Massage FAQ

What should I expect during my first massage therapy visit?

Your massage therapist may require you to fill out a health history form. Afterward the therapist will begin by asking you general questions to establish what areas you would like worked on, if there are any conditions needing to be addressed, and to determine if massage is appropriate for you.

It is important to list all health concerns and medications so the therapist can adapt the session to your specific needs without doing any harm. It is also important to list any allergies so the therapist is aware if he/she needs to use a different oil or lotion during the session.

Do I have to be completely undressed?

You should undress to the level you are comfortable. For a full body massage, most get completely undressed. However, if you will be more comfortable during the session if you leave your underwear on, that's fine. The therapist will work around the clothes you left on as best as he/she can. If removing all your clothes makes you too nervous and unable to relax, then you are not getting the optimal benefit from the session.
Your massage therapist will give you privacy to undress and get comfortable on the table.

If you prefer to stay fully clothed, then I recommend you explore the many other types of bodywork that are performed clothed.

Do I have to cover myself with a sheet or towel?

This is known as draping and depends on the therapist and in some cases, the law. The vast majority of therapists will insist on draping. Once you are undressed and on the table under the drape, the therapist will only uncover the part of your body being worked on.

What do I do during a massage treatment?

Make yourself comfortable. If your therapist wants you to adjust your position, she/he will either move you or will ask you to move what is needed. Otherwise, change your position anytime to make yourself more comfortable.
Many people close their eyes and relax completely during a session; others prefer to talk. It's up to you. It is your massage, and whatever feels natural to you is the best way to relax. Do not hesitate to ask questions at any time.

How long will a massage treatment last?

The average full-body massage treatment lasts approximately one hour. A half-hour appointment only allows time for a partial massage session, such as neck and shoulders, back or legs and feet. Many people prefer a 60 to 90-minute session for optimal relaxation. Always allow relaxation time prior to and after the session.


Will the massage hurt?

This depends on the type of massage and the depth of the strokes. A light, relaxing massage that doesn't probe very deep into the muscles, shouldn't hurt. With that being said, there is a 'feels good' hurt and an 'ouch, stop it' hurt. A good massage, even a really deep tissue massage, should always stay in the 'feels good' hurt range.
Pain can be an indication that the muscle is possibly injured or inflamed and pressure should be adjusted. Also, pain can cause you to tighten up and negate the relaxing effects of the massage. The most effective and deepest massage always works with your body's natural response, not against it.



How often should I get a massage?

"Some is better than none."
What does that mean? Well, it varies from person to person. If you are just looking for some occasional relaxation, then a session every 3-6 weeks may be fine for you.
However, if you are looking to address a specific condition, then it is recommended to go more frequently at first and then slowly taper down to a maintenance schedule. Sometimes more frequent 30-minute sessions can be effective until your goals are met and a maintenance schedule is in place. 
Frequency of sessions should be discussed with your massage therapist after your treatment when he/she has a better hands-on understanding of your particular muscular issues.

If I want a really deep massage shouldn't I see a male therapist?

The answer is NO. There is a perception that men give deeper massages than women. This is a myth. While some men do give a deeper massage, there are men who prefer to not work so deep. The same holds true for women.
It is a matter of style, training, and therapist preference. Some therapists prefer not to give really deep sessions while others specialize in this area. If you are looking for a deep massage, it is best to simply ask the therapist if she/he does this type of work. And of course, during your session it is perfectly ok to give the therapist feedback if you would like a lighter/deeper pressure. It's your session!
And remember, massage does not have to hurt to be effective.


Can I talk during my session?

Sure, if you'd like to talk go right ahead. The important thing to remember is that this treatment is all about you relaxing and enjoying the experience. Many therapists discourage talking in hopes that you will relax, let your mind float free and enter a state of massage bliss.
In many instances, people may feel more relaxed starting off talking, and as the massage progresses, enter quiet states of relaxation.

