Aug 29 2013

The little things do matter

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Bear with me as I share something that will seem unrelated to massage at first. I’ve been riding my bike to work for quite a while now, and I recently switched to a new bike. After a while, I started to notice a little knee pain when riding, and this got progressively worse the more I rode. I also felt a little uncomfortable with my position on the bike, like I might be a little low. So I raised my saddle, not by much, probably less than inch. The knee pain went away almost instantly, and I also felt more comfortable and more efficient in my pedaling.

I’ve worked with biomechanical models enough to know that a small change in the angle of a joint can make a significant difference in the forces across that joint during muscular exertion. So, if you’re experiencing some discomfort while giving massage, consider a small change to your table’s height, or a slight shift in your posture or how you position your client. Sometimes these little changes can prevent a bigger problem down the road.

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Jul 30 2013

Going to the dogs?

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More than 4.5 million Americans are bitten by dogs every year. If you have a mobile practice, it’s likely that you’ll come into contact with dogs that you don’t know, and that don’t know you. Knowing how to approach an unfamiliar dog is an important part of avoiding aggressive behavior such as biting. If you don’t know dog behavior well, your first instincts may be to smile, make eye contact, and reach out to pet the dog to show you’re friendly. But to a dog, teeth are fangs, fingers are claws, and direct eye contact is a challenge.

If you find your client’s dog blocking your way into their house, the best strategy may be to go back to your car and call your client so that they can come out and hold their dog while you come in. If you’re surprised by a dog, don’t run or yell. Hold still and allow the dog to sniff you. If you have your massage table with you, you can hold it between you and the dog to offer some protection.

Here are some dog bite prevention tips from the CDC and the AVMA.

And here’s a web site with visual guides to dog behavior.

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Jun 28 2013

Just change one thing

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When I teach workshops, I encourage therapists to change just one thing at a time about they way they practice. Sometimes the focus is on table height. Sometimes it’s their stance. Often when you make one simple change it has cascading effects. I believe that a lot of our poor postures are habitual, and one small change can help us break a number of bad habits. I’m encouraging you to consider making one small change in preparation for your next massage (unless you’re one of the lucky therapists who never feels tired or sore or awkward during or after a session).

When I’m working with people in person, I can observe their postural habits and give them specific feedback. Since I can’t do that with you, I’ll have to settle for a generic suggestion of one thing to change. A posture I see a lot is the forward-rounded-shoulders, hunched-over look. To me, the sternum seems to be the fixed point that the rest of the upper torso is curving around; so here’s the one thing I would suggest you try: Lift through the sternum. Focus on raising it up and bringing it forward, as if someone has just pinned a medal on your chest that you’re really proud of.

Hopefully this will allow your shoulders to fall back and down without you having to exaggerate that movement. It may also help you to keep your head more upright and the weight of your torso centered over your hips. So, give it a try and see if it helps your posture overall.

Be well, Rick

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May 30 2013

Start a conversation

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Massage can be a rewarding career, but it is not without some risks. We know from several surveys of massage therapists, including this survey that I helped conduct, that about 3 out of every 4 massage therapists experience musculoskeletal symptoms as a result of their work.

You see other indications that the potential for injury exists in our profession. Massage trade journals frequently publish articles on self care. A number of continuing education programs promise to teach methods that are “easier on the practitioner” and can help “prolong your career.”

But it seems to me that there still is some resistance to talking openly about injuries among massage therapists. It could be that some view having symptoms or injuries as some sort of personal failure, that we’ve done something wrong, used bad technique, or failed to “work smarter.” Not wanting to admit to symptoms could delay asking for help, getting a diagnosis, or starting a treatment program. The end result might be a more serious injury than should ever have happened.

We as a profession need to create a culture where we feel safe in speaking up about symptoms and seeking the help that we need. And that culture starts with each of us as individuals, and locally in small groups of therapists. So let’s start the conversation – with our co-workers, our networks, the students that we teach, and the therapists that we go to for bodywork. Share a link to this blog with your network. And please leave a comment if you have something to say.

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Apr 30 2013

Organizational well-being

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Just a quick post to bring up the concept of organizational well-being and the benefits it can have for employees and clients. If you work in a group setting or manage one, you might want to take a look at this article in the Gallup Business Journal.

The main point of the article is that managers can influence the wellness of employees by demonstrating their own commitment to wellness. Organizations with a wellness culture tend to have happier, more engaged employees who then go on to treat clients well, which makes the organization more successful.

And, if you’re self-employed as a massage therapist, you are both the boss and the employee. You can also benefit from creating a culture of well-being for one.

Take care, Rick

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Mar 29 2013

Save your fingers!

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I’ve recently been reviewing workplace injury reports for a presentation I’ve been asked to give on hand injuries. The hand and fingers are the most commonly injured parts of the body in workplaces, and I would imagine at home as well.

Fortunately most hand and finger injuries are minor and don’t result in missed work. But as massage therapists, we need to be especially protective of our hands. Even a minor injury could result in some difficulty using certain techniques. And of course any time we compromise the skin’s integrity we can allow infection in.

