We met on a frigid New England morning, just after the holidays, when everyone is acutely aware that the worst of winter looms ahead. But for Joana Brown, this is her time of year. That's because she has a rewarding career working with some of the toughest guys around—professional hockey players.
For the past three years, Brown has been working with the American Hockey League's (AHL) Lowell Lock Monsters in Lowell, Massachusetts, a minor-league team in the Eastern Conference Atlantic Division.
The AHL is the premier professional developmental league in the world, with nearly 75 percent of its players advancing to the National Hockey League (NHL). More than 100 graduates have been inducted into the Hockey Hall of Fame. The Lowell Lock Monsters are a minor-league affiliate of the Carolina Hurricanes.
Brown is the first massage therapist to work with these outstanding athletes, and it is here that she has found her true calling. It has been so gratifying, in fact, that she is compelled to inspire her colleagues and those still in training to choose sports massage as a specialty.
Brown herself is an inspiration. Born on the Portuguese island of Madeira with severe bilateral clubfeet, she endured more than a dozen surgical procedures before she was a teenager. The challenges were enormous, but they helped set the foundation at an early age for her to gain the ability to transcend obstacles, both physically and professionally.
One of her earliest triumphs involved learning to swim. With keen powers of observation and a sense of resolve honed by intently watching her parents and other avid swimmers day after day, Brown, in one try, walked into a pool and swam the whole length. Shortly after this, at nine years of age, her family moved to a second island—Isle of Jersey, England. In this situation, she had to get used to another country and language, and make new friends while dealing with ongoing surgery to reconstruct her feet.
Here, she learned to release her pain through meditation. At times her feet were so sensitive that even the touch of a bed sheet was excruciating. By sitting completely still, focusing on the pain and accepting it, she taught herself to relax until she could feel the pain dissipate. At this key point in her development, she realized that she wanted to help other people relieve their pain.
The therapeutic benefits of massage were inbred in Brown at an early age. "Massage was second nature in our home," she says. "Whenever we had a pain my mother would massage us or call a local woman to do home remedies. It was a comforting and natural part of what we did to stay healthy."
It was not until many years later, however, that she would take her instinctive knowledge of massage's benefits and translate it to her life's work: a career in sports massage. After moving to the United States, she was faced with new challenges. However, this time they were not physical, but professional and financial. Now a wife and mother of two young boys, Brown was laid off from her job at a major hospital in Boston. She had become well-known as a specialist in launching and managing mammography services, a career path that developed after she graduated from college as a radiology technologist.
After months of little income and much soul-searching to find her passion, Brown decided to go back to school to study massage therapy. "I had always taken it for granted that massage was a major component in staying healthy, but I had never thought of it as a career," she says. "It occurred to me that since I knew about bones, learning about muscles would be the next step and a natural complement to my clinical training."
She graduated from the Muscle Therapy Institute in Cambridge, Massachusetts. Later, Brown went on to study for a year with Grace Chan and James Waslaski. It is Waslaski's techniques that have had the greatest impact on her work with professional athletes because of the immediate results she saw. Brown follows his systematic approach to soft tissue work, and supplements it with the Proprioceptive Neuromuscular Facilitation (PNF) techniques of Reciprocal Innervation and Inhibition for relief of cramps and Tense-Relax to increase muscle pliability.
Because Brown works with the Lowell Lock Monsters throughout the season, as well as during training, she sees the players pregame, postgame, during competition and between games. The key points that differentiate sports massage from other specialties are timing of treatment, and the specific physical challenges of the sport.
Brown's pregame techniques are fast-paced to stimulate blood flow, flush the system and reduce resistance. Overall, she facilitates the players' warm-up, and helps them maintain focus and remain upbeat. During competition, she works primarily as an adviser, answering questions, helping to diagnose injuries and suggesting follow-up treatment. Her postgame techniques are geared toward relaxation and getting the circulation back to homeostasis. She tries to be sensitive to the emotions associated with a win or a loss, and to always convey a positive message.
For maintenance between games, Brown tends to use Swedish massage with deep transverse friction. It is a maintenance massage program, according to Waslaski's teaching, that can best provide the structural changes needed to prevent injuries and enhance athletic performance. Optimally, a maintenance program of sports massage can work with the athletes' schedules to delay or accelerate their periods of peak performance to correspond to the team's schedule of competition.
With hockey players, the majority of requests concern the lower back, hips and shoulder blades. Brown's focal points are usually the rhomboids, levators, trapezius and cervical area, along with the psoas, iliacus, quadratus lumborum (QL), piriformis and glutes. For "homework," she has the athletes stretch the muscles that are short and tight, and strengthen those that are overstretched and tight. With shoulder tightness, for example, she would have them stretch the subscapularis and pectoralis muscles, and strengthen the rhomboids, infraspinatus and teres minor muscles.
