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How Massage Therapists Can Remove Discomfort From Psoas Treatments

April 19, 2016/in Massage, Massage Clinic, Massage Therapist, Massage Therapy/by Erson Religioso

It can be painful and uncomfortable.

It is one of the more sensitive areas a Massage Therapist can treat.

Getting in and working on the psoas is a skill in itself. It takes practice and some clear communication with your patient.

Over the years I have had some great success with it and even have some people who request specifically to have it treated.

There is also a lot of debate over whether it should be treated manually or not. But if you take care with it, the treatment and learn some different modifications the benefit can outweigh the discomfort.

This post has some great tips on how you can treat this sensitive area and make it more comfortable for your patients.

How Massage Therapists Can Help By Treating Psoas

I want to share a technique that is as useful as it is uncomfortable, this is the way I used to do it.

The psoas has spinal attachments, and is more than just a hip flexor. Some studies think it functions as a stabilizer. Since it attaches to the spine, the only way to release it manually is to go DEEP.

This technique will help:

Female runners with SI problems (lack of hip extension causing SI and lumbar hypermobility, plus an inhibition of hip abductor/extensors)
Older patients with stenosis (lack of hip extension causes lumbar hyperextension, further closing the stenosis)
Hip capsular patterns – will improve hip external rotation
Posteriorly rotated ilium
Pt’s with diffuse anteriolateral thigh complaints from compression of femoral nerve
Pt’s with spondylolisthesis, may help in conjunction with soft tissue work to the paraspinals
And a stabilization program

Have your patient lay supine with knees and hips flexed. Use an even finger grip, both 3rd and 4th fingertips with your elbows flared out so that your fingertips have even contact. Start about 2-3″ laterally to the umbilicus and slowly move from superficial to deep until you can’t move any further.

The abdominal contents will move out of the way. If you move too quickly, you will activate the rectus abdominus and the contraction will push you out.

How do you know you’re on it?

Here are two signs to make sure:

It’s not pulsing, if it is, go more lateral as you’re on the descending aorta!
Ask the patient to slightly flex their hip; as soon as they do, you should feel it contract under your fingertips

Start with oscillations, and you can progress to functional release movements starting with heelslide (you push proximally as patient slides heel distally), ipsilateral upper extremity elevation, combination upper extremity elevation and heelslide, then anterior pelvic tilts.

The last is the most uncomfortable, and maybe even the first time you can get a patient to posteriorly pelvic tilt correctly, as they want to move away from your hands! Perform for 5-7 minutes or until you feel a change. Reassess function, ROM, special test, or however you came to the conclusion the patient had a restricted psoas to begin with.

Techniques For Massage Therapists To Work Psoas Pain Free

Let’s be clear, you are no where near the psoas when doing a release, but this is the new way I do it.

I am just targeting the area around and above, and am very general to release lower quarter tone anteriorly, that’s about it.

Why you should use this

it doesn’t hurt
it rapidly improves hip and lumbar motion
- if a patient needs sidegliding in standing for an ipsilateral lower quadrant issue, but is unable to move without discomfort

Patient:

supine, in hooklying
at least the involved lower extremity needs to be bent at the hip and knee

MT:

standing on the involved side
use either the pads of digits 3-4 of both hands or even easier, an EDGE Mobility Ball (any ball will do)
assess resistance to superficial to deep pressure lateral to the umbilicus on one side versus the other
the side with increased resistance is the side you should treat

Technique:

lightly apply superficial to deep pressure, it SHOULD NOT cause any pain
at the point of resistance that is highest, have the patient complete 3-5 diaphragmatic breaths
make sure they exhale fully
the exhalation will help reduce tone autonomically

re-test the limited hip and/or lumbar motion

As it is with so many other techniques in Massage Therapy communication and consent is key. Make sure when attempting this treatment that if you feel the pulse, you move off of it quickly as you do not want to compress the descending aorta. Whether you’re helping someone with stenosis, spondylolisthesis or just SI issues treating the psoas can give you and your patients greater success in treatment. Use both videos as a guide to help you with the treatment and see which one works best for your patients.

A Dangerous Client Fantasy

April 12, 2016/7 Comments/in Business, Massage, Massage Clinic, Massage Therapist, Massage Therapy/by Melissa Strautman

It was roughly midnight and for some reason I was still up.

Sitting at my kitchen bar trying to catch-up on emails and social media that I’d not had time for.

It was TGIW for me. “Thank Goodness It’s Wednesday”.

I pile 15-17 clients in on Monday through Wednesday and have the rest of the week to work on my online business academy. Needless to say, I was somewhat blurry-eyed.

My phone buzzed from a text message.

Ugh, I didn’t have the patience to thwart another “I want you to rub my groin pull” moron. It wasn’t a creepo.

It was one of my best friends and colleagues, Michelle. I knew this midnight text had to be an emergency phone call because she’s deaf and totally aware that I go to bed early.

I was about to get crushing news.

In The Shadow Of A Famous ‘Madame’

Up until about two years ago, my fellow Massage Therapist and I would get one or two calls for sexual massage per year in our county of 100K residence.

Then it became an everyday occurrence right after two hush-hush-windows-blacked-out massage places opened up. Apparently whatever they were doing had put Bowling Green, Kentucky on the map for “massage parlors” once again.

My little area of Kentucky is not only famous as the home of the Corvette, the largest cave on the planet and being the home of Bluegrass and Newgrass music; It is infamous as having been the home of the longest-running house of prostitution in America.

For 30+ years, Miss Pauline’s upscale brothel was a top must-do for businessmen, prominent politicians, military men and college students coming from all up and down what we call the ‘I-65 corridor’.

