Ep 53 - Hand & Stone Spa Check-In with Nathan Nordstrom

00:00 Kristin Coverly: Anatomy Trains is excited to announce a new on-demand video course with Tom Myers coming soon, Deeper Ground: Restoration and Vitality for the Female Pelvis. Reach your deeper ground of embodied awareness and strategic confidence with this four-hour tour of the female pelvis, including its key points and unique challenges. Course highlights include hands-on palpation certainty and technique review for the major muscle groups, assessments and techniques for posterior and anterior pelvic floor, psoas complex and diaphragm, common perinatal biomechanical issues explained, and much more. Sign up for the Anatomy Trains newsletter at AnatomyTrains.com, to be notified when the course is available.

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01:00 Darren Buford: Welcome to The ABMP Podcast. My name is Darren Buford, I'm the Editor-in-Chief of Massage and Bodywork Magazine and Senior Director of Communications for ABMP. I'm joined by my co-host, Kristin Coverly, licensed Massage Therapist and Director of Professional Education for ABMP. Our goal is to connect with luminaries and experts in and around the massage body work and wellness profession, in order to talk about the topics, trends, and techniques that affect our listeners' practices. Our guest today is Nathan Nordstrom. Nathan became a massage therapist in 2001. He is licensed in several states and is a board-certified massage therapist. He has taught massage therapists since 2004 and is a nationally recognized continuing education provider. As a massage therapist, he has worked in many settings over the years. He teaches classes in the application of ethics in daily life and advanced anatomy classes for massage therapists. He has served as a leader in many ways in the massage industry. He is now Director of Massage Therapy for Hand and Stone Massage and Facial Spa. Hello, Nathan and hello, Kristin.

01:58 Nathan Nordstrom: Hello.

02:00 KC: Hi, welcome. We're so happy to have you here. Actually, we should say we're so happy to have you back because you are a repeat guest here on the ABMP podcast. When you were on with us back in April, which feels like a decade ago in some ways now, all 450 Hand and Stone locations in the US and Canada were closed. How has Hand and Stone team successfully navigated the crisis in the seven months since then? I think everyone's curious about that opening. How was the transition? Where we stand now. So kinda give us the story of how that seven months has evolved.

02:32 NN: Well, I guess I really have to go back to April because when we really got together, I was passionately working to try and open spas. And that was kind of my go-to. My life force was focused on how to safely professionally open spas so that no one would get COVID or really any other virus from a spa. And I got through that process, and I knew I was through that process, that the initial big push, as soon as we had every spa open. And that was actually just a little over a month ago when California... We talked to the COVID community and the COVID doctors in California, to really push and engage them in opening up their doors, so that massage therapists could successively practice. They had a unique requirement that you could do massage, but it had to be outside. And it was really kind of bizzare. So each state had their own unique aspects. And really when I looked at how long different states were limiting the use of massage therapy, we had a big chunk of them. The majority of them were closed for 60 days. So in that closure, we actually had 60 days worth of creating policies, protocols and procedures that would allow for the spas to successfully open.

04:00 NN: Now, some of that challenge and blessing for a spa like Hand and Stone is that the owners were working in the background to make sure that each of the spas in the franchise were meeting specific requirements and obligations, not only that we put on them, but also the ones that their state licensing board or their governing bodies put on them. And so, to me, the story really starts with an owner who's excited to get the doors back open and get the massage therapists back to work, to help the clients that they have, that really needed massage, to stay away from pain medication or to stay away from injury, pain, long-term sitting from sitting on your couch trying to do all your work that you're used to being in an office and having an ergonomic set up. That was kind of the early days.

04:55 NN: Now, I think we're gonna get into kind of current standings, but really the key piece for me was as soon as I saw massage therapists coming back, and I got a lot of positive feedback from the massage therapists, who were saying, "Ah, it was so nice to work on this client," and vice versa. I get feedback from the massage clients that come in. And they said things like, "Gosh, I was kind of concerned before I came in. However, the spa was clean. Sanitation. They allowed us to have spacing so that we weren't back-to-back, and there weren't a whole bunch of people in the lobby. And I waited in my car until I could come in and my client walked up... Or my therapist walked up and greeted me right at that time and brought me right back to the treatment room. It seemed so smooth and so easy going." And that's because we preemptively worked on a plan. Trying to get a plan into action when you're in the middle of it is a real challenge.

