CE INSTITUTE LLC BLOG

by Selena Belisle, Founder and Instructor at CE Institute LLC

Tuina and Swedish Massage Names

In 1995, I was been certified in the United States as a Massage Therapist at the Massage Institute of New England.  There, in Cambridge Massachusetts, our primary form of full body manual therapy was Swedish massage.  The reason why we call the massage Swedish, is because many of our regular full body massage strokes are attributed to a Swedish physiologist and gymnastics instructor named Pehr Henrik Ling.

I earned my first Traditional Chinese Medicine (TCM) training certifiation at the New England School of Acupuncture, also in 1995.

In 2001, I spent close to a month in China where I trained in Traditional Chinese Medicine (TCM).  This included the massage practice of Tuina, which is also known as Chinese Massage.  Our training was conducted at the Beijing Massage Hospital in Beijing China.

TCM Versus American Massage Consultation

Americans practice sanitation measures between clients. And, we only spend a couple minutes chatting with our clients for a medical intake process prior to working on them.   

In China, patients regularly receive their massage bodywork at an Eastern Hospital.  There, the patient starts off with a consultation and is provided a handkerchief with the hospital logo on it.  The logo is always supposed to face the practitioner when the practitioner touches the patient.  This provides a physical barrier to prevent germ and pathogen transmission, given the hospital practitioners did not wash nor sanitize their hands between clients.  The patients are responsible for laundering their own handkerchief and returning with it for each visit.

Tuina patients were usually afforded a 40-minute or longer health intake process, discussing their diet, sleeping habits, work, family and all internal and external influences to determine their best tuina treatment with TCM.   

In China, they spend a much longer time generating a much greater comprehension of a client's bodywork and health care needs.  This is a major different between American Swedish massage versus tuina practice in China.

Of course, if we all spent 40-minutes or more discussing a client’s needs here in the United States, we probably wouldn’t need so much direction from our client's here in America for massage treatment! In America, our massage therapy is usually practiced as a service-oriented appointment because it is almost entirely client directed.

Different Tuina Business Practices in China

There are health care spas in China where tuina is provided for enjoyment and general well being. 

The Beijing Massage Hospital was for patients seeking tuina and TCM for serious illness and treatment.  That is where I observed tuina provided as a straight-up health care practice. 

We also had tuina practitioners come to our hotel in China for "house call" tuina service.  So, tuina is also practiced as out-call service, similar to the massage therapy in-home service that is practiced here in the United States through the Zeel or Soothe cell phone apps.

What is Tuina?

I would explain Tuina as something that probably feels a little rougher than a basic Swedish oil massage.  Tuina is probably closer in application to sports event massage, where an athlete is invigorated through successive compression maneuvers.  Except, in Tuina, these compression and applications are applied along a client's meridian points instead of trying to influence or stretch anatomical muscles.

Tuina is performed on a treatment table similar to how we practice here in the United States, although most Tuina bodywork is performed dry and through clothing. And at the hospital, it was provided through an additional physical barrier which is the handkerchief which was moved around the client to each new area worked.

There were also a couple of tables that were used for trampling with tuina.  These trampling tables had parallel bars about three feet higher than the table, running parallel to the table.  The practitioner would stand over the client and hold onto the parallel bars to administer the tuina treatment through their clothing with their feet. 

The two other primary forms of health care that was administered at this Beijing Hospital were room temperature foot soaks for herbal plant-based medicinal absorption and fire cupping.

Massage Health Care versus Client Directed Massage Service

Another difference with how tuina massage is applied in China, is that it is not a client directed service.  It is practiced more along the lines of a health care treatment instead of health care service.  In the United States, a massage appointment is almost an entirely client directed health care service.

The Beijing Massage Hospital patients received tuina as needed, where dozens of TCM doctors performed hundreds of hours of massage each day.  Tuina was one of their primary forms of healthcare in their eastern medical treatment arsenal. 

The patients had little to no say about how their massage or TCM was executed at this hospital.  It was the practitioner, who was also a doctor, who decided where they would work, how long they would work, with how much pressure and various techniques they would apply.  Of course, the doctor did not apply harmful techniques, but the massage treatment itself was not directed by the patient.  And these patients lined up out the door and down the street for that level of healthcare during normal business hours. 

Practicing tuina in this setting was extremely rewarding as a health care provider, because we regularly achieved the greatest measurable outcomes of medical benefits.  Tuina in China was not provided as a service-oriented massage, but it was a health care treatment.  