Not surprising since 80% of the US lives within 300 miles of it.

Due to our downtown’s redevelopment project, the house was torn down and individual bricks were sold off with plaques commemorating the establishment for $2,000 a piece. Miss Pauline was known for paying her girls high wages, free medical/dental care and helping them get college degrees. Once she retired, she picked up a different kind of hoe to become the first (non-Amish/Mennonite) organic farmer in Bowling Green.

Please don’t think that I’m trying to glorify Miss Pauline’s selective-exploitation. I’m not and I don’t believe that the creepos calling today even know this bit of history.

Be that as it may, somehow they now believe sex can be had at any massage establishment in Bowling Green; just like when Miss Pauline would set her milk can out on her front porch to let men know she was “open for business”.

Back to the midnight text

Did I Just Open A Massage Parlor?

Michelle’s text: I hope you’re sitting down.

Don’t freak just click this link http://www.rubmaps.com/bowling-green-massage-parlors-ky I’m here if you need to talk.

I clicked the link.

I was suddenly bombarded by an old familiar stomach-churning, black-out rage so intense that I couldn’t breath, scream or cry.

It felt as though every cell in my body turned from its position to flee in a lateral path out of me. I’m describing the quiet PTSD-bomb that goes off when you’ve been utterly violated by a monstrously exploitive excuse of a human being.

I had just been listed as a “massage parlor” and I had a “review” that identified me as a prostitute.

You’ll have to go to the link for yourself and click through to read the review from CalebIV on me. Yes, I pretty much figured out who he was just from doing a little detective work. Idiot! And just to set the record straight, His little fantasy description at the bottom is pure fiction. In order to read the other reviews, you have to pay.

So let me explain this new world of evil to you.

This website, as you can explore, is for the express purpose of training American men in the art of “mongering”.

It was originally called rubhub.com and based out of Sri Lanka for the US market. Men sign up for this site and learn a particular game called ‘mongering’, that will hopefully get them a variety of sexual acts performed by you, the Massage Therapist.

They have a lexicon, training classes and a forum hosted by “Mongo”.

Each individual man decides how long he will stalk a specific Massage Therapist and the tactics he will use. He then reports each session back to the forum and receives encouragement and advice on how to proceed for successfully procuring the desired sex act.

Some of these guys will play for up to 12 months to conquer one Massage Therapist.

Once they succeed, they’re done with you and move on to the next challenge (therapist). If a Massage Therapist is difficult to lead down the proverbial primrose path, that therapist then becomes a hot-ticket challenge for other misogynistic chest-beaters to go after.

Lucky me! My business, has gotten “mongered’ seven times.

Make no mistake, these men seem super legit.

They are seasoned clients who spend big money getting regular massage for their pursuits. Back when I discovered this, you could read the forum feed and the stories these men would tell as they came back from the battlefield.

They don’t use coupons and they book regularly. They even talk about their legit Massage Therapists back home whom they, oddly enough, treat with great respect and don’t monger. One guy said something about “not s****** where you eat?

…ahhhhh such valor

They decide on the number of massage’s they will get prior to their first attempt to coerce you.

Some of these guys will wait months before propositioning you. Their most popular way is to get you to feel sorry for them due to some life or relationship tragedy they’ve had and it really helps if they know you’ve had a similar one. They will loan you books or get you tickets to concerts, etc.

They become your big brother or fun friend.

They might even send you flowers on your birthday. Their complements are profuse as they slowly gain a sense of your moral compass. These men are truly skilled predators; no better or worse than men with lolly-pops and puppies at a park.

The Milk Can Is Back On The Porch

After enjoying nearly half a century without Miss Pauline’s entrepreneurial perfume clinging to my town, it had become painfully obvious that the milk can was back on the porch.

Given the two new massage parlors and being targeted by mongers, I decided to do something about it.

I formed a group of Massage Therapists. We all shared our strikingly similar stories and decided to do a little detective work to see if we could rid our town of the massage parlors.

Our hope was if they left, so would the creeps.

We gathered enough evidence to present to our chief-of-police and he then convinced our county prosecutor to do a sting operation on them. Unfortunately, just like in Miss Pauline’s day when the cops showed up, all the girls were just sitting around knitting.

Well, in this case, just nowhere to be seen and the sign that had read, “Ask us about Tantric Massage” was gone. They had protection, just like Miss Pauline and it didn’t take but about six months of them being in town. So sad.

We’ve accepted that there is not much we can do about the sex trade in our town. We now are focusing our efforts on self protection and better client screening skills. One of our members is talking to our state legislators in hopes of changing how we post our licenses.

Currently we don’t have to do that. She is hoping to get them to force us to have to post our licenses with a current photo. Then there would need to be public education to make consumers aware that if they didn’t see this upon entrance, to steer clear.

That helps protect the public but what about us?

Recently, I’ve seen a lot of buzz on social media as to whether or not Massage Therapists should have protection such as pepper spray, body alarms and firearms.

I totally respect everyone’s choices in self protection. I would say most therapists in my town are protected in one way or another. However, I’ve determined that never letting the creeps in your front door in the first place (creepo abstinence) works best.

In most places total client confidentiality is non-negotiable but if they’ve never been a client and have just let their lascivious intentions be known in a phone call, they are fair game for exposure. The therapists in our group have a communication chain where we share the details of any sexual massage requests from non-clients with each other. We find that if they call one of us, they call all of us. It’s awesome when we talk and find out that they got rejected over and over. These guys will often change their name but the phone number is the same. If they block their number, we just don’t answer, forcing them to leave a message if they dare. Occasionally they are bold enough to give their names, phone numbers and specific sexual request and ask us for a price…gotta love these guys. In these cases, I promptly call our local police force and give them the detail. After all, solicitation for prostitution is a crime.

