The new year is just around the corner, which means it's time to take stock of the current year and make goals for the next one. I don't make resolutions very often, but I respect those who do. While personal growth should be a constant factor in life, it's good to have a culturally sanctioned time to get properly motivated.

Not that it always works. The biggest cliche of resolutions is the one where you buy a gym membership, work out every day for the first few weeks, and completely forget about it by the end of January. It was a great goal in theory, but in reality there was nothing to sustain it.

But that doesn't mean you should scrap goal-making completely; just make reasonable ones. Change doesn't happen all at once, so you need to think and plan for the long-term.

How do you make a goal more than just a one-sentence declaration? Education. Read articles about the topic. Watch documentaries or news reports, if applicable. Talk to other people who have done the same thing. The more background knowledge you have, the more likely you'll be to follow through.

Understand your goals. If you want to lose weight, figure out why. Is it so you can fit into your old jeans? That's a pretty narrow goal. Is it so you can feel good about yourself? That's easier to tackle. Learn about the importance of healthy eating. Go to the gym to improve your cardiovascular strength, increase your stamina, improve your sleep, and maybe, eventually, drop a few pounds.

As a personal example, my goal for this year is to practice meditation. I know I want to do it - and, more importantly, I know why I want to do it. I'm motivated enough to read about meditation, but I'm not quite ready to add it to my life. Small steps. Ideally, though, I'll get there by springtime.

And whether or not you're making goals, have a healthy and happy new year!

I'm one of those strange people who actually doesn't care for foot massages. It's probably due to the fact that my feet are absurdly ticklish. Still, I know that the majority of people absolutely love getting their feet rubbed. And there are plenty of times - after a long walk or too much time in uncomfortable shoes, for example - when my feet hurt, and I need to make them feel better. But how?

If the thought of someone else touching your feet makes you cringe, or if your spouse/partner/close friend isn't around to help, use a tennis ball!


I know, I know - I didn't really need a diagram.

There isn't much to explain. Stand on a tennis ball; roll it around under your arch. Vary pressure as needed by shifting your weight from one foot to the other. If you find a painful spot, hold for 20 or 30 seconds before moving on. This is great to do regularly or just after a particularly tiring day. Your feet will thank you!

I just got credentialed with a bunch of new insurance providers! New on the list are: Optum Health, Great West, Health Allies, Access One, Medical Resource, PacifiCare, United and Premera Blue Cross. Do you have a plan with one of these providers? Call to see if you're covered for massage!

Check out the full list of covered providers here.

I had planned on writing about this topic for a while now, but with recent events it seems even more necessary. Elizabeth Edwards passed away last week after a long struggle against breast cancer. Click here to learn more about her.

It seems like there are breakthroughs every day when it comes to cancer research. Statistics show overwhelming progress with how we're treating and managing the disease. Cancer is becoming more just something to live with instead of something to die from.

Still, it happens. The cancer might be discovered too late, or it might spread too fast. Further treatment would only cause more pain and prolong the suffering. Instead of dying in the confines of a hospital, though, many people are choosing the compassionate care of a hospice.

In America, we (yes, I'm generalizing here) don't like thinking or talking about death. Death is a frightening concept, seen essentially as the end to all things one knows. And so discussions about death are systematically avoided; interacting with the dying is done with uneasiness behind closed doors.

While this mindset has plenty wrong with it in a general sense – that is, living in constant fear of an unavoidable fact – imagine what harm it does to a terminally ill patient. The loved one becomes a taboo, representing what people fear most. Interactions are suddenly colored with pity and sympathy; conversations are marked with hesitations so that feelings get spared and no one confronts the obvious.

But by its very nature, the hospice is a different world. Death is no longer something to fear – it happens, sure, but the doctors, nurses, and others are there to make the transition as agreeable as possible.

What can massage do for the dying client? It can provide the client with a safe space, where he or she can relax, find calm, and escape reality for a moment. Massage, as with everything else offered at a hospice, helps to remind the client that he or she is loved and cared for.

Touch is often used as a tool of comfort – holding a fearful child's hand or giving a hug to an upset friend – effective when words are not. And just like at the beginning of life, touch can be the most important way to communicate at the end of life. Massage therapists are good at touching; that's our profession. But we can also be teachers. Instructing the family or caregiver in basic massage techniques is a wonderful way for them to connect with their loved one during such an important time. Light strokes to apply lotion or just basic hand and foot holds are very easy for non-professionals to learn.

And while massaging clients in hospice care can be extremely welcoming and beneficial, there's yet another way to be useful in these situations - massaging the caregivers. The logic behind it is hard to refute: in order to take care of someone else in the most complete and effective way possible, you need to start by taking care of yourself. Unfortunately, most caregivers find themselves too busy taking care of their loved ones to find a spare moment for relaxation.

