Archive for Julie Onofrio

Massage and Sleep Disorders

Initial search for research on Massage and Sleep Disorders:

Int J Neurosci. 2001;106(3-4):131-45.

Lower back pain is reduced and range of motion increased after massage therapy. Hernandez-Reif M, Field T, Krasnegor J, Theakston H.

Palliat Med. 2004 Mar;18(2):87-92.

A randomized controlled trial of aromatherapy massage in a hospice setting. Soden K, Vincent K, Craske S, Lucas C, Ashley S.

Effects of massage therapy on sleep quality after coronary artery bypass graft surgery.

Parkinson’s disease symptoms are differentially affected by massage therapy vs. progressive muscle relaxation: a pilot study

Randomised controlled trial of the effectiveness of using foot reflexology to improve quality of sleep amongst Taiwanese postpartum women.

See more on massage and sleep disorders

Why do we need Massage Therapy Research?

Why do we need massage therapy research especially since we as massage therapists already see so much of the proof on a daily basis in the practice of massage?

Research is an important part of the next steps for the massage profession.  The biggest reason is that it can help the massage profession and your massage business gain the respect that is needed by the general public and also the medical profession.  It will also help get massage covered by insurance.  One of the things that Debra Senn (a past insurance commissioner in WA State who made it possible for WA State MT to become contracted providers with insurance) said one of the most interesting things about the process.  She said when insurance companies first heard they were going to have to pay for massage, they complained thinking that it would cost them more money.  They thought they would have to pay $10,000 for the carpal tunnel surgery (or whatever type of surgery and that amount is just for example- how much does a carpal tunnel surgery really cost?)  and then pay a few extra thousand to cover the massage.  They did not understand that massage could eliminate the need for massage.  I still don’t think they really get it as what I see in the way of referrals from most doctors is generally for back and neck pain.  The doctors don’t really understand how massage can be used for various things like musculo-skeletal injuries such as plantar fasciaitis, tennis elbow, sprained ankles, and things like that.  Doctors will relate more to evidence and research that shows how massage can help.  They will also start getting it when more people provide start using massage for just those kind of issues and start giving feedback to the doctors.

One of the other things about research is that it is important to have research that shows what massage does.  Many of the things that are currently being taught in massage school are inaccurate and have just been handed down through classes because that is what they are taught.  There are still many schools saying that massage should not be used on people with cancer which was debunked many years ago. (See massage and cancer)   The other big myth is that of toxins being removed (See Massage and toxins) from the body through massage and also the myth that massage removes lactic acid. (See Lactating Mythers – Massage and the Lactic Acid Myth)   Right now there are many massage therapists that continue to say those things and don’t have the latest research that shows otherwise and having so much misinformation makes massage confusing to the general public.

But having more research is not really enough since most massage therapists are not research literate- that is the don’t understand how to evaluate a research study.  Just because a study was done and shows positive outcomes does not mean that it shows anything unless you can understand it.  Research literacy is needed and it begins with having to read and learn about things that most have no interest in.  Most massage therapists are just happy to be doing massage or are struggling to get clients or find a high paying job.  Who has time for research or learning any more when of course we already know that massage works?

Research Literacy according to Ravensara Traviallian from her article in Massage and Bodywork Magazine in the Research Perspectives column is :

the ability to read, understand, and
apply information from published
research—

Once you are research literate, then you have the opportunity to start influencing research and even creating research studies.

In your massage practice, you will be able to look up research to help you address the needs of your clients when they come in with more difficult diseases and conditions and when you want to know if massage can help them.  When clients ask you how massage works, you will be able to give a knowledgeable answer.  When clients understand more how their bodies work, they have the power to take care of it better.  They also may pass this information on to their doctors- and so it goes.

So please share your comments or insights as to why we do need research and need to also be able to understand research.

 

A Career in Massage – Is it for you?

I just released my first book last month on amazon.com! A Career in Massage – Is it for you? It is something I have been working on for over 10 years really.  It actually started as my first Ebook which I sold on one of my first websites created using Site Build it!  I started selling ebooks a few months after starting the website and now it is a paperback book (kindle and nook coming soon!)

It has felt like basically my life’s work to complete this book.  It is everything that I wish someone had told me about becoming a massage therapist. 

No one ever told me it was going to be this hard!

No one ever told me that it was about building a business!

No one told me that I would get burned out helping and that helping was a sign of something that is going wrong!

What I did want was a more rewarding career- one where I could be making more of a difference and one where I had more freedom.  I got all that but I never thought having freedom would also mean having no money! I of course lived simply (and still do – living in a mother-in-law house on a 5 acre ‘mini’ farm with horses, chickens that I take care of when my landlords are away where I also have a very large garden.)  I could set my own schedule, sleep in, take long lunches which in the early days included a ferry ride to a neighboring island for lunch and I could just get by without many cares.

