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Transference

You probably learned in massage school how you will have to deal with other people’s issues and try not to let them effect you. This is something that is easier said than done at times. We come to care deeply for our clients and know so much about their lives, pain and happy times. I think it should be something that we remind ourselves of everyday that we need to be conscious of our clients transference and ours onto them as well. You might give a great massage one day but your client feels like it was lacking. This could be because they are just in a bad mood or pissed off about something their husband or wife had said at breakfast. This would be transference. There is negative transference and there is also positive transference. Lets compare the two.

  • Positive Transference

This would be when a client has special affection or adoration or deference towards us. Clients can feel as if they are small and relatively insignificant and we are large and benevolent. You’ll see this when clients have innocent crushes on you or are in awe of you and think that you are special and wonderful. Which of course you are but hopefully you know what I mean!

  • Negative Transference

We see negative transference in client who mistrust us without good reason, who expect us to hurt or criticize them. Here is an example so you can better understand what I’m trying to say:

You have a new client who is nervous and asking an unusual number of questions about your qualifications. During the bodywork session the client pulls back at the slightest hint of discomfort. Later, they reveal that abuse was part of their childhood.

This may give you the feeling like you did something wrong, but assuming your client was welcomed into the same safe environment that you welcome all of your other clients lets you know that it isn’t about you. Negative transference is no more about us than positive transference. Human nature being what it is, we often see negative transference as the client’s problem, as some kind of character defect, yet we see positive transference as a natural response to our winning personality or exceptional skills.

You can’t always know what your client is thinking or feeling and there is always transference happening, usually both forms at some point during the professional relationship. Or in any relationship honestly. Just be aware that clients are giving extra weight to what we say and do.

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MassageGeeks.com was launched by Willow Myles in August of 2007. This site was created with the intention of creating an environment that help professional massage therapists become better at their trade. By sharing ideas and opinions we can all become better massage therapists, and hopefully improve our businesses while we are at it.
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    Inspiration

    In the everyday structure of our jobs sometimes it’s hard to remember why it is that we do what we do and to be great. We’re human, we get bored especially if we’re not being challenged. There are those days when we don’t want to be challenged and we just want to walk in and go through the motions. Clients of course notice the difference on these days. We need to be able to inspire ourselves for the most part because we cannot count on others to do this for us. Sometimes though, a beautiful surprise walks through the door!

    I had forgotten how much I loved doing prenatal massages until I had one walk through my door. It came as a total surprise and at first, being the control freak that I am, I was miffed at the change in structure that I was going to have to incorporate. While setting up for this session though I noticed myself getting excited about it and the wonderful benefits it brings to both mother and baby. Before I knew it, I was asking if I could exfoliate her before her upgraded 90 minute session so her skin wouldn’t be so itchy from the stretching and with her calm maternal nature she was very open to all of my suggestions. :-)

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    Ooops! I Double Booked!

    One of the most embarrassing things as a professional is looking like you can’t even keep track of your own time.  Overbooking or double booking, not giving yourself enough to either talk with your clients or reset your room… these are all things that happen that can be easily bypassed with the right scheduling attention to detail. Some of us need all the help we can get in these areas.

    I have used my weekly planner and a pencil forever and don’t think it will ever be replaced but for those of us that need a little extra help there are tons of online scheduling service choices out there. Check out Schedapple or MindBodyOnline. You could also use a spa software like Millineum, depending on how big your practice is or what you foresee in your business plan.

    These sorts of online booking agencies or software programs will flag you to let you know when there is a discrepancy or an unforeseen problem.

    Trust me when I say that it is worth getting your scheduling under control and not having to spend any of your precious mental energy on silly things that you can have taken care of for you. Leaving you with the energy you need to give your clients the service they came in for.

    Good luck with your scheduling endeavors!

    Plantar Fasciitis

    One of the more common issues I have found people coming  to Massage Therapists for is Plantar Fasciitis. It is a pretty good indicator that this is the problem If your client complains of significant pain along the bottom (plantar) surface of the foot, especially at the heel when they are putting weight on the foot. The pain subsides when weight is lifted off and is resting. Typical causes of Plantar Fasciitis involve walking, running, things that put repeated stress on the fascia. Also, having high arches predisposes people to this condition.

