How Not To Rub Your Patients The Wrong Way

 

 

Your client is coming to you in order to feel better. They want an experience that is going to relax them or perhaps even energize them. They’re not coming to you to be rubbed the wrong way.

A good client consultation requires more than just technique in massage and the administration of physical therapies.

Your goal should be to give them a complete therapeutic experience not only for their body but their mind as well.

Here are three ways you can avoid rubbing your client’s body and mind the wrong way.

Ask Questions

One of the things I did as a matter of routine at the beginning of any client session was to ask them what they enjoy most about massage.

This might seem like a redundant question when you’re there to provide therapy, but your clients are looking for a rewarding experience.

Knowing their pain points as well as their pleasure points will make you much more sensitive to their needs and far more likely to result in the satisfying massage experience for your clients.

I have been massaged many times by professionals who never asked me anything beyond how I was feeling. All you have to do to win me over is massage my legs.

You can do that all day long, and I would walk out feeling great.

But if you fail to ask questions and just move on assumptions you’re probably going to spend an hour on my neck, and I’m just going to be irritated.

Sure, my neck may be the presenting problem, but part of remedial therapy is to bring the entire body back into a harmonic state.

And one of the best ways to bring the body back into a harmonic state is to compensate the discomfort with a positive experience.

Be Dedicated to Your Client

Your clients want your attention. They want a commitment from you.

A single-minded passion and focus on your profession and your client can take you a long way in the therapeutic and massage industry.

Robert Granter, a leading educator in soft tissue dysfunction and a trainer at the Melbourne Institute of Massage in Australia, entered the profession as a patient. Robert says he was so impressed by the effectiveness of the treatment that he decided to enter into the field himself.

His dedication, which includes a dedication to the clients themselves, has taken him to several Olympics and Commonwealth Games events as a therapist and opened up many doors for him in his profession.

Commitment means a willingness to not only improve your therapeutic and remedial skills, but it also means being entirely focused on the client right in front of you.

Your clients know when you are inattentive. They will sometimes twitch and move in discomfort on the table. Too shy to say anything, they are hoping you will respond by either adjusting your method or asking a question.

If your mind is distracted with the cares of this world and your other responsibilities, that disinterest in your client will filter down into your fingers, and your client will notice it.

They may not say anything but their feet will do the talking and you won’t see them again.

Continue to Develop Your Communication Skills

One of the motivations your clients may have in coming to see you is to unwind through communication. Others want complete silence so that they can let their minds rest.

Your job as a therapist is to know, when, what and how much verbal communication to engage in.

Not only that but when you do speak you want your words to further the therapeutic process, not detract from it.

There are countless therapeutic schools which provide training in the technical aspects of Massage Therapy but nothing else. If you want a thriving practice, one that grows over time, then it is in your best interest to continue your training.

One of the ways that you can do that is to develop your therapeutic communication skills.

I have found the study of things like neuro-linguistic programming (NLP) and other similar therapeutic modalities to greatly enrich my clients experience as well as my effectiveness as a therapist.

Whatever form of remedial massage therapy you are involved in, your goal is to provide the most satisfying experience for your customers and your clients.

Take these tips and find ways to implement them and perhaps even adjust your mode of operation so that both your professional expertise and your business will grow.

Improved Listening Skills For Massage Therapists

 

I took this amazing course on communication a few years back and I have never forgotten the first thing the gentleman said… you don’t really listen now, you never have and you probably never will.

Wow what a harsh way to start a communication course, but in a sense and for the most part it’s true.

But when I learned all the things that were preventing me from really listening, I actually started to hear more clearly what the people in my life were trying to say and sometimes I really noticed the things that were missing in the conversation.

It’s been said, and I believe it to be true, that most of communication is in the listening.

Now in order to really understand this statement we need to include not only the words being said but also the tone of voice, the pitch and rhythm and although it may be controversial in some circles I believe real listening requires visual cues like body language, posture and the physical response to questions especially when you are looking at communication from the therapist – patient relationship.

To really understand what our patients are trying to communicate we first need to understand how (in the context of communication) the majority of the message is relayed by the patient.

Remember that different experts break down things in different ways so the exact numbers may be slightly different but the idea is very similar.

We can break it down like this

Only 7% of the total message is found in the words

– Up to 38% of is in the paralanguage (this is the pitch, tone and rhythm of the voice)

– The remaining 55% of the message is found in the body language (mostly facial expressions)

Now this does not mean we should ignore the words, it just means, to get the full picture we must be present and pay attention to a number of different cues while our patients are talking.

