Special thank you for contributions by
Ellen Mossman, Beth Baron, and Francesca Genco
Dear Jim and Margery,
I love you guys. Huge fan! Listen whenever I can, live, and also subscribe to your show on Stitcher so that I can hear it when I miss it live. By listening to you I get to keep my finger on the community and political pulse. Also, you make me laugh, which I’ve especially appreciated during these last few months. I was sorry to have missed the beginning segment of your show yesterday regarding Part 2 of Phase 2 reopening the state. I would have called in, or at least tried!
I am a nationally certified and Massachusetts-licensed massage therapist. (I would be remiss not to take the opportunity to emphasize that my title is “massage therapist” not, as many folks call us, “masseuse.” Also, where I work is not a “parlor.” The connotation of the word “masseuse” and “parlor” is back rooms, secrecy, under-the-table and possibly illicit interactions and transactions. That is not what massage therapists do. Language matters!) I am a massage therapist with a private practice in an office. I love my work and would like to continue doing it for decades to come. But on March 17 I temporarily closed my doors and stayed home to do my part in stopping the spread of this novel SARS-COV2 corona virus — my part to keep my clients, myself and my community safe. Which brings me to the reason I am writing:
Re: re-opening massage therapy
No matter how therapeutic and healing it is, no matter how much we love it, massage therapy is not essential. More importantly, many massage therapists believe that massage therapy is a high risk profession when it comes to transmission of COVID-19. There is too much we don’t know or understand to be able to practice safely or confidently yet.
Although Governor Baker and state officials have said that it is okay for us to reopen as of yesterday, I —and many of us— would like for this matter to be reconsidered.
According to the CDC*:
COVID-19 spreads mainly among people who are in close contact (within about 6 feet) for a prolonged period.
There are aspects of the practice of massage therapy which fundamentally violate these CDC recommendations:
- We typically spend 60-90 minutes with each client*
- Much of that time, we are in direct physical contact. Social distance is impossible.* (Measures like contactless payment and asking clients to wait in their cars rather than the waiting room are laughable precautions when we are about to touch them — skin on skin— for 60 – 90 minutes.)
- Many of our treatment rooms are small, enclosed, and poorly ventilated spaces.* (Further, massage therapists who are employees or independent contractors in a spa or other clinic or wellness establishment may not have ultimate say in where/how they practice.)
Other extremely relevant concerns include:
- We cannot screen clients who are asymptomatic.* (Up to 45% of COVID-19 infections may be asymptomatic)
- Blood clotting: COVID-19-related blood clots occur even in “asymptomatic” cases. Clots are an extreme contraindication for massage therapy. We may not know if a client comes in with a clot. Early symptoms of clot may include “sore leg muscles,” which is often a reason someone seeks out massage therapy in the first place. Movement of a clot induced by massage can be deadly.*
- Best practice guidelines for the massage therapy profession require full PPE — not just masks — but full PPE among other strict and arduous sanitation practices. Proper use of PPE requires training. Proper use of N95 mask alone requires an hour long training. There are currently no trainings for this in place for our profession. Furthermore, availability of PPE is of concern, and considering the shortage, supply MUST go to essential medical providers, which massage therapy/bodywork is not.*
Most professions in the “personal services category” (in which we massage therapists in in Massachusetts have been included for part 2 of phase 2) do not share all of these risks.*
It is worth mentioning the reason I suspect some massage therapists have been pushing for reopening: financial concern and livelihood. Massage therapy is not a lucrative profession. For many it is a month-to-month kind of livelihood. Many massage therapists, especially therapists working in establishments like spas, work as independent contractors with no benefits by their employer. Or we are self-employed (like me). As such we are not eligible for regular unemployment benefits. Pandemic Unemployment assistance, which has been a life saver financially for many of us during the last 2 months, is slated to end in July. It is understandable then, though very unfortunate, that a number of people in our profession who, concerned for their financial security, may be pushing to overlook COVID-19 red and yellow flags related to safety.
If there is anything you can do in relation to this matter, even if it is giving voice to my/our concern, I’d appreciate it.
I’d also like to get word out about a great resource for other massage therapists who are feeling uncertainty and doubt about re-opening: The Facebook group,“Massage, Health Practitioners and COVID-19,” is filled with scientifically-based research and discussion, as well as support and community.
Lastly, if you ever wanted to do a segment related to this, I –and many in my profession– would applaud you and be very grateful for the airtime.
Experts in the field include local long-time oncology massage therapy practitioner and teacher Tracy Walton (see https://www.tracywalton.com/our-blog/) and Ruth Werner, who literally has written the textbook on pathology (now in its 7th edition) as it relates to practicing massage therapy (see http://ruthwerner.com/).