In the case of injuries, which often occur in the knees with hockey players, Brown's treatment protocol proceeds as follows in keeping with the approach that she learned from Waslaski: After assessing the active, passive and resisted range of motion, she prepares the area with some general sports massage strokes such as effleurage, kneading and compression. This is followed by strain/counterstrain techniques and myofascial work to release the fibers from their guarded state and access the deeper fibers. She then does some trigger point work, followed by cross-fiber friction and multidirectional frictioning. Brown winds down the treatment by increasing the range of motion, stretching through the use of specific isolated flexibility techniques and PNF.
Brown does not think it is beneficial to work at the level of pain, and will only do so on rare occasions and with clearance from a medical doctor. She thoroughly investigates the cause of recurring pain, and strives to make her clients aware of its cause. Homework frequently involves stretching and the use of a special 2-inch rubber ball for pressure point work; larger athletes may need something the size of a softball. "It's important to give a client one tool at a time, so you can track the progress of that particular approach; otherwise, it's hard to determine cause and effect," she says.
"Jim Waslaski also taught me to observe subtleties of movement and muscle strain in a client's gait," Brown continues. "I watch the players closely, especially as they enter and exit the ring, and I've learned to detect when someone is compensating." Her keen powers of observation enable her to provide valuable feedback to players between games. She'll let them know if she detected any signs of strain that might not have been obvious to them during competition, such as favoring one side, skating that is not as smooth as it usually is, or "sucking wind" from overwork and pain.
When Brown can treat a player soon after an injury or severe strain, she can be invaluable in helping return the player to peak performance quickly so the team is minimally affected. According to Theory and Practice of Therapeutic Massage, Second Edition, by Mark F. Beck (Milady Publishing Company, a division of Delmar Publishers Inc., Albany, New York, 1994), athletic massage can reduce the recuperation time by as much as 50 percent. It is also three to five times more effective in combating fatigue than simply resting, because it encourages lymph drainage to quickly flush out the metabolic wastes of exertion.
Brown recalls working with a sprinter at the University of Massachusetts—Lowell when she volunteered as a massage therapist in the school's Athletic Health Care Department. "The athlete was doing weight-bearing stretching that taxed her lower leg. I switched her to PNF stretching, which allowed her to use her hands to stretch her leg on a daily basis. Head Athletic Trainer Artie Poitras remembers it well: "Joana treated a wide variety of musculoskeletal injuries with profound results," he says. "Her expertise decreased our athletes' recovery time from both injury and intense workouts, which in turn helped to improve their level of performance and workout intensity as never before. The female sprinter went on to finish second in the nation in the long jump."
Another example involved a male 400-meter runner who had chronic hamstring problems for two years. After working with Joana for a month he was symptom-free, and had his best track season in two years.
The rewards of working with professional athletes are immediate. Their bodies are in top condition, so recovery time is dramatically reduced. Because of this higher fitness baseline, results seem almost immediate compared to the weeks it often takes with nonathletes. They do their homework because their bodies and careers depend on it. And when they show up for treatment, because their level of visceral awareness is so high, they can be more specific in "telling you where it hurts."
"Coming from a clinical background, I was accustomed to seeing results," Brown says. "It's gratifying to get that immediate feedback, to see the player you've worked on performing at peak level back on the ice."
There are challenges, however, that are unique to working with professional athletes. One is their need for privacy and downtime away from the public eye. This can manifest as moodiness or an unwillingness to communicate. Lack of communication can sometimes result from an athlete not wanting to admit feeling pain in an effort to 'tough it out' because he believes that bodywork at the pain level is good. Brown recalls one player who did not say the treatment was painful because he, in fact, wanted deeper muscle work. "The muscle spoke to me even though he didn't," she says. "I stopped and explained that if I worked deeper there would be bruising, and it would be counterproductive. He understood that, and in the future gave me regular feedback during our sessions."
Another challenge involves body mechanics, which will differ in competitive and noncompetitive situations. "The athlete might be a righty but shoot left-handed," says Brown, who claims it's important to see the athlete you are treating during competition, not just off the ice or the field. Also, body awareness can be extreme, so extra care must be taken to not talk down when providing treatment or advice.
Has being petite ever posed a challenge for Brown? "Not at all," she replies. "It had been a concern of mine, being 5 feet 1 inch tall. I asked the opinions of teachers, trainers, other therapists and the athletes I treated. It was a unanimous 'no.' Across the board, the opinion is that you can use your weight effectively if you know anatomy."
In this field, the biggest challenges often come from the business side of the professional organization, not from the players themselves. Not every team can justify allocating funds for massage therapy, even if it has the full support of the trainer. "It is often looked upon as fluff, as nonessential spending," says Kingsley, the trainer for the Lock Monsters. "In the minor leagues, because of budgetary concerns, the teams can't afford to have a person on staff at all times. The organization knows that it's needed, but can't justify it because there are so many other things that they have to do," he says.
Asked what he would say to encourage massage therapists who want to work with a team like his, Kingsley adds, "Persistence, whether it's ice hockey, football, soccer, baseball, track and field. Always continue to improve at all points and every level. If they have the desire to do the job they love to do, they will be able to promote performance in athletes and feel the rewards through those athletes."
