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 WInTer 2011 Issue

ConTenTs
Features
Keeping Great Associates 6
p20
RMT Tech Talk 13
Massage Therapy 14
Education

p14

departments
p11 Editorial 5
News 8
Resource Directory 28
The Therapeutic Quality 16
of Music Contributor to the 30
Profession
Understanding Stress 20
Part 1

Reducing Back Pain 24

Massage Therapists 26
at Work

Massage Therapy Canada WInTer 2011 3

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Editor
Winter 2011 - Volume 10, issue 1
from the editor
Jill Rogers, RMT jrogers@annexweb.com

T
(905) 516-8793
his winter issue welcomes us all to a new year as your editor, I
Managing Editor
Maria DiDanieli mdidanieli@annexweb.com would like to extend my wishes for good health, happiness and pros-
(289) 259-1408 (888) 599-2228 ext. 247
perity in 2011.
Sales Manager In the remainder of this note, however, you will find me wearing my mas-
Christine Livingstone clivingstone@annexweb.com
(519) 429-5173 (888) 599-2228 ext. 239 sage therapist hat. I underwent a peer review / assessment this past year and I
Sales Assistant wanted to share my thoughts about the process, having recently experienced it.
Sandra Mels smels@annexweb.com Although it is described as a review process carried out by ones peers, all
(519) 429-5183 (888) 599-2228 ext. 219
therapists and I can safely speak for the Ontario group who have gone
Production Artist
Emily Sun through this procedure would agree that it can be anything from unnerving to
Group Publisher downright intimidating. Prior to the experience, I felt as though I were scheduled
Martin McAnulty mmcanulty@annexweb.com
to undergo something much like a job performance review, carrying with it all
President
the impact of receiving a positive evaluation or not.
Mike Fredericks mfredericks@annexweb.com
Now that it is done, though, I must admit that, overall, I thoroughly
Mailing Address
P.O. Box 530, 105 Donly Drive South, enjoyed and appreciated the whole experience. My evaluator was both pro-
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fessional and respectful of my business, as well as of me, a fellow therapist.
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e-mail: cnowe@annexweb.com positive and negative, with my evaluator. This experience was a reinforcement
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Circulation
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www.massagetherapycanada.com

Massage Therapy Canada WInTer 2011 5

Feature By JIM sMyTh, rMT

Keeping
Great Associates
Foundations for building a committed team

T
his profession does make a difference
in peoples lives. And if you are a clinic
owner/manager who would like to con-
tribute to this difference as well as leave a
legacy, then you need to have reliable associates
working with you. To leave something for future
generations, and be able to sell what you have
built when the time comes, will require the best
possible team.

In order to meet the preceding objectives (i.e., making a dif-

ference, leaving a legacy) the following environment must be
cultivated:
supportive and fulfilled associates;
solid business reputation;
loyal clientele;
nourishing clinic atmosphere;
history of turning a profit.
Your ship will founder without these hallmarks of good
business acumen. However, the most essential of these maxims
is the crew i.e., your associates. The crew is the adhesive
that will hold the ship together and keep it ship afloat,
whether you are sailing in fair weather or stormy seas.

Why to avoid the revolving door

A viable practice cannot be sustained with a revolving door
of associates coming and going through the clinic foyer. The
coming involves continual retraining and orientation of per-
sonnel new and existing. The going typically means the loss
of therapist and clientele contract or not, clients will most
often stay with the therapist of their choice. So both sides of
this revolving door represent an unsustainable situation for
you there will be an impact on your profit, an impact on
normal operations and a disturbance to the nourishing atmo-
sphere. The inevitable result will be that your workload will
increase, your stress levels will rise and, as I said before, your
ship will founder.

