Articles Of The Week November 10, 2019

This one hits close to home but is amazing to see. Last year in Canada a junior hockey team was in a severe bus accident that killed some and left others paralyzed. With a new surgery, one of those players who were left paralyzed is actually moving his legs due to an implant that stimulates certain nerves.

“Paralyzed Humboldt Broncos player moves legs after experimental surgery in Thailand” – Joel Dryden

I always find this topic interesting, what does ‘deep tissue massage’ really mean? Another way to look at it is does this really matter? Should we be focusing on the modality or the person?

“Swedish or Deep Tissue Massage: What Do These Terms Really Mean?” – Nick Ng

Have any bad habits? I have about 1000 of them, so I could lend you one if you need it. However, this is probably a better approach, stopping bad habits. Here are nine ways you can stop them.

“How to Stop Bad Habits: 9 Scientifically Proven Methods” – Leon Ho

Here is a curated list of open access case reports on various topics surrounding massage therapy and it’s use. It might save you some time while looking for research.

“Open Access Case Reports For Massage Therapists” – Richard Lebert

As business owners, we are always looking at ways to market our business (even when it’s super busy at the end of the year with people trying to use up their benefits). So here’s something to share…reasons to give and get massage therapy as a gift.

“15 Reasons To Give (and Get) Massage as a Gift” – Raechel Haller

Anxiety, Crisis, And Recovery As A Massage Therapist

 

**The author of this post asked to remain anonymous, however, it is such an important topic we thought it VERY important to share and I can’t thank them enough for being brave enough to write this for all of our benefit. 

 

I made the mistake of going to a cadaver anatomy class, not really thinking if it was something I was fit to be doing, and signed up like you would any other continuing education.

I was at the height of a generalized anxiety disorder crisis that had been building for months, and my cognitive functioning was not letting me make the best choices.  I also failed to mention it to my psychologist who I had been seeing for three months and have a great relationship with. 

It wasn’t until I walked into the cadaver lab and the smell hit me, and I saw the people in bags on the tables that I realized I might have made a bad decision.

The bodies all looked like my Father, who I watched die and be put into the same bag two years before.  I was surrounded by them, laid out on stainless steel tables among buckets of tools from the hardware store and fans.

For some reason, because the money was non-refundable and I needed CEUs, I  justified staying when I should have left. I stuffed my nose with vaporub, put on a mask, and took breaks every 15 minutes.

We were able to touch, move, and dissect.

I kept my distance and observed, and forced my way through. There are many things I saw, which I feel today I should not have exposed myself to, although there are a few things I learned that were positive and do inform my massage therapy practice.

After throwing out my clothes and changing in the bathroom, I was tired and worn out. I drove home, showered, and went to bed.

Anxiety And Spiraling Negative Thoughts

The next day I was in shock without really understanding I was, I took a walk down to the lake. As I was walking I had some anxiety-provoking conversations on the phone with family and was in a complete daze.

As the day wore on, I got more and more anxious, and by 10 pm I was holding on just waiting for my partner to get home from work. Something snapped in me, feeling like I was full of anxiety on the inside like a container and it was everywhere all around me, there was no escape. 

I left the house and started walking really fast, blindly retracing my earlier walk. I was going to throw myself into the lake to escape the anxiety, thinking that hypothermia was the only way out.

I got to the lake but I could not see how to get in because it was dark and I was on an edge with a rock wall and vegetation, I didn’t want to mess it up. If I was going to do this I had to get it right. Delayed in confusion, I sat for a while on the ground.

Just then my partner called me.

I had left them a voicemail saying I was sorry and I had done everything I could, but it was too late. 

They kept alternating in a calm voice asking me where I was and telling me they loved me until I was able to respond and say where I was.

They came to get me and brought me to the hospital where I was put on a 17-hour hold. This was on a Tuesday when I was supposed to be in my university classes. On Wednesday I was let out and had an appointment with my psychologist, and was unable to really think or move or speak and was just wiped out mentally, emotionally and physically.

Massage Therapy Providing Comfort

The only thing I knew to do then was to keep moving through the things I normally do and had set up for the week, despite fully letting go of everything and giving up in my head.

I let myself physically go through the motions of doing things. On Friday I had a hair appointment, and the following Monday receiving a massage.

The feeling of being physically handled when you have given up is a thing I can’t describe. It’s like you have decided to fall into a giant hand and let it protect you. During each, I knew I could no longer comprehend caring for myself and was relying completely on the outside world, and the people touching me and making contact. 

It was complete helplessness with someone holding on to you.

I sunk deep into those hands and the relief I experienced with being able to shut down for a while and let others take over is the deepest relief I have ever felt in receiving massage and compassionate touch. I also kept all of my massage client appointments during this time, no matter how I felt or how long it took to get me to work. Once I was at work, I threw myself into my work and found extreme relief caring for others.

