissue, Stretching, Trigger Point Therapy, or a Gentle Relaxing Swedish Massage, or anywhere in between.

If you had a favorite therapist who has left the establishment or moved away feel free to ask if there is another therapist with a similar style.

The staff wants you to have the best possible experience and will do their best to match you with the therapist who’s skills seem closest to what you are seeking in a massage therapy session.

When you meet your therapist

Usually the Massage therapist will ask you a few questions before the session, I usually ask if there are any areas that you want to focus on and what type of pressure you usually prefer.

This is a good time to briefly explain any areas that have been bothering you, areas to avoid such as face and scalp, and any areas that you particularly enjoy having extra focus on such as the feet or head and scalp.

It is also a good time to discuss any injuries, surgeries, or areas of muscle tension or concerns.

Feel free to ask questions, also if you prefer no talking during the session let your therapist know that and they will try to keep the session as quiet as possible other than to check in with you about the pressure.

Sometimes we find something that we want to discuss with you such as ways to minimize the discomfort or some self help tips that you can do at home, but we can discuss our findings with you at the end of the session if you would prefer not to be disturbed during the session.

Many clients enjoy learning ways that they can manage their own areas of concern and we are always happy to give you after care and home care suggestions.

Some complaints that I sometimes see in online reviews:

  1. “The Therapist didn’t massage my face”
  2. “The massage was too hard and painful”
  3. “Therapist was too chatty”
  4. “Not enough time spent on my problem areas”
  5. “I wasn’t offered a robe or hair tie”
  6. “I asked for LIGHT pressure not therapeutic massage”
  7. “Paid for two hours and only got an hour and forty minutes”

The above quotes are a few of the more common complaints that I see in online reviews of various establishments.

I looked at reviews from several local spas both high end and chain establishments to find some examples where communication seems to be the biggest problem, so lets go through these individually….

  1. Client expected that all massage sessions include face massage. Personally I usually do not do face massage unless it is requested because not everyone likes or wants their face massaged. Some do not want the oils or lotions to clog their pores, or they have make up on, or simply do not want their face touched. If face or scalp is something you enjoy and expect in your session be sure to mention it to the therapist, your therapist will be happy to add that to your individual session.
  2. The massage being too hard and painful, first of all you do NOT have to grin and bear it, if it is too painful tell your therapist, if the therapist continues despite your wishes it is your right to end the session. You are always in control of your massage session.
  3. The “chatty” therapist, this one is more complicated because there are several different scenarios: The therapist may be sensing that you are uncomfortable and trying to engage in small talk because he or she is trying to put you at ease. The therapist is asking questions such as “What do you do for a living?” or “Do you work out?” to better understand your muscular condition to give you the best treatment and advice for after care. Or the therapist is simply friendly and outgoing and does not seem to understand that you simply want a nice quiet session. Communication in this case begins with saying “Can we discuss this after the session?” or “I just want quiet during my massage thank you.
  4. Not enough time spent on area of focus. Again this could be for a number of reasons such as the therapist has found that other areas are effecting the area of focus, such as muscles of the opposing side pulling on that area. Not enough time for everything, an example of this is the client who’s areas of focus are “stiff neck, tight shoulders, sciatic down right leg, tight hamstrings and calves.” That’s an entire laundry list of things to try and adequately effect in a short period of time. The communicative solution to this would be to focus on the main areas and skip the full body or certain parts such as arms and feet, however, if you feel that your therapist is simply not listening to you then bring this to the attention of the reception staff, they  will be more than happy to accommodate you and suggest a therapist who is more suited to your needs.
  5. Was not offered a robe or a hair tie, I assume when I see such things in reviews that the person writing the review is used to high end spas where you wear a robe because you will be leaving from one area to another before and after your session, in a day spa setting that is only done when you are going to be having dual services in different rooms that day, otherwise you will be alone in a private room where you can dress and undress in private, a robe is not necessary in such settings. The hair tie, yes high end spas usually have those and sometimes in day spas the therapist will provide them as well, but it is often best if you bring you own, but if you forgot to bring one we can always place a towel over your hair to protect it from the oils and lotions.
  6. Asked for LIGHT pressure but got therapeutic, the main problem here is that light, medium, and deep are all very subjective words. One persons idea of light is another persons idea of medium or firm. As for therapeutic, all massage is therapeutic in some way, that being said some therapists (myself included) cannot always control what your body is telling our hands to do and the impulse to give you what you need. It is best to speak up and remind the therapist that you asked for a light pressure and simply want to relax, I had a client who once said to me “I know I have knots but today I want you to ignore them and just pamper me.” I think that’s the best way to respond when you feel that your therapist is getting too focused on problem areas.
  7. THIS is the biggest complaint that I see, this is a miscommunication that is typical in most spa settings “I paid for an hour and only got 50 minutes.” “I was shorted 10 minutes on my massage.” “I paid for two hours and only got an hour and forty minutes.“In a typical spa setting both high end and day spa its is common that an hour session is 50 minutes hands on and 5 minutes before and after for you to dress and undress as well as the brief intake in the room. The two hour sessions can vary from establishment to establishment, in the case of the one I quoted above some of these spas bill a two hour as two fifty minute sessions making your session a 100 minute session, some places are careful to call it what it really is a 100 minute session, a 50 minute session or an 80 minute session. This miscommunication in my opinion falls squarely on the establishment for not being clear to the client about the real time length of the massage. These times are set in respect to time billed as well as to give the therapist time to clean and change the room over for the next client.

