Disclosure

Recently, one of my colleagues was massaging a client with some health concerns. There was an issue with the skin that needed to be addressed, but when the therapist said something about it, the client wouldn't say anything except, it doesn't concern you. While it is understandable that people can feel self conscious about various health conditions, there are some things that we as therapists NEED to know. We're not trying to be nosy, we're just thinking about three things. 1) The safety of ourselves 2) The safety of our other clients 3) The safety of you.

When you see a Massage Therapist, you will always do a consultation with them as well as fill out a medical history chart. The reason for this is so the therapist knows what to work on, and also what NOT to work on. There are some conditions for which massage is contraindicated, or not allowed. For example: A client reveals that she was in a car accident and she's sore now. Can she get a massage? Maybe. Depends on more information. How bad was the accident? Did she get violently jostled? When did the accident occur? If she got into the accident that day and she was thrown around, then no. If there is any injury, it is in it's acute stage for a couple days and any massage work will make things worse rather than better. Now if the accident was a couple weeks ago, that's a different story. The injury has left the acute stage and the inflammation has gone down to the point where it's safe to work.

Example #2: I have a female client who has been seeing me for a long time and loves getting a Hot Stone massage. (Who can blame her? They're amazing.) One day, she comes in for a Hot Stone and during the session, she says, "Oh by the way, I'm pregnant." What do I do? End right then and there. Why? Hot Stone is completely contraindicated for pregnancy because it raises the internal temperature of the woman too much to the point where it can be harmful to the baby. That is also why pregnant women cannot go into hot tubs or saunas. Even though I had a medical history on her that said "not pregnant," (because at the time, she wasn't) it's important to inform your therapist of ANY health changes because that could change the kind of massage you get.

Example #3: A client recently went camping and fell into some poisoned oak and managed to get a rash. Is massage indicated or contraindicated? Beyond a shadow of a doubt, contraindicated. While there may be precautions I can take to prevent myself, such as wearing gloves, there is still a safety risk to the client. Massage could actually spread it to other parts of the body. However, that is only a local contraindication, so as long as massage is being done on non infected areas of the body.

What it comes down to is that full disclosure is necessary to everyone's health regarding massage. Even if you are embarrassed about any given condition, the therapists have the same confidentiality ethics that doctors have as well. Whatever is said in the room stays between you and the therapist. Even if other people such as receptionists have access to your paperwork, it is still confidential and will not leave the clinic. Please, for the safety of all concerned, be open about your health because it does in fact concern us.

FAQ part 4- Pressure

Many times I will meet a client who tells me they want Deep Tissue because they have specific areas that are hurting and some big knots that are limiting their range of motion. While those are scenarios in which Deep Tissue is appropriate, how deep is too deep?

I work with a wide variety of massage styles and talents and among them, I tend to be one the therapists that gets requested for Deep Tissue frequently. One of the things that never ceases to amaze me is how a huge body building man asks me to ease up the pressure on him, while the tiniest, skinniest women will want me to go deeper, even though I feel like I might snap them like a twig. Shouldn't that be the other way around?

However, while that is a running joke among us therapists, I'm actually ok with it, because those clients are communicating with the therapist the way they should. One mistake that many clients can make is thinking they need to suck it up and breathe through it when they're getting Deep Tissue even though they are in a lot of pain. If you feel like you're at a 10 on the pain scale, the pressure is too deep. This happens with my clients frequently where I check in with them and offer to lighten and they say, "It's ok. I'll deal with it. I know I need it," while they're laying there unconsciously tensing up. The point of massage is to get rid of tension, not create more. Plus, if a therapist has her thumb embedded deep in a clients trapezius and then the client suddenly tenses up from the pain, they could end up harming their own muscles under the guise of, "I know I need it."

Deep Tissue is a wonderful modality that can have a very positive impact on the body and I strongly advocate it, but it must be used appropriately. Your doctors office probably has a pain scale chart hanging up somewhere, and that's the same type of basis we use. But we don't want a 10. Ideally, the client should be at around a 6 or a 7; deep enough where it hurts, but it doesn't hurt enough where you tense up. So the next time you're getting a massage and you think you "need" to feel the pain, don't take it to extremes. Enjoy your massage.

FAQ Part 3- Does Gender matter?

What's the difference between male and female therapists? Some people seem to have preconceived notions about men vs. women. The truth is, there is very little difference. There are however, some myths that exist, one of them being that if you want really deep tissue, you need a male. You just need one of my massages to know that's a myth.
I've also known some men and women who are simply uncomfortable having a male therapist, such as a client who said she was looking for a therapist who was non-judgmental cause she was slightly insecure about her body, but I can assure you that a legitimate massage therapist doesn't think anything about the body except as parts that need fixing, like the way a mechanic looks at a car.
However, there are times when gender requests are understandable. For example, there are some religions that prohibit women from being massaged by men. The other reason gender might be important is empathy. As a woman, there might be some specific areas of pain that I might have that a male therapist would not understand. When I was pregnant, there were various pains that I had where I would have to explain in gruesome detail to my husband, while any woman whose ever had a kid could say, "I've been there." Another example: I was working on a female client who never liked her calves being worked on cause it hurt too much, but as a woman, I understood the pain she was feeling because it was the result of wearing heels, something very few men do, so my approach ended up being more therapeutic.
To conclude, there's no difference between male and female in terms of pressure or technique. Any difference between genders is purely a personal choice or religious obligation. If you're worried about what they'll think about you're body, like they'll think it gross, or worse, that they'll be attracted to it, the truth is, they don't care. My challenge to you is to be adventurous. Call a clinic and get a massage from whoever is available regardless of gender. (Religious obligations excepted.)