Medically Directed Massage Therapy Application

There are hospitals in China that administer surgeries and pharmaceuticals similar to what is practiced in America and other modern countries, however, they did not have the lines of patients waiting down the street similar to the hospital where we trained in and executed tuina in China.

The notion of practitioner-directed massage healthcare practice is not exclusive to China. I have reviewed similar massage healthcare practice examples in Denmark and other developed countries where the medical treatments are directed by the health care provider.

Observing and practicing at the Beijing Hospital left a never-ending impression on me about how different massage practice was here in America versus mainstream massage health care in other countries.  In America, our clients want it their way.  That provides a big difference between how tuina is applied in China versus Swedish massage applied here in the United States.

Swedish massage practiced here in the United States is more service-oriented, where the practitioner follows the client requests and directions while straight-up health care massage practiced in China is usually directed towards specific medical objectives, beyond a client’s requests or directions.

Which Provides Greater Health Benefit? Swedish Massage or Tuina?

Both tuina and Swedish style massage are valuable forms of health care. While both applications have an individual style and technique, they both have wonderful health benefits.  Swedish massage and tuina both compress the soft tissues which allows for increased circulation, which is healthy in itself.  Both techniques can also increase range of motion and relieve pain by stretching and compressing the soft tissues and more.

The Client Directs the Massage in America, Perhaps with Some Disadvantages

The educational point shared here, is that when massage is practiced in China, it is regularly practiced as an integral part of health care, whether the doctor's chose the style and application of the bodywork, especially when this is administered in a hospital setting.

In America, the client usually chooses where to work, when to work, how long to work, and they might even choose if they prefer oil, lotion, cream, scented or unscented.  There are a lot of customizations and service-oriented goals that are applied with massage therapy practice in America.  And while some of those service-orientations may be valuable to a client, these clients may be best served when the practitioner has more say in their actual treatments.

Massage Therapy in all Forms is Health Care

All forms of massage are generally healthy, so there's usually no harm unless your client is asking you to do something that is contraindicated.  But oftentimes, a practitioner might be able to do more when the treatment is left to a practitioner's discretion. 

There are many times that a treatment could have been more successful if a practitioner was allowed to spend a little more time in an area, or focus on a different area than what the client had requested in massage appointments regularly practiced in the United States. For example, many clients who experience upper back pain have rounded shoulders.  As such, it's the muscles that are contracted in the front or anterior shoulders that are shortened and contracted, and need a greater amount of elongation work.  The focus of the treatment should be in the front, or anterior side of the body. 

However, in the United States, clients will often want their therapist to work where there pain is, in the back, which is not doing much more than providing temporary pain relief.  What a practitioner really should do is work the front of the shoulders while the client strengthens their back muscles so that they can correct their posture, hence eliminate the factor that is causing their pain.  This is working towards a more permanent treatment plan rather than a temporary one. 

In China, the practitioners would attempt to improve a client's overall well-being.  But in America, we usually just do whatever the client wants, whether it appropriately addresses their issue(s) or not.

Having the discretions to work where it might be needed most makes a big difference in successful medical outcomes with therapeutic massage, regardless of the massage style practice.

#massage #bodywork #bodyworker #massage #massagetherapist #mt #LMT #swedishmassage #tcm #tuina #chinesemassage #americanmassage #massagetherapy #swedishmassage #healthcare #medical #medicalmassage #healthcaremassage

Massage as a Health Care Service

Many massage therapists and bodyworkers view their work as health care practice, and tipping is not normal in most medical settings.  To start, we should be clear that massage therapy is health care.  In fact, massage can be used in both preventative and rehabilitative health care management which doubles its viable application. Even if a client schedules a massage on vacation for enjoyment purposes, the increased circulation and other healthy therapeutic benefits achieved in massage practice cannot be avoided.  Massage provides health care by almost any basic standard.

To answer the question of accepting tips, ask yourself:  do you consider your massage to be health care or service?  Most massage therapists will find it is both.  This places massage in two separate categories where tipping is accepted in service but not practiced in health care. This is what creates the dilemma.  How does a practitioner navigate tipping practices and policies when they simultaneously operate in two opposite worlds?

Is Your Massage Straight-up Health Care? Or is it Health Care Service?

