Friday, August 19, 2016

What is a Massage Franchise?

Recently I have begun to wonder how many individuals understand the franchise business model. Let’s explore this topic like a massage session: General –Specific-General.

GENERAL

A franchise is a way to do business. Franchising is a business opportunity that's somewhere between buying an existing business and developing a business from scratch.
The franchisor is the person or persons who did all the work from scratch to develop a successful business operations model.
The model is the franchise when the originator then sells the model to others who want to do business the same way.
The person(s) who buy the business model is call the franchisee. In exchange for an initial set-up fee and a monthly payment, the franchisor provides the franchisee a business model, marketing supplies, staff-training assistance, managerial consulting and brand awareness .

A short way to restate this information is:

A franchisee buys a license from a franchisor to be a dealer of that business model (franchise). The owner of the franchise sells a product or service through its franchisees.

There are many advantages to the franchise business model. Franchising is a strategic alliance between groups of people who have specific relationships and responsibilities with a common goal. A network of interdependent business relationships is formed that allows a number of people to share:

· A brand identification
· A successful method of doing business
· A proven marketing and distribution system

There are downsides to franchising as well. It costs money to buy and set up the franchise business. There is a onetime fee paid by the franchisee to the franchisor to "buy into" the franchise. The initial fees typically range from $35,000- $45,000. That is a lot of money. Generally, the fee reimburses the franchisor for the costs of initial training and support for new franchisees. Next the location must be rented or purchased and then remodeled, equipped and supplied to fit the franchise facility design. For example: we all recognize how a McDonalds building is designed. This part of the upfront money is really a lot ranging from $100,000 to over a million dollars. Then about a year of operating costs must be available. That is expensive too. The point is that the franchisee has to invest A LOT of money to get the business up and running.

In addition to all the overhead costs to operate the business there are additional ongoing fees related just to being a franchise business.

Staff are employees: This means that the business owner must pay at least minimum wage for every hour worked and all matching taxes as well as other federal and state mandated withholding.

Social Security and Medicare Taxes
Federal Unemployment Taxes
State Unemployment Taxes
Workers Compensation Average (varies by industry)

A conservative rule of thumb is to add 30% to an employee's wages to calculate the total cost to the employer. So if someone is paid $10.00 an hour the cost to the employer is $13-$14 per hour . If self-employed YOU have to pay those taxes. That means for every $ 10 you make you are only really getting about $7 in your pocket.

If there are 5 employees working each shift and the business has two shifts that means that the weekly payroll is about $6,000.00. If the cost of a service is $50.00 then 120 services a week must be sold just to pay payroll.

SPECIFIC

Massage Franchises.

As an employee in a massage franchise business you have to have the whole picture to understand why things are done the way they are done and why the pay rate is the way it is. Each of the franchise models is more or less the same. Really does not matter which one. Some have higher services fees for the massage or maybe a facial and some a bit lower. A middle range initial investment of the franchise owner is about $350,000 plus a year of operating costs. $500,000 as a commitment is reasonable. Before that franchise owner makes any money, the business must earn back $500,000. Let’s also use an average of $50 as the amount paid for each unit of service—a massage or facial. The business must sell 10,000 massage or facial sessions. –That is a lot. Full time massage practice ranges from between 1000-1200 massage sessions a year or 20-25 session weekly (based on 50 weeks). At the same time and for ever after, the business must generate enough gross income to pay all expenses BEFORE the franchise owners get any profits. This amount can range from $ 250,000 a year to $350,000 a year—about 6500 service units ($50 massage sessions).

It is time consuming and expensive to train new employees and turnover in the franchises is huge. Turnover occurs for many reasons but a couple biggies are ergonomics and unrealistic income expectations and those flawed foundations are often laid in the entry level education. Also the employers do not just have massage therapists to pay, but also receptionists and housekeeping, management, repairs and maintenance staff. In the massage franchises the product is quality massage therapy. It is hard to find dedicated massage therapists that really understand the difference between being self employed and an employee

What should a massage therapist be paid?

Based on educational and responsibility similarities when compared EMT(emergency medical technicians), medical assistants, cosmetologists, all of who have more training than massage therapists at the current 500-625 hour standard, $25,000 a year at entry level for a 40 hour work week(25-30 massage hours in the 40 hours)to $38,000 a year for an experienced massage therapist working a 40 hour work week.

A 40 hour work week is 2040 hours of work per year. You would need to provide 25 -30 actual hours of massage during the 40 hours or at least 1400 hours of massage per year. Now remember, the low end pay of $ 25,000 earned per year costs the employer an addition $7500 in taxes you would have to pay yourself if self-employed. So actual yearly wage is really $32,500.

If the cost of each massage is $50 you have to provide a minimum of 650 massage sessions per year just to pay your wages. In addition, all the other overhead operating expenses must be paid. I typically teach 30-50 percent of gross must be allocated to pay these bills so- $12,000- $14,000 in the mid-range (I used about 40% of $32,500). You have to earn this just to have a place to work- whether self-employed or employee. And as an employee, the operating expense amount is lower because others are sharing costs. This is another 250 massage sessions at $50 each. So when working at a franchise you have to do 900 massage sessions before the owner makes ANY money off of you IF you want to earn $25,000 a year.

REALITY CHECK--- And this is based off of $50 per massage. Most unit sales will be less than the $50 because of member discounts, coupons, specials, etc.

Also, the franchise environment is typically a place where massage therapists receive gratuities/tips which can add $7000-$10,000 to the income per year.

If massage therapists were paid a flat $15 per hour for a 40 hour work week, the yearly income is $30,600 which costs the employer $40,600 in payroll and another $12,000 in operating costs. So the franchise owner has to cover about $53,000 of expenses if they pay $15.00 an hour. That is 1375 hours of massage per year working 40 hour work weeks and based on figures of actual massage hours of 1400 per year (even though you are getting paid for 2040 hours a year).

Soooo-the profit to the owner on this model of employment is based on 25 units of service at $50 or $1250 a year. If that owner has 10 massage therapists working full time, yearly profit margin is about $20.000 and that is less than what each massage therapist makes. Quite a different picture isn’t it. These figures are within a realistic range and based on maximum schedule. What happens when there are no shows or a bad weather day? This is a tough cookie to eat. A lot of people have their fascia in a twist. The franchise model is misunderstood in the massage community. This is unfortunate.

What are the solutions? Paying employees less for sitting around when not doing a massage and charging more for the services hoping there is enough volume. The massage franchise membership model was originally based on affordable massage for the masses. The average yearly income is around $35,000 per year. The most a massage can cost to serve this majority of the population is $-40- $50 with the tip. That means the price point cannot be much more than $45 per massage and that only buys one massage a month which in really not enough to gain the health benefits massage can provide. Volume will likely decrease as the cost of a massage exceeds $50-$75 unless you are specifically focused on a demographic that earns more than $100,000 per year. $40 -$50 per massage is a better price point for client retention, multiple massage session and volume. So much for raising the price of services.

