Massage, Science, and Your Health, A Conversation with Dr. Andrew Weil

Massage, Science, and Your Health

A Conversation with Dr. Andrew Weil

By Loolwa Khazzoom

Originally published in Body Sense magazine, Autumn/Winter 2010.Copyright 2010. Associated Bodywork and Massage Professionals. All rights reserved.

Noted physician Andrew Weil, MD, author of Why Our Health Matters: A Vision of Medicine that Can Transform Our Future (Hudson Street Press, 2009) and a longtime proponent of integrative medicine, had a chance to sit down with Body Sense magazine to discuss the science behind massage and other effective complementary and alternative medicine (CAM) treatments.

Loolwa Khazzoom: What do you see as the benefits of massage?

Andrew Weil: Whether a massage therapist focuses on your feet, hands, scalp, or entire body, massage can be both wonderfully relaxing and clinically effective. It is also one of the CAM therapies most readily accepted by conventional medical doctors and hospital administrators.

Research demonstrates that massage therapy can offer a variety of healthful benefits, especially for people with significant stress or anxiety, strained muscles, or osteoarthritis. Massage therapy can enhance immune function, increase circulation while reducing heart rate and blood pressure, boost levels of endorphins and serotonin (the body's natural painkillers and mood regulators), and reduce stress hormone levels, all while easing sore and achy muscles.

If you have problems with tension headaches, back or neck pain, sports injuries, arthritis, or fibromyalgia, experiment with massage as an enjoyable way to help reduce or even eliminate associated pain. Mothers-to-be can reduce stress levels and pain associated with labor, preemies may gain weight faster, and children with asthma may breathe easier when massaged. Studies also suggest that massage therapy can help prevent or manage some side effects and complications commonly experienced by people with cancer, both during and after treatment.

Anyone with open wounds should wait until they are healed to receive bodywork, and deep-tissue work should be considered cautiously by people on blood thinning medication (warfarin, for example) and anyone recovering from surgery. Other than that, work with a licensed massage therapist to ensure you get the most out of your session. Many forms of massage therapy are available. It pays to ask massage therapists what types of therapy they have studied and whether their skill sets are a good match for your needs.

LK: What are some common ailments you have seen treated effectively through other CAM methods?

AW: First of all, in treating autoimmune and inflammatory disorders, I have seen great success using an anti-inflammatory diet. I also recommend the use of herbal medication (especially things like ginger and turmeric), mind-body methods (everything from guided imagery to stress reduction), lifestyle counseling, different forms of exercise, and sometimes the use of Chinese medicine.

For depression, I think there are a huge range of approaches that are very effective, from aerobic exercise to high-dose fish oil, and various dietary supplements. I find the anxiety-reducing breathing exercise that I teach to be more effective than the standard pharmaceutical drugs.

LK: How is it that all these methods are effective? People generally expect to have to do something high-tech to respond to something that's gone awry in their bodies.

AW: I think this is the key question of what's wrong with American health care. It has us all dependent on high-tech solutions that are expensive. I think these low-tech methods work because the body has an innate healing capacity, and there are many ways of accessing it. I think that people, in this culture especially, have little confidence in their body's ability to restore health.

Many of these methods have very sensible mechanisms behind them. High-dose fish oil affects brain chemistry; there's a lot of research on that. With breathing exercises for anxiety, there is a logical mechanism--breath affects the involuntary nervous system.

There is very little research on the impact of breath work, because it is something that is just not taken seriously by the research community, probably because it is so simple. I have worked for years to try and get studies going on it. The lack of interest in this kind of stuff is remarkable.

LK: What is the backstory on scientific studies of massage?

AW: Unlike pharmaceuticals, which can be manufactured to small tolerances, dosed by weight, and compared to placebos, bodywork is less consistent and often better tailored to an individual's needs. Massage therapy, nonetheless, has been studied and scientifically proven to be effective for reducing pain, fatigue, anxiety, and stress in patients with a wide range of medical problems, and to relieve a variety of symptoms in people with specific illnesses. In addition, the number of sound research trials into the potential benefits of massage therapy has grown significantly in recent years. Still, funding remains an issue. As is the case with any CAM therapy, funding will never be as accessible for research into massage therapy as it is for drug company studies.

A strong body of research that defines the clinical effectiveness of, and indications for, massage therapy will help promote greater acceptance of the approach and perhaps lead to wider coverage by insurance companies. I would like to see more studies comparing the effects of massage therapy to pharmaceutical agents for the relief of pain and anxiety, as well as cost-benefit analyses of the preventive effects of regular massage. Further investigation into the underlying mechanisms behind the benefits of massage should be encouraged as well.

LK: What do you tell people who insist on having hard scientific data before trying something from the CAM toolbox?

AW: There is a lot of science out there. It is just often published in places that most doctors don't look. I think the first thing is to see what evidence there is. Second, we should get into the habit of using a sliding scale of evidence, which works like this: the greater the potential of a treatment to cause harm, the stricter the standards of evidence it should be held to for efficacy. In the case of something like a breathing technique, the potential for harm is so low that I feel quite comfortable recommending it, in the absence of hard scientific evidence of its efficacy. I know it works, because I use it myself, and I use it widely on patients. It's not going to hurt people.

LK: I keep encountering a disbelief that simple things can actually work.

AW: There is a prejudice. People wonder how it possibly could work, being that it doesn't involve a drug, and it doesn't involve a device. That, to me, is the big problem in this area. I think that the answer is education about the body's remarkable capacity for self-maintenance and healing and about the value of knowing and using these low-tech solutions before going to complex, expensive ones.

If low-tech methods don't work, then sure, you go to stronger methods. Or if you're dealing with an emergency, then you use more drastic methods. But for the vast majority of conditions out there, there are inexpensive, low-tech, simple methods that people ought to know about.

LK: Do you see attitudes toward massage changing in the world of conventional medicine?

AW: The United States lags behind many other countries where massage is considered a trusted effective medical intervention. But surveys show it is one of the most popular forms of alternative medicine in North America and is increasingly incorporated into the services offered by hospitals and medical clinics. As more people, including doctors, experience its benefits and appreciate the healing power of appropriate human touch, I am confident that massage therapy will soon be offered within most cancer centers and readily available to at least expectant mothers and hospitalized children. Of course, additional sound research will help drive the inclusion of massage in the conventional medicine armamentarium.

LK: If there is an absence of hardcore scientific evidence proving that a given CAM treatment works, how can a person who is not that educated in CAM distinguish between what is medically sound and what is not?

