nurturing body, mind & spirit january/february 2008

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A TAKE ON
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42
Insight and Opportunity
When we look to the future, we see a
changing horizon for massage trends.
So, let’s shake the bodywork tree
and consider what’s in store.
By Karrie Osborn

52
What’s Up in Canada?
Practitioners to the north have a very
different professional landscape than
those in the United States. What can
you learn from their experience?
By Robert Chute

62
Myths of Thai Massage
Sometimes practitioners are intimidated
by this work that is so intriguing to
clients. Here, a Thai-educated teacher
82
massage for musicians
addresses some misconceptions.
Injuries are being recognized increasingly as a
By Martin Misenhimer potential hazard of the physical nature of playing
instruments. See how massage therapy can help.

74 By Doug Nelson, Deborah Lieberman,

Reclaiming its roots
Thai bodywork and herbal treatments
are the subjects of study thanks to
an initiative sponsored by Thailand’s
Ministry of Public Health.
By Perry Garfinkel
and Jan Kiener
92
appreciating challenges
Prospective clients with physical challenges
offer therapists opportunities to expand their
practices into new—and rewarding—realms.
By Diane M. Marty
 what’s inside?
JANUARY/FEBRUARY 2008

COLUMNS

30
20 TALK ABOUT TOUCH
A JARFUL OF PENNIES
By Mary Ann Foster and
Mary Kathleen Rose

THE FUTURE OF MASSAGE 28 PRACTITIONER PARABLES

THE SHAKEN THERAPIST
Have you glimpsed our profession’s path? By Robert Chute
This industry expert projects what’s next in 110 ESSENTIAL SKILLS
terms of consumer use, education, training, LATERAL ANKLE SPRAIN

research, and legislative initiatives and By Ben E. Benjamin

explores the division between massage and 118 PATHOLOGY PERSPECTIVES

WHAT’S NEXT IS WHAT’S NOW
bodywork as healthcare or personal service. By Ruth Werner
BY WHITNEY LOWE 126 SPA ÉLAN
WINTER WONDER WRAPS
—PART TWO
By Anne Williams

132 HEART OF BODYWORK

GOING OVERBOARD
FOR CLIENTS
By Nina McIntosh

136 BUSINESS SIDE

TEN LOW-COST PROMOTIONS
By Shannon Perez

142 SOMATIC RESEARCH

RESEARCH PERSPECTIVES
By Ravensara S. Travillian

DEPARTMENTS
6 EDITORS’ NOTE
8 CONTRIBUTORS
10 READER FORUM
14 NEWS NOTES
16 HAPPENINGS
18 NEW PRODUCTS
24 ’ROUND THE TABLE
102 TOUCH AND SUCH
106 TEN FOR TODAY
148 SPOTLIGHT ON EDUCATION
150 EDUCATION RESOURCE LISTING
162 CLASSIFIEDS
163 DISPLAY SHOWCASE
167 AD INDEX
168 FINGERTIPS FOR THE CLIENT
editors’ note
BY LESLIE A. YOUNG AND DARREN BUFORD

THE FRUIT OF OUR LABORS

You appreciate the beauty and benefits of continuing education.

This period of introspection is a chance to rejuvenate or learn

skills and an opportunity to bring new energy into your work.

Our equivalent at Massage & Bodywork magazine is this redesigned

January/February 2008 issue we’re so proud to present to you.

These pages represent the cumulative efforts of M&B staff, our Washington-DC
design consultants, and, of course, reader feedback. From the beginning this redesign
has been an interesting journey because M&B wasn’t “broken” per se. In fact, you
consistently tell us how much you enjoy the magazine. But we knew that in order to
help you stay successful in this ever-demanding profession, your magazine needed a
PHOTOS BY RICK GIASE PHOTOGRAPHY

more efficient look and feel, with reevaluated and reorganized contents.
We don’t want to be a flashy consumer publication. Rather we’re interested in a
timeless look that allows you to seamlessly access and integrate M&B features and
advertising into your practice. As the profession evolves, we’re keeping pace and, in
many ways, leading the way. Our gifts to you include keen page templates, inviting
color and font palettes, reconfigured feature placement, super-efficient copy flow, and
new short, yet highly useful, departments and columns.
Our newest offerings include Talk About Touch (p. 20), an exchange between
authors Mary Ann Foster and Mary Kathleen Rose; ’Round the Table (p. 24), a place
for readers to voice opinions about a variety of topics; Practitioner Parables (p. 28),
Robert Chute’s firsthand accounts of events that shaped his bodywork practice; and Ten
for Today (p. 106), advice for industry-related topics. Information expert Ravensara S.
Travillian joins M&B as our Somatic Research columnist (p. 142). You’ll be pleased we
haven’t deleted any of your favorite columns or departments. They may be in a little
different order, but they’re all dressed up and waiting for you.
At Massage & Bodywork, our strength has always been editorial excellence. We
believe this new design complements and enhances the editorial content you count on
and helps establish the magazine’s presence for another generation of bodyworkers.
Remember that Massage & Bodywork is always evolving. Please let us know what
you think and how we can continue to meet your needs. We hope you enjoy the fruit
of our labors.

LESLIE A. YOUNG, Editor in Chief

leslie@abmp.com

DARREN BUFORD, Managing Editor

darren@abmp.com

6 massage & bodywork january/february 2008

contributors
IN THIS ISSUE
1
Robert Chute
Besides juggling three jobs, Robert’s
a stay-at-home dad with two children.
He is a massage therapist, bibliophile,
cinemaphile, and SpongeBobophile.
His lovely wife is a psychologist.
2
Perry Garfinkel
Perry is an avid swimmer, mediocre tennis
player, slow cyclist, great chef, and
part-time jazz/blues drummer, who’s written
for The New York Times and National
Geographic. He’s been falling on and off
the meditation cushion for thirty years.
His latest book, Buddha or Bust,
is a national bestseller.
3
Whitney Lowe
Whitney is a key figure in the massage
therapy profession, known for his
contributions to quality education
and standards in the field. He feels
fortunate to have an occupation that
is such an inspiring passion.
8 massage & bodywork january/february 2008
Martin Misenhimer 4
Martin learned Thai massage from lineage
masters in Thailand and North America and
is dedicated to bringing the ancient art to
the West. When he’s not mountain biking
or sea kayaking, he searches the world for
exotic cuisines and amazing scuba diving.
Ruth Werner 5
Ruth is a key pathology expert and massage
therapy educator. She and her husband are
lovingly planning their next home, which will
be too small for Boomerang Children. She is
an avid quilter, and her pieces are displayed
in discerning locations all across the country.
Anne Williams 6
Anne demonstrates expertise in education,
esthetics, counselling, and massage therapy.
She’s a literature-loving, horse-loving,
Colorado-loving gal who only leaves her Mac
for yoga or globetrotting with her husband.
reader forum
WHAT YOU ARE SAYING
Remembering
MT School
I just fi nished reading Robert Chute’s
article, “What I’ve Forgotten Since
Massage School,” in the October/
November 2007 issue of Massage &
Bodywork (p. 56). While I was reading
the piece, I was laughing to myself
about my own forgotten knowledge
since I left massage school about six
years ago. I’m a full-time bodyworker
and I have about fifteen hundred hours
of schooling. I always felt that my
experience was my best teacher and had
gotten to the point where I felt I was a
very good therapist, but have to admit
that I felt I was lacking in my work
somehow for not being able to diagnose
and utilize anatomy and my biological
science studies in my work. As one of
the people written about in the article
said, “There is more art than science
to the way most therapists practice.” I
believe this is true for most therapists.
Last year I undertook teaching a
comprehensive massage therapy class. It
was at one of those career schools you see
on TV that offers varied degreed classes
in things like medical assistant, medical
billing, massage therapist, and computer
systems technician. So you know a school
like this is really invested in creating
a quality massage program (*note
10 massage & bodywork january/february 2008
I just wanted to let you know that I read
Robert Chute’s article, and I am proud
to say that I am a Canadian-trained
massage therapist. I have been practicing
and teaching in the United States for
the past five years. When I fi rst started
teaching here, the students were amazed
that I knew so much from all my hours. I
explained that if we were to be respected
we needed to know certain amounts
of information. I live and practice in a
state that has just received licensure. It
will not be effective till 2009. I taught
students about pathology, treatments,
hydrotherapy, orthopedic tests, remedial
exercise, and all the things that were
stressed by our school to become a
sarcasm). It was a difficult year teaching
knowledgeable therapist. I get calls and
for the fi rst time and being responsible
for teaching students anatomy,
e-mails regularly from students who
said they couldn’t have done it without
physiology, pathology, kinesiology,
the information that they had received.
massage business, and ethics and all the
LISA BALL
massage modalities including circulatory,
GR ANGER, INDIANA
deep tissue, tui na, passive joint
movement, pregnancy, reflexology, chair
massage, and spa services. I felt guilty for
I really enjoyed Robert Chute’s
my students having paid close to $13,000
article and received great comfort in
to learn all of this information from me
knowing I am not the only therapist
since my knowledge base was limited to
out there that can’t recall exactly what
a few of these subjects—and not very
a potassium pump does. I too enjoyed
thorough at that. I worked extremely
the clinical aspect of massage school
hard to learn as much as I could so I was
at fi rst. It helped me feel more legit as
able to teach them as best as I could.
a healthcare professional to spout off
In many ways I’m very grateful for this
the odd anatomical factoid here and
experience, as stressful as it was. The
there. However, on the whole, I did
outcome for me was I became, what
poorly in the anatomy and physiology
felt like, ten times the therapist I was
parts of school, while excelling at
a year before. Being forced to learn
the practical aspects of massage.
and then teach the science material,
With a lot of help and some dumb
the anatomy, and physiology ingrained
luck, I managed to pass my national
itself in my bodywork and I noticed I
certification. That was six years ago.
was able to look at my clients’ bodies
I looked at my study guide recently
in a new way. Putting this knowledge
and could not believe I ever knew any
to use I noticed my intuitive bodywork
of the answers to those questions.
improved immensely. It created a new
I have been a manager for three
confidence. All the learning I did during
years and a spa owner for two. A large
my time as a massage student came back
part of what I do involves interviewing
to me and more during my teaching.
therapists, most of who are recent
It felt like I was a student myself.
graduates. It saddens me to no end
JASON LEWIS
that these people are more than
SAN DIEGO, CALIFORNIA
prepared to take on the same sort of
testing fi rst year med students endure,
but they have no idea how to give a
relaxing, professional massage.
While I see the point in learning
advanced musculature, and even
stupid potassium pumps, which have
something really important to do with
how we absorb water ... or something,
I feel that massage schools are trying
too hard to seem “legit,” which really
detracts from the hands-on education
that is a must to succeed in a growing
business like ours. Or in the case of
my school, which was purchased by a
large resort company, they are too busy
trying to pass students through the
program so they can hire them to work
on cruise ships at minimum wage.
Whatever way you look at it, I
think it’s time for a little compromise
in our field. Less time with the books
and more time teaching people
how to feel comfortable working
one on one with actual clients.
MICHELLE SMELGUS
SHREWSBURY, PENNSYLVANIA
Massage
from Mars
I am writing in response to Karrie
Osborn’s “Gender in the Profession,” in
the August/September 2007 issue (p. 18).
I am a man and I have been a
practicing professional massage therapist
for more than four years. I am so relieved
that I didn’t read a similar article when
I was just starting my practice. This
article is tremendously disheartening
to me and would have done nothing
to boost my confidence as a male
massage therapist entering this field.
This article seeks to give the point
of view of male therapists and includes a
number of unfair generalizations about
men. More stories based on real people
rather than weary stereotypes would
have gone much further in advancing
the dialog about gender in the field.
Ethics for both sexes is crucial, period!
I have my share of gender issues
because of my fi rst name. I work at a
massage center and my name, which can
be male or female, has been surprising
to some clients. Some choose not to
go through with their massage with
me when they fi nd out I’m a man,
while others are willing to see me. I
have to let my work speak for itself:
when I work on a skeptical person, I
can often change their mind about my
gender by the quality of my work.
JESSE LOCKE
LOUISVILLE, COLOR ADO
I am not sure whether to thank you or
not for dedicating an issue to gender.
As a male therapist, I recognize what I
will refer to as the challenges of being
a man in this profession. Since you
opened Pandora’s Box though, I feel the
need to comment. Let me say that the
number one thing this profession can do
to overcome the issues you brought up
is to not make an issue of them. They
are what they are, and most of them will
not change no matter how much we try.
Recognize they are issues and plan a
practice accordingly. People will prefer
the services of one gender over another,
whether it is massage, a haircut, or
having their car fi xed. One way I make a
nonissue out of it is I tell my receptionists
massagetherapy.com—for you and your clients 11
to book appointments by using
therapist’s fi rst names. For example,
“I have a 10:00 with Bill or an 11:30
with Janet. Which time works best for
you?” This tactic lets clients know that
we are concerned with their schedule,
not their gender preference, but if they
have one, they are not put on the spot
saying, “I don’t want a man or woman.”
They can simply ask for another time.
If I am seeing a person for the fi rst
time, I let them know what to expect:
“Based on your goals today, my plan
is to have you start face down, under
the sheets. You may disrobe to your
comfort level, but be assured you will
be appropriately draped the whole
time. I think it is best if I start with
your legs, working up to your glutes,
then your back. I will then have you
turn over and we can concentrate on
your shoulders, hands, quads, and feet.
How does that plan sound to you?”
By letting clients know what your
plan is, and giving them a chance to
discuss it, they won’t be surprised
by anything and they know that
your intentions are professional and
focused on their well-being. This
should be the case no matter what
the gender of the therapist is.
RICK MORGAN
RESTON, VIRGINIA
 READER FORUM

STAFF
LESLIE A. YOUNG, EDITOR IN CHIEF
leslie@abmp.com

DARREN BUFORD, MANAGING EDITOR

darren@abmp.com

JENNY GOOD, ASSOCIATE EDITOR

jenny@abmp.com

KARRIE OSBORN, CONTRIBUTING EDITOR

karrie@abmp.com

LARA EVANS BRACCIANTE,

ONLINE PROPERTIES DIRECTOR
lara@abmp.com
ADVERTISING
JODI MILLER, MANAGER
jodi@abmp.com

ANGIE PARRIS-RANEY, COORDINATOR

angie@abmp.com

PRODUCTION & DESIGN

AMY LAZOREK, MANAGER
amy@abmp.com

JAMES SUTHERLIN, ASSOCIATE

james@abmp.com

CREATIVE DIRECTION & DESIGN

JAMIE MITCHELL, BUSSOLATI ASSOCIATES
www.bussolati.com For example, the anterior belly
Massage & Bodywork (ISSN 1544-8827; USPS
BPH—Much Work wall can be stretched superiorly to help
005-245) is a bimonthly magazine published by
Associated Bodywork & Massage Professionals,
to Be Done lift the urinary bladder and access the
1271 Sugarbush Drive, Evergreen, Colorado Men’s healthcare should be placed into connective tissues around the prostate
80439-9766. Periodicals rate postage paid at
Evergreen, Colorado, and additional offices.
the massage therapy vernacular, and gland. The pubovesicle ligament between
POSTMASTER: Send address changes to ABMP, 1271
we are pleased that Ruth Werner has pubis and bladder can be treated to help
Sugarbush Drive, Evergreen, Colorado 80439-9766. done so with her article (“Estrogen facilitate normal bladder emptying. The
Vol. #XXIII, Issue #1 January/February 2008 Dominance and Prostate Problems,” parietal peritoneum can be accessed near
SUBSCRIPTIONS page 122, August/September 2007). the lumbar bodies to further affect the
Annual subscription rate in the U. S. and Canada We feel it is important for all manual connective tissues and circulation to
is $26 for one year, $45 for two years (U.S. funds).
Subscription rate in all other countries is $75 therapists to understand the workings the prostate gland. “Sandwiching” the
per year (U.S. funds). To subscribe, write to the of the male reproductive system, and prostate between the pelvic floor and
address shown above or call 800-458-2267.
benign prostatic hyperplasia (BPH) in fundus of the bladder can help soften,
websites: www.massageandbodywork.com,
www.abmp.com, www.massagetherapy.com
particular. Where we disagree with Ruth dilate, and “unwind” these tissues. All
No part of this publication may be reproduced or
Werner’s presentation is in the realm of the above work can be done through
transmitted in any form or by any means, electronic of manually accessing the pelvic bowl a sheet or underwear, and does not
or mechanical, including photocopying, recording,
or by any information storage and retrieval
organs. We feel that the male and female involve penetrating any orifice.
system, without specific written permission from pelvis can be safely and appropriately A recent study published in the
ABMP. The views expressed herein are those of
the authors, and not necessarily of the publisher
accessed through the abdomen. Journal of Bodywork and Movement
or its advertisers. Publisher cannot be responsible Treating the pelvic organs and Therapies (April 2007) demonstrated
for any unsolicited articles or materials, or the
return of such items. The editorial and advertising
connective tissues is a great way to that noninvasive manual therapy for
content in Massage & Bodywork is for educational change fluid dynamics and improve BPH patients improved urination
purposes only and is not intended as comprehensive
modality training or medical advice. Massage &
overall function. Our practices focus performance and perceived quality of
Bodywork encourages practitioners and massage on digestive and reproductive system life for all forty-three participants.
therapy clients to consult a qualified professional
for individual diagnostic and healthcare needs.
healthcare, and we frequently work in CHRIS HUGHES
the abdomen and pelvis to mobilize LOUISVILLE, KENTUCKY;
© 2008 All rights reserved. Associated
Bodywork & Massage Professionals Inc. organs, release adhesions, transition MARTY RYAN
Printed in the U.S.A. on recycled stock. the autonomic nervous system, and SEATTLE, WASHINGTON
move fluids. In other words, manual
therapy can be applied here just like
in many other areas of the body.
 “My husband and I ride Harleys *

and BIOFREEZE sets us free!”

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Dear Mr. Cox,

What follows is how I feel about the use of your product.

BIOFREEZE SETS ME FREE:
My husband is 47 and I am 51 and we lead extremely active
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We both now find the use of Biofreeze the key toward “just ®
moving”
on some days. In 1972, I took a fall in Karate and had to
Bio Harley
disk removed in my lower back. MT Ad for Massage Today have a
Since that time, I have never really
been pain-less, or awakened minus stiffness. In addition, I
am
a writer with several columns, feature work and a magazine
to edit.
Sitting for hours at the computer tightens my shoulder muscle
s.
What follows is a horrible, painful headache that ultimately
affects
my vision and concentration.
Exercise is usually the key for people with my kind of
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Making productive exercise can begin. One small application of Biofre
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with all of the above pains and worry over how I’ll make it
POWERFUL next day. On my last ride through the Blue Ridge Mountains,
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Steve and Pam Mann

Performance Health
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BIOFREEZE®, PERFORMANCE HEALTH®, and the Associated Colors (TM)

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news notes
COMPILED BY SEAN EADS
SPECIAL ISSUE
ON ONCOLOGY
MASSAGE
In November, the Society of
Integrative Oncology (SIO), which
was founded in 2003 to promote
and integrate complementary and
alternative treatments into current
cancer therapies, published a
special massage-oriented issue
of the Journal of the Society of
Integrative Oncology. The issue
examines reports on massage
therapy in cancer treatments,
including overviews of massage
research methodology and
data on medical programs that
integrate massage therapy into
their cancer-fighting regimen.
Access to articles is free to
SIO members. The journal is
available at http://bcdecker.com/
productDetails.aspx?BJID=329.
14 massage & bodywork january/february 2008
MBLEx Test
The Federation of State Massage
Therapy Boards introduced its Massage
& Bodywork Licensing Examination
(MBLEx) in October and says, as of press
time, Arkansas, Iowa, Oregon, South
Carolina, South Dakota, Tennessee,
Texas, Washington, and West Virginia
have adopted it. “The profession is
past due for a current, comprehensive
test that is affordable, convenient to
take, and supported by a competent,
caring organization,” says Patty Glenn,
LMT and Federation president.
MBLEx testing features a strong
customer-service program, costs $195,
and can be taken year-round at more
than two hundred U.S. sites. Results
are available immediately. “This
represents a significant first step toward
reciprocity and portability of licensure
across state lines,” Glenn says.
The gifts
also marked
ABMP’s
milestone
of 61,000
members,
making it
the largest
massage
membership
association in
the nation.
ABMP Donates
$20,000 to
Nonprofits
Commemorating its twenty years
of service to the massage therapy
profession, Associated Bodywork &
Massage Professionals (ABMP) gave
$20,000 to nonprofit massage therapy
organizations—the Federation of State
Massage Therapy Boards and the
Massage Therapy Foundation—
at ABMP’s annual School Issues
Forum in October. The Federation
received $10,000 for promotion of its
new profession-entry test instrument
(MBLEx), already adopted by nine
states. The $10,000 Foundation funds
will be used to encourage massage
research literacy through its Student
Case Report Contest. The gifts also
marked ABMP’s milestone of 61,000
members, making it the largest massage
membership association in the nation.
HELP AFTER
HEART SURGERY
A Mayo Clinic five-month
pilot study shows massage
therapy dramatically reduces
pain levels for heart surgery
patients. The study involved
fifty-eight patients who were
asked to rate the level of
pain they were experiencing
on a scale of one to ten.
Thirty patients were then
given massage treatments.
The twenty-eight patients
who received no treatment
reported no change in pain
management, while the
other thirty lowered their
assessment scores to one. Meetings of the Minds
The findings prompted the Boston was buzzing with bodyworkers this past autumn when professionals
Mayo Clinic to hire a full- fascinated with the function of fascia gathered for the First International
Fascia Research Congress October 4–5 at the Harvard Medical School
time massage therapist. As conference center. A portion of those attendees then stayed on for the
an additional response to International Association of Structural Integrators (IASI) conference.
patient surveys, the Mayo More than seven hundred individuals from twenty-eight countries
representing sixty disciplines gathered to share their research and experiences
Clinic has also developed a with fascia, sparking a great deal of conversation about ways clinicians
CAM treatment series known and scientists can share information and partner on future research. A
as the Healing Enhancement proceedings book is available for purchase at www.fascia2007.com. A DVD
will be available for $100 to Congress attendees and $200 to all others.
Program, which incorporates An estimated three hundred fifty bodyworkers attended the IASI conference
music therapy, guided October 5–7 at the Hyatt Regency Cambridge. Keynote speakers included
imagery, and stress education Judith Aston, Emilie Conrad, Jane Harrington, and Joseph Heller. During
a Friday session, IASI unveiled the Ida P. Rolf Research Foundation for
classes to promote full-body research in the area of structural integration. Rolf’s sons, Alan and Richard
and emotional wellness as Demmerle, were on hand to host a presentation about her life and legacy.
part of recovery. The findings IASI was also pleased to host the first certification exam for structural integrators
on October 7. The exam is designed to help structural integration practitioners
of the Mayo Clinic study can define their work and underscore the safe and effective practice of structural
be located in the November integration. For more information about future exams, visit www.siexam.org.
2007 issue of Complementary
Therapies in Clinical Practice.

massagetherapy.com—for you and your clients 15

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Focuses on professional skin care and spa
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Offers new products, trends, seminars,
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16 massage & bodywork january/february 2008
PORTALS TO THE SELF:
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MARCH 29–APRIL 5
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Offers continuing education in Pilates,
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APRIL 27–29
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Provides education and show floors
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FIFTH ANNUAL INTERNATIONAL
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SEPTEMBER 5–6
CAMDEN, SOUTH CAROLINA
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Features a forum for animal massage
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new products
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18 massage & bodywork january/february 2008
AromaGear Acupressure
Evo Solutions’ AromaGear is an essential
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Taping
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the essential oil holster is designed to
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range between $499 and $599. Available
at 800-843-3860 or www.healthway.com.
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Massage Prep
Have test anxiety? Massage Prep is
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This online resource, developed by
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completion of all practice tests, students
can take a series of timed fi nal exams
that simulate the NCE. Access packages
start at $49 at www.massageprep.com.
massagetherapy.com—for you and your clients 19
talk about touch
WITH MARY ANN FOSTER AND MARY KATHLEEN ROSE

A JARFUL OF PENNIES

Those first few comments, those initial

moments of contact, are crucial for
setting the tone of the whole session.

20 massage & bodywork january/february 2008

MARY KATHLEEN ROSE: If I had a penny
for every time a massage therapist
touched my body and said, “You’re really
tight,” I’d have a nice chunk of change
to give to the first person who touches
me and says, “You must be very strong!”
Recently, I received a complimentary
massage from a therapist who started
working in a local medical clinic. The
first thing she said when she touched
my body was, “You’re so tight.”
MARY ANN FOSTER: How did
you feel about that?
MKR: That’s the problem. She didn’t
ask me how I felt. She told me how
I felt. I was looking forward to a
nice relaxing massage, but when
she said that, I feared the worst.
MAF: What did you fear?
MKR: I knew she had an agenda and
was going to do her best to fix me.
MAF: I find this an example of a bigger
problem in each field. We are working
to enhance each client’s overall health
and well-being, yet when someone says,
“You’re so tight,” the only thing I feel
enhanced is my tension. Comments like
this make me feel like defective goods,
and right away we’re off to a bad start.
MKR: Yes, I feel judged and wonder
about the practitioner’s intentions. Is
“You’re so tight” a useful assessment
or an irrelevant assumption?
MAF: It seems overly simplistic. She
jumped to a conclusion before you
two had begun to develop rapport.
Did she even know why you were
there, or indicate that she knew why,
or what you wanted, or needed?
MKR: Many therapists sincerely believe
they are demonstrating a level of skill
and perceptiveness by saying, “You’re
so tight.” But it implies that there
is something wrong with the client.
Massage given with that attitude can
hurt the client emotionally, because
it is judgmental. It can also hurt
the client physically, if the therapist
proceeds to work too deep, too fast,
or otherwise without listening to the
needs of the individual. Irene Smith,
a massage therapist with more than
thirty years of experience, says that
when she receives massage she wants
a therapist who knows that “nothing
about me needs to be fixed.” Rather, she
talks about the “need to be received.”
MAF: That’s what puts me off about
comments such as “You’re so tight,”
“Your left hip is higher than your right,”
“Your back’s inflamed, etc.” I realize
that the practitioner is not listening to
me. I feel like an object that’s too shiny,
too hard, too bent, too whatever.
MKR: Yes, a broken object to be
fixed. But what about me?
MAF: I feel like running up a white
flag and declaring, “Wait, I’m a person,
not a tight thing. I live in this body.
Just what are you planning to do with
it?” Then I get really, really tight.
MKR: Proving the therapist’s point!
MAF: Now that’s job security. But what
really keeps people coming back?
MKR: I’m not going to come back to
someone who isn’t listening to me. And
I trust that the clients who come back
to me as a therapist return because I
am doing my best to help them feel
better about who they are as whole
human beings. I focus on what’s right
with them rather any naive notion
about what’s wrong with them.
MAF: Those first few comments, those
initial moments of contact, are crucial
for setting the tone of the whole session.
MKR: They define the
relationship we are creating.
massagetherapy.com—for you and your clients 21
MAF: And they give the client powerful
clues about the mind-set of the massage
therapist, the model or paradigm of
healing in which the therapist is working.
MKR: Do you think massage therapists
feel duty bound to assess the client’s
body, by sharing their perceptions,
albeit assumptions, about what they
feel? What is so hard about saying,
“How are you?,” “What do you need
today?,” or “How can I help you?”
MAF: I find that with the proliferation
of techniques taught in massage
schools these days, many students
lose sight of the overall intention of
massage. Those questions aren’t hard.
They are the basic communication
skills and tools for building rapport.
I find them the best and easiest way
to start a client-centered session.
MKR: I agree. Here’s a postscript for
you: a few days after the aforementioned
massage, I attended my regular dance
class. During a break, a friend started
to massage my shoulders and arms. He
commented, “You are really strong!” I
almost broke into tears, then laughed and
said, “Thank you. You just made my day.
I’ve got a jarful of pennies for you!”
Mary Ann Foster, BA, CMT, has been
practicing and teaching massage, movement,
and experiential anatomy in the Boulder/
Denver area since 1981. She has extensive
experience in Rolfing movement and Body-
Mind Centering and is the author of Somatic
Patterning: How to Improve Posture and
Movement and Ease Pain. www.emspress.com.
Mary Kathleen Rose, BA, CMT, has
a background in shiatsu and integrative
massage and more than twenty-five years
of active involvement in the holistic health
field. She is the developer of Comfort Touch
and is a consultant for hospices and other
medical organizations. She produced the
video Comfort Touch Massage for the
Elderly and the Ill. www.comforttouch.com.
 I am ABMP.
Roberta Geier, Steamboat Springs, Colorado.
Member since 1999.

BACKGROUND: My life encircled theater and education,

but training in Healing Touch, neuromuscular therapy, Muscle
Release Technique, and Ashiatsu revealed my true soul. I
began by working with a chiropractor and a physical therapist,
developing contacts that led to my thriving private practice.

PERSPECTIVE: I listen carefully with my ears, eyes, hands,

and heart, striving to create a healing session that’s physical,
emotional, and spiritual. To guide others to heal themselves is
truly rewarding.

BUSINESS GROWTH: My client return base is excellent. I offer

discounted packages that can also be used by family members
and office staff. It’s incentive for them to continue the therapy
year after year.

ABMP AND ME: ABMP’s rate for liability insurance, along with
their publications and all the other services, is the bargain of the
century. I also appreciate how hard the association works for
legislation and positive media coverage.

LAST WORD: With broader communication about our

profession and higher standards for training, we’ll gain our
rightful place in the world of healing.

Comprehensive liability insurance and

practice support for massage and bodywork
professionals and students.

Associated Bodywork & Massage Professionals

800-458-2267 • www.abmp.com
 in perfect
alignment
with your goals.
certification

Every day, NCBTMB helps nearly 86,000 nationally certified

massage therapists and bodyworkers realize their professional
– and personal – goals.
National
NATIONAL

That’s because NCBTMB certification is more than a

credential, it’s the cornerstone of a successful career. It
establishes a practitioner as a dedicated professional, one
Certification
with the knowledge and skills to uphold high standards of
excellence. It communicates a commitment to ethics and Board for
safety, and assures consumers they are in good hands. In
fact, the benefits of national certification are immeasurable. Therapeutic
• Represents the highest • Gains visibility and
Massage &
credential in the field credibility
• Communicates a • Increases employment
commitment to safe, opportunities within/
Bodywork
ethical practice between states
• Provides a competitive • Includes a listing in
edge NCBTMB’s practitioner
• Reassures clients and locator service
employers • Establishes practitioners as
• Allows reimbursement by healthcare providers on par
some insurance with other professionals
companies requiring certification
To become nationally certified – or recertified – call NCBTMB
at 1-800-296-0664 or visit www.ncbtmb.com.

NCBTMB ... certification and excellence go hand in hand.

1901 South Meyers Road

Suite 240
Oakbrook Terrace, IL
60181-5243
www.ncbtmb.com

©2007 National Certification Board For Therapeutic Massage & Bodywork.

’round the table
GO AHEAD, SPEAK UP

When you consider

the future of the
bodywork profession,
what expectations/
concerns do you have?

COMING IN MARCH/APRIL: WHAT HAS SIGNALED SUCCESS FOR YOU OR YOUR PR ACTICE?
SEE PAGE 26 FOR UPCOMING TOPICS, DEADLINES, AND SUBMISSION INFORMATION.

24 massage & bodywork january/february 2008

As a massage professional,
I hope to see all fifty states
implement a national
certification requirement for
licensure. I am very aware
that many therapists, some
educators, and even more
than a couple state boards
disagree. However, in order
for our industry to become
more accepted within the
medical community, we
must first hold ourselves,
and our colleges, to a much
higher standard. For those
of you who are unaware,
we still have states with
no more educational
requirements than a weekend
of training. And yes, that
weekend can be done in
the convenience of your
own home on a computer.
Don’t we owe it to ourselves
and to all those who seek our
services to make sure that
future massage therapists,
and bodywork professionals,
are properly trained,
insured, and licensed?
Angela Barker
Milton, West Virginia
I believe we have an exceptionally bright
future, but beginning therapists are
much younger these days and there
is a sharp division in their goals. As a
school owner, I see an equal amount
of students who wish to become either
spa or clinical therapists. I believe that
both job markets are growing, while
completely different. In many states, we
are a licensed healthcare occupation,
and mandated foundations such as
anatomy and pathology are unexpected
and overwhelming for many students.
Potentially great therapists can become
lost when facing academic challenges.
We need to continue to meet their needs
during the application process and in
the classroom to see them gain success.
MIRR A GREENWAY
COLUMBIA, MISSOURI
With massage therapy as the new
lifestyle choice, businesses and jobs
are becoming readily available.
Meanwhile, regulations are becoming
stricter and the surplus in the market
permits prices to hit rock bottom at
the expense of the massage therapist.
As with any market on the verge
of supersaturation, receiving massage
at an affordable price may become
easier, however detrimentally to the
massage therapist. Massage companies
advertising record low $40 massages
are at the expense of the massage
therapist. Massage mills are able to turn
profits due to the volume of sales: their
establishment has multiple stoic rooms
they can fill, splitting their low price
among many therapists per hour. While a
chain massage mill can afford to schedule
a volume of massages, the therapist can
still only physically perform the same
amount of treatments. In the distant
future, action on behalf of the massage
therapists may require a state or national
labor union to enforce minimum pay
and fair treatment to contractors.
KENDR A HENDERSON
LOS ANGELES, CALIFORNIA
massagetherapy.com—for you and your clients 25
As a massage therapist in a state that
has no regulation, I believe that if this
profession wants to be taken seriously,
we need to have specific licensing
requirements for calling yourself a
massage therapist, as well as mandatory
continuing education. The public
needs one reporting organization to go
to if something inappropriate and/or
illegal occurs with his/her bodyworker.
Additionally, it would help educate
the public regarding our profession
and the public would have the ability
to verify the practitioner is properly
educated, licensed, and insured. My
concern is how to regulate such a wide
variety of bodyworkers. Someone
practicing medical massage versus
reiki, while both are powerful and
effective techniques, may necessitate
different licensing requirements.
I believe the massage therapy
field is on the brink of a powerful
inclusion within the world of Western
medicine. We need to present
ourselves as the professionals we are.
MARYANNE GILBERT
GOLDEN, COLOR ADO
Seeing our fellow massage therapists as
colleagues instead of a threat is one of the
most important factors of our profession.
There is strength in numbers. I recall
my business teacher in our massage
class stating, “Look around you. Here is
your competition and greatest threat.”
What a way to wage a war. Having
twenty-five years in education has taught
that the departments and classes that
thrived and survived had a common
bond of teamwork and family. We
need to encourage each other, offer to
pinch hit for each other for vacations,
sickness, and family crisis. Since we deal
so much with energy work, let us strive
to offer love of the profession as well as
the professional. No one is an island;
so let’s help each other sail the ocean
to that island. Look for opportunities
within our massage communities
and keep the channels open.
CAROL SUE RICHHART
INDIANAPOLIS/CARMEL, INDIANA
’ROUND THE TABLE

’Round the Table is a chance for you to UPCOMING TOPICS DEADLINE PUBLICATION DATE

offer insights and reflections on a particular

topic relating to the field. We’ll provide the What has been your Feb 15 May/June 2008
most challenging
topic, then we’d like you to give us your moment as a
expert opinions. Below, you’ll also notice bodyworker?
topics for upcoming issues in 2008, as well
How has partnering April 15 July/Aug 2008
as the deadlines for submission and the with other professionals
corresponding publication dates. You may paid off (or not)?
respond to any of the topics below at any time.
What is your best June 15 Sept/Oct 2008
Know, however, that we will not publish these marketing tool?
responses until the allotted publication date.
Please e-mail your submissions (250 words or What makes your Aug 15 Nov/Dec 2008
practice unique?
less) to darren@abmp.com with the subject line
’Round the Table. Submission does not guarantee
What is the best Oct 15 Jan/Feb 2009
inclusion. Also, due to space constraints, we professional advice
may edit your material to a suitable length. you’ve received?

My biggest concern is the lack of
leadership in the massage profession in
helping to define the profession. Since
massage is defined so differently by
each state, educating the public as to
what we do and the value of massage is
a struggle. Your recent member survey
that says that 62 percent of respondents
have never received a massage because
they didn’t perceive a value to massage or
feel it is necessary is alarming and also a
good motivation for us to work to clearly
define ourselves and the value of massage.
Our lack of a clear definition
for ourselves is now showing up
clearly in the medical massage
debate, with insurance companies in
Washington now defining it for us.
JULIE ONOFRIO
REDMOND/SEATTLE,
WASHINGTON
My current concern for this industry
is the big business coming in—i.e.,
Massage Envy franchises. While I agree
that business is the “American way,” I am
feeling like the LMTs/CMTs who go to
work there are traitors to the industry.
$39 massages! Ridiculous. How can a
small business owner compete with that.
I don’t know much about the health/
disability benefits available; however,
undercutting the “competition,” as we
were told in school, is bad business.
In my community, it’s not unheard
of for LMTs to discuss fee schedules.
Most of us will increase our rates to
match the others or offer discount
packages or specials. This allows us
to have cohesiveness and fair trade.
This is exactly the reason that I
try and shop locally owned businesses
in my town. I’d truly rather pay a
bit more than allow these places to
be gobbled up and lost forever.
WILLOW MUHR
NEWBERG, OREGON
With the high cost of health insurance
and the number of individuals without
it, I see more people turning to massage
and bodywork for their health needs.
Both massage and bodywork can be fairly
inexpensive ways to help individuals
manage and alleviate their health
concerns. The one main concern I have
is the high number of massage schools
out there, turning out subpar therapists.
Potential clients may have a difficult
time finding qualified practitioners,
especially in states where massage is
not regulated, like here in Colorado.
SUSAN CLINGMAN
AUROR A, COLOR ADO

26 massage & bodywork january/february 2008

massagetherapy.com—for you and your clients 27
28 massage & bodywork january/february 2008

THE SHAKEN THERAPIST
When I finished her massage, she
was ecstatic. She had never received a
professional massage, so the relaxation
she achieved was something of a
revelation to her. Then, four days
later, I got the phone call. She was
in a lot of pain. “What did you do?”
she asked. “I felt fantastic for the
first three days and now this!”
“You felt great for three
days and the upper back pain
has popped up just today?”
“Yes, so what did you do?” Her tone
was accusatory. You know how your
head gets hot when you’re in trouble?
My scalp could have ignited dirt. I might
have been sweating audibly but all I
could hear was my pulse pounding.
“It was your first time so I gave you a
very light full-body relaxation massage,”
I explained. “I doubt the pain you feel
now is a result of the massage four days
ago. If my work had harmed you, you
would have felt the pain right away
or at least within the first forty-eight
hours. This must be something else.”
It was something else. It went
away quickly with some exercises.
She got past the pain quickly, too.
Then, she remembered how much she
loved receiving massage and, much to
my surprise, even became a regular
client. There’s a small miracle right
there, and I’m grateful for it. She
never had pain after massage again.
However, I think part of me deep
down in the lizard brain was always
waiting for another accusatory phone
call each time she exited my clinic.
That phone call upset me because
it made me feel so vulnerable. Sure,
blaming her pain on me was a little
like saying, “I can’t understand how I
got hit by an ice cream truck today! I
took vitamin C four days ago!” Still, if
someone could have an unrelated physical
reaction and blame it on massage—even
after such a light relaxation-only
practitioner parables
treatment—did I ever want to do more
challenging work involving frictions or
trigger points? The thing about lawsuits
is, even if you win, it still costs you
money you don’t have and the emotional
strain of such a case is immeasurable.
Such worries would find me looking for
a hiding place under the rug. Sometimes,
even though you do everything right,
someone will still think you’re wrong.
“Maybe I’m too much of a delicate
doily to take on such a risky occupation,”
I complained to My Friend The
Chiropractor. “What’s less risky than
massage therapy?” I asked, straining
for an answer, getting nothing.
He assured me this was a rare
case. Then, he told me what he tells
his first-timers and I had my a-ha
moment. “I can’t control how your
body will react to treatment. However,
if there is a problem, there’s a lot
we can do together to resolve it.”
A-ha.
If clients can occasionally make a
good thing into a bad thing, it shouldn’t
be surprising that sometimes even doing
a great service isn’t enough to keep a
happy client. Case in point: I had just
opened my first clinic when a woman
wandered in for a massage. During the
intake interview, I asked about her wrist.
She showed me that it had very limited
range of motion and reported that it had
been stiff for fifteen or twenty years.
I assessed it, asked if I could help, and
with a huge pop, mobilized the wrist
joint fairly easily. She was delighted and
astonished to demonstrate full range
of motion had returned, pain-free.
She saw me a couple times for
relaxation massage and then disappeared.
It happens that people move or just move
on. I thought about the last time I had
seen her, and aside from appearing to
be in a hurry to leave, she had seemed
happy with her treatment. I never saw her
again, but I heard from her once more.
massagetherapy.com—for you and your clients 29
BY ROBERT CHUTE
Just as I was about to close down my
clinic—I was moving far away—I got
a phone call from this same lady. “Do
you remember me? I was the woman
with the wrist that didn’t move for
years and years and you really helped
me!” Of course I remembered her.
Progress is expected, but you don’t
forget the surprising miracles, even
the smaller ones. Excellent, I thought.
I can finally find out what happened
to her. Moved to Tijuana, perhaps?
Entered a kibbutz? Doing five-to-ten
for aggravated assault with a Nerf bat?
“I heard through the grapevine
that you were moving, and I just
wanted to say goodbye and tell you
thanks. My wrist is still just fine.”
“Glad to hear it! Um, where’d
you go?”
“Oh, I found another therapist,”
she said breezily. “I like to go
where there’s free parking, so
that’s why I didn’t come back.”
“Ah,” I said.
The lesson learned? For some
people you can turn water into wine
and they’ll take the glass and drink it
down with a smile. You are reminded
of the variability in working with
human beings when they then lay this
one on you: “I wanted red.”
Robert Chute, a writer and massage
therapist in London, Ontario, is still a delicate
doily, but dealing. He can be contacted
at consciousbodywork@hotmail.com.
the future
of massage
By WhItney lOWe
 S
omeone once said, “Predictions

are frequently inaccurate—

especially those about the

future.” It is likely that

fifty years ago few in the

profession could have guessed

massage would grow in the

ways and to the extent it has.