Owners may do better than the $20,000 profit mentioned earlier. They work off of volume and often own multiple business. There are product sales and add on services. Paying the low rate for sitting helps the profit margin. Still being a franchise owner is not the huge money maker many would think and the intent is not to work massage therapists to the bone and treat them badly.

GENERAL

You will make the most money as self-employed massage therapist going to client’s homes or places of work. BUT THIS IS A LOT OF WORK- You will have to charge a minimum of $75-$100 for each massage session provided. This fee is out of range for the majority of people but there are some who can pay. You will have to gross at least $80,000 to net $50,000 and you have to pay your taxes on the $50,000. It takes at least 3 hours of time to provide a 60 minute massage on site. With all the driving around and set up and take down time 3- 4 sessions a day or 15 -16 sessions is the max you can do within the 40 hour work week. You can gross $75,000-$80,000 a year—but you will only make $35,000-$40,000 a year after paying all taxes and operating expenses and with a mobile business there is no facility rental. You still have to do all the laundry and everything else. You will make-if no one cancels and you are booked full 51 weeks out of the year (I week vacation)- maybe $18 an hour. This is how I have structured my massage business for over 30 years so I have lived this model. AND I was really busy often seeing 6 clients a day. I have been my own employer and employee and up until a couple years ago maintained a full time practice.

In 2015, the average annual income for a massage therapist (including tips) was estimated to be just under $25,000 per year. BUT most massage therapists are only working 1/2 to 3/4 time and only providing 40-50 sessions a month ( 10-12 sessions a week--1/2 of full time at 25 sessions --60 minute sessions used as base)..You can do much better than that at a well-managed franchise if the number of massage hours is similar.

xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx PART TIME MASSAGE THERAPISTS.

According to the AMTA the average, massage therapist worked 25.3 hours per week in 2015 and was paid for 19.7 of the 25.3 average hours. Also indicated in the report massage therapists provided massage for an average of 45 clients a month or between 11 and 12 clients a week. Only about 50% of those surveyed by AMTA indicated that they wanted to work more hours. (AMTA-- The 2016 Massage Profession Research Report). Also according to the AMTA 2016 Massage Profession Research Report, gross income ( I assume that means prior to income taxes and after overhead is deducted if self-employed) was$24,132 in 2014 and $24,519 in 2015. That sounds terrible until you realize that is PART TIME and about 62% of the typical forty hour work week. 38% of the reported income of $24,519 is about $9500. Therefore , factored out to full time, this means that full time earning for a massage therapist (prior to income tax) is about $ 34,500 per year.

So why are massage therapists working part time? About 50% are happy with part time. So what about the other half? Why are massage therapist only providing 45 sessions a month—part time instead of 90 massage sessions?Two reasons come to mind.

Ergonomics/bodymechanics and lack of client volume. I have been pleading for an independent ergonomics and biomechanical analysis for massage therapy for YEARS. The massage therapy leadership organizations NEED to fund a “for real” independent analysis by objective experts outside the massage profession to get an unbiased perspective and usable recommendations. I do not care who you are or how long you have been doing massage or teaching (including me), all of us are guessing. We do not know for sure and it is time to know!

Client volume is an issue as well. So what are the obstacles preventing more people from receiving massage? Again, according to the AMTA 2016 Massage Profession Research Report, Females without children in the home with incomes over $50,000 are the main massage consumer and 1/3 of all massage consumers had a household income of $100,000 or more in 2015. Only ¼ of those with a household income between $75,000 and $100,000 received a massage in 2015. Seventeen percent of those with incomes between $35,000 and $50,000 got a massage in 2015, down from 22 percent in 2014. And only 7% of those with an income of less than $35,000 got a massage in 2015, down from 8 percent in 2014.

There is a huge potential to increase clients since only a small percentage of people actually receive massage. The largest group of people are those making less than $50,000 a year. Price point of a typical 60 minute massage session will need to be between $40 and $50 for these individuals

How often clients receive a massage is also an issue. Many who get massage only schedule once a month. Research has shown multiple times that that frequency is not enough to generate and sustain benefit. Weekly massage sessions are idea but realistic scheduling for clients is a massage every other week. Increasing the frequency of massage for current clients would double the session hours worked. What are the obstacles for receiving more massage sessions in a month? Cost and time with cost being the biggest deterrent. If the average fee for massage is $ 65 the monthly cost for a client receiving a massage every other week is $1625 a year or $135 per month. For those with incomes less than $40,000 a year that is a real chunk of money. For those with yearly incomes of $ 75,000 or more that is 2% of income but for those making $35,000 a year it is 5% of income. Those earning $35,000 -$40,000 only have $700 a year (2% of income) of disposable income to potentially spend on massage. The most they could spend is $30 a massage session if they received 1 massage session a month.

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Here is who is getting a massage----

From AMTA :
Average massage consumer is female, has a household income over $50,000 and does not have children under 18 in the household.Household Income – Thirty-one percent of all massage consumers had a household income of $100,000 or more in 2015, and 38 percent of consumers in households with an income of $100,000 or more had a massage in 2015.
 Twenty-four percent of Americans that have a household income between $75,000 and $100,000 received a massage in 2015, up from 16 percent in 2014.
 Twenty-one percent of Americans that have a household income between $50,000 and $75,000 received a massage in 2015, up from 17 percent in 2014.
 Seventeen percent of Americans that have a household income between $35,000 and $50,000 got a massage in 2015, down from 22 percent in 2014.
 Seven percent of Americans that have a household income of less than $35,000 got a massage in 2015, down from 8 percent in 2014.
The 2016 Massage Profession Research Report

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Most massage franchises are well managed, but not all. If you are working in the franchise system and the managers and owners are not doing a good job keeping up their side of the business----and if you are a good employee-- meaning appropriate business behavior, good retention rate for clients, tending to cleaning and facility management duties and want to be part of the solution---then diligently identify the problems as you see them, write them down with potential solutions and respectfully present to the franchise manager. If that does not work go to the owners and if there is still no improvement go to the Franchise corporate offices. IF STILL NO SUCCESS THEN QUIT. THERE IS A SHORTAGE OF MASSAGE THERAPISTS RIGHT NOW. YOU CAN FIND ANOTHER POSITION.

If you are motivated to complain, gossip and generally contribute the problem then quit, go into business for yourself . If you do not like all the standardization, rules and pay then go to work for yourself. If you are a quality massage therapist dedicated to service you will have a full schedule and won’t be sitting around making a minimum wage base an hour. If you are sitting around and not getting retention and client rebooking then take a good look at your professional behavior and skill set.

Employers: If your are good employers you realize that you are in a team relationship with your employees. Do not be aloof and distant. Be part of the team by sharing and communicating and you are not too good to clean the bathroom either ! Support your excellent employees and get rid of the employees that are a strain and drain. One bad apple spoils the whole barrel.

Finally: Educators stop instilling unrealistic income expectations. Present the employee model of career development with the same objectivity as you present self employed. Do not downgrade either career path- present the facts-the real facts.

Disclosure: My family owns a franchise massage clinic. We are excellent employers and ours employees are part of the success team.