Then my 40′s hit and the realization that retirement would be impossible at the rate I was going.  I also had some major health issues starting in 1998 which is one of the reasons why I did start this website. (I had severe, debilitating vertigo for about 10 years – gone now -knock, knock, knock.)  Back then it was just more something to do when I was stuck at home feeling sick.  I started writing and putting notes together on everything I wished I had more help with or had known about becoming a massage therapist.  It turned into this website that is basically my massage school notes.

Today it seems even more competitive with the increasing number of massage schools up until about 2007 when the number of schools started leveling out due to the economy.  There are many news sources like US News and World Report saying things like massage is an upcoming career for 2011.  The problem is that most statistics are really inaccurate because of things like most massage therapists are self employed so income and other stats do not count those massage therapists.  Schools take news reports like that and run with it continuing to tell potential massage students that they can make tons of money while having their own schedule and flexible hours.  Well you can get some of that but you won’t have enough money to retire on.

There are so many other things that massage schools are telling potential students that is just inaccurate so that they can make a career in massage sound more appealing:

  • You can make $60 an hour
  • Health insurance is covering massage
  • You will find a high paying job really easily
  • You can work on a cruise ship and travel the world having fun
  • You will be working in this soothing, relaxing environment like all the nice pictures they show at spas and health resorts
  • People love massage and will soon be flocking to your door if you just set up shop
  • You will be helping people

What they don’t tell you is that you will have to touch people! Imagine that!  Yes some massage students don’t realize that.  Touching has a much deeper meaning than most can imagine.  You can find out more in my book of course!

 


A Week of Massage Envy

Everywhere I looked last week, it seemed like someone was talking about Massage Envy (ME)- some good, some not so good as discussions about ME go…

Here is what I am referring too -(These are all from discussions on Facebook or linkedin.com or from newsfeeds.)

  • ME was mentioned in a thread saying that the massage therapists at one location were doing ‘Happy Endings” and the owner was notified and didn’t want to do anything about it.
  • One of the most searched for keywords on my site www.massage-career-guides.com is ‘massage envy sex’.
  • In one area, ME is connected to many companies who offer their employees health incentives or challenges.
  • Many massage therapists feel threatened by ME and feel that they have to reduce their rates to compete with ME and that ME are putting them out of business or at least making them work harder to get clients.  ME is said to be the Walmart of the massage profession.
  • ME is also a good way for massage therapists to get experience.  One long time employee is now going out on her own!

What interests me most about ME is the fear reactions that it brings up in many including myself at times.  Hearing that ME was offering massage to companies too left me wondering what is next – where will they go next?  Will there be only ME around the country offering low cost massage (good for the general public- not so good for employees paid low wages but they get experience.)

So if the general public is also moving towards preferring low cost massage what can the massage profession learn from this and what can be done about it?

The thing is that we don’t have any actual statistics to see what is really going on and how ME (or low cost massage franchises) are affecting the massage profession.  I am not sure if there is even a way to measure that or track that as there are so many other things going on in the profession right now- the Alliance for Massage Schools, the FSTMB, the NCBTMB, more research and teaching MT and medical professionals about research, more advanced training to learn new methods to help clients more, more acceptance by the medical profession and insurance is happening a little each day, moving into hospitals and hospice settings – many things are always changing and happening in the profession.

You can look at the few instances from your own practice and think that Yes ME is having an impact on your business.  Also looking at the list that I started with, it seems like ME is everywhere and into everything.  Will they start doing insurance billing?  ( I did hear that about a year ago but not sure if it happened or not).

Sometimes I also think that the best advice for a person considering massage school is to go to take business classes in college and buy a Massage Envy!  It is half being sarcastic and half truly what I think!

What do you think of ME?  How do you think it affects your practice and what you are doing?  If you work at a ME – what do you think? (There are always such a wide range of answers to that- many love it or many don’t like it.)

 

Massage Price Wars – What’s a massage worth?

Whenever massage therapists start talking about setting prices for their massage business the discussion can get quite interesting.  There is such a wide range of thinking and also a wide range of pricing.

Franchises have set low rates to try to get more clients over everyone else.  Many think that these low rates are hurting the massage profession.  Massage therapists who are located near these places feel that they can’t compete with such low prices or they lower their rate to match or undercut the franchises. On the other hand, many of these franchises actually have extensive advertising budgets and have commercials on TV and in major magazines such as Oprah.  Not everyone signs up for their memberships so in a way it is advertising for the massage profession.

On the other hand are the MT who charge way more than the going rate.  I have heard people who charge double and triple the going rate in an area.  It is illegal to do that when an insurance company is paying as far as I know. What are they doing for the profession? They of course also have to target people who have more money.  Why should people with more money have to pay more? Are they really worth that much more? When you charge more, you need to have more value or provide a specialized service.

