LEARN FROM US!
In this piece, several experienced massage therapists share advice on things they have done right -- and wrong -- throughout their careers.
By Clare La Plante
So what's the secret to a long and successful career in massage therapy? As in any field, the best teacher is usually hard-earned experience. Therefore, as a service to our readers, Massage Therapy Journal recently asked seven experienced therapists--all of whom have been working in the field for 10 years or more--about what they've learned through their hard work and real-life experiences in massage. The key question was: What would you do differently if you were just starting out?
Specialties: Deep tissue, sports massage, strain/counter-strain, trauma rehab
Our group included Nancy Curulewski (Frankfort, Illinois), Christine Ruppert (Rockville, Maryland), Richard Royster (West Palm Beach, Florida), Arch Harrison (Spokane, Washington), Elliot Abhau (Annapolis, Maryland), Pamela Sheridan (Boca Raton/Delray Beach, Florida) and Marcia Shaw (Allentown, Pennsylvania).
Most of their words of wisdom have little to do with specific techniques. Rather, they gave a hodgepodge of tips based on one essential notion--that to be a good therapist to others, you first have to be a good friend to yourself. "The biggest misperception about being a massage therapist is that it's easy," says Royster. "Being a masseur is an easy job, being a therapist is a challenging job." Here, in no particular order, are their top six pointers.
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Number One: Be A Lifelong Student
When Michael Jordan briefly left professional basketball to play with one of the farm teams of the Chicago White Sox, he wasn't only chasing a boyhood dream of his, he was branching out. Although he's returned to his first love, take a lesson from him. According to these therapists, one of the best ways to avoid burnout is to continue your education, and to specialize in more than one type of massage. "There is a tendency to get bored with anything, or fall into rut," says Curulewski. "This is especially applicable to doing massage."
Curulewski, who was initially trained in general massage, has since expanded her practice to include reiki, deep tissue work and CranioSacralSM Therapy. This variety, she says, has been her saving grace through the inevitable ebbs and flows of her work. "One of the things that is important as a therapist is to keep your work fresh--to keep experiencing and learning different types of work."
Ruppert, who began her training with Swedish and general massage, now focuses primarily on neuromuscular massage for pain management in her private practice. She attributes her longevity as a therapist in part to this commitment to continuing education. "It keeps me balanced," she says.
"It can also keep you modest," says Sheridan, who has her own private therapeutic massage practice. "When we first become therapists, we learn all this stuff. We start to feel confident that we're getting good at it. We can start to think we know a lot. But the more we know, the more we should realize that there's so much more to know. Staying humble is a good thing."
Having several specialties and investing in continuing education isn't just good for the soul, it also keeps you marketable in a constantly changing market. "Because massage fits on a broad continuum, there are so many ways it can be applied," says Abrau, whose practice includes Zero Balancing¨ as well as eclectic massage, and whose practice includes animal clients as well as human.
"I've used it everywhere, from working with hospices, or going into business settings," she says. "There are bodies all around us. It's always suitable. With bodywork, there's always something you can do."
Arch Harrison does home visits and also works at an outpatient clinic.
The real reward, however, for continuing your education may be the fresh perspective you can offer your clients. "Many massage therapists lose interest because they burn out mentally," says Royster, who also has a doctorate in naturopathy. "Patients pick up on this. It's important to always invest in yourself to keep interested, and to learn something new."
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Number Two: Look To Your Community To Market Yourself
When Curulewski first moved to the small community of Frankfort, Illinois, 35 miles southwest of Chicago, she was attracted in part to the town's historic downtown district and community feel.
At first glance, however, she wasn't sure how she would build her business. With further thought, she decided to go right to the source--the business community. Her first move was to join Frankfort's Chamber of Commerce. Once she was known to the other business owners, she arranged for them to carry her flyers in their shops. She even negotiated a "flyer exchange" with the owner of a local candle shop. Her creative marketing paid off. She now has a steady clientele and continued word-of-mouth business. "Word of mouth is good advertising," she says.
Ruppert also went into her community to market her business. She volunteers at local sporting events. "This gives me exposure," she says. Ruppert also uses the power of the written word by sending a two-page health and massage newsletter every quarter to existing and old clients. "It keeps people on my client list aware, and it brings back people I haven't seen in years," she says.