Indeed, it is not possible to

predict an absolute course

for the future of massage

therapy. Nevertheless, it is

valuable to review the general

trends in the profession to

gauge its growth patterns

and future possibilities.

massagetherapy.com—for you and your clients 31

THE FUTURE OF MASSAGE
In the last issue, which celebrated
the twentieth anniversary of Associated
Bodywork & Massage Professionals
(ABMP), industry leaders gave their
perspectives on notable changes over
the profession’s last twenty years.
Through the commitment of industry
leadership and professional therapists,
massage has grown into a modality
that is garnering far more respect
than at any time previously. Clearly,
massage therapy’s future, though not
firmly defined, is exciting and full of
possibilities. In this issue, we take a peek
into how massage is developing, what
trends are becoming established, and
what opportunities are lying ahead.
HEALTHCARE OR
PERSONAL SERVICE?
In the last few decades, a division
developed in the profession between
massage as a healthcare modality and
massage as a personal care service. The
boundaries between these styles are
sometimes blurry and practitioners
often practice both. However, an
increasing number of therapists are
choosing to identify with one aspect
of the practice over the other. Each
style has different professional and
educational interests that can either
merge or be quite disparate.
HEALTHCARE MASSAGE
Massage therapy has a long history in
healthcare throughout parts of the world.
However, in the United States, its use as
a healthcare practice greatly diminished
with the rise of technological medicine
and the pharmaceutical industry in the
early twentieth century. For example,
although once an integral part of physical
therapy, massage gradually became a
much smaller part of this profession in
the latter half of the twentieth century.
32 massage & bodywork january/february 2008
It wasn’t long ago that healthcare
professionals in the United States
scoffed at the idea of massage as a serious
modality for a wide array of healthcare
complaints ranging from musculoskeletal
injury to pain management for cancer
patients. Today, views are changing
significantly. Groundbreaking studies on
alternative medicine use by researchers
such as David Eisenberg and Daniel
Cherkin have shown a consistent pattern
of both increased use and acceptance of
massage as not only a viable healthcare
modality, but a valuable one.1,2
Massage and other complementary
and alternative medicine (CAM)
practices are gaining interest with
students in traditional medical schools,
which is an indicator of even greater
acceptance of these approaches by
tomorrow’s physicians. An example
of this came in June 2005 at the
National Education Dialogue (NED)
held at Georgetown University. This
was a meeting of more than seventy
healthcare professionals and educators
from conventional medicine and nine
CAM disciplines. These educators
discussed how to integrate CAM
training into future medical school
curricula. As a fortunate participant, I
was pleased at the warm reception we
received from educators from some of
the most prestigious medical schools
in the country. Many seemed not only
fascinated, but excited about the growth
and potential of our emerging profession.
A picture of the profoundly
expanding use of massage as a healthcare
practice can be gleaned from several
studies on the use of massage in the
United States. Recent investigations
show close to two hundred thirty
million massage sessions were
provided to American adults in 2006.3
Ineffective results in traditional medical
treatment for musculoskeletal disorders
has driven millions of Americans
to seek better care through CAM
approaches, such as massage therapy.
Another study on the practice
patterns of massage therapists
shows 60 percent of office visits to
massage therapists each year are to
address musculoskeletal symptoms,4
or roughly 138 million massage
sessions. That is a huge number of
massage sessions used specifically
for healthcare, and the numbers are
almost certain to continue rising.
For massage therapists wanting
to make inroads into the traditional
healthcare system in the United
States, the outlook for this branch of
the profession is bright. Practitioners
offering treatment for pain and injury
conditions, palliative care, and stress
and anxiety will find their services
in ever greater demand. In fact,
consumer expectations in this regard
are increasingly placing pressure on
massage therapists in terms of skills.
Therapists offering healthcare
massage are found in private clinics,
sports settings, and other healthcare
facilities. Increasingly, practitioners work
in chiropractic and physical therapy
clinics, doctors’ offices, hospitals,
universities, or other healthcare
establishments. Massage is also an
integrated healthcare program in
professional sports, dance, and other
physically demanding professions. We
can look for greater inclusion of massage
in mainstream settings, such as hospitals
and primary care health clinics. We
can also expect massage to continue to
garner greater respect, and thus referral,
by traditional medical practitioners.
Ground breaking studies on
alternative medicine use have
shown increased use and
acceptance of massage as
not only a viable healthcare
modality, but a valuable one.
An unsettled issue for massage as a
healthcare modality is whether greater
use of insurance reimbursement would
have a positive or negative impact on
the profession. This issue has been
discussed with more detail in other
articles. However, the main points
of contention pose several legitimate
questions that those in the profession
should think seriously about prior to
pursuing this course. Will, for example,
insurance reimbursement truly lead to
greater access for the consumer? Will
the cost per massage then increase, as it
did with physical therapy, thus reducing
access by those without insurance?
What will be the avenues and processes
for approval by health insurance
companies? How will this impact the
profession? Will practitioners make
more money? What are the true costs/
benefits for practitioners doing insurance
reimbursement? History has shown that
professions that have become enmeshed
with the insurance reimbursement
system have lost autonomy in
determining treatment for their patients.
There are other concerns not
mentioned here. Suffice it to say that
insurance reimbursement is one of
the issues facing massage that could
seriously alter the profession’s course.
Clearly, the current climate of increasing
insurance reimbursement has both pros
and cons. The trend toward increased
insurance reimbursement in massage
makes me nervous because corporate
greed has a way of superseding what
is best for the consumer/patient
in many cases, especially in the
current U.S. healthcare system.
PERSONAL CARE MASSAGE
Ask the average person what he thinks
of when you mention massage therapy
and he is likely to describe an image
straight out of popular media—someone
with a blissful expression getting
pampered in a luxurious resort. This
aspect of the profession is considered
a personal care service—that which
someone uses for overall wellness
enhancement, general relaxation, and to
feel good, not for specific pain, injury,
palliative care, or other ailment.
A majority of practitioners offer
personal care massage and work
in diverse settings such as home-
based practices, private clinics,
spas, and high-end resorts. With
the development of chair massage, a
plethora of settings has emerged—from
corporate offices to airports to malls.
The fastest growing environment
for this sector in the last decade is
the spa industry. Spas in the United
States employ more than two hundred
fifty thousand people and massage
therapy is the most requested service.5
The spa industry is experiencing a
high growth rate, an estimated 15–16
percent per year.6 Spas provide a distinct
employment advantage for some massage
therapists, especially those fresh out
of school. A new therapist needs to
gain confidence and experience by
working on a large number of people.
In addition, the economic pressures
of setting up a private practice may
be overwhelming when combined
with remaining school expenses. We
can expect steady growth in the spa
sector for at least several more years.
massagetherapy.com—for you and your clients 33
One area where health and
personal care styles of massage are
beginning to converge is in medical
spas. Medical spas offer similar services
to traditional spas but also frequently
employ licensed physicians or other
healthcare providers. Treatments at
medical spas often address not only
wellness or beauty enhancement, but also
various health problems as well. This
innovative development could provide
a greater degree of communication and
participation between the healthcare
and personal care sectors of massage.
However, medical spas will need to
employ practitioners with the skill
base to adequately accomplish spas’
advertised healthcare massage services.
Another trend likely to continue
in the coming decades is the growth of
massage franchise businesses. Advocates
for these businesses claim to offer longer
hours and charge less in an effort to make
massage more accessible to a greater
number of people. Some practitioners are
uncomfortable with the franchise business
model because they believe the lower
cost may undercut services provided by
private individuals or independent clinics.
However, franchise businesses could serve
an important niche in making massage
more visible and accessible to those who
might not ordinarily pursue it. On the
other hand, there are concerns about
how it will affect the overall perception
of massage therapy by the general
consumer. It remains to be seen how or if
franchise businesses—where treatments
are designed to be similar and greater
emphasis is placed on business success
for the franchise owner—will change
the nature of personal care massage. In
general, there are concerns about quality
with the franchise setting. This issue is
discussed below in education and training.
Given the demand for personal
care massage therapy, the outlook is
quite positive for these practitioners.
There are increasing opportunities and
lots of room for the entrepreneurial
creativity of massage therapists.
THE FUTURE OF MASSAGE
EDUCATION AND TR AINING
For years, the profession’s growth rate
has been considerable. Concurrently,
exponential growth occurred in the
number of massage schools. Statistics
from the recent ABMP school enrollment
survey indicate that close to 1,530
massage training programs are currently
in operation in the United States.7 That
number is up 7.8 percent over the figures
from 2004. It is also notable that while
the school numbers were going up, total
enrollment went down. The number of
students enrolled in or graduating from
massage programs declined from 2004
to 2006. Thus today we have a greater
number of training programs competing
for a declining number of students.
However, I don’t think the decline in
students is something to be immediately
concerned with. ABMP President Les
Sweeney refers to the decline in schools
A majority of as “a healthy market correction.” Growth
cannot continue like a runaway train
practitioners forever. This market correction could
remove lower quality or less competitive
programs and schools. However, there
offer personal is no guarantee that the reduction in
schools will leave only the very best
care massage schools. An unfortunate consequence
already appearing is the loss of some very
and work good training programs. These long-
established schools are getting caught
up in the economic pressures and are
in diverse unable to compete. A key question for
the future of the profession is whether
settings such educational quality will rise or erode
with the various changes in the field.
as home-based In the last couple of decades, new
players entered the arena of massage
school education. According to the
practices, ABMP school enrollment survey, 65
percent of recent graduates received
private clinics, training in proprietary (private) schools,
29 percent from career schools, and 6
spas, and percent from colleges.8 Increasingly,
technical schools and community
colleges provide massage education.
high-end These larger institutions are able to
leverage their resources to offer massage
resorts. programs at a significant cost reduction.
The easier availability of federal financial
aid in these institutions is also attractive.
34 massage & bodywork january/february 2008
Another influential trend that is
likely to continue is corporate ownership
of schools, which often entails the
purchase of established schools. As a rule,
corporations are primarily concerned
with efficiency, growth, and financial
viability. These are positive aspirations
as long as the quality of the product—in
this case education—continues to be
high. Advocates argue that standardized
curriculum and resource sharing can
lead to better, more consistent quality.
However, others express concern that
corporate ownership will remove
the individual elements that set the
school apart. There are also concerns
about how corporate ownership will
impact massage education overall.
Distance education is another
educational trend in entry-level
training. The development of Internet
technology has made significant inroads
in colleges and universities. There are
now hybrid distance education programs
for entry-level massage training.
These programs offer some course
work through distance learning while
hands-on techniques are taught in the
classroom. Distance education makes
training more accessible to people with
difficult schedules or time constraints.
How these hybrid programs
compare with training from a traditional
educational environment is a question
time will answer. Current education
research does, however, indicate
that most subjects can be taught
effectively in either format. There are
advantages and disadvantages to each
approach. Given that a significant
proportion of massage education
is not hands-on—such as anatomy
and physiology, ethics and business,
pathology, kinesiology, etc.—distance
education is likely to continue gaining
ground and be a beneficial option.
THE FUTURE OF MASSAGE
QUALITY CONTROL
The fundamental issue of most concern
is educational quality and the image
of the profession by other healthcare
professionals and consumers. If massage
therapy is going to continue on the
strong path it is today, then these
elements must be addressed by educators,
administrators, and practitioners.
In either health or personal care
massage, high-quality education for
practitioners is important—both for
their clients and for the practitioner’s
business success. For those practicing
therapeutic treatment, sufficient
and quality education is essential.
The issue of educational quality
is challenging and something that as
a developing profession we have yet
to resolve. The question of industry
standards is something other healthcare
professions were forced to address at
some point. Admittedly a hot button
topic, standards will be something
that, at least for healthcare massage,
the profession will need to deal with
as we progress. Healthcare massage
may eventually run into the same
issue that other healthcare professions
have, where different educational
levels needed to be established.
36 massage & bodywork january/february 2008
There are several issues related
to educational quality that the
profession will continue to deal with,
particularly faculty qualifications,
content, and curriculum.
There are already large discrepancies
in the number of hours, curriculum, and
content in educational programs. Yet, no
identifying degrees that distinguish those
with advanced training from entry-level
exist. Some community colleges offer
associate degrees for students graduating
from two-year programs. Private schools
sometimes offer tiered training. Purely
in terms of marketing, practitioners
would benefit from additional ways to set
themselves apart given their education
and training. Historically, certification
in advanced continuing education
has attempted to fulfill this need.
There are seven accrediting
agencies for the massage profession,
but no agreed upon standards. Not
everyone even agrees on the necessity
of accreditation. Part of the issue with
standards is the way in which they
would be established. Most believe that
competencies versus a random number
of hours should be the basis for an
entry-level standard. Organizations
such as the Commission on Massage
Training Accreditation (COMTA) have
worked to develop competency-based
training standards. However, only a
small percentage of schools currently
are accredited by COMTA. Competency
evaluation should be developed for
the various levels in which massage
is performed. As massage develops
as a legitimate healthcare profession,
industry standards and competency
will become even more of an issue.
QUALITY STAFFING
Massage therapists will continue to rely
on continuing education (CE) for most of
their advanced training. With the greater
number of courses available, there are
multiple opportunities for advanced
education. Certification and licensure
requirements continue to fuel the need
for continuing education courses. What
is distressing is the trend toward poor
quality training programs used simply
to fulfill CE requirements. There will
continue to be a wide discrepancy in
quality of continuing education.
There are several issues related to
educational quality that the profession
will continue to deal with, particularly
faculty qualifications, content, and
curriculum. Faculty experience remains
a challenge for schools. Schools have
generally faced difficulty finding
and retaining qualified faculty, often
resorting to recent graduates. There is
concern that with the rise in the number
of training programs there become more
challenges staffing programs. Educators
across the field express concern that the
lack of qualified staff is leading to lesser
quality training. Colleges requiring
degrees from their massage faculty face
a greater challenge as the best educators
may not have college educations.
Educational design also affects quality;
schools seeking to graduate the best
students work to develop effective and
well-developed curriculum and content.
THE FUTURE OF MASSAGE
As a growing profession that is
gaining respect among other healthcare
providers, it behooves us to continue
to work toward improving overall
educational quality. Superior training
is a financial advantage to practitioners
and educational institutions.
THE BUSINESS OF MASSAGE
Tabulating realistic numbers of
practicing massage professionals is
difficult. It is apparent, though, that
there is an exceptionally high rate of
attrition in the profession. Most people
leave the profession after only a few
years. While physical burnout is a key
factor, the most commonly cited reason
is inability to make an adequate living.
As discussed above, there are
increasing opportunities for practitioners
to work in settings where they are
employed versus private practice. The
advantage of employment is being able
to focus on the practice of massage
instead of business building. While
these options are appropriate for some,
the majority of therapists will continue
to work for themselves. Business and
entrepreneurial skills are mandatory for
practitioners promoting themselves.
There are estimates of close to
two hundred fifty thousand massage
therapists and bodyworkers in the
United States.9 Such a large number
introduces the question of saturation:
how many people can be reasonably
employed in this field in a given region?
Those two hundred fifty thousand
practitioners are not evenly spread
across the country, and it is doubtful
they are evenly spread out to match
the population densities in various
geographical regions. The number of
practitioners in any geographical area is
influenced by the population’s attitudes
toward massage, number of schools
in the area, licensure requirements,
and other factors. In certain regions
there seems to be an overabundance of
practitioners. Competition and greater
economic pressure will continue to
affect some of these high density areas.
38 massage & bodywork january/february 2008
Consumer education is a developing
issue for practitioners. As the general
population becomes more familiar
with their options and the promise
of massage, they will have greater
expectations. For some clients, a bad
experience will swear them off massage;
other consumers will be more adaptive.
Studies show that clients are disinclined
to express discomfort or unhappiness.
Yet, referral and repeat clients are the
thrust of a successful practice. Good
marketing, quality effective therapy,
and good communication will continue
to be keys for success. With increasing
competition, therapists will increasingly
need to find ways to set themselves
apart from their competition.
ASSOCIATIONS, POLITICS,
AND LICENSURE
As the saying goes, if you want a civil
environment at the dinner table, don’t
discuss religion or politics. Similarly
if you want to get a heated discussion
going between a group of massage
therapists just ask them, “What do
you think about state licensure, which
association do you prefer, what about the
NCBTMB, or maybe medical massage
certification?” These are all hot button
topics and are likely to continue being so.
Like it or not, licensing of massage
therapists in the United States is a trend
that will continue for the next few years.
At the time of this writing, thirty-seven
states, the District of Columbia, and
four Canadian provinces offer some type
of massage therapy credential. Several
other states are debating licensure
legislation. It is reasonable to predict
that we’ll see massage licensure in all
fifty states within a decade or so.
State licensure has its adherents and
opponents. An interesting development
to watch in the next few years is the
emergence of the Federation of State
Massage Therapy Boards (FSMTB).
This organization gives states a way
to work together in the regulatory
process; it is an excellent and timely idea.
We have yet to know how the testing
and examination process will unfold
(the Massage & Bodywork Licensing
Examination, MBLEx, was launched
October 1). A primary question is
what the presence of another exam
option for state licensing will mean.
The National Certification Board
for Therapeutic Massage and Bodywork
(NCBTMB) was originally created to
establish entry-level certification. Today,
a large number of states rely on the
NCBTMB’s tests for granting massage
licenses. Opponents argue a certification
program should be voluntary; state’s use
of the tests makes it mandatory. Recent
problems with the administration of the
tests, including lawsuits, resignations
of several members of the board of
directors, as well as accusations of
mismanagement and violations of bylaws,
do not bode well for this organization. As
a former chair of NCBTMB, these issues
are troubling. The organization needs
to regain its footing and improve its
credibility with the profession. Instead
of focusing on entry-level credentials
and state licensure, NCBTMB would
better serve the profession by offering
advanced credentials that designate
higher and specific levels of training.
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massagetherapy.com—for you and your clients 39

THE FUTURE OF MASSAGE
RESEARCH AND THE
FRONTIERS OF THE FIELD
The growth of any healthcare discipline
is related to its ability to demonstrate
beneficial therapeutic outcomes. Due
to funding challenges and the fact
that so few massage therapists possess
PhDs, there has not been anywhere
near as much focus on research in
the massage profession as there has
been in other healthcare disciplines.
The groundbreaking work of Tiffany
Field and her colleagues at the Touch
Research Institute in Miami has
paved the way for those interested in
massage research. These practitioners
and researchers help us look for ways
to validate and better understand the
outcomes we see in the treatment room.
In the next few decades massage
therapy will be increasingly integrated
into research protocols as effective
treatments are researched and
evaluated. A healthcare profession must
determine the most effective means for
addressing key complaints presented
to that profession. These approaches
are called best practices. The massage
profession, along with researchers
from other healthcare disciplines, is
looking to establish best practices
for massage as well. Best practices
guidelines are not rules or recipes, they
simply provide guidance about what
are the most effective treatments.
A SNAPSHOT
The future of massage therapy in
the United States is promising. Yet,
numerous issues face the profession,
and it is premature to know how they
will affect it in years to come. The
divergence in practice of massage as
health or personal care is one of the
largest issues facing the profession.
This division affects education,
licensure, and professional advancement.
Developments in educational options,
practice settings, and business
options present both opportunities
and challenges to the profession.
40 massage & bodywork january/february 2008
The divergence in practice of
massage as health or personal
care is one of the largest issues
facing the profession.
The increasing popularity of massage
as a personal service and health option
present a positive financial future for
those in the field. There is continually
greater acceptance of massage by other
healthcare professionals as a viable
and valuable healthcare modality.
Concurrently, those with ailments
wanting other healthcare options are
increasingly looking to massage. The
number of consumers seeking massage as
a personal care service is expanding. The
options and potentials for those wanting
to practice massage are extremely high.
Given the advancement to date of
massage as a therapy, it is to everyone’s
benefit to continue striving for the
highest quality in education, industry
reputation, and professional stature.
As an educator, I have had the
wonderful opportunity to meet and
work with some of our profession’s
most influential colleagues. These
visionaries have worked hard to help
shape and promote our profession in
the last twenty years. While many of
these people are well known, some
of the most inspirational people
I have met are those who are not
well known, but are out there in the
trenches doing great work every day.
Looking at a snapshot of our field is
like watching a river that passes before
us moving from the past to the future.
The water is different from day to day,
but it remains the same river. While
tomorrow’s massage therapy field will
be filled with different individuals
and experiences, it will remain the
same magnificent field we are all so
fortunate to be a part of today.
Whitney Lowe is a recognized authority
on pain and injury treatment with massage
therapy. His contributions to the massage field
are wide ranging and include extensive research,
professional publications, teaching, clinical work,
consulting, and participation in national boards
and committees. He is the author of the books
Orthopedic Assessment in Massage Therapy
(Daviau-Scott, 2006) and Orthopedic
Massage: Theory and Technique (Mosby,
2003), which are used in training programs
and schools nationally and internationally. In
1994 he founded the Orthopedic Massage
Education & Research Institute (OMERI)
to provide massage therapists the advanced
education they would need for treating
orthopedic soft-tissue disorders. He can
be contacted at omeri@omeri.com.
NOTES
1. D. C. Cherkin, R. A. Deyo, K. J. Sherman, et al.,
“Characteristics of Licensed Acupuncturists,
Chiropractors, Massage Therapists, and
Naturopathic Physicians,” J Am Board
Fam Pract. 15, no. 5 (2002): 378–90.
2. D. M. Eisenberg, R. B. Davis, S. L., et al., “Trends
in Alternative Medicine Use in the United States,
1990–1997: Results of a Follow-Up National
Survey,” JAMA 280, no 18 (1990): 1569–75.
3. ABMP, 2007 National Consumer
Survey, Evergreen, CO; 2007.
4. K. J. Sherman, D. C. Cherkin, J. Kahn, et al.,
“A Survey of Training and Practice Patterns of
Massage Therapists in Two US States,” BMC
Complement Altern Med. 5 (2005): 13.
5. ABMP, 2007 National Consumer Survey.
6. ISPA, Spa Industry Update, Lexington, KY:
International Spa Association; 2006.
7. ABMP, “A Changing Environment: Has the
Popularity of Massage School Peaked?” The ABMP
School Connection, vol. 5; 2007 (Spring).
8. ISPA, Spa Industry Update.
9. ABMP, 2007 National Consumer Survey.
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Q: What is Prossage® Heat? 100%

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Heat is a uniquely blended, 100%
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formulated specifically for deep tissue work, There is simply
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Prossage Heat is a revolutionary breakthrough
Available in 3 oz.,
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BIOFREEZE®, PERFORMANCE HEALTH®, THERA-BAND®, the Color Pyramid® and the Associated Colors (TM), and PROSSAGE® are all trademarks The Hygenic Corporation.
therapists to work more effectively.

Q: Why should I use Prossage Heat in my practice?

A:

Unauthorized use is strictly prohibited. ©2007 The Hygenic Corporation. All rights reserved. 09/07. Original testimonial on file.
We know that accurate and effective soft tissue work can be
difficult and painful to the patient. Prossage Heat makes it
easier to “hook” the deep fascia allowing you to work
faster and more efficiently. Heating the tissues with Prossage
Heat reduces spasms in muscles, ligaments and joint capsules.
The non-slip, controlled glide makes deep tissue work easier
and less painful for the patient and athlete.

“Thank you for making a product

that is not only suitable for use by
those who practice spot therapy,
but is a blessing to those of us
who combine spot therapy with
full body massage. I can work
more efficiently in the specific
areas and still have time to do
that full body work that keeps them coming back,
even in wellness!”

Sandi Russ , LMT, NCTMB

The Balanced Body Shoppe

1-866-4-PROSSAGE Mention Code:M&B

Performance Health, Inc.,

®
2230 Boyd Rd., Export, PA 15632
info@prossage.us • www.prossage.us
International call: 1-724-733-9500
42 massage & bodywork january/february 2008
Trends in the Profession

Insight and
Opportunity
BY KARRIE OSBORN

W
hile the days of frenzied exploration and moments of connection

within the massage and bodywork profession may be long gone,

there remains a wealth of insight and opportunity that still await

this field and the practitioners and educators within it. What

does the future hold for the profession? Tethered growth, unity,

divisiveness? Let’s take a look at what might be on the horizon, as a

shaking of the bodywork tree, a push toward supplements as a spa

specialty, and a focus on a healthy geriatric client are just some of

the trends coming to pass in the massage and bodywork profession.

massagetherapy.com—for you and your clients 43

INSIGHT AND OPPORTUNIT Y
TIMES OF CHANGE
It’s been a good ride for the massage
and bodywork profession of late, with
consumer acceptance at an all-time
high and validation within the medical
community continuing to gain strength.
And the party is hardly over. But there
is going to be a shift, according to some
veterans in the field, and we might do
well to heed the warning signs now.
For some, it might prove a difficult
time of the wheat being separated from
the chaff, but for others it will be a
confirmation of their valuable skills and
important contribution to the field.
“The biggest trend I see at the
moment is contraction,” says Thomas
Myers, author, educator, and creator
of Anatomy Trains. “Sorry to sound
the warning gong, but that’s what I
see. The boom is over, the tree will
be shaken, and those with strong
connections will survive.” Myers says
the signs are everywhere: from school
owners talking of declining enrollments
to increased competition within the
profession, change is in the air. Myers
believes the economic impact from the
U.S. war efforts will create a downturn
resulting in less disposable income,
by which spas and massage providers
will be affected. “There will be a
pruning, and the resulting tree will be
stronger, but it will take a while to
recover and find its direction again.”
In contrast, another veteran
expects expansion. “I think the
touch therapies will have continuing,
substantial growth for the foreseeable
future. Life is increasingly stressful,
so the demand for stress remedies
will expand and diversification will
continue,” says polarity therapy
practitioner and educator John Chitty,
the tree will only get stronger.
“My perception is that two branches
are growing vigorously, and that the
main trunk supporting them is also
flourishing,” he says. “The main trunk is
generic bodywork organized primarily
around massage for feeling good and
relieving stress. The two branches
44 massage & bodywork january/february 2008
When we look
at the growth
could be called medical/scientific
of the massage
and esoteric. The medical group is
more and more evident as insurance and bodywork
companies appreciate good results
and clients love the experience. The profession, we
esoteric group (my area of interest) has
fundamental problems: the presence
of scientifically indigestible ideas and
have to give a
the absence of scientific research.”
Regardless, Chitty says the big nod toward
esoteric touch therapies are becoming
increasingly popular because of their consumers’
effectiveness. “Many clients don’t
really care about modality titles or the
blessing of science, they just want relief,
loss of faith
few questions asked. I don’t think that
science is going to be able to help very in a medical
much in getting the esoteric branch to
be more accepted, for many reasons, but profession and
I think the branch will continue to grow
anyway. As Randolph Stone (the founder
of polarity therapy) said, ‘Whatever
an insurance
works, works!’ I think effectiveness alone
will keep the subtle esoteric approaches marketplace
in the game, defying the gravity of
financial, scientific, and political forces.” that has
Chitty expects, however, that
regulatory forces will continue to shape
the industry landscape. “I continue to
historically
think that the desire for more and more
regulation of touch, justified by the need ignored them.
for consumer protection, elevation of
professional prestige, differentiation
from sexual professions, and reciprocity
between jurisdictions, has some seriously Something subtle, precious, and wise
bad consequences in the real world,” is reduced by the regulatory process.”
he says. “These consequences include Still, Chitty thinks the esoteric side of
monopolistic educational and right-to- the bodywork tree will survive, as it
practice systems (‘No touch without a always has, through even more restrictive
massage license!’), reduced innovation times than the field faces today.
and fewer choices, higher costs for
students, and pressure on the smaller ON CONSUMERS’ TERMS
modalities to come under the umbrella When we look at the growth of the
of massage and lose their identity and massage and bodywork profession, we
deeper values.” And it’s that final aspect have to give a big nod toward consumers’
that worries Chitty most. “It is a sad loss of faith in a medical profession
commentary on our modern era when and an insurance marketplace that has
the McTouch Inc. and MassageMart historically ignored them. The solution:
phenomenon homogenizes education consumers who want healthy results and
and the right to practice for the will pay to get them on their own terms.
financial benefit of the biggest players.
 It wasn’t long ago that the medical
community was always held in the
highest regard, with patients taking
their doctors’ words as gospel. But this
was also a time when family doctors
made house calls, could crack a back
if need be, and delivered babies at
home with families surrounding them.
With today’s seven-minute, insurance-
mandated physician protocol being
added to the effects of an already wary
patient population, it’s no surprise
that people are seeking out better
answers, or at least better options.
Enter the world of medical tourism,
the latest in healthcare trends. More
than one hundred fifty thousand
Americans traveled abroad for healthcare
in 2007, and that number is expected
to double in 2008, according to Josef
Woodman, author of Patients Beyond
Borders. He says that patients can
save up to 80 percent of the cost of
a medical procedure, including the
cost of travel and lodging, when they
schedule it out of the country. The most
common medical tourism procedures
include orthopedics, heart surgery,
and cosmetic services, as well as those
procedures with a short track record.
“Amidst an increasingly bleak
U.S. healthcare landscape, medical
travel is a viable option for Americans
who find themselves priced out of
the domestic health market—those
forced to choose between debt and
discomfort or facing long-term
financial insecurity due to challenging
medical conditions,” Woodman says.
“Healthcare has become out of reach
in this country for many,” says Wouter
Hoeberechts, CEO of WorldMedAssist,
a medical tourism company that arranges
all the details for its clients’ healthcare
abroad. “Health insurance premiums
have gone up 87 percent since 2000,
resulting in more than 46 million
Americans that have no health insurance.
There are even more with deductibles
and co-pays that exceed what they can
afford.” And as those numbers continue
to grow, medical tourism offers options
TRENDSETTER
Kinesio Taping
Developed in Japan by
Dr. Kenzo Kase nearly
twenty-five years ago, this
therapeutic rehabilitative
taping protocol is being
used by massage therapists,
physical therapists, MDs,
and chiropractors. This
proprietary method of taping
works over and around
muscles to assist in support
or prevent overcontraction.
The taping method is said
to activate the neurological
and circulatory systems and
create a whole new approach
to treating nerves, muscles,
and organs.
massagetherapy.com—for you and your clients 45
the patient might not otherwise have. It’s
a sadly interesting twist in the healthcare
debate and undeniable evidence that
the problem is only getting worse.
“The best part is there’s no
compromise on quality,” Hoeberechts
says. “The hospitals we partner with
are internationally renowned and
typically have strategic partnerships
with leading U.S. medical institutions,
such as Johns Hopkins and Harvard
Medical.” For international spas, this
becomes an opportunity to market
themselves as pre- and postoperative
respites for the medical traveler.
For massage therapists and
bodyworkers, consumers’ loss of faith
has meant greater potential for manual
therapies. Chitty says unease with the
medical system has brought people
knocking on bodyworkers’ doors. “I
think discontent with mainstream
medicine and ‘Big Pharma’ is still
increasing, for a host of reasons explored
by Michael Moore and others, and
touch therapies are the beneficiary
of this discontent,” he says. “I think
it’s a great time to be in the touch
therapy profession, and opportunities
are proliferating in every category.”
MIND-BODY MARKETS
Whether it be a significant halo effect
from success of Rhonda Byrne’s The
Secret (and the reawakening to quantum
physics it’s created), a growing answer
for those needing something more, or
an inevitable path of exploration for
the self-aware, mind-body therapies
are picking up steam. An impromptu
poll of new modalities added to the
Associated Bodywork & Massage
Professionals modality library shows
mind-body therapies have led the
way. People are continuing to seek out
wholeness, and these therapies offer the
tools in which to achieve that goal.
Longtime therapist and educator
Suzanne Nixon says she’s had more
clients gravitate over the years toward
her mind-body work, a combination of
psychotherapy and energy work. “These
INSIGHT AND OPPORTUNIT Y
TRENDSETTER
Migun Beds
Touted by its South Korean
manufacturer as the
healthcare of the future,
Migun (pronounced MEE-
gan) beds are becoming all
the rage, finding special favor
with physical therapists,
chiropractors, and massage
therapists who say it loosens
clients’ stiff muscles before
treatment. The beds offer
clients a rolling action across
their bodies to relieve stress,
enhance rejuvenation, and
even relieve chronic pain.
They work on the principles
of acupressure to promote
well-being.
46 massage & bodywork january/february 2008
individuals are either trying to reduce
stress and anxiety or are searching
for understanding and meaning with
the self.” She says for those looking to
alleviate stress, the energy work aims to
provide relief through releasing excess
nervous energy and balancing the body's
frequencies toward well-being. “And for
the latter, the energy work is a vehicle
for them to deepen and connect with the
authentic.” As massage clients begin to
discover all the benefits traditional touch
therapies offer, it makes sense that they’d
be curious to go a step further along this
healthful path to see what the mind-
body connection might afford them.
The trend doesn’t stop with private
practitioners; it has become especially
prevalent in the spa world where clients
want to feel deep and significant change
from their experience and want more
than just a fluff-and-buff massage and
pedicure. According to the International
Spa Association (ISPA), clients expect
more from their spa visits than just
feeling pampered. Already more
than one in ten spa-goers treat the
experience as part of a larger health and
wellness lifestyle. As a result, spas are
incorporating things like fitness and diet
into the traditional spa menu, along with
wraps and facials, much like the early
spa days of John Harvey Kellogg and the
Battle Creek Sanitarium in Michigan.
SAV V Y SPAS
As a yin to the trendy medical spa’s yang,
wellness is the buzzword for today’s
spas—both big and small. “With the
tremendous growth of medical spas,
day spas are starting to counter this
with wellness programs that do not
necessarily need an MD or healthcare
professional on staff,” says Hannelore
Leavy, founder and director of the Day
Spa Association (DSA). “The wellness
movement is an established fact in
most parts of the world, but especially
in Europe and Asia,” she says. In fact,
that’s what “taking the waters” has
always been about. “We here in the
United States are just starting to realize
the benefits of prevention through
regular spa treatments ... Day spas
are now offering wellness treatments,
such as acupuncture and acupressure,
weight management, and more.”
Some spas have figured out how
to get consumers to take the spa
experience home with them. Canyon
Ranch Living in Chicago is the perfect
example. Akin to buying a home on the
golf course, Canyon Ranch in Chicago
is about living a healthy spa lifestyle
in a spa community. While Las Vegas
and Florida coasts have long been a
part of this trend, this newest entrée
on Chicago’s famous North Michigan
Avenue is the first of its kind. The
257-residence, 67-story elliptical glass
tower will house a 75,000-square-foot
wellness center where an integrative team
of physicians, behaviorists, therapists,
nutritionists, exercise physiologists, and
nurses will help residents take charge
of their health. Marketers tout it as
living the vacation lifestyle every day.
A more general lifestyle spa trend,
however, is about living the spa life in
simpler ways than buying an expensive
condo. According to ISPA, in 2005 more
than two million spa-goers took part in
lifestyle classes, such as healthy cooking,
managing stress, even customizing spa
treatments to use at home. This trend
will continue, no doubt, as consumers
search for the “aaaah” effect at home.
Following are some other trends
to watch from the spa world.
SUPPLEMENTS. With a recent study
from the Dietary Supplement Education
Alliance (DSEA) showing that a strategic
use of certain dietary supplements
could save more than $24 billion in
U.S. healthcare costs, it’s no wonder
spas have identified this as part of an
overall wellness offering. “I am excited
about day spas offering nutritional
products that complement different
spa treatments to enhance the internal
healing of their clients,” Leavy says.
In fact, the DSA and the International
Medical Spa Association (IMSA), of
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Massage accessories, tools, candles, hot stones, soaps, holsters, table
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Our comprehensive website has everything you need.
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      

 
         
           
           
   
  
          
   
     
    
             
           

      
    
    
                   
         

EUsk
2
n 1 oo
C
Ear r the b
Deep Tissue Massage and Myofascial Release
fo A Video Guide to Techniques
A SEVEN-VOLUME, 11-HOUR
encyclopedia of advanced massage • LEARN TO WORK deeply, safely, and effectively.
The video companion for • PROTECT YOUR BODY by learning proper use of your energy
the book – both by Art Riggs while utilizing fingers, knuckles, fists, forearms and elbows.
• EXPAND YOUR SKILLS in working with virtually every
troubleshooting condition encountered in a massage practice.
“…to anyone familiar with deep tissue or myofascial techniques these
2nd videos will be a significant contribution to your skill set.”
— ANATOMY TRAINS AUTHOR TOM MYERS, MASSAGE MAGAZINE
Edition
“Art Riggs is one of the most awesome bodywork teachers in our
profession.” “…a beautifully produced video set... (he’s) a great teacher
who shares an enormous amount of knowledge and wisdom.”
— LISA MERTZ, MASSAGE THERAPY JOURNAL

