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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Regarding the Massage Envy Allegations

The recent news about Massage Envy has shaken the entire industry

As Massage Therapists we go through extensive background checks and are required to take ethics courses to prevent misconduct in the work place.

We have worked hard to over come the stereo types and educate others about the dangers of elicit Massage Parlors and Human Trafficking and to set ourselves apart from that element.

The recent news about the allegations at Massage Envy and the way that those allegations were handled leaves the entire industry, not just the chain spas, with another obstacle to over come.

First and foremost I want to say , if you are sexually assaulted during a massage MAKE SOME NOISE!

I understand you are laying naked under the covers and feeling vulnerable, find your voice!

Yell “STOP!” or “GET OUT OF MY ROOM NOW!” Or even simply “HELP!” The walls are thin enough that the clients and therapist in the next rooms will hear you and I for one would politely excuse myself from the client I am working on to come to your assistance as would many other therapists.

Always remember that you are not alone and if you are being victimized forget about being quiet and polite, make some noise!

What changes need to be made in our industry to ensure client safety?

With all the stringent background checks, licensing requirements, and ethics training  one might ask how this even occurs at all, and that is a question that I have been asking myself over the past few days.

What I have come to realize is that a background check only assures you that the individual has not been caught and convicted of committing any crimes, that does not mean that they have not committed any and gotten away with it.

Which leaves us with WHY? Why have these incidents gone unreported or under reported? Why were these individuals simply fired and allowed to move on to other locations with an active license?

We can do better and protect other clients by making sure that these situation get fully reported and investigated.

Predators exist in all walks of life

We have all heard of Ministers, Doctors, and Nurses sexually assaulting parishioners and patients.

I once worked in an Assisted Living facility that had to deal with a predatory Nursing Assistant who was stealing patients jewelry, credit cards, and even their identities and I was horrified to see the lengths the company would go to protect itself, not the patient. The thought that that Nursing Assistant might still have a valid license to continue preying upon the elderly haunts me to this day.

This is exactly where the problem lies, if these predators go unreported and are quietly removed from their jobs they simply move on to another location where they can continue to victimize others until one day someone, somewhere will finally get up the courage to call the police and start an investigation.

Sexual assaults are even more complicated

Most sexual assaults go unreported by the victims. That means that the ones we are actually hearing about now are only the tip of the iceberg.

Victims of sexual assault are less likely to report right away because their initial response is to get away, which is why many of those who did complain called the company days or even weeks later to report the incidents and did not do so at the time the assault occurred.

A victim of sexual assault is dealing with many thoughts and emotions, feelings of being violated, guilt or shame for not yelling or making a scene, fear, and shock.

The fact that many of these victims were not taken seriously because they waited to make their complaint is concerning to me, victims of sexual assault often times need to get up the courage to even talk about it. All allegations of abuse no matter how long the victim took to come forward need to be taken seriously.

Another thing that complicates such allegations in this industry is that some allegations of sexual misconduct are in some cases simple misunderstandings such as the client not knowing that a glute massage is not a sexual act but a therapeutic treatment for low back pain. In that situation a therapist may find themselves being accused of sexual misconduct when nothing sexual was intended at all. That being said a therapist should always get a clients consent before working in areas such as the glutes or upper pectoral muscles.

What has prompted me to write about this today?

Yesterday at one of my places of employment all male staff members were pulled aside for a meeting which consisted of mostly telling them to be more conservative in everything that they do, from draping procedures to therapeutic services.

Later I spoke with the owner about this and asked her:

“Is every receptionist trained in how to handle such allegations, what to do, who to call, and when to call the police? Because this isn’t just about the men knowing what not to do, its about all of the staff knowing what to do should such a situation occur.”

Do we even have a protocol in place to deal with these kinds of allegations? If not, why not? All massage establishments should have a clear protocol in place when such a complaint is made and depending on the severity of the complaint when to involve the police.

It is the matter in which the allegations against Massage Envy were handled that is the most serious issue, such as why were the predators not reported to the police or the state boards? Why were they allowed to continue preying on other women? Why do some of these predators still have active licenses to perform massage services?

