Massage Therapy Journal Summer 2026

Summer 2026

CE Rheumatoid Arthritis: Techniques for Massage Therapists Massage Therapy Provides Real Relief to Grieving Clients In Praise of Listening

The benefits both on and off the court. Going Dancing How Some Elite College Basketball Programs Are Using Massage Therapy

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Massage Therapy Journal Vol 65. No 2 Contents

FEATURES

18 MASSAGE THERAPY PROVIDES REAL RELIEF TO GRIEVING CLIENTS Explore how massage therapy can help people experiencing grief, as well as some of the things you need to know to ensure you’re giving them

24 GOING DANCING: HOW SOME ELITE MASSAGE THERAPY The benefits of massage therapy for elite student athletes are getting more attention as some of the biggest programs integrate the practice with intention and enthusiasm. By David Malone COLLEGE BASKETBALL PROGRAMS ARE USING

30 RHEUMATOID ARTHRITIS: TECHNIQUES FOR MASSAGE THERAPISTS CE Learn more about the benefits massage therapy offers clients managing rheumatoid arthritis, and what you need to know to effectively work with these clients. By Julie Goodwin, LMT

60 IN PRAISE OF LISTENING Explore how broadening our understanding of listening allows us to better help our clients and ourselves. By Jennifer Leogier AMTA 2026 National Convention Speaker

the best care possible. By Jennica Klemann

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Unlock New Levels of Client Care

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How does Visceral & Neural Manipulation help your clients? Visceral Manipulation

N eural Manipulation Neural Manipulation (NM) enhances the free movement of nerves in relation to surrounding muscles, fascia, organs, and bones. Mobilizing nerve fixations can restore proper signaling, improving function in compromised structures like muscles, organs, and fascia.

Visceral Manipulation (VM) restores harmony in the body by enhancing its natural communication and healing processes. It targets functional and structural imbalances to relieve pain, improve posture, and address issues in the musculoskeletal, vascular, nervous, and other major systems, helping the body heal and revitalize from within.

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DEPARTMENTS

6

LETTER FROM THE PRESIDENT We Are All on the Same Team

Massage Therapy Journal ® | Official Publication of the American Massage Therapy Association ® Summer 2026 Vol 65. No 2 ISSN: 0895-0814 USPS 0010-218 Print and digital cover credits: Photo illustration with elements courtsey of Sanit Fuangnakhonand New Africa at Shutterstock.com Michelle Vallet Senior Publications Manager AMTA BOARD OF DIRECTORS (effective March 1, 2026) Rick Greely President Jane Horton Johnson President-Elect Cindy E. Farrar Immediate Past President

9

SHAREABLE RESEARCH Updates in Research: Massage + Sports

12

ADVOCACY How AMTA Is Increasing Access to Massage Therapy And Breaking Down Barriers to Whole-Person Care

Bernadette Binns Blount Director Heber J. Blackner Director Pamela M. Blazek Director Matthew Fecteau Director Donald Goodale Director Deb Kilty Director Cheryl L. Siniakin, Ph.D. Director Lee Stang Director

EDITORIAL REVIEW OPERATIONAL COMMITTEE Jacqueline Herbach, LMSW, LMT President, Momentum Massage, Jane Neumann, BS, LMT, NCTMB Private Practice

Fitness, & Mind New York City Steve Jurch, MA, ATC, LMT Director of Allied Health Training at the Community College of Baltimore County

AMTA Illinois Chapter Communication Chair

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Jessica Libero, LMT, NCTMB Connecticut and New York Licensed Reiki Practitioner Martha Brown Menard, Ph.D., CMT

66 RESEARCH Strengthening Community

Impact: The Next Chapter of the Massage Therapy Foundation’s Community Service Awards

