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Dissection is the Ultimate Learning Experience

Dissection is the Ultimate Learning Experience

By: David Kent, LMT, NCTMB

There is nothing like a full-body dissection seminar to alter and improve one’s understanding and appreciation of the human body. A dissection seminar offers a unique opportunity to learn about the intricacies of the human body and its various structural relationships in a three-dimensional way. During the seminar, students become familiar with a range of pathologies; they also observe how the normal aging process affects the body.  This article will discuss just some of the benefits of participating in a dissection seminar.

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BIOFREEZE: Massage Therapy Practice Building Tools

Watch two short video clips by David Kent on ways to build your massage practice with Biofreeze.

Biofreeze Locator – Where To Buy

The BioFreeze Educational Brochure is free to massage practitioners and a great way to promote your practice. One Biofreeze sample pack is attached to each brochure. Biofreeze will print three lines of customized information (Name, address, phone) on the brochure and ship them to you free.

The BioFreeze Countertop Display Case is also free and great way to build your massage practice

To order your FREE Personalized Biofreeze Educational Brochure with Sample Pack please click here.

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Comfort Craft Massage Table Model 800 Features & Benefits

David Kent uses Comfort Craft massage tables in each of his treatment rooms.

Take a video tour as David shows you the features and benefits of the Comfort Craft Model 800 Massage Table. Learn about the:

  • Comfort Conforming Face Cradle With Gliding Action prevents compression of the cervical spine. The face cradle can be set to any angle and when not in use can be quickly repositioned under the table.
  • Adjustable Arm Rest provides comfort at any angle. Multiple adjustments points gives you the ability to make the modifications for short or tall individuals .
  • Foot Controls allow you to easily adjust your table height and the angle of the mid-split table top throughout the treatment. There are two sets of foot controls, one set on each side of the table.
  • Treatment Stool with Large Wheels provides a solid base and lets the therapist position to the perfect angle throughout the treatment. Single hand lever allow for quick and easy height adjustment.
  • Side Lying Treatment Tips and Benefits
  • Prone Treatment Tips and Benefits

To receive additional information about the Comfort Craft Model 800 Click Here or call Jim Craft at 800-858-2838

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Back Pain from Gluteus Medius Trigger Points

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By: David Kent, LMT, NCTMB

Each week, I treat several clients who complain of “low back pain.” For many patients, however, the primary cause of pain is not the lower back but the gluteus medius muscle. No matter what kind of massage practice you have, a great deal of your success will depend on how quickly you are able to determine the origin of a patient’s complaint and your ability to produce measurable results. This article will review some ways to identify when the gluteus medius muscle is responsible for causing pain.

Anatomy:

The gluteus medius muscle lies superficial to the gluteus minimus muscle and deep to the gluteus maximus muscle. Proximally, it attaches along the external surface of the ilium between the anterior and posterior gluteal lines. Distally, it attaches to the lateral surface of the greater trochanter of the femur (See Photo 1).

The gluteus medius muscle “abducts the hip joint; the anterior fibers medially rotate and may assist in flexion of the hip joint; [and] the posterior fibers laterally rotate and may assist in extension.”1 It also helps to keep the pelvis level when the opposite leg is raised during activities such as walking, running, or standing on one leg.

Intake and History:

The first step to designing and implementing an effective treatment plan is to understand the client’s medical history and current circumstances. Utilizing health history intake forms will help you gather the appropriate information; they will also reveal important factors that could be relevant to a patient’s condition.

Using pain scales to document a client’s pain patterns are beneficial, as well. Ask the client to color the diagram form illustrating where on the body he/she experiences pain. Then ask the client to add modifiers that adequately describe the pain, followed by a number from 1-10 to rate its intensity (See Photo 2 ). This diagram provides a helpful visual tool that you can reference during the session. You will also see how pain patterns often match common trigger point patterns, which are discussed in more detail below.

