CE INSTITUTE LLC BLOG
Dynamic Cupping Language Has Different Interpretations & Meanings in the Massage Industry
A Case Report Shows a Massage Gun Caused Life Threatening Condition
Massage therapists cannot be replaced by tools or machines. True professional massage requires a human being to administer the appointment. People namely trained therapists, are able to observe the tissue they are massaging to ensure no harm is done.
A 2021 study in the Physical Therapy Rehabilitation Journal from Oxford Academic reported a case of rhabdomyolysis after massage gun use. According to the CDC, rhabdomyolysis "is a serious medical condition that can be fatal or result in permanent disability. Rhabdomyolysis occurs when damaged muscle tissue releases its proteins and electrolytes into the blood. These substances can damage the heart and kidneys and cause permanent disability or even death."
In the case study, a young woman with pain in her thighs received muscle gun treatment from her coach to relieve her pain. This resulted in muscle bruising and a severe case of rhabdomyolysis.
Massage guns have been trendy with increased use. Sharper image has sold thumper devices for years, and within the past decade, the number of massage gun manufacturers and sales have increased. Most notably Mark Whalburg was recently reported to gift a massage gun to one of his movie costars who thought the massage gun was for something other than therapeutic purpose.
Massage guns are fairly easy to apply, except when they are used by untrained professionals. That's because, when a massage gun is used over a contraindicated site, such as the carotid artery or a ruptured vertebral disc, it could likely do more harm than good.
Sports event use has seen perhaps one of the largest massage gun use increases, given it's fast application. Although again, when used by an individual who does not have proper training, a massage gun could be applied incorrectly to soft tissues which could result in medical harm.
The following image is an example of what a massage gun looks like; however, this is not the massage gun nor is it the massage gun brand that contributed to the rhabdomyolysis injury. Below is only an image to provide readers an example of what a massage gun looks like, and there are many different examples beyond this one image:

In the end, massage guns will never replace massage therapists given the real harm that could result with massage gun use. Furthermore, repeated machine compression to a soft tissue could be extremely harmful and result in cases such as rhabdomyolysis.
For now, we continue to recommend massage therapists simply use their hands for massage, and when properly trained, use hot stones and cups for manual soft tissue manipulation. Stones and cups still have to be applied by a trained practitioner who knows where and where not to apply such equipment.
So fear not massage therapists, massage guns will never replace us, unless we're at the time where causing possible and real life threatening harm by using a machine is desirable to replacing a real human being.
To learn more, please register for quality, affordable, professional training at: https://ceinstitute.com/
#massagegun #massagetherapist #lmt #massage #massagetherapy #health #healthcare #mt #manualtherapy #rhabdomyolysis #massagecontraindication #evidencebased
The Difference Between Evidence-Based and Evidence-Informed Massage Practices
by Selena Belisle, Founder/Instructor, CE Institute LLC
Evidence Informed Massage Practices
LMTs can share research and evidence to support the validity of massage work on websites or with clients, such as Swedish massage can be used to treat headaches. That in-part is of an evidence-informed practice when you have that research.
Evidence-Based Massage Practices
Using the actual hands-on massage protocol itself, from the research for any type of beneficial outcome, creates an evidence-based massage practice.
Massage-related Research which includes Machine, Equipment or Product Use
Some massage-related studies use machines, equipment and products because their manufacturers usually have larger budgets to produce research, to demonstrate efficacy for sales.
Practicing massage with manufactured items would require additional information and/or training for manufactured item use and more considerations beyond anything discussed in this article.
Other Variables
There are other variables and considerations that can be applied to define evidence-based and evidence-informed practices. These two explained above are simplified examples for evidenced massage therapy practices.
Practicing Evidence-Informed and Evidence-Based Massage
Sometimes a massage instructor will collect published research study data and provide the information in a neat, consolidated presentation. And there are plentiful industry trade articles available free of charge for LMTs to learn more about research terms and language, on their own.
In Summary
We hope this brief summary helps clarify the difference between evidence-based and evidence-informed massage. You can this and more by registering for training with us at: https://ceinstitute.com/
Evidence-Based and Evidence Informed Massage Practices
by Selena Belisle, Founder/Instructor of CE Institute LLC
All CE Institute LLC hands-on classes are taught from an evidence informed and evidence-based stance. It is important to practice from evidence and research to validate the work itself.
