Is “medical massage a" Buzz word?

Replies to This Discussion

Permalink Reply by Gary Mitchell on February 28, 2011 at 2:22pm

Hello everyone,

 

Boris you pose a very interesting question, because I believe that many terms are being thrown around, particularly within the realm of massage modalities.  In my short time as a therapist, graduating from Northwestern Health Sciences University in August 2008 and practicing since November 2008, I have always understood the term "medical massage" to refer more to the setting and special circumstances present within that setting, than the actual "style" of massage being done.  For example, while at Northwestern I participated in a hospital based massage elective in which I worked on inpatient floors of Woodwinds hospital in Minnesota.  Within that setting, I was working with med/surge patients, pre/post natal patients, as well as nursing staff and was responsible for charting in each patient's chart.  Along with that, there were other concerns that I would not consider typical of most massage.  The therapist has to consider whether or not to wear the proper PPE for especially contagious clients, working around IVs and other monitors that might be in the way, and even keeping proper body mechanics while working on a patient bed instead of a traditional table.  The work being done is essentially Swedish or Trigger Point Therapy etc, so the style doesn't particularly change, just the setting and concerns within that setting.  For me, the biggest part of that experience was not only working in the hospital setting, but giving positive touch to those who may have just come from surgery, or had chemo and for the most part had just been poked and prodded and needed positive touch that wasn't a thermometer, needle, etc.  

 

Overall, I would like to think that medical massage is more about the setting than the particular modality.  Unfortunately, it all depends on how each person views each topic, along with his/her varying education or skill set.  Could not the same conversation be had about the term "deep-tissue massage"?

 

Thank you

 

Gary Mitchell

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Permalink Reply by Boris Prilutsky on March 27, 2011 at 11:05am

Hi Gary.

My sincere apologies for late reply.simply didn't receive notification and only today accidentally discovered your post. Sorry about it.as I explained in my original post medical massage and massage therapy is a methodology when one provides therapy by means of massage.and no matter where one providing this therapy by means of massage.

In regards of deep tissue massage. It isn't some specific discipline and must be part of any clinical work, being it stress management, orthopedic or postevent rehabilitative sports massage. Many times it confused with vigorous pressure which is in most cases is a not therapy by means of massage but just wrong not  justified and potential for physical trauma effort.please visit my website www.medicalmassage-edu.com and click on free lessons. I'm offering 4 strategies for deep tissue mobilization as well explaining on how much pressure we can apply. Using the opportunity will repeat Prof.Popelynsky's definition:" pressure should be significant, but not to activate pain analyzing system"

Best wishes.

Boris

Gary Mitchell said:

Hello everyone,

 

Boris you pose a very interesting question, because I believe that many terms are being thrown around, particularly within the realm of massage modalities.  In my short time as a therapist, graduating from Northwestern Health Sciences University in August 2008 and practicing since November 2008, I have always understood the term "medical massage" to refer more to the setting and special circumstances present within that setting, than the actual "style" of massage being done.  For example, while at Northwestern I participated in a hospital based massage elective in which I worked on inpatient floors of Woodwinds hospital in Minnesota.  Within that setting, I was working with med/surge patients, pre/post natal patients, as well as nursing staff and was responsible for charting in each patient's chart.  Along with that, there were other concerns that I would not consider typical of most massage.  The therapist has to consider whether or not to wear the proper PPE for especially contagious clients, working around IVs and other monitors that might be in the way, and even keeping proper body mechanics while working on a patient bed instead of a traditional table.  The work being done is essentially Swedish or Trigger Point Therapy etc, so the style doesn't particularly change, just the setting and concerns within that setting.  For me, the biggest part of that experience was not only working in the hospital setting, but giving positive touch to those who may have just come from surgery, or had chemo and for the most part had just been poked and prodded and needed positive touch that wasn't a thermometer, needle, etc.  

 

Overall, I would like to think that medical massage is more about the setting than the particular modality.  Unfortunately, it all depends on how each person views each topic, along with his/her varying education or skill set.  Could not the same conversation be had about the term "deep-tissue massage"?