Please visit our website for specific information to help you determine how these materials can improve your skills.
www.deeptissuemassagemanual.com

massagetherapy.com—for you and your clients 47

INSIGHT AND OPPORTUNIT Y
which Leavy is executive director, are
in the process of developing a nutrition
supplement certification for day spas,
allowing therapists to advise clients on
any supplement needs for maintaining
health and vitality. It follows the
concept of beauty from the inside out.
“The consumer is so confused and the
medical profession is in most parts totally
ignorant [about supplements],” Leavy
says. “We may know how much vitamin
C and A and B12 we should take, but do
we know how and when? Do you take it
in the morning, at night, on an empty
stomach, with meals, after meals? So
many questions and really no answers.”
Leavy says her organizations are working
with two nutritional companies to
develop the course that will then be
introduced to the industry in early 2008.
SLEEPY TIME. Whether as a result of our
modern-day sleep deprivation, or the
sheer state of exhaustion we all walk
around in, spas are finding ways to
incorporate sleep into their offerings.
Where sleep specialists might work
with clients’ sleep apnea or insomnia
issues at a destination spa, hotel and
day spas will likely incorporate all their
tools into creating sleep environments
for clients. Leavy says clients typically
enjoy a spa treatment, then have to dash
off to their next appointment without
“letting the body truly absorb the
healing benefits of the treatment.” She
says the best thing is a nap, especially
after a detoxifying treatment, so the
body has time to renew itself. It’s this
concept that has prompted spas to work
sleep into their menu of services.
DE-STAFFED OR CUSTOMIZED? According
to SpaFinder.com, be on the lookout
for more “de-staffed” treatments as spas
try to watch their bottom line. What
does that look like exactly? Same-sex
groups of spa guests cover each other
in mud and go through a prerecorded,
guided meditation, without a therapist.
On the other side of that coin, we see
customization as a highly relevant,
48 massage & bodywork january/february 2008
Spas have been
going green
for years now,
often touting
organic,
energy-friendly
ways. That
trend hasn’t
backtracked
any and, in fact,
is spreading
out into the
private practice
arena as well.
evolving issue in the spa world. “One
size no longer fits all when it comes
to the spa experience,” according to
ISPA. What this has meant is a change
from clients booking treatments
to booking time, with the spa staff
creating a treatment especially for
them based on their needs that day.
SOCIALIZATION. In their latest set
of predictions for the spa industry,
SpaFinder.com says the social butterfly
will overcome the wallflower in the spa
experience and that the search for “spa
solitude will be trumped by the natural
desire for community and a growing
awareness that social interaction is an
important aspect of health.” While
“spa-ing” in groups has always been a
big part of the spa scene—bridal showers,
girls’ day out, baby showers—one aspect
of this trend has the potential to become
problematic and that’s playing up the
singles’ scene. This latest marketing
trend has singles venturing to the spa for
treatments and then mixing and mingling
with other spa guests in the lounge, before
and after treatments, with a glass of wine.
While marketing to couples has been
a widely popular hook, this new trend
might stretch professional boundaries in
that it flies in the face of the issues private
practitioners deal with on a daily basis.
This will be an interesting trend to watch.
MORE THAN GREEN. Spas have been
going green for years now, often touting
organic, energy-friendly ways. That
trend hasn’t backtracked any and, in
fact, is spreading out into the private
practice arena as well. From the type of
oil, lotion, and assorted product they put
on clients, to the promotional materials
they send, therapists are thinking
green. Meanwhile, in the spa world,
the green trend is moving beyond the
basics and is today including the eco-
buzzwords sustainable and responsible.
This fits well for clients who could
be considered part of the LOHAS
(lifestyle of health and sustainability)
movement. This is something to consider
as you think about providing/selling
product in your practice and what
your clients, who are already seeking
health and respite, will demand from
any product they buy to bring home.
CONVENIENCE MASSAGE
One of the results of greater massage
acceptance is supply keeping up with
demand. And that’s what convenience
massage works to fulfill, with
opportunities for massage showing
up now in the strangest places—the
brake shop, the luxury car dealership,
even a car wash. While many of these
massage services are offered as a way to
woo and please the high-end customer,
the concept is now broadening more
to the Average Joe (or Josephina if you
will). “It’s become more democratic,”
Mary Gilly, professor of marketing
at University of California at Irvine
told Los Angeles Times reporter Leslie
Earnest in a recent article on this
one-stop shopping that now includes
spa services. Gilly told the Times that
businesses are “introducing another
socioeconomic class ... to these [spa]
services by providing them in a
retail environment where they feel
comfortable,” instead of forcing them to
seek out the experience on their own.
Massage franchises are selling
fast, too, with Massage Envy now
sporting more than 140 operating
clinics and 430 franchises across the
country and imitators quickly following
suit. People are no longer shocked
to see massage at the airport, at the
farmers’ market, or at the mall.
OTHER “NATUR AL” TRENDS
The Natural Marketing Institute
(NMI) recently identified several trend
categories that have relevance to those in
the massage and bodywork marketplace
and anyone falling under the CAM
umbrella. Consider these when setting up
shop, revamping your current business
philosophies, or refocusing your work.
AGE OF THE INDIVIDUAL. NMI
identified this trend as a reaction to
mass marketing and a “declining trust
in the traditional authorities of church,
government, and the corporation.” What
does it mean for the massage therapist?
Customize it. Clients want personalized
service, and you can make it just that
much more special by personalizing
the care—whether it be offering them a
choice of which essential oil to be added
to the massage lotion or working with
other healthcare practitioners to create a
particular client’s health protocol. Some
hotels are even creating spa suites where
the client no longer needs to move from
room to room for various treatments—
the treatments are all brought to her.
A DEEPER VALUES EXPERIENCE. This
trend falls in the footsteps of the
green category, where consumers are
extremely interested in knowing where
that product came from that you’re
TRENDSETTER
Vinotherapy
Rivaling the decadent
chocolate therapies
of the Hershey Spa in
Hershey, Pennsylvania,
vinotherapy from the
Delluva Vinotherapy Day
Spa in New York has guests
“imbibing” while partaking
in this newest trendy spa
offering. Vinotherapy, also
known as wine therapy,
first found favor in France
before making its way across
Europe, South Africa, and
California. The vinotherapy
spa products use wine
extracts, grape skins, grape
seeds, grape seed extracts,
husks, grape seed oil, and
vine leaf extracts. These
skin care treatments are said
to deliver highly effective
antioxidants. Expect other
spas to pick up on this trend,
especially as the social
element grows.
massagetherapy.com—for you and your clients 49
putting on her face, as well as what’s in
it. Trade practices, social causes, and
sustainability issues are all tied into this
trend, which NMI says goes hand in
hand with the consumer’s willingness
to pay a 20 percent premium to have
healthier products. According to
NMI, product manufacturers have a
“significant” opportunity to build market
share through trust and reassurance.
The same must surely be true for
massage therapists and bodyworkers.
BACK TO THE FUTURE. This is all about
simplicity and authenticity. Consumers’
desires for natural and simple is not only
evident in the foods they buy, but also
in the decisions they’re making when it
comes to what they put on their body,
too. According to Nutraingredients.com,
“As female consumers become more
critical about beauty manufacturers’
complicated marketing strategies and
ingredient lists, many are now looking
to have the same simplicity as they
receive in their natural food product.”
As the European market for natural and
organic products grows 20 percent each
year, according to analysts at Organic
Monitor, the North American market for
organic product continues to build steam,
with nearly two-thirds of U.S. consumers
having purchased organic foods and
beverages in 2005, according to the
Organic Consumer’s Association. What
does this mean? Consumers are spending
more to get exactly what they want and
right now that’s simple, uncomplicated,
healthy products and services.
NOT YOUR MOTHER’S GERIATRIC
While baby boomers might be losing
consumer clout with cosmetics
companies in favor of their younger
counterparts, their value as a massage
client grows, no matter how gray they
get. These days, geriatric massage is
about much more than working with
the frail and dying, according to Sharon
Puszko, owner and director of DayBreak
Geriatric Massage Institute in Indiana.
Today’s geriatric client may well need to
INSIGHT AND OPPORTUNIT Y
fit her massage therapist in between an
early morning game of golf, an afternoon
swim, and evening dance lessons. More
than not, the geriatric client of today is
living a full and productive life and sees
massage as a tool to help her continue to
do just that. “I’ve seen such an amazing
change in the senior community,”
says Puszko, who’s been working with
this population for fifteen years.
People are aging more gracefully,
she says, as a result of better nutrition
and medical technology that keeps the
body working longer. NMI confirms
it by identifying the emergence
of the age one hundred and over
consumer group as a relevant trend
to watch. As the boomers age, they
will continue to influence this trend,
resulting in vigorous, robust geriatric
clients beginning to outlay significant
consumer dollars for massage time.
As a result, opportunities to work
with the geriatric population grow,
Puszko says. She says it’s important
to remember that even though you’re
working on a robust elderly client, there
is still a specific protocol for working
with this aging consumer. From thinning
skin to pharmaceutical interactions,
massage therapists need to know a lot
more than gentle touch when working on
the elderly—whether they are frail or fit
for the Olympics. Their changing bodies
warrant specific considerations either
way. And the message is being heard far
and wide, Puszko says, as she took the
institute’s training program to Nova
Scotia and Singapore in 2007. Spas are
even getting into the action as they cater
to the older traveler who ventures abroad.
SYSTEMIZATION,
INTEGR ATION, FUSION?
There is no doubt that the work within
the profession continues to meld, divide,
and find rebirth, just as it always has.
According to author, educator, and
industry expert Keith Eric Grant,
what we’ll likely see in the near future
is a systemization of sorts within the
profession. Grant has been working for
50 massage & bodywork january/february 2008
nearly two years with other industry
experts to create a framework for
establishing massage best practices, or
clinical guidelines. “I think eventually
to gain credibility with stakeholders,
the massage profession and states will
have to decide exactly what knowledge,
skills, and abilities an entry-level
license guarantees,” he says. While
exploration and discovery within the
field is certainly not over, the Esalen
days of “making connections” has made
way for a more linear time of thinking
about the work, he says. “I think that
massage education will also become more
of a standard career college/community
college/corporate thing ... We’ve moved
more into a period of systemization,
integration, and maturing than one of
development—much like many tech
start-ups have to do as they grow.”
On a more direct level, something
we’ll definitely be seeing more of in the
near future, according to Myers, is an
integrated therapist: “A practitioner
with both movement and manual
skills, verbal and nonverbal cuing, the
specificity of stretch and release of a
bodyworker or yoga therapist combined
with the shortening and stabilizing skills
of a sharp-eyed coach or trainer. This
could truly be the new practitioner/
teacher of spatial medicine.” Myers’s
thoughts on a synthesis between fitness,
personal training, Pilates, yoga, and
bodywork, follow in line with the
blending of practices like Pilates and
yoga, or “yogalates,” which is finding
ever increasing adoption among fitness
folks. It’s also the paradigm so many
have called for in truly integrative care.
Maybe we’re closer than we think.
Within the bodywork community,
Nixon says she’s seeing therapists expand
their training and add to their repertoire.
“Some are becoming personal trainers,
in addition to being a massage therapist,
or are learning more about nutrition.
Of course, the question becomes, ‘How
do you ethically practice?’ What I’m
seeing is multitalented individuals
with multi-trainings.” The result, she
says, is people finding ways to expand
their practice for greater longevity.
Debra Howard, president of the
American Organization for Bodywork
Therapies of Asia (AOBTA), says her
organization, which already subscribes
to working within a medical model
that “unifies the whole human being
(body, mind, spirit),” sees a future
of collaborative medicine. It’s what
she describes as “a cooperative blend
of modalities that respond to the
whole of human experience.”
Whatever lies ahead, we know
there is good work to be done. When
the oncoming educational and political
issues work themselves out, there will
remain a fleet of massage therapists and
bodyworkers ready to do good work.
And, according to Virginia Postrel of
The Atlantic Monthly, that good work,
subtle as it may be, is indicative of even
more: “The massage industry’s product
is invisible, less ‘real’ than a hamburger
or a video game. It doesn’t contribute
to national power or prestige the way
semiconductors or aircraft do. It doesn’t
create world-famous stars like sports
or the movies. Its establishments are
small, often run by a single individual,
and most of its practitioners lack a
college education. It is literally touchy-
feely. When Americans think about the
economy, we tend to focus on familiar,
‘serious’ businesses—computers or
autos or high finance. We don’t notice
Starbucks until there’s one on every
corner, changing not only what we drink
but also how we live and work. Massage
may not be the biggest new industry or
the most influential, but it’s a microcosm
of how commerce and culture interact.
The same creativity and resilience that
built the industries of the past, and the
ways of life that evolved with them,
are still at work, spinning out new
enterprises serving new values.”
Karrie Osborn is the contributing editor
for Massage & Bodywork magazine.
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What’s Up
in Canada?
A Case Study in Bureaucracy
BY ROBERT CHUTE

W
hen American therapists debate regulation of

massage, inevitably Canada’s example comes up,

either as a path to follow or a terrible warning

of how demanding regulation can be. Canada

has the highest standards in the world, but that’s

really only in three provinces—Newfoundland

and Labrador, Ontario, and British Columbia.

Most provinces aren’t ruled by a regulatory

college put in place by government legislation.

massagetherapy.com—for you and your clients 53

WHAT’S UP IN CANADA?
Looking deeper, it’s a long and
complex road to similar regulation in
the remaining seven provinces and three
territories, and success is not guaranteed.
For instance, a 1999 report by the Office
of the Professions of Quebec states, “The
Ministry for Education considers that
massage does not represent any danger to
the public.” Though there are lobbying
efforts from within Quebec to establish
a government-sanctioned regulatory
body, it’s clear the government
isn’t leaning that way since public
protection is job one for legislators.
Not all legislators are convinced
provincial regulation is necessary.
THE EDUCATIONAL NUMBER
“We’re looking to have a national
standard,” says Damon Marchand,
president of the Canadian Massage
Therapy Alliance (CMTA). The
CMTA is made up of provincial
associations in favor of a minimum
twenty-two hundred-hour massage
education for unregulated provinces,
the establishment of regulatory colleges,
and mandatory continuing education.
In nonregulated provinces, CMTA
associations set a common code of
conduct and in many ways mirror the
goals and language of the regulatory
colleges. Adherence to those standards
is enforced only by membership,
not by governmental constraints.
In the absence of regulatory colleges,
the rules can be a patchwork very
like the situation in the United States
where individual municipalities set the
guidelines for how much education is
required to practice massage therapy.
For instance, Sherwood Park, Alberta,
only requires a business development
permit, while just down the road, the
city of Edmonton requires a criminal
record check and two hundred fifty hours
of training from a recognized school.
54 massage & bodywork january/february 2008
In British Columbia, the educational
standard is three thousand hours.
Though “functionally” we talk about
three thousand hours, “we prefer to talk
in terms of competencies,” says Doug
Fairweather, president of the College of
Massage Therapists of British Columbia
(CMTBC.) “The three thousand-hour
standard is the minimum time it takes to
learn those competencies.” In Ontario,
it takes two to three years to learn the
competencies necessary to write the
provincial registration examinations to
become a massage therapist. Ontario
used to have a twenty-two hundred-hour
time-based standard, but changed to
a competency-based system in 1993.
Regulated or not, it’s clear massage
therapy is growing in numbers of
therapists and improving in how it
is perceived by the public. A study
published by the Fraser Institute
found that nationally, massage leads
the complementary therapies with 19
percent usage. The research states:
“On a provincial basis, Alberta saw the
largest increase in the use of alternative
therapies in the year previous to the
2006 survey (68 percent compared to 54
percent in 1997), followed by Ontario
(55 percent compared to 50 percent in
1997), and British Columbia (64 percent
from 60 percent in 1997). Quebec
and Saskatchewan/Manitoba both
experienced a 1 percent increase, moving
from 44 to 45 and from 58 to 59 percent
respectively, while Atlantic Canada
experienced a decrease in the use of
alternative therapies, falling to 39 percent
in 2006 from 45 percent in 1997.”1
According to Doug Alexander,
editor of the online magazine
Massagetherapypractice.com and
a teacher at Algonquin College in
Ottawa, newly-trained physicians are
much more open to what we do. After
twenty-two years of practice, he’s seen
a lot of changes in the perception of the
profession. “Massage therapy started
off very alternative [catering to] people
who tended to live outside the norm,” he
says. It’s commonly acknowledged that
thoughts and feelings can affect physical
health and now alternative is mainstream.
“We were ahead of the wave.”
ADVANTAGES OF REGULATION
The common impulse to regulate the
profession is to protect the public. “I
can easily get into resenting regulation
though I am a proponent of regulation,”
Alexander says. “[Regulation] helps
accessibility and I do want massage
therapy to be part of the world. Massage
therapy is a very safe intervention.” But,
Alexander says, regulation is a good
thing because it provides oversight when
therapists violate the relationship of trust
with clients. Alexander points to deep
vein thrombosis as an example of a health
threat for which therapists must have
higher levels of training to recognize.
Though harm can be hard to prove,
when working with patient groups
that have pathologies, you could do
things that could do harm, Fairweather
says. Beyond the safety of the public,
regulation to such high standards
also creates a clear identity and a level
of assurance of quality of what the
public will receive, he says, as well as
enhancing the confidence of third-
party insurers and health professions
who refer to massage therapists.
Another spur to regulation is tax
exemption. If a total of five provinces
become regulated by colleges, the
Federal Ministry of Finance has said
they will exempt massage therapists
from paying the Goods and Services
Tax—currently 5 percent of their fee.
 Without the establishment of a
regulatory college, “There is no solid
way for someone to have recourse if hurt “Multi-tiering training doesn’t
by a therapist,” says Chandra Kastern,
president of the Massage Therapist
Association of Alberta. “There’s no one
work. We view it as lowering
body to come down with a hammer on
MTs.” She points out that some instances
of competency standards.”
of impropriety don’t lend themselves to Damon Marchand, president, Canadian Massage Therapy Alliance
civil or criminal action. For instance,
a massage therapist could ask a client
invasive questions. “That crosses the
line ethically; in a civil court it means
nothing.” Kastern says peers would
see ethical faults differently from the
way a court might see the situation.
“There’s a whole lot of fear about
regulation,” Kastern says. However,
she predicts that when regulation goes
through, politicians will not only have
public protection in mind, but also the
well-being of people in the profession.
“You can’t suddenly axe people from
their jobs. Legislators are not going
to regulate in an exclusive manner. It
doesn’t happen like that and it won’t
happen for massage therapy in Canada.”
She suggests a grandfathering process
would protect therapists who haven’t
attained a twenty-two hundred-hour
competency, allowing them to continue
to work and upgrade to the new standard.

COMPETING VISIONS
OF REGULATION
Until a consensus among lobby groups is
achieved, regulation of more provinces
might be stymied. The opposing
models of massage regulation hinge
on whether regulation would embrace
a one-category or multi-category
model. The CMTA advocates a single
category model in which massage
therapists attain a minimum twenty-
two hundred-hour level of competency
to qualify to practice the profession.

massagetherapy.com—for you and your clients 55

WHAT’S UP IN CANADA?

Countering that is the multi-category

model proposed by the Association
“If there were some of Massage Therapists and Wholistic
Practitioners (AMTWP).2 They favor

compromise toward adopting regulation that would include three

the multi-category model, many
of the obstacles on the road
categories of practice: the general
intent therapist, the basic remedial
therapist, and the advanced remedial
therapist. The general intent therapist
practices relaxation massage for clients
with no pathological processes. The

to regulation would be cleared.” remedial therapist would be capable

Colleen MacDougall, executive director, Association of
Massage Therapists and Wholistic Practitioners
of working with issues like tennis
elbow, and the advanced remedial
therapist is capable of dealing with
complex conditions requiring a
higher degree of assessment skills.
“We are the largest national massage
therapy organization in Canada,” says
Colleen MacDougall, the AMTWP
executive director. “Representing the
majority of the MTs in Canada, we
certainly feel research has to be done
… to look at it [regulation and the
profession] from a broader perspective.”
That’s how the multi-category model
evolved, she adds. Still, she is concerned
about what form regulation may take.
“Regulation is not based upon the
[desire] of the profession to be more
credible. It’s based upon more elements
than that.” Access and choice, for
example, are factors that she feels the
single-category approach will limit.
Proponents see the multi-category
model as a way to include the full
spectrum of massage as it is practiced in
Canada. “Right now there are massage
therapists and nonregulated bodyworkers
practicing massage. Why not bring
them into the fold?” MacDougall asks.
“[Bodyworkers] might have a different
education and focus, but capture them
and create a place for them to exist so
they’re accountable for what they are
doing. If they encounter a condition
outside their scope of practice, they’d
refer on. You ensure that there’s training
in place to recognize [contraindications].”

56 massage & bodywork january/february 2008

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WHAT’S UP IN CANADA?
REGULATION TAKEN TO THE EXTREME
Many massage therapists would be surprised at some
of the responsibilities that come with regulation in
Canada. In an interview last July with Deborah Worrad,
registrar of the College of Massage Therapists of
Ontario, she detailed the role massage therapists
may play in pandemic flu emergency planning.
When we began the interview, Worrad began,
“If we have”—then she checked herself—“I must
remember to say when we have a pandemic, because
we have been informed we’re overdue. They run on
cycles on average of forty years and we are overdue.
It’s not if, it’s when it happens.” Worrad continued:
58 massage & bodywork january/february 2008
“We have been told by government
that members of the health professions will
not be conscripted [to work in a pandemic
emergency.] They will not be forced to
provide care. For our members it will be a
question for them to determine, will they,
or will they not participate? That will be
a personal choice. The other question
massage therapists will have to deal with,
and again it will be a personal choice, will
they or will they not keep their practices
open? Some of that may be contingent
on the severity of the pandemic. That will
depend on which virus hits us. We won’t
know until it happens whether or not there
will be general quarantine, in which case,
will we be asked to close all nonessential
services and stay home? That choice may
be taken away from them. But if they
can, how will they protect themselves
and their clients from infection?
“As a regulated health profession,
massage therapists’ inventory of
competencies have already been
supplied to the [provincial] government.
So for instance, they can take health
histories, they can take vital signs, record
clinical notes, [and have] knowledge
of infection control. These sorts of
things go into the [skills] inventory.
“Our job as a college will be to ensure
members receive the information. That
will be distributed electronically through
the Internet. Every morning all health
regulatory colleges will participate in a
teleconference with the [health] ministry.
We will receive our update. Bulletins will
go up on websites, so computer literacy
for MTs is critically important. For certain
information we may be doing e-mail
blasts. The college has a disaster plan set
up for any kind of disaster, including the
flu pandemic, so we can run the college
if necessary from two remote locations.

“For our members who opt to
participate, they must not get in over
their heads and operate beyond their
competency. I see a very significant
role for massage therapists in caring
for the caregivers. I don’t foresee them
on the front line doing bedside nursing
care. I see nurses, doctors, physios—the
people who are going to be pushed to
their limits—I see massage therapists
helping them stay on the job.
“We’re hoping massage therapists
will take the initiative and start setting up
the kind of response teams Americans
have for emergency response. They
have first-responder teams who do
phenomenal work. That’s going to
play a significant role in a pandemic.
“There’s lots for us to do and to think
about in preparing for the flu pandemic.
Communication is key to minimize public
panic and keep everyone informed.
“However, let’s face it, here’s a reality
check. We don’t know how bad it’s going
to be. The government can do whatever
it wants to when push comes to shove.
They are our government and we have had
powers of government exercised in this
country we never thought could happen.
I would not rule [conscription] out as a
remote possibility. It would be unrealistic to
think we could not be pressed into service,
and I’m not just talking about regulated
health professionals. I’m talking about all of
us. If the government saw a need and had
able-bodied people that could be engaged
and one would hope that, were we healthy
and able, we would rise to the occasion and
volunteer within our capabilities. People
do that in crisis. None of us can speculate
what that will mean. We just don’t know.
“Flu comes in waves. If it’s like with
the Spanish Lady [referring to the
Spanish Flu of 1918] the economy’s
going to tank. People will choose to
stay home because they want to protect
their families. Look at all the food that
arrives by truck. What if the borders are
closed? We won’t be able to import food.
We’ll have to rely on local stocks. People
will stockpile in a hurry. Stores will get
stripped. Will there be enough people
to run the water filtration plants? We
don’t know what it’s going to be like.
“Typically with a pandemic you get
the first wave and then three to six months
later you might get another wave. Of
course, there will be no vaccine available
in the first and possibly even after the
second wave, depending on how fast it
comes because of the time it takes to grow,
isolate, and produce the vaccine. We have
tremendous vaccine development facilities
in Manitoba. There’s a massive lab there.
Once we get it nailed down, Canada will
be able to produce vaccine in fairly large
quantities, but if you’re talking about an
entire country ... that’s a lot of people!
“Government will choose who gets
the first round of vaccination, but in the
short term, [with] Tamiflu I understand
decisions have already been made at
government levels as to which category
of people will get them. It hasn’t been
made known publicly, but one would
think that the frontline workers ...
emergency service—police, fire, doctors,
and nurses—anyone working with direct
care of patients would be the first ones
to get things like Tamiflu. And we are
stockpiling. It’s the big unknown and we
don’t have a handle on what will happen.”
INTERVIEW BY ROBERT CHUTE
massagetherapy.com—for you and your clients 59
MacDougall often feels the efforts
of her association are misconstrued. For
instance, despite the inclusion of holistic
practitioners in her association’s title
and membership, people who practice
reiki alone would not be included in
the proposed multi-category model
because they aren’t massage therapists.
“The future is positive for massage
as a whole if our focus is to ensure that
[we] recognize the competency of the
various levels of massage therapy within
a defined scope of practice. The more
people we have within the regulation
fold the stronger we will be in protecting
the public interest. I think massage
therapy can go upward, but it’s the
industry coming together that’s going to
make that happen,” MacDougall says.
Single-category proponents disagree.
“Multi-tiering training doesn’t work,”
says Marchand of the CMTA. “We
view it as lowering of competency
standards. Minimum standards and
training [of the one category model]
need to be set … to provide safe
and effective treatment. If practiced
incompetently, you can harm somebody.”
Marchand says interaction with clients
requires assessment skills, knowing
when not to treat, knowing what to
do, and knowing when not to do it.
Registered massage therapists
(RMTs) are not simply service providers
in Ontario, says Andrew Parr, executive
director for the Ontario Massage
Therapist Association (OMTA).
RMTs are an access point to the health
system, he says. The higher standards
of training required ensure public
safety in that RMTs can recognize
contraindications and refer out. “I’m not
sure the AMTWP’s model will allow
an individual to fill that role,” he says.
MacDougall is confident all
massage therapists can be trained to
recognize contraindications and refer
out, no matter their therapeutic intent
and focus. “A multi-category model
is not new to healthcare. It exists
already. Paramedics have a multi-
category system, for instance.”
WHAT’S UP IN CANADA?
DISADVANTAGES OF REGULATION
If or when regulation goes through,
many people agree that start-up can
be expensive. Ongoing operating
costs aren’t inconsiderable either;
the annual budget for the College of
Massage Therapists of Ontario for
2006 was more than $4 million.
When asked about the disadvantages
of regulation, Parr is frank, “Your costs
are a little higher. There are always
cost issues when you regulate a group
of individuals and … this tends to drive
consumer costs up somewhat.” Higher
educational standards mean it takes
longer to enter practice so there will be
fewer people able to provide the service,
he adds. However, Parr emphasizes that
the benefits outweigh the costs and there
are safeguards in place so standards don’t
change so fast as to be prohibitive. The
phenomenon of “creeping credentialism”
in which higher and higher standards
are fobbed on therapists too fast
is prohibited by the governmental
oversight process, Parr says.
“You have to follow the law and
work within the regulations … which
means you are not a free agent in the
world,” says Deborah Worrad, registrar
for the College of Massage Therapists
of Ontario. “You have professional
obligations and responsibilities. And
you have financial obligations. I don’t
necessarily see that as the downside, but
it is a reality.” There’s a cost involved
to balance out the benefits, she says.
“Some people like to be freer and of
course anyone has the option to be an
unregulated bodyworker; they don’t
have to belong to the profession.”
60 massage & bodywork january/february 2008
Marchand provides a personal An official for Nova Scotia’s Health
example of how regulation restricts Ministry said his office was flooded
his practice. “As an MT in British with letters that opposed regulation
Columbia … we are not allowed to use outright or expressed concern about
any sort of medical electricity [like] the form of proposed regulation so the
TENS machines, ultrasound, or cold legislation didn’t go through. A source
laser. The general public can go buy a at the Massage Therapy Association
TENS machine and use it on themselves of Nova Scotia who preferred not to
… and yet I’m not allowed to take be identified said the board intends
training and use that because it’s outside to take it back to the membership to
my scope of practice as a healthcare see if they will take another run at
professional. That’s a challenge.” establishing a regulatory college.
“New Brunswick has some legislation
THE ROAD AHEAD in front of them, but we spoke in
There are many broader challenges opposition to it,” MacDougall says.
ahead as letters are written, governments “It’s not multi-category based nor
are lobbied, and the paper piles up. were we consulted on development
Proponents of single-category and of that regulation. The last two years
multi-category systems all desire all I’ve heard is that [provinces are]
regulation, yet the obstacles are laid going to be regulated. I hear, ‘It’s
down not just by provincial governments coming soon! It’s coming soon!’ If
but by the competition itself. they were going to be regulated, why
Marchand makes no predictions when aren’t they already regulated?”
more provinces will be regulated, though
he says a lobby group like the AMTWP Robert Chute is a writer and
slows the march to regulation of massage massage therapist in Ontario.
therapy. “One of the difficulties we’ve
heard from the provinces [is that] if NOTES
there’s more than one association, 1. Quoted with permission from The Fraser
Institute, Complementary and Alternative
governments have told them, ‘We want
Medicine in Canada: Trends in Use and Public
to deal with one association,’” he says. Attitudes, 1997-2006, published May 2007.
“If there were some compromise
2. At press time, the AMTWP changed its name to
toward adopting the multi-category the Natural Health Practitioners of Canada.
model, many of the obstacles on the
road to regulation would be cleared,”
MacDougall says. However, as it stands
“We have no identification yet as to
when [regulation] would occur. Some
of the provinces have said no, outright.
They’re not going to move forward with
regulation. Quebec, in 1999, declined.
Saskatchewan is no. Manitoba said all
the profession needs to come together
to see what it would look like and even
then they weren’t sure it needs to be
regulated. Nova Scotia is no. They [the
provincial governments] haven’t been
convinced there’s significant risk of
harm. I know it’s purported that they’re
on the brink of regulation, but that’s
factually incorrect,” MacDougall says.
Misunderstood
Modality
Myths About Thai Massage
BY MARTIN MISENHIMER

62 massage & bodywork january/february 2008

 W hen Thai massage came on the

American scene some twenty

years ago, it seemed strange

and daunting to many massage

therapists. Its floor work and

use of yoga-like stretches

introduced an unfamiliar way

to work with clients. Now

after several years of practicing

and teaching Thai massage, I

have seen a number of myths

take hold in the massage

community in relation to what

this modality is all about. The

following explores some of the

most common misperceptions.

massagetherapy.com—for you and your clients 63

MISUNDERSTOOD MODALIT Y
MYTH: THAI MASSAGE IS HARD
ON THE PR ACTITIONER’S BODY
Would-be practitioners often fear that
Thai massage will be taxing to perform
because the work is done on the floor
and involves moving clients’ limbs. In
fact, Thai massage actually saves wear
and tear on practitioner joints and
muscles—sometimes even reviving the
professional lives of massage therapists
who otherwise would be driven out of
work by repetitive motion injuries.
The reasons for this have to do with
fundamental principles of Thai massage:
Thai massage actually saves
wear and tear on practitioner
joints and muscles.
64 massage & bodywork january/february 2008
ALL WORK IS PERFORMED WITH A
NEUTRAL SPINE. A practitioner's body
is positioned either directly above or at
roughly 90 degrees to the client’s body.
This eliminates the spinal torque created
when standing next to the client to give
a table massage. Working for hours
with a torqued spine creates back pain.
THE POWER BEHIND THAI MASSAGE
IS GRAVITY, NOT MUSCLE EXERTION.
For example, when standing upright
the bones of your legs are aligned and
gravity is working for you. However, as
soon as you begin to bend your knees
toward a sitting or squatting position,
your muscles have to work hard to hold
you up. It’s the same when performing
massage. Working with bent arms means
using muscle. By contrast, working with
extended limbs is almost effortless.
THE ACTIONS OF THAI MASSAGE
INVOLVE PUSHING AND ROCKING MORE
THAN STROKING AND KNEADING.
This eliminates continual exertion of
the vulnerable tissues of arms, wrists,
and fingers—a prime culprit behind
the repetitive motion injuries too
common among massage practitioners.
To see how this all comes together,
consider the example of a common
massage action: rotating the client’s leg
in its hip socket. In a traditional massage,
you stand next to the client and support
the leg with the contracting muscles
of bent arms; if your client weighs two
hundred pounds or more, that’s a lot of
work. With Thai massage, you’re in a
lunge on the floor and simply holding
the client’s heel. Gravity is doing most
of the work; you merely rock into the
client’s body. It’s deceptively easy. Plus
as practitioner, you are receiving the
rejuvenating effects of doing a yoga pose.
MYTH: YOU HAVE TO BE
IN TIP-TOP SHAPE TO
PR ACTICE THAI MASSAGE
I hear this often from potential
practitioners. Usually, they have
received a Thai massage and because
the experience was so powerful—and
because their eyes were closed—they
assume the giver was working very hard.
Not so. The power behind Thai massage
isn’t muscular strength. The power
behind Thai massage is excellent body
mechanics and conscious breathing.
 It does take some getting used to,
however. After their first weekend some
workshop students do feel as if they’ve
worked out a bit at the gym. I remember
at the end of my own first weeklong
training, I was required to give a full
ninety-minute treatment. By the end
of it, I was drenched in sweat. Now I
don’t perspire unless I’m working in
a very hot room. For most students,
regular practice eliminates the workout
soreness within a couple of weeks.
That said, people with severe,
chronic knee pain should probably stay
away from practicing Thai massage,
since much of it is performed kneeling
on the floor. Severe chronic back pain
also might rule out the practice.
MYTH: IT IS DIFFICULT TO
WORK ON THE FLOOR
Most Western adults, unless they’re
into yoga, have not spent much time
on the floor since they were children.
Since Thai massage is done mostly
kneeling and squatting, it can feel
initially challenging until your body
grows accustomed to moving in this
new way. For most students, however,
this unease starts to dissipate by the
end of the first weekend and is gone
within a few weeks of regular practice.
You don’t need a perfect yoga body
to perform Thai massage. I can’t squat
with my heels on the floor and I’ve
been giving Thai massage for more
than six years. The key is to modify
each technique not only for the client’s
comfort but also for your own—as
long as you follow the guidelines of
alignment and sound body mechanics.
One student I know cannot work
keeling; he has found ways to work in
a lunge or with one leg extended. The
techniques are highly adaptable.

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massagetherapy.com—for you and your clients 65

MISUNDERSTOOD MODALIT Y

MYTH: I’M TOO SMALL TO

WORK ON BIG BODIES
The power behind Thai massage
Tiny Asian women give Thai
massage all day long to big bodies, is excellent body mechanics and
then go home at night feeling fine.
This is possible because of the
ingenious use of body mechanics.
conscious breathing.
The basic Thai-massage routine
learned by beginner and intermediate
students does not involve much lifting
of the clients’ body weight. When a limb
must be moved, it often is possible just
to slide it into proper position. Even
lifting a limb is easier than it appears.
Working directly above or at ninety
degrees to the client lets alignment and
leverage do the work, not muscle.
I once taught a thirty-hour workshop
in which one of the students, a tiny
woman not more than five feet tall, got
paired up for the practicum with the
biggest guy in the class. Not surprisingly,
she was very worried about that. Yet
afterwards, she sent me an e-mail
saying how shocked she was not only
that the massage was easy, but that
she didn’t even feel tired afterward.

MYTH: YOU HAVE TO BE INTO

YOGA AND MEDITATION
TO DO THAI MASSAGE
Thai massage is a complete system
that has borrowed aspects of yoga,
acupressure, and a traditional
medical practice that has existed in
Thailand for more than a thousand
years. Some masters believe the only
way to teach Thai massage is in the
context of the spiritual traditions of
Thailand. Indeed, such commitment
can become an enriching way of life.
However, if you did nothing but learn
the mechanics of Thai massage, you
would still be able to give your clients
a powerful therapeutic experience. In
fact, the benefits of yoga and meditation
would sneak up on you as a side effect.
Attention to body mechanics itself
becomes something of a meditative
practice. For example, I start every
workshop having my students scan
their own bodies. From a standing
position, we go step by step from the
feet all the way up to the crown of the
head, coming into optimal alignment.
Once that experience is imprinted on
the body, it can be found again as we
learn the techniques of Thai massage.
Sometimes in class when I find
someone working out of alignment,
instead of immediately correcting
them I’ll go to the receiver and ask
them to pay attention to how it feels to
be receiving the touch as it is. Then I
guide the giver into better alignment—
usually just a small adjustment—and
ask again. Invariably, receivers can feel
the difference between, for example,
a bent arm transmitting stress and
a straight arm working effortlessly.
It’s part of the energy exchange
that occurs with any massage.

66 massage & bodywork january/february 2008

 The Thai massage touch feels much
better when the massage therapist is
attending to his own needs. Indeed,
giving the massage then becomes
a refreshing experience. That, in
and of itself, is a profound learning
in a culture that believes giving to
others means depleting oneself.
MYTH: THAI MASSAGE IS
PAINFUL TO RECEIVE
In fact, my very first Thai massage was
not just painful—it was excruciating. It
was back in 1993. My wife, Beth, and
I were in our twenties—young, naive,
adventurous, and poor—living and
working in Thailand. Eager to soak up
every bit of Thai culture we possibly
could, we went together one day to
receive Thai massages. Neither of us
had ever had bodywork of any kind.
Far off the beaten path, we found the
private home where our appointment
was scheduled. Out back was a raised
bamboo platform. Waiting for us on
the platform were two short, stocky
women. They didn’t speak English,
and we didn’t speak Thai. Eventually,
through their pointing and gestures,
we understood that we were supposed
to get on the platform and lie down.
Beth proceeded to have a wonderful
experience; she remembers her massage
as relaxing and blissful. All I can
remember is pain. This woman stood
on my inner thigh twisting, poking,
and jabbing. She moved my limbs as if
trying to tear them off my body. I just
lay there hoping the thing would end.
After that one awful experience,
I didn’t go back. But several years
later, back in the United States, I
read a magazine article about a Thai
massage therapist near my hometown.
The author portrayed the treatment
she’d received as a graceful, flowing,
harmonious dance between giver and
receiver. The article went on to describe
Thai massage as an ancient healing
art involving elements of yoga, t’ai chi
Chi, breathwork, and meditation.
That got my attention. I was
already incorporating many of those
practices into my private life and was
eager to learn more. So, I picked up
the phone and booked an appointment.
The massage was everything the
article described. I was amazed.
Why were the two experiences
so different?

