Posts

How Imposter Syndrome Could Affect Massage Therapists

September 22, 2015/7 Comments/in Business, Massage, Massage Clinic, Massage Therapist, Massage Therapy/by Jamie Johnston

“I have written eleven books, but each time I think, ‘uh oh, they’re going to find out now. I’ve run a game on everybody, and they’re going to find me out.’ “ – Maya Angelou

“There are an awful lot of people out there who think I’m an expert. How do these people believe all this about me? I’m so much aware of all the things I don’t know.” Dr. Chan, Chief of the World Health Organization

Sometimes I feel like I don’t know what the hell I’m doing.

And it doesn’t just apply to one aspect of life, with each activity I’m involved in, I question myself.

When I first started supervising at the college, students would sit down and rattle off orthopaedic tests they were doing and while I know I had heard learned those tests, I hadn’t done many of them since I was in college. I sat there and nodded, hoping I’d look like I knew what I was doing.

The first couple times I had to rush to help one of our players get off the ice after a big hit, all I could think was “there’s 1200 people, the team and three students watching, don’t mess this up”.

I’m guilty of comparing how busy I am at the Massage clinic to the other practitioners and wonder why some weeks, I’m just not as busy even though it fills up by the end of the week.

I’ve jumped on a firetruck and responded to hundreds of calls over the years, but there’s always questions in the back of my head coupled with a little bit of fear as we roll down the road, sirens blazing and wondering what we’re going to see when we get there.

Little did I realize that I’m not alone. In fact someone who is well respected (and who I respect) in the physical therapy community posted on Facebook a couple weeks ago that sometimes he feels like a pretender.

I was shocked.

Turns out this whole thing has a name.

“Imposter Syndrome”

Imposter Syndrome Defined

The Cal Tech Counselling Centre defines Imposter Syndrome as:

“A collection of feelings of inadequacy that persist even in face of information that indicates that the opposite is true. It is experienced internally as chronic self-doubt, and feelings of intellectual fraudulence.”

The worst part of this is when people are experiencing Imposter Syndrome, they don’t believe they deserve the success they are achieving. Accomplishments and accolades are often dismissed as luck or good timing.

But here’s the thing, people dealing with this are achieving success, they are just downplaying the difficulty, time and effort that went into achieving it.

I know that I’m not alone in feeling like this sometimes, in fact over 70% of people have experienced this at some point in their lives.

Even the likes of Albert Einstein, Kate Winslet and Tina Fey have experienced this.

But luckily there are ways to overcome and have confidence in your worth.

Ways For Massage Therapists To Overcome Imposter Syndrome

It’s time to let go of the voices in your head (especially if they’re answering), or at least acknowledge and realize they are there.

It’s a common tendency that if we feel passionate about something, then we think it must be true. Limiting questions will come up in practice and in life, but what can you do to reframe those questions? When these types of feelings come up, try to switch and reframe those thoughts.

“Why aren’t I busier this week in clinic?” = “What can I do to get busier this week in clinic?”

“I don’t belong here” = “I do belong here, look what I’m doing”

There is a drastic difference between feelings and reality. Just because you feel strongly about something doesn’t make it real. Your feelings can trick you about reality. Shift your focus to what you have done and what you have accomplished.

I remember sitting in College and thinking that if I’d known school was that hard I wouldn’t have taken the course. But, I passed.

Then came board exams.

I stared at the clinical science exam, completely frustrated about half way through and shaking my head, saying out loud “I’m gonna f&*#ing fail this”. The girl beside me probably thought I’d lost it. But I passed those too.

Take the time to make a list of your accomplishments and successes, then keep adding to it as you continue to progress.

When was the last time you paused to celebrate and appreciate all you have done? After you make that list, celebrate and enjoy it. Take a day off, go for a hike, go for a nice dinner, enjoy a good scotch, do something to recognize all you’ve done.

Too often nowadays we accomplish something and immediately look for the next problem we need to defeat, rather than focusing on what we have done to be successful.

Focus on what you HAVE done versus what you haven’t done.

You Don’t Have To Know Every Aspect Of Massage Therapy

Be confident in what you are doing.

Humility is a great thing, and has its purpose. But it can also help to reinforce imposter feelings.

When we avoid showing confidence in our abilities, we can persuade ourselves that we don’t deserve a positive outcome or success.

As I read through Facebook threads in Massage Therapy groups, the one thing that always gets me feeling negative is all of the topics on science. I’m not an overly scientific guy and struggled with some of the Anatomy and Physiology classes in college. Some of the other MT’s seem like they have it all together and talk fluently about their knowledge.

Sometimes I just stare at the screen and think “why can’t I be more scientific”? (Honestly I say sciencey, but I don’t think that’s a word).