4 Steps To Building A Successful Therapeutic Relationship With Your Patients

March 22, 2016/in Business, Massage, Massage Clinic, Massage Therapist, Massage Therapy/by Jamie Johnston

There was something different about the way she said goodbye.

The lack of communication was strange as her typical six or seven text messages were never sent.

I pulled in the driveway and wondered why she hadn’t gotten home from work yet?

I walked to the top of the stairs and there it was stuck to the fridge, almost glowing because it stood out from everything around it.

That letter told me about the pain she was feeling that I wasn’t able to fix, but really just didn’t know how to. It wasn’t that I didn’t want to, I just didn’t have the ability or maybe the proper tools to.

The last few months had been tough and I guess something I had said, done, or possibly not done was the last straw.

To be honest, I really didn’t know how to deal with our issues and sometimes chose to ignore things because well…it was just easier.

The strong woman that she was had long before decided to move on, since I couldn’t be the man she needed. She put her interests first.

I walked through the house alone.

The relationship we had taken so much time to build up was now gone because I didn’t know how to deal with it.

Why Therapeutic Relationships Are More Important For Massage Therapists

Our careers are built on relationships.

Patients can go to a Chiropractor, Physiotherapist or even their Doctor and sometimes get a total of 15min with them. When a patient comes to you they get you for anywhere from 30min – two hours, of direct contact.

That time is your opportunity, especially when it’s a first time patient. You could be the best therapist in the world but if you don’t take the time to cultivate a relationship with that person, your efforts will be in vain.

So what can we do to build a solid relationship with our patients?

Make a damn good first impression
Read your patient
Build a good foundation through assessment
Build trust

1. Make A Damn Good First Impression

Remember the old saying “you never get a second chance to make a first impression”?

It is quite frankly the start to any good relationship. Even the girl I spoke about at the beginning must have been impressed the first time we met, it turns out I just couldn’t sustain it.

Greet everyone with a big heartfelt smile, they can tell if you’re faking it. This can set the tone for the rest of the treatment.

It’s important to remember that when your patients come in, it’s all about them. They’re paying you and it is their time.

So, no matter what is going on in your life, it’s kind of irrelevant.

The more we can do to set them at ease before the treatment even starts, the better. Your patients have a ton of things going on in their lives stressing them out, including whatever injury they’re coming in for. This is not a time for you to come across in any kind of a frustrated way because you’re not having the best day, remember they’re paying you to help.

I used to work with a guy who was constantly stressed out about home life. He would fly off the handle about anything and could only communicate if he was yelling. Everyone was scared to deal with him. But, if he smoked a joint (yes this was happening in an industrial mill) he was way more approachable and easier to deal with.

The only way you could tell?

You could see him grinning ear to ear from across the mill.

Now in no way am I suggesting that you should smoke a joint at the start of your day in the clinic. But, the only way we could tell if he was going to be easy to deal with (which set us at ease) was when we saw that big grin.

Your patients will read you the same way. Most of the time they are coming in to relieve some stress and deal with a variety of other issues.

Do your best to set them at ease right away.

2. Read Your Patient

This starts to happen as soon as you greet your patient.

Are they in a good mood and happily walking into your room?

Are they slumped forward and feeling down?

Read their body language.

This makes a huge difference in your treatment. If they’re feeling down and in a bad mood, they may not be as happy with your treatment as when they come in with a better frame of mind.

The results of the treatment may reflect that.

Other than getting this massage and relieving some stress, what can be done to elevate their mood?

Change your music to something more upbeat. It doesn’t always have to be new age spa music (in fact if I played that all day in my treatment room, I’d have to jump out the window), throw some 80’s music or something else they like on and elevate the mood a bit.

Try telling them a story or a good (albeit clean) joke to bring their mood up. Recite your favourite part of a a Seinfeld episode to them.

Get them to tell you a story about something great happening in their lives right now. Get them to talk about their kids, another loved one, or some accomplishment they have had in the last while. People love to talk about themselves, so ask them to.

I’ve heard it said that “the only thing we should be talking to our patients about is their healthcare”.

If that was the only thing you ever talked to, or allowed your patient to talk about, I doubt you’d get too many repeat patients. While the conversation should always be kept professional, patients aren’t coming in to be treated by a robot.

Your personality is part of what keeps them coming back.

3. Build A Good Foundation Through Assessment

I didn’t completely understand what my teachers were harping on me so much about when I was in college.

They would get after me about “make sure you do three different assessments with each patient”. Then I became one of those teachers harping on the students.

Assessment is your foundation.

A good assessment isn’t just to give you an idea of what’s going on with your patient, to tell you what areas to treat.

It’s your proof.

It is your opportunity to prove that you know what you’re doing and that you did a good job, that you made a difference. When you can perform the same orthopaedic tests after their treatment and demonstrate the greater range of motion, decrease in pain or freedom of movement, it instills faith in you and what you do.

Even if you’re a little stumped on what assessment to do, make something up, figure something out. Then look up what test you could do while they are getting on the table. You can always do more tests during the treatment.

In fact, get them moving on the table, so that you both get feedback about how the treatment is going.

It’s amazing the difference it makes when part way through a treatment someone can only move a certain amount and it continues to get better as the treatment progresses because you continually assess.

Photo by: Roger Mommaerts

4. Build Trust

This is one of those areas where we are pretty privileged.

There is an assumed trust before our patients event get there. They know coming in that they are going to be naked on a table. That’s a pretty huge thing for anyone to give to us. Think about it, even before meeting us, they have enough faith to take their clothes off and just lay there, assuming we will be professional and bring no harm to them.

