Chapter 4 - Tappan's Handbook of Massage Therapy: Blending Art with Science, 6th Edition

4 Physical Skills, Fitness, Self-Care for the Massage Therapist Learning Outcomes • Develop good body awareness • Describe the elements of skilled touch needed by massage therapists • Summarize the basic elements of physical fitness • Evaluate your overall level of physical fitness • Explain how body–mind practices develop coordination • Improve concentration through meditation • Plan a personal stress-management strategy • Create a time-management plan • Describe the basics of good nutrition • Develop a holistic self-care program Lecture Outline I. The Physical Side of Massage A. Requires body awareness, touch skills, physical fitness B. Good physical condition necessary to perform massage C. Good physical condition helps prevent injuries II. Body Awareness A. Definition 1. Ability to sense where the body is in space while at rest and in motion 2. Ability to coordinate movement with mind 3. Integration of body and mind—embodied being B. Lack of body awareness 1. Difficulty following instructions for good body mechanics and for performing techniques 2. Not “in their bodies” C. Developing body awareness 1. Benefit of receiving massage and bodywork 2. Developed over time by moving and paying attention to its feel kinesthetically D. Center 1. Point of organization from which being and movement occur 2. Point at which the body is balanced from top to bottom, front to back, and left to right—center of gravity 3. Dan tian in traditional Chinese medicine a. Located about 1.5 inches below the navel and one-third of the way from front to back b. Called hara in Japanese 4. Develop sense of “center” with tai chi stance and walk [Show Figure 4-1: Tai chi stance] [Show Figure 4-2: Tai chi walk] E. Ground 1. The firmness of the earth 2. Establishing a connection to the earth through the legs and feet—grounding 3. Energy for movement comes up from the ground through the legs, into the center, and then into the upper body III. Skilled Touch A. Skilled touch essential for success as massage therapist B. Four dimensions of skilled touch in massage [Show Figure 4-3: Good contact feels full, confident, deliberate] 1. Contact a. Good contact feels full, confident, deliberate, warm b. Poor contact feels tentative, hesitant, unsure, fearful, nervous 2. Qualities of touch a. Vary from soft and gentle to hard and rough b. Quality may vary from client to client 3. Communication a. Achieved through contact and quality of touch b. Before, during, or after massage session c. Caring, but not personal, sexual, or aggressive 4. Palpation a. Sensing information about the client 1) Through touch 2) By the feel of tissues and movement at joints b. Palpatory literacy 1) Ability to locate specific anatomical structures 2) Ability to detect normal and abnormal conditions IV. Physical Fitness A. Reasons to maintain good physical fitness 1. Role model for clients 2. Avoid stress and strain on the body 3. Understand clients’ needs better [Show Figure 4-4: Physical fitness profile form] B. Cardiovascular fitness 1. Resting heart rate (RHR) a. Find pulse at wrist or lateral neck b. Count the number of beats per minute c. Normal: 60–80 beats per minute 2. Blood pressure a. Measured with blood pressure machine, sphygmomanometer b. Two numbers (e.g., 120/80) 1) Diastolic pressure—pressure of the blood on the vessels when the heart contracts 2) Systolic pressure—pressure on the blood vessels between beats c. Hypertension 1) BP over 140/90 2) Can lead to serious health problems 3. Cardiovascular endurance a. Heart’s capacity to keep up with a certain workload and to recover afterward b. Simple test: three-minute step test [Show Figure 4-5: Step test for cardiovascular endurance] c. CV endurance improved by vigorous exercise for at least 30 minutes 5 days per week d. Developing CV fitness [Review Reality Check, p. 83] C. Muscular strength and endurance 1. Muscular strength—muscle’s ability to move a maximum amount of resistance once 2. Muscular endurance—the capacity to move against resistance for a number of repetitions over time 3. Simple tests: number of push-ups or sit-ups in 1 minute [Show Figure 4-6: One-minute sit-up test for abdominal strength and endurance] 4. Muscular strength built using resistance bands D. Flexibility 1. Ability to flex or the possible range of movement at joints 2. Normal range of motion measured with stretching exercises or goniometer [Show Figure 4-7: Range of motion at the wrist] 3. Simple test: sit-and-reach [Show Figure 4-8: Sit-and-reach test for overall flexibility] 4. Maintained by regular stretching [Show Figure 4-9 A–F: Stretching exercises for massage therapists] E. Body composition 1. Body-fat percentage 2. BMI (body mass index) a. Compares height and weight b. Calculation: weight ÷ (height in inches x height in inches) x 705 c. BMI categories 1) Underweight (less than 18.5) 2) Healthy (18.5–24.9) 3) Overweight (25–29.9) 4) Obese (30 or greater) 3. Waist measurement indication of healthy body composition a. Women: 32.5 to 37 inches b. Men: 35 to 40 inches V. Self-Care Practices A. Term used by massage therapists to describe how they take care of their own well-being while they fulfill their career goals and are of service to clients B. Body–mind practices 1. Develop fitness, coordination, body awareness, and concentration 2. Require a conscious effort to link how (what) you are feeling to what your body is doing 3. Examples: yoga, tai chi, qi gong, Pilates [Refer to Chapter 25: Asian and Energy-Based Bodywork] [Show Figure 4-10: Pilates exercises strengthen the body’s core muscles] C. Meditation 1. Goals a. Quiet the mind b. Enhance the ability to pay focused attention 2. Good posture for meditation: upright spine, relaxed [Show Figure 4-11: Good posture for meditation is seated in a chair] 3. Meditation forms a. Peaceful abiding b. Quiet sitting 4. Massage therapists focus their thoughts before beginning session 5. Meditation practice [Assign Practical Application, p. 82] D. Stress control strategies 1. Negative consequences of stress overload 2. Stress control plans a. Good time management b. Adequate rest and relaxation c. Anxiety reduction techniques 3. Stress control and time management [Present Critical Thinking exercise, p. 84] E. Time management 1. First step: determine goals and priorities 2. Plot out a weekly schedule [Show Figure 4-12: Sample time management planning chart] 3. Eliminate time wasters 4. Reserve prime time for high-priority tasks 5. Use a daily or weekly planner F. Nutrition 1. Intake of food and drink to nourish the body and mind 2. USDA ChooseMyPlate program [Show Figure 4-13: USDA ChooseMyPlate program] 3. For self-care, not for advising clients (scope of practice) 4. Nutrients—substances in food used by the body to generate energy and to promote normal growth, maintenance, and repair a. Carbohydrates (sugars and starches) b. Lipids (fats) c. Proteins (amino acids) d. Vitamins (organic nutrients) e. Minerals (inorganic substances) f. Water 5. Food—familiar form of plant and animal products that we eat to obtain nutrients [Show Table 4-1: Basic Food Groups and Their Major Nutrients] 6. Calories measure the energy value of food a. Calories needed depends on gender, age, height, activity b. U.S. Dietary Guidelines VI. Holistic Self-Care Plan A. Elements 1. Activities that support your development as a massage therapist 2. Activities that minimize factors that lead to illness and injury B. Holistic plans: nutrition, physical fitness, rejuvenation, stress control C. Self-care journal [Show Figure 4-14: Sample daily log for holistic self-care plan] D. Making the plan [Present Case for Study: Robin and Getting into Shape for Massage, p. 80] VIDEO Holistic Self-Care Plan (MyHealthProfessionsLab.com) Discussion Topics • Discuss the practical implications for physical fitness related to success as a massage therapist. Learning by Doing • Have students sit quietly and close their eyes. At 5-second intervals, ask them to bring their awareness to different parts of their bodies in order from head to feet (e.g., head, neck, shoulders, upper arms, forearms, hands, etc.). Add movement of the body part to develop kinesthetic awareness. • Using simple massage techniques, have students experiment with making good contact and with different qualities of touch. Help them develop full, confident, deliberate, warm, and caring connections in the context of massage. • Lead students through simple tests for physical fitness: cardiovascular, strength, flexibility, and body composition. Have them fill out a physical fitness profile (Figure 4-4). • Using their physical fitness profile, help students plan activities for improving their fitness, as needed for a successful massage therapy practice after graduation. • Teach students some yoga, tai chi, or qi gong exercises. Do these body–mind practices as a class break from sitting for a long period of time. Draw students’ attention to feeling centered and grounded. See Chapter 25, “Asian and Energy-Based Bodywork,” for simple qi gong and yoga exercises. • Have students keep a self-care journal for 1 or 2 weeks making daily entries. Discuss their progress at the beginning of each class. Speakers and Panels • Invite a personal trainer to class to lead students in simple exercises with resistance bands to strengthen major muscle groups used in performing massage. Visual/Auditory/Kinesthetic Aids • Provide a blank time management planning chart to each student. Lead the class through development of a weekly schedule. Determine priorities and plan time for family, work, class, study, and recreation.