As more massage therapists do outcalls (bringing their tools of the trade to the client), they are also experiencing more injuries related to the improper handling of equipment, as opposed to injuries related to errors in body mechanics while administering the massage itself.

Preventing Injury
1. Buy a massage table or chair that is comfortable to carry. These days portable massage tables and massage chairs come in all sizes and weights. Even the top weight of 38 pounds for a portable massage table sounds light enough when compared to a permanent table weighing in at the very least, well over 100 pounds. But when you have to carry it around, in and out of cars, up and down stairs, a few pounds can make all the difference in how you feel at the end of a day. The lightest portable massage table weighs just over 20 pounds. You need to balance the weight of the table with what you need in the way of size and sturdiness to accommodate your clients and the modalities you most frequently use.

2. Have the client prepare an adequate space before you arrive. You shouldn't be responsible for having to move heavy furniture out of the way to create enough room for your massage table or chair. When the appointment is made, make it clear to the client how much open space is needed. Create an outcall specific brochure with guidelines as to what is required as far as space and privacy.

3. Make sure whatever transportation you use has ample space for your massage table as well as other accessories, including bolsters, linens and music player. Trying to get a massage table or chair out of the back seat of a two-door car or small trunk can wreak havoc on your back and nerves. You should be relaxed before giving a massage, not frustrated from trying to dislodge equipment stuck behind your spare tire.

4. Use a wheeled cart for transporting your table. A massage case is nice for protecting your table against rips and tears. The handles and shoulder straps may also seem convenient but, unless you are walking short distances, you may find yourself with shoulder and back pain from carrying the table. A wheeled cart will allow you to move your table and accessories with ease. Most massage chairs come with wheels and a case that accommodates using them for easy transport. Save your body's upper strength for the massage.

5. Check with the client beforehand with regard to access to the home or office. Is there a clear path? Are there lots of steps? Is there an elevator? Is there parking nearby, or is there a long walk from a parking lot? Is the client in an urban, suburban or rural area? Knowing these factors in advance will give you an indication of how easy or difficult it will be to get your massage table or chair to the location of the massage. If there is time, you may want to make an advance visit to see accessibility for yourself.

6. Stretch and exercise. As a massage therapist you do develop a lot of upper body strength, but this is not always enough to protect yourself against injury or strain with regard to carrying around a portable massage table or chair. There is a tendency to use one side more than the other when carrying heavy items, which may leave one side more strained. Make sure to stretch and strengthen both sides of your upper body, as well as strengthen both legs so as to avoid undue strain on your back.

7. Schedule regular massages - for you. You would probably recommend this for your client if he or she had similar job requirements. It is not an indulgence, but a necessity for keeping your body and mind in optimum condition.

8. Make sure your massage table or chair is in good working condition. Check cables, joints and screws regularly to make sure everything is tight and not frayed or split. A piece of equipment that collapses as you are working can cause not only great harm to your client, but to you as well.

9. Always take a charged cell phone with you. If you have problems while traveling to a client you can call ahead and notify him or her, and even call for help if needed.

10. Make sure someone knows where you are going, when you are leaving and when you are expected back to your office or home. Call when you arrive to let him or her know the name and address of the client and the approximate end time of the appointment.

Providing onsite or outcall massage to your clients is a great service. It allows you to accommodate those who may be disabled, who have a busy schedule, or who are homebound for whatever reason. But being in an unfamiliar location also allows for the possibility of more accidents resulting in injury. Following these safety tips can reduce the chance of injury or harm to both you and your clients and provide for a safe and lucrative outcall business.

Recommended Study:
Chair Massage Fundamentals
Introduction to Chair Massage

Resources:

Gill, Sandra. "Outcall Service and Safety: Preparation is the Key to Success." 2003. MassageTherapy.com. Associated Massage & Bodywork Professionals. 28 Jul 2009 http://massagetherapy.com/article/index.php/article_id/521.

Greene, Lauriann, CEAS, and RIchard Goggins, CPE, LMP. Save Your Hands: The Complete Guide to Injury Prevention & Ergonomic Solutions for Manual Therapists. 2nd. Coconut Creek, FLorida: Body of Works Books, 2009. Print.

"Massage Tables." Massage King. 23 Jul 2009 http://www.massageking.com/categories/massage-tables/13/1.

Located in the very center of the skull, the sphenoid bone is in a unique and influential position. While many allopathic physicians address a large span of health complaints associated with a restricted sphenoid, working directly with this bone is far from simple. However, learning how to effectively administer cranial-sacral therapy affords health practitioners this seemingly challenging feat. Since its assimilation into complementary medicine in the 1930s, bodyworkers trained in cranial-sacral therapy have been able to create many healing opportunities by gently manipulating this cranial bone.

Sphenoid Anatomy
Named for its wedge-like butterfly shape, the sphenoid is a prominent, irregularly shaped bone at the base of the skull. Because it is in contact with all of the other cranial bones, the sphenoid is often referred to as the "keystone" of the cranial floor.

The sphenoid has a number of features and projections, requiring a student to study it from various perspectives to fully appreciate its form. This single bone runs through the mid-sagittal plane and helps connect the cranial skeleton to the facial skeleton. The sphenoid articulates posteriorly with the occipital bone, laterally with the temporal and parietal bones, and anteriorly with the frontal and ethmoid bones. It consists of a hollow body, which contains the sphenoidal sinus, and three pairs of projections:

1. The more superior lesser wings
2. The intermediate greater wings
3. The most inferior projecting pterygoid processes

The anterior surface of the great wings forms most of the posterior walls of the orbital cavities. The optic foramina, located in the bases of the small wings, provide for the passage of the optic nerves from the eyes to the base of the brain. The superior surface of the body of the sphenoid contains a deep depression housing the pituitary gland, called the sella turcica, or Turk's saddle. In addition, the plentitude of surfaces and articulations of the sphenoid harbor the passage of:

· The ophthalmic artery into the orbital cavity
· The third, fourth, fifth and sixth cranial nerves from the brain into the orbital cavity
· The maxillary division of the fifth cranial nerve
· The mandibular division of the fifth cranial nerve
· The middle meningeal blood vessels

Separated by a bony septum projecting downward into the nasal cavity, the sphenoid bone also contains two sinuses, which lie side by side. The most common way for allopathic medical practitioners to access the sphenoid bone is through the nasal passages.

Sphenoid Movement
Cranial-sacral therapy was first developed by William Sutherland, DO in 1892. Dr. Sutherland realized the cranial bones allow for small amounts of movement driven by the flow of cerebrospinal fluid (CSF). Identified as a wave-like motion, the cranial-sacral rhythm carries CSF up and down the spine and around the brain. Despite it being tethered in many different planes, the non-stationary sphenoid bone plays an active role in the circulation of CSF. Within the brain, the cranial pumping mechanism known to circulate the CSF occurs where the sphenoid bone articulates with the basilar portion of the occiput bone.

With each breath we take, the nasal conchae fill up with air, which applies pressure on the anterior portion of the sphenoid bone and the sphenoidal sinus where it contacts the basilar portion of the occiput bone. This pressure causes the spheno-basilar junction to move slightly posterior and inferior. On expiration, the spheno-basilar articulation relaxes as the pressure created by the inhaled air is exhaled. This release of pressure causes the spheno-basilar junction to move slightly anterior and superior. These movements of the spheno-basilar junction are believed to drive the cranial-sacral rhythm. This rhythm pumps CSF down through the spinal canal on its journey around the spine, sacrum and back up to the cranium.

The movement between the sphenoid and the occiput has long been considered a primary focus in cranial therapeutics. In the osteopathic model developed by Dr. Sutherland and later presented in books by Magoun and Upledger, the following movements occur between the sphenoid and occiput near or at the sphenobasilar junction:

· Flexion/Extension
· Torsion (Right and Left)
· Side-Bending (Right and Left)
· Vertical Strain
· Lateral Strain
· Sphenobasilar Compression

Problems Associated With the Sphenoid
Medical professionals often perceive the keystone of the cranial floor as off-balance or restricted in its movement. When the structure deep inside the skull is not moving freely, there can be many repercussions. As a direct or indirect result of hindered CSF flow, an inhibited sphenoid bone can cause many conditions. Below are 18 ailments often associated with a restricted sphenoid:

1. Chronic Pain
2. Asthma
3. Anxiety
4. Bell's Palsy
5. Trigeminal Neuralgia
6. Depression
7. Ear Infections
8. Epilepsy
9. Dental or TMJ Problems
10. Dyslexia
11. Exhaustion
12. Hyperactivity
13. Insomnia
14. Eye Problems, Including Visual Disturbances
15. Sinusitis
16. Tinnitus and Middle Ear Problems
17. Headaches or Migraines
18. Hormone Imbalances

How Bodyworkers Can Readjust the Sphenoid
While specially trained physicians aim to reset an unbalanced sphenoid bone by inserting specialized instruments up both nasal cavities, these techniques are beyond a bodyworker's scope of practice. Luckily, cranial-sacral therapy accomplishes this same task through a non-invasive, extremely gentle application.

Bodyworkers trained in cranial-sacral therapy can free the sphenoid from any restrictions, by applying point and direction specific pressure on the cranium. Equivalent to the weight of a nickel, this pressure is barely perceptible to the recipient of the therapy.

Because it articulates with all of the other cranial bones and its movement is responsible for circulating the CSF, the sphenoid bone is one of the primary foci of cranial-sacral adjustments. Understanding the complex, 3-dimensional anatomy of this bone can help bodyworkers practicing cranial-sacral therapy better visualize their work. Through their influence over this cranial keystone, bodyworkers who include this method are in the best position to help clients recover from a long list of undesirable ailments.

Recommended Study:
Advanced Anatomy & Pathology
Cranial-Sacral Fundamentals

References:

http://education.yahoo.com, The sphenoid bone, Bartelby.com, 2008.