It’s our job to in still that trust immediately.

For me as a male therapist this is huge. Not everyone is comfortable coming in to see me, and some do it reluctantly. There are times I have to put people at ease before even starting an assessment (although I think I have an advantage from dealing with people in emergency settings) and let them voice how they’re not overly comfortable being treated by a guy, but they just need treatment.

Fair enough.

Let them talk. This is a big opportunity to build trust. After the treatment, when they realize nothing bad happened or was going to happen, they’re usually happy to book in again.

In a conversation with someone a couple of weeks ago, they told me that their spouse had asked:

“What is so wrong with you, that you have to go for a massage once a week?”

The response:

“It’s more than just a massage, It’s my therapy. I get to unload about life, I get a good belly laugh and I get to de-stress”

Sometimes people need a non-judgemental ear. Allowing them to unload about the stress of life can me more valuable than the actual treatment (while of course keeping our professional boundaries in check without offering advice or counselling).

When people know that what they say in the room stays in the room, (think of your room like Vegas, okay maybe not all of Vegas, but you get what I mean), it builds their trust in coming back to see you again. Especially when different family members come in and talk about home life. We definitely don’t want to cross a line and say something to another family member that was said to you in confidence.

If someone comes in with a condition or injury you’re not sure how to deal with, refer them to someone who can. It’s okay to admit you’re not sure how to deal with something, just get them to someone who does. Trust me they’ll respect you for it.

Use these four steps to build a therapeutic relationship with your patients. Although some of these suggestions may seem like common sense, sometimes it’s easy to become complacent in practice. Even though I named the fourth one building trust, using the first three steps are a good way to set up the foundation to build trust. Communicate effectively with your patients when they describe their pain to you, figure out how to deal with it. Refer out and collaborate if necessary. A patient can pick any Massage Therapist in their community to use for their healthcare, being engaged and building relationships with the people who come to see you is what will keep them coming back. Be the therapist they need so that you never get a “goodbye letter” from your patient. Now if someone could just tell me how to get the TV and the Netflix account back that would be awesome.

Is Volunteering Massage Therapy Worth The R.O.I?

March 15, 2016/1 Comment/in Business, Massage, Massage Clinic, Massage Therapist, Massage Therapy, Sport Massage/by Jamie Johnston

“Contact us and we’ll get you to the first page on Google”

We’ve all seen the emails come into our clinics (and maybe even personal accounts).

Then there’s the other emails. You know the ones.

“Our organization is doing a fundraising event and would like to give you the opportunity to donate some gift certificates to help raise money for our charity”.

Every year as business owners Massage Therapists must decide how they are going to spend their marketing dollars.

Where is the best place to spend money and what will the Return On Investment be?

Is volunteering our time really worth the effort it takes to provide free treatments?

As it is with any marketing venture, you have to ask “is there a return on investment of my time if I donate”?

Well it depends.

Donating Massage Therapy Gift Certificates

This can be a bumpy road.

Every year our clinic gets several requests via email, phone and our regular patients that come in, to donate a gift certificate to some sort of cause or function.

One of the interesting things about this (and I know from doing fundraising with the fire dept) is that once you say yes, the same organization is coming at you next year to ask again. While there is nothing wrong with them doing that, just make sure that wherever you are donating gift certificates is worthwhile.

Make sure to check that your donation is going to something you can actually help with.

I’m always more than happy to donate to local hockey teams, or different events that I can at least relate to. If there is a request to donate to an organization where I know the recipients are people who actually use massage therapy, then yeah I’ll donate.

For instance in our community, hospital workers (ie: nurses, pharmacy tech’s etc.) have amazing benefits when it comes to massage. So if I can manage to get one of them in the door, where there’s a really good chance they’ll rebook, I’m happy to help.

If the request comes from one of my current patients, again I’m happy to help. They support me in my business, so the least I can do is help them out with whatever endeavor they are putting their efforts toward.

If the request comes from someone or something that I don’t connect with, I’ll be far more reluctant to donate anything. Although from being involved in fundraising on the other side of the table, there’s something I’ve learned from making requests for donations.

Most of the time when we’re fundraising and ask stores for donations (especially the big box stores) they’ll donate just enough that it requires the recipient to spend more money.

Rarely do they donate a material prize, it will be a gift card for say $25-$50 so that the person will buy a bigger ticket item and just put the gift card toward the cost. It ends up being a win-win for both parties.

The other thing most of these places do, is ask for a tax receipt. At least this way, they are not losing out on the money, they will actually get a tax deduction at the end of the year which lowers their bottom line.

Before you just randomly donate to the next charity that calls, ask yourself (and the person asking) a few questions first:

What is my possible return on investment?
Can I get a proper tax receipt?
Is it better to give a discount rather than a full treatment, so I at least make some money?
Is the charity or cause something I actually believe in and can connect with?
Does my clinic schedule actually allow for someone to book in?

Gift certificates can be a great way to promote your business and be a great marketing tool, just make sure you donate wisely so it is still profitable for you in the end.

Volunteering With Sport Massage

When it comes to working in sports this is a bit of a vicious cycle.

So many sports organizations don’t have the funding or the money to be able to pay for the services of a Massage Therapist. Depending on the size of the community you live in this can be almost painful if you want to get involved.

Your average high school basketball team obviously can’t afford full, or even part time therapy and if there aren’t any teams in the area that can afford it and you want sport experience, what do you do?

One of the other issues with sport, is that if you do volunteer and decide that the organization should start to pay for your services and put up a hard stance with the team, there is someone around the corner who is willing to take your spot and start volunteering, just to get an opportunity.