The important issue here is that there are times when you need to speak up. If the therapist is doing anything to make you uncomfortable, you should let her/him know immediately. Also, let him/her know if you get too warm or too cold, if the room is too bright, or if the pressure needs to be changed (lighter or deeper). If something is not working for you - speak up! It's OK!

Do I have to listen to whale calls or flutes during my massage?

No. (Not that there's anything wrong with that.)
While many therapists play slower, quieter, 'new age' type music, you can choose to have different music or no music at all. Studies have shown that music at under 60 beats-per-minute has a calming, relaxing effect on the body and therefore can enhance your experience.

However, while this may be true, any music you like to listen to while you relax can be listened to while you get a massage. If it relaxes you and you enjoy it at home, why wouldn't it do the same during your treatment? Ask your therapist what music he/she has to offer or if it is ok to bring your own from home.


How will I feel after my massage treatment?

Most people feel very relaxed. Some experience a significant decrease or freedom from long-term aches and pains. Many feel a little slowed down for a short period and then notice an increase of energy, heightened awareness and increased productivity which can last for days.

If you received a deep massage, you may be slightly sore the next day - much like a good workout at the gym. Sometimes a hot shower, or an Epsom salt soak in the tub can ease this soreness.

After your session you should increase your water intake a bit. Just a glass or two more than normal is usually fine. This helps keep your body's tissues hydrated and healthy.

How many sessions will I need?

Every person is unique and every condition is unique to each person. It may take one session, or it may take several. You and your therapist will be able to talk more specifically about this after your first session and he/she has had a chance to evaluate your body's tissues.


When should I not get a massage?

In my opinion, there are few conditions which would prevent you from enjoying massage. You should not book a massage if you have a fever, cold/flu, or contagious skin infection. That's it. 

There are many other conditions in which your therapist may need to adapt his/her techniques (i.e. arthritis or osteoporosis) or avoid an area completely (i.e. cuts or burns). With some conditions it is a good idea to get an approval from your physician before you receive massage (cancer, certain heart conditions, pregnancy). This doesn't mean you can't get massage. But it’s always better to err on the side of caution.
Your therapist can advise you about your specific needs.

What if I get an erection during my massage?

Sometimes it happens. Yet, most men avoid massage for fear this will happen to them. Or, they get a massage but are unable to relax because of this fear. But there is no reason to be embarrassed.

Sometimes men get an erection during a non-sexual, therapeutic, full body massage. Touch administered to any part of the body can activate the parasympathetic nervous system, which can result in a partial or complete erection.

An educated, professional massage therapist understands this and it will not be an issue for him/her. If you are still concerned, I recommend wearing more fitted underwear (briefs or boxer briefs) which provide more support than traditional boxers.

Note: If the therapist feels that the session has turned sexual for the client, male or female, he/she may stop the session to clarify the client's intent, and may decide to end the session immediately.

 The information presented here is for general educational purposes only and is not intended to replace the advice of your physician.

Dietary Supplements- Friend or Foe?

Over the last decade, there has been an increased awareness to the food we consume and the impacts that it has one our bodies. Nutrition is increasingly important, and people are looking to more alternative forms of therapy to maintain optimum health without the aid of prescription medications and remedies.

More and more people are turning to supplements, which can provide essential minerals vitamins to support optimal nutrition. In 2016, supplements accounted for 121.6 billion dollars globally with sports related, meal, homeopathic, and specialty supplements having the strongest growth (Morton, 2017)

It’s a fair assessment to say that every person reading this has either been recommended to take some form of vitamin, herb, or mineral or is currently consuming one of these now. Supplements are a great way to supplement nutritional/ dietary needs without having to consume the actual foods that contain them however, unlike pharmaceutical companies that have to endure rigorous testing and efficacy trials (as they should!), supplements are not regulated by the Food and Drug Administration (FDA) and do not go through this testing. In fact, the FDA merely regulates the labeling and marketing of supplements to ensure they are not misleading to consumers but consider supplements to be considered as food and therefore not subject to pre-market approval (McGinley, 2019). It is the responsibility of the manufacturing company to adhere to the rules and regulations established by the Dietary Supplement Health and Education Act (DSHEA) and the FDA (FDA, 2011) with only a small portion of these being tested by third parties to ensure efficacy.

