Multiple Sclerosis (MS)

MS is an idiopathic nervous system disease that affects the spinal cord and brain. It damages materials that surround and protects nerve cells, known as the myelin sheath. This damage can block or slow down messages between the brain and body.  MS symptoms can include:

• Visual disturbances
• Muscle weakness
• Incontinence issues
• Trouble with coordination and balance
• Sensations such as numbness, prickling, or "pins and needles"
• Thinking and memory problems

Not all MS patients have these symptoms.  MS is symptomatic from patient to patient, and symptoms can vary.

No one knows what causes MS. It may be an autoimmune disease, which happens when the immune system attacks healthy cells in the body by mistake. Multiple sclerosis affects women more than men. It often begins between the ages of 20 and 40. Usually, the disease is mild, but some people lose the ability to write, speak, or walk.[i]

Advisements to provide massage or bodyworker service include: allow extra time for a MS client.  Depending on the severity of their disease and/or length of their service appointment, they may have to use the bathroom frequently, have trouble sitting down, standing up or moving, have communication problems, etc.  Do not work on any areas where the client has numbness or cannot feel.  Check with their physician for additional instructions or directions.

To learn more, please register for quality, affordable, professional training at: https://ceinstitute.com/

[i] U.S. Department of Health and Human Services. “Multiple Sclerosis | MS.” MedlinePlus, U.S. National Library of Medicine, 30 Apr. 2018, medlineplus.gov/multiplesclerosis.html.

Parkinson's Disease (PD)

Parkinson's Disease is a type of movement disorder. It happens when nerve cells in the brain do not produce enough dopamine.  PD symptoms begin gradually, often on one side of the body. Later in more advanced disease, it will eventually affect both sides of the body. Symptoms can include: 

• Trembling of hands, arms, legs, jaw and face
• Slowness of movement with muscle stiffness plus poor balance/coordination

As symptoms get worse, people with the disease may have trouble walking, talking, or doing simple tasks. They may also have problems such as depression, sleep problems, or trouble chewing, swallowing, or speaking.

Allow extra time to work with someone who has moderate or advanced PD.  While there are few contraindications to work with PD clients, they usually do require extra patience and time.  And as always, ask the client’s physician for any special precautions or considerations for their medical condition.

To learn more, please register for quality, affordable, professional training at: https://ceinstitute.com/

Many massage therapists and bodyworkers see their service as healthcare practice, and tipping is not normal in most medical settings.  This creates a lot of debate whether massage therapists should accept gratuities.

To answer the question of accepting tips, ask yourself:  do you consider massage to be healthcare or service?  Most therapists will find it is both.  Massage is often provided as a personal healthcare service.  This places massage in two separate categories where tipping is accepted in service but not practiced in healthcare. So what’s a therapist to do seeing the healthcare and service industries have opposite tipping practices?

I probably would not accept tips if I worked in a medical setting where I applied bodywork on clients of my choice at my office, weekdays only, Monday through Friday, between 9 am to 5 pm during normal business hours.  But, most massage therapists do not operate within this healthcare business standard.  Most massage therapists accommodate their clients with selfless acts of service. 

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

• Do you often work outside of regular business hours, sometimes providing appointments as late as 9 pm or later at night and most 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 provide whatever type of appointment a client wishes over the type of bodywork that you would prefer for that client?

Our massage therapy service standard usually places a client's personal wishes and directions first. That in itself is service. And it’s the service industry where tipping is normal practice. 

I personally accept tips because of the level of service that I provide for my massage appointments. One way a client cab show their appreciation for my level of service is through gratuities. Their gratuity seems like a fair exchange to compensate for the level of service that I provide when the massage is entirely facilitated at their direction.

Now ask yourself, does your massage practice lean towards healthcare or service? These questions have been provided to help inspire thoughts to create 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 one. 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.

