We’ve had to revise the schedule a little bit, but I am thrilled to share here that the wonderful Jacki Sellers of Greet the Day is returning to Chicago in September. We will be teaching the first level Oncology Massage class September 11-13 at Cortiva. We’re also still looking for volunteers to receive a FREE oncology massage on 9/13 at 10am or noon. This free massage is available to anyone in the Chicago area who is currently in treatment for cancer, or has a history of cancer treatment. Please contact me for more information.
After a recent post, I’m feeling in the mood to unpack language. I like picking things apart and losing sight of the big picture once in a while.
Many people who look at my website- or hear my speak about my work- think that when I refer to my work as being gentle, it means that I only use light pressure. In the beginning that was intentional- I didn’t think my wrist would necessarily allow me to get to deeper levels. Now I know that’s not the case, but I don’t want to erase the word gentle from my vocabulary.
“Light” to me means working only with the superficial layers of tissue. The massages I give to people in active cancer treatment and recovery are light. There’s too much going on in their bodies for them to tolerate massage to deeper tissues.
When I use the word gentle, I mean it as the opposite of forceful. I stay in tune with how far the muscle tissue will let me in, and don’t try to push through resistance. If someone’s superficial and middle tissue layers are loose and relaxed, even working with the deeper structures doesn’t feel hard or invasive. That’s what I mean by gentle.
I’ve had so many conversations with people lately- both clients and in social settings- where they talk about how they want to really hard, forceful massage so they “get their money’s worth”. When clients tell me these stories, so far they end with them admitting that the session they received from me was just as valuable for their money.
I’d love it if you could all take a moment to review my comments policy. The new update actually makes it a little less strict (and how often does that happen?).
Recently, I’ve been thinking about my friends and loved ones with cancer. Their triumphs and challenges; their stories, basically. It made me realize that under the old policy of, “no questioning current treatments”, I was potentially silencing people who could really contribute to this space.
The reason for the older, stricter policy was that I started getting a lot of comments attacking the accepted medical treatment model for cancer in the U.S. If this were strictly a personal blog, I would probably have let them through. However, this blog is mostly professional, and a massage therapist is not entitled to a professional opinion on the treatment of disease. So, those comments got the old heave-ho.
I see a pretty big difference between comments like that, and people wanting to discuss their actual experience with treatment. Those perspectives are very valuable to me. I won’t be able to respond in much depth to them, just a sentence or two to express compassion and gratitude. For locals I can offer private recommendations of other professionals (counselors, psychologists, etc) when asked for.
Let’s see where this takes my little nook of the ‘Net. Thank you, as always, for taking the time to drop by.
As some of you already know, the Heartwood Foundation’s Women & Cancer Program is a cause very dear to my heart. It’s the program that made me first consider joining Heartwood Center in the first place (best decision ever, FYI). Heartwood Foundation provides free services and classes to low-income women all over the Chicago-land area.
Funding for programs like this is getting harder and harder to come by. And they are so important, because everyone deserves to have access to complementary medical care during cancer treatment.
The good news is: you can help support Heartwood Foundation and have a great time doing it! On May 3rd, 2014 Heartwood Foundation is having their annual benefit at the Heartwood Center. Tickets are $50.00 and you can buy them here, at the door, from the Heartwood Center office, or even from me. As an added bonus, I’m planning to make my (in)famous raw fruit tartlets to serve.
And if that isn’t bonus enough: I am giving anyone who buys a ticket $10.00 off any massage or MLD session with me. Just take a picture of your ticket and/or come say hi to me at the benefit. I’ll be the one having lots of fun while dancing very poorly.
I hope to see some of you there!
I’m afraid that winter has officially tapped me out, writing wise. Every post I started went absolutely nowhere (except the little electronic trash can, love that thing). I think that means that now is a good time to share the newly announced dates for Oncology Massage training in Chicago at Cortiva. Both classes will be taught by Jacki Sellers of Greet the Day with some assistance from Rebecca Sturgeon and yours truly.
The Oncology Massage Foundation Course is first. In this one licensed massage therapists learn how to safely adapt their techniques for clients in treatment, or with a history of cancer. That will be June 5-7.
The second class is a more advanced training called Advanced Client Clinic. We’ll be covering treatments and side-effects in greater depth, as well as having client volunteers to work with. It should be a pretty amazing experience. Look for that on September 11-13.
If you’re a massage therapist who’s ready for a great class, get in touch with Margaret McNamara at Cortiva.
We’re also always looking for more people to be client volunteers. If you or someone you know is in treatment or has a history of cancer treatment, and would like a free 60 minute massage drop me a line.
