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Fibromyalgia and Massage: How to Help without Hurting

What is fibromyalgia, and how should we deal with it as massage therapists? Should we press directly on tender points, or avoid them? Should we use deeper pressure, or only lighter work?

If you’re completely unfamiliar with this condition, it means widespread pain that isn’t related to injury or overuse. If you’ve got fibromyalgia, a lot of your body hurts, and no one can quite tell you why. There are no lesions on MRI or CT scans, there are no strains or sprains; you just hurt. On top of that, there are other common symptoms: Poor sleep quality, fatigue, memory problems (often described as “brain fog”), and depression. You can read more at this Mayo Clinic article.

Fibromyalgia tends to be cyclical, with many sufferers noticing periods of flare-up and remission. Your clients will have bad weeks and good weeks, and finding out where they are in that cycle can help you determine how to proceed. More on that in a second.

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Video: 4 shoulder/neck stretches for your massage clients

Do you offer self-care to your clients? I’ve always been a big proponent of a little homework, and over the years I’ve come up with stretches that seem to help with pain, and that clients will actually follow through with:

And that’s what I’d like to talk about today—how to get clients to actually do self-care. In the world of medicine and physical therapy, this is called “compliance” or “treatment adherence,” and it can often make all the difference to patient outcomes. And still, it’s really hard to get patients to do exercises, take their pills, etc!

What hope do we have if people won’t even take a whole course of antibiotics? As massage therapists, we have a unique opportunity to bring our clients on board. I don’t just give a stretch printed on a piece of paper and see my client out the door. Instead, I relate it back to the massage I just gave: “Remember the tight muscles in your chest and shoulders? Those muscles are important for upper back pain.” We’ve just given the client a great deal of information about their body through massage, and that’s a much better motivator than “because I said so.”

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Building Your Massage Business (With a Little Help From My Friends)

People ask me about business stuff a lot, but… I stink at business stuff. I don’t promote myself often, or answer phones, or leave my house. I basically maintain a Facebook blog, advertise, and let clients come to me. This works for me and my social nopeness, but there are ways of tapping into your local client base quicker, finding the right people for your business, and getting the ball rolling in months rather than years. I can’t help you there, but I’ve got friends who can.

Allissa Haines and Michael Reynolds run the Massage Business Blueprint, which I’ve been an advocate for since it began. I’ve even helped with a podcast and an article (they were about working with the gluteal region, so we got to say the word “butt” a lot). In fact, they bring in experts in different fields regularly, so it’s a good way of hearing a lot of viewpoints about massage and business.

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Massage Tutorial Video: Reflexology basics, techniques, & routine

This week’s massage tutorial video is on reflexology basics. Now, I should point out that this is my version of reflexology—I’ve long since forgotten most everything about meridians and organ reflex zones, but I’ve been using the techniques for a decade now. This routine feels great, and it seems to create a more profound client experience than your typical Swedish foot massage.

So, does reflexology “work”? That’s a question that I hear from clients and therapists alike. I think people are asking if we can really influence distant organs by interacting with the foot, and I don’t know the answer to that question. I do know that the technique feels vastly different than the stripping and compression that we’re used to. I know that the rhythmic press, press, press of reflexology has an interesting effect on my body and mind, making me feel floaty and dreamy (and making my feet feel fantastic). In this way, I can emphatically say that, yes, reflexology works.

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So Your Massage Client Has an Anxiety Disorder

Clients have many different goals when it comes to bodywork, and a perfectly valid one is the management of their stress/anxiety. What are the different types of psychological disorders you might encounter? What do you need to know about anxiety as a massage therapist?

Credit: Jon Rawlinson, CC BY 2.0
Credit: Jon Rawlinson, CC BY 2.0

This article, “Worrying About Worrying” by Ruth Werner, is a good primer on anxiety disorders and how they affect clients. (If you’re an ABMP member, you can see the full magazine version here).

It addresses what you can do as a massage therapist. You’re not a psychologist, but you can create a supportive, nonjudgmental space for your client to finally just unwind. Massage has pretty robust support in the scientific literature for reducing anxiety in the short- and long-term!

Anxiety vs. Stress

Something interesting about anxiety is that it’s very difficult to disentangle from a concept that we’re all familiar with: stress. “I’m so stressed out from work/school. I’m so stressed I can’t sleep. I’m so stressed that it seems like I can’t ever relax.” “Stress” is just a word that we use as a proxy for that fluttery, clenching feeling in our chest that pops up whenever we expect something to require a lot of mental or emotional resources.

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