6 Massage Therapy Canada WInTer 2011

its not just one person
Lets consider the loss of one associate in a six-person clinic.
In this example, one associate could very easily represent 17
per cent of the clinics business. I can state this because, most
often, you are going to lose the best producers: the people
who have built their practice in your clinic and now envision
a better opportunity in a different location.
Seventeen per cent of any business is substantial; rebuilding
from this loss can be a leaders nightmare. As captain, you
must guide your ship through these rough waters and all the
while pay vendors, pay loans, pay mortgages or rents, meet
payroll and cover any other overhead expenses.
One person leaving will also have an effect on the rest of
your colleagues. A remaining associate may think that: If
Tom made the move then why couldnt I do the same? If
they also decide to go and do so too soon after the first
person leaves then you could be facing a 33 per cent col-
lapse in revenue. A 33 percent loss could create a situation
from which a business may not recover.
Before you begin the search for a
new associate, clearly define your
requirements and the needs of the
clinic and its existing staff.
preventing the loss of associates
Choosing your associates wisely is one of the most effec-
tive ways to prevent these challenging scenarios from
developing. You need to take the time to clearly define
your requirements, the needs of the clinic and the wants
of the existing staff, so that you can develop an outline
that is suitable for the whole clinic. This strategy will also
help the new associate understand the potential benefits
that will be available to them in their new situation. It is
important for you:
to be specific about what you need in an associate;
to know where to look for an associate;
to properly evaluate the new candidate;
and to understand the needs of the new person as well
as the needs of the clinic.
Before you begin the search for a new associate, you must
outline what you need and expect from a new associate.
Your outline must be specific and it must be prepared ahead
of time. There are a number of queries to address: Do you
want someone with experience who will require less training,
or are you willing to spend the time training a more junior
person? What skills do you require to enhance those of the
existing staff? Do you want someone who has similar skills
to the group you have in place now? Or do you want to look
for a unique set of skills that will allow you to create a foot-
hold and draw from a different sector of the population (i.e.,
a new market)?
It is important, also, to be conscious of the dynamics of the
existing clinic group and consider how the new person will
fit in. You need to consider a number of issues:
Is the new person going to get along with the existing
team?
Does it matter if there is potential for minor conflict/
confrontation?
How are you going to approach confrontation issues
during the interview process?
Put yourself in your potential candidates shoes, and com-
pile a series of questions and answers that you might ask
yourself.
Finally, it is more effective to prepare this list before writing
ad copy for the job.
effective ad copy for
finding an associate
Concise ad copy is the most effective from a dollars-and-
cents point of view. Budgets in massage clinics are usually
tight, so the fewer words you use to get your message across
typically means the more money you can conserve. Most
magazines, professional journals and local newspapers charge
by the number of words, so it is important to get your mes-
sage across in as few words as possible. There are six criteria
you should address in your ad:
experience;
background;
technique specialization;
hours of operation;
dollars/split;
contract/employee status.
Presenting these six items, in a straightforward manner,
allows you to get to the point and capture the readers atten-
tion, quickly. Here is an example of concise ad copy:
Remedial Inc. has an opening for a passionate registered mas-
sage therapist with three plus years of experience. You will be
joining a devoted team of professionals committed to client
rehabilitation and wellness. Competitive contract percentage.
Please send resum to: Remedial Inc., c/o John Doe, Etc.
This concise copy identifies the main criteria for the posi-
tion in the following ways:
it calls for a passionate registered massage therapist;
it makes clear that experience is expected;
it defines clinic specialization;
it identifies a professional approach;
it makes a reference to remuneration and contract
status.
The balance of the crucial items, split percentages and
hours, can be addressed during the interview process.
This clear, succinct message captures and holds the
readers attention quickly. Your ability to communicate
effectively is established by the clarity of the writing style.
This unambiguous message initiates the beginning of a
potential working relationship. People who act on the ad
will have a good idea of what to expect during the interview
process, and afterwards. The straightforward message will
lead them to expect clear, frank communication without a
lot of exaggeration. The implied professionalism in the text
indicates that each of you will have to live up to a profes-
sional standard during the interview process and after the
mutual decision is made to work together. Passion for the
work comes through loud and clear. And the clinic name
Massage Therapy Canada WInTer 2011 7
provides additional information regarding the type of prac-
tice in which the clinic specializes.
alternative communication strategies
Advertising, however, should not be your only resource for
filling that spot on your team. Great associates can be found
by using a number of methods: begin a word-of-mouth
campaign in your local community, connect with the local
massage therapy association, engage your existing associates
in the process, make contact with your competitors, visit the
closest massage college where you might speak with the
professors, post openings on the job board and touch bases
with other health-care professionals.
Any one of these resources could be invaluable to your cur-
rent search and could also be useful for future requirements.
Different people will provide varied levels of assistance.
However, it is important to note that anyone in business will
be encountering a similar set of the problems that you may
also encounter in operating your clinic.
As a final point, you should keep your eyes open and your
ears to the ground at all times, for any possibility that may
present itself. An accidental meeting, or someone moving to
town, could very well provide the opportunity for you to fill
that vacancy now or at some time in the future. My advice is
to use every resource at your disposal.
The following criteria covers the attributes that I explore in
a promising colleague:
dedication to his or her craft
exceptional client care
good communication skills
excellent documentation skills
dedication to continuous learning
commitment to the welfare of their clients
commitment to the welfare of the clinic
ability to be a team player
I must point out that finding someone with all of these
proficiencies is a difficult assignment. Each of us has some of
these qualities, but almost everyone will need to improve in
one or more of these competencies. As a bottom line, when
you are able find a person committed to continuous learning
and dedicated to their craft, then you have a candidate who
should prove to be a valuable asset in your clinic.
Taking the time to clearly define your requirements, and
outlining the needs of the clinic and the desires of the staff,
will allow you to develop an outline that will assist you and
your new crew member in making the right decision. Building
the proper foundation will also help you to develop a motivat-
ing culture that will keep your associates interested and com-
mitted to the long-term benefit of the clinic, the clientele and
themselves. This is only a first step in developing a long-term
associate, but it is a very valuable first step that will allow you,
the clinic, the clientele and the associate to garner numerous
benefits over the time period you choose to work together.
Jim Smyth owns and operates a clinic in
Peterborough, Ontario, with seven massage
therapists and a fitness facility on site. Smyths
e-Book Find and Keep Great Associates is avail-
able at www.MTCoach.com.
8 Massage Therapy Canada WInTer 2011
News
2010 case report contest winners
T
he Massage Therapy Foundation (MTF) is
pleased to announce the winners of the 2010
Practitioner Case Report Contest. This years
Grand Prize Gold Award has been awarded to
Rosemary Chunco, LMT, BA, MSc, of Plano,
Texas. Her winning case report was titled The Effects of
Massage on Pain, Stiffness and Fatigue Levels Associated
with Ankylosing Spondylitis: A Case Study. As the first
place winner, Chunco will receive a $2,500 cash award
contingent upon undergoing the peer review process
with a scientific publication, an invitation to present her
paper and poster at the 2011 AMTA National conven-
tion and a $1,000 stipend to be used toward travel to
the Convention.
Chunco said of the process of creating a case report,
Planning, implementing and completing a case study
in my own practice had an unforeseen positive impact in
many ways, including a noticeable increase in my level of
analytical thinking, increased confidence in an ability to
find pertinent information on a problem, and a signifi-
cant increase in my knowledge on a specific condition.
Moreover, being able to contribute to the profession by
the provision of information also gave me a feeling of sat-
isfaction that I have not encountered before... I hope that
others will decide to complete case reports and experience
the benefits that can result from such a venture.
Chuncos report focused on a 47-year old female
patient with ankylosing spondylitis (AS), a disease that
causes inflammation of the joints between the spinal
bones, and the joints between the spine and pelvis. With
massage, the patient reported a reduction in the intensity
of her stiffness, pain and fatigue, and Chunco observed
increases in forward and lateral flexion. Chunco con-
cluded that massage shows promise as a treatment for
symptoms associated with AS. The full abstract can be
found on the MTF website (see below).
An honorable mention was awarded to Rosalyn A.
Smarr, LMT, of Dayville, Oregon, for her case report
titled The Effects of Specific Injury Treatment and
Facilitated Stretching on Acromial Clavicular Joint Pain
with a Possible Separated Shoulder. This report focused
on the effect of massage at aiding in full recovery after a
shoulder joint injury with positive results.
Information about all previous MTF Case Report
Contest winners, as well as details regarding how to
enter the 2011 contest can be found on the website at
www.massagetherapyfoundation.org.
The Massage Therapy Foundation has chosen to
encourage the writing of case reports to provide an
opportunity for massage therapists and bodyworkers to
develop research skills and enhance their ability to pro-
vide knowledge-based massage to the public.
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Feature
GUILLAIN-BARRE
SYNDROME
Is there a role for massage therapy? Part 2
I
n part 1 of this article, the author reviewed
Guillain-Barre Syndrome and presented the
case of one woman who was struck with this
disease. The author then introduced paul
Lewis, an RMT who has developed an approach to
treating patients who suffer from the disease that
is very individualized, and takes into account its
dynamic progression and the ever-changing needs
of the patient. part 2 will describe how Lewis
dealt with the womans case, and how massage
therapy enhanced her recovery period.
massage treatment in hospital
It all happened so fast. The pain was unbearable and I
required a wheelchair from the point of admission because
I was too weak to even hold myself up, says Cindy
Cartwright, who found herself with Guillain-Barre Syndrome
(GBS) in April 2010.
Within the next 24 hours, various medical tests were per-
formed on Cindy, including an MRI, CT scan, bloodwork,
X-rays, ultrasound, nerve conduction velocity studies (NCV)
and a spinal tap (showing increased spinal fluid protein with
a cell count exclusive to GBS) before the GBS diagnosis was
made. Medical treatment for GBS began on April 28. This
included plasmaphoresis, the most crucial function of which
is to keep the patients body functioning during the initial
recovery of the nervous system. Cindy was admitted into the
intensive care unit (ICU) to monitor and assist as other GBS
symptoms occurred. At this point, she was fully paralyzed in
all her limbs and all organs up to the stomach area, and also
experiencing slight paralysis in her face, around the mouth
area, and loss of control of the swallowing reflex. In addition,
she was unable to close her eyelids and was hooked up to
feeding tubes and a urinary catheter.
To illustrate the dynamic progression of this disease, by
May 12 Cindys body began to turn around and caregivers
were immediately instructed to manually move her limbs.
She notes that the last areas affected with the paralysis were
10 Massage Therapy Canada WInTer 2011
By BarBara CunnInghaM, Ba, rMT
the first to come back. Over the next week, she became able
to close her eyes, then swallow, which allowed the feeding
tubes to be removed.
In a few days, Cindy was moved out of ICU to a regular
room where she began to receive massage therapy treatments
from Paul Lewis, who had successfully executed a three-way
consultation between Cindy, her doctor and himself.
It is wise, notes Lewis, to receive the doctors acknowl-
edgment before beginning massage therapy treatments in
hospital.
Physiotherapy was introduced shortly thereafter, as well.
Lewis notes that he also incorporated a little reflexology
along with the massage treatments from which Cindy reported
considerable pain relief.
Each in-hospital massage therapy treatment session took
from two to three hours. The length of time reflects the very
slow pace necessary, as the patient is in unbearable pain and
is still experiencing all the other aformentioned symptoms of
GBS. The patient cannot move, but can certainly feel, and
the sensation primarily registered is pain.
The main premise behind incorporating
massage therapy for this disease is that
massage can influence the afferent
neural pathways.
hoW massage therapy helps
The main premise behind incorporating massage therapy for
this disease is that massage can influence the afferent neural
pathways. When the Schwann cells are reproducing myelin
to repair the myelin sheath, signals are either slow, absent or
misdirected and registered as pain. In this instance, we can
use what we know about dermatomes, move the muscles and
joints and hope the body registers the signals as touch. It is
almost, but not quite, as though the RMT manually sends the