Here’s an example of massage practiced as health care without a service-oriented approach: working in a medical setting where the practitioner applies therapeutic touch to achieve the best health outcome, at a health care office, weekdays only, Monday through Friday, between 9 am to 5 pm, during normal business hours.

A large element of service can be extracted from massage health care practice.  I am not suggesting that anyone should extract their service element but it can be done.  And it is your service element that should be considered if you are questioning whether or not you should accept tips, because it’s the service industry where tipping is normally accepted and practiced.  Providing a service element with your massage is commonly accepted and expected as an American standard. 

What Massage Looks Like When it is Executed with Service

Massage therapy service standards usually place a client's personal wishes and directions first. That in itself is service. And it’s the service industry where gratuities are normally exchanged. Accepting gratuities does not make you any less of a health care provider.  Its simply acknowledging that you are providing a high level of service with your health care.  

The following are some questions to help determine the level of massage therapy service provided. The more you answer yes to these questions, the greater level of service you are likely providing with your massage:

• Do you often work outside of regular business hours, sometimes providing appointments as late as 7 pm or later at night or on weekends, giving up valuable personal time with your friends and family to serve your customers' wishes and needs?
• Do you accommodate last minute emergencies, making a choice to cancel your plans to care for someone else's?  Massage therapists often serve their client's needs first because they recognize that their client reciprocally pays for their plans.
• Have you worked in temperatures or spaces that you would not find comfortable, to keep a client comfortable?
• Have you hauled massage stones or acquired other equipment to provide better service without charging extra for it?
• Do you offer a client a choice of working with oil, lotion, gel, cream, aromatherapy or anything else they desire?
• Do you provide whatever type of appointment a client wishes over the type of bodywork that you would prefer for that client?

These questions have been provided to help inspire thoughts to create your own tipping policies. Now ask yourself, does your massage practice lean towards a high level of service? Or is it a straight-up health care operation with normal weekday business hours and best medical objectives practiced at all times? 

Do No Harm While Providing Massage Service

All forms of massage are generally healthy, so there's usually no harm unless your client is asking you to burn them with rocks or apply more pressure than they can tolerate or lie prone and flat on the table while nine months pregnant.  As long as you’re practicing within normal service standards, there’s little harm that can be achieved through quality therapeutic massage or bodywork.

While its difficult to do harm with proper practice, there are many times that massage therapists do less satisfying work, not from our own volition but because of our client’s choices, and because we regularly provide our massage appointments as a service-oriented business.

Providing Massage Service Instead of Practicing for Best Medical Outcomes

There are times that a client does not want to receive the bodywork that I believe would be in their best medical interest, such as deep cross fiber friction to break-down scar tissue.  Instead, some of my clients have preferred a good foot rub or nice oily back massage.  All of this is health care, but I feel like I am providing more service-oriented treatment when I practice what the client wants instead of fulfilling what I think would be best for their medical needs. 

Of course, best medical outcomes with massage therapy could be highly subjective.  For example, some clients would prefer a nice relaxing generic full body Swedish massage when they are in pain because of their bad posture.  It would probably be best to try to improve their posture with more technical bodywork, but instead the client has chosen a different form of massage to temporarily mask or relieve their pain. 

Most of the time I would prefer to work for best medical outcomes that can be achieved with highly technical bodywork, but to provide the best service, I'll explain my bodywork recommendations, and then I'll let the client choose whatever type of massage they would like to receive.  That is providing a service.

Accepting Tips for Massage Therapy Health Care Service

My clients have recognized the many selfless contributions I have made to provide them exceptional health care service and they appreciate it. One of the ways they show their appreciation is through gratuities. And yes, I accept them, graciously.  I appreciate them.  Their tips are one of the rewards I receive for a lot of selfless work that could be easier or more rewarding, but sometimes it is not. 

I answered yes to the list of questions above, often working outside of regular business hours, following a client’s requests at all times I can reasonably provide them, and as long as I do no harm with their service directions. Their gratuity seems like a fair exchange to compensate me for my level of provision and service.

Setting Your Own Tipping Policies

Tipping policies are a personal decision that each therapist must make for themselves. There is no massage industry tipping standard nor should there be. If you work for an employer, hopefully your attitude regarding tipping matches theirs.  And just know that there is no wrong or right answer about accepting tips.  This is a personal decision that must be made in a manner that aligns with your practice and best serves you.