Spence, Alexander P., Basic Human Anatomy - Third Edition, The Benjamin/Cummings Publishing Company, Inc., Redwood City, CA, 1990.

www.andreasea.com, Cranio-Sacral Therapy, Spirit Touch Healing Arts, 2008.

www.bodymath.com, Sphenoid Bone, Wholistic Seminars LLC, 2008.

www.csuchico.edu, The Sphenoid, Turhon Murhad, California State University Chico, 2008.

www.healtouch.com, The Art Philosophy, and the Science of Impeded CSF Circulation,
Dr. Don Glassey, MSW, DC, LMT, 2008.

www.innerbody.com, Sphenoid bone, Intellimed International Corporation, 2008.

www.kytbinc.com, Cranial/Structural Soft Tissue Release, Don McCann, KYTB Inc., 2008.

www.medterms.com, Definition of Sphenoid bone, MedicineNet Inc., 2008.

www.sotousa.com, Sphenobasilar Ranges of Motion, Charles L. Blum, DC, The Dural Connection, July 2000.

www.thesourceofwellness.com Craniosacral Therapy, The Source of Wellness, 2008.

All of the potential challenges of conception, pregnancy and delivery are supposed to dissipate with the arrival of a new bundle of joy. However, for the parents of an estimated 20 percent of newborns, infant colic can easily hamper that joy. Although a bodyworker may not see babies in their practice, they can indirectly improve a colicky situation. By sharing massage therapy's colic-easing techniques with a frazzled mom or dad, therapists can help relieve both the baby's and parent's discomfort.

About Colic
While all babies cry, some do so far more than others. Despite being healthy, well fed and well cared for, some babies cry inconsolably. Clinically defined as crying more than three hours a day, three days a week for more than three weeks in an otherwise well fed, healthy baby, infant colic usually starts a few weeks after birth. Incredibly frustrating and largely unexplained, colic often improves by the time a baby reaches being three months old.

A baby with colic typically exhibits:

· A very loud, inconsolable cry
· A red face
· A tense, hard abdomen
· Drawn-up legs
· Clenched fists

Seeking Help
Since all of colic's signs definitely indicate a distressed baby, a physician must be consulted to rule out a serious problem. A parent should call his or her baby's doctor or go to an emergency room, if:

· The baby has not previously been evaluated by a doctor for constant crying for more than three hours or the cries are unusually shrill or intense

· The baby seems to be in pain or acts sick

· The baby's temperature is over 100.5 º F

· The baby is vomiting or has diarrhea

· The parents are afraid of hurting their baby or feel as if they cannot care for their baby

No one is really sure what causes colic, but many experts suspect the following to be contributors:

· Intestinal gas
· Food sensitivity
· Immature nervous system

Luckily, colic is not considered to be harmful to the baby.

Postpartum Depression
Whether it is massage's release of mood-elevating endorphins, the relaxed state clients enter or its reduction in stress hormones, many people suffering with depression are known to benefit from massage therapy. Thus, new mothers tormented by postpartum depression often find some degree of relief from a nurturing massage session.

While it is no surprise that a colicky infant is especially upsetting for the parents, a Brown Medical School study proved a connection between colicky babies and postpartum depression. Presented in May 2006 at the Pediatric Academic Societies' Annual Meeting in San Francisco, researchers estimated that approximately 45 percent of mothers of colicky babies reported moderate to severe depressive symptoms. In addition to directly helping women affected by this kind of depression, massage therapists can also help the root of the problem indirectly. By teaching infant massage techniques for reducing colic, therapists can pass on a treasured skill for keeping a newborn's home peaceful.

Massage for Colic
Primarily based on the premises that infant colic is due to trapped gas, an underdeveloped digestive system and a highly sensitive nervous system, massage therapy can work wonders on an inconsolable infant. Using techniques to stimulate the digestive process and calm the nervous system, parents may have more power to help their baby then they previously realized.

Teaching your clients how to massage their babies can be explained verbally or demonstrated on yourself. Several moves are described below:

1. Direct Digestive Energy Down - Using a little massage oil or lotion on your hands, place your palm under the infant's chin, with fingers pointing towards the child's shoulder. Draw your hand downward along the chest, towards his or her diaper. Repeat with slow, gentle motions.

2. Breakup Abdominal Gas - Place the infant's heel next to his or her bottom by bending the knee. With the leg still bent, move the thigh towards his or her stomach until it rests on the abdomen. Move the other leg to this position as well. Slowly and carefully move the legs in a bicycle pattern.

3. Move Food and Gas Stagnation - Using as much of your palm and fingers as possible, circle the baby's belly button in a clockwise motion.

4. Induce Relaxation - Using only the thumbs, massage the sole of the baby's feet before bedtime at least 100 times. Remember to keep an even and smooth rhythm to the massage to help the infant relax.

Because an infant's body is much more responsive to touch than an adult's, only five minutes of massage several times a day is sufficient to strengthen digestion and generate relaxation.

Massage therapists have two ways to help a family with a colicky infant. A relaxing massage session for the parent can improve postpartum depression or the stress of a colicky new family member. Perhaps even more valuable, therapists can also give their clients a tactile skill for bringing peace into their home. By teaching clients with newborns how to massage away their baby's colic, therapists can effectively help them reduce their baby's discomfort. And anyone who has ever had an infant with colic knows - that is the most precious gift possible.

Recommended Study:
Aromatherapy: Mother and Baby
Infant and Child Massage
Pre- and Perinatal Massage
Prenatal Massage Fundamentals

References:

http://www.mayoclinic.com/health/colic/DS00058, Colic, Retrieved December 12, 2008, Mayo Foundation for Medical Education and Research, 2008.

http://www.med.umich.edu/1libr/yourchild/colic.htm, Colic, Kyla Boyse, RN, Retrieved December 11, 2008, The University of Michigan Health System, 2008.

http://www.pacificcollege.edu/publications/articles/2007/january/01-18-2007_Infant_Colic_Massage.html, Relieve Infant Colic with Massage, Michelle Fletcher, BA, Retrieved December 11, 2008, Pacific College of Oriental Medicine, January 2007.

http://www.sciencedaily.com/releases/2006/05/060502090732.htm, Fussy Babies And Postpartum Depression Linked, Study Finds, Retrieved December 12, 2008, ScienceDaily, May 2006.

http://www.taoofwellness.com/win2008.htm, Dr. Dao's 10 ways to help Reflux & Colic in Infants, Dr. Daoshing Ni, Retrieved December 11, 2008, Tao of Wellness Inc., Winter 2008.

http://www.targetwoman.com/articles/infant-colic.html, Infant Colic, Retrieved December 12, 2008, TargetWoman.com, 2008.

If you have a private practice, a sunburned client might return from vacation for his or her regular, weekly massage. If you work at a resort or on a cruise ship, your client may have a one-time visit and want a massage as part of the amenities the ship has to offer. In either case, the same precautions apply. Find out how to offer relief from the pain and discomfort of sunburn, as well as some natural remedies you can safely recommend.

What Is Sunburn?
Sunburn isn't simply a red discoloration of the skin; it's an actual burn causing damage to the various layers of the skin. The most superficial layer, the epidermis, is the thinnest layer of the skin and most susceptible to damage even from a mild sunburn. Skin that is red, painful, hot and has some swelling would be considered a first degree burn, whether it is from the sun, a sun lamp or tanning booth. A first degree burn will usually heal in two to three days with the burned skin drying out, eventually peeling and flaking.

A second degree burn, again, whether from the sun or another source, would include damage to the skin beneath the epidermis and include the same symptoms as a first degree burn, but with more pain, more swelling and usually some blistering. Healing can take place anywhere from one week to one month depending on how deep the damage goes. There may or may not be scarring as it heals, and there is usually little or no damage to the hair shafts or skin glands.

A third degree burn would include damage to the dermis and deeper tissue. It can destroy the hair shafts, oil and sweat glands, erector pilae muscles and nerve endings. The skin might appear white or look charred. There is a greater chance of infection with third degree burns as well as fluid loss and shock. Healing involves thick scar tissue, which makes mobility of the affected area restricted. This type of burn will usually result from chemical exposure or direct exposure to fire, but it can also be the result of overexposure to the sun if that exposure lasts an extremely long time in a harsh environment.

Natural Remedies for Sunburn
A third degree burn requires swift intervention by a medical team to prevent loss of life, but some second degree burns and most first degree burns can be treated using simple home remedies*. The burns won't go away, but the pain and discomfort can be alleviated

· If you have been sunburned, drink plenty of water to reduce dehydration. This will also serve to improve circulation and remove toxin buildup in the body.

· Apply cool water to the burned area. If it covers the entire body, take a cool bath. Adding oatmeal to the bath will increase the soothing effect.

· Cornstarch or baking soda may be added to the bathwater instead of oatmeal, or you can make a paste and apply to the reddened skin.

· Use olive, coconut or almond oil to replenish the skin and reduce the possibility of wrinkling and leathering of skin. Jojoba oil is also a good choice as it is the closest in composition to the natural oils of the skin.

· Ice cold whole milk or plain yogurt can be applied to the skin. It will cool and soften the affected area. You can also soak towels in the milk or yogurt and wrap the burned area.

· Aloe vera can be used on burned skin. It can be used straight from an aloe vera plant or can be purchased in the form of a lotion or cream. Caution needs to be used with purchased products. Make sure they do not contain alcohol or other ingredients that may sting.

· Cucumbers, strawberries or raw potatoes can either be applied directly to the skin or mixed with cold yogurt or milk to form a paste.

· Wet, cooled tea bags will draw the heat out of a painful first degree burn. You can also brew some tea, cool it and soak towels or washcloths in it and apply to the area.

*Note: These remedies should not be used on skin that is broken or otherwise compromised.

Is Massage Therapy Good for Sunburn?
The only type of sunburn that is not a contraindication for massage is a mild, first degree burn. Any second or third degree burn indicates more than just precaution, as far as massage goes, until the skin is no longer compromised and past the sub-acute stages of healing. Care must be taken to consider the client's pain tolerance and overall health.

With a first degree sunburn, there will be various stages of healing to consider. Is the client coming in on a Monday after a weekend at the beach, or is he or she arriving for a massage a day or two later? On the first day, the skin may still feel raw and painful. By the third day the skin may already be dry and peeling - thus, it may be more itchy than painful.

· Consider using a massage oil formula that contains ingredients specifically used for healing sunburned skin. Aloe vera is one of the most used ingredients you may find in such a product. Tea tree oil is another.

· Use techniques that offer smooth, gentle strokes. Avoid vigorous rubbing, strokes that would be over-stimulating or any techniques that could be potentially damaging to skin or underlying tissue.