To learn more, please register for quality, affordable, professional training at: https://ceinstitute.com/

Massage therapists mainly work through communications.  A client will explain what they want from their massage appointment, then the therapist will explain  reasonable available expectations and set goals.  This communication will continue throughout the massage session, when a therapist might ask the client about the pressure or area where they are working, as the therapist continues to move to each new body area, all the way to the end of the session.  No matter how the massage is executed, therapists use extensive communications to regularly execute a successful service.

All of CE Institute LLC's live training includes communications dialogue training. Please speak up and ask the instructor any questions you wish about client communications during your live training, given proper and professional communications are key to a successful practice.

To learn more, please register for quality, affordable, professional training at: https://ceinstitute.com/

This is a OPINION article, written by a longstanding LMT

Massage therapists usually possess excellent communication skills.  Afterall, it's client communications that help contribute to a successful practice. 

Recently however, some massage therapist have been channeling their extensive communications skills in a negative direction when they feel they have been wronged.  This includes ranting on public forums and social media about their industry experiences, in a manner that creates legal liabilities. Even for the cases without legal liability, these examples of public negativity could make a massage client think twice before scheduling their next massage.

It is perfectly normal to seek retribution when one has been wronged.  However, there are some more appropriate channels than others to seek retribution.  In this article, we will address the frequent wrongs massage profession faces, with the corrective action available, and what should be avoided.  In the end, massage professionals should seek corrective actions through appropriate methods and channels to maintain a professional existence.

Massage Therapists Abused by Clients

Massage therapists can be unfortunate victims on multiple fronts.  First, they could be subject to verbal assaults and abuse from clients, solicitating sexual favors and more. This is an unfortunate stereotypical massage industry problem.

There are other clients that may take advantage of a massage therapists kind nature in other ways, with request unreasonable expectations. An example of this would be to constantly expect a therapist to accommodate chronic tardiness without compensation. There are many circumstances where a massage therapist could be exploited by a client.

Massage Therapists Abused by an Employer

Massage therapists can also feel exploited or abused by an employer.  While there are some unreasonable cases where a massage therapist thinks they deserve the majority of appointment income without assuming any business owner risks or expenses, there are other unfair if not illegal scenarios where an employer expects too much of their employee. 

This includes telling a massage therapist they must remain available for work while not compensating the therapist for their availability.  Not compensating a therapist to remain available for potential work time, whether appointments are provided or not, is a possible example of an abusive or exploitive work example - if or when the therapist is not earning minimum wage for their total work  including available on-call time.  States laws can vary regarding employee compensation requirements.  Please check with your own state laws to view  employer compensation requirements prior to assuming that an employer's compensation is unfair or wrong.

Massage Professionals Abused and Demeaned by Vendors, Landlords and More

Massage therapists can face further abusive, exploitive and unfair conduct from landlords, insurance companies, vendors and more - simply due to the fact that the massage industry has had a long-time negative stigma against it as a professional industry. 

For many decades, illegal and illicit services were advertised and offered as "massage".  This makes conducting business as a massage professional difficult at times, when others may view you in a different light, thinking the worst of you or your practice before any opportunity to show or prove otherwise - not that a massage therapist should EVER have to prove themselves to be a professional.

Some insurance companies and landlords will not do business with the massage industry due to this old stigma.  If they do conduct business with a massage therapist, they may hold them to a different standard which is often discriminatory.

Even local boards who license or regulate the massage industry have been abusive. This includes requiring massage therapists to submit to extraordinary endeavors to achieve licensing to practice or work.  Unacceptable abuses have included subjecting massage therapists to STD testing, instructing them to cut holes in their treatment room doors so that an inspector can voyeur their sessions amongst other unreasonable requirements.

Abusive Treatment of Massage Therapists

It is no wonder that massage therapists have taken to social media groups, blogs and other social formats to voice their disgust of long-standing industry abuses.  Unfortunately, this public showing of massage industry negativity may deter patrons from thinking massage is a peaceful, enjoyable experience. 

 What's important to recognize is that LMT's have choices in most massage industry situations.  While a massage therapists may feel trapped in an abusive situation, they usually are not trapped.  A therapist can and should immediately depart an abusive situation to stop further abuse when there is no corrective action available for the abuse.