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massagetherapy.com—for you and your clients 67

MISUNDERSTOOD MODALIT Y
There are several reasons why Thai
massage might be painful. The therapist
might be inexperienced or poorly
educated. The therapist might be out of
tune with the receiver and inadvertently
push beyond the client’s comfort zone.
Or, pain might be accepted as part of the
treatment style. There are two dominant
styles of massage in Thailand: Northern
and Southern. The latter tends to be
a little more invasive and therefore
potentially painful. The Eastern cultural
attitude toward pain is different than
our Western sensibility, more accepting.
Even in the West, deeper work that
goes slightly over the edge toward pain
sometimes yields therapeutic benefits.
But as a whole, we tend to avoid pain.
Thai massage should be blissful
for the receiver. Practiced with
mindful intention to do no harm,
it deftly encourages clients to their
edge of flexibility but never beyond. It
respects the body’s limits. Each client
therefore has the same experience
of having a good stretch, regardless
of whether they are relatively stiff
or relatively open. The rocking,
rhythmic quality of Thai massage and
its gentle movements are experienced
as both comforting and liberating.
MYTH: MY CLIENTS ARE
TOO FR AIL OR ELDERLY
FOR THAI MASSAGE
Thai massage is wonderful for
elderly people and for those coping
with disabilities. In many cases,
it’s exactly what they need.
One of the main reasons people at
a certain age start deteriorating rapidly
in health is because they no longer
move. Thai massage takes their muscles
and joints through their optimal range
of motion. This can be a profound
and liberating experience for them.
68 massage & bodywork january/february 2008
Some seniors and people with
physical disabilities might have a tough
time getting down to or back up from
the floor. In that case, Thai massage
techniques can be adapted for table work.
Even in the case where a client is in full
health, each technique is always adapted
according to the individual client. For
those who are very frail, you must be
extra careful to stay within their limits
and use extremely gentle pressure.
MYTH: I CAN’T EARN A LIVING
DOING THAI MASSAGE
One reason people think this is because
until recently, relatively few people had
heard of Thai massage. That is changing.
The International Spa Association
(ISPA) identifies Thai massage as one of
the “key trends” in the spa industry and
one of the fastest-growing modalities
requested by customers. Eager to diversify
their offerings, many spas are looking for
practitioners with Thai massage skills.
For independent massage therapists,
the Thai modality can help you stand out
from the competition next door. In some
parts of the country, one can even charge
more for it. Thai massage also opens the
door to ancillary product sales, such as
Thai clothing and decorative objects.
The other great business advantage
of Thai massage is its connection
to yoga. Thai massage is sometimes
called “yoga massage” or “assisted
yoga.” Clients enjoy the benefits of
yoga—from opening tight joints to deep
relaxation—simply from being moved
passively into yoga-like poses. Thus Thai
massage appeals to yoga enthusiasts who
want to advance their practice as well
as to people who want the benefits of
yoga without having to unroll a mat.
Annual revenues for all things
yoga have reached an estimated $27
billion in the United States. The Thai
modality gives massage practitioners
a great way to tap into this booming
market. The first thing I did when I
moved to a new town was to contact the
local yoga instructor. He turned out to
be a truly gifted teacher, and today we
share studio space. His students provide
a steady stream of massage clients.
MYTH: THE LOGISTICS OF
OFFERING THAI MASSAGE
ARE TOO COMPLICATED
This myth has two main components.
I’ll address them one at a time.
“There’s not enough space in
my treatment room”: clinic and spa
treatment rooms typically are very
small, and there is quick turnaround
between clients. If you’ve got some
clients coming for table work and some
coming for floor work, it wouldn’t be
feasible to switch setups every time.
Thai massage techniques can be adapted
for table work. Many clients who
experience Thai massage on the floor,
incidentally, never go back to the table.
“I’d have to buy a lot of costly new
equipment”: the only equipment you
may want is a Thai massage mat. They
cost less than $200. What you don’t need
are sheets, lotions, oils, and a washing
machine; Thai massage is performed
with the client fully clothed. Incidentally,
a Thai massage mat weighs just seventeen
pounds and rolls up easily for transport
to 18” x 30”. The average portable
massage table, in contrast, weighs more
than thirty pounds and folded has
dimensions of 30” by 37”. Since nearly
half of massage therapists travel to
client locations or work in very small
treatment rooms, the Thai modality
eliminates the strain of carrying around
a heavy, awkward piece of equipment.
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MISUNDERSTOOD MODALIT Y
MYTH: LEARNING THAI
MASSAGE IS EXPENSIVE
AND TAKES A LONG TIME
To become a registered thai therapist
(RTT), students must complete a
one hundred twenty hour certificate
program approved by the Thai
Healing Alliance, the international
professional organization that defines
Thai massage educational standards.
As a point of comparison, the National
Certification Board for Therapeutic
Massage & Bodywork requires test
candidates to have at least five hundred
hours of training from an established
school of massage and/or bodywork.
What’s special about learning
Thai massage is its emphasis on
practitioner self-awareness.
70 massage & bodywork january/february 2008
Thai massage is no more complicated
to learn than any other massage modality
that involves a whole-body treatment
routine. A fifteen-hour weekend
workshop can teach a basic sixty-minute
sequence. Some massage therapists go
home to practice and refine these basic
skills and then decide ultimately to
pursue a certificate. But, Thai massage
does not have to be a stand-alone
modality. Many practicing massage
therapists take weekend workshops to
learn techniques they can integrate
into their existing table work. Or,
they come to learn biomechanics that
ease the strain on their own bodies.
What’s special about learning Thai
massage is its emphasis on practitioner
self-awareness. Students are taught
to attend to their own breath, body
mechanics, and inner experience
in ways that transform the massage
into a self-nurturing meditation.
This makes the massage a better
experience for the client, since any
tension in the giver will consciously or
unconsciously pass into the receiver. It
also leads to a safer and more satisfying
experience for the practitioner.
THE BEAUTY OF THAI MASSAGE
By now you recognize that I am an avid
proponent of traditional Thai massage.
There is one more thing I’d like to
add. After I’ve given a treatment, I feel
almost as refreshed as if I were the client
lying on the mat before me. The most
important thing to remember about
Thai massage is this: it does not tax
the therapist in order to yield profound
results for the client. I don’t work
hard because of the body mechanics,
meditation, and breathwork. Further,
the gentle rocking movements calm me
as much as they calm my client. With
breath and movement coordinated, I’m
doing yoga for myself. It’s brilliant!
Martin Misenhimer is the founder of
Zen Thai, a leading Thai massage school
offering weekend workshops, extended
seminars, certificate programs, and
international study. He can be reached at
800-507-5003 or martin@zenthai.org.
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Thailand
Reclaims
its Ancient
Medicinal
Roots

O
BY PERRY GARFINKEL

f the many Asian modalities

that have been passed from

East to West, Thailand’s

traditional medicine and

massage are among the more

recent to gain popularity.

74 massage & bodywork january/february 2008

massagetherapy.com—for you and your clients 75
ANCIENT MEDICINAL ROOTS
Now, as the technique sometimes
referred to as “the lazy man’s yoga” draws
more devotees, an interesting cross-
pollination is beginning to occur—but
this time it’s from West to East. Western
approaches to both medicine and
marketing are beginning to influence
how Thai massage and medicine are
practiced, researched, taught, and
promoted, resulting in unique blendings
of applications and adaptations.
Take, for example, Bangkok physician
Krisna Piravej, an associate professor
in the department of rehabilitation
medicine at Chulalongkorn University.
Faced with an increasing incidence of
autism in Thailand and frustratingly
few successful treatments, she resorted
to a treatment so common in Thailand
that most Western-trained doctors, even
Thais, overlooked it —Thai massage.
But, though many generations of Thai
patients could offer anecdotal stories
of its effectiveness, she knew that in
order to convince her colleagues and
her patients to try it, she needed to
prove it worked. So she conducted a
study that would meet the rigorous
demands now required throughout
the world of medical practices.
In her soon-to-be-published 2006
study, Piravej evaluated the difference in
benefits between two groups of children
with autism, one group treated only with
standard behavioral therapy (sensory
motor stimulation and occupational
therapy), the other adding Thailand’s
traditional massage techniques. Though
the sampling was small—a dozen
children ages three to ten, treated one
hour twice a week for eight weeks—the
results were strong enough to conduct
further studies. The most encouraging
finding, she said, was that all the parents
of the massaged children were so satisfied
with their kids’ behavioral improvements
that they asked if the massage could
continue after the study ended.
76 massage & bodywork january/february 2008
This healing
tradition is
older than
science. If
anything, it’s
science that
should be
questioned.
But science was what the medical
community needed. “As teachers
in the university hospital, we have
the obligation to prove empirically
these methods work, not just through
word of mouth,” Piravej says.
Hers is one of fourteen similar
studies funded by the five-year-old
Department for Development of Thai
Traditional and Alternative Medicine
(DTAM), under the government’s
Ministry of Public Health. Other
DTAM-funded projects researching
the efficacy of Thai massage target
migraine headaches, myofascial
pain, range-of-motion problems, and
osteoarthritis. Still others examine
the effectiveness of Thai herbal
treatments on functional dyspepsia,
acne vulgaris, influenza, and fever.
The impetus for setting up the
department followed a 1980 Association
of Southeast Asian Nation (ASEAN)
Health Ministers’ resolution advocating
“health for all by the year 2000.” But in
the intervening years, “We found that
Western medicine alone cannot achieve
this end,” said Dr. Vichai Chokevivat,
director general of the DTAM. “Each
country—Brunei, Indonesia, Malaysia,
the Philippines, Singapore, and
Thailand—knew it had in its medicine
chest this age-old treatment, which
we call traditional medicine. But now,
in modern times, belief is not enough.
We have to offer evidence it works.”
Modern times—and Western
influence—presented Thailand in
particular with another obstacle to
overcome with regard to validating its
traditional medicines. To many American
military men who served in Southeast
Asia in the 1960s and 1970s, the phrase
Thai massage has seedy associations.
“Thai massage meant sex to soldiers
coming to Bangkok on R&R from
Vietnam forty years ago,” Chokevivat
says. Now, he says, he hopes his
department’s studies will give legitimacy
to its traditional healing approaches,
as well as help turn travelers from sex
tourism to spa and health tourism,
both lucrative overlapping trends for
which Thailand has become known as a
top international destination. Though
the DTAM’s annual budget of 120
million baht (an estimated $3.81 million
US) is the smallest piece—less than
1 percent—of the Ministry of Public
Health’s annual budget, it may be the
government’s best investment. Backed
by the Tourism Authority of Thailand
(TAT) promotional campaigns that
cleverly connect DTAM findings to the
burgeoning spa and health travel boom,
those segments have grown significantly.
Before the establishment of the
DTAM, for example, the spa sector
grew 64 percent from 2000 to 2002
in Thailand, according to a study
undertaken by Intelligent Spas, an
independent analyst. The number of
spas jumped from 230 in 2002 to an
estimated 450 today. In 2004, spas
generated 5.3 billion baht (an estimated
$168.3 million US) in revenue,
exceeding the original target by nearly
10 percent, according to TAT.
In 2004, Thailand embarked on a
five-year strategic plan, spearheaded
by the Ministry of Public Health,
to establish Thailand as the “center
of excellent health” of Asia.
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ANCIENT MEDICINAL ROOTS
“Thailand’s spas are the new
churches, the new meditation
centers, and the new health
clinics all rolled up into one.”
Patrick Ghielmetti, regional vice president,
Four Seasons Hotels, Thailand
“Thailand’s spas are the new
churches, the new meditation centers,
and the new health clinics all rolled
up into one,” says Patrick Ghielmetti,
regional vice president of all four
Four Seasons Hotels in Thailand
and general manager of the Bangkok
property. The Four Seasons Chiang
Mai is a perennial award winner;
it’s Conde Nast Traveller UK’s 2007
Reader’s Award for world’s best spa.
“For a long time here, the hotel
spa was considered an amenity—now
it’s a key business revenue stream,” he
says. “It used to be an up-sell, but now
it has become a decision-maker for
guests who won’t come unless we have
a high-end spa that offers signature
traditional Thai medicinal herbal and
massage treatments. One big reason
is it’s now got more to do with health
than self-indulgent pampering.”
78 massage & bodywork january/february 2008
On the island of Phuket, at
the Trisara, a small luxury hotel
where each of forty-two rooms is
a private villa and each villa has its
own private pool, 100 percent of the
guests book at least one treatment at
the luxury beachfront hotel’s spa.
“The connection between the
guest and the masseur has such healing
power—and it’s often the most personal
interaction he or she has with our
staff—that we invest heavily in it because
we know how desirable this whole
signature Thai healing experience has
become,” says general manager Anthony
Lark, a native of Sydney, Australia, who
has lived on Phuket and worked in its
hospitality industry for nineteen years.
On Trisara’s spa menu is traditional
Thai massage (ninety minutes for
$135), but to stay at the cutting edge
the offerings also blend East and West,
including Native American Indian-
inspired Raindrop Therapy ($120 for
one hour). Similarly nontraditional,
the spa at the Four Seasons Resort Koh
Samui, which opened in February 2007,
offers treatments that complement the
seasons and the elements. Its Space
Nurture massage, available as a full
moon approaches, uses lotions that blend
warm mango butter, honey, and sweet
orange oil, complemented with a scalp
massage (3.5 hours for about $480).
A DEEPLY ROOTED
TR ADITION OF BLENDING
As with much of Thailand’s history,
the origins and evolution of the
country’s traditional medical practices
are a somewhat murky mishmash of
various cultural influences and oral
histories that freely intertwined fact
and legend over thousands of years.
Nuad boran (meaning ancient massage),
as it’s known by its Thai practitioners,
is a two-thousand-year-old system
said to have been brought to Siam by
an Indian ayurvedic doctor named
Jivaka Kumar Bhacca, revered as the
father of Thai medicine, who was said
to have treated the Buddha himself. A
combination of other regional healing
systems, it mostly draws on ayurveda
from India and acupuncture from China.
In the simplest of terms, the
theoretical basis for traditional Thai
healing is rooted in the belief that all
forms of life are sustained by a vital force
(lom) carried along energy pathways
(sen) that run through the body. It is
believed that disease and dysfunction
occur when these energy lines become
blocked, much the same way cholesterol
clogs arteries. Thai massage attempts
to release the blockage and stimulate
the natural flow of life force.
Though passed down orally among
the common people, the principles
and techniques were kept by the
royal court in reference texts. When
Burmese invaders destroyed the old
capital of Ayuthaya in 1767, most
of these texts were burned and lost.
ANCIENT MEDICINAL ROOTS
Remaining fragments of the texts,
however, were commissioned to be
redrawn as stone etchings by King
Rama III in 1832. Today, more than
sixty such epigraphs showing treatment
points and energy lines are on public
display at the famous Wat Pho temple
complex in Bangkok, where the golden
statue of the Reclining Buddha lies.
In 1856, King Rama V appointed the
royal doctors to also translate and edit
Indian Pali and Sanskrit medical texts
into a Thai version, called Medical
Science Textbook, with another version
known as Thai Massage Handbook.
Western medicine was introduced
to Thailand in the middle of the
nineteenth century, mainly by American
missionaries, and traditional treatment
approaches fell out of favor—another
example of Western influence on
Thailand. In 1962, as the story goes,
the current King, Bhumibol Adulyadej,
Rama IX, visited Wat Po and asked
about Thai traditional medicine and
particularly massage, which triggered
renewed interest in it. A council of
traditional medicine doctors was granted
approval by the Ministry of Heath to
establish Wat Phra Chetuphon Thai
Traditional Medicine Science School.
Since then, the so-called Wat Po style
of massage evolved. One of the original
teachers at that time, Ajahn Sintorn,
eventually moved to Chiang Mai,
where he started the Shivagakomarpaj
Hospital, now called the Old Medicine
Hospital. No longer serving as a hospital,
it has become one of the best-known
massage schools in the country.
THE DOUBLE-HEADED DR AGON
OF EAST MEETING WEST
The attempts to corroborate Eastern
approaches to healing by applying
Western empirical testing is “a mixed
blessing, a double-headed dragon,”
says Pierce Salguero, perhaps the most
knowledgeable Western authority on
Thai traditional medicine. He has
80 massage & bodywork january/february 2008
authored several books on the subject,
studied it for five years in Thailand, and
is currently completing his doctorate in
the History of Medicine Department
at the Johns Hopkins School of
Medicine in Baltimore, Maryland.
“On the one hand, it breathes
new life into traditions and practices,
dramatically increasing their relevance
and legitimacy on the world stage
and making them marketable and
exportable,” he says. “This awareness
of and attention to them will preserve
practices that could have been
lost and forgotten altogether.
“On the other hand, the marketplace
has forced a homogenization. What’s
now called Thai traditional medicine is
a standardized system that comes mainly
from the top down, from Bangkok
bureaucrats. We lose the regionally
distinct knowledge practiced by ethnic
minorities in the mountains of remote
Thailand, for example, who use local
plants and herbs. To a large extent,
those village healers are the losers.”
Among the winners is the entire city
of Chiang Mai, where Thai massage
schools have become a growth industry.
“When I first came to Chiang Mai
in 1997 to study, there were four or five
schools,” Salguero recalls. “I was in a
class with seven people.” Now there
are some thirty schools, plus many
other private teachers. Each class has
between twenty and thirty students
who sign up for five-day to two-week
courses (average cost is about US $160).
Wasan Sintorn, the son of the Old
Medicine School’s founder and now
director, said twenty years ago about
twenty non-Thai people took the
course each year; last year he had four
hundred. One of the reasons for the
increase, he says, was good old marketing
with a modern Western adaptation.
“My father was a great doctor but not
a good promoter,” he says. “When I
took over, we made brochures, put up
posters, and spread the word. But when
we put up a website, things really took
off. We got interest and inquiries from
all over the world. Now the majority
of our students are from the West.”
A former student, David Bliss,
a twenty-eight-year-old New York
massage practitioner who has lived
in Thailand for seven years studying
Thai traditional medicine and massage,
says the techniques he has picked
up are valuable assets to his body of
knowledge as a health practitioner. But
he remains ambivalent as to whether,
even as a Westerner, accumulating
data through the evidence-based
medical model adds anything to
his own knowledge of the body.
“Everyone here knows that
massage and herbal treatments are
good for you,” he says. “It’s the West
that needs to validate it with science,
because science is the religion of
the West. This healing tradition is
older than science. If anything, it’s
science that should be questioned.”
Nonetheless, he conceded, if not
for the interest from and influence
of the West, Thai massage and
medicine may well have become an
all-but-forgotten healing relic, to
be bronzed and displayed in some
imaginary Museum of Endangered
Healing Traditions. And that would
have improved no one’s health.
Perry Garfinkel is the author of Buddha
or Bust: In Search of Truth, Meaning,
Happiness and the Man Who Found
Them All (now in paperback from Three
Rivers Press, 2007 ; www.BuddhaorBust.
com). He’s covered the convergence of
Eastern and Western health, psychology,
and spirituality trends for thirty years.
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Massage
for Musicians
Linking Injuries to Instruments

M
BY DOUG NELSON, DEBORAH LIEBERMAN, AND JAN KIENER

usicians seldom think of themselves as upper body athletes,

individuals as immersed in the physiology of performance

as anyone who plays a sport. Each of the authors has treated

numerous athletes and has noted that athletes often have an

understanding of the physiology of movement that musicians lack.

This initial observation led to the performance of a research study,

by Deborah Lieberman, Jan Kiener, and J. McCrackan, examining

the correlation between certain instruments and the existence of

specific injuries. The plight that musicians encounter when faced

with musculoskeletal discomfort is illustrated in the narrative

of violist T.M. Her story is the story of countless musicians.

82 massage & bodywork january/february 2008

MASSAGE FOR MUSICIANS
“I just don’t understand why this is
happening. I used to have pain, but
I have been studying with this great
teacher and I changed my technique to
a more efficient movement pattern. I
just can’t have this pain right now!”
T.M. looked at me with eyes that
revealed her intensity, intelligence, and deep
concern. She has been playing the viola since
she was three—music is her whole life. It is
her dream and passion; T.M.’s deep emotion
is evident when she plays the instrument.
No longer just a collection of notes, in the
hands of T.M., the music cuts right to the
heart. Her playing is masterful, moving,
true art. Now physical pain threatens
all that she has worked for. In the short
term, it threatens her participation in an
upcoming orchestra recital, of which she is
the principal violinist. In the long term,
pain may destroy her performing career.
T.M. is not alone. Music injuries are
being recognized increasingly as a
potential hazard of the physical nature of
playing instruments. While high profile
artists, including pianists Gary Graffman
and Leon Fleisher, have suffered music
injuries from overuse, numerous other
musicians of all levels and disciplines
have suffered enormously, too.
In the past, there were few resources
for meeting the special needs of
musicians. Resources are available for
athletes, but students involved in the arts
are not treated in the same way. There
are perhaps two reasons: one is that the
revenue available for the arts is generally
modest; the other is that students and
their teachers do not think of themselves
as upper extremity athletes. The
physiology of artistry is often overlooked.
When student musicians hurt, rest seems
to be the only option. Student athletes
are immediately given strategies to get
them back on the field as soon as possible,
whereas musicians are consistently told
to take a break from playing. In one
sad but humorous encounter, a student,
getting his master’s degree from Juilliard
84 massage & bodywork january/february 2008
was asked by his doctor if perhaps he
would consider switching instruments
to help his hands. With quick wit, he
immediately asked the doctor if he had
ever thought about being a veterinarian.
When musicians hurt, three
questions must be explored. First: is this
pain the result of ongoing processes,
such as faulty technique? Second: is this
pain a result of inappropriate muscle
use, such as playing without warming
up, playing too long, lack of stretching,
etc.? Third: what is the underlying
history of this particular pain?
Technique issues can be the most
important aspect of healthy playing, yet
finding the right teacher is not an easy
prospect. There are few physiologically-
based methodologies in music education.
For playing stringed instruments,
the Rolland method is a fine example
of striving for the most elegant and
physiologically-based approach. One
of the authors knows of a fine piano
teacher who used a full human skeleton,
placed next to the piano during lessons,
to instruct students in the physiological
processes, as well as the musical and
physical technique. Finding such teachers
who understand physiology is not easy.
Musicians must be evaluated by
experts in their chosen instrument
who can help them play with maximum
physiological efficiency. Injury is a
substantial reason for students dropping
out of master’s programs in music
performance. If the professors who
attain an advanced degree have never
struggled with injury, their lack of
personal experience with performance
injuries leaves them ill-equipped to help
injured students. Most therapists who
treat musicians are not experts in each
instrument; meanwhile, instructors often
tell students just to play through the
pain, leading to disastrous consequences.
“She was amazing,” T.M. told me about
her new instructor. “After so many years
of playing, she completely changed the way
I play the viola. I guess, if you look from
the outside, I am not sure you could see the
changes. To me, the changes seem radical.
It took some faith and patience, but I play
better, use less energy, and the pain I felt
completely disappeared. That is, until
now,” T.M. added with remorse. Knowing
that T.M. was obviously in the hands of a
fine teacher, I resolved that technique was
not an issue. This made my job infinitely
easier. I could focus on other issues.
“How much have you been
playing lately?” I asked.
“About as much as I always do. I practice
a lot,” she added. “Actually, I guess that
is not true,” she corrected. “In addition
to my normal practice routine, I have
had this big orchestral concert coming up
and we are doing a Brahms symphony. It
is beautiful but there are some difficult
passages, which I have had to play over and
over to master. Also, my friend is doing her
doctoral recital and I told her I’d play for
her, which happens to overlap with my own
recital coming up, which I have also been
preparing for. I guess I have been playing a
lot more than I usually do,” she confided.
A STRUGGLE FOR SUPPORT
Researching the topic of musicians and
pain, we were struck by how taboo a
subject it appears to be. Though this
problem is widespread, apparently
musicians fear being blacklisted if they
admit they are struggling with pain.
In a May 2002 article in The
Neurologist, author Richard Lederman
details the frequency of playing-related
problems in musicians. He describes
a survey completed in 1988 by the
International Conference of Symphony
and Opera Musicians (ICSOM) in
which 2,212 instrumentalists responded
to a questionnaire about their medical
problems. This number represented
about 55 percent of the members of
the 48 orchestras surveyed. Of the
participants, 76 percent listed at least

The physiology of artistry
is often overlooked.
“one problem characterized as severe in
its effects on performance and the bulk
of these were musculoskeletal in type.”
The author continued by explaining
he has to do a musculoskeletal exam of
the upper body as part of his treatment
assessment of musicians who consult him
for care.1 Clearly, musculoskeletal strains
abound in instrumental musicians.
In his clinic in Cleveland, Lederman
has treated several musicians for pain
syndromes and nerve entrapment
syndromes. The musicians report pain
in the upper extremity, upper trunk,
and neck most frequently. Lederman
describes a correlation between injuries
and specific instruments played. For
example, violinists tend to injure the
left (fingering) arm or hand more
frequently than the right (bowing) arm.
Lederman also discusses focal dystonia,
or occupational cramp in musicians, as
well as nerve entrapment syndromes.
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massagetherapy.com—for you and your clients 85
MASSAGE FOR MUSICIANS

Questionnaire Results: Instrument(s) Played vs. Pain

AREA(S) OF DISCOMFORT

Extensors R

Extensors L
Shoulder R

Shoulder L

Flexors R

Flexors L
Hand R

Hand L
Neck R

Neck L

Other
Bass mm xmm m L Piriformis: x

Bassoon x

Cello x x

Clarinet xx

Drums m m

Flute x mm xxm m m

French Horn xx

Guitar m m xmm m m
INSTRUMENT(S) PLAYED

Harp x

Oboe x xx

Piano m m

String Bass/ m m
Electric Bass

Trombone x x x

Tuba x

Viola m xmm xmmn x nm xxm xm m xmx

Violin xxxmm xxxx mmm xxmm m mmm mm xmm m m

mmxm mmm mx mm m
mmm mmm
mm

Violin & m m m m
Mandolin

x = Questionnaires with one area marked.

m = Others who had more than one area marked, and m appears in all areas. One musician could have an m in 3 or 4 places.
n = Musician who played violin and viola.

86 massage & bodywork january/february 2008

 In her book Playing (less) Hurt—An
Injury Prevention Guide for Musicians,
cellist Janet Horvath writes, “We’re
all afraid of real or imagined stigmas
associated with injury. Rationally or
irrationally, we may wonder, does
our pain signal that we have failed in
some way? Will we be branded as bad
musicians, flawed people?”2 She then
explains that the risk of repetitive
strain injury (RSI) is quite high in
orchestral musicians. To combat this,
some organizations are advocating
assistance to musicians who are playing
with pain. The continued awareness
of RSI due to factory work and
computer work has helped open the
discussion of pain in musicians, too.
Drawing on comparisons between
instrumental musicians and competitive
athletes, authors Barbara Paull and
Christine Harrison outline many of
the causes for musculoskeletal pain in
musicians in their book The Athletic
Musician: A Guide to Playing Without
Pain. They point out the frequent lack
of supportive resources available to
instrumentalists, compared to athletes
who usually have a coach, trainers,
sports psychologists, and a slew of
other professionals at their disposal.3
Due to the lack of information and
assistance, musicians rarely understand
the importance of self-care as they are
practicing and performing numerous
hours a day. They often do not seek care
until the situation is advanced and they
are unable to play their instruments.
As massage therapists, we would like to
see that change, by seeking musicians
as clients before they are at that point
in their pain. The study described
below, is part of an effort to improve
bodywork approaches for musicians.
“In any way is the present pain like the pain
you felt years ago, before you started studying
with your new teacher?” I asked T.M.
“Yes,” she replied, “this is very
similar to what I felt years ago. That
is what is frustrating. I thought I was
done with this. My technique is good.
Why should this be resurfacing now?”
OUR STUDY
The idea for a musician research
study surfaced during a discussion at
a Precision Neuromuscular Therapy
(PNMT) seminar. One of the authors
(Lieberman) had played clarinet
since 1973 and was all too aware
from personal experience that pain is
frequently involved in playing a musical
instrument. Unfortunately, many of
the musicians who are playing in pain
believe there is no other way to play
their instruments. Our research study
was initiated to determine whether, in
musicians, there is a relationship between
the area of soft-tissue pain/discomfort
and the instrument played. This
information could be useful in treating
musicians as a starting point or guide
of possible areas of soft-tissue injury.
The investigators, Deborah
Lieberman, Jan Kiener, and J.
McCrackan, had each of the sixty-eight
study participants fill out a questionnaire
about the areas in which they feel pain.
(A chart summarizing the results is
on page 86.) The musicians also stated
whether or not the pain forced them to
stop playing their instrument(s). There
were several additional musicians who
filled out the initial questionnaire, but
who were not included in the study since
they played their instruments for too
few hours each week to determine if
their discomfort was due to playing the
instrument or to other life activities.
massagetherapy.com—for you and your clients 87
Seventeen different instruments
were played by the musicians in the
study. Looking at the data to compare
and contrast the players of the various
instruments, we drew some preliminary
conclusions. The wind instrument
players all had pain in their necks. The
flute players also exhibited discomfort
in their left shoulder and hand. Oboe
players also showed pain in the right
hand. Overall, the violinists most
often reported pain in their necks and
shoulders. There were some instances
of pain in hands and forearms, too. One
violin player noted pain in her left jaw
when she played standing up. The viola
players exhibited pain in almost all of
the observed regions, with the exception
of the flexors of the right forearm. The
cellists had pain in their right neck
and hand respectively. The guitarists
complained of pain mostly on the left—
in the neck, shoulder, hand, and forearm
extensors—with one player also feeling
pain in the right forearm extensors.
The drummer had pain in both sides of
the neck. The pianist had pain in both
shoulders. One violinist who also played
mandolin felt pain in both sides of the
neck, as well as the right shoulder and
right forearm extensors. Finally, bass
players exhibited bilateral pain in the
neck, along with left shoulder and left
piriformis, but a string bass player who
also played the electric bass had pain
in the right forearm extensors and the
left forearm flexors. The harp player
reported pain in the right shoulder.
MASSAGE FOR MUSICIANS
Overall, players of twelve of the
different instruments exhibited pain in
the right side of the neck, whereas pain
in the left side of the neck showed up in
players of nine different instruments.
The right extensors and left shoulder
areas had the next highest number with
players of six different instruments
affected. There were players of five
different instruments with pain in the
right hand or right shoulder. Players
of the same three instruments had
discomfort in the left hand and left
extensors, and a player of one other
instrument also had pain in the left hand,
but not extensors. Finally, players of
three different instruments mentioned
pain in the left forearm flexors, but
only one violinist of the group (who
also had pain in three other areas) had
pain in her right forearm flexors.
Following questionnaire completion,
investigators met with each study
participant for a free fifteen minute
massage, during which the therapist
palpated the areas of pain to determine
the specific hypertonic muscles. We
attempted to find the most aggravated
area, though some participants had
more than one region in which they
were experiencing pain. Finally, as a
thank you to the musicians for their
participation, we did a brief PNMT
treatment for each musician to release
the muscle or group of muscles that
were most contracted and painful.
“Did you ever have this treated?” I asked.
“Well, I did have massage and
physical therapy, but nothing so focused
and targeted as what you just did a
minute ago,” she replied. “Do you think
this is a remnant of my painful past?”
88 massage & bodywork january/february 2008
THE AUTHORS WOULD LIKE TO THANK: THE CINCINNATI CHAMBER ORCHESTRA, MISCHA SANTORA,
MUSIC DIRECTOR; THE DAYTON PHILHARMONIC, NEAL GITTLEMAN, MUSIC DIRECTOR; THE DAYTON
PHILHARMONIC, KAREN JOHNSON, VIOLIST; THE FT. COLLINS SYMPHONY, WES KENNEY, MUSIC DIRECTOR.
“I do,” I said. “I think these little
areas of injury were in the tissue, lying
in a latent state. With the sudden high
demand, your tissue reached what we call
failure tolerance; it just hit a threshold
where unresolved old injuries suddenly
resurfaced. If we treat them thoroughly,
not only will they stop hurting now, we
may be able to clear them out for good.”
RESULTS AND CONTINUED STUDY
It is difficult to come to any statistical
conclusions with the data from our study
for several reasons. Our study was not
blinded; subjects told the researchers
which instrument(s) they played. Also,
the researchers were not consistent in
asking the participants to self-select
one area that was the most painful to
touch. Some of the participants listed
several areas of discomfort, while others
focused on the most uncomfortable
area. At times, a participant said that he
or she felt the pain most prominently
in one area, but during the assessment,
discovered the most painful area(s)
were on the opposite side or in another
region altogether. This could be a
result of trigger point pain patterns in
which a subject feels the pain sensation
in one area of the body, though the
hypertonic muscle causing the pain is
elsewhere. For some of the instruments
played, the small sample size also
makes it difficult to draw conclusions.
Future observational or
interventional studies could be
completed to further the investigation of
a possible link between players of specific
instruments and the area of soft-tissue
pain/discomfort or musculoskeletal
injuries they sustain. We discovered
that many musicians had tenderness or
pain in the iliocostalis cervicis muscle.
A point for consideration in a future
study would be the determination of
whether this muscle is frequently painful
or tender in the general population or
just in musicians. The results would
then be evaluated to see if this particular
muscle is more often hypertonic in
players of specific instruments.
Ultimately, we hope the knowledge
we gain will aid in the prevention and
treatment of repetitive strain injuries
and other related problems experienced
by musicians. Other considerations for
future research include Lederman’s
suggestion of longitudinal studies with
instrumentalists from a young age.
Additionally, we could research the
possible benefits of PNMT treatments
and regular self-care techniques,
including stretching and postural
awareness on musicians as they learn
to play their instruments, as they
play as amateurs or professionals,
and as measured against a control
group of musicians who do not
receive the care. There are many
possible future research options.
“Do you think I can play in the
orchestral concert next Friday?”
“I think that is very possible,” I replied.
“It will mean some changes in your practice
routine. You will need to limit playing time
to no more than forty-five minutes at a
stretch. I want you to play difficult passages
slowly at first. Use your inner hearing, play
the passage in your mind before you play
it on the viola. If you can clearly imagine
the fingering, you will find your fingers
will follow what your mind has already
imagined. There is no need to practice
incorrect playing over and over. Also, you
are not to have large spikes in playing time.
You may play, but then you must rest.
Maximum efficiency is the goal. Okay?”
“Okay,” she replied, with a smile that
revealed a sense of hope and resolve.
THE ROLE OF BODYWORK
Possible preventive programs would need
to be designed to counteract problems
caused by muscle overload. As Precision
Neuromuscular therapists, our interest
in these problems lies in understanding
the causes of this soft-tissue pain and
in being part of the self-care regimen
to help alleviate potentially career-
destroying injuries. Besides receiving
PNMT therapy, practicing good
self-care habits can go a long way in
 L
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MASSAGE FOR MUSICIANS
diminishing a musician’s playing-related
musculoskeletal problems. Self-care
becomes more motivating when we
realize what a difference it can make.
The good news is that muscle pain
is treatable. As doctors Janet G. Travell
and David G. Simons say in Myofascial
Pain and Dysfunction: The Trigger Point
Manual, “When patients mistakenly
believe that they must ‘live with’ trigger
point pain because they think it is due
to arthritis or a pinched nerve that
is inoperable, they restrict activity
in order to avoid pain. Such patients
must learn that the pain comes from
muscles, not from nerve damage, and
not from permanent arthritic changes
in the bones. Most important, they
must know it is responsive to treatment.
This gives the pain a new meaning.
When these patients realize the twin
facts that their pain is myofascial and
is treatable, their lives take on new
meaning and they are started on the
road to recovery of function.”4
How do muscles get into trouble
to begin with? Situations that create
overwork and injury in muscles are:
small repeated actions (muscles thrive
on variety); intrinsic domination (small
muscles working when larger muscles
are better suited to the task); static
holding (muscles don’t get rest or blood
flow); and mechanical disadvantage
(using energy for less than optimal
positioning and posture).5 As the muscle
is put into any of the above situations,
it becomes constricted, develops trigger
points (a focus of hyperirritability),
and can constrict the blood vessels
running through it and entrap nerves.
Tendons of the muscles also can become
irritated or inflamed from the repeated
friction during use. Of course, playing
an instrument involves many of these
situations and the nature of the beast
is overuse of muscles and tendons.
90 massage & bodywork january/february 2008
The Breathe Rest Imagine Move
(BRIM) self-care chart, which follows
on page 91, provides a general list of
goals for muscle rescue. Where there is
constriction of blood vessels and loss of
oxygen and waste removal, our goal is
to increase circulation with movement.
Where there is tissue starved for oxygen,
our goal is to increase the supply with
occasional deep breaths. Where there
is muscle fatigue from repeated actions,
our goal is finding even minutes of
rest during activity. And finally, where
there is mechanical disadvantage
from awkward postures, our goal
is to bring the body into alignment
as much as possible with adaptive
devices and body awareness. This list
of goals is presented for therapists to
share with their musician clients.
What’s so encouraging is how
forgiving muscles are, how small
moments of rest, recovery, movement,
and adjustments in position can
be so restorative. These things,
especially when combined with well-
balanced, moderate exercise, and
massage therapy, can create a healthy
atmosphere for muscles, the delivery
system for the musician’s art.
Sitting in the concert hall that evening,
I resolved to observe and analyze T.M. to
detect any reason for her previous pain and
discomfort. While a noble intention, as
the music began and the emotional power
of Brahms filled every millimeter of this
immense hall, I could not seem to focus on the
nuances of her mechanics when presented with
the beauty that flew from her fingers. The
music was moving, powerful, commanding.
It would not let me disassemble the whole
experience into fragments. I stopped watching
T.M.’s graceful movements, content only to
close my eyes and let the music move me to
my very soul. Through discipline, science, and
attention to detail, the work with T.M. had
resolved her pain. Now, as I sat transfixed
by the beauty of the sounds, I was inspired
by the elevation of science and discipline
to mastery and artistry, a truly moving
experience at the very essence of art.
Douglas Nelson has been a massage
therapist since 1977. He owns a clinical practice
in Champaign, Illinois, which employs sixteen
therapists. In addition, he is the founder of
Precision Neuromuscular Therapy and has
taught hundreds of seminars across the United
States and abroad. His company, NMT
MidWest, Inc, has been conducting numerous
research studies in soft-tissue therapy. He can
be reached at doug@nmtmidwest.com or at
407 W. Windsor Road, Champaign, IL 61820.
Jan Kiener is an LMT and travels
across the United States as an instructor
for Precision Neuromuscular Seminars.
She maintains a private massage practice
in Cincinnati, Ohio, and has recently
produced a CD titled Relaxation Into Sleep
(www.meditatetosuccess.com), which
has been featured on Delta Air Lines.
Deborah Lieberman, MA, CPNMT, owns
L’Équilibre Massage (in both Boulder and Fort
Collins, Colorado) and focuses on repetitive
strain injuries. As a clarinetist, she directly
understands the challenges that face musicians.
Lieberman has written and published other
articles on alternative and complementary
healthcare. She teaches introductory massage
courses at Colorado State University.
NOTES
1. Richard Lederman, “Neuromuscular Problems in
Musicians,” Neurologist 8, no. 3 (May 2002): 163–74.
2. Janet Horvath, Playing (less) Hurt—An Injury Prevention
Guide for Musicians (Kearney, NE: Morris, 2003).
3. Barbara Paull and Christine Harrison, The Athletic
Musician: A Guide to Playing Without Pain
(Lanham, MD: The Scarecrow Press, 1997).
4. Janet G. Travell and David G. Simons, Myofascial
Pain and Dysfunction: The Trigger Point Manual
(Hagerstown, MD: Williams & Wilkins, 1983), 31.
5. Doug Nelson, Precision Neuromuscular Therapy:
Upper Extremity Manual (2000), 47.
BRIM Self-Care
1. Breathe. Holding breath during effort
closes the epiglottis and increases
intrathoracic pressure.1 Take occasional
deep breaths.
A. Inhale—feel the stomach expand.
B. Exhale slowly.

2. Rest. It’s all about recovery.

Take breaks: “Even after arduous exercise, the metabolic
recovery in muscles is ten to fifteen minutes. There is
80 percent recovery in your muscles even after one
minute of rest if muscles are not over-fatigued.”2
A. Dangle arms whenever possible.
B. Notice muscles that are tensed unnecessarily (Jaws
clenched? Shoulders raised? Fingers flexed?)
C. Try to schedule practice/performances to include time off.