Publication Management SPARK Publications sparkpublications.com

Project Manager: Jaclyn Yepsen Creative Director: Larry Preslar

Massage Therapy Journal is published quarterly by the American Massage Therapy Association (address below). Periodicals postage paid at Evanston, Illinois, and additional mailing offices. POSTMASTER: Send address changes to Massage Therapy Journal , 500 Davis St., Suite 900, Evanston, IL 60201-4695. SUBSCRIPTIONS: All subscription matters and notice of change of address should be sent to: Massage Therapy Journal Subscriptions, AMTA, 500 Davis St., Suite 900, Evanston, IL 60201-4695 (877-905-2700). Subscription rates: U.S. and Canada, $25 for one year (four issues); $45 for two years (eight issues). Foreign, $70 for one year; $120 for two years; available on a limited basis. Contact AMTA Member Experience, 500 Davis St., Suite 900, Evanston, IL 60201-4695. Phone: 847-864-0123 info@amtamassage.org EDITORIAL COPY: Queries should be sent to Michelle Vallet via email: mtj@amtamassage.org . Visit amtamassage.org/mtj for writer guidelines. Information contained in Massage Therapy Journal does not necessarily reflect the opinions or beliefs of AMTA and/or the staff of Massage Therapy Journal . ADVE RTISING: Contact the AMTA sales team at Smithbucklin to learn more about advertising and exhibitor opportunities: (301) 215-6710 Ext.130 or hbrown@smithbucklin.com. Copyright © 2026 American Massage Therapy Association MTJ-024

70 SOOTHE

Self-Care Tips for Career Longevity 74 TOOLS OF THE TRADE Meet Shawn Ellis

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FACILITATING HEALING: IMPROVING CLIENT OUTCOMES

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6 • Massage Therapy Journal

Letter from the

President

We Are All on the Same Team

As I began to try and put together this letter, I struggled with what I wanted to tell you all. But, never one to give up, I sat down at the computer and decided I’d just write some thoughts down and go from there. Writers call this practice “freewriting,” and oh did I have fun! Anyone who knows me can imagine how my notes looked. But for those that aren’t familiar, I’d like to share my process: First, I had a number of thoughts about a number of different topics that ranged from deep, existential questions like “How did I get here?” to my favorite snack I like to eat when trying to write these letters to what motivates me to volunteerism to what I imagined my two miniature to topic in no real sensical order (that’s actually the point of freewriting I learned!) But, nothing stood out as something I wanted to write about in my letter, and so I decided to call it a day and try again tomorrow. The next day—the first thing I did was throw my list from the day before out! Then, I realized that freewriting allowed me to find what I wanted to say by clearing my mind of everything I didn’t want to share with you (don’t tell my schnauzers!) The Meaning of TEAM OK, so what do I have to share? I want to share my thoughts on one simple word: TEAM I was very intentional about choosing the word team. schnauzers might tell you about me. (Probably that they appreciate the pets but could use more treats). My thoughts pinballed from topic

Here are some of my favorite quotes about what it means to be a team: • “The strength of the team is each individual member. The strength of each member is the team.” — Phil Jackson • “Individual commitment to a group effort — that is what makes a team work.” — Vince Lombardi • “The strength of a team is determined by the strength of the connections on the team.” — Urban Meyer • “All of us alone are weaker, by far, than if all of us are together.” — Mike Krzyzewski • “If everyone is moving forward together, then success takes care of itself.” — Henry Ford Together, We are a Strong TEAM What do I mean by TEAM? T — together . A team is a number of individuals working for a common goal. Each individual contributes their skills, talents and energy to achieve that common goal. E — everyone . The entire group benefits from the individual contributions. We all do better because everyone is working to achieve our common goal. A — accomplish . Each member of the group accomplishes more because of the contributions every individual makes to the group. M —that’s where the magic is. We all can accomplish more because of our shared goal and the work of each member . Everyone moves forward when each member brings their unique skillset and passion to achieve a common goal. We—all of us at AMTA—are a TEAM. A team of passionate massage therapists, each with our own unique and valuable abilities, who, together, work to advance the massage profession we love so much. I’m proud to be on the same team as you .

SEE YOU AT AMTA’S NATIONAL CONVENTION! Registration for the 2026 AMTA National Convention is now open! Come meet the TEAM, network with fellow massage therapists and take advantage of great continuing education opportunities, August 27–29 in Denver, Colorado! Register now!

Rick Greely AMTA President

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Summer 2026 • 9

Shareable Research

Updates in Research: Massage + Sports

Athletes have been using massage therapy for a long time, whether to help recover from injury, warm up for events or cool down. Research continues to support the benefits of massage for a variety of outcomes.

READ MORE! Learn how some of the most elite NCAA basketball programs are integrating massage therapy into athlete care by reading “Going Dancing: How NCAA Basketball Teams are Using Massage Therapy,” on page 24.

Photo courtesy of Mark Hanson Photography

Share this research with clients and colleagues by visiting amtamassage.org/research.

