Massage Tips: How To Make a Hot Towel

As mentioned in the above video, a hot towel is a fast and easy way to get some moist heat relief for pain.

The article that was mentioned in the video was this one: Should I Use Heat or Ice On My Injury?

Here are the steps and details of the video:

What you need:
2 hand towels
Water
A microwave

Steps to make a hot towel:
1. Soak one hand towel in water and wrap it into a tight ball
2. Put the wet towel in a microwave for 60 seconds (1 minute)
3. Take your dry towel and lay it flat over your sore area
4. Take your hot towel and fold it into a manageable shape such as a rectangle
5. Lay the hot towel over the dry towel and wrap the edges of the dry towel around the wet one.
6. Let it sit until it loses it's heat, or you start to feel better. Usually around 20 minutes is the longest it retains it's heat.

So what is the dry towel for?
The dry towel is simply there to keep the hot towel from burning or causing any irritation on the skin. If you are putting the hot towel over a piece of clothing, you might be able to get away without the dry towel, however I'd personally still advise you to use the dry towel just to keep an extra layer of protection and not get your clothing wet.

Why is moist heat important?
Moist heat is recommended for heat healing because since our skin and muscles are porous, a water based heat is more readily absorbed so rather than simply heating up the surface of the skin, the heat gets deeper into the area and therefore is more effective with the heat doing it's job.

I hope this hot towel tutorial helps you out with your fast moist heat needs!

How Long Should My Massage Be?

One of the first things people notice when they are scheduling a massage is that unless they are looking for a very specialized service, there are usually options for different lengths of massages. So how long of a massage should you get or do you need? Everybody’s needs are different and every therapist has different goals/procedures for each length of appointment, so just to break things down, here is how I personally look at appointment lengths and the benefits of each.

15 Minutes: In my practice, this is the shortest appointment length that I offer. I almost exclusively use this time for chair massages which are simple massages focused on the back, neck, and shoulders that don't require the client to disrobe, so the whole time is used efficiently. I also use this length for infant massages because depending on why I’m working on the baby, forcing the baby to stay still for long periods of time can stress them out, so I keep the sessions short.

30 Minutes/Half Hour: Many people get massages of this length as an introduction to a therapist or to massage in general so they can gauge if it is something that will work for them. Likewise, I usually recommend this length to someone who has something specific like an injury or a chronic issue. 30 minutes gives the therapist the time to determine how the issue is doing, and time to do the work. While it is possible to work on multiple areas of the body in this short time, the more areas being worked on means the less time spent on each area, which still works for some people who just want a bit of quick relaxation without any heavy focused work on anything specific.

60 Minutes/One Hour: This is probably the most common appointment length I see. It is the standard time for a “full body massage” which includes massage on the hands and arms, neck, shoulders, feet and legs, plus the back of the body. You get the complete body worked on as well as having time to provide extra attention to any specific 'trouble' areas such as the shoulders, neck, feet, etc. Some people will also request a one hour appointment if they really have a problem area or injury that needs a lot of focused work so all the time can be focused on that issue.

90 Minutes/Hour and a Half: Sometimes an hour just isn’t enough time to get through everything that needs attention during a massage. Some people will request a 90 minute massage when they want to relax with a full body massage, but also know that they have specific issues that need more attention than can be addressed without lessening the work on another body part. Or sometimes people just want the extra time to treat themselves to some bonus relaxation and quiet time.

120 Minutes/2 Hours: I personally don’t do many of these but do occasionally, and many other therapists also offer it. Usually when a massage is this long it includes not only massage for the whole body, but can also include additional modalities such as stretching, energy work, hot stones, or a host of other things depending on the therapist. The therapist has lots of time to focus on everything from relaxation to addressing injuries, without any work being rushed. While it is possible for therapists to offer longer appointments, anything beyond this time can start to get taxing on the therapist. While we may seem to have super powers, we are human after all, and we do get tired!