Tuesday, August 16, 2016

Adaptation and the New Normal

What is normal? Definitions include conforming to usual standards, typical, expected, customary, and established. The normal textbook definition of elbow range of motion is 0/145 degrees. Having assessed elbow range of motion thousands of times during my massage therapy career I have seen all levels of elbow movement that were different than 0/145 degrees with no limit in functional capacity. There must be a variation in normal a crossed a spectrum.

At 63 years old and pushing 38 years as a massage therapist, I have learned from my own life and the life stories of clients that the concept of normal is elusive. I have had many events in my life that have challenged me to find many new normals ( whatever normal is). So has everyone. We all have stories. Listening to someone’s story with empathy and avoiding personalization by giving advice, feeling judgement, admiration, disgust, pity or envy is a very important therapeutic skill. I am pretty good at it since I have had a lot of practice, took many professional courses in communication and have made plenty of mistakes and correcting them the best I could. There are things I had done or said to others that, to this day, make me feel guilty.

If I really am at fault then I should feel guilty. When I am not at fault then I should not have personal emotion attached to an event. After all, at any given point, based on the knowledge and skills we have, we can only do the best we can. Objective reflection can be quite the experience and often we need a professional such as a psychologist who is highly trained in listening and guiding reflection to guide us.

Most of the massage therapy clients I have had over the years, like myself, are on a continual journey of adaptation and finding new normals. I am going to share just a few of my own stories that have taught me to be a more empathetic and compassionate massage therapist and person.

I was bullied as a kid. I got myself crosswise in 4^th grade with the most popular girl in class and the bullying lasted through my freshman year in high school. To add fuel to the fire, I was chunky and clumsy with curly hair, wore thick glasses and had an unusual last name that was easy to make fun of. And I was really academically good in school but had terrible handwriting, spelling and difficulty reading out loud. This was in the late 1950s and early 1960s by the way. My tendency to support the underdog, keep trying with those that struggle and gut based understanding for those who look different come from those years.

In college (1972) I finally was tested and diagnosed with dyslexia type issues. When I was 5 or 6 years old I had a significant head injury when diving into a swimming pool. I often wonder if that was not at least a partial cause. My handwriting and spelling were a real hindrance and kept me from excelling like I might have at the time. The 1970s was still the dark ages for learning and functional differences.

I married too young ( in retrospect) had 2 babies and really tried to be the 1950s type homemaker like I had been indoctrinated to by TV. Those years are bitter sweet. The sweet part is my children. The bitter part was trying to be something I was not. The inner struggle surfaced my tendency toward anxiety which accelerated into panic attacks and agoraphobia. I was all into organic gardening, food preservation and holistic health. I worked from home as a seamstress and in-home daycare. I had taken some classes in massage and found I was good at it. In 1979 the critical point happened and I left the marriage. I knew that my tendency toward “close enough is good enough” would not serve me in business and accounting for which I trained for in college. How I overcame the fear of driving and going to unknown places is quite a story in itself. Why I struck out as a massage therapist is still an unanswered question for me. A single mother at 26 years old ---well that was a new normal for sure.

I was successful as a self-employed massage therapist working all kinds of hours, in all kinds of places from people’s homes to a home office. My kids really did grow up under a massage table. I credit my success to 2 or 3 clients who were my champions. I will be forever grateful to these individuals. Adapt, adapt, adapt.

In 1983 a few people asked me to teach them how to do massage and the foundation of my massage therapy school “Health Enrichment Center” was laid in the living room of my home. The school is entering 31 years as a Michigan state licensed massage therapy school. More adaptation. Now there were students and instructors to deal with. Another marriage, baby and divorce. The divorce primarily occured because my life changed so much with a busy massage practice and now the school and my husband just did not want to adapt to my new normal. In retrospect I don’t blame him.

In 1992 I was approached to write a massage therapy textbook and I declined. Remember I deal with dyslexia and I was computer illiterate. No way was I going to expose myself to the criticism of publishers and the public. A year later the publishing company promised me all the help I would need and to this day they continuing to provide the assistance. My copy editors are so valuable. I also learned to use the computer and by the time I got over my fear of it, I realized how much help it is. I still read through mistakes and when I write on my own they will show up, However, I decided when I was 50 years old to not let that prevent me from writing for the public be it on a flip chart in a class or in a blog or eventually on Facebook. Adapt, adapt, adapt and a new normal for quite a few years.

I did have a reoccurrence of the anxiety that this time manifested as obsessive compulsive behavior. I was finally persuaded to try medication and it has made a big difference. Wow another new normal. I was also diagnosed with benign paroxysmal positional vertigo which is a weird vestibular issue that may have actually occurred with the head injury when I was a kid. It is likely that the condition contributes to at least some of the anxiety, clumsiness and even dyslexic behaviors. I had been adapting my whole life to those sensations and didn’t even know it. At least now I had a name and with than the ability to find information and understanding.

Until 2006 that is. From 2006-2016 –the last ten years have been a constant demand to adapt and find short term new normals. Open heart surgery, triple bypass successful- but left with some cognitive issues. Tragic death of my oldest son, support for my daughter-in –law and birth of my granddaughter. 5 years of lots of supported care for my granddaughter which continues and always will but she is getting older. Yesterday I found a pacifier in the trunk of my car and finially threw it away. I maintained a busy massage practice including lots of travel with the athletes and managed and taught at the school. I managed to survive the great recession even while being embezzled for a lot of money by a trusted employee who began to take advantage right after the heart surgery when I was vulnerable. My daughter began working at the school in 2012 and found the issue and belss her heart has been a big part of digging out of that fiancial hole. I worked like this until 2015 when the glaucoma, I was diagnosed with 15 years earlier,became severe resulting in 5 surgeries and significant changes in my vision, which has never been very good. A few years ago I also tore my ACL and MCL which actually has required much more adaptation than the heart surgery.

My new normal today is limited driving and a change in client based since they need to come to me. I am working with many retired athletes as they find their new normal and adapt to the joint replacements and functional changes related to aging and years of professional sports. My daughter also manifested the dream of opening a franchise business. She had wanted to do this since her army days of working part time at a franchise business. So using the legacy left us from my oldest son, we opened Massage Green Spa in April 2016. Wow, big learning curve and important to understand since the world of massage is changing. Those entering the massage professional likely cannot –nor do they want to pursue their career like I did. In retrospect, I don’t blame them.

My new normal now includes teaching, writing textbooks, being 63 years old, seeing clients, mentoring the massage therapy employees and learning how to do more of the office work at the school including copy machine, running credit cards and stuff. My youngest son Luke graduated from my school and was out on his own as a massage therapist for 10 years. He fulfilled a plan for him to then come back to the school at age 30 to begin the process of slowly replacing me at the school as the lead teacher and eventually allowing me to step back a bit. Ha-- that may be when I am 90 since he too is actively involved with the massage franchise operations. My new normal is working with family---all the time. So far we are doing pretty well but tons of adaptation.

