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.

Related posts:

1. Is the pressure ok?
2. Defining Massage Therapy
3. The depth in deep tissue massage

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.

Related posts:

1. Defining Deep Tissue Massage
2. Is the pressure ok?
3. Defining Massage

Today I am starting a new thing which is posting blogs posts here to share my latest pages that I am creating on my websites.  This weekend was spent researching myofascial release and a new page in the types of massage section at www.massage-career-guides.com .  I have been reading about myofascial release for the last two days perusing books I have and looking online and I have to say it is one of the most confusing things and yes I was even trained in an offshoot of structural integration which can be considered a type of myofascial release.  The problem is that there are so many different types of massage that can really be called myofascial release.  In fact I would gather that any time you touch someone doing massage you are doing myofascial release because the fascia is an integrated part of the muscle.  You can’t separate the two.  So Rolfing, Structural Integration, cranial sacral therapy, effleurage , connective tissue massage are all forms of myofascial release.   More confusing yet is the fact that while John Barnes is the person who is making this type of work so popular and he has called his work specifically “Myofascial Release (MFR)” when in fact there are many type of hands on therapist that can release the myofascial structures.

As I read and learned I decided my background in fascia has long been forgotten or I am not even sure if they taught that in massage school so I followed up with a few pages on connective tissue and fascia. (Like how I use the keywords in the links?  That is one of the steps of good search engine optimization!)

Related posts:

1. Defining Massage
2. Working with a Psychologist doing massage
3. Massage Therapy Classes

There are still some places that won’t work on people with cancer or who have had cancer and rightly so without proper training and knowledge.

Today massage is far from becoming a standard part of cancer care but it is on it’s way into cancer patients lives, hospitals, hospices and keeping people healthy.

There isn’t much research on massage and cancer that shows that it can help the immune system.  What massage does for people with cancer is to help them deal with the stress, discomfort, symptom relief , help with anxiety, depression, fatigue, nausea and help increase spiritual aspects of dealing with a challenging disease like cancer.  The few studies that have been done show that massage looks promising for helping with anxiety and pain.

There are a few pioneers in the field of massage who studied massage and cancer and started making it OK for people with cancer to get massage.

Gayle McDonald is the author of  “Medicine Hands: Massage for People Living with Cancer.  She also teaches classes by the same name.  She also has a class called “Massage in the Oncology Setting: A five-day Hospital Intensive that she offers.  The 300 Hour Oncology Massage Certification Program is for people who are serious about doing massage with cancer patients.

Her expertise comes from more than 10 years of work with oncology patients at Oregon Health and Science University.  She has also supervised massage students and therapists on the oncology unit, in chemo infusion, radiation oncology, and the bone marrow transplant unit.  Her work has made it possible to take cancer off the list of contraindications for massage.

You can find more info on her classes and books on her website at www.medicinehands.com

Cheryl Chapman is another forerunner in the field of massage for cancer.  Cheryl is a pioneer in Cancer and Mastectomy Massage. She began teaching Cancer Massage in 1990.  She offers classes in breast massage to help keep breast tissue healthy and also deal with massectomies and other surgeries.

She is the author of  “The Happy Breast Book” .  You can find more information about her classes and work at her website www.cherychapman.com

Tracy Walton is a massage therapist and researcher.  Best known for an intensive continuing education course for massage therapists, Caring for Clients with Cancer, Tracy has taught it nationally since 1999. Her course offerings also include an Advanced Seminar and a basic one-day Cancer and Massage Training in safety essentials.   Her focus on research is an important step for the massage profession.  You can find a list of research papers on her website at  www.tracywalton.com along with details of her classes.

An ongoing project of mine has been to collect a list of articles on massage and cancer to have as a resource for massage therapists.  You can find it in the massage pathology section at the main website www.thebodyworker.com If you have any resources or information to add on massage and cancer – please share your information here!