___________________

This article is written by Selena Belisle, the founder and one of the instructors at CE Institute LLC in Miami, Florida.  There, they teach massage, nursing and cosmetology industry CE courses. Selena has been practicing massage therapy and bodywork for over 30 years. She is approved as a continuing education provider by many industry state boards and the National Certification Board for Therapeutic Massage & Bodywork.

#massage #bodywork #bodyworker #massage #massagetherapist #mt #LMT #tip #tips #gratuitites #massagebusiness #massageservice #healthcare #medical #medicalcare #serviceindustry #tipping

Massage Today Magazine recently asked readers what they felt about HYBRID EDUCATION.  Hybrid education for massage therapists could be taking your hands-on training in-person after you've completed your science and theoretical education online. 

We have asked NCBTMB to approve this method of training for over five years, but the answer has always been no.  The reasoning I have always been provided is that because universities and colleges were not providing or authorizing hybrid education, they couldn't either.  They said they wanted to follow mainstream education models and hybrid education was not there, yet. 

Since the pandemic, a lot of online learning has become the new normal.  And while we do not feel massage should be taught exclusively online, especially for those who wish for in-person hands-on training, we feel a hybrid model of learning the "book work" at home is long overdue.

Here is our response which Massage Today Magazine has printed:

We're going to offer hybrid education whether it's board approved or not. We'll provide two different continuing education classes and certificates if that is what is required to provide hybrid schooling. One class will be an online class/certificate while a second class will have the in-person class/certificate.

This will likely lead to student confusion plus an advertising and registration nightmare, but hybrid education must be part of today's educational model. And if the boards can't keep up with the times and offer legitimate approvals for reasonable training models, then we'll do whatever we have to do to offer it—which includes the example as provided above (offering both a hybrid option and in-person option).

We will explain to students that the boards require us to offer separate classes because they are not providing us an option to offer hybrid-approved training. This will likely lead to an unfavorable opinion of the boards and regulatory authorities who are not keeping up with the times of online education and offerings.

 You can review the full magazine article by clicking HERE.

#massage  #bodywork #bodyworker #massage #massagetherapist #mt #LMT #amta #massagetoday #education #training #hybrid #hybridmodel

To all of our loyal FL LMT students and new prospects!

CE Institute LLC has always been dedicated towards providing quality affordable education, and the 2023 Florida License Renewal Period will continue the same!

 We are in the works to provide these limited time offers:

24 CE FL License Renewal Prerecorded Training/Self-Paced Course for $99

24 CE FL License Renewal Live Interactive Webinar with Self-Paced Mandatory Training Course for $150

We also have new materials coming for the 2023 license renewal year!  These include:

• 18 CE Sports Massage with Active Assisted Full Body Stretching
• 12 CE Evidence-Based Massage & Bodywork
• 12 CE Chair Massage & Onsite Event Work
• 12 CE Active Assisted Full Body Stretching
• 12 CE Ayurvedic Poultice & Shirodhara Bodywork
• 12 CE MLD Arms & Leg - Acute & Chronic Routines
• 12 CE Advanced Geriatrics and Seniors Massage and Bodywork
• 12 CE Advanced Medical Foot Massage with Active Assisted Lower Body Stretching
• 12 CE Chair Event Massage with Active Assisted Upper Body Stretching
• 12 CE Chair Event Massage with Trigger Point Therapy
• 12 CE Foot Reflexology with Chair Event Massage
• 12 CE Sports Massage with Active Assisted LOWER Body Stretching
• 12 CE Sports Massage with Active Assisted UPPER Body Stretching
• 6 CE Active Assisted Lower Body Stretching
• 6 CE Active Assisted Upper Body Stretching
• 6 CE Chair Massage
• 6 CE Shirodhara Head & Scalp Treatment
• 6 CE Ayurveda Indian Poultice Bodywork
• 6 CE Ayurveda Foot, Face & Head Marma Massage
• 6 CE Sports Event Massage for Online Training

These new training options will be made available for sale by the Fall of this year, 2022.

If you have any questions about your training with us, please email us at info@CeInstitute.com.  Please note that offering this type of training requires special board approvals with we have obtained; however, we cannot answer questions about training with other providers outside of our school given not all are approved to provide this type of training.  Thanks!

Trigger Point Therapy Injections, also known as a TPI, are applied when a healthcare professional inserts a small needle into a trigger point.