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10 • Massage Therapy Journal

Muscular Endurance + Massage This 2025 randomized controlled crossover design study examined the effects of percussion massage and foam rolling on hamstring flexibility, reactive and explosive strength muscle performance, and muscle fatigue. The study. A total of 18 physically active university student participants all underwent three activities: percussion massage, foam rolling and a control. Each activity was separated by a four- to five day washout. Assessments to measure flexibility were performed via the active knee extension test. A single-leg reactive strength test and leg press explosive strength test assessed muscle performance, and a 30-s side hop test measured endurance and fatigue. Statistical analyses included repeated measures ANOVA and non-parametric tests where appropriate. The results. Percussion massage significantly improved hamstring flexibility, though no significant flexibility differences were found with foam rolling or the control. No significant effects of any intervention were observed on reactive strength index, leg press power or hop test performance. “Percussion massage provides an immediate enhancement in hamstring flexibility superior to both foam rolling and no treatment,” researchers noted. “These findings suggest that percussion massage may be an effective pre-activity tool for improving flexibility.”

Massage + Muscle Recovery Researchers wondered about the effects of sports massage, blood flow restriction (BFR) and cold therapy on quadriceps recovery in mixed martial arts (MMA) athletes following eccentric exercise, focusing on muscle biomechanical properties, pain and strength. The study. This randomized, single-blind clinical trial comprised 36 men and women MMA-trained participants who were divided into three groups: massage, BFR and cooling, and a control. Each group had 12 participants. To fatigue the muscles, each MMA participant performed five sets of plyometric jumps on a 50-centimeter box until exhaustion, with one-minute breaks between sets. Participants in the massage group then received a 20-minute massage using standard techniques. The BFR and cooling participants underwent a 20-minute alternating blood flow restriction and cooling treatment with ice bags on the quadriceps. The control group rested passively with no intervention. Assessments were done four times before exercise, immediately after exercise, 24 hours after exercise and 48 hours post-exercise. Perfusion unit, muscle elasticity, pressure pain threshold, reactive strength index and total quality recovery were all measured. The results. Statistical analysis showed both massage and BFR and cooling had significant effects. Post exercise 48-hour values for all four assessment measurements were significantly improved in both groups when compared to the control. “The study concludes that both massage and combined blood flow restriction with cooling interventions significantly enhance post-exercise recovery-improving muscle profusion, elasticity, reactive strength and perceived recovery compared to passive rest,” researchers noted. References 1. Trybulski R, Roczniok R, Olaniszyn G, Svyshch Y, Vovkanych A, Wilk M. “Sports massage and blood flow restriction combined with cold therapy accelerate muscle recovery after fatigue in mixed martial arts athletes: a randomized controlled trial.” J Funct Morphol Kinesiol. 2025 May 28;10(2):194. 2. Bartik P, Pacholek M. “Acute effect of percussion and foam roller massage on flexibility, reactive and explosive strength, and muscular endurance in young adult males: a crossover pilot study.” Peer J. 2025 Oct 30:13.

WANT MORE INFORMATION? For more information on some of the research being done on the benefits of massage therapy, browse the Research section of AMTA’s website at amtamassage.org/research.

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12 • Massage Therapy Journal

Advocacy Advancing the Massage Therapy Profession

How AMTA Is Increasing Access to Massage Therapy And Breaking Down Barriers to Whole-Person Care M assage therapy is increasingly recognized as an essential component of whole-person health care. Research

insurance coverage, workforce mobility challenges and gaps in awareness can prevent individuals from receiving massage that could significantly improve their health and well-being. Expanding access is central to AMTA’s mission. Through coordinated advocacy, research investment, policy engagement and public education, AMTA is building a future in which massage therapy is accessible, affordable and fully integrated into health care.

continues to demonstrate its effectiveness in managing pain, reducing stress, supporting cancer care, improving mobility and enhancing overall quality of life. Yet despite this growing body of evidence, there can be barriers to access when it comes to massage therapy. High out-of-pocket costs, limited

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Summer 2026 • 13

Expanding access is central to AMTA’s mission .

Making Massage Therapy More Affordable Through Insurance Advocacy Cost remains one of the greatest barriers to massage therapy. When insurance coverage is unavailable or limited, patients often delay or forgo therapeutic massage that can help manage pain, support recovery or reduce reliance on pharmacological treatments. AMTA advocates for expanded insurance coverage by engaging insurers, policymakers and health care leaders to recognize massage therapy as a research-supported, non-pharmacological option within patient-centered care. These efforts include encouraging Medicare Advantage and private insurers to provide coverage when evidence demonstrates improved outcomes. AMTA Helps Massage Therapists Navigate Medicare Advantage Plans Although original Medicare does not cover massage therapy, some Medicare Advantage plans may offer it as part of expanded wellness or complementary therapy benefits. To help increase patient access, AMTA provides education that equips licensed massage therapists to navigate billing codes, documentation standards and network participation requirements with confidence. Because coverage varies by plan, including eligible conditions, session limits, and reimbursement policies, AMTA encourages massage therapists to work closely with clients to confirm benefit details, including referral or pre-authorization requirements.

