Show them what you’re worth

A familiar image to New Yorkers – the fearless, hard working, mostly immigrant lot that helped build up the city skyline we are famous for…

 

In my family, your sense of worth comes from how hard you work. It doesn’t matter if there is little to no material pay off for this work. Your blood, sweat and tears are enough of a status symbol to make the neighbors unable to call you the worst of insults – useless! This work ethic has been passed down through four traceable generations. It’s very much alive in me and that air of purpose shows society that I’m grabbing life by its horns or its balls, depending on the situation. No family lore ever spoke of burnout, though.

I’ve mentioned this topic in another post “The Magic Number” where I discussed how too many massages with little self care leads to the need to set a professional limit in order to avoid burnout. Professional burnout is common in any career that involves caring for others. Our nurturing energy can literally be sucked dry if we don’t set up the proper boundaries and limits on “selflessness.” In extreme cases, injury and illness befall the individual who is worn thin. More common features of burnout are irritability, resentment toward those you are giving care to, impatience and clock watching. This last term is one the awful markers of burnout in massage. This is when a therapist counts down the minutes til the massage they are performing is over. I admit there have been a handful of massages where I dug deep in my psyche to get through it because every minute felt like an hour; however if I felt like that with every client and therapeutic situation, I would be in trouble.

The other evening, I chatted with two colleagues who have been licensed Massage Therapists now for almost a decade. We were discussing our “worth” within the corporate spa setting and one of them made a telling exclamation. Every three years, she is garnering new skills that she brings to the table outside of her hands on experience and spending hundreds if not thousands of dollars to acquire these skills and keep her license current. She lamented with an ironic laugh how she is getting better in every sense of the word, but has less to show for it each year. In fact, her commission rate straight out of school was 7% higher than it is currently at the ten year mark.

Her lament peaked my curiosity as to what salaries/commissions are like in other corporate owned spa settings. I wanted a comparison. Perhaps it was only this particular spa chain that so profoundly undercut its “talent.” What I learned was pretty disheartening. Granted, my research reflected the New York market; however, we have one of the most arduous and strictest licensing processes in all the country. If anyone deserves a proper salary for their training, it’s New York State licensed massage therapists. So, does the corporate spa setting undervalue therapists? YES!!!

The caregiver in need of care…

 

Before faces lengthen and spirits become disillusioned, it’s important to understand that there are many other options and specializations for a massage therapist. Your worth isn’t determined by one particular spa chain or corporate pay structure. In fact, you can set a rate per massage for your private practice that reflects the skills, continuing education and experience you have amassed. Also, many medical settings, like chiropractic, physical therapy and rehabilitation have a need for capable, experienced therapists to support their patients’ treatments. These places will pay sometimes fixed salaries and sometimes per documented massage hour regardless of how many patients you see in a day. The reality that newly minted and seasoned veteran massage therapist have to come to terms with is that you won’t be able to put all your eggs in one basket. Having two or three part time positions in addition to private clientele may be the only way to make a decent living and this reality could/can lead to burnout. Perhaps then this profession is something you can’t do for the long haul. This is what I have started to realize. This is why I made the decision to return to school and pursue a parallel, but different therapeutic career. Perhaps my colleague should do the same. Harkening back to my family’s legacy, I find that there isn’t any sense in showing the world how much of a hard worker I am when I may end up breaking both my back and my spirit in my effort. It’s time to rewrite the story and choose the gentler path for once; one that eventually will pay off and show the most important person of all, MYSELF, what I’m worth!

 

 

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Light Therapy: Baking the pain away