Inappropriate Massage Therapist Response to Abuse

It is a HIPAA violation to share texted screen shots and other forms of potential or real client communications.  Sharing these communications, whether the client paid for service or not, is a breach of confidentiality and extremely unethical.  Sharing client communications under the guise of trying to "warn others" of a potential abusive client is unacceptable, and does not negate the HIPAA violation.  There is no acceptable reason to share client communications, other than a possible exception where reporting abuse to law enforcement would be required to prevent an eminent risk of harm. A licensed attorney could provide possible exceptions when client communications can be shared.

It is a fairly negative experience for the massage industry for anyone who has experience a problem to publicly rant about their personal abuses or exploitations, especially when this violates client confidentiality or is a one-sided report of the facts .  Patrons seeking massage services may be deterred by the negativity.  Afterall, massage is supposed to a relaxing, stress-reducing experience.  How could peace or something enjoyable be achieved when there is so much negativity surrounding it?  The massage industry today is compiling a massive amount of negative experiences with the use of social media, blogs and immediate communications constantly available to everyone today with a cell phone.

Publicly slandering an abuser via social media and other public formats without formal due process.  They do not call it "airing your dirty laundry" for nothing.  This is usually seen as unprofessional conduct, and could be a possible deterrent for those who many have otherwise wanted to conduct business with you.

Stealing from an abuser is not unheard of.  Some massage therapists may feel unfairly compensated and could steal assets, cash or other properties in an attempt to remunerate themselves.  Any form of theft is criminal and could result in legal prosecution and a possible loss of licensure.  There is no reason available to legally justify criminal theft.

Holding Exploitive and Abusive People Accountable in the Massage Industry

While there are plentiful methods of how a massage therapist could "get even" with an abuser, some of those methods could be quite harmful to unintended parties.

It is vital to hold someone accountable for abuses and negative actions that have been harmful to you or others.  There are many methods and formats available to pursue grievances that could be a positive and productive process, without adding negativity to the situation.  Afterall, we should seek corrective action when we have been wronged - not vengeance.

How to Ethically Respond to Various Abuses

Responsibly responding to negative situations in the massage industry is an ethical responsibility for every professional.

If you are in danger of abuse, extricate yourself from the situation.  If you find yourself in an abusive situation before you were able to extricate yourself - leave the abusive situation immediately.  DO NOT BECOME AN ABUSER YOURSELF by reciprocating abusive behavior towards your abuser.  This will only allow your abuser to feel rightfully entitled about their bad acts towards you when they experience your own bad acts.  Abusing an abuser would likely lessen the character of an actual victim.

It is possible to hold those who abuse massage professionals responsible for their bad acts.  There are many proper channels and methods available to respond to abusive, exploitive, bad acts.

More appropriate channels to hold an abuser responsible would be:

File a police report with law enforcement if you have been solicited to commit a crime, such as provide sexual acts under the guise of payment for a massage therapy appointment.  Solicitation of a crime is punishable by law enforcement, and should be immediately reported to law enforcement to stop the abuse. (Publicly posting your experience on social media with the perpetrator's information is highly unethical and an inappropriate response to this type of crime).

File a complaint with your state's labor department if you feel your employer has unfairly compensated you.  All states have employment labor requirements.  Employers face serious consequences when they are found guilty of violating state labor requirements.  This includes remunerating any compensation owed to staff, plus financial fines and other violations when an employer is caught violating state employment laws which could included withholding payment due to an employee.

File a complaint with the state's attorney general office if you feel a vendor, employer, landlord or anyone else has exploited or discriminated against you professionally.  The attorney general will likely only pursue your complaint when it violates state law - so make sure to learn any state legal requirements prior to filing the complaint - and point out any state laws that you feel were violated in the complaint.

File a complaint with   if you have experienced discriminatory acts against your age, sex, ethnic background,

File a complaint with the FCC, if you have experience almost any abusive or exploitive issue with radio or TV advertising, internet or phone services or staff.

Retain an attorney to represent your interests when you feel wronged.  An attorney can advise you of your legal rights and any potential damages owed with any expenses required to achieve the legal action.

