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Massage therapy is becoming widely accepted as a way to maintain overall health and recover from injury. In fact, 63% of clients received massage for wellness purposes in 2020, according to a recent survey. 30% of those people reported that massage therapy was part of a treatment plan prescribed by their doctor. As a massage therapist, it’s your job to design a treatment strategy that gets the results clients are looking for. Let’s take a look at how to do that, as well as a few examples of massage therapy treatment plans that work for certain types of clients.
Things every client is wondering about Educating clients is an important part of your role as a massage therapist . Your clients aren’t just coming in for a massage, they are coming in for therapy. They trust you to have answers. Regardless of whether your clients come in for relaxation or pain relief, they all want to know the same things.
When you tell clients what they need to do, the quality of care they receive increases and so does your client retention. Creating a treatment plan isn’t a sales gimmick, it’s crafting a strategy for results. How to design a treatment plan that meets clients expectations While everybody is fundamentally the same, every person is different. Therefore, the same plan doesn’t work for everyone. Recommend what you truly believe will be helpful. That may be a monthly massage regime, or it may be something else. Clients want your expert advice. Speaking of goals, before you can come up with a strategy for treatment, you need to know what your client’s goals are. Don’t make assumptions. Ask. Start by asking your client what their goal for treatment is. What’s bringing them in? This could be stress relief, pain relief, better mobility, ect. Once you know what their goal is, the next question to ask is, “how will you know when we reach your goal?” This is a crucial question that many therapists don’t ask. If you don’t have a benchmark to measure your progress against, how will you know if your therapy is working? Often clients don’t notice small improvements over time. Having a benchmark is a way to show your results. Now that you know what you’re trying to achieve, you can start working on creating a massage therapy treatment plan. Create a template for documenting your treatment plan. You're probably already doing this with a traditional SOAP Note, but you might also consider creating something that you can give to your client. Once you’ve created a system, document it in your business plan and do the same thing with every client. Here’s an example of a template you can use for sharing your massage therapy treatment plan with clients. Treatment Goal: (Describe the client’s goal and benchmark indicating success) Treatment Plan: (Include things like duration of sessions, number of sessions, how far apart sessions will be scheduled, and what modality to use) Self Care: (Recommendations on what to do in between sessions. This could be things like stretching, exercise, heat, ice, rest, ect.) *Stay within your scope of practice when making recommendations. Examples of massage therapy treatment plans that work for different kinds of clientsHere are a few common examples of treatment plans for massage clients. Remember, each client is different. There’s no one size fits all. So, create your own customized plan for each person you treat. Example 1: Overworked and stressed outTina is a workaholic. She’s constantly in go mode, and her brain never shuts off. She’s been having trouble sleeping, and she was recently diagnosed with high blood pressure. Her blood pressure is being managed with medication, but her doctor says she needs to manage her stress levels and get more exercise. Treatment Goal: Stress relief and relaxation Benchmark: She’s able to easily fall asleep at night. Treatment Plan: 90 minute Swedish massage, bi-weekly over the next 2 months Self care: Take a 30 minute walk when she gets home from the office each day to mark the end of the work day, get much needed exercise and relieve mental stress. Example 2: Recovering from an injuryTom hurt his neck heading a soccer ball last weekend. Now he has pain and limited ROM when he turns his head to the left. He had x-rays taken. They didn’t show anything concerning. His doctor said his pain is probably just muscular. Treatment Goal: Relieve pain and increase ROM in his neck Benchmark: He can turn his head to check his blindspot while driving. Treatment Plan: Three 30 minute neuromuscular therapy sessions spaced every 4 days Self Care: Use moist heat to relax muscles 1-2 times a day for up to 10 minutes. After the application, laterally flex the neck left and right to stretch tight muscles. DO NOT stretch to the point of pain. Example 3: Chronic PainSarah suffers from fibromyalgia. Her doctor has prescribed a few drugs that help, but she doesn’t like taking all that stuff. She can hardly function when she takes muscle relaxers, but they are the only thing that seems to take the edge off. She wants to be more proactive in managing her pain levels, and not solely rely on medication. Treatment Goal: Manage chronic pain more naturally Benchmark: No longer relies on muscle relaxers Treatment Plan: 60 minute deep tissue massage every 2 weeks Self Care: Start a meditation practice, beginning with just 5 minutes a day and working up to more time. What do you do after you execute your plan? You followed your plan, and it worked! (Or maybe it didn’t.) Now what? If your plan doesn’t work, modify it or refer your client to someone who may be able to help. Changing course when something doesn’t work is part of any treatment plan. If your plan does work, now it’s time to create a plan for continued wellness. It’s also time to tell them about your referral rewards program. Satisfied clients are one of the best ways to promote your massage therapy business! Posted on October 7, 2021 ClinicSense