So what is normal anyway? Massage therapy clients bring us their life story every time they get a massage. I am amazed at our capacity for adaptation. When we realized that settling in to a new normal is an ongoing process, I think it is a little easier to be able to adapt. As I view the continuing education offered massage therapists, I begin to feel like the important outcome of adaptive support for life changes is seen as inferior and to be a “real” massage therapist we need to “fix things” and work in hospitals or be directly involved with the medical community. No one supports medical professionals more than me—they save my life and my vision. But life is typically messy and not a pathology. We all have the condition called life. We want to be able to move through life meaningfully. It is likely that each client is doing the very best they can at that time. Support and kindness coupled with subtle physiological shifts that manage discomfort, support sleep and help them live life easier is the real benefit of massage. Wellbeing is the most important outcome massage can provide.

Thursday, August 11, 2016

ADVANCED MASSAGE IS A WAY OF THINKING-

Two questions come to mind when I think about “advance massage”.

What is the goal of the massage?

Why is the body functioning the way it is?

One of my teacher’s years ago said.” Every behavior, physiology shift and anatomical change is an attempt at a solution.”

I consider this every time I approach a massage client.

So for a simple example: A client has a grade one medial collateral ligament sprain in the sub-acute healing stage.

Now if you do not know what this means you need to look it up. It is impossible to do so called “advanced massage” if you do not have a handle on anatomy, physiology and pathology. I think the best way to do this is to always look up any condition a client may have even if you think you know what it is.

The client is complaining about her calf aching. So my next thought is ,”What purpose does an aching calf have related to a knee sprain?”

Well, a sprain is a tear-which makes a hole-which has to knit together to heal. A grade one is a little hole and sub-acute means the connective tissue repair is occurring but is a little fragile. An aching calf would restrict movement so that the healing edges of the tear do not separate. Maybe the aching calf is a good solution right now. Think I will leave it alone. However, the change in how she is walking is making her hip sore. Maybe massage could help to normalize the soft tissue changes occurring secondary to the primary injury and local protective response (aching calf). Let’s check and see if there are some changes in the tissues around the hips and because of the gait reflexes that link hip movement with arm movement I think to also assess the shoulders. Yup it is tender to moderate palpation in both places. I ask if her neck been a little stiff since the IT band on the injured leg will also be involved in knee stabilization and that structure weaves into the glut soft tissue which weaves into the lumbar dorsal fascia and affects the resting length of the latissimus dorsi especially on the opposite side which alters position of the arm at the shoulder joint which then influences scapular movement resulting in trapezius and associated soft tissue shortening and since the upper trap attaches into the skull and scalp it would seem logical that she might have neck stiffness and even a headache.

In this case I think I will give her a really good full body massage, target areas that are logically part of compensation, gently mobilize soft tissue around the injured knee. Carefully massage the calf just to calm it down and manage some of the aching but not really change the muscle tone and then reevaluate the progression next session.

So advanced massage is a way of thinking—not advanced methods.

What do you think?

Friday, August 5, 2016

A BUNCH OF MENTORING TIPS

MY MENTOR- DR, LEON CHAITOW

I collected MENTORING TIP TODAY posts from Facebook. Here ya go:

MENTORING TIP TODAY

Suggestions for those seeking mentors. I have been mentored by some excellent therapists. The two that come to mind are Dr. Leon Chaitow and Dr. David Geurvich. Dr. Chaitow most know but Dr. Geurvich was a physical medicine specialist in St. Petersburg Russia. He came to the US via Jewish relocation services just after the Berlin Wall fell. He was at my school as a teacher and my mentor for 8 years before passing. I hounded him for information and he was so patient with me most of the time. Once he became frustrated with me and said"Sandy, I no not why. I am not GOD. I am only an old Doctor. Where is pain I rub."

I am so fortunate to have had these mentors and many others in my world over the years. If you want to have a mentor that will put up with you here are some suggestions:

Make yourself fit the mentor's schedule

Be helpful and of service

Listen and watch

Listen and watch some more

Ask questions you have attempted to answer yourself first.

Be willing to pay to be in their presence

Respond to their requests for help

Mentors do not always have to be nice to you. If they are the type of mentor you want they are busy.

When choosing a mentor:

Avoid gurus and those with narrow specialization that have named methods.

Seek those who are in practice

Seek practice experience. Lots of in the trenches experience.

Seek those who have challenged themselves to learn, unlearn and evolve.

Seek those that volunteer time to advance the profession especially those who work quietly behind the scenes.

Make sure they are willing to put up with you. Mentoring is a hard task that takes time. If the mentor does not think you have potential they may be unwilling to devote time.

MENTORING TIP TODAY

The SBA- Small Business Association is a great resource for those wanting to be self-employed massage therapists.

Reclaim the historical foundations of the spa as a place of healing and that a person healing and a person being treated for illness/injury and sometimes cured are not the same. You can heal without a cure and you can be cured without healing.

MENTORING TIP TODAY--ARE YOU WORKING PART TIME OR FULL TIME

Massage therapists you cannot work part time and expect to be paid for full time. Full time work is 35-40 hour in 7 days in the US. You should provide 25-30 hours of massage during a forty hour work week. If employed you’re done. If self-employed you still have the non-massage responsibilities to complete. Most massage therapists are only working 15-20 massage hours. This is 3/4 time. So if reasonable income pre- income tax is $30,000-$35000 a year then 3/4 time wages are $20,000-$22000. Which is what AMTA is reporting for average yearly income.

MENTORING TIP TODAY

For first time clients:

Carefully and thoroughly describe and demonstrate massage procedures such as how the draping works, where to hang clothes, a basic description of the massage sequence, sanitation methods etc. Otherwise the new client can be unsure, a little anxious and even embarrassed if they don't know what to do and what to expect.

MENTORING TIP TODAY- ongoing info from the research conference.

Professional development in massage therapy develops in stages. First you choose a quality education that will be vocationally/diploma based. Then you become licensed (except in a few states). This is a great beginning and sufficient for entry level practice. Next you can further your education with continuing education and achieve board certification. I STRONGLY RECOMMEND ALL SEEK TO BE BOARD CERTIFIED. IT SAYS YOU ARE NOT A BEGINNER AND HAVE GONE THE EXTRA STEP IN PROFESSIONAL DEVELOPMENT. This is as much as a massage clinician needs especially in the general population and wellness setting.

If you want to move into massage in the medical setting/or teach massage therapy/----

Next or at the same time, you can seek a complementing associates or bachelor's degree and or transfer credit based on board certification for either an associates or bachelor's degree based on the NCBTMB college partnerships. 33 college credits in worth a lot of money.

(NOTE - If you do not want to seek an academic degree for work in a medical setting then cross training to a complimenting diploma program is suggested such and a certified nurse assistant or a physical therapy aid )

Finally if you want to pursue becoming a researcher then based on the bachelor's degree you can seek a masters and or doctoral program in a complementary field such as public health. We have the pathway. It is in place. We just need to education the entry level student and those currently in practice.

MENTORING TIP TODAY

Do not ignore your massage elders. If they have been in professional practice for over 20 years they have been doing many things right.

Massage elders share you wisdom but also remember some of what we experienced, learned and even currently practice is often outdated or unrealistic for the new generation. Sift past education and experience through current and trending practice filters.