But here’s the thing, science is just one aspect of Massage Therapy. So is experience, techniques, first aid (yeah I snuck it in there), education and so many other things. Just like you learn new techniques as your career grows, you can also learn more about these other aspects.

The pounding drive to improve can wear you down. The need to make things happen feeds the sense that you are faking it. Develop the awareness that you can get things done without pushing, forcing and going harder.

You are living evidence of your success.

You don’t have to overcompensate so that others believe you. You are the only one that needs convincing.

There will always be things that you do not know, there are things that you will never know and there are things that you can decide to learn.

When I see those Facebook threads, I’m essentially comparing myself to those MT’s who have spent so much more time researching and putting effort into learning a science based practice.

If you find that you’re comparing yourself to others, don’t compare forwards, compare backwards. If you must compare at all, look at the people behind you, or look at where you were one, two, three years ago. How much more do you know now? Think about all the expertise you have gained through life, practice and your experiences.

Look at those behind you as those you can teach, your peers as your peers and those ahead of you as mentors. You can learn from each group.

Photo by: Sylvia Duckworth

Your Failures And Mistakes Make You A Better Massage Therapist

We all make mistakes in life and in our Massage practice.

The difference is what we do with it. Rather than being hard on yourself about it, work with them. Use it as a lesson and research in the name of personal and professional growth.

Get support from others. Talking with a more experienced Massage Therapist might help you understand that you are not alone and can give you the reality check you need. Just because you might need some help doesn’t mean you are inferior or unintelligent. In fact, knowing when to ask for help is one of the smartest things you can do.

The reality is, we will all have ups and downs within our career. While we all need to continue improving, taking CEC’s and expanding our education, you don’t have to do it all. Reaching out for help when needed, having confidence in our abilities and embracing our success are all steps we can take to overcome imposter syndrome. You do not have to attain perfection to make a difference in your practice or to be worthy of success. Question any negative thoughts that come into your head and reshape them to shift your thoughts into a positive state. It’s not about lowering the bar, it’s about resetting it to a realistic level that doesn’t leave you forever striving and feeling inadequate.

What Massage Therapists Need To Know About Cerebral Palsy

September 16, 2015/7 Comments/in Business, Massage, Massage Clinic, Massage Therapist, Massage Therapy/by Meaghan Mounce

“See the person, not the disorder” – Meaghan Mounce RMT

I stood holding a client health history file, suddenly nervous with my mind racing.

I had never massaged someone with this condition before.

It was my first week at a new massage therapy clinic. I had just moved to the city and stepped into a busy clinic where my first week was booked solid. The second day of work I was reviewing the files of the clients I was going to see that day.

My last client of the day was a young lady in her mid twenties. I read through her file and health history form and immediately felt the butterflies I used to get when I was a student!

My client had cerebral palsy (CP), was nonverbal, used a motorized wheelchair to get around and had a care aid with her at all times. No other RMT’s on shift at the clinic worked with this girl before and I so I had no one to ask advice!

A million questions flooded my brain at once. In my four years of massage therapy practice I had not worked with anyone with a severe disability.

How would I communicate with her?

How would I know if I was hurting her?

Is she able to move around on the table?

Do I have to help with lifting and transferring her to the massage table?

Dealing With Spastic, Ataxic And Athetoid Cerebral Palsy

Luckily, I had just taught the section on cerebral palsy in the Pathology course at the massage therapy college in Victoria, BC so I had some recent information on the condition. However, as we all know, dealing with a real life patient is far different than reading about it in a text book!

Cerebral palsy is a non-progressive neurological disorder caused by abnormal development of or damage to the brain. This damage usually occurs in utero and can be caused by exposure to radiation, infections or lack of oxygen to the brain. Less commonly, CP can be caused from trauma during birth or serious infections during infancy.

There are three main types of cerebral palsy, as well as mixed CP which presents as a combination of the other three. There seems to be a wide spectrum of how the symptoms can present, from mild to severe.

Spastic CP is the most common type and causes symptoms of an upper motor neuron lesion of the brain, such as hypertonia of affected limbs .

Ataxic CP shows symptoms of damage to the cerebellum. Patients with ataxic CP often have difficulty with balance, walking and fine motor skills such as writing or typing.

The final type of CP is Athetoid and has symptoms associated with damage to the basal ganglia and to the neurological structures that affect involuntary movements. These patients will present with a mixture of hypertonia and hypotonia and will experience involuntary movements.

Learning about the Condition Beyond a Textbook

From my knowledge of the subject, I decided my lovely client had athetoid type cerebral palsy. It was not stated which specific type of CP she had on her health history form.

