The Ins and Outs of the Massage Intake Form

In the March 5^th edition of LegitMassage.com we highlighted several things to know before your Massage session and briefly touched on the topic of the Client Intake Form. Today, we discuss in more depth the importance of the Intake Form and what information it should contain in order to maximize the effectiveness of the treatment. First, why is the Intake Form important?

• The Intake provides any necessary information that the therapist may need to know to effectively assess an issue and address with a personalized treatment plan.
• Because different issues and ailments vary from person to person, treatments will vary as well. What may be an effective treatment plan for one person may not be as effective for another. The Intake Form is the blue print of how to build a healthier structure.
• The Intake Form provides information to the therapist as to what focus areas to concentrate on. It allows you to take an active role in your own treatment plan and develop a priority of what needs focus.
• The intake gives the therapist an idea of any contraindications to avoid during the treatment. Many times the intake will reveal any allergies that you may have as well as any accidents or injuries you have suffered in the past that the therapist needs to know about. Like that dislocated shoulder you suffered in 6^th grade!

Next, what information does the Intake Form need to contain?

• At the very least, the intake should ask for a brief review of your medical history and include any current medications as that is important for the therapist to know. This includes any accidents, injuries, surgeries, or other medical conditions the therapist needs to know about.
• Any current issues or ailments should be addressed in the Intake Form. This gives the therapist an idea of what kind of treatment you desire. If you list sore Iliotibial Bands or ITBs on your Intake Form, the therapist will know that you are looking for more than a stress relief/relaxation massage and instead may benefit from deeper tissue work to the hip flexors as well as knee extensors and antagonist knee flexors, etc.
• Your contact data should be present on the form. This includes a contact phone number and email address. Home address, other phone numbers, and date of birth may be optional information as well.

Some Intake Forms include body maps and assessment charts. This enables the therapist to track any trigger points, ranges of motion, chart strengths of muscles and note any tissue characteristics. Maps and charts further increase the effectiveness of the treatment plan. I have sometimes seen longer Intake Forms that provide a detailed check the box list of many different and various pathologies. Others may include an area for the patient to chime in on their own preferences as to what kind of massage they like and any areas to key in on or avoid. Some states require that you sign a confidentiality disclosure as part of the Intake Form. If insurance is accepted, a HIPPA agreement is mandatory and is often filled out at the beginning of treatment. A HIPPA or Health Insurance Portability and Accountability Act of 1996 basically ensure confidentiality and limits who has the right to see healthcare information. Licensed Massage Therapists use the initial interview as the beginning point to a successful treatment plan. The Intake Form is the first bit of information that we learn about you. As the therapeutic relationship develops, we file the form of initial information and build upon it with a subsequent form called a SOAP note to track your progress. A SOAP form contains information that you tell us, information we observe, anything we assess during palpation or treatment, and lists what we did during our session. Hence SOAP, Subjective, Objective, Assessment, Plan. Intake Forms and SOAPs vary as do treatments. A commonality is the process and keystone in helping to render a healthier you.

Massage Therapist of the week : Jennifer Thomas (Cranston,RI)

Jennifer Thomas LCMT

"A Touch of Tranquility Massage Therapy"

Jennifer is a 2001 graduate of the Bancroft School of Massage Therapy in Worcester, Massachusetts. She opened A Touch of Tranquility in 2004 in Cranston, Rhode Island where she specializes in Deep Tissue and Swedish Relaxation massage and offers Hot Stone therapy and ear coning/candling. Additionally Jennifer is certified in Pregnancy Massage and Myofascial Release and Nationally Certified by the NCBTMB and is a Professional Member of the AMTA, as well as the American Pregnancy Association.

Jennifer is 1998 graduate of Rhode Island College with a Bachelor’s degree in Social Work.