Ask the client if any of his/her daily activities are affected by the pain. If the answer is yes, ask the client which muscles hurt, what movements aggravate the pain, and what he/she believes caused the pain. Ask if the client has recently started or modified an exercise program. Answers like walking, running, tennis, aerobics and other types of activities may indicate gluteus medius involvement. Has the client had any falls or sustained any hip injuries? What is the client’s occupation? Does the client place a wallet or tools in a back pocket? All of these questions will help you narrow down the origin of pain. (Read “Questions with Direction,”)

Gait & Postural Analysis:

Observe the client as he/she walks. A painful or “weak gluteus medius muscle forces the client to lurch toward the involved side to place the center of gravity over the hip; such movement is called an abduction, or gluteus medius lurch.”2

Show your client the relationship between posture and pain, and describe how you can help. Just like chiropractors advertise free “spinal exams” to attract new patients, you could provide free postural analysis to attract new clients. Market the postural analysis as a value that you include during the initial visit; then include a second postural analysis taken upon completing a series of treatments. This is a great way to sell packages, and it also demonstrates postural progress. (Read “Getting Comfortable with Postural Analysis,”) When conducting a postural analysis, look for signs of gluteus medius muscle involvement. Shortness of the gluteus medius muscle “may be seen as a lateral pelvic tilt, low on the side of tightness, along with some abduction of the extremity.”3

Trigger Points

“Myofascial trigger points (TrPs) in the gluteus medius are a commonly overlooked source of low back pain.”4 There are three trigger points frequently identified in the gluteus medius muscle. TrP1 (See Photo 1) is located lateral and superior to the posterior superior iliac spine (PSIS) just below the iliac crest. TrP1 refers pain and tenderness over the sacrum, above the iliac crest into the lumbar region, and throughout the gluteal region on the same side of the body as the trigger point.

TrP2 (See Photo 1) is positioned midway between the anterior superior iliac spine (ASIS) and the PSIS just below the iliac crest. “Pain referred from TrP2 is projected more laterally and to the midgluteal region; [and] may extend into the upper thigh posteriorly and laterally.”5

TrP3 (See Photo 1) is rarely present and can be located just posterior to the ASIS and just below the iliac crest. Referred pain is primarily produced over the sacrum bilaterally.

Educate your clients about trigger points. Use wall charts or flip charts to demonstrate their location on the body. Using charts and other aids will not only help the client, but it will also build your credibility with the client. This is also an excellent time to explain how the muscle affects posture.

Pain is a symptom. As massage therapists, our job is to address the cause of the pain and work to prevent its return. Educate your clients. Discuss proper ergonomics, stretching and strengthening. Identifying the gluteus medius as a source of back pain is easy once you have the knowledge.

David Kent, LMT, NCTMB

David Kent, LMT, NCTMB, is an international presenter, product innovator and writer. His clinic, Muscular Pain Relief Center, is in Deltona, Florida, where he receives referrals from various healthcare providers. David is President and Founder of Kent Health Systems which teaches Human Dissection, Deep Tissue Medical Massage and Practice Building seminars, and has developed a line of products, including the Postural Analysis Grid Chart™, Trigger Point Charts, Personalized Essential Office Forms™, and DVD programs. Visit www.KentHealth.com or call (888) 574-5600 for more information.

1, 3 Kendell FP, McCreary, et al. Muscle Testing and Function with Posture and Pain, 5th ed.  Lippincott, Williams and Wilkins: 2005.

2 Hoppenfeld S. Physical Examination of the Spine & Extremities. Appleton & Lange: 1976

4 Simons DG, Travell JG. “Myofascial Origins of Low Back Pain, 3: Pelvic and Lower Extremity Muscles,” Postgrad Med 73:99-108, 1983.