· In cases where the rubbing of a Swedish massage, or the stretching of Shiatsu might be too much, the cooling effects of a cold stone massage might offer a more comfortable relief.

An Opportunity to Educate
Prevention of sunburn is the only way to avoid potential damage. Whether it is a client who has already experienced the pain or someone who is getting ready to go on holiday, have handouts ready for clients informing them of the importance of avoiding damage to their skin. Sun exposure is needed for production of vitamin D in the body, but too much exposure can be dangerous and result in leathery, wrinkled skin, age spots and cancer.

Too much sun over a lifetime, along with just a few episodes of sunburn, has been shown to be a factor in certain types of skin cancer (melanoma, basal cell carcinoma and squamous cell carcinoma). Limiting the time spent in the sun (especially between 10 am and 4 pm when its rays are the strongest), choosing clothing that covers the skin and applying sunscreen will help reduce the possibility of a damaging burn. Even on a cloudy day, 80 percent of ultra-violet (UV) can reach your skin. Water and snow intensify the effects and can cause skin damage. It is also important to wear sunglasses to avoid damage to your eyes, including temporary blindness. A tanning booth is no better and can be just as damaging to skin over time.

As a massage therapist, not only can you help your clients to feel better after getting a sunburn, yet you can also help educate them in preventing one in the first place.

Recommended Study:
Advanced Anatomy & Pathology
Advanced Anatomy & Physiology
Cancer and Massage
Oncology Massage: Fact vs. Myth
Stone Massage

Resources:

"Home Remedies for Sunburn." Home Remedies. Home-Remedies-for-You.com, 30 Apr 2009. Web. 22 Jul 2010. http://home-remedies-for-you.com/blog/home-remedes-for-sunburn.html.

Pacholyk, Andrew. "Sunburn." Peaceful Mind. Peacefulmind.com, 2010. Web. 22 Jul 2010. http://www.peacefulmind.com/sunburn.htm.

Paramanoff, Nicholas. "Numerous Sunburn Dangers." Sunburn Magazine, 2010. Web. 22 Jul 2010. http://www.sunburn-magazine.com/sunburn-dangers.html.

"Sunburn." Facts About Sunburn and Skin Cancer. The Skin Cancer Foundation, 2010. Web. 22 Jul 2010. http://skincancer.org/facts-about-sunburn-and-skin-cancer.html.

"Sunburns and Massage." Fingertips: Tips, Pointers and Information for Improved Health and Wellness. largeheartedboy.com, 17 Aug 2009. Web. 22 Jul 2010. http://massage.largeheartedboy.com/archive/2009/08/sunburns_and_ma.html.

It is prevalent in our daily lives, yet many people struggle with grief. Usually beginning as an emotion, extended periods of grief typically manifest physically, a phenomena that clearly demonstrates the interconnectedness each human body possesses. By accessing the energetic manifestation of grief, bodywork can unlock this commonly repressed emotion. Upon associating physical complaints with barricaded grief, therapists who have the skills to prompt its release can help their clients achieve a major breakthrough in reaching their health goals.

About Grief
Grief is the normal response of sorrow, emotion and confusion that comes from losing someone or something important to you. A typical reaction to death, divorce, job loss, a move away from friends and family or loss of good health due to illness, grief has many dimensions. While conventionally focused on the emotional response to loss, grief also has known physical, cognitive, behavioral, social and philosophical dimensions.

There is no allocation for how long grief lasts. Accepting and learning to live with the experienced loss is the greatest determining factor in the time spent grieving. There are many reasons for these differences, including personality, health, coping style, culture, family background and life experiences. In addition, the time spent grieving depends on the relationship with the person or thing lost and how prepared the person was for the loss. For some, grief lasts several months - while grieving may take years for others.

Just after a death or loss, many people experience feelings of emptiness and numbness - similar to being in a state of shock. Physically, problems such as trembling, nausea, difficulty breathing, muscle weakness, dry mouth, lack of appetite and insomnia are common during the earlier stages of grief. However, prolonged, unresolved grief can have many additional physical manifestations.

Complicated grief, or Prolonged Grief Disorder (PGD), is diagnosed by mental health professionals when normal grief and loss processes appear to become "stuck" and persist for six months or more. While there are many emotional and spiritual signs indicating PGD, some of the problems often addressed by bodyworkers, include:

· Fatigue
· Insomnia
· Pain - especially of the neck, head and back
· Anxiety
· Gastrointestinal disorders
· Chest pain or breathing difficulties
· Palpitations

Bodywork for Grief
Although any kind of bodywork may reveal hidden feelings, certain modalities are more likely to access the energetics of grief for initiating an emotional release. Of the many types of bodywork to choose from, two healing systems identify grief as a component of an imbalanced element: Traditional Chinese Medicine (TCM) and polarity therapy.

Massage therapists using TCM and polarity methods on clients harboring grief are especially likely to have their clients release this repressed emotion and prompt harmonization between their clients' physical, emotional and spiritual planes.

1. TCM - According to TCM, grief primarily disrupts the metal element, which governs the lung and large intestine meridians. Symptoms relating to the lung or large intestine such as chest pain, breathing difficulties and constipation are common when these channels are blocked. Thus, applying acupressure techniques along the lung and large intestine meridians, and on their Front Alarm and Back Shu points, commonly accesses and releases stagnant grief energy.

2. Polarity Therapy - According to polarity therapy, ether governs the specific emotion of grief. Because ether's center is in the neck and throat, these areas must be open and relaxed for grief to flow freely and be released. Polarity therapy offers various techniques to unblock this area and harmonize ether with the other elements and with the nervous and musculoskeletal systems.

While today's healthcare system typically doesn't recognize or address the full gamut of grief-related problems, verbal therapists such as grief counselors or psychologists can provide substantial emotional support. Thus, massage therapists working with grief-stricken clients should have a referral list of recommended talk therapists.

Whether a client is grieving from a recent loss or harboring prolonged grief, bodyworkers who practice TCM-based acupressure or polarity therapy can be especially helpful. By enhancing circulation in the lung and large intestine meridians or in ether's domain, stagnant energy that houses grief can be freed - thus releasing the emotional, physical and spiritual blockages that have perpetuated a grieving client's disharmony.

Recommended Study:
Polarity Therapy
Shiatsu Anma Therapy

References:

http://en.wikipedia.org/wiki/Grief, Grief, Retrieved October 18, 2008, Wikimedia Foundation Inc., 2008.

http://mentalhealth.samhsa.gov/publications/allpubs/Ken-01-0104/default.asp, How to Deal with Grief, Retrieved October 18, 2008, National Mental Health Information Center, 2008.

http://www.grief-healing-support.com/complicated-grief.html, Complicated Grief, Prolonged Grief Disorder, Retrieved October 19, 2008, Grief-Healing-Support.com, 2008.

http://www.grief-recovery.com/Articles/Killer_Cliches_about_loss.htm, "Killer Clichés" About Loss, Russell Friedman, John W. James, Retrieved October 17, 2008, The Grief Recovery Institute, 2008.

http://www.largeheartedboy.com/massage/archive/2005/04/massaging_someo.html, Massaging Someone in Grief, Retrieved October 16, 2008, Fingertips, April 14, 2005.

http://www.massagemag.com/News/massage-news.php?id=3635&catid=175&title=10-ways-to-help-yourself-through-the-grieving-process, 10 Ways to Help Yourself Through the Grieving Process, Retrieved October 16, 2008, from How Massage Supports Grieving Client, Don McCann, Massage Magazine, October 2008.

http://www.massageandbodywork.com/Articles/AugSep2006/revisit.html, Grief as Grist - Revisiting our Trauma, Lyn Prashant, Retrieved October 16, 2008, Massage & Bodywork, August/September 2006.

http://www.massagetherapy.com/articles/index.php/article_id/54, Grief and Degrief Part 4, Lyn Prashant, Retrieved October 17, 2008, Massage & Bodywork, August/September 2002.

http://www.massagetherapy.com/articles/index.php/article_id/302, Touching Grief When Disaster Strikes, Judith McKinnon and Robyn Scherr, Retrieved October 16, 2008, Massage & Bodywork, April/May 2000.

Maciocia, Giovanni, The Foundations of Chinese Medicine, Churchill Livingstone, New York, NY, 1989: 131.

Sills, Franklyn, The Polarity Process: Energy as a Healing Art, North Atlantic Books, Berkeley, CA, 2001, 53-55.

Compression, friction and vibration are three classifications of massage strokes, or techniques that, when used, add a lot of variety as well as increased health benefits to the recipient. Depending on how they are defined, these techniques are considered by some to be sub-categories of effleurage, petrissage or tapotement.

Compression
All massage strokes offer some degree of compression, whether one is working with traditional Swedish massage or the various forms of Eastern bodywork, such as Shiatsu or Thai massage. Pressure can range from extremely light, such as manual lymphatic drainage massage, to very deep, as in deep tissue massage and certain sports massage procedures.

In massage schools, if taught as a separate technique, compression is often taught simply as a stationary laying on of hands or fingers with a slight pushing down on to the tissue, a lifting up of the hands and then moving over and repeating. This might be used on the clients back at the opening or closing of a massage session in conjunction with a slight rocking movement, which is meant to encourage the activation of the parasympathetic nervous system.

In addition to relaxation, effective use of compression has many physiological benefits, including an increase in circulation, reduction of edema and releasing of adhesions. Light compression can be used on almost anybody under any circumstances. It can be used during traditional on-the-table massage, chair massage or massage on floor mats, and can be used over clothing. Lubricant is not needed for most compression techniques, as it is not typically a gliding stroke.

Friction
Friction is another technique in massage therapy that rarely requires the use of oils or crèmes to be effective. Because it is a focused stroke used in a small, localized area, usually no bigger than a 50-cent piece, the hands or fingers of the therapist need to maintain a certain amount of stability and consistent pressure to achieve maximum results.

There are two broad classifications of this technique, circular and transverse. In circular friction the finger tips of the first two fingers and/or sometimes the thumb are used to create small circular movements. The fingers do not glide over the skin but, rather, press firmly on the skin, which then moves over the underlying tissue. Friction is a very effective way to break up adhesions, especially in areas such as the intercostal muscles, as well as the infraspinatus portion of the scapula.