Massage therapist Paul Lewis performs a treatment on a patient with
Guillain-Barre Syndrome.
signals back to the brain so that the patients pain decreases.
Cindy was on high doses of morphine and blood thinners,
she was in excruciating pain and she had not been actively
moving. There was a high resting tension in her muscles, and
diminished sensation in her limbs. Therefore, Lewis used slow
passive relaxed movements to help with stiffness and mobility;
and gentle muscle squeezing to create afferent response and
try to optimize circulation and drainage while slowly moving
the structure through its normal range of motion.
No hydrotherapy was used at this stage due to altered
sensation and the inability to detect temperature. Also, very
little lotion was employed. Joint mobilization was carried out
to help maintain range of motion (ROM) and decrease pain.
Adapted treatment protocols for TMJ were utilized, and
treatment for constipation was included, as was attention to
Thoracic outlet syndrome and Bells Palsy.
notes from the rmt
For treating GBS patients, Paul Lewis calls attention to a
number of factors that require thoughtful assessment and
approach.
You shouldnt use deep pressure because the patient is on
blood thinners, and always remember that pain medications
cloud their feedback. Remember to wear gloves and follow
other safety protocols while treating patients wearing medi-
cated dermal patches.
Be careful in repositioning the patient, he notes. In fact,
dont reposition the patient if its not necessary.
Use passive relaxation movements, and ensure your palpa-
tion skills are intact.
I looked at trying to maintain peripheral nerve system
(PNS) pathways via soft pressure adapting to the tissue tone
and structures, and by using a gentle form of Dynamic
Angular Petrissage (DAP).
massage treatment after discharge
In early June, Cindy was released from hospital to continue
her rehabilitation as an outpatient. This included physio-
therapy three times per week and massage therapy two times
per week.
Massage, reported Cindy, hurts for the first 45 minutes,
but after the session, I feel good for four to five hours.
Recovery was slow and very painful; however, the tech-
niques used in the massage therapy sessions by Paul Lewis
offered relief from the discomfort that Cindy was experienc-
ing. This allowed her the flexibility to continue with the
physiotherapy exercises, and meant she could take less pain
medication. It also helped her relax so that she could sleep.
While the medical community
investigates why only certain people
develop GBS, we can continue our
efforts to provide safe and effective
massage therapy treatments for our
GBS clients.
more rmt notes
Dynamic Angular Petrissage involves using one hand
to gently knead the muscle while using the other hand to
take the limb through the ranges of motion according to the
muscles line of pull, changing angles not only to simulate the
action of the muscle but also to help refine the movements,
explains Paul Lewis, who also found this technique to be
extremely gentle and helpful in Cindys case. The other
hand is gently adapting to the tissues texture, tone, tender-
ness and temperature while kneading the tissue. The knead-
ing technique is determined by the target tissue.
For example: If I am working on the tibialis anterior, or
just above the knee, I will use palm point kneading to pro-
tect the thumb and work around the knee area similar to
GTO but with gentle kneading action so that I can address
the quadriceps adductors hamstrings, and other leg muscles,
following the direction of the fibers in order to determine if
there is a high resting tension.
Now if the band is really taut, I will follow the band and
then bow to the left or right in order to help knead and
loosen it up. There is a similar concept in Aikido redirecting
a force that is coming straight at you to the right or left caus-
ing the force to weaken.
Massage Therapy Canada WInTer 2011 11
cindys progress
At the five-month mark, Cindy had all but recovered,
having residual numbness in her feet and hands. Her grip
strength was not 100 per cent, yet, and she still experi-
enced some fatigue, but she was happy to start exercising
again.
She reported, Massage still helps so much. Ideally mas-
sage every two or three days would be the best every
fourth day I am managing, but if I have to wait a week
its excruciating!
conclusion and research initiatives
Although GBS often follows a viral illness, there is no evi-
dence that the disorder can be transmitted from one person
to another. In fact, often the virus or bacteria is no longer
present in the patient when the peripheral nerve damage is
developing. While the medical community investigates why
only certain people develop GBS when millions of people
are exposed to its identified triggers such as infections,
viruses, surgery, and vaccines, we can continue our efforts
to provide safe and effective massage therapy treatments for
our GBS clients, thanks to the co-operation of client Cindy
Cartwright and therapist Paul Lewis.
Lewis is planning to conduct more research to further
explore the efficacy of massage therapy in the recovery
process of GBS clients. His treatment plan suggestions for
Guillain-Barre Syndrome should give other sufferers hope for
a more comfortable and speedy recovery.
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12 Massage Therapy Canada WInTer 2011
sources used for this article
1. Ashbury A.K., Hauser S.L. (2001). Guillain-Barre syn-
drome. In Braunwald E., Fauci A., Kasper D.L., et al.
(Eds.), Harrisons Principles of Internal Medicine (15th
ed., pp. 2507-2509). New York: McGraw-Hill.
2. GBS/CIDP Foundation International Summer 2009,
The Communicator.
3. National Institute for Neurological Disorders and
Stroke. Guillain-Barre Syndrome Fact Sheet, 2009.
4. Office of the Chief Science Officer for Disease Control and
Prevention, Atlanta, Georgia 30333, USA (PHaber@cdc.gov).
5. Porth, Carol Mattson. Pathophysiology Concepts
of Altered Health States. 7th ed. Philadelphia,
Pennsylvannia: Lippincott, 2005: 1204-1205.
6. Rattray, Fiona and Linda Ludwig. Clinical Massage
Therapy. Elora, Ontario: Talus Inc., 2000: 753-824.
7. Tortora, Gerard J. and Bryan Derrickson. Principles of
Anatomy and Physiology. 11th ed. New York: Wiley, 2006.
8. Werner, Ruth. A Massage Therapists Guide to Pathology.
3rd ed. Baltimore, Maryland: Lippincott, 2005: 261-263.
Barbara Cunninghams passion lies in research
and writing for the profession of massage
therapy. She works with Massage in Motion,
and recently opened her own practice, called the
Treatment Room, in Mississauga, Ontario. Her
ultimate career goal is to see massage therapy become tax deduct-
ible from the first dollar. Barbaras raison detre is her three children.
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Feature
RMT Tech Talk
Client communications
W
elcome to the first in a series of
articles that will discuss various
technologies and how they can be
beneficial in the massage therapy
workplace. Each article will examine certain
aspects of massage therapy practice management
and explore how technology can be applied to
simplify and / or enhance the process.
In this first edition of RMT Tech Talk, the subject of utiliz-
ing technology to optimize external communications with
your clients will be considered.
The intent of this article is to get you to think about your
methods of communicating with your clients and also to pro-
vide some options on how you might rethink your approach
to client communications. The intended result is to improve
the experience for your clients when they are interacting
with your services as well as for you as the care provider
and, where applicable, business owner. The final goal is to
optimize your patient care while improving the bottom line
for your business.
With any business, as Im sure everyone will agree, timely
communication by the business owner with clients is crucial
for establishing a positive professional relationship between
the two parties. This could not be more evident than in
todays connected society, where customers are looking for
immediate feedback from those they choose to do business
with. Massage therapy clients are no different.
What is Best for your clients?
There are many communication technologies for streamlin-
ing your client communications available for you to incor-
porate into your practice. These technologies include the
traditional telephone / answering machine, the postal service,
electronic mail (e-mail), online websites and text messaging,
to name a few. The question is, what combination of these
technologies is best suited to you and your clients?
To answer this question, you need to examine the demo-
graphics of your clientele. For example, if your clientele is
made up entirely or almost entirely of senior citizens,
it is unlikely that your primary method of communica-
tions should be text messaging over the cellphone network.
Conversely, if your clientele is made up of mostly younger
people, say in their 20s and 30s, they would likely prefer,
and expect, a form of electronic communication rather than
By JessICa FosTer
a traditional telephone voice call and the resulting voice mail
tag. You will want to keep in mind that this is really about
what is best for your clients, and not what your preferences
might be.
The reality is that your practice is likely made up of a
diverse group of clients ranging from children to senior citi-
zens. As a result, you may consider the adoption of multiple
methods of communicating with your clients. However, this
doesnt mean you need to add to your daily workload, as
many technologies available to massage therapists will actu-
ally save you time, effort and money.
smart tech multi-tasKing
Lets consider what the communication technologies might
look like in a massage therapy practice that has been opti-
mized to support a clientele with a diverse age demographic.
A home or office personal computer (PC) is a requirement.
E-mail accounts that work handin-hand with the
home or office PC, allowing clients to communicate
with the practice electronically.
A website to communicate information about your
practice such as hours of operation and directions,
treatment modalities offered, service rates, your no-
show policy, etc. Since the website is often a potential
clients first glimpse at your practice, it should be pro-
fessionally designed and convey relevant content in an
easy-to-navigate structure. First impressions are often
lasting impressions.
Online appointment tools on the website that offer
clients convenient access to your availability and allow
them to request appointments at their leisure. This
also saves the massage therapists valuable time.
Telephone service with supporting voice mail. Yes, this
may sound like it is old school, but it is still a require-
ment in any business setting. It will provide service to
those clients who may be less tech-savvy and to anyone
else who may only have access to a telephone.
Keep in mind the voice mail greeting should direct
your clients to the other methods of contacting your
practice, and offer the option to request an appoint-
ment with you from your website, as this is the most
common reason they are calling.
E-mail messaging services that will automatically com-
municate appointment confirmations and reminders.
Continued on page 15
Massage Therapy Canada WInTer 2011 13
Feature CourTesy oF The CanadIan CounCIl oF Massage Therapy sChools
Massage Therapy
Education
Best practices for textbook selection
A
s educators, we are all committed to
providing our students with a quality
educational experience. Instruction is
central to the delivery of this type of
experience and textbooks serve as the founda-
tions of classroom instruction. Massage therapy
educators, however, rarely receive any sup-
port or guidance in this regard. This article will
attempt to propose objective criteria for text-
book selection that we can utilize to assist us in
choosing texts that will best support and pro-
mote our curriculum objectives.
suBject eXpertise
Does the book in question contain the relevant knowledge
base for the subject area? The first and most important
criterion that we can utilize to assess the quality of a given
text in supporting delivery of curriculum content is subject
knowledge expertise. In other words does the book in ques-
tion contain the relevant knowledge base for the subject
area? How do we determine what is the relevant knowledge
base for the subject area? We are guided in this regard by the
professions (Registered Massage Therapy) competency docu-
ments and in their absence (non-registered provinces) the
professional associations curriculum standard or guidelines
for curriculum content. The professions competency docu-
ments articulate learning competencies for each subject area
that define, in broad, general terms, the appropriate subject
knowledge for these areas. A competent text will cover at
least 60 per cent of the subject base articulated in these
competencies.
Subject expertise also requires that a quality text cover
subject knowledge competently. A good text should pro-
vide accurate knowledge in the subject area and contain the
appropriate concepts and ideas in sufficient detail. How
can we ensure this? Typically by looking at who wrote the
text and asking ourselves, is the author a subject expert?
Anyone can write a book about anything; however, how do
14 Massage Therapy Canada WInTer 2011
we know that the author knows his or her stuff?
This typical tester question revolves around yet
another question; does he or she possess the appro-
priate level of knowledge or training required
to be considered a subject expert in the field?
Keep in mind that subject expertise is most
often judged by credentials, unless we are talk-
ing about a subject where there is no relevant
distinguishing credential. We also need to keep in mind,
here, that the subject expert must be a subject expert in the
field in question.
Are there any other tests that help us ascertain subject
expertise? Yes there are. Subject experts are often recognized
as subject experts by independent industry bodies and orga-
nizations and often have published extensively over a number
of years.
competence in delivery
A text that is competent in delivering subject knowledge is
clearly written, coherent and linear in the development and
presentation of ideas and concepts. It is written at a read-
ing level that is appropriate for the reading audience. It will,
where possible, include review questions and chapter exer-
cises to support the subject content and, very importantly
for us in an applied science health-care field, integrate theory
and practice.
support resources
Finally, how easy and convenient will the book be for the
teacher to use and adapt to his or her classroom instruc-
tion? Support resources are often taken for granted but are
very important to us as educators and instructors. Our time
is always limited and we need to find texts that are not
unduly burdensome in terms of implementation, or better
still, find texts that provide us with support for implemen-
tation in the form of a resource coach, training workshop
or online support, etc.
 Continued from page 13
This technology enhances your clients experience when doing business
with you. It keeps them informed throughout the entire life-cycle of
their appointments. Best of all, it is an automated process and does not
add additional workload on the personnel of the practice.
Cell phone technology that will allow the therapists to be more acces-
sible and responsive to their clients via voice, e-mail and text messaging.
During treatments of course, your cell phone ring function should be
muted or turned off.
The above communication tools are intended to accommodate everyone.
They provide traditional communication services, as well as modern methods
for those who prefer a more instant response. While this may appear to be
complicated and budget-breaking, it doesnt have to be. There are a variety
of service providers that make these technologies readily available to massage
therapists at a very affordable cost.
You will find that a large percentage of your clients will end up preferring to
use electronic methods to communicate with you. This will actually be time-
saving for you. You may elect to use this extra time to treat more clients or sim-
ply to spend more time with family and friends.
Until next time, be well!

