Massage World - Nov 2004

MASSAGE WORLD The Massage and Body Therapists Magazine £2.50 November 2004 30

Supporting Pregnancy –with massage therapy Digestive System –disorders and massage Why Learn First Aid Abyanga Ayurvedic Massage

calendar I industry I news & views I products I research I resource I directory I faq

MASSAGE WORLD EDITOR

Wendy Kavanagh

FEATURES WRITERS

Ravi Bhanot Su Fox Wayne Gill Carole Osborne-Sheets Mickey Wong

GRAPHIC DESIGN

Alex Demicheli Stephanie Serpick

SUB EDITOR & ADVERTISING

C J Newbury

PUBLISHERS

NK Publishing

welcome

editorial by Wendy Kavanagh

inter is really around the corner now with dark afternoons and ice rinks appearing in every major City Centre in preparation for the Christmas season. I like the Americans way of doing things, where Thanksgiving comes first and you don’t see a ‘holiday bauble’ until the turkey has come out of the oven. Talking of Christmas, don’t forget that we combine our December and January issues so that Massage World does not get put to one side in all the extra post that gets processed.

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Now is the time to get promoting those treatment gift vouchers to your clients as the easy way to do your present shopping. Mickey Wong talks about this in his business piece this month. We also have the start of a series of articles on first aid for therapists which is a must for anyone, whether just qualified or an old ‘hand’.

ANNUAL SUBSCRIPTIONS

UK / EU: £25 UK Student: £20 Rest of World: £40

In News and Views there is a copy of a letter from 100 years ago sent into the British Medical Journal that I would love your comments on.

Have we progressed much in a century?

Single Copies: £2.50 ISSN 1474-4171

how to contact us

If you haven’t already done so, order your appointment books for 2005 and make sure your clients know when you are away so you can guarantee they get a treatment before the holidays, and no doubt a well needed one afterwards as entertaining and shopping can be very hard work.

Massage World Diorama Arts Centre 34 Osnaburgh Street

Most of all remember it is a season of giving and good tidings and this includes being good to yourself.

London NW1 3ND T/F 020 7387 9111 E massageworld@btconnect.com DISCLAIMERS The publisher has taken all reasonable measures to ensure the accuracy of the information in Massage World and cannot accept responsibility for errors in or omissions from any information given in this or previous editions or for any consequences arising thereof.

The Editor may not always agree with opinions expressed in Massage World but allow publication as a matter of interest, nothing printed should be construed as Policy or an Official Announcement unless stated.

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Wendy Kavanagh Editor

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“As a result of the advert, on the CThA Members Forum, I have one new holistic massage therapist who has joined the team and is very much appreciated by the clients�

Donna Woodcock Massage Therapist

To find out how the CThA helped Donna and hundreds of other members last year just when they needed it, call a member of the CThA team on: 0845 202 2941or visit our website at: www.ctha.com

Professional help when you need it

contents Supporting Pregnancy–with massage therapy

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Carole Osborne Sheets began developing infant and prenatal massage therapy in 1980 and is an authority on the subject. She looks at how massage therapy supports pregnancy.

The Digestive System–disorders and massage I

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Su Fox’s pathology series covers disorders of the digestive system, from the Latin meaning dissolve and divide which is exactly its function.

Why Learn First Aid?

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The first of a series of articles by Wayne Gill highlighting the importance of learning First Aid in various specialised areas and focusing on therapists.

Abyanga Ayurvedic Massage

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Ravi Bhanot from the Ayurvedic Institute’s Karma Clinic talks about Abyanga, meaning body massage, being just one section of Ayurvedic Massage as a whole.

The Best Time To Do Marketing

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regulars

Mickey Wong has written extensively about marketing massage successfully and provides practical and proven strategies to build and grow a thriving practice.

editorial industry news and views student faqs aromatherapist of the year research product reviews resource directory calendar of events

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newsviewsnewsviews The necessity for improving the teaching of massage in England One hu ndred years ag o t h i s l e t t e r a p p e a r e d i n t h e B r i t i s h M e d i c a l J o u r n a l – i n t e r e s t i n g !

Sir,—As massage and exercises are now recognised in England as valuable therapeutic agents, it is time that something was done to improve the training of the English masseur or masseuse. This is the only way of stopping the “invasion of England” by the Scandinavian “medical gymnast.”

The mechanical manipulations that are now taught to nurses under the name of “massage” are useless for the treatment of local affections. I have seen massage carried out in large London hospitals in a way that has been nothing but an often elegant and intricate but useless playing about on the skin.

Beyond a slight stimulation of the superficial nerve endings, the effect of such a massage must be absolutely nil.

The French and the Germans have attempted to make an “art” of massage, and have invented an enormous number of complicated movements that can only appear ridiculous to an intelligent practitioner. As a handicraft, massage is very simple and can be learnt in a few days, but it is absolutely necessary that the masseur should have a knowledge of the muscles and their actions and the position of the principal blood vessels and nerves to be able to carry out instructions intelligently.

The treatment must necessarily differ according to the structure one wishes to reach. For

instance, the emptying of the superficial blood vessels is effected by means of a superficial “effleurage;” a wasted muscle is kneaded or “pétrissaged” in its whole extent, and the breaking down of adhesions or muscle infiltrations is effected by means of a localised friction over the affected area. Suppose I have a patient suffering from the common affection of supraorbital neuralgia with palpable thickening of the nerve sheath, and wish to cure this by massage, how is the masseur to carry out my instructions if he does not even know the position of the nerve? For the proper giving of exercises—and without additional exercises massage is not often indicated—the knowledge of the action of the muscles is essential, as every one knows that the number of muscles implicated in any muscular action varies with the primary position of the patient.

The correct giving of the exercises is of special importance in the treatment of lateral curvature.

The superiority of the Swedish masseur does not depend on the knowledge of any specially effective manipulations, but simply on the fact that he is taught the necessary anatomy and can therefore intelligently carry out one’s instructions.

At the two chief gymnastic institutes in Stockholm the training extends over two years, but this includes the teaching of drill

Rea l i t y T V Teresa Hale is regarded as one of the leading “health visionaries”. She has played a major role in growth of Complementary Medicine over the last 15 years. Her influence in fact, is certain to grow with a launch of her book “The Hale Clinic Guild to Good Health” together with plans for a major series of seven television programmes on her clinic for international transmission.

She founded the Hale Clinic, London in 1987.

The Prince of Wales opened the Clinic officially in 1988 and Teresa has been at the helm as Managing Director ever since.

As a Yoga instructor she found that students would frequently ask her to refer them to homeopaths, naturopaths, osteopaths etc.

