Archive for Julie Onofrio

Massage Jobs – Is there an Ideal Job?

June 3, 2011 Julie Onofrio Find a Massage Job, My Personal Thoughts

Massage jobs are a fairly new phenomenon in the massage profession.  When I started 24 years ago there were no real jobs.  There were just independent contractor positions where people could work at salons or spas mostly. (See more on independent contractors vs employees)  From what I understand now most of those positions should have really been an employee position with paid benefits. That seems to be the one thing that is most understood in this profession – whether or not you are a true employee with hourly pay and benefits like sick time, vacation pay and retirement funds.  While the creation of the many massage franchises has provided more jobs for the profession, I still cringe when I think of so many massage therapists out there working for $12 an hour when I make about $70 an hour working for myself – and yes that is after expenses.   I have my own business but I also rent a space from someone else and always have.  A phone system is included in my rent and access to a copy machine.  I have desk space in the waiting room and access to a massage room.  I pay extra and have my own website and that is about it.

In some ways I can’t understand why people want to take jobs when they pay so low but I know some people just want to go in and do a massage and leave but is any place really like that?  You still have to go in and do your best massage and provide customer service and educate clients so they will come back.  In some of the places you have to sell membership or retail items to clients.  If you don’t have any clients you don’t get paid for the most part in many places.  So there you are cleaning the bathrooms and doing laundry for free or minimum wage.  If you do take the initiative you can work to get new clients and get more repeat clients.  I go to a few mid range spas here in the area for my massage and I can say that they are not doing much to get the MT and other skin and nail care people busy.  I would say that a job in a busy clinic where you have a full schedule and are paid $35 an hour or more are rare.  But why do people take low paying jobs?  Do you have to?  Do you think there are not any other options? Is it that hard to start a business?

Starting a massage business isn’t easy but you are really left doing many of the same things to get and keep clients.  There are so many resources out there to help you start a massage business that most anyone can do it.  When I hear the many horror stories online about how people are being treated at massage jobs I just have to wonder what is going on.  It is like the many massage business owners many of who are not massage therapists figured out that massage was a lucrative business model so they are out there hiring the many massage school grads who were told that they could get $100k a year massage jobs.  Now I am not talking about those places who do hire MT and pay them well and also take the MT under their wing to teach them the ropes of running a business and being successful (See Laura Allens Therra-sage).

Why can’t MT stand up and ask for more for themselves and demand higher pay or go out there and create your own job?  I never have been a fan of jobs and the mentality that goes along with it.  People seek jobs out of what it can do for them rather than what they can do for the company or so it sometimes seems.  Find a health care provider that you respect and would go to yourself and talk to them until they create a job for you. No it isn’t easy and it might take a year or even a few and no most probably can’t afford to wait that long so I guess you have to take a low paying job.  Well there is nothing wrong with that at all.

How is it that massage employers have gotten to the point that they take so much advantage of MT? I only think of Dr. Phil’s comment about “You teach people how to treat you”.

I want to be clear hear that I am not bashing people who take jobs in massage and take low paying jobs, but I just wish more for you.  You should be making what you are worth and making a good enough living to pay the bills, save for retirement, take nice vacations, drive a reliable car, not be in debt and be happy.

I wrote the Massage Job Guide to hopefully inspire you and help you to do just that.  It requires that you make a stand for yourself – set your boundaries around the jobs you take and keep working until you get or create your Ideal Massage Job.  You are worth it!

Of course this is all just my ramblings on about massage jobs – my own opinions but I do value yours.  What are you seeing out there in the world of massage jobs?  Is there such a thing as an ideal job? What does that look like or what would it look like?

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What’s next for this blog/site?