With less than 25% of manufacturing companies actually being tested, only a fraction of those companies is actually delivering the active ingredient you believe you are consuming. Most of supplements do not have the active ingredient and/ or have added fillers to their product. In a study conducted by the University of Guelph in Canada in 2013, DNA tested 44 dietary supplements and found that only TWO companies were free from fillers and substitutions (PBS.org, n.d)

Long story short, if you’re consuming dietary supplements of any kind and you don’t know how to look for quality products, you could be throwing your money away.

How do I know what to look for?

 The FDA has recently released a statement acknowledging that the gap between testing and oversight of dietary supplements has grown exponentially and there is an increased need for more strict regulations and governance. Until then, there are ways to increase your odds of purchasing quality supplements.

1.     Third Party Testing/ Independent Lab- If your supplement is being tested in a third-party lab, they will be happy to display this label on their packaging! The United States Pharmacopeial Convention (USP) runs a voluntary program to certify and inspect the quality of a company’s facilities and product (less than 1% of products have this seal). There are also a couple companies that randomly evaluate dietary supplements and post their findings to the public. LabDoor and ConsumerLab.com will provide general results for free and more detailed findings for a fee. 

2.     Health Warnings/ Recalls- Consumers can verify supplements on the FDA website to understand if there are any health claims or sanctions for a particular supplement.  

Additionally, Consumer Reports has a list of supplements that are considered “The Dirty Dozen” because of know health implications, yet these products are still available to purchase. The Federal Trade Commission also has a list that can be found here.  

3.      Is the product too good to be true? If something sounds too good to be true, give yourself some space to pause. The LARGEST offender in the supplement game is supplements that are used for weight loss, body building, and sexual enhancement. Many of these products have been found to have substitutions like unapproved drugs, controlled substances, and possible cancer-causing agents (FDA, 2011)

4.     Is there evidence supporting the dietary supplements? The National Institute of Health composes fact sheets for commonly used dietary supplements. PubMed also has an easy to use website where consumers can research supplements to understand efficacy.

5.     Do you really need supplements? Could you already be consuming enough of the vitamin or mineral you are supplementing with? It’s always best to consult with your doctor/ dietician to ensure the best course of action.

It’s always best to consume the actual food versus taking a supplement, so here is a list of a few essential vitamins/ minerals and natural foods where you can find them:

Vitamin A:

Support eye health, growth development, teeth, and skin

Foods: Orange foods like carrots, cantaloupe, sweet potatoes, and melons

Vitamin K: Blood clotting

Foods: Greens! Kale, spinach, brussels sprouts, and broccoli.

B Vitamins: Energy Production, immunity function, and absorption of iron.

Foods: Whole grains, bananas, chili peppers, beans, and potatoes, and yeast

Folic Acid: Cell renewal and prevention of birth defects

Foods: Leafy greens, asparagus, broccoli, citrus fruits, beans, peas, seeds, buts, cauliflower, beets, and corn.

Vitamin C: Strengthens blood vessels, absorption of iron, anti-oxidants

Foods: Oranges, guava, green and red peppers, kiwi, grapefruit, Brussel sprouts

Vitamin D- Bone strength

Foods: You can get limited amounts of Vitamin D from eggs, fish, and mushrooms, though likely not all the vitamin D you require will come from food. The best way to stimulate Vitamin D production is to spend some time in the sun. If you would like more about Vitamin D, read my blog from April, 2018 here.  

This is one supplement that is highly recommended (especially in MN where we are further away from the equator and do not have as much sun exposure)

Vitamin E: Supports blood circulation, and protection from free radicals.

