The Massage Continuum

Masseuse vs. Massage Therapist

2010-02-04T17:09:00.000-08:00

There was a piece on a morning radio show yesterday about "Men Massaging Men: Is That Weird?". The discussion was pretty superficial, but at least there were positives that were introduced such as female MTs being able to deliver significant pressure. By the end of the show, myself and my MT peers were able to at least get the hosts to stop calling us "masseuses". This led to one of my co-workers sending me the following question:

"Is there a difference between a masseuse and a massage therapist?"

Here's the reply:

Sara,

Big Time.

We don’t have different gender terms for a doctor, physical therapist, or psychologist. “Masseuse” and “masseur” are outdated terms referring to male and female massage practitioners and nowadays it is often used to refer to a less skilled or less professional massage practitioner. The preferred term these days is massage therapist (MT) – which takes the emphasis off of the gender of the practitioner so it can be placed on what really matters; their competence. The gender of the MT is not nearly as important as their ability to address the needs of their client; a good MT will make a client feel safe, respected, welcome, and cared for.

Masseuse has connotations with the shady side of massage – bath houses, parlors, and the sex trade. The massage therapy profession is working hard to differentiate massage therapy from prostitution in the eyes of the public and, unfortunately, regulatory agencies in city government. Massage therapists, including our students, have to deal every day with people who illegitimize or invalidate what we do. We have to justify our profession, educate the ignorant, and refute misconceptions on a daily basis. The terms masseuse and masseur simply serve to reinforce those outdated misconceptions about massage and the people who practice it.

An MT would be ignorant and naïve to think that human sexuality can be exorcised from a person for the duration of their massage session. Massage is holistic and addresses a person’s entire being. Massage is an intimate service and obviously involves touching and disrobing. Our society sexualizes everything (especially women) and is highly homophobic. In the US, most of the touch people experience is either violent or sexual. If a person has never experienced anything else, it is easy for a person to simply classify massage as sexual (because it’s obviously not violent and it feels good, right?). As MTs, we have to educate our clients about even the very existence of nurturing, therapeutic touch as one of the primary responsibilities of our profession. Proper draping, establishing rapport with a client, and protecting boundaries are some of the foundational skills of a massage therapist. Some people will always have preferences for males or females, but many people don’t care and we shouldn’t emphasize gender through having different terms for male and female practitioners.

Calling an MT a masseuse typically reveals ignorance and is just repeating what somebody else has said. It is often received as a degrading, condescending, dismissive, or insulting comment to the MT. Often we patiently educate the one using the word or harboring the misconceptions, but inside an MT will feel the frustration of having to fight the battle one more time. It can truly be exhausting. All MTs dream of the day when stating you are an MT is a badge of honor, a profession that is understood and esteemed instead of joked about. We work towards it one conversation at a time and hope that we can get through to people such as yourself who are curious and desire to know. I hope that the next time you hear someone say “masseuse” or deride our profession that you can be an advocate on our behalf and change another mind.

Thank you for asking and thank you for the opportunity! Please let me know if you have any more questions.

Teach Your Inner Circle

This made me realize how even the people who I work with; fellow teachers, admissions reps, other program directors, and students in different programs don't know about what we do. It is up to us to teach our friends, family, peers, clients, and the general public about our profession. What we stand for and what we are about. We do it every day already. Your best friends may talk you up to their circle, but if they don't know the right things to say they may be hurting you and our profession through their ignorance.

Teach them. It doesn't have to be formal, but make sure that you explain how you would like them to discuss your work, what your philosophy is. Develop a mission statement and actually show it to people. Hone your message and you will find your circle using your own language when they describe your work.

Cause-Related Marketing in Your Massage Practice

2009-12-03T18:22:00.000-08:00

(Sorry it's been a while. I've been a busy bee...)

The economy isn't so hot right now, as if you need me to tell you. Unfortunately, that has a lot of implications for massage therapy. As a teacher, I get asked a lot about what the job prospects for massage therapists are these days. "Is there a market?", "Will I be able to find a job when I'm done with school?" I get asked a lot. From what I have seen, my graduates have still been able to find jobs, but the current state of the economy has created a bit of turmoil in our industry. What I've seen lately is that businesses that were on shaky footing may be closing their doors, laying off workers, or cutting hours and wages. Others seem to be experiencing an increase in business. There are many experienced therapists out looking right now. I haven't seen a drop in demand for massage therapy, but I have seen some shaking up as MTs move around. What gives?

Massage As a Luxury
Unfortunately, there are many people out there who still see massage therapy as a luxury service and not a necessary one. When the economy turns south, discretionary spending on luxuries is the first thing to go. Yesterday on NPR's Marketplace there was an item about shopper's guilt. It's a phenomenon in which in a down economy, people feel guilty about spending money on things that aren't seen as necessary. It kind of feels like you're rubbing it in on the less fortunate. So what can a massage therapist do to overcome shopper's guilt?

Cause-Related Marketing
This is a practice in which when a consumer makes a purchase, a part of the sale is donated to a charity. It can assuage the guilt associated with the purchase in hard times. The nice thing is that the donation is actually tied to a sale instead of just asking for money. You might even consider matching the client's contribution up to a limited dollar amount. You could support a cause that is dear to your heart or allow the client to select a charity of their choice. Both have advantages, some of which are discussed in the next section. Allowing the clients to choose their favorite charity can add value to your service and make it more personal.

Working with a Charity
Another option is to actually partner with a charity for mutual benefit. This can be practiced in a variety of forms, including the following:

providing complimentary services to the charity for them to use in their marketing efforts, gift certificates work well because they are easily transferrable
offer your services at their events with half or more of the proceeds supporting the cause
health education - teach the organization or the groups they serve. You may just pick up some clients

In this season of giving amidst a backdrop of economic uncertainty, give your clients a way to feel better about the money they spend while helping to make the world a better place. What could be better?

Using Movies to Teach

2009-09-02T08:41:00.000-07:00

I love introducing films into the classroom to illustrate topics. Educational video is great, but I'm talking about Hollywood. Nothing pulls in a student like a good story and the nice thing about a movie is that it wraps it all up in a tidy, 2-hour package. It is something that a student can relate to and it will engage them in their learning.

Prepare the Student

The important thing about using movies as instructional tools is to set the stage appropriately and follow up after. Typically, I show a film after I've had a lesson or series of lessons about the themes I want the film to illustrate. That way the class has already had a discussion about the theory and the film can demonstrate a "real life" application, albeit a dramatized one. To set the stage right, you need to give the student some information to look for while watching. This will change the viewing experience from a passive role to an active one. They will be searching the material for information and they will be comparing it to what they already know.

Follow It Up

Just as important as setting the stage is the follw up. The film should be followed by an activity to integrate the learning; ideally an activity that will allow the students to come together in their understanding. A good method is to have the students write a reaction paper to the film, giving them some guidelines for their discussion and tying their own emotional reactions to the material. Then bringing the students together in a discussion will emphasis the themes. Many students will come to the same conclusions, but they will all have different takes and some students will surprise you with what they find.

The Legend of Bagger Vance

I'm going to use this movie as an example of one of the films I use in class. In one particular class, we discuss the theory behind many topics vital to a massage therapist's success - ethics, boundaries, relationships, communication, thinking vs. feeling... all of which are addressed in this film.

Other Films:

Contact - Beliefs, values, persistence, communication, relationships
Pay It Forward - Ethics, values, social responsibility

The great thing is that the film brings the "real world" into the classroom. It gives the students a break from listening to a lecture from their regular instructor (students always love guest speakers). But the main advantage of using film to illustrate a point is that it gets the students thinking situationally - outside the classroom.

What films can you think of that could be used to teach?

Life, Outsourcing, and Massage Therapy – Part 2

2009-07-21T15:44:00.000-07:00

In part 1, we discussed general busy-ness in our clients’ lives and the reason people outsource. I also introduced the idea that we as massage therapists are contracted as outsourced wellness providers. So what can we do with this?

Extend Our Reach (and Role)

So what is your role? As a massage therapist, most people would give the simple answer of “giving massage to my clients”. Close, but too vague. Sure, that is how we go about it, but really we provide wellness, stress-reduction, and all of the other benefits that our clients experience out of our work. When I say that we need to extend our reach, I mean that we need to fulfill our wellness contract. If our clients have put it into our hands to be responsible for a part of their wellness, then we better see that it gets done!

First off, communicate what it is that you are doing. “I provide wellness”, “I improve athletic performance”, whatever your mission is. Make sure your clients know it, and then let your clients know what it is that you do to get them there – that you will proactively help them with their well-being.

Being a proactive partner in your client’s health implies action on your part. I see far too many therapists that sit back and wait for clients to come to them, wait for clients to rebook, or wait for clients to respond to their marketing. Although marketing might seem to be a proactive approach, really you do something and then you have to wait for the client to respond. Gaining clients proactively is a whole new discussion, but what about the clients you already have? What can you do for the clients you already have a wellness contract with?

Be An Active Partner

Let me paint a picture for you. You enroll in a class. You show up for your first day, excited about all the great things you are going to learn. The teacher sits you down, hands you a textbook and says, “I’ll be over there if you have any questions”. How would you feel about that?

Figure out what role you can play in helping their wellness goals to become a reality. One answer is to take on some of the responsibility yourself. And I mean the responsibility for making the massage session even happen. Make sure that for every client you have, you have a plan. Make sure that that plan is well communicated and understood by both you and the client. Make sure that the plan is as much the clients as it is yours. Maybe even have them sign it (not a binding contract!) to give it a little more weight. Then help them to fulfill it. That may mean telling them straight out that if you haven’t heard from them for two weeks, you’ll call to check in with how they are doing. It may mean sitting down and planning out their session schedule so you can have a number of appointments set up and in both of your calendars. It means following up with them by phone, email, text-messaging, and smoke signals. Get the client’s agreement of course from the start. We don’t want to harass them!

This approach may seem pushy to you. However, I have found that clients appreciate the concern. I’ve called clients that I haven’t seen in a while and it’s like they’re reading from a script every time – “Oh, hi! Has it really been that long? I really need a massage! I’ve just been really busy. Thank you so much for calling! Can I come in…?”. I think it’s because they outsourced this part of theiw wellness to you in the first place and they are happy to have you do it for them.

Reminder cards can work, but it is still putting the task of remembering on them. Don’t forget, they have to remember, it has to be at a convenient time, and it has to be urgent for them to pick up the phone. Make it as easy as possible by remembering and picking up the phone for them! I know I’ve found services like Genbook (a free online scheduling service) to be great boosts, because it makes it so easy for them to get an appointment AND it sends reminder emails (or text messages too if you pay for the upgrade). Remember, it isn’t their job to keep you in business, so do the remembering for them!

Outsourcing Wellness = Opportunity

I haven’t seen many therapists take this approach to their practice. However, if you look at it this way, you could expand it to include business wellness programs, government health programs, and more. The important thing there is to demonstrate benefit, and that means a lot more than your clients walking out saying they “feel better”. You need some proof. Use research from the Massage Therapy Foundation, the Touch Research Institute, or the International Journal of Therapeutic Massage & Bodywork to back up your claims. You want to translate those studies into something meaningful to your clients. Stress-reduction may not mean much to them, but maybe helping with insomnia might.

The key is to remember that people outsource work to people who can do it better and more efficiently than they can. I would start taking a look at the different programs out there to promote wellness, pain reduction, sports performance, or whatever your specialty is and develop a program to compare and compete. Ask yourself, “how can I make this easier, more effective, and more time efficient for my clients?” and “What can I do to help my clients take advantage of massage work and stay on track?”

My money is on the fact that if you start being more proactive about your clients’ wellness it’s really a win-win for everybody.

Life, Outsourcing, and Massage Therapy – Part 1

2009-07-21T15:28:00.000-07:00

Just reading the title, you may be wondering what the heck I’m talking about. Well, you may have noticed that it’s been a while since I’ve posted to this blog. Life happened. Life is still happening. I teach, I have a family, car repairs, sports massage events, I’m in school taking classes, and I’m working on setting up a business. I just got busy.

The thing is, so do our clients. Often, as massage therapists, we wonder where our clients go. The truth is that many times it has nothing to do with the client not wanting to come back. Life just got in the way. Very few people I know have large blocks of time in their schedules to do with what they wish. MTs often fall prey to thinking that they are only competing against other massage therapists. Some who see a little bit more realize that they are also competing against other niche products like chiropractic, pain relief, and stress-reduction activities. But in the broader scheme of things, we are fighting tooth and claw with almost every other business (and even person) out there for one thing. Time.

Time and Our Service Economy

We are competing with sports events, TiVo, concerts, charity events, kids’ recitals, theme parks, you name it. Time is our clients’ most precious commodity. It seems that all too often, even when you want to get together with a friend, they have to check their schedule and pencil you in in three weeks. More and more, people are just so busy they can’t get away for anything.

What does that have to do with the service economy? Few would deny that massage therapy is a profession that rests firmly in the service sector. Whether you look at it as health care or a luxury, it is still a service. In one of my business classes recently, I learned that the rise of the service economy in the U.S. really began after World War II. What ended up happening is that incomes rose so that people had more to spend. At the same time, a counter-trend was occurring in that people had more demands on their time. The result was this, people began to pay others to do time-consuming services that they didn’t wish to do. Things like dry cleaning, painting the house, dining out increased. People began outsourcing more of their needs to others.

Outsourcing

The way I see it is that our clients have outsourced some of their care needs to us. We provide a therapeutic service and can rattle off all kinds of therapeutic benefits for massage therapy. We’ve been contracted to provide something that our clients want or need, but either can’t or don’t want to do themselves.

Think for a minute about the things that you want or need and can’t/won’t do for yourself. A person could get in shape without a personal trainer or a gym membership, but isn’t it easier to pay the membership or have somebody else guide you? Massage is kind of the same. People could reduce their own stress, there are many forms of massage that people really could do for themselves. But that isn’t really the issue. It’s time and focus.

General Busy-ness

A month ago, I wrote about my TFL and my plan for addressing it. I was going to chart the progress and write about it here. I know this stuff. I teach this stuff. I recommend it to my clients. Did I do it? Nope. It wasn’t important enough to me at any given moment to do much. Oh, I worked on it a few times. I got some massages at my school. But did I do the entire protocol that I laid out for myself? Sorry.

The point is that our clients are the same way. It’s not that they’re lazy, or uncommitted, or that they don’t want to be healthy. It’s that they have a gazillion priorities and their health is only one of them. Proper nutrition requires a lifetime commitment while McDonald’s only requires a commitment of $5, right now. When so many people demand so many things, something has to give. Unfortunately for us, for many people that seems to be massage and taking care of themselves.

And Back to Outsourcing

The answer to busy-ness for most people is one of two things. Put it on the back burner to be ignored or forgotten OR… outsource it. Our clients are outsourcing part of the wellbeing to us. We just need to know the best way to go about it for our particular group of customers. So what can we do to fulfill our contract as outsourced wellness providers? I’ll save that for part 2… (nice teaser, eh?)

The Wolnick Trigger Point Protocol

2009-06-01T16:18:00.000-07:00

OK, lame name, I know. I’ll come up with something better soon.

Over the years, I’ve dealt with a lot of trigger points. I just talked about a few of my own in my last post. Now some of these trigger points are just plain nasty. They exhibit the kind of pain that simply wants to make you cry – the “exquisite tenderness” described by Travell & Simons. I’ve seen what’s out there as far as techniques for addressing trigger points and have developed a protocol for deactivating them that has worked very well. Surprisingly enough, I’ve never seen any one source that puts all of these techniques together into a single protocol. If you have, let me know, and I’ll give them credit! This is what I teach my students and use myself. Works like a charm!

Here’s a simple version of my protocol:

MET
Cross-Fiber Friction
Static Compression

In that order!

MET, aka Muscle Energy Technique

MET has to be one of my favorite styles. It has some great advantages, not the least of which that it can address a trigger point without the same kind of excruciating pain as the other techniques. Simply described, MET is a technique that you can use to reset the communication between the brain and the muscle. Often, at least part of the irritation is that the nervous system is maintaining a negative feedback loop that reinforces the dysfunction in the muscle. In my experience, using MET nearly always reduces the irritation of the trigger point before you start using any more painful techniques. This decreases the discomfort of the client, and some trigger points may even disappear entirely without any pain! I love the look of confusion on a client’s face when you do a simple exercise and then their pain has disappeared. They always ask “Are you pressing in the same spot?”

MET involves a thorough knowledge of kinesiology and the ability to apply very slight resistance in precise planes of movement. You establish a clear signal between the brain and the muscle and take advantage of innate reflexes to obtain specific effects. Sounds complicated, and the reasoning behind it is, but in practice it’s fairly simple to actually perform. You can learn more about MET here, a few videos here (1 and 2), and a technical paper here.

Cross-Fiber Friction (CF)

The favored technique of Clair Davies, author of the Trigger Point Workbook, this technique has seen a rise in popularity over the years. While it is still painful to the client, the pain is in short bursts rather than a sustained pressure. This allows the client to tolerate more, but also allows for more of a pumping action in restoring circulation to the area. Davies recommends that only 6-12 good, firm strokes over the trigger point constitutes a treatment – a guideline I agree with. This prevents you from overworking the point and causing the trigger point to go active on you. Ouch.

This technique is one that you can do easily on yourself as well. This is good, since it is better to work frequently and in short bursts on a trigger point than rarely but for a long time. It is something that your clients can do at home. Often, the cross-fiber friction will take care of the trigger point aggravation. If not…

Static (Ischemic) Compression (SC)

Ahh, the good old standby of Neuromuscular Therapy (video here). This technique involves holding sustained pressure directly over the trigger point. This has the effect of increasing the pain sensation and “overloading” the neurological circuit so that it shuts down, kind of like tripping the circuit breaker. The analogy that I like to use is that of a rain bucket. The water in the bucket is the amount of irritability in the trigger point. As it fills, eventually the bucket overflows (the TrP goes active) and starts sending pain elsewhere. SC is like tossing bricks in the bucket. It causes it to overflow, but after you’ve drained some water, when you pull the bricks out there is less water in the bucket.

This is certainly the most uncomfortable of the trigger point techniques – which is precisely why I save it for last. However, there are some trigger points that don’t seem to respond to anything else. The good news is that by the time you get to static compression, the other techniques should have reduced the irritability so that this one isn’t so bad.

To perform this technique, locate the precise point of the pain, sink in to the point until you get to a pain of 7 on a scale of ten (the point where if you go past you’ll need to tense up to resist it), and hold it. If the pain is increasing, release and try something else, if it is staying the same, hold for 8-15 seconds then repeat, if it is decreasing, ride it home until it levels off.

I recommend that you only combine up to 3 treatments of either CF or SC at one time to avoid overworking the point and sending the client home in pain. It is a very common mistake to overwork a point and it is very easy to do.

Happy Trigger Point Hunting!

Getting in Touch with Your TFL

2009-05-27T17:21:00.001-07:00

Your Tensor Fasciae Latae (pronounced Tensor Fah-sha Lotta), or TFL, is a small, upside-down teardrop-shaped muscle in your hip. While the muscle isn’t large, it certainly has a large role in how your hips function. You can see a picture here from Gray’s Anatomy and some interactive anatomy here. The TFL helps to abduct, flex, and medially rotate your hip as well as extend your knee (or prevent it from collapsing while walking). Of course it helps to regulate the opposite of those actions too. In short, TFL is involved in every motion of the hip and the major actions of the knee! The insertion for this important little muscle is on the Iliotibial Band (ITB), that taut strip of connective tissue going down the outside of your thigh. TFL can be responsible for some considerable tenderness and tightness on the outside of the thigh.

My Connection

I think it’s funny that I teach this stuff, and I pass it along to my client’s all the time about what is good for them, and yet I have problems with my own TFLs. I had reconstructive surgery on my ACL 12 years ago and I have to say that my hips and legs haven’t been the same since. Over time, I have slowly realized that it’s not so much the surgery as how my body responded to the surgery – and the protective mechanisms I developed. Don’t ask me why it took me so long to realize this; I guess it’s easier to look objectively at somebody else’s body.

How it manifests for me is a massive trigger point in my left TFL. It’s bothered me on and off over the years – some little stress sets it off and it will make my entire leg ache. Over the past few years however, I’ve found a new pattern of periodically tweaking my hip when I carry something awkward (like a massage table) on one shoulder. Invariably it causes my left piriformis to go into spasm so that I can hardly walk – limping for several days. Only just recently have I realized a direct connection between the two pains. I have the same problems mirrored on my right side, just not as severely.

Lifting something awkwardly for a Memorial Day picnic, my piriformis went into spasm again. In working on the area myself, I probed around the rest of my hip to try to see what else was contributing. When I pressed on the latent trigger point in my TFL, my piriformis began pulsating for as long as I help the pressure. When I dug in a little further, I felt a sharp pain in the middle of my anterior shin (Tibialis Anterior) – another common site of pain for me. AHA! Paradigm shift!

Bodywork

IN my next post, I’ll go into a little more detail over the treatment protocols I intend to use to get rid of these things. I’m a massage teacher, and I can receive bodywork on a fairly regular basis. Still, I’ve been receiving bodywork regularly for years and it hasn’t done much for these trigger points. Nothing short of direct, focused efforts will do it. So here’s my plan.

First, I will make sure that I get at least one massage per week with at least some special emphasis specifically on my hips and these trigger points. Good, but that won’t be enough. Clair Davies recommends that you work on them with 6-12 good strokes multiple times per day and that you’ll see improvement in less than 2 weeks, even for the really bad ones. Well it’s proving time! I’m going to work them at least three times per day for at least two weeks and gauge the results.

I’ll keep you posted!

Your Perception Is Your Reality

2009-05-12T14:17:00.000-07:00

“Your perception is your reality”

I recently heard someone say this and I thought it would make a great critical thinking question, especially when applied in context to massage and our client relationships. This is a pretty deep statement and has implications that affect all aspects of our lives. Many times people perceive what they want to perceive. In class, we identified five areas of impact – personally, professionally, communication, your clients, and your work.

Personal Perceptions

Your personal perceptions dramatically affect your own self-esteem and relationships. In essence, your own self-perception is actually the basis of self-esteem. Relationships also have a large element of perception. I know that I have seen people that when they state “I’m not happy in my relationship” it is less of an observation and more of a decision. They have decided that they are not happy and that nothing about it ever will. Others seem to be able to make it through hard times by having the faith that it is only a temporary struggle and that brighter times are ahead. We call these kinds of perceptions a person’s character and we describe it in terms of being optimistic or pessimistic or cheerful or sarcastic. These personal perceptions can really color a person’s world. Stereotypes are an example of this too.

Professional Perceptions

Let’s talk about ethics first. When it comes to ethics, there are times when perceptions can matter almost more than the substance. Were you to socialize with a client, another client or professional could easily perceive the relationship as being improper. Really any interaction is open to interpretation about motives and you only have any kind of control over the impression that you present (I call it impression management). While you can’t control the thoughts of another person, you want to avoid anything that could give the “appearance of impropriety”.

Professional perceptions are also exemplified in job interviews. Your performance in that interview is dependent on how that interviewer perceives you. In this case the perception can quite literally create the reality in that you will never really be that employee unless they perceive you to be.

Communication

Since communication takes two, and the two can never completely know each other’s mind, there is an aspect of interpretation. How many times have we discovered a miscommunication because one person perceived a meaning the other never intended? Sometimes perceptions can also relate to selectivity – only seeing or hearing what one wants to see or hear. Different perspectives will also place different priorities on different things. You may intend emphasis on one thing, but someone else prioritizes another.

Your Clients

I know I’ve seen many clients who say that they are stressed. Sometimes I have to wonder how much of that is a symptom and how much is a self-fulfilling prophecy. Are they stressed, or does believing that they are stressed just allow them to accept it and not find a way to get rid of it? If a client resigns themself to a life of chronic pain, does the perception create or contribute to that reality? There is a connection.