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Seeing the need for a centre where members of the public could consult a range of Complementary Therapists, she decided to start up the Nine Clinic in Kensington. It soon became apparent that the demand for this type of health centre was enormous and it wasn’t long before the space had to be abandoned for larger premises. The move took place in June 1987 when the Hale Clinic opened in London’s elegant Park Crescent.

Thirty purpose built consulting rooms, a library/bookshop and a dispensary are housed in the stately Nash Terrace building. The aim was to attract the highest calibre practitioners to further the acceptance of complementary medicine throughout the community and to offer the public a different approach to health care. And now it has attracted the lens of the TV camera.

and some theoretical teaching that would be considered unnecessary in England. I believe that a year’s, or even a nine-months’, training would be sufficient for an intelligent person to become a useful masseur or masseuse, especially as massage has at present only a limited use in England.

If the medical profession object to this training from the fear of turning out yet another set of unqualified practitioners it will be necessary for them to self-undertake cases of local massage if they wish to obtain such good results from this treatment as is obtained on the Continent.—I am, etc., ( BMJ 1904;i: 1347) G. B. Jacobi, London, W.

Just in time for Christmas Napiers, have been caring for the public since 1860, and are a leading force in complementary health care. They are now offering recognised practitioners and students of complementary therapies an exclusive 20% discount off the entire range of Napiers own brand products. This includes medicinal herbal remedies, aromatherapy and massage oils, supplements and a bath and body range all guaranteed to come from sustainable and ethical sources, many of them organic.

To take advantage of this fantastic offer, please contact Napiers for an application form. They will issue you with a discount card that can be used with purchases made through their shops or mail order department.

Unfortunately this offer is not currently available on purchases made on line.

Napiers Direct, www.napiers.net 35 Hamilton Place, Edinburgh, EH3 5BA T: 0131 343 6683 E: mailorder@napiers.net

Do email us your News & Views! massageworld@btconnect.com

Supporting Pregnancy – wit h m a s s a g e t h e r a p y Caro l e Osbo r n e Shee t s Carole OsborneSheets, a somatic practitioner since 1974, began developing infant and prenatal massage therapy in 1980. She has trained thousands of therapists and is the author of Preand Perinatal Massage Therapy and Deep Tissue Sculpting. She is the co-founder of the International Professional School of Bodywork in San Diego, USA.

urturing touch during pregnancy, labour, and the postpartum period is not a new concept. Cultural and anthropological studies reveal that massage and movement during the childbearing experience was and continues to be a prominent part of many cultures’ healthcare.1 Studies indicate that most of the more peaceful cultures use touch prominently during pregnancy and early childhood.2 Midwives, who for centuries have provided maternity care, have highly developed hands-on skills.

pregnancy, they touch their babies more frequently and lovingly.5 During labour the presence of a doula, a woman providing physical and emotional support, including extensive touching and massage, reduces the length of labour and number of complications, interventions, medications, and Caesareans.6

Current research on the benefits of touch is providing a contemporary basis for its reintroduction in many technological societies, including the United Kingdom. Scientists have found that rats restricted from cutaneous selfstimulation had poorly developed placentas and 50% less mammary gland development. Their litters were often ill, stillborn, or died shortly after birth due to poor mothering skills.3 Pregnant women massaged twice weekly for 5 weeks experienced less anxiety, leg and back pain. They reported better sleep and improved moods, and their labours had fewer complications, including less premature births.4 Studies show that when women received nurturing touch during later

Profound local and systemic changes in a woman’s physiology occur as a result of conception and the process of labour. Changes during pregnancy span the psychological, physiological, spiritual, and social realms. Massage therapy can help a woman approach her due date with less anxiety, as well as less physical discomfort.

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Why Prenatal Massage Therapy?

A typical session performed by a practitioner specialising in pre- and perinatal massage therapy can address pregnancy’s various physical challenges: oedema, postural changes, and pain in the lower back, pelvis, or hips. Swedish massage may facilitate gestation by supporting cardiac function, placental and mammary November 2004 M|W

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massagereport supporting pregnancy w ith massage therapy development, 7 and by increasing cellular respiration. It also reduces oedema and contributes to sympathetic nervous system sedation.8 Deep tissue, trigger point, and both active and passive movements alleviate stress on weight-bearing joints and myofascial structures, especially the sacroiliac and lumbosacral joints, lumbar spine, hips, and pelvic musculature.9 Specific structural balancing techniques and postural reeducation reduce neck and back pain caused by improper posture and strain to the uterine ligaments. Prenatal massage therapy can also facilitate ease of labour by preparing the muscles for release and support during childbirth.

Beyond these physical effects, an effective prenatal massage therapy session provides emotional support. In

the safe care of a focused, nurturing therapist, many women unburden their worries, fears, and other anxieties about childbearing. Massage therapy by a trained touch specialist can help the mother-to-be develop the sensory awareness necessary to birth more comfortably and actively. Labouring women whose partners learned and provided basic massage strokes to their backs and legs had shorter, less complicated labours.10

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The Postpartum Period Beginning with the baby’s birth, a new mother must cope with more changes.

She is typically only 10 to 12 pounds lighter, yet she is still maintaining her body with an anterior weight load posture. The maternity massage practitioner can facilitate proprioceptive reprogramming to gently return the body to its pre-pregnancy state, to alleviate pain, and to bring about a renewed sense of body and self.

As a specialist in postpartum work, practitioners can focus on repositioning the pelvis and re-patterning overall body use. Postpartum massage sessions can restore functional muscle use in the lumbar spine area, as well as strengthen and increase tonus in the abdominal musculature stretched and separated by pregnancy. Additionally, the overtaxed, hypotoned iliopsoas muscle functions can be improved.

Upper back muscles which now support larger breasts and the carried infant’s weight need work to reduce strain, and to help maintain flexibility despite the physical stresses of infant feeding and care. For post-Ceasarean mothers, specific therapeutic techniques also can reduce scar tissue formation11 and facilitate the healing of the incision and related soft tissue areas, as well as support the somatoemotional integration of her childbearing experience.

Pre- & Perinatal Massage Therapy Education To safely massage pregnant, labouring and postpartum women, it is imperative that practitioners be knowledgeable about normal pre- and perinatal physiology, high risk factors, and complications of pregnancy. Many

massagereport supporting pregnancy with massage therapy

Rese a r c h s u p p o r t i n g mass a g e t h e r a p y a n d p r e g n ancy Pregnant women benefi t from ma ssage therapy.

Labour pain is reduced b y m a s s a g e t h e r a p y.

Field T, Hernandez-Reif M, Hart S, Theakston H, Schanberg S, Kuhn C.

