Bodywork Buddy Blog

Bodywork Buddy: business management software for the solo therapist that keeps you organized and makes tax time a breeze.

Thursday, June 23, 2016

Manual Therapy for the Anterior Neck {Guest Post by Dawn Lewis}

Manual Therapy for the Anterior Neck
By Dawn Lewis

Recently I read an article about a woman suing a massage therapist and Massage Envy.  The woman believes that the massage therapist was aggressive enough on her anterior neck that it lead to a stroke.  I do not know if this is possible, but I do not know that it is impossible.  Since that article there have been multiple facebook postings about why bodyworkers should be afraid of the anterior neck.  This I completely disagree with.

We do not make bodywork safer for our clients by being afraid of their bodies or what is happening to them.  We make bodywork safer for our clients by being as educated as we can be.  There are times when we need to send our clients to medical professionals such as doctors, physical therapists, or chiropractors.  But when we see an apparently healthy individual and we are afraid to touch certain areas of their bodies, we do ourselves and our clients a disservice.

The anterior neck, in particular, is an area we should all know how to work.  Why?  Because humans spend a good deal of their time right now with their necks in flexion and their heads down looking at their devices.  This leads to shortened, tight musculature in the anterior neck.  Shortened, tight musculature in the anterior neck can cause a multitude of issues.

First, a muscle named longus colli runs the length of the anterior cervical vertebrae.  When that muscle is tight, the cervical spine is in flexion.  This pulls the lordotic curve out of the cervical vertebrae, moving the vertebrae toward the posterior plane of the body.  As the neck straightens and moves posterior, the clavicles and sternal manubrium move posterior as well.  This position of the clavicles and manubrium moves the upper rib cage posterior and the scapulas into abduction.  As the scapulas move into abduction, the shoulders round forward.  This all started with a shortened longus colli.

Next, we could look at longus capitis.  Longus capitis originates on the transverse processes of C3 through C6 and inserts on anterior aspect of the bottom of the occiput.  Again, this muscle tightens when we have our head in flexion looking at our devices, reading a book or magazine, doing bodywork, etc..  But this muscle is attached to the head.  When it tightens, it pulls the anterior aspect of the head toward the chest (think chin toward chest).  The natural antagonist muscles to longus capitis are the suboccipital muscles.  In this position, the suboccipital muscles are in stretched position, leading to weakness, and the possibility for suboccipital headaches.

Finally, a head down position leads to tension in the muscles attaching to the hyoid bone in the anterior neck.  These muscles attach the sternum, thyroid cartilage, head, and scapula to the hyoid.  As the chin moves toward the chest, the hyoid is moved inferior and posterior, causing tension in all the hyoid muscles.  This can lead to pain and tension in the mandible, the temporomandibular joints, or the shoulders.

It is imperative that we learn to treat the anterior neck in an effective way.  I have been teaching anterior neck work for decades.  I teach Spontaneous Muscle Release Technique (SMRT), a positional release modality I made up a couple of decades ago.  I was always fascinated by the anterior neck, but while in basic training for massage therapy 23 years ago, I had a learning experience.

I was in my third level massage course, which happened to be neuromuscular.  Please understand that I am in no way being negative about neuromuscular therapy, I am simply telling you about an experience I had.  One day, another student and I decided that we really needed to practice.  We had been avoiding the neck work because we were not very comfortable receiving it in class.  But we had to know it to pass, so we needed to practice it.  I went first.

I did the full neuromuscular neck protocol on her.  It took about an hour.  That night we had class.  When I saw her in class, her neck was red and looked marbled.  It looked like hamburger, I thought.  She was in pain.  I felt terrible.  The red, marbled look and the pain lasted for almost three days.  This turned me off to doing deeper work on the neck.  When I began to develop SMRT, I spent many hours studying the neck and figuring out how I could affect the neck without causing pain.