Another aspect is the “I can’t” mentality. You know what I’m talking about. A child is working on their math homework and is saying “I can’t do it” and then after a lot of frustration and agony they do in 30 seconds what they’ve been “unable” to do for half an hour. They’re just trapped in a mindset and convinced their self that it is too hard. They can’t do it as long as they believe that they can’t. Other examples can be clients stating that they can’t function without a steady stream of caffeine, that they don’t have time to take care of their self, or eating right is impossible.

In Your Work

Perceptions here can create some conflict when you perceive something to be beneficial to a client and others may disagree. A huge example of this is I have heard of some spas prohibiting their MTs from working on clients’ gluteal areas because of the perception that it is sexual. These clients miss out on an important integrative region of their body because of a perception (I’d say misconception, but that is my perception! :D). You may perceive that a client needs more pressure to achieve the results they seek, but they perceive that the pressure is already too hard. You perceive that trigger points are to blame for the agonizing pain they are in, but they perceive that trigger point work is simply increasing the pain they are experiencing.

So What To Do About Perceptions?

The good news is that you do have control over your perceptions and, to a lesser degree, others’ perceptions as well. Even a phrase like “look on the bright side” indicates that there is a choice about how you choose to perceive something. An important thing is to do some periodic self-evaluation and see (pun intended) if there are any perceptions that hold you back. Do you have any self-fulfilling prophecies? “I think, therefore I am” could be changed to “I think ______, therefore I am _______.” To a degree, when you think certain thoughts, you start behaving in a way to start to bring those thoughts into reality. Affirmations work this way. You choose something you want to be (a perception), and through repetition you change your thought processes to make it a reality.

Another simple strategy is to just do it. How many times have you thought something was hard or impossible only to realize it wasn’t all that bad? When an event occurs that dramatically changes our entire world view, we call it a paradigm shift. We can cause these to happen intentionally by opening ourselves up to new experience.

I certainly hope that you’ve perceived this to be helpful!

Diversity in Your Practice

2009-04-13T13:55:00.000-07:00

Jack of all trades, master of none - or so they say.

While there is a lot of merit in specialization and becoming a master of your chosen niche, it is important not to become overly limited and specialized as well. And in that respect, I'll use another old cliche - moderation is key.

Why Diversify?

In investments, you diversify to minimize risk. In the workplace to capitalize on different cultures and viewpoints. In massage, it's both.

Risks?

What risks, you might ask? In massage school, we all should have learned (and hopefully learned well) the risks associated with improper body mechanics and repetitive strain injuries. We learn how to help our clients deal with and prevent these things in their lives. But what about ours? Massage is physical work, and even using the best body mechanics isn't going to eliminate all potential problems. We all come into this work with a different history, a different accumulation of life's wear and tear on our bodies, and different genetic predispositions. Some can certainly last longer than others, and proper body mechanics employed consistently and habitually should allow any therapist to (as I always say in class) "let you work for as long as you choose to, not for as long as your body will let you." So, performing the same movements over and over again in your work can create the potential for RSIs.

Let's not forget that we are holistic beings here, so we can't neglect emotional, mental, and spiritual aspects of specialization as well. Personally, I thrive on novelty. I love new projects, getting things kicked off, establishing procedures and efficiencies, building businesses, and starting careers (that's why I love teaching). Doing the same darn thing day in and day out is torture for me. For me, psychological burnout is a bigger concern than physical problems. There is a real danger to the client-centeredness of your practice when things become so habitual you stop asking questions and start running on autopilot. Work becomes less fulfilling, monotonous, and a chore. I'd venture to suggest that just as many, if not more, MTs leave the profession because of this as for physical reasons. It can also lead down the slippery slope of focusing on what you're getting out of it (aka $). Not a good road to go down.

Specialization has its rewards too, but I don't hear too often any discussion about the downside. A healthy MT/practice/career strikes a balance.

Diversify

OK, so over-concentration in a single area can be risky. What do I do about it? How do I diversify?

Well for starters, it may mean using some different techniques. I'm sure there are a lot of things you learned in massage school that you haven't used in a while. Or you could watch a massage DVD, even search on YouTube so you could see some different techniques. Trade massage with an MT that uses a different style than you do or purchase one. Read a book. Even learn something from a discipline that is similar but different like PT, emotional healing, yoga, breath-work... You could also just make the effort to change up the emphasis in your sessions - do a lot more stretching, try some techniques that require client participation, mix zen shiatsu into your Swedish.

Another way is to provide some complementary services. Body wraps, exfoliations, hot stone, aromatherapy, and others are all great ways to mix things up. They can use your body in a different way or potentially use your body in the same way but with an entirely different thought process. It helps to keep you (and your client) engaged in the process.

It might also mean diversifying your work environment. Getting out of a rut means breaking routine. Try working in different environments - a spa, chiropractice office, a pain clinic, a law firm, a house call, outdoors at the charity 10K... Try working with some different clients that have different challenges for you to work with.

Got some ideas on how to diversify? Let me know!

Raising Your Rates

2009-04-08T08:49:00.000-07:00

A touchy subject for all massage therapists. When do you do it? How? What do you say? This question was recently posted on LinkedIn's Massage Therapists & Bodyworkers group:

I would like to hear what other therapists tell their clients when they ask why you've raised prices. (or if they complain about it). I raised my prices last year from $70 to $80/hour. I was underpriced for my area, now I'm competitive. I own the business so about 30% of my clients tip but I don't count on it and it isn't expected or considered in my financing. We all know why we have to raise our prices: 1) To stay competitive and not under-value our work. 2) To pay for the increases in the cost of doing business so that our profit margin remains the same. People who are employed get annual 'cost of living' raises. we don't unless we raise our prices. I am resentful of people who don't understand this, and have a hard time coming up with a concise, professional way to explain. I certainly think I'm worth the raise, so that is not the issue, and I'm not defending that. Thanks!
Cass Vertefeuille Garrett of Greenleaf Therapies, LLC

First off, Cass has it right. When we're self-employed, we are the ones who have to give ourselves a cost-of-living adjustment. I think that Cass has already presented some good reasons why we need to raise prices, but let's take a look at the thought process behind it and the when and how of increasing rates.

Why Raise Rates?

The thought process here is a simple one. Our prices aren't static, as our clients often seem to think they are, and like we MTs can even fall into the trap of believing. There are lots of factors that drive our pricing, some of the most obvious being: inflation, increased cost-of-living, increased costs of doing business, having increased experience, training, or specialized skills, and so forth.

Because these expenses aren't static, neither can our prices. We need to build that mentality into our business plans and practices. Ideally, we should also build this into our clients' expectations. Think about the example of a client who wasn't informed that they might be sore following a massage who then becomes sore afterwards. The are upset because it was a surprise and worried that something might be wrong. The same can happen with your business practices. Build in the expectation that prices will change periodically to reflect the current economic environment and it won't be such a nasty surprise when it happens. I'd include this expectation in your policies from the very first appointment with your client.

When to Raise Rates?

The knee-jerk response to this question is "when you need to" and that is a valid answer. But it is also an answer that implies a lack of planning or control. While you do need to be responsive to factors such as rent increases and the like, that shouldn't necessarily be the only reason to look at your rates.

My recommendation is to develop a process to systematically examine your pricing structure. Earlier, I used the word "periodically" to describe when rates would change (nice foreshadowing, eh?). That means that there is some kind of established and regular time-frame for when the rate changes occur. I go with a yearly period, but you could go shorter or longer if you'd like.

This evaluation should take into account all of the changes to your personal business climate over the course of that period. Some examples:

Taxes - increase or decrease?
Expenses - personal and business
Inflation - don't overlook this one!
Local changes in the market - competition, new regulations...

Inflation alone means a pay-cut every year if you don't adjust your rates. A 3% inflation rate means you essentially earn that much less in spending power that year. Over a couple of years of static pricing, that really adds up!

Generally, I would suggest that you factor all of the cost increases in and figure out the percentage that impacts your real income (not dollar amount, but buying power). If it's not too big, you can hold off tacking on another $5 onto your rates, but then plan on it for the following year. Just make sure that you establish a schedule - a fiscal year, if you will.

How?

This is probably the one most MTs have the problem with. How do I actually break it to my clients? Won't they be resentful? Will I lose clients? These are common fears.

As far as resentment from your clients, nobody likes to have prices go up, but it's a fact of life and if you have prepared they way with client expectations it won't be as big of a deal. And losing clients? Maybe. But if a client leaves because of a small and realistic price increase, they weren't there for you, the health of your business, or the results you deliver; they were there for price alone and you won't miss them. That's a reason why I only use low introductory rates with caution - it fosters an relationship where the most important factor is your low price relative to the competition. If you do have some clients that truly cannot afford your new rates but you want to keep in your practice and they need the work - try including these clients in part of your planned charitable giving. All individuals and businesses should plan on giving some of it all away, either for free or at cost. It's good for everybody. Set aside a certain number of appointments a week (I shoot for 10%) that you can either give away or perform at a reduced price. That way the cost to you is limited, accounted for, and planned on. Everybody wins.

Breaking the news is not the most pleasant of tasks, but like other forms of boundary enforcement, it is necessary. It should be done in the spirit of both acceptance of the fact it must be done and compassion for how it affects your clients. It should be delivered firmly and clearly, with compassion but not regret or apology. Some suggestions that I posted on the LinkedIn forum:

You might try something along the lines of:
"Dear valued client, As I'm sure that you are well aware, the current economic environment has placed additional pressures on all businesses. Unfortunately, my practice has not remained isolated from these pressures and in order to continue to operate soundly I need to increase my rates to (insert your new rate schedule). These new rates are effective on (date). Thank you for your continued support."
Or...
"Periodically, I must adjust my rates to reflect changes in inflation, cost of living, and operational expenses. As a result, I will be increasing my rates to... on (date)."

Promote It

As a teacher, I've had to deal with from time to time is change - curriculum changes, textbook changes, procedural changes - and times of change can be stressful to students (and clients). The important thing when you are implementing a change, even a rate change, is to promote the positives. Sometimes it icludes an explanation about why, sometimes you just emphasize the improvements. With rates, it could be as simple as "to continue to provide the same level of service in the face of rising costs". Your students, and you clients, will pick up on your attitude about it and it does influence how they feel about it. If you are positive, it will move their feelings about it in a more positive direction. If you are negative, they will fight you on it. And if you are wishy washy about it, they will feel they can get you to make exceptions and special allowances.

One thing that can turn the change more positive is to tie in the rate increase with a promotional period. Give a date for when the new pricing takes effect and allow your clients to take advantage of getting in some more appointments at your current rate. Even allow them to buy packages or gift certificates at your current rates up until a certain date. This can have the effect of increasing both the amount of business and having money in your pocket up front. If you worry that things might get tight, you could restrict the discounted certificates to certain times or days so it doesn't interfere with your full-priced business.

So to summarize, make sure you regularly evaluate your pricing and make sure that your pricing is optimal for your business climate and meeting your needs. Be positive, firm, clear, and compassionate about how you communicate a rate increase to your clients. Expect you may lose a few, but most will understand and the ones that leave aren't the healthiest clients for your practice anyway.

Good luck!

Harmony

2009-03-31T22:50:00.001-07:00

I recently returned from a road trip to Sedona, AZ and back. Something about the scenery along the way got me thinking about harmony. Maybe it was the way I saw so much land that man has bent to his will mixed in with the practical realities of having to work with it. Dictionary.com defines harmony as follows:

concord, unity, peace, amity, friendship
agreement; accord
a consistent, orderly, or pleasing arrangement of parts
a pleasing combination of elements in a whole
things intended to form a connected whole

I could wax on with old cliches about how we're all in this together, there's only one Earth, and so on, but let me bring this back to bodywork.

Harmony in Massage Therapy

I've been teaching for years now and of course I have seen many student struggles. One that is common is when students seem to hit a wall where they aren't seeing the kind of results they'd like, or they're working too hard, or their clients aren't falling asleep and raving about how wonderful their bodywork is like they do their classmates'. A common theme that I have noticed is the need for a very subtle, yet very profound, shift in their way of thinking. This is what I say...

"You need to work with the body, not on the body."

Simple, eh? For some, this idea comes naturally. Others must learn it. I don't necessarily advertise it, but I make it an objective that every student leaves my program with this concept. And for some that means that I need to teach it to them.

So what does it mean, with it not on it? It's subtle, but makes a big difference. For one, studies have shown that the intent behind your touch has a dramatic impact on the outcome (Got that from Salvo). But what is that intent?

Working ON the Body

When you work ON a person, you are coming at it with your own agenda. In a very real way it is assuming that you know what their body needs better than they do. It is attempting to inflict healing upon somebody. It is an attempt to make healing an event rather than a process. It is attempting to control the outcome in a prescribed way. It is neglectful of where the client is in their healing process. In short, it is just wrong.

Working WITH the Body

Fortunately, there is a better way. When you work WITH the body, you are a partner, a facilitator, a coach, an encourager. You become a part of the process. You assist and help rather than trying to hijack the process. It allows for adaptation and accommodation to what they want, what they need, and what they are prepared to receive. It allows for the reception of the subtle information that the client is giving you through their body. It is humble. It is harmonious.

There is an old saying that when the student is ready, the teacher appears. The teacher was really there all along, but the student wasn't ready to learn anything. Healing is much the same way - when the one who is hurt is ready, healing will happen. You can't force someone into the process, they must be ready and willing to accept it. Of course, you encourage them to push their limits, but that is what spurs positive change.

The point is that when you work WITH the body, you are working from a place of respect, not one of assumed superiority. Working WITH the body, you build trust with your client and they can begin to allow the healing process to begin in your presence and with your help. Working ON the body shuts down this process and can even reinforce defensive patterns that make the client feel even worse.

The Pain of Dis-harmony

It's a shame that not all massagers out there know this. I use the term massager because a massage therapist really should know this in my book. We've probably all had clients or potential clients tell us some horror story about a massage session where they were worked "on". Often you could equate this to being "worked over". Usually it accompanies complaints that the practitioner didn't listen, didn't care, hurt them, ignored their needs, and many other gripes that really amount to boundary issues centered around an improper intent.

The best massage comes from a place of proper intent, a sense of the sacredness of the soma (or the body-mind), a place of wisdom, and a sense of harmony.

Embodiment, Disembodiment, and Stress

2009-03-31T22:01:00.000-07:00

I'm busy working my way through Teaching Massage when I make the time and I came across the section in Chapter 2 on embodiment in hands-on training. I found it quite interesting, especially since I had never really seen this before (At least put in this way).

Embodiment

Essentially, your presence and awareness within your body. It is a very holistic concept - relating to your mental, emotional, physical, and spiritual connection to your own being. As massage therapists, you could say that our practice is all about facilitating and enhancing our client's embodiment.

Disembodiment

Even before I'd read this section in the book, I discussed these concepts in class. Our modern world has the effect of drawing our presence out of our bodies, with our consciousness out in the story we're watching on TV, on the conversation we're having with the person on the other end of the phone, on the information we see on the computer screen, on all of the tasks we have to do at work. The work that we do has the effect of drawing the recipient back into their body.

Stress

The book identifies a number of things that have a disembodying effect - all stressors. Technology was cited as a primary factor here. Most of what I mentioned in the previous section were based on technology. It makes sense to me since the technology encourages us to focus on things outside of our body. I suppose on a certain level, we could say that the stress response is a cry for attention to draw us back into our body - like a petulant child acting out for attention. Our society shows no signs of becoming any more embodying, in fact it shows just the opposite - a culture of people growing more and more disconnected with their selves.

Massage, meditation, Tai Chi, yoga, exercise, biofeedback - there are many methods for enhancing embodiment. Stress is a disconnection and all of these techniques reconnect.

Any discussion about stress should also include mention of coping strategies. One of the best methods that I have discovered is to determine your stress type. Once you've done that, you can employ coping strategies that help you to deal with your stress more effectively.

Personally, I began working out at the gym again about 6 weeks ago after a long hiatus. Now, I have more energy, a lot more patience, and have restored some of what I think of as my normal sense of calm. Embodiment at it's best!

Bad Experiences

2009-03-26T15:20:00.000-07:00

Another Critical Thinking Exercise from class...

The Question:

Think of a really bad experience you had with a “professional”, a business, or a service provider.
What went wrong – with the circumstance and the resolution process?
What happened after? Was it resolved?
If you were them, what could you do to have prevented or dealt with this situation?

The Ugly

The students had some fun with this one. I mean, who doesn't like to tell their horror stories about something like this. Statistically, if someone has a bad experience with a business, they will go and tell at least 10 other people about it. Why? Because people love to gossip about this stuff and see people's reactions ("They did what?!"). If only they did the same thing when they have a good experience.

These stories ranged from a hotel room paid for a month in advance with a bug infestation and the fight to get their money back, to a dentist that started drilling without anesthesia or permission, to auto sales, to insurance claims, to omnipresent and dastardly telecom companies, to a doctor that assumed everybody that he saw was filing a fraudulent workman's compensation claim and refusing to actually do his job and diagnose their pain, to a landlord taking a complaint about an authorized cat to the level of screaming that their tenant was a bad mother and a worthless human being. Man! Everybody has one of these stories to tell.

We've all had these ugly experiences. Getting shuffled from department to department and having to explain the same thing over and over to an army of people, none of whom are equipped to help you with your problem. Skepticism or outright disbelief that you, the customer, are actually telling them the truth!

The Bad

In these student stories, we identified a number of common themes that make for a bad experience:

Rude, abrasive, aggressive, or insulting: This one was common. Resorting to insults and attacks will never turn the conversation in a positive direction. In fact, it will almost inevitably escalate the hostility in the conflict. If a client does this to you, it still isn't right to return the favor.
Assumptions: We all know the old saying here about assume and "u and me". There is a distinction between using experience to make an educated guess in anticipating the needs of another and making an assumption that you already know what they're thinking or want.
"Own Agendas": One of the biggest problems I see with unsuccessful MTs/sessions is that the therapist thought they knew better than the client about what was right. That way the needs were ignored. You use your knowledge to inform your work, but we don't dictate to the client what is right for them (and it is unethical to do anything that benefits you at their expense!)
Conflicts of Interest: Who are they really working for? You or their shareholders? This goes hand in hand with having your own agenda. Client-centered practices require that you do what is best for your client. It should for all business!
Bait & Switch: Of course this is illegal as well as unethical. Misleading clients into getting something other than what they expected won't win any hearts.
Lack of Concern: They just don't care about you and your life, only about your customer number, payment history, profitability. Massage is a people business, so caring is our business. Don't make this mistake.
Incompetence: There's no excuse for not knowing what you're doing or what you're selling. One student had an experience where the sales clerk didn't even know the most basic things that they sold in their store, before copping an attitude about it!
NOT LISTENING: Big one, this, and common. It goes along with agendas, rudeness, and others. When customers get angry, it's most often because they aren't being heard (of course this is set off by something). You can't solve the problem if you don't listen to what it is.

The Good

Whew! A lot went wrong, didn't it? On the other hand, the class identified a number of themes as being essential to the relationship either to begin with... or to repair it when things have gone wrong.

Boundaries: Know what you are willing to give and take and stick to it. Communicate it clearly and firmly and keep things "in bounds". Limit discussions to the matter at hand. That landlord was way out of line for calling her a bad mother simply because she had a cat!
Respect: We've all heard of the Golden Rule - treat other the way you would want to be treated - but the platinum rule takes it to the next level - treat others the way that they would want to be treated. Not everybody wants to be treated like you would. This automatically rules out aggression, insults, and dismissal.
Follow Through: If you say you're going to do something, do it. No excuses. You should always operate this way, but when you are trying to mend a relationship, it is an absolute must. Don't make promises you can't keep.
Accomodation: Know what you are willing to part with or what you are willing to do to placate this customer. Figure this out ahead of time so that you don't make a mistake in the moment. It may include bending the rules a little - like coming in on your day off or staying late for them, or comping a service or gift certificate. Remember - a customer who had a problem that was resolved to their satisfaction is more loyal than a customer who never had a problem at all.
Communication: Honestly, most conflicts are the result of mis-communication. Don't make it worse by continuing the mistake. Make sure that you take extra efforts to ensure that both parties are clear on the message. Listen. Listen. Listen. Often, when people are angry, it is mostly out of frustration that they are not being heard. Allow them to speak. Make sure you pay close attention not just to the words, but to the meaning behind them.
Informed Consent: They want to know what their in for and it is your job to let them know. Build realistic expectations with your clients and make sure you give them all of the information they need in order to make an educated decision about what is right for them.
Professionalism: Conduct yourself appropriately and diplomatically. Make sure you maintain your client-centered attitude throughout. Professionalism is a skill and a habit. Make sure you think about these kinds of situations ahead of time and figure out how you would like to handle them to create and ideal resolution.
Deliver: Make sure they get what they pay for. Don't overstep your bounds (and scope of practice), but make sure you live up to your billing. Make sure you bring your A-game to the table every time, for every client, without fail.

Once again, an excellent discussion. Mind you, I helped to frame some of these terms, but my students came up with all of this on their own, simply by relating their own stories. Kudos!

Missing Beauty

2009-03-24T15:58:00.000-07:00

A former student of mine sent me this and I used it in class as a Critical Thinking Exercise.

What do you see?

Washington DC Metro Station on a cold January morning in 2007. He played six Bach pieces for about 45 minutes. During that time approx 2 thousand people went through the station, most of them on their way to work. After 3 minutes a middle aged man noticed there was a musician playing. He slowed his pace and stopped for a few seconds and then hurried to meet his schedule.
Four minutes later the violinist received his first dollar: a woman threw the money in the till and, without stopping, continued to walk.
6 minutes, a young man leaned against the wall to listen to him, then looked at his watch and started to walk again.
10 minutes: a 3 year old boy stopped but his mother tugged him along hurriedly, as the kid stopped to look at the violinist. Finally the mother pushed hard and the child continued to walk, turning his head all the time. This action was repeated by several other children. Every parent, without exception, forced them to move on.
45 minutes; the musician played. Only 6 people stopped and stayed for a while. About 20 gave him money but continued to walk their normal pace.
One hour; he finished playing and silence took over. No one noticed. No one applauded, nor was there any recognition. He collected $3.

Not too surprising, don't you think? We've probably all seen something like this happen before, right? Maybe...

No one knew this but the violinist was Joshua Bell, one of the best musicians in the world. He played one of the most intricate pieces ever written, with a violin worth $3.5 million dollars. Two days before Joshua Bell sold out a theater in Boston where the seats averaged $100.
This is a real story. Joshua Bell playing incognito in the metro station was organized by the Washington Post as part of a social experiment about perception, taste and peoples priorities. The questions raised: in a common place environment at an inappropriate hour, do we perceive beauty? Do we stop to appreciate it? Do we recognize talent in an unexpected context?
One possible conclusion reached from this experiment could be:
If we do not have a moment to stop and listen to one of the best musicians in the world playing some of the finest music ever written, with one of the most beautiful instruments.... how many other things are we missing?
What we pay attention to isn’t always deserving of it. We could be missing the blossom of a wild rose.

Interesting, isn't it? I broadened the discussion to include what happens to we MTs if we neglect to pay attention. What do we miss? I've known many MTs that never have time to take a vacation, or work seven days a week, or go in to work on a single client on a day they were supposed to be off. Are we too busy?

It's important to take the time out to recharge your batteries or you'll burnout quick. Massage therapy is a demanding profession, one in which we must don our professional mask and play the part for our clients. We create a client-centered practice, but what about us? Do we get too drained from giving that we have no more to give? Are we too focused on what we need to do to make our practice thrive that we forget who we are, why we're doing it, or what is really important? Maybe that is related to the change in motivation I discussed last week.

How many of us have experienced something wonderful, something beautiful that happened spontaneously? I'm sure all of us. In our rush to create our practices, our futures, and to control our world, we can also unintentionally plan "out" the room for spontanaiety and appreciation of the unexpected. Don't be so present in your practise that you cease to be present in the moment!

