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Do you tip? Are you supposed to be nude?questions_poster.gif Do you say anything if the pressure's not deep enough? What if you're self-conscious about your body? Here are the answers to 12 massage questions you want to ask, but may be too embarrassed to:

  1. What conditions can be treated with massage?
  2. What are common massage techniques?
  3. What are the qualifications of a massage therapist?
  4. What are the Benefits of Sports Massage?
  5. Am I supposed to tip my massage therapist?
  6. Am I supposed to take off my underwear when I get a massage?
  7. What if I realize I've drooled during the massage?
  8. Will the massage therapist be there when I undress?
  9. Should I talk to the massage therapist during the massage?
  10. The pressure isn't deep enough, but I don't want to insult the massage therapist's technique. What should I do?
  11. I'm self-conscious about a certain part of my body and don't want the massage therapist to see me. What can I do?
  12. I'd rather see a female massage therapist. Should I request this?

1. What conditions can be treated with massage?
Most people think of the 'relaxation' massage when asked about massage therapy. While this is one of the major uses and benefits of massage, its usefulness does not end there. Today, massage is commonly used to treat everything from carpal tunnel syndrome to tendonitis to breathing difficulties. A few of the conditions that massage therapy can help relieve includes: adhesive capsulitis, sprains and strains, osteoarthritis, sciatica, headaches, iliotibial band syndrome, chrohn's disease, menstrual difficulties, pregnancy and much more.

2. What are common massage techniques?
Our massage therapist utilize Swedish massage, trigger point techniques, and manual lymph drainage. Swedish massage uses a variety of manipulations that include effleurage (gliding), petrissage, which includes kneading, squeezing, wringing, picking up, and skin rolling techniques, tapotement (percussion), shaking, stroking, and vibration. The uses of these techniques are many and varied depending on the goals of the treatment. Thermophores (heating pads) are a form of moist heat used on various areas of the body to help relax deep muscles. Cold and ice are also used to help decrease any swelling or inflammation. Trigger point techniques are often used to rid a muscle of any trigger points. Trigger points are a hyperirritable spot within a taut band of muscle or fascia that are painful on compression. The techniques used include muscle stripping, direct compression and stretching. Manual lymph drainage is used to help decrease edema (swelling) caused by trauma. Drainage is performed by lightly compressing lymph nodes located in the area of congestion thereby creating a passage so that the lymph may drain. Other techniques used by the massage therapists include deep tissue and fascia mobilization, and friction therapy.

3. What are the qualifications of a massage therapist?
In Ontario, the minimum requirements to practice massage therapy are quite high. In fact, the only place that has higher qualifications in the world is British Columbia. Presently, the therapist is required to undertake a minimum of 2200 hours of intense academic training, where the student learns anatomy, physiology, pathology, massage treatment & assessment skills, and many other topics. In addition, the student must also complete a minimum of 150 treatment hours with members of the general public. The student is then required to pass a comprehensive exam prepared by the attending school. Upon passing the exam the student is then required to take a two-part exam with written and oral-practical components. Successful completion of this exam bestows the title of massage therapist along with the rights and responsibilities of the profession.

4. What are the Benefits of Sports Massage?
Sports massage can serve three distinct purposes: preparing for and recovering after an event, preventative maintenance, and recovery from injury. A pre-event massage can help heat the muscles, reduce excess muscle tension and create a sense of psychological readiness. A post event massage can help lessen the effects of physical trauma, mainly by enhancing blood flow to the muscles, removing toxins such as lactic acid, and delivering oxygen and nutrients. This process helps speed recovery.

Maintenance massage sessions scheduled regularly during training do much the same - relax and prepare the muscles for hard effort, and speedy recovery. By increasing the blood flow to the muscles, massage helps repair the small tears - micro-traumas, which occur after strenuous activity. A massage therapist will develop a strategy that best suits the condition and physical history.

5. Am I supposed to tip my massage therapist?
If you get a massage at a spa or hotel, a 15% to 20% tip is standard if you were pleased with the services. On the other hand, there are no real ground rules or norms when it comes to massage in a medical setting. Some massage therapists and massage associations suggest that tipping isn't appropriate in a medical or clinical setting. If you're not sure, don't be afraid to ask if tipping is customary. You can call ahead to ask if you don't want to do it face to face. If tipping isn't the norm, you can always show your appreciation by referring friends, family and co-workers to the massage therapist.