Let the sun’s rays bake my pain away…

I am FINALLY on vacation after a long, hard year of doing what a New Yorker does best – hustling! Gratuitous amounts of massage meant that business has been very good, but inevitably that overwork had its downside a.k.a tendonitis. My workouts helped me push through and past my ¨magic number¨ of massages per day, but with all that repetative movement it was inevitable that I would develop an overuse injury. Nevertheless, in the weeks that led up to my Mediterranean vacay, I had been laying out in the sun every morning before work to both settle my mind and develop a ¨starter¨ tan. The added bonus was the heat of the sun hitting directly onto my upper back and shoulders really dissipated a lot of the pain and tension I felt from the previous day´s physical demands. Unbeknownst to me this heliotherapy I was giving myself is actually a therapeutic technique dating back to antiquity. A number of ancient cultures had an idea of the healing properties of light. Hippocrates, the father of modern medicine, prescribed sitting in the sun to heal a variety of illnesses. Herodotus, the ancient Greek historian, preached that the sun could help heal nerves and muscles. Many ancient Greeks built roofless buildings for the purpose of exposing themselves to the sun´s rays. Outside of ancient Greece, the Egyptians took it a step further and practiced bathing themselves in various colored light to cure diseases. Thousands of miles away in India, medical texts dating back to 1,500 BC also note the healing properties of light for skin disorders. Go even further to China and their medical texts from over 2000 years ago detail a range of color and light therapies for skin and mental illness.

A woman receiving light from a modern light therapy i.e. phototherapy box

So, seeing that the ancients had an inkling of what the sun could do for one´s health, modern medicine didn´t get the memo until the early 19th century, where Niels Ryberg Finsen, a Danish doctor of Icelandic decent, studied the medicinal affects of light rays. His impetus was the severe metabolic disease he suffered from whose symptoms  he experimented with sunbathing to relieve. He died a year after winning the Nobel for a phototherapeutic device he created that simulated sun light to treat several skin conditions. Thirty years later, scientists realized a lack of Vitamin D produced in the body by exposure to sunlight, was the main cause of a disease known as ¨Rickets¨ which leads to the weakening and softening of bones. Twenty years after that, researchers in Hungary used soft laser light to relieve arthritis pain. In later years, NASA scientists did a plethora of research on the manner that LED light affects plant biology in an effort to understand how to grow plants in space. What they found was a very small spectrum of light provided most of the energy needed to grow plants. From this research, more strides were made in the understanding of the healing properties of light within animal and human cells. Currently, two forms of phototherapy exist; Non targeted light therapy that comes from a box, like in the image of the woman above and targeted light therapy, which is administered by a laser. These forms are used with much success in the treatment of such skin disorders as psoriasis, non-severe acne, vitiligo, eczema, atopic dermatitis, polymorphous light eruption and lichen planus. They have also been effective at treating mood and sleep disorders like SAD (seasonal affective disorder), non seasonal depression and circadian rhythm disorders like delayed sleep phase disorder. Further medical research is being done with light therapy to address accelerated wound healing and pain management, which brings me back to my tendonitis. My experimentation with light therapy from its natural source (the sun) elicited the following note. On the days that I did not lay out because weather did not permit me to, I found that the pain and weakness in my anterior shoulder and neck would become mildly worse and last the full work day. The days that I did get about 45 mins of sun exposure, it felt more like a dull ache and only after doing 6 hours of massage at the end of my day. It is clear to me that the sun does heal. In the two weeks I will be bathing in its Mediterranean glory, my hope is to eradicate most of the pain and heal those weary tendons. I am looking forward to the day when the medical community finally approves its use for pain management. We need more natural and ancient approved manners to heal our bodies and minds.

Bringing Balance One Adjustment At A Time

Outside of spa work and my private clientele, I also provide massage at a Wellness Center in midtown. This little den of health offers chiropractic care, massage therapy, holistic health & nutritional counseling and postural exercise. The approach is corrective and the result is a stronger, pain free and more erect version of your former self.  In order to understand fully what the corrective approach entails, one must first comprehend what chiropractic care is. Many people hear the term Chiropractor and immediately shudder. Images of having one’s head placed at odd angles for the “cracking” of bones turns the fear-o-meter up high. Worse yet, is the notion of chiropractor as being a fake doctor, sadly due to the gads of crooks that run insurance scams and give the profession its bad rep. I recall being eleven years old and walking past this man in the street with a little skeleton propped on a table advertising a Chiropractor’s office. Five years later, when my mother had a car accident and was advised to get chiropractic adjustment for her case, into that same office we went. During each visit the doctor did the same thing to her back and neck , which left my mother feeling much better than she went in. However, within a few days, the pain and stiffness would return. When she had brought this up to the chiropractor, he told her that she would need chiropractic adjustment for the rest of her life if she wanted to remain pain free. This sounded unfathomable to my mother and once her case was settled out of court, she stopped going.