Effects and Benefits of Massage Therapy

2009-03-24T15:13:00.000-07:00

This is the first in my Critical Thinking Series of questions from class discussions.

Question:

How does understanding the effects and benefits of massage or massage techniques make you a better massage therapist and/or more successful?

As we discussed this topic as a class, several themes emerged:

Effectiveness & Outcomes
Contraindications
Professionalism
Marketing
Communication & Education

Effectiveness & Outcomes

The very first student comment to this question was in selecting treatment. We examined the adage "If all you have is a hammer, everything looks like a nail" and how it applied to this idea. In understanding how a massage technique will affect the body, we also can determine whether or not it is appropriate or effective for a given problem. Selecting more effective techniques leads to better outcomes.

Contraindications

Naturally, the prior discussion led right into the discussion of what to do when massage is not appropriate. Understanding the effects is a large part of the "do no harm" mantra. It can prevent possible harm, but sometimes it can serve another positive function in practice - positive regard for the client. This overlaps into the next theme, but it demonstrates a positive regard for the client's well-being to help them find the help they need, even if it isn't with you.

Professionalism

As part of this discussion, I asked the students how many of them had had a client who had asked them about a particular massage style or technique and what it did. Of course they all had. The follow up was "what did you say?". It was quickly determined that many hadn't felt they had provided the best answer, or that they had to think about how to condense an entire class down into a simple, understandable statement. The consensus was that you look like an idiot when you are unable to give an answer to those questions. Who should know better what a technique does, you or your client? Understanding these effects makes you appear more professional in the eyes of the client - more competent, more knowledgeable, more credible.

Marketing

Why should they buy what you're selling if you can't even give them a reason? Understanding effects is the foundation of what you need to communicate to your clients. But it doesn't stop there. A discussion of effects seldom means a whole lot to the client. Enter benefits.

Effects vs. Benefits

Effects are what happens in the body - mechanical, physiological, reflex... increased circulation, parasympathetic stimulation, enhanced lymphatic flow, and many, many more. Benefits are what the client experiences because of those effects - they sleep better, experience reduced pain, improved body image... Clients for the most part don't care about the effects (in marketing we call them features) because it doesn't really mean much to them. Benefits, on the other hand, are the things they care about - that register on their consciousness.

Back to Marketing

When a student learns the effects of massage techniques, the next step is to be able to translate those effects into why it is a good thing for the client, aka the benefit. Often this is a very different way to frame it and it is also highly dependent on the audience. It doesn't do a whole lot of good to discuss with an athlete how massage will help them sleep better when they are really concerned with performance improvement. Likewise an insomniac won't care about increased rang of motion and power out of their throwing shoulder. A thorough understanding of effects and benefits allows you to speak in your client's language about their problems. Not grasping this is like trying to speak a foreign language with only half the alphabet.

Communication & Education

Effective marketing is honest education - education about why your service is valuable to your client. Communicating and educating about effects/benefits effectively increases the value that you offer to your clients. You can't teach someone why what you do is important if you don't already know it yourself! To be honest, this category encompasses all of the ones we've talked about so far because education and communication are such an integral part of what we do.

Anything we missed? Please add it to the comments below. Happy massaging!

Critical Thinking Exercises

2009-03-24T14:53:00.000-07:00

Lately I've introduced regular critical thinking exercises into the classroom. I take a question that may or may not have a correct answer, but at the very least draws together various concepts that we've looked at in class, come from the media or current events, or are items that should be part of the students' burgeoning awareness. This has been more successful than I could have imagined.

Originally, I started the practice simply to get my students to think on a higher level than brute memorization, but the effect has been more dramatic. The students are engaged in the topic more, taking more ownership of the concepts, and participating as individuals and a group more heavily. Seeing the impact, I have decided to include this as a daily exercise. I write the question on the board, along with any additional points or lines of thought I'd like the student to consider in their response. Then I give them about 5 minutes to organize their thoughts and write some notes. Then we discuss it as a class and see where it goes. Everybody participates.

Almost invariably so far, I've been impressed. While the students don't necessarily pick up on all of the lines of thinking that I had in mind, they often pull out some ideas that I hadn't considered, or they bring in a different perspective.

Ah, such is the power of collaborative learning!

Enough Rope to...

One thing that I have noticed above all is that given the opportunity, students will usually impress. It makes me think back to the old saying "give them enough rope to hang themselves" and turn it on its head. In this case it seems like I am giving them enough rope to build a bridge. With more or less guidance from me, the students take on the task and pursue the subject - usually with some excitement. It's amazing to see how the students are more engaged - and no wonder, they get to say something instead of just sit back and be talked at.

The reason I chose the rope-bridge analogy is because I have seen this exercise drawing the class closer together as well. The sharing of ideas and group effort to find solutions has had the result of the students participating more as a team than before.

The Future

I'm thinking of turning this into a slightly more formal exercise and have the students note this discussion in a log. That way it won't be some here-and-gone discussion, but there will be a record - something for each student to look back on about all of these important subjects. I know I wish I'd had more detailed notes to reflect back on from when I was in school. Many things become clearer when you talk about them in school, gain some experience, and them come back to ponder them again with new perspective.

I'll post at least some of these discussions here in this forum - as many as I have time for. I hope they help you as much as I've observed!

2009-03-21T09:30:00.000-07:00

A question from the LinkedIn Massage Instructor's Forum involving the creating of a program curriculum. I thought it would be good to add here as well...

Thank you Michael for the opportunity to expand the conversation. We are looking at about a 750 hour course. The intention is to create a program that is at the forefront of massage education, equipping students with what they will need to be effective and successful in the coming years in a new economy.

Some of the specs... I'd like to create a bridge for the graduates to understand the language and relate with doctors and other mainstream medical professionals in the care of people who are already being treated within the western medical model -- that would be most of the population. Along with that, students will graduate with the technical training to treat clients who present with a variety of clinical diagnoses and be able to refer to others when they have reached the limit of their scope of practice. To equip them, I want to integrate training in Neuromuscular Therapy, Myofasical Release, MET, PNF, orthopedic assessments, and other modalities

During the past ten years, I have seen a trend continually moving toward a more integrated medical model that includes what we talk about as "alternative" along side the "western". It wasn't too long ago that chiropractic care was where massage therapy is now. Unless a massage therapist is only interested in doing stress-relief massage, they will need a greater understanding of and ability to relate within the larger medical system in the United States. So, they need their bearings in that world.

I also want the training to encompass an appreciation for and competence in a variety of energetic modalities as well. It really is apparent that all bodywork is energy work, regardless of how "clinical" or "medical" the approach. Cultivating intuition and creativity I think will go a long way to put graduates in a strategic place to do well and meet some of the needs that other medical professionals don't have the training to address.

So Michael, considering this perspective, yes, I do want to develop a broad eastern-western program. I wonder how others who have existing programs might be adapting or altering what they teach to be relevant within our changing world. That is the basis of this conversation. Thank you all for contributing.

Here was my response:

In my experience teaching programs of 720 and 620 hours ranges, you will be a little hard-pressed to fit all of that in and still cover it at the depth you would probably like. Have you taught and developed curriculum before?

It sounds to me that you have a focus on western massage styles and integration with health care. I think that you will have time to cover most of what you mention there at sufficient depth in a fundamental program. An initial question I might ask is are you taking students from zero to hero? Will they have a background in massage already or are they starting from scratch?

For the moment, I'm assuming you are talking about a fundamental program and not an advanced one.

I think the challenge you will find is that orthopedic assessment is certainly a process for students and one that takes a long time to develop. It certainly is in the upper levels of Bloom's Taxonomy and you have to lay a strong foundation of the fundamentals before they can even begin to synthesize them and apply them in this process. Question. Are you looking at a sequential program or a modular one? That can make a difference in how you choose to address this challenge.

With everything that you are talking about, another big challenge that you mention is the language to relate with other medical professionals. Learning all of this language and vocabulary is a huge mountain for most students to climb - it quite literally is a new language for most students. Try to be realistic about how you balance all of the new terms with the expectation that they also understand the concepts, how to use the word, and eventually being able to relate that word/concept to the others that they have learned as well.

I teach a modular program that includes 5 classes that a student can start at any point and take in any order. We have swedish, zen shiatsu, deep tissue, sports, and a chair/business development module.

From experience, the more you emphasize the western clinical model, the more time it seems to take away from eastern/energetic. I find that spending time with the zen shiatsu is incredibly beneficial - but it is an entirely different language and mode of thinking than the western medical model.

Business as well is a large skill-set that many students don't have and need to be successful. You have to know how much time you will need to spend on professionalism skills. It won't do any good if they have amazing technical skills if they don't know the professional mind-set to be a team-member, how to manage money, or even dress/speak on the job. Just teaching the medical terminology isn't enough if they don't know how to put a sentence together in plain english.

I know that this is a lot, but I can probably narrow it down to:
What is the starting level of your students - technically, educationally, and professionally?
You have a limited amount of time to accomplish your goals, what are the most important things you'd like them to be able to do when they walk out the door?

Mike

I'll continue to follow this discussion here, so stay tuned!

Massage Student Motivation - Part 4

2009-03-19T12:48:00.000-07:00

Continuing my discussion of International Journal of Therapeutic Massage and Bodywork's article A Qualitative Investigation into Why the Motivation of Massage Therapy Students Changes over the Course of Their Professional Education from parts 1, 2, and 3...

So What Does It All Mean?

So far we've established that over the course of a massage program, intrinsic motivation decreases and extrinsic motivation increases in students (see the article above for the study). To summarize:

Students become more aware of financial responsibilities (debt load)
Students grow to understand the contributions and limitations of their work (effectiveness)
Students place more value on their skills as they realize the commitments required in their education
Students begin to make associations between professionalism and their career. They identify with being a professional and what that implies.
Interaction with seasoned professionals (faculty) moderates students' idealism with "realistic altruism"

How Can Massage Educators Use This Information?

So it is a fact that students experience decreased intrinsic motivation and increased extrinsic motivation over the course of their program. Dr. Finch concludes that this isn't actually a problem, but a natural progression and reflects a healthy change in attitude. They learn a more balanced perspective.

As educators, we need to be conscious of this shift, and address it appropriately as we bring our students along. We need to be cautious about not injecting the realities to quickly, which may disillusion new students at the outset. At the same time, we need to make sure that students recieve the realities "on schedule" to achieve the balance necessary by the end of their training. We must ensure that we include this transformational process as part of the training, not a side-effect. It deserves some focused attention and even to be raised to a conscious level in the students as well.

It requires also a conscious effort to maintain the altruism through the end. Instructors must be careful to moderate the realities so that the ideals of their students aren't shattered. The idealism should be fostered and molded into something tangible that the students can use. In my classes, I teach my students to build their altruism into an intentional plan. It helps to have a target, or quota for their altruism - I teach 10%. It helps the students to have that target - that way they don't feel guilty about not giving anything away, have it as part of their plan to give something away, but don't give away the farm. This principle can also help to stave off the problem of viewing clients as numbers, or as a means to an end - becoming too extrinsically motivated.

As teachers, we have to be conscious of giving our students what they need in its proper time. This study shows that their exposure to us is a part of this process. We have to bring our students along as they are ready and not introduce them to all of our "realities" too soon. We also need to make sure that as we teach professionalism, we cultivate their altruism as part of the process.

Happy teaching!

Massage Student Motivation - Part 3

2009-03-19T12:10:00.000-07:00

The Evolving Self Image As a Health Care Professional

Again, Dr. Finch broke this theme down into parts:

Rigor/Intensity of the Educational Program
Developing Perspective of Massage Therapy As a Career
Interaction with Faculty

Let's discuss these themes individually (summarized from the article).

Rigor/Intensity of the Educational Program

Dr. Finch describes this theme as the students expectation of commitment to the program. Most students "were largely unaware of the commitment it would take to successfully complete the program". This had the effect of increasing extrinsic expectations because of acceptance of implied level of expertise. It kind of makes me wonder if some of the problems we face in our field comes from the fact that many people aren't aware of just how much we massage therapists know! As the student becomes more aware of the level of knowledge required, they also place more value on their skill and with it the expectation of more rewards. It fits well with the risk/reward paradigm, in that the more you risk, the more you typically expect to receive in return. When the student makes those sacrifices, they look for "a return on all that investment".

As much as I try, it is nearly impossible for my incoming students to fully comprehend what they are signing on to. It is invariably more involved, more work, more homework, more reading, more massage, more, more, more, than the students expect. This leads to Dr. Finch's last point on the theme, that the amount of focus on the details of the work can draw focus from the why behind it - that students quickly run out of time for even thinking about the intrinsic rewards to what they do.

Developing Perspective of Massage Therapy As a Career

As a student progresses through the massage program, they increasingly identify with being part of health care. They realize that they can and often are expected to assist with clients' health problems and that accompanies a level of responsibility.

In addition, students learn about what it means to be a professional and the thought processes, behaviors, and "things" that go along with it. Often there is an association between being successful as a professional and the freedom that goes along with having more money. Personally, I include it as part of my program the entire thought process behind making massage therapy work as a career. The students must think about how they are going to support themselves and their business, pay the bills and enjoy life too. I see it as part of my job to help them figure out how to get there.

Interaction with Faculty

Of course, faculty have been through massage school already. They have experience working as a massage therapist. They have been through the struggles and triumphs of being a practicing massage therapist. They've had their naivete stripped away already. While of course many things must really be experienced before they are truly learned, the instructors begin the process of creating more realistic expectations for the students. It's a part of the process. Altruism is taught as well, but from the tempered perspective of the seasoned professional, and as the students look up to their instructors as role models, the attitudes begin to have an impact.

I've met some very jaded massage therapists in my time - the kind that won't lift a finger for anybody else (figuratively!) unless they're paid for it (can you believe I've had MTs ask to be paid for their time when students asked them for a 10-minute interview?! Talk about a learning experience for the students!). Who'd want a person like that as a teacher? So a good teacher will still maintain some of the altruistic, idealistic spirit to impart to their students - albeit with a realistic and experienced frame of reference.

I love the term that Dr. Finch uses for this - "Realistic Altruism". Boy am I going to start using that!

So what does this all mean? On to part 4...

Massage Student Motivation - Part 2

2009-03-19T10:51:00.000-07:00

The Reality of Life in Practice

This is what Dr. Paul Finch decided to name the first theme that his study identified. I think it is a very appropriate title. He further breaks this theme down into two parts:

Debt Load
Effectiveness in Achieving Positive Health Outcomes

Let's examine each of these sub-themes and before discussion (I summarize from the article).

Debt Load

This one seems fairly self-explanatory. When the student first begins their studies, their loan repayments are generally a long way off. As they progress through their program, the reality that they will soon begin to have payments due, coupled with a mandated financial aid exit workshop and discussion in class about business, making a living, and other financial education means that the students become more financially savvy. As the end of the program approaches, and students face the prospect of being out on their own, responsible and independent professionals, without the crutch that being a student offers. Looking for a job also heightens awareness of the importance of financial acumen to their future.

Effectiveness in Achieving Positive Health Outcomes

Dr. Finch describes this one as a growing awareness that what the student can do can make a real difference in people's lives. Students become aware of the contribution that they can make to a person's well-being and health. They also obtain an understanding about the knowledge that is behind what they do. That might lead you to think that intrinsic motivation increases with this, but it is tempered by the fact that students also learn that massage isn't the answer to every problem and "you are not going to help everyone with everything". To me that indicates a loss of idealism, which isn't an entirely bad thing if their idealism is now balanced with realistic expectations.

Discussion

The reality of life certainly does have a moderating effect on idealism and naivete. To me, I feel it is an instructor's duty to assist the students' growth through this process into a mature professional. It is a disservice to move students through a program without educating them about these realities. Of course, as Dr. Finch mentions, it is also the instructor's job to balance this fact with maintaining support for the "humanistic mission of the profession". I believe that in essence it is a teacher's job to take a dream and turn it into a reality. Part of that process is to help the student to have more realistic expectations about what those dreams really are.

Both of these are a natural part of the process of education. In school, we discuss the practical realities and real-life situations that our students will face. But still, I believe that for me, the value of this discussion is in raising the awareness of the need to keep the realities from crushing the ideals. It is important to find the healthy balance.

On to part 3...

Massage Student Motivation - Part 1

2009-03-19T08:55:00.000-07:00

The second issue of the International Journal of Therapeutic Massage and Bodywork came out today and there was a very interesting article about the changes that massage students experience in motivation over the course of their program. I found it fascinating and it reflected a phenomenon that I have observed over the years in the classroom and in practice - particularly with the "jaded" massage therapists that are just in it for the money.

Here's the article:
A Qualitative Investigation into Why Massage Therapy Students’ Motivation Changes over the Course of Their Professional Education (and their license)

To summarize, the study is about why massage students' motivation changes from more intrinsic to more extrinsic over the course of their education. It takes place at only one school, with a small sample size, but the author recognizes this weakness, and from my observations in my classes the findings are accurate. Please note that I am commenting on this article and adding my observations - Paul Finch, PhD (the author) deserves all of the credit for the article and the pieces I quote from it.

Intrinsic vs. Extrinsic Motivations

First off, many massage students enter their massage programs with some "naive expectations", as Dr. Finch puts it. These expectations manifest as a desire to help others, an altruistic ideal about the work they are about to learn to do. The naivete isn't so much in the altruism as in that it isn't balanced by the realities of the profession they have yet to learn. Intrinsic motivation also comes from things like the satisfaction in the work being done and the self-esteem derived from being skilled and appreciated. IN-trinsic motivation is IN-ternal and given to yourself.

By extension, EX-trinsic motivation comes from rewards from EX-ternal sources. Of course those include compensation, the praise and recognition they get from happy clients, prestige, and more.

Past studies have shown that as a massage student progresses through their program intrinsic motivation decreases and extrinsic motivation increases. This study looked at why.

So Why?

Dr. Finch identified several themes prevalent in the study participants' responses. He describes them as follows:

Reality of Life in Practice

Debt Load
Effectiveness in Achieving Positive Health Outcomes

An Evolving Self-Image As a Health Care Professional

Rigor/Intensity of the Educational Program
Developing Perspective of Massage Therapy as a Career
Interaction with Faculty

Don't worry, I'll discuss each one of these in more depth in this series. I'll also introduce my perspective on how we as educators could use this information to foster this development appropriately and help our students leave our programs best prepared for a vibrant, healthy career. So let's get started!

On to part 2...

Other Massage Bloggers

2009-03-13T11:05:00.001-07:00

There are some amazing blogs out there discussing different topics on massage therapy. I thought I'd put some links down here to some of my favorites (in no particular order). I tried to place links to some of the interesting articles, but this is by no means exhaustive for everything available. Enjoy!

Fingertips:

Massage, Mind, and Body:

The Bodyworker:

Recession Proof Your Massage Business

Massage Therapy Benefits Blog:

Massage Success Tips:

Attending Massage Conferences

Massage Geek Blog:

What CEUs to Take?

The AromaConnection Blog

Massage Marketing Rebellion

Creating a Prosperous Practice

The Enlightened Body Blog

Massage Therapy Online

Free Massage Video Blog

Massage Nerd Blog

Please feel free to comment and add your own blogs or favorites to this list. Thanks!

Standards for Massage Education and Educators

2009-03-13T10:16:00.000-07:00

Whew... it's been a while. But at least it's because I've been busy!

There was an interesting question posted in the "Massage Instructors" group on LinkedIn.

How much education does a massage therapist need?
We all know that different states have different clock hour requirements for entry into the profession (where there are requirements at all). What do you think is the minimum education for an entry-level therapist? Is there a need for an associate's level degree? What about for educators?

Here was my reply:

Minimum Requirements

I think the entry-level requirement varies with the intent of the work. I think that a 2-tier system for licensing requirements is appropriate and wish they'd keep it here in CA instead of eventually switching to a single 500-hour requirement.

In general, I am in favor of higher standards, but I also know that there are many good relaxation-massage practitioners out there. They don't have a corrective intent, can't do a SOAP chart to save their life, but they do have a role in simple relaxation massage. I think that the 250-hour "massage practioner" requirement just passed in CA is appropriate for this level of practice. I know of a school or two that under the current system only teaches a 100-hour program; enough to learn a set sequence, but very little in the way of pathology, anatomy, physiology, ethics, or professionalism.

Advanced Training?

On the other hand, for a corrective intent, I think that 500-hours might still not be enough. At least for a broad, fundamental program that teaches the basics. 100 hours is enough for teaching chair massage or a basic swedish sequence, but a student can't become proficient in deep tissue or sports massage in such a short time. Unless they have prior training of course. I think it might be more effective to categorize programs as fundamental or advanced training programs. Although standardization across all curriculum can have it's problems, I think it could be valuable to establish some levels of training this way.

Degree Programs

As for Associates Degrees, I think it is a good move. A post-secondary degree is becoming more and more necessary in today's work-force. Heck, I see ads for receptionist positions these days that require a Bachelor's! I can see that in the future an AS or BS will be the new minimum standard instead of a high school diploma. I always encourage my students to take advantage of their opportunity to get their AS (it is optional at my school) as it opens a lot of doors for them in the future.

Educator Standards

And finally, as for educators, I think there is a real need for high standards here. I kind of got thrown into teaching and was fortunate that I had prior teaching experience in martial arts. But I now know that there is a significant difference between being a good massage therapist and being a good massage instructor. Teaching material and using it are not the same beast. I am really glad that the ABMP now has a course in Teaching Massage. It is an awesome resource and I'm happy that somebody recognized the need for teacher training.

I do think that as a profession, we need to do a better job of defining what the essential knowledge that a massage therapist needs to be effective. As it stands now the most we have is some requirements for some accreditations that say we need to spend a certain number of hours on a particular subject, not what needs to be taught during those hours. I personally am in favor of educators being held to a higher standard than just practitioners - they should have had at least as much training as they are teaching and experience to boot AND they should have (or get) some training in how to teach as well.

Your Massage Business Plan

2009-02-16T21:14:00.000-08:00

I was approached recently by a friend who had a business idea and wanted my take on it. In talking with him, it refreshed for me the importance of developing a solid plan to work with. It occured to me that it is very similar with massage students. In my friend's case, he had a business idea for a product - he had no real expertise in designing it or in marketing it. In massage it is a little bit different, but many of the principles remain the same. Chances are at some point when you are conducting or planning a business, private practice or otherwise, you will need to borrow money from somewhere. And to do that, you'll need a business plan.

It Starts With An Idea

I've mentioned this in prior posts before, but you have to have a firm idea of what it is that you want to do. Form a picture in your mind and abide by Stephen Covey's words, "begin with the end in mind". What is it you are trying to create? The typical answer is "a successful business", but you need more than that. What is successful? A full schedule of regular, loyal clients, or a team of MTs that work for you in your own spa? What clientele are you wanting to work with, what kind of challenges do you want to handle? Pregnancy, cancer, orthopedic surgery, stressed-out executives? In what environment? Describe it all.

Develop it into a mission statement. Then take it down to 3-4 sentences at the most. This will be your pitch (they call it the elevator pitch). It has to describe who you are, what you do, and where in a short, concise statement. Think long and hard on making this perfect - people will decide if they want to know any more based on this statement alone.

What Do You Bring To The Table?

In my friend's case, this was a hurdle. If you want to start a business, you have to have something to offer. I tend to simplify it into three general categories:

Expertise
Money
Connections

Expertise

When it comes to massage, schools quite rightly put a lot of effort into graduating competent massage therapists. Their technical skills are sound. In this conext it means that they have technical expertise - they know how to do the work.

Money

Any business is going to require start-up money. The bigger the business (or dream) the more money it usually takes. For a private practice, we're looking at money to support you unless you have another job, licensing/permit costs, marketing costs, transportation, decor, supplies and equipment, rent, utilities, phone, and any other expenses one has in order to conduct business. This is often a challenge for many new therapists, so it is usually a good idea to have a job or "boot-strap" a business start - starting small and allowing the growing business to pay for it's own growth.