Blocks To Listening

Are you really listening to the other person when you already have an opinion about the person?

It’s kind of like looking at life through rose colored glasses.

We have so many opinions and preconceived notions about how things are and how people are that it completely invades our listening and hence how we relate to other people.

Some of the blocks to listening:

  • Mind reading: assumptions do not help us hear what the other person is actually saying, they are self-confirming beliefs.
  • Judging: Do I agree, do I disagree with what this person is saying are they right or wrong… these thoughts pull you away from listening they don’t help you hear what the person is saying.
  • Identifying: This is when you relate the speaker’s story to something similar in your life. This is a block to listening because you are not actually listening to their story so you may miss important details that are not in your story.
  • Filtering: This is only listening to the parts of the story that resonate with you and skipping over the parts that don’t.
  • Placating: Bypassing the tough parts of the conversation or saying things like “at least they passed at home or they are no longer in pain”… this is what we sometime do, not for the speaker but for ourselves to avoid our discomfort.
  • Advising: Thinking about advice we can give to help the person while they are talking is noble, but it can take us away from listening to what is actually being said.

These are just a few of the blocks to listening, there are many more.

But if you look honestly, you may see yourself in a few of these examples.

It is not bad and wrong to do these things, it’s just not an effective way of listening to other people.

Pseudo Listening

Pseudo listening is basically pretending to listen but not really listening to what the other person is trying to say.

The intention is NOT to listen, but to have some other needs met.

I know I am guilty of this from to time in my personal life and it has even entered my professional life occasionally.

This is something to be aware of, because only when we are consciously aware of something we have the opportunity to shift.

Some of the reasons we may be pseudo listening:

  • Sometimes we just want to be liked, so we try to give the appearance of listening intently.
  • In social situations we may be checking for signs of rejection.
  • With a spouse or an adversary we could be hunting for a specific piece of information.
  • Sometimes we are buying time  or rehearsing our response.
  • From time it is  Quid Pro Quo I am listening to you, so you will be listened to.
  • During arguments we may be listening for weak points; gathering ammunition.
  • Trying to be or look  good or nice.
  • Sometimes it’s as simple as not knowing how to leave without offending.

Think about the times you are doing this, were you really listening to the other person or were you so distracted by your own thoughts and motives that you completely missed what the other person was trying to say?

Real Listening

So what, you may ask, is real listening?

The Messages Workbook (a text we used to use in PD100), says that being quiet when someone talks does not constitute REAL LISTENING.

REAL LISTENING is based on the intention to do one of the four following things:

  • Understand someone.
  • To enjoy someone.
  • To learn something.
  • To give help or solace.

Intention has a big role to play in real listening, when you get out of the way, listen and watch the person in front of you listening will come easy.

Active Listening

In order to not only hear what the person is saying but also let them know you heard and understood what they said. You can use a three step process called active listening.

1 Paraphrasing

Paraphrasing is simply repeating what you heard back to your patient, but in your words.

In other words ….

So basically how you felt was…

Did you mean…?

Paraphrasing should be used any time your patients say something of importance about their pain, accident, injury etc.

2 Clarifying

We use clarifying to make sure we have understood not only what the person said but also the context.

When we take the time to clarify we show our patients that we want to fully understand the communication, we understand the impact of the situation and we are willing to put in the work to fully know and understand the person and the impact the condition is having on them.

3 Feedback

When we understand what has been said and we have clarified that we understand the context we can now give feedback.

This can be in the form of a treatment plan, a referral to another healthcare professional when the issue is out of our scope, or it may be reminding someone that compliance to home care is vital to the treatment plan.

Listening With Openness

Have you ever heard the phrase “ looking at the world through rose colored glasses”?

I have always believed that this points to the fact that we all have some idea of the way things should be.

This is right and that is wrong, this is good and that is bad.

All of these strong beliefs, thoughts and opinions change the way we listen to others. In fact, when we come from this place we are not really listening to the other person, we are just listing to our own opinion of what the other person is saying.

To really listen to other people we need to stop “shoulding” on ourselves and others, let go of our personal opinions and really objectively listen to what the other person is saying.

Photo by: Unsplash

Photo by: Unsplash

Listening With Empathy

When I teach this type of listening at VCMT I usually feel like I am preaching to the choir.