Field T, Hernandez-Reif M, Taylor S, Quintino O, Burman I.

Touch Research Institute, University of Miami School of Medicine, USA.

Touch Research Institute, University of Miami School of Medicine, USA.

Twenty-six pregnant women were assigned to a massage therapy or a relaxation therapy group for 5 weeks.

The therapies consisted of 20-min sessions twice a week. Both groups reported feeling less anxious after the first session and less leg pain after the first and last session. Only the massage therapy group, however, reported reduced anxiety, improved mood, better sleep and less back pain by the last day of the study. In addition, urinary stress hormone levels (norepinephrine) decreased for the massage therapy group and the women had fewer complications during labour and their infants had fewer postnatal complications (e.g., less pre-maturity).

Twenty-eight women were recruited from prenatal classes and randomly assigned to receive massage in addition to coaching in breathing from their partners during labour, or to receive coaching in breathing alone (a technique learned during prenatal classes). The massaged mothers reported a decrease in depressed mood, anxiety and pain, and showed less agitated activity and anxiety and more positive affect following the first massage during labour. In addition, the massaged mothers had significantly shorter labours, a shorter hospital stay and less postpartum depression.

Publication Types:

Publication Types:

• Clinical Trial

• Clinical Trial

• Randomised Controlled Trial

• Randomised Controlled Trial

PMID: 10212885 [PubMed indexed for MEDLINE]

PMID: 9443139 [PubMed indexed for MEDLINE]

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massagereport supporting pregnancy w ith massage therapy of these conditions necessitate adaptations and consultation with physicians and/or midwives prior to sessions. Various techniques and methodologies must be modified or eliminated, depending on the individual and the trimester of pregnancy.

Footnotes:

Practitioners will find reliable detailed, research based protocols and contraindications in the book, Pre- and Perinatal Massage Therapy. For those seeking comprehensive hands-on training as a maternity massage specialist, I recommend a 32-hour certification course to qualify.

3 Rosenblatt, J.S. and D.S. Lehrman. Maternal behavior of the laboratory rat. Maternal Behavior in Mammals, Wiley, New York, 1963, p. 14

Instruction offers practitioners a safe and comprehensive approach to pregnancy, labour, and postpartum massage therapy. I also encourage an empathetic, non-judgmental attitude in supporting women’s ‘pregnant feelings’. The course includes over 80 techniques specifically adapted for preand perinatal needs, and they include the practical marketing strategies, ethics, and skills to elicit collaboration with other perinatal specialists and to build a successful maternity massage therapy practice.

1 Goldsmith, Judith. Childbirth Wisdom. New York: Congdon and Weed, 1984.

2 Prescott, James. The Origins of Love & Violence and the Developing Human Brain.

Touch the Future, Long Beach, CA, Fall, 1995, pp. 9-15.

4 Field, T., M. Hernandez-Reif, S. Hart, H. Theakston, S. Schanberg, and C. Kuhn.

Pregnant women benefit from massage therapy.

J. Psychosomatic Obstetrics and Gynecology, 20(1), March, 1999, 31-8.

5 Rubin, R. Maternal Touch. Nurs Outlook, 11/1963, ppp. 828-31.

6 Kennell, J.H., M.H. Klaus, S.Robertson, C. Hinkley. Continuous emotional support during labour in a US hospital. J Am Med Assoc, 265, 1991, pp. 2197-2201 7 Rosenblatt, op sit, 14.

8 Zanolla, R., Monzeglio, C., Balzarini, A., et al.

Evaluations of the results of three different methods of post-mastectomy lymphedema treatment. J. Surg. Oncol. 26:1984, p. 210-13.

9 Quebec Task Force on Spinal Disorders. 1987.

Scientific approach to the assessment and management of activity-related spinal disorders.

Spine, 12:, Supplement 1.

10 Field, T., Hernandez-Reif, M., Taylor, S., Quintino, O. Touch Research Institute, University of Miami School of Medicine and Iris Burman, Educating hands School of Massage Therapy.

Journal of Psychosomatic Obstetrics and Gynecology, (in press 1998).

11 Hufnagel, V., M.D. “Medical basis for using massage after surgery.” Massage Magazine #17, Dec-Jan/1988-89, p. 21.

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Carole will be teaching qualifying certification courses in Scotland and Ireland in September, 2005. The IGPP has awarded 20 continuing professional development (CPD) points to the Preand Perinatal Massage Therapy course under reference number C200.

Ronnie Allan of Maybole, Ayrshire, Carole’s UK sponsor, has also had several feature articles published about his maternity work in the national press.

To order a book or to learn more about the Pre- & Perinatal Massage Therapy course for September in Scotland, call the local sponsor, Ronnie Allan on Tel 01655 882742 or E-mail randmallan@ aol.com. For Ireland, call local sponsor James Earls on Tel 028 9059 0594 or E-mail jearls@eim.dnet.co.uk You can also call Body Therapy Associates at 001 858 748-8827 (U.S.A). Website: www.bodytherapyassociates.com

Digestive system disorders and massage patho l o g y – p a r t n i n e Su Fox Su Fox is a psychotherapist, massage and craniosacral therapist in private practice in North London.

She lectures in anatomy, physiology and pathology for The Massage Training Institute and Chiron Centre

he word digestion comes from two Latin words, one meaning dissolve and the other meaning divide. The digestive system does both these things; dissolves the food and drink we take in into very small particles, and then divides them into those useful to the body and those that can be eliminated. The whole digestive tract, a continuous tube from the mouth to the anus, is a bit like an assembly line in reverse; products are taken apart and broken down into their components.

We usually know quite quickly when there are problems on the line - a faulty product gives us stomach ache, vomiting or diarrhoea; too long a gap and we feel hungry.

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G e n e ral r e c o mmendations When doing firm massage on the abdomen it is essential to follow the direction of the large intestine, circling in a clockwise direction, so as not to risk pushing faecal material back into the small intestine. This may also assist the movement of faeces, and be helpful for relieving constipation.

Peristalsis in the digestive tract, and the secretion of digestive juices, are activities associated with parasympathetic nervous system activity, occurring when we are relaxed, and have energy available for the process, and ceasing in times of activity or stress, when energy is needed elsewhere in the body. As many disorders of the digestive system are exacerbated by stress, relaxation massage of the whole body is helpful because it facilitates peristalsis and the secretion of digestive juices. Massage of the abdomen is beneficial for someone with high levels of sympathetic nervous system arousal, because it helps the nervous system switch to parasympathetic.

Disorders of the digestive tract Constipation Unless the cause is an abdominal obstruction, in which case abdominal massage is a local contraindication, abdominal massage following the lines of the large intestine is recommended.