Connections

Deal-maker skills, that's what this is all about. It can be who you know, it can be access, it can be the ability to get the right people together. This is the ability to go out and sell yourself, your idea, your plan, and recruit others to the cause. If you have no money and no expertise, you at least had better have the ability to get people who do on-board.

What About The Idea?

My friend's thought was that the idea was a piece of this equation. The original idea is simply the little nudge that gets the ball rolling. It isn't much in the way of capital all by itself. You have to have one of the other elements to have anything to work with. The idea is the fuel that feeds the business plan, the unifying theme that ties it all together, but is as useless as a fleeting thought all by itself. It needs the plan to become a reality.

Writing The Plan

A key point to remember is that this document is for them, not for you. Leave nothing out and make no assumptions about what the reader knows and does not. For ease of understanding and readability, there is a standard format that you should follow in your plan. There is a good business plan outline available for you to follow online. This has all of the elements that an investor is going to want to see. Remember, although you are trying to promote and sell your vision to the other person, it is your vision and not their's. The prupose of the plan is to demonstrate that you know what you are talking about, you've done your homework, minimized the risks, and maximized the potential for the investor to get their money back and have a return on their investment.

As I was explaining all of this (admittedly in more detail), my friend chuckled and asked if I was trying to scare him into abandoning his idea. "If you can't even put the work into this plan, how can you expect anybody to believe you could actually make this dream into a reality?" was my reply. I consider the business plan an acid test, a rite of passage to see if the entrepreneur has the mettle to get the job done. Have they looked at every angle? They better have, because I'm sure not going to place my money on their faith!

A Closing Word On Doing Business With Friends & Family Members

In my experience, it is always risky to mix business with personal relationships. In the world of business, money, and livelihoods, the decisions and the relationships are often necessarily objective and calculated. You wouldn't think twice about changing banks or insurance companies for the same service at a lower price, would you? You wouldn't expect your credit card company to simply forgive your debt.

The problem is that personal relationships are never so clear-cut. We accept people's faults and forgive them for them. We teach and educate those we care about because we care. We have different boundaries with those we are close to in the same way we have different boundaries with our clients in the therapeutic relationship than with a friend. And because of that, business and personal relationships - with their contrasting boundaries and demands - can be sticky things to mix.

Good luck!

Recharge Your Batteries

2009-02-05T09:45:00.000-08:00

Just a quick note on taking care of yourself.

Some time ago, a healer told me that I needed to get out into nature more often - away from people and civilization - because that's where I recharge my batteries. She told me this unprompted, and to this day I still wonder how she knew, but she was right. When the inevitable stresses of life start to wear me down, I step away and go take a hike, watch the waves at the beach, or head for the mountains. It's amazing how refreshing it is to my mind, body, and spirit.

My wife is different. She needs to socialize and feed off of other people's social energy. She likes to go dance and have a few laughs with friends to recharge.

So how do you recharge your batteries?

You might not have had the benefit of someone telling you how you recharge, but it is important you try to find out. Try thinking of the times when you have felt most at peace and revitalized and then figure out what those times have in common. Is it music, friends, peace & quiet, a getaway, good food...?

Burnout in Massage Therapy

Massage Therapists are subject to the same kind of burnout as other healthcare service providers. It is a phenomenon called Compassion Fatigue, a result of giving so much of yourself to others all of the time. This is a subject we never really talked about in massage school, but it is something of a problem.

Every year, studies by the ABMP and AMTA mention that the average span of time a massage therapist stays in the profession is 7-8 years. Not a very long career. Granted some of them leave the profession to go into physical therapy or other related or complementary health professions, others lack the business skills to succeed, and others practice poor body mechanics and wear themselves down physically. But I contend that a large contribution to many leaving the profession is Compassion Fatigue and lack of Compassion Satisfaction - or Burnout.

As people, we all need to find a balance between giving and receiving. The giving portion of that equation could be called generosity. In my experience, many MTs start their career wanting to give and give and give, but as time passes many become less and less generous, even jaded. For example, an assignment in class is to go out and interview practicing massage therapists. Every time we do it I get students coming back with interesting stories about even trying to ask a person some questions. Some are very giving and generous, others have even asked students to pay for the time of the interview. Ouch. (Who would you want to go to as a client?)

Avoiding Compassion Fatigue

If you want to be successful in this profession, you have to first accept that burnout happens, then understand why, have tools and skills to deal with it, and then act to address it. I'm assuming if you've read this far that you have at least a little acceptance and understanding about why this happens.

A good place to start is to measure your level of burnout, there is a Compassion Fatigue and Satisfaction Survey (here's a more detailed one) available for you to do so. This is a good tool to help to determine if you are at risk. Once you have determined if there is a problem and what it may be, then you'll be in a much better position to do something about it.

Massage Specifics for Burnout

Here are a couple of things that I have noticed that often affect massage therapists:

Poor professional boundaries. These all manifest as allowing another to take advantage of you in some way. It could be clients conviincing and MT to give them extra time, overlook their lateness, or pressure them for freebies. It could be a boss or supervisor getting you to wait around without appouintments on the off-chance there will be a walk-in, work more hours than you are comfortable with, or demand your time on-call without the business to back it up.
Poor personal boundaries. Letting personal life infiltrate business. Allowing yourself to become personally invested in your clients' outcomes and lives. Allowing business to stray into and interfere with your personal life. Also known as the "I'm cancelling my plans because I have to work" syndrome.
Focus. When money is a struggle, it can become easy to start thinking of each client on the table as "1/10 of my rent" or "gas in my car this week". Allowing your personal life to creep into your thoughts when it should be on the client (thinking about the errands you have to run after the appointment is over while you work). Forgetting why you are in the business in the first place.
Time. You will never find the time for recharging your batteries if you don't make the time for it. You have to prioritize it and factor it in to your schedule. Bouncing around without a plan means you'll never find the time.
Lack of planned generosity. We're in a giving business and you'll struggle if you never want to give anything away. It seems counterintuitive, but give it away to get it. If you factor compassionate giving into your plans then doing it is achieving your goals. Set a quota of what you want to give away, track the results, don't feel bad about giving that part away, but stick to your guns and only give away so much. People will take as much as you will let them.
Others. Please post any other issues you've seen lead to burnout in the comments section.

Don't risk losing all that you've worked toward just because of Compassion Fatigue. It's depressing, but it's not the end of the road or the end of your career. Recharge your batteries and take care of yourself. That way you'll be much better able to take care of your clients!

Teaching Massage

2009-01-28T09:57:00.000-08:00

Since I'm on a roll discussing the process of teaching, I wanted to talk about how excited I am about ABMP's new "Teaching Massage" book and class. I've taught martial arts and I've taught massage therapy for almost 5 years now, but this is the first time I've such a great resource for the art of teaching massage.

About the Book

I will say that I haven't read the entire book yet, but I have read the first few chapters and had time to browse through the rest with some depth. The book is authored by some of the major players in massage education over the years and was written collaboratively. Even just a glance through the table of contents is enough to get a massage teacher excited. It is packed with information about different learning and teaching styles, classroom management, learning theory, instructional methods, adult learners and special needs, lesson design and planning, and tips from the experts on how they teach certain subjects like pathology or ethics.

Why It Is Needed

I don't know about any of you massage teachers reading this, but when I started teaching I was thrown to the wolves. I'd never had any formal education or training in education itself. All I had was my natural talent for teaching. I'm told that I am a good teacher by people who have had the training, but that doesn't mean that I have a solid theory or system to what I do. I'm still, 5 years later, feeling my way through the process. This book (and course) is a Godsend for the massage instructors who experienced the same thing I did - which I am sure is most of us.

Unfortunately, it is often assumed that if you are good at what you do, you will also be good at teaching it to others. I have known brilliant practitioners that simply fall apart in the classroom because it requires a completely different set of skills. Instead of being the authority on where people go for the answers, as a teacher you have to set the stage for the students to discover them and be able to apply them - a very different prospect.

Because there also seems to be a fairly high turnover in the teaching of massage as well, I think it is fantastic that there is now a resource in which a massage teacher can get a foundation in instructional methodology and be better prepared to hit the ground running.

Why so expensive? It actually is sold as part of a 20CEU class, so at a little over $150 (or around $121 through amazon) it's well worth it.

I'll keep posting as I work my way through the book. Until next time...

Mirror Neurons and Learning Massage

2009-01-28T09:30:00.001-08:00

I just received the most recent issue of "The Massage Educator", ABMP's newsletter for massage schools. In this issue there is an interesting article on mirror neurons and their role in learning.

Mirror Neurons

Mirror neurons are a relatively new discovery - only found and researched since 1996. They are specialized neurons and connections in your brain that are associated with learning by observation. The key to this is that when you watch somebody do something, it activates the same parts of your brain as if you were the one doing it. In essence, observing someone perform a task is akin to practicing it yourself (If only I could watch Santana and play the guitar so well).

These connections also help us to associate the observed behavior with existing concepts, which increases retention and understanding of the subject.

Familiarity of the Teacher

What's more is that the effect is increased through familiarity with the demonstrator. So a child would learn better through observing his parent than a total stranger. Perhaps this is because we already have stronger associations with that teacher and are less focused on learning their mannerisms.

So What Does This Mean?

First off, it validates the old screenwriting adage "Show it, don't tell it". Standing in front of a class lecturing is a poor way to deliver information. In fact studies show that people only retain about 5% of the information they hear that way. It means that it is important to bring demonstration and experiential learning to your classroom in as many different ways as possible. Don't just limit it to showing the bodywork - demonstrate the subject.

Be the part. When teaching a subject like say professionalism, it is vital that you demonstrate it to your students. With clients, it is important that you demonstrate the qualities that you are trying to promote to them.

Effectiveness of Learning from DVDs and Books

This goes to show that learning from a DVD can be an effective method, particularly with a clear and concise framework for the demonstrated techniques and with a respect to prior knowledge of the observer. The demonstrator on video must be sure to relate the new material back to knowledge the observer already possesses to reinforce the learning.

In my opinion, books can be a highly effective method for delivery a ton of material, but can also be quite weak at providing a learning experience for practical technique. Books excel at delivering lots of information, but really need to have some additional support to provide for the understanding necessary for the learner to truly own the knowledge. This is why I think the most effective books have DVDs or video to accompany them, or are used in the classroom in tandem with live demonstration.

The challenge is to strike the proper balance. I have found that as an instructor I am often faced with the difficult task of having too little time to pack in too much information. It is a choice many times between the increased amount of content covered or increased student understanding. There is a certain level of knowledge that must be achieved, but there appears to be increasing pressure to pack more into the same program time-frame.

Personally, I am never satisfied with what I'm already doing and constantly search for better methods for better student outcomes. Mirror neurons are another piece. Happy teaching!

Earthlite Massage Tables

2009-01-20T13:33:00.000-08:00

About the time I started this blog, I got the opportunity to go down to Vista, CA and tour the Earthlite factory. I've been wanting to write about it this whole time, but (insert excuse here) so now is the time. I learned a lot about massage table construction during my visit, and I thought I'd pass it along to you. By the way, I don't have any affiliation with Earthlite other than I was part of the decision of my school to use their products. I have had great experiences with Earthlite for my entire career.

Table Construction

Apparently Earthlite is one of the last mills in California. I didn't know that before. They actually cut down all of their wood components right there in their own factory. But on to general massage table factoids:

You want maple. Cheaper massage tables use birch for the legs. They last a little while, but because birch is a softer wood, before long the screw holes loosen up and the table starts to squeak. Not so with maple.

You do want some birch. Maple is heavy, and birch is lighter. While you don't want birch on the legs and frame, the flat decking can get really heavy if it is too dense. So birch is ideal there, but not just any birch. Aircraft quality birch from Russia is the ticket. Really light and strong, it's the same stuff they used to make planes out of.

Wood blocks. Cheaper tables use plastic blocks to anchor the legs into. The problem is that plastic doesn't bond to wood very well, making for a potential weak spot where the legs join the table. A quality table will have wood blocks.

You want 3" of foam. Different tables will layer their foam differently, with various foams and even memory foam, but you want 3". Some of the cheaper tables have 2". Even some of the 3" foam tables you have to make sure that you can't bottom out on it (take a fist and push down. Can you feel the wood?)

Double-locking legs? I've heard it said that you are supposed to have double-locking legs on your table, but the high end tables I've used haven't had or needed them. I still have my first Earthlite Spirit table from 11 years ago (heavily used and transported) and I still can't get it to squeak. I suppose it could be a fail-safe, but I've never seen any problems with single-locking legs.

Weight. Some cheaper tables pack on strength by packing on weight. This can be fine if you never move it, but if you do any out-call - Fuhgeddaboudit!

Vinyl. Ultraleather feels nice, but it isn't all that durable. Both duraleather and Earthlite's Natursoft feel great and last. Although how important this is may depend on how often your clients actually touch the table vinyl directly.

Full width hinge. A good table will have a sturdy hinge on it, preferrably the entire width of the frame rather than a couple of dinky hinges to support the entire weight in the middle.

Some Earthlite Specifics

I love their Caress and Flex-Rest face cradles. If you've ever had that splitting sinus pressure during a massage getting a table that one of these babies will fit in would be worth it by itself. The Flex-Rest distributes the pressure a little more evenly (and is a little lighter) and the Caress molds to your face. Beautiful. Earthlite also uses more eco-friendly products like water-based varnishes and renewable hardwoods.

Quality Controls (aka Made in China)

OK, I knew Earthlite was a quality company before I went down there, but this part blew me away. I had had some doubts about switching to Earthlite simply because they had acquired Stronglite - a company that I had had endless headaches with in the past. Their tables had simply fallen apart with alarming regularity. We finally got rid of (broke) the last one not long ago. Not one table (or chair) lasted. I was concerned what impact that that would have on Earthlite.

I learned a lot about doing business in China from this trip. That doing business there can be a blessing or a curse. Apparently this is how it works. You usually don't do business directly with a Chinese factory, you deal with a broker who then lines up a factory for your production as well as the suppliers for your materials. The broker charges a fee and then lines up his suppliers to make the most profit. The broker will swap out factories and suppliers at any time to maximize his profit - and leaving you out of control of your product. Hence all these problems with products made in China. U.S. companies are learning the hard way how to do business there.

Earthlite impressed me with how they handled this situation. Yes, they do have a factory over in China. They run the factory and even house their employees (to ensure that they get proper shelter and nourishment). They employ the same kinds of quality controls there as they do here and I met the man that oversees them. They also worked out direct contracts with each supplier and even visited their factories to QC the parts they receive! They cross-inspect between factories - the finished products here and the wood components there (that get sent there from CA).

The vinyl is a story all of itself. Duratouch vinyl can get expensive and apparently there is somewhat of a corner on the market. Earthlite wanted to reduce costs so they created their own vinyl (Natursoft). Personally, I think that it feels better than ultraleather. Anyway, as far as quality control, they send their own chemist to the factory that inspects all of the ingredients and then the finished product of each batch of vinyl. Feels better, lasts longer, and is cheaper than the alternatives.

I got to watch the table tests too - static load and the drop test. It's pretty darn cool to see a forklift set a few thousand pounds on a table and it doesn't break. The drop test is even more dramatic. They suspend weight (in this case around 500 pounds) over the table and drop it so that it hits the center of the table (at the hinge) with force. First they dropped 450 lbs. Then they upped it to 495 lbs. Finally 540 lbs caused the table to give. Give mind you and not break. The real-life equivalent would be three clients of those weights each taking a turn to run up and jump on your table. Right.

I did notice that their warranty service area was conspicuously bare. They just don't get that much warranty work.

Company Culture

Of course we were there in the capacity of "potential clients", but I met a great bunch of people down there. Certainly a bunch of guys I could hang out with even if it wasn't business. They have been very responsive to our needs and I could certainly tell that they all have a genuine interest in making a great product. They didn't need any hard sales pitch and didn't use one either. They did what I recommend for any product - build a great product and then all you have to do is teach about it instead of "sell" it.

The Meaning of Touch

2009-01-20T12:19:00.000-08:00

Touch is complex. Really complex. And it is something that we all take for granted. Even us massage therapists tend to overlook how complex touch really is.

Part of the problem is that touch isn't really one sense, but many. What we call touch is really the assembly of a myriad of different sensations that our brain constructs. We can feel temperature, pressure, light touch, heavy touch, tickling, the movement of a hair, vibration - and we lump it all together into this thing called touch. A lot of the touch we experience gets relegated into the subconscious realm as well - proprioception and the inner workings of our bodies are things we don't really have to think about much, they just happen on their own. It is the first sense to develop and our sense of touch is a direct extension of our nervous system.

Just to make things more complex, we have a huge psychological component to it as well. Touch has meanings. Meanings that are different from person to person. Touch is a fundamental part of our being and our attitudes and needs regarding touch affect our entire person.

Describing Touch (what it means to us)

As part of an exercise out of "The Bodywork Entrepreneur", you are asked to complete the following with as many words as you can:

Touching is/touching can...

Comforting, soothing, trusting, helpful, dangerous, harmful, uncertain, consoling, tentative, nervous, habitual, unconscious, calculated, planned, unplanned, inadvertant, unintentional, accidental, malicious, mean, cruel, sadistic, sexual, caring, intimate, arousing, exciting, functional, professional, technical, practiced, misinterpreted, cold, warm, aloof, distracted, possessive, communication, protective, reflexive, condescending, controlled, wild, friendly, loving, intrusive, invasive, good, bad, hard, soft, sensual, formal, informal, welcome, ritualistic, unwelcome, illegal, therapeutic, legal, appropriate, inappropriate, courteous, kind, reverent, sacred, vital, necessary, saving, passionate, angry, violent, aggressive, selfish, unselfish, generous, peaceful, sedating, agitated, shakt, certain, irritating, hurtful, pleasing, scary, fearful, purposeful, thoughtful, regretful, tired, victorious, contentious, competitive, playful, light, creepy, salvation, inclusive, honest, dishonest, shady, meaningful, careless, confident...

...and these words are just the first page of five that I was able to come up with in 20 minutes. See what you can come up with. Obviously touch is complex and runs the gamut of human experience - from one end of the spectrum to the other. It makes sense since it is so fundamental to our nature.

Misinterprating Touch

Seeing how many meanings touch can have, it is no wonder that it can be the cause of so many misunderstandings. You can mean one thing when you touch, but the receiver can interpret it a different way entirely. One of the biggest mistakes a massage therapist can make is to forget that - to assume that the client has the same attitudes about touch as you do. We have to make the effort every time, with every client to understand where they are coming from. They won't know or have thought about it, so it is your job to make sure that this is addressed. Make sure that you are very clear about the intention, form, structure, and application of the touch you do. And don't be afraid to re-emphasize them at any time.

Touch and Relationships

To complicate things even more for massage therapy, the confusion doesn't end there. Touch spills over into relationships and that can lead to a whole new level of challenges. There are five levels of relationship:

Functional-Professional (like at the doctor's office)
Social-Polite (like a hand shake)
Friendship-Warmth (a hug or holding hands)
Love-Intimacy (lying together, arms around their shoulders, or affectionate kisses)
Sexual-Arousal (duh!)

In many of our interactions, we have a fairly clear understanding of the boundry but in our profession, there is so much more room for misinterpretation. Under normal circumstances, you would progress through these levels as you get to know a person and build trust. But in massage we push the boundaries immediately simply through the nature of our work.

Massage operates at multiple levels of this spectrum simultaneously, leading to more confusion. Is it any wonder our clients sometimes don't know how to behave? America is a touch starved society (my daughter's school passed a no touch rule) due to culture and litigation. People are afraid to touch each other. Much of the touch that many Americans regularly experience only falls into one of two categories - sex and violence. If those are the only two categories of touch a client knows, and your massage isn't violence, then it must be sexual, right? I mean how many of even their close friends rub their hands all over their unclothed body?

Denial of the Impact of Touch

Massage Therapy as a whole seems to have trouble coming to grips with the nature of touch. Often times we MTs see only the aspects of touch that we want to - the healing, trusting, gender neutral side - and try to ignore the rest. Unfortunately it's like ignoring the elephant in the room. Touch is intimate and carries with it all of the baggage that people have about intimacy. We can't be our most effective if we have our heads in the sand about that. We can scream at the top of our lungs that massage therapy is not sexual, but we have to teach our clients about the difference. And to do that we must first understand all of the things that touch can mean to a person - the good and the bad.

Professional Massage Products on Amazon.com

2009-01-20T08:53:00.000-08:00

Amazon is huge. And I'm not talking about the 1.6 million square mile rainforest in South America. Amazon.com is even bigger.

Although Amazon offers many navigational aids such as categories, similar items, "customers who bought this also bought...", reviews, wish lists, user lists, forums, and more, finding your way around can be a pain. A few weeks ago, I sapped several hours of my time browsing for books on only a single subject. It seemed that every book or DVD I found led me to a choice of a dozen more products, each leading to even more. After having a few dozen tabs open (like a trail of breadcrumbs to let me know where I'd been) it got a little overwhelming.

I decided to compile as much professional massage material as I could locate. A hard task. When you search for "massage" and "massage therapy" and many other terms that seem pretty self-explanatory the stuff you want is interspersed with many sexual massage products, online marketing courses and the like. Products aren't always filed under the keywords you would expect them to be and there is little to distinguish products for professionals and home-user materials. It's a lot of work. But the good news is, I did a good amount of that work for you.

I set up an aStore at Amazon called the Massage Continuum Store (a standing link to it on the right) that breakes up a lot of these Amazon products into more professional massage therapist friendly categories - primarily into DVD, book, and equipment categories. I have not reviewed, nor would I recommend every product in there, but at least it is in one place for you to evaluate on your own. I will be posting my reviews of the products I do have experience with and will attempt to move the ones I recommend and have had experience with towards the front of each section.

I hope that this helps finding the products you need!

70% Living

2009-01-15T10:26:00.000-08:00

You know I really wish I could remember where this idea came from (if you know, please tell me so I can give credit where credit is due), but it is something that I teach in all of my business classes. It is a powerful tool to help you to realize you financial goals and take a measure of control in your life.

70% Living

As the name implies, with this method you live on 70%. In other words, all of those expenses, bills, and all that should total no more than 70% of your income. Easier said than done you might say. True, but we all need goals to aspire to. This is a roadmap for you to be able to achieve those goals. So this leads to the first step - figuring out your expenses.

Expenses

Although this is the first step in just about any financial process, many people take the wrong attitude at the outset. When you figure out your expenses, don't go for the bare minimums. In other words, don't go into this process with the idea that you are finding out the bare minimum needed to survive. It's about lifestyle. What you want to do is figure out how much your lifestyle costs - without the scrimping and scrounging. That doesn't mean spend exorbitantly, but don't cut out expenses in your head before you even write them down. We're looking for frugality, not miserliness.

Add up all the expenses you have and then translate them all into a monthly format - easy for things like rent, but requiring a little more estimation for things like clothes and gifts. Don't forget annual expenses like car registration (just divide by 12). You will probably have to make some estimates and you're better off estimating too high rather than too low. Include entertainment and vacations and all the rest. Everything that you spend should be accounted for here.

Once you have your number, divide it by 70% and that is the income you need for this.

The Other 30%

So what about the rest? This is where the power of this technique becomes apparent, mainly because most of us live our lives in the other 70%. But it is the remaining 30% that can really get your financial ball rolling. This money is used to fund three things - your rainy days, your future, and karma.

The Rainy Day Fund

10% of your money should go into savings. Most financial advisors recommend having at least 3 months expenses (what we figured out above) in the bank - 6 months for a business. This money helps to prevent living paycheck to paycheck. As a massage therapist, we know that business is not constant. It fluctuates and we have our busy months, weeks, days, and seasons as well as our not so busy ones (boo). The money in your savings can help to offset that variability. It is also used for life's unexpecteds - which to be frank we should expect anyway. Things like car repair, medical bills, emergency plumber visits and the like. If we don't have a savings cushion, these things can be major disruptions in our lives.

Keep your savings in a separate account than you pay your bills from - preferrably something that pays interest too. I usually recommend ING Direct (no affiliation, although I do have an account). They can even withdraw a set amount each month from your checking account to enforce your savings. It needs to be regular and habitual.