Most teams are going to do whatever they can to save money, so if you’re not willing to volunteer your time anymore the general attitude can be (and I’ve heard this from team managers) “no biggie, we’ll just get someone else”.

While there are teams that can afford to hire a full or part time therapist, those spots are tougher and tougher to get into. It also completely depends on where a team gets their funding from or if the team is privately owned. Usually if a Massage Therapist gets one of these spots, they’re reluctant to give it up and they hold onto it like Donald Trump grabbing his hair in a windstorm.

I’ve debated giving up one of my sports volunteer positions but hesitate because I always wonder if I’ll get the chance again.

If you decide you’re going to volunteer your time, make sure it’s worth your while.

At a minimum, make sure the team is willing to promote you. In return for your donated time, the athletes should be willing to come and see you in your clinic as well. If the athletes are minors, their parents should be made aware of who you are and that if they need treatment, your clinic is where they should go.

Check to see what kind of insurance the athlete or team carries.

I used to do one day a week at the rink with the hockey team where I would bill hockey canada. If a player was injured, the team doctor would sign off on the insurance form recommending massage therapy so I could then fill out the form and submit it for payment from the insurer.

Find out what other healthcare practitioners the team uses and see if you can set them up as a referral base. I still have a steady stream of people who come in from the team chiropractor and we refer back and forth for each other regularly.

Just make sure that if you’re volunteering your time with sports you get more from it than just experience.

Photo by: Elvert Barnes

Fundraising Massage Therapy Outreaches

Every year in our city there are charity 10K’s, Run For The Cure’s, Goddess Run’s and various other charity events looking for Massage Therapists to volunteer.

They can all be great events to volunteer at and hopefully generate some business for you.

Just like the gift certificates, if you volunteer one year you can bet the event is going to call you next year to see if you’ll come out again.

But choose wisely.

I have done some volunteer work for events like this in the past, both as a student and as a registered therapist. I’m much more likely to spend my time at a half ironman or a 10K because most of the people involved in these are going to look for more therapy after the race day.

If they have spent enough time training to get ready, they’re more likely to keep exercising as a regular habit, thus needing more therapy. This is where I’m more confident that I can turn a couple of them into a regular patient with a little education and discussion on race day.

I’m far less likely to volunteer at a Run For The Cure, or a Goddess run. Not because I don’t think they’re great causes or that the athletes won’t need further therapy. It’s because it’s harder for me to connect with the participants (which is my own issue). I worked a couple of these kinds of events as a student and had a tough time watching people crying as they crossed the finish line. I hate seeing women cry!

If you decide to volunteer at one of these events for the first time, keep track for the rest of the year and see how many people come to your clinic as a result of your attendance. If you get a few new people, then you’re getting a return on your time investment.

I’m not saying that volunteering your time is a bad thing. I volunteer hundreds of hours a year between the fire department and sports. Both have their own set of rewards and both have given me some great opportunities. However our time is valuable, maybe the most valuable thing we have. While volunteering can help give you better community engagement as a business person your time shouldn’t be given away randomly. As you should with any marketing you do, track how successful the marketing strategy was. Track how much business comes your way from your volunteer time and weigh out whether it was worth the investment. I mean you paid a lot of money to go to school and learn how to be a therapist, you should at least get paid for it!

10 Business Mistakes I’ve Made As A Massage Therapist

March 8, 2016/8 Comments/in Business, Massage, Massage Clinic, Massage Therapist, Massage Therapy/by Jamie Johnston

“Success is walking from failure to failure with no loss of enthusiasm.”

— Winston Churchill

“There are no secrets to success. It is the result of preparation, hard work, and learning from failure.”

— Colin Powell

I couldn’t wait to get out of school.

25 hours a week was all I was going to have to work to make a great living.

It would be so easy, this is why I spent two years in school.

Then I got my first job and went to work. I think I had three patients my first week. Why wasn’t everyone just lining up to get a massage?

I worked in a room adjacent to a gym. All these healthy people that were into fitness and taking care of themselves, why weren’t they booking in?

The following week wasn’t much better.

Why wasn’t it just happening instantly like I thought it would?

Because assuming it would just magically happen was my first mistake. Unfortunately I made other business mistakes along the way. Some big, some small but they were all mistakes that I was clearly not ready for.

Here’s 10 business mistakes I’ve made along the way.

I’m sure there’s a lot more, but these are the ones I can remember.

1. Taking The First Job Offer, Without Actually Looking

I couldn’t believe my luck. I bumped into my sport massage instructor one afternoon and asked about getting involved in sports.

As the conversation progressed, she asked if I had a job lined up after school was done.

I hadn’t yet.

She told me about a great opportunity at a local rec-center. I would have full access to the gym, steam room, equipment, pool, everything. I’d also be working with a kinesiologist who had been at the rec centre for 15 years and had a great client base.

He would also be more than happy to refer people to me.

This was awesome, I don’t even have to look for my first job.

I was set and couldn’t wait to get started.

Once I got out there and got all set up, I had to start networking with the employees. None of them knew who I was, what I was doing, or really knew anything about Massage Therapy. They were willing to put an ad about me in their newsletter that went out every quarter, so there I had a bit of advertising. A friend of mine who owns a decal company made me up a sign for the treatment room, to show people in the gym what was being offered.

Then I’d show up and wait.

And wait.

Some days people would come in and ask questions, sometimes they’d book in for a massage. I ended up getting one or two regulars that would come in once a week. Some days I would get super excited that I’d have three people booked in.

Other days, there wouldn’t be anyone.

I worked there for about nine months before I had to move on. And it was MY fault. The kinesiologist was a great guy, who did his best to help, my former teacher did everything she could to help, it just wasn’t a good fit for someone fresh out of school with no business experience.