In transverse friction, the tips and pads of the fingers are used and, if the pressure desired is to be deep, one hand may be placed over the other as reinforcement. As in circular friction, the fingers do not glide over the skin, but press down on it and move across underlying tissue. Instead of circular movements, the direction of transverse friction moves either at a 90-degree angle or, in some cases, slightly oblique to the muscle fibers.

Friction strokes should not be used on pregnant women. During pregnancy the hormone relaxin is produced, which results in a softening of ligaments, tendons and fascia. This can easily result in the dislocation of joints if certain friction techniques are used. Friction is also contraindicated over varicosities, active inflammation, skin infections or recently strained muscles. While friction techniques are a great way to increase circulation locally, it can also act as an irritant and aggravate underlying conditions and must be used with care.

Vibration
Vibration is probably the least used of massage techniques. Students are somewhat fearful of doing it, and performing it for a final exam is often the last time it is used. Done correctly, though, it is one of the most effective techniques for soothing irritated muscles. Vibration uses the tips of the fingers moving in a very rapid back and forth trembling movement on the skin with a light pressure. The vibration originates in the forearm muscles of the therapist and moves down through the hands, creating a motion similar to shivering. It is used only for very short periods of times, anywhere from five to 20 seconds in a given spot, as it is extremely tiring for the therapist.

Using vibration helps stimulate circulation and promotes healthy glandular activity, improves lymphatic flow and muscle tone and, if used along with friction techniques, loosens scar tissue.

Precautions
As with any massage technique, certain precautions or contraindications should be taken into consideration either prior to or during the session. If the technique applied produces pain, especially along nerves, the massage should be stopped as it could aggravate an existing pathology. Areas that are inflamed or have open wounds should be avoided, as should recent injury sites. Care should also be taken when working on a woman who is pregnant. If in doubt as to whether a certain technique can be used, check with the client's physician or a more experienced massage therapist.

Each person offers a different landscape of skin, muscle and bone. Opening your massage routine to different techniques helps to make your sessions more effective and shows clients you are giving them a therapeutic treatment tailored to their body. Varying your strokes to accommodate each client's individuality is also a way of becoming more familiar with the art and science of the profession. It helps to increase your palpation skills and knowledge of anatomy as well. This, in turn, helps you to become a more proficient massage therapist.

Recommended Study:
Advanced Anatomy and Pathology

Resources:

Cassar, Mario-Paul, ND DO. Handbook of Clinical Massage: A Complete Guide for Students and Practitioners. 2nd. Philadelphia: Churchill Livingstone an imprint of Elsivier Ltd, 2004.

"Glossary - Friction & Vibration." Ivy Rose Holistic Health and the Human Body. 30 October 2008 www.ivy-rose.co.uk.

Mally, Dr. James. Swedish Massage with Dr. James Mally. Roseville, CA: Abundant Health Resources, 2000.

Just about everyone going through massage school learns about the various categories of massage strokes on the first day of class. Effleurage - the gliding stroke; petrissage - the kneading stroke; and tapotement - the percussion stroke.

And, while most students enjoy watching the instructor demonstrate tapotement, they often become apprehensive trying to do it themselves. They are afraid of not getting the rhythm right, or of hurting the client, or of over-stimulating a client after a relaxing hour of slow gliding strokes. The key to proper tapotement is in "letting go" - getting out of your head about what you are doing and just letting your hands do the work.

What Is Tapotement?
The word tapotement originates in the French verb "tapoter," meaning to tap or pat. It is often interchanged with the word percussion, which seems to be more understood by the English speaking community.

What all the tapotement movements generally have in common is a rapid, rhythmic movement by the hands, originating from a relaxed wrist, which strikes the body briskly and alternately, usually at a rate between 4 to 10 strikes per second. The differences comes from what part of the massage therapist's hand is used, as well as the depth of pressure applied.

At the end of a relaxing massage session, the stimulation provided by tapotement brings the client back to a more grounded consciousness and, if done well, does not agitate the body to a point of stress or nervousness.

Categories of Tapotement
· Hacking - This is perhaps the most familiar form of tapotement, often seen in films, especially in sports warm-up scenes. The therapist's hands are held outstretched with palms facing each other. Wrists are kept loose. Both hands alternately strike the client's body, with wrists having a slight rotation as hands rise and fall in rapid succession. Only the ulnar border of hand, and to some extent the tips of the three medial fingers, touch the body. The fingers and hands should remain relaxed at all times.

· Pounding/Pummeling - The main difference between hacking and pounding or pummeling is that the therapist's hands are held in a soft fist with the little finger portion of the hand making contact with the clients body.

· Cupping - In cupping, the therapist forms the palmar aspect of his or her hand into a cup-like shape, by slightly flexing the fingers. These "cups" are then struck against the client's body. The palm of the hand does not touch the body. Only the outer edges that form the rim of the cup come in contact with the client. There is often a distinctive "clop, clop" sound that results when performed correctly.

· Tapping - Tapping is the lightest and most gentle of all the percussive movements and is often performed at a slower rate than the others. The therapist's hands are loose and relaxed. Only the tips of the fingers are used to gently tap the area. This movement can be used on the more delicate areas of the body such as the head and face.

· Plucking - In plucking, the client's skin is gently picked up by the thumb and fingers of each hand in a kind of light pinching or pecking motion. The tissue is picked up and released in rapid, alternating movement, using both hands.

Four Benefits of Tapotement
1. Tapotement has a hyperemic effect. That is, it increases local blood circulation, which, in turn, helps to warm and soften the underlying tissue. The skin will feel warm to the touch and appear flushed. It is often used to help warm-up an athlete prior to an event.

2. With this technique, nerve endings are stimulated, which produce tiny muscular contractions, resulting in an overall increase in muscle tone. This is thought to happen because of the stroke pressure being registered by the muscle's mechanoreceptors in the fascia and Golgi tendon organ. A reflex action follows, resulting in the contraction of both voluntary and involuntary muscles.

3. Cupping, specifically, can be used over the upper and middle back to loosen mucous in the lungs, and has been helpful with those suffering from cystic fibrosis. Any client appearing to have respiratory problems should be cleared first by his or her physician to make sure massage is appropriate for his or her condition.

4. When used in combination with other massage techniques, tapotement helps to reduce fatty deposits and tone flabby muscle areas.

Contraindications and Precautions
Tapotement should only be used on the fleshy portions of the body - never on bony areas. For example, it maybe used on the posterior portions of the leg, such as on the gastrocnemius and soleus muscles, but never along the anterior tibia.

Additionally, it should not be used on:
· the spine, the head, the neck or back of the knee
· inflamed, strained or abnormally contracted tissue
· any area of hypersensitivity
· varicose veins
· directly over kidneys
· paralyzed, flaccid or otherwise compromised muscle tissue
· suspected or diagnosed fractures

The massage therapist's movement during tapotement comes from relaxed hands and wrists, never from the shoulder or elbow. If your body mechanics are not correct you will be quickly exhausted. Tapotement is a stroke that should be used only for short periods of time, as prolonged use will result in muscle fatigue and become counterproductive.

Done correctly tapotement should have a stimulating effect, though some clients actually find it relaxing.

The best tapotement comes when you are not thinking about it. Let it just flow. Trying to concentrate on getting it correct will result in an uneven rhythm and a massage session that feels a bit disjointed to the client. If you have been reluctant to include tapotement in your sessions, try practicing with another massage therapist, or recruit a friend or relative to be a test subject. Perfecting your tapotement can add not only increased health benefits to your client, but also provides a stimulating closing to your routine that enables them to return to their day relaxed and refreshed.

Recommended Study:
Anatomy Review for Professionals
Clinical Massage Therapy
Swedish Massage tor Professionals

References:

Cassar, Mario-Paul. Handbook of Clinical Massage. 2nd. London: Churchill Livingston, 2004.

"Ivy Rose Holistic: Therapies: Massage." Tapotement. 2008. Ivy Rose Holistic. 30 Sep 2008 http://www.ivy-rose.co.uk.

Mally, Dr. James. Swedish Massage with Dr. James Mally. Roseville, California: Abundant Health Resources, Inc., 2000.

Due to its benefits becoming more widely known, an increasing number of people are booking massage for the first time ever. Unfortunately, many seasoned bodyworkers are so accustomed to their routine that they easily forget about the fears often accompanying first time massage recipients. For many people, the idea of taking off their clothing to receive a touch-based therapy from a stranger sounds to be anything but relaxing. However, therapists who are sensitive to a first time recipient's anticipation can help these clients feel at ease right away.

Massage therapists commit to long hours of learning and log in countless practice sessions before they even enter the professional arena. By the time their career is established, most bodyworkers are completely comfortable and trustful of intentional, therapeutic, physical touch. However, this comfort level with touch therapy is not shared by everyone. Considering the concentrated focus massage therapists must have on how the human body's form and function impact health and wellness, they may not always be thinking of a client's massage worries. Upon learning that an upcoming session is your client's first massage experience, directly addressing several common uncertainties can help them relax so they can have a positive experience.

Some unknowns that could be anxiety-provoking to massage newcomers, include:

1. Should I take off all my clothes? - Casually informing a client to take off as much as they wish is usually too vague for a first-timer. If you offer massage where the recipient is clothed (such as Shiatsu Anma), make sure to provide this as an option for anyone potentially shy about disrobing. Otherwise, describe the clothing options in detail, such as leaving underwear and bra on or taking everything off. Make certain you explain that, regardless of what the client wears, he or she will be professionally draped to fully conceal his or her private regions.

2. Should I assist? - A person unaccustomed to massage may be unsure about assisting the therapist when a part of his or her body is lifted or moved. To prevent this uncertainty, explain that, unless specifically requested, clients should resist any attempts to help you. Furthermore, encourage recipients to be a limp noodle in order to support the session's therapeutic benefits.

3. Should I speak up? - Make sure to ask your client what his or her goals are for your session, and to keep you informed if he or she is uncomfortable with your degree of pressure, the temperature of the room, etc. Because newbies might be shy in conveying their needs, periodically ask your clients how they are feeling.

4. Should I tip? - While the answer to this question depends on your employment situation, tipping policies should be shared with all clients. Although this may be uncomfortable for some massage therapists to address directly, most first-time massage recipients don't know if tipping is appropriate. A discrete sign explaining a standard tip percentage if a client is pleased or describing any other type of tip policy removes the awkwardness associated with not knowing what is expected.