AW: This is the whole point of the integrative medicine that I teach. We have now graduated over 500 physicians from intensive training in the program in integrative medicine at the University of Arizona College of Medicine. The training enables them to make those distinctions and teach their patients to do the same. Ideally, you find a trained health-care professional, preferably a physician or a nurse practitioner, who has this kind of training, who can advise you. Our website gives a directory of all our graduates.

On a related note, if pharmacists were trained in the use of vitamins, minerals, herbs, and other dietary supplements, they would be the best people to advise both patients and doctors about the uses of CAM and its interactions with pharmaceutical drugs. It's really a matter of getting trained people out there.

LK: What are three safe and relatively easy ways people can try out CAM at home?

AW: Learn the basics of good nutrition and how diet affects health. The simplest rule is to try and get rid of refined products and manufactured foods. They may be what is causing all the trouble. It's also a good idea to have a home medicine chest with simple remedies. There are about half a dozen herbal treatments that are very useful--like Valerian for sleep and peppermint for stomach upsets. Lastly, have some kind of relaxation technique to practice. My favorite is simple breathing methods, because they are so time-efficient.

LK: Is there anything you would like to add about getting professional massage treatments?

AW: Keep in mind that massage therapy typically provides short-term relief of symptoms and that the benefits of massage accrue over time. To experience the greatest benefit, try to schedule sessions at regular intervals and treat them as you would any important business appointment: non-cancellable.

Loolwa Khazzoom (www.loolwa.com) is a health and wellness coach, journalist, and media strategist who developed a dance method to heal from chronic and debilitating pain. Her company, Dancing with Pain (www.dancingwithpain.com), offers a full line of natural pain relief products and services.

Sitting Too Long is Bad for Your Health

Whether you have a desk job or otherwise sedentary lifestyle, prolonged periods of sitting may be unavoidable for you. Chances are you are sitting as you read this article.
New research published in the Archives of Internal Medicine and other journals shows that sitting for long stretches can be detrimental to your health, contributing to obesity,   cardiovascular disease, diabetes, cancer, and chronic kidney disease.
“The best defense -- the only defense -- is to move more,” says Dr. Keith Overland, president of the American Chiropractic Association.

Walk

 The simple act of walking can help you get in shape and feel great. It’s easy, burns calories, reduces the risk of heart disease, tones muscles and increases cardiovascular endurance. Walking as little as 12 minutes a day can have a significant positive effect.
To get the most from your walk, move your arms freely in coordination with the opposite leg, walk “with purpose” to maximize your cardiovascular workout, don’t stoop your head or look down as you walk and don’t carry weights, as they’re better used as a separate part of your exercise regimen.

Alleviate Pain

 Aches and pains prevent many people from even taking that first step toward better health.  Chiropractic physicians -- experts in treating muscles and joints -- offer not only a drug-free approach to alleviating pain through spinal adjustments and manipulation, they also promote overall health and wellness through nutritional counseling, rehabilitation and exercise and lifestyle recommendations. Search for a chiropractor in your area by using “Find a Doc,” the American Chiropractic Association’s online member database, www.acatoday.org/FindaDoc.

Sit Correctly

“When you do sit, make sure to do it correctly so you don’t ruin your posture or strain your muscles, leading to pain that could inhibit you from getting the activity you need,” suggests Dr. Overland.
To prevent problems, keep your feet on the floor or a footrest and don't cross your legs. Your knees should be at or below the level of your hips. Adjust the backrest of your chair to support your low- and mid-back or use a back support, and avoid sitting in the same position for long periods of time.
Include frequent micro-breaks into your sitting time, stretching your neck, arms, wrists, back, and legs. Simple stretches include neck rotations, fist clenches, arm dangles, and shoulder shrugs.
Most of all, don’t sit for too long. Stand up and stretch your legs with a short walk about every 20 to 30 minutes. Avoid working through lunch.

Maintain Good Posture

Poor posture not only consumes more energy but also can lead to excessive strain on your postural muscles and may even cause them to weaken when held in certain positions for long periods of time. The postural muscles are prone to injury and back pain, but maintaining good posture, sitting properly and moving regularly can help you stay pain-free.

Sitting Too Long is Bad for Your Health

David Whyte and Floating

I've been floating a lot lately, at least twice a month, sometimes more. 
Floating is the absence of distraction, direct access to your Self. It is transformational.

This weekend I attended the float conference here in Portland. A poem was read by Michael Taft. He was talking about understanding ourselves better.  

Here's the poem:

Sweet Darkness

When your eyes are tired
the world is tired also.

When your vision has gone
no part of the world can find you.

Time to go into the dark
where the night has eyes
to recognize its own.

There you can be sure
you are not beyond love.

The dark will be your womb
tonight.

The night will give you a horizon
further than you can see.

You must learn one thing:
the world was made to be free in.

Give up all the other worlds
except the one to which you belong.

Sometimes it takes darkness and the sweet
confinement of your aloneness
to learn

anything or anyone
that does not bring you alive

is too small for you.

~ David Whyte ~

as posted on http://www.panhala.net/Archive/Sweet_Darkness.html

Body Sense - Autumn 2012

Body Sense - Autumn 2012

Online Magazine Link - What You Might Not Know About the Benefits of Bodywork

Six Ways I Changed My Life and How You Can Change Yours | Dr. Mark Hyman

 A great article: Worth a read. Great strategies to slow down and enjoy life and health.

~ Dana

 