and reimbursed in the U.S. health care system. Because insurance companies and government programs rely on CPT codes to determine what treatments qualify for coverage, participating in these discussions allows AMTA to advocate for appropriate coding of massage therapy services. This work supports greater integration of massage therapy into health care settings, improves opportunities for insurance reimbursement, and helps make therapeutic massage more accessible and affordable for patients as part of comprehensive care. Advancing Legislation That Expands Patient Access to Massage Legislative advocacy is another critical pathway to expanding access. AMTA continually works with federal and state lawmakers to promote responsible policies that integrate massage therapy into clinical care. These efforts are vital in the context of pain management, where patients and providers increasingly seek safe, effective, non-opioid treatment options. By supporting legislation that facilitates appropriate referrals to massage therapy, AMTA helps broaden the range of accessible, evidence-based As part of these efforts, each year AMTA attends the Annual Coalition Meeting of Voices for Non Opioid Choices (Voices) in Washington, D.C., joining more than 100 national partners working to prevent opioid misuse in pain treatment. These important events include physicians, policymakers, and patient representatives discussing the ongoing impact of opioid abuse. AMTA will continue its efforts to collaborate with Voices and other organizations to highlight the role of massage therapy in helping address the opioid crisis. AMTA was also an active participant in an earlier Voices advocacy effort to help pass the 2022 Non Opioids Prevent Addiction in the Nation (NOPAIN) Act in Congress. This Act intends to increase patient and provider access to non-opioid approaches for pain management for those enrolled in Medicare and to help stem the opioid epidemic across the nation. It also therapies within whole-person health care. Addressing the Opioid Crisis with Massage Therapy

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AMTA Advocates for How Massage is Coded, Recognized and Reimbursed in the U.S. Health Care System AMTA’s involvement in the American Medical Association’s (AMA’s) Current Procedural Terminology (CPT) Advisory Committee and the Health Care Professionals Advisory Committee (HCPAC) helps ensure massage therapy is represented in decisions about how health care services are coded, recognized,

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14 • Massage Therapy Journal

AMTA regularly invests in massage therapy research .

includes language which aims to increase awareness that patients need access to complementary and integrative pain therapies such as massage therapy. Promoting High-Quality Research to Expand Access and Public Awareness Research plays a foundational role in expanding access. Strong evidence supports broader insurance coverage, informs clinical guidelines and increases adoption in hospitals, VA and DoD clinics and community health centers. Through its partnership with the Massage Therapy Foundation, AMTA has invested more than $16 million in massage therapy research since the foundation’s inception 35 years ago. In 2025, AMTA pledged an additional $2.5 million over the next five years, representing an unprecedented level of support for research that strengthens the evidence base for massage therapy as an effective integrative health treatment. Research in pain management, oncology, pediatric care, pregnancy, trauma recovery and veteran health not only improves clinical practice but also advances the policy and reimbursement changes necessary to make massage therapy more accessible nationwide. Expanding Workforce Mobility Through Licensing Portability Access to massage therapy also relies on a strong, mobile massage therapy workforce. Significant variation in state licensing requirements creates barriers for massage therapists who relocate, particularly military spouses and families, and can contribute to uneven provider distribution. AMTA supports the Revised Interstate Massage Therapy Compact, which allows licensed massage therapists who meet established eligibility requirements to practice in multiple states without obtaining additional licenses. Why the Revised Massage Therapy Compact Matters for Access • It increases flexibility for active-duty military families, making it easier to maintain licensure when relocating. • It strengthens professional mobility while maintaining public protection through consistent eligibility and verification standards.

• It improves workforce distribution, helping underserved communities gain access to qualified massage therapists. When qualified licensed therapists can move and practice more easily, communities across the country gain greater access to massage therapy. Elevating Public Awareness and Professional Education Improving access also requires increasing awareness. Many individuals and even some health care providers remain unfamiliar with the growing body of research supporting massage therapy. AMTA addresses this gap through research-based publications, continuing education and national media outreach that highlights emerging research across a range of health conditions. These efforts reach millions of people each year. As awareness grows, referrals increase, insurers better recognize the value of massage therapy and consumers feel empowered to seek out massage therapy for their health and wellness needs. Greater awareness supports policy progress and ultimately expands massage therapy access.