What if I pick an appointment time that’s too short? Sometimes therapists will let you extend your appointment - meaning if you start with a half hour and realize you need more work, you can ask if you can extend to an hour. However this is 100% dependent on the policies of the therapist/company and the therapist’s schedule after your massage. Often if they have an opening after you they may be able to extend an appointment, but a therapist will likely never bump or delay another client just to extend an appointment. If a therapist can’t extend, they may work with you to schedule another appointment at the next earliest availability.

So the answer of which massage length is right for you completely depends on what you are looking for. If you want full-body relaxation, 60 minutes should do it. Just want regular work on those chronic knots in your shoulders? 30 minutes focused on the neck and shoulders should be fine. If you are ever in doubt, just ask your therapist what they recommend.

How Often Should I Get A Massage?

We all know that massage is good for us. It benefits both our mental health by relieving stress and giving us a sense of calm, as well as helping any pain or physical issues we may have. One question I am frequently asked is, "How often should I get a massage?" I often hesitate with this response because it isn't a standard one-size-fits-all answer. The frequency that you should receive massage depends on a few different factors.

Firstly, why are you getting the massage? Is it for stress relief? Maintaining your overall health and keeping everything working? Keeping away a recently healed injury? If the massage is more for maintenance or not geared toward a specific goal, most people find that one massage every 4-6 weeks is a good time span to go between massages before your body starts to feel too crunchy and angry with itself. The goal of these massages are usually more relaxing and maybe taking care of a few "trouble spots" but overall just a calm, quiet time for you to take care of yourself.

If you have an injury or something chronic like 'that thing in your neck that hurts every time you turn your head but you've learned to live with it', you may need massage a little more frequently - at least at first. In the case of helping to repair an injury, I generally recommend a little more intense of a schedule such as 2-3 massages during the first week or two, then we "wean" off the massages with more time between each session such as one a week for 3 weeks, then once every 2 weeks, etc - adding or subtracting as needed, until the issue is resolved. The reason for the more intense schedule is because the goal of this massage is to help the body heal and almost "reprogram" itself and not fall back into it's injured state, then as healing happens, the muscles re-learn what is "right" and the massage goals become more maintenance and less repair.

Now there are always special situations don't fit into this mold. For example, I leave the recommendations for prenatal massages up to the client because although, with the constant changes in the body, massage every week would be fabulous, but sometimes that isn't practical. A mom-to-be may want to schedule appointments around her doctor's visits, or she has child care for other children that she needs to coordinate, or perhaps her doctor recommends a different frequency. So in situations like this, I make recommendations, but leave it flexible and up to the client's preferences.

Other small things in life can also dictate how frequently one can or is able to receive a massage. Some people like to coordinate massages with other doctor's appointments such as physical therapy or chiropractic adjustments. Other times, people have issues with distance to travel or work schedules, and finally some have financial considerations that may influence how frequently they receive a massage. These considerations must also come into play when deciding when to come back for your next massage.

Sure, as a business owner who makes a living off of performing massages, it would be easy for me to tell people that they need to come in for massage at least once a week every week, but as a humane human being who is supposed to be looking out for the health and well-being of my clients, there is no one "best" answer as to how frequently they should get a massage. This is another reason why it is important to have a comfortable and confident relationship between therapist and client. They should be able to work together to determine the best frequency and schedule for the massage routine that works best for you.

Massage For a Sinus Headache

One day last year I woke up with a nasty sinus headache. Before reaching for my bottle of decongestants, I decided to try and massage out the pressure first. Then I flipped on the tv and saw a news report about the opioid crisis and a theory about one reason it is so bad is because people get over-prescribed medications. So I sat down and while I was massaging out my sinuses, I recorded a video about how I was doing it, so that perhaps I could help someone else stay away from their bottle of decongestants. I know that massaging away one sinus headache isn't going to make that much of a difference in the grand scale of things, but personally, any time I can fix my pain without something I have to swallow is preferable for me!