Six Ways I Changed My Life and How You Can Change Yours

I admit it. I was addicted to sugar, caffeine, and adrenalin. I am a recovering dopamine addict, and it almost killed me. Twenty years ago, as a freshly minted doctor, I swallowed the propaganda that doctors are invincible, that “MD” stood for “medical deity.”
During my training, one of my surgical residents told me, “Real doctors don’t do lunch.” I thought I didn’t need to follow the same rules of biology like everyone else. I believed sleeping, eating real food, and resting were luxuries, not necessities.
In fact, even though I knew about healthy lifestyle and nutrition, and had always exercised, I felt I could push the boundaries of my body. When I started my medical career, I worked 80-100 hours a week as a family doctor in small town in Idaho.
I delivered hundreds of babies, ran the emergency room, and saw 30-40 patients a day. Sleep was an afterthought. It was the early 1990’s and I ordered Starbucks coffee by the case straight from Seattle, bought an espresso machine, and served up 4-5 espresso’s a day. I lived in a perpetual state of fatigue and pushed my way through on adrenalin.
I continued those habits when I moved to Massachusetts and worked in an inner city emergency room. At the time I had two young children to care for, and worked endless odd shifts in three different hospitals. Some days I went without sleep. I got through the night shifts by downing a quadruple espresso, a pint of Haagen Daz ice cream (coffee flavor), and a giant chocolate chip cookie.
I learned how to keep myself awake despite my exhaustion. I didn’t have a stop button. I lived on adrenalin—until my adrenalin ran out and I suddenly got very ill with chronic fatigue syndrome. Every system in my body broke down.
I didn’t choose to change my life—my body chose for me. That is when I had to learn to rebuild my life and my energy and respect the way my body worked. I learned the hard lesson that my body was a biological organism that needed care and attention, that it wasn’t there to sustain my abuse and serve my needs. I realized that if I wanted to enjoy my life, I would have to learn the care and feeding instructions needed for being a human.
Unfortunately, many suffer the same fate I did. We have all been given a beautiful creation—our physical body. But none of us were born with an operating manual or instruction book. How do we make it feel good, take care of it, make it run like it was designed—balanced and in perfect rhythm?
Most of us don’t learn how to manage our energy and bodies well. We use drugs—sugar, caffeine, alcohol, adrenalin, or worse to manage our energy and moods. Most of us don’t connect our behaviors and choices with how we feel every day.
We don’t connect what we eat, how much we rest and sleep, how much we exercise, how much time we make for connecting with friends and community, or the kinds of media and news we watch with how we feel every day.
Feeling fully energized and vitally health comes down to a very simple principle: take out the bad stuff and put in the good stuff. Health results from what you get too little of (good food, nutrients, light, air, water, rest, sleep, rhythm, exercise, community, love, meaning, and purpose) or too much of (poor quality food, stress, toxins, allergens or microbes.)
This affects how our bodies, minds, and souls function. For each of us the ideal mix is a little different, and what is needed to thrive is unique to each individual. It takes a little experimentation, observation and fine-tuning to achieve, but there is nothing better than being the best you can in each moment. It is what makes life sweet.
This is what I have spent the last 20 years studying—how can I thrive and help my patients thrive, what prevents us from being well, and what helps us. This approach to health and medicine is called Functional Medicine or “The Medicine of Why”—that is, why our bodies work well or don’t!
It’s actually quite simple.
How to Get More Energy
Simply make a list with two columns. In one column list all the things that give you energy. In the second column list all the things that drain your energy. Each day try to let go of one thing that drains your energy and add one thing that gives you energy.
Here’s my list. Take a piece of paper and make your own now.
My Energy Drains

• Not getting enough sleep (less than 8 hours)
• Eating too much sugar
• Drinking too much coffee (more than 1 cup)
• Skipping meals
• Eating anything made in a factory (junk and processed food)
• Eating bread
• Eating dairy
• Drinking more than 3 glasses of wine or alcohol a week
• Working too much
• Not exercising at least 4 times a week
• Not doing yoga
• Spending too much time on the computer
• Watching TV
• Not being outside in nature
• Not spending time with friends
• Getting dehydrated

My Energy Gains

• Eating a high-protein breakfast (shake or eggs)
• Eating fresh, whole real food
• Having a protein snack in the mid-morning and afternoon
• Eating 10 servings of vegetables a day
• Not eating 3 hours before I go to sleep
• Doing yoga
• Playing tennis
• Running in the woods
• Swimming in lakes or rivers
• Hugging my kids and wife
• Talking to friends
• Dinner parties with friends
• Helping others and volunteering
• Taking my vitamins (multivitamin, fish oil, vitamin D and a few others)
• Drinking 6-8 cups of filtered water a day
• Being creative in the kitchen and cooking for family and friends
• Thinking of my day as a sacred thing—a canvas for living an artful life—and shaping it to have good memories, good blessings, and good feelings
• Learning new things about our extraordinary world and the people in it

As John Lennon said, “Life is what happens when you are making other plans.” We all get kicked off our plan from time to time. Something intrudes, somebody gets sick in your life, you may lose your job, your kids may do something stupid, your spouse may cheat on you, the stock market might crash, or it might even rain! These are the inevitable struggles that are part of being human.
Let me share with you how I manage these struggles (yes, they happen in mine too,) and how I stay motivated.
Overcoming Obstacles on Your Path to Health
Dealing with challenges in life is like surfing. You get on the wave, and all is great … and then the wave drops out from under you, or it grows into a huge wave and pummels you into the ground. When that happens, you paddle back out, get back up on the board, and keep surfing.
Here are some ideas on how to do that:

1. Plan, plan, plan: You wouldn’t take a trip to climb a mountain or take a vacation to France without planning first. It is THE most essential activity you can do to create health. Plan your day, your week, your month and schedule in time for the things in your life that support health—food, fun, sleep, exercise, friends, or whatever else puts deposits in your health bank account.
2. Think of food first: Most of us are opportunistic eaters—when the opportunity comes, or when we get hungry we eat whatever’s in our path. In our culture that means junk food, fast food and vending machine “food like substances.” We live in a vast nutritional wasteland, a food desert. Every week plan where you are going to get all your meals. Think ahead; don’t end up in a food emergency where the only thing open is a fast food restaurant or convenience store. Think breakfast, lunch, dinner, and snacks. It will become a habit. Plan, shop, prepare, and eat. Create an emergency food pack and buy quick-to-cook meals or make whole foods at home.
3. Design fun and play into life: MacDonald’s was good for something—it gave us the ditty—“you deserve a break today.” Think of your day as a canvas and think of how you can paint yourself some fun. Learn new things—try yoga, dance, or a new sport. I like to get my exercise by having fun and playing not by going to the gym.
4. Prioritize sleep: We have a second national debt crisis—sleep debt. And there is no way to trick biology and raise the debt ceiling. Get at least 7-9 hours of sleep a night. Everything in your life will look and feel better and you will make better choices when you do this.
5. Avoid drugs: Almost all of us use drugs every day to manage our energy. These include sugar, caffeine, alcohol, and more. Think about taking a “drug holiday” for six weeks and see how much better you feel.
6. Remember feeling well: When I get off track, I simply remember what it is like to feel great and what I have to do to get there—eat better, sleep more, exercise more, or do nothing more!

Some of these habits might not be second nature. But our lives are about the thousand little choices we make every day. When I am really off track, I do a reboot—a week-long detox that resets my body, brain and rhythms. I use my UltraSimple Diet. It is a simple whole foods, sugar-free, drug-free, and allergy-free nourishing way of eating and living for one week that can create dramatic and rapid changes in your biology. Try it. Then you may remember what it feels like to be well, some of you for the first time.
Now I’d like to hear from you …
What steps have you taken to change your health? What obstacles do you face and how do you overcome them?
Have you tried taking a drug holiday like the one in The UltraSimple Diet? What were the results?
Why do you think we live in a culture where the simple act of being healthy is so difficult? How can we change this unhealthy culture to one that supports optimum energy and vital well being?
Please leave your thoughts by adding a comment below.
To your good health,
Mark Hyman, MD

How to Start a Mastermind Group

I want to inspire the world. I know myself and am proud of who I've become. We can't do this alone. We aren't meant to do it alone. Sometimes we all need prodding or a swift kick in the rear or an understanding look or hug. Inspiration. Evaluation. Reflection. Intention.