Or maybe it was for someone else, I just couldn’t make it work.

I was so excited to get that first job out of school, I just assumed it would come easily. I didn’t even bother to look for another job at another clinic. I didn’t look to see if maybe there were other places that would be a good fit, where I could be busy right off the bat. I just assumed it would be easy.

It isn’t.

2. Not Starting In A Busy Clinic To Actually Learn The Business Of Massage Therapy

Since starting in the clinic I work at now, it has been a constant learning experience.

Compared to that first job, I have gotten to learn more about the “business” of Massage Therapy as opposed to being a Massage Therapist.

Actually signing a contract with the clinic and realizing the importance of that for both parties involved.

Understanding the mix of personalities in a clinic and how that affects not only the running of the clinic, but also how different people book in.

Getting into billing insurance companies directly and realizing the convenience it brings to patients. And this one is huge. I have seen a significant increase in patients ever since we started doing this. When the patient realizes that they don’t have to pay anything out of pocket and you handle the billing, they will choose your clinic over one that doesn’t.

Taking the time to understand how rent, tax and other deductions are all calculated has been a steep learning curve since starting there.

All things I should have learned earlier in my career.

3. Being Timid About Re-booking Patients

I really struggled with this early in my career.

Then one day I had a conversation with a local Chiropractor who runs a very successful clinic and has Massage Therapists working there.

He told me that one of the biggest mistakes he sees Massage Therapists make is when they concern themselves with what a patient can afford. Our job as therapists is to lay out the best treatment plan possible for the patient. If you say they need to see you twice a week for the next three weeks and then tell you they can’t afford it, alter the plan.

He backed that up with a story about a patient that had gone to a specialty clinic for some specific work. When they layed out the treatment plan it was very sporadic. Once they found out the patient had insurance coverage, the treatment plan changed dramatically and the patient was given better care.

The patient was understandably confused and didn’t go back to that clinic again.

Our concern (especially in patient centred care) is what’s best for their health, so give them the best possible plan for their recovery.

All too often I would be concerned about the patient’s finances when considering re-booking them. I’d say things like “well if you can afford it, I’d like to have you come back next week”.

Little did I realize that by communicating like this, I was losing the patients confidence in me.

Remember, you are the therapist and the patient is coming to you for your skills and knowledge.

Only worry about their pocket book if they bring it up.

4. Listening To The “Myths” I Heard From Other Therapists

The myths in Massage Therapy aren’t just around the therapy end of things.

They are also around who to work with.

All too often I’ve heard about therapists who had bad experiences in dealing with insurance, lawyers and workers compensation companies.

While the stories are true and some therapists have been stung by not getting paid, it doesn’t mean this happens every time. I know some clinics around town who are very successful in dealing with some of these insurance companies and make a good living off of referrals coming in from them.

Early in my career I would avoid these type of things like the plague because of the stories I’d heard.

Last year for the first time I entered into a “Direction To Pay” agreement with a local lawyer. The agreement is between the lawyer and myself, not between me and the patient. When he has people come in who have been in a car accident, he refers them out to healthcare professionals that he uses exclusively.

When the patient comes in to see me, they sign a contract which is then signed by the lawyer. When their claim is settled, the lawyer (not the patient) pays me out of the settlement.

Most of the stories I heard where this goes bad is when the patient calls the therapist and wants to negotiate a reduction in pay after the settlement. In these cases it is usually the patient who has made the agreement with the therapist, not the lawyer.

While it does take time to get paid from these agreements, it has filled my practice and made me busier than ever before.

I truly wish I had started doing this right out of school. It would have brought me more patients and I would have a steady stream of recurring income from a consistent source.

5. Not Getting Proper Accounting Advice

I’m not good with money.

I find managing money, balance sheets and accounting software confusing and frustrating.

I’m five years into my career and am just now starting to look at how to properly budget to make sure my finances are completely taken care of. Back when I first started I would just take my books to an accountant once a year to get my taxes done.

I am ALWAYS shocked at how much I end up owing.

At the start it wasn’t quite as important because I wasn’t busy. It was simpler to just take things in at the end of the year and have someone deal with it.

It was a terrible approach. It never made me understand where money was going, or where money was coming in from and I was never prepared to pay that tax bill.

Using a proper accountant and book keeper has helped to change all that. Now I can delegate a lot of that work and the accountant keeps me up to date on when things are due. I get regular communication about when quarterly taxes coming, how much is due and what things are good to spend money on business wise.

I’m also fortunate as I can just email back and forth with the book keeper regarding business questions, email receipts and she doesn’t tear me a new one when I walk into her office with a pile of unorganized junk that she has to figure out.

Now that we are working on a proper budget it should keep me in better financial shape for the future.

Had I started doing this from day one, I would be in much better financial and business shape today.

6. Not Having Another Job To Make Ends Meet

This is especially important if you’re just starting out.

Things are going to be slow while you build your practice. Even if you start in a busy clinic, you’re not going to be booked solid right from the start. Plus you have the added stress of student loans and the fact that you probably haven’t made a dime while you were in school.

There is no shame in having another job to support you while you build your practice.

When I first started in that rec-centre half the time I had do idea where I was going to get the money to pay the bills for that month and even had to borrow money from my parents at the start (and I hated that).

Then an opportunity came and I got my job working in dispatch with the fire department.

You have no idea the relief that brought. I was working construction on the weekend, just to get enough money to pay bills for that month when I found out I got the job. It was like I had just hit the jackpot.

I could schedule my clinic hours to work both jobs and this way had some money coming in while my practice was building. Even after starting at the busier clinic I kept working the dispatch job. Fortunately my clinic owner was understanding and would help me work around those shifts.