Here are some tips for practicing massage from evidence:
Seek Large Sample Size Research Studies for Use
When using researched protocols for hands-on practice, one recommendation is to review studies with large subject numbers. Following hands-on protocols that are provided to a large control group is preferred to using something practiced in a single case study.
Unfortunately, usually due to budgetary constraints, most massage studies are researched with exceedingly small subject numbers. However, in research, there are other studies called a meta-analysis and systematic reviews. These can collect similar massage studies, regardless of size, to review their data in totality to provide a broader and enhanced picture of results and outcomes from similar studies.
Finding Massage-Related Research
There are thousands of massage-related published studies with valuable information that can be used to improve massage efficacy, notably when using resources such as pubmed.gov. Unfortunately, there are still many massage topics that have not been studied or published yet, and when they are published, they might not provide the specific information you are seeking given there are millions of possible variables.
Do not let this information process frustrate you. Instead, we should all be grateful. There is a massive amount of available information, only seconds away at the stroke of a keyboard, which provides incredible and increasing access for evidence-based practices.
Sometimes you will find rare or unknown information while reviewing research because foreign published studies often fail regular massage keyword searches from language translations. Research can be a lot of fun, but it can also take a lot of time and practice to become efficient in finding what you need, if it is published.
I have spent decades scouring massage-related studies in both journals and online. Seeking usable researched hands-on protocols for evidence-based massage training can be long and hard work. However, it is always worth it when you learn something new.
What to do if a client is not Benefiting from Massage
Sometimes clients may not benefit from massage at all, regardless of research, training, protocols used or hands-on work. Every available method in your bodywork arsenal may not work! If or when this happens, the client could be suffering with an undetected underlying disease causing whatever prompted their reason to schedule their massage appointments.
Massage therapist should refer their client back to their doctor for further medical recommendations when the client is not reasonably achieving mutually agreed massage goals.
How to Learn which Massage Studies are Considered Better Quality
There are many industry trade magazine articles that provide language of how to read or interpret a research study. LMTs can learn much of the language interpretation on their own with these magazines.
We now spend twelve hours teaching about this and more in an evidence-based massage CE course, so there are various opportunities available for practitioners to learn more about how to use research to establish an evidence-based massage. You can this and more by registering for training with us at: https://ceinstitute.com/
Corporate Chair Massage Decreases Pain and Improves Range of Motion
by Selena Belisle, Founder/Instructor, CE Institute LLC
Corporate massage including business onsite chair massage is an incredible benefit for employers to offer, especially during labor shortages. It's the perfect wellness perk. Chair massage has a number of healthy benefits and is likely to boost employee morale and performance.
The following is a 2011 research study to review when considering chair massage at a workplace. The research title of this published study was called: The Effect of a Corporate Chair Massage Program on Musculoskeletal Discomfort and Joint Range of Motion in Office Workers by Polona Kršmanc Šiško, Mateja Videmšek, Damir Karpljuk.
The study stated: “Between the first and the last measurements, a significant increase in range of motion was found for cervical lateral flexion and cervical extension. A significant decrease in Musculoskeletal Discomfort was found in the neck and the upper back.
On-site massage sessions twice per week for 1 month are the most effective interventions (compared to one session or no massage intervention) for decreasing the duration of musculoskeletal ache, pain, or discomfort and for increasing range of motion.”
Readers can purchase and view the study in its entirety at: https://doi.org/10.1089/acm.2010.0400
These are incredible health benefits to achieve during a chair massage. Massage is well known to relieve pain, and this study showed that pain relief was achieved even when the client was massaged in a seated position.
Improving range of motion is also associated as an aid to decrease pain. Improving range of motion may help an employee with their physical function at work as well.
Chair massage is a wonderful way for LMTs to meet new clients. It is great for a quick session during work. It can also be performed clothed so the client does not have to disrobe at work to receive their chair massage appointment.