    Massage Therapy is GREAT for relieving the symptoms while rest is the best cure. Ice Therapy can be used in conjunction with massage to relieve symptoms as well. In the acute stage, ice applications and keeping weight off of the foot are important to reduce inflammation and avoid reinjuring the fascia. Once the inflammation has decreased, cross-fiber friction of the plantar surface of the heel can help reduce the possibility of adhesion formation. As long as it causes no significant pain and the acute inflammation is resolved, passive movement of the foot will have a similar effect and can help increase range of motion. If there is any swelling of the ankle and leg due to inactivity, deep effleurage and lymphatic massage techniques can be used to move the collected fluids away from the foot. Any muscular spasms and myofascial trigger points will benefit from deep effleurage, petrissage and static compression in the muscles. These may especially be found in the tibialis anterior and posterior and peroneus longus muscles, all of which insert onto the plantar surface of the foot. Movement therapy, especially passive stretching and isometric exercise, can help these muscles retain their normal tone during the period of rest required in the treatment of plantar faciitis.

    If you find the problem persists try looking into chronic tendinitis for more information. Please feel free to leave comments, suggestions, or personal techniques that have worked for you and your clients.

    Benefits of Routine Massage - Part 3

    Get ready folks cause now we’re going to discuss the Muscular System, if you didn’t hear it let me tell you that the Muscular System is said in a very godlike voice. Since this is such a HUGE system I am going to break it down like this:

    • Cellular Level
    • Relaxation
    • Joint Mobility and Flexibility
    • Posture

    Let us begin our journey, this is SO much fun! Maybe I’ve just drank too much coffee today! Which makes me think of the urinary system, but wait, let me get back on track. Okay, here goes… onto how massage effects our muscular system on a cellular level!

    Movement is the key to maintaining normal cellular levels. Muscle contraction puts mechanical pressure on the veins and lymphatic vessels, causing fluids to be pushed along and carry away metabolic byproducts. As muscles relax, fresh blood flows into them, bringing nutrients to the area. When you don’t get enough exercise or activity this is thrown out of balance. Over working can also throw you out of balance.

    Massage given immediately after strenuous activity reduces muscle stiffness and soreness. A combination of effleurage and petrissage flushes metabolic wastes, brings oxygen and nutrients to the area, and enhances tissue repair. These things are good to know for sports massage.

    As for Muscle Relaxation, do I need to say anything more? No, but there are reasons that massage is so relaxing, check this out. Using massage to relax hypertonic muscles may be due in part to the stimulation of the parasympathetic nervous system. There may also be a conscious letting go of muscle tension by the higher brain centers as the client assumes a passive state during massage.

    Yates (1990) reasons that massage causes a massive increase in the sensory input to the spinal cord, which results in readjustments in reflex pathways, which leads to spontaneous normalization of imbalances of tonic activity between individual muscles and muscle groups. Residual muscle tension left over from past activity or emotional stress is released as the system balances itself. Thus, muscular relaxation results from the general application of a variety of basic massage techniques such as effleurage, petrissage, friction, tapotement, and vibration.

    Onto Joint Mobility and Flexibility: Flexibility refers to the degree of range of motion in a joint. It is a function of the combined muscular and skeletal systems with some nervous system involvement. Hypertonic muscles, scarring in muscle and connective tissues, myofascial adhesions, trigger points, and general connective tissue thickening and rigidity may all restrict movement at joints. Massage and passive point movements can be used effectively to help maintain joint mobility and normal range of motion by addressing any abnormal conditions found in the soft tissues surrounding the joint.

    Proper body alignment is the combined function of the muscular, skeletal, and nervous systems. Poor posture usually results from a combo of things such as inadequate workstations, injuries, or just poor posture, some of us just slouch… we can’t help it! This leads to imbalances between muscle groups, hypertonic and shortened muscles, fascial adhesions, trigger points, just to name a few. Certain forms of massage focus on improving body alignment.  This typically includes strategies such as relaxing and elongating muscles with massage, lengthening muscles groups with stretching, or breaking of fascial adhesions with myofascial techniques.

    Okay, so… there we have it… any questions? Well, you know how it works! Leave me some comments!

    Geriatric Outreach

    Do you have a grandmother or grandfather that are in pain or general discomfort from lack of mobility? Do you often think that massage would feel great for them but are intimidated by the contraindications that may occur? Here we will discuss some of the things that you should be concerned about and the things that you should know in order to have a successful massage relationship with the elderly.