Foods: Almonds, sunflower seeds, and tomatoes

Calcium: Health teeth and strong bones

Foods: Dairy like yogurt, milk, and cheese. Additionally, tofu and black molasses.

1.     Morton, C. Top Takeaways on the 2017 global supplements market. New Hope Network. (November, 2017) Retrieved from https://www.newhope.com/market-data-and-analysis/top-takeaways-2017-global-supplements-market

2.     McGinley, L. The FDA launches tougher oversight on supplements.  Washington Post. (February 11, 2019) Retrieved from https://www.washingtonpost.com/health/2019/02/11/fda-launches-tougher-oversight-supplements/?noredirect=on&utm_term=.cbe9f574500c

3.     Beware of Fraudulent Dietary Supplements. Food and Drug Administration.  https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm246744.htm. March 2011

4.     National Institute of Health. Dietary Supplements: What you Need to Know. https://ods.od.nih.gov/HealthInformation/DS_WhatYouNeedToKnow.aspx

5.     FDA Statement. Feb 11, 2019. Statement from FDA Commissioner Scott Gottlieb, M.D., on the agency’s new efforts to strengthen regulation of dietary supplements by modernizing and reforming FDA’s oversight. Retrieved from https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm631065.htm

6.     Five Questions to Ask before When Considering Health Supplements. https://www.pbs.org/wgbh/frontline/article/five-questions-to-ask-when-considering-health-supplements/

7.      October, 2013. 11 Essential Vitamins and Minerals Your Body Needs. GoodNet. Retrieved from https://www.goodnet.org/articles/11-essential-vitamins-minerals-your-body-needs

Can I Lose Weight With Fat?

What is the Ketogenic Diet?

A ketogenic diet consists of a diet that is composed of primarily of fat and protein, with very little carbohydrates. There are varying levels of ketogenic dieting with a typical diet consisting of daily carbohydrate intake around 5%, protein intake around 20%, and the remaining 75% intake consisting of fat.

Glucose vs. Fat as Energy

Your body primarily is fueled by glucose and inhibiting carbohydrates means that your body cannot rely on glucose as an effective energy source.

So, your body will rely on dietary ketosis instead of glucose metabolism as a resource for fuel. Ketone production increases and glucose production slows.

When the body is lacking carbohydrates, the mobilization of fatty acids from adipose tissue speeds up and the liver converts acetyl CoA into ketone bodies acetoacetate and 3-hydroxybutyrate. Since the liver lacks the mitochondrial enzymes to utilize the ketone bodies, they transfer to the extra hepatic tissues like the brain,1 thus replacing the need for glucose (carbs) as energy and allowing for ketone bodies to burn fat as energy instead.

Inducing starvation or a diet in low carbohydrates encourages ketone production. When an otherwise healthy individual consumes a diet consisting of mostly fat and protein and limited carbohydrates, they will tend to lose more body fat quickly and maintain lean body mass.1

Short Term Effects of Ketogenic Diet and Weight Loss

According to a meta-analysis of controlled random studies by Nordmann, Nordmann, Briel, et.al, the short-term effect of a ketogenic diet in an otherwise healthy individual supports the idea that the individual will lose more body fat and increase their lean body mass in a six-month period, however, when this length was extended to one year, there was no longer a noticeable effect,2 meaning that weight loss with this diet was not sustainable.

Long Term Effects Questionable

In another study published by the American Physiological Society published in 2014, mice that sustain a ketogenic diet long-term (over one year) have a higher likelihood of dyslipidemia and increased inflammation as well as glucose intolerance and insulin dependency, 3 further suggesting that a long-term ketogenic diet is not healthy and should be further evaluated with your physician.  