June 2, 2011 Julie Onofrio News

I haven’t been doing much blogging or work on this site.  I was shocked to just find that it was last Nov that I even posted something and that I hadn’t posted anything regular for awhile.  The thing with blogs is that you need to keep the content fresh for the search engines to keep coming to your site.  I have been uncertain as to what to do next with this site.  It makes me about $1000 a month in Adsense income so I don’t want to lose that but the site is done in Frontpage 2003 which is so outdated.  I don’t have time to learn new software and if the world were made of chocolate- I’d be moving it over to Site Build it! but this site is massive – over 1000 pages of content and over 500 posts here – that makes for a lot of work!  Site Build it! is so much more effective though I have to make the change sometime.  I still have tons of material to put up from my massage school notes too but massage school seems like a lifetime ago and it isn’t something that I want to spend time on right now.

My focus right now is on getting a few books together to self publish.  I have been working on my Massage Career guide which is for people who are looking to get into a career in massage. It is for sale as an Ebook but I want to get it on amazon.com and out to more people. It has sort have been my ongoing project.  I originally wrote it in I think it was 2003 when I started my first Site Build it! website – www.massagetherapycareers.com – which I sold in 2009.  I replaced that site with www.massage-career-guides.com and it took longer than I thought to get the same traffic and keyword results back to the level of that old site but it is getting there.  I made a few mistakes when rebuilding that I have course chalked up to learning.  I have thought of just moving the whole site over to that site too but not sure.  I would also like to focus more on the massage school directory with such exciting and controversial things happening in education currently in the massage profession with the Alliance for Massage Therapy Education moving forward on creating standards for massage schools.

I have also been plagued with health issues since the beginning of the year having found out that I have a type of cholesterol that likes to stick to arteries but I have been working to stay healthy and it is working.  My massage business this year has been a challenge to maintain because of this and also I am very discouraged about what is happening in the insurance billing world in WA State.  I had the best year I have ever had in my 24 years of doing massage last year mainly do to insurance billing. This year they cut their allowable fees in half meaning that to make the same amount I have to do 2x the amount of massages and at this point in my career, my body just can’t do that.  I still see my 12 clients a week or so but am making way less.  I don’t see anyone doing anything about it or not sure what we can even do about it.

So I just keep writing about it all including reviving my Insurance Billing for Massage Therapists Manual which I hope to get on amazon.com this summer.  Billing insurance has allowed me to stay in this career for this long and it has also been the biggest thorn in my side.  I do feel that it is important for every MT to learn to bill and to see what the issues are so that we can begin to join forces to be able to have a say in what goes on.  Right now the massage profession is so all over the place and divided from what I see but I might be jaded from only being on Facebook and not seeing what is really going on by going to conventions and such.  I do hope to start getting out to some to see more of what is going on.  I am also going to be doing more get togethers through Meetup.com and seeing first hand the issues people are having.  What I have already seen is that MT are struggling with physical issues as well as financial issues.  Yes it is hard to keep financially sound when dealing with physical issues – I know that first hand.  My health was one of the reasons I started this website and all of the others along with finding out I like to write!

My passion is writing and creating websites.  It is such an amazing process.  I didn’t know anything about writing and frankly I am not even really good at it.  There are many better writers than me out there in the massage profession. It is really a personal growth process and spiritual process for me – sharing my thoughts and insights.  It was and is a process to find my voice and keep clear of things that get in the way like viscous verbal assaults that often happen online because of not being able to hear people’s voices.   I get caught up in it every once in awhile still because I feel protective of the massage profession.

I also wonder about things like where is this all going – the massage profession itself.  There is so much going on right now with like creating standards, doing more research and becoming more evidence based but sometimes it seems like the fight between the Evidence people and the energy workers is separating the profession which I guess isn’t good or bad but just sad to see really for me. It is the egos vs the crystals – which one will win?  and why does someone need to win?

I always think about the late Robert Calvert and some of the discussions I had with him about licensing and legislation.  After reading his book on the History of Massage and taking some classes from him – what has happened to touch and massage in our society and world? What has happened to touch being a part of families like passing massage onto sons so they can massage their pregnant wives or people massaging each other? I sometimes think that every MT could be teaching massage to the general public and that would do more good than anything else we do.  Teach friends how to massage friends, couples how to massage each other, parents how to massage their children and teach the children to massage each other.  I used to think there could be world peace if everyone just got a massage every day.  We are getting so far away from that in some ways in the massage profession.