Licensed massage therapists who want to learn more about how to offer their own corporate onsite chair massage event, or how to practice chair massage itself can register for training with us at: https://ceinstitute.com/collections/chair-massage-event-work
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Professional Massage Therapy, Bodywork and Spa Draping Practices with Sheets and Large Bath Towels!
by Selena Belisle, Founder/Instructor, CE Institute LLC
Massage sheets are supposed to cover a client for warmth, modesty and protection. Massage draping is provided to prevent nudity, excessive exposure and demonstrate a clear and professional line between a massage therapist and client. There is no excuse to provide excess nudity in a professional massage therapy session when the draping itself is supposed to be a physical barrier to prevent it.
Massage Clients Who Do Not Want Any Massage Draping
So what should massage therapists do when a client doesn't want to be draped or use a sheet to cover themselves. Massage therapists and bodyworkers should simply explain to the client that the draping is required as a professional standard and that the service cannot proceed without.
If the client requests to remove their drape after the massage has started, repeat the standard that it is required or that you can terminate the service if the client does not want to be professionally draped.
How to Drape When it's Too Hot
Women who are experiencing hot flashes, or any client who's overly warm can expose their feet, legs and arms to minimize the draping or heat, but removing the draping or using a hand towel should never be an option.
An NFL Player Who Wanted Only Minimal Massage Draping
Recently, there were several massage therapists who publicly complained about an NFL player who only wanted to use a hand towel to drape himself, and he exposed himself to the therapists as well by removing the hand towel. This is unacceptable behavior on the behalf of the client. More so, the practitioner should have never started the service with just a hand towel over a client's genitals.
When a client is draped minimally with a hand towel, there is a larger chance that they could expose themselves, whether it was intentional or not.
A Doctor's Office Experience with Draping
Think about when you go to the doctor's office. Your annual physical might be a lot more violating than a massage! But what does the doctor's office provide you for your invasive exam? Most clients are regularly provided a full paper gown and sometimes even a paper sheet to place on top of your paper gown.
Doctor's could provide paper panties or a small paper towel if that was professional, but it's not. It would be cheaper to give out paper panties or a paper towel but they don't. So why would a massage therapist think it is acceptable for a client to drape themselves with a hand towel when this standard is not practiced anywhere in modern day medicine?
Unacceptable Massage Draping Practice Standards
The NFL player who insisted on only using a hand towel and exposed himself to unsuspecting therapists stated he was allowed to do this with other therapists. And indeed he was. There were massage therapists that spoke up on his behalf, saying they were fine in just using a hand towel. In our opinion, this is an unacceptable standard and practice. Massage therapists need to provide more than a hand towel to provide comfort, warmth, protection and professionalism.
Very large bath sheet towels are acceptable to use as a massage drape. A hand towel is not. Remember, draping is to prevent excess nudity, so proper and professional draping should be practiced at all times.
Draping for a Professional Massage Therapy Session
Draping is provided for professional reasoning. Draping is not a suggestion, nor is it a client dictated protocol. Massage therapists must execute and reliably practice professional draping standards at all times if they want to be seen as massage professionals.
Professional massage therapy draping with a sheet or very large towel should always cover the buttocks, genitalia and the client's chest area. The draping should be large enough to cover the entire client if so desired.
Therapists should only undrape the area that they are working on, and that area should be immediately draped and covered again, once the work has concluded in that area.
The Only Time a Hand Towel Could be Incorporated Into Professional Draping Practices
Practitioners may use a hand towel to work on a client's abdomen when a client is lying in supine position on the treatment table. The hand towel would usually be folded in half long-ways or horizontally, depending on the amount of coverage required. Then the hand towel would cover the client's breast area as the top draping sheet is lowered to expose the abdomen. At no time should the client's breast area be exposed during this draping practice.
Massage therapists should seek additional training if they do not know how to use a second drape such as a hand towel to cover a client's breast while exposing the abdomen.
Business Standards with Draping
Massage therapists can incorporate a draping policy within their massage therapy or bodywork practice. Adding a draping policy will help provide a standard that can be shared with clients if or when they are demanding something different.
Preplanning ahead of time by creating a standard draping policy could help a therapist prevent an awkward situation by simply falling back on the policy. Therapists can always state they are simply following company policies whenever a client wishes for different draping, especially if it feels like the request is for nefarious purposes. Citing a company policy may feel less confrontational or less uncomfortable than telling the client no for other reasons.