As promised last week, this is my inaugural post on a study about the effects of massage therapy on cancer patients. Specifically this study, from Memorial Sloan-Kettering Cancer Center (I call it the Sloan-Kettering or MSKCC study). I’ll copy the abstract here:
Massage is increasingly applied to relieve symptoms in patients with cancer. This practice is supported by evidence from small randomized trials. No study has examined massage therapy outcome in a large group of patients. At Memorial Sloan-Kettering Cancer Center, patients report symptom severity pre- and post-massage therapy using 0-10 rating scales of pain, fatigue, stress/anxiety, nausea, depression and “other.” Changes in symptom scores and the modifying effects of patient status (in- or outpatient) and type ofmassage were analyzed. Over a three-year period, 1,290 patients were treated. Symptom scores were reduced by approximately 50%, even for patients reporting high baseline scores. Outpatients improved about 10% more than inpatients. Benefits persisted, with outpatients experiencing no return toward baseline scores throughout the duration of 48-hour follow-up. These data indicate thatmassage therapy is associated with substantive improvement in cancer patients’ symptom scores.
– Cassileth, Barrie R., PhD and Andrew J. Vickers, PhD. “Massage Therapy for Symptom Control: Outcome Study at a Major Cancer Center.” Journal of Pain and Symptom Management 28.3 (2004): 244-249. Print.
When I read the article for the first time back in March of 2012 I wasn’t terribly impressed. Two years and dozens of studies later, I have a much greater appreciation for this paper.
Some of the results:
- All symptoms studied showed improvement immediately following massage. (Table 2. Ibid, 246.)
- When the severity of the predominant symptom was of at least moderate severity: massage had the strongest effect on anxiety (59.9% improvement) and the weakest effect on fatigue (42.9% improvement). These improvement were consistent regardless of the severity of the baseline score. (Table 3. Ibid, 246-7)
- Once the baseline score was adjusted for outpatients showed a greater improvement of around 10% higher than inpatients. (Ibid, 246)
- There was no statistically significant difference between light touch and Swedish massage in symptom improvement, and both had better outcomes than foot massage. (Ibid, 246)
- The effects of massage appeared to be cumulative when symptoms were studied for sessions two through five in the individuals they followed who received five session. (Ibid, 247)
- The effects of massage on inpatients were not long-lasting. They hypothesized that scores would return to baseline in approximately one day. (Table 5. Ibid, 247)
- They found no evidence that outpatient scores ever returned to baseline scores. (Fig. 1. Ibid, 247-8)
Pretty interesting results, I’d say. Certainly they make a compelling case for including massage therapy as part of standard cancer treatment. Particularly in outpatient settings (like the one I worked in). Now let me get picky about the details.
First the pros:
- Size- This is a study of 1,290 patients and 3,359 massages given over a period of 3 years. That is approximately 100 times the sample size of many of the other “large” groups studied.
- Comparison of different types of massage used. So many studies are just massage vs. control group. I really like that they compared outcomes for Swedish, light touch, and foot massage.
- Attempting to avoid bias by having other staff rather than therapists give patients the cards to rate their symptoms. Maybe it seems like a small detail, but I’ve already covered my love of those.
Now the cons:
- The two different session lengths for inpatients and outpatients (20 minutes vs 60 minutes respectively) were not really accounted for. They are not separated in Tables 2, 3, and 4. 20 minutes of massage seems to be right on the border of getting into the parasympathetic (“Rest and Digest”) state that is such a valuable part of massage. I think this accounts in part for the foot massage seeming less effective than the other two.
- Correlating with number one. The study adjusted for the different baseline scores between in- and outpatients, but not for different session lengths. Is probably a significant physiological difference between a 20- and a 60 minute massage (This question requires more science! And to their credit, the authors admit, “The relationship between the length of massage treatment and the size and duration of effects is worthy of future research.” Ibid, 248)
- Finally, I would have liked more specific information about how the sessions were given. Swedish and light touch are broad enough terms, that I want more information about how they were actually applied to patients. No one else could replicate this aspect of the study with much accuracy.
- lack of a control group. I’m kind of on the fence about this one, because this is studying clinical rather than mechanistic outcomes. I’d still have included a group where people got 20 or 60 minutes of quiet time (Unless they were getting interrupted during the massage sessions. We don’t know [see #3 above]!).
That’s the Sloan-Kettering study and my super-fun science dabbler take on it! There are more posts like this to come. I was thinking of doing one a month, but this post is really long and it took a long time to write. So, it probably won’t become a regular thing until I learn to be more concise. Or if this post proves to be wildly popular.
One of the first types of posts I envisioned for my blog was to share scientific studies on massage, and my opinion on them. Time hasn’t been on my side so far, but, I think the New Year is a good time to start. Beginning with my next blog post, I’ll introduce a study and then talk about what it means for LMTs and their clients. I might also share ways that further studies could be improved.
Before we begin that, it seems appropriate to give some background about me. My education, and my strengths and weaknesses from a scientific perspective. I don’t want to inflate my credentials, or claim expertise that I don’t have.