05:53 DB: There's nothing like that appreciation, and I'm sure we're hearing it internally when we're working with our authors who if they haven't already begun to massage again are doing so. And just that appreciation of that hand-on touch has just been... You can just feel it. Everybody is so glad to be working again, if they are able to work with regards to state regulations. Let me ask you, the last time we talked a lot about the protocols that you are instituting. How do you feel about those now? Have things changed since re-opening? What have you learned during that process?

06:31 NN: There's several pieces to that. Have things changed? Yeah, slightly, but truth be said, there really hasn't been much at all. The majority of the policies that we put into effect were smart processes that we already knew, that could be moved and implemented, but it took something like an urgent request and requirement to put it into effect. And so for me, really seeing that masking is a key piece. And early on, actually, I think I got some negative feedback on this because for Hand & Stone, our requirements stated that massage therapists need to be masked and that the clients need to be masked if the state mandated it. And each state has had slightly different protocols and procedures. The key thing for us is that we know who we have control and expectations to be working with. And so we can say, "Hey, employees need to be masked up." When it comes to customers who come in, the authority and responsibility in their daily life is the governing body. It's not a third party business that they are trying to come and really patronage.

07:54 NN: And so when we come down and when we say, "Hey, you know what? You have to wear a mask in our facility," we have to be very strong in that, and we have to know that we have good support and good science behind it. And when it comes really down to it, we knew that the governing bodies in the local areas are going to be differing in every state. And so states that have a very low COVID count and are doing really well, that is up to them to really engage. And so each policy really has shown strength and challenge. There are some policies that were actually quite difficult. For example, table covers, so the plastic vinyl covers for a massage table, it wasn't a problem getting people to implement it, it was actually a problem to get enough in the country so that all the spas in all of the country could actually have a cover.

08:50 NN: And we dealt with those. We definitely made sure that there were plenty of options in making that possible. Other challenges were even implementing the extra cleaning time, or a spa back support. We had some challenges with owners who felt like they could do the protocols, but we still said, "No, here's the protocol." Or the second one was massage therapists who didn't want to add 15 minutes in between each of their sessions, because they knew they could do it in the right amount of time. And we had to really kinda be conscious with our owners in making sure that the therapist understood why we had what we had, why we really connected with the importance of having the right amount of time between services. And so we created several training protocols and several video presentations to really make sure that spa sanitation and illness prevention is on the top of the mind of every massage therapist.

09:46 DB: Let's take a short break to hear a word from our sponsors.

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10:21 DB: Now let's get back to the podcast.

10:24 KC: So I know that talking to a lot of solo practitioners that have gone back to practice, we're seeing a wide variety of percentage of clients returning, from 30% to 60%, sometimes only 10%, so it's really across the board, up and down, there's no consistency to it. How has the client volume been like at the Hand & Stone locations?

10:45 NN: So we're gonna have a little bit of difference than the solo practitioner. And this is what I really wanna point out to people, because it's intriguing to me. Just a couple of weeks ago, our CEO pointed out that we had more total services, massaging and facial, and actually, it was more massages as well, the previous week than we did a year ago, the previous week. And I looked at that number and I was like, "That doesn't sound right." And so I dug into our business intelligence tools and started looking at the numbers, and there's two main pieces that kind of opened my mind. The first one was, back in January, we had 6000 massage therapists working at Hand & Stone across the country, and in that 6000, we had on average, even including someone who came in and did one massage and then decided they didn't want to work, we had an average of 10 sessions per therapist.

11:47 NN: So now we go through COVID and we get post-COVID, and now we're at about 5000 massage therapists. However, we're averaging 13 sessions per massage therapist. So that means that the massage therapists who are actually getting back to work and getting supported by the industry and by the spas, actually are being more successful, seeing more clients, and the ones who are holding back are actually still limiting themself down, but they're opening up the doors for those massage therapists who are getting back to work. Once again, making sure that they're following the healthcare, the sanitation protocols. Whenever we get a survey that says, "We had a massage therapist whose nose was exposed over their mask." The corporate side, we send that back to the owner and to the manager, and say, "We're concerned. Sanitation protocol needs to be followed." And so we follow up with them and connect with them, and make sure that when someone walks into the spa, they're not going, "Yeah, I don't know if I'm gonna be safe or not." We wanna make sure, across the board, that everyone's going to feel safe.