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 Why your legs need a massage
Our legs do a lot for us. We use them all day, every day. Like other parts of our body they can get tired, overused, sore, and in need of some care. Our legs take us where we want to go. They let us walk around to do what we need to do - even if it’s just to grab a snack from the kitchen. Some jobs are physical and involve being on your feet a lot. If lifting and moving things are involved you use your legs to lift and haul them around. Job responsibilities can have repetitive actions than can overwork your muscles. Other jobs are not very physical and involve a lot of sitting. Long periods of time with your legs in the same position causes your leg muscles to shorten, so when you do stand and walk your legs feel tight. Add commuting time in a vehicle and your legs may spend most of the day inactive. Try to include regular times through the day to get up and walk around if you can. We may run to catch a bus, keep up with a child, or to get out of the rain. At home we walk around to take care of our place, our family, and our things. We carry laundry and groceries. We shop, cook, clean and put things away. If you have stairs you will make multiple trips up and down every day. Yard work and home maintenance such as mowing grass, gardening, and digging puts our legs to use. If you enjoy sports you use your legs to run, jump, and kick. You pedal your bike, kick your legs to swim, and run and kick in soccer. You jump in volleyball and basketball. Depending on where you live you may surf or ski which involves a lot of leg use. For exercise or fun activities you use your legs for yoga, pilates, or fitness classes. You use your legs for lifting weights, boxing, hiking, climbing, kickboxing, and dance. Your hip, knee, and ankle joints are all affected by your legs. Joints are under pressure from muscles and bones pulling and twisting on them. Relieving muscle pain decreases the pressure on those joints and you feel better. Wearing high heels can add to pain in your legs, too. The heels cause your muscles to be used in different ways since they not in their natural positions. Hip and back pain can start in your legs. If one leg hurts you will change how you walk, stand, and even sit to keep it from hurting. That adjustment will affect your other leg. Your legs attach to your hips, which connects to your back, and as more muscles are out of normal position pain begins to develop there too. Your legs do a lot for you. Give them some attention with a massage so you can keep doing what you want.  The short answer is “No. Absolutely not.” But the long answer is, well, much longer. This is one of the most frequently asked questions about massage and deserves some discussion. In massage school it was suggested we say to clients, “Undress to your level of comfort.” I found that’s way too vague, and doesn’t really answer the questions. Heck, I’m not even sure what that means. {Depending on your script with clients, this part should be changed or removed} At some point I switched to, “I’ll leave the room so you can undress, there’s a hook behind you for your clothes. Bottom undergarment on or off, however you’re most comfortable is just fine.” That’s been working okay, but sometimes I feel more of an explanation would be useful. First, no matter what, you’ll always be covered (draped) with a sheet and a blanket. You’ll never be left feeling exposed or chilly. When I work on an arm, I fold the sheet back and tuck it under your arm so it’s secure. (No drafts, my friends.) I follow the same protocol for the leg. When I work on the full back, I fold the drape down at the hips. If you’re wearing underwear I’ll gently tuck the sheet around the waistband, to protect your clothes from massage oil. If you’re wearing a bra, I’ll work around it. If you’re wearing a t-shirt or tank top or space suit, I’ll work through it. I know plenty of very effective massage techniques that can be administered over clothing. If I feel I can’t effectively treat your issue through the clothing you’ve chosen to wear, I’ll tell you, and we’ll figure out another approach. I don’t care, and I’m not judging you. This massage is about you and it’s important you feel comfortable. For some people that means leaving some clothing on. For others, it means taking it all off. There is no right or wrong, this is your massage. Enjoy your next massage!  