 

Thank you

 

Gary Mitchell

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Permalink Reply by Boris Prilutsky on April 13, 2011 at 8:55pm

Hi Mary.

In my opinion  you expressed many important concerns and offered opinions that it is important to discuss. Thanks for doing it. I hope you expecting from me my honest opinion therefore will express my agreements and disagreements.

You said:” I do advanced therapy and so do many others and to have that treatment put in the same category as a Swedish massage was rather offensive”

As much as I learned  there is no unified protocol  for Swedish massage. Every one calling this name but in most cases doing some different stuff. What I have learn that Swedish massage name stand for full body relaxation/ feels good massage. Here I agree with you. It is wrong, and we should stop to compromise on “feels good”and in such a case this type of procedure cannot be in clinical category.

But in case If one performing full body massage and calling it Swedish massage, but will spend 50% of procedure time by providing petrisage/ kneading techniques, and long strokes will be perform towards the  heart only  then one will perform medical stress management massage. Giving to the fact that stress related anxieties, clinical depression, hypertensions, muscular pains and  aches is debilitating on modern societies, and at least 90% of doctor visits related to stress , full body medical stress management massage in my eyes is advance massage therapy,

  You said:”I did not go to massage school, I went to learn Myofascial Trigger Point Therapy, a medical modality out of medical text. WE did not learn any massage.”

Here I disagree with you. Traditionally any soft tissue mobilization provided by hands we calling massage therapy. And in order to release and eliminate Myofascial dysfunctions as well trigger points we are performing special soft tissue mobilizations by means of massage. For 39 years I am very proud massage therapist and believe each  of us who providing therapy by means of massage including  Myofascial  mobilizations should be very proud to call her/himself massage therapist.

 

You said:”As someone who had a lot of pain issues and was looking for help, even the very skilled Swedish massage therapist was useless to me. i surely got nothing out of a "massage" no matter how therapeutic the therapist thought she was.”

Usually people who trained in full body massage shouldn't try to perform disciplines of orthopedic massage because they do not trained how to address orthopedic status disturbances. Sorry you shouldn't in first place to go to therapist who trained in Swedish massage only for pain treatments.

You said:”And that goes for physical therapy too, why on earth they will pay for hot packs, e-stim and "go in the corner and do these exercises even if they hurt you" is beyond me!”

Absolutely agree with you. As you can see this RPTs and DPTs having so speaking  advance and unified training as a results of educational standards. But is all of them are useless in treatments of painful disorders?? My answer is no. This is supporting opinion that even giving to the fact that people getting the same training” human factor” making huge different. The same in our occupation.

You said:” They want the cause addressed and they want to KNOW that there is a good chance that the therapist standing by the table really does have a good chance at finding that cause.”

Absolutely agree with you and strongly believe that our professional community will advance and much more than other physical procedures community because they spending very little time on hands- on procedure, and never where trained how to perform massage therapy. I passionately love massage therapy because of simplicity, side effects free and significant therapeutic power.

Really really appreciate your post.

Best wishes.

Boris

Mary Jo said:

I am bumping into this conversation late, but I must say something. Even though there is not a standard for Medical Massage or most other modalities, there is still a big difference in the treatments. I was part of the David Luther Medical Massage "issue". I had been billing auto insurance as a Myofascial Trigger Point Therapist for many years before happening upon his work. I was in before he started the uproar.

 

The 2 lawsuits against insurance companies set the mark for us in PA at least. Without them, the insurance companies would have been paying us much less. I do advanced therapy and so do many others and to have that treatment put in the same category as a Swedish massage was rather offensive. I did not go to massage school, I went to learn Myofascial Trigger Point Therapy, a medical modality out of medical text. WE did not learn any massage.