P.S. I hate how I look and sound in video and this was a BIG leap out of my comfort zone, so if you watch it, enjoy and please be nice!

Why Do I Have To Do Paperwork Before My Massage?

If you go in for a massage, chances are that you will be asked to provide some personal information before the massage begins, and that is usually done by filling out paperwork. Every massage therapist and company is different, and your overall experience with paperwork will be different, but why do we make you fill out that paperwork in the first place?

We know you come in for a massage to relax and escape from the everyday, and filling out paperwork is not something you do for fun. So why do we make you do it? Well, it is for your good as much as ours.

Every therapist is different and prefers/needs different types of information. I actually have different forms with different information for specific types of massages (prenatal vs. regular, etc), but overall, they serve the same purpose. Personally, in my practice, for a new client, I have two pieces of paper that are handed to the client before a massage. The first page is basic information including medical history such as allergies, surgeries, chronic issues, etc. Why does this matter? The short answer is that we don’t want to make anything worse. We need to know allergies so that we don’t use a lotion or oil with an ingredient that will give you a reaction. If you have had any surgeries or other chronic issues, we want to know so that we don’t pull or stretch or work on anything that had previously been repaired. While some surgeries leave an obvious scar such as a knee replacement, others like plates in your neck may not be as easy to see, so we have to adapt our technique accordingly. My second page of paperwork is given at every visit, even if the client sees me every week/month/etc. This page asks the client to specify what specifically brought them in for massage that day, and what they want me to be focusing on or avoiding, as well as any immediate changes in health.

Now every therapist is different, and some may never give you a shred of paper, but may ask you questions, to which they may go and write the info down themselves. Some therapists may not ask you a single thing about your medical history, but I’ve never known a legit massage therapist who doesn’t at least ask about allergies. Also, you don’t need to worry about what information you put on that paperwork. As health care professionals, massage therapists are bound by the same HIPPA laws as your doctor, so we can not share any information with anyone without written consent from you.

In my own experience, I’ve had a range of emotions from my clients about paperwork when they come in for massage. Some just go through the routine without questioning anything, some outright complain about “having to fill out that thing again”, and some have fun with it - I once had a regular older male client check the box marked “pregnant” and then admitted with a laugh that he just wanted to see if I was actually paying attention to the paperwork.

So as much as all of us hate dealing with paperwork, it can be considered a 'necessary evil'. Records need to be kept because massage does deal with a human being’s health, so to help us provide the best care, we need to keep everything in writing. With the digital age, there are many paperless and digital options coming into common practice, but it will still involve you answering questions in some form. Nevertheless be assured that we hate paperwork as much as you do, and we hate giving it to you as much as you hate filling it out, but overall, it is there for the best.

To Tip or Not To Tip Your Massage Therapist?

I recently had a client come in for a massage who admitted that she hasn’t really had many massages before. She asked “Is this like a haircut where there is one price listed and then I’m expected to pay a tip on top of that price?” It was an interesting way to put it, but I do get asked this question frequently by clients. Tipping is often something that many people aren’t sure what exactly the protocol is when it comes to massage because massage exists in so many different forms and is used for so many different reasons. 

According to Wikipedia, “A gratuity (also called a tip) is a sum of money customarily given by a client or customer to a service worker in addition to the basic price.“  Many times when we hear the term ”service worker” or “service industry” we immediately think of restaurant servers, taxi/Uber drivers, or hairdressers. We tend to view massage therapists in mainly one of two ways: spa employees or health care professionals. This creates an odd divide for individuals who do relatively the same thing. You usually wouldn’t think twice about tipping your hairdresser (service industry) but would never dream of tipping your doctor (health care industry). But ultimately, massage therapists can fall into both categories. They provide a service to individuals, so they qualify as members of the service industry, however they are also responsible for improving your health, so they are also members of the health care industry. 