VIEW RECENT RESEARCH SUPPORTING MASSAGE THERAPY FOR A VARIETY OF HEALTH CONDITIONS

Scan the QR code to view content that AMTA has distributed to the public via national media.

A Future Where Massage Therapy Is Accessible to All At AMTA, we believe access to safe, professional massage therapy is an essential part of whole-person health. That belief drives every step we take to expand insurance coverage, champion legislation, invest in research, advance licensing portability, and educate the public. Together, these efforts are breaking down barriers and building a stronger, more integrated health care landscape — one where massage therapy is recognized, accessible, and affordable for the individuals and communities who need it most. Learn more about AMTA’s advocacy efforts at amtamassage.org/advocacy.

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18 • Massage Therapy Journal

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Summer 2026 • 19

Massage Therapy Provides Real Relief to Grieving Clients

Explore how massage therapy can help people experiencing grief, as well as some of the things you need to know to ensure you’re giving them the best care possible.

By Jennica Klemann

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20 • Massage Therapy Journal

Most people think of big, tragic events like the loss of a loved one or a chronic or terminal diagnosis, a wanted pregnancy cut short by miscarriage, or a friend or loved one navigating infertility. They think of something that is often beyond the person’s control, or at least not completely within their control, that is often also long-term, life changing and almost always devastating. Many people who encounter someone grieving have an almost automatic sympathy for and empathy with them. Of course, there are many other life events that can cause grief, too, like divorce, retirement, financial difficulties and family estrangement, all examples that a person might actually choose or need but still bring feelings of immense sadness and loss. No matter the source, all grief has one thing in common, at least in the U.S.: A culture that doesn’t promote a healthy grieving process. We don’t talk about grief because it’s uncomfortable, and many of us stay stuck in the grief process because we don’t know how to “fix” it. As a massage therapist, you may be feeling apprehensive or even fearful if a client gets emotional during a session. You may be afraid to say the wrong thing or worry you’ll make your client feel worse. Of course, you also have ethical boundaries you’re constantly reinforcing so want to ensure you’re not providing a grieving client any therapy that bleeds outside your scope of practice. W hat is the first thing you think of when you hear that someone is grieving? Grief is not a one-size-fits-all experience and will show up in people differently because everyone will process grief in a unique way.

Understanding grief for yourself, however, will help you feel more confident and capable of helping your clients understand what massage therapy can offer and the profound difference massage can have in easing emotional pain, as well as when you’ll need to refer out to another health care provider. We already know that grief hurts, but physical pain is also part of the healing process and one area where massage therapy can really shine. So, let’s break it down and talk about it. What is Grief? According to the American Psychological Association’s (APA) Dictionary of Psychology: “Grief is the anguish experienced after significant loss, usually the death of a beloved person. Grief often includes physiological distress, separation anxiety, confusion, yearning, obsessive dwelling on the past and apprehension about the future. Intense grief can become life-threatening through disruption of the immune system, self-neglect and suicidal thoughts. Grief may also take the form of regret for something lost, remorse for something done or sorrow for a mishap to oneself.” Even more simply, The Cleveland Clinic suggests grief can “accompany any event that disrupts or challenges our sense of normalcy or ourselves.” Everyone will experience grief differently. We must remember that although we can lean into broad definitions and the outdated and often inaccurate “stages of grief,” grief is not a one-size-fits-all experience and will show up in people differently because everyone will process grief in a unique way. The Physiology of Grief Notice the APA definition of grief above mentions “physiological distress,” “anxiety” and “disruption of the immune system,” which begs the question: What does grief do to our body exactly? Experiencing grief is one of the most intense stress responses our bodies can endure, and not