3. Imagine. Use imagery to enlist ease of

posture and movement.
When our skeleton is in perfect alignment, the muscles
rest. When the skeleton moves off the midline, the muscles
have to work. Therefore, whenever possible, return to
the balanced midline. Studies show that imagery can
impact subcortical patterning of muscle coordination and
can help the body move effortlessly into alignment.
Visualize (without using muscular effort):
A. The head as a helium-filled balloon which, being
lighter than air, rises.
B. Sand pouring slowly from the lower back to the floor.3

4. Move. Movement can imitate a massage,

bringing warmth and circulation and
decreasing muscle pain.
A. Do non-painful, gentle exercise that works muscles
in the front and back of the body evenly.
B. Do gentle stretches and effortless movement to
keep muscles and joints warm and well lubricated.
C. Read Playing (less) Hurt by Janet Horvath. It is a trove Now
Available!
TheraStone
of practical dos and don’ts, stretches, and adaptive Instructional
DVDs
devices, written by a musician for musicians. For example,
try Horvath’s shower stretches: bring your shoulder
blades together; keeping them together, raise shoulder
blades toward your neck; roll your shoulders forward.4

NOTES
1. Lulu Sweigard, Human Movement Potential: Its Ideokinetic
Facilitation (University Press of America, 1974), 137.

2. Janet Horvath, Playing (less) Hurt—An Injury Prevention

Guide for Musicians (Kearney, NE: Morris, 2003), 55-56.

3. Lulu Sweigard, Human Movement Potential: Its Ideokinetic Facilitation, 249.

4. Janet Horvath, Playing (less) Hurt—An Injury Prevention Guide for Musicians, 134.

massagetherapy.com—for you and your clients 91

Appreciating
Clients’ Health
Challenges
BY DIANE M. MARTY

W
hen people with chronic

diseases cross the threshold

of a massage therapist’s

office, they bring with them

hopes of relief. Some health

issues, like fibromyalgia

(FM), cause clients pain.

Others, like Parkinson’s

disease (PD) and multiple

sclerosis (MS), match pain

with life-altering disabilities.

massagetherapy.com—for you and your clients 93

APPRECIATING CLIENTS’ HEALTH CHALLENGES
While numerous studies confirm
the usefulness of massage as a tool for
total health, recent research explores the
potential value of bodywork as a means
to a higher quality of life for people
living with health challenges. In the case
of FM, a new Zealand study highlighted
how massage therapy can bestow higher
pain tolerances and lessen negative
emotions.1, 2 People with PD may find
living easier and, embedded within
a particular therapy, the possibility
of a normal appearance.3, 4 And with
the help of massage, people with MS
may complete daily living tasks.5
It’s common for clientele with FM,
PD, and MS to endorse massage as a
valuable component in their struggle
to keep life normal. “Massage therapy
twice a month has been part of my
overall healthcare plan for ten years,”
says Gloria, an Ohio mother of three
and grandmother of six who was
diagnosed with FM thirty years ago. “It
is not a cure-all. However, an hour of
treatment improves blood circulation
and removes toxins from my body.”
With research like that above
demonstrating the effectiveness of
bodywork, techniques targeted for
special conditions should be basic
knowledge for therapists, right?
Unfortunately, the answer is no.
When presented with clients who
need special treatment, massage
therapists may find themselves in
uncharted waters.
94 massage & bodywork january/february 2008
“I’ve had several different therapists
over the years and only one knew
something more about fibromyalgia
than that it existed,” Gloria says. “And
she only had more knowledge than the
others because her therapist ex-husband
specialized in fibromyalgia patients.”
When presented with clients who
need special treatment, like Gloria,
massage therapists may find themselves
in uncharted waters. “Most therapists
don’t really know a great deal about
pathological conditions and, therefore,
will be uneasy about dealing with
adverse health conditions,” says Whitney
Lowe, director of the Orthopedic
Massage Education & Research Institute
(OMERI) in Sisters, Oregon. He advises
bodywork professionals to admit to
clients when they don’t know much
about a condition and, then, to get as
much information as possible. That
way, they can make more informed
judgments about what type of massage
interventions might be appropriate.
Until training and education
correspond with research and necessity,
therapists will have to rely on the words
and wisdom of their more experienced
peers. “In school, aside from not
massaging arthritic areas during a flare-
up, we didn’t cover conditions,” says
Christy Wilson, a licensed massage
therapist with a practice in the Los
Colinas area of the Dallas Metroplex.
Wilson credits advanced study and
years of practical experience with
making her feel comfortable treating
clients with significant ailments.
Tracey Dronet, a licensed massage
therapist in Frisco, Texas, agrees.
“School taught the basics of touch,
as well as the possibilities of our
profession. But my real education began
with my first client and continues
with each subsequent client.”
At his school, Tony Scanu, a massage
therapist at the Center for Natural
Wellness in Guilderland, New York, says
the students learned some general facts
about special conditions, “but not nearly
enough. We didn’t go over particular
syndromes or how to resolve them with
bodywork.” To increase his knowledge
base, Scanu attends workshops. He
researches diseases either with books or
on the Internet. Then, he supplements
those sources with articles by industry
gurus like Whitney Lowe and Ben
E. Benjamin. “They explain clearly
and in detail the exact procedures for
specific complaints,” Scanu says. “If
I’m concerned with contraindications,
I use A Massage Therapist’s Guide
to Pathology by Ruth Werner.”
Continuing education workshops and
academic and peer-reviewed periodicals
like the Journal of Manipulative and
Physiological Therapeutics, Journal of
Bodywork and Movement Therapies, and
Complementary Therapies in Medicine
offer the best venues for learning about
various diseases and provide cutting-
edge research and a glimpse into
coming trends for those in the field.
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massagetherapy.com—for you and your clients 95

APPRECIATING CLIENTS’ HEALTH CHALLENGES
Dronet, like so many others,
researches medical conditions on the
Internet, in books, and through health
professionals. “But, when I want to
know what it feels like to live with a
particular condition, I turn off my
computer, put the books down, skip
the medical professionals, and ask the
experts—those people living with that
particular challenge. They usually share
their stories freely and with great candor.
I can’t imagine a better education than
that.” Websites like DailyStrength.org
and WebMD.com provide community
networks for people affected by an
ailment to connect and converse.
EASY DOES IT
With some guidance from industry
experts and clients, massage therapists
can construct perfect bodywork
sessions for those suffering from
health challenges. But tailoring the
type of massage to the client is equal
amounts technical knowledge and the
artistry and intuition of the therapist.
“Choosing modalities should take
into account the person’s individual
circumstances,” says Bradly P. Jacobs,
MD, senior medical director, and
head of Integrative Medicine for
RevolutionHealth.com, a website
dedicated to health topics. “Each
person’s health issues, preferences,
experiences, expectations, and
cultural beliefs should be weighed.”
Wilson says, “Regardless of the
condition, I tend to blend techniques
to achieve the best results for that
particular client on that specific day.
I’ve found that fibromyalgia, arthritis,
and chronic fatigue symptoms decrease
with traditional Thai massage.
Myofascial release and primal reflex
release techniques complement the
deep-tissue techniques that benefit so
many people with health complaints.”
96 massage & bodywork january/february 2008
When working with people who
have significant health problems,
an easy-does-it philosophy is most
prudent. “During the massages, I felt
wonderful,” says Jane, a thirty-five-year-
old Ohio mother with fibromyalgia. “But
afterward, I felt nauseated, light-headed,
and just plain rotten. No one could
figure out why I had those reactions.”
Another massage recipient
experienced migraines after her
treatments—a common complaint
that sends many newcomers
scurrying in the opposite direction
of what might be their salvation.
“I suspect that in both cases
too much work or too aggressive an
approach caused the typical symptoms
of what I call ‘overload,’” Wilson says.
“Less is often more, especially with
people’s heavily taxed physical systems.
These clients frequently hurt so much
that they believe deep-tissue massage
will bring them respite. But I have
much better results when I combine
a calming and balancing atmosphere
with gentle physical manipulation.”
To prevent these painful backlashes,
Wilson recommends shortening
the session time. She also blends a
bioenergetic synchronization technique,
myofascial release, traditional Thai
sen work, and primal reflex release.
Wilson recommends checking in
with the client during and after the
session—including the next day and a
few days after that—then, for the next
session, adjusting the amount of time
and type of treatment accordingly.
RESPECTFULLY PRESENT
Accommodating the needs of clients
comes naturally to most therapists. And
that generous attitude easily translates
in situations where their clients are
in need of particular support due to
chronic illness. “Most therapists will
do whatever they can to help their
clients,” Whitney Lowe says. “This
would include unique positioning on
the table, extra blankets, customized
techniques, or special lubricants.”
“Even if you never treat someone
with limitations, having handicap-
accessible offices with nearby parking
will assure clients they’ll always be able
to reach you,” Wilson says. “Clients
in pain appreciate not having to climb
stairs or walk long distances. First-floor
accommodations with nonslip surfaces
will lessen the chance of falls.” Extra
bolsters, pillows, and adjustable tables
ensure optimal experiences. Clients
appreciate offers of assistance while
moving on and off the table, as well
as disrobing and, later, dressing.
Lia Baker, a massage therapist with
the Pritikin Longevity Center & Spa
in Aventura, Florida, says, “We have to
pay close consideration to the responses
of our clients. Reactions to massage
vary by individual and time. Clients
might endure the slightest touch with
difficulty on one day and, at another
time, easily tolerate the most aggressive
and invasive techniques.” Baker says
that cold or heat packs relax or distract
the more anxious clients, so they are
more receptive to the deep, trigger-
point massages. “Packs applied to
tender spots bring instant relief, while
those placed distant to the area being
massaged divert attention,” she says.
AOBT_JF_08 10/20/07 3:35 PM Page 1

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massagetherapy.com—for you and your clients 97

APPRECIATING CLIENTS’ HEALTH CHALLENGES

A Personal Vignette
Just over two years ago, I was diagnosed with
Parkinson’s disease (PD). An arbitrary affliction,
this neurodegenerative disease may or may not
include such symptoms as walking backward,
losing vocal volume, and intense cramping.
Tremors, stiffness, and imbalance are almost
universal in sufferers.
No cure for PD exists. While medications
target specific symptoms, there are no
treatments to halt or even slow this disease’s
progression. But, through alternative therapies,
I’ve found relief, respite, and restoration.
Yoga poses stretch muscles in danger of
becoming locked from lack of use. Controlled
breathing reminds me to inhale and exhale
deeply. Pilates cultivates a strong core, which
fosters a steady balance and good posture—two
of the first characteristics PD steals from its
victims. Meditation halts negative thinking
and anxiety—both insidious side effects of
dwindling dopamine.
A decade ago, a painful skirmish with TMJ
spurred me to learn biofeedback. That modality’s
focus on manipulating bodily functions has been
an ally in maintaining my quality of life.
Finally, the gold standard—massage. With
joints and limbs becoming rigid, the relief
of deep bodywork soothes my aching body. I
leave the room with a rejuvenated attitude, an
improved range of motion, and reduced tremors.
Now, I can’t prove to a scientific standard
that the reason I’m doing so well has a cause-and-
effect correlation to the alternative therapies
I’ve exploited. But I will continue to turn to these
modalities in my fight with PD.
Diane M. Marty

98 massage & bodywork january/february 2008

 Alan M. Abromovitz, a Phoenix
physician who uses massage, osteopathic
manipulation, and acupuncture to
treat his patients, says, “Chronic
conditions require longer and more
persistent treatment. Massage, moist
heat, and healing oils such as olive oil
and peanut oil improve local circulation
and fluid mobilization. Most chronic
conditions require treatment three to
five times weekly for six to eight weeks
initially. Ongoing maintenance ensures
maximum continued benefits.” To
make massage pressure and stroking
most effective, Abromovitz advocates
positioning the areas being treated
to maximize the benefit of gravity
with elevation. This technique will
assist fluid return toward the heart.
Some of the more immobile clients
might require special treatment.
“If clients cannot come to me, I am
happy to go to them,” Wilson adds.
“Avoid bodywork on infected areas,”
Jacobs says. “Same with limbs that have
blood clots in the veins. People with
immunosuppression issues, bleeding
disorders, or low platelet counts—such
as people undergoing chemotherapy—
benefit from gentle and light bodywork.”
People with significant health
challenges benefit greatly from positive
feedback about what their bodies can
do, rather than the limitations, Wilson
says. “I have never thought of my clients
with ‘health concerns’ or ‘health issues’
as such. And I never allow diseases
or diagnoses to define my clients.”
When asked about communication
between clients and therapists, Dr.
Georgianna Donadio, founder and
director of the National Institute
of Whole Health in Wellesley,
Massachusetts, quotes Maya Angelou:
“People may not remember what you
do or what you say, but they always
remember how you made them feel.”
“Our whole program focuses on
teaching healthcare professionals
how to be mindfully and respectfully
present for their clients,” Donadio says.
“Whenever clients speak, massage
therapists should listen respectfully.
Then, they should reflect back to the
client their understanding of what was
said. Therapists should do this, not only
to gather important information relevant
to their work, but to respond to the four
most basic questions all clients have: (1)
is anyone listening to me? (2) are my
symptoms explainable? (3) does anyone
care about my experience? (4) are my
symptoms or condition controllable—not
necessarily curable, but controllable?”
When clients ask questions that
enter the territory of health advice,
therapists should be clear about their
expertise. “Most massage therapists
have no training as health educators,
health practitioners, or health coaches,”
Donadio says. “So, as professionals,
they need to be clear about their
boundaries regarding discussions
and comments on healthcare issues
outside their scope of practice.”
Taking notes may be protocol
in all cases but, when dealing with
clients in health crises, these records
become vital tools. Baker says her
massage notes include trigger and
tender points, areas of involvement,
and observations of progress.
“I maintain records on all clients,”
Wilson says. Whether done on
loose-leaf paper or on sophisticated
computer programs, whether elaborate
and detailed or brief and focused,
Wilson says she has found her comments
essential components for success.
“I take detailed histories, including
a comprehensive list of medications
my clients take,” Dronet says. “If
I don’t know what a particular
medication is, I ask. Most people will
gladly educate you. Then, we decide
together what will work best.”
massagetherapy.com—for you and your clients 99
When catering to challenged clients,
clear and concise communication with
other professionals is vital. “Some
physicians like to be kept abreast of
progress and will request copies of
your records,” Wilson says. “I never
share any information without a
client’s express authorization.”
“I speak with physicians daily in
my line of work and feel perfectly
comfortable doing so when necessary,”
Dronet says. “I have also spoken with
counselors to assist in developing
care plans for several clients.”
Jacobs encourages therapists
to maintain contact with clients’
doctors for two reasons. “First, the
client’s quality of care improves,”
Jacobs says. All healthcare providers
should be aware of treatments their
patients receive, he adds. Better
understanding leads to better care. Open
communication sidesteps conflicting
treatments, while conventional or
alternative treatments can be adjusted
for best possible outcomes.
Second, Jacobs believes doctors need
exposure to bodywork and bodywork
therapists. So, the more contact, the
better—whether by phone call or letter.
Summaries of the client’s progress or,
lack thereof, keep massage therapy in
the forefront of the physician’s mind.
Beyond the physical problems,
clients bring their willingness or
resistance for accepting help to the
table with them, Abromovitz says.
MTs with positive and open minds
have the advantage. Dronet adds, “I
find that clients tell me what they need.
I let them guide me. Very often, they
will tell me what is wrong and how to
address it. Sometimes, they reveal their
needs articulately. Sometimes, I have
to read between the lines. Sometimes,
body language does the talking.”
APPRECIATING CLIENTS’ HEALTH CHALLENGES
REWARDING AND RENEWING
Both clients and therapists cite cost as
a major—and often, only—deterrent.
Even though they’re a population that
could most use bodywork, people with
physical problems generally have more
fiscal constraints. “After paying for
medications, treatments, and physician
fees, people with chronic medical
concerns find themselves unable to afford
massages, even though bodywork greatly
improves their quality of life,” Dronet
says. She often works with medical
clients to try to accommodate their
financial needs. And she’s attempting to
partner with a nonprofit organization
to bring in grants for those in need.
“In New York State, there isn’t
any coverage under insurance, so the
individual pays,” Scanu says. “It is
difficult for the client. Many times,
I have lowered my bill substantially.
That tactic usually has an adverse
affect, because the client doesn’t
want to ‘take’ anything from me. It’s
just a totally frustrating situation.
Losing a client to fees can be heart
wrenching, especially when you
have achieved some success, and you
believe that success can continue.”
Despite the extra effort and education
involved, working with clients who have
physical problems can be rewarding and
renewing. “Having a person come into
your office in pain and leave feeling at
least a little better inspires me,” Scanu
says. “This is especially true when
I’m the last resort before surgery.”
“My patients say all the time
that massage represents a gift of
energy,” Donadio says. “They
say that energy uplifts them.”
100 massage & bodywork january/february 2008
Physical therapists may think of
bodywork as strengthening exercises
and balance training, chiropractors
may consider it relaxation prior to
spinal adjustment, and physicians may
refer to it as a spa day, Abromovitz
says. Clearly, the medical professions
underappreciate the benefits of attaining
and maintaining maximum skeletal and
muscular function. “In my opinion and
experience, bodywork is as essential
to health and well-being as diet,
exercise, love, compassion, forgiveness,
and gratitude,” Abromovitz says.
Dronet says, “My most challenged better sleep and had lower stress hormone levels.
clients teach me about loss, joy, and M. Hernandez-Reif, T. Field, S. Largie, C. Cullen, J.
Beutler, C. Sanders, W. Weiner, D. Rodriguez-Bateman,
grief. Being invited to join them on
L. Zelaya, S. Schanberg, and C. Kuhn, “Parkinson’s
their journeys honors me, as does being Disease Symptoms Are Reduced By Massage Therapy
allowed to see their pain and fear. And Progressive Muscle Exercises,” Journal of
Diseases might be breaking their bodies, Bodywork and Movement Therapies, 6: 177–182.
but they find the courage to present 4. Researchers at the Montreal Neurological Institute in
themselves to me. I find their faith very Montreal, Quebec, noted that after Trager therapy on
humbling, spiritual, and grounding.” their most rigid arms, patients with Parkinson’s disease
(PD) experienced a 36 percent reduction in involuntary
Now, how many occupations
movements immediately following treatment. The study
can claim similar perks? strongly suggests that Trager therapy may reduce muscle
rigidity and eventually lead to the development hybrid
Diane M. Marty is a Colorado- therapies for PD. C. Duval, D. Lafontaine, J. Hébert,
based freelance writer who specializes A. Leroux, M. Panisset, and J. P. Boucher, “The Effect
Of Trager Therapy On The Level Of Evoked Stretch
in holistic health topics.
Responses In Patients With Parkinson’s Disease And
Rigidity,” Journal of Manipulative and Physiological
NOTES Therapeutics, 25, no. 7 (Sept 2002): 455–64.
1. Kieren Faull, “A Pilot Study Of The Comparative
5. Weekly one-hour therapeutic massage treatments
Effectiveness Of Two Water-Based Treatments
conducted over a sixteen-week period at the Sutherland-
For Fibromyalgia Syndrome: Watsu And Aix
Massage,” Journal of Bodywork and Movement
Chan School of Massage Therapy in Toronto,
Canada, indicate that massage therapy increases
Therapies, 9: 202–10. When thirteen females
the effectiveness of clients with MS, potentially
diagnosed with FM completed watsu treatments,
resulting in an improvement in their emotional state.
researchers noted significant changes in bodily pains,
This outcome dissipated with time, suggesting that
vitality levels, and physical and social functions.
the positive changes require on-going treatments.
2. In another study published in the Journal of Clinical Paul Finch and Pauline Becker, “Changes In The
Rheumatology a month of biweekly massages improved Self-Efficacy Of Multiple Sclerosis Clients Following
sleep patterns and decreased pain, fatigue, anxiety, Massage Therapy,” Journal of Bodywork and
depression, and cortisol levels in people with fibromyalgia. Movement Therapies, 11, no. 3 (July 2007): 267–72.
T. Field, M. Diego, C. Cullen, M. Hernandez-Reif, and W.
Sunshine, “Fibromyalgia Pain and Substance P Decrease
and Sleep Improves After Massage Therapy,” Journal
of Clinical Rheumatology, 8, no. 2 (April 2002): 72–6.
3. At the Touch Research Institute in Miami, sixteen
adults diagnosed with PD received either thirty minutes
of massage therapy or progressive muscle relaxation
exercise sessions twice a week for five weeks. Massage
participants improved in their ability to complete daily
living activities. They also rated themselves as having
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• A free monthly newsletter sign-up, keeping you up-to-date on the benefits of massage.
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• And more—on this advertising-free site.

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800-458-2267 • www.abmp.com

massagetherapy.com—for you and your clients 101

touch and such
BY KARRIE OSBORN
Pure Pomegranate
Packs a Punch
I’ve heard it makes a yummy martini,
but now pomegranate juice and
pomegranate polyphenol extract can
work for everything from food poisoning
to cavity prevention. Research from
New York’s Pace University found
that pomegranates have antiviral and
antibiotic effects. Within ten minutes
of ingesting pure pomegranate juice,
the virus that infects E. coli decreased
up to 100 percent. Researchers say
juice from the fruit can also destroy
the bacteria Streptococcus mutans (which
causes cavities), Staph aureus (a common
cause of staph infections) and Bacillus
cereus (which causes food poisoning).
According to researcher Milton
Schiffenbauer, PhD, who also did much
of the early work on antimicrobial effects
of white tea and green tea extracts,
pomegranate juice has had even better
results. The research was funded by
Pace and by POM Wonderful LLC.
102 massage & bodywork january/february 2008
NEW YEAR’S It’s A New Day
RESOLUTION— Need to know when National Pig Day
is? Can’t wait for Smokey the Bear Day
VOLUNTEER to arrive? Or maybe, you just need
Have you ever wanted to some good newsletter tie-ins? Go to
www.earthcalendar.net for all that’s
find a great project to which happening on the globe. Whether it
you could volunteer some be the reverent or the inane, this site
time, but were unsure where has an interesting collection of dates.
your efforts might best fit?
Volunteermatch.org makes
it easy. Type in your zip
code and area of interest,
and a list of volunteer
opportunities appears.
Check under the Health and
Medicine category if you’d
like to donate your massage
and bodywork services, or
find other ways you can
donate by simply giving
your time and attention.
Nonprofits needing help are FOOD SPEAK
able to ask for volunteers “It’s bizarre that the produce
from the other side of this manager is more important to
public service website. my children’s health than the
pediatrician.” —Meryl Streep

Avoiding Arthritis
As the number one source of pain
for older Americans, arthritis is a
life challenge we’ll all be dealing
with—whether personally or
professionally— at some point in our
lives. Dr. Jason Theodosakis, author of
The Arthritis Cure (St. Martin’s Press,
2003), told CBS News recently that
we can start addressing the inevitable
in our thirties and forties, long before
pain has actually arrived. Following are
his suggestions for what you or your
clients can do to keep the pain at bay.
SHED THE POUNDS AND/OR STAY
FIT. Every extra pound of weight
adds burden to the joints, but also
upsets the delicate balance between
buildup and breakdown of cartilage.
AVOID HIGH-IMPACT EXERCISE.
Swimming, yoga, Pilates, walking,
low-impact biking, and weight lifting
are all less stressful sorts of exercise.
BE MINDFUL OF BIOMECHANICS. This
is especially important for massage
therapists and bodyworkers; even
more so for those providing outcall
service and hoisting tables in and
out of their car. Minimize strain on
your body as much as possible.
ATTEND TO INJURIES QUICKLY. If
you can’t avoid them, then at least
make sure you address an injury
before the body starts compensating,
further affecting body mechanics.
CONSIDER A SUPPLEMENT FOR
NUTRITIONAL SUPPORT. Theodosakis
said glucosamine and chondroiten
help avoid cartilage deterioration. For
women, especially, check your daily
calcium intake and make sure it’s
meeting current recommendations.
DO YOU HAVE SOME WISDOM YOU’D LIKE TO SHARE WITH YOUR
PROFESSIONAL PEERS? WRITE TO ME AT KARRIE@ABMP.COM.
NIH Gives More
Money to Study
St. John’s Wort,
Echinacea
The National Institutes of Health
(NIH) gave $4.4 million to the Iowa
Center for Research on Botanical
Dietary Supplements at Iowa State
University in Ames to study echinacea
and St. John’s wort over the next
three years, noting that although the
public has long purported the value
of these herbal supplements for their
immunity, mental health support, and
anti-inflammation benefits, there isn’t
much research to stand behind them.
What researchers have found so far is
that certain species of these herbs work
better than others. And, in both herbs,
researchers said compounds such as
polyphenols contribute to their antiviral
properties. “This suggests that we’re
not going to find a single compound
or even a subset of compounds that are
responsible for health benefits,” says
Diane Birt, director of the research
center. “A complex chemical profile is
contributing to the health effects, so it’s
more likely that we’re moving toward
improving these supplements, rather
than identifying chemicals for use as
drugs.” Nothing like keeping it real.
Chalk one up for botanic integrity.
massagetherapy.com—for you and your clients 103
Don’t Flush It
Have you ever thrown old medicines
down the drain or flushed them into
oblivion? According to the American
Pharmacist Association (APhA), that
could be reason for concern as more
and more water supplies are showing
up with pharmaceuticals that cannot be
removed by standard sewage treatment
systems. Scientists began sounding
the alarm for just such an effect in the
1980s, when throughout Europe and
the United States, aspirin, nicotine,
caffeine, and by-products of soaps,
shampoos, and other personal care
products began showing up in water
tested near wastewater treatment plants.
Since then, the number of chemicals and
pharmaceuticals found in water samples
has been steadily increasing, and now
everything from antibiotics to growth
hormones is showing up in water supplies
and groundwater tables. While water
treatment plants can remove many of
these chemicals, the United States does
not implement the technologies that
are most effective at doing so. Those
technologies include advanced oxidation,
membrane filtration, and nanofiltration.
The least effective method, and most
commonly used here, is chlorination.
So what should you do with old
meds needing discarding? According to
the APhA, crush solid pills or dissolve
them in water and mix with kitty litter
or similar textured kitchen waste—like
coffee grounds. Put them in a sealed
plastic bag before placing in the trash.
This also reduces the risk of poisoning
for children, pets, and wildlife. Better
yet, check for local and state collection
programs or hazardous materials
facilities. Some pharmacies will even
host days where the public can return
meds needing to be destroyed. Mother
Nature might certainly need a break—
but she doesn’t need your Valium.
I am ABMP. Miguel D. Hudo Ricci, San Juan, Puerto Rico.
Member since 1997.

BACKGROUND: My father introduced me to massage when I

was a small boy. I was on my way to law school in 1976 when I
came across a massage school ad and I’ve been doing massage
ever since. Since the early nineties, I’ve been lobbying for
implementation of a comprehensive massage law in Puerto Rico
that will really raise the bar. Finally, it seems close to reality.

PERSPECTIVE: After more than thirty years and almost thirty

thousand massages, I have developed what I call my own style.
It is eclectic–the product of the different schools, techniques, and
protocols I have studied.

BUSINESS GROWTH: Word of mouth has been the major

factor in growing my client base. Being always ready and
available at the same place over the years has also helped.

ABMP AND ME: I feel very much at home with ABMP. I

appreciate how they backed my group with information and
logistic support in our legislative endeavors. Their Internet tools
are also very helpful.

LAST WORD: Massage therapy can stand toe-to-toe with any

other healthcare profession, conventional or alternative. The
sky’s the limit.

Comprehensive liability insurance and

practice support for massage and bodywork
professionals and students.

Associated Bodywork & Massage Professionals

800-458-2267 • www.abmp.com
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ten for today
BY LIZ PRATO
MT STRAIGHT TALK
CLIENTS KNOW MORE
THAN YOU DO
Even if they don’t know the name,
origin, insertion, and action of every—or
any—muscle, even if they don’t have one
clue about physiology or kinesiology
or any other ology you’re trained in,
clients still live in their bodies every
single day. Don’t try to push them
through something they don’t want.
Help them get in touch with and listen
to their own bodies, and then listen to
them. Your clients trust you enough
to place their bodies in your hands.
Treat this gift with loving respect.
CLIENTS WILL TELL YOU THINGS
YOU WISH YOU DIDN’T KNOW
The intimacy of the massage
environment means clients tell
you stories not fit for dinner table
conversation. These stories often involve
confessing their addictions. There will
also be stories they don’t tell you, but
you witness: the bruises left on their
backs or thighs by someone they’ll
never name. You can’t fix this, so say a
loving prayer over them and move on.
CLIENTS WILL TELL YOU THINGS
YOU FEEL HONORED TO KNOW
They will tell you about surviving
cancer. They will tell you about the
death of their lover. They will tell
you about struggling to overcome
an addiction. They will tell you
about falling in love. They will tell
you about falling out of love. These
are their secrets. Honor them.
CLIENTS WILL PASS GAS
They will often do it when you’re
massaging their gluteals. Sometimes
you’ll be so deep in your massage
trance that the flatulence will startle
you, and your hands will jerk away
from the body. To their credit, they
will almost always say, “Excuse me.”
106 massage & bodywork january/february 2008
YOU WILL SOMETIMES
HAVE POOR BOUNDARIES
It’s easy to believe you’ll maintain
firm boundaries when you’re thinking
about them in the abstract. However,
when your favorite client fails to show
up for two appointments in a row, you
may feel uneasy about charging your
missed-appointment fee. Don’t panic.
Boundaries are flexible, not rigid lines.
Sometimes pushing beyond what we
think is professional can built trust.
Sometimes it destroys it. Be careful.
OBESE CLIENTS ARE DIFFERENT
In a well-meaning effort to stave off
prejudice, massage school instructors
told us there is no difference between
massaging an obese client and a thin
client. This just isn’t true. Obese
clients’ bodies rise higher off your table.
Depending on their size, your height,
and the height of your table, it may be
physically impossible to maintain proper
body mechanics while you work. It’s
often difficult to find bony landmarks,
and sometimes you’re massaging an area
because you know that’s generally where
a muscle begins and ends. None of this
means obese people are less deserving
of massage. It does mean that your skills
and body mechanics might be challenged.
CLIENTS CAN CHALLENGE YOU
They will show up late, talk through the
entire massage, smell bad, wear perfume
that never washes out of your sheets, pass
gas (see number four), and cancel at the
last minute. They are not trying to annoy
you. They’re just going about their
lives, and you’re most likely annoyed
because of issues going on in your life.
The good news is that being with them
usually helps you feel better. If not,
maybe it’s time for a new line of work.
YOU WILL SPEND A LOT OF
TIME FOLDING LAUNDRY
You will also spend time checking
messages, returning phone calls,
designing business cards, sticking
mailing labels on promotional fliers,
filling out bank deposits, writing
SOAP notes, sitting on hold on the
phone, placing ads, compiling your
taxes, joining networking groups, etc.
In other words, you are in business for
yourself. The buck starts and stops with
you. If you don’t want to be responsible
for—or won’t be good at—all these
tasks, work for a spa or chiropractor.
YOU WILL NOT GET RICH
DOING THIS
When you were planning your career,
you figured you’d charge $65 per
massage, give twenty-five massages a
week for fifty weeks. You’d make over
$80,000! This is fuzzy math, and it
doesn’t take into account how difficult
it is to find twenty-five clients per week,
much less how physically and emotionally
demanding it is to give them all good
massages. It doesn’t take into account
when you might be sick or injured or
when your clients are sick or injured.
The reality is, many massage therapists
struggle to make ends meet. You don’t
go into this profession to get rich. You
go into this profession because you
really, truly love giving massage. That
doesn’t mean you shouldn’t make a living
at it. As a matter of fact, if you’re not
making a living at it, consider a different
profession. We all deserve a career that
feeds our soul while paying our bills.
 When you were
planning your career,
you figured you’d
charge $65 per
massage, give twenty-
five massages a week
for fifty weeks. You’d
make over $80,000!

machinery that carries us through the Liz Prato has been a massage therapist
YOU HAVE ONE OF THE
world. You work with other human in Portland, Oregon, for more than twelve
BEST JOBS ON EARTH
beings when they are physically, and years. Her writing has appeared in numerous
They probably did tell you this in
often emotionally, vulnerable—in publications, including LivePdx, Iron Horse
massage school—it’s how they got you
other words, when they are most Literary Review, Subtropics, Northwest
to hit the books every quarter. The
human. This makes you more human. Women’s Journal, Berkeley Fiction Review,
thing is, they were right. You have
Be grateful you are smart enough, and and ZYZZYVA. She’s working on a novel
a job that allows you to move your
blessed enough, to do massage. about grief, art, sexual identity, and the cosmos.
body instead of sit in a cubicle from
nine to five. Every single day you get
to learn something new about the
human body—this awesome piece of

