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SuperCutsChair Massage Proposal

Time Kneaded Massage & Bodywork

Kimberly Medeiros, L.M.T.

Business License #

NVMT-4325



Table of Contents Background

Benefits to Employer/Employee

Benefits of Massage Chair Massage Proposal

Services

Supplies

Compensation Sample Schedule

Qualifications

Research



Background Many companies now provide wellness

programs to help their employees stay healthy and satisfied with their jobs.

Carpal tunnel syndrome is estimated to afflictmore than 10 million Americans

It is believed to be the most common cripplingaffliction of the hand and arm.



Benefits

To Employer To Employee

Decreasesabsenteeism

Increasesproductivity

Decreases work-related injuries

Prevents work-related injuries

Decreases employee

turnover Decreases worker

compensation fees

Reduces health costs

Decreases stress

Relieves mental &physical fatigue

Leaves employee

feeling energized Increased circulation

of blood & lymph

Decreases muscularpain

Increases alertness Decrease risk of

Carpal TunnelSyndrome



Benefits of SeatedMassage

Recipient is fully dressed

No oils or lotions arenecessary

Minimal space isrequired

Addresses commonstresses and

problems in the workplace

Privacy is notnecessary

Takes less time thanfull-body massage,

usually 15 min Focuses on the

head, neck,shoulders, back,and arms

It is cost effective



Chair Massage ProposalServices

Therapist will visit each store in the Las Vegas valley area once a month unlessotherwise agreed upon.

Provide a 15 minute chair massage to allemployees.

Supplies

All supplies to be provided by Therapist.

Compensation Options

Therapist would charge a corporate rate of $10per massage.

Payment can be made entirely by yourcorporation.

Payment can be split by corporation andemployee.

Payment can be made by the employee.



Research~Carpal Tunnel Syndrome

Carpal tunnel syndrome is a painful disorder that affects the hand and wrist. What is the carpal tunnel? Actually, anatomically speaking, it is a real tunnel formed by the bones and tissue of your wrist. Itserves as a protector of the nerve that innervates your thumb, index, middle and ring fingers. When thetissue in the carpal tunnel becomes inflamed, the nerve is irritated and in turn, your hand may hurt orbecome numb.

Symptoms of Carpal Tunnel SyndromeCarpal tunnel syndrome typically starts gradually. You might feel an ache in your wrist that may

eventually move into your hand or forearm.

You might also experience: numbness or tingling in your hand and fingers increased pain when moving your hand or wrist weakness and difficulty gripping objects noticeable pain in your wrist, palm or forearm increased pain and/or numbing while trying to sleep

Causes of Carpal Tunnel SyndromeRepetitive hand movements is typically the main cause of carpal tunnel. You may have heard the term,repetitive strain injury. This term is used to describe carpal tunnel syndrome because it is associated with repetitive hand movements. It can also be caused by awkward hand positions, frequent grippingaction, continuous vibration, and/or continuous stress to the palm of the hand.

Prevention of Carpal Tunnel SyndromeOne of the main preventative measures of carpal tunnel syndrome involves making physical adjustments in

the work environment in order to minimize repetitive work habits. Create an ergonomic work stationand use proper body mechanics. You can actually have fun trying different ways to perform your workin a way that won't cause undue stress and strain on your body.

Massage and the Treatment of Carpal TunnelMassage therapy research has shown that massage can often reduce and slow down the progression of carpal tunnel symptoms. According to a recent study by the Touch Research Institute at the University

of Miami School of Medicine in Florida, massage therapy helped to reduce pain, increase grip strength,and reduce carpal tunnel symptoms for participants who were computer operators or word-processors(Field et al, 2004). So if you are in a high risk group where repetitive movements cannot be avoided, you might consider incorporating massage into your lifestyle.

“massagetherapy.suite101.com/article.cfm/massage_and_carpal_tunnel_syndrome”



~Carpal Tunnel Syndrome

Prescription for Relief

By Michael Young, NCTMB

Originally published in Massage & Bodywork magazine, June/July 2001. Copyright 2003. Associated Bodywork and Massage Professionals. All rights reserved.