12:54 NN: And it's been noticeable, as those numbers have continued to go up for the number of clients. This also includes a little bizarre caveat, because as a franchise that has a membership base. A lot of those message therapy clients have had two months, or two or three months, or maybe even four months, where they hadn't received a massage, and so when the spa doors opened, they were not only just wanting to come in, they're like, "I already pre-paid for these massages." And so they may be coming in twice a week, or they may be coming in one and a half times a month or once a month, and then having an extra add-on where they wanted some extra time or anything else. So that membership has really kind of spurred the possibility for people to say, "Hey, you know what? I really do wanna use the services that I have."

13:47 DB: So they're able to roll those over, month over month?

13:50 NN: Absolutely, absolutely. So month by month. And actually, we've seen those banks, and we actually keep a data of how many, what the average is, and it went up definitely as the doors were closed, and we're starting to see them taper off and come back down as they're getting either extra enhancements, so they might want a Himalayan salt stone massage with CBD, or they may want an enhancement where they get a hand and foot scrub or any specific enhancements, they can use those in their regular service and have that be in their added experience or their month's expense towards those enhancements that they get.

14:29 KC: Yeah, that's a really interesting, unexpected advantage to the client in a way of having them banked as they feel that freedom to try things they may not have before when they just had the one a month, and they felt like, "I have to use it for this one thing that I know I like." Here, now they have a little freedom to play and explore, see what else they might like. That's really interesting.

14:50 NN: It creates great excitement and interest, not only for the client, but then the massage therapist, because so many massage therapists are afraid to offer an enhancement because they feel like they're trying to sell. And anybody from Hand and Stone's gonna know that I am an anti-sales person. I don't believe massage therapists are ever good at selling. Now, there's like a small niche group, but really we're educators in the best potential service for the client. And I always connect back to what a doctor does. A doctor doesn't sell you on a prescription. He educates you on the value of using a specific prescription and gives you the other options that you can physically use to be healthy and to be strong, so that you can actually recover from whatever condition you have.

15:39 NN: And as massage therapists, when we take that Hippocratic Oath, we're doing the same aspect, in our own hearts and in our own minds, "You know what? Maybe a deep tissue massage would work for you, but I know I'm gonna be working harder, and it's gonna be more uncomfortable on you, but if we use these Himalayan salt stones, that's gonna bring hydrotherapy into the service. That's gonna melt and soften your tissue a lot quicker, and that's gonna create a more comfortable and exciting experience for you." And I will be able to also get the benefits of not having my thumb die on me by the end of the day.

16:14 DB: Yeah, absolutely. This is a frequent topic on the podcast, Kristin and I talk about this, which is I am not a massage therapist, but I'm a client. And I can't say this enough, massage therapists, you're the expert, and we're going to listen to you. Trust me, as a client, I'm going to listen to you when you're telling me that I should try this service or I should... I am absolutely dialed in, and I believe in your expert and your education, and I'm going to follow whatever you're suggesting.

16:40 NN: I love the ask of, "But why?" Like if I suggest something and they say, "Well, why?" Oh, I just get excited because I'm like, "Oh, well, here's the science behind it, here's the reason, here's the newest coolest thing." And they go, "Oh wow, yeah, you really do know this stuff. Yeah, I definitely want that."

16:58 DB: Absolutely. Nathan, we know that, overall, in the nation right now, the numbers keep increasing with regards to COVID. Have you had to close locations, or open and close locations, and how are you preparing for that? Or maybe your spas are equipped right now to weather this storm. Can you tell us a little bit about that?

17:21 NN: Definitely, we're seeing this next wave in different regions and different areas, and kind of seeing those numbers go up and being conscious of that. And a lot of the key things that I think most of the states are looking at is, "How do we know that there's actually a problem with a specific industry and how it affects groups?" We're really being isolated away from large group events, like religious connections, which we weren't before, and they said, "Well, if we're gonna close churches, we're gonna close spas, and we're gonna close this, and we're gonna close that." And they didn't realize that a one-on-one with a person for 15 minutes is completely different than 100 people getting in an auditorium together.