5 Simons DG, Travell JG. Myofascial Pain and Dysfunction, The Trigger Point Manual: The Lower Extremities, 2. Lippincott, Williams and Wilkins: 1992

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Practice Building For Massage Therapists: Consistency Breeds Success

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By: David Kent, LMT, NCTMB

The current economic slowdown is stressful to everyone. Business is slow, treatments are down, and both are affecting the bottom line. During these challenging times, however, there are things you can do to consistently to breed your success. Instead of getting frustrated and discouraged, use this extra downtime to your advantage. Following the tips in this article will help you achieve ongoing success in your practice, whether you are in a clinical, spa or outcall setting.

Getting Out There

Marketing professionals know how important repetition is to “imprint” a product in the mind of the consumer. This same concept applies to massage therapy and your ability to imprint your services on potential referral sources. Each week, I visit specific locations that have become my best referral sources. If you aren’t getting the number of referrals you would like, it’s time to get out there and introduce yourself. Here are just a few places to start:
o      Medical and chiropractic clinics

o      Acupuncturists and homeopaths

o      Hotels and salons

o      Personal training centers and gyms

o      Tennis and golf courses

o      Yoga studios

o      Health food stores

o      Gymnastic and dance studios

o      Business centers

Talk it Up

You took the time to get out there; now you need to make it count! Your goal is to attract business by educating your referral sources about the importance of massage therapy.  Advertisers use test markets and focus groups to refine their messages. But before you begin pitching your services, you will need to practice and refine your “commercial” with your “test market,” which is located in the next community over.

That’s right. You need to practice your selling skills before you officially launch your marketing campaign with your “real” audience in your own community. Practicing gives you the opportunity to build your confidence while simultaneously getting comfortable with introducing yourself to strangers, telling them what you do, and answering commonly asked questions. But don’t let yourself off the hook with your practice sessions. Make sure that you are as professional and courteous with your test audience as you plan to be with your “real” audience. The following tips will help you get comfortable in this newfound role as salesperson.
o      Introduce yourself. Let people know who you are, what you do, and where you practice.

o      Talk to everyone you come into contact with—everyone! From waiters and waitresses to the FedEx delivery person to your mechanic, dentist, or insurance agent.

o      Never assume that people know what massage is or how it can help them.

o      Following each encounter, reevaluate your performance and ask yourself the following questions: What did I learn?  What will I do different next time? What other strategies could I try in the future? Answering these questions will help you do a better job each time.

o      Finally, ask your clients and referral sources what they think is important for you to tell others when marketing your services. You’ll be surprised at how helpful their feedback will be.

Show and Tell

Explaining the basics helps others understand how massage therapy can help with headaches, sciatica, neck and back pain, and more. Additionally, using “props” can help educate your clients.
o      Carry a trigger point flip chart with you. Explain how trigger point patterns are often the cause of severe pain.
o      Take a moment to examine the posture of the person you are speaking with. Educate your contact about how each individual’s unique postural pattern can be treated with massage therapy. Then describe your ability to custom tailor your treatments accordingly.

Mutual Benefits

Discuss how you can be of mutual benefit to each other.
o      Can you send them business?

o      Take some of their business cards to pass out, and ask them to do the same.

Leave Treasures

Do something unique so that your referral sources remember you.

o      Give a helpful tip. If you are talking with a secretary who complains of neck pain, suggest that he/she try a telephone headset, or adjust the height and angle of the computer monitor or chair.

o      Teach simple stretching techniques.

o      Leave healthy snacks. I know people who are always on the run and rarely stop to eat. Sometimes, I’ll drop off an apple, nuts, and a bottle of water, along with my business card.

o      Leave samples of topical pain relievers.  

Contact Information
You’ve invested your time and energy marketing your practice. Now make sure that your referral sources can find your name and number when it counts. Be sure to leave
o      Business cards

o      Magnets

o      Flyers

o      Pens

o      Notepads

o      Any other tool you think will leave an impression.