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Summer 2026 • 21

only impacts our brain, but every system in our body through neurotransmitters (stress hormones). When you’re in a stressful situation, your body is flooded with adrenaline, norepinephrine/ noradrenaline, and cortisol, triggering what is commonly known as the “flight, fight or freeze” response. Serotonin and dopamine are suppressed because your brain thinks you’re in imminent danger. These stress hormones increase the force of skeletal muscle contractions, redistribute blood to the muscles and alter metabolism; regulate visceral functions, increase heart rate and blood pressure, and expand the lungs. Cortisol alone can contribute to high blood pressure, muscle weakness, changes in mood, tiredness and impaired brain function, and increases the risk of infection. But we’re not running from a bear. Instead, our bodies are reacting to a significant life changing event we are trying to process while also managing our usual—and sometimes stressful—day-to-day routines. So, what might a grieving client be experiencing? Some examples include: • Poor Sleep • Abdominal Pain/Digestive Disruptions • Brain Fog/Cognitive & Functional Impairment • Headaches/Muscle & Joint Pain • Anxiety/Depressed Mood • Colds/Flu • Infections • Increase in accidents & injuries Identifying Some of Your Clients Potential Coping Behaviors People who are grieving can be at risk for isolating themselves or engaging in coping or avoidance behaviors. Statistically, the most common coping mechanisms are drugs and alcohol, including mixing medication with alcohol, and abusing prescription medications. Cell phones, too, provide an easy avenue to distraction and allow people to sometimes rationalize avoidant behaviors, like staying in bed, not engaging with friends or family, and losing interest in their own health and well-being regimens.

To be clear, there is nothing wrong with having or using a cell phone—even when sometimes you are indulging in avoidant behaviors—but especially for people who are processing grief, being careful they aren’t endlessly scrolling on social media, becoming dependent on virtual relationships, gaming, gambling, shopping—any number of things—is essential. Massage therapists must also be aware of “decision fatigue,” a term coined by social psychologist Roy F. Baumeister, and used to describe the emotional and mental strain resulting from a burden of choices. “When humans are overstressed, we become hasty or shut down altogether, and that stress plays a huge role in our behaviors,” says Tonya Hansel, Ph.D., Associate Dean of Research at the University of Texas, Arlington. This type of fatigue typically leads to one of two outcomes, she adds—risky decision-making or decision avoidance. People who experience despair or whose lives are complicated by loss are especially vulnerable to mental health issues, including addiction disorders.

The Ethics of Working with Clients Who Are Grieving Massage therapist who work with clients experiencing grief need to always maintain their scope of practice and healthy boundaries. We do not give personal or professional advice or counsel, but we can offer resources for clients and help them find self care strategies they can do between sessions that might help extend the benefits of the massage session and give them a way of relieving stress on their own. The SAMHSA.gov website provides a variety of 988 crisis materials for free. You should also consider having an emergency contact on file for clients, as well as a list of professional therapists you might refer out to when needed.

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22 • Massage Therapy Journal

feeling or what they need verbally. It’s ok to “take the reins,” so to speak, and guide them through the session. For example, during intake, you might remind them that they can talk or stay quiet during the session, whichever is more comfortable for them (and you should take your cue from them in knowing if they want you to talk during the session, beyond the needed check-ins around pressure and other information you need). Also, they aren’t obligated to share any details of their loss; the “what” isn’t relevant, but how they’re feeling is important. Direct your clients out of their heads and into their hearts as much as possible. Tears may or may not happen, and either is OK. But if they do feel emotional during the session, let them know they’re in a safe space where tears are welcome and encouraged. Let them know where to find the tissues (keep them within reach next to the table). They can also direct you to stop the session, or pause and keep contact at any time—whatever is the most comfortable for them. If you’re already in a regular session and a client discloses a loss or a tragic life event, you can check in and ask them if they would like to continue with their regular session or try work that is more focused on connection, then honor whatever they request. How the end of massage sessions may differ for grieving clients. Following the session, give the client time to get dressed and compose themselves, then communicate the importance of doing more grief-specific work. Nurturing a broken heart is just as important as healing a physical injury. The appropriate treatment plan would be the same as you would recommend for acute pain (about twice a month). The goal is to help them feel better without having to lean on coping mechanisms that might not be as healthy or provide as much relief as massage therapy. Facing Your Own Fears and Feelings Around Loss and Grief The biggest fear massage therapists face is usually saying the wrong thing, and that’s valid. In fact, certain cliches or figures of speech can make someone feel misunderstood and guarded. Being

How Can Massage Therapy Help People Manage Grief? Massage therapy alone will not fully relieve a client’s grief, but as with so many other client populations, massage can be an integral part of a person’s overall approach to managing feelings around grief, both physical and emotional, like anxiety and stress, as well as pain. What makes a grief-centered massage different? Clients who are suffering from loss are already in pain. So, we need to be sure we’re not using techniques that might compound their discomfort, like deep tissue, myofascial or trigger point work. Our intention is to calm an overstimulated nervous system while maintaining heart-centered contact throughout the session. Many times, someone who is actively grieving is more than likely disconnected from their body in order to process their loss. They could be caring for others and putting themselves last, or they might be organizing funeral arrangements, managing legalities, going through belongings, or navigating numerous health care appointments. As best we can, we want to “defragment” them and facilitate their need to release physical and emotional tension while they are on our tables because that may be the only place they will allow themselves to let go. What makes holding space different for grievers? You’re allowing them space for what’s said and what is unsaid . Going back to the “decision fatigue” mentioned earlier, our clients may become apathetic or frustrated if we ask too many questions or give them too many options during intake. If that happens during a session, please don’t take offense or question your ability. Grievers don’t always have the mental capacity to articulate what they’re Many times, someone who is actively grieving is more than likely disconnected from their body in order to process their loss.