 

IMHO  There was and still is a big reason that there should be a distinction. As someone who had a lot of pain issues and was looking for help, even the very skilled Swedish massage therapist was useless to me. i surely got nothing out of a "massage" no matter how therapeutic the therapist thought she was. I also found therapists that stated they were doing "trigger point therapy" or "trigger point massage" and again it is far less effective than true Myofascial Trigger Point Therapy". Many have no idea where the pain patterns are, they just know they found a trigger point. They are also in-effective at getting rid of it.  I speak from experience.

Just because one is told in school that they are learning trigger point therapy, or medical massage or what ever does not make them a well trained therapist when it comes to pain and injury management. And honestly, an insurance company should not be paying for anyone that does not have advanced training and is getting results. And that goes for physical therapy too, why on earth they will pay for hot packs, e-stim and "go in the corner and do these exercises even if they hurt you" is beyond me!

 

I thank you Boris for teaching good classes. There will probably never be a standard set, the incredible flack that David L got from trying was impressive. It showed me that there needed to be standards. The more the minimally trained therapist stomped up and down that their massage was therapeutic the more it proved the need. And yes, it may be, but when someone has constant migraines from an accident, that person needs advanced medical massage, or what ever you want to call it. They want the cause addressed and they want to KNOW that there is a good chance that the therapist standing by the table really does have a good chance at finding that cause.

 

I thank ALL of the teachers that teach advanced pain treatment types of bodywork!

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Permalink Reply by Boris Prilutsky on April 14, 2011 at 11:58am

Dear Mary.

When I am talking on stress management by massage, then it's procedure that sustain results such as less anxieties, normalization of blood pressure etc. and one do not need to come for massage therapy 3 to 7 times per week but for best results client have to come twice a week for six weeks. Most of the people(90% of total doctors visits) trying to manage anxieties, clinical depression, sleep disorders, muscular aches and pains by taking antianxieties, antidepressants, sleeps, pain killers medications and doing this all their life. Besides side effects this medications not really working. Even medical doctors professional publications starts talking about it. BTW. Clinically and scientifically proven that massage therapy is the most powerful treatment tool in all of available other healthcare procedure when come  to real , natural and sustaining stress management.

 

Even you are refusing to call myofascial mobilizations as well trigger point therapy as an massage therapy modality they still massage therapy modality. In our fields no modality or techniques or discipline is superior to others. I feel comfortable to claim it because I was trained to perform full scope of practice disciplines, which is around 70 cases presentations, as well during my 39 years of experience applying it constantly.

I'm glad that you offered link to my reply to you some time ago. Absolutely forgot about it , and maybe if would remember, Wouldn't start from the beginning. Will not have to repeat myself . I hope members will have time to read it .

 http://www.massagetoday.com/print_friendly.php?pr_file_name=http%3A...

you stated:” Travell and Simons books and the protocol of the NAMTPT does NOT call the work massage. There are no "massage strokes" and it us usually dont clothed. Trigger points refer pain to other areas. the trigger point is seldom at the point of the most pain. “

I'm sorry that long ago my reply didn't change your views. As you understood from my six years old reply to you I was familiar with Dr. Travell’s work long before 1983 when Travell and Simons books was published. This is great book but not for massage therapists. Travell and Simons never did advocate  hands-on procedure and proposed this text for medical doctors who are addressing trigger points by injections. And even NAMTPT does not call the work massage but if you utilizing hands-on mobilizations/simulations than this is massage. Please trust me that during my long career I perform and performing  myofascial mobilizations as well trigger point therapy as a part of orthopedic massage much more times than you can imagine. During 20 years working with Olympian teams I performed on average 300 treatments per months, working in average 11 hours per day and dealing with difficult cases. Of course last 19 years I  am continue to do the same work  but not 300 treatments per months. Much less.

Please  review  again Travell and Simons books definition of trigger points, you will find that morphology is ischemia and  only one time ischemic compression by hands was mentioned as a reference. Also you will find that I am talking exactly like they teaching with difference, that I and you are doing  it by hands and they proposing injections, which is much less adequate treatment then ischemic compression. View the clip please.

http://www.youtube.com/watch?v=PgisAtZJ7k4

Honestly in your post I felt some frustrations that I am sharing with you, and especially if people do not trained in some particular discipline but trying to perform it. This is not professional and not fair. But I am believing in a beautiful future of our occupation. Actually we are improving and  a lot, much more clinically oriented. I understood you, and would recommend with this kind of post to challenge groups of physical therapists, chiropractors ect. In perspectives of myofascial mobilization and trigger point therapy they not doing better job than in average massage therapists.

