What Are We Doing To Meet Challenges Posed by COVID-19?

We are open!

We have reworked virtually every aspect of our procedures to ensure that they are the best we could implement. We are combining the most stringent elements of the guidelines from the CDC, Federated State Massage Therapy Boards (FSMTB), and leading practitioners in states that have already re-opened.

However, the situation is dynamic. Guidelines are subject to change. We may also have to close temporarily again. At this time, the Illinois DCEO has removed the prior 30 minute session limit. Current re-opening guidance for our profession can be found here

However, we also just received confusing, and wildly incorrect, guidance from WHO regarding spread of coronavirus by asymptomatic people. Although it MAY be true a person who never develops symptoms may not spread the virus effectively that statement misses the point. People are MOST contagious during the 1-3 days BEFORE symptoms start. So you may without symptoms at this moment, you could be highly contagious and about to develop symptoms in the day or two. This is one of the reasons we continue to exercise significant precautions.

In many ways, things haven’t changed that much. Compared to some of our competitors, ranging from independent practitioners to chiropractors and “chain” locations, we have always had a higher bar. Cleanliness and sanitation have always been important in hands-on therapy.

We’ve always had a higher standard than most for everything from medical history and quality of treatment to the followup that goes along with it. Some offices and some practitioners may be less careful with their own health and yours. There is broad agreement that failure to follow appropriate precautions is dangerous and will contribute to the spread of coronavirus.

These are some of the things we are doing differently:

  • Additional pre-screening questions
  • Use of necessary PPE for everyone
  • Installation of HEPA air cleaner/purifiers
  • Online versions of paper forms and followup material
  • Greater spacing between sessions
  • Thorough cleaning of all surfaces in the treatment room, restroom, and hallway area between each session
  • Complete uniform change between sessions

To put it in a nutshell, we are engaging together in over an hour of close physical contact, breathing the same air.

You have never had an appointment with any doctor or ever had another medical procedure that creates similar exposure for either you or the practitioner.

This has always been true of manual therapy.

What is different now is that we know the factors that increase spread of COVID-19 are extended close contact, enclosed space, sharing the air in that space and extended conversation or other forceful exhalations like coughing.

Although sanitation has always been very important in hands-on therapy, we have not confronted contagion the air like this, including aerosolized droplets and surface transmission in this way. We are also mindful that fatality rates are still much higher than the flu and common illnesses.

This is why we are working so hard to protect the health of everyone we treat.

What Can You Do?

Masks are required for therapists and other medical workers and their clients/patients. We understand masks aren’t always comfortable. We know they don’t always fit properly. However, they do substantially reduce the shedding of coronavirus and other microbes. We do not anticipate that this requirement will change in the foreseeable future.

If you locate another therapist that is will work without requiring you to wear a mask, remember that all the people before and after you aren’t wearing one either. It is not a question of whether that therapist will become infected and begin spreading to other people. It is a question of when.

Outside of our sessions, please wear your mask when out in public. If you contract the virus, you may not know for weeks. You may never know. But you might infect me or my other clients. With contact tracing rapidly arriving, locations that are identified as infection vectors will be shut down quickly and contacts of those establishments asked to completely quarantine for 14-days.

COVID-19 and other contagious diseases will persist to some degree for many years. Hopefully, it won’t be forever or always, but continuing to reduce the spread for extended periods of time is the new normal.

It will be more helpful for you and those around you if you wear your mask properly. If it is loose around your face or not covering your nose, it isn’t helping much.

A good mask, whether handmade from cloth or an N95, should be a little uncomfortable. Not hard to breathe, you should be conscious of your own breath. As a quick test of the material, try to blow out a candle. You should be unable to.

Remember, we don’t sit around watching Netflix in these masks. They are for public places, including massage therapy and other medical and professional services.

Try to get with the spirit of the program, not just the letter.

It’s summertime and the weather is nice. It’s definitely sandal weather. However, if you’re willing to wear a mask and gloves to the grocery store but still have your sandals on, think about it. That floor is not a clean place. Most floors aren’t.

But we’re not concerned about general dirt and grime. If you want to wear your sandals outside in the park, knock yourself out! More comfortable around the yard in sandals than gym shoes?

But when we are around other people, who may be shedding the virus with each breath, we should avoid sandals. We also need to wash our feet more often when we do wear them.

Sandals and other summer shoes are fun and comfortable. However, in my articles about foot pain, you can find other reasons to re-think sandals besides hygiene. Make sure your sandals have a flexible sole and a back than hold your heel in place.

What To Expect – Booking and Treatment Procedures

We are making some changes to our appointment booking process.

The first and most important change is that the office is not open to the public. Services have always been by appointment only. However, we are also not open to salespeople, delivery people, cleaning staff, or other general visitors.

This means that we have full knowledge and absolute control of the number of people who have access to our facility. We are also not currently treating patients in chiropractor’s offices or outside spa locations. We are not doing corporate outcall work. Closing to the general public and reducing outside contacts allows us to be more aware of any outbreak that may occur among our clients.

Regrettably, there are some people I am unable to treat at this time due to safety concerns related to COVID-19. Some of these have always been contraindications for massage and other bodywork. However, as with other procedures in the office, we are stepping it up a bit.