She was bound to a wheelchair, had hypotonia (no muscle contractions) in her lower limbs. Her legs and feet had no voluntary movement, were very thin and cold to the touch. Her upper limbs were spastic. Her fingers were curled around the thumb in flexion. While she had some voluntary control of her arms, the movements were very jerky and she often had flailing limbs that were out of her control.

She could not speak, but had an amazing computer that she could press a button and it would say a few programmed sentences for her.

On the day I was to massage her, I waited patiently, nervous but also excited for a new challenge.

Get To Know Your Client And See Beyond Types Of Cerebral Palsy

She rolled into the clinic on her motorized wheelchair, controlling it herself with her head. Her care aid walked behind her encouraging her in a relaxed manner to drive the wheelchair forward.

The first thing I saw was a huge smile on the client’s face. After I said ‘Hello’, she quickly pressed a button on her computer and an electronic voice replied, “Nice to meet you!”.

I quickly had a huge smile on my face too and some tightness in my throat from emotion.

The care aid placed my client on the massage table on her side with a pillow between her thin legs, another under her head and one for the client to hug.

I was told that she usually feels good, but often suffers from constipation. She had a feeding tube directly inserted into her abdomen, so I was shown where that was.

After the quick run down we were left alone for an hour to get acquainted. My nerves went away quickly and were replaced with admiration.

I was able to communicate easily with this client through yes or no questions. A ‘no’ response was given with a lowering of her eyes and chin towards her chest. A ‘yes’ response was shown through raising her eyes and chin. An excited ‘yes’ was accentuated with a cry of ‘yeaaaahhhhh’, which made me laugh every time!

I quickly found out about how many siblings and pets she had and that she really loved when she got to ski at the local skill hill the month before!

Massage Treatment For Cerebral Palsy

I massaged her in her side lying position the entire treatment. She confirmed she was comfortable the entire time.

I did a full body massage to all the areas I had access too. Through her lower and upper back I performed mostly general swedish massage with some gentle muscle stripping through the erector spinae and upper trapezius muscles.

On her lower limbs, I did mostly circulatory work. I started distally and used small, but broad strokes to help encourage blood flow. I massaged her feet, which were very cold, and moved her ankles through passive range of motion.

I also did some abdominal massage to help with her constipation issues, while avoiding the feeding tube.

Her arms were the trickiest to massage. With any quick movements her arms would jerk into a flexor pattern (internal rotation of the shoulder and flexion of the elbow, wrist and fingers). I used slow strokes moving from proximal to distal to relax the muscles of the upper limb.

She watched thoughtfully as I slowly opened up her palm to allow some kneading to her hands.

The client seemed to relax easily and I noticed her eyes drooping a few times into almost sleep.

Once the hour treatment was up, her care aid dressed her and situated her back into her wheelchair. She steered herself out of the treatment room and pressed a button on her computer that said, “Thank you! See you in a month”.

I was thankful she was my final client of the day because I was fairly emotional after the treatment.

Photo by: Incase

Using Conditions Like Cerebral Palsy To Find A Learning Experience Anywhere

I felt extremely grateful that I got to be a small part of her health care plan. I learned how to communicate with someone who doesn’t speak the same way you and I do. I got to experience outside of school what hypertonia, spasticity and hypotonia really feel like.

Most of all I got to see what an amazing personality she had.

I was lucky enough to work with her a few more times before I moved away. Even though she no longer is my client, I will never forget her.

Working with her was one of the best experiences of my life.

From this experience, I learned to not shy away but embrace situations that may be challenging. You can communicate easily with someone even if they cannot verbally tell you their thoughts. You can use vision to see someone relax and feel tension ease. I always figured I would learn more once I was out of school and working with people. I thought I would gain this knowledge from continuing education or from the opinions of other health care practitioners. What I didn’t know is how much I would learn about each client’s view of their own condition, disease, injury or how they see themselves in the world; knowledge that you cannot find in school or a textbook. Embrace every client and experience you can! You never know what you will learn!

Massage Therapist Treatment For An Achilles Tendon Rupture

September 14, 2015/3 Comments/in Business, Massage, Massage Clinic, Massage Therapist, Massage Therapy, Sport Massage/by Jamie Johnston

“I heard a loud pop and it felt like somebody hit me in the heel.”

I’ve had a few friends and patients over the years that ruptured their achilles tendon.

It just sounds terrible and I hope I never have to experience it.

The last time I heard a story about it, the guy was playing tennis and lunged after a ball. He just dropped to the ground.

He knew he shouldn’t move because the foot didn’t feel right and when you hear something like that, the last thing you want to do is move the injury.

Fortunately keeping still was the right thing to do.

First Aid For An Achilles Tear

I would treat this the same as I would for a fracture.

The person may still be able to limp or walk because the peroneals and other muscles deep in the leg compartment that remain in tact do not require push off with the superficial calf muscles.