Colleen entered massage school with all the hopes and dreams of someone searching for the perfect,mid-life career change. She simply wanted to help people, while making a decent living in the process.Little did she know the repetitive use injury she would fall victim to began early in her training -- whileshe was still attending massage school. Unfortunately, as a new massage therapist, Colleen could helpher clients' pain, but she didn't have the knowledge necessary to remain pain-free herself.

Working in a chiropractor's office for several years, Colleen's clients came in with numerouscomplaints. She offered them many techniques, including Swedish massage, neuromuscular work,trigger point therapy, cross-fiber work and deep tissue massage (the technique leading to early retirement for many massage therapists). After several years in the profession, Colleen thought hermuscles were getting stronger from all the bodywork she was doing. Unfortunately, many massagetherapists fall victim to this assumption. Eventually, the inevitable happened -- Colleen's musclescrossed the fine line from being strong and healthy to short and tight. This chronic condition causedexcruciating pain in her hands, thumbs and arms with each massage she gave.

In school, Colleen was trained in the importance of receiving regular massage therapy treatmentsherself. She did as she was trained and scheduled her regular appointments. The massages she receivedhelped to relieve the constant pain, however, that relief was only short-lived. Soon the pain returnedand Colleen began to wonder if the pain would force her to give up the profession she loved so much.She wondered if there would be any relief for her condition.

Colleen finally sought help from her family doctor, but found herself on a journey of drugs andreferrals. She was sent to physical therapy and told that her muscles needed to strengthen. Then it wason to acupuncture, chiropractic treatments and Rolfing.

When none of these therapies gave her the relief she was seeking, Colleen was referred to a neurologist. A nerve conduction test was performed and the results were positive. She was given the dreadeddiagnosis of carpal tunnel syndrome (CTS). Colleen explained to her doctor she wanted to try anything

and everything to avoid surgery. The doctor prescribed more physical therapy treatments. She was puton another strengthening program by the physical therapist, but her symptoms continued to worsen.She returned to her doctor to explain the dilemma and was told her problems had now progressed tothe point where he considered surgery the only option.”



Colleen sat in the doctor's office and convinced him she did not consider surgery an option at all. Thedoctor contemplated her request and told her about the claims of another one of his patients. Thispatient claimed to be able to help people suffering from CTS by utilizing a bodywork technique. Colleen

thanked her doctor and went home to make the call. That was three years and one workshop ago andColleen is now completely pain-free. Instead of being forced out of the career she loved, she now hasher own office and is doing more massages than ever.

What is CTS? When a person uses a muscle over and over again, the muscle tightens and restricts circulation. Whenthis occurs, muscle memory is lost and the muscle is unable to go back to a full resting length. Theresult is inflammation, swelling and nerve entrapment. As the inflammation and swelling increase, thesymptoms also increase. For example, if you were to put a belt around your arm just below the elbowand pull it tight enough to restrict most of the circulation, what symptoms would you experience?

Likely numbness, tingling, throbbing, aching, swelling and inflammation. These symptoms are also thesymptoms of CTS. Couldn't the muscles in the forearm produce these same symptoms if the musclesgot tight enough? Yes. To rid yourself of the symptoms produced by the belt, you simply remove thebelt. The powerful muscles of the forearm are like the belt. By releasing them, circulation is restored,and the symptoms of CTS disappear.

CTS is a repetitive use injury preying on literally thousands of massage therapists, not to mention office workers, construction workers, truck drivers, hairdressers and more. In this profession, many areleaving massage altogether after four to six years of practice. They are in more pain than the clients whocome seeking their help. It need not be. Therapists simply need to learn how to release the culpritmuscles responsible for their repetitive use injuries. With constant muscle use, these same injuries can

occur in any part of the body.

Could All This Really Be Muscles? Short, tight muscles are responsible for most pain syndromes with which people are diagnosed. Don'tgive up simply because of the diagnosis. In his book, Healing Back Pain Naturally, Dr. Art Brownstein(1999) states: "Even if you've been told by your doctor that your back problem is the result of degenerating disc disease, bone spurs, spinal arthritis, a pinched nerve, scoliosis or some othercondition, remember that all of these conditions started with problems in the muscles of your back. When you restore the health of your back muscles, these conditions will be reversed, and you will,ultimately, be free of your pain."