MENTORING TIP TODAY

Massage therapy in acute care settings in hospital is palliative comfort care. Very important but not modality fix it. Additional training involves behavior and adaptation to the hospital setting not specific massage methods

MENTORING ERRRRR UGG TODAY.

It takes a lot of energy to mentor.

MENTORING TIP TODAY

Too much, not enough, JUST RIGHT. This is the wisdom of the three bears fairy tale. For massage, using this to evaluate many aspects of massage therapy practice can be helpful. In general 'TOO MUCH" such as too many items on the massage service menu can become very confusing. Attempting to include too many methods or working on too many issue during a massage session can be counter productive. "NOT ENOUGH" is also problematic. Not enough clients certainly is an issue. Not enough focus on customer service will negatively impact retention. Not enough massage experience or skills can be an issue. " JUST RIGHT" can be hard to find because it varies with individual clients, environments, massage approach and client outcomes. However when JUST RIGHT is found, it is a sweet spot.

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The MBLEX exam does not seem to be the type that you can specifically study for. Often terminology is the challenge. A way to expand terminology knowledge is to read glossaries in textbooks.

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Learn from your own body, I have an aggravated SI joint. It will not kill me and I know it will resolve. It is a lesson however. It reminds me of short term limitations, muscle spasm and the body's attempt to protect, body compensation above and below the area, how sleep is disrupted when movement is uncomfortable., how the caution and apprehension of protective spasm is fatiguing, how good ice acts as a pain control measure and more. I am my own laboratory and research project. These types of events make me more compassionate, more patient and more aware of the experiences of others. All the physical and emotional experiences of my life help me understand others. Each of us has our own way of experiencing big and little issues. Know one can really walk in another's shoes. However today my own glitch in my git along reminds me to not judge others. PS--And massage will not fix this. Know limitations.

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Your posture and actions while giving a massage should be similar to most daily activities. If you freeze position while doing a massage then step away from the table maintaining that same position and look odd or awkward something is needs to change.

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Massage in the medical setting is not more valuable nor does it alone increase the validity of massage therapy. It is one emerging setting. The major care process in a medical, setting such as a hospital, is palliative care for a short duration since people do not stay in the hospital for long periods. This offering of massage is important however, the medical setting does not lend itself to health maintenance especially condition management of chronic conditions. People are not in the hospital long enough to provide long term massage care. The wellness and self-care settings are more viable environments for long term massage care.

MENTORING TIP TODAY. I think there is a big push toward wellness and necessity for wellbeing, being productive and performance as outcomes for massage therapy. There is something called resilience that massage can support. And multiple hospital systems are adding spa type wellness centers or palliative care in hospital. Research does not support "fix it" pathology based care but there is good evidence quality of life improvement. Carefully evaluate your marketing, explanations about regular massage and the type of continuing education you invest in.

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Employers of massage therapists, spas, franchises,

chiropractors, medical facilities, sport facilities, single location clinics or studios ----- If you have excessive employee turnover consider first the quality and commitment of who you are hiring. If committed massage therapists are leaving then take an honest and hard look at you management style and the quality of the work environment you create. Also evaluate all employees to make sure there is not a bad apple in the mix spoiling it for everyone else and get rid of them.

· Entry level education in my opinion is cluttered with the concept of multiple styles and specific routines. I think of prenatal massage or infant massage or sports massage as examples. Instead we should be teaching students how find relevant content( MedlinePlus.gov is excellent) to adapt. based on condition, medication, stamina, coexisting conditions and so forth. For years, as I have written textbooks, I have gently but consistently pushed for more competency in entry level education. At the same time I have advocated for less focus on adjunct methods and more on critical thinking and ability to adapt massage to client outcomes and unique situations. I have also shown that many methods are not unique, but instead a modification of massage to more specifically target a physiological function - fascia or fluid movement for example. Lets get rid of the clutter in entry level massage education..

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If you are unhappy with the location and circumstances where you are practicing massage therapy it is time for you to leave and do something about your career in a different way. If you stay you will remain miserable and make those around you miserable as well.

· Part of the problem are all the gimmicks. I have a real hard time with applications that become complicated such as "stone" massage. I teach it and present it in the textbooks as a thermo therapy and mention it as an implement to use during massage but honestly it is so cumbersome to prepare the equipment, fish out the stones, make sure they are not too hot, etc. Heat is nice--what happened to the good ole hot water bottle.

· We actually do have competency guidelines that can be used. They are from COMTA and I have supported using these for entry level education curriculum design regardless if pursuing accreditation or not. They are good. You can find them on the COMTA web site by searching for Competency Table: under the resources tab.

· Another way entry level education gets cluttered is by using too many textbooks especially by different authors. I know this may sound self-serving but better to really use a book to its fullest then to have a bunch that are barely opened. In an entry level massage textbook each chapter or unit -depending on the organization should be more than effective for an individual course.

· .So in my opinion you need a text that focuses on massage application and professional practice and a science based text that covers anatomy, physiology and pathology. I am not a fan of the huge comprehensive A&P texts typically used in college general A&P courses. They are overwhelming and really expensive. I think they should be a library resource. I have written Essential Sciences for Massage Therapy which is a comprehensive but focused and functionally relevant science text targeting massage. Even when students have to take general A &P such as occurs in some community college programs it is helpful to have a functional science course for massage students. I am not the only author with textbooks that fit these criteria. Depending on the science text, an additional muscle skeletal anatomy text and or pathology text may be used so at most 4 books. I use 2- 625 hour ELAP content covered and based on COMTA competencies.

· Educators : Remember ELAP elapmassage.org as you update your curriculum content. -Oh and by the way. Update curriculum content.

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· When providing massage therapy we use mechanical force application to mimic normal physiology. Therefor if we are going to provide intelligent massage therapy we better know what normal is.

· Simple is usually just as effective as complex--How about that!

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Massage therapy provides the best benefits when received regularly. This means client retention is a foundation of success.

· SCHOOL OWNERS- So I just got off the call with COMTA and the outline of the proposed certified /endorsed curriculum is a great step forward for uniting the entry level educational standards without undermining the uniqueness of each individual program . We need to remember that COMTA is still in the development stage. I will say to school owners out there. In order for any program to be successful there needs to be a critical mass for buy in. Even if in the initial stages it does not seem as if there is an immediate return to the school and even that the workload may increase a bit there are times when it is important to do things because it is the right thing to do.

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· My goodness there are a lot of myths and fear based "rules" about working with women who are pregnant. Most are related to the myth that massage can cause miscarriage. More miscarriage does happen in the first trimester but unless the massage involved pounding on the abdomen massage has nothing to do with it. Correlation vs. causation is the fancy way to say it. True miscarriage is a traumatic event and there is a small possibility that the women, looking for cause, blames the massage because both occurred in the same time frame. This is sad but not a reason to deny women who are experiencing a normal pregnancy.