Once that tendon is ruptured, immobilize as soon as possible, you want to do everything possible to prevent the calves from balling up.

Make sure to immobilize in the position found. Since the gastrocs cross the knee, do not straighten it because that motion would place more tension on the calf muscles and could further complicate the injury. However this is just my opinion from experience in dealing with things like this on an acute level (this study says that knee position does not affect the tendon gap at the injury site).

Once immobilized check the pulse distal to the injury to make sure circulation is okay.

If you’re not sure whether the injury is a rupture there is a few signs and symptoms to look for:

visible separation in the tendon
unable to stand or balance on the affected leg
swelling and bruising around the ankle
excessive dorsiflexion of the ankle
positive Thompson’s test.

While all of those signs and symptoms and the Thompson’s test are quality things to look for, I would be hesitant to have someone try to stand on the injured side or perform the test for fear of causing further damage. You are much better off to look at the mechanism of injury and let the doctors at the hospital perform any further testing that is required.

Achilles Tendon Rupture: Surgical Or Non-Surgical

I had no idea that there was a non-surgical procedure for this injury until just recently.

In doing research, there is quite the debate over which is better between surgical and non-surgical procedure and both have their advantages and disadvantages. It seemed like I could find just as many pro or against for either treatment.

In the non-surgical treatment the foot is braced in plantar flexion and three weeks later progresses to weight bearing exercise and manual therapy. Scar tissue fills the space between the ends of the torn tendon, which lengthens it and gives the patient less push off strength. It takes longer to recover, longer immobilization time and has a higher risk of a deep vein thrombosis.

There are a few different methods to the surgery but it comes with the risk of wound closure problems, infection and nerve damage.

One systematic review looked at seven articles from the last ten years and found:

there wasn’t a significant difference in re-ruptures of the tendon
more soft tissue injuries from the surgery (we could probably help out here)
better function after surgery
quicker rehab after surgery

The review also points out the difference between surgical and non-surgical treatments were minor so the importance lies in the rehab.

Photo by: Bob~Barely Time

How To Rehabilitate An Achilles Rupture In The Massage Clinic

Your approach to helping rehab this injury is going to vary depending on when the patient comes to see you and what type of repair was done to the tendon.

There are two approaches to rehab, the conventional approach and an early remobilization approach.

Getting a good history from your patient will be crucial to providing the appropriate care (as it always is).

When the conventional approach is used, somewhere around the 4 week point (after the operation) the person is usually put into a walking cast (ankle is placed in neutral) with some weight bearing exercises are started. Around the 8-10 week mark, the walking cast is taken away and range of motion exercises begin. After 12 weeks things are getting back to normal and full weight bearing activities are okay again.

When the early remobilization approach is used, weight bearing and range of motion exercise starts immediately (or within 2 weeks) after surgery while wearing a brace that holds the ankle in plantar flexion. Full weight bearing happens gradually at 3-6 weeks with orthotics in place that allow more dorsiflexion.

With either approach, weight bearing exercises are used around that 6 week mark. At this point it is also okay to start some Massage Therapy work around the tendon and the calf muscles. The biggest thing we want to do is help with increasing the ankle range of motion. Using some techniques like joint mobilizations, mild stretching, active and passive range of motion and manually stripping out the gastrocs will all help contribute to these goals.

The next goal should be strengthening the calf muscles. After being in a splint, brace or cast for that long there will be some wasting of the muscle. I had a knee surgery back in 2005 and had to wear a full length leg splint for 3 months after the surgery. My leg looked like it belonged to a 10 year old kid compared to the other one.

Because weight bearing is allowed in both approaches at the 6 week mark, strengthening should be tolerated as well. If you’re not comfortable setting up exercise programs, reach out to someone in your network that is and get some help with it. Chances are the patient will already have exercises in place, either prescribed by the surgeon or from a physio they have been referred to.

Whichever rehab approach is being used will be dictated by the doctor or surgeon. Reach out to them and find out which approach is being used and get some feedback on what they have seen success with. Sometimes with surgery structures are taken from flexor hallucis longus, plantaris, peroneus brevis or parts of the fascia from the gastrocs. Getting that kind of information from their doctor is valuable information and may alter your treatment. If you’re dealing with an acute achilles rupture, even though they may be able to limp on it, get them down on the ground and splint the ankle in place. Do whatever you can to prevent any further injury or complications. When a person is coming in to your clinic for rehab, do a little research on what works best for a successful outcome and have some open communication with the persons other practitioners. And hopefully the next time you’re out exercising it never feels like someone kicked you in the back of the heel.