The Key to the Perfect Massage is Communication

From the moment that you set up your appointment to the moment you check out the key to the perfect massage is communication to get the therapist that is the best fit for your needs and the massage session that you prefer.

Yours in Health and Wellness,

Kristeen Smart aka Kristeen Kish

CAMTC Certified Massage Therapist

 

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Your Massage Session, What to Expect

  1. Arrive early to fill out intake paperwork if this is your first visit. Intake paperwork may include a full medical history.
  2. Please call if you are going to be late or not able to make it as soon as possible. Make sure you are aware of the cancellation policy, many places request you call a day ahead of time if you cannot make it to avoid cancellation fees.
  3. Silence your phone when you arrive. The session is your time away from everything, we do not want that interrupted from outside forces.
  4. Let your therapist know about any conditions you may have that could be adversely effected by massage, such as bruising easily, past surgeries and injuries, pregnancy, osteoporosis, or high blood pressure.
  5. If you need special assistance such as help getting on or off of the table please discuss this with your therapist at the start of the session, we are more than happy to accommodate your needs.
  6. Do let us know if there are any areas of concern to be focused on or if there are areas you do or do not want massaged (IE: you love or hate scalp massage.)
  7. Please wait until we leave the room to disrobe.
  8. Let us know if you need any accommodations such as a pillow or breast cushion.
  9. Dress down to your level of comfort unless instructed to leave clothing on. Some therapists may request that you leave your underwear on while others may do massages fully clothed.
  10. Get between the sheets, not on top of them, and cover your body before your therapist returns.
  11. If you wish to talk during the session please keep your voice down so as not to disturb others in adjacent rooms.
  12. If you wish for no talking during the session tell the therapist at the beginning, let them know you just want to relax undisturbed and that any suggestions can be discussed at the end of the session.
  13. Feel free to speak up if the pressure is too much or too little, you are in control of your massage.
  14. Relax and enjoy your session, if you fall asleep that is fine, if you snore we don’t mind at all.
  15. If at any point in the massage you feel uncomfortable for any reason you can end the session. If your therapist has made you feel uncomfortable do bring this to the attention of the management right away.
  16. At the end of the session please wait until the therapist has left the room to get off of the table and get dressed.
  17. Be careful when first getting off of the table as people sometimes feel light headed following a massage.
  18. Your therapist may offer your some fresh water and after care instructions when you come out of the room. Those instructions may include some stretches or suggestions for heat or ice following the massage as well as suggestions for future sessions to meet your needs.