Education
Clients often want to understand and learn more about their condition, so put your education to good use.
o      Continually educate and re-educate your clients.

o      Show them how to stretch and maintain themselves between sessions.

o      Explain the importance and benefits of regular exercise.

o      Use visuals, such as anatomical models, textbooks, trigger point charts or other charts to show the musculoskeletal origins of their condition.

o      Review the effects of poor posture and explain how it contributes to pain. Since a picture is worth a thousand words and many cell phones have cameras, taking postural analysis photos on the road is easier than ever. Read “Getting Comfortable with Postural Analysis” (Massage Today, July 2008) for more tips on using postural analysis photos.

o      Discuss the uses of ice, heat, and topical analgesics for pain.

Say “Thank You”

o      Place follow-up calls to new clients.

o      Send thank you notes to clients and referral sources.

We typically avoid the things that we are uncomfortable doing; however, with practice, you will quickly realize that certain thoughts and actions consistently focused in positive directions will ensure your success. And if you practice your selling skills consistently, you will improve each time you sell your services to somebody new. Remember: practice makes perfect! Hang in there and don’t get frustrated. Results don’t always happen overnight. Just invest the time and keep a positive attitude. You’ll be amazed with the results!

David Kent, LMT, NCTMB

David Kent, LMT, NCTMB, is an international presenter, product innovator and writer. His clinic, Muscular Pain Relief Center, is in Deltona, Florida, where he receives referrals from various healthcare providers. David is President and Founder of Kent Health Systems which teaches Human Dissection, Deep Tissue Medical Massage and Practice Building seminars, and has developed a line of products, including the Postural Analysis Grid Chart™, Trigger Point Charts, Personalized Essential Office Forms™, and DVD programs. Visit www.KentHealth.com or call (888) 574-5600 for more information.

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Subscapularis: Overlooked and Under Treated

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By: David Kent, LMT, NCTMB

The subscapularis is often neglected and/or undertreated as a cause of posterior shoulder pain with restricted range of motion (ROM). According to Travell and Simons, “differential diagnosis of subscapularis TrPs includes C7 radiculopathy, thoracic outlet syndrome, adhesive capsulitis and ‘impingement’ syndrome.”[1]In this article, I will review how to determine when the subscapularis muscle is responsible for causing shoulder pain and restricted ROM, as well as review its anatomy, function, trigger-point patterns and treatment options.

Intake and health history forms will help you identify some common factors that may contribute to the formation and perpetuation of trigger points, as well as the shortening of the subscapularis muscle. According to Travell and Simons, some of these factors include the following:

  • Repetitive movements that involve medial rotation, such as swimming the overhead stroke, playing tennis or pitching a baseball;
  • Repeatedly lifting boxes or other objects overhead with both arms extended;
  • Reaching backward to break a fall;
  • Soft-tissue stress when the shoulder joint is dislocated;
  • A fracture to the proximal humerus or trauma to the shoulder joint capsule;
  • The immobilization of the shoulder in an adducted and medially rotated position over a long period of time, such as when the arm is in a sling; and
  • Prior surgeries and procedures.[2]

Taking a photo of your client in front of a postural analysis grid chart is an effective method of evaluating, documenting, educating and ultimately showing a client his or her postural progress over a series of treatments. For example, a constant slumped, forward-head, adducted-scapulae posture will perpetuate trigger points and the shortening of muscles, like the subscapularis, by continually keeping the humerus in a position of medial rotation.3 [Photo 1]

 

 

Symptoms

 

Trigger Points: When trigger points are present in the subscapularis muscle, they produce referred pain “in the posterior deltoid area…down the posterior aspect of the arm, and then skip to a band around the wrist.”4 [Photo 2] Remember that referred pain is a symptom; we want to address the cause. So intake forms, postural analysis evaluations, range-of-motion and orthopedic assessments, and being familiar with trigger point patterns are all helpful to designing and implementing a customized therapy plan. But treating a trigger point is only part of the solution. We need to avoid a recurrence in the future. It is therefore necessary to demonstrate to your client which muscles need more lengthening and which ones need more strengthening so that all of the joints are properly aligned and moving through their full range of motion.