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massagefeature digestive system disord ers and massage

Nausea and vomiting There are many factors that can cause nausea, including travel sickness, the hormonal changes in early pregnancy, food poisoning, and bacterial infection.

Nausea can lead to vomiting, which is one of the body’s innate defence mechanisms for expelling harmful substances. A person who is nauseous probably wouldn’t want a massage.

Gastro-enteritis Nausea and vomiting, together with diarrhoea and a temperature, are symptoms of gastro-enteritis, which is inflammation of any part of the digestive tract. The cause can be viral (the most common), bacterial or food intolerance. Acute gastro-enteritis is a contraindication to massage because of the risk of infection to the practitioner and because the person probably wouldn’t want one. This condition usually resolves in a few days. If the symptoms are longer term they are probably associated with another digestive system disorder and relaxation massage, avoiding the abdomen, may be helpful for the reasons given above.

I ndigestion or heartbur n Sometimes also called acid reflux, heartburn occurs when the sphincter at the end of the oesophagus malfunctions and acid from the stomach flows into the oesophagus.

This condition can be worse after eating, so the client may be more comfortable to receive massage on an empty stomach. Lying flat may be uncomfortable so consider propping the client into a semi- sitting position.

Ulcers Ulcers of the stomach or duodenum cause burning pain in the upper abdomen and possibly bloating and gas. Stress, diet smoking and alcohol may be contributing factors, although a common factor is also bacteria that survives in the acidic environment of 12

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the stomach. Abdominal massage, except holds or gentle stroking, is contraindicated, but relaxation massage to restore autonomic functioning is beneficial.

D i s o r ders of the l a r g e intestine Ulcerative colitis Ulcerative colitis refers to a condition where the mucous lining of the large intestine becomes inflamed and ulcers develop on the wall of the colon or rectum.

C r o h n ’s d is e a s e This is a progressive chronic inflammation of any part of the wall of the bowel.

The symptoms are similar to ulcerative colitis, but it is a different condition.

Irritable bowel syndrome This condition refers to a situation where the peristaltic waves in the bowel become irregular but there are no structural changes to the digestive tract compared to ulcerative colitis or Crohn’s disease. Diarrhoea alternates with constipation, the abdomen bloats and there are cramp like pains.

Diverticulitis This refers to little pouches that protrude outward on the wall of the large intestine, and can become inflected and painful. Constipation, diarrhoea. bloating and wind occur.

Recommendations for massage Abdominal massage, except for holds and light stroking within the limits of tolerance of the client, is contraindicated for all these conditions. General relaxation massage to restore autonomic functioning is beneficial. Be sensitive to abdominal discomfort when the client lies on her front, and offer appropriate supports.

Disorders of the liver Hepatitis Hepatitis is inflammation of the liver. It can be caused by a toxins, alcohol or prescribed drugs, or by a variety of infections. There are different kinds of infectious hepatitis, each having different modes of transmission and producing different symptoms with varying degrees of severity. Hepatitis A is short lived with no lasting damage. Hepatitis B carries the risk of long term complications but the majority of hepatitis C carriers do d develop chronic infection. The virus is carried in faeces and body fluids and can survive outside the body.

Symptoms of hepatitis are lethargy, nausea, weakness, temperature and possibly jaundice, which causes yellowish skin and eyes, from the excess of the pigment bilirubin in the blood. Not everyone who has hepatitis has symptoms, which means a person may have the disease without knowing.

R e c o m m e n d a t i o n s f o r m a s s age Hepatitis is a contraindication to massage while it is infectious. This stage varies from type to type, so it is advisable to get medical permission to massage. Avoid abdominal massage, particularly in the area of the liver, on someone with chronic hepatitis, and avoid techniques that stimulate the circulation and could put pressure on a weakened liver. Adapt the massage, and the duration of the treatment, to the general vitality of the person. Take particular care with usual hygiene precautions, and do not massage if you yourself have an infectious disease, because a hepatitis sufferers immune system is compromised. There is no reason not to massage a person who has recovered from hepatitis normally.

Cirrhosis Cirrhosis of the liver occurs when healthy liver cells die, and are replaced

massagefeature digestive system disorders and massage with fatty fibrous tissues, causing liver malfunction and possibly death. There are many possible; causes including hepatitis and alcoholism. There may be no symptoms initially, but then vomiting and weight loss, and finally a range of serious disruptions to many other body systems.

Inguinal hernia

Recommendations for m a s s a g e

Hernias can arise where the muscle of the abdominal wall have been cut through for major surgery.

If the cirrhosis is connected to hepatitis, do not massage during the acute stage and get medical advice.

Avoid abdominal massage, circulatory massage and if there is oedema in the legs, avoid draining techniques on the legs.

The place where the testis and sperm duct descend through the abdominal wall in a young boy remains a potential weak spot where the intestines or bladder can protrude later in life.

Abdominal hernia

Femoral hernia Another site of weakness is the place where the femoral artery passes through, in the groin.

Gallstones

Recommendations for massage

These are hard little deposits of cholesterol or bilirubin in the gallbladder. A person with gallstones may not be aware of their existence, but when the stones try to pass down the bile duct they cause severe pain.

Whatever the cause, hernias are a local contraindication to massage. A person with a hiatus hernia will be more comfortable sitting than lying, and should be massaged with her upper body raised.

Recommendations for m a s s a g e Do not massage during an attack, although the person would be too ill to want a massage. At other times, there is no reason not to massage, but avoid deep daring work in the area of the liver.

Hern i a s

References Su Fox and Darien Pritchard. Anatomy, Physiology and Pathology for the Massage Therapist, 2001; Corpus Publishing

Hernias develop when there is a weakness in the muscles around the abdominal cavity allowing an organ, or part of it, to protrude through. They can be pushed back (don’t attempt to do this!) and disappear when the person lies down

Gordon MacPherson, ed. Black’s Medical Dictionary. 2002. A & C Black

Hiatus hernia

Peter Wingate & Richard Wingate. The Penguin Medical Encyclopaedia. 1996. Penguin Books.

This refers to a condition where part of the stomach protrudes through the diaphragm into the thorax, and gastric juices may flow into the oesophagus causing acid reflux. It is more common in older people.

Werner, Ruth. A Massage Therapist’s Guide to Pathology. 2002 Lippincott Williams and Wilkins

Kalyani Premkumar. Pathology A to Z — a handbook for massage therapists . VanPub Books 1996 Dr Tony Smith, ed. The British Medical Association Complete Family Health Encyclopaedia; 1990; London: Dorling Kindersley

Acknowledgements Material in this article is taken in part from Fox & Pritchard’s Anatomy, Physiology and Pathology for the Massage Therapist.