Future Fund

10% gets invested. This is for your future and once it is there, you shouldn't touch it. Until that future arrives of course. I'm not going to spend a whole lot of time on this because there are so many resources out there on this subject, but do make sure you do it. It is scary how many people have not planned for their future. Seek out a good and experienced financial advisor to help (ask around). Don't just pick the kid who just finished their FA training program - get somebody who's been doing it a while and has a track record. It shouldn't cost you much because FAs make their money by growing yours.

Karma Fund

Give 10% away. That's right, you heard me. 10%. Give. Away. Whether it is to church or charity, the homeless or polar bears, this is your contribution to a better world. Sometimes this can be 10% of your work (i.e. if you can do 20 appointments a week then you can give 2 appointments away) or time (work 40 hours, give away 4) or a combination of those and money. This creates a habit of generosity. You'll find you don't resent the freebies as many can come to do and that you feel like you're doing some good in the world. There is a lot of anecdotal evidence out there that whatever you give away comes back to you multiplied. Just make sure that anything given away is done so with the spirit of generosity and not expecting something in return. It just doesn't work that way.

Generosity is good business and good practice. Think about it - would you rather go to a business that is helpful, welcoming, and generous with their time and attention, or one where you are seen as dirt until you seem interested in paying money? I've seen both and to me it's a no brainer.

Parting Thoughts

This system is really about setting up the right habits. If you can even adhere to a part of this system, you'll still be moving in a more positive direction. Good luck!

5 Quick Tips to Build Clientele

2009-01-15T10:15:00.000-08:00

I posted this response to a question on the Associated Bodywork and Massage Professionals group on LinkedIn.com. I thought I'd repost it here since there are some good, quick tips for building your client base.

The Original Question:

Hello, I am a massage therapist in training. I will be completing my studies in
October 2009. Is there any advice that can be given or suggestions as to how to
start building a clientle. -Nicole Morris

My Response:

Nicole, There's a lot of great information here (referring to other posts)! You need to find your balance between different methods of building your business. I'm always for spending as little as possible to the best effect, so let's look at a few to get you started. Others have mentioned networking here. Networking is in my experience by far the most effective, but it takes time to build it up. There are however some things you can do to speed the process.

Be ready to talk to everybody about it. And even more importantly, you have to know what you want to say. Make sure you know your market and what it is that they are looking to get out of what you do. Then you can craft what you say to appeal to them. Get your message as clear and concise as possible, then be ready to say it whenever anybody asks what you do.
Recruit your network. You're a member of Linked In here, so you know the power of networking. Use the network you already have of friends and family. I have my students write a letter to them explaining what they've been doing and what they do (back to #1). By telling them in your words, they are more likely to use your language in describing your work to their friends and family - which appeals you your target market more. And then be sure to ask them directly for their help - "please help me build my practice by telling all of your friends and family about my work" - or more directly - "invite your friends and family...". That way they know what you'd like them to do.
Partner-up. That doesn't necessarily mean a business partner, but build a network of people to refer to you. In my work it used to be networking with concierges in hotels, who in turn referred clients to me. Think about how you can create win-win-win situations for you, your referral network, and your clients.
The right kinds of incentives. Don't assume that everybody wants to have a free massage or a discounted rate as a reward or incentive. Sure they can be the cheapest, but they aren't always the most effective. Ask them what they want and give it to them - then they'll give you what you want.
Track it. Make sure you keep tabs on where your business is coming from. Track the top 20% of referrers in your network and make sure you keep them happy and referring as they'll probably send 80% of your referrals by themselves. Hope that helps. I write on these and other topics frequently on my blog ( http://www.linkedin.com/redirect?url=http%3A%2F%2Fwww%2Emassage-continuum%2Eblogspot%2Ecom&urlhash=OjAp&_t=tracking_disc ) if you'd like to read more.

Additional Comments:

I can add to this that as she is a student, she should start building her client base now. Word of mouth takes a while to build and the sooner she starts, the better. She should begin letting her potential clients know where she is with her business development and can start working on these clients (maybe with student rates even). Many students who choose not to charge while they are in school still make quite a bit in tips. One word of caution though, make sure you build in the expectation up front that rates go to your normal professional rates after you graduate. If you don't build this in from the get-go you may run into problems later in transitioning these clients to paying (or paying more).

Constant Vigilance!

2009-01-12T13:30:00.001-08:00

Having just gotten off the phone with our friendly neighborhood police department, I thought Mad-Eye Moody had it right in Harry Potter when he said "Constant Vigilance!".

Unfortunately, we live in a world where you have to watch over what is yours and keep it safe and sound. In my case today, somebody got hold of my debit card number and wired themself some money from my account. Luckily I caught it before the charges actually hit my account, but still I spent the last hour on the phone with my bank and the business charging me and with the police department. I certainly can think of better things to do with my time. It is very frustrating to have to spend a lot of time and effort dealing with something that shouldn't have happened in the first place.

It got me thinking about the importance of keeping your eye on things. Complancency can get you into trouble. Many of us have the tendency to assume that things will continue along just as well as always - even if we don't pay attention to them. Generally however, it is the things we don't pay attention to that go awry.

Business Sense

Really it is like driving a car. You wouldn't go out and drive a car by leaving your hands off the wheel and then just before you crash trying to get back on track. It is much more effective to make little corrections, to monitor your travel constantly and avoid trouble before you come to it. That's how we need to run our businesses (and lives?) as well - not taking things for granted, giving everything the proper attention, and dealing with problems before they arrive instead of damage control.

The majority of the students that enter my massage program want to have a private practice or even their own massage business that employs other MTs. Although owning a business does take a certain temperament and willingness to take risks there really isn't anything all that special about it. The most important thing to being successful in running a small business is managing the details - lots of details. Of course managing them the right way is the other half of the equation.

Top dogs don't stay top dogs by accident. Success is a process that doesn't end - it must be maintained.

Confidentiality

My current problems with my bank account really come down to the fact that somebody didn't manage my private information properly. I've purchased things online from unkown vendors without much of a thought about whether they would protect my information/ Part my fault for trusting them, but definitely their fault for negligence.

We can run into the same problems with our massage businesses. We keep private health information, contact information, collect checks and credit cards. As business owners, it is our job to safeguard that information. HIPAA laws detail the protection and obligation to protect health information, but we don't have the same kinds of standards for the other sensitive information that we handle in our work.

Controlling Access

Make sure that only those who need to see the information can access it. That means securing it so that the opportunity isn't even there for unauthorized access. Password protect. Locked and secured storage. Provide physical barriers to the access.

If you work with others and especially if you employ others, you need to establish policies about protecting client information. Your employees need to know what information they need to safeguard and how. Contractors also need to receive this instruction. If you work in a group setting, make sure that you have these policies outlined with your colleagues. If you work in a business where these policies are not in place, initiate it. The last thing that you want to have happen is to get involved at the center of a fraud investigation.

Positive Habits

It is a good habit to get into to keep a close eye on your obligations. Make sure you access your accounts regularly and frequently to make sure all is well. Respond quickly if there is a problem, as these matters often take time to resolve - the sooner you get started the better. It may seem like a hassle to keep an eye on everything, but you will avoid the aggravation of having to prove your innocence of fraudulent charges and the navigation of countless automated phone menus.

Massage is an Art

2009-01-08T13:07:00.000-08:00

Massage is an Art. And that's Art with a capital A.

Sometimes people use art to describe something that must be felt, that isn't scientific, planned, or even well-thought out. I beg to differ. I think an art is the expression of knowledge layered in emotion. Our feelings add meaning to it and art that has no plan, rhyme, or reason seldom works.

The great artists - Da Vinci, Beethoven, etc... - could not have done what they did without a deep understanding of their craft. To draw you have to have an understanding of weight, perspective, shading. In music an understanding of timing, harmony, and pacing. In dance, fluidity, grace, dynamics. In massage it is physiology, timing, strokes, fluidity, relationships. All involve knowledge and intelligence - what can be called craft.

Craft

You can't create art until you thoroughly understand the techniques used to create it. It must be internalized, digested, and assimiliated into your being before it can emerge as an expression.

A wise teacher once told me:

"I show you something and you do it, it is mine. You do it ten times and it is still mine. You do it a hundred times and it is still mine. You do it a thousand times and then it is yours."

That has stuck with me through all of these years and is very true. It takes practice to assimilate new knowledge. Once it has been absorbed, only then can it be expressed in your own way, with your stamp on it. You go to school, learn a new technique, and then it is up to you to make it yours. Then you can craft it and use it.

Let's Get Buck

Lil' C, a choreographer on So You Think You Can Dance uses the term "buck" to describe peak artistry. He defined buck as meaning the union of internal artistry with external expression. Ideally, this is what we all strive to achieve. That ultimate union between what we have learned to do, expressed to the world at the perfect moment, in the perfect manner.

Now that's Art.

Massage and the Happy Medium

2009-01-08T12:01:00.000-08:00

Massage takes place at the hands.

It sounds obvious, right? Maybe. Maybe not.

I've taught massage therapy for almost five years now, I've educated clients for almost 11 years, and before that I taught martial arts. I've observed how people learn and practice their skills for quite a while. In my experience teaching, I've noticed that there is a spectrum that all students fall upon...

Intuition (Client) <---------------> Intelligence (Therapist)

...where the intuition refers to your feelings and sense of the way things should be and the intelligence refers to your knowledge and thoughts. That naturally begs the questions where are you and where do you want to be?

Intuition

I always ask my students when I first meet them about what drew them to massage. A common theme in their responses is often a story about how they have always done massage in some form. People tell them they have a good touch. They have a talent for finding the knots and even though they don't know what they're doing or how to describe it, they are able to melt the knots away.

I place these students high on the intuitive side of this equation. They are sensitive to other people. They are able to work from information that they gather through their hands from the other person's body. They are responsive to the changes they sense in the other's body and adapt to it. When they do massage, they are performing "inside" the other person's body - on the client side.

Intelligence

People high on the intelligence side of the spectrum operate from the confines of their own head. They intellectualize things, do very well with tests and theory and assessments, and are good at putting the pieces of the puzzle together. They can also see how different techniques and styles can be used effectively on various conditions. They perform massage mostly in their head, thinking through the process - they have a plan. They are performing massage "at" the body, almost as an academic exercise.

Intuition vs. Intelligence

As a teacher, I have observed many students who tend to struggle on one side of the spectrum or the other. First, the problems...

Intuition Problems (or the too-touchy-feely sydrome)

When it comes to the intuitive students, they often have issues with timing, assessment, and figuring out the puzzle. Their sessions can become muddled because having a plan comes from within the therapist. The client's body can lead them in different directions or because every area is crying for help they can get caught up in one spot and neglect the other problems. They can also sometimes have difficulty reconciling the difference between what the client's mouth says and what their body asks for. These students also can have problems in finding where the problems really are when the issues require critical thinking to pin down. They can also overlook some problems because others are "talking louder" and drawing their attention.

On the other hand, these students can seem naturally gifted because their bodywork addresses the clients' needs. They often seem to take a new technique and while they might not always do it right, they take it to a point where it feels good to the client quickly. Because that's where their focus is. One thing to watch out for is the potential discouragement these students can experience when they used to get praise for the quality of touch they had when they didn't know what they were doing and then in school they fumble around with some techniques that engage the intelligence side of the spectrum.

Intelligence Problems (or the you're-thinking-too-much sydrome)

Students who are too far over on the intelligence side of the equation over-think most of what they do in class. They're always worried that they are doing it right. They seem to be able to nail the theorey quickly, but then can struggle with the application. Placement of hands, body mechanics, or doing techniques in a way that are both effective and feel good to the client can be challenges. By the self-focus (hence the therapist-oriented approach), they can sometimes neglect the clients' needs, forget simple things like noticing that the client is cold, or miss some observable information from their client because they are focus inwards. Sometimes these students can get discouraged because they don't seem to get the high praises that the intuitive students get for their work. That just fuels the insecurity that it isn't right and spurs more furious thinking.

These are great people to talk to if you need to get your mind around a problem or you need to piece together pieces of information. They can often, even as a student, piece together some great assessments and make connections between disparate symptoms. They can figure out what is going on with the client and are usually quite good at formulating a plan to do it. They can prioritize the problems and design a session for the best results in the time they have.

The best bodyworkers strike a balance between Intuition & Intelligence

So now we get back to it. Massage takes place at the hands. That means that your massage must be a marriage of the knowledge in your head and the wisdom in their body. Your head will come up with brilliant ideas about what is going on and where to look and their body will tell you "over here!". It's all about the balance. Massage doesn't take place "inside" their body or in your head - it takes place where you and your client connect - at your hands. Where the rubber hits the road, so to speak.

If you perform your massage too far onto the intuitive side, it may feel good, but often the client leaves feeling like you didn't get to everything, that you spent too much time on their (insert body part), or that the results were short-lived.

If you perform your massage too far onto the intelligence side, your client may feel disconnected or that you're very smart, but it dodn't feel good, or again that their needs are ignored. Or perhaps that the massage addressed everything but left them feeling like something was missing.

If you are intuitive, take steps to think things through and plan your strategy. If you're intelligent, work on setting yourself free from the shckles of your thoughts and feel what the client's body tells you - put yourself in their skin.

The hands inform the head.
The head guides the hands.
The union of your intuition and intelligence is wisdom

And that's the Happy Medium.

Massage and Money

2009-01-07T11:35:00.000-08:00

Money. It's a word that has a lot of baggage tied up with it. And it's something that I have noticed that many people seem to be uncomfortable with. Especially massage therapists. I have had plenty of students and seen plenty of practicing MTs that have an unhealthy relationship to money. Why? Massage is about relationships, and this post is about a massage therapist's relationship with money.

I've heard many people misquote the Bible as saying that "money is the root of all evil". Actually it says that the "love of money is the root of all evil." A big difference and a lot more true. Money itself is just a tool. A medium of exchange. A knife isn't a good tool or bad tool, it's how you use it.

Another heavily quoted line is "do what you love and the money will come". A lot of people do what they love and money doesn't come, so what gives? This statement has the priorities right, but misses the mark. I choose to interpret it as

"do what you love (follow your passion with a systematic plan) and the money will come (if you respect it for what it is and what it means to you)"

So why do so many people have such an antagonistic relationship with money?

First off, some people hate what money represents. They have seen what some people do to others to get it and don't want to be associated with that. It could be a matter of worth or value - the the therapist doesn't feel that they are worth the money - a self esteem issue. It could be a sense of idealism or a genuine desire to help without need for compensation.

Money can seem hard to come by. It can seem like there is a chronic lack of it. Especially in these economic times. A person can get used to thinking that there is never any money for them, hating it all the while. Some people pursue money as an end to itself, a way to keep score, as if just having money affords the status or life that they want.

The problem with the pursuit of money is that money is a very poor motivator for happiness. People (and studies prove this) don't gain a whole lot of satisfaction or improved quality of life from having more money. Ironically, the reverse is true though, that not enough money is a huge de-motivator and a source of distress and unhappiness. Money can't buy happiness, but not having any leads to sadness.

Putting Health and Money at Odds

Our society often seems to pit health and money against each other. When we hear studies of the impact of some diseases on the poor and the exclusion of 40% of americans from our health care system because they can't afford it, there is an association with money. In fact, the increasing inclusion of massage in health care may make massage more exclusive instead of more accessible.

Many massage therapists have an idealist streak that creates guilt about charging money for what they do. Massage is like a divine gift, something that is present in all of us and can sometimes feel like charging for bottled water when people can get perfectly good water out of their tap.

Unfortunately, this can lead some MTs with a burden of guilt about money and their business. It sets the stage for a struggle with their career. After struggling in their private practice, they may get a job at a massage business and harbor resentment towards the business for collecting the money the therapist feels guilty about charging! Sometimes the MT grows disillusioned, thinking that the bodywork itself was tainted when it was their attitudes and beliefs about money that were the problem. They end up moving into a profession they don't really care about but is more "reconcilable" with their ideas about money.

Cultivating a Healthy Attitude About Money

If you already have a healthy attitude about money, you can skip this next part. This is for any MT who feels at all guilty about collecting money for their services.

Money isn't evil. I'll say it again. Money isn't evil. You say it. Really. That wasn't so bad, was it? The first step to cultivating a healthy attitude about money is to acknowledge that, at the risk of being redundant, money isn't in fact evil. It's your attitude that is.

You have to realize that you need to make a living. If you can't make a living doing massage, you'll need to make a living doing something else to pay the bills - which means that you won't have nearly as much time to give the gift of massage. Massage-wise, everybody loses that way. You aren't doing what you love and your clients won't get to receive the benefits of your work. I suppose your new employer would benefit from your awesome-ness, but that's not quite the point.

A healthy business supports both you and itself. And when I say supports, I don't mean just squeaking by. It should support your lifestyle and help you to achieve your dreams.

Example. I knew a massage therapist a while back who had been working longer than I had. She'd been out of school for maybe four years and still had plenty of clients that were paying her student rate - half her regular rate. I found this out after asked some questions following her wondering why she was having trouble making her car payment. When I asked why a significant number of her clients were still paying such a reduced rate, she told me that she was afraid of losing them if she charged them more. Several weeks after we spoke, she did decide to raise her rates. Not all the way, but much closer to her going rate. She did lose a few clients, but most stayed with her, and a few even told gher straight out that they had wondered why she hadn't raised her rates a long time ago. She ended up making more from the remaining clients than she did with her full load at the prior rate. The clients that left only came to her because she had the cheapest rate around, not out of any loyalty.

There Is Plenty Of Money To Go Around

You may not believe it, but there is. For example, here in the Bay Area we have around 7 million people and a median household income of a little over $70,000 per year. If we estimate an average household as 4 people then we're looking at somewhere around $120 billion every year flowing through this area. That's a plentyhuge pie to capture a very small slice of.

The other thing is that that money is going to be spent anyway. Either they go to buy a car, or they go to the mall, they order an iPod online, or they invest it somewhere - but money is changing hands all the time. All you want to do is have some of it pass through your hands first. There's no need to feel guilty about that. Shed the attitude that just because you make money, somebody else loses it. It's just not true. All you need to do is figure out how to tap into that flow.

Tapping the Flow

Think synergy (boy am I full of cliches in this post!). It's not really a competition. When you do well, your clients do better, you do your part to keep the economy chugging along, et cetera. Synergy is when the sum is greater than the parts. In this case, your massage + your clients' money = better lives for everybody. Really, your work helps to make your clients' lives better, and isn't that what they are out there earning money to do? Gee, I hope your guilt meter is starting to read zero by now!

Think Win-Win-Win

Thinking synergy involves thinking win-win-win. You win, your employer or business partners win, and you client wins. Everybody likes to play when they can't lose. Think of money as the tool that it is - a device to help everybody win.

Another way to look at money to develop a positive attitude about it is to look at it literally - as a means to an end. Money by itself doesn't do much for you. It's what it allows you to do that makes it important. Think about the things that enough money will allow you to do - expand your business, take that vacation you've been longing for, take scuba lessons, whatever. Look at money as a stepping stone to your goals (see my last post for more on defining success).

Parting Thoughts

Think about money differently. It is not a dragon to be slain, a mountain to be conquered. It is a tool of the trade. A necessary tool that will allow you to continue helping people while also experiencing what life has to offer. Now get out there and tap into the flow.

Defining Success

2009-01-06T14:07:00.000-08:00

Me: “So what are your goals as a massage therapist?”
Student: “I want to be a success…”

Every time I teach my business classes the subject of success comes up. So what is it? Students want to be successful… who doesn’t? The problem is that people seldom know what they mean by “success”. It’s made more difficult by the fact that it means something different to everybody. Let’s take a look at this thing called success.

Dictionary.com defines success as:

the favorable or prosperous termination of attempts or endeavors
the attainment of wealth, position, honors, or the like
a successful performance or achievement
the achievement of something desired, planned, or attempted

What is Success?

The first three definitions above sound good, but when you get right down to it, do they really mean anything? How do I know if I am successful? I could argue either way about my success to this point and I would be right – if those are the criteria. The fourth definition is a little bit better – it introduces a concept of planning and a desired outcome. It turns out that that is the key to finding success – knowing what you want in the first place.

Intention & Priorities

You have to start by asking yourself what you want to accomplish. Simply saying that you want a successful business isn’t enough. What do you want to get out of it? And who do you want it for? You could say “I want to help people”. OK, a little better. Wait, you want a business that earns money too? Now you’ve got more than one person involved! How much money? “I want to be rich” is often the facetious reply to that question (and I’ll tell you now that there are much easier professions to grow rich in). My reply is usually, “How rich is rich?” In essence, you need to make it definable.

I like to use visualization in this process. How do you picture success? I want you to get that image in your head and then start to think of all of the elements that make your vision so appealing to you.

What gets me is that many people don’t really think about what they want to get out of their “success”. Money is one way to define it, but certainly not the only one. Do you want freedom – financially and with time? Esteem, reputation, honors & accolades, respect, credibility, recognition, gratitude, satisfaction, or any of the other things that can be derived from your work? These can all be measures of success.

There, I said it. Measure. It is one of the key points in attaining success. In order to do this right, you should list out all of the things that you want you or your business to accomplish. Then you should prioritize them in order of importance. Finally, you have to find a way to measure it.

For example, you could define success as:

Having work that allows you to earn a full-time income on 30 hours a week
Operating a business that earns enough to support you and itself (be sure not to short-change yourself and set this number as the bare minimum to pay the bills – it has to support your lifestyle)
Being able to take a 2-week vacation to another country once a year.
Owning a home (again, be specific about the type of home and where…)

…or a combination of things. Setting SMART goals is an effective method that helps you to define and attain success for yourself. More on that later. The most important thing for defining success though is being specific.

Stay on Target

Knowing what you want helps you to stay on track and not go astray. I have witnessed massage therapists let their career get away from them – either drawing in clients that weren’t their intended market or growing so dissatisfied with their jobs that they leave the profession. I would say that this is most often an alignment problem – that their internal (and undefined) idea of success and what they were actually doing were worlds apart. Defining your idea of success gives you a gold standard to compare everything to – a set of criteria. If what you’re doing doesn’t fit in with your vision of success, if it doesn’t move you closer to those measurements of success, then it’s not for you.

The best part of setting measurements of success is that you know when you get there. Do you ever wonder why kids always ask “Are we there yet?”? It’s because they don’t have a measure of how far you’ve gone or have to go. As we get older, we do have those tools. We see a sign that says 20 miles and we can instantly figure out that we’ll be there in 20 minutes – counting down the time all the way. It makes the long trips easier (and your career).

Having a specific measure of what success is to you provides motivation as well. You’re on the way. Your path. To a place that you know you want to be. And when things get tough, it’s the light at the end of the tunnel.

What to Measure

That being said, think carefully about what you measure. Make sure it really is what you’re looking for. I get asked all the time by my graduates “They pay this much at this spa. Is that good”. I don’t know, is it? The real question is, does it get you where you want to go? I’ve seen many people, in many different kinds of jobs, lose focus of what they really wanted and leave a better, lower paying job for a higher paying, higher stress job that they hate and tears their family apart. Or they do it for benefits. Or sometimes worse, they settle. Don’t do it just for the money.

If I measured my success based on money, then in my eyes I’m a failure. I won’t tell you what my definition of success money-wise is, but I can tell you that I’m not making it on a teacher’s salary. I did not say that I’m not a success though. I’m esteemed in the eyes of my colleagues (OK, so that is hard to measure). I just finished a degree. And here’s my favorite one. I’ve personally graduated and changed the lives of 120 students who by the averages are out there having made a combined $8 million! If only I got royalties!

That is a serious measure of success in my book.

Leadership & Massage 3 - Characteristics

2008-12-22T15:46:00.001-08:00

Part 1 Part 2

In the last post, we looked at the power that leaders possess. Here, I’ll take a look at what makes a leader a leader. While there are many descriptions and lists of leadership characteristics, there are a few that seem to be universal.