“Jenn Thomas is a master of deep tissue massage in Cranston. I have slight scoliosis (and a bunch of stress) and Jenn just works her magic on my back every time. I feel like a new man after every massage session with her. I've tried a few other massage therapists in the area but they didn't work out for me for one reason or another. I recommend A Touch of Tranquility for anyone needing or wanting the best 60 minute massage in providence or Cranston area.”

-Jimian-

“Excellent!!!! Jenn is amazing. She is a true professional. She takes the time to listen to the concerns of her clients, offers very insightful suggestions and remedies, and knows the exact location of the points that need massaging. I am a very satisfied returning customer and haven't visited (or needed to visit) any other therapist in the past 8 or 9 years. She is truly amazing and the quality of her massages is A++. I highly recommend her.”

-Bob-

To contact Jennifer for massage see her profile

THE MANY FACES OF PAIN

Pain experienced anywhere in the body is not fun. Pain, however relative, affects different people in different ways. What may be excruciating for one may be a walk in the park for another. This is why when medical professionals are assessing pain; we use a 1 to 10 scale because what may be a 6 to me is a three to you. Yet this seems to be one of the toughest self-assessments to make. Characterizing your pain is not easy. There are many words to describe how you are feeling and this makes communicating your pain to your therapist or physician that much more difficult. I hear words like “weird” or “funky” to describe qualities of pain and I hear phrases like “I don’t know, I guess a little” or “not that much” to describe degrees of pain. The following is a helpful set of guidelines to aid you when attempting to describe your condition to a health professional.

• Numbness- used to describe a tingling feeling such as you may feel when a hand or foot “falls asleep”. Most likely caused by compression of vascular structures or nerves. When this happens, blood supply or nerve conduction is slowed and results in a “pins and needles” feeling. Most of the time, this is felt in the extremities.
• Burning pain- is difficult to quantify because essentially you know it when you feel it. However, most burning pain is attributed to issues to our autonomic nervous system which innervates our organs. Hence burning pain is usually felt deep and diffuse or widespread.
• Sharp- this pain is almost always attributable to a nerve root being injured. Have you ever bent over to pick up something and your mind immediately said, “Stop right now what you are doing” accompanied by pain? That is most likely caused by a nerve root becoming impinged by a vertebra such as pain with a herniated or slipped disk. Not to be confused with…
• Lightning-like- which is the type of pain you might feel in a terminal or peripheral nerve injury. I imagine that this pain is not only sharp but jolting, convulsive. The movie 127 Hours did a magnificent job in characterizing this type of pain when James Franco, playing the hiker who saved his life by cutting off his forearm to free himself from the boulder under which he was trapped. Watch that and when he severs the nerves in his arm, you will get a feel for lightening –like pain.
• Throbbing- a pulsing type of pain most likely associated with vascular structures as tight muscles may be affecting circulation.
• Dull/aching- almost always associated with muscle, joint, or ligament pain. This type of pain is generally difficult to localize and usually affects more than one structure. This is the type of pain more often but not exclusively treated by licensed massage therapists.

The numbering system is also sometimes challenging to get a grasp of but it is also universal in its application. The Numerical Rating Pain Scale is numbered 0 to 10 and offers the guideline of 0= no pain whatsoever, 1 to 3 is mild pain, 4 to 6 is moderate pain and 7 to 10 being severe pain. Before a treatment is applied the pain number is recorded and again after the treatment is applied. I find it an excellent tool in assessing a treatment plan’s feasibility. The pain is ranked depending on how they subjectively feel. Because pain is subjective, the individual rating of pain is all over the chart. For me, a 1 is an insect bite. I feel it but it does not affect me in a huge way. Bumping my funny bone however, ratchets my pain to a number 3. Stubbing my toe, a 4. Breaking my hand to catch a baseball bare handed, a 6. My wife says I act like a big baby when I am sick so I will quantify the pain associated with nausea and stomach cramps a 7.Whatever your degree or quantity of pain or your quality of pain, knowing how to speak with a health care professional about it is key to understanding and treating it appropriately. Being in tune with your pain and effectively communicating it makes formulating a treatment plan that much easier. Think of it this way, pain is the body’s way of saying it needs help and relief. What better way to answer that need quickly than to articulate that pain.