Two big things also help make tipping confusion stronger; Environment and purpose. If someone is an employee in a spa, it seems like a no-brainer that, like a hairdresser, you give them a tip. However, if someone providing the same service in a doctor’s office, tipping may not seem as natural. Likewise, the purpose or reasons a person receives a massage can change the perspective as well. Some people get massage purely as a relaxing treat, while others get massage for therapeutic or medical reasons. This can change their perspectives on if a tip is warranted. This is probably the reason I get this question. I work out of a chiropractors office, but I am self employed and my rate doesn’t include gratuity built in. Plus, I may be in a health care setting, but, (at least in the state of Pennsylvania) every massage therapist, even those that work exclusively in a spa setting, has to have a license to practice just like medical professionals.

So I guess this whole article is a very long-winded roundabout of a very simple question and answer: should you tip your massage therapist? The answer that I give to anyone who asks me is: A gratuity is never required, however it is always appreciated.  Bottom line, massage therapists are members of the service industry. They provide you a service - making you feel good. They also are members of the health care field - so it is their job to make your health and well-being a priority. If you choose to and you feel it is appropriate to tip your therapist (unless their employer or organization specifically forbids it), it is never required but always appreciated. There is no right or wrong answer, it is all in how you view your therapist and the care that you get from them. 

Should You Talk or Not Talk During Your Massage?

Massages are supposed to be a relaxing experience. But does relaxing mean the same thing to everyone? Case in point; one question that I frequently get asked: "Should you talk or be completely silent during a massage?" Well, like many areas of massage, there really isn't one answer because everyone is different, and their needs as well as reasons for coming to massage are different.

One side of the argument says that you should be relaxing during a massage, so that means be quiet, listen to calm, quiet music, and just mentally let yourself enjoy the quiet to allow yourself to relax. The other side of the argument says some friendly banter allows the person receiving the massage to ask questions and get educated about things going on with their body, and can also be a form of relaxation therapy in itself by allowing the client to expend any pent up energy, frustrations, or just basically having someone to talk to.

Sometimes the technique itself can work better if there is talking versus no talking. Cranial Sacral or Myofascial work is more effective when the therapist can quietly concentrate on the sensitive and intricate things they are working on, while something like stretching or deep tissue work might require communication between therapist and client to make sure that the modality is working and not too much, as well as some conversation about what caused the issue in the first place.

I have seen forums and routine questions throughout the massage industry about what other therapists think of this topic. I've seen answers that range from therapists who find it fine to be sociable and chatty, while others state that they prefer to work in silence and have gone as far as to gently tell chatty clients to be silent 'for their own relaxation benefits'.  There are also factors such as the environment or the rapport of the staff that can influence whether talking is discouraged or encouraged during a massage.

Personally, as a therapist, I believe that it is ultimately up to my client - the person receiving the massage. After all, they are the ones coming to me for relief, healing, relaxation, or whatever their reason. I should allow them to achieve their goals however they need to. Some people do want the silent, quiet relaxation, and it can be a calming, almost meditative session that lets them fall asleep and me to put extreme focus on what I'm doing. Other times, people will ask questions, vent frustrations, relate plans they are excited about, etc. I used to wonder how they were able to relax while being so chatty, but I realized that perhaps they don't have anyone else to talk to so they need an outlet to vent or just enjoy speaking to another adult before they can unwind. In these cases, the talking is therapeutic and relaxing in itself, so I don't discourage it. I do, however, strive to let them lead the conversation or lack of it. The only time I usually try to initiate conversation is when I'm either asking about conditions, giving instructions, or reassuring a fear or concern. I work with many Prenatal clients, and many first-time moms can get concerned with all the strange things that are happening to their bodies, so sometimes I need to reassure them and will sometimes tell them about my own experiences in the same situation to help put their minds at ease and give them a chance to relax.