A Compelling Vision

So where are you leading your followers? A leader has a vision of the future. Something that isn’t here yet, and will take work and time to get there, but is possible. An effective leader has a very clear vision, one that is almost tangible. A vision that offers hope of a better future, a place that others want to be. Nobody wants to follow a vision that takes them to a worse place – although they may be willing to suffer hardship to get to a better place.

Having this vision is central to leadership and directly impacts other essential leadership components such as passion and inspiration. It isn’t enough to just have a loose idea of the future, the vision must be clearly defined and articulated. Write it down as best you can. Try to formulate a simple statement that encompasses your vision. It isn’t a good vision or goal until it’s outside of your head. Which leads us to our next vital component of effective leadership…

O Come All Ye Faithful

Sorry, I couldn’t resist the holiday cheer! But it is a very appropriate statement in this case because we’re talking about communication. Not just communication, but creating the faith in others that they want to follow you. This is why it is so important to clearly define and articulate your vision – you have to share it with others. You should be able to describe it easily to other people. And frequently. As a leader, nobody should have to wonder what it is you’re all about. Why? Because you will tell them straight up consistently and often.

You need to tell people where you are going and if your vision is compelling enough they will join you.

Passion, Enthusiasm, and Optimism

These three go hand in hand and all spring from your vision. When the vision is compelling, it is a source of motivation. Most people, even the extremely unmotivated have little trouble getting started when they are working on something inspiring. It becomes a positive circle in which the vision feeds the action, passion, and motivation and they feed back into the vision. It is hard to get motivated and passionate about a ho-hum vision.

Hope springs eternal and it also is the fuel for the journey. A positive outlook is attractive and draws others into following you. People like to be around positive, energetic people. You need to believe that your vision is possible – if you don’t you need to choose something you can believe in. Think Eeyore from Winnie the Pooh, he was always depressing to be around – not exactly an inspiring figure.

A Plan

Finally, a leader must have a plan. You must know how to get there, or at least a pretty good idea. Your followers want to see progress, action, something being done to reach the goal. The vision can be a prize that can get a person through a rough patch along the way, but if no progress can be seen, if the leader seems to be uncertain, then the followers will begin to lose interest. Have a plan. Create milestones. Chart the progress. Take the time to step back and reflect on how far you’ve come from time to time. Leaders hate to be stagnant and are always changing and reworking things to better fit their vision.

Control

Leaders will not hesitate to enforce boundaries or redirect the course of events to stay on track. The first sign that things aren’t quite going right is the feeling that things aren’t quite going right. Evaluate it against the vision and if it doesn’t fit, redirect. Non-followers can damage your following through negativity. Leaders employ a “healthy surveillance” to monitor the goings-on within their sphere of influence and act accordingly.

Leadership in Context

Just to bring things into perspective a little, let’s take a look at the recent presidential election. In my opinion, Barrack Obama won because he demonstrated stronger leadership qualities than his opponent. Obama campaigned on a vision of hope, restoring American status in the world, a new energy future, and better health care. He was able to convey the hope well and I think that this was the primary reason that he one so convincingly.

In order to keep us engaged however, he’ll have to fill in some blanks and operate on more than just hope. We’ll need to see a plan and the milestones along the way. He’ll need to repeat the vision often and clearly.

Other characteristics that I’ve seen described as essential to leadership are:

Sacrifice – This one goes with passion. If you’re fired up about your vision, you’ll go to great lengths to see it through and be willing to put up the time, money, and effort to achieve it.
Moral Character – People hold their leaders to a different standard. We expect them to be better than us. Make sure you demonstrate the qualities that your followers expect. A part of this is to “practice what you preach”. Related to this are credibility and honesty
Self-Confidence – When you have a clear idea where you’re going, there is a degree of certainty about your actions that creates confidence in yourself and your followers.
Emotional Intelligence – AKA empathy, it’s the ability to recognize emotions in yourself and others. Great leaders are able to feed off of, address, and even develop desired emotions in their followers.
Desire – You have to want it.
Comfort Zone – Ironically, although leaders push their followers outside of their comfort zones in the pursuit of a better future, the leaders themselves create a new comfort zone within the vision. They provide a structure or framework from which to operate. The leaders don’t have this safety net however, and must draw on their own drive and passion to persist.
Win-Win Thinking – Leaders get the advantages of power, but they have to bear in mind that following is voluntary and that the power is received at the whim of the followers. In other words, the followers must see the advantage of following. For that to happen, the leader must operate from a position of mutual reward.

Leading & Massage Therapy

Your clients come to you to be led. That’s a part of the therapeutic relationship. It’s up to you to exercise that power in the most effective manner for your client. Pay respect to client-therapist boundaries; to the effects your actions, words, and attitudes can have in either a positive or negative way. Understanding leadership is an important part of leadership.

Where are you leading your clients? Are you on the same page? Are the benefits balanced? Do you have clarity about your vision? Do your followers? How can you use your power for the most benefit? These are all questions you should ask yourself in your massage practice so that you can truly own your role as a therapist… and a leader.

So where are you leading your clients?

Compiled from various sources (Human Relations, Dubrin), (Supervision Today!, Robbins & DeCenzo), (Leadership, Chapman & O’Neil)

Leadership & Massage 2 - Power

2008-12-22T15:44:00.001-08:00

<<< Part 1 Part 3 >>>

I know that you didn’t get into the field of massage therapy because you wanted power over people, so don’t get your bonnet in a twist. You do have power, however. A leader’s power is derived from the followers. In other words, they give it to you! There are three different kinds of power:

Role Power

As I mentioned in the last post, power is inherent in the therapeutic relationship. The client has lost power over their condition somehow and is turning to you for help. This kind of power is called Role Power – or the power of your position. You are the therapist and they the client. They have given you power over their healing. As we facilitate the healing, we gradually give their power back, but there will always be a degree of role power in play.

Other examples of roles that are given power (to a greater or lesser degree) are parents, your boss, teachers, police officers, or the president of the United States. Sometimes these roles have authoritative power attached to them – such as the police officer’s ability to have you do something against your will.

Role Power is effective when you need to “lay down the law” such as with enforcing boundaries when someone in your charge has stepped out of bounds. However it becomes less effective the more you use it. It is best to rely on role power only when necessary.

Personality Power

Charisma. Likability. The power of persuasion. This power comes not out of respect for the role you occupy, but because of respect for who you are. Are you courteous, respectful, trustworthy, optimistic, communicative, amiable, welcoming, helpful, and/or a whole bunch of other good things? Have you ever convinced (I won’t say manipulated) a friend or family member to do something they didn’t really want to do but you could get away with it because of your relationship? Personality power in action!

Knowledge Power

People like to be led by others that have the answers. It is a cliché that knowledge is power, but clichés only become clichés when they are true. The more knowledgeable you are about something, the more power others will give you with regards to it. Never stop learning! The more knowledge power you have, the more credibility you will have when you give you clients helpful information.

Use of Power

Obviously we need to wield our power effectively and appropriately. Our job is to gradually give our clients back much of their power. We use our power in our clients’ best interests. That is part of the essence of being a leader – the proper use of the power that has been given them. The most effective leaders apply these different types of power at different times and in different situations, something called situational leadership. There are times where you need to put our foot down and use your role power to redirect the ship. At other times, you convince. Others you educate. Wise leaders learn when to do which.

Next, we look at the characteristics of leadership…

Leadership & Massage 1 - Intro

2008-12-22T15:42:00.001-08:00

Massage Therapy and leadership? What do those have in common? You might say, “I got into this profession to help people, I don’t want to lead them!” But you do.

Why Leadership?

Leading your clients is an unavoidable circumstance in massage or any other healing profession. It is inherent in the therapeutic relationship. They look to you for guidance. In the therapeutic relationship, one person is always in need. They seek out the therapist to address that need. Your clients will have varying needs, some common themes, but they all are coming to you for help. They look to you for guidance, expertise, assistance, and yes, they want you to lead them to their goal. Sometimes a client won’t even know what they want from you, so again it takes leadership to help them to discover it!

Leaders and healers are both involved in empowering their followers.

You steer the ship. You chart the course. You choose the destination. When you allow your clients to participate in the planning, you are still the one that decides upon how to get there. In some ways it can help to envision your massage practice as a kingdom with you at its heart. Your clients are the people who live in your kingdom (just don’t get too carried away with this image!). People choose to live in your kingdom or not, they must have a reason to stay there. You control that for them. No matter whether it is your private practice or some regular clients at your work, your practice (your little universe) is centered around you (take that Galileo!). If you cease to lead, your universe (or massage practice) ceases to be.

So what makes a leader anyway?

Are they born or made? Most sources will say that although some characteristics of leadership come naturally to some people, most leaders are developed. The good news about that is that it means it is something you can learn to do. If you truly want to be successful in your massage business/career, you need to learn to develop these skills.

Even better news for us all is that there is no standard definition of what it means to be a leader. How is that good, you might ask? Because it means that there is flexibility both in how you choose to emphasize your leadership, and on the leadership characteristics that you choose to develop!

Defining Leadership

In my studies, I have come across numerous definitions of leadership. Here are a few to wet your appetite (not my definitions, although I modified a few slightly):

“Leaders have the ability to influence others towards challenging goals.”
“Leaders bring about constructive change”
“Leaders get people to think, believe, see, and do what they might not have otherwise without your presence”
“A person with a compelling vision that he/she can communicate to and inspire others with.”
“A leader is a conductor, director, or guide”
“One who has influence or power”

In a later segment we’ll take a look at specific leadership characteristics, but first, let’s see where leaders get their power in part 2...

Creating a Safe Space

2008-12-11T07:24:00.001-08:00

I just returned from a trip (not by choice) to Ciudad Juarez, Mexico. Murder rates are sky high, crime is rampant and there is a three-way (at least) drug war going on. And the only place in Mexico to get a US resident visa happens to be there. Go figure.

When we got back onto American soil, I had a vision of how it is in the movies - where the hero returns home and kisses the sand of his homeland - and believe it, I understood exactly how he felt. It was good for my companions to have me there, even though as a gringo I stuck out like a sore thumb. And it was against this backdrop that I began pondering the idea of "creating a safe space" for your clients.

I've taught the concept of creating a safe space to my massage students for years. However, my recent experience very much deepened my understanding of it.

Everyone needs to have a safe place to be - to work, to play, to be. Good old Maslow placed safety in second place on his pyramid of needs - second only to physical existence needs like food and shelter. When we exist in a place in which we don't feel safe, our body's natural defense mechanisms kick in. Stress chemicals flood our bodies - cortisol, epinephrine (aka adrenaline) - as our bodies prepare to either flee from danger or to fight it. (More on stress in a later post) When we are stressed, we seek a safe haven to retreat to - a safe harbor to weather the storm and recuperate.

A Safe Space For Healing

Massage can be a truly therapeutic form of healing if this idea is taken to heart. Most of us therapists understand this on some level - Our clients seek us out to find that safe space for healing. This safe space can be physical - such as our office space, a quiet room, seclusion from the hustle and bustle of life outside, privacy. And it can be conceptual as well, like an invisible bubble that shields your client in the same way a physical space can - a blanket of trust, warm and welcoming energy, moral support, encouragement.

You see, all healing takes place when we are at ease. Relaxed, stress-free and safe. Stage 4 sleep. Massage. Studies have shown that we heal at least 50% faster when we are stress-free and relaxed. Interrupted sleep, high-stress jobs, constant activity all interfere with our bodies' ability to cope and recuperate.

One of the most profound benefits that you can offer to your clients is that safe haven. A place where they can go to get away from it all and focus on what they really need - healing at every level, emotional, spiritual, mental, physical. This safe space is one of the most important, yet most intangible qualities about the work we do. It is vitally important to our clients and our success as massage professionals, and it is one of the hardest things to communicate.

Creating a Safe Place

Trust
We all know that it is difficult to relax with somebody that we do not trust. We keep our guard up and remain wary and suspicious. But we also all know (I hope!) the feeling of ease we get when we are with someone we can trust and let down our guard, take off the mask we show the world and just relax. Trust is something that can be granted in a surprisingly short period of time when the stage is right. It is impossible for our clients to trust us if we don't first start with the wholehearted intention to do well by them (see point #3)

Consistency
Consistency will build trust over time. We humans enjoy the stability that comes with regularity. It is difficult to trust and relax when we are on edge from not knowing what is coming next. When we do know what to expect, we get "in the groove". Consistency is comfortable. Think of all of the little things that you do the same way, just because it feels right. Brushing your teeth, crossing your arms, even the way you walk - it's all habitual. Clients will come to you not just because of the great work you do, but that you have a groove they can relate to, that is comfortable to them. They don't want things shaken up every time (or to come and listen to your drama). They want the stability and strength that rises from the Earth element. We can foster this consistency by creating little rituals - starting and ending your session the same way, greeting our clients the same way, finding out what they like and making sure it is there for them every time. Clients are attracted to the familiarity you create, if they aren't, they go elsewhere to find it.

Intention & Attention
These two go hand in hand. First you must start with the intention to build this safe place, then you must pay attention to the details to make it so. Make sure you ground yourself sufficiently before each and every session - clear your thoughts of your to-do lists and the guys who cut you off on the freeway on the way to the office - those aren't client-centered thoughts. Bring your whole attention to your client, because that is your role to play, the "safe space maker", so that they can heal the way they need to.

Remember the Process
Healing occurs in its own time. Let it take its course. Your job is simply to create a conducive environment. That doesn't mean that healing will take place, only that it can.

Playing It Safe

A key to remember is that healing only occurs when the client is ready. I have known many therapists (massage and otherwise) that have grown frustrated that a client doesn't seem to be making any progress. Well they never will until they're ready and I always say that

"You can't inflict healing, it must occur from within."

Creating a safe place is the first step in the process as the client's mind will never allow the healing to begin in an unsafe environment. Healing requires one to drop their defenses. If you can do this for your clients, you can bring to them the same feeling of overwhelming relief and joy as I felt as I passed into El Paso and touched home again. The funny thing (or not so funny) is that the stress of the trip has lingered and I still haven't been able to fully relax yet.

I think I'll head over to my safest massage therapist to find my peace of soul.

Stacking Services with Massage Therapy

2008-11-23T18:45:00.001-08:00

Would you like to be able to earn more money for your work?

The real question is who wouldn’t? There are several ways you can earn more money by increasing the value of your work – making it more convenient, offering better results with advanced techniques, et cetera. Today I’ll talk about stacking you services.

What does “Stacking Services” Mean?

Stacking services means performing more services that you can charge money for within the same amount of time. An example from my spa days was to have a base rate for a one-hour massage and then charge more for add-ons. For instance, you could charge an extra $10 for deep tissue or aromatherapy, or $15 for both together. The key here is that you are increasing revenue without increasing time.

Stacking services is a way to become more efficient with your time. Let’s step into the shoes of a spa manager for a moment. You’d know that you have a certain number of treatment rooms and that you are open for a certain number of hours per day and per week. That means that there is a certain dollar-value in revenue for each room. What stacking services does is to increase the revenue that each room would make every hour.

Doing More with the Same

The same thing applies to large spas or private, individual practices – you have a certain amount of work that can be performed and it is limited. For an individual therapist, that limit would be the number of massages one could do in a week. For a simple example, if a MT can do 20 massages a week and makes $50 per massage then they are limited to a maximum of $1000 per week. In a perfect world, this MT would earn that much, but in the real world we know that they would seldom be fully booked and would be lucky to make 75% of that.

Now if this same MT stacked some services and raised the average profit per massage to $60, then the weekly income would go up by 20% without working any extra hours. Nice improvement!

For a real-world example, at my old spa, we charged an even $100 for our base one-hour service, a one hour Solace Massage (more on branding later), but our average billed service ran $128 for an hour. All due to stacking. Needless to say, this improved our profitability by 28% without any more hours.

What Can I Stack?

The key to stacking is to do more things in the same time frame. It is fairly common for massage establishments to charge more for specialized massage treatments that require additional training – clinical deep tissue, pregnancy massage, manual lymph drainage, hot stone therapy, and so on. This reflects the fact that fewer people know how to do it. Do you have skills that you could charge a premium for? If you are looking to acquire some skills, find a good balance between what you want to do and what your clients are looking for. If you don’t know what your clients really value about your work – find out! Here are some examples of things you can stack easily:

Hot Stone Massage
Aromatherapy
Deep Tissue work
Sports Massage
Reflexology
Body Treatments – Exfoliations & Body Wraps
Eye Zone treatments
Signature treatments (i.e. your specialty scalp massage)
Postural Evalutations

This is by no means an exhaustive list. Do some brainstorming and think about what you can do to add value for your clients. Will they all jump to take advantage of your add-ons? No, but if you really take into account what they want and look to you to deliver, these add-on services can tailor their treatment to even more perfectly fit their needs.

Adding Time

Another relatively easy way to increase the efficiency of your time is to increase the length of your service. I found that when I was doing outcall massage to the hotels in San Francisco that maybe half of the time if the client had booked a one-hour massage and I asked if they would like to go for a 90-minute session they would say yes.

Now this is different than stacking because it actually does take more time, but especially for outcall massage it is more efficient because it maximizes your travel time.

You see, it would take about 30 minutes to get to and from each appointment for me. That meant every appointment actually took me 2 hours for a one-hour massage. However, with the upsell to 90-minutes, I got paid for 90-minutes of 2.5 hours instead of one-hour out of two. That’s 10% better. You’re already there, so why not make more while you’re at it?

The only problem with this one is when you’re already working close to your limits. Adding time isn’t the best option in that case.

Wrapping It Up

Make sure that when you think of these things that you are looking at it from your clients’ perspective. What do they value about your work and how can these add-ons make it better? If an add-on isn’t a win-win for both you and your clients, don’t do it. They’ll resent it and feel you are trying to gouge them if it only works for you. And you’ll resent having to do it if it only works for the client. If you own a massage business, it has to be win-win-win: for you, the client, and for the massage therapist doing the labor.

Repeat Clients Are Golden

2008-11-12T22:35:00.001-08:00

Have you ever noticed how cell phone companies always seem to offer the best deals to new customers? To customers that switch from other carriers? How you, as a loyal customer only get ho-hum deals on upgrading a phone or changing your plan?

Another one I love is when you’ve been a customer of a company for a while, you call to cancel and they transfer you to “customer retention” where they offer you a deal at half the rate you’ve been paying. Why didn’t you offer me a better rate before?

How does this make you feel as a customer?

In many business and marketing classes, you are taught how to find new customers – a necessary and worthy endeavor. The trick is to balance the quest for new blood in your practice with honoring those who have been with you all the while.

The Cost of a New Client

What many people don’t realize is that gaining new customers costs money. If not money, it costs time; but as the old saying goes, time is money. So just how much money does gaining a client cost you?

Well first you have to determine how much money you are spending on your marketing efforts. Tally up what you spend on business cards, mailers, maintaining your website, open houses, charity functions, etc… so you have a dollar amount. The next part is a little harder – figuring out the intangible costs.

To figure out the intangibles, ask yourself, “Are any of my promotional efforts costing me money in time or potential lost business”? If your time is plentiful, this may not really be a cost. But if it isn’t, you might be “spending” money that way. Also factor in things like transportation, refreshments and any other costs direct or indirect.

Let’s take an example (numbers entirely fabricated) by evaluating all you spend on marketing broken up by category. Then, you have to keep track of how many clients you get from each source. And finally you divide to see how much each new client costs you…

Biz Cards	$25	5 clients	$5 each
Paper Ad	$150	3 clients	$50 each
Online	$50	2 clients	$25 each
Health Fair	$400	8 clients	$50 each
Mailer	$100	5 clients	$20 each
Totals	$725	23 new clients	$31.52 average

What this does is allow you to see how effective each effort is. In this example, our imaginary MT spent $31.52 to gain each new client. New clients are expensive! But wait, there’s more! If you give an introductory discount, it can be even more.

Say your normal rate is $70 per hour. If you give a $20 new client discount on top of that then those clients from the newspaper ad and the health fair were given a free massage. You’d better make sure they come back! The business cards were more efficient, but during this time frame their appointment was still given for:

$70-31.52-20 = $13.48

New clients are vital to any business, growing or established, but don’t lose sight of the big picture and focus all of your efforts here. Not many of us can afford to do all of our work for $13 an hour. It can be an eye opening experience to find out exactly how much we can spend to get those clients in the door. The added bonus to this strategy is that it can really help us focus on our most successful and efficient marketing efforts.

Repeat Clients Are Golden

Now that we’ve seen the sticker shock of how much new clients can cost, how much do returning clients cost?

Nada.

Quite often a client will come back with a simple “would you like to book your next session now?”? Don’t miss this opportunity to ask the client to come back. Show your appreciation for their business and to let them know how much you genuinely value them. Gratitude can go a long way.

Going back to the cell phone company example from the start of this post, why don’t you go a step further and offer a VIP program, a “frequent flier” type program, or a discount for booking a massage at least once a month?

If you look back to working with new clients, you have to look at your conversion rate – how many of those new clients come back for another massage? And another? Personally, unless there is a major clash of personalities, I consider it a problem with my service if a client wouldn’t come back for another session. I use that as an opportunity to evaluate if I could do something better. Of course there could be any number of reasons why a client doesn’t return, so find out what those reasons are! You can’t do anything about it if you don’t know!

Invite those clients back, entice them for more, and as they say in show business, always leave them wanting more (but not wanting what they came for in the first place).

The 80/20 Principle tells us that 20% of your clients will provide 80% of your bookings and income. Make sure you know who they are and you treat those 20% the way they deserve. (More on the 80/20 Principle to come)

I had a client once that turned to me as he handed me the check with a bemused grin on his face and said “wow, with all this money I’ve spent on massage I could have bought a car!”. He followed that statement up by saying that he had enough cars anyway (much to my relief) but it also made me realize that he had spent thousands of dollars with me. When I looked at the books, it turned out that this one client had provided almost 10% of my income for the year!

Follow Up

If you haven’t heard from one of your regulars in a while, make a point of calling them to see how they are doing. Although many new massage therapists blanch at the idea because they are afraid it seems pushy, it has always been a good thing for my practice. In fact, I usually get a booking out of it and I have had quite a few clients thank me for calling – genuinely grateful because I was concerned for their well-being. You’d be surprised how many of your clients think about coming to see you but life gets in the way and they don’t get around to it. Make it easy for them.

There are any number of strategies out there to maintain contact with your clients, so look them up and use them! Ask your colleagues what they do. Ask your old teachers. But above all…

Don’t neglect your repeat clients!

Building Your Personal Network To Build Your Massage Business

2008-11-02T15:38:00.001-08:00

This is a very simple, yet powerful technique to kickstart the best way to build your business – word of mouth. I’ve taught this method in my business classes for years, and the students who apply it meet with great success.

Building Word of Mouth

This is far and away the most effective long-term strategy for a healthy business. It involves building a reputation and confidence in your customers that if they send their friends to you that they will be well taken care of. It starts with exemplary service to your customers. Provide top-notch customer service to every client and potential client. They won’t recommend you if they did not have a good experience.

But how do you take the next step, getting them to refer their friends and family to you? With some clients, you don’t have to do anything – they will sing your praises to anyone within earshot. It’s the others that you should focus on (without forgetting these wonderful people of course!)

What Do You Want Them To Say?

One thing that I’ve seen very few people pause to think about is what people are saying about you. Remember that everybody has their own view about what massage is and what it means to them. People will talk about what massage does for them, not necessarily what it can do for their friend.

To tailor this message a little more, first you need to understand what it is that you deliver. That involves several pieces…

What do you do? (Frame it in terms of what the client gets out of your work) and what do you enjoy doing? What are the challenges that you like to face in your practice?
Who do you work with? This ties in to what challenges you like to face, but what kinds of clients do you work with? Athletes? Pregnant women?
What environment do you practice in? Clinical? Spa? Outcall to clients’ homes? This is tied heavily to the clients you work with. It can also include the kind of “functional” environment that you create. You can create a spa feeling within a clinic and vice versa.