If you do not want to hire an attorney, look at the American Arbitration Association and other mediation services to see if you can privately resolve any differences or damages with another.

If you feel you have been wronged by an attorney or any other licensed professional, file a complaint with their regulatory board. Keep in mind, there could be a hearing if the regulatory board choses to pursue your complaint, and you may be asked to attend or provide additional information for the hearing or action. 

Massage establishments usually have to acquire licensure to operate in the state where they conduct business.  Even if filing a complaint with your state licensing massage therapy board against an establishment or employer does not result in the manner desired, your complaint will put the establishment on the board's radar about your undesirable experience. 

If you do not feel you received a fair response from other regulatory boards, you can report your experience to your state's attorney general office.

Report a bad employment experience on glassdoor.com.  Glassdoor allows for anonymous reports that can be publicly view on its website, and their website also fairly allows an employer to respond to the public complaint.  

If or when all other matters fail, or if you feel you need a more urgent response to your individual situation than what regular professional channels can provide, you could always contact the reputable news media to share your story.  Responsible journalism is supposed to report on the facts without emotion.  Keep in mind that responsible journalism would require an investigation of the facts, and include a response from the accused. While this would obviously be a very public and possible negative display of the massage industry, it is equally important to hold industry abuses accountable - as long as it is a PROFESSIONAL, RESPONSIBLE, TRUTHFUL TWO-SIDED REPORTING of the facts.

Details for Filing a Report or Complaint

When reporting bad acts, try to include as much information as possible, such as the time, date, location and any witnesses to the bad act.  Try to keep it factual and without emotion. You can always share your emotional reactions to the abuse when you are interviewed or at a later time if needed.

Keep in mind that public reports of bad acts may be retained as public records.  Someone may be able to view your report decades from now.  This includes social media rants that a commentator may forget about, until a patron brings it to your attention and asks you about your negative experience.

Be Ethical, Professional and Responsible

Ranting on social media and other public formats is rarely the answer to obtain corrective action or remuneration for when someone has been wronged.  Oftentimes, a bad act will be dismissed when proper corrective action was not engaged.  

Passing judgement of others in a negative light rarely results in a positive outcome.  When conducting yourself as a massage professional, think of the ways you can positively contribute to the profession.  Conducting professional acts will help others view you as a professional person, and likely provide you the respect you deserve.

To learn more about massage therapy and bodyworker ethics, please register for quality, affordable, professional training at: https://ceinstitute.com/

Acne is a noncontagious skin condition that occurs when your hair follicles become plugged with oil and dead skin cells. Blockages, inflammation, and infection can develop deep inside the skin and produce a cyst-like lump within the skin.  

Depending on its severity, acne can cause emotional distress and scar the skin.  In older adults, a sudden onset of severe acne may signal an underlying disease requiring medical attention.[i] 

It is important to note that some instructors teach different “grades” of acne (i.e. Grade I, Grade II, Grade III & Grade IV – or another system).  However, the American Academy of Dermatology states that “…there is no universally agreed upon grading system, and systems can differ greatly between studies…”[ii]

Massage Therapists should never work on or over broken skin.

That means that service or touch should be avoided over facial or body areas that have severe acne break-out.  Not only is the skin broken and prone to infection, but there could be underlying medical condition as well.  Refer a client (with severe acne) to a dermatologist or physician for proper medical care.

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

#massage #massagetherapy #massageprecautions #massagecontraindication. 

[i] Mayo Clinic Staff. “Acne.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 31 Oct. 2017, www.mayoclinic.org/diseases-conditions/acne/symptoms-causes/syc-20368047.

[ii] “Practice Management Center.” Systems for the Grading and Classification of Acne: Recommendations | American Academy of Dermatology, Retrieved on: 25 Apr. 2018, www.aad.org/practicecenter/quality/clinical-guidelines/acne/systems-for-the-grading-and-classification-of-acne.