Ok so I have gotten way off track but that’s OK.  I just needed to start writing again to get this blog and site going while I wait and see if I should move this site over to the new Block builder system at SBI which should be coming out soon I hope!

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Glossary of Massage Terms -D,E

November 24, 2010 Julie Onofrio Massage School Notes

Glossary of Massage Terms (D,E)

Deep Tendon Reflex – knee jerk reflex that occurs as a result of a strike by a rubber mallet to a tendon

Desquamation – The shedding of epithehial elements mainly the skin, in scales or small sheets: exfoliation

Direct Compression – Sustained pressure on a muscle cramp or tight muscle often using the hand, fist, forearm or knee

Dislocation – Displacement of a bony part within a joint leading to soft tissue damage, inflammation, pain and muscle spasm

Distraction – A pulling apart or separation of joint surfaces

Dysfunction – Adapative shortening of soft tissues resulting in loss of mobility

Eccentric Muscle Contraction – Lengthening of the muscle while it is contracting or resisting a work load

Efficiency – the Ratio of work output to work input.  Output divided by input and multiplied by 100 equals 100% efficiency

Electrolytes – Ionized salts in the blood, tissue fluids and cells

Empty Calories – calories obtained from food such as sugar, which are devoid of any dietary essentials like amino acids, vitamins and minerals

End-feel – the quality of feel the massage therapist experiences when passively applying pressure at the end point of the available range of motion

Endurance – The ability of a muscle to perform repeated contractions over a prolonged period of time before fatigue failure begins

Energy- The capacity for doing work

Engaging Tissue – When a sufficient amount of pressure is applied during palpation or treatment in order to move or compress the structure, then the tissue is engaged and assessment or treatment will be efficacious.

Enzymes- Complex proteins that are capable of speeding up chemical changes in other substances without being changed themselves.  Enzymes are found in digestive juices where they break down food into simpler compounds

Ergogenic Aids – Stimulants and other substance that when taken orally or by injection, increase the potential for exercise performance.  Most are illegal substances

Ergometer- A stationary bicycle used for training or for lab tests to measure work performed

Excursion- In friction, it refers to the distance of movement or glide available from the starting point in a pattern of oscillation or alternating movements with a return to the starting point.

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The depth in deep tissue massage

October 30, 2010 Julie Onofrio Become a Massage Therapist, Massage Theory

Learning deep tissue massage is one of the many things you can do to set yourself apart from all of the other massage therapists out there.  Having a good deep tissue instructor in massage school can help.  How will you know if they are good?  They will teach that it isn’t about applying more or deeper pressure using physical strength.  Good deep tissue won’t leave you bruised or feeling hurt the next day.  The other part of this is how people feel or what they are able to feel and what they want to feel in their massage.  I for one have really ropey back muscles from arthritis and scoliosis and find that I can’t feel it when most people say they are doing deep tissue.  I also have had years of structural integration (Zentherapy) where the goal was to create pain in some ways (more on that later).   I personally get better results when I can feel the pressure being applied.  The pressure doesn’t feel painful to me.  It feels good!  It helps be to feel better and feel more!  To me that is what all massage is really doing – helping people to feel more.