I really believe that the vast majority of people who have entered the massage therapy profession have done so as an expression of the empathy and compassion they already have.

Listening with empathy comes from an understanding that people, for the most part, are just doing their best to survive and all the crazy things they do are an expression of this.

I remember a few years back when a patient came into my office in severe pain, very short and almost angry.

He kept saying get me on the table we don’t have to do all this other stuff. I realized this man was just in pain and he really did not mean to be rude or short. I calmly explained that the interview and special testing was necessary to determine the approach I would be taking with the treatment and that the better I understood exactly what was causing the pain the more effective I could be in treating him.

To make a long story short, the treatment went quite wall and the man could not shake my hand enough at the end of the treatment.

Remember, no matter what the patient is expressing, its not personal.

People in pain can sometimes say things they don’t mean. Always come from a place of understanding, a place of empathy. Try to put yourself in their shoes, how would you feel if you were on the other side of the room? How would you want to be listened to and treated? I always tell my students that true success is not just about being the best technical Massage Therapist. True success is becoming a well rounded therapist with excellent communication, listening, knowledge and technical skills. I believe that a present compassionate therapist will achieve measurably better outcomes with all their patients.

Basic Communication Improvements For Massage Therapists

I always tell my students “when you get into the real world… you may be the best technical massage therapist but without great communication and listening skills you may not have the most successful practice”.

I remember when I was in Massage Therapy College, immersed in anatomy, physiology and manual skills (sometimes known as the hard skills) then once a week, we would go to a class where we worked on self-reflection, communication and listening skills (the so-called soft skills).

I know many of my classmates thought this class was a waste of time and completely irrelevant to the education they were now immersed in.

Me on the other hand, I love this stuff.

Over the years I have spent many hours in training and working on crisis lines, communication, conflict resolution courses and even peer counseling.

My passion for communication and listening came from, like many of us, a pretty tough childhood and teen years. When I was 12 years old a friend of mine took his own life.

Now (and to some extent then) in retrospect and had I known how, I may have been able to stop this tragedy. This event shaped my passion for listening and communication.

But this work requires a lifelong commitment with constant work and no matter how skilled you are, you may still miss things. This became all too real to me this January when at 4 am, my phone rang, it was news that another person close to me had taken their own life.

In retrospect, I could see the signs, but they were quite subtle. This is one of the reasons I am an advocate for communication and listening.

Now not all situations will be this intense but as healthcare professionals, we need to have superior skills in the areas of communication and listening and this is why I am writing blog posts on communication, starting with the basics.

Building Rapport With Massage Therapy Patients

One of those make it or break it skills for all Massage Therapists.

If a patient does not feel comfortable with you in the first 20 seconds it may hinder your ability to really help them.

Some of the things you can do to help build rapport are:

  • When you first meet the person look them in the eye.
  • Call them by name (sometimes it’s best to ask an elderly person permission to call them by their first name.)
  • I normally shake the person’s hand.
  • I always check if they need to use the washroom before we get started.
  • Invite them into the room.

Remember most of the communication is not the words, in fact more than 50% of communication happens in the body language and much is also connected to the tone or rhythm of the voice.

  • Be on time, nothing destroys rapport more than always being late.
  • Watch their face, do they look calm?
  • When you go to shake their hand do they pull away or do they move towards you?
  • Is their voice quiet and timid?
  • When you make eye contact do they hold your contact or look away?

The best way to build initial rapport is to meet them where they are.

Don’t hold eye contact too long if they are showing signs of being uncomfortable, give them space if they pull away and meet their tone and rhythm of voice with yours.

The Interview

Set up your treatment area so it’s calming but professional.

Remember the power differential, if you sit and talk to your patient (at eye level) it is less threatening and can make the person feel more comfortable in your presence.

Utilize the space between you and the patient, if you are too far away you will seem distant and uncaring, being too close might make the person feel defensive, I find 4 feet seems to be a good distance.

Take notes during the interview and special tests but do not allow your note taking to interfere with you being present with your patient.

  • Be professional at all times.
  • Be present at all times during the interview.
  • Use clear communication.
  • Avoid using slang and overusing of technical terms (or educate the patient so they understand).
  • When a patient says something important, paraphrase (repeat back what they said to you) so they know they have been heard.
  • Clarify what they have said so you understand what they meant.
  • Get a detailed history around their general health, details of the current issue and any pain related questions or physical limitations due to the condition.
  • Ask them what their goal for the treatment is.
  • Finally ask the patient what they would like you to address today (every so often I have a patient come in and describe many health concerns, then, when I ask, they request work on an unrelated problem).