FAQ Part 2

These next few posts talk about Frequently Asked Questions that many might have about legitimate massages. While talking to my husband about his massage experiences, he asked me a question that I never even thought about answering: Should I talk during a massage?
Answer: Not loudly. Many places have more than one room therefore loud conversations may interfere with other clients. However, this does not mean that all talking is prohibited. Communication with your therapist is key to providing the most therapeutic massage possible. You need to let them know if the pressure is too much or not enough, or if there are areas to avoid. Even though a lot of this can be covered in the consultation, sometimes there are things going on in the body that you didn't know about until someone gets in there and starts working. So don't be afraid to talk to your therapist during the massage if you have specific needs.
But how does this apply to regular conversations? That is entirely a personal choice. We do call it massage therapy for a reason. We hold stress in our body and many times a massage can stimulate some emotional release and that could involve the need to talk. I had a client who was kinda chatting throughout, but still not too much, till I got to her neck. After that, there was a flood of conversation involving all kinds of work and personal problems. When I moved on she said, "I don't know why I just told you all that." It happens.
In general, talking during a massage is fine. Just keep the volume to a minimum if there are other clients in the clinic.

What actually happens?

I've had some first time clients who have not only never had one of my massages, but never had a massage in general. Sometimes they have an no idea about what to expect, sometimes they have some idea, though those ideas are necessarily accurate. I've even talked to a client who was treated inappropriately by the therapist without realizing it. So, what should you expect from a legitimate massage? The next couple posts will have a FAQ regarding massage.
1) Do I have to get completely naked?
- It's up to you. You only need to dress down to your level of comfort, and if you feel you need to keep your underwear on, that's fine. No matter what, there are certain areas of the body that will remain covered at all times- Breast area, genitalia area, and the crevice of the rectum. If anything, the only undergarment I recommend taking off is the bra, and this is to allow for more fluid strokes along the back and shoulders. However, there are some styles of massage that are completely clothed, such as Shiatsu, so if disrobing is an issue for you, consider finding a therapist who does Shiatsu.

How to NOT see your therapist

One of the first questions you always have to ask yourself when you start a career path is, "Why?" Why are you doing this? Why do you WANT to do this? What's your higher purpose? When I started Massage Therapy, I wanted to be able to help people feel better and actually know what I'm doing. As I've gotten older, my higher purpose turned from just helping people feel better to educating people on feeling better on and off my table. It might mean they don't need to see me as often, but I'm ok with that.

There are many ways for you to take care of yourself, but let's start with one of the easiest which is water. As a therapist, I'm able to tell when clients drink water and when they don't. When they do, the skin is softer, the muscles are more pliable, and even if I feel knots, it's infinitely easier to work on them. When they don't, the muscles feel like beef jerky. 

The problem in our world is that we tend to depend on soda for energy as well as thirst quenching. The thing that fools us into believing that our thirst is getting quenched is the carbonation. But the truth is, we'll end up feeling even more thirsty because of the sodium. (Just a reminder, sodium is not good for blood pressure.) Sports drinks are not a good option either unless you're a hard core athlete. The best way to quench is plain pure H2O. Try exchanging 1-2 drinks for water for a few weeks and see how much better you feel.

Why get a massage?

Have you ever heard the phrase, “There's always a million reasons NOT to do something.” This can apply to starting a new career, starting a new relationship, having a baby, but unfortunately, it also applies to relaxing. A couple months ago, I surprised my husband with a massage at my job. It was during his vacation from school, it was on his day off from his work, and it was with his favorite massage therapist. (Aside from me, of course.) And yet, he seemed irritated that I did this for him. It seemed as though he was finding every reason he could think of to get out of it. However, afterward, he was in a state of permasmile and he was very grateful. So, why was he resisting? We determined that he was afraid to relax.

Many people consider anything relaxing to be a luxury; something that implies that we're lazy or we don't have anything better going on. It's almost considered a badge of honor if you don't have time to relax. They tend to have the same mindset as my husband, that if you relax, you will lose your momentum and stop being productive with anything your doing, be it work or school. In my opinion, this is not totally without merit. But with too many people having stress related disorders like hypertension, increased cortisol, heart disease, we cannot use the excuse of decreased productivity as a reason NOT to relax. People are not willing to risk their careers, but they are willing to risk their health. What is wrong with this picture?

That also begs the question, does relaxation cause you to decrease productivity? It depends on how you utilize it. We're always told that if you feel thirsty, you should have been drinking water a long time ago. The same is true of relaxation. If you feel like you need to relax, you should have been relaxing a long time ago. When you wait too long to take a time out from life and decompress, then you'll be in such dire need to relax that you're more likely to not want to get back into life. If you take time to regularly relax, then getting back into the craziness of life won't be so difficult. If anything, I believe it will increase productivity because you will be thinking more clearly and working more thoroughly. You may not SEEM to be working as quickly, but remember the tortoise and the hare. Slow and steady wins the race.