So in learning deep tissue in basic massage school, you will most likely be learning about connective tissue and the deeper muscles of the body like the psoas, piriformis and other muscles.  A good deep tissue massage therapist will learn to palpate the various structures and be able to feel the tightness in different layers of the muscles.  Just taking a weekend workshop or two in deep tissue is only just the beginning.  It really takes practice and developing your skills to go deep.   As I said, I also took Zentherapy training in the 1990′s with it’s founder William “Dub” Leigh.  He combined his training with Ida Rolf and a Zen Master from HI and tried to teach that using “Ki” or “Chi” was a much more effective way of doing deep tissue.  The only problem is that most people were still having deep tissue forced on them instead of “using the force” and people were often screaming on the massage table.  When force is used it creates more resistance and tension usually.  People will tense up more rather than relax more.  It is also a matter of learning to work with clients using deep tissue and keeping in contact with them and keeping them in their bodies while you are doing deep tissue.  It is about engaging them in the process and teaching them about their bodies showing them how their bodies work and how they can learn to relax tight muscles with things like breathing and awareness.  Getting them to notice the change that occurs in their body when you are working on them can help to show them the value of massage and what it can do which will hopefully help you in getting regular weekly clients.

While the Zentherapy deep tissue is now too extreme for me now, I did learn some key things to doing deep tissue through their trainings.  One of them is to use your body and your breathing to apply deep tissue pressure instead of trying to use strength or force.   I first let my elbow or knuckle or fingertips touch the surface and then take a deep breath myself and allow my body to relax and ‘sink into’ the clients body gently yet firmly.

Most spas and massage franchises say that they are doing deep tissue massage but I have found to be the work and skills very inconsistent.  It also seems like many spas define deep tissue as just applying more pressure and don’t really know the difference.   So learning ‘real’ deep tissue can help you to make a difference in your job performance and help to set you aside from the other massage therapists at places like these.  There isn’t a clear definition of deep tissue massage that is understood even among massage therapists.  So when clients are getting deep tissue at one place and it is just deeper pressure, they don’t really get the full understanding of what deep tissue could really be like.  Things like this make it challenging for massage therapists to be in and stay in business and find jobs.  How a clear definition can be created and put into the hands of every massage therapist is the issue.

To explain further with an example:  I do deep tissue massage and triggerpoint therapy work.  I had a client come in a few weeks ago saying he had been seeing a MT at a local franchise weekly for over a year but he was in a significant amount of pain.  He had been getting deep tissue massage.  When I worked on him one time he said he had never gotten a massage like that and most of his pain was gone.

I used to even give clients a handout on getting deep tissue massage but now I just verbally talk to people about deep tissue work.

It is important if you are learning deep tissue to be worked on  people who are doing good deep tissue.  It is also recommended that you practice and learn. It takes a few years or more to be really good and proficient in deep tissue massage. I have outlined some of the things about deep tissue massage on the main website and am also creating a section on deep tissue massage on my other website -www.massage-career-guides.com to help teach massage students about the concepts of deep tissue massage to help them decide on a course of study.  Share your stories there about how learning deep tissue or getting deep tissue massage has helped you.

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Massage Advanced Certification?

October 24, 2010 Julie Onofrio Licensing and Legislation, Massage Politics, News

The NCBTMB (National Certification Board for Therapeutic Massage and Bodywork) is currently in the process of creating an advanced certification massage exam.  I have to say I am skeptical right from the start and always have been since the inception of this organization.  It was created back in 1988 just when I was getting out of massage school. Their history is quite rocky to begin with. I was never a supporter mainly because I saw how it was created.  There was never any research done from what I could see at that time to see if it was needed.  It was supposed to be an entrance exam for the AMTA and it somehow all of a sudden just became a certification exam for the massage profession.  It was funded by AMTA for starters.  They did pay the money back to AMTA and are now independent of AMTA and in fact AMTA has disowned them and does not professionally endorse them any longer and changed their support to the Federation of Massage State Boards exam -the MBLex (AMTA Press Release).

The latest news from the NCB says in their latest news(pdf):

The credential will be the first to enable accomplished practitioners to differentiate themselves in the massage marketplace. It will also make it possible for employers and members of the conventional and integrative healthcare arenas to hire practitioners based on a certified, advanced level of experience and expertise.