Anatomy: The subscapularis is one of four muscles that make up the rotator cuff, along with the supraspinatus, infraspinatous and the teres minor muscles. In my dissection seminars, I always highlight the subscapularis, which is the most anterior of the rotator cuff muscles. [Photo 2] It is a thick triangular muscle that attaches medially on the anterior or costal surface of the scapula on the subscapular fossa; it forms part of posterior wall of the axialla. Laterally it attaches on the lesser tubercle of the humerus and the lower half of the shoulder joint capsule.

Actions: The subscapularis is primarily responsible for medially rotating and adducting the arm. It also helps to hold the humeral head in the glenoid cavity. To check for shortening in the subscapularis it is necessary to evaluate both abduction and external rotation.

Abduction: According to Travell and Simons, when evaluating a shoulder with restricted abduction, it is first necessary to determine if the restriction is being caused by the inability of the scapula to move on the rib cage, the humerus to properly articulate in the shoulder (glenohumeral) joint, or a combination of the two. The difference can be easily determined by placing your hands on the client’s scapula to prevent its movement while asking the client to abduct his/her humerus. [Photo 3] When the subscapularis is involved, it restricts glenohumeral movements like abduction and lateral rotation, but it does not restrict scapular movements on the rib cage. If scapular movements are restricted, it is necessary to evaluate muscles that run from the torso to the scapulae like the pectoralis minor, serratus anterior, trapezius and the rhomboids.5

Lateral Rotation: When checking lateral rotation at the shoulder, adduct the arm by placing the elbow at the side. Bend the elbow 90 degrees to show the amount of rotation at the shoulder joint. [Photo 4] The arm should be able to laterally rotate 90 degrees. In addition to the subscapularis, other synergistic muscles like the teres major, latismus dossi and pectoralis major also adduct and medially rotate the arm. These muscles must also be evaluated and treated. Keep in mind that the antagonistic muscles are weak and over lengthened, so they need strengthening. Muscle movement charts can aid in quickly identifying the muscles involved and show the normal range of motion for the muscles and joints being evaluated. [Photo 5]

Treating the subscapularis: While there are many different approaches to treating the belly of the subscapularis muscle, I find one particularly effective; however, with this method some clients may only be able to tolerate static pressure versus movements, such as with-fiber or cross-fiber techniques.

  1. Place the client in a supine position.
  2. Stand facing the client at level of client’s shoulder.
  3. In the palm of your non-treating hand, cradle the scapula while using your fingertips to secure the vertebral border of the scapula; abduct the scapula.[Photo 6]
  4. Position the fingers of the treating hand against the belly of the subscapularis muscle. [Photo 7]

NOTE: Some clients may be ticklish, but this is easily overcome by using the client’s hand during the treatment. Have the client place his/her hand on the ticklish region while you treat the area between his/her fingers. [Photo 8]

  1. Drape the client’s arm across his/her chest (adduction) to shorten the muscle. [Photo 9]
  2. Press the fingers of your treating hand down toward the table and into the subscapular fossa.

Before the session ends, advise your client that he/she will receive the most benefit from your therapy session by actively engaging in self-care stretching techniques, such as the doorway stretch, which will further help improve muscle length, and create and maintain balance in the shoulder. [Photo 10]

You have now identified several factors associated with subscapularis pain and discomfort with the help of assessment aids and tools like intake forms, charts and postural analysis photos. Continue to study and broaden your skills with hands-on seminars and DVD programs. And to share your tips and experiences in the treatment room, please drop me a line at [email protected]

For more information related to this month’s topic, check out “Charting Your Progress: Visuals for Success” (February 2008) and “Getting Comfortable with Postural Analysis” (July 2008) online at www.massagetoday.com.