Best wishes.

Boris

Mary Jo said:

Boris said "But in case If one performing full body massage and calling it Swedish massage, but will spend 50% of procedure time by providing petrisage/ kneading techniques, and long strokes will be perform towards the  heart only  then one will perform medical stress management massage. Giving to the fact that stress related anxieties, clinical depression, hypertensions, muscular pains and  aches is debilitating on modern societies, and at least 90% of doctor visits related to stress , full body medical stress management massage in my eyes is advance massage therapy."

Yes, the stress management is truth and real, but how long does it last? Can one continue it at home each day as in doing a relaxation recording, self hypnosis  or other stress reduction techniques? To get real results, such as lowering BP, eliminating depression, helping sleep issues, one would need to have that relaxations massage 3 to 7 times per week for some time. Just as we can feel relaxed while on vacation and the stress hits us like a brick on walking back ion the door at the office job, the results are not very long lasting. Should an insurance company pay $60 or $80 per session for something that a warm bath or a self hypnotherapy CD could give the same results? I have also been told that Swedish massage can raise BP!

 

I expect that actually eliminating the cause (the trigger points) of the pain and dysfunction, might be pretty effective at relieving stress in a much more direct way. It would also eliminate the need for medications that cause long term problems, such as ulcers, liver and kidney damage and such.

 

Boris said: "Here I disagree with you. Traditionally any soft tissue mobilization provided by hands we calling massage therapy. And in order to release and eliminate Myofascial dysfunctions as well trigger points we are performing special soft tissue mobilizations by means of massage. For 39 years I am very proud massage therapist and believe each  of us who providing therapy by means of massage including  Myofascial  mobilizations should be very proud to call her/himself massage therapist.

 

Interestingly we have had this discussion before:

http://www.massagetoday.com/print_friendly.php?pr_file_name=http%3A...

Your comment  about being proud to call ones self a massage therapist made me sure enough to go look and yes, we have. And I will still disagree with some of your statements on "trigger point treatment" although many of the points you had in the response were well taken. I hope that the misunderstanding of wording does not stop this conversation. I probably offended you quite a bit back then. Actually I never imagined that my comments would be printed. Imagine my shock at discovering my only ever published letter was one that I never even re-read for corrections or second thoughts. Ouch

Although some of us that are trained in Myofascial Trigger Point Therapy also perform massage, the training form the Travell and Simons books and the protocol of the NAMTPT does NOT call the work massage. There are no "massage strokes" and it us usually dont clothed. Trigger points refer pain to other areas. the trigger point is seldom at the point of the most pain. Please, pick up and look at the "Red Bibles"  and see if you see anything that looks like massage strokes in there. It is not myofascial manipulation either. We do not use injections, we use hands or tools to apply pressure to the trigger points. David Simons discontinued the use of the term ishemic in the 2nd edition and added more hands on work to the books because of the work of the NAMTPT, PTs and continuing research. There is a very good training program for dry needling and TrP injection that is very well taught and effective.

At our conference this fall we will be concentrating on the Travell and Simons protocol as the focus of the event. Perpetuating factors, stretches, home self-care etc.

 

You  said: "Usually people who trained in full body massage shouldn't try to perform disciplines of orthopedic massage because they do not trained how to address orthopedic status disturbances. Sorry you shouldn't in first place to go to therapist who trained in Swedish massage only for pain treatments."