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· Other really stupid stuff: Massage causes the immune system to attack the fetus. Massage moves toxins to poison the fetus. Avoid massage on the ankles because there are acupuncture points that cause uterine contraction. Common sense people. Learn more about the process of pregnancy and make logical and biologically plausible decision for each individual client. Here are some realistic adaptations. Avoid essential oils since the sense of smell related to hormonal changes is altered and they may smell unpleasant. Hormonal changes do affect the pliability of connective tissue including the ligaments. Caution with stretching. Side lying is likely going to be the most comfortable position as the pregnancy progresses. By the way side lying position is a GREAT position for massage for everyone not just those who are pregnant. I am not a fan of the tables with openings to accommodate the .abdomen. They are too rigid. Lots of bolsters that can be moved and squished around work better. Watch for signs of preeclampsia (look it up on Medline Plus) and refer immediately. This is a medical emergency. Offer the restroom. Do not keep the women in the flat supine position for very long when in the third trimester- the weight and mass of the baby can interfere with breathing and it is uncomfortable for most women. Do not talk about your own pregnancies Ya got to be tough to be pregnancy and give birth. Pregnant women are not fragile- just changing based on the stage of pregnancy. If you are scared then refer. Also massage does not make breast milk toxic.

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· This one is for educators. I think there is a terminology gap related to educational language and how massage therapists who are now teaching understand the language. We have some excellent educators in the massage profession that have not been formally trained in education. There can be a point of confusion when those of use who have formal educational background use unfamiliar terms. If is likely that educators coming from the field are actually using many of the processes but may not have the formal language. Terms that come to mind are formative and summative assessment. The goal of formative assessment is to monitor student learning to provide ongoing feedback that can be used by instructors to improve their teaching and by students to improve their learning-think a quiz or informal hands on assessment. The goal of summative assessment is to evaluate student learning at the end of an instructional unit by comparing it against some standard or benchmark such as a midterm or final exam. Another example is concept mapping. A concept map is a drawing of ideas, information and relationship as boxes or circles, which it connects with labeled arrows. It is kind of like brain storming which most people are familiar with but work with understanding relationship more than solving a problem. SO-- educators, when using terminology that may be unfamiliar to others let’s begin to define the terms within the posts to reach a broader audience and include examples when possible.

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· What is a massage session? A session includes greeting, intake, assessment, the client getting ready, the massage , the client redressing, post assessment and saying goodbye. The hands -on portion of the massage session is only one aspect of the therapeutic interaction. A massage session may be 30 minutes long, 60 minutes long, 90 minutes long, but the actually massage will be less time. Typically 5-15 minutes of a session is allocated to “non- massage “activities. This means that we have to be able to be efficient both with massage and non-massage aspects of the massage therapy session. It is important that you practice time management. The concept of the therapeutic hour as 50 minutes of time spent with the therapist is common in many professions. Scheduling is most easily done “on the hour”. This would mean that a common scheduling for a massage session would be on the hour mark and the actual massage portion would be about 50 minutes. There is ongoing confusion in many areas of the massage therapy practice. For example the concept of the 60 minute session being an example of the therapeutic hour-50 minutes. So the confusion is about session verses hands on the client. Does that mean that assessment time is not valuable. Assessment includes conversation as well as other activities. Education works off of the 50 minute educational hour. So if I pay for 1 hour of education what does that mean. Some of what is being discussed is semantics and terminology. Others have asked-where did the 60 minute massage come from anyway. It is kind of like the 500 hour massage program that is now being altered by ELAP to 625 hours and where did that come from???? My concern is the entry level job market and as educators we have an ethical obligation to make sure graduates can perform in that market. If many of the entry level positions are based on the 50 min. massage than our graduates need to be able to do that.

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Of course we clean and are clean because that is what respectful professionals do.

: free from dirt, marks, etc. : not dirty : We clean ourselves, our attire, the linens, equipment, facility, the surrounding environment. We clean up messes when we find them not just when we make them.

: free from pollution or other dangerous substances: not causing pollution: We respect the environment, clients and ourselves by recycling, using environmentally safe products and services and cleaning up messes around us.

: not infected maintain sanitation: We use CDC recommended cleaning, disinfecting and sanitizing practices in the work environment.

: not showing evidence of any broken rules or laws: We abide by standards of practice set forth by professional organization , legislation and where we practice massage.

: not connected with or involving anything illegal or morally wrong: We behave ethically and respectfully to support the entire massage profession We do not gossip, bring drama into the work environment, or act or speak in a derogatory way about others or ourselves. We report in the appropriate way illegal behavior of other.

: not referring to anything sexual or offensive: We present ourselves as health and wellness professionals both when working and when in public knowing our behavior influences the entire reputation of massage. We do not tolerate offensive behavior by coworkers, clients, other massage professionals or the public. We use respectful education to clean up misconception and demeaning statements about massage therapy practice.

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· The concept of the 50 minute therapeutic hour is not new. Students should be trained to provide full body general massage sessions meeting the outcome of relaxation in this time frame. And please, when providing a full massage session DO NOT spend more than 10 minutes on the back. The 50 minutes allocated for the massage needs to be efficiently used to address legs back, front and sides including the gluteal area, the abdomen because the low back begins at the linea alba, the anterior and lateral thorax, arms, shoulders, neck, head and face. Do not skimp on the feet and hands and head.

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· Remember ELAP. Following is an example of the use of ELAP terminology. Example: The goal of the massage is to increase the length of the soft tissue in the calf. The massage therapist will choose an anatomical tool (forearm), to apply a force (push and pull) at the back of the leg just below the knee(point of application) using moderate pressure (magnitude) and push the tissue toward the ankle(direction) The applied force loads the tissue causing tension stress and the tissue changes shape due to the strain..

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· Friction and Traction: The Importance of the Feet. Body mechanics for massage begin at the feet. Ground reaction forces at the foot and floor are one of the most important—yet often the most overlooked—aspects of massage application. For our purposes, we can say that ground reaction forces occur when the body pushes into the floor and the floor pushes back, so long as no slipping occurs. Friction is the force that prevents slipping. Traction is required to prevent slipping. Traction is the maximum frictional force that can be produced between surfaces without slipping; this applies, during massage, between the foot and the floor, or in the contact with the client's body.

· Friction that allows ground reaction forces works for the massage therapist by enabling the pressure exerted during massage to move toward the client's body. Massage should not be performed in bare or stocking feet, because this hinders the ability to perform massage and also is unsanitary. The only way to ensure adequate friction (and therefore the ability to generate force) is to wear shoes that have a rubber-type sole and that can be tied or strapped around the arch (e.g., athletic shoes) Fritz. Mosby's Fundamentals of Therapeutic Massage, 5th Edition. Mosby, 2013. VitalBook file.

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· When we nourish faith, we find strength to survive, thrive and help others. When we nourish hope, we can endure, create, and plan for our future. When we nourish love, we care, have empathy, and support vibrant life in all its forms and bring respect and strength to support what is right and good. Fritz. Mosby's Fundamentals of Therapeutic Massage, 5th Edition. Mosby, 2013. VitalBook file.

· SCHOOL OWNERS AND PROGRAM DIRECTORS. An entry level training program does NOT benefit from lots of textbooks. Students become overwhelmed and books from different authors can be contradictory confusing students .In massage there are 2 distinct but overlapping content areas. Methods/ professional behavior and practice and Sciences. Each unit or chapter in a textbook becomes a “course book” An entire entry level curriculum should be able to be presented using no more than two or three books.