I want to create big things. To reach people. To help the world and myself heal. To be and do the best I can while I'm here on this planet. 

I'm a massage therapist and a student of Tibetan Chi Kung and mysticism.

There comes a time in a persons life when relationships are falling into place. I have people in my life a shaman, an acupuncturist, massage therapists, a grad student, a CPA, an account manager at United Way, and a wanna be cartographer. Each of these people know the truth when they hear it. They know how to be honest and vulnerable, to question and to acknowledge. I want to bring these people together to build something great. Each of us doing our own thing, moving forward and supporting each other. 

See what I'm talking about for yourself! Start your own mastermind group http://ow.ly/aUoMm  

The Role of Minerals in the Body | Divine Health

The Role of Minerals in the Body | Divine Health

Minerals are basically the spark plugs of life, or keystones to our health. Minerals are the catalysts that keep our ‘battery’ going and hold it’s ‘charge.’  Minerals compose about 4% of the human body. We cannot produce minerals within our bodies, so we must obtain them through our food. They ultimately come from the earth. Good soil is 45% minerals, yet our soils today are quite lacking due to synthetic fertilizers, mono-cropping and more. In the US our soils contain 86% less minerals than they did 100 years ago (based on a study done in 1992). Minerals are what remain as ash when plant or animal tissues are burned. (approximately 5 pounds from a cremated body.) They come from the earth and will eventually return to the earth.
There are 103 known minerals, at least 18 of these are necessary for good health. Mineral imbalance is epidemic. Osteoporosis is on the rise in our nation, 30 million people in the US over 50 are susceptible to fractures caused by mineral deficiencies in their bones. Over 1/3 of the women in America will have diagnosable osteoporosis in their lifetime. Osteoporosis isn’t even diagnosed until you’ve lost 30% of your bone mass. Nearly 100% of Americans have some type of joint degeneration by the time they are 40 years old.  Zinc deficiency is very common, evidenced by such health issues as; prostate cancer, breast cancer, hormonal imbalances, hydrochloric acid deficiency, skin cancer. Magnesium is a key element to keeping the cells metabolizing, involved in at least 300 functions in the body. It is particularly sensitive to stress, and can easily be lost. Most everyone is deficient in magnesium anymore, along will all of the main minerals of the body. It can take several years to re-mineralize the body. It can take 12 months to replace one mineral such as iron, so to replace more can take awhile.

Role of Minerals in the Body

•    Minerals act as cofactors for enzyme reactions. Enzymes don’t work without minerals. All cells require enzymes to work & function. They give us our vitality.
•    They maintain the pH balance within the body.
•    Minerals actually facilitate the transfer of nutrients across cell membranes.
•    They maintain proper nerve conduction
•    Minerals help to contract and relax muscles.
•    They help to regulate our bodies tissue growth.
•    Minerals provide structural and functional support for the body.

There are two categories of minerals essential within the body, macro-minerals & micro-minerals. There is no one mineral deficiency, they all must be maintained in balance within the body.

Macro-minerals
•    Calcium
•    Phosphorous
•    Potassium
•    Magnesium
•    Sulfur
•    Sodium
•    Chloride

Micro-minerals (or Trace Minerals)
•    Iron
•    Boron
•    Chromium
•    Iodine
•    Manganese
•    Molybdenum
•    Selenium
•    Silicon
•    Vanadium
•    Zinc
•    Lithium
•    Germanium
•    Rubidium
•    Cobalt
•    Copper

Of all of these minerals found in the body, calcium is the main mineral, it comprises almost half of the mineral content in the body. Just 1% of the calcium in the body is actually in the blood, so blood tests are not accurate answers to just how much calcium our body truly has. The other 99% is stored in the bone. In order for calcium to be absorbed and utilized by the body there are several factors to consider. For example, if the overall systemic pH is off, it will be difficult to utilize the calcium you eat. Also, your hormonal function affects your ability to attain the calcium you consume, as well as whether or not you are adequately hydrated or if you digestion is impaired. Calcium also works in tandem with other minerals (particularly magnesium), vitamins and fatty acids. If you are not eating a properly prepared, whole foods, nutrient dense diet, staying hydrated and improving your over all digestion, you could be eating all the calcium in the world and not be able to retain it. Most everyone gets adequate calcium in their diet, but are missing some or all of the above co-factors in their lives to make it of use to the body in the way it is intended.
Having appropriate calcium homeostasis plays a significant role in bone remodeling. Old bone tissue is continually being destroyed and broken down and new bone is continually being created. Osteoblasts are bone-forming cells that convert cartilage to bone. Osteocytes  are our primary bone cells, and they maintain bone tissue. Osteoclasts are the bone-destroying cells that help with the function in resorption.
Calcium is only made available for other tissues in the body when the bone is broken down during remodeling. Bone helps to buffer the pH level of the blood through the release of calcium from the bone. (Bone is a major buffer of calcium and calcium is a major buffer of blood pH.) When blood is too acidic it will pull calcium from the tissues. And when the blood gets too alkaline, calcium can separate out and get deposited into the wrong tissues, thereby causing problems if an excess occurs in those tissues. Calcium is also needed for every nerve impulse.

In order for calcium to be absorbed it needs an acidic environment. If there is inadequate hydrochloric acid in the stomach you won’t be able to utilize the calcium you consume. Additionally, zinc is needed to help create the hydrochloric acid. Minerals are more difficult for the body to extract from the food. Absorption from the GI tract is the first step to getting the minerals into circulation, it can be a fairly complex process. If you see any aspect of undigested food in the stool, you can be sure you are not getting your minerals. Anyone with osteoporosis or osteopenia should check the pH of the stomach and check for adequate hydrochloric acid levels.

If certain hormones are dysfunctional in the body this will also affect our bodies ability to utilize calcium. Such as parathyroid, thyroid, adrenal and sex hormones. The parathyroid hormone is primary in regulating the blood calcium levels. The mineralcocoritcoids produced by the adrenals are very important in regulating minerals, particularly sodium/potassium homeostasis which has a role in calcium homeostasis as well. Women that go through menopause have a much greater risk of bone loss. Estrogen and progesterone need to be in balance at this time to help with osteoclastic activity.