David Kent, LMT, NCTMB

 

David Kent, LMT, NCTMB, is an international presenter, product innovator and writer. His clinic, Muscular Pain Relief Center, is in Deltona, Florida, where he receives referrals from various healthcare providers. David teaches Human Dissection, Deep Tissue Medical Massage and Practice Building seminars, and has developed a line of products, including the Postural Analysis Grid Chart™, Trigger Point Charts, Personalized Essential Office Forms™, and DVD programs. Visit www.KentHealth.com or call (888) 574-5600 for more information.


1-5 Simons DG, Travell JG, et al. Myofascial Pain and Dysfunction: The Trigger Point Manual, volume 1, 2nd ed. Williams and Wilkins: 1999.

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Questions with Direction – Practice Building Tips

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By David Kent, LMT, NCTMB

One of the most challenging aspects of being a massage therapist is trying to build a thriving practice with repeat clients. So, it’s no surprise that many therapists have felt the crunch with the recent downturn in the economy. And, unfortunately, services like massage therapy are often among the first things to be cut from one’s budget in times of economic crisis.

Therefore, it is now more important than ever to convince your clients to stay the course with their massage therapy sessions. This article will show you how asking some simple questions can ultimately lead to repeat clients, whether you work in a spa, outcall, seated- or clinical-massage setting. Soliciting a client’s feedback by way of asking thorough questions will better help you understand you client’s needs and deliver results. But even more important than asking the question, is listening and responding to the information your client provides.

One way to organize your questions is to make use of the wide-range of forms available for these purposes. In fact, your questions will, to a degree, be directed by the information you obtain using forms. I have my clients complete intake forms prior to therapy; these help me develop targeted questions to clarify my knowledge about their health history, their specific areas of pain, the stresses in their life, the ergonomics of their activities of daily living (ADLs), medications they are taking, and to identify any precautions or contraindications before the session begins. Using intake forms helps me develop goals for the client’s current and future sessions—which is also useful in persuading my clients to commit to ongoing treatment.

There are various types of questions; however, this article will focus on two primary categories: general and those related to a client’s pain. General questions are great for helping you understand your client’s expectations, no matter what kind of practice you have.

General questions:

  • Question: What are your goals for today’s session?

Reasoning: If you don’t ask this question, you won’t know if a client wants a relaxing Swedish massage or a vigorous sports massage that integrates stretching. This is also important so that you are responding to your client’s needs and not responding to your perception of your client’s needs.

  • Question: What areas you would like me to focus on today?

Reasoning: This question also relates to the question above. At one time or another, we’ve all probably had an experience with a therapist that seemingly ignored the very thing that brought us to therapy in the first place. When you ask this question, it is very important to listen closely to the answer. When you listen to the client and deliver results, it increases the odds that your client will reschedule and/or refer others.

  • Question: Have you received massage therapy before?

Reasoning: Regardless of the client’s answer, this is the ideal time to communicate to the client how you will perform the session. For new clients, you might advise the client to disrobe to his/her level of comfort and then discuss draping techniques. For veteran clients, you might ask if they’d like you to do something extra special, such as incorporate essential oils into the session.

  • Question: If you have received massage therapy previously, please tell me where you received it, by whom, and which treatments were the most beneficial?

Reasoning: This information can help you understand how to adapt the session to the types of massage therapy that have produced positive responses for the client in the past. You might also ask the client what he/she thinks makes a great massage—and then do what you can to meet the client’s expectation.

  • Question: What type of pressure do you prefer?

Reasoning: Keep in mind that levels of pressure are subjective for each client; what you perceive as light pressure and what the client perceives as light pressure could be entirely different. It is important that you check in with the client at the start of and during the session.

  • Question: Have you ever had any negative effects and/or experiences from receiving massage in the past?

Reasoning: People respond to massage in different ways. Some people get ill or are sore for several days after they receive a deep massage. This is where intake forms and questions can be very useful. Some questions might include what medications the client is on, if he/she bruises easily, what the client’s diet is like, as well as questions related to general health and exercise.

  • Question: Is there anything else that I should know?

Reasoning: I intentionally keep this question open-ended so that the client can add additional information at their discretion. It is up to me to connect the dots. I am frequently amazed by how many clients will tell me about a traumatic accident and/or major surgery in the past that they didn’t mention previously.