See also:  Society for Oncology Massage

Related posts:

1. Benefits of Massage Therapy
2. Pathology for Massage Therapists

Ethics classes used to seem like the most boring part of being a massage therapist but studying ethics now seems like the only thing we should have to do as a massage therapist.  The techniques don’t really matter much if you don’t have clear boundaries and relationships with clients.

Ethics is just about relationships.  Relationships are the core of building a successful massage business or being successful in your massage job.  Studying ethics will help you if you are male and in this female dominated profession helping you to understand your role.   Women can benefit from studying ethics to help them deal with the many challenges of working on men (yes the dreaded E!) .

Ethics is just the process of uncovering your values and learning about relationships and how your work as a massage therapist can influence those relationships.   The clients that fall in love with you and want to marry you, the people who want to always get a discount or will hate it when you raise your rates.

People who are under stress and in pain and are half naked underneath a sheet are vulnerable.  As a massage therapist it is your responsibility to understand your role and understand where they are coming from or at least be able to not interfere in their lives.   I remember Oprah saying once on TV that she just wished massage therapists would shut up!

Ethics requires rational thought about what it is that you are doing or what is happening in your massage world.  Many may first think that they know what to do when a client asks them out on a date and may think there is no harm in dating clients or even just being friends with clients.  Educating massage therapists as to what happens in the therapeutic relationship can help them make more informed decisions about their actions.

It isn’t about being right or wrong.  It is about making a decision that supports you and your massage business.  There is also a legal side to being a massage therapist and working within your scope of practice.  What is legal is not always ethical and what is ethical is not always legal.  Ethics is about striving to be the best you can be and about treating people decently and respectfully.

Taking massage ethics classes is the most important thing you can do for yourself and the massage profession.

Related posts:

1. Exploring Ethics
2. Massage Ethics
3. Code of Ethics

The body stores memories of feelings in it’s cells.  It starts at an early age when we hold back our feelings and emotions.  It is often taught that it is not good to have feelings and emotions.  People will buck up and keep their feelings inside. Touch has a way of allowing these emotions to come to the surface.  As massage therapists it is out of our scope of practice to deal with the emotions.  We of course have to learn how to deal with them when they do come up or it could cause further problems.

Emotions can be anything from anger, sadness, grief, panic, anxiety, frustration and even laughter and joy.  It can be a simple sigh of relief or a deep breath.  It can be heat or cold in an area of the body.   It can be people who ask for extreme deep tissue sessions because they actually can not feel and are numb both physically and emotionally.   People may say they have a  high tolerance for pain and won’t feel pain or will ignore it for a long time before doing anything about it. Anyone can experience emotions on the massage table.  Elliot Greene in his book The Psychology of the Body (Lww Massage Therapy & Bodywork Educational Series)
says that people who suffer from chronic pain are also somewhat more likely to experience emotional release.  When the massage therapy begins to disrupt the underlying physical patterns behind the pain, then emotional patterns related to the chronic physical pattern may surface.”

Sexual, physical and emotional trauma at an early age or in any stage of life for that matter can leave it’s mark on a persons body and emotions.   People with a history of  abuse of any kind have a high likelihood of having body armor.  It includes people who have been traumatized in war, natural disasters and things like car accidents or crime victims.  Armoring in the body is a natural result of trauma.  It is defined as chronic patterns of involuntary tension in the body that dampen or block emotional expression, alter perception of both the outer and inner psychological world, diminish or eliminate kinesthetic awareness and other sensations and restrict the range of motion according to Greene in the “Psychology of the Body”.   The war vet will think that everyone is following them and be sent into fight or flight when someone touches their neck if they sat in a trench for awhile waiting for the enemy to come from behind.   People in car accidents that experience intense physical impact while they turn their head may years later recall the sound of the crash every time they turn their head in the same way.  Stress can build up so much in tense muscles that just the lightest touch can bring tears to the eyes of many.

To be able to work with people who are undergoing emotional release requires that you be able to be present with the client.  This basically is staying in a non-judgmental open state and not ask questions or direct peoples conversation.  It is a state where you totally allow the experience to unfold and focus on the client without letting your emotions and agendas (if any) to get in the way.  To do that requires that you do your own personal emotional work either through massage and bodywork or with a skilled therapist.  Supervision can also help you in learning to deal with emotional releases on the massage table.