Jessica Foster writes on behalf of mindZplay Solutions a leading

provider of massage therapy websites and practice management
solutions. To learn more about mindZplay Solutions for Massage
Therapists please visit www.massagemanedger.com or call toll free
888-373-6996.

cost effectiveness
Lets face it, cost matters and it makes
a difference. If a textbook is over-
priced, and our students cant afford
to buy it, then it isnt a good option
for us. A good quality textbook should
be reasonably priced and this means it
should reflect a price that is commen-
surate with other books in the subject
field on the market. How do you know
if this is the case? You must research
the market, look for other books in the
subject area and determine what the
average price is for a text on this topic.

ccmts teXtBooK revieW

service
The Canadian Council of Massage
Therapy Schools now offers a Textbook
Review Service. The CCMTS Education
Committee will review texts according
to criteria in this article and publish
their results in the form of recom-
mendations. CCMTS invites authors
and publishers to forward their texts to
the CCMTS Education Committee.
Additional information regarding the
CCMTS Textbook Review Service and
an application for review of a textbook
can be downloaded from the CCMTS
website at www.ccmts.ca.

Massage Therapy Canada WInTer 2011 15

Feature By sChroeder nordholT

The Therapeutic
Qualities of Music
Choosing the right sounds for a perfect massage

J
ust as the supple hands of a seasoned body worker caress and ease away stress and strain from
the physical body, the right kind of music clears the mind and opens the emotions. Music
absorbs the thoughts and emotions of its creator and takes on the properties of those very
thoughts and emotions, whether positive or negative. This is what makes music such a powerful
medium in all our lives our spiritual natures resonate with the deeper underlying emotions that
connect us as humans and that the music embodies. Therefore, in effect, by working on the clients
emotional body, music can partner with the practitioner, combining to create the perfect mind/body
reconnection and optimized treatments.

Although this sounds obvious, the fact is, this is a challeng-
ing and sometimes complicated subject given the many vari-
ables in the field. Make no mistake: the right kind of music
will vary from client to client, and even for repeat recipients.
How do you know where to begin when choosing the right
music for a treatment session? How do you know which CD
to play when each client walks through your door?
My aim is to help you discover how to do just that, by giv-
ing you some tools you can use. After performing a quick
assessment of your clients condition, you will feel more
confident about choosing which type of music can best bring
him/her back to a place of balance and calm.
Within the absolutely never-ending genre of relaxation or
new age music, there are many elements, each with unique
effects upon the listener. It pays well to have some knowledge
about these elements, as they can profoundly impact clients
overall massage experience, resulting in a positive and benefi-
cial treatment or not.
For example, a relaxing drumbeat is going to have a certain
effect on the listeners heart rate, mental function and overall
ability to relax. A solo flute playing long notes will have an
entirely different influence. And, so forth.
Lets take a beginners look at the inseparable relationship
between healing touch and music. The following are some com-
mon elements found in relaxation music, and their effect traits.
teXture
First, we must define the word texture with regards to
music. Texture has to do with how thick or thin the lead
instrument comes across as in how many notes are played,
how busy or sparse they are, etc. It also refers to the quality
of backing instruments and ambient sounds (for example,
nature sounds).
The busier the music is both lead and backing instru-
ments and/or the heavier the quality of the ambient
sounds, the heavier the texture of the piece will be. Read
on, to find some examples of lighter and heavier textures in
music and how they might be harnessed to balance your cli-
ents energies in a way that will complement your massage
treatement.
string instruments
Light acoustic guitar, sparsely played, light in texture
The vibrations of the strings of a guitar have a unique qual-
ity of entering the mid-level frequency range in the listener
at an average frequency of 82 Hz. This results in a soothing

16 Massage Therapy Canada WInTer 2011

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Massage Therapy Canada WInTer 2011 17