These articles are due to be published by Corpus Books in autumn 2004

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Why learn first aid?

Wayne Gill The articles are written by Wayne Gill who is a experienced First Aid instructor and qualified Sports and NMT Practitioner. He is the author of the books A Practical Guide to Sports First Aid and A Practical Guide to Basic First Aid.

here are times when members of the public, trained in first aid, have had to make decisions on the treatment and care of injured people which normally would have been the responsibility of ambulance personnel or a doctor. This is especially relevant in country areas where medical aid may be some time away. Trained first aiders have never been more needed due sadly, to the ever growing dangers we face on a daily basis.

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Good instructors are professionals working frontline in the healthcare sector who appreciate the importance of quality training but also believe in training people to deal with medical emergencies in situations they will most likely encounter. The ‘one size fits all’ approach to teaching First Aid skills is no longer enough in the diverse and challenging workplace of modern society Look for training companies who address these individual needs by having a wide range of courses to suit your needs.

Over 80% of all accidents are witnessed by family or friends. This said do you want to be the one who is unable to help a family member or friend in the case of an emergency? Having attended a First Aid course, you will learn vital

skills to assist you to remain calm, act responsibly and most important get the correct medical assistance as soon as possible. In all our lifetimes we will experience some medical emergency situation; this may be a child scratching his knee or someone having a cardiac arrest. Having the knowledge and skill to deal with these situations will help you to simply comfort the child and clean their knee, or in the worst case scenario you could give the kiss of life to the person having the cardiac arrest while waiting for an ambulance, thus giving that person the best chance of survival that you can. Remember when we see these situations in real life we think to ourselves “It will never be me” but it can be you or a member of your family. Don’t let someone you care about become a statistic; you have the ability to save them so learn how!

In the next few editions of Massage World, we will be highlighting the importance of learning First Aid in various specialised areas.

Wayne kicks off the series with a timely reminder that all massage therapists should consider taking a First Aid course to bring themselves in line with the recommendations from the General Council of Massage Therapy.

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bodymechanics why learn first aid?

F i r s t Aid for T h e r apists

Allergies and Anaphylactic Shock

As a therapist you will appreciate the value of providing a good customer service to all of your clients, this should include having qualified first aid personnel working in your clinic or salon.

Many therapist use products on an hourly basis, but at times do not get the opportunity to pre-test their suitability to the client. It is possible that you may use a product that will cause a reaction for the client. Allergic reactions present in two ways: minor and severe. With a minor allergic reaction the client may experience reddening of the skin, a small rash or itching. This can be dealt with by the GP fairly quickly and easily. However, major allergic reactions (anaphylactic shock) is a life threatening condition, which unless treated by emergency services quickly, will result in death. It is vital for all therapists to learn the correct method of skin testing and how to deal with these reactions.

We all encounter minor problems on a daily basis like cuts and bruises that everyone is capable of dealing with but how confident would you be with the following conditions that may present at any time in your career:

Fainting Angina attack Diabetic coma Epileptic episode Heart attack Cardiac arrest Anaphylactic shock

would you know how to recognise someone experiencing high or low blood pressure?

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Many people who enter your clinic or salon have medical conditions but may not advise you of it. If they were to have an emergency situation how would your respond? These conditions are very scary to the untrained person and can lead to panic and distress which adds to the emergency situation.

A First Aid for Therapists course addresses the risks that may present to therapists during their working life.

As you complete this training you will receive expert training in how to deal with an emergency situation, recognise the signs and symptoms of the conditions you may be faced with, how to get the correct medical assistance to you as soon as possible, how to treat these conditions and most importantly, what not to do.

CPR The core of basic First Aid skills is a knowledge of BLS (Basic Life Support) or CPR training. During initial screening of your clients, they may disclose they have a heart condition or may not even know they have one, but if they were to have a heart attack, what do you do? Without BLS training, not a lot. Everyone should have this life saving skill.

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Would you know how to recognise someone experiencing high or low blood pressure? During training you will have learned the contra indications to massage for these conditions but how do you recognise the client at risk that has not been diagnosed? Having the skill to use a blood pressure monitor will assist you in determine the risk factors.

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November 2004 M|W

17

newtechniques abyanga ayurvedic massage

Written by Ravi Bhanot

byanga is a traditional Indian body massage. Two distinctly different types of people have practised it over centuries. One by people using on themselves as a self-massage as the other by Therapists using the massage for rejuvenation or for certain conditions.

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The techniques of Abyanga started in Kerala in South India and as the benefits were seen it spread to North India and slowly across Asia and now Europe and America. A number of five star hotels such as the Hilton group are now offering Ayurvedic massages as a standard massage therapy in their hotels.

Philo s o p h y Ayurveda means the Science of Life. It encompasses a lifestyle that includes 18

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diet suited to your constitution, lifestyle that includes some exercises- such as daily self-massage or Abyanga, yoga and meditation to relax and to body regenerate. If there is an imbalance in the energy forces that make up your constitutional forces the body is diseased or diseased. This is called the Tri-Dosha theory.

Our body and nature are made up of five elements-air, space, earth, fire and water. These five elements combine to control all processes within the human physiology. These elements, in different combinations make up the three Doshas or energies that are unique to us all. We all have the three Doshas but one may have one or two doshas that are prevalent to a higher amount.

People of Vata constitution are primarily air and space, Pitta are fire and Kapha are earth and water. Vata governs all

motions or movement, Pitta controls all transforming processes and Kapha is responsible for cohesion and growth.

Benefits Abyanga is used to manipulate and correct dosha disorders, especially of the vata kind, to relieve swollen tissues, to promote regeneration of the tissues and organs and the internal functioning of the body. It stimulates skin, muscles, circulatory system and the nervous system. It improves the skin, strengthens the lungs, intestines and bones and helps regulate the digestive system. By improving circulation the body is helped to remove waste products and promote vitality, strength and flexibility.

newtechniques abyanga ayurv edic massage

The M a r m a p o i n t s and A b y a n g a

impure blood to the heart for purification. The revitalised blood is then distributed via the arteries throughout the body.

Ayurvedic massage is based on the knowledge of marma points. Marmas are the vital points defined as the junction where flesh, veins, arteries, tendons, bones and joints meet. There are thousands of marma points in the body although 365 are essential.

Abyanga helps stimulate the main marmas and circulatory channels. The massage acts directly on blood, nerves and lymph circulatory systems. By stimulating the lymph nodes, the therapy, especially when performed with warm oil or substances, serves to cleanse and revitalise the body.