If we look at our examples above, it is extremely easy to relieve tension in longus colli.  At one point in my career, I was taught to go into the anterior neck, move the esophagus to the side and cross fiber this muscle.  I have it more effective to place my hand on the top of head and manipulate the head position until I get a release in longus colli.  The pressure of my hand on the top of the head is minimal, as are the movements I make to find the correct position.  When longus colli regains length, the curve in the cervical spine begins to reappear.

When the flexion of the cervical vertebrae eases and the natural lordotic curve begins to re-establish itself, the cervical spine moves away from the posterior plane and into a more neutral position.  This allows the clavicles and manubrium to move into an anterior plane, and the scapulas to move to a more neutral position on the back. As a side note, when the clavicles and manubrium move to the posterior plane, as they do when the neck is too straight, a significant amount of tension is created in lower fibers of sternocleidomastoid.  Allowing the position of these bones to move toward a more natural anterior position, instantly eases the pressure on sternocleidomastoid.

In our next example, we had tension in longus capitis that was causing suboccipital muscle weakness and possibly headaches.  Many times this pattern leads to a report from the client that the "problem" is at the base of their head.  When we palpate the suboccipital area, it feels tight, so we work that area.  But, I find that by again placing my hand on the top of the head and moving the head into the needed position, longus capitis is able to release and allow the chin to come away from the chest, which lessens the stretch on and alleviates the pain in the suboccipital muscles.

In both of these examples, I do not have to work directly on the anterior neck.  In our third example, however, direct anterior neck work is beneficial.  SMRT allows us to do this work in a non-intrusive, gentle fashion, while still getting the desired results.  All of the hyoid muscles can be released and returned to normal tone by working with the position of the hyoid, the thyroid cartilage, and the sternum.

Some therapists believe that it is impossible to get the results a client needs by working with a light touch or by working remotely (i.e. using the head to release the neck muscles).  But I believe it is impossible to get the desired results without knowing the possible reasons for the tension in the muscles being addressed and while working in a way that causes pain and tension.  I have taught anterior neck work to almost 2000 therapists (and that number will continue to grow).  Anterior neck work is not something to be frightened of, it is something to be learned and understood.

In my last SMRT: head & neck class, there was a older woman who had been doing massage for over 30 years.  When we got to the anterior neck, she said to me, "I don't really want to practice this because I will never use it.  It scares me and I will never do it to my clients.  But I don't want to disappoint my partner either."  I encouraged her to try it in class, with the understanding that her partner would be very vocal about whether she was hurting her or not.

45 minutes later, by releasing the anterior neck muscles, she felt a significant change in the position of the hyoid and her partners chin had come into an anterior plane.  Her partner sat up, rotated her head around, sighed, and said, "that was awesome!  Thank you so much!  I slept funny last night.  I had a headache and that catch in my throat that makes you want to cough all the time, feels like a knife stuck in your throat.  It's all gone now.  That was great!"

When I see training experiences like this, I get rather irritated at the facebook posts that insight fear and tell us to stop treating this area immediately.  It is essential that we work on the anterior neck, yet most of the students in my SMRT courses do not work this area when they come to class.  Within the few hours that we concentrate on the anterior neck, they become confident in their ability to effect change without causing pain.  If you feel you do not know enough to work this area, by all means, don't - until you have taken a class, and then by all means, do work the anterior neck.

Dawn Lewis owns Full Circle School and teaches Spontaneous Muscle Release Technique or SMRT. Please check out the Full Circle website for live seminar dates, course videos, free sample videos, and other articles. 

Thursday, June 16, 2016

Steamy Wonder Update

BlushingWow, it's been a few years since I added the Steamy Wonder to my services and I still haven't posted my promised update of how it's worked out in my practice...oops!

I started out with adding a complimentary 20 minute steam with each session for them to experience it for the first time. After that, it was a $30 add-on. (Without really adding on any time to the session.) About 2 out of every 3 clients seems to love it, and many have added it to their regular routine. After having worked with the steam for a while, there's a few things I have changed:

  • I only steam for about 15 minutes now instead of 20. This includes the cool-down time at the end of the steam, so really more like 10 minutes of solid heat.