That being said, I do believe the answer of "to talk or not to talk" is up to the person receiving the massage, and what their goals of receiving the massage are. Sometimes quiet silence is needed and wanted, and sometimes chatting, venting, or letting off steam is just as important to their relaxation and healing. If my client wants to talk, I'll talk, but if they want to be quiet and go to sleep, I'm not going to engage them in deep conversation. I'm there to provide my clients with what they want and need, and everyone's wants and needs are different but no less right or wrong.

Should I Use Heat or Ice On My Injury?

If something hurts, one of the things that people tell you is to "Put ice on it" or likewise "Put heat on it". A common question that my clients ask me is "Which one should I use?" Both have their benefits, and either one can be used - depending on what is causing the problem.




Let's look at Heat
First of all, what does applying heat do? When heat is applied to an area of the body, it causes your muscle fibers to soften, loosen, and relax. It also attracts red blood cells to the area which help increase your circulation and those red blood cells then bring nutrients and good stuff to the area. Also, as the heat makes those fibers relax, any nasty stuff like lactic acid and toxins that were hanging around in the area or tangled in the muscle fibers are then carried away by those same red blood cells. 

When to use heat
Heat is best used when muscles are tight or in the case of an injury such as a muscle pull or an overuse / repetition injury. Lifting too much weight or being a weekend warrior and being sore the next day could use heat to relax muscles and take away the lactic acid that is causing the soreness. Heat also helps muscle spasms relax. If you sit in front of a computer for work too long and constantly have neck or low back issues, some heat can help those stiff and 'stuck' muscles soften. 

How to apply heat
There are a number of ways to safely apply heat. You can use an electric heating pad, a hot water bottle, or one of those popular rice-filled pillows that you can microwave to get warm. However the best type of heat to use is moist heat. Since your skin is porous, adding a little moisture lets the heat soak into your muscles a little more for a deeper, more effective treatment. You can add moisture to your heat by sprinkling a little water on your rice pillow before microwaving it, and some electric heating pads have a thin sponge that you can dampen and slide in under the cover. Another method is to make a simple hot towel: Take a regular hand or dish towel, soak it in water, wrap it up and put it in the microwave for about 60 seconds. Take a dry towel and lay that on your sore area, then lay the hot towel on top of it, then either take another dry towel and lay it on top, or if the bottom dry towel is long enough, you can wrap it up over the hot one, then just let it sit until it cools off. They key for using any type of heat application is to make sure that the actual hot object is not touching your skin directly and there is some sort of barrier (A towel, a cover, etc) between the heat element and your skin to prevent burns. Most doctors recommend either heat or cold treatments be done in increments of 20 minutes on the sore spot, then 20 minutes off, then repeat. 

Now about cold
Cold is usually recommended when you need the opposite effect of heat. Cold makes things condense or shrink so it is used to make things smaller, decreasing things like inflammation, swelling, and bleeding. You may have heard of R.I.C.E. in first aid - Rest, Ice, Compression, and Elevation as a first step for an acute injury. The ice keeps the swelling following the injury from getting too bad so that a proper diagnosis can be made, then it can help calm down the side effects of that injury.

When to use cold
Cold is best used if there is swelling or inflammation that you want to decrease. Conditions such as tendonitis, bursitis, or a sprain or strain on a joint where there is swelling or irritation can be calmed down by cold. Occasionally, even migraines are advised to use cold to numb the nerves and decrease pain levels. Cold is also useful if there is a chance that an injury could leave a bruise since cold can help slow internal bleeding, therefore making a bruise less severe.

How to apply cold
Just like with heat, whenever using an application of cold, you want to make sure there is a barrier such as a towel between the cold object and your skin. You don't want to risk frostbite or the cold object sticking to your skin because that will just make things worse. Ice or an ice pack is a quick and easy way to get cold applied. In a pinch, you can always use the "mom trick" of grabbing a package of frozen vegetables for a short term fix. You can also freeze that same rice pillow that you have on hand for heat applications as well. Physical therapists often have a mixture of water, salt, and rubbing alcohol that freezes very cold but stays pliable so it can be wrapped around an area such as a joint to keep it cold for a long time. 