At this time, we observe contraindications based on FSMTB guidelines that include, but are not limited to:

  • Age over 69 (note that the FSMTB cutoff is 65)
  • BMI over 40
  • Diabetes
  • Kidney or liver disease
  • Any current respiratory disorder
  • Asthma, COPD or any other chronic lung disorder
  • Those who have or have recovered from any blood cancer
  • Anyone with a fever, cough or other symptoms consistent with COVID-19

As more information about the prevention, implications, and treatment of COVID-19 develop, these recommendations are likely to change.

medical history myofacial therapy trigger pointWe are no longer using paper forms. Our pre-appointment history form is now online. It is safe, secure and HIPAA-compliant. We are also asking certain additional screening questions that may require follow up. This form also includes new informed consent language related to COVID-19.

Please make sure to submit your history form no later than 24-hours before your appointment.

In an attempt to minimize the airborne spread of the coronavirus, we will reduce the total amount of conversation related to your medical history during your session. That means that some of our dialogue about your history may happen by phone, email, or telehealth session.

Our goals are to minimize the chances of treating someone carrying the virus while simultaneously assuming that everyone who arrives may be carrying it and observing appropriate precautions.

Anyone providing massage therapy is expected to prepare to cooperate with contact tracing efforts. That means we need to know who you are. Even if you are not using insurance, we will need a copy of your driver’s license or other government-issued photo ID.

Please provide a copy with your pre-appointment history form no later than the day before your appointment.

Please wear gym shorts, t-shirt, a sports bra, etc, that will facilitate range of motion assessments and self-care work. Loose clothing such as sweats can be worn to and from the session but not during it. Jeans and other tight clothing restrict movement during self-care work and are not practical. The hands-on portion of your session can still be done unclothed.

It is very important to let us know if you, or anyone that you have been in contact with, have tested positive for COVID-19 or developed symptoms consistent with it.

Seasonal allergies, with associated occasional runny nose, sneezes, or cough are not contagious and are not a cause for concern. However, we have always asked anyone with a cold, flu or other contagious illness to reschedule. In that sense, there is nothing new here.

However, due to the pandemic, it is even more important to reschedule if you experience characteristic signs of COVID-19 including:

  • Persistent dry cough
  • Sudden loss of energy
  • Breathing significantly faster
  • Loss of sense of taste or smell
  • Unusual redness or swelling in your extremities
  • Fever of 100 degrees or above (normal average temperature is 97.8, not 98.6 – this means two degrees above normal)

If you have experienced any of these since making your appointment, please contact us to reschedule.

You must wear a mask. In addition, we will provide you with a clean mask for the session.

There is a proximity alarm at the entrance. We will hear you as you approach and will open the door for you. The idea is to get you all way from your car to the treatment room without touching anything. Please call at 630 858-0000 if you have any questions. Everything will be sanitized before you arrive.

I will also be wearing a mask and gloves when you arrive and will take your temperature with a no-touch infrared thermometer. We will smile at each other with our eyes and great each other kindly but will have no contact until the session begins. 

If you are wearing gloves we will ask you to remove them.

Once you have been escorted to the treatment room, you will be provided with a plastic bin for your personal belongings. It will be covered during the session.

Despite these limitations, we will aim to create a calm and soothing environment. The table is highly adjustable and we will seek to ensure your comfort.

After a brief intake, range of motion assessment and palpation of relevant areas, you will undress to your level of comfort without removing your gloves.

Please place all your remaining clothes in the bin. Your mask must remain on. Finally, lay down on the treatment table face up. Because of the mask, we will do much, if not all of your session facing up or side-lying.

We are now using HEPA air cleaners and will keep the windows open when possible to reduce the accumulation of airborne virus particles.

Every touchable surface in the treatment room and on the table is thoroughly disinfected between each session with EPA approved disinfectants. The entire table setup is stripped and changed out. The floor is cleaned. All the self-care equipment is disinfected.

There are no area rugs, drapes, fabric, or foam items that cannot be sanitized. The restroom is thoroughly cleaned between each session if it was used.

The only fabric will be the sheets and padding on the table. The waste receptacle has a lid and foot pedal. There is never soiled laundry from prior sessions in the treatment area. It’s always been that way here, but you might not have noticed before.

We apologize in advance, but some changes mean that the table will not be as comfortable as it used to be. The thick foam pads that helped make our tables soft cannot be sanitized properly nor washed and dried effectively. Most electric heating pads cannot be disinfected properly. We continue to evaluate alternative solutions.

I may enter the room with an eye or face shield in addition to my mask. Apologies in advance for my appearance. Hopefully, we can both laugh.

To reduce potential airborne transmission, we will minimize conversation during the session. We will have a discussion about gloves and cross-contagion.

I may ask you to adjust your mask to ensure that both your mouth and nose are covered. If we are working on your head or neck we will sanitize that area as well. We cannot work on the face or provide intraoral work at this time.

We will both take special care with our masks when working on any areas near your face.

Depending on your preference, the work we do and other factors, I may or may not wear gloves throughout and may sanitize my hands more than once. We will finish the hands-on part of the session with work on your hands, including sanitizer.

Please do not prepare to leave right away.

A significant part of each session is self-care work. Please keep your mask on as you get dressed. You will be provided with a final pair of gloves while handling the self-care tools.

Written self-care instructions to you will be provided electronically to minimize exchanging physical materials that might be contaminated.

Cash is messy during these times. If you are happy with the session, the best way to say thank you is to return for another session 🙂

I will contact you 2-3 days after the session to see how you are doing. We will also revisit some of the initial screening questions with you.

For the 14 days following your session, PLEASE CONTACT US IMMEDIATELY if you develop a fever, cough, loss of smell/taste, or other signs of COVID-19 infection, if you test positive for COVID-19 or if you are informed that you have been in contact with someone who has.

We will fully sanitize everything after you leave, but because of our close contact during the session, we must be prepared to report any positive COVID-19 encounters we may have had.