Appropriate fatty acid intake in the diet is necessary for the calcium to be transported through the cells walls. Fatty acids also help increase the calcium levels in the tissues. Weston Price and Royal Lee talked about the relationship between vitamin D and vitamin F (or fatty acids) through their studies. Vitamin D gets the calcium into the blood, fatty acids get it into the tissue. Without appropriate fatty acids you won’t get calcium into your tissues which is where a larger quantity of our body houses calcium. Vitamin D is necessary for calcium homeostasis and bone health. (if supplementing be sure it’s in the form of D3, not D2)

Additionally, we need good hydration to ensure that the  blood is fluid enough to efficiently transport calcium throughout the body to other tissues. We also need to get balanced electrolytes (electrically charged ions of calcium, sodium, potassium , chloride, bicarbonate) to ensure an appropriate transfer of calcium in and out of  the cells. This is only the beginning of understanding how just one mineral works within the body. However, they all work synergistically, so it is very important to consume a high quality real food diet based on the properly prepared foods paradigm discovered by Weston A. Price through his studies of indigenous people groups. We need a full spectrum approach to ensure we are getting adequate mineral intake, not just supplementing with some or one or two individual minerals, hat will always throw off the mineral balance in the body. Be sure to consume a wide array of fresh real whole foods in season and properly prepared.

Best Food Sources of Minerals

By far the best and most ionic form of a full spectrum of minerals is bone broth. A full spectrum good quality sea salt is also a fabulous way to get in minerals and trace minerals. Also good mineral rich water from wells is a great option, but one that most of us no longer have access to. Animal proteins from well raised animal on pasture and grassfed as well as wild seafood are another great source. Properly prepared nuts, seeds  and legumes are excellent as well. Remember to pair these foods with good fatty acids to ensure you are actually utilizing them well. If you are not well versed on which fats are optimal, please read my post here on; ‘What Fats You Should Be Consuming.’  Raw milk dairy products (not pasteurized or homogenized), cultured dairy and cheeses are an excellent source. Pastured eggs are rich in a wide array of nutrients that all synergistically support each other. Dark leafy greens, sea vegetables, oysters, even butter and liver. If you are familiar with the foods recommended in ‘Nourishing Traditions’ and make sure to get a balanced diet from them you are likely getting the minerals your body needs. Just remember that there are cofactors to consider when your body shows signs of deficiencies.

Using Rhythm to Reinforce Your Healing Practice

adapted from "Awakening Beauty the Dr. Hauschka Way"

It is good to have a massage, acupuncture, chiropractic care or other therapy, but one session will not create lasting effect. The reason is that the impact of the treatment will dissipate with time. On order for healing touch, massage, acupuncture and other forms of mind, body, spirit health care to transform you, their effects must be reinforced with regular treatments. If you want to maximize the power of those treatments, use rhythm to reinforce their healing effects. 

Let's say you see a practitioner weekly, or even once a month. Schedule your appointments for the same day each week, or each month, at the same hour-for example 3 P.M. every Thursday, or 3 P.M. on the third Thursday of each month. Your body, mind and spirit will then become aware that they are getting a boost of healing energy in a rhythmic, or wavelike, pattern. With continued treatments, that pattern will be reinforced, deepened, and strengthened.  Soon, your internal rhythms will rise automatically as the time approaches for your treatment, thus boosting your self-healing forces and conditioning your body to heal.

Thank you to Susan West Kurz and Tom Monte

what do you want to revolutionize?

Top Five Regrets of The Dying - Exposing The Truth

Top Five Regrets of The Dying

December 1, 2011 By T Kelly 33 Comments

For many years I worked in palliative care. My patients were those who had gone home to die. Some incredibly special times were shared. I was with them for the last three to twelve weeks of their lives.

People grow a lot when they are faced with their own mortality. I learnt never to underestimate someone’s capacity for growth. Some changes were phenomenal. Each experienced a variety of emotions, as expected, denial, fear, anger, remorse, more denial and eventually acceptance. Every single patient found their peace before they departed though, every one of them.

When questioned about any regrets they had or anything they would do differently, common themes surfaced again and again. Here are the most common five:

1. I wish I’d had the courage to live a life true to myself, not the life others expected of me.

This was the most common regret of all. When people realise that their life is almost over and look back clearly on it, it is easy to see how many dreams have gone unfulfilled. Most people had not honoured even a half of their dreams and had to die knowing that it was due to choices they had made, or not made.

It is very important to try and honour at least some of your dreams along the way. From the moment that you lose your health, it is too late. Health brings a freedom very few realise, until they no longer have it.

2. I wish I didn’t work so hard.

This came from every male patient that I nursed. They missed their children’s youth and their partner’s companionship. Women also spoke of this regret. But as most were from an older generation, many of the female patients had not been breadwinners. All of the men I nursed deeply regretted spending so much of their lives on the treadmill of a work existence.

By simplifying your lifestyle and making conscious choices along the way, it is possible to not need the income that you think you do. And by creating more space in your life, you become happier and more open to new opportunities, ones more suited to your new lifestyle.

3. I wish I’d had the courage to express my feelings.

Many people suppressed their feelings in order to keep peace with others. As a result, they settled for a mediocre existence and never became who they were truly capable of becoming. Many developed illnesses relating to the bitterness and resentment they carried as a result.

We cannot control the reactions of others. However, although people may initially react when you change the way you are by speaking honestly, in the end it raises the relationship to a whole new and healthier level. Either that or it releases the unhealthy relationship from your life. Either way, you win.

4. I wish I had stayed in touch with my friends.

Often they would not truly realise the full benefits of old friends until their dying weeks and it was not always possible to track them down. Many had become so caught up in their own lives that they had let golden friendships slip by over the years. There were many deep regrets about not giving friendships the time and effort that they deserved. Everyone misses their friends when they are dying.

It is common for anyone in a busy lifestyle to let friendships slip. But when you are faced with your approaching death, the physical details of life fall away. People do want to get their financial affairs in order if possible. But it is not money or status that holds the true importance for them. They want to get things in order more for the benefit of those they love. Usually though, they are too ill and weary to ever manage this task. It is all comes down to love and relationships in the end. That is all that remains in the final weeks, love and relationships.

5. I wish that I had let myself be happier.

This is a surprisingly common one. Many did not realise until the end that happiness is a choice. They had stayed stuck in old patterns and habits. The so-called ‘comfort’ of familiarity overflowed into their emotions, as well as their physical lives. Fear of change had them pretending to others, and to their selves, that they were content. When deep within, they longed to laugh properly and have silliness in their life again.