What that chiropractor told my mother would only be true IF the approach was not corrective. His care consisted of giving people quick fixes for their pain, so they would keep coming back. This is no different than popping a pill. It is not dealing with the root issue(s). The body is comprised of superficial and deep layers of muscle all covered by connective tissue. When a joint is misaligned, say in the vertebrae of your back for example, then the muscles surrounding that joint try to stabilize it and protect its position, even if it causes them to function improperly. They are like the dutiful bodyguards of a volatile criminal – the more they support his activities, the more they plunge themselves toward certain destruction. I know I am making a rather “dramatic” analogy here; however, this is serious stuff. No one should be okay with being in chronic pain and having limitations in their mobility and life activities. When the joint is adjusted which is basically giving it a little help to go back into its proper position, not “cracking” as we all like to refer to it, the muscles can let go. Depending on the individual’s condition, the muscles might have a hard time settling into their new normal, which is why massage pre and post adjustment really helps to flood them with the nutrients and support they need to move in their proper way. Take a look at the videos below where both doctors explain the corrective approach and especially the client testimonials, some of which were in dire physical straits when they first came in.

and client testimonial

I’m really lucky to be able to work with this group of medical professionals and it has taught me so much about a comprehensive approach. We all work as a team, consulting one another to find the best way to bring a client/patient’s body back into balance. If you are within the NYC limits and dealing with chronic pain resulting from an injury, lifestyle or some unknown factor, definitely make it a priority to visit the office, where you will get a complimentary spinal screening, along with adjustment and report of findings to let you know what is going on underneath those layers and what your treatment options could be. Everything in its proper place, starting from the inside out.

BIBC team candid Jan 2014
Our little wellness family 🙂

The Magic Number

What’s your magic number?

How many massages can you do in a day?

This is a popular question posited to me by many a new and regular client. You can never be fully honest for obvious reasons. You don’t want to seem tired and overworked, even if you are, because now the client is thinking they will get a shitty massage or feel guilty that they are number (insert double digit) of the day. If I am in the spa setting, I usually make a joke and say that I am “strong like bull” in a mock Eastern European accent and tell them not to worry. If I am in a clinical setting, I distract them back to the matter at hand – their condition, thus dismissing the question altogether. If they bring it up again, I then tell them these clinical massages are shorter and more focused, so don’t worry about me. Let’s focus on you!

The only thing a client should be focused on…

Truthfully, there is a magic number of massages a therapist can perform consecutively before burn out happens. Of course, this number is different for all of us. I weight train and exercise at least three times a week; therefore I am “strong like bull.” Despite this strength and stamina, I know that if I do 5.5 hours of consecutive massage, I am at my body’s limit for the day. I learned this from the rare times I had done 7 or even 8 hours of consecutive massages. The next day, I could barely make my hands into fists coupled with the ache in my forearms and shoulders. Now, for those of you who may say, “You work a 6 hour shift? That’s so part time.” Let me take a moment here and define what consecutive means in this context. These massages are occurring literally back to back. Once the one client is off the table, there are between 5 to 7 minutes to get the room changed over, grab a sip of water, then run to get the next guest without looking like you ran to get them. This is usually what happens in a spa setting, as the booking is done to maximize profitability; not to consider the physical demands made on the therapist. So, you see how 5.5 hours of continuous physical work plus the added cardio of running up and down stairs for guest pick up, drop off and supplies is enough of a full work day for me. You cannot compare it to a 9-5 p.m. desk job, which exhausts many in a different manner (i.e. from holding their bodies in poor sedentary posture and mentally focusing on a screen with few breaks).