WebMD reports:  "The injection contains a local anesthetic or saline, and may include a corticosteroid. With the injection, the trigger point is made inactive and the pain is alleviated. Often, a brief course of treatment will result in sustained relief. Injections are given in a doctor's office and usually take just a few minutes. Several sites may be injected in one visit. If a patient has an allergy to a certain drug, a dry-needle technique (involving no medications) can be used."

To provide trigger point therapy, we would prefer manual hands-on application instead of the more invasive use of needles which risks infections, allergic reactions to injected substances or more.  However, if your client receives a TPI and then seeks manual therapy from you afterwards, the manual service such as massage therapy could be temporarily contraindicated.

Massage, trigger point therapy and any other hands-on manual service would be contraindicated immediately after a TPI because of broken skin. Skin must be whole and intact prior to manual application to prevent infection and infection causing disease. 

Please also keep in mind that there could be blood exposure on the skin on the same day as injectable application.  Blood exposure is another service contraindication, especially on the day of service when the client's skin has been punctured by a needle.

Providing massage or other bodywork services is usually acceptable depending on WHEN the TPI is provided. Services immediately AFTER a needle injection in the affected area are generally contraindicated due to broken skin, however, manual services such as massage therapy or bodywork should be acceptable to resume once the skin has healed.

If you're concerned that your bodywork or other service could interfere with the client's injections, you should contact the client's TPI provider to discuss this more with them.

To learn more, please register training with us at:  https://ceinstitute.com/collections/trigger-point-therapy

#tp #triggerpoint #triggerpointtherapy #injections #contraindication #massagecontraindication #serviceprecaution #bodywork #bodyworker #massage #massagetherapist #mt #LMT

Providing massage, facial, bodywork, cosmetology appointments and more direct hands-on contact over tissues that have cosmetic fillers is CONTRAINDICATED. 

One of the reasons why manual services over cosmetic or dermal fillers is contraindicated is because of something known as shifting or migration.  

While there are few published articles that have been written about cosmetic injectable shifting, our anecdotal experience has seen a significant increase of clients who are suffering from shifting and migration of cosmetic injectables, which can cause pain, swelling, physical disfigurement, obstruction of circulation and even death.

When a practitioner manipulates soft tissue over an injectable, the practitioner could be blamed for shifting the filler away from its original placement site. While the chance of this happening might depend on the technique and force used with hands-on application, it is an incalculable risk for the potential of client injury or lawsuit. Any injectable failure due to shifting could be blamed on a practitioner who has physically manipulated the affected area, which is one of the reasons why we label cosmetic fillers as a service contraindication for any hands-on manipulation in the affected area.

Some practitioners have chosen to work over a filler with the physician's written direction and consent; however, the practitioner provides their work at their own risk knowing that working over cosmetic fillers is a general  service contraindication.  If you do chose to work with cosmetic fillers with these written approvals, know that it is additionally contraindicated to provide massage, facial, bodywork, cosmetology appointments and other services that have direct contact over the broken skin where any filler has been applied with needles on the same day as application. Skin must be whole and intact prior to working over the direct area to prevent infection and infection causing disease.

Please also keep in mind that there could be blood exposure on the skin on the same day as injectable application.  Blood exposure is another service contraindication, especially on the day of service with cosmetic fillers.

There are many different types of cosmetic fillers on the market today.  The FDA has recently approved some dermal fillers that have a temporary effect, because some of these fillers contain materials that are absorbed by the body over time.

Silicone injectables are an example of fillers used that are not approved by the FDA because they are permanent and remain within the body. The FDA warns: “It can move throughout the body and cause serious health consequences, including death. In fact, when injected into areas with many blood vessels, such as the buttocks (butt), silicone can travel through those vessels to other parts of the body and block blood vessels in the lungs, heart, or brain. This can cause a stroke or even death.”[i]

To learn more, please register training with us at:  https://ceinstitute.com/

[i] Commissioner. “Caution: Injectable Silicone and Dermal Fillers for Body Enhancement.” 19 Nov. 2021, U.S. Food and Drug Administration, FDA, https://www.fda.gov/consumers/consumer-updates/fda-warns-against-injectable-silicone-and-dermal-fillers-large-scale-body-contouring-and-enhancement. 