Why Every Massage Therapist Should Be Using Linkedin

September 6, 2015/in Business, Massage, Massage Clinic, Massage Therapist, Massage Therapy/by Jamie Johnston

“Help the people in your network, and let them help you” – Reid Hoffman, founder of Linkedin.

“James, please add me to your Linkedin network”

Why do I keep getting these requests from people?

I finally gave in and signed up for a Linkedin profile.

I just sat there, blankly looking at the screen like someone was trying to explain astrophysics to me. I just didn’t get it.

Is this like a new facebook? But it’s for business right?

I didn’t understand what I was supposed to do with it. After some reading and research it finally started making more sense.

It was originally created for job seekers and has evolved into a tool for any business owner.

Some of the biggest companies in the world are using it as a major part of their social media and recruiting campaigns. It has become the biggest social networking site that is strictly for professionals.

You use facebook to connect with your fans, twitter to connect within your community, but you use Linkedin to connect with your client (B2C) and other businesses (B2B).

Linkedin For B2C Marketing

Most people only think of Linkedin for B2B marketing and connecting with other professionals.

However there are ways to use it to market to customers. If I’ve heard it once I’ve heard it 1000 times, “content is the new currency”. Linkedin provides a great platform for this because you can use it as a method to post blogs.

Imagine that you are regularly generating content for your current patients that are following you on your facebook page. Why not use the same posts to engage with possible new customers?

There’s a higher level of trust when potential customers are reading your posts on Linkedin because it is THE social media platform for professionals.

Another interesting statistic is that 41% of internet users in the U.S. that are on Linkedin have an average income of over $75,000. So guess what?, they can afford to come in for a Massage.

But remember, don’t just use it for self promotion also look into groups to see how you can be of help and provide service.

Linkedin For B2B Marketing

Linkedin is different than using facebook and twitter.

Although facebook does have the option of business pages, those are meant more to engage with your customers. Twitter is meant more to engage with your community.

Linkedin is all about business.

According to this graph, hospital and healthcare make up 8.2% of the users on Linkedin. As we try and use Linkedin for B2B (business to business) marketing this is valuable information.

While 8.2% may not seem like a big number, their membership has grown consistently from 37 million in 2009, to 380 million in 2015. That’s over 31 million members working in healthcare.

This creates a huge opportunity for referring and getting referrals in business.

If you haven’t started creating relationships with other practitioners, here’s your chance. Use Linkedin to do a little bit of a background check on some of the Chiro’s, Physio’s, AT’s and other complimentary therapists in your area.

If you see some that are close to you or one you seem to have something in common with, start reaching out to them.

Ask them some questions about issues one of your patients is having and see if they come back with any recommendations. Ask about their treatment style. Ask what they would do to help.

Start building a bit of trust and then send one of your patients their way. Don’t be afraid to break some new ground being the one who is reaching out to others.

Using Linkedin To Get Referrals

If you look at your Linkedin profile (assuming you are using it, if not start) you’ll see that some in your network are 1st, 2nd connections etc.

Too often people think they should just reach out to people who they know directly (1st connection) instead of others who are also in their industry or similar to their industry (2nd connection).

Linkedin is there to be used, so use it to leverage yourself and start generating referrals.

Think about what happens if you were looking for someone to refer to and they only had a handful of connections. You’re going to question if they’re actually worthwhile doing business with, especially if you’re considering referring one of your value patients to them.

Open up and add as many people as possible, grow that network. Once you do it will help you to be found more often when people are doing searches.

As you begin to grow that network you will start to see other people who maybe you didn’t realize were on the site. Also having more connections makes you more approachable for those looking to network and so does the more recommendations people have made about you.

I used to think it was redundant to hit those endorsement buttons for my connections. But each time you do that (or someone does it for you) it increases your credibility. If someone is looking to refer to you and a lot of your connections have endorsed you, it reflects to the person looking at your profile that you’re good at what you do.

Start building up that network so people can refer to you. Build your business.

The Ultimate Pyramid Scheme

Connecting with people on Linkedin is kind of like a pyramid scheme or similar.

I tried one of these things in my early 20’s.

All I had to do was get ten of my friends to sign up to a company and use their long distance services.

Then get ten of my friends to sign up ten of their friends to sign up ten of their friends and so on. I went to some of their conferences and tried to drink their Kool-Aid.

I hated it.

But Linkedin is a place where this could actually work (and it’s legitimate). Think of each of your 1st connections as ways to develop relationships with 2nd and 3rd connections.

Looking at the above example, for every 6 connections you have on Linkedin there is an opportunity for them to introduce you to 6 more people (36 second connections) and for each one of those, they could introduce you to 6 more people (216 third connections) and so on.

I’m not sure that you could get down to a 13th level of connections, but you get the point.

