That is probably the question I am asked most above all others. Do my hands hurt?
Rarely, but when they do it usually is not related to Massage. A skilled body worker does not rely solely on one’s fingers to do the work. In a session I will use my palms, knuckles, fists, elbows, and on special occasions-feet.
A good Massage or Shiatsu session will also include stretches and body mobilization techniques; which are great for the client and the therapist. They add variety as well as they are very effective.
Now that I am teaching Swedish Massage, I drill the students constantly on proper body mechanics. Our work doesn’t come from the hands, but rather the core. If you watch a Massage therapist work you will notice a lot of lunging. It is from that movement that the pressure comes.
Over the last 17 years when I have had hand injuries, the culprit has often been a vigorous day in the garden or too much typing. Rest assured your massage is not causing my hands pain.
On a regular basis clients experiencing some sort of anxiety come into my office. Anxiety shows up differently from person to person; for example, one client may have a general sense of stress and worry while another might already be under the care of a doctor or psychologist for a diagnosed condition. Some people feel it in a general sense of agitation while others might have headaches. Body work helps ameliorate the signs and symptoms of anxiety both on a mental and physical level.
Bodywork calms down the nervous system
Basically, Massage therapists are wizards of the parasympathetic nervous system. The parasympathetic system is in charge of “rest and digest” and is when it is on the healing happens. Part of what is at play with anxiety is a heightened flight or fight response which is hardwired into our sympathetic nervous systems. We live our lives with our sympathetic nervous systems keyed up to handle what ever threats(real or imagined) are around the corner. What we do as body-workers is provide an opportunity for your sympathetic nervous system to turn off and your parasympathetic nervous system to turn on. Signs that your body has switched to the parasympathetic nervous system are slower breathing, gurgling tummy, and a drop in body temperature. When you sit up and say, “wow, I can get on with my life” I know that I have done my job.
There is a method to the calmness of a Massage room as the soothing music, the aromatherapy, the heated stones all trigger the relaxation response.
The Physiology of Worry
Not only does body-work engage the parasympathetic nervous system, it actually causes changes in the endocrine system; the system in charge of hormone secretion.
For example, massage has been linked to elevated levels of dopamine and lower levels of cortisol, which provides evidence of reduced stress.”
Benjamin, Patricia J Tappan’s Handobook of Massage Therapy p.136
Dopamine and oxytocin are feel good hormones whereas cortisol is emitted during times of stress. Due to the relationship of the PNS and impact on hormones Massage also helps with the psychosomatic signs and symptoms like headaches, tight muscles and upset tummy through hands on application. Regardless of the science behind Massage, caring human touch makes people feel good.
Emotional release is when a clients might have a deep sense of letting go of some intrinsic stress that has been held in the muscles and it usually involves a good cry during a bodywork session. Our muscles store our memories and sometimes when we are touched in a safe environment our minds and muscles let go of some negative feelings that has been stored inside. Not to worry if this happens, crying is a normal way to shed stress and most people feel better afterward.
It’s not the job of the Massage therapist to process the feelings like a talk therapist would, but rather to hold the space so that you can release deep tension. I like to say that we listen with hands and heart.
The Practical Healer Full Body Approach
Whether you choose Massage or Shiatsu a full body approach is best. For example; the scalp muscles can tense from making worry faces. Also Abdominal massage is great if worry has your stomach tied in knots. Rubbing out the shoulders is a way to take off the weight of the world. Working on the feet helps bring the energy down from the head and is deeply relaxing. Also, evening out the energy of the channels from an Asian bodywork perspective helps support the underlying condition.
Comfort and Safety are Key
The cornerstone of working with anxiety is good communication. No two clients need the same thing. I have anxious clients that prefer the deep pressure points of Shiatsu and others that prefer a soft Swedish Massage. One thing that everyone has in common is a need to be comfortable and safe. It’s not uncommon for those with anxiety to need adjustments to the bolsters, face cradle, music, lighting and so on. A good Massage therapist is there to help and can make infinite adjustments.
As far as aromatherapy goes, Frankincense, Lavender and Ylang Ylang are notorious for calming the mind. I can send you home with an aromatherapy inhaler which you use in times of stress. It’s also great to use before you fall asleep.
There are many acupressure points that are associated with couple the mind. Below are a few examples. A therapist trained in Shiatsu can access these points to augment a treatment for someone struggling with excess worry.