18:06 NN: And so we're watching and we're checking in to see, really making sure that different states, if they've got a question, we're more than willing to answer their question and work with them to make sure that they have all the answers that they need, but we have seen specific areas where they have closed things down. We're seeing a lot of states that actually are referring to the local jurisdiction, so it's no longer the state is gonna close all the spas in the state, but the counties and the local municipalities are saying, "You know what? We're concerned, so we're going to stop this type of work for this period of time."

18:47 NN: And in my local county right now, they've closed pretty much everything for four weeks, and they're saying, "You know what? We just wanna make sure that everyone's safe." Even with that, we don't have a Hand and Stone in my county, but there have been a lot of exemption of kind of services, and what those expectations are. The biggest thing is that most counties are saying, "Everyone needs to be masked up," and we're saying, "Perfect, we have that policy in place, to make sure that everyone is masked up."

19:21 KC: So, a hot topic the last few weeks are vaccines, and several are on the forefront of promising to be available in the next few weeks. Question for you, when vaccines are available to the public in a more widespread way, do you anticipate requiring therapists or clients to be vaccinated to either work or receive massage?

19:38 NN: It's a good question, and because it is such a hot topic right now, I don't think we actually have a solid answer for it, because there's possibilities that there can be problems. And really, when we look at all of our clients, we're going to see that spread perception of a vaccine that has been in test for less than a certain period of time, how is that going to affect me effectively in the future, as well as in the next six to nine months. So I know we're going to maintain our standards, and we're definitely going to be watching as those vaccines get implemented. I don't really believe that we would feel comfortable at any point saying, "Okay, effective Tuesday, everybody needs to be vaccinated," because not only would we potentially offend clients, but massage therapists are on every gambit of that same challenge. Having had the COVID test touching the back of my spinal cord, you know what that challenge is, and you know how uncomfortable it is, but when a state like New York says, "Hey, you know what, you have to have a COVID test before you can come back to the spa," they go, "Okay," and you feel for them, you got a huge amount of empathy.

21:02 NN: And then when they say, "And you have to have one every two weeks," 'cause early on the New York came in, it was, you're tested, and then you're tested every two weeks, that was a challenge for New York spas. And then as the policies changed and evolved into what they are now, it's open, and they're definitely doing a lot more intake interview and making sure that the communication is effective. But when I was talking to California, this is one that really came out to me was the doctors were like, "Well, you're taking their temperature, but we know that temperature isn't one of those early symptoms that would show up."

21:41 NN: And so I we had... Let's see, we had, us and Elements, and we had Massage Envy, we had several of the CEOs up with us, and I had to stop and say, "You know what, that is the least of the intake that we do with every client," the important things that massage therapists do is that when a client comes in, we're gonna ask them, "How are you feeling? Are you feeling feverish? Are you feeling achy? How is your sense of smell?" All of those things are the exact same intake questions that we're gonna have every employee being asked when they walk in the doors, it's not just "Okay, you're good," it's, how you feel? What's going on? Do you have anybody in your home that came up COVID positive?" Those questions are the things that are going to make or break a successful practice, so much more than if you got a number and you wrote it down.

22:36 DB: Can you tell me a little bit about the environment right now? For any solo practitioner who's working out there and they've come back, maybe the numbers aren't what they were with regards to clients coming in, but maybe they're comfortable with that just because of where they feel about COVID and their safety out there practicing. Can you tell us a little bit about why Hand and Stone is a good place for those solo practitioners to come to work?

23:04 NN: Well, so early on when I was getting ready to come out of massage school, the one thing that I wanted was a billionaire to come fund my dream practice, that to me, I was like, "Oh man," and actually in massage school, they had us build your dream practice, and they had you not only create your forms and create a floor plan of the massage room and all of these things. And so we were sitting there going, "Oh, this is... And it's gonna be in the middle of a desert island, and it's going... Oh yeah, and we're going to have palm trees, but I'm gonna have a cabana, where I can actually do message out there."

23:44 NN: And so we created this dream idea of what massage therapy would be to me, and then we graduated and got our license, then I went, "Okay, I want to practice." And we didn't know what to do, and we had then, especially right now, in my mind, if I came out of massage school, really in the last nine months, I guarantee I would be scared, because I wouldn't know what to do or where to do it and what limitations, and I wouldn't even really probably know where to find the right county protocols and the limitations for what massage therapist should and shouldn't be doing. And that's a nightmare to me, and because massage schools aren't gonna teach that, they don't have that in their curriculum.