For many years, we provided phone support and answered questions over the phone which many students stated was hard to find and valuable. We'd have students tell us that we were the only CE provider who answered the phone after calling over a dozen other providers.  We were happy to provide this service; however, it was occasionally abused by students who for example, wanted us to break board policies to issue them CE credit while absent, and that's the reason why they wanted to speak to us by phone instead of documenting such an unethical request in an email.  These calls usually lasted half an hour, or longer, and would end with an upset student not getting what they wanted which was a lose lose for all. It's like they would keep us on the phone for as long as possible thinking we would give-in to their request if they took up a lot of our time, and it started to feel manipulative and abusive when we were trying to be empathetic to their needs. Unfortunately over the years, this has occurred amongst dozens of individuals and has never been a one-time incident. 

We also have had students call upset about their order or transaction, and it would be really hard to extract the info we needed over the phone to help correct an erroneous registration and other issues.  We have regularly endured profanity, name calling, screaming and other atrocities which cannot be continued or tolerated. These are things that customers usually do not write in an email, so emailed communications have felt less abusive for our operations.

We operate a school that provides massively discounted training with a limited staff on razor thin budgets. This does not allow us to spend half an hour or more on the phone with a student who's asking/demanding we break board policies, or sustain verbal abuse from a customer who's upset, usually due to their own errors or attempts to break our school policies and other unethical situations.  As such, terminating phone service has allowed us to increase the professionalism and reduce the strain on our business operations.

Email has also provided a consolidated place to keep all communications stream lined with less room for miscommunication. We usually respond to students email within 24-hours of receipt, and sometimes within minutes. We take great pride in offering the best customer service possible when a student emails us their inquiry.

If you need anything from our school at CE Institute LLC, please email us via the website contact form and we'll be happy to help.  Please note that we do not call students, especially upon request, for the very reasons mentioned above. We do not want to have to increase our class prices to pay for extra staff to take and return phone calls all day, and we'd prefer to keep our communications professional, in writing and consolidated as well.

We hope to hear from you via email and serve your future educational needs at CE Institute LLC. Thank you!

Spinal Stenosis:

The abnormal narrowing of a passage in the body. Examples include:

• Cervical Spinal Stenosis
• Lumbar Spinal Stenosis
• Foraminal Stenosis
• Aortic Stenosis

There are several surgical options available for  spinal stenosis today.  No amount of massage will create a larger or “better” opening in the spinal canal; however, massage therapy can help relieve pain and irritation for some of the painfully affected or “referring pain” areas.

Lamina:  It is the bone that forms the backside of the spine and creates a “roof” over the spinal cord.

Laminectomy: Is a surgical procedure where a portion of the lamina is surgically removed to release pressure within the spinal column.

Bodywork Precautions & Contraindications for Laminectomy

• Do not apply pressure on laminectomy site
• Pull skin to the left or right of laminectomy scar to perform cross fiber friction techniques (specialized training required)
• Do not work around or over a laminectomy without physician referral and specialized training

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

#massage #massagetherapy #massageprecautions #massagecontraindications

Every client must be able to provide informed consent for each service they request or receive. Informed consent includes telling the client of any possible consequences for the service, including known risks and benefits. The client can only provide consent for the service once this information is understood/shared.

A person who is under the influence of alcohol or drugs is not of legal capacity to provide informed consent, therefore their service would be  contraindicated and inappropriate to provide. This person may exhibit slurred speech, could be off-balance or is unable to make sense of their surroundings, etc.  They are not of “sound mind” to provide consent.

As bodyworkers, we are not able to make medical diagnoses.  Unfortunately, a person exhibiting imbalance, slurred speech, etc., may be having an acute medical episode that requires immediate medical attention.  Regardless of the situation of why a client might exhibit unsteadiness, service can only be provided when an individual can provide informed consent and is competent enough to provide it.

Bodywork, massage, etc. should not be provided to an individual who is under the influence of alcohol or drugs that reduces the client’s capability to provide informed consent. Not obtaining informed consent for a service appointment for any reason would be considered unethical in most to all cases.

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

#massage #massagetherapy #massageprecautions #massagecontraindications