Alejandro Gomez - Massage Profile of the week - legitmassage.com

Alejandro Gomez LMT, NMT, MLD-CDT

"Neuromuscular Therapy & Lymphatic Drainage"

A graduate of the Praxis Institute in Miami, Florida, Alejandro operates out of Inspiration Spa in Miami. Alejandro is certified in Manual Lymphatic Drainage and Neuromuscular Therapy and offers Swedish massage, Deep Tissue massage, Sports massage, Reflexology (foot and face), and Chair massage at Inspiration Spa,Dolphin Mall Miami, and Miami area homes and offices.

Additionally, Alejandro speaks English, French and Spanish.

  "First massage ever and I loved it!! At first I felt kinda uncomfortable with the idea that he was a guy but I am regularly at Inspiration Spa and I would always see people walk out of the room after a massage with Alejandro and they all just seemed so pleased. I finally decided to gift myself a massage on the day of my birthday and I could't have made a better decision, he was really professional and respectful. I came out very happy and relaxed, he transmits a really good energy..I definitely recommend him!" – Grether

To contact Alejandro for massage see his profile on legitmassage.com

Seasonal Allergy Sufferers, Rejoice! Massage Can Help

Spring is finally here. The Cherry Trees at the Brooklyn Botanical Garden are in full bloom, the mourning doves that nest in the tree on our terrace have returned from their excursion south, and the daffodils planted last fall on the Pratt University campus are blossoming. It is a really beautiful time of year but if you are a seasonal allergy sufferer you may wish for this time of high pollen and other seasonal allergens to quickly pass by. Though old man winter was gentle to us in the Northeast this year, there is no guarantee that Lady Spring will be. I have seasonal allergies. Admittedly, they are worse in the fall than during the spring but where I used to take conventional allergy medications and pray for that first big April rain to wash away the allergens or the first freeze to kill them, I now consider other treatments a viable option. I receive regular massage and my allergies are not as bad and I find that the massage treatment lasts longer than a pill.

To first understand how massage therapy can alleviate symptoms of seasonal allergies; let’s first understand what seasonal allergies are. An allergy is simply an adverse physiologic result of our immune system to any allergen. Without going into too much detail, we get a whiff of too much pollen and or body begins to release histamines to combat the allergen. The release of histamine however, causes inflammation and injury to tissue. Conventional treatments and medications contain antihistamines or drugs designed to block the actions of our natural histamines. The problem with antihistamines and other conventional treatments such as steroids and decongestants are the unfavorable side effects. There are warnings on allergy medications not to operate heavy machinery as drowsiness may occur. Heart palpitations and arrhythmias or irregular heartbeats may also occur as a side effect to these drugs. Another problem with conventional treatments is that they do not last long. You may have to take another pill in another 6 hours and most medications do not last twenty-four hours. This is why we at LegitMassage advocate regular massage from a licensed massage therapist to help alleviate your seasonal allergies.

How does regular massage help and how long does the effect last? We already know massage therapy decreases stress, increases circulation and releases muscle tension. We also understand that while there may not be much research in the matter of how massage therapy benefits seasonal allergy or yearly allergy sufferers, we have scientific proof that the release of histamines is exacerbated by stress. A 2008 study by Dr. Rosalind Wright at the Harvard Medical School, concluded that responses to stress “may influence the expression of immune-mediated disorders such as asthma as well as enhance an individual's susceptibility to other environmental factors that may also contribute to asthma risk” (Allergy, Asthma & Clinical Immunology March 15 2008). In addition to inducing a relaxed state in which the body is freed to operate more smoothly and optimally, massage therapy addresses physical symptoms as well. When you cough or sneeze, you engage your ribs, neck, shoulders and spine and when you undergo a sneezing or coughing fit as is customary with seasonal allergies, your body can be thrown out of alignment. Remember when Sammy Sosa of the Chicago Cubs had to go on the disabled list for spraining a lower back ligament while sneezing? Additionally, sinus trigger points reside on the neck in the SCM. Recall that the SCM or sternocleidomastoid muscle is the muscle that enables one to glance down for a dropped coin and deeper trigger point therapy to this muscle will address pain that is referred to the sinuses. One of the bonuses of massage for your seasonal allergies is that there are no dangerous side effects. Feel free to hop of the massage table and go back to work as a fork lift operator. Another added benefit is that massage last longer than conventional treatments – oftentimes weeks longer.