Considerations for your therapist:

  1. Arrive clean and ready for a massage.
  2. Avoid wearing heavy perfumes.
  3. If you have athletes foot or other contagious conditions please let your therapist know so they can avoid that area during the massage. Foot massage can be done through the sheet if needed.
  4. Please find a baby sitter for your children, the massage rooms are small and as much as we adore your children they can get in the way while we are trying to massage you.
  5. Please do not ask your therapist for services that are out of their scope of practice such as chiropractic adjustments.
  6. If you are sick please reschedule your appointment.

Communication is key to getting the massage experience that you are seeking.

When you communicate with the therapist before and even during the session as to pressure and preference you can get the prefect massage tailored to your individual needs.

Enjoy your service!

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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Postpartum Massage

Recently I massaged a woman who was only two weeks postpartum

My first thought was about her comfort and I offered her a breast cushion, my next thought was about precautions post pregnancy…

In my last post I wrote about prenatal massage and the changes experienced in pregnancy. Following child birth some of those same conditions still apply.  Relaxin, the hormone that loosens ligaments is still present and can remain present in the body up to four months after discontinuing breast feeding, so her joints, especially the SI joints may still be causing her discomfort. The coagulating hormones that poses a risk for deep vein thrombosis during pregnancy may still be present for up to four weeks or more following child birth so deep tissue work is not advised during that time and specifically to be avoided on the back of her legs.

The client may be positioned prone (face down) at this time but if she has had a cesarean section it is advisable for her to wait until after the scars have healed and to speak with her physician before getting massage and to seek her doctors approval before having any abdominal massage work.

The following article by the American Pregnancy Association highlights the Many Benefits of postnatal massage

Postpartum Massage

The Benefits Of Postpartum Massage

Postpartum massage has been shown to be effective for a quicker recovery and better health. Integration of maternal bodywork may add welcome value to your healing journey and transition to motherhood.

Relaxation and Stress Reduction

Massage relaxes muscles, increases circulation and lowers stress hormones, bringing relaxation and stress relief. All body systems appreciate treatment after nine months of change, culminating with the delivery of the greatest miracle in life.

Some women prefer lighter pampering massage while others enjoy deeper techniques to work out the knots. Adding myofascial release and craniosacral therapy reaches deeper into the body for more complete healing. Any of these massage styles will bring relaxation and stress reduction.

Anxiety and depression respond very well to skilled therapy. About two-thirds of new moms experience temporary postpartum blues related to hormonal changes, new responsibilities and adjustment frustrations. Emotional support and the other benefits of massage can help during this transition.

Postpartum depression is a more serious, longer-lasting condition that affects 10-15% of mothers. Studies show massage to be beneficial for treating postpartum depression. Don’t hesitate to consult healthcare providers for assistance, including a postpartum body worker.

Pain Relief

Residual body aches from pregnancy are normal. Adding breastfeeding and childcare can intensify arm, shoulder and back pain. Massage is an effective holistic approach that relaxes muscles and relieves pain without medication. A skilled therapist may also resolve even associated numbness and tingling. Chronic or severe pain may require multiple sessions for resolution.

Hormone Regulation

Massage greatly improves postpartum hormone balance. Estrogen and progesterone hormone levels are very high during pregnancy and decrease after delivery. Prolactin and oxytocin hormone levels rise to facilitate breastfeeding. Studies indicate that massage reduces the stress hormone cortisol. Certain essential oils may also bring hormone and mood balance.

Massage also reduces naturally occurring biochemicals associated with depression (dopamine and serotonin) and cardiovascular problems (norepinephrine), supporting Mom with the challenges of motherhood.

Decreased Swelling

Body fluids need to find balance after pregnancy, in which there was an increase of about 50% in fluid volume. Massage increases circulation and lymphatic drainage to facilitate elimination of excess fluids and waste products. Tissue stimulation assists your body to shift water to the right places.

Swelling is also affected by hormones, which go through major changes after delivery. Massage helps hormone regulation, which also decreases swelling (see Hormone Regulation). Continue your high fluid intake for healing and lactation, even though you may still have swelling.

