Make the Most of Massage

Author: Mark Liskey

  • No Leverage = No Power to Change Things

    No Leverage = No Power to Change Things

    Win-win picIf you feel undervalued as a massage therapist there’s one sure way to change things. Create leverage.

    Early on in my massage career I thought that leverage meant that one person had the upper-hand and the other person (me) was basically screwed.

    But I was wrong. Very wrong.

    Leverage, an advantage or power to accomplish something, doesn’t have to be one sided. And in my experience, if you want a win/win in any relationship, it shouldn’t be.

    Losing Money

    Unfortunately, it took me a long time to get comfortable with idea of leverage. During that time, I made some bad deals, including being locked in a rent contract with a fitness center that cost me thousands of dollars. Another time I did a lot of free massage to build a clientele that ultimately wasn’t mine. All these bad deals involved a misunderstanding of leverage.

    My first glimpse that leverage could be a good thing happened accidentally. I worked for chiropractors when I started as a massage therapist. It was a great learning experience, but at one point I felt trapped. I thought Ed, the chiropractor I was working for at the time, was underpaying me.

    You Have More Power Than You Think

    I didn’t approach Ed for more money because I didn’t think that I had any leverage. For one, Ed, could hire another MT to take my place for the amount he was paying me. And secondly, I lacked confidence in my massage work which translated into me thinking that Ed didn’t value me.

    But after talking to my wife, Lisa, I realized that my perceived leverage was off the mark. Yes, Ed could hire someone else to replace me—but besides making a mess in the sink when I washed my hands after a massage—I was a decent employee. Also, Ed often thanked me for my work. So, he actually did value me—he was just a little on the cheap side.

    Make Yourself More Valuable

    Coincidentally, at this time, I began training as a neuromuscular massage therapist (NMT). I loved NMT and I immediately incorporated it into my massage at Ed’s office. Suddenly my client base grew. (Not because I was practicing NMT. It was because NMT taught how me to deliver the full range of pressures. I explain how to do this in Competing with Bob for Clients).

    Though unintentional, I now was a more valuable employee to Ed because I made him more money. And, subsequently, I had more leverage.

    Eventually, I used my leverage. I went to Ed for a raise and we negotiated. I got enough of a raise to keep me happy, and he knew that he could continue to count on me to grow his practice.

    Over the next decade it was two steps forward and one step back until I finally embraced the good of having leverage to create fair deals. Here are my leverage steps for negotiating:

    Step #1 : Accept The Need For Leverage

    If the idea of leverage still bothers you, try thinking about it this way. Leverage (power) is neutral until you use it. Use your leverage to create a win/win (fair deal)—and at the end of the day, you’ll feel really good for taking care of yourself while not compromising your integrity!

    Step #2 : Understand Current Leverage Points

    It’s not easy to see your leverage points. When in doubt, ask someone who you can trust to give you an honest appraisal of your work situation. It could be a work colleague. Or it could be someone completely removed from the situation. The key is to find someone who can see your situation as an observer.

    Step #3: Create Leverage By Adding Value

    It only works as leverage if the value you are creating is meaningful to the person you’re trying to influence. If I had studied to be an esthetician instead of a neuromuscular therapist, I wouldn’t have had any more leverage with Ed because selling adjustments and massages paid his bills—not facials and peels.

    You’re Not Ruthless

    Let’s face it, in our business, a boss, whether it be an employer or a client, is NOT going to voluntarily hand out raises. At some point, if you want more money, you’re simply going to have to ask for it.

    Before you do, evaluate your leverage situation. If you need to tweak your massage (to get more repeat clients) before you go to your boss for a raise, check out New Therapists Can Be Good Therapists.

    If your massage is good to go, you may already have enough leverage to negotiate for a raise or to raise your price.

    I promise you that when you find your leverage points, you won’t turn into Montgomery Burns. In fact, you’re probably going to become more empathic as you work towards getting a fair deal.

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  • Massage for Lower Back Pain 101: The Brain

    Massage for Lower Back Pain 101: The Brain

    This is a story of massage for lower back pain not working (but there’s a lesson).

    Casey was crippled because of his lower-back pain. And nothing worked.

    In fact, after 4 injections his pain got a lot worse. He went from lying face down on my table to lying on his side to sitting up to not coming in.

    The last time he came in, we used a wheelchair to get him in and out of the office.

    I was 99% sure that Casey was heading for the knife.

    A few weeks after Casey stopped coming in to see me, I met Dr. Charlie Johnson, a PT who specialized in back pain. I thought Charlie might be able to help Casey, and Casey agreed to see him if I came along.