One fact really leaps out from the injury statistics: Knives cut fingers! I know this isn’t exactly shocking, but it’s an extremely common injury. Again, most cuts are minor, but every once in a while someone manages to cut into a tendon or even cut off the tip of a finger.

With that in mind, here’s a video on knife safety in the kitchen.

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Sep 04 2012

The link between sleep (or lack thereof) and pain

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This will be a short post, since I’m on vacation. One of the things I’m focusing on while on vacation is getting enough sleep. I’ve always known that sleep is important for my overall health, but now there’s new research from Harvard that shows that getting enough sleep is important for avoiding pain.

The study found that sleep deficiency “is significantly associated with pain, functional limitations of daily living tasks due to that pain, and difficulty performing work tasks due to that pain, among hospital care workers.” The study has some relevance to massage therapists, since it was done with healthcare workers, and with a population that resembles the massage profession as a whole (predominately female, average age in the early 40′s).

So sleep, heal, and feel better. And I can highly recommend vacations. Take care, Rick

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Jul 22 2012

how r yr thmbs?

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There’s been a lot of discussion in the ergonomics community about the use of mobile devices lately. Most people look at devices like smart phones and tablet computers and think: “This is great. I can take this with me and really stay connected.” Ergonomists look at these new technologies with a different perspective: “I wonder what types of injuries might result if someone overuses these things?”

It’s not that ergonomists are overly pessimistic, we just understand human nature. Every technology has a potential misuse, and so the odds are that a popular device will lead to some sort of problems. A lot of ergonomists worried about the potential for thumb injuries with too much texting, and we’re starting to get an indication that our concerns are well founded. There are people who send thousands of text messages a month, and a number of them are developing osteoarthritis at an early age because of it.

What’s a safe number of text messages to type in a month, or week, or day? We don’t have an answer to that question yet. The best approach to the unknown may be a conservative one. With all of the potential for thumb injury in massage work, why add to it with a lot of unnecessary texting?

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Jun 17 2012

Five really easy things you can do for self care

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There are enough challenges in life right now, so I thought I’d share some self-care tips that don’t require a lot of effort. Some of these I’m sure you’ve heard before, but I’m throwing in a little scientific explanation of why they’re good for you so there’ll be some value added.

1. Get enough sleep. We’re talking the full 8 hours here. There’s a small percentage of the population that can get by on less sleep. There’s probably a slightly larger percentage that think they can by on less, but really can’t. Adequate sleep is more than just feeling rested and alert. Sleep is also the time when your body repairs any damage done to it during the day.

2. Avoid deep forward spinal flexion in the morning. As you sleep, fluid returns to your intervertebral disks, part of that nighttime repair process. This “plumps up” the disks and makes your spine a little stiffer for the first couple of hours in the day. While the extra fluid helps keep the disks healthy, the resulting stiffness actually makes your back temporarily more vulnerable to injury. So, it’s best to avoid bending forward at the waist or doing any heavy lifting when you first get out of bed. After a couple of hours of being upright, gravity pushes a lot of the fluid back out of your disks and your spine regains its flexibility.

3. Take an Epsom salt soak. Yes, it’s old school, but Epsom salts are making a comeback. I saw scented Epsom salts prominently displayed in the grocery store the other day. A soak in warm to hot water (keep in mind that heat is contraindicated for acute inflammation) helps to relax the muscles, and the Epsom salts can help reduce inflammation.
4. Drink water. Hopefully the tap water is good where you are. If not, there are a lot of filter options. Even being a little bit dehydrated can reduce muscle performance and cause fatigue. If you’re thirsty, that likely means you’re already somewhat dehydrated. Drink regularly, especially as the weather warms up.

5. Go for a walk. A brisk, 10-minute walk before a massage session is one of the best ways to warm up your muscles and get your blood flowing. Even better if you can get outside for a little sun, for the Vitamin D production and mood enhancement.

What simple things do you do to keep yourself well? Please share with others by leaving a comment.

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May 28 2012

The importance of light

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In my last post I wrote about how much I missed the warmth of the sun during the winter and spring. The sun also provides light, which is more important to us than simply allowing us to see. In addition to stimulating the retina and optic nerve, light also affects the endocrine system. Bright light increases the levels of cortisol in our bodies, which increases our arousal level during the day. Decreasing light levels trigger an increase in melatonin, which helps us to feel sleepy at bedtime.

Sleep problems can occur when we don’t get enough bright light during the day, or when we get too much bright light in the evening. Many massage therapists work in low light levels, since this creates a relaxing environment for the client. Massage rooms are most likely lit with a “warm” light, such as an incandescent bulb or artificial candle. “Cool” lights, such as daylight fluorescents or LEDs may seem harsh, but the blue end of the spectrum that they provide is important for increasing wakefulness during the day. Of course all artificial light is just that – artificial. Natural daylight, as long as we avoid over-exposure, seems to be the best thing for our well-being, both physical and psychological.

So, if you’re not having any issues with sleep or mood, you probably don’t need to make any changes to your light exposure. But if you are having sleep problems, you might try getting more natural light during the day, and using low level, warm lighting in the evenings.

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