Better Sleep

Most new moms feel exhausted after labor and delivery, complicated with around-the-clock baby care. Massage will ease the fatigue, promote relaxation and assist with sleep. Studies have shown an increase in delta brain waves (those that accompany deep sleep) with massage therapy.

That is why it is very common to fall asleep during a massage. Getting enough sleep is key to postpartum recovery. Everything improves when you feel rested! Arrange some help and get regular massages for better rest and sleep. One study correlated better sleep with losing the baby fat on the tummy!

Improved Breastfeeding

Breastfeeding is a beautiful gift to your newborn, but can also be a challenge for some moms. Massage therapy relaxes the body, increases circulation and increases milk production. Studies show that massage increases prolactin levels, a lactation hormone.

Relaxation in the chest muscles opens the shoulders and improves lactation. New research indicates that breast massage helps relieve breast pain, decreases breast milk sodium and improves newborn suckling. Consult with your therapist about this service as work directly on the breasts may not be legal in some areas.

Her level of comfort and tolerance are as much a concern post pregnancy as they were when she was pregnant.

If at any time she feels uncomfortable with the position, pressure, or duration of the massage be prepared to make accommodations for her.

Her breasts may be tender, swollen, or engorged with milk and it is possible that she may experience a let down of her milk (leaking) during the massage. There is no risk associated with contact with breast milk.

She may be exhausted and sleep soundly through the massage, allow her to fully relax and enjoy the experience.

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

 

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Prenatal Massage

Last night I had two back to back prenatal massages, one only a week until her due date followed by one only 16 weeks pregnant.

The first one, oh so beautiful in her last trimester but so ready to finally go into labor soon. She had never had a prenatal massage before, she loved it and she wished that she had been getting massages throughout her entire pregnancy.

The second, so very happy to be pregnant following a partial hysterectomy and just coming into the discomforts of her changing body.

Both of these women are first time mommies and it is such a joy to have the opportunity to give these women the benefit of a relaxing and therapeutic massage.

Her Changing Body:

When a woman is pregnant her body is in a constant state of change in preparation for the birth process. A hormone called Relaxin loosens ligaments and the SI joints to help widen the pelvis. This can sometimes lead to low back and SI discomfort.

It is also not uncommon for women to experience sciatica in later stages of pregnancy as her changing body and the pressure of her baby can irritate the sciatic nerve.

A woman’s body also produces hormones that effects the clotting factor to prevent her from losing too much blood when giving birth. Because of that we do not use deep tissue on the back of a pregnant woman’s legs as she is more prone to blood clots at this time.

In later stages of pregnancy she may experience swelling of the feet and legs, but if that swelling is mostly on one side that can be an indication that there may be some problems and that should be addressed with her doctor.

She may become more off balance as her body is changing and she may also experience some dizziness when getting up from a resting position, so it is important for her to be careful when getting off of the massage table or out of bed.

How Massage Can Help:

  • Reduces muscle and joint discomfort
  • Provids needed relaxation
  • Improve sleep
  • Help minimize foot and leg swelling
  • Improves circulation
  • Help move lymphatic fluids
  • Minimizes anxiety and stress

Contraindications and Precautions:

Hot stone therapy and aroma therapies are often avoided at this time as they can effect blood pressure and in some cases can effect hormone levels.

Some use of aromatherapy have been shown to be safe during pregnancy  (such as lavender oil) but due to the highly concentrated nature of essential oils it is often suggested that aromatherapy should be avoided at this time and avoided all together in the first trimester.

High risk pregnancies such as preeclampsia or a history of blood clots should avoid getting massage until after delivery.

Many therapists may refuse to massage a woman in her first trimester because that is a time in which miscarriages are most common and it is always best to be cautious.

In the second trimester it is not uncommon to do some of the massage supine (face up) as long as the client is still comfortable laying on her back, but by the third trimester the massage needs to be done in the side lying position.

Pregnancy massage cushioning systems are sometimes used by some therapists and spas in the second and part of the third trimester, but if at any time the client feels uncomfortable it is always best to perform the massage side lying.

Always remember that if at any time you or your client feel uncomfortable in any way about the massage it is always better to err on the side of caution.

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

 

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