There are other complementary and alternative therapies to turn to for allergy relief as well. Reflexology encourages sinus drainage and helps to decrease inflammation brought on by histamines. Shiatsu or finger pressure uses acupressure to address specific points on the body to alleviate allergy symptoms. As with any condition, if you are taking prescribed medication, massage and other therapies are not a replacement therapy but a conjunctive therapy. So enjoy the blooming flowers and blossoming trees this spring… I know I will.

source: http://blog.legitmassage.com

The Carpal Tunnel and Its Many Avenues

Do you, like the vast majority of the human population, operate a computer from time to time? Have you ever experienced discomfort in the wrist and forearm from too much time typing your many emails, status updates, blogging and what have you? The pain probably went away after you stepped away from the computer and did something else. The discomfort or pain is your body’s way of saying “answer that request later” or “step away from the computer and back up slowly partner.” Many times it is not as easy as that. Modern technology has placed at our fingertips many diverse jobs that require long hours in front of our desk and in front of our computer screens. Deadlines loom as projects must continue, numbers must be crunched, blog entries typed and then we spend an inordinate amount of time at our keyboard. You are most likely reading this at a computer screen right now. Stop and take a look at your hand position. Your wrists are probably a little extended just resting your hand on the keyboard page-down arrow or flexed over the mouse that will enable you to move to the next screen. Imagine holding these positions for hours at a time, repetitively throughout the days and weeks. You may begin to experience tightness in the wrist and forearms and eventually compression of a nerve which would then lead to real pain and not just slight discomfort. If allowed to get out of control, the repetitive actions could result in what is clinically known as Carpal Tunnel Syndrome – a condition that results from median nerve compression in the carpal tunnel at the wrist. CTS is the most common entrapment syndrome in the arm… it is also one of the most misdiagnosed maladies in the arm.

There are many causes for CTS. Among the most prominent of which is the aforementioned repetitive flexing and extending of the wrist which can lead to swelling and the formation of thickening tissues and if left untreated, chronic fibrosis. Fractures of the wrist can also result in CTS as well as systemic conditions such as diabetes, rheumatoid arthritis, and hypothyroidism. Many pregnant women as a result of swelling can develop CTS that may not resolve until the postpartum stage. There is some belief that a vitamin B6 deficiency which results in smaller connective tissues may be a cause as well. CTS often only seen in the dominant hand, exhibits thenar muscle wasting. The thenar is the muscle at the base of the thumb and weakness can result in clumsiness with simple tasks such as buttoning clothes or holding a mug. As a result of median nerve compression and subsequent malnourishment of the tissues, metabolic waste can build up causing fibrous tissues in the forearms- another CTS symptom. A differentiating characteristic of CTS is the presence of nocturnal pain that wakes you up. This is most likely due to sleeping with the wrists in a flexed position and compressing the median nerve. It is important to note that it is not only computer workers that are susceptible to CTS. Butchers/meatpackers and assembly line workers are vulnerable to CTS as well as anyone who repetitively uses their hands... massage therapists I am looking at you.

Depending on the severity of the symptoms, doctors may prescribe anti-inflammatory's or in worse cases steroid injections but it is also important to point out that with any steroid injection, the pain relief is temporary and overtime rendered less effective. Splinting may be prescribed for CTS and in severe cases surgery may be necessary. This is the part where misdiagnosis becomes a scary reality. Often CTS is diagnosed with electromyography (EMG) which measures nerve conduction and if the median nerve shows a diminished conduction time, the patient is slapped with a diagnosis of CTS. But could it be something else? There is a phenomenon called double crush in which other syndromes are involved and increase susceptibility to CTS. In some cases these other syndromes or issues are the actual and only cause of the pain and discomfort.