Resistance Training and Building Muscle Mass

As suggested in the control trial conducted by Vargas, S., Romance R., Pedro J., et. al, there is an increased impact on weight loss when resistance training is incorporated into a ketogenic diet however would not be suggested for an individual looking to build more muscle mass.4

Summary

Several studies support1,2,3,4 a short term benefit for a faster weight loss prediction with the ketogenic diet, however, there is zero evidence that supports this method long-term and many suggestions that long term use of ketogenic diet could be detrimental to an individual’s overall health with potential negative impacts on LDL-C, glucose dependence, and insulin resistance, regardless of potential favorable outcome to HDL-C and triglyceride levels2

Other Considerations

A ketogenic diet has been proven to be very beneficial to specific groups of people with underlying conditions including epilepsy and diabetes. As with any change to your diet or lifestyle, be sure to speak with your health care practitioner regarding your all of your options and what is best for you, individually.

1.     Manninen, A. Metabolic Effects of the Very-Low-Carbohydrate Diets: Misunderstood “Villians” if Human Metabolism. J. Int Soc Sports Nutr. 2004. Doi: 10.1186/1550-2783-1-2-7

2.     Nordmann AJ, Nordmann A, Briel M, et al. Effects of Low-Carbohydrate vs Low-Fat Diets on Weight Loss and Cardiovascular Risk Factors- a Meta-analysis of Randomized Controlled Trials. Arch Intern Med.2006;166(3):285–293. doi:10.1001/archinte.166.3.285 

3.     Vargas, S., Romance, R., Pedro, J. et. al. Efficacy of ketogenic diet on body composition during resistance training in trained men: a randomized controlled trial. J Inc. Soc Sports Nutrition. 2018. Doi: 10.1186/s12970-018-0236-9

4.     Dashti, H., Thazhumpal, M., Husseinm ,T, et. al, Long-term effects of a ketogenic diet in obese patients .Exp Clin Cariodol. 2004. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2716748/ . Accessed October 6, 2018.

5.     Ellenbroek, J., Djick, L, Tons, H., et. al. Long-term ketogenic diet causes glucose intolerance and reduced β- and α-cell mass but no weight loss in mice. American Physiological Society. 01 March 2014. Doi: https://doi.org/10.1152/ajpendo.00453.2013

Why Massage

Massage has been a practice that dates back thousands of years with origins in China, Egypt, and India. Each culture believed in the vast medical benefits that massage could provide including the ability to heal injuries, relieve pain, and the ability to prevent and cure illnesses. 

Although therapeutic massage has been in practice for thousands of years, it has only been within the last fifty years that massage has been considered therapy in the West and has become increasingly accepted as a form of alternative medicine. Massage and alternate healing is now commonly integrated into people's daily lives as part of a healthy lifestyle regime and is even becoming more and more accepted by insurance carriers and medical practitioners. 

We are becoming an increasingly aware society that is more mindful of the things that we put into our bodies and the paths that we take to recovery on a physical, mental and emotional level. Massage has been proven to provide an Ayurvedic and holistic path to wellness and according to the American Massage Therapy Associate (AMTA) can provide the following: 

• Relieve stress
• Relieve postoperative pain
• Reduce anxiety
• Manage low-back pain
• Help fibromyalgia pain
• Reduce muscle tension
• Enhance exercise performance
• Relieve tension headaches
• Sleep better
• Ease symptoms of depression
• Improve cardiovascular health
• Reduce pain of osteoarthritis
• Decrease stress in cancer patients
• Improve balance in older adults
• Decrease rheumatoid arthritis pain
• Temper effects of dementia
• Promote relaxation
• Lower blood pressure
• Decrease symptoms of Carpal Tunnel Syndrome
• Help chronic neck pain
• Lower joint replacement pain
• Increase range of motion
• Decrease migraine frequency
• Improve quality of life in hospice care
• Reduce chemotherapy-related nausea (AMTA, 2017)

(AMTA, March 16, 2018). 25 Reasons to Get a Massage. American Massage Therapy Association. Retrieved from https://www.amtamassage.org/articles/1/News/detail/3124/25-reasons-to-get-a-massage