effect around the heart and solar plexus areas, and can result
instantly in the sense of release, unwinding and destressing.
Light piano, sparsely played, light texture
Played in a relaxing, yet masterful, manner, the piano will
provide an instant effect of a sense of unwinding. The piano
has a unique quality similar to that of an acoustic guitar,
with the added benefit of its superior range in frequencies
and depth in overtones. Overtones are frequencies inherent
in regularly played notes on acoustic instruments. Although
these tones are often undetectable by the human ear, the
energy body, or emotional body, of the listener will become
harmonized by them passively.
Piano and/or guitar, relaxing manner, thicker texture
For clients who dont necessarily want to drift off completely
this music will be soothing and relaxing, but also engaging
enough to retain the attention of the listener, thus enabling
them to stay in their bodies. Artists to look for in this area
are Fiona Joy Hawkins, among many others. Try Googling
relaxing classical piano or relaxing classical guitar. These
instruments played tastefully in a classical style can be incred-
ibly effective in assisting clients to unwind. The potent com-
bination of the very nature of the frequencies transmitted
from the instruments themselves to the listeners ear, and the
living 3-D geometrical and mathematical structures of classi-
cal music, is unparallelled in its transformative potential.
Harp
The effects of the harp are going to be similar
to those of the guitar, and the texture is
usually very light. So this will be perfect
for clients who need to escape from their
current mind/body set leave their body
for a mini vacation in your care, in order to
bring them back to a place of alignment and
peacefulness. A popular source for great harp
playing is Loreena McKennitt, a favourite
for massage therapists, and also lesser-known
harpist Kaia Nightingale.
Sitar
This instrument is useful in ridding the
environment of all kinds of disturbances
and negative energies. The sitar embodies
the rare trait of micro-tones that is, notes
between the Western 12-note scale to which
most of our ears are accustomed. This can
have the rare effect of breaking up blocked
energy patterns in the listener including
yourself as the therapist and can assist
in releasing unwanted habits. It can
bring all chakras or energy centres,
into alignment very quickly and
easily due to these rare sonic per-
sonality traits. A good source for
relaxing sitar music is Stephan
Mikes.
18 Massage Therapy Canada WInTer 2011
Wind instruments
Flute
The flute is obviously an air instrument, and thus works
in the higher sonic spectrum. This will serve well for clients
who feel heavy and downtrodden. It operates at an aver-
age frequency of 261 Hz, which will resonate and positively
affect the area of the head and even the energy emissions
(mental and spiritual exhaust) in the space above it. The
flute has a way of clearing the room of unwanted heaviness,
replacing it with light frequencies, enabling a very effective
massage treatment. Great flute players include Robbie Hanna
Anderman, Paul Adams, R. Carlos Nakai and Tim Wheater.
Of course there are many others.
Saxophone
The sax operates in the mid- to high-level frequencies
103-207 Hz. This is perfect for blending the energies, and
promotes reunification of the fragmented person. This
instrument carries a vibration that may evoke a lot of emo-
tion in the listener greats such as John Coltrane and Dexter
Gordon proved this wonderfully. Applied to the relaxation
music genre the saxophone can very quickly soothe the lis-
tener into a sensory paradise.
orchestral strings
These can alleviate both physical and mental stress very
quickly, and provide a deeper sense of awareness and enjoy-
ment. Frequency ranges depend on the actual instrument
(cello, viola, violin, etc.), but when used together in a piece
as an orchestral ensemble, as is often the case, the strings
have a similar effect to the piano: they can cover the widest
available range of frequency, thus providing maximum heal-
ing and relaxation benefits. If you do a Google search for
relaxing classical music youll find lots to choose from.
the human voice
The human voice is one of the quickest sounds in opening
the chakras in the body for both the singer and the listener,
cultivating an immediate space for healing and rejuvenation.
The human voice is considered to be the first or primary
instrument connecting the singer and listener to something
both primal and divine. Many artists vocalize with their
voices, with few or no lyrics, or chant in an enchanting
exotic language; popular examples of this chanting include
Enigma and Deva Primal.
percussion
Light hand-drumming is very grounding for people who
seem to have little control of their emotions and are spinning
in their minds. Perfect for soothing feelings of being over-
whelmed and for coming back down to reality. Some of the
Native relaxation CDs are perfect examples of this and are
easily found using a Google search. New Earth Records has
lots of this type of music.
something completely different
Crystal bowls
The calming sound of the crystals and their pure sine waves
open the chakras and create a balanced and restful ambiance
for your clients. Crystal music can help facilitate optimum
peace and relaxation. The sounds are created by placing
moistened fingers on the edges of the revolving crystal bowls.
Sometimes ghost notes and complex rhythmic beats occur;
they produce a sound spectrum that features harmonic par-
tials. This results in a sound that consists of a fundamental
note plus a number of harmonic overtones. There are a num-
ber of artists who produce crystal music, including Yatri and
David Hickey.

Chill-electro
Perfect for the client who just wants to unwind. This type of
music will carry a familiar pop vibe, yet be chilled enough make
them say aaaahhhh. (But not in the dentist kind of way!!)

conclusion
Clearly, it is becoming more important to offer a greater variety
of music for an optimally effective and satisfying massage
treatment. Clients are becoming more and more discerning
with regards to the interaction between their treatment and
the role music has to play. Just as we crave different foods
without necessarily knowing why, our emotional and cell
bodies crave certain types of music, and having different
styles on hand and an understanding of the various elements
in music and their unique effects, makes a huge difference.

Knowing just which tracks to play for each client is a combination of using
the tips youve learned here and harnessing your instinct and experience.

This actually gives you an edge when your clients realize

that you have knowledge of the interactivity between music
and massage at your disposal, they will be more apt to trust
you and to return, and also to spread the word about the
great RMT they have found.

Schroeder Nordholt is a seasoned musi-

cian, producer and composer. Currently he
chooses music from around the world for the
ASOMAssageMusic.com catalogue.

Massage Therapy Canada WInTer 2011 19

Feature By CaTherIne ryan, rMT

Understanding
Stress Part 1
Triggers, responses and long-term consequences
When we know better, we do better. Maya Angelou

If you are a manual therapist of any denomination, your

hands have touched it stress. Tissues so tightly wound
and densely compressed that you pause for a moment and
contemplate . . . is this bone or is this flesh? There is an old
saying that goes: There are only two things in life that are
certain, death and paying taxes. By the looks of it, we need
to add a third experiencing stress. Although some stressors
may be obvious and some avoidable, it would be virtually
impossible to eliminate all potential stress triggers from our
lives. Whether you are human, cat, dog or mouse experi-
encing stress is simply a part of life. Although not all stress
is harmful, its estimated that somewhere between 75 and 90
per cent of doctors visits are for conditions that are stress-
related. It is probably not much of a stretch to apply this
statistic to massage therapy visits!
Because stress is such a highly subjective and complex What is stress/a stressor?
cornucopia, in terms of the variety of its triggers, percep- In 1936, Hans Selye coined the word stress and defined it
tions, responses and impacts on the bodys systems, it can as; the non-specific response of the body to any demand
be pervasive and difficult to manage effectively. for change.1
However, as previously noted, response does have its time A stressor is defined as an event or perception that triggers
and place like when we need to run fast or leap far to avoid the stress response.
some calamity. However, when the imminent danger is or
seems unavoidable, or is continuous or non-productive, What are some common stress
then one can be adversely impacted rather than assisted by triggers?
the stress response. Common stressors, or stress triggers are:
Cultivating a better understanding of what stress is, its environmental elements (e.g., elevated sound levels,
potential stress triggers and how our bodies respond to stress over-illumination, overcrowding, and/or an unsafe
will improve our ability to support our body and being in home, school or work environment);
ways that fortify our resilience, health and well-being; alter daily events (e.g., family, school or work responsibili-
stress-inducing situations and behaviours; implement strate- ties, personal conflict with family members, peers or
gies that help us manage unavoidable stress more effec- co-workers, dealing with traffic);
tively; and reduce the adverse impact of prolonged stress significant life changes (e.g., bereavement, relationship
response on our health and well-being. dynamics, health-related issues, job loss).
And thus . . . when we know better, we improve our poten- Prolonged or repeated stress responses can be triggered by
tial to do better! physical threats, emotional distress and/or psychological trig-
gers that are either current, perceived or remembered.

20 Massage Therapy Canada WInTer 2011

 Like musculoskeletal injury, a stress trigger can occur as an
acute episode or chronic syndrome. Therefore, stress response
can occur as a short-lived episode, or as an insidious under-
current that is known to have a detrimental impact on ones
health and well-being.
Massage therapy fulfils a number of the
strategies for stress support and is a
means by which to reduce the adverse
impact of prolonged stress response on
the soft tissues.
hoW do We respond to stress?
Tend and befriend
There exists a vast array of potential stress responses. In any
given circumstance one may run like crazy, fight when cor-
nered, stand perfectly still so as not to be seen or gather with
others i.e., the safety in numbers paradigm. eventually some means of coping with the stress becomes
Tend and befriend refers to coping with stress through
social or group support (i.e., befriending) and providing or
receiving protection, nurturing or emotional support (i.e.,
tending to others or being tended to).
Social isolation significantly enhances risk of mortality,
whereas securing social support results in beneficial health
outcomes, including reduced risk of illness and death.2
Fight or flight (flee)
Fight or flight is mediated by the sympathetic nervous system
(SNS) and is recognized as the initial stage of stress response
adaptation.
Fight may manifest not only as a physical exchange but also
as vocally aggressive or argumentative behaviour.
Flight can occur as escaping in either a sensory way (e.g.,
social withdrawal, substance abuse or television viewing3) or a
physical way (e.g., running away from something perceived as
threatening or towards something that is needed or feels safe).
general adaptation syndrome
Selye went on to describe the universal response to a stressor
as the General Adaptation Syndrome (GAS). GAS comprises
three stages:
The first stage is alarm Governed by the SNS, alarm
results in the production of adrenalin, which is the fuel for the
fight-or-flight response. There is also some activation of the
hypothalamic-pituitary-adrenal (HPA) axis, producing cortisol.
The second stage is resistance; if the stressor persists, then
necessary. Prolonged and continuous adaptation (coping) will
eventually deplete the bodys resources.
The third stage is exhaustion. Once the bodys resources
have been depleted, normal functioning breaks down. If stage
three is extended (i.e., prolonged SNS predominance) long-
term damage may result.4,5
Once activated, the SNS sparks a cascade of physiological