Massage therapists who are just starting out will often feel like their work is not worth charging more.  They have less experience and are not as skilled as someone who may have been in the business for 5 or 10 years.  I have also seen many MT who have been in the business for 10 year or more who have never raised their rates and started out low to begin with.  How can someone charge so much for something so wonderful?

When I first started out in massage, I opened my practice in a health club renting a treatment room.  A friend of mine from massage school had just started there and had taken the practice over from a guy who was charging really low rates even for that time.  I can’t remember exactly what he was charging but I know we raised them a little to be more of the going rate for the area.  A year or so later, I was talking to a client who was also an accountant about raising rates and he said flat out not to raise my rates because I will lose too many clients.  I didn’t listen to him and went ahead and raised my rates.  I might have lost a few but I also gained many.  It was really scary to raise them thinking that I would lose too many clients.  What I found though that there were people willing to pay more for my massage services. My schedule was filled with people who were doing just that.  Yahoo!!!  Making more money!

Every few years I raise my rates.  I do give regular clients discounts when they buy packages of massage up front.  I have had all sorts of experiences when raising rates.  I had one client who was really wealthy and never minded me raising my rates every so often until one year he started complaining saying that he came so often that I should give him a discount.  He was also my most difficult and physically demanding client to work on.  I did raise his rates despite his complaints and he was unhappy and looking for another MT but was also moving out of town soon so didn’t bother to change.  I had another client once tell me – “You never have to explain why you are raising your rates and I would think less of you if you didn’t raise your rates each year.  It is just business.”

That brought me out of the fear of charging more and raising my rates each year. That’s what it is all really about I think – the fears.   If I don’t charge lower rates than everyone else I won’t get any clients.  If I charge too much, I won’t get any clients.  Either way it is just fear.  It takes time to work through those fears or you can take the leap and charge what you need to to make a decent living right from the beginning.  You have to be worth it -in skill and in self confidence.  The process can move faster when you have a mentor or group for support.

What is a massage worth?  What is your time worth?  That is what you are really being paid for – your time away from your family and friends.  How many people on their death beds have said “I wish I had worked more”?

My goal is to work less and make more.  Yes many will probably think that is being greedy.  I see it as one of the highest forms of self care.

A few years ago, I decided to stop taking clients who had a certain insurance plan that paid the lowest out of any insurance company.  At first, it hurt my business for a few months but I stuck to it and all of a sudden my schedule was filled with clients who had the insurance that paid the most.  I had never had many of those clients previously.  I just thought it was because no companies in my area carried that insurance or something. It wasn’t true.

Recently, I have had to make big changes in my massage business. One of the insurance companies who paid the most out of all of the insurance companies, cut their allowable fee almost in half.  Half of my massage business last year was working on those clients.  This year I have had to focus on getting more cash clients to make up the difference.

It takes time to adjust to price changes usually, but it is well worth it in the long run. Working for less than you need to make can be draining and make you feel resentful. (Yes, massage therapists may have bad feelings toward people who pay less. We are human!)

People are willing to pay more for a massage (or anything for that matter) when you offer something with more value.  Value determines price.  The thing though is in defining value.  It is basically what your client wants or needs.  If your massage business looks like and feels like everyone other massage business, then your potential clients can not easily decide on who to go to so they will choose the massage therapist with the lower price.  (As I just wrote that, it made me think of the many massage franchises out there.  Are they able to have lower rates and be successful because most massage therapists don’t know how to separate themselves from everyone else? Hmm..just a thought.)

Separating your massage business from everyone else can be a challenge for many MT. I separate myself from others simply by writing about massage and what it does extensively on my office website.  I don’t do any other marketing or advertising.  I provide the information that shows that I am different than a franchise or local chain that has lower prices. My massage is unique.  I do deep tissue work but use a lot of triggerpoint work combining the two.  It just works for me.

When it comes down to competing on price alone, no one wins.  Someone will always be out there offering a lower rate.  Someone is always going to charge more.

What is right for you depends on how much you need to make, how many hours a week you are able to work and the rate that you charge.  You need to be able to stay in business.  You will need to take a salary and pay your bills, stay or get out of debt, take nice vacations, get a massage once a week and save for retirement.  Just set your fees according to what you need to make!  It is also about what you feel comfortable charging and working towards developing your skills and confidence to be able to charge more.  What is your time worth?  What is it worth to be able to give someone their life back who has been living in pain for the past few years?  What is it worth to provide regular massage to a world class athlete to allow them to be the best in their field?  What is is worth to give a massage to someone who just lost their spouse or are in the end stages of life? What is it worth to give a massage to a homeless person who is in pain from living on the streets?  What is it worth to give a celebrity a massage or CEO of Microsoft?  What is it worth to give a massage to the local grocery clerk or factory worker?