16.3.20

Massage in the Time of Covid-19

WV Massage Gathering friends -

[this is an old web site of mine from "way back when," but I just needed a fast, easy place to share this information with you]

I am posting this on March 16, 2020, and will likely edit/add/delete information in the future, so feel free to check back over time. At the time of this writing, WV remains the only state in this country without any confirmed Covid-19 cases. Given the kind of work we do, we need to be very careful to be a part of the solution and not part of the problem.

I encourage you to look at reliable web sites for more information about the virus (CDC, WHO, etc.), as well as look at web sites that some massage therapists have on which they have published a statement about their office's response to the Covid-19 issues. I am in the process of doing my research, deciding what I think is important to share with my clients in my own practice, and putting it on paper to post and share with current and future clients. I offer the following merely as ideas for you to consider, research, and possibly share in your own offices.

If you have comments, suggestions, ideas, or whatever, please share them with me so I can share them with other bodyworkers. I hasten to add that I haven't yet gone onto the ABMP (or AMTA) websites to see what they have. This is a very rough first draft of ideas that resulted from our WV Massage Gathering this morning at Cracker Barrel in Fairmont. I hope it helps you as you face the effects of Covid-19 in your professional and personal life.

These are in no particular order:

"First, do no harm." [well, okay, that order was deliberate, "first" and all...]

Learn about Covid-19, and update your knowledge daily as it changes quickly these days.

TAKE CARE OF YOURSELF! Breathe, hydrate, SLEEP, exercise, eat healthy foods.

Consider keeping your hands in your pockets when you are out in public so you are less likely to touch surfaces and/or your face.

Consider writing some sort of statement to share with your clients, so they know that you are doing what you can to take good care of them and they can know what changes, if any, to expect.

Respect the fact that you are a risk to each of your clients as a potential source of Covid-19 even if you feel well. Also, each of your clients is a potential source of Covid-19 to you, and to all the rest of your clients.

Understand that their discretionary income may be lower than usual or severely limited. Many people will have no source of income. Your practice may slow down for a while.

Make some decisions ahead of time, including your attitude about "social distancing" in your practice. Many of us hug clients. Figure out if you are going to continue to do that or not. Then let your clients know ahead of time so it's not awkward and/or they don't think you suddenly don't like them. You might decide to continue to hug. You might want to put your palms together and slightly bow. You might hug yourself while they hug themselves, have a laugh, and feel hugged.

Perhaps you're not a hugger, but when meeting a new client they might extend their hand to shake it. If you don't want to reciprocate, make sure you clearly explain why so they don't stand there feeling stupid or thinking you are rude. Again, let your clients know ahead of time about anything you are changing.

Be honest with your clients about your practices so they can assess their risk in continuing with their massages. They deserve to know, and they need to know.

In light of the fact that this may affect us for quite a while yet, budget your money wisely. This may not be the time to sink money into a whole new stash of essential oils or that fancy new table you have your heart set on. Or it might be. Just be smart.

Clean and sanitize your office, obviously. I know we all work hard to keep germs away from clients, but this is even more crucial right now. Rather than just changing linens, actually clean the face rest itself after every massage. Clean your oil pump and bottles. If you use cream, make sure you don't double-dip from one client to another. Put it into little 1 or 2 ounce containers, then throw away what's left after a massage. Do some research to decide what's best for you to use to clean various surfaces in your office (including your phone, your stereo, door handles, light switches...).

Wash that fleece face-rest cover thingie that goes under your pretty face-rest covers (or have enough on hand to put on a fresh one for every massage, or consider not using a fleece one and cleaning the vinyl face rest itself each time). Wash your blanket daily - better yet, have enough to swap out blankets for every massage (clients often touch blankets, as do we). Wash all cloth items after each use, not just your sheets. And wash them appropriately to kill the virus. Do your research about washing fabric. It does require soap to break the membrane around the virus (which kills it), so don't be stingy with your detergent.

Before you leave your office at the end of your day, clean all touched items. That way you don't have to come in the following day and immediately start cleaning. Do your research - the virus can live, I believe, from 3 hours to 3 days depending on the surface. So at least you can give your office a headstart to killing the virus in your absence.

Dry your hands on paper towels, not cloth towels - unless you throw every towel into the hamper after it's used just that one time.

We wash our hands all the time, I know. Wash them even more, better, longer. Do some research on what to wash them with and for how long. Wash them right before you put them on your client, and right after you walk out at the end of a massage. Wash your hands the minute you walk into your office at the start of the day so you don't drag in something you picked up on your way in. And wash your hands the minute you walk into your house at the end of the day.

