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Massage Today
April, 2001, Vol. 01, Issue 04


Touching the Massage Today readers one letter at a time...

By Lynda Solien-Wolfe, LMT

Dear Lynda LMT,

Love your articles in Massage Today. Quick question. What are the IRS' rules about being an independent contractor, as they apply to massage therapists?

The reason I ask is that everyone seems to be doing something different.

At the health club that I work at, I:

  1. Set my own rates.
  2. Set my own hours
  3. Collect the monies from the clients.
  4. Do my own advertising.

This seems to be working out OK so far, but now the club wants to change things.

  1. They set my rates.
  2. They set my hours.
  3. They have the clients pay them, and then they issue me a check on a weekly basis.
  4. They have me wear a spa logo shirt.

Sounds like I am an employee to me. Please help.

-- Ken from San Diego, California.

Dear Ken,

I contacted the IRS, and they sent me some forms to help you with your question. The IRS has a Form 1779 -- independent contractor or employee. It goes over the three main categories the courts have used in deciding whether a worker is an independent contractor or an employee: behavioral control; financial control; and relationships of the parties. The determination of whether an individual is or is not an employee is based on all the facts and circumstances. The IRS uses a 20-factor test in determining whether an individual is an employee or independent contractor. The 20 factors are:

1) instructions;
2) training;
3) integration;
4) services rendered personally;
5) hiring assistants;
6) continuing relationship;
7) set working hours;
8) full-time employment;
9) work done on premise;
10) order or sequence set;
11) reports;
12) payments;
13) expenses;
14) tools and materials;
15) investment;
16) profit or loss;
17) works for more than one person or firm;
18) offers services to the general public;
19) right to fire; and
20) right to quit.

An employer can get a ruling on whether an individual is an employee by filing Form SS 8 -- determination of employee work status for purposes of federal employment taxes and income tax withholding. The form presents the 20 factors as a series of questions and answers.

You can contact the IRS AT 1-800-829-1040. To order forms you can call 1-800-TAX-FORM, by fax you can dial 703-368-9694, or you can visit them on the internet at to download and print IRS publications.

I showed your e-mail to certified public accountant Jay Edinger. His clientel includes many massage therapist and small business owners. He mentioned that, as mentioned above, the IRS uses three basic categories when deciding whether a worker is an independent contractor or an employee: behavioral control; financial control; and relationships of the parties. With the limited information you shared, Mr. Edinger said once the health club changed the behavioral control, financial control and the relationship to the parties by setting your hours, collecting your monies, setting your rates etc., your status probably went from a independent contractor to an employee.

Ken, a last bit of Dear Lynda advice: Look at both sides of the coin and decide if you want to be a employee or independent contractor. There are pros and cons to each. Choose your approach with the health club wisely.

Dear Lynda LMT,

I am really enjoying reading Dear Lynda. I am looking for a video on carpal tunnel syndrome techniques -- do you know of any? I also wanted to find out what self-help techniques other massage therapists use to deal with carpal tunnel symptoms from doing massage. I am going into my 11th year as a massage therapist and am starting to have carpal tunnel syndrome (CTS) symptoms, but I still love what I do as much as I did when I first started.

Thank you for your time.

-- Joel from Texas

Dear Joel,

I have attended a few classes on carpal tunnel techniques in the past from fellow Florida massage therapist Don McCann MA, LMT, LMHC. I have found his techniques to be very beneficial when working with clients with carpal tunnel syndrome. Don has been a massage therapist and educator for over 20 years. He has a video and a book on carpal tunnel syndrome to his credit, both of which address ways to learn to effectively treat carpal tunnel syndrome using advanced massage therapy protocol. His work also addresses ways to save your own hands and wrists from damage utilizing proper body mechanics.