If a client continually requests less draping, simply inform them that they are requesting you to violate a company policy, which cannot be done. The only action you have beyond breaking the company policy is to either proceed with the service in accordance with your policies, or to provide no service at all because their request cannot be provided within the company's policies.
In addition to adding a draping policy to your website, a practitioner could also print their draping policy on any standard client intake form or paperwork. Having a standard preprinted policy in writing where it is accessible to the client may help prevent clients from approaching your business for something different than what is professionally practiced.
To learn more, please register for quality, affordable, professional training at: https://ceinstitute.com/
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The Many Uses and Health Benefits for Coconut Massage Oil, Lotion and Cream
by Selena Belisle, Founder/Instructor, CE Institute LLC
There are many claims that the properties of coconuts can help improve digestion and immunity against a host of infections. The chemical constituents with coconuts may also help with various skin problems including psoriasis, dermatitis, eczema and other skin infections or disease.
Coconut massage mediums are usually rich and thick in texture, unless it has been fractionated which is a process where some of the lipids are removed from it's consistency. Fractitionated oil should feel less greasy to a client, and will lessen the chance of clothes or sheets becomes rancid when in frequent contact which can lessen the chance of dryer fires when laundering these linens. However, there will be less glide and possibly even more friction when applying bodywork or massage therapy with a fractitionated coconut oil.
Coconut oil is a great massage medium to make your own salt scrubs or sugar scrubs. These scrubs can be applied to the back, hands, feet or full body. It is recommend to warm coconut oil when making your own scrubs because the oil will change it's consistency from liquify to solidify at 78 degrees farenheit. When it's 78 degrees or above it will liquify. And anything below 78 degrees will allow the oil to solidfy.
Coconut oil and massage mediums can also be purchased in two distinct and separate products. There is processed coconut products and unprocessed coconut products, which are also known as virgin coconut products. Unprocessed or virgin coconut manufacturered products are created without the process of adding any heat during manufacturing.

While providing a massage medium such as coconut oil, lotion or cream can deliver many health benefits for your massage client, it could also feel uncomfortable, especially if the client does not shower after their massage therapy service. Practitioners may want to wipe any excess coconut massage medium with a dry or wet towel from the client's skin prior to the client's table dismount or getting dressed, to prevent the client from staining their clothes.
Always remove all massage mediums including oil, creams, lotions or gels from a client's feet prior to allowing the client to stand. This can help ensure that the client will not slip in their shoes or on the floor when their feet are less slippery. Using a nice hot towel is a wonderful method to remove a massage medium, plus deliver the thermal therapy benefits from the heat itself to a client's feet.
When using coconut massage medium as an oil form, it is best to keep oils in “tinted” amber or cobalt glass bottles. This will help preserve the coconut oil product's shelf life when it is protected from light.
When using oils, they should always be stored in a cool dry dark place at room temperature, anywhere between 50 to 74 degrees Fahrenheit to help prolong the massage medium's shelf life and slow the process of a coconut oil becoming rancid. Coconut oil will be solidified at these storage temperatures. Simply warm the oil to 78 degrees or greater if you wish to use coconut oil in a more liquified form.
CE Institute LLC reviews host oils and essential oils in our aromatherapy courses. Come learn more with us at: https://ceinstitute.com/
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Relieve Pain and More with Almond Oil, Lotion and Cream in Massage Therapy and Bodywork Application
Almond oil is thought to affect human physiology, and has purported benefits to reduce blood pressure. Almond mediums are also thought to provide skin benefits with skin conditions such as eczema and psoriasis. Some even purport that it can relieve muscle pains and soreness. It's no wonder that almond oil is a popular choice for professional massage therapy service.
Practitioners can also find massage products manufactured with almonds in the form of lotions and creams, which may feel less sticky or greasy to the client.

While providing a massage medium such as almond oil, lotion or cream can deliver many health benefits for your massage client, it could also feel uncomfortable, especially if the client does not shower after their massage therapy service. Practitioners may want to wipe any excess almond oil with a dry or wet towel from the client's skin prior to the client's table dismount or getting dressed, to prevent the client from staining their clothes.
Always remove all massage mediums including oil, creams, lotions or gels from a client's feet prior to allowing the client to stand. This can help ensure that the client will not slip in their shoes or on the floor when their feet are less slippery. Using a nice hot towel is a wonderful method to remove a massage medium, plus deliver the thermal therapy benefits from the heat itself to a client's feet.