The interview is your opportunity to recognize any contraindications that your patient may have, create a hypothesis for the condition you believe is affecting your patient and consider the level of special testing to either confirm or rule out your clinical reasoning around your patient’s complaint.

The Assessment

We as Massage Therapists are very well trained in assessment using range of motion, manual muscle testing and other various special tests to confirm or rule out conditions.

We have to remember that every patient is unique and just because the last three people had back pain due to trigger points in the gluts, it does not mean your next patient has the same issue.

A good assessment can narrow down the cause of the issue, help speed up recovery time and most importantly get our patients get back to their normal activities.

  • Consider a test that could confirm and a test that could rule out the condition you suspect.
  • Remember to ask permission before placing your hands on the patient.
  • Explain your special testing before you do it.
  • What you are testing for?
  • What a positive result will feel like?
  • Always test the unaffected side first.
  • Be honest with what you find.
  • Remember as a massage therapist it is not within our scope of practice to diagnose a condition, although we can state that the patient is presenting signs and symptoms consistent with a condition

A thorough assessment will help create confidence from your patients, reduce recovery times and help the profession by creating consistency in massage therapy treatments.

Photo by: StartupStockPhotos

Photo by: StartupStockPhotos

Create Your Treatment Plan

Now that you have the history and have done assessments, the next step is to create a treatment plan.

For this treatment, then for subsequent treatments and the home care exercises (stretching and strengthening) hydrotherapy and any changes to activities of daily living.

When you give patients a solid treatment plan they are more likely to trust you, follow the plan and recover more quickly.

This is where research and experience comes very handy, if you understand the condition and the length of time the patient has been affected by it you can start formulate a plan.

When my patients come in with an acute issue I normally start them off with one treatment per week for four weeks then we reassess and back off from there but this always depends on the condition.

  • Discuss the techniques you will be using and why.
  • Discuss the areas of the body you would like to work with and why you recommend working with these areas.
  • Discuss a pain scale or intensity scale.
  • Discuss the possible side effects or complications of the treatment.
  • Discuss the level of dress.
  • Get consent to treat.

I always check in and regain consent when I am about to work with a more sensitive area like the gluts, lateral rotators, abdomen or the adductors (especially with new patients).

We are also required to monitor the intensity of treatment with the patient, so I always check in to ensure the treatment is not too intense (I am 240 pounds and have very strong hands), some patients may not tell you it’s too much unless you ask.

Before you leave the room to allow the patient privacy to dress down and get on the table, remember to discuss the level of dress and how to get on the table between the sheets with their face in the headpiece.

Don’t assume they understand the routine.

I have heard stories of more than one RMT returning to the room only to find the patient naked on top of the blanket.

Knock on the door before you re-enter the room, this way you can be sure the person had enough time to get on the table.

There is a debate in the world of massage if we should talk during the treatment or not.

I always say the difference between getting a massage and getting a massage therapy treatment is the fact that we educate the patient. After I know a patient and if they prefer I will talk a lot less during a treatment. Remember to keep your conversation within your scope of practice. Many of my students have asked me why I should be concerned about what I say or how I say it in my practice. We have to take into consideration the dynamic of the session and balance of power in a treatment. The patient (in many circumstances) is naked or nearly naked on the table (covered by sheets and a blanket) we, as the therapist, are pretty much towering above them speaking down to them. The patient (depending on the treatment) may be in a very relaxed or semiconscious state and these facts could possibly put the patient in a little too open state and cause them to believe what we say without question. At the end of the treatment,  give everyone some form of home care and ask permission to send a follow up email with pictures, videos and details of the stretching and strengthening exercises.

Using Evidence Based Practice To Avoid Fear Tactics

Sometimes I just have to shake my head.

I’m sure we’ve all heard the same kind of things in our clinics when patients go to other practitioners.

“I have compressed discs in my spine, I’m out 14 degrees here, 12 degrees here and 8 degrees here”

Yeah, I probably have all that too, but I’m not in any pain. 

“I went to this other therapist, and they said I’d probably never get better”

Well that’s not true.

Then there’s my favourite (I wish there was a sarcasm font).