In conclusion bodywork is an effective tool for coping with anxiety-whatever form it takes. On a personal note, I too can find myself taking a ride on the worry wagon. Over the years I have learned that that talk therapy, medication, exercise and great body work are all helpful ways for me to deal with stress of anxiety. In particular bodywork helps with the psychosomatic manifestations like headache and stomach ache. I hope that you will find relief too so that you can continue to enjoy a vibrant life.
A client recently asked: “Massage removes lactic acid, doesn’t it?” This gave me pause. While it was thought to be true a decade ago, it is now considered to be unequivocally false. At that time it was also touted that massage removes toxins. It turns out that wasn’t accurate either.
Twenty years ago there was very little research or science around why massage does what it does and why it might be good for a person. Thankfully, research and science have come a long way in proving what many have known all along — therapeutic touch is good for health!
For more information on lactic acid read this article from Scientific American. It explains how lactic acid is part of a chemical reaction involved with anaerobic activity. Along these same lines it has been determined that lactic acid has nothing to do with delayed onset muscle soreness caused by exercise.
What does cause delayed onset muscle soreness? When muscles are exercised beyond their normal load they experience micro-tears. These tears incite inflammation. The good news is that studies show that massage helps reduce the inflammation associated with second-day muscle soreness.
I just finished a weekend of learning at the Northwestern Health Sciences Massage Symposium. A highlight of the symposium is an opportunity to spend 30 minutes in their prestigious cadaver lab over the lunch hour. So, yes it was billed as Lunch and Cadavers. Stop reading if you are easily grossed out.
Into the Cadaver Lab
Outside the lab I was informed by the experienced attendees that I might want to put some Vick’s VapoRub under my nose to keep out the smell of formaldehyde. Thankfully, I was at a massage symposium and there were samples of smelly unguents to be had around every corner. I chose a packet of China Balm to be my olfactory friend. The smell was nothing compared to the existential unease that came over me.
For the most part, the bodies were mid-dissection. The skin was mostly removed and the exposed muscles were dry to the point of looking like beef jerky. That was less problematic for me than the intact body parts that gave hints of the life once lived.
For example, while the size of the femoral artery was fascinating to see I couldn’t help but notice the chipped blue nail polish on the intact, but wrinkled, toes of the donor. My vivid imagination overtook my scientific mind. I began playing out my own personal morgue scene from one of those murder mystery shows I love so much. Surely, she must have painted those toes about three weeks prior to her death but never had a chance to remove or re-apply the nail polish. So sad.
Deep breath, April. Stay focused on the anatomy!!!
We moved on to the second cadaver. While my colleagues were eagerly grabbing at the glutes to get a better look, I was focused on the short curly hair of the donor; not to mention its missing face. As everyone “oohed” and “aahed” over the the third cadaver I was mesmerized by its intact ears and hands. They looked like something out of a mad scientist’s lab in a classic horror film. The pacemaker cords sprouting out of another donor’s chest didn’t bother me as much as the detail of the coarse hairs growing out of his ears. I couldn’t not create stories in my mind about these people. After only ten minutes I was the first to leave the lab.
The other attendees were mostly graduates of the Northwestern Health Sciences massage program so perhaps they were more accustomed to an academic morgue. The instructors in the lab were way more interested in teaching anatomy than helping me process my encounter with death. Perhaps she was putting on a brave face for me but my fellow therapist said bluntly, “It’s no big deal, you get used to it.” The more I write this I realize I was less put off by the lab but more so by the insensitivity of my fellow massage therapists.
Allow Me to Process
Sadly some of my former clients have passed away. I have experienced that strange feeling of knowing that someone who was once pulsing and alive under my hands is no longer with us. There is a certain intimacy between my clients and me. I have a great respect for the vulnerability they bring into my room. It is always sad when I hear that someone I once worked with is gone. Let me just take this moment to say “thank you” into the great beyond to all those who have shared sessions with me and have crossed over.
Maybe next year will be the year that I put my imagination aside and join the cult of dissecting the dead. But this was destined to be the year where I humbly observed the fragile mortality of my fellow human beings. For now I will appreciate learning through palpating living breathing humans!
If you clicked through to this link there is a good chance that you get occasional hand and arm pain. You may have tried to Massage your hands only to get no relief. There’s a trick to this-pain in the hands almost never originates from the hands. Hand pain is almost always referred from higher up on the body.
Culprit number one: The Forearms……
Pain in the hands often starts in the forearms. The joints of your hands are mostly surrounded by tendons that connect to muscles that are located in your forearms. It is often the muscles in your forearm that are contracted and tug on the tendons in your hands. The remedy is usually to stretch and massage your forearms. In particular there are usually trigger points around your elbows. To review, trigger points are little sore spots in the muscle belly that refer pain to another part of the body.