Abyanga is usually performed using warm oils. Cured or warmed sesame oil is used as base oil because of its nutritive and warming qualities.

Different oils at a ratio of 20-25% can be added to the sesame oil (see table).

The m a s s a g e techn i q u e s There are three main types of massage techniques in Abyanga therapy- active, passive and persuasive. Strong pressure is used in active massage whereas delicate strokes are employed in passive massage. Pinching and kneading the small muscles between the thumb and forefinger is used in persuasive massage. Active and passive massage is used in vata (for example joints and movement pain) and pitta (for example skin) conditions whereas in kapha (for example respiratory) conditions active and persuasive massage is used.

Massage is started with the head, neck, face and upper chest with the general flow movement to the soles of the feet and continuing upwards to the heart usually. By massaging the body from the soles of the feet upwards activates the veins and carries the

OIL

THERAPEUTIC USE

Sesame Oil (carrier oil)

Nutritive and warming qualities

Maha Narayan Oil

Soothes sore, painful muscles, traditionally used for arthritic or rheumatic conditions and stiffness in the joints and spine. It helps restore elasticity to the skin in dry eczema

Saththavadi Oil

Counters the effects of stress on the nervous system.

Promotes relaxation and renewed resilience and stamina and helps in insomnia

Ashwaganda Oil

Nourishes the bones, muscles and tissues. Promotes relaxation whilst tonifying and strengthening the nerves. Helps in: reducing joint or muscle pain, poor circulation, debility and anxiety. Helps restore the skin’s natural suppleness and elasticity and helps hydrate dry skin and reduce wrinkles. Used as an anti inflammatory it helps alleviate swelling associated with intense physical training

Siddharta Oil

Soothes respiratory disorders due to congestion and accumulation of mucous, especially during spring. It is used as massage oil for the chest and throat area

Pasoria Oil

Psoriasis, Dandruff and other scaling & fungal Skin infestations.

Neelyadiya Oil

For excellent hair growth and nourishing the scalp.

Controls dandruff and alleviates itchy scalp associated with dry skin.

November 2004 M|W

19

newtechniques abyanga ayurv edic massage

Case S t u d y

Marma points

Krishna was given a series of massage as she complained of painful knee joints. She was on anti-inflammatory drugs from her Doctor but the pain was getting continually worse.

We gave her Abyanga massage therapy and Boswellia Plus, natural anti-inflammatory and pain killing Ayurvedic herbal capsules. We also recommended her a Vata pacifying diet.

We informed her that she would need to come for seven sessions before she would appreciate the difference.

She returned on the second day feeling a bit rejuvenated but nothing more. She returned for seven sessions of Abyanga in total as we had recommended.

After the seven sessions, the morning stiffness had reduced significantly. Her knee swellings reduced in size and the pain was much reduced. She was grateful for the for what the treatment was able to do for her.

Ravi Bhanot works at the Ayurveda Institute’s Karma clinic in Ilford, Essex.

For details of Practitioner Abyanga Training on 22/11/04 and 23/11/04 and 24/1/05 and 25/01/05 at University College London please contact: Ayurveda Institute of Europe 386 Green Lane, Ilford, Essex IG3 9JU T: 02085979039 W: www.ayurvedainstitute.org E: info@ayurvedainstitute.org

ayurvedic massage is based on the knowledge of marma points October 2004 M|W

21

faqs!faqs?faqs!faqs?

STUDENT Q&A

Let me introduce myself, I am Isabelle Hughes and will endeavour each month to answer all those questions that never seem to get answered or that you forgot to ask.

You can write or email me at Massage World. Here is a selection of recent enquiries and their replies:

Q. I am a new massage therapy student. What is the general policy concerning massaging the gluteal muscles if the client is wearing underwear. Do you still include the area in the massage or assume that the client does not want that area treated?

A. If they mention in their case history that they have lower back or leg problems, then I usually explain that I may need to work the gluteal muscles and ask if they are OK to remove underwear. If they say they feel more comfortable leaving them on then ask permission to apply some compressions through the towel or drape. The situation is then addressed prior to the start of the treatment and everyone is happy. It is always very important to get permission and explain what you will be doing in sensitive areas, otherwise your client cannot relax fully, especially if this is their first appointment.

Q. I am looking for some information on palliative massage: effects, do’s and don'ts etc. Can you point me in the right direction?

A. The dictionary definition of palliative is: relieving without curing. Palliative massage is basically stating that you can massage anywhere on the body using gentle techniques, to

better the comfort level of the client in need. These are often terminally ill clients and need comfort for living.

Naturally as with any massage receiver there may be contraindications to any medical conditions which need to be taken into consideration.

Q Is it legal to give massage treatments only to women or would that be considered discriminatory?

A. As far as I am aware you are not breaking any rules only treating women. Gender discrimination would only apply within Employment Law . I know of many therapists who work on women and only on men by referral, for example if they were a husband of an existing client etc. It is also a good idea if you are visiting them at home, whatever the gender of the client, to ask for someone else to be in the property at the time. This safeguards you and them against any future actions regarding the treatment.

Q. Have you had any experience with Spasmotic Torticollis?

A. Massage can produce excellent results especially in the area of pain relief. It can also help with mobility and a better outlook on life altogether. Concentrate on the sacrum, upper trapezius and pectoral muscles. Let your hands work intuitively and include some stretching. Keep everything very mild to start with. A massage once a week for the first three weeks followed by every two weeks for maintenance should be enough to bring change to the condition.

Some homework stretching will also help.

Isabelle Hughes has been practising and teaching massage since 1989 and is also an external examiner for massage therapy.

Drawing on her experience as an ante-natal teacher with the National Childbirth Trust, she currently runs workshops for practitioners on Massage for Pregnancy and Labour and has contributed to books on the subject.

Q A

If you would like your questions answered, please send them by post or email to our address on page 3, marked Student Q&A. November 2004 M|W

23

The Marguerite Maury AC Aromatherapist of the Year 2004

By Carole Preen (AC S e c r e t a r y )

his award is given annually to aromatherapists of the Aromatherapy Consortium (AC) Register. The AC is the emerging regulatory body for the UK aromatherapy profession and is developing the structures for regulation in consultation with the whole profession and other stakeholders.

T

For the first time, the esteemed author and world’s leading aromacologist, Danièle Ryman, gave permission for us to use the name of Marguerite Maury on the award, her close friend and mentor. Danièle Ryman has herself written many books on aromatherapy and she has recently joined forces with Boots to produce a perfectly balanced signature beauty range. Using some formulations that she previously only prescribed to private clients, the range includes products for the face and body that contain plant extracts and Manuka honey from New Zealand.

