Features Continuing Education Education
Practice Management: Winter 2006

With over 15 years of practice under my belt, I’ve begun to feel the strain of treating patients day after day. Many seasoned therapists have related to me the challenge of providing enough care to make a reasonable living, and yet address fatigue, overuse strain and trying to protect one’s vitality.

Our business success relies on our stamina, and our effectiveness in creating a positive experience in every treatment.  I believe a goal of many therapists is to maximize the client’s/patient’s experience while limiting strain on one’s own body. Thankfully, many opportunities exist to off-set this strain.

I think one of the reasons that our professional lifespan can be short-lived is we’ve indoctrinated the belief that we must provide 55 minutes of hands-on
care in every one hour treatment. We can take a lesson from our colleagues, the physiotherapists, in utilizing exercise, electro and hydrotherapies more directly.

Spa therapists are well-versed in maximizing effects while minimizing strain, by providing mud wraps and other hydrotherapy applications. This combination of hands-on bodywork and ancillary modalities is far less strenuous but still very effective in addressing muscle tension and emotional stress. Modifying our approach after these models can still guarantee a positive experience while minimizing strain.

By utilizing various adjunctive methods, we can actually increase our treatment capacity if we desired. If you worked four days a week and provided an additional treatment a day, that would calculate to about $1000/month of income you’re not currently making. What could you do with another $1000/month income?

So what can you do starting tomorrow to lessen your strain and increase your capacity to provide care? I recommend the following six practices:

1. Use heat and exercise to increase visco-elasticity of soft tissues. My clinic operates in conjunction with a fitness centre. I tell patients to sit in the sauna or exercise before their treatment to warm their tissues so the person will experience less discomfort. As we know, warm soft-tissues are much easier to manipulate than normally rigid muscles. It also prepares their mind for the bodywork by relaxing and centering their focus on the body. If you don’t have access to these amenities, you can ask the person to take a hot bath, or go for a walk before their treatment.
2. 2. Only use thumbs and fingers for small, precise manipulations, and only after thoroughly preparing the body area with heat and general massage.  We should never try to pry apart rigid muscles with small levers like thumbs and fingers when the soft-tissues haven’t been properly warmed and prepared. That’s a recipe for early osteo-arthritis in the hands!
3. Use equipment such as electric or pneumatic table, Body Cushion™, pressure bars to increase your biomechanical leverage and lessen strain. I’ve used these devices for years but it’s only been in the last few that I’ve learned to appreciate them. I’ve found that as I age I can’t muscle through my treatments like I did in early practice, and so I need to maximize my leverage with the proper equipment. The small investment in these products will add many years to your professional lifespan.
4. Incorporate patient in treatment with isometrics or active movement during release – as in ART (Active Release Techniques). Doing so increases the patient’s feeling of control, kinesthetic awareness and empowerment in constituting change in the body
5. Incorporate electro-therapies like ultrasound, infrared heat and TENS pre-treatment, with cryotherapy or sauna post-treatment. These therapeutic modalities add positive effect without requiring a lot of effort on your part.
6. Exercise and stretch every day. To provide bodywork day after day requires training, as an athlete would train. Build your strength and stamina so you are up for the task. Martial arts, such as Tai Chi, help you to generate force from the pelvis, as opposed to the upper extremities. Generating force properly also extends your professional lifespan.

By utilizing the methods about, you can experience less strain and more gain in your daily practice. You can increase your potential for income and lengthen your professional lifespan. Focus not only on the patient’s/client’s experience of the treatment, but make sure at the end of the day you aren’t requiring care yourself!

Don Dillon, RMT, provides seminars for CIMT, and is the author of Better Business Agreements: A Guide for Massage Therapists.