5. Should I chit-chat? - A common question first-time massage recipients have is whether or not they should talk to their therapist during a massage. At the onset of a massage, directing clients to close their eyes and relax helps put many people at ease. While most people enjoy meditating or forgetting about their worries during a massage, some will chit-chat to mask insecurities and nervousness. Gentle encouragement to focus on breathing and/or directing a client in some guided imagery (see article 5 Tips for Combining Guided Imagery with Massage) are great tools to help someone relax and forget about his or her conversation concerns.

Preemptively addressing these five common preoccupations of a new massage recipient helps ease the first time jitters. Once someone relaxes into receiving a treatment, massage's therapeutic benefits can really take effect - and chances are you will have gained a new, regular client.

Recommended Study:
Ethics: Therapeutic Relationships
Shiatsu Anma Therapy

References:

http://ezinearticles.com/?Avoiding-Common-First-Time-Massage-Mistakes&id=516487, Avoiding Common First Time Massage Mistakes, Elizabeth Pugh, LMT, NCTMB, Retrieved November 6, 2008, EzineArticles.com, 2008.

http://www.massagemag.com/News/massage-news.php?id=4551&catid=21&title=the-new-spa-customer-may-just-be-the-guy-next-door-, The New Spa Customer May Just Be the Guy Next Door, Jean Shea, Retrieved November 6, 2008, Massage Magazine, October 30, 2008.

http://www.naturalhealers.com/qa/massage-business-tips.shtml, 8 Massage Tips to Put Your Clients at Ease, Retrieved November 6, 2008, All Star Directories, Inc., 2008.

As healthcare professionals who work very closely with their clients, massage therapists are often called upon to interfere with a painful muscular problem. Accordingly, the discovery of a potentially therapeutic connection between two seemingly unrelated areas can help therapists unlock a complex pain puzzle. By recognizing that tension in the jaw can equate to tension in the pelvis, bodyworkers can devise a strategy to effectively reduce a person's pain. While centuries of non-traditional, clinical evidence demonstrate a connection between the hip and jaw, a German clinical study has recently validated a relationship between these two regions.

A connection between the hip and jaw can help practitioner's understand how congestion in the hip could translate to tension in the jaw - or vice versa. But most importantly, recognizing a mechanical, neurological or muscular problem in the hip or jaw areas might justify a therapeutic approach toward the other.

Traditional Chinese Medicine
Although the jaw and hip are separated by many different body parts, including the structures composing the neck, thorax and torso, Traditional Chinese Medicine (TCM) credits the Gallbladder channel as their unifying thoroughfare.

On the head, the Gallbladder channel:

· begins at the outer canthus of the eye
· ascends to the forehead
· passes through the temporomandibular joint
· curves downward to the region behind the ear

From there, the Gallbladder channel's main portion:

· progresses down the neck to the supraclavicular fossa
· passes the axilla
· goes down the lateral side of the chest to the ribs
· convenes at the hip with the channel's internal branch
· descends along the lateral aspect of the thigh and leg
· ends at the lateral side of the fourth toe

Although there are a variety of structures traversed by the Gallbladder channel, the temporomandibular joint and the hip are two commonly affected areas by a channel blockage. Thus, shiatsu massage along easily accessible Gallbladder channel portions can relieve pain anywhere along its course, including the jaw and hip.

Midwifery
Healthcare professionals who give prenatal care to expecting mothers, attend births and provide postpartum care, midwives generally strive to help women have a healthy pregnancy and natural birth experience. Certified Professional Midwife (CPM) Ina May Gaskin, has been described by many in the field as the mother of authentic midwifery.

To help women take control of their birthing experience, one of the many pearls of wisdom Gaskin has taught is the "sphincter law." This law states that if your jaw and mouth are slack, so is your bottom. The connection between the jaw and bottom (or pelvis) is paramount during labor and birthing because it can facilitate or impede the mom and infant's progress. Thus, high-pitched noises (where the jaw is tense) during labor can be counter-productive for pelvis relaxation and opening of the birth canal. Conversely, a low moan with the mouth open gently (where the jaw is loose) is a powerful catalyst to an infant's delivery.

Modern Research
As published in the June 2009 edition of Journal of Manipulative and Physiological Therapeutics, researchers from Hanover Medical School in Germany concluded the hip and jaw connection long known by TCM practitioners and midwives. By studying patients with complex regional pain syndrome, researchers looked at changes in range of motion following myofascial release and following jaw clenching.

Confirming a connection between these two regions, the researchers concluded that temporomandibular joint dysfunction plays an important role in the restriction of hip motion experienced by patients with complex regional pain syndrome, which indicated a connectedness between these two regions of the body.

Whether you are a student of TCM, midwifery or myofascial release techniques, there is no questioning the hip and jaw relation. By applying shiatsu techniques to the gallbladder channel, encouraging clients with hip pain to open their mouth and moan or using myofascial release on both the hip and jaw for pain in either location, Gaskin's "sphincter law" can help bodyworkers deliver pain relief to their affected clients.

Recommended Study:
Myofascial Release
Shiatsu Anma Therapy

References:

http://en.wikipedia.org/wiki/Ina_May_Gaskin, Ina May Gaskin, Retrieved July 18, 2009, Wikimedia Foundation, Inc., 2009.

http://www.massagemag.com/News/massage-news.php?id=7215&catid=1&title=research-tmj-related-to-hip-pain, Research: TMJ Related to Hip Pain, Retrieved July 15, 2009, Massage Magazine, July 15, 2009.

http://www.naturalbirthandbabycare.com/birthing.html, Pain Relief for Natural Birthing, Retrieved July 17, 2009, Natural birth and baby care.com, 2009.

http://www.ncbi.nlm.nih.gov/pubmed/19539119?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum, Influence of the temporomandibular joint on range of motion of the hip joint in patients with complex regional pain syndrome, Fischer MJ, et al, Retrieved July 15, 2009, Journal of Manipulative and Physiological Therapeutics, June 2009.

Maciocia, Giovanni, The Foundations of Chinese Medicine, Churchill Livingstone, New York, NY, 1989; 443-457.

Despite its commonality, genital herpes remains a poorly understood and, thus, a greatly feared virus. Based on recent data, the U.S. Centers for Disease Control estimate that one in every six Americans is infected with herpes simplex virus type 2 (HSV-2) - the most likely cause of genital herpes. Because HSV-2 is a highly contagious, incurable infection that lasts a lifetime, it is no wonder that herpes invokes fear among those who have it and those who don't.

Herpes simplex virus is among the many diseases caused by the herpes virus, a viral family with five different strains causing many ailments, including cold sores, chickenpox and shingles. Herpes simplex is the most common strain and has two variations:

1. Type 1 - mostly associated with cold sores around the mouth

2. Type 2 - generally infects the genitalia, sacrum, buttocks and thighs

Although they are separate strains, these two types of herpes are known to overlap.

Signs and Symptoms
Herpes simplex has a fairly predictable presentation. Initially, the affected tissue may exhibit pain or tingling a few days before an outbreak, and then a blister or cluster of blisters appear on a red base. Eventually, the painful, itchy blisters erupt and ooze a virus-rich liquid. The blisters form scabs after a week to 10 days, ending the most contagious phase of the disease. From start to finish, outbreaks typically last between two and three weeks.

After initial infection, the herpes virus typically becomes dormant in the nerves and only recurs following a stressor. Stressors initiating a herpes outbreak can range from a minor infection such as a cold, a trauma or sun exposure to an emotional or environmental stressful event. Managing HSV usually consists of maintaining a healthy immune system and minimizing stress for outbreak prevention.

Acquisition
Herpes simplex is spread through mucous secretions. A person's first outbreak, which usually occurs two to 20 days after exposure, is called primary herpes. All subsequent outbreaks are called recurrent herpes. Unless spread to other locations, recurrent herpes typically occur in the same place as the primary lesion, where the virus has taken up residence in the affected nerve root.

Because herpes simplex viral strains I and II often overlap, it is important to be attentive for preventing cross-contamination. The primary vehicle for overlap is acquiring genital herpes through oral sex with a partner who has an active cold sore. However, HSV also has the potential to spread to different areas of the body through casual contact. Touching a cold sore with the finger can infect other body parts touched by that contaminated finger, such as the eyes and genitals.

5 Useful Facts
One of the most common sexually transmitted diseases in the United States, HSV-2 is an incurable infection that lasts a lifetime, causing recurrent and painful genital sores. Due to its high prevalence, bodyworkers are likely to have clients with this virus or be infected with HSV-2 themselves. Hence, knowing about and being able to communicate some basic facts about herpes can help reduce transmission and ease the fears of therapists and their clients. Touching on viability, transmission and infectivity, the following five facts are extremely useful for the purpose just described:

1. There is no cure for genital herpes. Although it is possible to go long periods of time between flare-ups, the herpes virus does not ever fully leave its host. The virus hides in the dorsal root ganglia of the spine waiting for a trigger (illness, stress, hormone changes, sunburn) to resurface. While conventional and natural medicines might help shorten the length of an outbreak or prevent future ones, they cannot eliminate HSV-2 from the body.

2. Herpes can be transmitted in the absence of visible lesions. The likelihood of transmitting herpes is very low when the infected person is in remission. However, there are three stages of herpes when contagion is most likely. HSV-2 can be transmitted during the prodromic phase (usually characterized by pain or tingling several days before an outbreak), during an active outbreak (when there are actual genital herpes lesions/blisters present), and as the person recovers from an outbreak (skin cells that shed off of healing blisters). Because the virus is capable of shedding at the skin's surface, there is a small chance of transmission during periods of remission. All it takes to catch herpes from another person is skin-to-skin contact with live virus. No sore or break in the skin is necessary. For bodyworkers, this means that frequent hand-washing is essential.

3. HSV-2 can spread beyond the genitals. Although the chance of transmitting HSV-2 to areas other than the sacrum, thighs, buttocks and genitals exists, it is not very common. However, HSV-2 can spread to non-genital regions of your own or someone else's body. The virus can spread by touching the infection and then transferring the virus particles. Besides the genital region, the mouth, fingers and eyes seem to be the most vulnerable. This risk increases:

· When the recipient's immune system is compromised

· If there is a tear or break in the skin allowing easier access for the virus to gain entry

· During the first herpes outbreak, before the body has time to build up sufficient antibodies (for spreading elsewhere on the person already infected with HCV-2)

This possibility serves as another reminder for massage therapists to frequently wash their hands, and never touch their face while working.