Marguerite Maury is known as the Mother of modern aromatherapy practice. She was the pioneer of her time starting her research in the 1940’s continuing right up until her death in 24

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1968. Her book “Le Capital Jeunesse” was first published in 1961 and translated in to English by Danièle Ryman in 1964 and is a valuable resource for aromatherapists today.

She worked tirelessly and discovered the value of the active zone of aromatic particles, paying particular notice to their effective through skin absorption and inhalation. Madame Maury tried to prove and demonstrate through her research the effects of essential oils and she lectured all over Europe, opening aromatherapy clinics in Paris, Switzerland and in England. She won international prizes in 1962 and 1967 for her research in essential oils and cosmetology. Her work lives on in modern aromatherapy and we in the profession will be eternally grateful for her outstanding contribution. We hope that she would be proud that we have honoured her memory by naming the aromatherapist of the year award after her.

Maury’s book as pictured above.

There were many nominations but we selected 4 finalists who were present at the award ceremony, which took place at the Complementary Healthcare Exhibition (CHEXPO) at ExCel in the London's Docklands on the 25th October 2004. The four finalists, who are all outstanding aromatherapists, were Hilarie Barr from Stoke on Trent, Heather Dawn Bratt from Pontefract, Jeanette Britten from Sutton in Ashfield in Nottinghamshire and Sue Mousley from Nuneaton in Warwickshire. It was extremely difficult to select a champion from these four finalists, but as always there can be only one winner. Danièle Ryman presented the award to Heather Dawn Bratt along with a copy of Marguerite

Her work has also be praised as “life changing” and “her gentle soothing approach is always of great benefit”.

Her patient’s praise her commitment to her “caring and professionalism”. In summary, one of her patient’s described simply “she is the best” and therefore we are delighted to have presented this prestigious award to her.

Heather Dawn trained in 1998 and since then has worked very hard in her career in aromatherapy. She works in her own business “Elemental Health” and also visits elderly or disabled patients, sometimes travelling quite a distance and she is also employed at the Prince of Wales Hospice in Pontefract, where she often puts in many extra hours “to ensure the best possible patient care”.

She has received nominations from patients, colleagues, nurses and consultants who have told us of her remarkable effect of integrated healthcare on the delivery of palliative care within the hospice. For example, “the use of lip balms to stimulate saliva and mouth care blends have been essential” was reported in one of her nominations. Dr B. A. Young has stated that Heather Dawn “demonstrably improves their [patient’s] quality of life”.

If you would like to contact any of the aromatherapists finalists, please contact the Aromatherapy Consortium on 0870 7743477. We are able to direct you to properly trained aromatherapists throughout the UK from our national register. More information can be found on our website at www.aromatherapyregulation.org.uk

researchroomresearch washing hands before and after performing massages?

Changes in bacterial survival count on skin of a massage therapist and a client during massage therapy.

Donoyama N, Wakuda T, Tanitsu T, Ishii E, Ichiman Y. Department of Acupuncture and Moxibustion, Tsukuba College of Technology, Tsukuba, Ibaraki, Japan.

B a c k ground Massage therapy involves direct contact between the therapist and the client in a clinical setting, which can result in the transfer of bacteria. The purpose of this study was to determine the degree of bacteria transfer between a therapist and a client during a massage session and differences between types of lubricants used.

M e t h ods Medium cultures were taken from the therapist’s palms and the client’s skin 26

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before, during, and after the massage session. Experiments proceeded with the following settings: use of three different types of lubricants, without the use of a lubricant, and without massage as control. After each massage session, the therapist washed his or her hands and a bacterial sample was again taken.

Results Bacteria count on the therapist’s palms increased during and after massage with and without the use of lubricant.

There was no change in the case of no massage.

Bacteria count on the client’s skin decreased during and after massage with the use of three different kinds of lubricants compared to the no-massage control. However, an increase was evident when no lubricant was used.

After hand washing with water for 20 seconds after each massage session, there were still bacteria on the therapist’s palms. However, bacteria count differed with the type of lubricant used.

Conclusions Bacteria from the client’s skin transferred to the therapist’s hands during massage therapy. Bacteria count when no lubricant was used was greater than massage sessions using lubricants.

Publications Type PMID: 15353027 [PubMed - in process] esperance.dono.@nifty.com

each issue we will feature abstracts from evidence based research publications and their conclusions.

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This album includes seven works, each written in a key that resonates within one of the seven main chakras of the body. It begins with the crown chakra working down to the base which makes it ideal for massage or reiki practitioners in particular. By listening to the whole album a subtle chakra balance will be achieved. All the tempos are below the average heart rate at rest to induce deep relaxation or meditation. There is clever use of Nye flutes, guitars, harps and lyres, in fact track four has a slight resemblance to something from Close Encounters of a Third Kind – very out of body.

This book is for anyone wanting to learn and incorporate MFR within a practice of manual therapy. It is an excellent guide and workbook. The text offers the reader who has seen demonstrations a chance to take in what they saw and apply at progressively deeper levels. I am sure that after attending workshops you go home and wish you could view the demonstrations again. This book with its 210 illustrations gives you a step by step guide of applications for both adults and children, splitting the body into eight sections. In bodywork, a picture is often worth a thousand words. There is also an introduction that includes developing a hypothetical model and a contemplative approach.

Its spiral binding makes it easy to lie flat for instant viewing during practice sessions and the wipeable cover is also a thoughtful touch.

This simple but attractive device combines soft glow lighting with an essential oil diffuser. Made out of ceramic or porcelain with a variety of hand painted designs from seascapes to lanterns, it is very easy and safe to use. The light is plugged directly into a mains socket with an integral plug, controlled by an on/off switch. There is a recess in the top that can be filled with water and a few drops of essential oils of your choice. Once the light is switched on, the heat diffuses the aroma around the room. This is a lovely addition to any clinic space, it is well priced and provides a safe flame free alternative to other diffusers.

For more details or to order visit www.Elsevier.com

For more details or to order contact cindyqiu@acjade.co.uk

This makes a refreshing change for use during treatments as it is very subtle and non intrusive.

For more details or to order www.absoluteambient.com

November 2004 M|W

27

The Best Time to do Marketing

by Mickey Wong Mick e y Wong Mickey Wong is Editor & Publisher of “Massage Marketing Success™ Digest” – a popular newsletter that provides practical and proven marketing strategies, tips and techniques to build and grow a thriving practice faster and easier – and author of “How To Get Endless ‘Word Of Mouth’ Referrals”.

here’s a serious and common mistake that even successful therapists make with their marketing. You see, the time when most therapists start thinking of marketing is when business takes a turn for the worse. When they used to get 3 or 5 bookings a week, they’re now getting just 3 or 5 a month.

