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Massage Today
April, 2005, Vol. 05, Issue 04

Staying Workable

By Keith Eric Grant, PhD, NCTMB

"Greatness is not in where we stand, but in what direction we are moving. We must sail sometimes with the wind and sometimes against it - but sail we must and not drift, nor lie at anchor."

- Oliver Wendell Holmes

Last time, we explored factors that lead to business survival in the practice of massage ("Meaning Business," Feb.

2005, What I emphasized were the skills of attitude, business, presentation, niche identification that provide a focus for work, and a stream of clients to work with. This time, I'm focusing on factors that allow you to physically stay in practice. Some of these are mostly within your control and planning; others - like the direction of the wind - can only be known and contended with.

To survive physically, respect massage as a body-based endeavor. Our bodies have their rules as to training and accommodating to new stresses. One of the cardinal rules of increasing sports training is to increase activities by no more than 10 percent per week.3

Physiologically, the ability to increase use is partly due to the effects of super-compensation on muscle strength and endurance discussed in my article, "Training Effects." (June 2003,

The structural accommodation of bone and connective tissues to stress, over time, is conceptually captured in Wolf's and Davis's laws, respectively. Increase your use of a given body area too fast and it can't accommodate before it breaks down. Respect your body, and its time for adjusting in your enthusiasm for doing the work.

Apart from controlling the rate of ramping up the total amount of massage you do, it's important to control both how the massage is done and the cumulative after-effects. Less stress is placed on your body when you vary the means of applying pressure, alternating the work you are doing between different body surfaces - fingers, palms, open fists, knuckles and forearms. Just as important, is learning to work equally with both sides of your body rather than always using a dominant side.

As your work becomes deeper, the additional pressure should come more from your weight and stance rather than your hand and arm muscles. Having a table that is about fingertip high is one measure of height I use for sports or deep-tissue massage. Another measure is having a table at a height that allows me to place a flexed knee on its surface with my other foot flat on the flow, while still being able to freely lean forward to apply weight. Using a stance with one foot in front of the other will allow you to push your body forward and back from your legs in a rocking motion, rather than pushing from your shoulders. Movement training from tai ji or qigong can help in getting the feel of moving your body with intent. Squeezing petrissage that intensely uses hand and forearm muscles can be supplemented or replaced with rolling the tissue as you rock forward. Finally, both getting massage for yourself and using body-care techniques, such as those given by Sharon Butler and Lauriann Greene, can increase your professional longevity.4,7

Staying in the massage business goes beyond just doing the work. In the United States, provision of health insurance is largely gained through employer plans (or by marriage to an employed person). Distinctions are made between individual plans, small-business plans covering two to 50 persons, and larger employer plans. Planning for health care can be vital to both your family and business finances. A recent review of 1,771 bankruptcy filings revealed that 52 percent of them resulted from medical costs.9 The study showed that involuntary lapses in health coverage can be financially devastating. Even when people had medical insurance coverage, the co-payments and deductibles for serious health crises coupled with loss of income accumulated overwhelming debt.

While there is little you can do outside of politics to change the structure of health insurance provisions, there are a number of resources you can use to learn about small business health insurance, including coordination with the new, pre-tax, health savings accounts (HSAs).1,2,8,11,12

In looking through the state health insurance guides by Georgetown University8 and the coverage offered by organizations, such as the National Association of Female Executives (NAFE),10 I noticed much of the provision was done through a single Internet broker.5 May the days of your practice be long and fulfilling.

"The dictionary is the only place that success comes before work. Hard work is the price we must pay for success. I think you can accomplish anything if you're willing to pay the price."

- Vince Lombardi, former NFL coach


  1. AHRQ, 2005: Consumers and Patients, Agency for Healthcare Research & Quality, Department of Health and Human Services,
  2. Applegate, Jane, 2001: Expanding Health Insurance Options for Small Businesses,,,4621,289264,00.html.
  3. Burfoot, Amby, 2005 (accessed): The 10-Percent Rule, Runner's World Online.,5033,s6-51-0-0-1051,00.html.
  4. Butler, Sharon, 1996: Conquering Carpal Tunnel Syndrome and Other Repetitive Strain Injuries, New Harbinger Publications, ISBN 1-572-24039-3.
  5. EHealthInsurance, 2005: Health Insurance Quotes & Medical Insurance Plans Online.
  6. Grant, Keith, 2003: Training Effects, Massage Today, June,
  7. Greene, Lauriann, 1995: Save Your Hands - Injury Prevention for Massage Therapists, Gilded Age Press, ISBN 1-883-19503-9.
  8. GUHPI, 2005: Consumer Guide For Getting And Keeping Health Insurance, Georgetown University Health Policy Institute,
  9. Himmelstein, DU, E Warren, D Thorne , and S Woolhandler, 2005: Market Watch: Illness And Injury As Contributors To Bankruptcy, Health Affairs, February, Web Exclusive,
  10. NAFE, 2005 (accessed): National Association for Female Executives.
  11. USSBA, 2005: Small Business and Health Care, U.S. Small Business Administration.
  12. USSBA, 2005 Health Care Economic Research, Office of Advocacy, U.S. Small Business Administration,

Click here for previous articles by Keith Eric Grant, PhD, NCTMB.


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