When you are on your deathbed, what others think of you is a long way from your mind. How wonderful to be able to let go and smile again, long before you are dying.

Life is a choice. It is YOUR life. Choose consciously, choose wisely, choose honestly. Choose happiness.

Source: http://www.activistpost.com/2011/11/top-5-regrets-of-dying.html

What Knot

by Matt

“What is that thing, anyway?”

I’m always getting asked this question. I’m a massage therapist, and “that thing” is a knot. But what’s a “knot”? The short answer is “I don’t fully know,” but I’m not fully convinced that anyone else does either. Given my experience and education I will try my best to explain what we’re talking about when we say “knot” in massage.

Embarrassingly, the word “knot” occupies a kind of conceptual no man’s land between clinical definition and common language. Basically, we know one when we see one, but no one really knows of what it is comprised, or what set of criteria its qualities must satisfy to be called a knot. There is no medical definition of a knot.

photo by woodleywonderworks

It would probably be more accurate for me to say that no one really agrees on every aspect of what constitutes a knot, how you get knots, and how to treat them. However everyone agrees that a knot forms in muscle tissue. This includes connective tissue such as fascia and maybe tendon. Blood almost certainly plays a role, as does our nervous system. They are raised from the rest of the surface, and sometimes they are tender.

Secondly, knots also tend to form in stressed or damaged muscle. Overdoing it in the gym or on the trail will certainly aid this, but most massage therapists I work with are more inclined to find knots in muscles associated with desk work. These associate with the commute and compute postural distresses of holding your head and arms away from your body for too long.

Knots, as we vaguely understand them, are also likely to form in stressed or challenged people. I don’t mean to overstep my scope of practice here, but I will simply observe that people undergoing emotional stress due to family, career, or other life events often are also going through emotional stress. I’m constantly hearing, “Oh I keep all my stress in my neck and shoulders.” And I often find knots up there.

In my experience adhesion between muscle fibers or muscles, trigger points, and/or some combination of the two commonly present as something we clumsily describe as a “knot.” The term is nonspecific and could refer to cases that are dissimilar in most other aspects, but knots of any variety are non-lethal. Massage, rest, stretching, detoxification, lifestyle changes all contribute positively to their mitigation, though there is some debate as to whether they can actually be removed. This is true for which ever classification of knot we describe.

Still, knots remain elusive to clinical definition. To my knowledge no one has tried to biopsy one, I don’t know if they show up in cadavers. Based on the indications for treatment from my perspective as a therapist, I suspect most knots are masses formed from thickened muscle tissue and attendant metabolic wastes and associate with the combination of adhesion and trigger points.

Some knots seem to invest more than one muscle tissue. Comprised of inflamed myofascial layers, and almost always including a concentrated degree of connective tissue, these knots feel gristly, and their size does not predict sensitivity to pressure. These knots tend to sound and feel “crunchy.” I’ve heard this crunchiness comes from either connective tissue build up or from calcium crystal build up. It may not even be associated with the muscle, but with the ribs underneath the tissue.

Knots that refer pain within the domain of a predictable pain pattern are more accurately described as trigger points, and I get the feeling that most practitioners and quite a few clients are really talking about trigger points when they are speaking about knots. Trigger points are germane to our weird little world where a phenomenon of objective anatomical pathology overlaps with the intellectual property of their namer, Dr. Janet Travel, but the medical field officially recognizes them.

Where knots are general, trigger points are specific, predictable, and often don’t even present as knots. I find the most common ones show up in the upper back and in the calves. Trigger points by definition form within tight bands of muscles in predictable locations, they grow in mass, sometimes produce greater heat, and are sensitive and painful to the touch. Frequently, the pain associated with a trigger point refer to other points in the body. In my opinion treating trigger points are clinically more significant than the general presentation of knots.

Most therapists will treat knots of any variety with localized pressure delivered directly to the knot. More sophisticated practitioners, whether from training or experience, will undoubtedly apply different techniques to your knots based on what they feel. Generally speaking, true trigger points respond better to direct pressure than the more gristly “adhesion” knots. Releasing trigger points in this way can relax the entire muscle. Adhesive knots seem to respond better to being “ironed” or “combed” out of the tissue. Sometimes separating one muscle from the other through movement can deal with those types of knots.

So, if you suffer from knots, be they trigger points or of a more general character, massage can certainly help. But keeping in mind that they seem to form in relation to how we use our bodies, I would also suggest taking the time to assess your lifestyle and how you inhabit your body throughout the day. You may be able to change a habit or arrangement so that you don’t form the knots as quickly in the first place.

Massage: It's real medicine

Knead Massage?

Massage: It's real medicine - CNN.com

POSTED: 9:48 a.m. EST, March 8, 2007

By Kristyn Kusek Lewis
Health.com

Having your honey rub your back is sweet, but it's tough to compete with the hands of a pro. A good massage therapist can make you feel like a new person. And now research suggests massage can ease insomnia, boost immunity, prevent PMS, and more. Maybe that's why hospitals are making it a standard therapy.
"All of our surgery patients are offered the treatment -- I call it 'service with a smile' -- and it's a mandatory weekly prescription I give myself," says Mehmet C. Oz, M.D., director of the Cardiovascular Institute at New York Presbyterian Hospital--Columbia Presbyterian Medical Center and a member of the board at LLuminari, a health-education company.
Our advice: Enjoy your hands-on time with your sweetie, but set aside some time for a real massage, too. Here are some feel-good reasons:
Goodbye, pain
It sounds like a no-brainer, but rubdowns are especially effective for aches like low-back pain. Researchers at the Group Health Center for Health Studies in Seattle, Washington, found that massage works better than common treatments including chiropractic therapy and acupuncture. It's not clear why, but several studies show massage reduces levels of the stress hormone cortisol while boosting the feel-good hormones serotonin and dopamine. Those changes slow your heart rate, reduce blood pressure, and block your nervous system's pain receptors. Massage also increases blood flow to the muscles, which may help them heal. (Health.com: Frequently asked questions about massage )
A bonus: Massage also seems to ease distress from migraine, labor pain, and even cancer, as well as the body tenderness seen with fibromyalgia, says Tiffany Field, Ph.D., director of the Touch Research Institute at the University of Miami School of Medicine. Plus, the benefits may last as long as a year after just a few treatments, says Partap Khalsa, Ph.D., a chiropractor and a program officer at the National Institutes of Health's National Center for Com­plementary and Alternative Medicine, the agency funding many major studies on massage.
Hello, dreams
Fluctuations in several types of brain waves either relax you or wake you up. Massage increases delta waves -- those linked with deep sleep -- according to a study at the Touch Research Institute. That's why it's easy to drift off on the massage table, Field says.
Nice to have you back, brain power
The Touch Research Institute study that connected massage to sleep also found that a 15-minute chair massage boosted alertness. "Subjects reported that it felt like a runner's high," Field says. Tests also show that brain-wave activity stimulated by massage is linked to improved attention.
Take that, colds
Massage helps ward off bugs by boosting your "natural killer cells," the immune system's first line of defense against invading illness. "We know that cortisol destroys natural killer cells," Field says. "Therefore, since massage decreases cortisol, your immune cells get a boost." Massage even seems to boost immunity in those people with severely compromised immune systems, such as breast-cancer patients.