Burnout of a different kind…

I recall working an event where another therapist boasted at the amount of clients they could take on in a day. Observing their body mechanics, I assessed that within a few years this therapist would surely burn out. Chronic Tendonitis is a common occurrence in any profession that requires repetitive movements over long periods of time. Taking breaks to stretch, hydrate and regroup mentally and physically allow this career to last beyond the statistical death knell of 3-5 years. I’m not ashamed or scared to say NO when asked to go above and beyond my limit at this 3 year mark of my professional career. After all, I want to be able to straddle both physical worlds – the demands of my fitness regimen with those of my profession. I feel blessed that I know what my magic number feels like, as it makes me a better practitioner for my current and future clients. As for the rest of my fellow LMT’s, may yours pop up sooner than later.

Over Exposed

Do you see anything you shouldn’t be because I don’t?

A million moons ago, I remember laying on the table in my massage school’s practice room waiting for my student partner to work me over for the sake of learning. Before any hands on techniques were ever taught, our instructors put massive emphasis on how to properly drape a client. I remember it was sweltering hot down there in that basement room and I asked my partner to leave whichever areas he had finished massaging uncovered. As he migrated to the backs of my legs, I heard this woman’s voice say, “Do I really need to see her tattoos?” About a minute or two later, I heard the teacher who was proctoring our sessions come over and say to my partner that he was exposing too much of me. “Keep the body parts you are not working on covered at all times.” Cringe! He made it sound like I was being dissected on a lab table. I popped my head up and said that I wanted to cool down since the room was too hot and that I didn’t feel in the least over-exposed. In a firm voice he said, “This is New York State Law, young lady” and walked away. The girl who made the comment about my tattoos was shaking her head at my partner adding, “You guys have to be careful.” Really?

This experience poses a conflicting scenario between what “THE LAW” says and communicating client comfort properly as a therapist in a professional setting. Let us dissect draping methods here: Some spas provide their clients towels to be used as a drape sheet. In some European styled facilities, you are handed a washcloth sized square to cover your pubic area and gluteal cleft (anatomical language for one’s butt crack) while the therapist works on you. An equally small cloth is used to cover the chest when laying face up. And if you want to get even less coverage, try the spas that provide just disposable underwear and bra. Our prudish classmate might have popped a gasket if she knew just how little coverage is actually mandated by the law. Still, in order to cover themselves (pun intentional) from potential law suits etc. many spa chains have disclaimers on their sign in sheets that note what our instructor admonished us to do. All parts not being worked on with any variation of said massage techniques (insert list here) will be covered. No genitals and no breasts. Should the client become uncomfortable at any time they have the right to tell their therapist and end the session.

How about that for coverage?

I supposed being a child of European parents has allowed me to be very comfortable with the nude form in a non-sexual manner. Here in the States though, with its Puritanical hypocrisy, everything becomes sexualized. I have seen commercials in Greece for bath soap that featured a fully nude mother bathing her child in a tub, while the father stands by with a towel to dry them both off. A beautiful family moment, au-naturale. This would NEVER AIR in the U.S. and yet other programming featuring pretty overt sexual and borderline sado-masochistic action does. It doesn’t take a psychology degree to know the message being plugged into people’s consciousness.

With that thought in mind, let us return now to the matter of draping per the LAW. I have had clients with major body issues, in the sense that there was a definite discomfort in uncovering ANY part of their anatomy. As an intuitive person and a professional, I addressed their issue immediately to prevent any blurred communication or innuendo. In one case, a young woman kept tucking her hands under her pelvis, which made accessing her arms impossible without having to reach underneath her into the groin region. Without hesitation, I gently told her what I wanted to do and asked if the position she put her hands in was a matter of comfort or otherwise. She sighed deeply and apologized, admitting that she was molested as a child and this face down position was bringing back memories. We decided together to do the massage face up and I let her know that any feeling she experienced was safe and okay in this context. I draped her very securely, folding the sheet into origami like patterns to ensure she felt covered at all times. By the end of the massage, she was almost asleep, which demonstrated to me how trust had been established. Imagine though that I proceeded massaging her without saying anything at all. With such a damaged relationship with touch, can you imagine what this poor young woman might have misconstrued as sexual? I believe this is the reason why many straight male therapists get into trouble with female clients. They are doing their “routine” without picking up on the body language that would let them know the client is not okay.