“Well the muscle pain you’re having stems from something that happened when you were a child, it’s going to be really hard to get rid of it”

I’m sorry about whatever it is that happened, but that is going to take some counseling to help, you should talk to your doctor about a referral to a mental health professional to get the appropriate care.

Sometimes I wanna phone up these other practitioners and ask what the hell they are doing saying things like that to a patient but apparently I’m supposed to be professional or something. 

Instilling Beliefs In Patients

As therapists we play a role in which we can be either effective or detrimental.

There is a strong correlation where what we say to a patient has a huge impact on their improvement or just instilling fear that makes them have to keep coming back in for more therapy.

Unfortunately instilling fear in patients with the language we use has become more of a marketing gimmick than using our words to help a patient. 

This is called the “Fear Avoidance Model”.

The fear avoidance model shows that patients can develop pain as a result of fear and avoidance behaviour. Typically it is referring to a patients fear of movement as it might cause pain.

However studies have shown how this model can be developed in other ways.

If a patient can’t make sense of the pain (which is part of our job to explain to them), have some societal beliefs associated with past experience or have a diagnosis of something that can’t be fixed are all things that can be associated with this fear avoidance model. 

If a patient comes in for treatment and already has some of these underlying issues, we have the opportunity to either correct or reinforce what is going on with them. 

We can have a strong influence on those patients beliefs and in turn can influence those beliefs in a positive (or negative) way.

If we decide (and it is a decision on our part) to use negative language like “tissue damage, out of alignment, or structural problems” we can change a patients beliefs for many years to come. One study showed that it can even lead to feelings of increased vigilance, guilt and worry.

The same study showed that if we take an approach of providing reassurance, which increased confidence we could positively influence a patients movement and activity.

So, imagine if just the way you communicated with your patients, made them want to adhere to their home care and gave greater outcomes overall in their treatment?

Photo by: PublicDomainPictures

Photo by: PublicDomainPictures

Improving Communication For Better Outcomes

So where do we go from here?

We are always going to have other therapists and practitioners who use scare methods like I mentioned at the beginning.

I’m pretty sure a little piece of me dies inside whenever a patient tells me about these things they’ve been told. 

In the case of the patient saying they have compressed discs and are out of alignment, well I’m pretty sure if they x-ray’d me they would find the same thing however I’m not in any pain. In fact Todd Hargrove wrote a great article on the topic that we have used on this site, which you can read here and is a good reference to show a patient when they are worried about imaging and disc issues.

The way we communicate has to involve positive reinforcement, with good explanations of what is going on with the patient.

Being able to describe to them that pain is just the nervous system reacting, not tissue damage, is a hell of a lot better than reinforcing some old beliefs or scare tactics.

There is a new model of rehab being developed that outlines four elements that could lead to better outcomes:

  1. Knowing the person and building a supportive relationship
  2. Effective education and information exchange
  3. Goal setting and action planning
  4. Fostering positive, realistic, cognitive and self framing.

Those four steps represent a golden opportunity for us as Massage Therapists. 

All four steps are well within our scope of practice and we quite frankly have the opportunity to reinforce those steps more than any other practitioner due to the time we get to spend with patients. Because we get to spend so much time with our patients our ability to build that supportive relationship is paramount to what we do.

Even being able to read the mood of our patient who we have built that relationship with can make a difference in the outcomes of their therapy.

As much as the terms “evidence based”, or “research based practice” gets thrown around (I know some of you don’t like it), there is sound justification to making this a part of your practice. Research is actually showing us the importance of how we communicate with our patients. There is even studies that show how contextual factors like a therapist and patients features can contribute to outcomes. Now I know there is no way you can do anything about your features, but you can do something about all the other things we discussed. Staying up to date on new research, working on communication skills and not being afraid to “forget” some of the things we used to know goes a long way to establishing ourselves as the more trusted source of therapy in our communities. Being able to educate a patient when they come in, helps to build that supportive relationship and puts you at the forefront of their healthcare as a professional. Help your patients to set goals aligned with their home care by making them positive and realistic. Our biggest job is always going to be education. Educating our patients and explaining what is happening to them is a key factor in getting them back to their activities of daily living. Unfortunately as other practitioners use fear to market their practice, they make our jobs just a little bit tougher.

Tips For Writing Amazing Massage Therapy Blog Posts

The first one took me hours.

I mean loooong hours to write.

I hired a professional writer I know to help me get into this whole writing thing, read books on it and even debated taking some classes.