    The comfort that massage can bring to someone that is bedridden is proven and wonderful! Just being touched in a safe environment when touch is something that has become few and far between, say at the doctor’s office, can be a major luxury. The effects that are especially relevant to the special needs of those who have been physically inactive or bedridden are general relaxation, improved circulation of blood and lymph, reduced muscular tension, and one of the most important I think is skin stimulation. These are pretty general effects of massage that everyone acquires, what I would like to make clear is that these effects are directly linked to helping alleviate problems with insomnia, digestion, constipation, difficulty in breathing, and skin degeneration, which will help to prevent bed sores.

    If the recipient has a communicable disease, proper precautions and hygiene should be observed. Although potentially awkward, either latex or another type of glove should be worn if necessary for protection. Always use your intuition and sensitivity in determining how to approach each person. Hand and arm massage is a useful approach for getting to know a new patient or client and for nursing home and hospice volunteers to give.

    Working with the elderly and or the terminally ill can be physically & emotionally challenging. It is important to practice conscious self-care to help maintain your own wellbeing.  The actual techniques used with geriatric clients tend to be simple and light and easy on your hands.

    There is a wide range of opportunity available for massage therapists in this particular industry, just make sure to take care of yourself and always keep a safe environment for you and your recipient.

    Benefits of Routine Massage - Part 2

    Next in line are the Skeletal System and Muscular System. I think the Muscular System will be a Part all on it’s own, cause lets face it, it could take awhile! So here I’ll discuss the benefits to the bones, oh how we would just be a pile of mush without them! Not that bones are all that make up the skeletal system, lets not forget about all the associated cartilage, ligaments, and other stabilizing connective tissue structures. In addition to general tissue health promoted by good circulation, massage and related joint movements help maintain good joint function and range of motion. Movement of the joints stimulates production of synovial fluid that keeps joints moving smoothly. I love using joint movement in my sessions and my clients love it too!

    Optimal range of motion is achieved when the bones are in proper alignment and the tissues surrounding the joints are healthy, pliable, and relaxed. Joint flexibility is enhanced with massage and stretching movements, exercise, and proper nutrition. Exercising your muscles also helps to exercise your joints, it makes everything stronger, the ligaments, tendons, everything. I’ll discuss this more in the muscular system post so…

    Our skeletal system takes a big beating during activities and a lack of activity isn’t good either so make sure to tell your clients about all of the good things they are doing for their bones, joints, and associated cartilage by getting a great massage.

    Benefits of Routine Massage - Part 1

    Oh yes, my friends… The routine massage, and how it effects us. Not just good for the body, good for the WHOLE body. The benefits we forget about sometimes because they’re so specific. A LOT of people still think of massage as pampering, I won’t name any names but… westerners… We all know that there are at least 10 different body systems. Well, I’m going to touch today on how massage benefits each system. Please add any in the comments box if you would like!

    I always go through my Systems from the outside in so let’s start with the benefits for the skin or Integumentary System. This system is the primary point of contact between the giver (you) and the receiver (client) during massage. Of course this system isn’t just skin, it is also hair, nails, sebaceous and sweat glands. We have sensory receptors in the skin that detect touch, pressure, pain, and temperature and relay that info to the nervous system. Once of the major effects of pressure to the skin is stimulation of the sensory receptors found here. This stimulation has beneficial effects such as relaxation, pain reduction, and body awareness. Good body awareness enhances a person’s sense of integrity and wholeness, and is important for good mental and emotional health.

    Okay, let’s dig a little deeper and talk about the glands in the skin. In order for them to work properly, skin pores must be free from blockage. As we all know, they very easily get clogged up with dirt, makeup, dried oils and seat, or the accumulation of dead skin cells. Massage helps to exfoliate the skin by the friction and rubbing, this also raises the temperature which gets the oil glands to secrete. Just like going into a steam room or hot tub. And of course, the oil/lotion adds moisture.

    Massage is also great in facilitating the formation of healthy scar tissue on the skin surface following lacerations, surgery incisions, or burns. Applying cross-fiber and with-fiber friction techniques to scars during the remodeling or scar maturation phase helps form strong mobile scars, break adhesions to underlying tissues, and reduce scar thickness.

    Considering this is the first primary point of contact in massage and your clients are already receiving such benefit why isn’t everyone aware? Do your part in spreading massage therapy awareness, leave a comment, tell a friend, write a press release!