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Massage Therapy Canada WInTer 2011 21

events. SNS predominance will suppress or alter any func-
tion that is governed by the parasympathetic nervous system
(PNS).
A fundamental function of the PNS is to govern homeo-
stasis. Any system or physiological function that is generally
the domain of the PNS will be impacted when the SNS
takes the helm.
prolonged stress response
Prolonged stress response (triggering continuous SNS predomi-
nance) has been shown to suppress the immune system, disturb
diurnal rhythm, stimulate or sustain obesity, adversely impact
the bodys pH balance and increase the incidence of chronic
myofascial tension to list but a few potential health risks!
Research shows that the human body more readily suc-
cumbs to illness and disease when pH is unbalanced and min-
eral reserves are depleted. Constructive enzymes can become
destructive. Oxygen delivery to cells can be diminished.
Stress and cancer
According to Nobel laureate Dr. Otto Warbur: When pH is
off, and our bodies are running more acidic, our cells are get-
ting less oxygen. Cancer thrives in an acid tissue pH/oxygen
deficient environment.
Stress and the cardiovascular system
In an acidic environment, fatty acids (circulating in our
bloodstream) switch from a negative electro-magnetic charge
22 Massage Therapy Canada WInTer 2011
to positive and automatically are attracted to, and stick
to, negatively charged, arterial walls (i.e., athlersclerosis).6
Prolonged acidic pH has also been shown to play a role in
degeneration of the internal arterial walls.
Stress and the myofascial system
Psychological distress or anxiety has clearly been identified as
a source of unnecessary muscular tension. Unnecessary
muscle tension is defined as the confusing intermediate
Dr. Chaitow . . . And what about massage?
The list of conditions that have been shown to be helped
by means of application of massage is so comprehensive,
it is safe to say that this is a form of therapeutic input that
should/could be offered to all patients, of whatever age or
level of well-being or illness. The musculoskeletal system is
both the greatest energy consumer of the body and its larg-
est organ of sensory input. While this primary machinery of
life has long been unappreciated, in therapeutic terms, soft
tissue manipulation is an important diagnostic and treat-
ment modality and should be considered an integral part of
care for the whole person. The professions within medicine
that utilize manual therapy, such as physiotherapy, have
tended to discard the tradition of hands-on treatment in
favour of a more technological approach, leaving the soft
tissues to massage therapists and sports therapists.
between a non-voluntary muscle contraction (spasm) and
viscoelastic tension (a fascial property) showing no EMG
activity.7
According to Dr. Leon Chaitow, the shortened fibers of
the soft tissues may be the result of a combination of structur-
al anomalies, trauma, and/or physical or emotional stress, and
are always influenced by underlying nutritional and behavior-
al elements. Some of these shortened fibers and tender spots
(i.e. trigger points) may be the source of reflex symptoms
and pain. All such soft tissue dysfunctions respond to manual
pressure in the form of modalities like massage therapy.8
Clearly, massage therapy fulfils a number of the strate-
gies for stress support (e.g., tend and befriend, providing a
safe and calming environment) and is a means by which to
reduce the adverse impact of prolonged stress response on the
soft tissues. As you are probably thinking all that stress talk
just to plug the virtues of massage therapy? Well . . . yes!
In Part 2 of this article an interview with Dr. Leon Chaitow
we will look at stress, breath and pH. Dr. Chaitow will
expand on the impact of pH imbalance on the soft tissues.
references
1. www.stress.org/topic-definition-stress.htm.Stress,
Definition of Stress, Stressor, What is Stress?, Eustress?
Retrieved from www.stress.org on December 10, 2006.
2. Cohen, S., Willis, T.A. (1985). Stress, social support,
and the buffering hypothesis. Psychological Bulletin, 98,
310-357.
3. Friedman, H.S., and Silver, R.C. (Eds.) (2007).
Foundations of Health Psychology. New York: Oxford
University Press.
4. Selye, Hans: A syndrome produced by diverse nocuous
agents (1936). Nature 138. Selye Biologic Reaction to
Stress chart.
5. Poesnecker, G. Chronic Fatigue Unmasked (1999);
ISBN 0916285618.
6. Philpott, W. Heart disease is really a function of heart
muscle acidosis. Biomagnetic Handbook.
7. Simon, D. G. and Mense, S. Understanding and
Measurement of muscle tonus as related to clinical
muscle pain. Fascia Research, Basic Science and
Implications for Conventional and Complementary
Health Care. Elsevier (2007).
8. Chaitow, L. ND, DO. Soft tissue manipulation: diag-
nostic and therapeutic potential. Retreived from, www.
leonchaitow.com on March 10, 2007.
additional references
www.leonchaitow.com
Fascia Research, Basic Science and Implications for
Conventional and Complementary Health Care. Elsevier
(2007)
www.biomedex.com
www.wikipedia.org
www.webmed.com
www.mayoclinic.com
Cathy Ryan has maintained a diverse, treat-
ment-oriented massage therapy practice, and
an extensive postgraduate training roster, since
1990. She is a long-standing member of the
OMTA and has served as a subject matter expert,
examiner and examiner trainer at the CMTOs provincial licensing
examinations. Ryan is the managing and commissioning editor for
TouchU.ca, which provides education for touch professionals, stu-
dents and the public. She is available to teach workshops and can
be reached at: cryanrmt@gmail.com or www.touchu.ca.

How to test for pH imbalance

and what to do about it!
You can easily test your own pH by purchasing pH test strips
at your local health food store or pharmacy. Instructions for
use will be provided with the product typically you test
your first morning urine or saliva, prior to any food, bever-
ages or brushing your teeth. You then compare the colour
of the test strip to the graph provided. Neutral pH is around
7.0, with normal morning-urine pH being between: 6.2 and
7.0 (6.0 and below would be considered acidic). A number
of factors can influence pH, including nutrition. Information
on acid/alkaline foods is readily available on the web. If you
are concerned about more serious health issues or you are
having difficulty balancing your pH, it is recommended that
you see a naturopath.