I have a Bachelor of Science in Biology from the University of Illinois at Urbana-Champaign. My class was the last year that Biology General was a major, but my courses would have made me a Micro- and Cellular Biology major these days. I was interested in the minutiae of life, that’s for sure.
My strengths first: I was trained in the scientific method. I designed experiments, carried them out, and then interpreted the results. If I recall correctly, I never received below an A- in any of my science courses (though I’d need to check my transcript to be certain, and I haven’t managed to de-clutter that part of the apartment yet). This gives me a stronger scientific foundation than most of the massage therapists I have met so far.
On to weaknesses: No advanced training! I took graduate-level courses, but those do not a Master’s degree make. I got better grades than most of my college classmates, but I still only have a B.S. The other big weakness of mine to keep in mind is that it’s been close to ten years since I graduated from college, and there was a long period of time when I wasn’t really using these skills. I’m still not using them to the extent that I might like.
So, that’s me in a nutshell. I guess you could call me a well-informed dabbler, rather than an expert. Scientific research into massage is still so new though, I think a curious person like me could come in handy. Someday I’d like to help move things along even.
The research posts will get tagged as “Science Monkey” for those who want to look out for them (either to read or avoid, no judgment here). First up: the massive Sloan-Kettering study that is still the talk of Oncology Massage.
One of the biggest possible side effects of cancer treatment is the risk of lymphedema (LE). Unlike many of the other side effects, this one is for life. If you had lymph nodes removed, irradiated, or tested from your neck, axilla, or groin as part of your treatment, you run the risk of developing LE.
I see it as my responsibility to help educate clients about LE. What it is, what it does, and how I can help support the work of a Complete Decongestive Therapist (CDT)* with Manual Lymphatic Drainage. But I think my most important job is to educate clients on how to minimize their risk of triggering it. The National Lymphedema Network’s position paper on LE risk reduction is the number one resource that I give to all oncology clients who may be at risk for developing LE. You can check it out for yourself here.
It is a long document. I find it a little overwhelming to read through sometimes, and I have no reason to worry about developing LE personally. Sometimes I feel almost, well, guilty for sending people who are already stressed out and overwhelmed a link to this big document. As if I’m overburdening their system with information, the same as I could do if my massage were too forceful.
I squash those worries by thinking of my nightmare scenario: someone coming to me with LE saying, “If only I would have known…”. I warn people that it’s a long document, and to read it in pieces if need be. But I’m going to give it to every single person I see who might need it. And recommend that they check out the rest of NLN’s website. Because there is so much information about the topic, and I hope that people find comfort and empowerment there too.
*As a Certified Manual Lymphatic Drainage Therapist I do not meet the minimum basic standards to treat someone with LE. I am trained and qualified to give MLD to someone with LE, but they need to be under the supervision of a CDT to get exercise, bandaging, and other therapy. This is my dream certification, but I need a to achieve a pretty high level of success in my business before I can justify going for it. The blog post announcing that will require GIFs. Really big, sparkly ones, and a space background (and a midi-player, I will transform this blog into a 90’s website when I’m ready celebrate signing up to take that class).
I’m so excited to officially announce that I have rented space in the beautiful Heartwood Center in Evanston, IL. I’ll begin seeing clients on December 6, 2013. This right here? This is the final adventure of 2013 that I’ve been hinting at.
After a rough year, it feels so amazing to be able to share my talents with clients again. And to build my practice the way I’ve always dreamed it.
The next couple of weeks are going to be full of getting equipment and supplies, and generally getting things ready for people. Mostly, though, it’s going to be full of doing rather than talking. This is one of the biggest adventures of my life, and I can’t wait to share some of it here.
On the day this post goes up, I will be traveling home from my second-to-last adventure of 2013. If everything goes according to plan (what are the odds?) I will have gone from Chicago, IL to Kalamazoo, MI to New York, NY to Stamford, CT back to NYC, then finally back to Chicago. All in five days. As you read this I am probably either on a plane or collapsed on my floor.
But that isn’t the adventure I want to discuss today. I want to talk about my final adventure of 2013: Opening up my own massage practice. I’m working on renting a room in Evanston, IL, and I have every reason to expect that I’ll be ready to see clients before the year is over!
Of course, once everything is finalized and I’m taking on new clients I’ll make a big announcement on this blog. But, if you’re interested in getting on my email list, please let me know. Don’t post your email address in the comments, but you can just ask to be added. Or, you can contact me through my website: http://margaretolson.massagetherapy.com/
Finally, you can reach me through my good old gmail account: olson . margaret @ gmail (no spaces)
As always, thanks for sharing this journey with me. There are lots of good things ahead.
I made it to every city I was hoping to see, and then back home with only one minor hiccup- the flight was cancelled. The gate agent who got me on the next flight out of LaGuardia was the same one who got me on a new flight the day after the big blizzard 2 years ago… by switching me to 1st class. I thanked her again this time for all her help both times.