My professional writer friend gave a great piece of advice when he looked at me and said:

“Jamie, writing is like a muscle, you have to use it and develop it to make it strong”.

Blog articles still took me hours to write, I wanted them to be perfect (but honestly not one of them ever has been).

However as time goes on things got a little easier, sort of like a new workout program. At first you’re sore all week, then a month later you’re getting a bit of a high after each workout and the pain goes away. But just like that workout, it’s usually better if you have someone coaching you and helping you.

So here are some methods to help you start getting some blog posts out for your clinic.

Getting Started With Massage Blogging

Before you get going, make sure you are setup to be distraction free and in a comfortable space.

Choose whatever you like best, computer or pen to paper. If it’s pen to paper you prefer, get yourself a really nice smooth writing pen to make it as enjoyable as possible.

If it’s keyboard you prefer, do your best to stay disconnected from the internet so you’re not tempted to constantly check Facebook, twitter or play angry birds.

I always like to have a really good cup of coffee and put some music on.

I know some people like to put on some hip-hop or reggae, but for me it’s George Strait.

Okay, now that you’re set let’s get going.

Telling Your Story

While blogging is a great way to educate your patients, the real thing you want to do is entertain them.

Tell them a story, tell them your story.

If you’ve been following this blog for a while, I try to start every post off with a story as it is a great way to intrigue a reader (and hopefully keep them reading),

A good example is the post I wrote about dealing with someone who has had a stroke. I started off the post talking about a real life situation where I helped a friend of mine who suffered a stroke. It’s effective because it gets the reader involved and adds more weight to the post than me just simply saying: this is what you will see.

“It was around 1am Monday morning, when I realized there was an issue.

That night, something seemed different but nobody else really noticed. Standing with his arms crossed almost supporting one arm with the other, our conversation seemed confused as he constantly gazed at the floor.

As we walked to the First Aid shack for a coffee, I asked how he was feeling:

“not good”

How was the weekend?

“I don’t remember, apparently I didn’t show up to work on Friday”

Did you leave the house to go to work that day?

“I remember dropping the kids off at school Friday morning, but that’s really the last thing I remember”

As we kept talking, his slurred speech became more noticeable. When he relaxed, those crossed arms became one crossed arm and one seemingly limp arm. Looking into the eyes and face of this normally strong, athletic man there was something missing. His left side was almost motionless, wilted.

Can you lift your arms above your head for me?

The right arm went up, left one didn’t move.

Can you kick your legs out for me?

The right one kicked out, left one stayed put.

We need to get you to the hospital.”

Seeing how this person moved and was reacting to our conversation paints a better, more realistic story than me just explaining what the symptoms of a stroke are.

So if you were doing this as a post for your clinic, using a real life experience of how getting a massage has helped you in the past, or how you have helped someone else with a particular condition. It will make your reader engage and think “yeah that’s exactly how I feel”, now you’ve hooked a potential or current patient who recognizes you as the professional and the Massage Therapist who can help them.

Always try to lead with a good story.

The Disney Method For Massage Therapists

One of the toughest things about writing is how hard we are on ourselves.

If you’ve ever tried to write anything there is a constant voice in your head saying:

“that was terrible”

“no one is going to read this”

“you’re like the Adam Sandler of serious writing” (okay maybe that one is just me, but you get the point).

This happens to everyone when they start trying to write, it’s our internal editor and it’s harder on us than anyone who reads our writing.

The hardest thing to do is turn off that internal editor, but to start that’s what you have to do, you can edit after you’ve actually written something down.

The Disney Method is how Walt Disney used to come up with ideas and he made it a three phase process.

It consists of:

  1. The Creative Phase (or dreamer phase)
  2. The Realist Phase
  3. The Critical Phase

Once you start to practice this, it can make the whole process of writing a blog a lot less daunting and time consuming.

1. The Creative Phase

Pick a topic, it doesn’t have to be fancy, pick something about massage therapy you’re passionate about and know a lot about, it’s a good place to start.

Just start writing.

Write with reckless abandon, like there is no chance anyone is ever going to read this.

Turn off that internal editor and just let whatever thoughts are in your head pour on the page or the keyboard, whatever your choice is for writing.

Be the most creative you can be, don’t worry about spelling, grammar, mistakes or anything and for god’s sake don’t hit the delete key. Use whatever tone comes natural to you because at this point it doesn’t matter, just let it pour out.