Everyone wants a massage, but sometimes making it in to see your favorite massage therapist (hi there!) just isn’t feasible. It’s in those unexpected and inconvenient moments that knowing how to give your partner a pretty great massage yourself can make the difference between a rotten day and a better one. But of course, this hinges on one thing: do you know how to give a good massage? Giving an at-home massage is not that hard. Here are my favorite tips: Use firm pressure, but not hard.People get confused about pressure in two opposite ways. If your partner is smaller than you, you may have a tendency to use very light pressure. This is okay to a point (you probably won’t hurt anyone), but can be a little frustrating if your partner is tense or sore or, even worse, ticklish. On the other side are the people who come from the “no pain, no gain” school of massage. Don’t buy into this myth! Massage should be pleasant. If your partner has to tense their muscles and clench their jaw in order to get through your ministrations, it’s not helping. Slooooooow doooooown.There are absolutely occasions where someone might want a fast-paced, vigorous massage. But unless your partner is getting warmed up for a race or ballroom dancing competition, this is probably not one of them. You’re not going to miss some key muscle if you take your time. If you seem relaxed, your partner is going to relax too. So take a deep breath, put your hands out, and make each stroke last. If you meet a bone, leave it alone.There is one exception to the firm pressure rule, and that is bones. You don’t need to be an anatomist to recognize the ones that stick out, like knees, elbows, ribs, and spines. With little padding between them and the skin, these areas can be quick to bruise or feel painful. If you find your hands arriving at one of these bony landmarks (yes, that’s actually what massage therapists call them, it’s like reading a topographical map), you have two options: turn around and go back the way you came, or skim over them using gentle pressure and keep going with your massage on the other side. Practice good body mechanics.If massage shouldn’t be painful for your partner, it also shouldn’t be painful for you. If you are hunched over, if your wrists are bent at an awkward angle, if you are using your thumbs or fingers in ways they weren’t designed to work, you will end up regretting the day you ever offered to give a massage. Use bigger muscles in place of small ones whenever you can: use your back to provide pressure instead of your arms, and your arms instead of your fingers. Whenever possible, push instead of pulling. When you move to a new part of your partner’s body, adjust your entire position, not just your hand placement. It may feel strange at first, but imagine if you tried to shovel snow by standing in one place and using just your arms to move the shovel from one side of you to the other. If that image seems ridiculous, you already understand why proper body mechanics are so important. Communicate, communicate, communicate.Really, you probably don’t need to talk to a massage therapist to learn that open communication between you and your partner is key to anything you undertake together. But it’s especially true in a situation like a massage, where one of you is more vulnerable than the other. As the massage giver, it’s important that you check in regularly: How does this feel? Would you like more or less pressure? Do you remember whether I turned the oven off? (Okay, maybe not that one.) The same goes for communicating your own needs. If you are getting tired, or thirsty, or really need to leave for work, say something. Don’t leave your partner feeling guilty about enjoying a massage because you made a unilateral decision to sacrifice your needs for theirs. Learn from the pros.As with any skill, one of the best ways to learn to give a massage is by watching the people who are already great at it. Getting regular professional massage (hello again!) and taking a couples massage class are both helpful. Barring that, YouTube is a fantastic source of tutorials for beginners. You can search for a style you like--Swedish massage is a great place to start—or an area you’d like to focus on, like the neck and shoulders. If you follow these guidelines, you’re going to be fine.You may not be winning any championships, but massage isn’t a competition. If you can give a caring, relaxing massage without hurting your partner or yourself, you’re way ahead of the curve on this one. And if you feel like you need more than that … well, give me a call. April is fun for a few reasons. Exciting basketball, green beer, and a confused body clock. Wait, that’s not fun. April is when we attempt to shake off the winter doldrums and see the light at the end of the tunnel in the form of daffodils and light sweater-weather. Daylight Savings Time robs us of a precious hour of rest we won’t see it again ‘til fall, and our sleep cycles get all out-of-whack. But sleep issues aren’t just a seasonal problem. It’s estimated that over 60 million Americans suffer from short-term (a few days or weeks) or long-term (more than a month) insomnia. Most cases of chronic insomnia are secondary, which means they are the symptom or side effect of some other problem. We’ve all heard the standard ‘sleep hygiene’ tips about avoiding caffeine, using room-darkening shades, and going to bed at the same time every night. Here are a few other ideas that aren’t as well known. Nap properly Taking a nap during the day can be great for productivity and fabulous for health, but you’ve got to do it right. Aim to nap for 20 to 25 minutes, any longer than that and you’ll feel groggy when you wake up and you risk not being able to fall asleep