Wash your hands where your clients can see or hear you doing it, so they know for a fact that you are taking the best care of them that you can. If you have to wash hands outside of your massage area, then come back with the paper towels in your hands so you don't touch surfaces on the way back - and to show the client that you did, in fact, wash your hands.

I'm not face-mask conversant, but will learn more about them. You may want to have one available in case your client asks you to wear one. I'm sure they cut down on how often you touch your face, too, since it's hidden behind cloth.

If you do home visits, give serious consideration to the risks to you, your client, and their home.

This might be a good time to slow down at work. See those who really need to be seen, but take more time off than usual.

And if you end up doing a self-isolation or quarantine, etc., use that new-found time to earn CEUs online! Catch up on client paperwork! Find ways to augment your income. Use the time to get healthier - cook real food, sleep, exercise at home, hydrate, etc. Educate yourself even more about Covid-19. Stay up to date every day with the latest news on the virus.

This is a time when we all want our immune systems to be as strong as possible, so do take care of yourself especially now. You can live without air only a few minutes. Without water for only a few days. The third most important thing to remain alive is, truly, sleep. Not food. Not shelter. Sleep. So make sure you are getting plenty of good, solid sleep right now.

During the massage, consider not sitting at the head of the table with your client supine because your face is right above theirs. A mask might be smart in that situation if you must sit there.

Consider not massaging the face, but again, be sure you tell your client ahead of time and explain why. Of course, if they are having problems with muscles in the face, then do that massage but do it carefully and with whatever precautions you can.

Consider not massaging their hands - unless you have them wash their hands in front of you after they are in your office (assuming you have a sink in your treatment area). Again, if they have issues that need to be addressed in their hands, then proceed with due care.

Thinking again about the face rest cleanliness issues, consider not using a face rest right now unless absolutely necessary. Is there a way you can provide pillows so they can be comfortably prone without the face rest? Maybe this is a great opportunity for you to practice more sidelying massage techniques. Or seated massage. Or have them supine and slip your hand between the back of their body and the massage table. Incorporate more stretching in place of the neck/shoulder/back work you might want to do. Get creative with your forearms (especially if you just came back from Forearm Fusion), tools, stretches. Think outside the box. Mix it up. Kick it up a notch. Make it even better!

Do what you can to not breathe on your clients. Don't exhale out of your nose because it often points right at the client. Exhale sideways from your mouth, or at least turn your head away. And keep doing that even after this virus is gone. Clients don't appreciate being breathed on.

Obviously, don't touch your face. Either use your shoulder or use mind-over-matter to make it go away. If you must, then do it, but go wash your hands afterwards before you return to your client.

Oh, and DEFINITELY don't go to your office if you don't feel 100% healthy. Or if anyone in your home or who has been near you doesn't feel well, is sick, is waiting for a Covid test or the results of a test. Tighten your budget rather than risk anyone's health.

Make sure your clients know that they can cancel at the last minute (of course, we don't like no-shows, but better even a no-show than a sick client on your table). If you charge clients for a less-than-24-hours cancellation, consider dropping that policy for now. And if you do drop it, make sure your clients know so they will more likely be honest about how they feel.

Make sure your clients cancel if they don't feel well, are in isolation/quarantine, or live with or have been around anyone who doesn't feel well or thinks they might have the virus or been exposed to it.

Encourage your clients to tell you what they want you to do or not do. Open, clear communication is even more important right now. Set aside your "usual routines" and be mindful of that person in that moment so you can accommodate them (or explain why you can't or won't).

Consider telling your clients that for the time being you are starting a new practice, and that is that they are to wash their hands in front of you in your office before the massage and again as they leave your office.

With all the handwashing we already do, I know my hands sometimes get pretty dried out. I use a heavy moisturizing cream at night, then slip cotton gloves on and sleep that way. It really helps. Right now, I find it even more necessary with all the extra scrubbing of my office and my hands. Don't let your hands get rough and dry and scratchy on your client's skin. Take care of your hands!

This all may sound like overkill, and maybe it is, but at the very least I think we each need to educate ourselves and behave in a responsible fashion for the people who trust us with their bodies.

But also make sure to find fun things to share with your clients, smile, laugh, relax, engage and connect in the most pleasant ways possible for both your client and for you. 

In closing, I will make a final suggestion. Get that clear plastic "cone of shame" that you put on a pet after surgery and put it on yourself to keep your hands off your face. Then put on a pair of mittens - that will effectively stop you from using your hands/fingers... LOL

Be well, and stay that way, my friends!

- Nancy Goodpasture