My personal thoughts on heat vs. cold
Over the years, I've sustained many injuries and while I try to stick to what the research and doctors tell me, when it comes to heat vs. ice I have found that truly, the best thing to use is whatever feels right for your body. Yes when I roll over my ankle I put ice on it, but personally, when my hip flexor tendonitis flares up, I will usually use heat on it because if feels good and I know my body will respond positively to it. When my hands are swollen at the end of a marathon day of massages, I dip them in a hot paraffin bath - cold really bothers my hands so I usually turn towards heat even if the research says that this condition should have a cold application. So ultimately, there is research, there is recommendations, but if you really want to know which you should use for your pain - ice or heat, check to see what your doctor says and try it, but if it doesn't feel like it is working, or if you are more comfortable with another method, don't be afraid to use whichever temperature feels best for you.

3 Ways to keep "Too Much, Too Soon" from ruining your New Year's Fitness Resolutions

 One of the most popular New Year's Resolutions is to lose weight and/or increase fitness. More than 45% of people make this resolution every year. The first two weeks of January, gyms are packed, search engines see a 35% jump in "workout" as a search term, and morning talk shows all feature easy ways to get in shape for the new year. Unfortunately, by February, 73-80% of these resolutions have been abandoned. So why? One of the biggest reasons it fails is because people simply push themselves too hard too quickly. The excitement of getting started with a new routine can really get you going, but if you haven't worked out intensely in a while, it is really easy to overdo it and suddenly be incredibly sore or exhausted the next day, which can lead to "Oh, I'll take a day off to recover" which leads to never going back. To avoid running into this, it is important to take care of yourself outside of your new fitness routine. Here are some things to help:
   
1. Stretch - Many people know cardio and strength training helps condition their muscles and make them healthier, but many people forget about stretching. It is a common misconception that you only need to stretch if you want to increase your flexibility, but stretching can also help you prevent injuries and soreness. You know how you feel sore and burn-y after lifting something heavy? That is lactic acid - the by-product of muscles working. Stretching helps increase circulation which keeps muscles healthy and also helps flush away lactic acid, keeping you from getting too sore. Stretching also helps your muscles from getting injured. When working out or lifting something heavy, your muscles can get something called micro tears - little tears in your muscle fibers. These micro tears are usually no big deal, and we routinely get them all the time doing everyday things and usually we don't notice them at all. However, when a micro tear happens, it can fill in with scar tissue - again, something we all have and usually doesn't cause any issues. Stretching keeps this scar tissue long and loose rather than tight and bunchy so your new strength training doesn't feel like an injury.

2. Massage - Massage also helps with increasing circulation, flushing lactic acid, breaking up scar tissue, alleviating soreness, and many other things that can minimize the achy side effects of your new fitness routine that might make you tempted to quit. In addition, it can also help your mental state. Reducing stress through getting a massage helps flush away the stress hormones of cortisol and adrenaline which sometimes can contribute to bloat around the midsection. Massage also gives you a chance to help your mental calm and clarity which can go a long way towards making your workouts more effective and seeing results faster.

3. Avoid unrealistic expectations - It is very tempting to go hard into your new workout and eat nothing but smoothies and salad for two weeks, then put on your "skinny jeans" only to still have them not fit, so you get frustrated and give up. Often, it can take as much time to undo something in your body as it takes to do something to your body. So if you have been gaining weight for 5 years, it will be rare to lose that whole 5 years of weight in two weeks - or if you do, you might have other health issues. Keep your workouts simple, healthy and consistent, stick with it, and celebrate small victories rather than getting frustrated if you don't achieve the big ones right away.

Overall fitness resolutions are a case of 'slow and steady wins the race'. The temptation to push yourself to do too much too soon will almost always result in frustration and pain which leads you to be more likely to give up. If you want to push yourself hard, don't forget to take care of yourself outside of your fitness routine as well.