#lymphaticfacial #mld #filler #cosmeticfiller #injections #MLD #manuallymphaticdrainage #lymphaticdrainage #bodywork #bodyworker #massage #massagetherapist #mt #LMT #lymphedema #postsurgical #cosmeticsurgery #plasticsurgery #swelling #edema #facial #cosmetology #cosmetologist #spa #salon #makeupapplication #esthetics #esthetician

by Selena Belisle, Founder/Instructor, CE Institute LLC

Providing massage, facial, bodywork, cosmetology appointments and other non-invasive services is usually acceptable depending on WHEN this service is provided. Massage, facial, bodywork, cosmetology appointments and other hands-on services immediately AFTER Botox application is contraindicated.

It is contraindicated in most massage, facial, bodywork, cosmetology appointments to work directly on broken skin.  According to WebMD:  "Getting Botox takes only a few minutes. You won’t need anesthesia. The provider uses a small needle to inject Botox into specific muscles with only minor discomfort."

According to Medline:
Botox is a drug made from a toxin produced by the bacterium Clostridium botulinum. It's the same toxin that causes a life-threatening type of food poisoning called botulism. Doctors use it in small doses to treat health problems, including:

• Temporary smoothing of facial wrinkles and improving your appearance
• Severe underarm sweating
• Cervical dystonia - a neurological disorder that causes severe neck and shoulder muscle contractions
• Blepharospasm - uncontrollable blinking
• Strabismus - misaligned eyes
• Chronic migraine
• Overactive bladder

Botox injections work by weakening or paralyzing certain muscles or by blocking certain nerves. The effects last about three to twelve months, depending on what you are treating. The most common side effects are pain, swelling, or bruising at the injection site. You could also have flu-like symptoms, headache, and upset stomach. Injections in the face may also cause temporary drooping eyelids. You should not use Botox if you are pregnant or breastfeeding.

The Broken Skin Contraindication with Botox or Dysport Application
The majority of botox service is not provided with a singular needle application. Botox providers may insert needles in a dozen different placements and more based on the areas where a client wishes for treatment. This could create multiple areas of broken skin with these needle injections.

It would be contraindicated to provide massage, facial, bodywork, cosmetology appointments and other services that have direct contact over the broken skin where botox has been applied with needles on the same day as application.  That is because the skin is broken, and it will take some time for the skin to heal and proliferate before hands-on services will no longer be contraindicated.  The skin is usually healed within a day or two from needle punctures; however, each client heals in different time frames.  Simply make sure the skin is intact prior to providing hands-on service to the affected area.

Massage Contraindication: Blood Exposure with Botox or Dysport Application
Please also keep in mind that there could be blood exposure on the skin on the same day as Botox application. Blood exposure is another service contraindication, which is why the skin must be healed and intact prior to massage and other appointment services.

The main concern of working with Botox is the broken skin that results with application.  However, if you're concerned that your bodywork or other service could interfere with the client's injections, you should contact the client's Botox provider to discuss more with them.

To learn more, please register training with us at:  https://ceinstitute.com/

#lymphaticfacial #mld #botox #injections #MLD #manuallymphaticdrainage #lymphaticdrainage #bodywork #bodyworker #massage #massagetherapist #mt #LMT #lymphedema #postsurgical #cosmeticsurgery #plasticsurgery #swelling #edema #facial #cosmetology #cosmetologist #spa #salon #makeupapplication #esthetics #esthetician

Infestation is the presence of an unusually large number of insects, parasites, rodents, pests, etc. - in one place, typically so large that it could cause damage or disease.  An infestation could result in fines, bad press, unsanitary work and appointment service conditions plus it could close your massage or cosmetology establishment until the infestation has been eliminated - so it's best to try to prevent this from happening in the first place.

Some of the best ways to prevent against infestation is to eliminate food sources.  Empty trash regularly and use thick plastic or metal garbage cans (with tight lids).  Keep trash cans at least one foot off the floor. 

Helpful tips to prevent infestation are to seal any gaps or holes where pests could gain access in the workplace.  The CDC recommends[i] to seal gaps and holes with “steel wood” then caulk around the steel wood.  Just be sure that you do not block access to vital air supply, ventilation, water drainage or other important access areas for your practice. A licensed rodent control professional can help with this process.  Consider areas such as:

• Inside, under, and behind work stations, mirrors, hot towel cabis, furniture and appliances
• Inside closets near the floor corners
• Around windows or doors
• Around the pipes under sinks and washing machines (this includes around pedicure tubs)
• In laundry room floor drains
• Around the pipes going to hot water heaters and furnaces
• Around floor vents and dryer vents (check any fans used for manicure or pedicure drying)
• Inside the attic or basement
• Between the floor and wall juncture
• Around holes for electrical and other utility lines

Being clean and sealing up are some of the best ways to prevent infestation!