Is that what is needed for a massage therapist to differentiate themselves in the marketplace?  What proof is there that an exam will help do that?  What about teaching MT to do just that by learning a specialty and learning to present themselves in a way that differentiates themselves from all of the other massage therapists out there in their neighborhood.  If everyone takes the exam – will they all be differentiated?

Those who earn the advanced credential will be nationally recognized for possessing the critical thinking skills necessary to function in complex situations. In addition, they will be relied upon for their ability to work in a team environment utilizing treatment plans based on research-informed outcomes.

How will they get that training in critical thinking skills and on research when most of the massage therapists out there have little training in research since research is really just in it’s infancy in this profession.

“NCAP practitioners will offer the advanced capabilities increasingly sought out by discerning clients, employers and healthcare providers,” said NCBTMB Chair Neal Delaporta. “The credential will open up new opportunities for therapists in conventional, integrative and clinical healthcare settings. It has the potential to take the entire profession to a new level within the medical community.

Is that what will help us be recognized as a health care profession and be able to work in the medical community billing major medical insurance companies and working with injuries and diseases?  Here in WA State we are already recognized as a health care profession and we are able to work with doctors and insurance companies.  We are able to do that because we had a very savvy insurance commissioner who also had a great massage therapist – Lori Belenski- who is now working for the WA State Chiropractors Association as a lobbyist.  Debra Senn, the insurance commissioner created a law that mandated that insurance companies must pay for massage, Naturopaths and Acupuncturists.  The WA State Legislature adopted the “every category of provider” mandate as part of the 1993, Health Care Reform Act to go into effect in 1996.  The insurance companies fought it and took it into Superior Court and held it up until 2000.  Here is the report done at the time “Issues in Coverage for Complementary and Alternative Medicine Services: Report of the Clinician Workgroup Jan. 2000.  The full report that I have a copy of lists the timeline of events leading to the passing of this law.

Does it take an exam to make massage accepted by insurance companies?  Not based on WA State since we only have the minimum of 500 hours of education required for massage professional licensing.

What will take the profession to a new level is having reciprocal licensing!  Come on already!  That’s a simple one to me anyways.

Chair-Elect Alexa Zaledonis added, “For practitioners with the NCAP credential, it means a potential for increased marketability and heightened earning power. It will help connect advanced therapists of all modalities to rewarding positions with high-level employers.”

How will it do that when the major employer in the massage profession are massage franchises.  There aren’t any higher level jobs or at least very few.  What it takes to find or create higher paying jobs is saying “NO” to low paying jobs and going out there and showing employers just what massage can do and how much you can make for an employer.  It is about having the skills to market yourself and negotiate pay – just like most other careers.  Since most massage therapists are locked in the “Noble Poverty” – “It’s not about the money” – too many Massage Therapists are not standing up for themselves and are looking for what a job can do for them rather than what they can do for a job.

The next step is a job task analysis “that will ask practitioners to determine the knowledge, skills and abilities that an “advanced practitioner” must possess, as well as the level of importance that should be placed on each.”

What makes for an advanced massage therapist?  Is it their skills and training?  Is it the amount of time they last in the field?  With over 250 different kinds of massage and bodywork out there (and that number growing everyday)- how will they come up with skills that all types of massage therapists will be able to acquire?

In 2009, the NCBTMB did a needs assessment survey to ask the profession to help define the criteria for the possible exam.  The survey looked at:

•Defining the Advanced Practitioner
•Identifying the Necessary Characteristics of Advanced Certification
•Identifying the Criteria for Advanced Certification

Personally, I find it interesting that they didn’t ask if they thought an advanced certification was needed.  They just assumed that it was and went on to ask questions about it.   Since I never saw any benefit to the regular certification exam, what will people get out of the massage advanced certification?  I have never in 23 years been asked if I was licensed or certified.  I guess I am lucky to live in an area where massage is accepted more and seems to be ahead of the game in being accepted by health care companies.

What makes for an advanced massage therapist?  Anyone who can last more than 3-5 years would qualify in my book!

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