Pronator Teres Syndrome is also a condition in which the median nerve is compressed by the Pronator Teres muscle. The Pronator is a forearm muscle that enables you to move your wrist and forearm out of a neutral position and rest your hand on a flat surface (like a keyboard or assembly line or massage table). The pronator also makes dribbling a basketball possible. Unlike CTS, PTS is exacerbated by elbow movement and not wrist movement and pain is felt at the elbow. Thoracic Outlet Syndrome is a condition that not only involves compression of the median nerve but also the radial, ulnar and other nerves emerging from the brachial plexus as well as vascular structures that can become entrapped by tight muscles and tissues in the neck and chest or impinged between the clavicle and 1^st rib. Compression of spinal nerve roots for C6 and C7 can refer pain to the thumb, index, and middle fingers (also innervated by the median nerve), and the lateral forearm and produce biceps and triceps weakness with pain in the neck. In some cases, CTS symptoms may be only symptoms of a much bigger disorder. There have been documented cases where surgery used for CTS and was a complete failure because though CTS symptoms were present in the wrist, the actual problem was located further up the arm, in the shoulder or at the neck.

By now most of our loyal readers are probably wondering, “Ok, but what can massage therapy do to help alleviate these symptoms?” Massage therapy can be a great benefit to those who suffer CTS or any of the other above syndromes if the focus is on decreasing swelling and tone, and addressing any adhesions or trigger points that are present. By reducing stress and restrictions, massage nourishes fibrous tissues, maintains range of motion, and reduces the pain associated with CTS. If you are experiencing prolonged pain and numbness of the forearm, wrist, thumb or middle/index fingers, you may assuage the pain by running cool or warm water over the hand until you can see your massage therapist. It is out of the scope of practice for a licensed massage therapist to diagnose any condition so an EMG from your physician may be necessary. However, when it comes to relief from the pain and discomfort of CTS, there are many avenues to travel. Besides massage, acupuncture, physical therapy, and exercise are healthy alternatives to invasive procedures most of the time. Good luck and long may you use your hands.

source: http://blog.legitmassage.com/

Jeff Byrd LMT, CMTBW

"a massage experience that can help heal body, mind, and spirit."

Jeff founded Adobe Massage Therapy in Las Vegas, Nevada in 2010. Each patient at Adobe Massage Therapy receives a personalized treatment plan and Jeff works with your physician to insure that you are getting the exact treatment you need to produce optimal results. Using a range of Swedish, Deep Tissue, and Energy massage techniques, Jeff benefits the body, mind and spirit by improving circulation, detoxifying the body, relieving tension, improving digestion, enhancing muscle tone, and increasing mental alertness. A graduate of the Southern Nevada School of Massage Therapy in Las Vegas, Jeff provides massage and reflexology services to help people recover from automobile accidents, sports injuries, and workplace injuries caused by repetitive motion, poor posture, and poor lifting habits.

Jeff, a member of the AMTA, is currently enrolled at the Southern Nevada School of Massage Therapy Master Body Worker program and is licensed in both Nevada and New Mexico.

 “Jeff made me feel comfortable right away. I had a workplace injury that was interfering with my life. Jeff had an amazing technique that brought me relief after just one visit. I have been going to Jeff twice a month since, and now feel better than ever. Thanks Adobe Massage Therapy!”                                                                                                             -George P.-

“Jeff not only relieved my pain, it hasn't returned in the six months since my first Adobe massage therapy massage. This has brought me much joy, as it is the first time in twenty years that I can say that I'm pain free!”                                                                                                                                            -Mark M.-

To contact Jeff for massage see his profile on legitmassage.com