In the example I gave about the person having the stroke, when I sat down to write that, it was full of swear words (I kinda have a mouth like a sailor) because I remember that night and couldn’t believe my friend and mentor was in that condition.

It was a rough and I mean rough draft.

But that’s fine, you can clean up anything you write in the next phase, but you have to get that first draft out.

2. The Realist Phase

In the realist phase you want to make sure your story flows.

You’re going to go through and edit that rough draft with very broad strokes to make sure your story makes sense. Don’t worry so much about grammar and spelling at this point, just see if sentences need to be changed to give the story some real body.

Does a sentence work better a few paragraphs up or down?

Does a paragraph need to be moved?

Just shape your story to make sure it flows in a logical sequence and put the big pieces together so it makes sense to your reader.

In the stroke article, the story was the introduction, then the body of the post was video that gave instructions on how to deal with a stroke in your clinic. Go through your post and make sure the story ties in to what you can do for your potential patient with whatever topic you picked.

Now  your potential patients are starting to put together how you can help them and why they should be coming to you for treatment.

3. The Critical Phase

Now it’s time to rip things up.

Go through and get ruthless with your editing.

Sentence by sentence trim what isn’t needed. Line by line slash what isn’t needed.

Take out any and every word that isn’t needed.

See if you can take as many words as possible out of each sentence without changing it’s meaning or tone.

When people are reading blogs they skim through them, it’s rare they get read word for word (seriously, you aren’t reading these posts word for word!?).

Go through and take out the word “that” wherever possible along with phrases like “in other words”. And don’t ever say things like “in my opinion”, we know it’s your opinion, you’re writing it.

You get to be creative in the first phase, but now is when you need to be critical (but don’t be super hard on yourself, remember writing is a muscle).

This is also a good place to go through and add any research you think is applicable that you have done for the post. It’s always good to add some kind of research into a post to give it legitimacy, especially if you’re writing for patients, it will reinforce you are the professional.

When adding your research to a post, you don’t have to use specific referencing styles, you can just add hyperlinks in the appropriate text of your article.

It’s a blog, not a research paper.

Photo by: fancycrave1

Photo by: fancycrave1

Coming To Conclusions

Now that you’ve gone through and edited things and the post is looking great, you’ll need to come up with some sort of conclusion.

A conclusion is a great way to wrap up the post and highlight the main points.

The conclusion is also a great way to leave an impression on your reader. Always try to leave them with a smile on their face, it will make them want to come back for more. This is how I wrapped up that post on dealing with strokes:

Later that morning I went to the hospital to check on him. As I walked in the room he looked at me and shouted to the nurse:

“Hey nurse there’s the little jerk that sent me in here” (they had him on some pretty good stuff)

“You should thank that little jerk, he saved your life”

I’ll be honest, that took some editing because the language he used was a lot stronger than “little jerk”, but you get the idea. While it can be tough getting into blogging for your massage business on a regular basis, if you start making it a practice it will get easier. If you try writing and you get stumped, take a break and go do something else, go for a walk, play angry birds for 15 minutes, just get a break. It’s amazing how much your ideas and writing can change with even a 10 minute break. Also, don’t be too hard on yourself if the first one takes you a bit of time. Set a timer for 20 minute time intervals. Use each interval to go through the Disney method to be the creative, the realist and the critic. See how your article looks after each time interval and continually build it up until you’re happy with it. Feel free to share your posts in the comments below when you try it. Hopefully before too long we’ll be able to get a guest post on theMTDC from you.

Avoid Becoming A Bully Massage Therapist

He pulled me to the side and I was immediately uncomfortable.

It used to happen all the time. One of my friends dad when I was growing up was a bully.

He was REALLY old school and believed that he was always right. It didn’t matter if he was blatantly wrong.

The worst part was when he would force his opinion on you and expect you to respect whatever his opinion was. He would regularly use intimidating factors to push his way around, especially if you ever had the nerve to question him.

Then the day came that I had enough. 

When he pulled me aside that day, we were at a graduation party in a different town and he didn’t like the environment and the way other people were conducting themselves.

The reality is he just didn’t understand their culture so that made it wrong in his eyes.

However, he was going to enforce his opinion and demand this group of people change their behaviour and do what he thought was appropriate. The worst part was, he wanted me to go tell them to change, he didn’t want to do it himself.