  • I've moved into a new space and don't have a good area to hang the tent with the pulley system. I realized my previous post didn't make it clear that the pulley system is optional, totally not required. I liked the pulley system, but some clients did mention that it looked like a huge casket hanging from the ceiling... (yikes?!). Now I stand it on it's end and partially tuck it behind my armoire. It doesn't take up much space and is still easily accessible.

  • I used to use a sheet as a drape, and would slide it out after putting the tent over the table - leaving the client uncovered under the tent. I have recently switched to a bath towel for a drape, and leave it on the client during the steam. They can choose to slide the towel off to the side if they want, but most leave it on during the steam. It's comfortable and leaves the client feeling less exposed. It also helps to soak up some of the sweat, and then after wiping the client off with hot towels, I switch out the drape to a clean sheet and remove the bath towel.

Bodywork Buddy online scheduler

I offer it as a combined service in my Bodywork Buddy online scheduler. So, for example, under my "deep tissue massage" service group, I have these choices:
  • 90 minute deep tissue massage plus steam
  • 90 minute deep tissue massage
  • 60 minute deep tissue massage plus steam
  • 60 minute deep tissue massage
  • 30 minute deep tissue massage plus steam
  • 30 minute deep tissue massage

massage business management software

I can run a report on specific services within Bodywork Buddy to show how much of my income each year has been from what service. Handy, right?

The small investment of adding the steam service has definitely been worth it. *Pro-tip: Be on the lookout for a used Steamy Wonder in good condition to save money.

So, there's the scoop! Do you have any specific questions on how I use the steam in my practice? Let me know and I can answer them in another post.

BTW, if you're interested in checking out Bodywork Buddy for your business needs, there is a 
free trial to see if it's a good fit for you. *Special discounts for Board Certified therapists and members of ABMP!*

Cindy Iwlew is co-founder of Bodywork Buddy Massage Software, a complete online management solution for independent massage therapists that includes online scheduling

She continues to operate her own private massage practice since 1999, and has been an associate instructor for Ashiatsu Deep Feet Bar Therapy since 2007.

Thursday, June 9, 2016

Bodywork Buddy Member Spotlight: Angela Schiavi

Today's member spotlight is Angela Schiavi. Angela owns Nurtured Soul Ashiatsu and Massage in Kalamazoo, Michigan.

  • Q: What inspired you to become a massage therapist? A: I have wanted to become a massage therapist since I was 7. My aunt always wanted me to rub her feet and I enjoyed how much it helped her and how much she enjoyed it. 

  • Q: How long have you been doing massage? A: I have been doing massage since 2003, but only practicing in my own business since 2014.

  • Q: What is your favorite thing about being a massage therapist?
  • A: My favorite thing about being a massage therapist is helping people feel better, and having found Ashiatsu, I am able to assist my clients better.

  • Q: What is the most challenging issue for massage therapists? 
  • A: For me, I feel the most challenging part as a massage therapist is breaking the stigma that massage is "just a luxury " instead of "preventative wellness. I love to educate my clients on how massage is so important for them.

  • Q: What advice would you give to other MT’s to help build their business?
  • A: I am still working on building my business. I would say it's really important to hold integrity for yourself and your business, don't give away so much just trying to get clients. Hold on to your worth and your clients will see that you're worth it.

Sunday, May 8, 2016

*New Feature* Client Message

Last week we added a new feature that allows clients to leave a quick note for you when they schedule online. This is great if a client has a gift certificate they are redeeming, they need to tell you something that pertains to their appointment, etc.

It's completely optional, so clients don't need to leave a message in order to schedule.

When a client does leave a message, a speech bubble icon will show up next to their name for today's schedule on the dashboard as well as in the calendar. You can click on the bubble or hover over it to read the message.

Cindy Iwlew is co-founder of Bodywork Buddy Massage Software, a complete online management solution for independent massage therapists that includes online scheduling

She continues to operate her own private massage practice since 1999, and has been an associate instructor for Ashiatsu Deep Feet Bar Therapy since 2007.