In The Whartons' Stretch Book , by Jim and Phil Wharton (1996), the authors write: "There is a bigdifference between a strong muscle and a tight one. A tight muscle can be very weak. Tightness doesn'thelp, in fact it hurts....To avoid carpal tunnel syndrome, concentrate your flexibility work on arms,elbows, wrists and hands." They go on to say we can avoid problems like plantar fasciitis scoliosis,arthritis, tendinitis, tennis elbow, chronic low back pain, hammer toes, bunions and Achilles tendoncontracture by simply concentrating the flexibility work on that portion of the body. In other words,stretch. A brilliant and revolutionary stretching technique -- Active Isolated Stretching by Aaron L.Mattes -- could help therapists avoid falling victim to these repetitive use injuries.



What's so extraordinary about this stretching technique is the stretch reflex of the muscle is neverengaged because each stretch is only held two seconds. I know this goes against traditional stretchingtechniques, but it works.

Once Colleen had developed her repetitive use injury, stretching alone would not repair the problembecause the adhesions and scar tissue had built up in the belly of the muscle. Stretching alone will notbreak up scar tissue as effectively as a comprehensive treatment plan. When a person stretches a musclethat is full of adhesions and scar tissue, the muscle is more prone to damage. Most people stretch toohard and hold the stretch too long, creating more scar tissue which keeps the muscle even tighter. Butthere is hope for permanent relief.

Treatment Plan Use your massage table or find a tabletop that is a good height for you. Place the palm of the hand (onthe arm you're going to stretch first) down on the table with your fingers pointing behind you. Use yourlegs to move your body up and down in order to stretch the flexor muscles of the forearm. Hold eachstretch for no more than two seconds. This is very important. Use your other hand or thumb to apply

moderate pressure, stroking down the "stretching" arm during each stretch. Be sure to move thestroking hand over all the different flexor muscles in the forearm. The elbow, of the arm that's beingstretched, should be locked. Repeat this technique 20 to 30 times.

Next, stretch the extensor muscles. Make a soft fist and put your fist flat on the table. Again, using yourlegs, as you bend at the knees, roll your wrist forward to stretch the extensors. It is important to holdthe stretch for only two seconds, returning back to the neutral position between each stretch. Use yourother hand or thumb to apply a moderate amount of pressure, stroking down the extensor muscles.Keep the elbow, of the arm you are stretching, locked. You only need to stretch hard enough to feel agood firm stretch. If you stretch too hard, you will cause your muscles to tighten up even more. Repeatthe stretch for the extensors approximately 20 to 30 times.

Everyone suffering from CTS will begin this routine in a different place, so do not be discouraged if your range of motion (ROM) is not the best. The tighter the muscles, the less ROM you will experience.

It is important to start where you are, and stretch only until you feel a good, firm stretch. You will beamazed at how quickly your ROM will increase. This technique allows the muscles to be released, thuscirculation is increased. No healing will ever take place without circulation. When moderate pressure isapplied to the muscle during the stretch, scar tissue is broken up more quickly and the muscle islengthened, restoring muscle memory. When scar tissue re-forms, it forms in a more organized, elastic way.

A person does not need the diagnosis of carpal tunnel syndrome to reap the benefits of this work. If youexperience tightness in your arms or hands, try this technique to avoid the possibility of your problemprogressing into a chronic pain condition.

Follow this stretching routine daily and you will be absolutely amazed with the results. The symptomsof CTS will soon disappear. It is wise to continue to perform this muscle release even after thesymptoms completely vanish. These muscles did not become short and tight overnight. Therefore, it

will take some time to train the muscles to remember the original relaxed state we all were blessed withat birth.