4. In those with an active outbreak, avoid touching their hands. Because HSV-2 can spread beyond the genitals, the hands are the most likely vehicle for aiding transmission. This is especially true during the prodromic phase, the actual outbreak or as the lesions heal (all of these describe the most infectious periods), because the affected area is likely to be itchy - and hands are used for scratching.

5. The herpes virus can survive for days on contaminated linens. Most herpes infections are contracted from skin-to-skin contact. However, the virus can persist outside of the body - facilitating additional modes of transmission. As published in the August 2006 edition of BMC Infectious Diseases, German researchers found that HSV-2 can survive outside the body for up to seven days. Thus, a bodyworker's linens must always be treated with universal precautions, infection control guidelines designed to protect workers from exposure to diseases spread by blood and body fluids - especially for those with herpes. This also means that the face pad used with an infected client may function as a source to pass HSV to your next client. The heartiness of HSV marks yet another reason why it is imperative to provide clean, fresh linens for each client.

An Infected Client
Knowing a client has a history of herpes mandates a discussion about its transmission. Explain to the client why it is undesirable to receive massage during a herpes outbreak or when pre-blister signs are present. Sometimes, circumstances will make working with a client with a herpes outbreak unavoidable. In these instances, massage therapists are best advised to steer clear of the client's hands as well as the outbreak area.

Until a cure or vaccine for HSV is developed, all healthcare professionals in close contact with their clients must take steps to prevent its spread. While some bodyworkers may only apply universal precautions to clients known to carry the HIV or a hepatitis virus, knowing about herpes' level of contagion justifies using universal precautions for every client entering your practice.

There is a lot to know about herpes to completely understand this virus. However, the facts listed above help give bodyworkers a more solid picture of its viability, transmission and infectivity - issues that directly impact a massage therapy practice.

Recommended Study:
Anatomy and Pathology
Infectious Disease: HIV/AIDS

References:

http://www.ashastd.org/herpes/herpes_learn.cfm, Learn About Herpes - Fast Facts, Retrieved April 28, 2010, American Social Health Association, Inc., 2010.

http://www.herpes-coldsores.com/herpes_prevention_tips.htm, Herpes Transmission Facts and Tips, Retrieved April 28, 2010, Herpes Support Network, 2010.

http://www.massagetoday.com/mpacms/mt/article.php?id=12048, Herpes Simplex Demystified, Ruth Werner, LMP, NCTMB, Retrieved April 28, 2010, Massage Today, November 2004.

http://www.ncbi.nlm.nih.gov/pubmed/16914034?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum, How long do nosocomial pathogens persist on inanimate surfaces? A systematic review, Kramer A, et al, Retrieved April 29, 2010, BMC Infectious Diseases, August 2006.

http://www.nlm.nih.gov/medlineplus/news/fullstory_96190.html, Herpes Infects One in Six in U.S., Retrieved April 28, 2010, US National Institutes of Health, 2010.

Next to effleurage, as a massage category, petrissage is probably the most often used technique. In itself, petrissage is not a particular stroke, yet a classification of various movements consisting of rhythmic lifting and compression type movements. The word petrissage is derived from the French word "petrir," meaning to knead, and was among the terminology first used by Dr.Johan Georg Mezger in the late 1800s to give definition to a certain type of bodywork.

Petrissage Basics
With the opening strokes of effleurage having been performed at the onset of the massage session, you presumably have been able to spread the oil or cream and had a chance to palpate for any stress or adhesions in the underlying soft tissue. Your next step may be to use petrissage to help not only stretch and relax the tissue, but also bring increased blood circulation to the area and help flush out toxins.

If you ever made bread from scratch and kneaded the raw dough, you already have a good sense of what petrissage is. And, kneading dough is a great way to keep your hands in shape and practice your massage technique! Most often, both hands are used, working alternately together as one unit. It may be hand over hand, one hand towards the other, or one hand moving away from the other, but it is always a kind of one-two rhythmic movement.

There are several stroke techniques classified within the definition of petrissage. Kneading, lifting, rolling and wringing are just some of the more common terms used to describe the various movements.

· Kneading is a kind of picking up and squeezing motion performed in a circular fashion. It may be a light movement or it can be rather deep depending on how much pressure is used. The skin and underlying tissue is lifted and first rolled away from, then back towards the bone with a squeezing, compressive motion.

· Lifting differs from kneading in that you first lift and squeeze the tissue, and then release it. It is more of a single-handed movement as opposed to kneading and, rather than the whole palmar portion of the hand being used, the action occurs between the thumb and first two fingers of the therapist.

· There are two types of rolling. There is muscle rolling, whereby the lifting and compression movements are applied laterally across the muscle fibers, and skin rolling with just the skin being lifted and rolled between the fingers.

· Wringing may be used on both large and small areas of the body. The tissue is first compressed against underlying structure, such as bone, and is then gently lifted away from it. Generally, you pull the tissue with the fingers of one hand, while pushing the tissue back with the thumb of the other hand.

What all the strokes of petrissage have in common is the push-pull of tissue and the rhythmic motion of the movement. Petrissage differs from effleurage in that the strokes, while they can be relaxing, are generally stimulating to the body.

Benefits
As with any of the basic massage strokes, when performed correctly, petrissage has many benefits, including:

· increased circulation
· muscle relaxation
· reduction of pain
· improved lymphatic drainage
· reduction of adhesions
· fat emulsification

Petrissage is often used in pre- and post-event sports massage, as it helps to quickly warm up and stimulate major muscle groups as well as reduce stiffness and muscle tension. Before an event or period of exercising it helps to get the muscles ready for action, afterwards it helps to disperse lactic acid buildup and prevent muscle stiffness. Petrissage is also used extensively in rehabilitative massage, after an injury, as it helps to stretch muscle fibers, reduce adhesions and facilitate healing.

Precautions
Used on the fleshy parts of the body, petrissage is a powerful and effective tool, but there are several precautions. Never use petrissage on an inflamed area or recent injury where there are newly formed scars, swelling or broken skin. Also, an adequate amount of time should pass after surgery, such as after an appendectomy or hernia repair before using petrissage type techniques. Certain petrissage techniques should not be used on a pregnant woman (this is in part, because of the hormone relaxin, produced during pregnancy which softens the ligaments, fascia and tendons, causes instability of joints), and never over her belly area. If there is any doubt as to the appropriateness of use, you should consult with the client's primary care physician before proceeding with the massage.

In a full hour traditional Swedish massage, petrissage often provides the bulk of strokes used in the session. It is important to be proficient in its use it as well as use it appropriately with each client. Doing so will provide the most beneficial outcome for both the client and the practitioner.

Recommended Study:

Advanced Anatomy and Physiology
Anatomy Review for Professionals
Clinical Massage Therapy
Swedish Massage for Professionals

References:

Beck, Mark F. Milady's Theory and Practice of Therapeutic Massage. 3rd. Albany, NY: Milady Publishing, 1999.

Calvert, Robert Noah. The History of Massage: An Illustrated Survey From Around the World. Rochester, VT: Inner Traditions/Bear & Company, 2002.

Cassar, Mario-Paul, ND DO. Handbook of Clinical Massage: A Complete Guide for Students and Practitioners. 2nd. Philadelphia: Churchill Livingstone an imprint of Elsivier Ltd, 2004.

"Glossary - Petrissage." Ivy Rose Holistic Health and the Human Body. 31 Jul 2008 www.ivy-rose.co.uk.

Mally, Dr. James. Swedish Massage with Dr. James Mally. Roseville, CA: Abundant Health Resources, 2000.

Its ability to improve many aspects of both physical and emotional health makes the benefits of massage therapy extremely far-reaching. Because of the major structural, physiological, psychological, spiritual and social changes that occur during pregnancy, massage is especially valuable to women at this juncture in their life. However, massage therapy is commonly denied to those who could benefit most from bodywork - women with high-risk pregnancies. By learning more about expectant mothers in this category, bodyworkers can distinguish between pregnancies requiring additional care and situations that carry too great a risk for bodywork.

Defining High-Risk Pregnancy
According to the respected physician's reference, the Merck Manual, there is no formal or universally accepted definition of a "high-risk pregnancy." Despite the casual reference, experts agree that a high-risk pregnancy involves at least one of the following:

1. The woman or baby is more likely to become ill or die than usual.

2. Complications before or after delivery are more likely to occur than usual.

Certain conditions or characteristics qualify a pregnancy as high risk. Approximately 5 to 10 percent of all pregnancies in the U.S. fit into a high-risk category. Although not a comprehensive list, the most common culprits for placing a pregnant woman in a high-risk category include:

· Age - A mother under age 15 or over age 35

· Diabetes - Having diabetes prior to pregnancy or developing it during pregnancy (gestational diabetes)

· Pre-eclampsia - A syndrome that includes high blood pressure, urinary protein, and changes in liver enzymes during pregnancy that can affect the mother's kidneys, liver and brain

· Multiple Pregnancy - Carrying more than one child at once increases the stress on the mother's body

· Other Pre-existing Health Conditions - Asthma, high blood pressure, cancer and heart, kidney, lung or liver disease

Massage for High-Risk Pregnancy
The benefits of prenatal massage are not contested; in fact, they are even proven. In a 1999 study published in the Journal of Psychosomatic Obstetrics and Gynecology, prenatal massage decreased anxiety and stress hormones, resulting in fewer obstetric and postnatal complications, including lower pre-maturity rates.

Prenatal care for women with a high-risk pregnancy typically involves extensive testing, more frequent prenatal visits, medications and bed rest. Unfortunately, the stress of worrying about one's own health or the fetus's viability only magnifies whatever problem exists. In addition, the reason a woman is in a high-risk category typically lends its own physical challenge to the expectant mother's body. Thus, massage therapy can be even more therapeutic for high-risk pregnancies.