when it’s bedtime. (If you really want to get good at power naps, there’s a whole kit to help you get it right.) Be mindful of the temperature. Take a warm (not hot) shower or bath about an hour before bedtime, and keep your room cool at night. The drop in body temperature signals your body to calm so you’ll fall asleep faster and sleep more deeply. Turn off the electronics. Okay, so you’ve heard this one. But it’s the most important and the least followed piece of advice. Get an old fashioned alarm clock so you don’t need to use your phone. Turn your phone, iPad, Kindle, or whatever you’ve got off, and put the devices in another room. Yes, a whole other room. You may think that a phone on silent, hanging out on your nightstand, won’t disturb your rest, but it will. Just knowing it’s there puts your body on alert. It’s far too tempting to reach over and ‘just check a few emails’ if you do wake up in the middle of the night. Save yourself. Break this habit. Get a massage Yup. Massage can help with sleep issues. There have been several studies demonstrating the efficacy of massage in people with sleep problems, especially when treating secondary issues that may impair sleep, like back pain, pregnancy and migraines. You can call me at 757-840-9954 or schedule online here www.osorelaxed.org and get ready for a better night’s sleep.  Anxiety Disorders affect about 40 million American adults in a given year. Anxiety is described as a feeling of dread, fear, or apprehension often with no clear justification. Most people experience symptoms of anxiety at one time or another, but for those with a disorder, normal daily life is often interrupted and limited.
A few common anxiety disorders are panic disorder, Generalized Anxiety Disorder (GAD), social phobia (Social Anxiety), and Post Traumatic Stress Disorder. While there are varying symptoms with each, many physiological responses overlap with the different disorders. Many people are able to function with symptoms while others are unable cope with them. Some disorders manifest with physical symptoms like sleeping problems, shortness of breath, heart palpitations, nausea, sweating or dry mouth. Others are purely emotional, denoted by excessive, unrealistic worry, feelings of panic, fear, and uneasiness. Usually, there’s a combination of physical and emotional symptoms. Massage may help anxiety The American Massage Therapy Association has adopted a position statement based on research findings asserting that “massage therapy can assist in reducing the symptoms of anxiety.” It goes on to say that massage may reduce symptoms of anxiety in women in labor, psychiatric patients, cancer patients, patients with Generalized Anxiety Disorder, children with illnesses, and many more types of clients. The effects of massage therapy include reduced blood pressure, slowed/regulated breathing, and a slower pulse rate. If increased heart rate and rapid breathing are symptoms of anxiety could massage therapy may have a positive effect. Simply taking time to relax and removing yourself from the busy-ness of daily life can be helpful in handling some kinds of anxiety. Those with more complicated anxiety issues may benefit from regular massage in conjunction with talk therapy, medication, and lifestyle changes. <<<if you have advance training in massage for anxiety, or any particular forms of anxiety disorders, this would be a great place to talk about it! >>> Ask questions If you are unsure about trying massage to help your anxiety, ask questions. Call me and we can talk about your experience with massage and how it may help you. Check in with your health care provider and your therapist or counselor. (Be sure to let me know if they would like more information about massage and anxiety, I can provide that!) When you’re ready, we’ll schedule an appointment and you can see firsthand how massage may help you.  An estimated 1 in 10 adults in the United States suffers from some kind of depression, according to the Centers for Disease Control. That’s around the same percentage of American adults who are left-handed, and yet while handedness is seen today as a quirky curiosity (or sometimes an advantage, in the case of athletes), there is still stigma and silence surrounding depression as an illness. So let’s talk: what is depression? Why is it problematic? And is there anything that can help? What is depression?Let’s start with what depression isn’t: a bad day, a brief period of mourning after a loss, or a pessimistic outlook on life. It consists of a period of more than two weeks of a bad mood, decreased interest in things that one normally finds enjoyable, and can also include fatigue, changes in weight, difficulty concentrating, inappropriate guilt, and even suicidal thoughts. While two weeks is the minimum length for defining depression, it can continue for months or even years. Are there different kinds of depression?Yes. Major depression is an episode of depression two weeks or longer that messes with your ability to function throughout the day. People can have multiple episodes of major depression throughout their lives. Postpartum depression is a depressive episode that occurs after a woman has given birth. Seasonal Affective Disorder (aptly abbreviated SAD) is a form of depression during the winter months, when there is less sunlight. Manic Depression (also called bipolar