What are the primary things Kingsley looks for in a therapist? "Licensing, certification and reputation," he answers. "Personality is also very important. Not everyone is cut out to be around professional athletes."
Brown's own advice for massage therapists hoping to work with a professional team? First and foremost, know your anatomy and your muscles. Every muscle has its own trigger point for release. Second, know the body mechanics for the particular sport. Every sport will put its own demands on the body. Third, communicate well. Being able to give the athlete feedback and insight, and to get that in return, is critical to both treatment and the therapist/client relationship. Finally, remember when working with a sports team that you, as a massage therapist, are also part of a team whose leadership begins and ends with the athletic trainer. Sports massage should be considered complementary to other treatments.
Brown has several tips to colleagues looking to make a career move into sports massage, but unsure about where to begin or how to approach a team. Here are some of her recommendations:
1) Set your goals strategically. First, determine what organizations you are interested in contacting, then prioritize on paper. Break down your tasks into smaller pieces, and take action every day. Give yourself a deadline, even if you have to readjust later.
2) Find out the best time of year to make an introduction. "Hockey teams, for example, start training when fall begins, so late August is a good time," suggests Kingsley.
3) Contact the athletic trainer for your number one team. Introduce yourself by phone, and if he or she is able to spare a few minutes to talk with you, give a brief explanation of why you are calling. Ask if the team is currently working with a massage therapist.
4) If the answer is no, ask if you may set up an appointment to discuss your services and how they might benefit the team. If the answer is yes, inquire as to what type of services are currently being provided. Perhaps you could offer a complementary type of massage therapy. If appropriate, ask if you may give their therapist a call. You might get hired to provide adjunct services; at the least, you will have expanded your networking for future work or referrals.
5) When meeting with the athletic trainer, be sure to bring the following: a) a list of points to discuss and questions to ask; b) several business cards; c) a brochure (if you have one) that will ideally list the conditions you have successfully treated; d) testimonials from other athletic trainers, athletes or clients; e) your resume and mission statement; f) any pertinent articles that reinforce the benefits of sports massage.
6) Find out what is important to the athletic trainer so you will be able to tailor your presentation accordingly, and stress the benefits that you can bring to the team. Keep your discussion succinct so he or she knows that you understand that time is valuable.
7) Be prepared to discuss your schedule and fees, and to present a business contract should there be a positive response. Organizations interested in using services such as yours for the first time may not have allotted funds in their yearly budget, but may be able to offer alternative means of compensation. "I've bartered time for advertising space in and out of the arena, and it proved valuable beyond my expectations. This took the form of print ads in event flyers, pregame and halftime announcements, and a table set up during games. I even did 15-minute chair massages in the arena for fans. The exposure was tremendous; I received dozens of new clients," says Brown of her initial "contract" with the Lowell Lock Monsters.
If a paycheck is a necessity but no funding is available, consider finding a sponsor. Corporations, civic groups or sports-minded individuals with money to spare may just be inspired to help their team reap the added benefits of sports massage if you can present a convincing case.
8) Once a decision has been made and the meeting is over, follow up with a letter detailing your agreed-upon arrangement with the athletic trainer. If you prefer a signed contract, let it be known that you will be preparing one.
"I hope everyone who has ever dreamed about working with professional athletes will take the time to test it out," Brown says. "It is so satisfying to know that you have made a real difference in someone's health and career, in helping them recover from the pain of an injury. You can see that your efforts make a difference in their performance, so you are constantly reaping the benefits of your work."
For those who are not able to work with a professional team, or who do not feel that they are ready, there are other avenues: college athletic departments, local and regional sports teams, health-club leagues, referrals from personal trainers, and volunteering at special events, such as marathons, bicycle races and triathlons. All of these can be excellent training grounds because working with people who are serious about their bodies will accelerate learning with regard to how muscles respond, which will in turn teach you so much more about how to prevent injuries and alleviate pain. Additional training can also prove invaluable, such as taking classes in advanced sports massage, orthopedic massage and myofascial release.
The results Brown has seen, and the feedback she has gotten from the players and their trainers, have convinced her that sports massage is an optimal career for any therapist interested in continually learning and mastering his or her technique. It follows naturally that she has become an educator of sorts in her own right, instructing physicians and nurse practitioners on the benefits of massage for their patients, and her own clients in how to prevent and alleviate their own pain.
Joana Brown has come a long way from the girl who tried to ice-skate with her first American friend, and wound up walking two miles home with a severely sprained ankle, as well as to and from school for a week, so she wouldn't have to tell her parents or admit to herself that her feet held her back. In addition to working with the Lowell Lock Monsters, she now has a flourishing practice in two locations, and shuttles her own two little hockey players to practice in her hometown.
Brown's final advice is to "let your passion show in all that you do and say, and always hold your clients in your heart and in the palm of your hands."
With such a vibrant spirit of encouragement, who can resist forging ahead to actualize potential in the "New England winter" of a career?