I spent most of the year working with my psychologist unraveling my anxiety that was now paired with suicidal ideation. 

I am proud to say that my anxiety is very much managed with my preventative care as well as my suicidal thoughts. This involves being vigilant about checking in with myself about my stress and anxiety levels, and determining what I need in terms of self-care for the day, and following through. I also make time regularly to reach out to the supportive people in my life and connect.

Showing up no matter what to my massage appointments and doing the work saves me, connects me to clients through touch and our therapeutic relationship. No matter how I am feeling, generally within 20 minutes of working on someone I feel better, and a day at work always makes me feel great, as well as the clients. I am so grateful there can be comfort on both sides, and I can make a massage session all about the other person while receiving human connection. I am also thankful to have worked with an amazing psychologist during that time and having school to occupy my mind, and a fantastic partner.

Massage continues to save me. Those days that I wake up and feel not quite like myself, when I get to work and focus on clients it brings me back, and generally, at the end of the day, I feel amazing and lucky. I also continue to feel a tremendous amount of relief from anxiety as the massage client.  I am unsure if it is the connection to people, or the actual massage process, or both that brings relief to me. I am grateful to massage therapy for helping my clients and helping me. 

If you are struggling with anxiety or suicidal ideation, it is important to reach out to someone. It can be difficult to break through the guilt and shame or even be able to talk about it. But, taking the first step is necessary because it is difficult to think clearly in that temporary irrational state, and you need the help of someone else to get through it. I have learned you don’t need to explain, just be clear and direct, and say, “I am having thoughts about ending my life.”  Start with calling or talking to someone you know, or if you can’t, go to or call your nearest community mental health center, or hospital emergency room. There is also calling 911 or the National Suicide Prevention Hotline, 1-800-273-8255 (U.S).

If you know someone that struggles with suicidal thoughts, call and check in with them occasionally, or spend some time with them. What keeps people well is human connection. 

 

Articles Of The Week November 3, 2019

 

It’s one of my favourite words and one of the most important things we can instill in our patients. Resilience.

“Resilience” – Adam Meakins

As business owners, it’s almost inevitable, we’re going to get the odd negative review (but hopefully rarely). But, is there really much we can do about it? While something called the “Consumer Review Fairness Act” may limit what we can do, there are still some options.

“Why You Can’t Stop Negative Reviews: Understanding The Consumer Review Fairness Act” – Erin Jackson

I’m sure it’s seen everywhere in health care, but it feels like we may face pseudoscience a bit more than others? At least it feels this way to me. So, why do so many people fall for it, and what can we do about it? A number of things, but working on our communication is a good start.

“Why People Fall For Pseudoscience And How Academics Can Fight Back” – Sian Townson

We shared one of her articles last week and she’s at it again with this great post on helping people with something called a “Window Of Tolerance” so we can understand how to work within a person’s tolerance, depending on what they are facing.

“The Window Of Tolerance And Massage Therapy” – Jennifer Fleming

This is great to see! Great that some organizations are changing with up to date research for the betterment of patients. They are opposing the use of degenerative disc disease as a diagnosis for back pain as this is a normal part of aging and not related to a disease.

“AAOMPT Opposes Use Of ‘Degenerative Disc Disease’ As Diagnostic Term For Neck, Back Pain” – Kate Anderson

Why Your Body Is A Hypocrite

What you see is affected by what you know, and what you hear, and what you touch, and vice versa. This is an example of multi-modal perception. The brain is very complex, and all its different parts integrate and share information acquired from any source – eyes, ears, touch, memories, predictions, expectations, Facebook, etc. We often think pain relates only to “issues in the tissues” but in fact other sources of information about the state of the body matter as well. It’s all connected.

Or is it?

I am currently reading a great book by Robert Kurzban called Why Everyone (Else) Is a Hypocrite. The title is a little bit misleading because the book is not so much about explaining why people lie, but more about working through implications of the modular theory of mind. Kurzban is an evolutionary psychologist, and one of EP’s main theoretical claims is that the mind is modular, meaning that it evolved to have certain specific competencies, as opposed to a general all-purpose problem-solving intelligence.

This idea is best understood in reference to creatures that are far less intelligent than humans, such as spiders. Spiders are architectural geniuses when it comes to building webs, and are also very good at solving problems related to getting food, avoiding predation, and finding mates. But outside these specific contexts, they are idiots.

Natural selection provides living things with specific cognitive competencies, not general all-purpose intelligence. We can look at the mind as a smartphone with various apps, or a swiss army knife with separate tools. Humans have far more computing power and apps than spiders, but it is the same basic modular operating system, which is why we are amazing geniuses in certain areas, such as motor control and language (where we outperform any computer), and not so strong in others, such as math computation (where we are put to shame by simple calculators.)