Blues, be gone
Less cortisol and more serotonin and dopamine in your system may also mean less stress, anxiety, and depression. "We know that the right side of the frontal lobe of the brain is more active when we're sad, and the left side's activated when we're happy," Field says. "Our studies have observed that massage decreases activity in the right lobe and increases functioning in the left." The well-being people feel after a massage is a big reason why some hospitals offer it to anxious patients pre­paring for surgery and cancer patients going through chemo.
Shove off, PMS
A small study of 24 women with severe PMS found that massage reduced symp­toms such as pain, water retention, and mood swings. Try it with proven remedies such as exercise (and who-cares-if-they-work solutions like a little dark chocolate).

Hydrotherapy at Home

Simple Ways To Complement Your Massage

By Marybetts Sinclair

Originally published in Body Sense magazine, Autumn/Winter 2010. Copyright 2010. Associated Bodywork and Massage Professionals. All rights reserved.

Hydrotherapy treatments can be relaxing, healing ways to extend the benefits of your massage. Treatments you perform at home can help you take charge of your own health. Aches and pains, injuries, muscle tightness, and even joint stiffness can all be soothed with these simple, at-home hydrotherapy treatments.


Epsom Salts Footbaths
Epsom salts footbaths may be helpful for bruises, sprains in the subacute stage, soreness after exercise, soreness after massage, chronically cold feet, edema of pregnancy, or arthritis pain. You will need a water thermometer, a chair, a plastic tub, 2 cups of Epsom salts for an adult (1 cup of Epsom salts for a child), 1 bath towel, and a bath mat.


Procedure
1. Place a bath mat on the floor in front of the chair.
2. Fill the tub with warm (not hot) water, about 98-102F. Pour the Epsom salts directly under the spigot as soon as you begin filling the tub to make sure they dissolve completely. If your massage therapist has suggested you add essential oils to your footbath, add them after you have finished filling the tub.
3. When the tub is full, place it on the towel, then sit on the chair and put your feet in the water.
4. Keep your feet in the water for 15-20 minutes.
5. At the end of your footbath, rinse and dry your feet.
6. Apply a moisturizing lotion to your feet and then put on socks.`


Shower Exercises
A hot shower and neck-limbering exercises may be helpful for chronically tight muscles, stress, injury, soreness after exercise, muscle spasms, or arthritis pain. These exercises may be performed as frequently as three times a day.

Do not stay in a long, hot shower if you have any of the following conditions: cardiovascular problems, diabetes, hepatitis, lymphedema, multiple sclerosis, seizure disorders, hypothyroid conditions, loss of sensation (lack of feeling), or any condition that might make you unsteady on your feet or unable to tolerate heat, including alcohol or drug use. If pregnant, reduce the temperature of the shower.

You will need a water thermometer, bath towel, and bath mat.


Procedure
1. Turn on your shower to hot and get in carefully.
2. Adjust the temperature so it is toasty, but to your tolerance (about 105-115F). Let the water beat on your neck for at least three minutes. Move your head as if you were drawing all 26 letters of the alphabet with your nose. This will release muscle tension and make your neck more limber.
3. Stay in the shower for no longer than 10 minutes.
4. Get out of the shower carefully so you do not slip.
5. Dry off and get dressed. Select a shirt that will keep your neck warm.

Marybetts Sinclair has been a massage therapist in Oregon for more than 30 years. She is the author of Modern Hydrotherapy for the Massage Therapist (Lippincott Williams & Wilkins, 2004). For more information, visit www.marybettssinclair.com.

Your Massage Session

Dialing in the Details for a Great Experience

By Karrie Osborn

These basic bodywork etiquette guidelines will help you get the most out of your massage, create a healthy client-therapist relationship, and address some of those unknowns.


It's All About Timing
Be good to yourself, and show up a few minutes early for your session. This allows you to transition into calm, healing space and focus on the massage. It also ensures you'll receive your full time allotment for the massage.

When scheduling at a spa, most guests are asked to arrive early to prepare for their session, stow belongings, and even enjoy the facility's amenities, such as a steam room, before the scheduled service begins. New massage clients will also need to fill out health history intake forms.

If you do get held up in traffic and arrive late to your appointment, the therapist will probably not be able to give you a full session. Respect your therapist's time, call if you're going to be late, and understand that your session must end on time, regardless of when you arrived.

When it comes to cancellations, most spas and private practitioners require a 24-hour notice to avoid fees. Every situation is different, so check with your therapist about his or her specific cancellation policy, and then honor it.


Honor Your Body
Some people have a hard time even considering massage because they are so unhappy with their body. Primarily a female issue, poor body image can be extremely damaging. While it's hard to imagine that taking your clothes off and lying on a massage table will make the situation any better, massage therapy can do wonders to bring an individual back into body awareness. Bodywork can help mend the body-mind chasm that is created through self-hate, bringing the two pieces back together in a peaceful, healthy union.

Massage therapists and bodyworkers not only have advanced knowledge of tissues and structure, they also have a great appreciation for the human body as a whole, no matter its shape or size.


Communicate
One thing that will make your massage both more enjoyable and more beneficial is communicating with your therapist. If the room is too warm, if the bolster under your legs isn't in the right spot, if the music is driving you batty--whatever the issue--let your therapist know right away so you can get back to the business of enjoying your massage.


Skip Alcohol for Water
In resort settings, it can be hard to step away from icy margaritas on the beach to make that afternoon spa appointment. But the last thing you want is to be "tipsy" on the massage table. There are several downsides to being under the influence during a massage, the most important being how alcohol wreaks havoc with the body and can have a negative interaction when combined with bodywork. The result can be dizziness and nausea. That's no fun and a waste of good massage time and money. Leave the alcohol for another time. Water, before and after a therapeutic massage, is what the body really wants.