    When I went to pick Casey up for the appointment, I expected to see a slumped over, broken man. But what I saw was Casey close to how he used to be pre-back pain.

    What the hell?!

    Did the nerve compression ease up?

    Did the inflammation go down?

    Wait…I’ve been down this road before…these questions imply that pain is only a product of tissue damage.

    But research shows that pain is not simply a tissue damage event.

    Pain is an experience.

    I Can Heal You (NOT)

    When I opened my neuromuscular massage (NMT) practice in early 2000, I thought I had the playbook for correcting things like lower-back pain.

    I’d go through the NMT evaluation protocol, identify the eccentric and concentric muscle issues, add in trigger point therapy, and BAM!–pain get ready to get your butt kicked.

    But massage for lower back pain and other issues produced inconsistent results.

    I soon became frustrated and started to look for answers elsewhere.

    So for the next ten or so years, I studied and wrote about back pain.

    At this time, a new view of pain and how it should be treated was just starting to emerge.

    The old way for understanding pain was that pain is strictly a matter of tissue damage. The new way for understanding pain was that pain is complex and is influenced by social, emotional and conditional factors.

    When I think about Casey’s back-pain story, it makes more sense to view it through the new lens.

    Here’s what I mean.

    Casey’s Lower-Back Pain

    When Casey hurt his back, he stopped working. And as it got worse, his world got smaller, so small that he wouldn’t even leave his house.

    By five months, he was basically incapacitated.

    But then things started to improve as he approached the 6 month mark.

    Interestingly, 6 months marked the time short-term disability would be cut off and Casey would have to go back to work. If he didn’t go back to work, they’d fire him.

    I’m not at all suggesting that Casey was faking his back pain. I was there and it was real—to the point where he lost leg functionality.

    I’m saying other factors played into Casey’s experience of back pain.

    The Other Parts of Back Pain

    In his book, Itty Bitty Book About Lower Back Pain, Charlie the PT explains that “pain does not equal damage or injury…it is simply an experience created by the brain when it thinks your body is in danger.”

     

    He goes on to say that it takes 3 – 6 months for ligaments, muscles, nerves and discs to heal in your back. After that if pain persists it could be that your sensing system is revved up and you’re brain “is still sensing danger.”

    Now, let’s back up to when Casey hurt his back. A physical event happened in his back, like a tear or strain or rupture or impingement or something.

    About a month post injury, he was doing better. Then things suddenly got worse. At the time, he was still seeing a personal trainer and my hunch is that the personal trainer was having Casey do something that aggravated his back condition.

    Then Casey started injections. Each injection helped for a very short period of time, but then the pain returned and eventually got worse. During this time he had some falls and could’ve re-injured his back.

    But eventually, the potential back-pain, perpetuating factors were eliminated–no more falls and he stopped seeing the personal trainer. So he was healing and feeling better, right? Actually, no. The pain now was the worst it had ever been!

    Why?

    Maybe because there were things revving up his sensing system, like:

    Casey HATED his job because his boss stressed him out!

    According to the research Charlie sites in his book, if you hate your job, you’re likely to experience more pain than someone who likes her job.

    In addition, it’s been shown that memories can impact pain. Casey constantly talked about his boss as being psychotic.

    Memory of Psychotic Boss + Thought of Going Back to Work = Stress Hormones Shooting Up.

    Okay, but you could argue that Casey’s stress level should’ve gone down because he was away from the hostile work environment while on disability.

    True, but Casey also knew he’d be fired if he didn’t return to work after 6 months of disability.

    That worried him A LOT. By the way, if you’re sad or worried you’re likely to feel more pain than someone who’s happy and relaxed.

    OMG, no wonder the poor man couldn’t sleep! And, yes, bad sleep habits equal more pain.

    Can you feel the pain intensifying?

    Casey (Massage for Lower Back Pain) Revisited

    “Pain is an experience” makes complete sense to me. Casey’s lower-back pain fits this view to a T.

    If I could have a do-over, here’s how I’d try to help Casey now.

    First, I’d let him know that the injury to his back will heal in 3 to 6 months. This should ease some immediate anxiety regarding his back pain.

    Next, I would jump into action once I heard Casey repeating things.

    For instance, each time I massaged Casey while he was in back pain, he told me (and I could see) how stressed out he was. But I didn’t appreciate the significance of what stress can do to the experience of pain.

    If I had really gotten this, I would’ve pestered Casey endlessly to get counseling or find a professional who could teach him how to meditate.

    Lastly, it doesn’t matter how well I listen to a client and recognize a need if I don’t have someone good to refer her to.

    With Casey, I learned that my referral list had holes in it.