Questions about Pain:

 

  • Question: What other healthcare providers have you seen recently and for what?

Reasoning: This question immediately informs you if your client has seen a doctor or if the client has self-diagnosed. I can then quickly perform a postural analysis (See my article, “Getting Comfortable with Postural Analysis” in the July issue of MT), check range of motion, and perform relevant muscle tests and orthopedic assessments to determine if it is appropriate to proceed or if the client needs to first follow up with a physician.

  • Question: Have you tried different healthcare practitioners over time? If so, which one(s) provided the most relief? What did they do and how long did the results last?

Reasoning: Understanding more about the treatments a client has sought for pain relief will give you insight into how you can best help him/her. For example, if the client sees a chiropractor on a regular basis, you might suggest that he/she schedule an appointment with you immediately before the appointment with a chiropractor for maximum results.

  • Question: What do you do for pain relief?

Reasoning: I am always surprised by how many people buy topical pain relievers at a drug store. Why should the drug store get the money? Consider selling topical ointments in your practice. Integrate a topical into the therapy session and then send the client home with a sample. The next time the client buys a topical ointment, it might just be from you.

  • Question: What aggravates your condition?

Reasoning: If the client reports increased back pain when standing or straightening after bending down, it might indicate lumbar and hip flexor or extensor involvement. A muscle-movement chart can help you determine exactly which muscles to assess. Trigger point charts are useful for educating clients about referred pain. Additionally, using the postural analysis information combined with photos helps show the client how stressed or shortened muscles have contributed to the formation of trigger points. This further leads into a discussion of how a series of treatments can be beneficial.

Asking the right questions can help your practice tremendously. I am looking forward to learning how the questions in this article worked for you. I encourage you to read my other articles that can help during these challenging economic times.

David Kent, LMT, NCTMB, is an international presenter, product innovator and writer. His clinic, Muscular Pain Relief Center, is in Deltona, Florida, where he receives referrals from various healthcare providers. David teaches Human Dissection, Deep Tissue Medical Massage and Practice Building seminars, and has developed a line of products, including the Postural Analysis Grid Chart™, Trigger Point Charts, Muscle Movement Charts, Personalized Essential Office Forms™, and DVD programs. Visit www.KentHealth.com or call (888) 574-5600 for more information.

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First Aid Tips For Your Patients – Practice Building Tips

A simple acronym that reminds you how to treat injuries.

By David Kent, LMT, NCTMB

By David Kent, LMT, NCTMB

As a practicing massage therapist, I’m exposed to a variety of clients every day, some of whom suffer from debilitating pain brought on by soft-tissue injury. Sometimes, clients wait weeks, even months, to see me after sustaining a soft-tissue injury because they think that the pain will go away by itself; however, more often than not, by the time they do finally see me for treatment, the pain has progressed to the point that it has impeded on their daily activities.

Depending on the extent of one’s soft-tissue injury, there are steps that can be taken at the time of injury to minimize damage, reduce pain, and help aid in the healing process until the client can make it in for treatment. This article will discuss self-care first aid tips that your clients can apply when they sustain a soft-tissue injury.

Emergencies don’t occur every day, but when they do, there are simple and swift actions that can help improve the odds of a speedy recovery. There is no question that your clients will need this information at some point for either themselves or to help a friend; however, the question is: When they need the information, will they remember what to do?

The answer is yes, and it starts with the acronym R.I.C.E:

  • R – Rest the injured region or limb. Pain is the body’s way of signaling that something is wrong and needs attention. Rest will prevent further injury by not using the affected muscle(s) or joint(s).
  • I – Ice the area as soon as possible after the injury. Cold packs or ice baths will limit swelling. When using ice, be careful not to use it for too long, as this could cause tissue damage.
  • C – Compress the area with an elastic wrap or bandage to reduce swelling.
  • E – Elevate the injured body part. Elevation works with gravity to help reduce swelling by allowing fluid and blood to drain toward the heart.