massagetherapy.com—for you and your clients 107

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essential skills
BY BEN E. BENJAMIN
LATERAL ANKLE SPRAIN
I have rarely met a person who
has not sprained at least one
ankle. After the low back, the
ankle is probably the second
most common area of injury.
The seriousness of a sprain
can vary considerably. In
minor sprains only a small
number of ligament fibers
swell or tear, while in most
serious sprains, one or more
ligaments rupture completely.
The vast majority of ankle
sprains affect one or more of
the three lateral ligaments: the
anterior talofibular ligament,
the calcaneofibular ligament,
and the posterior talofibular
ligament (see Figures 1 and 2).
ANTERIOR TALOFIBULAR LIGAMENT
FIGURE 1
CALCANEOFIBULAR LIGAMENT
The anterior talofibular ligament FIGURE 2
connects the distal anterior fibula to the
neck of the talus and prevents anterior
subluxation of the talus. It is the shortest
and weakest of the lateral ligaments
and the most vulnerable to injury. The
calcaneofibular ligament, the longest
lateral ligament, is a narrow, rounded
cord that connects the distal tip of the
fibula to the posterior lateral aspect of
calcaneus. This structure plays a major
role in stabilizing the ankle joint and
limiting inversion. Because it is not
contiguous with the joint capsule of the
ankle, it causes relatively little swelling
when injured. The posterior talofibular
ligament connects the posterior surface
of the lateral malleolus to the lateral
tubercle of the talus. It is strongest
of the lateral ligaments and prevents
posterior subluxation of the talus.
In the majority of ankle sprains, the POSTERIOR TALOFILBULAR LIGAMENT
anterior talofibular ligament is most
CREDIT: Putz/Pabst: Sobotta, Atlas der Anatomie des Menschen,
strongly affected, and in severe sprains,
22nd edition, 2006 Elsevier GmbH, Urban & Fischer München
one or both of the other two lateral
ligaments may be affected as well.
massagetherapy.com—for you and your clients 111
ESSENTIAL SKILLS
When dealing with any sprained
ankle, especially when swelling
and pain are present, be sure
to have the client get an X-ray
before you begin treatment.
HOW IT HAPPENS
Lateral ankle sprains commonly occur
during athletic activity. They are often
caused by a sudden, severe trauma such
as landing incorrectly from a jump in
basketball, crashing into somebody in
soccer, sliding into third base, or tripping
on some uneven ground while running.
In some cases, the person immediately
feels severe pain. They may also hear
a disconcerting snap. After an hour or
so, swelling occurs, the pain gets worse,
and it becomes very difficult to walk.
In other cases, the sprain is not
immediately apparent. In the heat and
excitement of activity, a slight falling over
on the ankle is barely noticed; the person
recovers balance without missing a step.
A little while later, a nagging discomfort
begins to develop. It may be just a slight
ache or irritation that slowly worsens
over the next few days as the ankle is
used, or it may become very painful.
There may or may not be swelling.
Ankle sprains can also occur during
everyday activities like taking a walk
on uneven ground, stepping off a curb,
or horsing around with the kids.
112 massage & bodywork january/february 2008
A variety of factors can increase
vulnerability to ankle sprains. These
include high arches, which make the
ankle less stable; poor alignment of
the bones of the feet, where the arches
pronate and drop toward the ground;
and extremely hypertonic calf and
shin muscles, which reduce a person’s
ability to adapt to changes in the
ground surface. Excessive flexibility
at the ankle joint due to stretched
or congenitally loose ligaments also
increases the likelihood of a sprain.
Other causes include muscular imbalance
in the lower leg and wearing very
high-heeled shoes or platform shoes.
Of course, a person may be doing
everything just right and yet slip on
a patch of ice or trip and fall and end
up with a severely sprained ankle.
When an ankle sprain does not
heal properly, it can become a chronic
problem. The ligament may have been
stretched or may have developed poorly
formed (and therefore weak) adhesive
scar tissue, causing instability at the
joint. Strenuous activities continually
re-tear the scar tissue, resulting in a
seemingly endless cycle of pain that
comes and goes, with intermittent
swelling. This can continue for many
years if the injury is not properly treated.
INJURY VERIFICATION
Within about an hour after an ankle
is sprained, the swelling and pain are
usually quite severe. In fact, the ankle
can swell to the size of a grapefruit. This
can make it difficult to perform a precise
assessment at that time. It may take a
few days before the swelling goes down
and an accurate assessment is possible.
There are three grades of sprains:
Grade 1 (slight damage, not affecting
ankle stability); Grade 2 (more serious
damage, with no significant instability
but pain on walking); and Grade 3 (a
complete tear of one or more ligaments,
causing instability and typically making
walking difficult). Usually the more
severe the damage, the greater the
pain and swelling. When a ligament
totally ruptures—although the ankle
feels extremely unstable, the pain
often subsides quickly. The most
commonly ruptured lateral ligament
is the anterior talofibular ligament.
When dealing with any sprained
ankle, especially when swelling and
pain are present, be sure to have the
client get an X-ray before you begin
treatment. The ankle could be broken,
requiring medical attention before any
hands-on treatment is appropriate.
If the X-ray is negative, proceed
with the following tests, which attempt
to reproduce the type of movement
that originally caused the sprain.
TEST 1. PASSIVE SUPINATION
(ANTERIOR TALOFIBULAR LIGAMENT)
With the client lying supine, place your
left hand under the back of the client’s
left heel for support, then firmly grip
the top of the foot with your right hand.
(Reverse these directions if you’re testing
the right ankle.) Now gently supinate
the foot (supination is a combination
of plantar flexion, medial rotation, and
inversion, all done simultaneously).
Pull the foot medially into plantar
flexion as you internally rotate it. If
the ankle is sprained, this should cause
pain at the anterior lateral ankle.
ESSENTIAL SKILLS
If the sprain is very mild or if it is old
and chronic, you will need to give the
foot an overpressure movement after you
have it in the fully stretched position.
This should reproduce the pain of an old
or mild sprain. Remember to go gently
at first and press harder only if necessary.
Stop as soon as the client feels discomfort.
TEST 2. PASSIVE INVERSION OF
THE HEEL IN DORSIFLEXION
(CALCANEOFIBULAR LIGAMENT)
Hold the client’s foot in dorsiflexion
with your medial hand wrapped
around the ball of the foot, and grip
the calcaneus with your lateral hand.
Now, forcefully stretch the lateral
ankle by rotating the heel medially
while keeping the foot in dorsiflexion.
TEST 3. RESISTED EVERSION
(PERONEUS TENDONS)
Note: I include resisted eversion in the
testing protocol because injury to the
peroneus brevis or longus tendon is
sometimes mistaken for a mild ankle
sprain. These two tendons pass around
the back of the ankle very close to
the lateral ligaments and therefore
cause pain in a similar place.
114 massage & bodywork january/february 2008
Also, in cases of severe ankle strain,
it’s common for one or both of the
peroneal tendons to be stretched and
injured along with the ligaments. As a
result, while the ligaments may heal,
the pain remains until the strained
tendons get treated. If five or six weeks
pass and an ankle you have treated still
hurts posterior or inferior to the lateral
ankle, check the peroneal tendons. Better
yet, check them before you begin.
Resisted eversion in dorsiflexion (tests
the peroneus brevis). Place your medial
hand on the client’s heel for support
and your lateral hand on the lateral foot
just proximal to the toes. Then, ask
the client to push outward forcefully,
keeping the foot in a dorsiflexed position
as you push inward with equal force.
Pain is felt at the lateral foot and ankle.
Resisted eversion in plantar flexion (tests
the peroneus longus). Perform the same
action as in the previous test, but with
the foot extended in plantar flexion.
Pain is felt at the lateral foot and ankle.
TEST 4. PALPATION (POSTERIOR
TALOFIBULAR LIGAMENT)
Aside from palpation, there is no
effective assessment test for injury to this
ligament. The client will point to the
posterior ankle as the site of pain, and the
ligament will be tender upon palpation.
TREATMENT CHOICES
SELF-TREATMENT
In any case of ankle sprain, the individual
should immediately stop strenuous
activity, elevate the leg, and ice the ankle.
A doctor should be consulted right away
to check for broken bones or complete
rupture of the ligaments. As soon as the
ankle can be moved, the foot should be
flexed, extended, and moved circularly
in both directions throughout the day
in order to prevent scar tissue adhesions
from forming. It is best for the leg to
be elevated during these exercises. The
person should not walk on the ankle until
only mild discomfort is felt; with proper
self-care, this should take no more than
three to five days. Care should be taken
not to rush into any sports or strenuous
activities, for a re-sprained ankle is
often worse than the original injury.
In mild cases of ankle sprain,
these self-care measures can promote
successful healing without any other
form of treatment. Recovery usually
takes three to six weeks, depending on
the severity of the injury. However,
in most of the cases I have seen, ankle
sprains do not heal well without some
treatment. Instead, they improve
and then recur regularly. Initiating
massage therapy within two to six
weeks of a sprain goes a long way
toward enabling proper healing.
In any case of ankle sprain, the individual should
immediately stop strenuous activity, elevate the
leg, and ice the ankle.
FRICTION THER APY AND MASSAGE
Friction therapy stimulates healing of
a ligament while removing adhesive
scar tissue. Combining friction therapy
with massage makes treatment even
more effective. Massage applied directly
to the foot and leg can reduce the
swelling and help speed the healing
process. Gentle effleurage may begin
soon after the injury occurs.
FRICTION OF THE ANTERIOR
TALOFIBULAR LIGAMENT
With the client lying supine, gently
supinate the foot with one hand and
use the thumb of the other hand
to feel the lower edge of the lateral
malleolus. Go to the base of the lateral
malleolus and then work your way
around toward the anterior portion
of this bone. The anterior talofibular
ligament is located slightly medial to
the distal aspect of the lateral malleolus.
When the ankle is sprained, it is
not difficult to locate this ligament,
because it is very tender. Keeping the
ligament stretched by holding the foot
supinated, friction in either direction
with your thumb or forefinger.
FRICTION OF THE
CALCANEOFIBULAR LIGAMENT
The calcaneofibular ligament is located
directly below the lateral malleolus
and runs vertically down and slightly
back to the calcaneus. The tear may
occur anywhere along the length of the
ligament but is usually just inferior to the
malleolus. Frictioning is done by pressing
the ligament up under the inferior
edge of the malleolus or against the
calcaneus. Sometimes both this ligament
and the anterior talofibular ligament
are sprained. In these cases, alternate a
minute or so on each ligament and come
back to each place two or three times.
FRICTION OF THE POSTERIOR
TALOFIBULAR LIGAMENT
With the client lying supine, use
one hand to rotate the foot medially.
Place the index finger of your other
hand directly on the posterior aspect
of the lateral malleolus and friction
in a superior-to-inferior direction at
the ligament’s bony attachment.
massagetherapy.com—for you and your clients 115
EXERCISES
To increase the stability of the ankle
and prevent the development of poorly
formed scar tissue, clients should
perform the following exercises
daily during the rehabilitation
phase of therapy. Give them
the following instructions:
ANKLE CIRCLES. While sitting in a
chair, cross the injured leg over the
uninjured leg. Rotate the foot in as wide
a circle as you can, both clockwise and
counterclockwise. Begin with ten circles
in each direction and build up to fifty.
ANKLE FLEXION. Sitting in a chair
with the injured leg crossed over the
uninjured leg, flex the ankle so the
toes come toward the knee. Hold
the flexion for one or two seconds,
and then point your toes and hold
that position for one or two seconds.
Begin with five repetitions of flexing
and pointing and build up to thirty,
taking rests as you need them.
ESSENTIAL SKILLS
HEEL RAISES. Stand holding on to
something for balance. Keeping your
feet parallel, rise up onto the balls of
your feet without bending your knees.
Stay there for a moment and come
down again. Begin with five repetitions
and then repeat this same exercise
with the knees slightly bent. Build up
slowly to eight repetitions of five.
INNER-ANKLE LIFT. To do this exercise,
you’ll need some props. You can use
weights that attach to the foot in some
way or use a small plastic shopping bag
containing either a two- to five-pound
weight or cans that total five pounds.
Sitting in a chair, cross the injured leg
over the uninjured leg with the weights
or loaded shopping bag across the front
part of your foot, just behind your toes.
Now raise the foot toward the ceiling five
times. Repeat after a brief rest. Gradually
build up to three sets of ten repetitions.
116 massage & bodywork january/february 2008
OUTER-ANKLE LIFT. For this exercise,
you’ll need the same props you used for
the inner-ankle lift. Lie on your side on
a couch or bed with your knees bent and
the injured ankle on top, then extend the
top leg off the edge of the couch or bed.
Now, with the weight or the shopping
bag across the front part of your foot, lift
the outside of the foot toward the ceiling,
keeping the foot pointed. Repeat this
exercise ten times and then do it again,
this time keeping the foot flexed. Build
up slowly to three sets of ten repetitions.
SURGERY
When a ligament is totally ruptured,
surgery is required to sew the torn
ends of the ligament together. This
type of surgery tends to be very
successful. However, the more time that
passes after the injury, the less likely
it is that the surgery will succeed. A
ruptured ligament will tend to shrivel
up and adhere to whatever structure
it is nearest to, making it difficult or
impossible to perform the repair.
A FREQUENT CHALLENGE
Lateral ankle sprains are one of the
most common types of injury, affecting
almost all of us at some point in life.
Because they happen so frequently,
it’s easy to regard them as merely a
minor, temporary annoyance. However,
without proper care, even a relatively
mild sprain can develop into a chronic
problem. I’ve seen clients who have
suffered from a poorly healed ankle
sprain for fifteen to twenty years
before receiving effective treatment.
When an ankle
sprain does not
heal properly,
it can become
a chronic
problem.
After reading this article, you’re in a
better position to help any client with a
lateral ankle sprain, no matter how old
or recent the injury is. You’ve learned
how to perform assessment tests to
determine which structure or structures
have been injured; use friction therapy
and massage to stimulate healing while
removing adhesive scar tissue; and
teach the client exercises to promote
stability and prevent any more damaging
scar tissue from forming. You’ve also
learned about other treatment options
that may be appropriate in certain
cases, including self-care and surgery.
Armed with this knowledge, you can
help ensure that an ankle sprain remains
a temporary problem, allowing your
clients to return as quickly as possible
to a pain-free, active life.
Ben E. Benjamin, PhD, holds a doctorate
in education and sports medicine. He is founder
of the Muscular Therapy Institute. Benjamin has
been in private practice for more than forty years
and has taught communication skills as a trainer
and coach for more than twenty-five years. He
teaches extensively across the country on topics
including SAVI communications, ethics, and
orthopedic massage, and is the author of Listen to
Your Pain, Are You Tense? and Exercise Without
Injury and coauthor of The Ethics of Touch.
He can be contacted at bbby@mtti.com.
SHAPE

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massagetherapy.com—for you and your clients 117

 pathology perspectives
WHAT’S NEXT IS WHAT’S NOW
This column is usually devoted to a specific
pathological condition or concept that is
connected to the overall theme of the current
issue of Massage & Bodywork. In this edition,
however, we will take a moment to look at what’s
next for massage in the context of pathology:
a different direction altogether.
I am a pathology wonk. I actually enjoy reading
about diseases. I love the sense of how much medical
writing I can understand, even when the jargon is highly
technical and intimidating. (Here’s a secret: it’s not as
hard as it looks.) More to the point, it is inspiring to
learn about the amazing regenerative capacity of the
human body and exciting to follow how our efforts can
recruit and influence those innate healing energies.
References to massage therapy in most technical journals and
medical website periodicals are typically few and far between.
But a headline in a recent edition of Medscape, a medical journal
that collects and distributes material for several different
specialties, read this way: “Effectiveness of Massage Therapy
for Chronic, Non-malignant Pain: A Review,” Jennie C.I. Tsao,
Evid Based Complement Alternat Med. 4, no. 2 (2007): 165–179.1
This was on the same page with titles that included,
“A Review of Biologic Treatments for Psoriasis with
Emphasis on Infliximab” and “Common Causes of Nausea
and Vomiting and Treatment Reviewed” (both fascinating
articles—if you’re interested in that sort of thing).
The article about massage and nonmalignant pain
was a meta-analysis: the author compiled findings from
multiple projects about massage to look for predictable
trends. Her findings were mixed. Results showed that
bodywork is a good option for pain relief in some
situations and only so-so for others. The article further
found that most of the studies were done with small
sample sizes and warranted further investigation.
massagetherapy.com—for you and your clients 119
BY RUTH WERNER
In the best of all possible worlds,
readers are now clamoring with more
questions: what kinds of massage were
investigated? Did massage therapists do
the work or was it done by untrained
clinicians? Were the studies blinded?
How were participants selected?
Was there a sham treatment for a
comparison? Did the researchers who
did the massage also collect the data?
All these variables influence outcomes,
and no individual study can be
evaluated for accuracy and importance
without answering these questions.
This kind of meta-analysis is not
unique. It reflects an enormous body of
knowledge that is being generated right
this minute about the effectiveness of
massage therapy. What makes this article
special is where it appeared: not in a trade
magazine marketed primarily to people
in this profession, nor in an obscure
academic journal; it was a headline in
an open forum targeted toward many
types of healthcare providers. Research
about massage creates a bridge to the
rest of the healthcare community: it
provides a language that we can all
speak and understand together.
And so we see that the discussion
of massage in technical or research-
based terms isn’t what’s next; it’s what’s
now. Our profession is being studied
and written about so that medical
doctors of all disciplines, naturopaths,
chiropractors, physical therapists, nurses,
and others may be educated about what
the evidence says regarding our work.
PATHOLOGY PERSPECTIVES
So what is next for massage in
this context? I identify three major
areas that need leadership and
development: massage therapist-
generated knowledge, accessibility of
information, and the establishment
of some best practices protocols.
PROBLEM: MASSAGE
THERAPIST-GENERATED
KNOWLEDGE
One concern is that the research
being conducted is not always done by
massage therapists, and the definition
of massage is sometimes loosely used.
Obviously, this can alter the results of
any attempt to gather information. It
is imperative that massage therapists
participate in the research process.
Even therapists who don’t work
in clinical settings still work with
clients who are dealing with acute and
chronic conditions. Most of us have
seen our work inf luence headaches,
or muscle strains, or recovery time
for injuries. Our clients live with
diabetes, depression, anxiety disorders,
fibromyalgia, Parkinson’s disease,
and a host of other challenges, and
they choose massage as part of their
coping strategies. We should be the
ones leading the way in testing and
questioning the practice of massage.
It is time for us to get serious about
documenting our work in order to
trigger large-scale research projects.
120 massage & bodywork january/february 2008
PATHOLOGY EXPERT RUTH WERNER SERVES AS CHAIR OF THE
MASSAGE THERAPY FOUNDATION EDUCATION COMMITTEE.
PROBLEM: ACCESSIBILITY
OF INFORMATION
Any reader who wants a taste of the
vast amount of research being
compiled about massage can visit
PubMed at www.pubmed.gov or the
Massage Therapy Research Database at
www.massagetherapyfoundation.org/
researchdb.html. Enter massage and
whatever variable interests you, and you
may generate a list of dozens, or maybe
hundreds of highly-credible, peer-
reviewed published articles that include
your keywords. Many of the articles have
available abstracts (brief overviews of the
scope and conclusions of the project), but
most full texts are only available through
the publishing journals or medical school
libraries. Most scholarly articles of this
nature are unavailable to the general
public. This can be a frustrating and
ultimately defeating roadblock to anyone
outside the academic world who wants
to gather important information.
PROBLEM: BEST PRACTICES
Finally, while an avalanche of
information is currently tumbling
all around us, some key questions
still await our attention. Most people
now agree that massage therapy is
an unusually positive intervention:
when done with care and education
the risks are relatively low, while the
potential benefits are significant. This
is important information, and as larger
research projects are launched, we
can all feel confident that carefully
conducted studies will reinforce what
It is imperative that
massage therapists
participate in the
research process.
we’ve known for generations: that loving,
educated, nurturing touch supports
health and improves the quality of life.
The benefit of knowing the why
and how of massage is that it gives us
tools to make choices and adjustments
to reap the best possible benefits that
bodywork can offer. This process is
called developing a “best practices”
protocol: based on the accumulated
body of knowledge we can make some
predictions about what kinds of massage
might be most effective under what
circumstances. Then we can choose
what modalities, frequency, and duration
may have the most positive outcomes.
GOOD NEWS: MASSAGE
THERAPIST-GENERATED
KNOWLEDGE
By the time this issue of Massage &
Bodywork publishes, the first annual
Practitioner Case Report Contest
will have concluded. This event is
conducted under the auspices of the
Massage Therapy Foundation (MTF)
and follows three successful years of
Student Case Report Contests. The
winner’s case report will first appear
in print in the Journal of Bodywork
and Movement Therapies, and then
will appear on the MTF website,
www.massagetherapyfoundation.org.
PATHOLOGY PERSPECTIVES
Picture this: an electronic journal
that focuses on current research in
massage therapy that is instantly
available and free of charge.
It is not too early for any interested
readers to prepare for the 2008
Practitioner Case Report Contest.
This is one avenue where our work to
carefully document changes that massage
brings about can come to fruition. In
addition to doing the right thing for the
profession, winners are also awarded cash
prizes and other incentives. For details
and a complete set of entry guidelines,
visit www.massagetherapyfoundation.
org/practitionercontest.html.
GOOD NEWS: ACCESSIBILITY
OF INFORMATION
Picture this: an electronic journal that
focuses on current research in massage
therapy that is instantly available and free
of charge. This project is in the works.
Also led by the MTF, the e-journal will
be called the International Journal of
Therapeutic Massage and Bodywork, and
its launch is planned for fall 2008. It will
have departments for research, education,
and the practice of massage, and it will
be available to anyone who is interested.
The plan is that the journal will start
slowly but eventually publish quarterly
updates with an accessible archive.
122 massage & bodywork january/february 2008
GOOD NEWS: BEST PRACTICES
The long-term goal for any healthcare
modality is to establish a set of best
practice protocols. This allows
practitioners and professionals to
continually hone their skills with an eye
for creating the best possible outcomes
for the people in their care. The MTF
is now in the very beginning stages of
creating a best practices discussion,
which, if all goes according to plan,
the project will begin in 2009. This is
a long-term project that will probably
never be complete, because it provides a
place for the accumulation of knowledge
to turn into practical applications.
The common thread in all three of
these projects is the Massage Therapy
Foundation, a 501(c) (3) public charity.
This is an organization with which I am
proud to be associated, because it works
specifically to identify needs in our
profession, and to find ways to meet those
needs. Its stated mission is to advance
“the knowledge and practice of massage
therapy by supporting scientific research,
education, and community service.”2
Through the Practitioner Case
Report Contest, the International Journal
of Therapeutic Massage and Bodywork,
and the discussion of best practices, the
MTF is helping to identify what’s next
for massage therapists seeking the best
they can do for themselves and their
clients. I encourage every practicing
therapist to support the foundation.
This can be done financially, of course
(www.massagetherapyfoundation.
org/found_makedonation.html), but
also through participation: enter the
Practitioner Case Report Contest or
support a colleague to do so. Watch for
the launch of the International Journal
of Therapeutic Massage and Bodywork
and consider submitting material for
publication. When the best practices
discussion gets underway, watch
how it develops, and answer calls
for input. We’re all in this together.
With a united effort, our future’s so
bright we gotta wear shades.
Ruth Werner is a writer and educator who
teaches several courses at the Myotherapy
College of Utah and is approved by the
NCTMB as a provider of continuing
education. She wrote A Massage Therapist’s
Guide to Pathology (Lippincott Williams
& Wilkins, 2005), now in its third edition,
which is used in massage schools worldwide.
Werner is available at www.ruthwerner.com
or wernerworkshops@ruthwerner.com.
NOTES
1. J. Tsao, “Effectiveness of Massage Therapy for
Chronic, Non-malignant Pain: A Review,” Evid Based
Complement Alternat Med. 4, no 2 (2007): 165–79.
2007 Oxford University Press. Available at www.
medscape.com/viewarticle/559775 (accessed July 2007).
2. Mission and History. Massage Therapy
Foundation. www.massagetherapyfoundation.
org/mission.html (accessed July 2007).
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spa élan
BY ANNE WILLIAMS
WINTER WONDER WRAPS—PART 2
The Cocoon
The weather outside might be
frightful, but the delightful
scents and sensations of
holiday-inspired body wraps
provide a useful respite from
seasonal stress and give
massage clients some new
treatment options. Part one
focused on the hot sheet
wrap procedure (October/
November 2007, page 118).
This installment looks at the
cocoon procedure. (These
wrapping procedures can
be mixed and matched with
different products for a variety
of winter wonder wraps.)
126 massage & bodywork january/february 2008
In a cocoon, the treatment product is
not dissolved in water as it is in a hot
sheet wrap, but is applied directly to
the client before he/she is wrapped in
plastic and a blanket. Mud, seaweed,
emollient-rich heavy butters (i.e.,
almond, babassu, shea, etc.), and other
natural products (oatmeal, pumpkin,
yogurt, etc.) are often used with this
procedure. The warmth from the
heated products, the use of massage
to either apply the product or as a
separate treatment step, and the time
for quiet reflection while enveloped in
winter-inspired smell-scapes reduce
stress and muscular tension, leaving the
client feeling revitalized and rested.
GENERAL TREATMENT
CONSIDERATIONS
Before delivering any type of body
wrap, a careful pretreatment health
interview must be carried out with
the client to make sure there are no
contraindications for the treatment. For
example, clients with shellfish allergies
are likely to be allergic to seaweed, while
clients with broken skin should not
receive a treatment with mud. Sudden
claustrophobia is always a concern with
body wraps. Even clients who have no
previous experience with claustrophobia
can become anxious or panic stricken
when wrapped up. It is recommended
that the therapist remains with the
client at all times, in order to remove the
wrapping if the client becomes anxious.
WINTER COCOON IDEAS
HEAVY BUTTERS
Heavy butters like babassu butter,
almond butter, or shea butter feel warm,
rich, and luxurious as they are applied to
the skin. Shea butter, which comes from
the nut of Vitellaria paradoxa (synonym:
Butyrospermum parkii), a tree found
only in parts of Africa, is particularly
popular. Shea nuts have traditionally
been processed and used by women in
West Africa to protect their skin from
drying out in the hot African sun. Pure
shea butter has a firm texture and must
be slowly warmed in a double boiler until
it is a liquid and applied to the body to
absorb. Excess shea that has not absorbed
is massaged into the skin at the end of the
service; it does not need to be removed.
Shea butter is composed mainly
of triglycerides and linoleic acid. It is
high in vitamins A, E, and F. It has
antioxidant, anti-inflammatory, anti-
arthritic, skin soothing, skin healing, and
skin moisturizing properties, and it is
believed to bring relief from chronic skin
diseases, scarring, and stretch marks.
An emollient cocoon using a heavy
butter might be delivered as follows (I
will detail these steps later): exfoliate,
massage warm melted butter onto the
body, cocoon, unwrap, and perform a
full-body massage using the excess butter
as the lubricant. If the spa or clinic has
a steam canopy, the client might be
steamed in the butter instead of being
wrapped up. Emollient cocoons can
be customized with different essential
oil smell-scapes (see Shea Winter
Smell-Scapes, page 129, for ideas).
For the winter
season,
chocolate,
honey, and
pumpkin
provide a
starting point
for uniquely
fragrant
cocoons.
NATUR AL ELEMENTS COCOONS
Some spas specialize in using natural
food elements such as avocado, chocolate,
cucumber, honey, oatmeal, papaya,
pumpkin, or yogurt in cocoons. Often,
the food item is mashed or mixed up
and spread on the body in the same
manner as seaweed or mud. For the
winter season, chocolate, honey, and
pumpkin provide a starting point
for uniquely fragrant cocoons.
Hot chocolate is mixed up with
water into a paste and blended with
an emollient body cream before it is
warmed and applied to the body with
massage. The smell of warm chocolate
is intoxicating and lingers on the skin
long after the conclusion of the wrap.
Honey is mixed up with hot water
into a glaze and brushed on the skin
before the body is wrapped. Massage
cream is applied over the top of the
honey at the end of the wrap and
both are massaged into the skin.
Add spices like nutmeg and
cinnamon to warm pumpkin pie mix
(canned pumpkin mix is easy to use
and inexpensive) and slather it on
the body with a variety of massage
strokes after an exfoliation. The
texture of the mix combined with
massage is unique and enjoyable.
massagetherapy.com—for you and your clients 127
THE COCOON SESSION
The massage table is set from the
outermost layer to innermost layer as
follows: blanket (wool or cotton), thermal
space blanket (optional), and a plain flat
sheet in its normal orientation on the
massage table (for dry room removal
only). On top of this, place a plastic
sheet turned sideways on the table so
that it covers the blanket. A bath towel
is placed across the top and bottom of
the plastic sheet at either end of the
table to anchor the plastic wrap sheet.
EXFOLIATION
Begin the session with the client in the
prone position and exfoliate the posterior
body with a sugar scrub. Undrape
the body area and apply massage oil
with effleurage and petrissage strokes.
Add extra oil at the end of this initial
massage step to provide lubrication for
the exfoliation. Shake a small amount of
sugar on the area from a cheese shaker.
Use light circular strokes to exfoliate the
area with the sugar. Remove the sugar
with a hot, moist hand towel. Turn the
client supine and repeat the exfoliation
step on the anterior body (image 1).
PRODUCT APPLICATION
The knees are bent, and the treatment
product is applied to both the anterior
and posterior sides of the legs. The legs
are flattened against the plastic body
wrap, and the client is asked to sit up
(remove the bolster first). The treatment
product is applied to the back and
gluteals, and the client is asked to lie back
down (image 2). Finally, the belly, upper
chest, and arms are treated (image 3),
and the client is wrapped in the plastic.
SPA ÉL AN

PROMOTING YOUR COCOON

The plastic wrap is pulled up around
PUMPKIN PICK ME the client and tucked in loosely. Next,
UP WRAP the outer wrapping materials are pulled
up and around the client (image 4). The
Revitalize your body, mind, bath towel at the top of the massage table
and sense of humor with can be used around the client’s head in

this luscious and light- a turban drape or tucked into the top of
the cocoon. The feet are wrapped with
hearted body wrap. The body the towel at the bottom of the massage
is buffed to smoothness table. While the client is processing

with brown sugar before in the wrap, massage the face and feet
to enhance the service (image 5).
warm pumpkin, spiced with
cinnamon and nutmeg, and UNWR AP

slathered in a thick layer to To remove the wrap, the blankets

are pulled off the client (image
relax muscles and enchant 6). At this point, the client is still
the senses. While wrapped wrapped in plastic. The therapist

in this fragrant mix, the
feet and face are massaged
to ease tension and get
feet ready for dancing. The
client emerges revitalized.
now has three options based on the
equipment available and the product.
Option 1
If a shower is available, the therapist
can leave the client wrapped loosely
in the plastic and move the client to
the shower. As the client steps into the
shower, the plastic is handed back to the
therapist, who throws it away. While
the client showers, the therapist changes
the treatment table to massage sheets.
The treatment can end with a full-
body massage or with the application
of a finishing lotion, cream, or gel.

Option 2
If the product is messy and a shower is
not available, the plastic sheeting will
need to be removed completely from
underneath the client as the body is
cleaned off with hot towels. To remove
a plastic sheet, a clean sheet will need
to have been placed under the plastic
when the table was made up. The
product is removed from the client’s
arms, upper chest, and abdominal area
(image 7), and the client is asked to hold
onto the breast drape and sit up. The
product is removed from the back and
the posterior arm (image 8). The plastic
sheet is rolled up until it sits as close

128 massage & bodywork january/february 2008

SHEA WINTER SMELL-SCAPES
Winter Rose
MASSAGE OIL: (used for the sugar exfoliation) 1
ounce expeller pressed sunflower oil; 6 drops lemon
essential oil (Citrus x limon); 4 drops frankincense
(Boswellia carteri); 3 drops cypress (Cupressus
sempervirens); 1 drop rose (Rosa x damascena).

BLEND FOR SHEA BUTTER: 1 drop rose, 7 drops mandarin

(Citrus reticulata); 4 drops myrrh (Commiphora myrrha).

AROMA MIST: (use to mist over the client while

he/she is wrapped) 1 ounce distilled water; 1
drop rose; 4 drops sweet birch (Betula lenta);
9 drops bergamot (Citrus x bergamia).

Alpine Meadow
MASSAGE OIL: 1 ounce expeller pressed sunflower oil;
4 drops fir needle (Abies alba); 6 drops clary sage (Salvia
sclarea); 2 drops fennel seed (Foeniculum vulgare).

BLEND FOR SHEA BUTTER: 6 drops bay laurel (Laurus

nobilis); 4 drops cardamom (Elettaria cardamomum);
2 drops thyme (Thymus vulgaris–linalol type).

AROMA MIST: 1 ounce distilled water; 4 drops

juniper berry ( Juniperus communis); 2 drops neroli
(Citrus x aurantium); 4 drops frankincense.

Peppermint Twist
MASSAGE OIL: 1 ounce expeller pressed sunflower
oil; 2 drops peppermint (Mentha x piperita);
6 drops lavender (Lavandula angustifolia); 4
drops cedarwood (Cedrus atlantica).

BLEND FOR SHEA BUTTER: 4 drops myrrh; 6 drops

sweet orange (Citrus sinensis); 1 drop peppermint.

AROMA MIST: 2 drops peppermint; 2 drops jasmine

( Jasminum officinale form grandiflorum); 2 drops
rosemary (Rosmarinus officinalis), 6 drops lemon.

massagetherapy.com—for you and your clients 129

SPA ÉL AN

PROMOTING YOUR Option 3

WINTER ROSE WRAP If the product is an emollient base, like
almond butter, babassu butter, or shea
There is nothing more butter, it will not need to be removed.
delicate, graceful, or rare Instead, it is massaged into the client’s
than a bouquet of winter skin to conclude the treatment.

roses. This elegant spa The important thing to think about

treatment captures the when planning your seasonal wrap is
restful tranquility of a aroma, indulgence, and texture. Mix
the different ingredients so the client
moonlit walk in a snow- is constantly experiencing new scents.
covered garden. The session Use a variety of different massage
begins with a rose-petal strokes so that the client can experience
the release of muscular tension, while
polish that prepares the body enjoying the textures of the products.
for the luxury of rich shea Add small enhancing elements like a face
butter spun to an alabaster and foot massage or a warm cup of hot,
spiced cider to make the treatment feel
glaze. While enveloped in complete. Finally, give the treatment
warmth and the aroma of seasonal flare in the choice of products
winter roses, the face and and enhancers. When you take the
time to plan ahead and develop menu
feet receive a soothing services that capture the spirit of the
massage. The client emerges season, you encourage clients to take
transformed and glowing. care of themselves and enjoy the New
Year—all at the same time.

Anne Williams is a licensed massage

therapist, licensed esthetician, aromatherapist,
certified reflexologist, registered counselor,
as possible to the gluteals. The feet are
educator, and author. The work outlined
wiped with a hot towel, and the client
in this article and the images are adapted
is asked to bend the knees and hold the
from portions of the author’s textbook,
feet up. The plastic that is underneath
Spa Bodywork: A Guide for Massage
the client’s feet is rolled so that the dirty
Therapists (Lippincott Williams & Wilkins,
side is rolled up. The client’s clean feet
2007). Williams is also the education program
are placed on the massage sheet, which
director for Associated Bodywork & Massage
was placed beneath the plastic earlier
Professionals. She can be reached at anne@
(the client’s knees are still bent). The
abmp.com or anne@spabodywork.com.
product is removed from both legs with
hot towels and then plastic is rolled up
as high as possible under the gluteals
(image 9). The clean legs are placed flat
on the massage sheet and covered with
a sheet or towel for warmth. The client
lies back down on the massage sheet and
slightly lifts up the hips for the plastic
to be removed completely (image 10).
The client is now draped with a massage
sheet for the rest of the treatment.

130 massage & bodywork january/february 2008

heart of bodywork
BY NINA MCINTOSH

Some emotionally unbalanced people are

especially skilled at manipulating others
into taking responsibility for them.

132 massage & bodywork january/february 2008

 GOING OVERBOARD FOR CLIENTS
—AND DROWNING
I have a dilemma I haven’t encountered
before. Doris—fifty-five years old and
recently widowed—became my client several
months ago. In the first session, she said she
was lonely and didn’t have anyone to talk
to. Her sad situation touched me, perhaps
because it reminded me of how I felt when
I lost my husband several years ago.
Soon after the first meeting, Doris
began calling me. She started out asking
questions related to massage, but then
the conversations became more casual and
chatty. I should have cut her off, but I guess
I felt sorry for her. As the weeks have gone
by, she has called me more frequently and
also started to e-mail me several times a
week. If I don’t respond, she complains at
our next session: “Why didn’t you return
my call or write back?” I’ve tried to tell her
that I’m busy, but that doesn’t satisfy her.
Now I’m sorry I ever showed her
such sympathy. How can I get her
to quit calling and e-mailing?
Anna K., Bakersfield, California
DEAR ANNA,
This is a great example of how a
misguided attempt to help a needy
client can backfire. It sounds as if your
compassion for Doris has caused you to
take on her problems in a way that’s not
good for either of you. She’s become too
dependent on you and you’re resenting
her demands. Not having set appropriate
limits the first time a phone call turned
chatty, you’ve given her the impression
that you’re available to her as a confidante
and friend. Moreover, she has taken
advantage of your unwillingness to say
no to her by imposing on you more and
more. Setting things straight is going to
be hard. You may not be able to turn this
into a healthy professional relationship,
but there are some things you can do
to at least reestablish your privacy.
First, you need to give her a clearer
message than simply not responding
to her calls and e-mails. I recommend
that you call to talk with her before the
next session. (E-mailing would be too
impersonal and taking up session time
would be inappropriate, along with likely
ruining the relaxing atmosphere for her.)
massagetherapy.com—for you and your clients 133
HEART OF BODY WORK
Be compassionate but firm. You
could say something along these lines:
“I’m sympathetic about the hard time
you’re having and want to support you
in taking care of yourself. However, I
made a mistake when I gave you the
idea that I could be available to you
outside of sessions, because I like to
keep my private time separate from
my professional relationships. Our
professional relationship will work better
for both of us and be less complicated
if we keep it within the boundaries of
our sessions together. That way, you can
use that time to relax and unwind and
not be concerned about anything else.
So, unless you have questions related
to massage that can’t wait till our next
meeting, it would be best if we limit
our contact to just session time.”
134 massage & bodywork january/february 2008
Use your own words, and deliver your
message with warmth and sympathy. If
she protests, just reiterate in a caring but
firm way that you can’t be available to
her except during sessions. No matter
how you present these new boundaries,
she may feel rejected and not return to
work with you—that’s a risk you have
to take. If she continues as your client,
she will surely test you to see if you
mean what you say. You have to stand
your ground while also being friendly:
“I’ve got to get off the phone now. You
can tell me more about (whatever it
is) when I see you on Wednesday.”
At some point, you may want to
recommend that, during this time of
grief and transition, in addition to
massage therapy she might also seek help
from a mental health counselor or grief
support group. If you want to make this
suggestion, it would be best to do so
when she’s calm and not upset or angry
with you: “Have you considered getting
support from a counselor or seeking
out a support group?” If she’s interested
and you know of such resources, you
could point her in that direction.
No matter how you present these
new boundaries, she may feel
rejected and not return to work with
you—that’s a risk you have to take.
If she continues as your client, she
will surely test you to see if you
mean what you say.
Because this situation hasn’t
happened for you before, you might
want to take a look at what motivated
you to go outside your usual professional
boundaries this time so that you can
avoid such entanglements in the future.
You mentioned that you could empathize
with her experience, but could there
also be needs of your own that you
might have been trying to fulfill by
helping this client? An honest self-
appraisal might show you some areas
of self-care that need your attention.
INAPPROPRIATELY TAKING
RESPONSIBILITY FOR CLIENTS
Clients will come to us for a number of
reasons other than muscular relaxation.
Like Doris, sometimes they are lonely
or feeling lost and needing contact.
Sometimes we can sense they have
deep emotional wounds. Taking too
much responsibility for a client is
probably an occupational hazard in
this work—we want to help our clients
feel better, and in the intimacy of the
work, we often “feel their pain.”
 The ways that we take on too much
responsibility are usually more subtle
than in the situation described above.
For instance, you may find yourself
feeling as if you’ve failed when a
client’s aches and pains don’t magically
disappear. You might notice that you
always work longer than usual with a
client. In these circumstances, you have
to keep reminding yourself that your
goals are limited. Your responsibility
is to do the best you can in the session
time you have. Outside of that, you
need to have faith in the client’s ability
to solve his or her own problems.
If you feel drawn to bending over
backward for a client (unless that client
has legitimate special needs), that
impulse should raise a red flag for you.
If you find yourself wanting to help your
new client in ways that you don’t usually
extend to clients—feeling compelled to
give her a ride home or coming in on
your day off to work on her—stop and
ask yourself what is going on. “An hour
ago I didn’t know this client. How did I
suddenly become responsible for her?”
There’s usually no problem in doing
something extra for a regular client
who is temporarily in a bad spot, but be
careful about setting a precedent with a
new client. Giving extra help to a client
who is an able-bodied adult can create
an unhealthy dependency that both
sides will eventually come to resent.
Find out what the resources are in your
community so that you can steer clients
toward them as the situation warrants.
Another reason to be cautious is that
some emotionally unbalanced people
are especially skilled at manipulating
others into taking responsibility for
them, and the repercussions can be
greater than unwanted phone calls. A
colleague reports: “The most difficult
client I ever had was one who, from the
beginning, was good at manipulating me
by making me feel guilty. For instance,
even though she had a good job, she got
me to give her a discount on my fee by
telling me all the tragedies in her life.
She also made me feel like I was the
only person who could help her back
problem and I often worked overtime
to try to make it better. However, my
work was never good enough for her; she
never felt relief. After several months,
she asked for her money back, saying I
hadn’t helped her. She also began bad-
mouthing me all over the community
and threatening to file groundless ethics
charges. In the end, I had to hire a
lawyer to negotiate with her to accept
a partial refund as a final settlement.
It was a very unpleasant experience
and taught me to be more consistent
about staying within set boundaries.”
REAL HELP
When you find yourself going overboard
for a client—feeling as if she needs a lot
of advice, wanting to take extra time
with her, and so forth—step back and ask
yourself whether you might be taking
too much responsibility. Chances are
that person has managed to muddle
through without you all these years.
Check in with yourself about whether
you’re meeting some needs of your own
by rescuing this client and whether
you’re really comfortable with what
your relationship with her has become.
Going outside your boundaries to
help clients can give the wrong message
to them—and to yourself. The message
to them is that you don’t trust that
they can take care of themselves. The
message to yourself is that you don’t
trust how much help you are already
giving them. Don’t get roped into
feeling that you have to do more for a
client than you usually do. And don’t
underestimate how much healing there
is in an hour of caring attention.
Nina McIntosh combines more than
twenty years of experience as a bodyworker
with her previous years as a psychiatric
social worker. She is the author of The
Educated Heart: Professional Boundaries
for Massage Therapists, Bodyworkers,
and Movement Teachers, now in its
second edition. For more information,
contact Lippincott Williams & Wilkins at
800-638-3030 or visit www.lww.com. To
learn more about professional boundaries
and ethics, visit www.educatedheart.com.
To learn more about illustrator Mari Gayatri
Stein, visit www.mariscardsandmore.com.

massagetherapy.com—for you and your clients 135

business side
BY SHANNON PEREZ

People need to see your

name at least three times
before remembering it and
approximately nine times
before becoming a client.

