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Massage Today
June, 2002, Vol. 02, Issue 06


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

By Lynda Solien-Wolfe, LMT

Author's note: Welcome to my monthly column, DearLyndaLMT, where I answer questions from you, the readers. I have been blessed this past decade by working with many experts in the massage profession who will serve as resources, mixed with a touch of Dear Lynda's views and advice.

So ask away with all those things you've wondered about but didn't know who to ask! I can't guarantee that all of your questions will be published, but I will do my best to answer you, or at least point you in the right direction.

Please remember, as with all advice, it is just that: advice. Always check to make sure that you're working within your scope of practice in your city/county and state. Please send your questions to or:

P.O. Box 173,
Cocoa, Florida 32923


I recently had a fellow massage student tell me that when she works on people she knows to be HIV positive, she wears latex gloves to protect her from catching AIDS. Is this true? Should I wear gloves with clients?

-- Mary in New England

Dear Mary,

I contacted Jonathan Williams, LMT, NCTMB and member of the Maine HIV Prevention Community Planning Group, to respond to your letter. Here's what he had to say:

I have heard of this practice before. While we need to be careful any time there is the possibility of contacting open, bleeding cuts, the chance of contracting HIV from a client is extremely low. If the client's skin is intact, the chance is virtually nonexistent.

You see, HIV needs blood-to-blood or mucus-membrane contact at a significant level to infect. If the client has an opening in the skin, or you have cuts on your hands, you might want to take some precautions. You could ask the client to clean up really well before the session and cover the areas that are open. Other than this, you would be able to work without fear of complications.

Nurses in AIDS wards have been working without gloves on patients for many years. The truth is, blood splatters to the eyes and needle sticks make up almost all of the accidental transmissions in this kind of venue. There are some other opportunistic infections that may affect your treatment, but you can evaluate those risks depending on our technique and the client's status. The fact is, even with the advances in treatment in the past few years, HIV carries a stigma, and those willing to disclose their status often find their opportunities for warm, caring touch might be reduced.

If we punish them by refusing to touch them except with a latex barrier between us, we are pressuring them to keep quiet about their status in order to receive the same care you would provide them if they would have been silent. Given your "risk," this seems like an easy decision. Take precautions when necessary, or pass the client on to someone else who provide appropriate care.

You can contact Jonathan by e-mail at .


I am in the process of receiving my certification as a massage therapist, and am looking for information concerning massage for clients with sciatica. I would appreciate any help you could give me.

-- Kristin in the USA

Dear Kristin,

I get the best results with clients with sciatica pain by using compression and stretching techniques. I contacted James Waslaski, who has a video on orthopedic massage that addresses sciatica conditions. Here is what he had to say about your question:

Too many schools call sciatica the "piriformis" syndrome, and mislead therapists to believe that just releasing the piriformis on the painful side is the treatment. There are so many more things that can cause radiating pain down the leg. You need to start with large structural muscles such as the iliopsoas and quadratus lumborum, because they can compress nerve roots on the tight side. There can also be a herniated or ruptured disc that may show up on an MRI or bone scan. But even in the case of disc pathologies, I recommend a pain-free technique that consists of creating bilateral balance of five muscle groups to decompress the lumbar spine, balance the iliums and release the sacrum. In order, the five muscle groups to be balanced are:

  1. iliopsoas;
  2. quadratus lumborum;
  3. deep six hip rotators;
  4. quadriceps; and
  5. hamstrings.

Good functional assessment is important and a multidisciplinary bodywork approach is necessary. The most critical missing link however, is to address the client's posture and biomechanics, and give the client specific stretches to keep the involved or shortened muscle groups released.

For more information, go to James Waslaski's website:


I like doing Shiatsu on a mat, but my knees are starting to hurt after each session. Do you have any suggestions so I can keep doing the bodywork that I love?

-- Kimmy from San Francisco

Dear Kimmy,

A letter I received last month from a reader in Annapolis, Maryland suggests a solution to your problem. Here is her letter:


Recently someone wrote in with a question about Asian bodywork. I have a suggestion for all bodyworkers who work off a mat on the floor: Wear kneepads! I found kneepads at my local rug installation store, and in the garden section of my local hardware store. Both sets work wonderfully. My knees feel fine, including the one that was injured in a car accident.

As bodyworkers, we are in pursuit of prevention, and of course that begins with myself. My clients like the feel of the kneepads, and a few even comment that I am smart to take care of my body. I occasionally get teased about looking like a soccer player, but humor is a great healer. I am the only shiatsu therapist I know wearing kneepads -- maybe I am just the first kid on the block!

-- Leeann Irwin

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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