Massage Therapy Canada WInTer 2011 23

Feature
Reducing Back Pain
Top 10 tips for your patients and you!
B
ack pain, while among the most common
complaints of our society, and the reason
for much expenditure of resources within
our health-care system, remains elusive
to efforts at characterization, both in terms of
etiology and treatment. It is the cause for a
variety of lifestyle issues ranging from reduction
of daily function and/or participation in favoured
recreational activities to missing work, both in
the short and the long term. prevention has
demonstrated a degree of effectiveness as a
strategy to counter back pain, whether it be injury
prevention or vigilance to daily habits that may
cause or promote musculoskeletal issues that can
lead to back pain. The following article explains
ways of preventing, reducing or eliminating back
pain that I have found to be very useful for my
patients as well as for me.
1. perform daily BacK eXtension eXercises
A lot of back pain is generated from bulging discs. Discs
typically bulge posteriorly, or backwards (no pun intended).
Back extension exercises help to move the bulge forward
again. This reduces the pressure on the annulus (outer fibres)
of the disc and allows the nucleus (inner gel-like substance)
to move forward.
You can improve disc health and reduce back pain by per-
forming 15 back extensions twice a day, every day, or after
prolonged sitting at a desk or in a car.
To perform back extensions, stand up straight with your
feet shoulder-width apart.
Place your hands on your low back, and then bend back-
Figure 1 Figure 2
24 Massage Therapy Canada WInTer 2011
By MIke dIxon, rMT
wards to your point of comfort. Repeat 15 times. (Figure 1)
Another way to perform a similar exercise is to do a push-up,
arching your back while pushing your upper body away from
the floor.
2. lift properly
Improper lifting will increase the pressure on the disc in the
lumbar spine by up to 400 per cent. In other words, lifting
50 pounds incorrectly can add 200 pounds of compression
onto the discs this may be enough to rupture the disc if the
disc is already compromised. Disc ruptures and bulges are a
major source of back pain and disability.
Always bend your knees and keep your back straight when
attempting to lift a heavy object (Figure 2). Never attempt to
lift weight beyond your ability.
3. fight gravity do daily posture
correction eXercises
Gravity tends to lead us to having poor posture over time.
Poor posture includes head-forward carriage, rounding of the
shoulders, forward rounding of the upper and mid back (tho-
racic spine) and flattening of our low back (lumbar spine).
These positions put a lot of force onto the musculoskeletal
systems, which eventually leads to back pain.
To perform posture correction exercises, find a wall, place
your heels against the baseboard and bend your knees slight-
ly. You should feel the base of your spine and your shoulder
blades touching the wall. Think tall and straighten up. Now
tuck your chin in and try to touch the wall with the back of
your head without extending your neck (lifting your chin).
If you cant, put a small pillow or towel in the space between
the wall and the back of your head. Most people have slight
head-forward posture. Do these exercises regularly and you
can remarkably reduce and prevent back pain.
4. Keep active
Your back needs oxygenated blood flowing to the muscles and
surrounding tissues in order to eliminated toxins. Toxins in
the tissues can cause muscles to tighten and even spasm. Tight
muscles not only use up more energy because they are work-
ing too hard, they produce toxins that generate back pain.
You can eliminate excessive toxins with aerobic exercise,
which in turn improves circulation. Improve muscle health
and reduce pain by going for a brisk walk or swim every day.
Save your back and heart. Get moving!
5. ensure proper Biomechanics at your
WorKstation
Poor ergonomics at your workstation can lead to repetitive
strain injuries, as well as back, neck and shoulder pain.
Have your computer mouse close by so that you are not
reaching, straining or rounding your shoulders. Your elbows
should be close to your sides and your arms at a 90-degree
angle. The computer screen should be at the same level as
your eyes so that you are not extending your neck this may
generate tension headaches.
An adjustable height chair with a good lumbar support will
help eliminate back pain. The chair height should be adjust-
ed so that your hips are at the same level as your knees and
your feet are firmly planted on the floor. This will prevent
back and neck strain.
6. do not sit on your Wallet
When you sit on your wallet, it tilts your pelvis unequally this
not only puts stress on your joints, but causes pressure on your
sciatic nerve. The sciatic nerve, when compromised, causes sharp
pain that radiates into the low back and down the leg.
Stay off of your wallet, so that it does not cost you what is
in your wallet!
7. limit the Wearing of high-heeled shoes
High heels force your low back into extension (backward
bending) and this stresses the joints and intervertebral discs
in the lumbar spine. This puts a lot of extra stress on the
spine. Try limiting the use of the high heels to special occa-
sions. If you must wear heels during your workday, consider
wearing a lower heel or a platform shoe.
8. practise correct sleeping posture
Try to position yourself in proper spinal alignment before
going to sleep. If you sleep on your side, put a pillow
between your knees and a comfortable supportive pillow
under your neck. If you typically sleep on your back, put a
large pillow under your knees, which takes the stress off of
the low back. Your pillow should be the right size so that
your neck is in neutral position, not flexed (chin towards
chest) or extended (neck bent backwards).
Try never to sleep on your stomach, as this causes your
neck to be turned to one side or the other in order to
breathe. Prolonged rotation of your neck will wreak havoc on
your neck and back and may cause back pain.
9. Watch your Weight
Extra, unwanted weight adds to the compressive forces of the
whole back, particularly the weight-bearing structures of the
lumbar spine. The more weight you carry on your body, the
more the lumbar spine tends to flatten out to support the added
weight. This is called hypolordosis, the result of which adds com-
pressive loads onto the intervertebral discs. The extra pressure on
the discs can lead to tearing or rupturing of these discs. Reduce
unwanted weight and save your discs to prevent back pain.
10. dont ignore BacK pain
Remember to treat your back better than your car - that is,
dont ignore back pain until the problem it is trying to alert
you to is costly and difficult to fix.
There are many sources of back pain. It could be due to
something as simple as a muscle strain or it could be the sign
of a nerve compression. A professional such as a massage
therapist can provide a medical opinion and set a patient on
the road to recovery and a pain-free back.
Encourage your patients to give their backs regular mainte-
nance and tune-ups and to be vigilant regarding prevention,
and they will find that their backs treat them well!
Mike Dixon, RMT, has practised massage
therapy for 25 years. He is an educator, a pub-
lished author, and an international presenter
in massage therapy continuing education
(Arthrokinetic Therapy). Mike graduated from
the West Coast College of Massage Therapy in 1986 and has
been teaching at the school since 1993.
Massage Therapy Canada WInTer 2011 25
Feature By don dIllon, rMT

Massage Therapists
at Work
What now? Whats next?

C
limate is changing, culture is changing, the economy is changing, and with it, the massage
therapists workplace is changing! Varying considerably from the previous era, the current era
is tinged with economic and job insecurity, an aging population and rising health-care costs,
and increased reliance on government, technology and credit. Home-based or small facility self-
employed practitioners are subject to increasing competition by well-financed and sophisticated rehab
centres and spas, family medical practices (with in-house physiotherapy assistants) and various low-cost
modalities purporting the reduction of stress, strain and pain.

Given this environment, massage therapists need to
observe, respect and respond to the following trends:
shift from self-employed practitioners
to employees in large, commercially
viaBle enterprises
Through social networks and collective conversations, a pri-
mary problem is apparent therapists worldwide struggle
to maintain their practices. Most practitioners lack business
experience or time, energy and the required capital. They
prefer someone else handle marketing, maintenance and
business operations while the practitioner focuses on his or
her first love providing care.
Rehab centres, spas and massage franchises offer solutions
to the common problems of self-employed practitioners:
highly visible commercial real estate, rigorous marketing
campaigns, equipment, supplies, financed leasehold improve-
ments, the opportunity to work as a team/staff within
available hours, time-tested operation and administration
procedures, and a cost-point and service convenience that is
hard to beat. Michael Gerber, author of The E Myth, reports
franchises have a 75 per cent success rate compared to small
businesses where four in five fail within five years of startup.
Many self-employed practitioners recognize the clear time-
and money-saving advantages of working in an established
business and will jump their own ship to join one.
Employed practitioners have opportunity for workplace
benefits such as pension plan, employment insurance and
maternity/paternity leave, extended health-care and dental
plans, and holiday/vacation pay. Some companies offer profit
sharing or the opportunity to buy into the business as a
partner/investor. There is room for organizational growth as
a lead therapist, which moves the practitioner into a man-
agement position hence, less physical wear and tear on her/
his body.
Despite this shift, there is still room for the self-employed
specialist who provides sophisticated massage/manual therapy
and has built a loyal following. New massage practitioners,
however, face greater competition to grow alongside stream-
lined and sophisticated rehab and spa facilities.
massage therapists as assistive/
adjunctive care
Massage therapy may approach mainstream health care in public
perception, but it remains adjunctive in health-care policy and
funding. In Ontario, massage therapists are regulated health
professionals, yet face barriers to funding from provincial
health care, auto insurance and workers compensation.
The reasons stated by the powers that be are i) lack of
degree-level education, and ii) insufficient research. A third
reason, I suspect, is a largely unsupported professional asso-
ciation. Its the job of the professional association in your
province to advocate and lobby on behalf of the massage
profession to government, the insurance industry, other
health-care providers, the media and public. Massage therapy
is viewed as mostly harmless, but hardly curative, and thus it
lacks credibility to receive full health-care funding. RMTs are
reliant on gatekeeper health professions to access to health-
care dollars.
Government policy continues to download duties and
responsibilities to lesser-trained, lower-salaried health-care
positions. Physicians defer to nurse practitioners or physician
assistants, dentists to dental hygienists, nurses to practical
nurses, and so forth. In 2009, physiotherapy and pharmacy