Actually we are in agreement here. My point was that if all massage is "medical or therapeutic" then a person or even doctor seeking the medical massage has no real way of knowing the difference. I get calls from people who's doctor has suggested they try "massage" since all else has failed. The reason they find me is because none of the other massage therapists they called would accept their auto insurance. I now have several doctors that refer to me, because they understand that there is a difference and that what I do is usually effective.  Sadly, far too often a person says "sure I tried massage 3 years ago and it didnt get rid of my daily headaches at all. I had "massage" at PT" or "the massage therapist at the DC office I went to after my accident didnt help at all" 

 

I must say that much of my emotion when writing my post to you was irritation, not at you, but at the fact that most people do not know that there is a difference... massage is massage and it is for the rich or what men get for the "happy ending". The public, doctors and the therapists themselves usually do not understand the power that proper treatment can have at eliminating pain. Proper treatment is different in each situation, but misdiagnosis, mistreatment, pain meds, strengthen till it hurts, and "learn to live with it" is seldom the proper treatment.

 

I feel that as bodyworkers we need to see the difference in levels of training and what we offer. I am far from an expert and  you are far better trained than I in massage. My main objection is that the massage therapist graduating school believes they are trained in "medical massage", trigger point therapy, and ready to take on the world of pain management. I have been the "body" for several final exams at a massage school, some are ready and really understand the work, but  far too many will hardly make it through their internship let alone actually treat pain.

 

Advanced training is key. Interesting how we can disagree and agree at the same time. Thank you for this conversation!  Mary Jo

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Permalink Reply by Gordon J. Wallis on April 15, 2011 at 2:59am

I live in my own little massage world...I work in a spa now...When I have a client that comes into see me..I find out why they are getting a massage. If its because they are hurting somewhere..Well then my focus is to take them out of pain, and its Medical Massage...If they are seeing me because its their Birthday and they feel good..Well then its spa massage, perhaps more flowing, rhythmic, full body strokes,and so on.   Then sometimes a combination of both...But then I dont think about names..I just go with the flow.

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Permalink Reply by Gordon J. Wallis on April 16, 2011 at 1:00am

I kinda think more tiered levels and testing will only make it worse...As it is now, most of the newer schools seem to be set up so students can pass National Certification and State exams. Forget about really teaching massage...The average career span for a massage therapist is now only six years...A high percentage  leave because of various repetitive stress injuries.  The very thing massage is best at..  So that National Certification exam is not setting that good of a standard..So adding more levels...I'm not sure,,but I think the whole teaching system needs to be reexamined.

HolisticWomen'sWellness said:

I have long believed that there should be a two-tiered training and licensure system for massage practitioners - a basic education and license process for "aesthetic", spa and relaxation massage and a more rigorous training and licensure process for practitioners of therapeutic or clinical massage and bodywork. 

 

As to the term "Medical Massage", as with any term that has not been copyrighted, it is inevitably hijacked by those who are interested in making fast money, whether or not they practice or teach with integrity.

 

 

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Permalink Reply by Boris Prilutsky on April 16, 2011 at 10:05am

Hi Gordon.

absolutely agree with you. Many massage schools putting most effort to prepare graduates to pass board exams, and very proud in high statistics.at the time when programs have to prepare to successful career which can happen if one will deliver results by providing hands-on therapy.the same happens with physical therapy schools, chiropractors ect. Of course theoretical knowledge not always reflecting clinical capabilities and therefore meantime massage therapy not at position where it's supposed to be in stress management, pain management, detoxifications ect.

you said:".A high percentage  leave because of various repetitive stress injuries."

Gordon.most likely you will agree with me in regards of unity of body and mind. To this terrible statistic not only contributing wrong biomechanics  but also stress of desperation of not to know what to do in treatment room.we have to learn from negative aspects of other physical means of therapy schools, and to reform education to  much more clinical direction as well mandatory student clinics including instructors with good personal clinical experience.

Best wishes.

Boris

Gordon J. Wallis said:

I kinda think more tiered levels and testing will only make it worse...As it is now, most of the newer schools seem to be set up so students can pass National Certification and State exams. Forget about really teaching massage...The average career span for a massage therapist is now only six years...A high percentage  leave because of various repetitive stress injuries.  The very thing massage is best at..  So that National Certification exam is not setting that good of a standard..So adding more levels...I'm not sure,,but I think the whole teaching system needs to be reexamined.