While your 1st degree connections are important, they’re not as important as those 2nd and 3rd degree. You’re already doing business with your 1st degree connections, so you want to dig deeper and create more business opportunities further down the line.

You need to develop relationships with people outside your direct network in order to increase your Massage Therapy business.

Remember it’s all about networking and that is the essence of the value in Linkedin, networking with other professionals.

Linkedin Profiles For Massage Therapists

You want to make sure that your profile is going to be seen by as many people as possible.

Do a quick google search of the top Registered Massage Therapists on Linkedin.

What do these profiles have in common?

Each one has a welcoming picture (except one) of the therapist, which is immediately engaging for anyone who is doing a search (possible potential clients). When someone does a search they don’t see your complete profile, they see an abbreviated one like the ones in the link. You have to try and engage right away.

They each have a great headline that represents them and their purpose well. Notice that they all have specific keywords related to Massage Therapy which increases their visibility.

Each one has at a minimum which province they are in, but even better is to put which city you’re in. This is crucial as it helps to narrow down searches when someone is looking for a Massage Therapist in their area. They also have the name of the clinic they work at listed making them easier to find.

Do an advanced search on Linkedin and see who comes up as the top Massage Therapists and use their profiles as a guide to setting up your own profile (just click on “advanced” beside the search box).

There’s a reason they’re ranking high in searches.

Linkedin is the place you want to start making business connections. Use it to start connecting with other businesses and practitioners in your area to generate referrals and build relationships. Unlike other social media applications this one is truly about generating business, so make sure your profile is easy to find and engaging for anyone who is searching. Just don’t try and convince any of them to sign up for long distance phone plans.

5 Misconceptions About Posture That Could Hurt Your Clients

August 18, 2015/1 Comment/in Massage, Massage Clinic, Massage Therapist, Massage Therapy/by Todd Hargrove

As a Rolfer, I see many people who want to improve their posture. Many are already in the process of applying some questionable advice they may have read on the Internet.

This post summarizes some of the major misconceptions people seem to have about posture.

Bad Idea #1–Bad Posture Is The Cause Of Your Pain

The idea that bad posture will result in pain, or that you can cure pain by improving posture is a myth. You can read these claims everywhere. Sure, they may have an intuitive appeal, but they have no strong evidence support them.

If bad posture is a major cause of pain, you would expect to find that people with measurable postural distortions would have more pain than people who do not. But that is not what studies show. As summarized in a previous blog post, the weight of the evidence is that pain does not correlate very well with measurements of posture such as spinal curvature. This is surprising and somewhat counterintuitive, but it should definitely be kept in mind by anyone who plans on investing considerable time and effort trying to correct posture for purposes of pain relief.

Bad Idea #2–Good Posture Requires Constant Attention

Many of my clients believe their poor posture is the result of failed attention. As a practical matter, we cannot spend all day worrying about our posture. Our bodies are not designed to require conscious monitoring of muscular activity. We can walk without reminding ourselves to activate flexor digitorum longus at the right time, and we can also sit upright without being mindful to activate the core or retract the scapula.

We really have no choice but to allow posture to be dictated by unconscious processes. Even the most vigilant conscious policing of your posture will be abandoned after a second or two, as soon as some other distraction arises. So, if you want good posture, you must somehow make it an unconscious act.

Bad Idea #3–Good Posture Requires Extra Effort

Many of my clients believe their bad posture results from laziness, or possibly poor strength in certain postural muscles. They feel tired after only a few minutes of assuming what they think is a good posture, and then conclude they must increase their endurance at holding the position. This is a losing battle.

The solution is often not to increase your ability to sustain effort, but to find a posture that requires less effort. The sense of effort associated with movement is a good way to determine whether the movement is right for you. In regard to posture, this means your optimal posture should feel easier, not harder, than your current posture.

If a certain posture feels like it requires extra effort, it’s probably not going to work. In any event, your brain, which prefers the most efficient way to do something, will be smart enough to abandon an inefficient postural strategy the very first moment that you stop consciously controlling it. Which should be about three or four seconds.

Bad Idea #4–Posture Means Holding Still

People think of posture as the opposite of movement–as something that you “hold.” This is why people often become stiff when they assume their “good” posture. This is a bad idea because it interferes with all the movements that must occur constantly during any posture.

Every posture requires ongoing breathing, which is a movement that can involve nearly every muscle in the trunk. This fact works against the common advice to suck in the abs as a means to become more upright and stable. Consciously sucking in the abs might make you feel taller, but it also tends to lock in some of the muscles that must move to allow breathing.