    This became apparent when Casey filled me in about the back doctor he was seeing. I was not impressed. For one, the doctor gave Casey more injections than most other doctors would and he never used imagery when injecting.

    But I didn’t have an alternative for Casey to see at the time. If I had known about Charlie, I would have sent Casey to him.

    Old Dog, New Trick

    Here’s how I’m gonna fix my referral list. I’ll talk to people in the health and wellness industry who I trust. I’ll get their recommendations, then I’ll vet their recommendations. Here’s how I vet.

    Also, going forward, this is big, I promise to NOT take stress or any other factor that influences the experience of pain, for granted—ever, ever again.

    And, if things are looking bad because the pain won’t go away, I’m going to remember that in 3 to 6 months most back issues have healed.

    Maybe there’s something revving up the pain system.

    Time to look with a magnifying glass.

    P.S. When Casey went back to work, he had a new (and nice) boss:-)

    Need more help with your back pain clients?

    Check out Common Sense Ways to Treat Sciatica.

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  • When You’re Most Likely to Get Hurt

    When You’re Most Likely to Get Hurt

    I was taught in neuromuscular therapy that if you were having trouble identifying a potential gait distortion you should have the person walk faster. This works because when the person is walking faster she doesn’t have time to adjust to an imbalance (e.g., pronating foot ) before she takes the next step.

    A while back, I drastically increased the amount of massage I did per day. In a way, this was similar to having someone walk faster to accentuate a gait distortion. Doing the extra massages without a break put me in a situation where everything was magnified including warning signs that I might be in danger of injuring myself. Though this is not an experiment that I’d like to repeat, I’m glad that I was able to learn from it. Here are my top four “When You’re Most Likely To Get Hurt” scenarios:

    When You’re Tired

    We can all relate to the mental effort it sometimes takes to get through the last massage of a long night—and it’s precisely at this time that body mechanics fall by the wayside. Why? Because it’s easier to reach (low energy expenditure), potentially compromising a shoulder joint, instead of moving (higher energy expenditure) to be in a better position to apply pressure.

    Suggestion: Move your feet. No matter how tired you are, keep telling yourself to move your feet. Once you move your feet and are in a good position for your next move, you can lean all you want on the table (or the client, depending on the amount of pressure she wants) and “catch your breath”.

    When You’re Drifting Drift Off

    Admittedly, I sometimes have gone off into la-la land during a massage. I’m usually brought back to reality by pain. The pain is often a result of me overusing a body part (thumb, fingers, knuckles, elbow-forearm) because I hadn’t been paying attention to what I was doing.

    Suggestion: Practice with all of your body part tools to the point where you are changing them without thinking. So when you drift off, your automatic pilot (body-part tool-changing pilot) will kick in before the pain does.

    When You’re Brain-Glucose Is Low

    In 2015, I wrote an article for Massage & Bodywork Magazine (Minimizing Injuries: Some Common and Uncommon Advice ) and an article for Spirituality & Health (The Fuel of Good Decision Making) where I talk about how brain-glucose lows can lead to poor decision-making. I also go on to explain that complex carbohydrates can immediately reverse this condition.

    Here’s how a brain-glucose low could play out in the massage room. You’re on your 3rd back-to-back massage of the day, but you didn’t have time to eat before your first massage. The last person you worked on talked constantly and towards the end of the massage you found it very difficult to both carry on a conversation and do the massage. Now, at the beginning of your 3rd massage you’re having trouble remembering what your client wanted you to focus on. At this point, there’s no way that you brain has enough mental energy to worry about body mechanics.

    Suggestion: Have healthy, complex carb snacks, like an apple or granola bar, available to eat between clients so that you can recharge your brain. Personally, when I have a back-to-back client day, I make sure that I have an ample meal before I start massaging for the day. Then it only takes a few bites of a healthy snack to avoid a brain-glucose low.

    When You’re Determined

    When I was first starting massage, I would disregard technique/form because I was determined to get the job done no matter what. For example, if I was working the pec minor and my thumb was killing me I would simply ignore the pain. But over time, my thumbs started to bother me.

    Suggestion: Practice good technique/form to the point where it becomes automatic and overrides your determination to get the job done. Good technique to me starts with being comfortable with all the tools (body parts to press and glide with) in my tool kit so that I can switch out a tool before I burn it out. My idea of good form includes a neutral back whenever possible, joints stacked over each other when delivering pressure, and stances that take the strain out of my upper body. Because of different body types and pre-existing conditions, you’ll have to define good form for yourself.

    The 10 Massage Challenge

    You can probably get away with not paying attention to these four scenarios for a short time, but eventually things will catch up to you. And if you ignore a few at once, there’s a potential for some serious pain.