136 massage & bodywork january/february 2008

TEN LOW-COST PROMOTIONS
YOU CAN START TODAY
Promoting your massage
business to potential customers
takes work and persistence as
well as creativity. Research
shows that on average,
consumers need to hear a
message at least three times
before developing name
recognition or recall and nine
times before they become a
customer. Promotions that
target new customers must
therefore be consistent and
continuous, but they don’t have
to be expensive to be effective.
A successful campaign can
generate hundreds if not
thousands of dollars in new
revenue each year. The
following ideas represent
low-cost promotions that can
translate into big results.
massagetherapy.com—for you and your clients 137
1. CELEBRATE COMMUNITY. As
a massage therapist, you intuitively
understand the importance of
relationships, but may forget the
importance of integrating that sense
of community into your professional
business-building activities. Collaborate
with local artists, musicians, and small-
business professionals while hosting
an open house for the general public
at your establishment. It’s a fun way to
meet people while allowing everyone
involved an opportunity to mingle and
demonstrate their talent. Consider
targeting this activity toward a group
that you would like to work with—for
example, a hip interactive meet-and-
mingle night for singles or a business
card exchange for small-business
professionals. Music, art, and even
catering will add to the ambiance of
the meeting while reducing or even
eliminating your primary costs. It’s free
or low-cost exposure for those who desire
to showcase their talent, plus it’s a great
way to meet people while giving back
to the community. Invite your regular
clients and have them bring a friend.
Post notices on the local community
event boards—most are free—and ask
the other presenters to do the same.
Total cost: usually free or under $100.
BUSINESS SIDE
2. LOYALTY EXCHANGE CLUBS
(LECS). Not familiar with LECs? Don’t
worry, most people aren’t and that is
exactly why they can be so advantageous
to your practice. A Loyalty Exchange
Club builds on the 80/20 rule that states
that 80 percent of your business will
come from roughly 20 percent of your
clients. Those same people who are your
very best clients are likely to be great
clients to other small business owners
and vice versa. For example, perhaps
you have a client like Ted. He comes
in for a massage every two weeks like
clockwork. The beauty salon around
the corner has a similar client by the
name of Diane who comes in weekly
for her hair, nails, or a facial. This is a
great way for you to meet Diane and
introduce Ted to the salon. And your
clients will thank you for the benefit.
The key to making an LEC work is to
recognize and reward your loyal clients
with a free membership in the LEC,
allowing them discounts for trying out
other services. To do this, you only need
to coordinate with other local business
providers who all agree to recognize and
reward their best clients—usually the top
20 percent—with LEC cards. Each LEC
card list looks like a standard business
card from the originating company on
the front, but on the back lists other
participating businesses for your client
to receive a discount. Total cost: shared
cost of printing a batch of two-sided
business cards, usually less than $100.
A successful campaign can generate hundreds if
not thousands of dollars in new revenue each year.
138 massage & bodywork january/february 2008
3. CELEBRATE. Who doesn’t love
a good party? Who doesn’t love a good
massage? Combine the two and you have
a double reason for celebration. Some
small epicurean delights, great music,
and a relaxing atmosphere combined
with good company and massage or
facials make for an engaging pre-wedding
celebration or fun and relaxing girls’
night out. Offer an assortment of healthy
vitalizing energy drinks, jazzy music,
and invigorating sports massage for a
pre- or post-sporting event celebration.
Private massage parties are all the rage in
many metropolitan areas and represent
premium revenue opportunities.
Team up with event planners, bridal
consultants, photographers, travel
agents, and others to let them know
of your services. Total cost: free.
4. BE YOUR OWN BILLBOARD. As
a small business owner, you are your
business and should be proud of that fact.
Unfortunately, many massage therapists
miss the opportunity to engage hundreds
of potential clients each and every day.
Remember, people need to see your name
at least three times before remembering
it and approximately nine times before
becoming a client. You can be seen for
very little money. Have a custom T-shirt
with your business name, logo, and
phone number printed on it and wear
it in public while you do your routine
errands and shopping. Ditto for magnetic
car signs. Want an even bigger response?
Include an introductory offer for anyone
who sees your T-shirt and stops you
to request a business card. Likewise,
offer a discount massage for those who
see your car and call in to schedule an
appointment. It’s a great way to be seen
and an even better way to let people meet
you in person. Total cost: less than $100.
5.
CREATIVE CHARITY CAMPAIGNS.
Support that special cause while growing
your business. Team up with the Lions
Club to collect used eyeglasses for
the visually impaired while offering a
discount day for those who donate or
collect three canned goods to feed the
needy during the holidays. The list is
endless and can reflect those causes
most near and dear to your heart. As
an added benefit, many charitable
campaigns are eligible for free press
coverage in local news or community
event calendars. Total cost: free.
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BUSINESS SIDE
There are literally hundreds of inexpensive
ways to promote your business by simply using
technology and a lot of creativity.
6. TAME TECHNOLOGY. More than
80 percent of people use the Internet
routinely and you should too. Even very
simple promotions can bring exposure
when consistent. For example, many
communities have free online bulletin
boards or classified ads, like Craigslist.
com, where you can post. Use e-mail
to book yourself solid by sending out
last-minute specials when you anticipate
a slow day. Write a small newsletter or
create a list serve with healthy tips for
your clients that promote the benefits
or special offers you have planned.
Join a professional networking site like
LinkedIn.com to virtually meet others
in your community. There are literally
hundreds of inexpensive ways to promote
your business by simply using technology
and a lot of creativity. Total cost: free.
7.
GO VIRAL. Infect the community
with a buzz while creating good will
and fun. Select a small item that
symbolizes your business—this may be
a customized coin, massage money, or
even a small figurine. Almost any item
will do. Have your name and contact
information engraved on the item and
then let it loose in the community. For
instance, you might leave it as a tip
for your favorite waitress. The person
who brings the item back to the office
receives a deeply discounted or even free
service and then is free to take the item
and pass it along to the next recipient
of their choice who then passes it along
again. The end result is word-of-mouth
advertising. Total cost: less than $100.
140 massage & bodywork january/february 2008
8. BECOME AN EXHIBITIONIST.
Approach local corporations and
nonprofit groups that rely on exhibitions
and entertainment to offer your services.
Be prepared to demonstrate the strong
response and attention generated by
free massage. If you have attended trade
shows, corporate events, or fundraisers,
you understand how much planning
goes into presenting a compelling
attraction to bring attention to the
company. Offer a free chair massage
by the display or provide a sign-in
sheet and randomly select from the
list every fifteen to twenty minutes
and watch people line up. It’s a win-
win for the corporate or nonprofit
client and yourself. Total cost: free.
9.
CREATE A CLUB. It’s not only
profitable, but educational and cost
effective. For a small annual membership
fee, your clients receive the gift that
keeps giving. A club is a great way to
educate members on the benefits of
massage, stay in constant contact with
clients in a positive and educational
manner, and gain valuable insight into
what is on the minds of your members.
The club benefits members by providing
special offers and discounts to products
or services that you have reviewed,
educating clients on important issues.
And, most importantly, a club fosters a
sense of belonging and loyalty among
your clients. Total cost: less than $100.
10. THE ART OF APPRECIATION.
Your clients are the key to your success,
but showing appreciation—and allowing
others to show their appreciation—can
benefit your bottom line while creating
fanatical customer satisfaction. Many
massage therapists send out birthday
cards or special occasion reminders, but
the art of appreciation takes it one step
further by allowing the community an
opportunity to nominate special people
in their own lives. Sponsor an art of
appreciation day with refreshments,
flowers, and a drawing once an hour for
special prizes, awards, and recognition.
Have nominations sent in by family
members, friends, or employees
explaining why someone deserves
an extra special recognition, a bit of
relaxation, or just a little pampering.
Don’t forget to invite the community
editorial pages, local radio station, or
other media to cover the event and
remind people to nominate that very
special someone. Most importantly,
the art of appreciation allows the
massage therapist to sponsor an event
that touches the lives of those across
the community who give so much
to others. Total cost: free.
Shannon Perez has worked extensively
with leading organizations, including the
CDC, WebMD, and others. She has taught
college health for a decade while writing and
consulting in the industry. She holds master’s
degrees in health science and business. For
more information about her upcoming books,
planning guide, and practice management
tools, visit www.massagepracticeplanner.com.
 Structural
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somatic research
BY RAVENSARA S. TRAVILLIAN

142 massage & bodywork january/february 2008

RESEARCH PERSPECTIVES

A massage
practitioner
who is research
I would like to take this opportunity to introduce myself
literate can
as the new Somatic Research columnist. My name is
read a research Ravensara S. Travillian, and I have practiced massage in the
article, Seattle area since 1991. Most of my practice has involved
understand treating survivors of war and genocide for trauma, but in

the essential addition I have worked with people living with the effects

take-home of stroke and with women having high-risk pregnancies.

I am also an informatician, which is a word most people

points, and
have never heard of it. Think mathematician or statistician,
apply them except instead of math or statistics, I study information: how
in practice we gather the information we need and how we organize it,
with clients. use it, and share it with others. Information management

is what I study, and more specifically, information with

regard to massage therapy—what information we need as a

profession, what information we already have, and what we

do (or want to do) with it. That is a story that continues to

be written, and we will be working together to explore it.

massagetherapy.com—for you and your clients 143

SOMATIC RESEARCH
One informatics issue that I am
deeply involved in and committed to is
the integration of research information
into practice, as well as the other way
around. Practice needs to inform
research and to play an important role in
setting research agenda, while research
needs to generate useful, applicable
information for use in practice. This
two-way flow of information is essential.
Without that connection, much of the
information generated from studies
doesn’t give practitioners anything they
can use directly. A big step in building
that interactive flow of information is
the development of research literacy—
the ability to read, understand, and
apply information from published
research—which is a skill that we will
continue to mentor in this space.
Among us we have a great deal
of collective experience regarding
massage, but few reliable ways to
communicate that experience with
each other. The two-way information
flow can integrate these separate
domains—practice can help determine
what research is relevant, and research
can provide insight into what we can
use in practice. That leads us into the
realm of research capacity—the ability
to participate in designing and carrying
out research—another skill that we will
talk about and foster in these pages.
144 massage & bodywork january/february 2008
One of the roles I envision for this
column is an embodiment of that process
of communication—I do not want this
to be a lecture where I present facts
for you to passively receive and digest.
Instead, I see it as a dialogue. I want it
to be as interactive as it possibly can
be, given, of course, the limitations of
the printed column format. I have been
away from practice for a while, since I
returned to school. I will share with you
what I have learned during that time
and what I continue to learn. In return,
I want to hear from you about what
information active practitioners are now
seeking. I hope to hear from you about
what is important for you to know, and
in that way, we will create a dialogue on
massage research. Ready? Let’s begin.
WHAT YOU CAN EXPECT
One of the exciting aspects of research
in massage is the sheer number of
topics and specialties it touches. A
sample information search in PubMed
(a national database of journal
articles related to medical topics) for
articles related to massage, returns
studies on the following topics:
• Complementary and alternative
medicine usage among children in a
Scottish ear, nose, and throat hospital.
• A review of compression in
lymphedema management.
• A case of someone who experienced
blood clots in the lungs after
receiving leg massage.
• Aromatherapy for children
who were deprived of oxygen
at or shortly before birth.
• How reflexology from a partner affects
pain and anxiety in cancer patients.
• A model for developing and
carrying out policy regarding
massage in a medical center.
• Massage as a comfort treatment for
patients undergoing heart surgery.
• Breast cancer patients’
experience of massage while
undergoing chemotherapy.
• How massage affects the biceps
femoris muscle as it undergoes
isometric contraction.
And these are just some of the first
articles of more than thirty-six hundred
in just one database. The diversity and
range of topics on research in massage
never fails to amaze me, and I will share
that wonder with you each time by
selecting a particular topic to examine.
In addition to the broad scope of
topics we will look at, we will also take
the opportunity to examine various
research issues in depth: ethical issues
surrounding research on vulnerable
populations, the policy and practice
implications of research outcomes,
social justice aspects of access to
information, and contributions to the
development of research agendas.
BECOMING RESEARCH LITERATE
First, let’s clarify what we mean by
research literacy. A massage practitioner
who is research literate can read
a research article, understand the
essential take-home points, and apply
them in practice with clients. By
“understand the essential take-home
points,” we’re certainly not talking
about analyzing every detail of the
article, nor about getting bogged
down in every technical issue. Rather,
it means condensing the article into a
message and determining the meaning
of that message for your practice.
SOMATIC RESEARCH

For example, let’s imagine that one of

your clients asks you if there’s anything
that massage could do for a relative of
hers who is in the final stage of kidney
disease and who is having a great deal
of difficulty sleeping due to discomfort
and anxiety. You do a literature search

The diversity and range of topics to find out who has already researched
and published on this topic. You find:

on research in massage never • Tsay, S. L. and M. L. Chen. 2003.

Acupressure and quality of sleep

fails to amaze me. in patients with end-stage renal

disease—a randomized controlled
trial. International Journal of
Nursing Studies. 40, no. 1:1–7.
You scan the abstract (summary of
the entire article) to find out whether
it is on topic for your question.
There, you read the following:

• Results demonstrated significant

differences between the acupressure
group and the control group in
subjective sleep quality (p=0.009),
sleep duration (p=0.004), habitual
sleep efficiency (p=0.001), and
sleep sufficiency (p=0.004).
One of the things we are going
to do is to demystify the jargon, so
that the purpose and meanings of
the technical terms in the sentence
above are clear. For the purpose of the
exercise now, let’s just say that, having
developed the skill of research literacy,
you get the following important
nuances from the sentence above:

• In comparison to the patients [in the

final stage of kidney disease] who
received no treatment, the group of
patients who received acupressure
showed noticeable improvements in
their self-described quality of sleep, in
their length of sleep, in how effective
their sleep was, and in getting enough
of the sleep they need. The researchers
are very confident that these outcomes
are valid and meaningful, and there

146 massage & bodywork january/february 2008


is an extremely low probability that
these outcomes are the results of
chance, rather than being a result
of the acupressure treatment.
I know, right now it looks like a
long way to get from the first version
to the second. But trust me, after
we’ve practiced the skill of research
literacy for a while, this will come
naturally to you. We’ll continue to
build this skill, and like everything
else, it will be easier with practice.
DEVELOPING RESEARCH CAPACITY
Just as with any other skill, we start
with the basics, and then build on that
foundation to progress to carrying
out more advanced tasks. With that in
mind, since research capacity depends
so much on the skills of research
literacy, we will first concentrate on
building research literacy, to lay that
strong foundation, but we won’t totally
shy away from developing skills in
research capacity, even at the outset.
Think about how we learn language.
Speaking a language is an active skill,
since it requires generating meaningful
speech, while reading is somewhat more
of a passive skill, since recognizing
meaning is easier than generating it, yet
we certainly don’t insist that children
learn to read before they speak. The way
we naturally learn our native language
is through a mixture of speaking
and, later, reading. In an analogous
way, we will focus on laying a solid
foundation of research literacy that we
can continue to build on and apply.
NEXT ISSUE: THE SCIENTIFIC METHOD AND THE STRUCTURE OF A RESEARCH ARTICLE;
THINKING STATISTICALLY; RESEARCH OVERVIEW—MASSAGE AND CANCER.
One research capacity skill that can
be developed initially is adding to our
knowledge of massage by contributing
our own narratives. There are many
ways to write about our experiences,
from creative writing to poetry to
nonfiction and more. One rather
specialized form that is often found
in medical journals is the case report,
often a detailed description of a clinical
encounter with a client or patient, a
treatment for a particular condition,
and an outcome of that treatment. In
upcoming columns, we’ll step through
the structured exercise of writing in the
style of published case reports. Perhaps
while we get to that, you can think
about what cases you’ve seen in practice
that might make a good narrative to
relate for sharing your experience.
For example, at dinner not too
long ago, I met a massage practitioner
who works with two patients, both of
who are in a comatose state from brain
damage after severe head injuries. She
seemed pleased that I was interested
in hearing about her work. However,
when I asked her if she had thought
about writing about it, she admitted
that she never had—in fact, she seemed
to shy away from the very idea.
I pointed out to her that surely she
was not the only massage practitioner
who had ever been asked to work
with brain-injured comatose patients,
and yet, if you carry out a PubMed
database search to find any existing
research literature on the subject,
you yield no results. So this massage
therapist has experience that is
potentially very valuable to someone
out there just starting to practice,
but doesn’t quite know what to do.
massagetherapy.com—for you and your clients 147
The way this knowledge gets shared
is through publication, such as case
reports. It’s how we see what else is
going on out there in the world, what
kinds of conditions others are seeing
in practice, and what they’re doing to
treat them. And we give back by sharing
our knowledge, as well. Talking about
writing up case reports may sound like a
big step right now. But like any new skill,
we’ll build it up with practice over time.
One of the facets of the research
process I love most is the shared
connection with others across space
and time. Taking an active part in
exploring the natural world around
us, and committing to the scientific
method as a way of carrying out that
exploration, gives us an intellectual
connection to many people on the
same journey now, as well as to those
who went before us. In a similar way,
this column will be what we make it
together, out of our shared interest in
discovering what research means to the
field of massage and the people involved
in it. I am excited about co-creating
this process with you and look forward
very much to our dialogue.
Ravensara S. Travillian is a massage
practitioner and biomedical informatician in
Seattle, Washington. She has practiced massage
at the former Refugee Clinic at Harborview
Medical Center and in private practice. In
addition to teaching research methods in
massage since 1996, she is the author of an
upcoming book on research literacy in massage
(working title: Massage Journal Club: A
Guide to Reading the Research Literature).
Contact her at researching.massage@gmail.
com with questions and comments.
spotlight on education
BY REBECCA JONES
ELI THOMPSON
Massage therapy student Eli Thompson
was halfway through his two-year
training program at the Muscular
Therapy Institute in Cambridge,
Massachusetts, when he happened
onto a blurb about an upcoming class
that changed his life … again.
His career plans had already done a
one-hundred-eighty-degree turn in less
than two years. The son of a software
engineer, Thompson had followed
his father into the hard sciences. He
was pursuing a degree in mechanical
engineering because he loved the
mechanics of the physical world, loved
knowing the way things worked.
Then, in his third year of college,
an infection left him bedridden for six
weeks. And when he finally returned to
class, he realized he had been following
his father’s footsteps, not his own.
“I spent about a year very frustrated,
feeling that I had wasted so much of my
life,” says Thompson, now thirty-five.
“And then I stumbled onto massage.”
Thompson instinctively knew
that massage and bodywork were
good for him. He liked connecting
with people, liked making their pain
go away. He didn’t expect he’d make
a long-term career out of it, but he
enjoyed what he was learning.
“I had decided to take several CEU
courses to get a sense of the potential
and breadth of bodywork,” Thompson
says. “I had taken an energy course and a
craniosacral course. We’d been exposed
to several different modalities in class.”
148 massage & bodywork january/february 2008
Then, in that summer of 1998, he
saw an ad for a Tom Myers’ Anatomy
Trains workshop. The ad explained that
the body is really a continuous web of
fascial interconnections, not separate
parts. Anatomy Trains was the map that
explained it. The systems analyst in
Thompson emerged. This sounded a bit
like Systems Theory and Chaos Theory,
topics that fascinated him. It focused
on the relationship between the parts
in a complex system. In a way, it was
mechanical engineering for the body. By
focusing on the relationships between
the parts we begin to see how the whole
can be greater than the sum of the parts.
He signed up for the three-day
workshop. His “aha” moment came
in the introductory lecture. From
that moment on, he was hooked.
“It was the way Tom Myers brings in
so many fields,” Thompson said. “The
old and the new sciences, like systems
theory, chaos theory, quantum theory—
he brought all that into the humanitarian
fields, into the bodywork field. It’s
basically the unifying field theory of
us. It gives a holistic perspective on
what it is to be human. It was the most
complete picture I had experienced yet.
“When he coalesced it for me, it
changed my worldview completely. I
saw the potential of bodywork, how
you can impact people. I saw, really, the
complexity of what it is to be human.”
Thompson went on to complete
his massage therapy training. It took a
couple of more years after that before he
could complete Myers’ full five-hundred-
hour Kinesis Myofascial Integration
(KMI) structural integration training,
but by that time he knew his purpose
in life and he pursued it with gusto.
“I knew I wasn’t going to be fulfilled
by relaxation massage or even therapeutic
massage,” he says. “Therapeutic massage
deals with current, acute stress-based
problems. But I wanted to become a
structural manipulator, to deal with
long-term problems, like debilitating
back pain or posture deficiencies, or
anything people weren’t able to get
resolution from with other means.”
Thompson likens what he learned
about structural integration to
the ancient Asian art of bonsai. A
bonsai gardener will wrap a tree’s
branch in metal to make it grow
a certain way. A month later, the
gardener removes the wrap, but the
tree remains in the new position.
“It’s the same in our bodies,” he
says. “Being able to intervene or impact
a person at the structural level can have
long-term changes. If their pattern
sets them up for shoulder or neck pain,
massage will alleviate the pain. You can
give them a cortisone shot or meds,
but it still just deals with the symptom.
Exercise may stabilize them enough
to sustain the strain caused by that
pattern, but it’s still dysfunctional.”
Structural work, however, goes still
deeper. It is designed to impact the
fascia rather than the muscle. “You focus
on a specific part of the body, and you
determine how to get it to support a
better pattern. In each session, we focus
on a specific part of the body in context
to the whole and determine how to get
it to support a better, more functional
pattern.” Thompson says. “You get
more and more of the body involved
in this change. And the body gets to a
point where it likes the change better.
As the sessions accumulate more of the
body’s fascial web becomes involved in
this change. The client gets to a point
where the new pattern works better and

feels more natural than the old one.
You reach a tipping point, in a sense.
“If I hadn’t taken that first course,
I might have continued with massage,
might have gotten into energy-based
work, but I don’t know what satisfaction
I would have gotten from that.”
Thompson saw this play out in
his own life. As he learned more
about structural integration, he
saw the destructive old patterns of
his old life slipping away, evolving
into healthier patterns.
As a boy growing up in Israel,
Thompson had been outgoing and
sociable. But when his family moved
to the United States when he was
nine, he withdrew. The change in
culture left him traumatized.
“It was tough transitioning,” he
says. “I had to conform. The way I
did that was by shutting down and
burying everything about me that was
different, everything that was special or
Israeli. I became a different person.”
It wasn’t until years later, in the
summer after he took that first Tom
Myers class, that Thompson made a
visit abmp.com for a calendar of ceu listings 149
breakthrough. He went to Israel for a
three-week vacation, “and something
changed during that trip,” he says.
“Something changed within me.” All
of a sudden, he started reading Hebrew
in a way he hadn’t been able to before.
“The shift was really kind of a
surrender,” he says, “a letting go of
all the anger and frustration. It was
the accepting of a new path. I became
committed to this new direction
and dived into this new life. Since
then, so much has changed.”
His structural integration
training impacted his life in one
more very profound way: it’s
where he met his wife, Debbie.
“She was one of the ‘practice
bodies,’” he says. “She heard me speak
Hebrew, and it just went from there.”
Today, the Thompsons have been
married five years and have three
children: a four-year-old son, Noah,
and two daughters—two-year-old
Talia and seven-month-old Nava.
Thompson now happily has a
full-time practice in Brookline,
Massachusetts, doing structural
integration work, and as of 2005 he
became a certified teacher of Kinesis,
teaching Anatomy Trains. He has
also opened a second business called
Benchworks, selling the ergonomically-
correct benches (pictured) required
for structural integration work.
Using his mechanical engineering
background, he redesigned the old
Ida Rolf bench, giving it a modern
look and several color options.
“My life,” he says, “is a wonder
to me.”
Rebecca Jones is a Denver-based freelance
writer who embraces life and a myriad of topics.
Contact her at killarneyrose@comcast.net.
education resource listing
SCHOOLS, SEMINARS, AND WORKSHOPS
Contact Angie Parris-Raney at 800-458-2267, ext. 641, or angie@abmp.com for more information.
Visit ABMP.com for a calendar of CEU listings.
INTERNATIONAL
THE ARVIGO INSTITUTE, LLC
77 West Street, Antrim, NH 03440
Tel: 603-588-2571; E-mail: atmam@tds.net
Website: www.arvigomassage.com
CARE INTERNATIONAL—
CENTER FOR AROMATHERAPY
RESEARCH AND EDUCATION
RR 4, Box 646, CR 800, Marble Hill, M0 63764
Toll-free: 800-758-8629
Tel: 573-238-4846; Fax: 573-238-2010
E-mail: care@raindroptraining.com
Website: www.raindroptraining.com
CERTIFICATE PROGRAM IN
INTEGRATIVE AROMATHERAPY
Institute of Integrative Aromatherapy
PO Box 130166, The Woodlands, TX 77393
Toll-free: 877-363-3422
E-mail: Valerie@floramedica.com
Website: www.floramedica.com
KINESIS MYOFASCIAL
INTEGRATION
318 Clarks Cove Road, Walpole, ME 04573
Toll-free: 888-KINESIS (888-546-3747)
or 207-563-7121
E-mail: info@anatomytrains.net
Website: www.anatomytrains.net
150 massage & bodywork january/february 2008
The Arvigo Techniques of Maya Abdominal Massage
Become a member of a new, vital, and growing profession that addresses the physical emotional and
spiritual well being of your clients. These ancient techniques were brought to America by Dr. Rosita
Arvigo, DN, a Naprapathic physician who apprenticed with Don Elijio Panti, one of the last Maya
Healers from Belize. Maya Abdominal Massage addresses reproductive and digestive health including
the tilted or prolapsed uterus, prostate swelling, and chronic digestive complaints. Program of study
includes Self Care, Professional, Certification Teacher Training, and Maya Spiritual Healing.
Courses offered in the USA, Canada, Belize, and United Kingdom. We are a Continuing Education
Provider under NCBTMB for Massage, MEAC for Midwifery, ANCC for Nursing.
CARE International has a growing faculty of Certified CARE Instructors (CCIs) who teach throughout
the United States, Canada, and selected other countries, including Mexico, Australia, Europe, and the
Far East. Approved by NCBTMB for continued education credit, the CARE curriculum consists of 25
hours as follows: Applied Vitaflex, Raindrop Technique, Essential Oil Chemistry, Science and Art of
Aromatherapy, Healing Oils of Ancient Scripture with Associated Massage/Anointing Techniques,
and Emotional Release by Touch and Aroma. CARE sponsors more than 100 week-end seminars worth
25 CE Hours each every year. See the CARE Website for a calendar of classes. Check periodically for
functions in your area because new programs are added almost weekly. Completion of the first 72 hours
of the CARE Program qualifies you to become a Certified Raindrop Practitioner (CRP). Completion
of the entire CARE Program of 164 hours qualifies you to join the CARE faculty as a Certified CARE
Instructor and Board Certified Raindrop Specialist (BCRS).
The highly acclaimed and respected Institute of Integrative Aromatherapy, based in Houston, Texas,
provides massage therapists with specialized and professional training incorporating essential oils
effectively and safely in their massage practice through the most comprehensive correspondence
course available today. The program offers 325 contact hours, and includes everything needed to
complete the case studies, essential oil profiles, and 36 home blending practicums, including program
manuals, text books, 50 essential oils, and an assortment of blending supplies.
The Certificate Program is fully endorsed by the NCBTMB, AHNA, NAHA, and AIA and is co-written
and personally mentored by best-selling author and Holistic Nurse Valerie Cooksley, RN, OCN,
FAAIM.
For a brochure and to learn more about becoming certified in Integrative Aromatherapy visit
www.floramedica.com or contact Valerie@floramedica.com.
Kinesis Myofascial Integration (KMI) is a Rolf-evolved method for transforming postural dynamics.
KMI presents a 12-session series of integrative bodywork, based on Tom Myers’ Anatomy Trains and
his 30 years of practice in Structural Integration. KMI classes are rich laboratories for exploring your
assessment skills, manual technique, movement, and personal/professional development. Train with
old-world craftsmanship and 21st century delivery. The 500-hour KMI certification program is designed
for successful somatic educators who want to expand their vision and practice, and join a group
dedicated to creating meaningful work in this world. Approved by the NCBTMB under Category A.
Introductory courses on Anatomy Trains and other publications available.
 PRE– AND PERINATAL MASSAGE
THERAPY—CAROLE OSBORNE-
SHEETS, COURSE DEVELOPER
11650 Iberia Place, Suite 137
San Diego, CA 92128
Toll-free: 800-586-8322; Tel: 858-748-8827
Website: www.bodytherapyassociates.com
SOCIETY OF ORTHO-
BIONOMY INTERNATIONAL®
5335 North Tacoma Avenue, Suite 21G
Indianapolis, IN 46220
Toll-free: 800-809-3747; Tel: 317-536-0064
Fax: 317-536-0065
E-mail: office@ortho-bionomy.org
Website: www.ortho-bionomy.org
TRAGER INTERNATIONAL
United States Trager Association
13801 W. Center Street, Suite C
Box 1009, Burton, OH 44021
Tel: 440-834-0308
E-mail: admin@trager-us.org
Websites: www.trager-us.org, www.trager.com
NATIONAL
BASTYR UNIVERSITY
14500 Juanita Drive NE, Kenmore, WA 98028
Tel: 425-602-3330; Fax: 425-602-3090
E-mail: admissions@bastyr.edu
Website: www.academic18.bastyr.edu
Continuing Education Program
Nurturing the Births of Mothers and their Babies™
Occasionally seeing pregnant clients? Want to specialize in maternity massage therapy? Choose from
among Carol Osborne-Sheets’ popular educational programs:
Book: Critically acclaimed 178-page manual offers a comprehensive practitioners’ guide to prenatal,
labor, and postpartum therapy.
Home study and Introductory Courses: Essential courses emphasize safe prenatal positioning and
contraindications for low-risk, uncomplicated pregnancies.
Pre- and Perinatal Massage Therapy Certification: 32-hour workshop features 80 specific techniques
to meet the structural, physiological and emotional challenges of the childbearing year. Carole and
her instructors bring warmth, academic excellence, and over 30 years of somatic wisdom to these
educational offerings. CEU approved by various agencies; scheduled worldwide. Also available, Deep
Tissue Sculpting: Details techniques and theory of myofascial bodywork.
• Gentle, osteopathic-based positional and movement techniques which access and educate the body’s
inherent resources for self-correction.
• Highly effective relief for acute and chronic discomfort, stress, injuries and challenges associated with
postural and structural imbalances.
• Assists athletes to maintain peak performance and balanced tone with fewer injuries.
• Easy on the practitioner. Easy on the client.
• Combines well with any system of health care.
For more information on Course Schedules and Training Programs taught throughout the United
States, Canada and Australia or to locate Registered Practitioners and Instructors, please go to
www.ortho-bionomy.org.
The TRAGER® Approach is on the cutting edge of mind-body education with this deeply effective
and transformative work. As you learn at your own pace you discover ease—the key to longevity in your
career. For information about the Trager Professional Certification Program, a listing of Level I classes,
and local Practitioners, visit our web sites www.trager-us.org and www.trager.com or call and request a
brochure.
Trager®, Mentastics,® and the Dancing Cloud logo are registered service marks of Trager International,
licensed for exclusive use within the United States to the United States Trager Association.
When you come to Bastyr University to earn an undergraduate or graduate degree, you take the
first step towards building a richly rewarding career in acupuncture and Oriental medicine, applied
behavioral science, exercise science and wellness, herbal sciences, health psychology, naturopathic
medicine, or nutrition. In our multidisciplinary approach to teaching the natural health sciences—heart
meets science, East meets West—and each student begins an amazing journey.
At Bastyr, you will become part of a close-knit and nurturing community that thrives on diversity and
the free exchange of ideas. Internationally renowned for its innovative curriculum and outstanding
faculty, Bastyr University programs are constantly evolving to keep pace with and prepare students for
the demands posed by the burgeoning field of natural health. Learn more at academic18.bastyr.edu.
State-Approved Massage Therapy Program Both
visit abmp.com for a calendar of ceu listings 151
EDUCATION RESOURCE LISTING
Continuing Education Program State-Approved Massage Therapy Program Both

BODYWORK FOR THE 34-Hour Advanced Certification Program: Bodywork for the Childbearing Year is an intensive
CHILDBEARING YEAR® four-day seminar that provides therapists with the knowledge and skills to practice competently and
8950 Villa La Jolla Drive confidently with pregnant, laboring, and post-partum women. Participants learn: pregnancy anatomy
Suite A217, La Jolla, CA 92037 and physiology and its effect on bodywork practice; contraindicated conditions and techniques;
Toll-free: 888-287-6860; Tel: 760-436-0418 Alexander Technique for pregnancy; pregnancy exercise; therapy and positioning guidelines for the
Fax: 760-436-6998 three trimesters; labor preparation and labor support; postpartum therapy, including post-cesarean
E-mail: pregnancymassage@aol.com recovery and scar massage. Also explores emotional issues, ethical issues and, marketing. Specific
Website: www.katejordanseminars.com modalities modified for pregnancy include strain/counterstrain, muscle energy technique, myofascial
release, joint mobilization, and reflex techniques.
2008 Schedule: January—San Diego, CA; February—Tampa, FL; March—Chicago, IL; April—Seattle,
WA; May—Santa Monica, CA; Washington, DC; July—San Francisco, CA; August—Chicago, IL,
Bloomington, MN; October—Austin, TX.
For publications and more information and locations, please contact us.

BOWENWORK™—BOWEN Searching for a modality that gives excellent, long-lasting results and is easy on both practitioner
THERAPY ACADEMY and client?
OF AUSTRALIA
Then learn Bowenwork™—the light-touch technique that:
337 North Rush Street, Prescott, AZ 86301
Toll-free: 866-862-6936 • Accelerates healing by gently resetting the body’s innate healing mechanisms, replacing dysfunctional
E-mail: usbr@bowtech.com; patterns with healthy ones.
Website: www.bowenwork.com • Deeply relaxes and affects the entire body; addresses underlying causes of pain and dysfunction, not
enwork just their symptoms.
ow
• Is appropriate for acute and chronic conditions of young and old, pregnant women, elite athletes—just
B

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about everyone.
BO W

que
hni

• Allows time between sequences of moves for the body to respond, enabling practitioners to work on
TE

c
Te
CH

en
®
-T w
several clients at a time.
he
O ri g i n a l B o

• Is taught by NCBTMB-approved providers in an internationally recognized 120-hour course (2-day

seminars spanning 9–12 months).

CLAIRE MARIE MILLER INTEGRATIVE REFLEXOLOGY®—BRING THE FEET TO LIFE

SEMINARS, INC. REFLEXOLOGY WORKSHOP AND CERTIFICATION—30 hour
AMTA Registered, Nationally Since 1993. Brochure available upon request. North Carolina licensed Massage Therapist #580
Certified, North Carolina Licensed Claire Marie Miller Seminars, Inc. is approved by the National Certification Board of Therapeutic
Massage Therapist Massage and Bodywork (NCBTMB) approved provider. Integrative Reflexology® is another choice
8703 Rollingwood Road, Chapel Hill, NC 27516 in reflexology designed with more ease and therapeutic applications for the massage therapist. The
Tel: 919-967-9015 course weaves the four theories together to give a new perspective on reflexology with structural
E-mail: clairmar@bellsouth.net alignment, zones, meridians and proprioceptors. Techniques are easier on the hands and thumbs than
Website: www.integrativereflexology.com the conventional reflexology methods. Integrative Reflexology® is practiced at many of the top spas
world wide. It is recognized for its prevention of hand injuries for the therapist and loved by many of the
clients for its therapeutic benefits without pain
Creator and instructor, Claire Marie Miller, brings more than 27 years experience as a massage therapist
and seven years prior as a Radiologic Technologist. Claire’s combination of anatomical knowledge
through the experience of performing x-ray procedures that led to the creation of the new anatomically
correct reflexology charts, posters, cards and videos (for sale on website). Integrative Reflexology®
certification is available as a home study course.
Check the website, schedule and click on the site for more information.
Look for hands on workshops in Integrative Reflexology®, as well as new workshops in Hot Rockin’
Reflexology, Sweet Feet, Muscle-Meridian Reflexology, and Lymphatic-Reflex Detox at the
following sites:
2008 LOCATION SITES: February—Chapel Hill, NC; Myrtle Beach, SC; March—Charlotte, NC;
April—(Advanced Reflex classes) Topsail Beach, NC; May—Omaha, NE; Richmond VA;
June—Concord, NC; Baltimore, MD; Dayton, OH.