The thing to know about working with people is that the goal is not to try to get an emotional release.   The feelings can actually be released without having emotions come forth.  Because it is inevitable that a client will have an emotional release at some time on your massage table it is important to get further training in this area to be able to support the client appropriately.

Online Class:
Body Psychology

Recommended Reading:
The Psychology of the Body (Lww Massage Therapy & Bodywork Educational Series)
-Elliot Greene

Somato Emotional Release
by John Upledger, DO

Related posts:

1. Effective Massage Therapists Master Their Emotions
2. Psychology of the Body
3. Working with a Psychologist doing massage

Some people get it confused with just being relaxation massage.  While it is probably the main method used for relaxation it is not the only one and it is also used for therapeutic reasons.  Many massage therapists who go on to take training in other methods seem to get confused and think that Swedish Massage is only for relaxation.  It was created for the purpose of being therapeutic – to work with pain, injuries and various conditions that are related to health issues and are causing health issues.

Robert Calvert, historian and founder of Massage Magazine talks about the history of Swedish Massage.  It is not the work of Per Ling as many massage therapists are incorrectly taught in massage school.  Per Ling developed Swedish Gymnastic Movement but did not have any of the things that are now considered to be basic massage strokes in his work.

Basic Swedish massage is defined like this from Robert Calverts pages in history section on Massage Magazine:

Swedish massage is defined in large part by the original strokes that compose its method: effleurage (stroking), petrissage (kneading), tapotement (striking), and frictions (rubbing), with vibration added later. The French terms – effleurage, petrissage, frictions (massage a’ frictions) and tapotement – were never used by Peter Ling, by any of his successors nor by the Central Gymnastic Institute.

Dutch practitioner Johan Georg Mezger (1838-1909) is generally credited (by physicians such as Emil Kleen and Richard Hael, who researched the origins of massage and gymnastics) as the man who adopted the French names to denote the basic strokes under which he systemized massage as we know it today, as Swedish or classic massage.

There is also some confusion when massage therapists start billing insurance companies and are required to choose a code for the procedure being done.  97124 is supposed to be for therapeutic massage and it is further defined as effleurage, pettrisage and the other so called Swedish Massage Strokes.   It is therapeutic in nature so it can be used to bill insurance companies.   It usually doesn’t pay as much as another code that is sometimes used -97140 and that may be part of the problem.

Swedish massage is also very therapeutic in relaxation mode.  Since most diseases and disease processes are now being linked to stress, it is necessary to have many skilled in relaxation massage.  I personally have never in my 20 years of being in practice had someone who just wanted a relaxation massage that didn’t have some pain, tightness or tenderness in their muscles that needed to be worked out.

Also most of the research that is being done in the massage profession employs using Swedish Massage!  So there again Swedish massage is really therapeutic Swedish Massage.

I created this basic chart on my website a long time ago with the basic strokes and summary of what they do.

See Therapeutic Swedish Massage Section at www.thebodyworker.com

Related posts:

1. History of Massage
2. Relaxation vs Medical Massage
3. The therapeutic relationship

I thought it was quite an interesting question since it really couldn’t be answered.

What makes a perfect massage is what is right for each individual.  It is a massage that serves their needs at that present moment in time.  Each massage is so different and will feel different at different times on different days.

A perfect massage is one where the client gets up off of the table and says “WOW!  What did you do to me!”   In my 20 some years of getting a massage I have to say I have only had that experience about a handful of times.   I get massage almost every week now and have on and off through my years of being a massage therapist.  The other times massage has been great, good, fair, poor  and really just awful.

A great/good massage will address the areas of pain or discomfort that the client has at that particular day/time.

A fair/poor massage will just sort of smooth over those areas and be relaxing but not really be what you want.