Won't Find That Here
It's unfortunate that massage therapists even have to address this subject, but they do. So the answer to late-night callers is, "No, we don't give happy endings. No, you may not pleasure yourself. Therapeutic massage has nothing to do with sex." If a misinformed client somehow ends up in the massage room of a professional therapist and asks for something other than therapeutic massage, they will be asked to leave. Flirting, inappropriate touching, and sexual innuendos will not be tolerated. Keep the relationship professional and above board and your therapist will be a valuable member of your healthcare team.


You're Human
The body can have a lot of responses to therapeutic massage. While avoiding food at least one hour before your massage will help, there's still the chance that you'll have tummy gurgles or even pass gas. It's okay. As the body relaxes and systems get moving, the body can play all kinds of tricks. Your therapist has seen it all, yet sees well beyond those kinds of issues.

For men, there's even a possibility that massage will cause an erection--a normal response to nervous system activation. It rarely occurs, but if it does, your therapist will likely shift the focus of the work.


Time To Wake Up
While a nap after your massage may sound lovely, other massage clients will be arriving soon and the room must be readied for them. When your massage concludes, your therapist will say something along the lines of, "Our session is over. Take your time getting up." That's your cue to take a moment as you come back to the here and now. Carefully sit up, allowing your body enough time to readjust. Go slow or else your body will knock you for a dizzying loop. Also, be careful not to slip getting off the massage table, especially if your therapist used oil on your feet.


Insights on Tipping
While it's customary to tip 15-20 percent, most experts say it's ultimately the client's decision. Like in other service industries, providing a tip is usually done in response to excellent service. A couple of notes: Many therapists who work in spas earn only a small percentage of what you've paid for their services. For these therapists, tips are an important part of their income. On the other hand, tips are usually not accepted for massage performed in a medical environment. Unsure what to do? Ask if tipping is customary and what is the policy.

Making the Most of Your Massage

How To Achieve Lasting Effects

By Nina McIntosh

Originally published in Body Sense magazine, Autumn/Winter 2005.
Copyright 2005. Associated Bodywork and Massage Professionals. All rights reserved.

It may seem like all you have to do to get the most out of a massage is show up, relax, and let the massage therapist do the rest. In some ways, that's true. But there are also some things you can do that will make your experience even more enjoyable, all while building a solid working relationship with your massage therapist. Following are some "insider tips" to help you get the most out of your sessions.

Speak up about your concerns and questions.
I've learned that expressing myself to my massage therapist is an important key to my sense of security during the treatment. Of course, you want to let your massage therapist know if the room is too hot or too cold, whether the music suits you, and so forth.

But beyond those comforts, you also have a right to ask questions related to the work at hand -- for instance, the therapist's training in a particular technique or any risks involved. Also, don't be embarrassed to ask for a clearer explanation of anything the massage therapist says that is too technical or in jargon you don't understand.

Don't be embarrassed by "betrayals of the body."
Your massage therapist knows that, as people relax, they can have responses not considered "acceptable" in polite society. People can pass gas or, when on their stomach, drool on the sheet. Men may have erections if they fall asleep or simply from the pleasure of relaxation and not because they are thinking about sex. Your massage therapist will generally ignore such unintentional occurrences.

Go regularly.
Though treating yourself to a massage every now and then is a valuable boost to your self-care, you're likely to see even more benefits with regular treatment. Try getting massage at least twice a month for a while to see the power of the cumulative effects.

Enhance the benefits both before and after the massage.
Most clients know they will get more out of their massage if they try to wind down before it starts and give full attention to it once it's begun -- turning off cell phones while also clicking off the mental switch on the day's concerns and problems. It's also helpful if you know to schedule your massage at the end of your workday and bring along your casual clothes to wear when you leave. Struggling into panty hose or retying a tie can be a nuisance after a relaxing hour.

Keep appointments, and pay at the time of the appointment.
As with other professionals, massage therapists expect you to keep your appointments and pay for them at the time of the service, unless you make other arrangements ahead of time.

If you show up late, understand that your session will likely be shortened to be able to keep the therapist on schedule. Even if your therapist has no other appointments that day, she has a right to keep to her schedule.

Similarly, if you show up early, your massage therapist probably won't be able to begin your appointment until the arranged time. Even if your therapist isn't with a client when you arrive, she may need the time to return phone calls or just gather herself so she can be at her best for you.

If you must break an appointment, know your therapist's policies. Most ask for at least a 24-hour notice. Because they need that time to fill the slot with another client, many therapists will ask you to pay if you cancel without enough notice. Of course, if you have an emergency, you usually won't be charged.

If you miss an appointment altogether without notifying your therapist, don't be surprised if she crosses you off her client list. If you are able to make another appointment, expect to pay for the missed hour.

Be ready for home sessions.
If you receive massages in your home, be ready for the session to start at the appointed hour. You'll enjoy it more if you turn off the phone and don't have children running about or a baby to attend to. Try to give yourself uninterrupted time for the session.

In a spa, ask about tipping.
If you receive your massage at a spa, ask the therapist (or the front desk person) if tipping is appropriate. Often those who work in spas count on gratuities to supplement a relatively low salary. If the spa doesn't have an automatic percentage, adding 10 percent to 15 percent is customary.

When in doubt, shower beforehand.
Most people perspire as they go about their normal day, especially in warm weather. A slightly moist client isn't a problem for most massage therapists. However, if you've been working in the yard, jogging, playing tennis, or the like, jump in the shower or take a relaxing bath before you go to your appointment. If you're slippery with perspiration, the therapist will find it difficult to work on you, to say nothing of not wanting to push grime into your body. And it will only help you relax that much more in preparation for your appointment.

Mums the word.
If you have a friend or family member who also sees your massage therapist, don't try to engage your therapist in conversation about them. While it's fine for you to talk about these folks, know that it will be a one-sided conversation. Your therapist is bound by confidentiality and can't answer questions or gossip about clients.

Let your massage therapist know ahead of time about illnesses or contagious conditions.
Your massage therapist probably asked your about your history of physical conditions when you had your first appointment. However, keep your therapist current on any physical problems that come up, even if they seem to be temporary.

If you have a cold or flu, talk with your therapist before you go for your session. Your therapist may decide that a massage that day isn't a good idea, either because you may be contagious
or because you might feel worse afterward.

If you have any contagious skin conditions, such as athlete's foot or poison ivy, be sure to let your massage therapist know.

***

While it's your massage therapist's job to make sure you are pampered and taken care of, being "in the know" can make your massage sessions feel even more relaxing and worthwhile.

Nina McIntosh has more than 20 years experience as a bodyworker. She's the author of The Educated Heart: Professional Guidelines for Massage Therapists, Bodyworkers and Movement Teachers, and Massage & Bodywork magazine's Heart of Bodywork column. Contact her through www.educatedheart.com.