When using almond in an oil form, it is best to keep oils in “tinted” amber or cobalt glass bottles. This will help preserve an almond oil's shelf life when it is protected from light.
When using oils, they should always be stored in a cool dry dark place at room temperature, anywhere between 50 to 74 degrees fahrenheit to help prolong the massage medium's shelf life and slow the process of an almond oil becoming rancid.
CE Institute LLC reviews host oils and essential oils in our aromatherapy courses. Come learn more with us at: https://ceinstitute.com/
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The Incredible Health Benefits of Olive Oil added to Geriatric Bodywork to Sports Massage
According to multiple sources, olive oil is considered to have anti-inflammatory effects on human soft tissues. This makes it a great massage medium candidate for working with a great variety of clients, from athletes to geriatrics, all of whom may be suffering from inflammation.
Olive oil is also purported to help with heart issues and even help with the prevention of gallstones. In many senses, it truly is a wonderful oil, especially given the fact that it can be used as a food grade substance.
The skin is the largest organ of the body and it does perform absorption, therefore, we should never apply anything to human skin that we cannot orally consume to prevent adding toxins to our bodies.

While providing a massage medium such as olive oil can deliver many health benefits for your massage client, it could also feel uncomfortable or greasy, especially if the client does not shower after their bodywork treatment with olive oil. Practitioners may want to wipe any excess olive oil with a dry or wet towel from the client's skin prior to the client's table dismount or getting dressed, to prevent the client from staining their clothes.
Always remove all massage mediums including oil, creams, lotions or gels from a client's feet prior to allowing the client to stand. This can help ensure that the client will not slip in their shoes or on the floor when their feet are less slippery. Using a nice hot towel is a wonderful method to remove a massage medium, plus deliver the thermal therapy benefits from the heat itself to a client's feet.
Whenever possible, it is best to keep oils in “tinted” amber or cobalt glass bottles. This also helps preserve an oil's shelf life when it is protected from light.
When using oils, they should always be stored in a cool dry dark place at room temperature, anywhere between 50 to 74 degrees Fahrenheit to help prolong the oil's shelf life and slow the process of an oil becoming rancid.
CE Institute LLC reviews host oils and essential oils in our aromatherapy courses. Come learn more with us at: https://ceinstitute.com/
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Safflower Oil Health Benefits in Bodywork or Massage Therapy Treatments
*According to WebMD* and other sources, safflower oil has many purported physiological benefits including:
- Prevent heart disease, atherosclerosis, hardening or arteries & stroke
- Fever
- Tumors
- Coughs
- Breathing problems
- Expectorant to loosen phlegm
- Clotting conditions
- Pain
- Traumatic injuries
- Induce sweating
- Laxative
- Stimulant
- Antiperspirant
Safflower oil is usually light in consistency and available at most grocery stores a food and orally consumable cooking oil. There is some debate with the use of safflower oil, so practitioners should do their research prior to choosing and using any product.

While providing a massage medium such as oil can deliver many health benefits for your massage client, it could also feel uncomfortable or greasy, especially if the client is not showering or bathing after their massage therapy service. Practitioners may want to wipe any excess oil with a dry or wet towel from the client's skin prior to the client's massage table dismount or getting dressed, to prevent the client from staining their clothes.
Always remove all massage mediums including oil, creams, lotions or gels from a client's feet prior to allowing the client to stand. This can help ensure that the client will not slip in their shoes or on the floor when their feet are less slippery. Using a nice hot towel is a wonderful method to remove a massage medium, plus deliver the thermal therapy benefits from the heat itself to a client's feet.
Whenever possible, it is best to keep oils in “tinted” amber or cobalt glass bottles. This also helps preserve an oil's shelf life when it is protected from light.
When using oils, they should always be stored in a cool dry dark place at room temperature – anywhere between 50-74 degrees fahrenheit to help prolong their shelf life and slow the process of an oil becoming rancid.
CE Institute LLC reviews host oils and essential oils in our aromatherapy courses. Come learn more with us at: https://ceinstitute.com/
*Referenced: www.webmd.com/vitamins-supplements/ingredientmono-96-safflower.aspx?activeingredientid=96
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