You do not need to memorize this chart. I just want you to understand how this pain relationship works. Go ahead, do your favorite arm stretches. It’s always a good idea to self-massage around the elbow.
A lot of arm pain actually starts in the shoulder girdle. There is a really good reason for this-the brachial plexus nerves starts up in your neck, goes under the clavicle and works it’s way down to your arm. Different branches of it go into your pecs, your armpit and back. Often when you come into my office with arm pain I will check out your neck muscles, chest muscles, armpit muscles and back to see if we can find any referral patterns. This is why it is erroneous to only think locally about hand pain.
Over the years, when I have had bouts of thumb pain it has been very important to have a Massage therapist work on my pectorals as well as dive into my armpits.
My clients are often surprised that a session treating arm pain will include the shoulder girdle.
This image shows the referral pattern of a trigger point in the pectorals. The x is where the trigger point is and the red shows the referral pattern.
Stretch the shoulders for the good of your hands
This is why it is also important to stretch out the shoulders. For Massage therapists our all time favorite stretch is the “Doorway stretch” This opens up the shoulder girdle and allows blood flow to the hands.
Keep those shoulders loose to keep your hands warm…..
As a side note, I’ve learned that opening the shoulders is key to keeping the hands warm on a cold day. So much blood passes through the shoulder girdle that if you are tensed up whilst outside on a chilly day your hands will get cold. Breath while raising and lowering those shoulders and you will notice your hands warm up. Swing your arms in front of you-it’s better than a hot pocket!
Same thing with biking
Similarly, you may numbness notice tingling while riding your bicycle. Most likely, the pain is not directly in your hands, but rather from crunching the shoulders in. I find that if I can stretch my arms behind me while riding I can usually get better blood flow in my hands.
What about arthritis?
Arthritis is deterioration of cartilage of the bone. Massage cannot reverse arthritis-however we can reduce the inflammation in the tissue surrounding the arthritis. Sometimes the irritated tissue is as painful, if not more than the arthritis itself. Also, I have formulated an ointment specifically for joint pain using trauma oil, essential oils of cardamom, ginger, and juniper. Read more about April’s Active Again Arthritis Antidote.
Hopefully, I’ve given you some insights into hand pain. Self care is awesome and a Massage or Shiatsu from a trusted professional is even better. All the best.
Clients often wonder: Do I tip my Massage Therapist and if so how much?
Here’s the clear answer:
If the Massage Therapist works at a Spa, especially a Massage Envy type place then you absolutely must tip them!!!! Their wages are lower. If it is a Groupon then you must tip them well!!!!
Here’s the less clear answer:
If you are seeing an independent practitioner like myself it can vary. We can set our own rates and have more control over our overhead. I have some colleagues that set their prices about 15 percent higher than mine, but don’t accept tips at all.
I would say 70 percent of my clients tip me and they tip between 15 and 20 percent. My clients that tip me usually have the financial means to do so and come in about once a month.
For the clients that don’t tip, the appointment with me is already a financial stretch and the tip would be cost prohibitive. Some clients also don’t tip because they take the view that I am a private business owner and I can set my own rates.
I don’t want to turn anyone away because they can’t tip and it is really important that you come in as often as you like.
I have colleagues that don’t accept tips, but charge a higher hourly rate. I prefer to keep my rate lower. As I said, those that can usually do and those that can’t don’t. I want to leave that up to the client to decide. It’s like a self-selecting sliding scale. Whether you tip me or not I am grateful for your patronage and will give you a great Massage or Shiatsu.
Thai Reflexology is a wonderful way to feel more grounded and calm. In addition to using my hands and fists, I use a rosewood stick blessed by Thai Buddhist monks to perform a reflexology treatment for feet. This is an overall treatment that will make your feet feel great as well ground your whole being. It is deeply rhythmic and relaxing. Pairs great with a foot soak. Can be incorporated into a Massage or Shiatsu of any length session. When I do the full treatment it is about 10 minutes total.
Thai Reflexology is a free add-on to any service by request!
Four years ago I learned this technique from Jill Burynski, Thai Yoga Instructor. It was one of the best workshops that I have ever taken and use these ideas in many treatment sessions. In addition to learning to do a Thai reflexology session I learned some wonderful stretches for the legs. I often incorporate Thai Massage Techniques into a Shiatsu therapy session.