26 Massage Therapy Canada WInTer 2011

received more powerful scopes of
practice in part to supplement short-
age of physician, nurse and hospital
resources. An insidious possibility is
that physiotherapy/occupational ther-
apy assistants employed by gatekeepers
may usurp massage therapists, pro-
viding massage therapy at lower cost
and greater accessibility to patients.
However, its also possible RMTs
could be retrained to work in family
practice and provide supportive care
to patients alongside physicians, nurse
practitioners and physiotherapists.
and ergonomic assessments are a few
of the gems that would be included in
the package . . . a seamless transition
from fitness to health and back again.
It is this authors strong suggestion
to press your training institutions,
regulatory bodies and professional
associations to collaborate within the
profession and make inroads for col-
laboration with other CAM profes-
sions . . . theres no time to lose!
SubScribe TODAY !
heal yourself 4 Issues
health care

interdisciplinary
collaBoration
At the Highlighting Massage Therapy
in CIM Research conference of May
2010, William Meeker, DC, MPH,
asked the salient question Why are
we trying to do this by ourselves?
Moderating the panel Role of
Massage Therapy in Public Health,
Meeker described that complementary
and alternative medicine (CAM) pro-
fessions are pursuing the same goals:
generating research and evidence-based
practice, lobbying government for
policy change and inclusion in health
care, negotiating with the insurance
industry, and raising the standards of
education and training in their respec-
tive practitioners. Working alone,
each profession is limited by resources
and is ultimately slow and ineffective.
Meeker suggested CAM professions
collaborate on resources, share knowl-
edge and co-ordinate lobbying and
education initiatives.
There is also opportunity to align
with the fitness and wellness indus-
tries. Dr. Jayne Alleyne, MD, wrote,
Perhaps the time has come to con-
nect the fitness and health care indus-
try together in a joint action plan
of education, service delivery and
preventative medicine. I would like to
see a Wellness Package that includes
a monthly fee for health services that
would be used over the year for pre-
vention, performance or treatment.
A wellness coordinator would meet
with all clients and set out a plan for
achieving an improved state of health
and wellness over the year. Services
such as massage therapy, dietary con-
sultations, injury prevention assess-
ments, stress management strategies
With the advent of the Internet and
a me culture focused on consump-
tion and choice, boomers and their
children and grandchildren will be
looking for sophisticated, effective
bodywork. Boomers and generations
X and Y are information-savvy and
will look far and wide for solutions
to their somatic problems. Many
boomers suffer the body-breaking
effects of the second industrial then
information era, while generations
X and Y require care for extreme sport
pursuits and chronic stress syndromes.
Boomers exercise their buying power
and demand exclusive, sophisticated
results-oriented care.
Like all things popular, massage
therapy has attracted profiteers that
commoditize product or service to
yield higher profits. Beyond the con-
cern of diffusing the original potential
of bodywork, there is definite value
in making it available to the masses.
I suspect people will continue to seek
ever-sophisticated forms of its heal-
ing properties. The human potential
movement began with the boomers
in the 1960s, and I believe well see a
renaissance. More people seek embodi-
ment in a culture that continuously
disembodies. In a technology-saturated
world, massage therapy will become
more important than ever.
Don Dillon, RMT, is
the author of Better
Business Agreements:
A Guide for Massage
Therapists and the
self-study workbook Charting Skills for
Massage Therapists. Don has lectured in
seven provinces and many of his articles
have appeared in industry publications.
Visit his website, www.MTCoach.com.
only
$
2995 Plus GST
US $44.95 (USD) Foreign $59.95 (USD)
For even better pricing go to
www.massagetherapycanada.com!
Name: ________________________
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Address: ______________________
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Prov: _________________________
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Tel: __________________________
Fax: __________________________
e-mail: ________________________
TO ALLOW uS TO SerVe YOu beTTer,
PLeASe iNDicATe YOur TiTLe beLOW:
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& Printing inc.
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expiry: ___________________________
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TO SubScribe:
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Mail: Massage Therapy canada
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P.O. box 530
Simcoe, Ontario N3Y 4N5
e-mail: cnowe@annexweb.com
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Massage Therapy Canada WInTer 2011 27

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Biography
Meet Mike Dixon, RMT
tell us aBout yourself
I am guessing that everyone has their story about how they
entered into this profession and became a massage therapist.
Well, when I was young and foolish (19 years of age), I was
up in a tree fort in a friends backyard and we were jumping
off of the roof onto a rope swing. When it was my turn, I
jumped and the rope broke; I dont even think it slowed me
down. I ended up with an anterior compression fracture of
T12 and fractured the bodies of all the lumbar vertebrae. It
was three days before high school graduation. Needless to say
I spent graduation in the hospital. This was in 1980; at that
time there were not too many massage therapists in Victoria,
but I found a good one. The massage treatments were terrific
and really helped with my recovery.
Three years later I decided to become a massage therapist. I
have now been a massage therapist for 24 years (since 1986).
I have been known to wear several hats: father, therapist, col-
lege instructor and author, and am constantly struggling to
find the right balance between my family, my work and me.
I enjoy being out on my boat with friends and family in
the summer, and look forward, every year, to the family
camp-out somewhere in British Columbia, where the lakes
are pristine.
Every year for the past 25 years, our extended family have
gathered for this annual get-together.
But enough about my personal life.
professional profile
I am a 1986 graduate of the West Coast College of Massage
Therapy (WCCMT) in New Westminster, B.C. It was the
second graduating class from this college and young in its
development as a college but I enjoyed the training and the
people immensely.
I really enjoy my massage therapy practice in downtown
Vancouver, The Electra Health Floor. I am there two
days a week Monday and Saturday. Tuesday through
Friday, I teach at WCCMT , where my main subjects are
orthopedic treatment, regional and spinal orthopaedics
and consolidated practice. Consolidated practice is a
course that prepares the students for their licensing board
exams, and I will say that the students have always kept
me on my learning curve.
influential people and eXperiences
I think it is really important to recognize the people who
30 Massage Therapy Canada WInTer 2011
ConTrIBuTor To The proFessIon
provided the experience and
the foundation to help you
arrive at where you are today.
You have to say thank you to
people for their strengths and
their weaknesses, for without
both to learn from, you would
not be the person you are
today. Some of the people I
would like to thank are John
Ranney, RMT (founder of
WCCMT), John Yates, PhD,
Claudia Scrivener, PT, Doug Fairweather, RMT, and all my
instructors in the past, as well as those from whom I am still
learning today.
most cherished eXperience
or accomplishment
I have authored two books on joint and soft tissue manipula-
tion and muscle energy. One is called Joint Play the Right Way
for the Peripheral Skeleton and the other is titled Joint Play the
Right Way for the Axial Skeleton.
The genesis to produce this resource was a need, within
the profession, for a book tailored to the massage therapist;
it could be successfully used in the classroom and, ultimately,
as a valuable resource in the clinic setting. Today, both books
are widely used across Canada.
This year, I was very honoured to receive the Legacy Award
from the Massage Therapy Association of British Columbia
for outstanding contributions to the profession. It definitely
made me feel proud, and that I have made a difference in
this profession.
hope for our profession
I have seen this profession grow tremendously over the past
25 years; we are definitely more organized, more knowledge-
able and much more highly educated. We certainly are more
accepted within the medical community and more respected
in the public eye. If we can continue on this path, I look for-
ward to what the next decade or two will bring.
Words of Wisdom
Become an expert at something, and that something should
be your passion. This coupling of the two will surely bring
you success, however you define success.
6 Canadian Campuses

Toronto (english)
Winnipeg (english)
30 years of experience in the Traditional Manual Practice of Osteopathy
877-893-0367
416-597-0367 This 5 year part time program is designed for health-care professionals to gain
experience and evolve their practices while studying.

The Canadian College of Osteopathy offers:

Halifax (english) A program tailored to professionals already in clinical practice
Vancouver (english) A professional student clinic experience
A low instructor to student ratio
Quebec City (francais) Experienced faculty with many years of clinical practice
Montreal (francais) The practice of traditional manual osteopathy requires a fine touch, a gentle heart,
800-263-2816 and a desire to learn. The emphasis at the College is to ensure that the hand-to-hand
transmission of traditional osteopathy is preserved. Our lead instructors hold
514-342-2816 specialization in certain aspects of the program to ensure that the knowledge passed
on is of the highest quality.

www.osteopathy-canada.com Successful graduates of the Canadian College of Osteopathy receive a Diploma in

www.osteopathie-canada.ca Osteopathic Manual Practice (DOMP) and are automatically eligible to become a
member of the Ontario Association of Osteopaths and the Canadian Federation of
Osteopaths.
Join our
Any practitioner, who is licensed, certified, or registered, in the province of Ontario, is
Osteopathic eligible to enrol today. Having this uniform high admission standard allows the
Family Canadian College of Osteopathy to tailor its program to those therapists already in
clinical practice, so that they can evolve their practice from one that is satisfactory, to
one that offers daily gratification to both the patient and the Osteopath.