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· Outcomes not modalities.

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· I was listening to a farmer explain sustainable farming practices through intermingling diversity. He said" Nature resists monoculture and thrives in poly culture." Made me think about massage these days as groups embrace one method or teacher (monoculture) instead of searching and learning how to integrate many methods and teachers into their professional journey. Poly-culture.

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Recent AMTA fact sheet indicates that over 50% of people seek massage for medical reasons. This DOES NOT mean clients wants you to fix them. It means they want you to help them feel better. They do not want a method, they want an outcome: to relax, reduce stress, manage pain sensations and move easier. I dislike the term medical massage as much as I dislike the whole deep tissue thing. Provide an excellent massage adapted to the client.

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· The connective tissue, myofascial, and trigger point assessment and interventions methods are adapted massage. When combined, these approaches form the basic techniques of many different fascia based methods and neuromuscular therapy. Understand that just because something has a different name does not mean it is a different method. Usually the name of a method is a marketing strategy especially if the name does not describe what anatomy, physiology and pathology is being targeted by the approach. For example, this combination of approaches has been incorrectly called "deep tissue" massage. Pressure is a modifier used to adapt massage application. Deep as a descriptor is much too abstract and is a directional term. There are many layers of soft tissue in any given area all superficial or deep to each other. The name “deep tissue massage” is inaccurate, confusing and should be avoided.

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· Since I have worked for many years with professional athletes and celebrities I can tell you that everyone has a intergluteal cleft, also known as the natal cleft, the vertical gluteal crease, the gluteal cleft and no one is more special than anyone else. It is unethical to name drop or brag about who you have worked with. All clients are important.

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· Study to be able to ask intelligent questions and find relevant information. Avoid excessive memorization of facts. You can look facts up if you can ask an intelligent question.

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· Clients pay for service, results and compassion. Clients really do not pay for modalities unless whatever it is provided results.

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· There are four main evidence informed outcomes related to massage therapy. They are: Relaxation, Stress Management, Pain Management, and Functional Mobility. Relaxation, Stress Management and Pain Management outcomes are directly related to how massage interact with the autonomic nervous system. The approach to massage that is most apt to achieve these outcomes is a general, full body nonspecific, non-painful, pleasurable massage using moderate pressure and moderate drag on the tissue and lasts about 60 minutes. This approach is the single most important skill set you will deliver as a massage therapist. Typically the interaction is to quiet the sympathetic output and support parasympathetic relaxation, restoration and rest. Often called relaxation massage, you may find people who indicate that this approach is only basic and does not take much skill. On the contrary, the ability to intelligently, mindfully and compassionately perform this approach to massage requires great skill and much practice.

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· Terminology changes.

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· Be excellent at delivering a nonspecific full body massage in a 60 minute session. This massage approach should be your palpation and joint movement assessment foundation.

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· Claims made for massage therapy effects and benefits need to be biologically plausible. Biological plausibility refers to cause and an outcome that is consistent with existing biological and medical knowledge.

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· Take care of your hands. Wear gloves out in the cold and when working outside.

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· Learn to read research articles.

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· We are most likely to harm our clients when we are too invested in fixing them.

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· It takes a mixing bowl of assessment information to intelligently provide a teaspoon of intervention.

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· Career focus changes as experienced is gained. Sometimes massage therapists will begin to feel limited or discontented by the environment where they practice massage therapy. Often individuals begin to dislike the practice setting and begin to degrade the value of massage offered in a particular environment. It is likely that these feelings indicate that you have out grown and are no longer challenged by the type and focus of massage in that practice setting. Instead of complaining or being frustrated, get additional training if needed and move on.

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· Massage is a general system meaning it influences all body systems and functions directly or indirectly in a nonspecific way. This is a good thing.

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My advice to the entry level educators—get over thinking entry level education content is something unique. We should all be teaching same content at entry level. Quality comes from HOW the information is delivered-NOT WHAT THE INFORMATION IS.

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· The massage profession continues to be misunderstood because of the many unique names for what is really an adaption of massage to more specifically target a particular tissue type or physiologically function. For example, one significant difference between myofascial release and massage is the use of a lubricant. A lubricant reduces drag on the tissues making it hard to move the tissue. Instead, lubricant supports sliding over the tissue. Targeting fascia requires that the tissue is moved into a variety of directions with the tissue maintained in a tension or torsion stress state. If you are going to be a professional it is important to logically evaluate and to use research to prevent being confused by multiple names for essentially the same approach.

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· No CE class replaces experience.

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· If it hurts or strains you to apply a massage application then don't do it. Figure out another way to get the same result. DO NOT injury yourself for a client.

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· I am aware that compensation for massage therapist is a difficult issue. In my most current blog state that I believe $15 per hour on site based on a 40 hour work week for a typical 600-900 hour entry level vocational education is a reasonable starting wage. There are other blogs I have written that can further clarify the issue. My concern is that split compensation common in the franchise industry. - minimum wage is on site and $15 when doing massage. The amount earned each week is then averaged. While gratuities are common in the service industry massage therapy is considered health service and the whole tip issue is confusing. In a typical 40 hour work week it would be realistic to expect a massage therapist to complete 20 -25massage sessions- not 40. If you want to considered this pay rate on a per massage basis that would be $25-$30 per massage paid to the practitioner. Be realistic and compare earnings of other professionals with equal or more education.

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· Many times the abdomen is given only superficial attention during massage—avoid this tendency. This is an important area that deserves effective massage application. The abdomen has an expansive fascial system that influences lumbar and core stability via connection to the deep fascia laterally and posteriorly and abdominal muscle pull to maintain a taut fascial girdle surrounding the entire thorax.

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· This is an important one. All of us are responsible for being informed about what the massage organization are doing, the status of the Model Practice Act put forth by the Federation of State Massage Boards, the process of evidence informed massage practice. We are also responsible to be proactive in the important topics.

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· There really isn't anything brand new or unique in massage and bodywork. It is all recycled. That doesn't mean we shouldn't renew our skills and passion for the work we do.

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· When you purchase a textbook or reference book you are saving yourself hundreds and hundreds of hours of necessary research and fact checking that the author(s) have done for you.

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· Learn to be quiet.

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· When providing massage in the client's home be prepared for the entire family to want a bit of attention.

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· When providing massage in the client's home put a flat sheet on the carpet and set the massage table up on the sheet. This protects the carpet from marks from the table legs or lotion, gel or oil drips.

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· Massage does not always have to fix something. The goal of pleasure is enough

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· STOP OVER WORKING AND STRETCHING ATHLETES. I get so tired of hearing about being sore from the massage. If the client is sore than the massage created inflammation. It really bugs me.

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Do not spend so much time on the back.

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· Greet clients warmly and professionally.

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· Understand the difference between an assessment and an intervention. Realize general nonspecific massage is assessment but ya have to pay attention. Interventions intend to change something. Out of a 60 minute massage session- 45 min. general massage pleasantly exploring tissue and joint mobility. No more than 10 min of intervention and only if the change relates to client goals.