24:35 NN: So one of the things for me that Hand and Stone really brings to the forefront is that they have a corporate massage therapist, and that's myself, and we have Carrie Wiedemann, who's the assistant director, and we've got several wonderful people on the corporate side who create policies and tell these people who, in most case, the Hand and Stone owners are not massage therapists and don't really know about massage therapy too much, as they continue to manage their spa, they get more knowledge and more understanding, but not really as what a massage therapist would be.

25:11 NN: So simply by educating these really industry supporters, they love massage therapy, they love healthcare, and they want to have a career that supports the health and well-being of the community. And so they're hiring massage therapists to do the massage, but they are financially backing the industry so that massage therapists can feel successful. When I talk to an owner who interviews a massage therapist, and they say, "Well, the massage therapist doesn't know about this policy or this protocol, and they're kind of concerned about this before they want to start," I get excited, because it's a massage therapist who's interested enough to want to know why.

25:58 NN: And my whole life has always been, not only know the answer, but know why the answer is. When I took the National Certification Board exam, I had so much fun, because I wasn't just answering the questions, in my brain, I was going, "Well, this is the right answer because... Oh, that's the right answer, because... " And being able to say that gives you the confidence that when it comes down to walking into a treatment room, it's not, "Well, because I was told that," it's, "Here's the reason why, and here's how we can be better, and how you can be better and what we can do," really being engaged by challenge, makes you a stronger individual, and it makes you want to be educated throughout your life. So when it comes down to why Hand and Stone is so supportive to the massage therapist? Well, it's because we're not actually forcing you to do anything. We're giving you options that you can give to your clients.

27:00 KC: Nathan, massage therapists have learned a lot since the start of COVID back in March. We've made some progress, we feel good about some things, but there's still a lot of worry and concern about not only what might happen in our personal lives, but also professionally. Do you have any words of encouragement or thoughts for the profession at this time?

27:18 NN: The first thing that I want to say, and it's probably something that's not your go-to answer, but study virology, and people don't think of this as a huge study. But in massage school, you took anatomy, you took physiology, you took pathology, and usually in pathology they talked about viruses slightly. They didn't give you a huge depth of what viruses all are and how they work and why. The more you can actually dig into viruses, the more you'll understand they're all biological creatures, and they have a pattern to them, just as you and I have patterns to us. And so when we look at really the basics of the virus system in the human body, you have some ability to understand a process, a protocol and a procedure, and why you would create specific process, protocols and procedures, to make you feel safe.

28:17 NN: Now, I've also been known for putting out the concept of, really, if you're not uncomfortable, you're probably doing it wrong. You should have things that are challenging you in life. If you don't, then you're not growing. And as a massage therapist, we get really comfortable seeing our same 40, 60, 80 clients, and then just moving on and setting sail. But you know what? It's that new client who comes in who has a pathology that you don't really know about that's gonna make you think and make you work to understand it. You know what? Be comfortable being uncomfortable.

29:01 NN: Anxiety is not just a pathology, anxiety is also a condition where you have noticed something that you don't understand. And so simply by reaching out and studying something so that you can have control of your anxious behaviors in certain circumstances is going to make you a better massage therapist, a stronger individual, and a more successful and loving person. You're gonna be more empathetic for other people if you're willing to face those challenges in your life with love, care and compassion. That's what I want for massage therapy. And massage therapists, notoriously, look at "How can I help other people?" But really, sometimes the best way to help other people is to study yourself and have compassion for yourself.

29:55 NN: That's a beautiful message. Thank you.

29:57 DB: I wanna thank our guest today, Nathan Nordstrom, for joining us. Find out more information about Hand and Stone at handandstone.com. Thank you, Nathan.

30:04 NN: Thanks for being with us.

30:06 KC: Thank you so much.

30:09 DB: This has been a production of Associated Bodywork & Massage Professionals. ABMP is the leading association for massage therapists and bodywork professionals in the United States and beyond. From liability insurance to professional advocacy, award-winning publications, to the world's largest continuing education library for massage, to this podcast, no organization provides more for its members and the profession than ABMP. ABMP works for you.