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considerate and aware, especially if you don’t know the circumstances around why someone is grieving, should be your primary concern. It’s also important not to assume loss is always bad. Sometimes, a loss is a relief, such as a complicated or abusive familial dynamic, or a divorce. Avoid saying common phrases like: • Give it time (time is different for everyone and each loss is unique) • Keep busy (this can encourage avoidance behavior) • Referring to “stages” of grief/loss (grief isn’t linear and can’t be compartmentalized; sometimes, people feel like they are grieving wrong if they aren’t following a process in order) • Any religious or spirit/spiritual existence (you may not know their belief system or their current relationship with their faith) • Saying “I know how you feel” or talking about your own losses. You can’t know how someone feels, and making a client’s loss about you can be off-putting. You don’t want to put a client in a position where they feel compelled to offer you comfort or support during their massage session. If you feel the need to say something, try to be comforting, like: “I can’t imagine how you must be feeling right now, but I’m here for you and you’re not alone.” Simply be a heart with ears and listen. Taking Care of Yourself While Taking Care of Others Caring for people who are grieving is sacred work; you’re engaging with someone at a very vulnerable time in their life, and that can be very emotional and energetically intense for you. If you have unresolved grief yourself, you may not be equipped to hold space for someone else who is actively processing a loss, and it’s OK to own our limitations. This work isn’t for everyone, and it’s also not for everyone at all times . Know when you need to step away.

We have our own personal losses, plus client losses, peer losses, and even location or financial changes. Finding healthy outlets for yourself is imperative for you to care for others in a meaningful way. You can try: • Meditation/mantra with balancing and “clearing” essential oils as well as gemstones • Take a walk outside, plant your bare feet on the ground • Take a salt bath; burn sage, use sound therapy • Journal — write affirmations/gratitudes/lessons for yourself • Connect with your pets, kids, partner and friends • Seek peer support and receive your own bodywork When I first started my career as a massage therapist, many of my clients were retirees. I realized that they were experiencing the loss of their parents, spouses and friends. They were struggling with retirement, health issues and transitioning into assisted living. Being considerate and aware, especially if you don’t know the circumstances around why someone is Through this work, I began feeling like these clients might benefit from a unique treatment plan that would help them give themselves permission to feel their way through their loss. So, in 2004, I added a “Grief Massage” to my menu options. I was afraid of grief pain myself, but I jumped in and embraced it. That one shift in my practice changed everything for me. I became a grief coach and educator in 2019, and now I enjoy empowering others to grieve mindfully. So here is my final piece of encouragement: When you can’t find the words, your hands and your heart will know what to do. grieving, should be your primary concern.

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24 • Massage Therapy Journal

Going Dancing: How NCAA Basketball Teams Are Using Massage Therapy The benefits of massage therapy for elite student athletes are getting more attention as some of the biggest programs

integrate the practice with intention and enthusiasm.

By David Malone

Irina Segina / FabrikaSimf / shutterstock.com

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26 • Massage Therapy Journal

T he Big Dance. Cinderellas. Bracketology. The Final Four. Every year when March rolls around, 68 teams vie to cut down the nets and hoist the NCAA Championship Trophy. But to do so is no easy feat, with the winner needing to win six single-elimination games in a two-week period.

Massage therapy has become part of some of the most elite programs’ winning strategies—and not just during the tournament, but throughout the season. How Are NCAA Basketball Teams Using Massage Therapy? Massage therapy has transitioned from a spot treatment meant to target a specific condition or injury to being a regular part of a player’s wellness routine. “Our use of massage therapy has evolved significantly in recent years, both in how intentionally it’s applied and how fully it’s integrated into our overall sports medicine model,” says Jose Fonseca, Duke’s Associate Director of Athletic Medicine/Head Men’s Basketball Athletic Trainer. “It has transitioned from an ‘as-needed’ modality to a strategic, integrated element.” Athletic directors at the University of Michigan also use massage therapy in an intentional, focused way year-round to help keep players healthy. “We use massage therapy in season and out of season here at Michigan,” explains Chris Williams, an athletic trainer for the men’s basketball team. “In season, we use massage for recovery for our entire roster. Every week, we have two massage therapists come to our facility to work with our athletes for 30–60 minutes each. In the off season, we use massage therapy as needed for injuries and recovery on an individual basis.”