What needs to happen to protect our clients?

Retraining the male staff members is not only unnecessary but discriminatory. We ALL took the ethics classes, we ALL were fully background checked, and we ALL know right from wrong. This has nothing to do with the sexual orientation of the therapist, a predator is a predator and they need to be weeded out of our industry through the proper channels and brought to justice.

I am all for a nationwide protocol and reporting system, that being said I am also aware that there are people who might make reports out of retaliation or spite that may be unfounded, so each case should be taken case by case.

Every company should have a protocol in place with specific instructions on who to contact in the company, such as the manager on duty or owners, and when to contact the police. This should also apply to cases where the therapist is the victim of a sexual assault, that too goes sadly unreported as well.

Reporting to the state boards

The following link will give you information of the various massage boards by state, most states have their own licensing board that you can contact to look up someones license or make a complaint about a therapist. https://www.abmp.com/practitioners/state-requirements

In Closing…

As a Massage Therapist who is also a survivor of sexual abuse I take this situation very seriously and very personally. I look forward to an open dialog with my peers about how to prevent future sexual assaults in the massage industry.

Yours in Health and Wellness,

Kristeen Anne Smart aka Kristeen Anne Kish

CAMTC Certified Massage Therapist

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Looking Forward to The World Massage Festival 2018

World Massage Festival 2018

The 2018 World Massage Festival will be held in Las Vegas at the Rio All-Suites Hotel and Casino.

World Massage Festival 2018

For those who have never attended a World Massage Festival, this is an opportunity to learn new skills and modalities from some of the biggest names in the field.

The festival includes up to 24 hours of hands on continued education in a number of specialties including Oncology, Geriatric Massage, Bamboo Fusion, Orthopedic Massage, and Native American Energy Work, and man many more .

Their Mission Statement:

To honor those who built the bridges for our profession,
to educate the general public about massage, to educate therapists
about different types of massage and to have fun.

Reasons why you should attend…

A chance to network with Massage Therapists from around the world and learn from some of the leaders in the industry at a remarkably low cost.  No organizational memberships needed! You do not have to be a member of any massage organizations to attend and you are welcome to bring a guest for the festivities.

The “Early Bird Special” before Dec 31st is only $350 and can be made in four payments, after that the cost is only $400. Most of these courses if taken alone can cost more than cost for this entire festival.

There will be drawings for various prizes including a Trip to Hawaii and a 2018 Kia Rio as well as scholarships for upcoming World Massage Festivals.

Vendors will be there displaying all of the tools of the trade and some that you may have never seen or heard of before. The vending hall is a plethora of amazing items and service!

Classes fill up fast!

To ensure that you get into the classes of your choice you need to sign up as early as possible because the classes do fill up fast. You can take up to 24 hours of continued education, however, some of the class schedules conflict with one another so choose the one that you want the most and work other classes into the schedule around it.

This year I was inspired by several of my clients to take an Oncology Massage course and that is what I have chosen this year for my focus class.

The course will be taught by Christine Courtney who owns and operates her own massage school in Ireland and teaches internationally in several countries.

That class will be all day for the first two days of the festival which left me one last day to decide on another course.

I chose for my last day of the event a Pre and Post Event Russian Sports Massage class with Oleg Bouimer, who has worked with NHL, NFL, and NBA athletes.  I have been curious about Russian Sports Massage for a while now and I am excited for the opportunity to learn this modality.

Choosing your course is not easy as there are many wonderful course and modalities to choose from!

So many classes to choose from including: Hands free Ashiatsu, Activated Isolated Stretching, Lomi Lomi, Manchurian Acupressure, Thai Reflexology, Ethics, and various Sports Massage Modalities.

With so much to choose from it is difficult to choose between them, but you cannot go wrong with any of the choices, so even if you cannot get into your favorite class because it is full there are so many amazing classes to attend!

Yours in Health and Wellness,

Kristeen Anne Smart aka Kristeen Anne Kish

CAMTC Certified Massage Therapist

 

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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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