To learn more, please register for training with us at:  https://ceinstitute.com/

[i] “Rodents.” Centers for Disease Control and Prevention, 29 July 2010, www.cdc.gov/rodents/prevent_infestations/seal_up.html.

#cosmetology #nailtechnician  #salon #spa #business #massage #massagetherapy #massagetherapist #bodywork #bodyworker #lmt #massageestablishment 

Avoiding, eliminating and reducing the amount of germs at work or anywhere could help prevent illness and disease. Pictured above are protozoa.  Protozoa are one of the four common groups of germs that include:  Bacteria, Virus, Fungus and Protozo.

The following are some of the most common methods of how germs are transmitted from one individual to another.

1. Direct Contact: when body fluids are directly transferred from one person to another. Examples of direct contact consist of providing massage, spa or cosmetology services with an infected individual. 

2. Droplets: when secretions fly out of noses and mouths (when we sneeze, cough, spit, drool, slobber, or vomit) into the air and then land on a hard surface or are inhaled by another person.

• Droplets can fly only a short distance (such as a sneeze). If these human droplets land on another’s eye, nose, or mouth they can spread disease.
• Germs can also be spread when we touch droplets (from another person) that land on a surface like a table and then touch our own eyes, mouth, or nose before washing their hands.
• Most of the germs that can be spread by direct contact can also be spread by droplets.
• Germs that can spread by droplets are more contagious than germs that require direct contact. When an infection can spread between people that are only near each other, the infection is more contagious. Diseases caused by viruses and bacteria can be spread this way.
• Fungi and parasites are not transmitted by droplets.
• Germs live longer on stainless steel, plastic, and similar hard surfaces than they do on fabric and other soft surfaces. Germs also live longer when the surface is wet and dirty. Food and water on a surface provide germs with all they need to survive and multiply! When droplets land on a hard surface like a table or a doorknob, the viruses in those droplets can live several hours or more. Bacteria can live for even longer.

3. Airborne Transmission: when germs float suspended in the air attached to small droplets or dust particles and travel more than 3 feet.

• Airborne germs can travel across a room, down a hall, into a ventilation system, to another floor, or even from one building to another where another person can breathe in the germ.
• Germs that spread by airborne transmission are the most contagious of all. We can inhale them deep into our lungs where they can cause more serious illness. Disinfecting doesn’t help with the spread of these kinds of illness.
• Luckily, not very many germs can travel this way. Those that do are difficult to control. For example, the viruses that cause chicken pox and measles are spread by airborne routes. Nine out of ten unvaccinated people who breathe the air of a person infected with chicken pox or measles will get sick. Cleaning and disinfecting will not prevent air-borne illnesses. This is why vaccination is so important. It is the one of the few ways we have available today to protect ourselves from these extremely contagious diseases.

4. Fecal-oral Transmission: when germs in stool from one infected person make their way into the mouth of another person. These germs usually cause vomiting and diarrhea.

• This happens most commonly when infected people don’t wash their hands after using the bathroom.
  • When dirty hands touch food, the germs from that person’s stool are transferred to the food. When that food is eaten by someone else, the germs enter their body and they can get sick.
  • When dirty hands touch surfaces or objects, the germs are transferred there. When another person touches those same surfaces, he gets the germs on his hands. If he eats or puts his hands in his eyes, nose, or mouth without washing them, the germs get into his body and can make him sick.
• Infections from animals can also be spread this way. For example, reptiles and rodents have caused Salmonella outbreaks. They also carry germs on their skin which can cause illness through direct contact.
• Some common viruses, including Hepatitis A, Norovirus, and Rotavirus, are spread through fecal-oral routes. They may also be spread by droplets that are produced when a person vomits – this makes them very hard to prevent!
• Handwashing is our best defense against germs spread by the fecal-oral route!

5. Blood: when an infected person's blood enters another person's body through a break in the 2^nd person’s skin. Many of the germs that can be found in blood can cause life-threatening disease. However, most blood-borne infections come from infected needles, not from nonmedical workplace hazards.

6. Insect Bites: when an insect transmits bacteria and viruses to humans through their bites. West Nile virus is a disease that is transmitted by mosquitoes, which are insects.

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