Kurzban’s interesting twist on this idea is that the different modules don’t necessarily share information with each other. They often work independently, and mistakes in one area can’t necessarily be corrected by more accurate information in another. He uses two common visual illusions to illustrate.

What do the dots in this picture show?

Hidden-Dalmatian.jpg

If you don’t already know the answer, you might struggle for a few minutes before you “see” the dalmatian. As soon as you know what’s in the picture, you can see it almost immediately, and in fact, it becomes hard to “unsee” as well. According to Kurzban, this means that a conscious module in the brain shared information about the picture with a visual processing module, and this affected its computations and therefore your perception of the picture. For similar reasons, this is why wine tastes better when we think it is expensive, and pain hurts more when we think it is caused by major damage in the body, as opposed to some innocuous healing process. But “top-down” information sharing won’t always change your perception.

Consider the checkerboard illusion. Squares A and B are actually the same color!

Figure-ground_Organization_2.jpeg

There is a visual processing module that processes a ton of information to provide you with this (incorrect) perception. It considers the location of the cylinder, the shadow that it casts, the regularity of the squares on the checkerboard. Based on all of this computation, it “decides” that the squares are different colors, and therefore you see them that way. You are never provided with the “raw data”, the set of assumptions, or the thinking process that led to this conclusion. You just get the final product – a mental picture showing the squares as the same color.

And, interestingly, your conscious knowledge that the squares are in fact NOT the same color does nothing to change your perception. Unlike the dalmatian photo, conscious knowledge is not used by the visual processing module to make your perception more accurate. So the illusion remains. According to Kurzban, this is evidence that the work done by the modules is often fairly independent, immune to correction or maybe even input from other modules that know better.

(This is part of why Kurzban thinks we can be hypocrites – there is a social relations module in the brain – a public speaker – whose priority and function is giving you high social status. It doesn’t really care or maybe even know about information located in other modules of the mind, which proves that you aren’t as smart or moral or innocent as you claim in public. The separation of the modules creates “strategic ignorance.”)

Now consider this idea in the context of pain. Sometimes our knowledge and conscious thought processes about the body will affect how a body part feels. If we think that a body part is broken, degenerated, falling apart, unstable, this can make pain worse. And if we think that our body is robust, strong, and capable, this can make us feel better. This is multi-modal perception – sharing of information between the different modules. It explains why in the Dalmatian picture, conscious knowledge about the meaning of the picture affected our perception.

But pain is unfortunately sometimes more like the checkerboard illusion – immune to logic. People often have pain in areas where there is no damage, and sometimes in areas where there aren’t even body parts! Having conscious knowledge about these facts sometimes cannot affect perception. In terms of modules, we could say that the pain module is just not very interested in hearing corrective information from the cognitive modules. It was designed to be strategically ignorant about their conclusions. This is frustrating, but I think an interesting theoretical way to look at the problem of pain having “a mind of its own.” If the pain module won’t “listen” to the more cognitive modules, which modules might be better at speaking its “language?” The movement modules would be first on my list. If you move in a way that demonstrates strength, endurance, or skill, you will get a visceral “bottom-up” feeling of safety that speaks a different and more powerful language than Stuart Smally-style top-down daily affirmations.

Articles Of The Week October 27, 2019

 

The number one reason patients come to see us is to help them with their pain, which makes it important for us to understand how pain works and in turn how we can help them. This is a great post that shows us how our brain and central nervous system modulate pain and how it applies to us.

“Descending Modulation: Why Massage Therapy Can Alleviate Pain” – Mark Olson

While it’s important to share content on therapy topics, we are all in business, so it’s great when another therapist shares what they’ve learned from making mistakes. Here’s some help on what you can do with SEO for your therapy website. 

“An SEO Odyssey” – Jennifer Fleming

For those of us who work in sport (and perhaps some of us who don’t) how many times have you been asked for a “leg flush”? Well this stems from some old school thinking that we could somehow flush toxins, more specifically lactic acid out of the legs to help with recovery after exercise. Well, we can’t actually do that and this post gives us some great clarity on that. 

“Mythbusting: Massage Removes Lactic Acid” – Daniel Wonnocott

We are constantly recommending self care to patients, but how often are we taking it ourselves? Another question is, are we taking the right type of rest? It turns out there are seven types of rest we need and different ways to get it.

“The 7 Types Of Rest You Need To Actually Feel Recharged” – Molly Shea

When you’re working with female patients do you interact or communicate with them differently than male patients? Are the narratives we use different between genders? According to our friend Ellie Somers, there is.

“Considerations for Female Athletes Part 1: Fragility Narratives” – Ellie Somers

Learn How Community Involvement Can Improve Your Business

 

Absolute Therapy is a clinic in Victoria BC, home to an amazing team of fifteen talented practitioners and a collaboration-based treatment environment that epitomizes the ideals of client-centered care. 