On average I would work 36 hours a week in dispatch and about 30 in the clinic.

Every Friday for about two years I would work in the clinic from 11am – 5pm, then head straight to the dispatch job and work 6pm-6am. Then another two shifts in dispatch between the weekend or during the week.

It was a lot of work, but eventually I was able to back off the hours at the other job as my practice grew.

Now I just work the dispatch job one or two shifts a month, and more because it interests me, not because I have to.

Don’t be afraid to pick up extra work while your practice builds, it will make you appreciate things when you’re busy that much more.

7. Thinking “Giving Away Free Massages” Was Good Marketing

This may be one of the worst things I did when I started out.

I would put up posters around the rec-centre promoting coming in for half price massages and did a bunch of them for free. My thinking was that I just needed to get people through the door, no matter how much the treatment cost.

It was terrible.

While I thought it was a good marketing ploy, all it did was open the door to people who didn’t want to actually pay for anything. One man during the treatment asked how long my schooling was. When I told him it was two years, he said “my son went to school for four years to be a welder and only gets $30 an hour, how the hell do you think you’re worth $90 with only two years of school?”

Most of the people I treated at a discount, expected their next massage to be the same price or cheaper and refused to pay full price.

While I still donate some time to sports teams and am willing to give out gift certificates for fundraisers when requested, I won’t market myself by doing discount massage ever again.

I also believe I was just cheapening the profession by doing that.

8. Not Networking Properly

A friend of mine invited me to a networking breakfast that he went to every week to see if it could help drum up some business.

I went to my first BNI meeting. There was a cost for breakfast (and for membership if you sign up), but there was a large group of people there who met regularly to refer and create business for one another. I thought it was a good enough idea, so I signed up for a year with a chapter closer to where I worked.

While I made some great friendships, it didn’t end up creating a lot of business for me (however I know several people who swear by it for their business).

I should have been trying to network with local healthcare professionals instead.

Reaching out to local Chiropractors, Physiotherapists and Doctors would have brought greater returns than what I was doing. Once I started dealing with other healthcare professionals and communicating with them effectively, I started having more patients referred to me.

Now when I say networking properly, this doesn’t just mean the initial introduction. It’s an on-going process. Following up on the referrals and reporting back what you found and what you did with each patient grows a stronger relationship with those other practitioners.

If one of them sends you a patient, send back a thanks along with a report of what you did.

When you start comparing notes back and forth, they will be more likely to keep referring to you.

But make sure you return the favour.

If you get someone in who could use the help of a Chiro or Physio, make sure you refer back to them as well.

Photo by: Maryland GovPics

9. Not Asking For Referrals

This is something I still struggle with, but continue to work on.

The biggest marketing advice I was given in school was: “just give the best damn massage you can to every patient, you never know who they’re going to tell”.

While we live in a digital age now, word of mouth is still one of the best marketing tools out there.

Don’t be afraid to ask your current patients for referrals. If they start talking about a friend who’s injured, explain what you can do to help, tell them a story about how you helped someone else with the same issue.

If they’re a regular patient, they obviously have faith in you and what you can do. So let them tell their friends about you.

Usually people are only too happy to make the referral, sometimes they just need a little nudge to remember to do it.

10. Not Being Active On Social Media

I’ve been studying and reading a ton about this over the past couple of years.

Social media is probably the most cost-effective tool you can use to promote yourself and your business. The only real cost is time and when you’re just starting out, you have lots of it.

Social media platforms are a free place to do business.

Facebook is the place to start connecting with your patients, it allows them to communicate directly with you as a therapist. Every time they interact on your business page with shares and likes, it opens you up to be able to market to their friends when they see this interaction taking place.

You can also set up ads and messages to reach a target audience, which you can structure to appeal to certain demographics. So you can actually aim your marketing at specific groups that you would like to have as patients.

Twitter is a great way to start interacting with local businesses and potential customers. Be a curator of content and provide useful information about Massage Therapy to start building a following in your community.

Use Linkedin to start connecting with local professionals in your area. Use it to grow business to business associations. You can also use it to blog about your practice and grow awareness about it in the business community.

There is so much more to being a Massage Therapist than just giving a great massage. You have to be a business person, marketer, accountant, networker and social media personality. It is just as important to learn how to run a business and be a sole proprietor as it is to learn a new technique at your next continuing ed course. In fact, there should be some solid continuing ed courses just on being in business. I’ve made lots of mistakes in my career, but at least with every mistake there is also a learning opportunity. Take the time to track what you’re doing for marketing and make sure you’re getting a solid return, whether it’s attending networking functions, volunteering your time or working directly with insurance companies. And even if you have a busy practice, you should still continue to market yourself. Even McDonalds still has to advertise.

6 Tips For Getting Involved In Sport Massage

March 1, 2016/in Massage, Massage Clinic, Massage Therapist, Massage Therapy, Sport Massage/by Jamie Johnston

I was so excited to get my first chance to work in sport.

Walking through the staff entrance to the rink, players were running around getting equipment, doing their warm ups and reporting to medical staff. I remember it like it was yesterday.

I stood in awe.

One by one, the training staff introduced themselves to me. Chiropractor, Sport Med Doctors and equipment managers all welcomed me to the team.

Then it was time to get to work.

Sport Med Doc was assessing a player with a concussion, the AT was doing some taping and players were popping in to get some work done from the Chiro. As the Chiropractor was getting ready to do some manipulation, he introduced me to another player and asked me to work through his low back before he did any work with him.

Player after player worked their way through before the game started. There was almost a pageantry to it in my mind. Watching each health care person work together in combination with the equipment managers to get everything and everyone ready before the game.