disorder) involves cycles of depressive lows and manic highs. There are also mild forms of depression that do not meet all the requirements of major depression. What are some of the health consequences of depression?Aside from just feeling like crap on an emotional level (entirely bad enough on its own), depression can also have other serious effects on a person’s health. People who suffer from depression are more likely to engage in negative habits such as smoking and excessive drinking. They are also less likely to get sufficient exercises, and are more likely to stop the physical activities they used to participate in. Depression can disturb sleep schedules and also negatively affect one’s professional and personal relationships, resulting in more stress, which leads to its own host of health issues. It’s a truly nasty cycle. So why aren’t we all talking about this?Mental illness has always been something of a taboo subject. Those with more severe problems are seen as crazy and unstable, while those with more mild issues can be accused of making it up for attention, or using the term as an excuse for ordinary laziness. Depression isn’t sexy like breast cancer (boobies!) or have the sorts of clear paths to prevention that lend themselves to awareness campaigns, like HIV. And so we’re left without the sorts of public conversations that in turn become private ones between friends. It’s easy to ask a friend if she’s taking painkillers for her broken leg. Asking her if she’s considered antidepressants? Not so much Is there anything that helps with depression?Absolutely, and the first step is diagnosis. (Sorry, looking up your symptoms on Google doesn’t count.) A physician will be able to speak intelligently about options like therapy, medication, and other treatments and lifestyle changes. Oh, and you might also want to get a massage. Massage for depression? Really?Absolutely. Massage has been found to reduce depression and improve mood in people of all stripes, from children with HIV, to adolescents with psychiatric disorders, to hospice patients. Why does this work? Well, that’s still being researched. The what is often much easier than the why. But caring touch does seem to have a real effect on mood, whether it’s from a loved one, a massage therapist, or a favorite pet. Of course, if you’re a regular recipient of massage, you can judge for yourself: is your mood improved after a massage? And if you haven’t received a massage lately (or ever!), this is a great opportunity. Do it for science! Or, do it for yourself. Because everyone deserves to feel better, including you.  Only 32% of adult Americans got a massage in the past 5 years. And only even fewer get massage regularly. So it's not surprising that most people don't know much about massage. Here are some fun facts to build your knowledge: Massage can help you sleep better. (Even if you don't nap during the actual massage.) When your back hurts, that might not be the only area that needs massage. Sometimes back pain comes from the hip, legs or even the abdomen. Likewise, sometimes hand and arm pain is caused by dysfunction in the neck and shoulder. The body is so crazy and weird and neat-o! You can stop a massage session at any time. You never cede control of your body. At any time during a massage you can say "no", "stop", or even "can you just work on my neck for the rest of the time and skip everything else?" If you are uncomfortable or feel like the therapist isn't hearing your feedback, or if you just feel like the table is too hard and you have to pee and gosh, this is awful. You can end it. Massage can help your mood. It's been shown to be helpful in treating both anxiety and depression. Even small therapists can provide deeeeep pressure. It's not about size, it's about the techniques we use! Massage doesn't 'detoxify' your body. That whole thing is a silly myth. It was taught in many schools and you may have heard me say it, back before I knew better. But we know now that it's just not true. Massage is safe in the first trimester of pregnancy (unless there are unusual health issues). Some practitioners choose to not do it, but that's a liability choice. Deep tissue massage, or any massage, doesn't need to be painful to be effective. For reals. Run screaming from any practitioner who insists there needs to be pain in a treatment. Scars are living tissue that can be transformed with massage and other manual therapies, no matter how old they are. And they can be affecting you in places farther away from the visible scar than you'd ever suspect. It's OK to focus on certain areas of discomfort and not always get a full body session. If you only want your arms massaged, that's fine, too. Your massage therapist loves feedback. We like to know if you hate having your feet touched, and if you looove having your ears massaged. We like knowing your musical preference and if you prefer to start face down or face up. We're also cool if you just want to chill and let us use our judgement to design the treatment. Do you have questions about massage? Contact me or ask at your next appointment and I would LOVE to answer them!  We’ve come such a long way since the early ‘80s, when AIDS crashed onto the scene, killing many and frightening more. There was so little known at that time. It was through the hard work and advocacy of many people that we discovered HIV, learned how to prevent its transmission, and how to hold it in check. Today, HIV is a chronic illness, but some of the fear still remains. There are still people working tirelessly to eliminate stigma just as there are those working to find a vaccine and a cure. Still more are working to make the lives of people living with HIV better in whatever ways they can. Some of these are massage therapists like me. Massage therapy is not a cure. It’s not even a treatment. But it can help HIV+ individuals live happier, healthier lives:
You will never be turned away from my massage table due to your HIV status. When you have secondary issues that mean that massage would be harmful to either you or me, I will let you know specifically what they are, so that you are not left in the dark. If you find yourself with a condition I am not trained to work with, I will do my best to find you another massage therapist who is. Your HIV status is private. I will not tell your partner, your mother, your employer, your doctor, or your best friend, unless you specifically ask me to, in writing. If you would like copies of any records or notes I keep about our sessions together, you are welcome to them. But they are not for others’ eyes. How you contracted HIV is none of my business. Unless it’s something that affects your health in other ways (like current drug use), it has no impact on your massage. But if you do decide to share, I will not judge you. December 1 was World AIDS Day. This month, whoever you are, take a little time to learn about what’s been discovered about HIV since you first heard of it all those years ago. We now know about different strains of HIV, and how our bodies react differently to each. We know how to prevent mother-to-child transmission, and how serodiscordant couples (couples in which only one partner is HIV+) can safely conceive children together. And we know that the support of friends, neighbors, family, and loved ones is one of the key factors in the health and wellbeing of people with HIV. This post is just one small action I’m taking to help everyone feel more welcome in my practice. What will yours be?  Body image. Almost everybody has something about their body that they don’t like. For many people it’s a minor issue, no big deal. But some people have a major issue with their body image. It affects how they live and their happiness.
When I tell some people that I’m a massage therapist it can cause a strong reaction. They tell me, whether verbally or through their reaction and body language, that massage is not for them. Their body image is such an issue that they don’t think anybody else can accept them. The paradox here is that massage can really help with body image issues. In massage school we were all nervous about taking off our clothes and letting somebody else touch us. It didn’t take long for us to discover that bodies are just bodies and become much more comfortable with our own. We also experienced how good receiving a massage made us feel. Something unexpected happened – when our bodies felt better we felt better about our bodies. I think there are three options to consider. Let’s look at the risk versus reward for them. 1. Don’t get a massage. This is the easiest because it involves doing nothing. The risk is low since you are not letting another person see or touch you at all. The reward is zero. You didn’t get a massage so your body doesn’t feel any better, and you still have the stress you had before. 2. You get a massage, but the massage therapist either makes note of how you look, as if it matters. If this has happened to you, I’m sorry. You got a crappy massage therapist. That’s a bummer, and I’m really sorry. You took a risk, and even if the rest of the massage was decent, got very little reward. This is not going to happen if you come to me. Never. No way. I can’t say this strongly enough. It goes against the very nature of who I am, how I treat people, and what I believe. 3. You get a massage. A great massage. And the therapist does nothing to make you feel uncomfortable about your body. In fact, you feel pretty good about your body after the massage. In this option your risk is low. I don’t care how your body looks. That’s none of my business. I just want to help it feel better. Your reward is high. Again your body will feel better from the massage and you can start feeling better about it. I have no idea how your body got to be in the condition that it’s in. You may be dealing with something that you can’t control, such as a medical condition or an injury or accident. You may be in a lot of pain or are limited in what you can do physically. Since I don’t know what caused your body to be like it is now I can’t make any judgments about you. I’ve worked on hundreds – maybe thousands – of people. Each body is interesting and I’ve yet to come across one that I could not help. If you have been avoiding massage because you feel uncomfortable about your body, let’s find an option that works for you. You don’t even have to explain anything to me. Leave your clothes on. Stay sitting up or face down or lying on your side or however you want. It’s up to you. It’s my job to help you feel better. That’s it. Together let’s find a way to help you relieve your pain and stress. Don’t let your body image keep you from feeling good. |
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