I have also had a client with hyperthyroidism, who begged me to un-drape him as much as possible due to his elevated body temperature. Even with a hand towel covering his pelvic region, he was still profusely sweating. The thing is, he never wrote this on his intake form. When I led him to the room he immediately blurted that he didn’t like to be covered with anything. Usually, this sets off my pervert flags. After explaining that certain regions of the body need to be covered per the LAW and the facility’s policy, he insisted that covering him up would make him sick. I had to pry it out of him, but he finally told me his condition and we proceeded in the manner I described above. Without this communication, I could have easily felt violated and threatened by this client’s desire to over expose himself.

Ultimately, we all have a baseline of how much or how little we are comfortable uncovering. However, as a licensed professional in an industry that is often joked about or targeted in a sexual manner, it is up to me to bridge the gap between what state of undress puts them at ease and what keeps me licensed and gainfully employed.

**A funny addendum here: Many male clients think they are being helpful when they spread their legs to allow for us therapists to tuck the sheet down properly for draping; however, what they don’t realize is they inevitably flash us their testicles. Every single time. Without fail. Dear future male client: Please just lay there as un-helpful as possible and leave the tucking to the professionals.

My Plastic Brain

My intellectual crush….Professor Eagleman, I am all ears!!

Your brain’s fitness is largely overlooked. Most of us focus on cardiovascular exercise for a healthy heart and strength training for a healthy musculoskeletal system. The mass of nerve tissue in your skull also needs its own training regimen. The “use it or lose it” adage is often quoted, but it wasn’t until I did some focused reading on the living organ that is our brain that I truly understood how this works (or doesn’t). The brain is comprised of precious real estate maps that correspond to regions of the body, as well as various cognitive activities. Should that particular region of the body become useless or an activity cease, the real estate doesn’t die off, but gets replaced by another area altogether. And in cases where are a part of the brain dies or is damaged, other parts are recruited to compensate for that loss. No corner of the working brain is squandered. Here’s an example:

A man working a job site accidentally saws through his hand, severing the nerve that feeds his pinky and ring fingers. After recovering from the initial trauma, he begins doing physical therapy to strengthen his hand and get the rest of his fingers to work without the 4th and 5th fingers. If we cut open his brain and mapped out the region that represents those two useless fingers with little lights, you would see a pretty amazing thing happen. Every time he recruits his other fingers and working parts of his affected hand, the region representing the two appendages that no longer receive commands from the brain will light up. How is this possible? In a remarkable feat of engineering, the silenced region of the brain is over grown by the working areas around it. They take over and grow stronger, thus maximizing their neurological property.

This is just one demonstration of the brain’s adaptability. Calling one’s brain “plastic” means that with the right exercises and activities, we can train our minds to circumvent any issue, like say a stroke, allowing us to recover lost function by recruiting other regions’ maps to take over those activities. Here’s another example:

Acclaimed American nueroscientist, Paul Bach-y-Rita, was a pioneer in the field of nueroplasticity. Early in his career he created a system of vibrating plates that were attached to a blind individual’s back. The plates would vibrate in connection to a forward facing camera that “observed” objects in what would be one’s visual field. The patterns of vibration were different depending on the object, but what ended up occurring was the ability for the blind person to “see” the world surrounding him. His skin sensors sensing the vibrations were sending the information to his visual cortex. One sense, touch, compensating for the other sense that did not function.

Further along in his career, he created a device that helped people whose vestibular systems (i.e. what helps us maintain balance and spatial awareness) were damaged. These people literally couldn’t stand upright; their world was in perpetual motion, like being on a rocky boat. The device attached sensors onto the patients’ tongues, which is a region saturated with sensory receptors, that interpreted forward, back and side to side movement. Accelerometers attached to them and linked to a computer would give the “position” in space of the patients and allow them to stay balanced. After using the device initially, a patient would experience the residual affects for many hours, despite still having a damaged vestibular system. Used for several weeks and many patients were completely cured. This just shows how the brain is able to reorganize itself and adapt to new information from an unlikely source.

Perhaps the best example from Bach-y-Rita’s career was his father’s massive stroke. After his father passed away years later, an autopsy indicated a large part of his brain stem had died, which would have left him unable to do most basic functions. However,  through neuroplastic exercises that Bach-y-Rita and his brother gave to their father, he was not only able to recover the basic functions, but more complex ones as well, which allowed him to return to teaching. His brain reorganized itself on very large scale.