In addition to breathing, static posture (especially standing) involves constant oscillatory movement. Standing is actually a highly unstable position–it’s like balancing a fifteen pound bowling ball on top of a stick on top of two other sticks on top of two bony feet. Standing is a continual process of tiny falls and recoveries, where the muscles constantly adjust to tip the body one way and then the other. This results in a very small but perceptible oscillating pattern where the head moves above the feet in a figure eight or circle. So, posture is not about preventing movement, but about allowing very small movements around a central balance point. Try to imagine that you are a bobble head doll and you can feel this subtle process of movement and readjustment happening constantly and involuntarily.

Another important aspect of posture is that it is the place from which the next movement will come. Optimal posture allows the next movement with a minimum of preparation and effort. This is of course vitally important in a sporting context, where players wait for the next move in a posture (usually a crouch) that allows quick movement in any direction with little effort or preparation. But such a consideration also applies to everyday life, and you can be sure that your brain is constantly anticipating your next move no matter how small, and making postural preparations for it.

One movement that occurs almost constantly in most sitting and standing postures is turning the head from side to side to scan the horizon and take in sensory information. Each head movement, when executed optimally, requires movement of the neck and more subtle compensatory movements in the trunk and even pelvis. Turn your head from side to side while sitting and you may feel your sit bones shifting slightly on your seat. Holding the head and trunk in a rigid position will restrict the freedom of these movements and make them stiffer and less comfortable. Try adopting your “good” posture and then see if you need to soften it a little to turn comfortably from side to side. Again, your brain won’t let you adopt a posture that prevents a quick and easy scan of the horizon, and therefore any such posture is doomed to fail.

Another motion that takes place almost constantly while sitting is reaching for a keyboard, mouse, phone, doughnut, remote control, etc. If the scapulae are held to the spine by the conscious retractions recommended by many posture experts, the arm is not ready to reach. And this is again why advice to consciously stiffen certain muscles is likely to fail. The brain knows that sitting at a computer means constant reaching, and it will not allow the scapulae to be constantly pinned back.

The bottom line is that posture is not a static position to be held, but rather a dynamic and constantly changing series of subtle movements that allow breathing, turning and reaching, preserves easy balance, and prepares for the next movement.

Bad Idea #5–Straighter And More Symmetrical Is Always Better

Many people assume their posture will improve if they get “straighter” and more symmetrical. However, it is a bad idea to place too much emphasis on how your posture looks. More important is how it feels and what it can help you do. The visual emphasis on posture probably results from spending too much time looking at pictures of platonically ideal posture shown in books. Trying to deform your body into the shapes in these pictures can be a bad idea.

Every person has a unique bone structure and therefore each person has a unique ideal posture. We all have at least some minor asymmetries in the bones from left to right. If you look closely at a model skeleton you will notice that the ribs on the right side are not the same shape as the ribs on the left. You will also notice places where the spine curves from left to right. Bones are not made by machines like interchangeable pieces of Ikea furniture, they are shaped by years and years of an organic process of growth which responds to tensional and compressive forces. Such forces are bound to be different from side to side and therefore asymmetries are the rule not the exception.

If the bones of your spine naturally tilt a little to the left near the sacrum, they will have to tilt back to the right at some point to keep the head over the pelvis. The resulting curvature is entirely natural and perhaps optimal for that particular person. Trying to straighten out the curves works against the grain of the bone, and is bound to cause unnecessary stress and tension.

The same principles apply to the size of the forward and backward curves in the low and upper back, which are very much determined by the shape of the bones, particularly the sacrum, whose shape varies markedly between different people.

Altogether, the ideal posture is different for everyone, so don’t rely too much on how your posture looks, judge how it feels. If it doesn’t feel natural, it won’t work.

Why Every Massage Therapist Should Be On Twitter

August 12, 2015/3 Comments/in Business, Massage, Massage Clinic, Massage Therapist, Massage Therapy/by Jamie Johnston

I looked at the person next to me, we couldn’t believe what we just heard.

I did a full on palm slap to the face while shaking my head.

It was during a social media camp while a woman was doing a presentation on how to use twitter for your business. Apparently they didn’t screen the participants.

Someone put up her hand and asked “Is twitter a place I go to, like a coffee shop”?

But some good things did happen that day.

I was fortunate enough to have lunch with one of the presenters. He told stories over lunch about how using social media had benefited his business.

His marketing budget compared to the previous year was cut by ? which also increased their profit margins. And one big difference was they were actually getting more customers through the door. It was fascinating talking to him and seeing the passion he had for this relatively new marketing concept.

College had only ended six months before and I was looking for ways to promote myself, so figured I’d sign up for this social media camp.

The best marketing advice I’d been given in college was “just give each person, the best damn massage you can, because you never know who they’re going to tell”.

While that may be true…how you gonna get them in the door in the first place?

Twitter.

Why Massage Therapists Should Be Tweeting

Massage Therapy is more than than just giving good treatments.