Seven reasons massage helps during pregnancy include its ability to:

1. Reduce stress, encourage healthful sleep and promote relaxation - especially needed during a high-risk pregnancy

2. Provide emotional support and physical nurturing - especially for those alone during their pregnancy or who feel scared because of their risk status

3. Reduces or alleviates neck, back and joint pain caused by posture, muscle weakness, tension, extra weight or imbalance - especially needed in women over age 35, who are obese or who are carrying multiple fetuses

4. Relieves muscle spasms, cramps and fibrosis - all of which can be intensified by several pregnancy risk factors

5. Via relaxation, reduces blood pressure - especially valuable to a woman with pre-eclampsia

6. Increase blood and lymph circulation which minimizes the edema, varicose veins and leg cramps common with pregnancy and exacerbated in many high-risk pregnancies

7. Encourage deeper and easier breathing - especially important for women with asthma or lung problems

Caution or Contraindication?
Because complications, illness or death are more likely to occur in a high-risk pregnancy, any healthcare provider must proceed with caution and vigilance. For the safety of the client and the massage practitioner, any high-risk pregnancy necessitates communication with the woman's prenatal healthcare provider and a signed release form. This release form should contain at least two components:

1. Confirmation that the prenatal healthcare provider (physician, ob-gyn or midwife) approves massage therapy

2. A listing of any precautions or limitations of massage procedures

When working with a high-risk pregnant client, observing basic precautions and contraindications for bodywork in pregnancy is crucial. Restrictions and considerations for pregnant clients may include:

· Positioning for a Massage Session - the side lying position is often advised for pregnant women.

· Modifications for Bodywork on the Lower Extremities - Because blood clots are more likely to develop during pregnancy, deep pressure or friction should be avoided on the legs. In addition, all leg techniques should go in the direction of the heart since hormonal changes in pregnancy weaken the vein's valves.

· Abdominal Massage - Since 80 percent of miscarriages occur in the first trimester, abdominal massage should be completely avoided during that time span. In addition, therapists are advised to minimize abdominal massage to high-risk pregnancy clients even in their second and third trimesters.

· Acupressure Points - With high-risk clients, it is even more crucial to avoid the acupressure points contraindicated in pregnancy.

· Heart Condition - In general, massage therapy techniques that encourage circulation should be avoided in the third trimester for clients with a heart condition.

Despite a therapist's best efforts, there are several situations where even a cautious approach and a signed release form are insufficient. In addition to massage therapy being contraindicated, an immediate healthcare referral is mandated for:

· Possible Miscarriage - Signs include a bloody discharge, continual abdominal pains and sudden gush of water or leakage of amniotic fluid

· Urinary Tract Infection - Signs include frequent urination with burning, low back pain, increase in thirst, chills and fever

· Eclampsia (Toxemia) - This is an emergency situation! Developing in 1 out of 200 patients with pre-eclampsia, symptoms include persistent severe headaches, persistent severe back pain unrelieved by change of position, severe nausea/vomiting, systemic edema, pitted edema, increased blood pressure, visual disturbances and convulsions

If massage therapists don't allow the possible dangers of a high-risk pregnancy to frighten them, working with this population fulfills an enormous need for specialized prenatal care. By communicating with prenatal care providers, obtaining signed release forms and being aware of the difference between massage cautions and contraindications, bodyworkers can be a tremendous ally to expecting mothers - especially to those who need it most.

Recommended Study:
Advanced Anatomy and Physiology
Deep Vein Thrombosis
Ethics: Practice Management
Infectious Disease: HIV/AIDS
Prenatal Massage Fundamentals

References:

Cassar, Mario-Paul, Handbook of Clinical Massage: A Complete Guide for Students and Professionals, Second Edition, Elsevier Health Sciences, 2004, 142-143.

Field, T., et al., Pregnant women benefit from massage therapy, Journal of Psychosomatic Obstetrics and Gynecology, 1999:19 (31-38).

http://www.hpakids.org/holistic-health/articles/110/1/Pregnancy-Massage, Pregnancy Massage, Melody Cook, BS, RMT, Retrieved August 25, 2008, Holistic Pediatric Association, 2008.

http://www.massagetoday.com/mpacms/mt/article.php?id=10192, High-Risk Pregnancy, Kate Jordan, NCTMB, Retrieved August 25, 2008, Massage Today, January 2001.

http://www.merck.com/mmhe/sec22/ch258/ch258a.html, Women's Health Issues, Retrieved August 26, 2008, Merck & Co., Inc., 2008.

http://www.nichd.nih.gov/health/topics/high_risk_pregnancy.cfm, High-Risk Pregnancy, Retrieved August 26, 2008, National Institute of Child Health and Human Development, 2008.

http://www.thebodyworker.com/pregnancycontraindications.html, Pregnancy Contraindications, Retrieved August 25, 2008, thebodyworker.com, 2008.

The term effleurage is derived from the French word effleurer meaning "to touch lightly." The first use of the word to describe effleurage as a massage stroke category is attributed to Dr. Johan Georg Mezger (1838-1909) of Amsterdam. One of the primary techniques of massage therapy, effleurage is very versatile and easy to perform.

Aside from a specific rehabilitative medical massage or a particular individualized overall technique, effleurage is a part of every massage routine and usually the first stroke a massage student learns how to do. Learning how to do effleurage with confidence and skill is very important, as the recipient can be sensitive to a therapist's insecurity or lack of proficiency.

Effleurage Basics
Effleurage is often used as an opening stroke in a massage routine. It helps spread the lubricant evenly and is invaluable as a hands-on assessment tool. It is also used as a transitional, or connecting, stroke between other techniques. It allows the massage therapist to maintain continuous contact with the client's body throughout the session and gives the receiver a feeling of one continuous movement as the session progresses.

With effleurage, the massage therapist's hands are relaxed and usually open-palmed, but variations of the stroke can also be done with the forearm, the knuckles or even just the fingers. Even pressure should be maintained from the tips of the fingers to the palms of the hands, with as much of the palmer aspect of the hand in contact with the client's body as possible. The strokes should be long, steady and rhythmic. They should have an even flow to them with no jerky or abrupt movements.

Effleurage can be done very lightly, with the skin not moving or "buckling" as you glide over it. This is helpful for assessment as it allows for the evaluation of superficial tissue regarding temperature, muscle tone and edema. It can reveal possible inflammation, injury or stress in your client's body. Light effleurage is also a gentle way for you to introduce your hands to the client, and induces a relaxation response via the parasympathetic (rest and digest) nervous system. (A version of extremely light effleurage would be lymph drainage massage, which uses almost no pressure at all and the strokes are very slow.)

Deeper effleurage can be as calming as lighter strokes. As you press deeper, the skin beneath your hands may ripple slightly ahead of the stroke. It has an inhibitory effect on muscles and their proprioceptors (nerves, muscle spindles, Golgi tendon organ). When first learning massage, students are often nervous about going too deep for fear of hurting the client. But, done correctly, you can put an enormous amount of pressure on a person's body without injuring them. It is important to continuously check in with your client to make sure he or she is comfortable with the pressure depth.

Mechanical Effects of Effleurage
The mechanical, or physical, effects of effleurage include helping to move blood and lymph more efficiently. The general rule with effleurage is to perform the strokes centripetally, or toward the heart (along venous return). This helps to bring nutrients to, and remove toxins from, various organs and muscles. The exception would be in atypical circumstances where you might want to warm extremities and improve blood flow to the feet or hands. In those cases, moving blood along the arterial flow would be preferred.

Effleurage can be very effective in reducing pain. Pain is often produced by edema, or fluid buildup, that produces pressure within the tissues and causes a stimulation of pain receptors (nociceptors). The increased venous flow caused by massage can reduce this pressure by helping to drain the fluids. The reduction, or even elimination of pain, also comes from the fact that effleurage strokes stimulate the release of natural painkillers (endorphins) and help block pain impulses.

Reflex Effects
Effleurage strokes also stimulate nerve endings, which, in turn, have an indirect effect on other areas of the body. This is done through the autonomic nervous system, which in part, innervates the cardiac and smooth muscle, various glands and the gastrointestinal tract. This reflex effect can influence the release of chemicals and hormones into the system that induce relaxation, such as various neurotransmitters, vasopressin and oxitocin. This can also help to decrease blood pressure, lessen overall stress or even alleviate depression.

Precautions
In general, effleurage is a safe technique that can be used in almost any situation, though there are a few precautions. You would not want to use it on someone with a recent injury, an open wound or over skin irritations such as a rash. The backs of knees, the areas over the kidneys and the front of the neck can receive a light touch, but no deep pressure, as these areas can easily be injured.

5 Things to Keep in Mind
1. While contact between your hands and the client's body is always maintained in effleurage strokes, pressure is only applied in strokes going toward the heart. The return stroke is lighter and should not affect the blood flow.

2. Keep the pace of your strokes even and rhythmic. When done slowly (no more than 1-2 strokes per second), it produces a sedative reaction in the body much in the same way that rocking a cradle relaxes a baby.

3. The longer the stroke, the better it feels to the client. Long, gliding strokes that go along the entire length of a muscle, or even the entire length of a limb, feel much more soothing than short, quick movements. With practice you will be able to perform quite long strokes and still maintain good body mechanics.

4. If you try to do deeper effleurage strokes for an hour or more, you may become quite tired. Work using your own body's center, your own body weight and gravity to achieve effective depth of pressure, and you should find that it is not as tiring.

5. While an entire massage can be performed using only effleurage, you will usually want to include other strokes such as petrissage, friction, tapotement and vibration along with some range of motion.

Effleurage techniques are the ones clients are the most familiar and comfortable with. It is the primary tool in the massage trade and easy to perfect. Done well it will keep your clients relaxed and eager to return for more.

Recommended Study:
Lymphatic Drainage Massage
Swedish Massage for Professionals

Resources:

Beck, Mark F. Milady's Theory and Practice of Therapeutic Massage. 3rd. Albany, NY: Milady Publishing, 1999.

Calvert, Robert Noah. The History of Massage: An Illustrated Survey From Around the World. Rochester, VT: Inner Traditions/Bear & Company, 2002.

Cassar, Mario-Paul, ND DO. Handbook of Clinical Massage: A Complete Guide for Students and Practitioners. 2nd. Philadelphia: Churchill Livingstone an imprint of Elsivier Ltd, 2004.

"Glossary - Effleurage." Ivy Rose Holistic Health and the Human Body. 31 Jul 2008 www.ivy-rose.co.uk.