Things are looking bleak.

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A flurry of e-mail is sent to friends and family in the desperate hope of getting someone interested in having a treatment. Perhaps even dip into savings to try an advert or two in the local papers and magazines. Or do the worse thing possible in this situation and that’s to jump on the bandwagon of doom and gloom and blame the economy. Then wait, hope and pray for things to get better.

For a start, things won’t get better by sitting back and doing nothing.

Secondly, they would never be in this dire position if they did marketing when it was busy.

Contrary to conventional thinking, the time to do marketing is not only when business is slow. It’s the opposite. You should also do it when you’re busy, when you do have regular clients and

28

M|W November 2004

constant bookings. That’s the time when there’s still so much you can do to safeguard your financial future. Not doing so is a major mistake.

I know what you might be thinking.

You’ve got your hands full, things are going well, and you’ve got a constant stream of bookings week in and week out. So, why should you do any marketing when business is good?

Besides, you’ve only got two hands and only so many hours in the day.

You don’t need to, right?

Well, listen carefully. The reason why you must do marketing even when you’re busy is this: you’ve got more to work with than when it’s quiet.

It’s simple. Let me explain by showing you a few things you should be doing:

Building Your Mailing List When you’re busy… building and profiting from your mailing list is easier.

Your mailing list of potential, past and existing clients is one of the most valuable and profitable assets in your business. People on your list have already seen your marketing. You’ve

businesstools the best time to do marketing already established trust and credibility with them. So selling treatments to them is easier because they already know you.

get far more new clients through referrals when you’re busy than when you only have a pitiful trickle of clients?

Of course you would!

If you start building a list when your backs up against the wall, you’ve got to build the relationship, trust and credibility with the people on it first – especially with potential clients. Like any relationship, this takes time. When you’ve got a mountain of overdue bills to pay, time is not a luxury you’ve got.

So, no matter what state your practice is in right now, get referrals from each and every client you have. Some of the referrals you get will book an appointment. And, with those that do, repeat the process and ask them for referrals.

However, if you have a mailing list, you can easily get bookings by sending out a special offer. A simple e-mail offer takes just minutes to create and costs you practically nothing to send. And, it’s possible to get enquiries and calls for bookings the same day you send it out.

Keeping in regular contact with people on your list allows you to build and nurture your relationship with them. So, when you have something special to offer, you’ve got a loyal audience ready and willing to listen.

This relationship building is simple to do. Just send out a monthly newsletter that combines useful information with your special offers. Using the Internet, this is quick, simple and cheap to do.

So, if you haven’t started building a mailing list yet – and nurturing relationships with the people on it – start today. Right now. You’ll be glad you did.

Getti n g R e f e r r a l s When you’re busy… you’ve got the perfect opportunity to create a constant stream of referrals.

Ask yourself, “Who are you going to ask referrals from when business is quiet?” The best people to recommend you are happy clients. But, how will that happen when you have few, or none at all?

Think about this for a second…if you asked every client for three people to recommend you to, do you think you’ll

Keep asking for referrals, make it a habit, and you’ll never run out of new clients and bookings.

G e t t i ng Testimonials A n d Building C a s e Studies When you’re busy… it’s the best time to ask for testimonials and to build up case studies.

The experience of a wonderful treatment is fresh in people’s minds.

They’d be delighted to tell you how good you and your treatments are. So, you’ll have no problem getting endless glowing comments.

And, with the high number of clients you’re treating – and the various problems you encounter – you have a great opportunity to build a variety of case studies you can use for future marketing.

These case studies will prove useful whenever a potential client, with a specific problem, asks if you can help them. There’s a good chance you’ll be able to show them a documented case study of someone who had the same or similar problem, and how you were able to help them with your treatments.

One of my mentors, a well-known and highly respected marketer, has over one hundred testimonials for one of his products on his web site.

Overwhelming proof! He has many more. However, I think people get the

contrary to conventional thinking, the time to do marketing is not only when business is slow it’s the opposite November 2004 M|W

29

businesstools the best time to do marketing point loud and clear from reading just those on his site. How did he get so many? He made it a habit of asking for them.

soothing, relaxing, professional massage is a wonderful gift for anyone at any time.

When you have few clients, getting glowing testimonials for marketing purposes is harder. And, when you have few or no testimonials and case studies, convincing people you can solve their problems is like climbing a mountain… an uphill struggle.

Conclusion

S e l l i n g Gift Vouchers

Using the Internet, some of these strategies can be set up and automated so that there is little or no extra work involved thereafter. And, once implemented, these systems can be left to go about doing their jobs – building your mailing list and relationships with the people on it, gathering testimonials, selling gift vouchers – so that you can continue to provide a great service to your clients.

When you’re busy… you can sell more gift vouchers to improve your cashflow.

Gift vouchers are a great source of immediate income. And you’ll know you will have bookings in the near future because some people will use them. Not everyone will. Some may forget, or be too busy to get round to making use of them. But that’s all right with you, isn’t it? They’ve already been paid for.

However, it seems these only pop up around Christmas. Just recently I got two e-mails from therapists saying, “By the way, if you’re stuck for Christmas presents, I sell gift vouchers.” Before then, I had no idea they sold them!

So why leave them in the background during the rest of the year?

Marketing is a constant process, not just for when you start your practice or when business is slow. Don’t make the mistake of thinking you don’t need to do marketing because you’re “too busy”…only to leave it until it’s too late.

The only thing you might panic about is getting more bookings than you can handle! But, that’s easily solved. Get help and split the workload with another therapist, or two. It might just be the beginning of something exciting… a growing, profitable and valuable practice that one day might attract someone who buys it for a handsome price… so you can retire happy and financially comfortable!

When you’re busy, you have more people to sell gift vouchers to. More happy clients who will want their family, friends and colleagues to experience the wonderful treatments you provide.

Your mailing list comes in handy here because you can let people know throughout the year that gift vouchers are available as the perfect gift for any special occasion. Not just reserved for Christmas.

So, don’t hide your gift vouchers until you feel like selling them. If you do, you’re losing out on a great deal of additional income. Remember, it’s someone’s birthday or anniversary every day of the year. And, like I said, a 30

M|W November 2004

To get your free newsletter subscription and the special free report, “10 Serious and Common Marketing Mistakes Massage Therapists Make… and How To Fix Them”, visit: http://www.massage marketingsuccess.com/go/mw To learn more about and purchase a copy of his book, visit: http:// www.massagemarketing.co.uk/

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