A bad massage is one where the massage therapist is totally out of tune and doing only what they want to be doing.  I have had plenty of those too.  I go in and say my leg is hurting and they only work on my back and then the last 5 minutes they work on my leg.   (That was my first and last Massage Envy experience.)   I am sure I have given them too.

What makes for the perfect massage is what each person needs at that exact time.  Being able to communicate their needs is often very difficult.  Doing a thorough intake and asking them questions in detail can help you start your detective process of trying to figure out what you are going to do.  Then as you work being present to your self and what you are feeling you can also learn to assess the situation and work more efficiently engaging the client in their massage process.

The challenge of how to give  a perfect massage or what makes for a perfect massage is left to you!

Related posts:

1. Attracting Perfect Customers
2. The Perfect Massage Job
3. From Massagenerd.com – RE: NCBTMB

Many professional associations have a so called “Code of Ethics” which members are supposed to abide by.  The thing is that they are so general in nature that they can be widely interpreted.  Here are some sample code of ethics statements of professional associations:

The AMTA Code of Ethics:

This Code of Ethics is a summary statement of the standards by which massage therapists agree to conduct their practices and is a declaration of the general principles of acceptable, ethical, professional behavior.

Massage therapists shall:

1. Demonstrate commitment to provide the highest quality massage therapy/bodywork to those who seek their professional service.

2. Acknowledge the inherent worth and individuality of each person by  not discriminating or behaving in any prejudicial manner with clients and/or colleagues.

3. Demonstrate professional excellence through regular self-assessment of strengths, limitations, and effectiveness by continued education and training.

4. Acknowledge the confidential nature of the professional relationship with clients and respect each client’s right to privacy.

5. Conduct all business and professional activities within their scope of practice, the law of the land, and project a professional image.

6. Refrain from engaging in any sexual conduct or sexual activities involving their clients.

7. Accept responsibility to do no harm to the physical, mental and emotional well-being of self, clients, and associates.

The ABMP Code of Ethics is a little longer.

Client Relationships

• I shall endeavor to serve the best interests of my clients at all times and to provide the highest quality service possible.
• I shall maintain clear and honest communications with my clients and shall keep client communications confidential.
• I shall acknowledge the limitations of my skills and, when necessary, refer clients to the appropriate qualified health care professional.
• I shall in no way instigate or tolerate any kind of sexual advance while acting in the capacity of a massage, bodywork, somatic therapy or esthetic practitioner.

Professionalism

• I shall maintain the highest standards of professional conduct, providing services in an ethical and professional manner in relation to my clientele, business associates, health care professionals, and the general public.
• I shall respect the rights of all ethical practitioners and will cooperate with all health care professionals in a friendly and professional manner.
• I shall refrain from the use of any mind-altering drugs, alcohol, or intoxicants prior to or during professional sessions.
• I shall always dress in a professional manner, proper dress being defined as attire suitable and consistent with accepted business and professional practice.
• I shall not be affiliated with or employed by any business that utilizes any form of sexual suggestiveness or explicit sexuality in its advertising or promotion of services, or in the actual practice of its services.

Scope of Practice / Appropriate Techniques

• I shall provide services within the scope of the ABMP definition of massage, bodywork, somatic therapies and skin care, and the limits of my training. I will not employ those massage, bodywork or skin care techniques for which I have not had adequate training and shall represent my education, training, qualifications and abilities honestly.
• I shall be conscious of the intent of the services that I am providing and shall be aware of and practice good judgment regarding the application of massage, bodywork or somatic techniques utilized.
• I shall not perform manipulations or adjustments of the human skeletal structure, diagnose, prescribe or provide any other service, procedure or therapy which requires a license to practice chiropractic, osteopathy, physical therapy, podiatry, orthopedics, psychotherapy, acupuncture, dermatology, cosmetology, or any other profession or branch of medicine unless specifically licensed to do so.
• I shall be thoroughly educated and understand the physiological effects of the specific massage, bodywork, somatic or skin care techniques utilized in order to determine whether such application is contraindicated and/or to determine the most beneficial techniques to apply to a given individual. I shall not apply massage, bodywork, somatic or skin care techniques in those cases where they may be contraindicated without a written referral from the client’s primary care provider.