Mally, Dr. James. Swedish Massage with Dr. James Mally. Roseville, CA: Abundant Health Resources, 2000.

Uvnäs Moberg, MD, PhD, Kerstin. The Oxytocin Factor: Tapping the Hormone of Calm, Love, and Healing. Cambridge, MA: Da Capo Press, 2003.

If you assume that cocaine use is reminiscent of an archaic era long gone, think again. Whether credited to the continually increasing speed of life in the fast lane or a steadily growing number of people laden with fatigue and depression, millions of people still get tangled up in the powerfully addictive world of cocaine. For cocaine addicts ready to abandon this dangerous illicit drug, massage therapy offers a therapeutic, grounding and welcomed addition to any cocaine recovery program.

About Cocaine
Due to its classification as a Schedule II drug, cocaine has a very high potential for abuse and addiction. Generally snorted or injected, cocaine usually makes the user feel euphoric and energetic. A cheaper version that is typically smoked, crack is cocaine that has been processed from cocaine hydrochloride to a free base form. Because of the pleasure and alertness resulting from its use, cocaine and crack use can quickly transform into a compulsive and deadly addiction. These drugs are known to attract those who are seeking escape from depression and fatigue. Since the cocaine high is short and tolerance escalates quickly, addiction to this drug can develop almost immediately.

Cocaine Consequences
Because it is one of the most potent central nervous system stimulators, cocaine's effects include:

· Increased energy
· Heightened sensory arousal and pleasure
· Euphoria
· Decreased appetite
· Reduced sleep requirements
· Elevated body temperature
· Constricted blood vessels
· Increased heart rate and blood pressure

Physically, cocaine can cause many problems, including:

· Chest pain and nausea
· Blurred vision
· Fever
· Hypertension
· Heart problems (including a heart attack)
· Headaches and seizures
· Lung damage
· Chronic cough
· Kidney failure
· Coma
· Death

Psychologically, cocaine can cause many problems, including:

· Poor judgment
· Anxiety and irritability
· Depression
· Suicidal feelings and behaviors
· Insomnia
· Aggressive behavior
· Psychosis

Symptoms of psychiatric disorders such as schizophrenia, panic disorder, depression or mania can be triggered or exacerbated by cocaine use or withdrawal.

Quitting Cocaine
Cocaine addiction can occur very quickly and be very difficult to recover from. People addicted to cocaine typically go to great lengths to get their drug despite its damage to their physical, emotional and social health. Those who abruptly stop cocaine abuse can experience cocaine withdrawal symptoms as they adjust to functioning without this central nervous system stimulant.

Cocaine withdrawal symptoms include, but are not limited to:

· Intense drug cravings
· Anxiety, agitation and anger outbursts
· Depression
· Extreme fatigue
· Nausea and vomiting
· Shaking and muscle pain
· Disturbed sleep

Bodywork for Recovery
Through appropriate touch applications, bodyworkers with an interest in helping addicts can help them conquer from cocaine withdrawal. However, recovering from an addiction is best accomplished through a comprehensive program incorporating various disciplines. When it comes to addiction recovery, Barrie R. Cassileth, Ph.D., an adjunct professor of medicine at the University of North Carolina at Chapel Hill and Duke University says, "As a general rule, holistic therapies are most helpful when they're used in conjunction with - not in place of - other treatments." Consequently, there are many opportunities for massage therapists to join a recovery program team.

While several types of bodywork can be helpful adjuncts to a cocaine recovery program, the following two stand out:

1. Manual Lymphatic Drainage - As part of the natural detoxification process, the lymphatic system cleanses the body's connective tissue of foreign substances to strengthen immune function. Although cocaine itself is usually metabolized by the body quickly, performing lymphatic drainage massage enhances an addict's immunity. This immune system advantage eases the body's transition to functioning without cocaine.

2. Swedish Massage - Long, nurturing effleurage strokes can ground a person recovering from a cocaine addiction. Because this Swedish massage technique has been shown to slow and calm the central nervous system, it is particularly valuable when a person's body is trying to readjust to life without cocaine's stimulatory effects.

Due to this drug's influence on the body, cocaine addiction is a very dangerous problem. Because of the potential for serious physical and psychological problems being triggered during cocaine withdrawal, bodyworkers are urged to work together with other professionals.

Understanding the physical and psychological problems associated with cocaine abuse and the challenges of withdrawal better prepares bodyworkers to work with this population. Since providing comfort to people who are at their most vulnerable is one of the most satisfying experiences a bodyworker can have, helping cocaine addicts recover is ultimately rewarding.

Recommended Study:
Lymphatic Drainage Massage
Swedish Massage for Professionals

References:

Apostolides, Marianne. "How to quit the holistic way." Psychology Today. (September/October 1996). June 26, 2008 http://psychologytoday.com/articles/pto-19960901-000026.html.

Cassar, Mario-Paul. "Massage for detoxification." (September 1, 2006). Pacific College of Oriental Medicine. June 27, 2008 http://www.pacificcollege.edu/publications/articles/2006/september/09-01-2006_massage.htm.

"Cocaine addiction." Cocainedrugaddiction.com. June 27, 2008 http://www.cocainedrugaddiction.com/cocaine-addiction.asp.

"Cocaine addiction." Southcoast Recovery. June 26, 2008 http://www.southcoastrecovery.com/cocaine_treatment.html.

"Cocaine rehab and cocaine treatment." Cocainedrugaddiction.com. June 27, 2008 http://www.cocainedrugaddiction.com/cocainerehab-treatment.asp.

Prilutsky, Boris, "Lymph Drainage for Detoxification." Massage and Bodywork. (June/July 2006). June 26, 2008 http://www.massagetherapy.com/articles/index.php/article_id/1200.

Reader, M, Young R, Connor JP. "Massage therapy improves the management of alcohol withdrawal syndrome." Journal of Alternative and Complementary Medicine. 11(2):311-3 (April 2005). June 26, 2008 http://www.ncbi.nlm.nih.gov/pubmed/15865498.

"Withdrawal Detox." Southcoast Recovery. June 26, 2008 http://www.southcoastrecovery.com/cocaine_treatment.html.

Stress is a known cause for many different kinds of ailments. Some people even receive the embarrassing diagnosis from a physician that their problem is psychosomatic, or residing entirely in their head. However, those who study health from a holistic perspective know that all illnesses originate from a person's thought processes and emotions. By understanding and teaching their clients that emotional health precedes physical health, massage therapists can surpass their contemporaries and step into the role of holistic healer.

Holistic Healing
Many mistakenly assume that, by definition, massage therapy is a holistic profession. However, this is not necessarily the case. Just like their allopathic counterparts, massage therapists can easily focus unilaterally on one issue, such as stress relief, releasing back pain or improving range of motion.

A holistic approach includes all parts of an individual, not just the most apparent manifestation of an illness. While physical discomfort is typically what prompts someone to seek medical help, holistic medicine does not consider physical health in isolation. Instead, physical, emotional and spiritual aspects of well-being are all evaluated for their part in a person's total health.

A holistic healer recognizes that pain or disease is merely indicative of an imbalance. More often than not, such an imbalance stems from negative emotions. Many holistic practitioners believe that working to modify thought patterns gives people control over their emotions. This transformation eventually creates a joyful emotional state, which will foster spiritual satisfaction and a healthful physical existence.

Vibration
Humans are energetic beings, with every cell possessing its own energetic vibration. When our cells are vibrating harmoniously, we feel wonderful on all planes. However, a resonance incongruent with neighboring cells creates resistance and can eventually lead to illness. Through emotional awareness and desire for wellness, people can detect an initial incongruence and change their own cellular vibration.

Emotions are really energy in motion, or e-motion. Many leaders in holistic medicine teach that negative emotion is the origin of cellular resistance. This beginning moment of dis-resonance is also the easiest to change. By applying a different thought process to an emotional reaction, people are capable of literally turning their thoughts around. Shifting from a negative perspective to a positive one consequently changes a person's cellular vibration.

Awareness
Just like the arrival of chronic illness, a hurricane does not appear instantaneously. If extreme weather arose out of the blue, weather forecasters would be out of a job. Subtle environmental precursors, such as air pressure and temperature, must gradually mount in intensity before gale force winds and torrential rain can affect a community. Similarly, our bodies possess an early indication system warning us when all is not well.

As the primary root of most physical and emotional health problems, emotions serve as our wellness indicator. Awareness of negative emotions is essentially a warning sign of vibratory imbalance that will progress to physical imbalance if uncorrected. Thus, shifting from negative to positive thought patterns is the only lasting way of achieving health. Once a negative emotion is recognized, an adjustment can be made towards a more positive mindset. While this shift requires practice, anyone with an awareness of their emotional well-being can adjust their own vibratory state.

Massage typically feels great and allows a person to deeply relax. Recognizing the impact bodywork has on how they feel emotionally and physically, recipients are more open to the idea of their vibratory resonance or resistance. Massage therapists who understand the interconnectedness of the emotions with physical health can translate this phenomenon to their clients. By learning about a client's emotional set-point and coaching them to shift into more positive thought processes, massage therapists can step into a holistic healing role. With this added dimension of caring, practitioners can help clients identify their ailment's true, vibrational cause and offer them hope for lasting wellness.

References:

http://healing.about.com/od/faq/p/holistichealing.htm, What is Holistic Healing?, Phylameana lila Desy, Retrieved January 8, 2009, About.com, 2009.

http://stress.about.com/od/stresshealth/f/psychosomatic.htm, How Can I Prevent Stress-Related Psychosomatic Illness? Is It In My Head?, Elizabeth Scott, MS, Retrieved January 8, 2009, About.com, September 2008.

http://www.consumerhealth.org/articles/display.cfm?ID=19990303155602, Unlocking Your Emotions for Better Health, Jon Greenberg, MD, Retrieved January 7, 2009, Consumer Health Organization of Canada, 2009.

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1200705, Move into health,
Peter J. Rappa, MD, Retrieved January 7, 2009, Proceedings (Baylor University Medical Center), January 2005.

http://www.massagetoday.com/mpacms/mt/article.php?id=13918, It's All in Your Mind, Ralph Stephens, BS, LMT, NCTMB, Retrieved January 5, 2009, Massage Today, January 2009.