Andrey_Popov / shutterstock.com

Similarly, Duke University uses massage therapy as both a preventive and restorative measure. “Massage therapy is an integral part of our comprehensive program,” says Fonseca. “We use it as both a preventive and restorative tool, tailored to the individual needs of each student-athlete and the demands of the competitive calendar.” Nick Richey, senior associate athletic trainer, men’s basketball at Michigan State University, makes sure that massage remains integrated into it’s integrated into our overall sports medicine model.” —Jose Fonseca, Duke’s Associate Director of Athletic Medicine/Head Men’s Basketball Athletic Trainer “Our use of massage therapy has evolved significantly in recent years, both in how intentionally it’s applied and how fully

Jose Fonseca

“In season, we use massage for recovery for our entire roster. In the off season, we use massage therapy as needed for injuries and recovery on an individual basis.” —Chris Williams, athletic trainer for the men’s basketball team at the University of Michigan

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Duke University Player Talks How Massage Benefits Him During the Season Playing at Duke University wasn’t the first time the basketball player we talked with had heard of the benefits of massage therapy. “During my senior year in high school, I heard from some other players about how massage might be beneficial,” he explains. Going to an elite program turned those whispers into real life experience with how massage therapy can be integrated into training. “For me, I believe massage helps most in recovery,” the player tells us, but he receives massage weekly, “… which keeps my body feeling great.” Communication between players and the massage therapists who work with them is important, as everyone we spoke to noted, including the player. “We have great communication before and during each session,” he explains.

the basketball program by including soft tissue days during the week, typically on Friday mornings, where the sole focus is massage therapy. “We will often try and sneak in some time during a week where we have high volume practice and game play as well,” he adds. The team’s massage therapist also travels with the team, Richey says. “We book our therapist in advance so that she can travel with us and be available in the hotel and/or after games in a tournament setting,” he explains. During heavy travel, Williams improvises when the team’s massage therapists, who only travel during tournaments, aren’t there. “I contact the massage therapists the host team uses and schedule massages at our hotel the night before the game or early in the morning of the game,” he says. The same is true at Duke University. “We travel our massage therapist during the post season where there is a high demand for soft tissue work and small windows for treatment,” Fonseca says. Although fair to say that a majority of the work focuses on the physical benefits offered by massage therapy, many athletic directors and trainers acknowledge the very real advantage of having players who can relax and get good sleep. “The mental reset is also very beneficial for us,” Richey says. “I also think that during a tournament setting, massage encourages relaxation, which is helping us with sleep after a game.” What Massage Therapy Looks Like for Elite College Athletes Assessment is key to players getting the most benefit. “I always go in with the standard SOAP notes method, asking them if there is anything in particular that’s bothering them, and then I write it down to see whether or not improvement is happening when I work on them next,” says Jenna Sundberg, a licensed massage therapist who works with Iowa State university basketball players. Sundberg will write her own observations down after each session (which typically lasts 30 minutes) and tell the player about anything she’s noticed. Sundberg can then plan an approach to help players sustain the benefits, as well as what they might need to address in subsequent massage sessions, whether stretching, deep tissue or other specific massage techniques.

“No matter the positions they play on the court, most of the players have the same ailments when it comes to the focus of their massage,” Sundberg says. “For example, most common areas of focus would be their traps and arms, which could be caused by the guarding or shooting that happens during a game. The same could be said for tension in their hamstrings, quadriceps or gastrocnemius muscles. With all the moving and jumping that is going on, muscles are in constant movement and become worn out.” Additionally, taller players may have more impact on their muscles compared to a shorter player, which could cause a slight difference in their sessions. Thomas Matthews, LMBT and Certified Advanced Rolfer, who works with players at Duke University, uses subjective self-reporting as his most important form of assessment on a weekly basis. “These young, elite athletes know their bodies extremely well, even if they are not always able to articulate in words their physical experience as clearly as older clients do,” he says. “Learning to speak and reflect the language that they themselves use about their own bodies is critical in this regard.

Thomas Matthews

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