HolisticWomen'sWellness said:

I have long believed that there should be a two-tiered training and licensure system for massage practitioners - a basic education and license process for "aesthetic", spa and relaxation massage and a more rigorous training and licensure process for practitioners of therapeutic or clinical massage and bodywork. 

 

As to the term "Medical Massage", as with any term that has not been copyrighted, it is inevitably hijacked by those who are interested in making fast money, whether or not they practice or teach with integrity.

 

 

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Permalink Reply by Gordon J. Wallis on April 16, 2011 at 11:43am

Well gosh..Even highly educated well meaning people are teaching incorrectly. The whole thing or subject is very complicated.  Part of it is  that massage, whatever style or approach, at its highest levels is an art.   And the field is so huge in scope...Well you can just study forever...And I think most of us do.  I personally think they need to tone down all this National Certification.  Make it easier.  Yea, not so intellectual.. Just basics. Fundamentals. Contraindications..How hard to press and so on..  What a knot in a muscle is.. I visited a school a couple years ago as a guest speaker. Everybody attending that school was ready to pass National Certification... If I took it right now..I dont think Id pass? Anyway,after I was introduced.. I asked the students if anyone could tell me what a knot in a muscle is? And how massage addresses a knot, if it does at all... I got blank stares...I turned to the instructor and asked her(she has a masters degree in teaching)...She shook her head and said I dont know.  Yet, they can pass all these exams..haha!    I dont know...Something is wrong...I mean imagine.  Well you dont need to imagine...They are graduating people from massage schools that can pass various state boards and national exams that dont even know what a knot in a muscle is, or how massage addresses  a knot in a muscle???????  Thats why all these exams and crap....for me they are only a pain in the ass.  If they do add tiers and levels of certification. I will start screening!..I honestly believe that one could reach the highest of levels of their certification and know nothing.

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Permalink Reply by Boris Prilutsky on April 18, 2011 at 11:08am

Dear Mary.

yes I agree with you on most of what you have expressed in your post. Just would like you to realize that in fields of physical therapy,chiropractor's, with all board certifications, and so-called advanced trainings, you will find many, many cases like you described. For last almost 20 years I see huge improvement in our industry and especially at CE education, which must to advance massage practitioners.A) we have too many schoolsB) not enough clinically experienced teachers in this schools. In order to teach advance you have to share knowledge from treatment room and not only from books.it must be combination .text books offering scientific data including counterindications that extremely important but cannot be substitute to clinical experience exactly like only clinical experience cannot be substitute to text books.

Best wishes.

Boris

Mary Jo said:

Orthopedic massage, medical massage what ever you want to call it. It is advanced training. There are many really good modalities out there, but when the school tells someone that they are "learning" it in the initial 500 hour program, they are doing a disservice to everyone! Whether it be telling the student that ALL massage is "medical" or that they are learning Trigger point therapy, or shiatsu or acupressure. I argued with a teacher who insisted that Acupressure, trigger point and myotherapy were the same!  This guy teacher all over Pittsburgh!  I called the school when he was giving CEU weekend class in Trigger points and told them they should be ashamed to have him as a teacher let alone teaching "trigger point"! He had no idea what he was talking about!

I had written another in depth letter to all the schools he taught for when he was instructing a woman in a 20 hour "massage for friends" I took with my sis in law (so she had a partner) how to tell the employer that she had training in "acupressure". After the class, I called where she worked and ask about her credentials. She stated that she was trained in trigger point, acupressure and something else. Even more impressive was when she told me that she went to the trigger point therapy school that I went to (500+).  YES, after a 20 hour Community College clothes on class. Oh and he gave us all a "certificate" with the name of a Dean that had not been there for years, with no indication of hours. It just said "completed Massage 1" 

 

We will not have a license, which might help this, but if she had been working as a massage therapist the whole time, she could be grandfathered in.  Let the buyer beware!

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