    Shiatsu for Expecting Moms

    A woman’s body undergoes many changes and adaptations for the growing fetus. A few good tricks and techniques for helping mom stay comfortable can be quite simple. Here are a few treatments for morning sickness and lower back pain.

    Morning Sickness: The Bladder Channel affords a very balanced treatment in pregnancy: it helps the Kidneys which are the main source of nourishment for baby and also influences all the other Organs. Concentrate on the middle region near the points for Liver, Gall Bladder, Spleen, and Stomach. Then give particular attention to the Pericardium Channel. Point P 6 is good for all sickness. On the Stomach Channel, work on St 36 and St 44. Ending, give steady pressure to Liv 3

    Lower Back: Because of the strain on the mom’s spine and a downward pressure on the pelvis, I have found the Bladder Channel one of the best to work with for relief. Begin by palming on the back and continue all the way down the legs then move to thumbing and repeat. Lean into it and don’t be afraid to use some pressure. Of course always make sure your client is safe and comfortable. These area is also good for varicose veins.

    The only cautions I am going to mention are concerning strong pressure on the Ball Bladder Channel at the top of the shoulders, and points LI 4 and Sp 6. Also, avoid all the Yin Channels on the inside of the lower legs, if you are worried about the possibility of a miscarriage in the early months. Other than this shiatsu is safe during pregnancy.

    Sacro-Lumbar Region

    As you know, working the buttock muscles with your thumbs is oh so tiring. Use of elbows in this region is definitely best. Considering the gluteal muscles are the largest in the body they hold a lot of tension and can be the source of much referred pain all throughout the body, emotions also get stored here.

    The area of the buttocks, hips and pelvis is often affected by stress, poor posture, and a sedentary lifestyle, yet many of us do not recognize the degree to which we accumulate tension here. Tension can produce a misalignment of hips and spine and vise versa.

    Basic emotions, such as anger and hatred, affect this area and find expression in kicking and stamping. Our natural sexuality is expressed in pelvic mobility and a natural swinging of the hips. But we restrain all these for much of the time. There are often insufficient healthy avenues for the expression of such natural feelings, I like to let clients know of a few like engaging in sports, music, and dancing activities with your friends. These are all helpful.

    The sacral squeeze is very nice for opening up the hips. This is done by placing your client face down and leaning gently for support, step over their thighs. Interlace your fingers and lean into each side of the sacrum, squeezing with the heels of both hands. Reinforce the action by bringing your body forward; you may find it more comfortable to support one elbow with your leg. Your client will actually feel it opening up while you are applying the pressure. This is easiest on the floo

    Spinal Cord Injuries

    Spinal cord injuries can cause a bruise, hemorrhage or laceration in the spinal cord. There is often concern about using bodywork under these sorts of circumstances. These damages can result in short- and long-term motor and sensory disability. You certainly want to be clear with the client and with their physician about any contraindications.

    The level of symptoms will differ depending on the level of the trauma.

    • Above C3. A serious spinal cord injury above C3 means that the client will have a respirator to survive and that the diaphragm has lost its ability to function.
    • Above C5. An injury above C5 can result in the lower and upper extremities being paralyzed.
    • Below T1. Below T1 the lower extremities may be paralyzed but movement in the upper extremity is retained.

    Sensory changes and dramatically increased deep tendon reflex responses also occur as a result of spinal cord injury. Bowel and bladder control may be lost, with an increased susceptibility to bladder stones. Increased blood pressure, heightened perspiration levels and headache. If you are dealing with someone confined to a wheelchair or bed for that matter, decubitus ulcers, thrombosis, osteoporosis from lack of weight-bearing exercise, and swelling of the lower extremities from inactivity are also things to be watchful of. Spinal cord injuries usually cause spastic paralysis, in which the involved muscles have highly exaggerated tone. The flexor muscles tend to be more hypertonic that the extensor muscles, so the client with a spinal cord injury may appear to be in a permanently flexed position throughout the body.

    You must always remember when treating a client with a spinal cord injury that the presence of sensory deficits requires caution since a client might not be able to feel when they are experiencing pain. Associated problems such as increased blood pressure, thrombosis, osteoporosis and spastic paralysis should inspire great caution in the therapist because these conditions can contraindicate massage. Decubitus ulcers should not be massaged. Your client will receive spasm relief, edema reduction, range of motion improvement, restoring of motor function, stress reduction, and of course circulation increase.