Image / Advertising Claims

• I shall strive to project a professional image for myself, my business or place of employment, and the profession in general.
• I shall actively participate in educating the public regarding the actual benefits of massage, bodywork, somatic therapies and skin care.
• I shall practice honesty in advertising, promote my services ethically and in good taste, and practice and/or advertise only those techniques for which I have received adequate training and/or certification. I shall not make false claims regarding the potential benefits of the techniques rendered.

The basics of ethics is uncovering your own beliefs and values and understanding what motivates your actions and thoughts.  In doing so you can create a massage business or find your ideal massage job that is a clear reflection of you and your values.   It is an ongoing process because most of our values are ‘inherited’ from our early upbringing and not really chosen by us.  They are taught to us by our parents and in school.

Massage clients also come to a massage therapist seeking help.  The dynamics of the helping relationship recreate the dynamics of the parent/child relationship.  It is important to be clear about what is what to become an effective massage therapist.  Situations will arise on a daily basis as a massage therapist that will constantly challenge your values and your core beliefs about yourself.  To help you unravel the underlying needs and perceptions participating in peer supervision groups or individual supervision classes can help you to do that.

Since we need to take ethics to meet continuing education requirements and to build successful careers finding the best massage ethics classes isn’t always so easy.  There are a handful of online classes that you can read some material and take a test.  While this fulfills the requirements for continuing ed having a live interactive class  or participating in supervision will help you in creating your own code of ethics and help you in learning to live by your values and create meaningful therapeutic relationships with you clients.  It is the therapeutic relationship that will help you build your career.

I have started an small directory of the online massage ethics classes where you can post your class and also write a review on the class and rate it.   There is also some more information on massage ethics that I have started and will be adding too on my www.massage-career-guides.com website.  I also have some earlier writings on ethics in the massage profession on this site and in my blog posts on ethics for massage therapists.

Online Ethics Classes
The 2-Hour Ethics Course: Professional Roles and Boundaries

The 6-Hour Ethics Course: Ethics from the Dalai Lama

The 4-Hour Ethics Course: Legal and Ethical Issues

Related posts:

1. Massage Ethics Classes
2. Exploring Ethics
3. Code of Ethics

Massage has been used throughout history to ease the pains of pregnancy and labor.  Robert Calvert in his book ‘The History of Massage’ outlines some significant points in the history of midwifery which included massage.  I also remember taking a class with Robert and he mentioned that there was some culture that used to train their sons how to do massage so they could be prepared to guide their wives through labor! (Whatever happened to that!  Are we actually going backwards by incorporating pregnancy massage into a massage business?)

The Touch Research Institute finds that:

Massage for Labor Pain
Massage therapy during the first 15 minutes of every hour of labor decreased anxiety and pain and the need for pain medication. In addition, the massaged mothers had shorter labor, shorter hospital stay and less depressed mood.
Field, T., Hernandez-Reif, M., Taylor, S., & Quintino, 0., & Burman, I. (1997). Labor pain is reduced by massage therapy. Journal of Psychosomatic Obstetrics and Gynecology, 18, 286-291.

Massage during pregnancy can help alleviate back pain associated with the postural changes due to the exess weight gain.  It can help alleviate symptoms of nausea.   It can help reduce the amount of stress and anxiety that a mother often experiences.  Sciatica is often a part of pregnancy because of the increased weight and the changes in the hips that occur to make room for the baby and the birth process.

Massage during labor can help with easing back labor pains as well as just making the mother as comfortable as possible.

I just updated the pregnancy massage section on www.thebodyworker.com:

Pregnancy Massage Articles : Links to many online articles on Pregnancy Massage

You can read the many articles and research pregnancy massage and create an informative section on your website to promote your pregnancy massage practice.

Related posts:

1. Massage Marketing -Make your words sell
2. History of Massage
3. Working with a Psychologist doing massage