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· No one owns information.

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· Lots of changes. That is OK. Stay informed. Let situations sort. Avoid getting your fascia in a twist.

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· Every time I revise a textbook I get to fact check myself and challenge my beliefs about massage-- We all need to do this- especially teachers.

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· If you look professional and act professional you will be treated as a processional.

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· Ask for help. Find a mentor. Respect the mentor's time. Be the type of massage therapist they will want to invest time. Avoid being a pain in their acetabulum.

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· Teachers of massage therapy---It is absolutely necessary for all of us to remain up-to-date. Information changes and so must we.

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· Be attentive to professional appearance. What you think looks professional may not look professional to others.

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At least once a month log on to Pubmed and search for massage related research. Read the abstracts and think about how the information influences your massage practice. Sometimes there are free full text article. Read though and see if you can figure out how the research was conducted.

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· Study anatomy and physiology more than a method.

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· Include the abdomen in the massage and don't spend so much time on the back.

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· More is not better but you do need enough.

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· A really good foot massage makes a difference in the quality of the client's experience. Ya don't have to call it reflexology.

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· This tip is actually from my mentor Dr. Leon Chaitow. I read it in a comment he posted. Soft tissue work involves pulling against restraint much more than pushing against a block.

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· The more complex the client history the more basic the massage.

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· Distinguish theory from facts question validity of what you hear and read. Most of the methods used in massage and bodywork are theory based not fact based. This makes a huge difference in the claims that can be made.

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· Avoid gimmicks and gurus.

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· If you are having difficulty maintaining a retention client base take a good look at yourself. Do you provide excellent massage skills, look and act like a professional, charge a reasonable fee and have excellent client service? All the marketing and advertising will only get clients on the table for the first massage. If they do not rebook the issue often is something you are doing. This is a tough luv statement.

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· Be skeptical of those telling you that you can make a six figure income doing massage. You can make a solid income as a massage therapist but we are limited by the number of clients we can see. Yes there are opportunities for supplemental income from rentals and maybe products but these endeavors take time too.

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Those who walk a path of service will never be paid enough money. Compensation includes knowing you made a difference.

Monday, August 1, 2016

MEDICAL MASSAGE vs THERAPEUTIC MASSAGE

So here we go again with the labels and names. It gets tiresome doesn't it? I am going to attempt to sort this out-again.

I attended the 2016 Massage Therapy Foundation International Research Conference. It was excellent and the focus of the conference was Integrating Therapies for Pain. There were many excellent speakers but for this conversation 3 stand out.

Wayne B. Jonas, MD
Wayne B. Jonas is the President and Chief Executive Officer of the Samueli Institute, a non-profit medical research organization supporting the scientific investigation of healing processes and their application in health and disease. He is a widely published scientific investigator, a practicing family physician, Professor of Family Medicine at Georgetown University, and Professor of Family Medicine at the Uniformed Services University of the Health Sciences. Additionally, Dr. Jonas is a retired Lieutenant Colonel in the Medical Corps of the United States Army. Dr. Jonas was the Director of the Office of Alternative Medicine at the National Institutes of Health from 1995-1998, and prior to that served as the Director of the Medical Research Fellowship at the Walter Reed Army Institute of Research.He is a Fellow of the American Academy of Family Physicians.

Samueli Institute is advancing the science of healing worldwide by applying academic rigor to research on healing, well-being and resilience; translating evidence into action for the U.S. Military and large-scale health systems; and fostering wellness through self-care to create a flourishing society. http://www.samueliinstitute.org/

The Impact of Massage Therapy on Function in Pain Populations—A Systematic Review and Meta-Analysis of Randomized Controlled Trials: Part I, Patients Experiencing Pain in the General Population

, , , , , , ,

DOI: http://dx.doi.org/10.1093/pm/pnw099 pnw099 First published online: 10 May 2016

http://painmedicine.oxfordjournals.org/content/early/2016/05/06/pm.pnw099

Brett A. Bauer, MD
Dr. Bauer is board-certified in Internal Medicine, a Professor of Medicine and has been on staff at Mayo Clinic for 23 years. His main research interest has been the scientific evaluation of Complementary and Alternative Medicine (CAM) therapies that patients and consumers are using with increasing frequency. He has authored several book chapters and over 100 papers on this topic, and is the Medical Editor of the Mayo Clinic Book of Alternative Medicine. He is a member of numerous scientific review panels and is currently collaborating on over 20 studies being conducted at Mayo Clinic evaluating CAM therapies. Dr. Bauer spoke proudly of the healing environment created at Mayo Clinic called Rejuvenate Spa. He reclaimed the historical foundations of the the spa as a place of healing and explained that a person healing and a person being treated for illness/injury and sometimes cured are not the same. You can heal without a cure and you can be cured without healing.

Rejuvenate and Restore

SPA AT MAYO CLINIC

Experience a tranquil environment that embodies the essence of wellness.

Enjoy an array of esthetic treatments and integrative therapies designed to improve your quality of life. All services are delivered by licensed and certified professionals with extensive experience in esthetics, massage, and wellness. https://healthyliving.mayoclinic.org/rejuvenate-spa.php

AND FROM ANN BLAIR KENNEDY IMPORTANT GUIDANCE FOR UNDERSTANDING THE PRACTICE OF MASSAGE THERAPY TWO IMPORTANT PAPERS------------

Clarifying Definitions for the Profession: The Results of the Massage Therapy Foundation's Best Practices Symposium - Ann Blair Kennedy, LMT, BCTMB, DrPH

http://scholarcommons.sc.edu/etd/3206/

Process for massage therapy practice and essential assessment

Ann Blair Kennedy, LMT, BCTMB, DrPH

Jerrilyn A. Cambron, LMT, DC, MPH, PhD

Patricia A. Sharpe, PhD, MPH, LMBT

Ravensara S. Travillian, PhD, NA-C, LMP

Ruth P. Saunders, PhD

http://www.bodyworkmovementtherapies.com/article/S1360-8592(16)00008-5/abstract

Massage therapy is a HEALTH PROFESSION. Massage therapy can be delivered in multiple settings. I keep reflecting on comments from both Dr. Jonas and Dr. Bauer about the importance for shifting from an illness model-pathogenesis to a healing and wellness model- salutogenesis. The question is---Is the medical/illness setting the best place for a focus on Healing, Resilience, Wellness and Performance? I don't think so and neither did these experts. Another question ---Is massage therapy valuable in the medical setting-- OF COURSE especially for palliative outcomes which are so very important. Massage therapy for comfort care is maybe the most important outcome achieved. Massage therapy does not have to cure to be valuable. Massage therapy is rarely curative anyway.

I support the self care side of the figure above. I support an integrative approach where the circles overlap in the figure above. I support health care professionals that provide care primarily in the health care circle and believe appropriately trained and respectful massage therapist can add to the quality and effectiveness of their care. I believe we can care for the care givers.

NONE OF THIS IS GOING TO OCCUR IF WE KEEP SPLITTING OURSELVES INTO FACTIONS

PLEASE -- STOP IT.