The final step in this process is to create a mission statement that includes these pieces. Try to make it clear and concise – preferably something that is easy to say aloud. Why? Because you will be saying this to your clients in so many words and more importantly, this is what you want your clients to be saying to other people.

Get The Word Out

Once you have refined a mission statement, you need to get it out there. Let all of your current clients know about it and use it in your marketing and in conversation with potential clients. You don’t have to say it word for word every time, but it should be clear enough that every person hearing or reading your message will be able to describe fairly accurately what you are all about.

It is not limited to only potential clients though, and here is the magic. When you make a simple, clear statement about what you do (that really communicates your mission) then that is what sticks in the person’s mind. You’ve created an association in their mind, you’ve created a special category for you, your brand of massage therapy, who you work with, what environment you work in, and what problems you deal with. From that point on, any time one of those topics comes up, they have a much better chance of recalling you.

Recruiting Your Army

Finally we get to the simple, yet powerful, technique I mentioned at the start of this post. The Friends & Family Letter (FFL). To understand how this works, think about what you do when you need something you don’t know about. Where do you turn to first? Simple, you turn to the people you know to ask about their experiences. Then you rely on other people’s testimonials and personal familiarity (like you drive by the business every day but have never been in it). Then, and only then, do most people turn to marketing. Of course that doesn’t mean that you should neglect your marketing, but that shouldn’t be your first effort.

The FFL is designed to recruit the people you already have a relationship with to be your sales & marketing force. The good news is that because these people know you they will hear you out. They care about you and they want you to succeed. You can sound like a dork in the letter and they won’t care because they already like you!

To write it, discuss the following:

What you’re up to: Are you just graduating or still in school? Are you starting a private practice? Are you job-hunting? Give them an update
What you do: Here is where the personal mission statement kicks in. Make sure you frame it in terms of how you can benefit them (your friends & family). Make sure it is in terms of how they should talk about it to their friends and family. It is very important to be clear here, because what you say here heavily influences what they say about you – which is exactly what you want.
What you want them to do. ASK! Make sure you come out directly and ask them to help you. They like you already so it isn’t a great imposition. Do you want them to come in and get a massage? Do you want them to tell all of their friends and family about you? Do you want them to ask their friends and family if they have heard about any massage jobs for you? All of these? Make sure you ask them directly – don’t just hope that they understand what it is that you are looking for.
Thank them and let them know what they get out of it. You might have a referral program or you might offer your undying gratitude. Make sure you show your appreciation.

You can tell your friends & family that they can forward it on. Send it as a letter or as an email.

Effective?

So does this work? I had a student who sent out a FFL by email the night of this class lecture. Over the next 2 days she got over 20 new appointment bookings from people she knew, booked herself out for that weekend, and ended up getting established with a successful weekend BBQ massage business – all by referral. In fact it was so successful that she turned it into a monthly newsletter that continued to help grow her business.

These people know you, so they are likely talking about you already. But are they saying the right things? Do they know what you’d like them to say? Do they know you’d like their help? Do they know what they can do to help? This FFL helps to answer all of these questions.

Good luck! And let me know how it works for you!

Massage Therapy in a Down Economy

2008-10-29T20:45:00.001-07:00

Given the fact that there is an update in the news every single day about the steps the government is taking to address the current financial meltdown, I thought it was appropriate to talk about how the general economy affects massage therapy.

It’s not as simple as saying business hurts during a recession. There is a letter from a massage therapist in the current issue of Massage & Bodywork that says their practice is thriving in spite of the economy. So what gives? Why are some MTs continuing to see success ad others going bust when the economy takes a downturn?

So What Happens?

There is some good news these days. Massage isn’t seen as solely a luxury anymore. The MTs and massage businesses that cater to clientele in this category can experience some belt tightening, but this isn’t the only market segment. Many more people see massage as therapy and health care these days than in the past. Before you get out of the massage-for-luxury market though, there are still people out there spending money on these things, so it isn’t as if the jobs are going to vanish. Hiring may slow down, MTs may not see as many clients these days, but the world isn’t going to end.

The simple fact is that when times are hard economically, people cut down on their spending and some of that spending may be massage. Usually people cut out what they see as dispensable first. So whether your massage business suffers greatly depends on how your clients value our work.

Building Value

Value is a perception. It is a perception of how much something is worth. Yes, there are some universal qualities to value, but it is mostly subjective. When you go to the ballpark and get charged $4 for a soda, you may feel like it is overpriced, but it is worth more to you there at the time than leaving the park to go somewhere else to get it more cheaply. So really the value is in the convenience.

If you sell your services as relaxation, people associate a certain value with that. People will associate a different value with pain-reduction; with athletic performance; with restored function, etc… You need to know what it is that you provide to your clients. Find out what makes you indispensible.

So What Can You Do When The Economy Isn’t Working In Your Favor?

Diversify
Refine (or Learn) Your Mission
Target Your Market
Be Proactive
Roll With the Punches

Diversify

Branch out a little. Don’t be afraid to explore new markets, new niches, for some extra income. Be creative in some of the ways you can do massage. You aren’t necessarily tied to your office. Do some chair massage, supplement your private practice with a job at a chiropractor or some independent contracting. Find some local sports events and call up the coordinators to see if you can come down to work on the athletes. Work a charity event and split the proceeds with the charity. Use your imagination.

Another option is to take a look at your books and your schedule and figure out when your down time is. At our spa, we found that M-Th before 3:00pm was our dead time. Then figure out what you want to do with that time, you can offer a discounted rate to book during that time, we closed our doors during that time without prior appointment, or you could even use that time to hold down another job.

Refine (or Learn) Your Mission

When things become challenging, it is a good time to make sure that your message is on target. What are you trying to accomplish with your work? Of course for you, but more importantly to your clients, what does it do for them? Really home in on that benefit and make sure that is the message you’re sending. If you have never really sat down and thought about it, start. And keep reading this blog because I’ll keep building on this topic.

Target Your Market

Once you have a really good message you have to make sure it is getting to the right people. Who benefits from what you do? And don’t say everybody. A mission that is too broad has little appeal to most people. Try to hone your message so that it really appeals to precisely the people you want to come into your practice. A jack of all trades is a master of none they say, so try to become a master of your chosen niche. Since I’m speaking in clichés – you can please some of the people all of the time, all of the people some of the time, and some people none of the time. You don’t want to try to appeal to everybody all of the time – focus on the some people you can please most of the time.

Be Proactive

When in doubt about what to do, do something. One thing is for sure, sitting around and whining about how things aren’t going well isn’t going to make them better. Massage is a business that little just falls in your lap. You may be the best MT in the world, but if nobody knows about you, you’ll have no business. The only way they’ll know is if you tell them.

Being proactive isn’t about just doing anything though, it’s about working smart. Take the time to identify the things that are in your control, that you can control, and focus on them. Try to break it down into small, actionable steps, preferably into steps that you can do in a short period of time, like an afternoon or a couple of days. That way you don’t have to wait too long until there is some kind of payoff. Set some attainable goals that allow you to taste some success and keep you moving in the right direction.

If you aren’t already, call up those clients who haven’t been in for a while and check up on them. You’ll find that a good number of them will be happy that you care about them and you’ll get some appointments out of it. Send a letter or email to all of your friends and family and ask for their help (more on this technique in another post). Nothing beats referrals.

Roll With the Punches

It can be hard on your attitude when times are tough, but you have to maintain your outlook. Don’t waste your time dwelling on the obstacles, but look for the silver lining and the paths around those obstacles. I know it sounds trite, but there really is an opportunity in every problem, so try to look for the bright spot and how this can benefit you in the long run.

Conclusion

Above all, realize that things will turn out alright. I speak from experience. When we opened our spa in the Westin in Silicon Valley, we did our very first appointment the night before the 9/11 attack and the bottom fell out of the travel to our region. We rolled with it although it certainly changed our business plan. Do what you can do, try to minimize your risks, and don’t worry about the things you can’t control.

More Thoughts on Muscle Energy Technique

2008-10-28T10:23:00.000-07:00

In the latest (Nov/Dec 2008) issue of Massage & Bodywork Magazine, there is an article entitled “Sports Injuries: Breakthrough Methods in Treatment” by Karta Purkh Singh Khalsa. There is a lot of great information in this article, but something strikingly lacking is the use of MET (Muscle Energy Technique) in treating these injuries. I can see great value in the manual techniques that Mr. Khalsa describes, but have to argue that those should come after MET has been employed.

As my work has grown, I have moved away from a purely manual approach – in the sense that I used to do it all myself. Teamwork is key, and in this case your teammate is your client; more specifically, their brain. If their brain is holding tension or inhibiting a muscle, it can take quite a bit of work to get it to normalize, and often the effects are short-lived. You can be much more successful when you engage the client from within, instead of simply inflicting
a fix upon them.

In addition, MET reduces the irritability of the tissue so that the subsequent work is less uncomfortable. And it creates conditions in which I don’t have to work so hard. I prefer to work from the inside out on a client instead of the outside in.

There is no “I” in TEAM, but there is “A MET”!

This also helps to start the process of rebalancing the joint. Sherrington’s Law of the Reciprocal Inhibition of Muscles…

“When one set of muscles is stimulated (our agonist, or target muscle), muscles opposing the action of the first (antagonists) are simultaneously inhibited.”

…is important to understand. Many novice therapists make the mistake of only working the sore muscles. Often the soreness is caused by excess eccentric load caused by hypertonic muscles on the other side of the joint. In simple terms, they are sore because they are exhausted from resisting the tension of the opposing muscles. They are also weak (inhibited) because of the hypertonicity of their antagonists. Relax that tension and the load on the sore muscles is decreased. MET is great because that is exactly how it works – by balancing the muscles on both sides of the joint.

Incidentally, MET improves the communication between the brain and the muscles and clears dysfunctions such as the negative feedback loop created by a trigger point (TrP). I always use MET to reduce TrP activity prior to more aggressive and painful techniques such as cross-fiber friction or sustained (ischemic) compression. Sometimes MET alone is enough all by itself, but even when it isn’t, almost every time the irritability is reduced so that the other techniques cause much less discomfort to the client.

Yet another effect is that MET retrains the brain as to what the state of the tissue is and how it should be. It allows the brain to do a reset of the proprioceptors. Ultimately, it will be the new and healthier movement patterns that allow the work to endure.

So I will close with the immortal words of Snoopy.

“Get MET, it pays!”

Muscle Memory

2008-10-28T00:12:00.001-07:00

We’ve all heard somewhere along the line that muscles have memory. So do they? Yes and no. What does that really mean?

The Muscles Themselves

Muscles themselves only have a little “memory”. Myofascia is designed for movement, and it molds itself to the stress that it experiences. In that capacity, if the myofascia has been shaped by habitual movement, the muscles will only be used to, or even able, to move within that range. So in that sense, muscles do have a memory.

The Bigger Picture

More to the point, it has more to do with the nervous system’s relation to the muscles. When the nervous system generates an impulse, neurons talk to each other – a line of communication is opened, potentially where none existed before. But once that line of communication is established, every time those neurons speak to each other it reinforces the connection. Of course this is why practice makes perfect – every time we do a particular action, our brain gets better and better at coordinating the muscles to do it. incidentally, when we start resistance training, the initial gains in strength are more due to improved communication between the brain and the muscle than any physical increases in the muscle itself.

This is what we’re really talking about when we say muscle memory – these habitual patterns of movement. When we learn how to do something a particular way, it can become very hard to undo it. For instance, you know how you can identify many people by the sound of their footsteps? This is because when we learn to walk we develop a unique gait. It takes over a hundred muscles working in coordination to walk and we all learn how to do it in a slightly different way. These patterns become ingrained and the connected neurons prefer the familiar. This is also why we massage instructors harp on our students to use proper body mechanics all the time – if you start by learning it the wrong way, it will be much harder for you to learn it the right way.

These connections, once learned, go on autopilot. And a good thing too. Who would want to have to constantly think about putting one foot in front of the other, or the position of your tongue while you are speaking? But once they become unconscious, we also lose some awareness about what we are doing. This is fine if things are working the way that they should, but when things are off we need to bring the awareness back.

When we get injured, we can develop bad habits, maybe habits that were necessary while we were hurt (limping), but no longer serve a purpose once we’re better (continuing to limp after healing). Our bodies adapt wonderfully to remain functional in response to these things. But once your body has found a way it likes to do things it can be hard to get it to go back to do it the right way, the optimal way.

Can it be done? Of course, but it may not be easy. Stroke victims can relearn to do things that they lost because of the neurons that knew how to do it dying. It is a matter of re-patterning.

So What Does This Mean?

For our clients, this means we need to understand how these patterns affect them. What factors were in place when developing these movement patterns? Did they break their leg as a child, or have something disrupt their development? Was there an injury? Athletic training? How long has it been there? The old saying that you can’t teach an old dog new tricks is somewhat valid – It’s a lot harder to break a habit that has been there a long time because to break a habit, you are really creating a new one to replace it.

Progress will be slow with long-term patterns. I have found that often, clients will feel some relief after massage, but it is short lived. This is because although massage is great, once they leave my office their old patterns begin to dominate again. I always tell my students that even if they come and see me once a week, there are 168 hours in a week – leaving 167 hours for them to undo everything that we worked on in that session. It is vital to educate your clients about what they need to change and think about in between sessions to let the work take hold.

Another implication is that as much as we work on the soft-tissue, it will have little to no long-term effect if we don’t address the neurological functions that maintain the pattern. It’s akin to eating one healthy, nutritious meal (your massage) amidst a sea of junk food (their bad habits). It won’t have much of a lasting effect. It is a process, and one that the client must be on board for. They won’t change until they are willing and ready to.

Reboot

I love Muscle Energy Techniques (MET), PNF (Proprioceptive Neuromuscular Facilitation), and Neuromuscular Therapy (NMT). I will focus on MET here, but use a variety of NMT techniques. They are all techniques that reboot the system by resetting the lines of communication. MET uses the higher thinking of the conscious brain to reprogram the lower order unconscious functions.

In every case you come across, resetting the interface between the brain and the muscles will make your job easier. You recruit the most powerful force in your client’s body, their brain, as an ally. If you neglect to address the neurological dysfunction, those old habits will be actively working against you. Most often this also clears the way to reveal the problems as well. MET will reduce hypertonicity (excess tension in the muscles) so the knots really stand out in the tissue.

Re-educate

Once you’ve done your part as a massage therapist, then you have to recruit the client to do their part. Do your best every session to give them something to go home with that they can do to take some ownership of their healing. An exercise, a stretch, a new movement pattern, a breathing exercise, or just some homework to take note of their posture once or twice a day. These things will help to begin the process of creating new movement patterns. Awareness is key.

The Challenges of Being a Male Massage Therapist 4

2008-10-22T22:35:00.001-07:00

In part 4 here, we will conclude our look at these challenges with the idea that women are more nurturing and better healers than men. You can look at the original three posts here (1,2,3).

Are women more nurturing than men?

The answer to this one is hard to pin down. Certainly there is a lot of variation depending on a persons personality. I’m not a psychologist, so I won’t delve into the inner workings of the gender-based mind. What I can say is that a most people, male or female, must have some kind of nurturing bent to enter this profession. Sure, I have seen some that just don’t seem to get it, but they don’t last long. Ideally someone should have clued them in before they spent a lot of money in education for a career that won’t work for them. However, opening oneself can be a process, so we can’t just write people off.

I would venture to generalize that the men who enter the field of massage therapy really do have a desire to help. Men have a different kind of energy about them. It is easy to think that males tend to have a more yang healing energy about them, but I have known incredibly nurturing male therapists before. I also know plenty of clients that once they have experienced a truly good male therapist don’t want to go back because they prefer the uniquely male energy.

Culture can have a huge impact on this as well. Traditional gender roles paint women with the nurturing, motherly brush, which certainly works in their favor in this profession. It isn’t to say that men can’t be nurturing in Western culture, they just aren’t seen that way most of the time. Ironically, there is still a lingering perception that men are better than women in the more power-healer roles such as doctors. These attitudes are changing, but the impression can seem like women are making more headway in the medical professions than men are in the nurturing ones.

Since the public perception persists that women are better healers, what can men do about it in a profession like massage therapy?

Diligent attention to professionalism is a must. I know I’ve belabored this point in this series, but it is so important. Often, people are really looking for any excuse not to buy your services, so why give them a reason on a platter? Professionalism is a skilled way of being welcoming, caring, and appearing competent in what you do. Make sure this is always on. Communicate and present that you do care and you are a healer. Walk the walk and talk the talk.

Recognize that not everyone has to like you. Not everyone will warm up to you as a male massage therapist, but they don’t have to. All massage therapy is a construct of trust, respect, and safety – a framework in which the healing happens. Some people just don’t click. As much as we are working to create standards so that a person can go to any therapist and receive the same level of care, it’s the relationships that make it work. Do your best to make everybody comfortable with you. Ask for the honest opinions of those closest to you. “Do I inspire trust?” “Do you feel safe around me?” Et cetera…

Put yourself out there. Realize that the business won’t just come to you. You need to take the first (and sometimes second and third) step in building relationships with your clients. A good first step is to get out there and get your hands on your clients. It’s harder to say a guy isn’t a good healer when you’ve felt the healing power of his hands.

Cultivate references and testimonials. Develop a body of evidence that you are a healer. Don’t be afraid to ask your clients for their opinion.

In Conclusion

So yes, male massage therapists do face challenges, but not insurmountable ones. With a little thought, a little preparation, professional skills, and the right attitude men can find the success they desire in this field.

The Challenges of Being a Male Massage Therapist 3

2008-10-22T00:01:00.001-07:00

Part 3 of 4 (1,2,4)

Homophobia and Thinking Sex in Massage Therapy

Sexuality has no place in massage therapy. Or so we’d like it to be. We can no more leave our gender, sexuality, or identity at the door than we can leave our endocrine system. We are sexual beings and even when it isn’t sexual, it still is in part.

What I mean by that is that we have a lot more tied up in our sexuality than we realize. It falls into a much larger category of gender identity, which includes the roles we identify with men and women and ourselves in relation to them. It encompasses the culture we are part of, religion, and past experience. It colors our attitudes, beliefs, and morals. It is such an integral part of who we each are that it is a little ludicrous to think we can do any kind of holistic treatment without taking it into account.

We need to accept that it is there instead of denying it. Then we can do something about it and make sure that it isn’t the central issue in our sessions. practices, and careers.

Homophobia

In this series, we are talking about this from the perspective of men not wanting massage from other men, as that is much more the issue in our profession.

In practice, you can break this into two categories. At the extreme, you have men who will never get a massage from another man under any circumstances. Don’t waste your time trying to convince these guys, but talk to them anyway. Remember that no man is an island and they have friends and family that they talk to. They may never feel comfortable with getting a massage from you (it’s their issue, not yours), but that doesn’t mean that they wouldn’t feel comfortable recommending someone else to you.

The other category is men who aren’t so adamant about it. They may never have had a massage from a man before, but this is often due to inexperience. Unfortunately, sometimes it is due to a bad prior experience with a male therapist as well. The key with these men is to pay extra attention to their comfort zone and don’t push their limits too much. I’ve had plenty of past clients (male and female) who commented after that I had completely changed their mind about getting massage from a man. Often men in this group will feel more comfortable receiving massage in a more clinical and less of a leisure capacity. Speak to them in terms of functional outcomes to make them feel more comfortable.

Make it easy and safe for your clients (and this goes for working with women as well). For massage rookies, usually disrobing is a point of distress. Tell them that they should only disrobe as far as they’re comfortable or that you can even work on them clothed (the Magic Massager works great for this). Mind your professionalism with a microscope and make sure that there is nothing in your speech, demeanor, or presentation that implies anything sexual about what you do.

Thinking About Sex

This is another common perception about men – that they are constantly thinking about sex. I’m not about to debate here whether this is true or not. I suppose it could be on a subconscious level that affects behavior, but it’s not really all that important.

What is important is that actions speak louder than words. The words are certainly important. Make sure that none of your words give any room for misinterpretation. However, you need to focus all of your attention on making sure that your actions scream professionalism, trust, respect, safety, and client-centeredness while leaving sex out of the equation.

Some women choose not to work with a male therapist simply because they don’t want sex to even be a possible issue, some because they may have experienced abuse in the past, some because they have body image issues and fear that a male will judge them, some because they don’t feel comfortable “letting it all hang out” in front of a man. There can be many legitimate reasons that a woman doesn’t wish to receive massage from a man. Of course, almost all of those reasons could make a person prefer a male as well. Although we strive to reduce gender preference, we will never eliminate it entirely. Understand it, reduce it, and work with it.

How do your friends talk about what you do?

An important thing that I see many MTs overlook is non-client communication. If you let your friends get away with joking around about what you do, you are tacitly condoning their inappropriate attitude. Make sure that you discuss with your friends some of these issues or they will be talking about the same inappropriate things about you to their friends. You have to emphasize and embody what you want your friends to say.

One of the main things I want to get across here is that an MT does not have to appeal to everybody. There are plenty of clients out there and the way the business is trending, there are many more to come. Find your niche and stop trying to be everything to everybody.

In part 4, we’ll take a look at the idea that women are more nurturing and better healers than men…

The Challenges of Being a Male Massage Therapist 2

2008-10-22T00:00:00.001-07:00

Part 2 of 4 (1,3,4)

The Problems

In the previous post, I mentioned four specific problems that impact male MTs. Job discrimination, homophobia, the impression that men are always interested in sex, and the impression that women are more nurturing and better healers.

Job Discrimination

As I mention before, I got passed over in at least one instance for a job because I am male. I’m sure every other male therapist has and will encounter this particular problem at some point. Many of the male students that graduate from my program get disheartened when they experience this – I have come to see it as an opportunity.

It’s not OK for massage businesses to perpetuate this gender gap. They see it as catering to their clients, but really it is just reinforcing a major problem in our field.

When I was fresh out of school, I went to work for a massage business called Equilibrium in San Francisco that was opened by two of my classmates, one of them male. As I would listen to them on the phone booking appointments I learned something – it is really up to the business the impression they give to their clients. When a client would call asking for a female, they would start in pointing out out all of my virtues and almost every time the session would be booked. And then out of those sessions, almost every time the client was very happy with the experience. How do I know? Because of all of the “I never thought I would get such a great massage from a guy” comments I received.

We need to work to change the lopsided preferences in our field, while accepting that some legitimate concerns do and will always exist (abuse, religion…)

So what can a guy do about this?

First of all, don’t be afraid to say something. I used to just let it go and move on, but I’ve learned over time that it is important to speak up. There seems to be a prevailing attitude out there that “that’s how it is” and the businesses go with the flow. Never pass up this opportunity to educate. It may not help you personally, but it will help all of the men out there in the profession. In this respect, we certainly all must work together to address this issue. We’ll all benefit in the end.

Secondly, accept that things won’t change overnight and some won’t ever change. Move on and look for a place to work where it won’t be as much of a struggle. Look for places that are more male-friendly; establishments that are more sports, clinical/medical, or deep tissue oriented. In this respect, sometimes men even have an advantage. Men still dominate in sports massage (Benny Vaughn mentions it in his Olympic massage blog) and the perception remains that men can perform better deep tissue work.

Almost all spas want to have at least one man on staff because they will get some male requests. Be aware that at some spas, those requests might not be enough to keep you busy.

Once you’re working, one of the best things you can do as a male is to make sure that whoever books the appointments is on your side and trained to promote you well. Believe it or not, I’ve seen places where they almost talk down about their male therapists! The scheduler is the person who can help you the most so get them on your side! Make sure that they have experienced the wonders of your work. Make sure that they understand the challenges you face as a male MT and that they know to steer more non-gender-specific appointments your way. Make sure that they know how to sing your praises because when a person calls to book their appointment, the scheduler becomes a testimonial. They get asked often “who’s good” and ideally you want them to say your name. Train them how to say, “Yes, I had the same fear about seeing a male at first, but after one session with Mike I don’t go to anybody else.” If you an get the scheduler to say that on your behalf, great! Now the ball is in your court to deliver!