Jim and Margery, thank you for listening/reading. I appreciate your time! And please, don’t ever go off the air.
Warmly,
Heidi Fischbach
P.S. I will likely post this letter to you on my blog. More eyes!
An enormous thank you to Ellen Mossman, Beth Baron, and Francesca Genco for their research, advocacy and concise wording in the CDC quote and bullet point sections of my letter. The bulk of the starred wording(*) comes from letters they wrote to their governing bodies and representatives, and generously shared with the massage therapy community.
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Heidi Fischbach, LMT, Ed.M.
Do you feel at home in your body?
www.HeidisTable.com
Thank you Heidi!
Hello Heidi,
I commend you in writing this well written letter. I am at a loss for words as I know that you and most massage therapists are overwhelmed by the current discussion of being back to work as massage therapists. I have a specialty in oncology massage in addition to many other modalities. I am a senior myself. A healthy senior at that and I have been working at a nursing home this past year. I am not back to work yet, but the nursing home has contacted me to let me know that if I want to return to work I would have to do two very brief trainings. So I went for the first training which lasted about 30 minutes. An infectious disease nurse specialist gave the training. She showed us how to put on a mask, (not a N95 just any mask). Then she showed us how to wash hands. That was the end of the training.
It is appalling how this is being handled. I have tried and tried to contact anyone who could tell me if there have been any recommendations placed on nursing homes who offer massage therapy to perhaps forgo having that service provided now until we
have more experience with where this virus is going. I have not been able to get anyone to answer the question should massage therapy be taking place in a nursing home?
I thank you once again, and would welcome any feedback.
Sincerely,
Michele Bouchard
Wow, Michele, I really feel for you. I would agree with your caution about providing massage in nursing homes until we know more, much more, about the transmission of this virus. Especially since nursing homes have been such a hot bed for transmission in our country. At the very very least I’d be concerned for your own safety, as a senior yourself, working in intimate contact with seniors in nursing homes. I recommend to you the FB group https://www.facebook.com/groups/covidandmassage/ — I’ve found them super helpful in sharing info as we learn it, keeping our finger on the pulse of science findings as they relate to covid-19, and also just plain and simple support and community for people in our profession.
Thank you for writing this. I am also a self employed in my own office setting, In a larger office building which is in itself an entire city, with drs offices, gyms, lawyers, restaurants, bookkeeping, website development, this list just goes on and on.
I am choosing to open for the healthy person in July, but who am I to decide who is healthy or not. That’s not my scope of practice. ( Clients that have already booked are dental hygienist, Dietician, a retired fire fighter, and some nurses. )
I’ll adhere to all quidelines but still the sinking feeling that I may be doing harm eats away each day as my opening date creeps closer.
I feel I’m ignoring the scientific data and I feel pressured by clients to open as early as when phase 2 started 6/8.
I’m not alone in opening in July. I know I’m not alone in my fear of opening anyway.
Just wanted to add my thoughts. Thank you!
Naomi, I really feel for you. I think I know that sinking feeling that you speak of, your body letting you know something needs attention, awareness, and at least turning toward with interest and curiosity… in my experience our very own bodies are a wealth of wisdom, of knowing, moment to moment for us… even if just in telling us –like your body seems to be doing for you– to tread carefully, or to wait, that something doesn’t add up, or something isn’t quite right as is…
You say, “who am I to decide who is healthy or not. That’s not my scope of practice.” That right there, speaks to the heart of what we are taking upon ourselves if we do decide to practice at this time, given what we know, and given all that is unknown.
Hello
I feel your pain. I have closed the business I built from the ground up over the last 20 years. I had 7 treatment rooms and 25 phenomenal LMTs working along side me. They were all w2 employees and thus qualified for unemployment. However, my LL would not work with me on rent abatement and offered me out of the lease. I am feeling both thankful and anger over that. I had rented from him since 2013 and not once been late on rent. Last year I expanded and spent 100k on the construction and new hydrolic tables and other furnishings. Money that was willed to me by my parents. But at least I do not have to make the hard choices other people are having to make. I will not go back to treatment until I can do so safely. And yes I know that there is always a risk under our work conditions but this virus is so tricky I do not feel that I can function until we know more definitively how to mitigate the risks.
Oh Jett, I feel for the heaviness of this decision, and the huge grief you must be going through… having invested so much love and work and money into your own place, your wonderful therapists who were not just independent contractors but employees… I’m so sorry for you and can just wish you all the very best and hope that some sense of possibility, of life moving forward in spite of all this hardship, can be there for you, too. (Even if you can’t see it quite yet. We can only ever be with what is there for us, in us, can’t we.) All the best, Jett. A bow of respect to the care you took in coming to these hard decisions.