However back in 2010 during our humble beginnings, I was the clinic’s sole practitioner – it was just me. With a brand new lease in place and tenant improvements complete, it was time to sink or swim. 

I knew I loved being an RMT, but how would I fare as an entrepreneur? How would I succeed? Well, there’s that old saying: it’s not what you know but who you know.

Anyone who has spent any time in Victoria will tell you that despite its size, it behaves very much like a small town, so to me, just getting out and getting involved seemed a good place to start.

Getting Involved In The Community

I started by offering free educational opportunities (about injury prevention, stretching, workplace wellness – you name it!) to any group keen to host me. 

I did casual talks for office groups in my area, banks, local fire halls, or sometimes more formal engagements such as ProD workshops with schools – I was happy simply to chat about wellness and provide education that would make massage therapy more accessible. Initially, much of my motivation with these talks was of course to promote my practice and business, but the more time I spent with local groups made the larger impact I was having become evident. 

Not to mention the support I was receiving for my business was inspiring. The more connections I made, the more motivated I became to find new and different ways that I could engage with and provide value to this community that was supporting me in my own entrepreneurial journey.

That same year, a friend of mine suggested I join a local business networking group (Business Networking International, or BNI), and it was through this group of connections that Absolute Therapy became involved in its first on-site fundraising gig. One of the members of my group was married to an organizer for Turf Burn, a local soccer tournament. 

The second year of the event was being planned and the organizers were excited about the opportunity to have a couple of RMTs present to provide short treatments for participants (by this time I had one other RMT working with me). We agreed to provide the treatments by donation and, in return for the exposure and the marketing we received, we would donate all the proceeds back to the tournament to go towards their fundraising initiatives. 

And so it began.

 The model of “help-us to help-you to help-them” was officially adopted by Absolute. (Side note: we had our 10th consecutive year with Turf Burn this past Summer; it has grown into a much larger tournament with a great following and now fundraises big bucks for local non-profits – so cool!)

I began researching other local events in which the participants or people involved could benefit from on-site massage therapy and reaching out to the organizers to pitch our “in-kind” sponsorship. We soon became involved in the Victoria Dragon Boat Festival, another event that we would end up sponsoring for many years to come. The Victoria Dragon Festival Society has been a long-standing supporter of the BC Cancer Foundation, and the participants were very appreciative to have the option of pre and post-race treatment. 

The resulting donations we collected on behalf of the VDBF for the BC Cancer Foundation were sizable, and I was once again filled with gratitude for the opportunity to be included in such an amazing local event and awed by the fundraising potential of our involvement.

Building A Reputation By Helping

Event by event, and year after year we gained more notoriety as a clinic passionate about being involved in local events and fundraising initiatives. We became more established in Victoria’s healthcare community, and through our events and other marketing endeavors, garnered a large client-base able to sustain new practitioners on an ongoing basis. 

Throughout all of this, I volunteered with a number of event committees, which of course led me to know other event organizers, which led to more events. As a clinic we have been lucky enough to work with so many local organizations over the years; groups like MEC who tirelessly fundraise for non-profits like Power To Be, or the Victoria Goddess Run who have raised countless dollars for groups like the Victoria Transition House and the Victoria Sexual Assault Centre. 

Trust me when I say that in the amazing community we live in, the opportunities are endless.

I am immensely proud of the efforts that the Absolute team members contribute each year at our on-site events. They come out to events on Saturdays and Sundays in the middle of Summer (when I’m sure there’s a part of them that would much rather be at the beach!) and provide treatment after treatment – and they do it with smiles on their faces.

Sure, we make it fun; we have good snacks, and we goof around and we treat each other during the downtime – but I do not want to minimize the amazingness of how much this team gives. It is part of OUR community – our clinic culture. When I am considering new practitioners for our team – we talk about this. I always endeavor to be clear that this is not a clinic where you can come in and do your daily treatments and leave; we expect greatness, but the personal and professional support one can expect in return from simply being a part of this remarkable team is pretty great too.

I asked our friends at the Victoria Foundation (a registered charity that funds hundreds of initiatives large and small, both locally and throughout BC and Canada – if you don’t know them please look them up) to help me summarize the important part that local business plays in Victoria’s community:

“The Victoria Foundation has a vision to make our community stronger, and our shared quality of life better now, and for the long term. We’re inspired by the shared commitment of the local businesses we’ve worked with to help make this vision a reality, and by their passion to make positive changes in Greater Victoria and in communities across B.C. and Canada.”

-Sandra Richardson, CEO

In short – just get out there and get involved. Your clinic will receive recognition in the community, your practitioners will thrive, massage therapy as a profession becomes more accessible, events have more to offer, and local non-profits and charities receive more support to continue doing all the awesome things that they do! Everyone wins.