Part 3: Homophobia and Thinking Sex in Massage Therapy

The Challenges of Being a Male Massage Therapist 1

2008-10-21T20:52:00.001-07:00

Several years ago, I responded to an ad calling for massage therapists at a small day spa. The woman on the phone was very polite when she told me that they had already filled the position. Out of curiosity, I had my wife call about the same position only ten minutes later. They wanted her to come down for an interview.

Men can sure face a lot of challenges in the massage business – job discrimination like I just mentioned is only one. Homophobia, the impression that men are always interested in sex, and the impression that women are more nurturing and better healers are other obstacles that men can face.

Am I advocating that this isn’t a profession for men?

Of course not.

All of these challenges can be dealt with, overcome, and sometimes even made into a non-issue. There are even some factors that work in men’s favor.

According to the latest surveys at ABMP and others, around 80-83% of the MTs out there are female. The good news is that in my experience far fewer than 80% of massage clients out there will only have work performed by a female therapist.

The Politics of Gender

As much as all of us would love to change massage into a gender-neutral profession (and of course need to endeavor to do so) the reality is that it is not. Massage by its very nature is an intimate experience, so attitudes about intimacy will always be a factor. For some people this is more of an issue than others and there is a large part of this that is based on past experience, culture, and learned attitudes. These attitudes can be changed, however, and it is important for male MTs to be pro-active about educating their clients about this.

I intend to write an entire post on the complexities involved in touch and communication since it has such a big impact on what we do.

The spa I mentioned above actually did something illegal. At the time I chose not to bother doing anything about it (I might do differently now). My school’s career services department fields many calls about externship sites where they only want female therapists as well. Although I could wish otherwise, that all massage businesses would take the high road and educate their clients that males aren’t evil, the truth is that many cave to the requests of their clients without even an attempt to steer their preferences. As a learning institution, we weed out extern sites and clients for our clinic that attempt to perpetuate the gender gap in our profession.

There is an interesting article from Massage & Bodywork Magazine on this subject, even though I have to disagree with some of the expert opinion expressed in it. (more on that later)

What’s Next…

These problems are not insurmountable and we’ll take a look at some strategies for male massage therapists to use to deal with them in part 2…

Hybrid Education in Massage Therapy

2008-10-19T23:03:00.001-07:00

Right now, we’re standing on the cusp of a new era in education. With the advent of Learning Management System Software (LMS), there is a lot more power at the fingertips of teachers in delivering course material. Some material works fantastically well in an online environment delivered via LMS. Courses that are heavy in theory, reading, or lecture work very well. Of course, massage therapy does require a substantial hands-on component so online delivery isn’t a complete option for most courses. A hybrid model is to combine part in-class training with part online. This solution is ideal for massage therapy because the online component can replace or reinforce the lecture components of a class, leaving potentially more hands on time with the teacher.

What can LMS Software do?

An LMS is a system for the delivery, tracking, and management of training (wikipedia). It can include everything from online test-taking, grade-reporting, lecture & powerpoint components, video and multimedia presentations, online forums and class discussions, wiki’s, and more. One of the advantages is that the LMS can be either a guided, structured process or more free-form and self-paced.

I've been interested in using LMS ever since I found out it existed in a few online classes I’ve taken and trainings at work. As a teacher, I’m always looking for better ways to implement learning objectives. Technology isn’t always better, but it is a tool. Most of the students I see in the classroom are increasingly tech-savvy (text messaging anyone?), so moving some of the learning online isn’t that much of a leap. The added bonus is that after some work to set it up, some of the process is automated.

I’m planning on bringing LMS into my classroom in stages and I’ll keep you posted here about how the implementation is working. The first step is to take the testing online. LMS software includes the ability to import/create a testbank and administer the tests online. The nice thing about it is that the test is automatically scored and their grade entered in the LMS. Our program is spending too much time on tests and retests and grading and I’m hoping that after the initial testbank entry that this process will be much more streamlined.

As a parent, my daughter’s middle school just implemented an LMS called School Loop. It’s great to be able to log on and see your childs progress any time you like and check how they’re doing. She’s on there every day making sure she’s completed all her assignments. It’s great. So much for the old “I forgot my assignment at school” excuse.

What Are The LMS Options?

There are quite a few options out there, from the very expensive to the free. Commercial vendors include Blackboard, eCollege, and others. The two big free players are Moodle and the Sakai Project; both are open-source and have similar functionality. I have chosen Moodle, primarily because there is a larger user base and to the uninitiated I thought Moodle seemed easier to get into. I’m not a big advocate for one or the other, but from here on out I’ll be talking about Moodle, since that is what I’m using. Here is a good place to take a look at some of the eLearning options.

Hosting

Once you decide on your LMS, you’ll need to host it. There are packages that you can download to host a server on your own, but I elected to go with a free (ad-supported) off-site server called NineHub, but there are other free hosting solutions available. If you choose to go commercial, you’ll probably want to set up a vendor-hosted solution that can provide enterprise support. Setting up NineHub was a breeze though and I was off and running.

A Sample Test

Once I got into the system, it took a couple of hours to learn my way around. Give yourself some time to get acquainted, especially if you aren’t at all familiar with the online classroom environment. You can get some help from a downloadable guide from Moodle. In short order I was able to figure out how to import some of the questions from an existing testbank and set up a small quiz. It worked! Based on that test, I’ve decided that we will try a pilot test in a few weeks in an actual class to see how it goes. We’ll gauge student response and see if it has the desired results in reducing teacher overhead. I’ll let you know how it goes.

Closing Thoughts

I’ve been in classes using online learning before and can definitely see the potential. I’m excited to try some of these solutions in my class now. As learning continues to evolve, as teachers we need to use the best tools available to ensure the best learning. While technology can’t guarantee more effective learning, it has a place, and in it’s place it excels over anything that has come before.

You can read more about eLearning here and here.

Killer Introductions for Massage Therapists pt3

2008-10-19T13:36:00.001-07:00

This is the final entry in the “Killer Introductions for Massage Therapists” series. See parts 1 and 2 here (1 & 2)

Putting It Together

Once you know what you deliver and who you deliver it to, you are ready to design your killer introduction. Now you are equipped to frame what you do for your potential client instead of letting them put you in a box. Try these introductions on for size:

“Hi, my name is Mike Wolnick and I’m a Massage Therapist.”

“Hi, my name is Mike Wolnick and I use massage therapy to help athletes overcome chronic pain and injury to maximize their performance.”

Which introduction do you think is better? This kind of introduction is very powerful. Let’s look at why:

It describes your work specifically. It’s hard for anyone to frame #2 as a sex worker or a spa therapist.
It appeals to your niche. If you are really good at dealing with certain client issues, or just really enjoy working with some types of clients, why try to appeal to everybody? This introduction is going to appeal to athletes.
It plants a seed. If you just introduce yourself as an MT, if they personally don’t need massage right then, they’ll forget about you. But if you frame it right, you’ve made a connection in their mind. In this case, if the client experiences an athletic injury, that is tied in their mind to you now. Even better, if they have a friend in a month complaining of some nagging sports injury, you’ve made that connection for them too! Otherwise they might never have associated massage with their friend’s pain.
Sounds more professional. Which introduction would you take more seriously?
Changes Your Competition. Do you think introduction #2 is competing with the spa down the street? Of course not, now your competition is other things that help with athletic injury. You even set yourself up in a better position to work with other professionals in that new area – sports medicine, orthopedic surgeons… Now it’s a matter of the client thinking about what very different method they can use to deal with their injury. Would you rather have surgery or get a massage…?

I’m just using sports massage as an example here, so adapt the idea to your own work. One other thing to note is the tone of the introduction. Use action words (overcome, maximize) and address the partnership involved in massage (help). And finally, make sure you don’t promise on anything you aren’t positive that you can deliver!

Using this process will help you to better build your business with the kinds of clients you want to work with. I guess you could say my introduction is:

“Hi, my name is Mike Wolnick and I help people change their lives and develop exciting, successful careers in massage therapy!”

Let me know how it works for you!

Benefits vs. Features in Massage Therapy (Killer Intros pt2)

2008-10-19T13:35:00.003-07:00

This is a continuation of a series entitled “Killer Introductions for Massage Therapists”, see part 1 here.

Benefits vs. Features

Simply defined, a feature describes what it is and a benefit describes what it does. This is a very important distinction. Features are things like the style of massage, techniques, and anything that describes your work. Benefits are what the client actually gets out of it; how their life is affected by the bodywork.

One of the biggest problems is that most of the things described in textbooks as benefits are really features. Do you think your clients really care about better circulation? Endorphin release? Decreased secondary edema? Any of the other things that are commonly described as benefits? Of course not.

What they really care about are the benefits they receive from these effects.

Better circulation = More energy, less pain (from stagnant irritating chemicals)
Endorphin Release = Less Pain so maybe they can sleep better at night
Decreased Secondary Edema = faster recovery from injury

It is vitally important that you translate what you do into something meaningful to your clients. They care about what your work will do for them, not about what it is you do. So make a list (write it down!) of the benefits you deliver to your clients.

Taking The Next Step

The next step is to figure out who you give these benefits to. You deliver different results to stressed out executives, pregnant women, and athletes, so why would you say the same thing to each of these clients?

Massage has a great many effects and benefits on the human body, pick the ones that are going to have the most effect for your target market. Going with these examples:

Executives: Stress-reduction, better job performance, increased energy, reduced headaches…
Pregnant Women: Decreased sciatic pain, Reduced discomfort from side-lying positions…
Athletes: Increased performance, reduced risk of injury, more playing time…

Think about what is important to your target market. Once again, write it down!

Back to Part 1 On to Part 3

Killer Introductions for Massage Therapists pt1

2008-10-19T13:35:00.001-07:00

When Massage Therapists are taught how to be professional and build their business, they are often taught to introduce themselves with the good old “Hi, my name is Mike Wolnick and I’m a Massage Therapist.”

Although this isn’t really a bad thing, it’s just not quite good enough. Why, you might ask? I mean it gives your name and it lets the client know what you do. So what’s the problem? Let’s dig into this a little deeper.

The Problem

Every person out there is going to have a different body of experience with massage therapy – shaped by the media, past personal experience, the past experiences of the people they know, etc… In other words, they already have some kind of opinion about what massage therapy is. When you tell that person you are a massage therapists, you are now whatever they think that means. If they think that MTs are prostitutes, that is what you are to them now. If they think of spa massage, you are now a spa MT, if they think of clinical massage, now you’re a clinical MT. So what do you do about this?

The problem is that you allowed them to define what you do for you.

So What Do You Do About It?

You want to turn the tables and frame what you do for them, as it should be. The key to this is a thorough understanding of what it is that you really do. Your first thought is “I do massage”, but this isn’t quite as simple as it sounds. What is your focus? What is it you really bring to your clients? Start to think in terms of benefits.

Part 2

Making a Living with Massage Therapy pt4

2008-10-16T12:52:00.001-07:00

This job pays x (insert rate here). Is that good?

I don’t know, is it? Asking this question is putting the cart before the horse. There are a couple of things that must be considered before this question is asked.

How much do you need?
How much work can you do?
How busy will you be?
What do comparable establishments with comparable clientele pay?

How much do you need?

The first and foremost item that needs to be considered is what you need to live. If you are young, single, and living at home with mom and dad, your expenses may only be a few hundred dollars a month. On the other hand, I had a student that had over $9000 a month in expenses by paying 2 mortgages and the like. Obviously their needs would be very different.

Start by figuring out your bills and obligations on a monthly basis. Rent, car payment, gas, insurance, cable, phone, memberships, etc... add it all up. Don't forget to include annualized costs as well like car registration, magazine subscriptions, or that annual family trip you take (just divide by 12 for a monthly cost). Also, estimate what you spend irregularly on things like clothes, new shoes, and the like. Try to average it out into a monthly cost. The important thing here is to put a number on your lifestyle, NOT to give yourself a bare minimum budget that you can just barely survive on. It is good to know the bare minimum that you can scrape by one, but you don't want to live that way all the time. You can even plan for the future by adding in the things that you aspire to - new car, starting a family, starting a business.

How much work can you do?

Because we work directly with our clients, and generally we can only work with one client at a time, we MTs are inherently limited in the quantity of work we can do. There are also physical limits as well. Although I've done 10 massages in a day before, I certainly wouldn't and couldn't keep up that pace on a regular basis. Personally, I found my comfort zone to be about 15-20 massages a week. What is your number? It may be higher or lower, but how many appointments a week works for you? Without putting your body, your health, or your family/social life at risk? There are 4.33 weeks in an average month, but using 4 will help you to play it safe and estimate higher.

How busy will you be?

Before you can determine if you will be able to live off of the income from your practice or that job you applied for, you need to know how much work you will be getting. This isn't as important if you are making a set hourly wage, but it is vital if you are paid by commission or per client. This is so important that you should never leave an interview without finding out how many appointments a typical MT at a business does a week. Why? Because it may sound great that a spa will pay you $60 an hour, but if you're on-call (or worse, sitting around) and only getting 3 appointments a week, you're making a lot less than $30/hr at 10 appointments per week. Also find out the cycles of the business. Some places are relatively steady, others are feast or famine. Make sure you see the big picture.

What do comparable establishments with comparable clientele pay?

If everything is working for you in these other questions, this one isn't so important. If you ain't broke, don't fix it! But it is good practice to know what comparably experienced MTs, in comparable establishments, working with comparable clientele, and in comparable locations are paying their MTs. Minimize comparisons between massage businesses that seem similar but are not. A small day spa that caters to locals in a ritzy resort town won't be comparable to the huge, posh spa at the resort up the hill. Compare apples to apples. Still, the difference isn't as much as you might think. Cost structures in massage businesses can vary widely - how the business is run and the cost of overhead can be very different from place to place. Spas are expensive to run, so don't expect the lion's share of what the client pays.

Another common mistake is to compare what the business charges the clients. Sure the sticker price of the services can give you a good idea about the clientele, but it isn't necessarily an indication of how they pay their MTs. My wife and I took a look at working at the Ritz-Carlton Spa in Half Moon Bay when it first opened. We were shocked to see that they only paid their MTs what amounted to $10-15/hr in commissions (on a service price of $100+). The 10% they were paying wouldn't have been bad if they were charging $300+/hr, but they weren't. They claimed they had interest from MTs as far away as Utah, and my immediate thought was they would have to be from out of state and have no idea about the cost of living here! Needless to say, we passed on it. They wanted their MTs to rely on tip income, which in my experience, no matter the setting, is unreliable at best.

Summing it up

Once you have answered these questions, then you'll be equipped to determine whether the pay is good or not. If a job isn't going to make enough for you, then you either should pass on it or you'll need to supplement it. If it will keep you busy but the pay is low, how will you have time to supplement it? Or if you are already doing your limit in appointments per week, how can you add more to make more money? These questions will allow you to figure out if a job or practice will allow you to live the way you'd like. A good job or practice will balance all of these elements.

Making a Living with Massage Therapy pt3

2008-10-16T10:26:00.000-07:00

Will people pay $xx?

Maybe. There are a lot of factors that go into a purchasing decision. It’s really all about value. If the perceived value is equal to or higher than the price, a person will buy it. The trick is to find the right balance.

A frequent concern is that a MT down the street charges a different rate. It is absolutely OK for you to charge something different – as long as you can justify it! It’s called differential (competitive) advantage. What sets your service apart from theirs? Although you do have to account for the price levels in your area, it isn’t the most important factor. Sometimes it can even work in your favor!

A MT I knew had an office on Union St. in San Francisco, a posh little shopping district. She was charging $60/hr and couldn’t seem to get clients to save her life. She looked at what the other massage businesses in the area were doing and realized that she was by far, the cheapest place around. Seems like it would be a good thing, right? Nope! It turned out that her low price was giving her potential clients the idea that she offered a sub-standard service. Believe it or not, when she raised her rates to $85/hr the clients started coming in!

Build the value of what you do, tailor it to your specific clients’ needs and you are on your way to finding the success you want.

Differential Advantage

Simply put, this is what makes you different than your competition. Just like you never see a business advertising "we have the same prices as everybody else!", you need to talk about what makes you better as well.

A differential advantage (DA) could be anything, but it's important that you find out what yours are. Pricing is an obvious one, but others can be location, convenience, specialty techniques, parking, outstanding customer service, testimonials, education, experience, etc...

A little less obvious can be some of the intangible DAs, things like a warm and welcoming personality, inspiring trust, creating security, excellent communication skills, personality, sense of humor. These things can be harder to pin down and you can't really advertise most of them ("Come on down for the funniest massage in town!"), but they have an important impact on the value that people perceive in your service - and on client retention.

Most people are willing to pay more for something that they see more value in. Differential Advantage is a topic that warrants its own post, so keep an eye out for more on setting you and your business apart.

Making a Living with Massage Therapy pt2

2008-10-16T10:11:00.000-07:00

Should I charge while I am in school?

In my opinion, yes. I always think it is a great idea to set up your clients’ expectations to the fact that you offer a valuable service that is worth paying for. Bear in mind that you may need a license to legitimately charge money for your services. I generally suggest that you charge about half of what you would once you are out of school and a practicing professional. I tell my students that they need to build the expectation with their “practice clients” that there when they finish school that the rates will change. Even if you choose not to charge while in school, you still need to build this expectation from the very beginning.

I used to work with a MT years back who was struggling in her practice. She had enough clients, but was still having trouble making ends meet. It turned out that she had quite a number of clients who were still paying her student-rate of $20-25 for an hour session! Her normal rates were $60/hr or 2 sessions for $100. She had been scared to raise her rates with these people for fear of losing the clients. After some convincing, she decided to raise her rates in compromise, to about $40-45. So did she lose clients? A few. But she also had a few comments of wonderment that she hadn’t done it sooner. And she earned more from the clients that stayed than she did in total from all of her clients at the lower rate.

It’s OK to give your loyal customers a preferential rate, just make sure it’s not hurting you more than helping! Think about the business and practice you are trying to build and work from there. It is a common mistake for MTs to chase down the bargain hunters, dropping their prices to where they can hardly sustain themselves. Bargain hunters will come to you for the low rates and will just as quickly go to someone else offering a special deal. These clients are hard to retain and you have to ask yourself, how hard do you want to work to keep them?

The other thing to bear in mind is what the massage laws are in your area. California thankfully just passed a state certification law SB731, but it is voluntary, and until then all of the old piecemeal laws remain in effect. Right now, in San Jose, you only need to be certified for 100 hours to get your license. Palo Alto is 72 hours! Once you have a license, I believe you should be charging as a professional (based on your abilities), not as a student.

Making a Living with Massage Therapy pt1

2008-10-16T10:06:00.000-07:00

What to Charge for Massage

As a teacher, this is one of the most frequent questions that I get asked. The answer is $75. ;)

I wish it was that simple. The truth is that there a number of factors that go into deciding both how much to charge and also in determining if a job is going to pay you enough. As I began writing this, I realized that it is too large a topic to cover in one post, so welcome to the introduction for a series on Making a Living with Massage Therapy!

In this series of posts I’ll examine some of the factors that go into setting prices and taking jobs. There are no cut-and-dried answers to these questions. As much as my students would love me to be able to just hand them a number, it is different for everybody. Each part of this series will pick apart a FAQ (frequently asked question).

I’m sure I’ll come back later and edit this list, but here are some of the questions I’ll take on in this series:

Should I charge while I am in school (and how much)?
Will people pay $xx?
This job pays $xx (insert rate here). Is that good?

Your comments and questions will help to make this post and series more illuminating, so please, fire away!

EDIT: By the way, this does seem to be a hot-button topic, as described in this blog "Do Massage Therapists Work As Slaves?

Traveling with the Team: Sports Massage

2008-10-15T14:16:00.000-07:00

Although this isn't what I would probably write about for my first real post, it did just happen this past weekend, so I thought the timing is right.

My sister plays Ultimate Frisbee. Passionately. This past weekend she had a tournament in Denver, CO. Fortunately for her, she has a brother who is a massage therapist and has thoroughly indoctrinated her into the benefits of massage therapy for the past 10 years. The cool thing is, she took it upon herself to arrange it so that 10 of her teammates all pitched in to fly my wife (who is also an MT) and I to Colorado and put us up in a hotel for 3 days for us to work on them. Granted, we didn't make any money on top of that, but my wife and I had been hankering to go to Colorado anyway. There were a couple of things that I'd like to point out about this trip.

First, massage can be a great tool to use to travel. This is one example, but traveling to take a Thai Massage class in Thailand can be another example. If you look for the opportunity, massage can really take you places. Incidentally, I laid the groundwork for this trip last year simply by proposing to the team that I could do sportsmassage and coming down to one of their local tournaments.

Second, massage is one of those things that is almost infinitely barter-able. I have traded massage for merchandise, discounts, services fees, business advice, and even paid for more than half of our $20K wedding that way. You can use your skills to trade for most anything you can think of (if only the DMV took backrubs...). Use your imagination.

Thirdly, this trip also emphasized the dynamic educational relationship that MTs have with their clients. Most of the people that pitched in to pay for us to go had some appreciation for massage, but had no idea that sports massage was something different. Most of them had the impression that it was just about feeling better afterwards. As my wife and I started to educate them about the value of pre-event massage and how it was different than your typical spa massage, I could see how their viewpoint changed. Some of the best comments that we received were "After that massage, I had the best warmup ever", "I felt so much looser. It was great", and "My calf didn't cramp up on me at all today". I could see their level of respect rising.

Finally, this leads me to my last point. It is vital that we Massage Therapists really know how to speak to our clients. Speak to them in their language and in terms of what they care about. Carry it a step further and use words and terms that they can remember and talk about themselves. It is great for your business when your clients can describe what your work has done for them to their friends - the way you'd like it to be described! You create an evangelical client that will spout your praises to everybody they know.

What is the Massage Continuum?

2008-10-15T13:16:00.000-07:00

We all know that to be the best you can be you need to keep on learning. This blog is dedicated to the idea that the more we learn, the better we can achieve our potential. The massage profession is constantly evolving as well, never static, and as massage professionals we must evolve along with it.

So why blog?
I’ve been a massage therapist for 10 years now, and a massage instructor for 4. It’s very gratifying to help a student grow into becoming a wonderful, effective, and successful massage professional. As a teacher, I get bombarded with questions all the time about where to learn more, for more detail about a particular subject, or for my opinions about some aspect of the profession. I decided to start this blog to answer some of those questions and to extend what I do beyond the walls of the classroom to help the greater massage community. If you want to know a little more about me click here.

I love to teach. I have found that there is great variety of often conflicting information out there – some of which is very difficult to even find. I hope to provide some of those resources here. I’ve never written a blog before, so please bear with me as I get the hang of it.

Who is this blog for?
Practicing and aspiring massage therapists. In my experience, many practicing massage therapists have as many or more questions than massage students do. What can I do to be more successful? What do you do? What techniques work best for what conditions? Where are the best places to work? How much do I charge?... The list just goes on. If you work in massage therapy, you should find this blog helpful. I won’t make any claims about being the final authority, but I do have experience as a massage therapist and a spa owner, a consultant and a teacher. My hope is that my experience can help your career flourish.

Topics
While I already have pages of ideas to write about, this blog is more about you, the reader, than about me, the writer. I want to know what you want to know. If you have any topic that you’d like me to write about, send it along and I’ll do what I can to help. Here are some sample topics I already have in the works:

Professionalism in massage massage therapy
Building a career vs. finding a job
Two-tier licensing
What state certification means in California
The magic of M.E.T. (muscle energy technique)
Why doesn’t everybody know about Trigger Points?
The insidious (and much farther reaching than you think) effects of stress
Massage CEUs and DVDs: Which one should I buy?
Massage DVD and book reviews
Creating opportunities to grow your massage business

Like I said, this is just a sample. My intent is to build a body of work here in relatively short order. Let me know what you think!