Thursday, May 5, 2016

Pillossage Class

I took Pillossage with Karen Kowal a few weeks ago in Grand Rapids, Michigan.

It's no secret I love Mother Earth Pillows (they're like heaven!), and I've been wanting to learn the thermal connective tissue release technique that Karen created using them ever since I first saw it at NERC (AMTA New England Regional Conference) in 2008. I was working in the Ashiatsu Deepfeet Bar Therapy booth, but got a chance to check out the other booths and fell in love with the aromatic Mother Earth Pillows. I hadn't gotten a chance to receive the work at that time. (Bummer!)

I found in class that it's nearly impossible to stay awake while receiving this work!  It completely zones clients out while receiving it. It's a great addition to any session, especially for those chatty clients that can't seem to relax.

From that first feather stroke down the body wrap pillow over the spine, clients seem to just sink into the table a bit more and really open up to receive. It's a gentle technique making it work well for most clients.

My clients comment all the time on the great aroma of the pillows. I've been incorporating them into my work for a while (mostly just to help keep clients warm) but after Karen's class, I have all sorts of awesome tricks to add in to my sessions with the warm pillows.

I found this arm and shoulder work in class especially yummy:

Went to write this blog post and realized I didn't get any pics with Karen while in class! Looks like I might have to make a road trip to her next class sometime soon for the self-care workshop she teaches. ;)

Cindy Iwlew is co-founder of Bodywork Buddy Massage Software, a complete online management solution for independent massage therapists that includes online scheduling

She continues to operate her own private massage practice since 1999, and has been an associate instructor for Ashiatsu Deep Feet Bar Therapy since 2007.

Thursday, April 21, 2016

6 Problems Massage Therapists Solve Using Bodywork Buddy

  1. Phone tag with clients

    If using the online scheduling aspect of Bodywork Buddy, massage therapists can greatly cut down on phone tag with clients and the back and forth of trying to get an appointment time that works for both client and therapist.

    The online scheduler will show open appointments in real time to clients looking to schedule while still allowing the therapist to keep control over their schedule.

    Clients want the convenience of online scheduling, so not only does it eliminate phone tag but it gives your clients what they want!

  2. Being unprepared for tax time
    Have you ever waited until the end of the year or even April to go through your entire book and add up your income? Uh... me neither....

    BWB actually makes it really easy to make recording your income a daily habit. And if you don't do it for every session? Those sessions will stay on your dashboard as overdue appointments so you'll remember that you still need to complete those and add payment info.

  3. Setting boundaries and enforcing policies
    Policies are included on the email reminders sent to clients, and you can also add them to your online intake forms for clients to agree to.

    It's important to have clear boundaries and policies, and BWB helps you enforce those.

  4. Tracking growth of business
    Do you know where your business is for this quarter? This month? How have you grown since this month last year? BWB makes it easy to find out with just a few clicks.

  5. Tracking gift certificates and packages
    "Oh you have a gift certificate but you didn't bring it with you or you don't know the number? No problem! I have it on file."

  6. Having a professional online presenceThe BWB microsite design has been made specifically for massage and to help you have a professional online presence. With massage specific images and videos, our online scheduler helps show clients what you do and how you can help them. You can also add your own images and text to completely personalize your microsite.

Sunday, March 13, 2016

What's Your Definition of Success?

I've been mulling over this topic for a while now, and keep trying to put into my own words what I'm thinking and feeling.

But this story of the Mexican fisherman is so on point for me, that I decided to just share this today and also the 10 lessons from this story shared by Courtney Carver on her blog

10 Lessons From the Story of the Mexican Fisherman

It's a quick read and worth it. I promise.

Cindy Iwlew is co-founder of Bodywork Buddy Massage Software, a complete online management solution for independent massage therapists that includes online scheduling

She continues to operate her own private massage practice since 1999, and has been an associate instructor for Ashiatsu Deep Feet Bar Therapy since 2007.