Royster recommends donating time to your local house of worship. "Do demonstrations," he says. "Offer one-tenth of your time for free. This will help you to network and to have contact in the community."
Shaw, who works as both an accountant and a massage therapist specializing in deep muscle massage, began her massage practice while still working full time as an accountant. Her first foray into marketing led her down a blind alley, but she eventually got the hang of it. "I advertised in the local paper," she says. "One of the phone calls I got, the person wanted to know if spanking was involved." Needless to say, she opted for other marketing means. "Instead I've joined clubs--the Allentown Hiking Club and the Hellertown Women's Club," she says. Fellow members pass the word to others about Shaw's expertise. "The word of mouth has been good," she says.
Number Three: Take Care Of Yourself
Repetitive stress injury, work overload, simple burnout. Sound familiar? It was to most of these therapists until they discovered a truism recommended across the board: Take care of yourself.
It's not simply indulgence; it's good business. "You have to take care of yourself in order to run a business. Self-care is highly important," says Curulewski. She learned the hard way. "I was working six days a week for three or four years until I got regular bodywork myself."
Ruppert learned the value of bodywork while she was still in school. "I realized how good it felt for me, and I learned much from it," she says. Now, she gets a massage every week. "I pay attention while on the table, not so much that I'm not allowing my body relax, but to notice how the stroke feels on my body, and applying it to my clients."
Boca Raton/Delray Beach, Florida
Specialties: Neuromuscular therapy, myofascial work
For Ruppert, it's a matter of survival. "I hear of many people who come out of school and never get a massage themselves. It's a contributing factor in burnout," she says. "We're putting out a lot of energy; we're giving a lot. Many of us give too much. You need to receive, too, in order to set yourself back up for your own healing process, and for self-awareness."
This combination of self-care and self-awareness also led Ruppert to a lyengar-style yoga practice. "It's very balancing for me, and it has a strong physiology component." As she does with the bodywork she receives, she uses her yoga practice to enhance her massage work. "I like studying anatomy, looking at those body parts and explaining what's going on as part of the session enables people to understand what's happening."
Shaw also gets regular bodywork, which she gives and gets through other therapists in her town. She also stays in shape with outdoor sports, such as hiking and kayaking, which, she says, helps mitigate the effects of her downfall--chocolate.
Sheridan agrees that staying in shape is important. "It's a physically active thing that we do; we need to take care of ourselves," she says. "And we're preaching health, so we need to be healthy, or try to be."
Curulewski also recommends a meditative, psychological or spiritual practice for massage therapists. "Whatever will get you in touch with yourself," she says. "This is especially important for those therapists who plan to work with clients on a deeper level with any type of energy work--CranioSacral Therapy or Ortho-Bionomy. If you haven't dealt with yourself, you won't be there for clients when they need you."
Sometimes self-care comes down to technical points. Harrison has a quick and easy tip for self-care: "Learn three different ways to do the same thing. Know how to do the same strokes with three different parts of your body," he says. "You will not overuse one part of your body."
Having trouble setting boundaries or letting go? A meditation practice may help. Check out Meditation for Dummies by Stephan Bodian.
Ben Benjamin's Corner
Nutrition: Its Influence On Healing And Optimal Health
Balancing Macronutrients: Carbohydrates, Proteins And Fats
A proper balancing of these macronutrients can provide the fine-tuned maintenance of blood glucose required for optimal health.
BY JOY BICKNELL
EDITED BY BEN E. BENJAMIN
The Physiology Of Low Blood Sugar
When the blood glucose level drops, the adrenal glands are stimulated to release epinephrine (adrenaline). The epinephrine, in turn, stimulates the pancreas to release glucagon. Glucagon stimulates the liver and muscle to convert the glycogen--the storage form of glucose--back to glucose. The liver releases this glucose into the blood. This results in a temporary rise in the blood glucose level. If the person does not eat within an hour, the adrenals start releasing cortisol. Cortisol stimulates the breakdown of muscle tissue and the release of the amino acids into the blood. The liver takes up some of the amino acids and converts them to glucose. The amino acids the liver cannot convert to glucose are broken down, and the by-products are excreted by the kidneys. If the conversion of amino acids to glucose cannot maintain an adequate blood sugar level, fat stores are eventually accessed for energy. Fatty acids are the preferred fuel for the liver. The muscle, however, only uses fatty acids when there is insufficient glucose to support its energy needs. This mechanism of maintaining energy is secondary to glucose, and only happens if the necessity arises.