6. Am I supposed to take off my underwear when I get a massage?
Many people prefer to keep their panties or briefs on during a massage, while others prefer to be completely nude. It's up to you. If your problem areas are your lower back, hips, buttocks, or groin, tight-fitting underwear can sometimes get in the way of massage work, but a thong for women or briefs for men should do the trick. In North America, if you do remove your underwear, massage therapists must ensure that you are always properly covered by a sheet or towel. Only the area being massaged will be uncovered.

7. What if I realize I've drooled during the massage?
Many people fall into a peaceful slumber during the massage but when they wake up, they notice a pool of drool on the pillow or massage table. This is very common. It often happens when people are being massaged while lying face down on the massage table. Don't be afraid to ask the massage therapist for a tissue.

8. Will the massage therapist be there when I undress?
In North America, the massage therapist will leave the room so that you can remove your clothing and lie on the massage table (usually face down) under the top sheet. Don't rush or worry that the massage therapist will walk in on you - the massage therapist always knocks and asks if you are ready before entering the massage room.

9. Should I talk to the massage therapist during the massage?
Although some people prefer to talk throughout the massage, don't feel like you have to make conversation with the massage therapist. After all, you're having a treatment; you're not at a cocktail party! Feel free to close your eyes and relax, which is what most people do. Deep tissue massage and sports massage are just some of the types of massage that require more feedback. The massage therapist often works on deeper layers of muscle and will want to ensure that the pressure is not uncomfortable.

Be sure to speak up if:

  • The room is too hot or too cold
  • You experience pain
  • You have any questions related to the massage
  • There's anything you forgot to mention during the consultation

10. The pressure isn't deep enough, but I don't want to insult the massage therapist's technique. What should I do?
Communicate openly with the massage therapist. Keep in mind however that it's a myth that massage therapy has to hurt to be effective. Some of the most effective types of massage therapy are gentle and do not involve deep pressure or pain. In fact, too much pressure can cause muscles to seize up. Here is a good rule of thumb - on a scale of one to 10 where one is no pain and 10 is extremely painful, the pressure should always be less than seven.

11. I'm self-conscious about a certain part of my body and don't want the massage therapist to see me. What can I do?
People are self-conscious for various reasons. Some of the more common concerns are:

  • I'm overweight.
  • I have excessive hair growth on my body.
  • I've got acne on my face or back.
  • My feet are ugly.
  • I have scars.

Being self-conscious should never keep you from seeking health care, whether it's visiting your doctor or seeing a massage therapist. If you're self-conscious about a certain part of your body, you can ask the massage therapist to avoid that area. Or, you can opt for a therapy that is done through clothing, such as shiatsu or Thai massage. Because no massage oil or lotion is used, you remain fully clothed during the session. You can even bring your own comfortable clothes to wear. Just remember to provide complete and accurate information on your health history form, so that the massage therapist is aware of any precautions or contraindications.

12. I'd rather see a female massage therapist. Should I request this?
Some men don't feel comfortable having a massage by a male massage therapist. It may be due to outdated social and media stereotypes of the profession. Some women also prefer a female massage therapist because they say they feel more comfortable. This doesn't just apply to massage therapy. A University of Michigan study found that 43 percent of women preferred a female doctor for a colonoscopy. Of these women, 87 percent said they would be willing to wait more than 30 days to get an appointment with a female colonoscopist, and 14 percent would be willing to pay more for one.  Unfortunately, men who choose to become massage therapists are often unprepared for the discrimination they face. When clients request female over male therapists, spas stop hiring them, however skilled they are.

That's why it's important to challenge your preconceptions. Here are some tips to help you:

  • If you see other practitioners in the clinic or spa, ask if you could meet the massage therapist before you book the appointment.
  • Try booking a massage at a health club or a clinic, where there's usually a higher percentage of male clientele and staff.

You may wish to start with an active form of massage, such as deep tissue or sports massage or a type of massage that is done fully clothed, such as shiatsu or Thai massage.

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I have been a patient of Dr. Pisarek for a few years now. Every morning I have to say "thank you Dr. P.!". Your care and your treatment renew my energy... no more pains in my lower back, knee and foot. With your help I lost 20 pounds and I am keeping it off. I am really grateful to you and your wife Hilda for taking care of me. My retirement got a new meaning, thanks to you.

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