    So here’s my challenge to you: For the next 10 massages note when you feel pain. Each time you do, ask yourself if you’re tired, hungry, foggy, drifting or overly determined? If you answer “yes”, on average, one out four times then try some of my suggestions.

    Please let me know how it goes and I’d love to hear your top “Most Likely to Get Hurt” scenarios!

    Can you massage pain-free?

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  • Massage Biz Shortcut: Find Your Target Market

    Massage Biz Shortcut: Find Your Target Market

    You have a target market in mind—seniors with disposable income who can come in during the day.

    Cool.

    What’s the first thing you should do to get in front of that audience?

    Ten years ago I would’ve said something like put up a flier at the most expensive retirement community nearby.

    Going for this mother lode of seniors would be sort of a long shot, right? Especially if I didn’t have any connections to anyone in the retirement community.

    Today, I see things differently.

    The shortcut to success for finding a target market is not to look into the distance, way beyond my current reach. Instead, it’s to look right under my nose.

    Here’s why I say that:

    Mark is Schooled In Finding a Target Market

    A while back, my wife, Lisa, and I started developing and teaching massage-CE courses.

    You’d think that the biggest obstacle to launching a CE course would be creating content. Nope. It’s finding the audience to purchase the courses.

    Traditional Options

    There are a lot of options to getting a class in front of MTs, like running your class through a massage school, hosting a class yourself and advertising on your own, or connecting with a massage professional organization and teaching at one of their events.

    Of course, I didn’t do any of them.

    Instead, I went for the home run ball.

    Lisa and I met with a big company in the travel industry who owned massage schools.

    Here’s the short version of what happened. Our contact person seemed to like our presentation. And we walked away dreaming about how we would travel the world teaching massage in their schools both in the States and abroad.

    But there was one small problem.

    This big corporation was the wrong audience. They weren’t in the market for what we were offering.

    Next thing we knew, a year (or two) had gone by and we had nothing to show for it.

    In Retrospect

    Here’s what we should’ve initially done and eventually did do: Engage people who were right under our noses.

    After our dream fizzled out, we told MT colleagues about our classes. We also reached out to MTs on our email list that we had built over the years via a newsletter.

    Slowly but steadily the word spread.

    These MTs (under our noses) provided great feedback which allowed us to refine and redesign our classes to meet their needs.

    Eventually, business owners and colleagues started seeking us out. Then when a spa owner read an article I wrote, she hired us to travel across the US to teach our CE classes to her employees.

    Target Market: Seniors/Money/Daytime

    Now, let’s do the same for your hypothetical, target market of well-to-do seniors.

    First…

    1. Start with people you know.

    Look through your client contacts. More than likely you’re going to find a client that fits the “senior citizen/available during the daytime” bill.

    Let’s pretend Andrew is one of these clients. He’s 80 and loves your massage. You talk to him and find out that some of his friends don’t drive.

    Hmm…looks like an on-site massage opportunity to me. You tell Andrew that you go to peoples’ houses to do massage. He tells his friends.

    Andrew also plays tennis. You give him some cards to pass out to his tennis buds.

    After a while, you start to see that Andrew is pretty good at talking you up. So you read How to Get Someone Else to Sell Your Massage, and you turn Andrew into a selling machine.

    One of his friends, Hung, comes in to see you, and you…

    1. Get a small win.

    Hung loves your massage, too. During a conversation with Hung, you find out that he plays golf. Some of his golf friends have back issues.

    You tell Hung that you’d be happy to do free, 20-minute demo massages on any of his friends. He tells them, and his friend Jose takes you up on the free demo.

    Jose goes to your office, but he’s moving super-slow. You don’t rush him.

    Later on, as policy, you decide to allow an extra 15 minutes in your schedule for transitioning whenever you have a senior-citizen client.

    Jose comes back to see you. He’s got all the time in world to get on and off the table. and really appreciates you not making him feel old.

    Now, you’ve worked on 3 seniors. You’ve gotten great feedback and have adjusted to your target market’s needs. It’s time to…

    1. Go all in.

    Like, seriously go all in.

    Why?

    You’re in your target market. They love you. Cash is coming in. And you’re getting helpful feedback.

    Here’s how I go all in: A Niche Market = More Clients.

    Right Under Your Nose 

    The “right under your nose” strategy is hard work, but, ultimately, it will save you time because you’re testing as you go in your target market.

    At some point, there’s nothing wrong with taking a swing for the fence, but it shouldn’t be your first step to finding and growing your target market.

    P.S. If you need some help, start by signing up for my email group. I’ll let you know when new videos and articles are out.

    Oh, and if you let me know what you need help with when you sign-up, I’ll make sure that you’ll get the material you need:-)