Timing Of Meals And Snacks
Many people make the mistake of skipping meals. Frequently, they skip breakfast because they "are not hungry in the morning," and they skip other meals in an attempt to lose weight. Unfortunately, skipping meals results in low blood glucose, and frequent low blood sugar can be the stimulus for a cascade of health problems.
In general, eating breakfast within an hour of getting up in the morning is ideal. The body has gone all night without any food, so the blood glucose level in the morning is very low. After breakfast most individuals must eat a meal every four to five hours or their blood glucose level drops. If they eat only a small amount of food, such as a snack, they will need to eat again two to three hours after the snack.
All snacks also must be a combination of protein, carbohydrate and fat. For example, a good snack would be a medium-sized apple and 2 ounces of low-fat cheddar cheese. You get the protein and fat from the cheese, and the carbohydrates from the apple.
Maintaining an adequate blood sugar level is not only important for optimal energy and mental function, but it also greatly reduces the stress on other organ systems in the body. (See sidebar on Page 30.) Frequent low blood sugar can greatly increase the workload for the liver, adrenals and kidneys. The cortisol stimulated by the low blood glucose level causes suppression of the digestive function and the immune system. Consistent rises in cortisol will contribute to reduced bone density and osteoporosis. The breakdown in muscle stimulated by cortisol results in decreases in lean body mass, but not the body fat. As the lean body mass drops, so does the metabolic rate. The metabolic rate is the rate at which the body uses the energy from food. A lower metabolic rate makes it easier to gain weight and more difficult to lose weight.
The blood glucose level is also used by the body to help predict the possibility of future starvation. Unfortunately, the body cannot distinguish between a person choosing not to eat and actual starvation. Many people diet by eating only one large meal each day. This meal is usually at dinner time, thus they go through most of the day with low blood glucose levels. The blood sugar/starvation monitoring mechanism is so fine-tuned in some individuals that everyday periods of low blood sugar cause the body to react as if it is going into a period of starvation. Remember, fat is the only long-term energy store in the body. So when the dieter finally eats that one big meal, the body very efficiently takes any extra calories and readily converts them to fat. That way there will be sufficient energy stores to prevent possible starvation.
After years of skipping meals and/or dieting, many individuals develop chronic health problems, all resulting from frequent low blood glucose. An overworked pancreas can result in adult onset diabetes. Excess cortisol and overworked adrenals contribute to osteoporosis, sleep disturbances, menopausal difficulties in women, poor immune function, resulting in frequent colds and flu, and general malnutrition due to suppressed digestive function. As a result of this general malnutrition, muscles, tendons and ligaments tend to injure easily and heal poorly.
Quality Time For Meals
Rushing through meals and eating on the run are a way of life in our society. Unfortunately, these lifestyle habits have a negative impact on the digestive function, in particular, and the quality of health, in general.
Digestion requires the action of the parasympathetic nervous system. This is the part of the nervous system that handles resting and digesting. Driving through traffic, rushing through breakfast to get to work on time, or watching a suspenseful movie all stimulate the sympathetic nervous system. The sympathetic nervous system is the flight or fight part of the nervous system. When the sympathetic nervous system is stimulated, the parasympathetic shuts down. Given this scenario, how well do you think the digestive system works while rushing, driving or watching a movie thriller? Not very well.
Taking time to eat in a relaxed environment can do wonders for the digestion and absorption of nutrients, which, in turn, will improve healing time and optimize health.
In the next article, we will discuss the all-important micronutrients (vitamins and minerals) and how they fit into the picture of nutrition.
Joy Bicknell, MS, CNS, has been working in alternative health care for more than 15 years. She has a Master of Science in Human Nutrition, and is a Certified Nutritional Specialist. She may be contacted at: firstname.lastname@example.org.
Ben E. Benjamin, Ph.D. in sports medicine and education, is the founder and president of the Muscular Therapy Institute in Cambridge, Massachusetts. If you wish to purchase a bound copy of the entire article series, E-mail Ben@mtti.com, or write to Benjamin at: 175 Richdale Ave., #106, Cambridge, MA 02140.