However, our clients will only remember the acronym R.I.C.E. and its significance if we, as massage therapists, put into practice another acronym: R.E.S.T.

  • R – Repetition is necessary if we are to teach our clients about the importance of self-care.  Most people need to see and hear the information, as well as perform the task, numerous times before it becomes routine. During my sessions, I ensure that my clients have all the information they need via handouts, books, Web sites, and anything else that I think will be helpful. During follow-up phone calls to the client, I review the actions that I would like them to take to expedite and maintain their recovery.
  • E – Education and training are the keys to preventing and treating soft-tissue injuries.   Most clients will take appropriate action once they know what to do, when to do it, how to do it and why they are doing it. Whenever possible, I teach using as many senses as possible, including visual, auditory, kinesthetic, olfactory and gustatory. For example, when I teach a client how to use ice, instead of just talking about it, I demonstrate how to do it so that the client can feel and see the process. Then I allow the client to ask questions as they do it to themselves so they are confident with the process.
  • S – Stretching is another useful aid. (Raising your arms and yawning after getting out of bed in the morning doesn’t count!) When it comes to stretching, it is very important to describe the reasons why it is important, most notably, for injury prevention. Create a stretching routine for each of your clients depending on his or her physical condition and abilities; then demonstrate how to perform each stretch. Taking photographs while the patient stands in front of a postural analysis chart is very useful to show clients distortions in their body. This helps clients understand the stresses being placed on their joints and soft tissues.
  • T – Topicals can help by creating a cutaneous (skin) distraction, which reduces pain intensity and helps the muscles relax during stretching. I hand out trial samples to my clients for their use, and I use topicals to promote my clinic by asking my clients to give samples to friends, family and coworkers. Topicals like BioFreeze and other devices, such as the TheraBand, can also produce additional income for you if you choose to sell them in your clinic.

The educational process empowers clients on many levels. It also elevates your reputation as a highly knowledgeable massage therapist. These self-care skills are practical and will help clients who have sustained a soft-tissue injury get some instant relief from their pain. Thanks to your first aid tips, your clients will know how to help themselves and others when soft-tissue injuries arise, and they will sing high praises about the therapist who taught them.

Got some great first aid tips? Are you selling a fantastic product in your clinic? Drop me a line and share your tips!

David Kent, LMT, NCTMB

David Kent, LMT, NCTMB, is an international presenter, product innovator and writer. His clinic, Muscular Pain Relief Center, is in Deltona, Florida, where he receives referrals from various healthcare providers. David teaches Human Dissection, Deep Tissue Medical Massage and Practice Building seminars, and has developed a line of products, including the Postural Analysis Grid Chart™, Trigger Point Charts, Personalized Essential Office Forms™, and DVD programs. Visit www.KentHealtht.com or call (888) 574-5600 for more information.

David Kent – Massage Today: First Aid (08/2008)

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Simple Answer, Positive Results

Finding the source of your clients’ pain

By David Kent, LMT, NCTMB

Addressing the pain and discomfort associated with trigger points is one of the most common complaints massage therapists deal with in the treatment room. It’s not uncommon, for example, to palpate a trigger point in the upper trapezius, sternocleidomastoid or suboccipital muscles that produces a referred phenomenon to a completely different area of the body, such as the head. When trigger points refer into the head the phenomenon is often described as pain, a headache, pressure, tingling and/or numbness. Although clients are often surprised at this phenomenon, most are thrilled when I am able to isolate and treat the trigger point. Occasionally, however, a client might show distress at this discovery and say something like, “I’m all screwed up,” “I’m wired wrong‚” or “I’m weird.” In this article, I will share simple solutions for addressing these types of comments in ways that will help empower your clients to have a positive attitude and take a more proactive approach to their health care.

To read the full article, click here:

David Kent – Massage Today: Simple Answers Create Results (05/08)