152 massage & bodywork january/february 2008

CLAIRE MARIE MILLER
SEMINARS, INC.
AMTA Registered, Nationally
Certified, North Carolina Licensed
Massage Therapist
8703 Rollingwood Road, Chapel Hill, NC 27516
Tel: 919-967-9015
E-mail: clairmar@bellsouth.net
Website: www.nurturingthemother.com
CORTIVA INSTITUTE
Schools of Massage Therapy
Tel: 866-CORTIVA (866-267-8482)
Website: www.cortiva.com
FELDENKRAIS® RESOURCES
West Coast Office: 830 Bancroft Way
Suite 112, Berkeley, CA 94710
Toll-free: 800-765-1907
Tel: 510-540-7600; Fax: 510-540-7683
E-mail: feldenres@aol.com
Website: www.feldenkraistrainingprograms.com
East Coast Office:
Toll-free: 800-482-3357; Fax: 215-230-9086
Website: www.feldenkraisresources.com
NURTURING THE MOTHER®
PREGNANCY, FERTILITY, LABOR, AND POSTPARTUM MASSAGE WORKSHOP AND
CERTIFICATION
Since 1990. Hours vary with site 24/34 hours. Brochure available upon request.
North Carolina Licensed Massage Therapist #580
A Body, Mind & Spirit approach to all stages surrounding pregnancy. This course offers a rich blend
of massage for fertility, pregnancy, labor, postpartum, infant and partners. Additionally taught is
reflexology for childbirth, birth rituals, storytelling (the origins of birth wisdom), networking, pregnancy
and birth anatomy, and physiology.
Claire Marie Miller, RMT, LMT, conceived this workshop when having her three children and received
massage throughout her entire pregnancy and birth, as well as postpartum. She has served hundreds
of mothers through their prenatal journey. Products include Nurturing the Mother Pregnancy Massage
VHS & DVD, Fertility Massage DVD, Postpartum Massage DVD and Nurturing the Pregnant Couple
DVD all available for purchase.
NEW Nurturing the Mother® is available as a home study course in January 2006, it is pending
NCBTMB approval. New 7 CE class is Fertility Massage Intensive.
2008 LOCATION SITES: March—Concord, NC; Omaha, NE; April—Baltimore, MD.
Hello, we are Cortiva, a family of massage therapy schools dedicated to preparing passionate people
for successful careers. We have over 200 years of collective massage therapy education experience.
Our expertise reflects a practical understanding of theoretical concepts and the importance of healing
therapeutic relationships.
To prepare for a therapeutic massage career, visit www.cortiva.com or call 866-cortiva.
Advance continuing education also available.
Denver, CO • Tampa, FL • Chicago, IL • Boston, MA • Piscataway, Wall Township, NJ • Philadelphia,
PA • Seattle (2 locations), WA • Tucson and Scottsdale, AZ.
New Feldenkrais Training Programs
San Francisco Bay Area • New York City • San Diego • Washington • Baltimore
We are pleased to announce four new fully-accredited Feldenkrais Method Training Programs on both the
East Coast and the West Coast. Our San Francisco Bay Area, New York City, and Washington/Baltimore
trainings meet in a convenient weekend format and our San Diego program meets four times per year. The
program directors are David Zemach-Bersin on the East Coast and Elizabeth Beringer in San Diego. They
are both original students of Dr. Feldenkrais.
Highly recommended by Dr. Andrew Weil, the Feldenkrais Method® is a unique and sophisticated approach
to human understanding, learning and change, internationally acclaimed for its remarkable ability to improve
many areas of human functioning. Join a growing interdisciplinary profession at the leading edge of the
somatic field. You will learn both applications of the Feldenkrais Method: Awareness Through Movement®
and the hands-on approach of Functional Integration®, and develop the skills to work with restricted movement
and poor posture, chronic tension and pain, psychological, neurological, and developmental problems,
performing artists, athletes, and everyone wishing to move more comfortably. Feldenkrais Resources is also
the publisher of Dr. Feldenkrais’ audio- and video-tape programs.
Call for more information or for a free catalog of books, audio, and video programs on the Feldenkrais
Method and the entire somatic field.
visit abmp.com for a calendar of ceu listings 153
spotlight on education
BY REBECCA JONES
MALINDA PATCH-GRAY
Time after time, Malinda Patch-
Gray, a part-time massage therapist
in Indianola, Iowa, saw the ad for a
series of continuing education classes
in oncology massage, and time after
time, she talked herself out of it.
“Too far away,” she thought, noting
that the classes were taught in New
Mexico and the hospital practica were in
Arizona, Oregon, or Ohio. “Too much
money,” she thought, calculating the
more than $4,000 just in tuition that it
would cost to take the complete series
of classes, not to mention travel costs.
“Too much commitment,” she thought,
thinking of the three hundred hours of
work it would take to become certified.
But finally, she relented just enough
to call the Peregrine Institute of
Oncology Massage Training in Santa
Fe and ask for more information.
“That’s when I realized that Gayle
McDonald was one of the instructors,”
Patch-Gray says. “I’ve had her book,
Medicine Hands, for probably ten years.”
Assured that taking the three-
day introductory class, Massage
for People Living With Cancer,
required no further commitment if
she decided the whole series was not
for her, Patch-Gray took the leap. She
loved it. And a short time later, she
took a second class. Then a third.
Today, with five classes completed,
she is two classes short of completing
the entire series. More importantly,
she is no longer a part-time massage
therapist, scheduling a few clients in the
evenings, and relying on a daytime job
as a corporate trainer to pay her bills.
154 massage & bodywork january/february 2008
She gained so much assurance
through the oncology massage
coursework, and became so convinced
that this is what she wants to do with
her life, she left her corporate job in
Des Moines at the end of September.
She’s going to devote herself full time
to her massage practice and hopes
to introduce a massage program
for cancer patients into her local
hospital as well as providing massage
in the homes of hospice patients.
“It’s scary to step away from a good
paycheck,” says Patch-Gray, forty-two.
“But I used to think there were a lot
of things I needed to have a good life.
Now I can see that many of the things
I thought were needs were really just
wants. This sounds corny, but this has
made me a softer, gentler person.”
She acknowledges that her husband,
Roger Gray, was reluctant to see her
leave the security of her job. “So I started
having him make the bank deposits, so
he could see the checks I was getting
for my massage work, could see that
it is financially viable to be a massage
therapist,” she says with a laugh.
Patch-Gray says she has always
had a bent for medical-type things.
When she first got into massage
therapy fourteen years ago, she never
envisioned herself giving massages to
wealthy patrons at a spa. She’d much
rather be in a hospital setting.
She recalls with great tenderness
the first cancer patient to whom she
gave a massage. He was in the bone
marrow transplant unit at Oregon
Health Science University in Portland,
and he was a very sick man.
“I had to glove up and gown just to
go into his room,” she recalls. “I went
in and said, ‘This is what I’m about’
and ‘Would you be interested?’ And he
said, ‘I don’t feel very good today.’ So I
suggested maybe we’d just start with a
foot massage, and anytime he wanted
me to stop I would. He let me work the
whole forty-five minutes—he even fell
asleep in the middle of it. Then he asked
if I could come back the next day. And I
thought then that this is beautiful work.”
Many massage therapists have long
been taught not to give massage to cancer
patients, for fear that it might somehow
dislodge cancer cells and cause them to
spread. In fact, Patch-Gray says, that
won’t happen, but massaging a cancer
patient can still be risky. An improperly
given massage can leave bruises on
a patient’s skin or can leave him/her
feeling rotten, with flu-like symptoms.
“A cancer patient has an altered sense
of pain or touch,” she says. “Many may
have neuropathy because of the harsh
drugs in their system. Or their radiation
treatment may leave burn scars. It may
not register to them that something is
painful. Or it could be that everything
hurts, even the slightest amount of
pressure. They don’t want covers on,
they don’t want shoes on, and they can’t
stand to think of anyone touching them.”
Yet she believes that massage
can also help in a patient’s healing.
That’s why she is going to lobby to
start a massage program for cancer
patients in her local hospital.
 “I guess the biggest obstacle I will
have is not being a part of the formal
medical community,” she says. “What I
need is a champion within the medical
community to tell the medical board
that this would be a great thing to
provide for our patients.” She believes
this is more than just a way to earn
a living. She sees it as a calling.
In one of her reflection papers,
written for class, Patch-Gray spoke of
just this notion. She recalled coming
upon a book, Callings—Finding
and Following an Authentic Life by
Gregg Michael Levoy, which helped
crystallize her thinking on this.
The first page she opened to had this “For me, this work feels like coming
quote: “Calls are essentially questions. home,” Patch-Gray reflects. “It is very
They aren’t questions you necessarily centering for me, and in spite of my
need to answer outright; they are preconceived notions of the hospital
questions to which you need to respond, environment, I love that work best.”
expose yourself, and kneel before. You
don’t want an answer you can put in a box Rebecca Jones is a Denver-based freelance
and set on a shelf. You want a question writer who embraces life and a myriad of topics.
that will become a chariot to carry Contact her at killarneyrose@comcast.net.
you across the breadth of your life. A
question that will offer you a lifetime of
pondering, that will lead you toward what
you need to know for your integrity, draw
to you what you need for your journey,
and help you understand what it means
to burst at the seams. Those questions
will also lead you to others whose lives
are propelled by the same questions,
and from them, you will receive, ‘Oh,
never an answer,’ as writer P. L. Travers
says, ‘but a spark of instructive fire.’”
visit abmp.com for a calendar of ceu listings 155
EDUCATION RESOURCE LISTING
Continuing Education Program
GREEN RIVER DANCE FOR
GLOBAL SOMATICS
Twin Cities, Minnesota and
Grand Marais, Michigan
Tel: 651-257-8697
E-mail: dance@globalsomatics.com
Website: www.globalsomatics.com
INSTITUTE FOR
HEALTH & HEALING
Tel: 415-600-5751
E-mail: Taguec@Sutterhealth.org
Website: www.myhealthandhealing.org
INSTITUTE FOR INTEGRATIVE
HEALTHCARE STUDIES
PO Box 1783, Pine Bush, NY 12566-1783
Toll-free: 800-364-5722
E-mail: info@homestudycredits.com
Website: www.homestudycredits.org
INSTITUTE OF SOMATIC THERAPY
Box 520, Springville, CA 93265
Toll-free: 866-328-9703
Tel: 559-539-3851; Fax: 559-539-3871
Website: www.massagecredits.com/mb
156 massage & bodywork january/february 2008
State-Approved Massage Therapy Program Both
Green River Dance for Global Somatics (GRDGS) is a health resource center known for innovative
continuing education, professional trainings, research, and therapeutic services. Founded in 1982 by
Suzanne River, developer of the Global Somatics™ Process, GRDGS is the only Midwest somatic
school providing a comprehensive curriculum in experiential anatomy, developmental movement, and
embodiment of the energy field.
Offerings:
Private sessions, single class, day/weekend intros, week/seasonal courses
Curriculum:
• Body Systems: Fluids, Skeletal, Organ, Ligament, Endocrine, Muscle, Nervous, Cellular, Energy
• Body Processes: Senses, Breath, Voice
• Developmental Movement: Pre-Vertebrate, Vertebrate, Reflexes
• Additional Offerings: Body-Mind Centering® Courses, Inside-Out Asana™
Trainings:
The Global Somatics Practitioner Training (GSPT) 1,400 hours, 15-month, or 20-month offered each fall.
• Affiliations: ISMETA, ABMP, BMCA, MOHE
• Financial Aid for those who qualify
Institute for Health & Healing Integrative Medicine Education Program at California Pacific
Medical Center. First hospital based training program in the U.S. designed for licensed massage
therapists who wish to expand their whole-person philosophy and approach into a clinical practice.
Program combines supervised clinical training, hands on experience with patients and education.
Building on your expertise as a practitioner, we teach three domains of focus so that your unique healing
abilities are embodied in patient care. Developing these skills and insights enables you to participate
in a multidisciplinary team of health professionals. Curriculum includes comfort and care, massage,
professional development, and a health care team approach. 120- or 500-hour commitment required.
Programs start September 2008. Applications accepted from January. Call Carolyn Tague, 415-600-
5751. www.myhealthandhealing.org.
BUILD your practice, ENHANCE your skills, IMPROVE your session results with convenient,
affordable CE programs.
Expert instruction delivered to your doorstep or online to your computer. Affordable tuition includes
everything you need: course materials, test and Certificate, plus toll-free student advisory support at no
extra charge. For more flexibility, ease and convenience, you can get your certificate instantly with each
of our 35+ continuing education programs, if you choose.
The Institute has been approved by the NCBTMB and the Florida Board of Massage as a CE Approved
Provider. Our credits are also accepted by the AMTA, ABMP and most state boards. With over 57,000
enrollments since 1996, we can help you meet your requirements, too.
Take the pain out of continuing education. Why miss work, pay travel expenses and expensive
tuition when you can study at home in your spare time for less?
If you value immediate shipping, fast processing of transcripts, no arbitrary completion deadlines, and
unlimited phone or email support, call for our catalog or visit us online. Ask about current special and
our free ethics offer. Mention this ad, and we’ll send you three business building articles absolutely free,
with no obligation.
Institute of Somatic Therapy is approved by the NCBTMB as a Continuing Education Approved
Provider (280672-00), and by Florida (MCE-326). Our CEs are accepted by ABMP, AMTA, and most
states. For a list of our courses, see our full page ad on page 69.
 PACIFIC COLLEGE OF
ORIENTAL MEDICINE
Website: www.PacificCollege.edu
San Diego: 7445 Mission Valley Rd.
Ste. 105, San Diego, CA 92108
Toll-free: 800-729-0941
Chicago: 3646 N. Broadway, 2nd Floor
Chicago, IL 60613; Toll-free: 888-729-4811
New York: 915 Broadway, 2nd Floor
New York, NY 10010; Toll-free: 800-729-3468
UPLEDGER INSTITUTE, INC®
11211 Prosperity Farms Road, D-325
Palm Beach Gardens, FL 33410-3487
Toll-free: 800-233-5880; Fax: 561-622-4771
E-mail: upledger@upledger.com
Website: www.upledger.com
ZERO BALANCING HEALTH
ASSOCIATION
8640 Guilford Road, Suite 240
Columbia, MD 21046
Tel: 410-381-8956; Fax: 410-381-9634
E-mail: zbaoffice@zerobalancing.com
Website: www.zerobalancing.com
CALIFORNIA
HEARTWOOD INSTITUTE
220 Harmony Lane, Garberville, CA 95542
Toll-free: 877-936-9663
E-mail: hello@heartwoodinstitute.com
Website: www.heartwoodinstitute.com
We teach medicine that’s good for the practitioner and the patient.
If you are looking for a new career, follow an old path—Traditional Chinese Medicine. Pacific College is
one of the nation’s leaders.
Pacific College offers:
• Accredited Master’s degree programs in Acupuncture & Oriental Medicine
• Bachelors and Associate degree programs
• A Doctorate of Acupuncture and Oriental Medicine
• Flexible class schedules
• Massage and Asian Bodywork Certificate programs
• Financial aid for those who qualify
Integrate Body, Mind, and Spirit on a higher level…Study acupuncture or massage with Pacific College.
The Upledger Institute is recognized worldwide for groundbreaking continuing education programs
and therapeutic services. Founded in 1985 by John E. Upledger, DO, OMM, developer of CranioSacral
Therapy, the Institute conducts hundreds of workshops each year educating healthcare practitioners
of all disciplines in CranioSacral Therapy and other progressive therapies including Lymph Drainage
Therapy and Healing From the Core.
CranioSacral Therapy has proven effective in aiding individuals with a wide range of medical
challenges, including:
• Migraines • Central nervous system disorders
• Neck and back pain • Autism
• Fibromyalgia • Post-traumatic stress disorder
The Zero Balancing Health Association offers a certification program for massage therapists and other
health professionals in this modality that aligns body energy and body structure. Zero Balancing (ZB)
was developed by Fritz Smith, M.D., and has roots in osteopathy, acupuncture, rolfing, and meditation.
ZB integrates fundamental principles of Western medicine with Eastern concepts of energy. ZB
provides clients the possibility of health and healing at the deepest level of energy flow in the body—the
skeletal system. By working with bone energy, ZB corrects imbalances providing relief from pain,
anxiety, and stress while facilitating a profound experience of wellness and integration.
Continuing education and certification classes offered nationwide. Certification can be self-paced or
taken in a pre-scheduled, group-oriented format. Approved CEU Provider for NCBTMB, NCCAOM,
California Nurses, Illinois Physical Therapists, Florida Massage Therapists.
Heartwood Institute is one of the most successful and longest running experiments in alternative
education in the world. For more than 25 years it has been the only residential school of its kind. The
retreat-like setting, the nurturing organic food, the healing community environment, and our commitment
to excellence create what our students report is the most meaningful experience of their lives.
Accredited Programs
Holistic Health Practitioner: 12 months—1,035 hours
Massage Therapist: 9 months—805 hours
Asian Healing Arts and Whole Foods Nutrition: 9 months—810 hours
Massage and Bodywork Therapist: Certification through Intensives, externship, and tutorials
—585 hours
Continuing Education Intensives
Heartwood also has an extensive calendar of intensives for bodyworkers seeking to expand their
existing practice with the newest techniques. Subjects include: Cranial Sacral Therapy, Polarity
Therapy, Shiatsu, Hot Stone Massage, and much more.
For more information call us toll free at 877-936-9663 or visit us online at www.heartwoodinstitute.com.
visit abmp.com for a calendar of ceu listings 157
EDUCATION RESOURCE LISTING
Continuing Education Program
INSTITUTE OF PSYCHO-
STRUCTURAL BALANCING
5817 Uplander Way, Culver City, CA 90230
Tel: 310-342-7130; Fax: 310-342-7135
E-mail: massage@ipsb.com
Website: www.ipsb.com
NOVATO INSTITUTE FOR SOMATIC
RESEARCH AND TRAINING
1516 Grant Avenue, #212, Novato, CA 94945
Tel: 415-892-0617; Fax: 415-892-4388
E-mail: info@somaticsed.com
Website: www.somaticsed.com
SCHOOL OF SHIATSU & MASSAGE
Box 889, Middletown, CA 95461
Toll-free: 800-693-3296; Tel: 707-987-3801
E-mail: info@waba.edu
Website: www.watsucenter.com
COLORADO
AGUA ALMA—AQUATIC
BODYWORK TRAINING
612 Alpine Avenue, Boulder, CO 80304
Tel: 303-440-0973
Website: www.aguaalma.com
158 massage & bodywork january/february 2008
State-Approved Massage Therapy Program Both
IPSB has established its impeccable 26-year reputation as Southern California’s premium school for
teaching the art of creating sensitive, self-aware bodyworkers. We are innovators of holistic techniques
through the mastery of artful movement, sensory awareness, and body psychology. Our wellrounded
approach focuses on the whole person, recognizing that touching the body touches the soul. We
incorporate the practice of Tai Chi for a more powerful experience for the client and a stress-free,
energizing, and low risk experience for the practitioner.
Flexible class hours are offered in both our 150-hour Massage Technician and 550-hour Massage
Therapist programs.
Our specialties include:
*Deep Tissue *Pregnancy *Craniosacral *Sports *Sensory Repatterning *Polarity *Thai *Reflexology
*and much, much more.
Why wait? Contact us today to change your life and the world one body at a time.
The Novato Institute offers the original 3-year Hanna Somatic Education® (HSE) Training Program,
workshops in Somatic Exercises™, Somatic Yoga, Equine Hanna Somatics®, training, and private sessions
in somatic bodywork and biofeedback with Eleanor Criswell-Hanna, Ed.D. The Institute publishes
Somatics: Magazine-Journal of the Mind/Body Arts & Sciences (semi-annual; premier issue Fall 1976),
and offers a wide variety of resources for the layperson and professional: Somatic Exercises™, CDs/
audiotapes, DVDs/videos, books, teacher’s kits for Somatic Exercises™ and Somatic Yoga, and a full
library of Somatics Magazine back issues. Please see website for complete catalog and Hanna Somatic
Education® training prospectus.
“Help Yourself to Good Health”
Recognized as one of the world’s premier learning institutes for aquatic and land-based healing arts,
the School of Shiatsu & Massage offers programs designed to integrate personal growth and a strong
foundation in technique. Choose from weekend classes, week long intensives, certification, and
residential programs. We offer aquatic certifications in Watsu®, Waterdance, and Healing Dance. Land
programs include Shiatsu, Therapeutic Massage, Deep Tissue, Craniosacral, Reflexology, Lymphatic,
Lomi Lomi, Thai, and more. Licensed by California BPPVE; approved Continuing Education Provider
by NCBTMB and Board of Registered Nursing.
Whether you are just beginning massage training or wish to enhance your existing practice, you’ll be
impressed with our comprehensive curriculum, professional staff, and breathtaking campus north of the
Napa wine region. Visit us online or call for a free catalog.
Colorado State Certified, NCBTMB CEU approved via Healing Spirits Massage School.
Deep communion with water is the basis of Agua Alma, aquatic bodywork.
A fusion of in-depth aquatic bodywork, Aston-Patterning, and deep ecology, Agua Alma weaves together
support for both personal and planetary healing. Four cornerstone sessions further positive relations with
Self, the Elements, and the Web of Life:
• Water~West for Calming and addressing Trauma
• Earth~North for Centering and sensing Purpose
• Air~East for Structural Balance
• Fire~South for Play and Creativity
This training prepares the practitioner to provide quality aquatic bodywork grounded in the Aston-
Patterning movement principles of fluid dynamics applied to biomechanics. A beautiful healing retreat and
an opportunity to deepen one’s bond with Nature and the collaborative potential within Nature’s healing
forces for both clinical application and personal growth.
 BOULDER COLLEGE OF
MASSAGE THERAPY
6255 Longbow Drive, Boulder, CO 80301
Toll-free: 800-442-5131; Tel: 303-530-2100
E-mail: info@bcmt.org
Website: www.bcmt.org
COLORADO SCHOOL
OF HEALING ARTS
7655 West Mississippi, Suite 100
Lakewood, CO 80226
Toll-free: 800-233-7114; Tel: 303-986-2320
Fax: 303-980-6594
Website: www.csha.net
CONNECTICUT
CONNECTICUT CENTER
FOR MASSAGE THERAPY
Newington, CT (Main Campus)
Toll-free: 877-282-2268
Groton, CT (Branch Campus)
Toll-free: 877-295-2268
Westport, CT (Branch Campus)
Toll-free: 877-292-2268
E-mail: info-newington@ccmt.edu
Website: www.ccmt.edu
HAWAII
SPA LUNA HOLISTIC SCHOOL
810 Haiku Road, Suite 209, Haiku, HI 96708
Toll-free: 800-347-6449; Tel: 808-575-9267
Fax: 808-575-5440
E-mail: school@spaluna.com
Website: www.spaluna.com
CELEBRATING OVER 30 YEARS OF EXCELLENCE
BCMT has maintained a reputation for excellence since it was founded in 1975. Our comprehensive
programs not only focus on academic rigor but the profound process of personal growth. The program
combines advanced coursework in anatomy and physiology with progressive bodywork techniques,
allowing for a more field-focused approach to massage therapy. Through our continuing education
program, students can explore new areas, expand their techniques, and gain specialized certifications.
Programs: 1000-Hour Massage Therapy Certificate Program • Associate of Occupational Studies in Massage
Therapy Degree Program • Continuing Education • Advanced Certificates in Zen Shiatsu, Prenatal-Labor-
Postpartum Massage, Canine Massage, Spa Elements, Energy Healing, Orthopedic, and Sport Massage.
BCMT is accredited by the Accrediting Commission of Career Schools and Colleges of Technology.
Financial aid is available to those who qualify.
For more information, please visit www.bcmt.org or call 800-442-5131.
“A Legacy in Education”
The Colorado School of Healing Arts (CSHA) celebrates 21 years of Educational Excellence! The
school emphasizes community and views the field of massage therapy as a service to humanity. CSHA is
accredited by the Accrediting Commission of Career Schools and Colleges of Technology (ACCSCT).
The 700-hour program is offered in 6, 12, 15, and 18-month schedules. The 700-hour program transfers into
the 1,000-hour Massage Therapy Program and/or the AOS Degree in Massage Therapy.
• AOS Degree Massage Therapy • 270-hour Oncology Massage Program
• 1,000-hour Massage Therapy Program • 100-hour Trauma Touch Therapy Program™
• 700-hour Massage Therapy Program • 224-hour Reflexology Program
• 300-hour Spa Arts & Sciences Program • 110-hour Sports Massage Program
• 110-hour Lymphatic Drainage Program • Financial Aid Available for those who qualify
• 524-hour Cranial Sacral Therapy Program • Daytime/evening flexible scheduling
• 300-hour Neuromuscular Massage Program
Approved and regulated by the Colorado Department of Higher Education, Division of Private
Occupational Schools. Call or write today for your free catalog.
Connecticut Center for Massage Therapy is dedicated exclusively to providing massage therapy
training since 1980. CCMT’s comprehensive approach integrates technique, science, and business with
extensive hands-on practice. The school’s focus on mind-body-heart empowers students to make a
healthy difference in the lives of the people they touch.
• Flexible full and part-time schedules
• Financial aid available to those who qualify
• Selected courses approved for college credit at Charter Oak State College
• Supportive guidance every step of the way in a collaborative work environment
• Accredited by the Commission on Massage Therapy Accreditation
• Lifetime support for graduates including placement assistance, job postings, and continuing education
seminars
• Experienced, dedicated faculty
For more information visit www.ccmt.edu.
Spa Luna’s mission is to instill in our students the qualities of professionalism, integrity, and
competence, and to facilitate an inspiring, creative, and fun learning experience.
At Spa Luna you will not only learn and practice the therapeutic art of massage therapy, you will also
create a circle of mentors and friends, interact with challenging situations, establish healthy boundaries,
and deepen your relationship with yourself and others.
Located in beautiful upcountry Maui, Spa Luna Holistic School is known throughout the Hawaiian
Islands as being no ka oi (The best)!
700-hour Full- and Part-Time Massage Therapy Programs, 600-hour Full- and Part-Time Esthetician
Programs, as well as continuing education and workshops.
Contact us for more program information and assistance with FINANCIAL AID.
visit abmp.com for a calendar of ceu listings 159
ILLINOIS
ZEN SHIATSU CHICAGO Zen Shiatsu is a bodywork style incorporating Japanese Medicine, Anatomy & Physiology, Zen
825A Chicago Avenue, Evanston, IL 60202 quietude, and dance-like improvisation into a graceful healing art.
Tel: 847-864-1130 Shiatsu Certification: Our 625-hour program qualifies students as Certified Practitioners of Asian
Website: www.zenshiatsuchicago.org Bodywork through the American Organization for Bodywork Therapies of Asia. A 380-hour fast-track
program is available for Massage Therapists.
Continuing Education: Short CE workshops are available, and the entire 380-hour program counts for
CE credit.
Financial Aid: Student loans, payment plans, and workstudy are available for vocational training and
continuing education.

MASSACHUSETTS
BANCROFT SCHOOL OF Since 1950, Bancroft School of Massage Therapy has had uncompromising dedication to training
MASSAGE THERAPY individuals to become professional massage therapists. Our diploma program is a well-planned
333 Shrewsbury Street, Worcester, MA 01604 series of courses that allows our graduates to enjoy a high rate of employment. The program can be
Tel: 508-757-7923; Fax: 508-791-5930 completed in 9, 13, or 17 months with classes starting in January, May, and September. It is approved by
Website: www.bancroftsmt.com the Massachusetts Board of Regents of Higher Education for the training of veterans, and the school is
authorized under federal law to enroll nonimmigrant alien students.
Bancroft is accredited by ACCSCT and is licensed by the Department of Education, Commonwealth
of Massachusetts.
Financial aid available for those who qualify; graduates receive job placement assistance.

NEW MEXICO
NEW MEXICO SCHOOL OF With our reputation as one of the most comprehensive courses of natural therapeutics in the U.S.,
NATURAL THERAPEUTICS the New Mexico School of Natural Therapeutics has been graduating highly-skilled and well-trained
202 Morningside Drive Southeast, Albuquerque, professionals in the field of massage and holistic health since 1974.
NM 87108; Toll-free: 800-654-1675 Our 800-hour course is unique in the broad range of alternative therapies offered. Our program
Tel: 505-268-6870; Fax: 505-268-0818 focuses on Therapeutic Massage and Polarity Therapy, and also includes Shiatsu, Reflexology, Bach
E-mail: nmsnt@nmsnt.org Flowers, Herbology, Body/Mind Counseling Skills, Nutrition, and Philosophy of Nature Cure.
Website: www.nmsnt.org
Six-month courses begin each March and September, our one-year evening program in May, and our
one-year morning program in October. International student visas are available.
Contact us for your free catalog.

SCHERER INSTITUTE OF It is an honor to touch another human being.

NATURAL HEALING
Box 5737, Santa Fe, NM 87502-5737
Toll-free: 866-505-2006; Tel: 505-982-8398
Fax: 505-982-1825
E-mail: tsinh@cybermesa.com
Website: www.schererinstitute.org
The Scherer Institute has been a leader in bodywork education since 1979. Students from all over
the world come to learn the sacred art as well as the science of massage, and gain skills to work in
more traditional Western settings while maintaining the integrity and principles of holistic bodywork
traditions. Full-time, 6-month, 780-hour Massage Certification programs begin in January, May, and
September. A Part-time, 10-month, 680-hour program also begins in September. Financial assistance
is available for students who qualify.
Contact us for dynamic Continuing Education courses as well. We invite you to join us in the beautiful
high desert of Santa Fe, a center of the healing arts. The Scherer Institute is well-known and loved.
Find out why!

NEW YORK
NEW YORK COLLEGE OF
HEALTH PROFESSIONS
6801 Jericho Turnpike, Syosset, NY 11791
Toll-free: 800-9-CAREER (800-922-7337),
Ext. 351; Fax: 516-364-0989
E-mail: admissions@nycollege.edu
Website: www.nycollege.edu
Career Satisfaction for Life—Become a Licensed Professional in Holistic Health Care
New York College has been a leader in holistic education for more than 25 years. It was the first
Massage School approved by the New York State Education Department to give college degrees in
Massage Therapy, an Associate Degree, and now also offers a Bachelor degree in Advanced Asian
Bodywork for those who wish to continue their studies. Our graduates consistently have high pass rates
on the State licensing exam. New York College’s Acupuncture and Oriental Medicine programs were
also the first such programs approved in the state. They are ACAOM accredited and award combined
Bachelor/Master degrees. Financial aid is available to qualified applicants. The College offers CE
courses in many modalities and is conveniently located on Long Island, outside of New York City.

160 massage & bodywork january/february 2008


Continuing Education Program
SWEDISH INSTITUTE
College of Health Sciences
226 West 26th Street, New York, NY 10001
Tel: 212-924-5900
Website: www.swedishinstitute.edu
NORTH CAROLINA
BODY THERAPY INSTITUTE
300 Southwind Road, Siler City, NC 27344
Toll-free: 888-500-4500
Website: www.massage.net
OREGON
OREGON SCHOOL OF MASSAGE
Portland Campus: 9500 SW Barbur
Boulevard #100, Portland, OR 97219
Toll-free: 800-844-3420; Tel: 503-244-3420
Salem Campus: 2111 Front Street NE,
Salem, OR 97301
Toll-free: 877-588-8912; Tel: 503-585-8912
Website: www.oregonschoolofmassage.com
PENNSYLVANIA
GOLDEN LIGHT PRANIC HEALING®
& MEDITATION CENTER
19 North Centre Street, Merchantville, NJ 08109
Toll-free: 866-200-9038; Tel: 856-216-7531
E-mail: PranicHealing@comcast.net
Website: www.PranicHealingCenter.com
EDUCATION RESOURCE LISTING
State-Approved Massage Therapy Program Both
Students at the Swedish Institute come from all walks of life. What they have in common is a
creative approach to living and a desire to find meaningful work that involves helping people. We
offer a Massage Therapy Program that provides an Associate in Occupational Studies degree, an
Acupuncture Program that offers a Master of Science degree, and an Advanced Personal Training
Program. We also have extensive Continuing Education classes. We are located in Manhattan, a
stimulating center for learning, dreaming, and living. For Open House dates, check our website or call
an Admissions Advisor at ext. 125.
Learning that Changes Lives
Located in the heart of the North Carolina Piedmont, BTI is one of the leading massage therapy
schools in the country. Our beautiful 150-acre campus at South Wind Farm is the place where you can
realize your goals and dreams!
BTI’s 650-hour Massage Therapy Diploma Program is based in an approach which supports healing
and integration of the whole person. Student loans are available.
Our schedule of continuing education workshops and advanced training programs features many of the top
professionals in our field. BTI is accredited by the Commission on Massage Therapy Accreditation, state approved
by the North Carolina and Florida boards, and is an NCBTMB Approved Continuing Education Provider.
The school is located halfway between the Atlantic Ocean and the Blue Ridge Mountains in an area
with abundant educational, cultural, and natural resources.
Our 555-hour Western and Eastern certificate programs prepare students for Oregon, Washington
and National licensure, integrating personal as well as professional growth. Our highly competent,
professional instructors support and challenge students. Training includes a learning retreat at
Breitenbush Hot Springs. Classes begin quarterly in both Portland and Salem; next terms begin
January 7th and March 31st. Daytime or evening classes and payment options are available. OSM
offers a wide variety of Continuing Education classes: Aromatherapy, Craniosacral, Deep Tissue,
Hospital, Lymph Drainage, Nutrition, Reiki, Side-Lying and more.
Upcoming dates: Ortho-Bionomy® Posture Work (1/25); Revitalizing with Polarity Therapy (1/26-27);
Universal Reflexology (1/27); Myofascial Trigger Point Therapy (2/9-10); Shamanism Today (3/14-16).
Visit www.oregonschoolofmassage.com for a complete list of classes.
The GOLDEN LIGHT Pranic Healing & Meditation Center is a premier provider of Pranic Healing®
education and clinic in New Jersey, Pennsylvania, and Delaware. The flexible convenient weekend
classes are taught by certified instructors, authorized representatives of grandmaster Choa Kok Sui,
the founder of Pranic Healing.
Learn Pranic Healing®, a fast-growing modern no-touch Energy medicine that already gained
tremendous popularity in over 90 countries in 20 years. Techniques and methodology of Pranic
Healing® are the direct results of a comprehensive contemporary research of the most established
ancient traditions and modern modalities.
Pranic Healing® is taught to general public as well as massage therapists, acupuncturists, chiropractors,
psychotherapists, doctors, nurses and many others in the healing field. It enables our graduates to
expedite the healing process, protect themselves against the energetic contamination and draining
connections, achieve higher degree of fulfillment.
Workshops: Pranic Healing Course, Advanced Pranic Healing, Pranic Psychotherapy, Psychic Self-
Defense for Home and Office, Crystal Healing.
The GOLDEN LIGHT Center has been approved by the NCBTMB as a CE Approved Provider.
visit abmp.com for a calendar of ceu listings 161
classifieds
A LISTING OF PROFESSIONAL PRODUCTS AND SERVICES
Contact Angie Parris-Raney at 800-458-2267, ext. 641, or angie@abmp.com for more information.

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including 2-Day PetMassage WaterWork* also accepted by the AMTA, ABMP and most
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166 massage & bodywork january/february 2008

 ad index
NEED IT? FIND IT HERE

ABMP . . . . . . . . . . . . . . . . . . . . . . . 22, 104
Academy of Lymphatic Studies . . . . . . 47
Aesthetic Video Source . . . . . . . . . . . 165
Agua Alma . . . . . . . . . . . . . . . . . . . . . . . . . 158
Alignment Technique . . . . . . . . . . . . . . 97
Arvigo Institute . . . . . . . . . . . . . . . . . . . . . 150
Ashiatsu Bar Therapy . . . . . . . . . . . . . . 97
At Peace Media . . . . . . . . . . . . . . . . . . . 27
Aura Cacia . . . . . . . . . . . . . . . . . . . . . . . . 65
Bancroft School of
Massage Therapy . . . . . . . . . . . . . . . . . 160
Bastyr University . . . . . . . . . . . . . . . . . 95, 151
Bellanina Institute . . . . . . . . . . . . . . . . 108
Benjamin Institute . . . . . . . . . . . . . . . . .124
Bindi Skincare . . . . . . . . . . . . . . . . . . . . 105
Biofreeze/Performance Health . . . .13, 41
Biotone . . . . . . . . . . . . . . . . . . . . . . . .IFC-1
Body Support Systems . . . . . . . . . . . . . .51
Body Therapy Institute . . . . . . . . . . . . 161
Bodywork for the
Childbearing Year . . . . . . . . . . . . . . . . . 152
Boiance . . . . . . . . . . . . . . . . . . . . . . . . . .125
Boulder College of
Massage Therapy . . . . . . . . . . . . . . . . . 159
Bowenwork . . . . . . . . . . . . . . . . . . . . . . . . . 152
Breema Center, The . . . . . . . . . . . . . . 165
CARE International . . . . . . . . . . . . . . . . . 150
Carpe Diem Strategies . . . . . . . . . . . . 164
Cell Charge . . . . . . . . . . . . . . . . . . . 113, 163
Claire Marie Miller
Seminars . . . . . . . . . . . . . . 117, 152, 153
Colorado School of
Healing Arts . . . . . . . . . . . . . .123, 159
Connecticut Center for
Massage Therapy . . . . . . . . . . . . . . . . . 159
Cortiva Institute . . . . . . . . . . . . . .39, 153
Curties-Overzet Publications . . . . . . . .91
Day-Break Geriatric Massage . . . . . . .125
Deep Tissue Massage . . . . . . . . . . . . . . 47
Earthlite Massage Tables . . . . . . . . .7, BC
Elements Therapeutic Massage . . . . . 131
Feldenkrais Resources . . . . . . . . . . . . . . . 153
Fibromyalgia Aware . . . . . . . . . . . . . . . 108
Freedom from Pain Institute . . . . . . . . 89
G-Jo . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Golden Light Pranic Healing . . . . . . . . .161
Got Your Back . . . . . . . . . . . . . . . . . . . . . 9
Green River Dance for
Global Somatics . . . . . . . . . . . . . . . . . . 156
Hands-On Aromatherapy. . . . . . . . . . 108
Harmonious Life Institute . . . . . . . . . . .71
Hawaiian Temple Bodywork . . . . . . . . . 95
Heartwood Institute . . . . . . . . . . . . . . . . . 157
Holistic Alliance, The . . . . . . . . . . . . . . .17
Hughes Henshaw . . . . . . . . . . . . . . . . . 164
Information for People . . . . . . . . . . . . . 95
Innerpeace. . . . . . . . . . . . . . . . . . . . . . . 165
Institute for Health & Healing . . . . . . . . 156
Institute for Integrative
Healthcare . . . . . . . . . . . . . . . .123, 156
Institute of Integrative
Aromatherapy . . . . . . . . . . . . . . . . . . . . 150
Institute of Psycho–Structural
Balancing . . . . . . . . . . . . . . . . . . . . . . . . . 158
Institute of Somatic Therapy . . 69, 156
Jeana Naluai . . . . . . . . . . . . . . . . . . 117, 164
Jojoba Co, The . . . . . . . . . . . . . . . . . . . IBC
Kinesis/Anatomy Trains . . . . . .141, 150
Lippincott Williams & Wilkins . . . . . . . 67
Massage & Bodywork . . . . . . . . . . . . . 166
Massage Marketing . . . . . . . . . . . . . . . 165
Massage Online Professor . . . . . . . . . 166
Massage Publications . . . . . . . . . . . . . . 27
Massage Review
Publications . . . . . . . . . . . . . .35, 163-166
Massage Supply . . . . . . . . . . . . . . . . . . . 47
Massage Therapy Foundation . . . . . . . 117
Massagetherapy.com. . . . . . . . . . . . . . .101
My Receptionist . . . . . . . . . . . . . . . . . . .125
Myofascial Release Seminars . . . . .57, 101
Myokinesthetic System . . . . . . . . . . . . 109
NCBTMB . . . . . . . . . . . . . . . . . . . . . . . . 23
New Mexico School of
Natural Therapeutics . . . . . . . . . . . . . . 160
New York College of
Health Professions . . . . . . . . . . . . . . . . . 160
Novato Institute . . . . . . . . . . . . . . . . . . . . 158
Oakworks . . . . . . . . . . . . . . . . . . . . . . . .2-3
One 8 Publishing . . . . . . . . . . . . . . . . . 166
Oregon School of Massage . . . . . . . . . .161
Pacific College of Oriental
Medicine . . . . . . . . . . . . . . . . . . . . . . . . . 157
Pre- and Perinatal
Massage Therapy . . . . . . . . . . . . . . . . . .151
Push Trainings . . . . . . . . . . . . . . . . . . . . .81
Scherer Institute . . . . . . . . . . . . . . . . . . . . 160
School of Shiatsu & Massage,
Harbin Watsu Ctr . . . . . . . . . . . . . . . . . 158
Serenity Music . . . . . . . . . . . . . . . . . . . . 39
Set-N-Me-Free Aloe Company . . . . . . 73
Sew & Sew . . . . . . . . . . . . . . . . . . . . . . . .163
Society of Ortho-Bionomy . . . . . . . . . . .151
Sombra Cosmetics . . . . . . . . . . . . . .61, 145
Spa Bodywork . . . . . . . . . . . . . . . . . . . . .123
Spa Luna Holistic School . . . . . . . . . . . . 159
Steamy Wonder . . . . . . . . . . . . . . . . . . . 27
Stronglite . . . . . . . . . . . . . . . . . . . . . . . . . 121
Swedish Institute . . . . . . . . . . . . . . . . . . . . .161
Take My Registration . . . . . . . . . . . . . . 72
Tallgrass Publishers . . . . . . . . . . . . . . . 166
Talus Corp . . . . . . . . . . . . . . . . . . . . . . . . 85
Tao Trading . . . . . . . . . . . . . . . . . . . . . . . 79
Thai Bodywork . . . . . . . . . . . . . . . . . . . .123
Trager International . . . . . . . . . . . . . . . . . .151
Universal Companies . . . . . . . . . . .37, 139
Upledger Institute . . . . . . . . . . . .77, 157
WaterColors . . . . . . . . . . . . . . . . . . . . . . 97
Zen Shiatsu Chicago . . . . . . . . . . . . . . . . 160
Zero Balancing . . . . . . . . . . . . . . . . . . . . . 157
EDUCATIONAL RESOURCE SECTION
Both
Continuing Ed Program
State-Approved Massage
Therapy Program

massagetherapy.com—for you and your clients 167

fingertips for the client

MASSAGE THERAPIST OR BODYWORKER: ATTACH YOUR BUSINESS CARD HERE

BY DIANE M. MARTY

THE TRUTH ABOUT STRETCHING

The results are amazing: a long,
lean body, the release of cramps, the
stance and strength of a true athlete.
Even with these benefits, stretching
remains a much neglected activity.
Ann and Chris Frederick, directors
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Stretch to Win Institute in Tempe,
Arizona, have suggestions to make a
few minutes of stretching an effective,
efficient, and enjoyable part of your day.
So, what stretches are right for you?
Find out by downloading a
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tests will lead you to a customized
program. After all, shouldn’t your
stretching routine be as unique as you?
• Test stretches to their fullest arcs The pendulum-like movements
• Prevent overtraining or overuse or amplitudes. Likely you’re less of dynamic stretching become
injuries. Balance your day-to- flexible in one direction. Start and progressively deeper. Activity and
day repetitive motions with end every stretch with the tighter sport specific, these warm-up positions
stretches that work those muscles side for a two-to-one ratio. aid speed and power. An example:
in opposite directions. • Concentrate on elongating competitive swimmers swinging their
Weight lifters who also perform muscles by extending both arms before diving in the water.
hip extensions prevent tight hips ends in opposite directions. Rhythmic bouncing, bobbing, and
by releasing the tension that • Inactive lifestyles guarantee stiffness, kicking characterize ballistic stretching.
causes glute weakness, which soreness, and body asymmetries. Dancers, gymnasts, and martial
could strain the hamstrings. While sitting at a computer, stretching artists all stretch ballistically. People
• Remember that pre- and post- the wrists thwarts ergonomic impacts. outside these physical realms should
exercise stretches have distinct Try simple stretches done during avoid this type of stretch, as experts
characteristics. Before exercising, television time to save your back—or believe the motion causes injuries.
your concentration should be on faster another part of your anatomy.
movements starting with the large • The most common type of Diane M. Marty is a Colorado-
muscle groups. Post-exercise or before stretching, the static variety, based freelance writer who specializes
sleep, static stretches aid recovery. involves placing a muscle or muscle in holistic health topics.
• Stretching should never group in a lengthened position,
hurt—especially in the joints. then maintaining it for a few
Skip that stretch if you become seconds up to several minutes.
more than uncomfortable. You
should only feel mild tension at
the position’s deepest point.

NOTE TO MASSAGE THERAPISTS AND BODYWORKERS: EACH ISSUE OF MASSAGE & BODYWORK CONTAINS A FINGERTIPS FOR THE CLIENT COLUMN TARGETED TO CLIENTS.

FEEL FREE TO COPY THIS PAGE, ATTACH YOUR BUSINESS OR APPOINTMENT CARD, AND SEND IT HOME WITH THEM, COMPLIMENTS OF ASSOCIATED BODYWORK & MASSAGE

PROFESSIONALS. THIS COLUMN IS ALSO AVAILABLE ONLINE AT WWW.MASSAGEANDBODYWORK.COM AS A PRINTABLE FILE.

168 massage & bodywork january/february 2008

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