It felt so amazing being around the team and seeing what happens behind the scenes. As a student, sitting there watching and listening to those healthcare professionals doing their assessments and talking about what was going on with each player (and actually understanding them) made it that much more amazing.

This is why I wanted to be a Massage Therapist.

Getting Into Working With A Team As A Massage Therapist

When I decided to become a Massage Therapist, one of my main goals was to work with athletes and be involved in sport.

I talked to a few of my teachers in college about their experience. Some had been to olympics, some worked with specific teams and some worked with everyday athletes in their clinics.

While in term two of college, a buddy from my hometown was playing on the local Junior A hockey team. So, I gave him a call to see if they had a Massage Therapist on the team, he said they had an Athletic Therapist, Chiropractor and Sport Med Doctors, but no Massage.

Maybe I had an in.

Talking with one of my teachers who works in sports and is heavily involved in the X games, I asked for his advice on how to approach the team. The advice he gave, helped me to have a better outlook on how different Athletic Therapists look at roles on teams and where everyone should fit in.

His advice was to find out what kind of work the A.T. was doing with the team. Some like to do their own massage and don’t want to outsource it or have someone else do it for them. “Find out if he does his own massage, so that you’re not going to step on his toes or take something away from him by getting involved”. He told me to use my First Responder background as another manner in which I could help the team, in case he did his own massage.

Armed with his advice I approached the team A.T. one night after their game was over.

I explained that I was a student looking to get some experience. He was pretty happy to hear about my First Responder background and was gracious enough to have me start coming to games and helping out.

6 Tips For Working In Sport Massage

Working in sport can be a tough scene to get into.

Some people have to work their but off to get into it and others can end up just falling into it. Either way, if it’s something you’re interested in, here’s a few tips to help you get started.

Get your First Responder license. It is almost worth its weight in gold. Not only do most teams need someone to act as a First Responder, it will add to your clinic experience as well. Being able to recognize and deal with medical emergencies in a confident manner not only adds to a patients confidence in you, but can literally be a life saver in the clinic or in the sport environment. In fact some leagues require teams to have a certain number of First Responders at every game, it could be one of the things that gets you in the door. Over the years I have done far more First Responder work than Massage Therapy working with the team.
Volunteer in a sport you’re passionate about. If you’re passionate about the sport, you won’t even feel like you’re working when you go there, you will actually look forward to it. There is also a reward in knowing that you are one of the people who contributed to the athletes and team success.
When approaching a team, go directly to the head trainer. Little did I know (until someone else on the team told me), the biggest reason the A.T. welcomed me to the team is because I approached him directly and not the front office staff. The head trainer is in charge of all medical and therapy issues with the team and they are in control. Having someone come in the back door because another team person brought you in isn’t going to go over very well. Always try to contact the head trainer and talk to them.
Look to see if you have any local Sport Massage organizations you can join up with. Once I joined CSMTA (Canadian Sport Massage Therapy Association) I was given the chance to work with the Rugby Canada National Men’s 7’s team because their main Massage Therapist wanted to use therapists from that organization. Here in BC we recently started a Sport Professional Practice Group that is focusing on Massage Therapists becoming more recognized in sport. Reach out to these types of organizations to see if there are opportunities in your area to get involved.
Be willing to help with things other than massage. Need water bottles filled?, towels for the athletes?, equipment issues? Be there to help out with all aspects of what happens behind the scenes. As much as the athletes are a team, so is the background staff, make sure you’re an important part of the team.
Always be willing to learn from the other medical professionals you’re working with, you will learn a lot which will add to your experience and make it more positive.

If you’re interested in sport massage, get out in your community and see what’s available. It doesn’t matter what level the team is, it will be a way to get experience, build your network and help increase business.

Photo By: Brian Cribb

The Benefits Of Volunteering In Sport Massage

This is where some therapists have a hard time.

Getting paid in Sport Massage can take some time. There are some organizations out there that are willing to pay and others that are regulated by governing bodies who decide on funding and what gets paid for.

For instance, in Canada OTP (Own The Podium) decides on funding for Olympic athletes and organizations as well as where the funding is spent. So some teams may be bound by whatever funding is given as far as therapy.

In private teams, the team will typically have a budget they work in and will decide whether having a Massage Therapist is something they can afford.

As difficult as it may be to find the time to volunteer, there are other benefits.

In the past I have taken days at the rink to work on players where the team doctor signed insurance documents for whenever a player needed some Massage Therapy. I would then fill out the signed document, submit it and get paid via the league’s insurance policy. The turn around to get paid is a little slow but hey, I was working in the sport I love.

The team Chiropractor sends me more referrals to the clinic than any other source the clinic uses, or any marketing I have ever done. I counted up one week a little while ago and in a five day period, half of the patients I saw, came from that Chiropractor. So even though the majority of my work with the team is on a volunteer basis, he has sent me a lot of business over the years.

Being able to say you work with a local team changes the way patients look at you, especially new ones. A number of times I have had people book in with me because they see that I work with the team and they want a therapist that can help with athletic injuries. The hockey team’s front office even tries their best to refer people to me and some even bring family members in.

I get asked several times a year by other therapists interested in working in sport if I know of opportunities for them. I still think the best way to get in is just by marketing yourself to different teams and volunteering your time to get started. The paid positions will come, but they don’t always come easy. By taking continuing ed courses based around sport (like First Responder), making sure to approach team head trainers, joining Sport Massage organizations, volunteering where you’re passionate and having a great work ethic are all steps that will get you closer to being able to work in sport. But whatever sport you’re passionate about and decide to get into, (keep in mind I’m Canadian) it’s just not as cool as hockey.