After reading so much about nueroplasticity, I can’t help but think about my grandmother and how her brain was eaten away by a combination of stroke, Alzheimer’s and Aphasia; the latter two being a one two punch of memory loss, dementia and the inability to speak. I wonder if nueroplastic exercises done early after the stroke that started the ball rolling would have helped her brain remap itself enough to prevent many of the symptoms of the other two neurological diseases to manifest. There is some fascinating research out there that makes a brilliant case for this.

I guess the “use it or lose it” adage should be changed to just “USE IT!!!!” Crack open some of the below books if you are as intrigued as I am and get started this new year.

Recommended Reading List:

http://www.normandoidge.com/normandoidge.com/ABOUT_THE_BOOK.html

http://www.amazon.com/Incognito-The-Secret-Lives-Brain/dp/0307389928

http://www.amazon.com/Sum-Forty-Afterlives-David-Eagleman/dp/0307389936/ref=la_B001JRX0OQ_1_2?s=books&ie=UTF8&qid=1387720746&sr=1-2

Models and Problems

This is my brain performing “massage”….any questions?  🙂

There is nothing better than a person who is health and wellness minded coming to me for massage. You don’t really have to convince them of the benefits or teach them about its affects on their body because they are already informed and on board. Instead, as you work with them, they learn more about their body’s movement patterns and underlying stored tensions, making release and corrective care all the more possible. After a series of sessions they will be right at home in their new state of being and come to you for follow ups whenever they feel the need for them. Sigh…if only all client situations were like this.

One client that I have been working with now for a few weeks fits the model client moniker to a tee. He comes in with stories and updates on the results of his last session and what his activities/work/lifestyle have procured for me this time around. I share him with another therapist. We both approach his motley crew of issues with different perspectives and techniques, but always end up with some kind of change/result. This weekly challenge is such a learning process for myself. Having to get creative in order to circumvent limitations and other obstacles takes me away from my usual approach to a particular muscle issue and brings back the spark of why I got into this profession in the first place. It also makes me hungry for more education, which (lucky me) New York State is going to require in just a few short months to renew my license. I do my little happy dance post session, when I can see the effects of the work; a little less rounding of the shoulders, an arm fully flexing up to one’s ear, a little pain free spring in one’s step. It’s a great feeling.

In contrast to the model client, is the problem client. They come in many forms, sometimes seeking out massage on their own or having it forced on them by a health care professional or a loved one. They almost never feel comfortable with anything you may try out to address their issue(s), that is if they can pinpoint what it/they are in the first place. They don’t communicate their feelings easily or over communicate as in “choreograph” the entire massage session. On the one hand, I welcome clients being specific about where their trouble spots are and what they prefer me to do; however, one has to be a little reasonable. After all, there is a flow involved with a good massage and jumping back and forth between body parts, over flipping from supine to prone or over working a particular region or muscle kind of kills that vibe.

A funny thing happened a few weeks ago with one such problem client. After a handful of sessions where said client answered all my intake questions with shrugs and my inquiries on our work with a down-tempo “it’s ok” I had become a little more than frustrated. I was starting to gas out completely and couldn’t count down the minutes until our session ended. No longer client centered and feeling drained, I stopped focusing and sort of mindlessly moved about the tissues and musculature I was addressing. My zombie massage was, to me, the worst massage I could ever give a person. However, in this state, my problem client finally let go. In my daze, I heard a comment on how sore the front of their thighs were. At first, I thought the voice came from the inner recesses of my head…or the television blaring in the client’s family room. When it dawned on me that the client was actually communicating with me, I snapped out of my zombie mind and asked where they felt the soreness might have stemmed from (activities, diet, etc.) In three minutes, I received more feedback than in all the weeks I had been working with this individual. My crappy massage was this person’s saving grace. I know now to start off in a general way with said individual and allow them to lead me where they need. This problem turned out to be a model – a learning experience to challenge my approach to different personality types. Sometimes the egg can be cracked without too much force or effort. Take that, brain!!