I got my back up and wanted to go toe to toe with him (except he was way bigger and I don’t know how to fight). When I told him I wouldn’t have anything to do with it, he got angry and I mean really angry. He got in my face and looked at me saying “I’m a parent, not you, what I say goes”.

I had to put my foot down and tell him he could do whatever he wanted, but I would have no part of it.

A Balance Of Power

In this case there was a major imbalance of power.

This guy thought he had the right to impose his opinion on not only me, but every other person who was at this graduation party.

The problem is, he was blatantly wrong.

According to bullyingstatistics.com these type of people use their strength or position to harm, control and manipulate others, especially when those others have a difficult time defending themselves.

Do we consider this when we are dealing with our patients? Is there a balance of power there?

According to the College of Physical Therapists of BC “There is an inherent power imbalance in favour of the physical therapist, because the physical therapist has a disproportionate amount of knowledge compared to the patient, and the patient relies upon the therapist for care”

When we have a patient on our table we have to be careful of our communication and whether we are expressing opinions or fact. The two could be easily misinterpreted.

We must not impose our opinions on our patients.

It’s not only wrong, it’s against our ethics as Massage Therapists and healthcare professionals.

We see a variety of patients every day who walk into our clinics, some of us see a new person everyday, especially when we are trying to build our practice. Regardless of your background each one of the people who come to see you have a different background or come from a different culture that you may or may not be familiar with.

Whether we disagree with their lifestyle, religion, sexual orientation or anything else, we are medical professionals that must treat each person the same regardless of our opinion.

This also applies when speaking to them about other healthcare practitioners. We have to choose our words carefully. 

We have all wanted to look at a patient and say “well your doctor is an idiot” but again this would be expressing an opinion, which could be potentially damaging to not only our relationship with the patient, but the relationship they have with other practitioners.

Remember the patient relies on us for care, not our opinion. 

Applying Research

Staying up to date on research can be a difficult road to navigate.

Quite often it is going to challenge some long standing beliefs we’ve had, which can also change the way we treat and our relationship with a patient. 

However it is part of our responsibility as healthcare professionals.

I saw a quote on Facebook the other day where someone said they had lost the passion for their practice because research has proven a technique they loved wrong. This could be debilitating for some, especially when we are talking about some long standing beliefs.

It is important to understand that the technique hasn’t necessarily lost its effectiveness, but our explanation of what is happening has to change. If our understanding has changed and we don’t relay the information to our patient this could be considered a form of harm.

Our patients look to us to stay informed and assume that we are doing everything in our power to provide quality care.

With so much information readily available to us nowadays we should be able to find a few ways to incorporate research into our practice for the benefit of our patients.

Whether it’s via Facebook groups, blogs or just searching for research online we should be making this part of our regular practice.

Take some time and check out a couple of blogs and websites. A few that I like are painscience.com, the international journal of therapeutic massage and bodywork, pubmed.com and rmtedu.com which all have some great information on various areas of research and evidence based resources.

Photo by: Foundry

Photo by: Foundry

Communication Outside The Treatment Room

“If I wasn’t standing there, they would have had my daughter booked in once a week for the next two months!”

When I hear things like the statement above I think a little piece of me dies inside.

There is a drastic difference between a treatment plan and fear mongering.

Telling patients that they must come in for extended periods of time, without even knowing how a person will react to your treatment is a bullying tactic and it has to stop.

So does using terms like “well I only have one spot left, so you better take it before it’s gone”.

I get it, we all want a full practice but trying to tell someone you know how their body will be reacting two months down the road isn’t a treatment plan, it’s ego.

A proper treatment plan involves continual assessment and re-assessment to gauge progress.

As we move towards a patient centered healthcare system, these choices will more and more be the patients decision. Laying out a sound treatment plan and then incorporating the patient as part of the decision is how we will gain more respect in our medical community. 

A patient should never feel pressured in making their healthcare decisions. We have to remember, even though it may not seem like it, there is a balance of power between us and our patients. We have responsibilities not only with our treatment but also in the way we communicate. Using any kind of communication where a patient feels pressured to book back in is an abuse of that power differential. As we strive to be more a part of mainstream healthcare all of these factors come in to play. Staying on top of relevant research can be intimidating but it improves not only our relationship with patients but also with other healthcare practitioners. It is our duty to stay informed and keep our patients informed so they can make the best decision for their healthcare. Just make sure you’re never in a position where a patient has to put their foot down with you.