Michael Young, NCTMB is an injury and rehabilitation therapist who has a private practice in Evergreen,Colo. He is an author and the founder of Repetitive Use Injury TherapyTM, P.O. Box 358, Evergreen, CO80437-0358, phone 303/674-7948, fax 303/679-0805. He holds workshops across the United States,designed to train therapists in the Muscle Release Technique.TM For more information on workshops,articles, etc., visit his website at www.mrtherapy.com.



~Ease Symptoms of Carpal TunnelCarpal tunnel syndrome is a progressively painful condition that causes numbness and tingling in thethumb and middle fingers. Traditional treatments for carpal tunnel range from a wrist brace to surgery.

However, a 2004 study found that carpal tunnel patients receiving massage reported significantly lesspain, reduced symptoms and improved grip strength than those patients who did not receive massage.Source: Touch Research Institute, University of Miami School of Medicine, Journal of Bodywork and

Movement Therapies, 8, 9- 14. “www.amtamassage.org/news/06factsheet.html

~Massage for Carpal Tunnel Syndrome Massage therapy eases the symptoms of carpal tunnel syndrome and increases grip strength, accordingto a recent study.

“Carpal tunnel syndrome symptoms are lessened following massage therapy” was conducted by staff atthe Touch Research Institutes at the University of Miami School of Medicine in Miami, Florida.

Symptoms of carpal tunnel syndrome include pain, tingling, burning and numbness of the hand.

Sixteen people diagnosed with this syndrome participated in the study. All of them held jobs involvingheavy word processing or computer work.

Subjects were randomly assigned to either the standard-treatment control group or the massage-therapy group. Those in the massage group received one massage per week on the affected arm for four weeks. They were also instructed in self-massage, which they were to perform each night before bed.

The massage routine consisted of stroking of moderate pressure from the fingertips to the elbow. A massage and pain log was kept by subjects in the massage group. In the log, participants recorded thetimes at which they began and ended self-massage, as well as their levels of pain on a scale from zero to10.

Subjects in the control group received no intervention, but were taught the massage routine after thestudy ended. Physicians evaluated participants’ carpal tunnel symptoms, such as tingling, numbness,pain and strength, at the beginning and end of the four-week study. The Tinel sign, which tests to see if

light tapping of the affected area elicits pain or tingling, was also used at the start and finish of thestudy. Physicians used the Phalen Test at the beginning and end of the study as well. The Phalen Testinvolves flexing of the wrists to see if numbness or tingling occurs.

A nerve conduction test was also performed at the start and finish of the study. This involvedstimulation of the median sensory nerves through electrodes placed on each subject’s index finger and wrist. Peak sensory latencies were recorded to test for nerve compression at the carpal tunnel. Medianpeak latency was the primary outcome measure.

Assessments were also made before and after the massage sessions on the first and last days of thestudy, including the Perceived Grip Strength Scale; VITAS, a pain assessment using a visual analoguescale; the state anxiety inventory; and the Profile of Mood States.

Results of the study showed that the subjects in the massage group had significantly less pain andreduced carpal tunnel symptoms, as well as shorter median peak latencies and increased grip strength.

“Functional activity also improved as noted in reduced pain and increased grip strength in the massagetherapy group, both immediately after the first and last massage therapy sessions and by the end of thestudy,” state the study’s authors. “Finally, the massage therapy group reported lower anxiety anddepressed mood levels both immediately after the first and last sessions and by the end of the study.”

- Source: Touch Research Institutes at the University of Miami School of Medicine in Miami, Florida. Authors:Tiffany Field, Ph.D.; Miguel Diego; Christy Cullen; Kristin Hartshorn; Alan Gruskin; Maria Hernandez-Reif, Ph.D.; and William Sunshine. Originally published in the Journal of Bodywork and MovementTherapies, 2004, Vol. 8, pp. 9-14.



~Massage therapy is effective in reducing hand pain and increasing grip strength, accordingto a study conducted by the Touch Research Institutes (TRI) at the University of Miami School

of Medicine in Miami, Florida. The full research report of “Massage Reduces Hand Arthritis Pain andIncreases Grip Strength,” ran in the print edition of MASSAGE Magazine's February 2007 issue.

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