But they do need it. Studies show that spouses who act as caregivers report as much (or more) anxiety as the person in care [source]. It's easy to imagine how caregivers can become so overwhelmed and exhausted. And exhaustion will just breed more exhaustion, more stress and anxiety, with nothing to break the cycle.

Luckily, massage is there to help. The sessions don't need to be long or elaborate; just a quick, seated massage when they have a small break. Short, 20-30 minute massage sessions have shown to significantly decrease anxiety, depression and fatigue in caregivers [source]. The best thing about having massage therapists available in hospice settings is that they can work freely with both populations. The caregivers don't need to leave the hospice or even set aside much time in their already overburdened schedule.

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The best part about massage is its flexibility. A ten minute foot rub to lower anxiety before a radiation treatment; an hour-long session working to regain full shoulder motion after a mastectomy; a light massage in a hospice bed whose purpose is more emotional than physical. It would be impossible for me list all of the times and places in which massage can help, just as I could never emphasize enough how beneficial a caring touch can be. Oncology massage isn't unique because the techniques are vastly different from the norm; it's unique because of how integral massage can be in treatment and recovery.

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Part One: Introduction
Part Two: Benefits
Part Three: Adjustments
Part Four: Hospice

This is what it all comes down to: the adjustments needed to make massage possible (and comfortable, safe, and effective) for cancer patients and survivors. But let's back up for a second and take a look at the larger picture. What are these adjustments for, exactly?

To state the obvious, cancer treatment puts the body through a lot of stress. The lymph system spends extra energy filtering out dead cells and cellular debris left over from chemotherapy and radiation. Drugs and medication can increase pain and nausea. Surgery leaves painful scars; radiation can leave the skin raw and tender. Lots of treatments, little time to recover in between. The body is overwhelmed from invasive procedures and needs to heal as best it can.

It's easy to see how an overeager massage might add to the troubles. If the therapist enters the massage session with the mindset that she will be fixing the client, she may wind up introducing new stressors to the client's already overtaxed body. Instead of healing itself from the cancer treatment, the body will need to spend extra time and effort repairing the tissue damage brought on by a deep massage.

In this setting, the therapist needs to have a new goal: not to heal, but to help. I've already talked about the benefits of massage, the ways that a massage session can truly help the oncology client - less pain and nausea, increased relaxation and a better sense of wellness. Some of these goals are a little vague, but perhaps that's the point. The massage is creating an environment in which the patient's body can properly heal itself.

There are a lot of potential adjustments, but most of them fall under just a few categories. Site adjustments: where on the body you'll be massaging. Avoid scars from recent surgery and don't massage near medical devices (e.g. chemo ports). Positioning adjustments: Does the client have trouble breathing when laying down? You can easily prop him up with some pillows. If the client is most comfortable when sitting, a chair massage might be the best option.

Pressure adjustments: As I explained above, a massage that's too strong could interfere with healing when someone's body is already under a lot of stress. Of course, different bodies have different thresholds, so what's too much pressure for one client might be perfect for another. Pressure adjustment is often a source of contention: The client might feel that he or she can tolerate a deep, strong massage, but the therapist may not be comfortable working at that level. The best option is to start with soft, light pressure and build up over several sessions. This way, the client can see how his or her body responds to the increase. As long as both the client and therapist remain in communication, they should be able to find the appropriate balance.

The final adjustment category is the level of demand. Beyond just pressure level, there are a wide number of factors that determine the intensity of the massage. What parts of the body will the massage focus on? A full-body massage has a higher level of demand than a hands-and-feet massage. Will the client remain clothed or be draped? Clients undergoing invasive treatment might be extra protective of their body and not be comfortable with having certain areas touched or exposed. How long will the massage session be? It hardly needs to be said that an hour-long session has a different level of demand than a 10 minute one.

While some of the goals of massage in this setting are pretty general, it's still possible for the client and therapist to develop a set of goals specific to the client's needs. This is especially true when working with cancer survivors. For example, let's say a client wants to regain range of motion in her shoulder after a mastectomy and subsequent reconstruction. It's a very common goal, but the steps taken to reach it are different depending on the client's history. How long ago was the mastectomy? Did the client have lymph nodes removed in that area? How active is the client in her daily life? All of these details will determine the details of the massage session.

Massage is always possible in an oncology setting; it might just take a little refining. The best thing is to be flexible, and to view the massage as a learning opportunity. The client and therapist have to forget what they know about "normal" massages and open themselves up to new techniques and approaches. Working together, they can tailor the session to meet the client's needs and easily create the best possible massage.

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Part One: Introduction
Part Two: Benefits
Part Three: Adjustments
Part Four: Hospice