It’s about building relationships.

Twitter is a great tool for doing this. It’s not just about promoting your business, it’s about getting people to interact with it.

Don’t be afraid to show your personality. If there’s one thing that’s true in this industry, there is a VAST array of personalities.

While we all want to project a professional image, people don’t come in to be treated by a robot. Show people what you’re interested in. Retweet what you’re interested in.

If someone is looking for a new Massage Therapist and you’re tweeting about some of their interests, who do you think they’re going to want to talk to while on the table for an hour? You, or the guy who refuses to show they actually have a sense of humor?

I have patients that come in regularly, just to hang out. One patient I’ve had in the past would regularly come in and when I asked why she was in today:

“was at work and thought, I’m gonna go hang out with Jamie for a bit”.

Don’t be afraid to have the personality that keeps them coming in, engaging with them outside of the clinic.

But there is a fine line here.

You don’t want to send out tweets thanking them for coming in today. There is still a professional boundary that should not be crossed. If they tweet out a thanks to you, it’s fine to favorite it or respond but remember that coming for a Massage is still something personal they may not want broadcast to the public.

Leave that communication in their hands.

Connect With Your Clients And Build A Massage Therapy Community On Twitter

Do a little research on twitter on your own and find out what your local community uses to connect.

I live in Victoria BC and the most common hashtag I see here is people using #yyj because it’s the code for the local airport. Each community will have their own thing they are using.

Just do a simple search of the name of your town/city and you will see some of the hashtags and commentary used to identify what’s going on.

If you can’t find one, start one. Develop something you think people in your community would connect with and promote it. You never know, it just might catch on.

Are there upcoming events that maybe you can contribute to or get involved in? Do you see opportunities where your knowledge would be an asset? For instance, if there were some local marathons, Run For The Cure, or other events where people could use Massage?

If you see things like this trending within your community, try and join the conversation and give some information to the people tweeting about it. As it is with any conversation, the more value you can add the more welcome you’ll be.

As I do a #yyj search writing this post, I see three tweets about coupons to a local gym, one about WWE wrestlers in town and one about our local football team carrying momentum. With each one of these, it would be easy to make up a quick comment about how Massage Therapy could help anyone involved.

Offer up some quality information about how Massage Therapy can help, not just a link to your website. The more information you can give back the better, it’s all a method of building trust in your community.

Building trust isn’t done by just providing great content.

It’s also in the mentions, the retweets, the favorites, the thank you’s. When others in your community see these interactions, you are starting to build yourself up as a trusted source.

Refer For Other Businesses

Remember that content has become currency.

As you scroll through your twitter feed, there are endless ways to have it be a benefit.

If you see people in your community asking questions, try to be an answer. Be a curator of information.

Know some great businesses out there? Promote them. Use them as an answer to people’s questions.

Someone asking where’s good to eat?, tell them about your favorite restaurant.

Need a good place to workout?, recommend your gym.

Someone looking for a chiropractor?, refer them to whoever you have a professional relationship with.

It doesn’t always have to be about marketing yourself. If you become that curator of information, you will build trust with present and potential customers. But you’ll also start being recognized by those other businesses and get the same in return.

You have an opportunity to add value, not only to your customers, but to other businesses in the area. You’re in the same boat as those other businesses, why not give a helping hand to each of them and support local?

Use Twitter To Gain Intel On Your Competition

There is a general theme among Massage Therapists where we don’t really talk about competing for business.

However, it’s the reality of what we do.

We are all usually pretty good about referring to each other when we can and generally getting along and making space for each other. The reality is we are all competing to have a busy practice and need to make a living.

Use twitter to find out what others are doing. Use it as a tool to learn.

Watch and see if people are griping about some of the other businesses in town.

What things are those patients complaining about? Customer service? Lack of direct billing? Difficult to get booked in at certain hours?

Use those complaints to see if it’s something your practice can offer.

If you can offer some of those things, send out some tweets to your followers about it.

Here’s a great example of a Massage clinic doing just that:

Anybody who follows them gets to see the great new service they are offering and it may get some people to book in since they know that it’s now less hassle to submit their insurance claims.

However (and I can’t stress this enough) DO NOT negatively call out other businesses or people on twitter, or any other social media for that matter.

If you see gripes about another business don’t respond to the gripe saying that you’ll offer a better service at your clinic.

It’s unprofessional and does not represent you well.

The bottom line is we all care about our patients. But shouldn’t we care just as much about getting more patients? Marketing is hard, especially when you don’t have a ton of money to spend on it. But the biggest thing you have to market is YOU. Make who you are known and connect with like minded patients. Engage with them, like them, thank them, refer them. The more you give, the more trust you will gain, the more trust you gain, the more you will be a fixture in your community.