I contacted Don to address your question on self-care techniques. Here is what he shared with me:

Lynda, thank you for this opportunity to add to Joel's knowledge about carpal tunnel syndrome, a problem facing many massage therapists. The nature of applying massage techniques to clients has MTs leaning over a table, which can result in shoulders rolling forward and arms rotating internally. This structural imbalance will leave the arms and shoulders weakened, which will result in strained fibers in the arms, wrists and hands. The strains will produce microtears in the soft tissues, causing adhesions to form in the carpal tunnel and the entire arm and shoulder, resulting in nerve entrapment. I recommend that massage therapists maintain awareness of their body mechanics, and use leverage from their legs for pressure. They also need to be aware of over internally rotating their arms during massages, and concentrate on keeping their shoulders back and down. In addition, the worst way a MT can work is by hyperextending the thumbs while doing trigger-point or other specific work. Correcting these ergonomics will help.

My number-one recommendation for a MT who already has developed the symptoms of carpal tunnel syndrome is to find a MT who has been trained and is getting good results in the treatment and prevention of CTS. I have taught several hundred MTs in Florida. If you do not have an MT who has been trained in CTS, I recommend you correct your body mechanics and start a stretching program. I have found that using a direct/indirect stretching protocol will produce the best results. Here's a brief example of such a protocol:

To stretch the wrist, move it into flexion as far as it will go, then stop and note how far it moved. Next, move the wrist into extension as far as it will go and stop, noting how far it moved. Whatever way moved the farthest, take it that way again to its limit. Hold it with slight pressure and take several breaths, concentrating on relaxation in the wrist and in your breathing. Now move it in the other direction and hold it, again applying light pressure and breathing. You should not stretch into pain. If done correctly, the wrist will show improvement in ROM (range of motion) after the first stretch. Be sure to stretch it in the opposite direction for additional ROM and balance. Do this with the shoulder, elbow, wrist and fingers. You should see improvement within several days of stretching three times a day.

I am presently working on a book on self-massage techniques for the treatment and prevention of carpal tunnel syndrome, to be out sometime this summer. Good luck, Joel, and take care of your arms and hands, so you can do what you love for years."

For more information on preventing and managing carpal tunnel syndrome, you can contact Don McCann at or call him at 813-949-2933.

Dear Lynda LMT,

I usually get excellent results treating headache sufferers. However, I have a few frustrating clients who are not responding to my typical therapy sessions. Do you have any recommendations?

-- Stacy from California

Dear Stacy,

I recently heard David Kent, LMT, NCTMB, present at a convention on the topic of headaches. He suffered for over 20 years with debilitating headaches and is totally headache-free today. He explained that while massage therapy is usually very effective in the treatment of headaches, there are numerous contributing factors a therapist should consider. Here is a short synopsis of what David said:

  • Analgesic rebound headaches (ARH), the "side effect" or "withdrawal" from medication(s), are frequently the problem with chronic headache sufferers. This is similar to someone getting a headache if they don't drink their morning coffee (caffeine withdrawal).
  • Other headache "triggers" include stress, allergies, hormones, depression, constipation, certain foods, excessive noise, over eating, strong odors (perfume), poor posture, high blood pressure, missing or delaying meals, irregular sleeping schedules, change in barometric pressure, eye strain (ie. viewing TV or movies, reading), bright sunlight, fluorescent lights, alcoholic beverages and recreational drugs.

David Kent can be reached at 407-574-5600 or Another source of information would be the National Headache Foundation at (800) 843-2256.

David strongly stressed that when working with headache sufferers, massage therapists must operate within their scope of practice. A massage therapist cannot diagnose the cause of a client's headache, advise a client to stop or start taking prescription or non-prescription medication(s), or advise a client to ignore the recommendations of other health care professionals. Also, massage therapists cannot prescribe supplements, herbs, fitness regimes, etc. without proper training, accreditation and/or licensure.

If you have a question on the massage profession for DearLyndaLMT, e-mail them to her at: or write her at:

c/o Lynda Solien-Wolfe
P.O. Box 173,
Cocoa, Florida 32923

Lynda Solien-Wolfe is Vice President, Massage and Spa at Performance Health. She is a Licensed Massage Therapist and has been in private practice in Merritt Island, Florida for more than 20 years. Lynda graduated from Space Coast Health Institute in West Melbourne, FL.


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