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Massage Today
April, 2003, Vol. 03, Issue 04

We Get Letters & E-Mail

By Editorial Staff

Editor's note: The following two letters are in response to Ralph Stephens' December 2002 column, "No Better Time Than Now." The second letter is accompanied by a reply from Mr.


Responding to the Call for Activism

Dear Editor:

It is not often that I comment on articles written in publications. However, as a massage therapist in Texas who is not a prostitute, I was compelled to write after Ralph Stephens' column. Ordinarily, I would have dismissed his statements as erroneous and ignorant, and felt assured that only a few people in Texas would read them. However, since your paper boasts of more than 1 million Internet hits, his published comments raise deep, genuine concern here in Texas.

I accept Mr. Stephens' challenge for each individual massage therapist to become active and "do his or her part" to correct this misconception about Texas. In particular, I ask that Mr. Stephens show documentation to support his statement that "As the emergence period ends, the co-opting period is beginning. It is going quite well in Texas. Prostitution has just about reclaimed the term 'massage' there. Many of what are called 'massage schools' in Texas crank out prostitutes faster than therapists," or retract the statement with an appropriate apology. I also ask that the above quotation (or the entire article) be deleted from your Web site.

By the way, I agree with Mr. Stephens' assessment that massage therapists must defend and protect our scope of practice through individual legislative activism. Thank you for your consideration of my concerns; I look forward to Mr. Stephens' reply (either his research or his apology).

Orbie Ratliff, RMT
Houston, Texas

"It is now time to do the right thing"

Dear Editor:

This e-mail is regarding Mr. Stephens' comments about Texas massage schools producing prostitutes. I am no longer comfortable leaving Massage Today in the reception area where I work. Mr. Stephens' comments were not supported by facts and could easily cost us accounts to provide massage services. The way I see it, Mr. Stephens has two choices. He can name names and make a report to the Texas Department of Health; if it fails to do its job by taking action against such therapists, you can complain. The system in place is complaint-driven, at least to some degree. Mr. Stephens has an ethical obligation to file a report. If not, he is "aiding and abetting." On the other hand, if Mr. Stephens is unable to provide specifics to back up his comments, they are nothing more than hearsay. In my opinion, his only other choice in this case is to make an unqualified apology; specifically acknowledge the information is hearsay; and resign his position. His irresponsible comments jeopardized a profession we have spent years building. Our most difficult struggle with our clients is in helping them get past the notion that massage is about sex. Presently, myself and others are researching legal options regarding some sort of libel lawsuit. I suspect our options will be limited, but we believe that as long as Mr. Stephens' comments stand, our practice is threatened. It is now time to do the right thing.

Lori Dupree, RMT
Austin, Texas

Dear Lori:

Thank you for your response to my column. Let me address each of your comments, more or less in order.

  1. I have written two columns regarding the problem of prostitution in the massage industry. In my December 2002 column, I referred to schools; I assume that is the column that has caused your discomfort. If you read my January 2003 column, I apologize to therapists such as yourself and to the ethical school owners Texas. I also promised not to comment further on the problem, but only to report on positive progress - "good news." So, you can leave issues of Massage Today in your waiting room from the February 2003 issue on without fear of losing any "accounts."
  2. I have plenty of facts to back up my articles. I have an entire folder of advertisements from Texas newspapers and phone books; ads in which supposed "RMTs" offer sexual services under the heading of massage. My comments also area based on numerous interviews with therapists and school owners in Texas confirming the problem, including leaders of the professional associations in Texas. My comments are not hearsay. There is not adequate space in Massage Today to list every ad and every report I have - and there is no need to. Do you honestly feel there is no problem in TX with prostitution posing as massage therapists, and that I have made false statements? Please understand, I do not believe (or state in my article) that Texas massage schools deliberately or knowingly train prostitutes. Prostitutes are enrolling in massage schools to "legitimize" themselves so they can legally advertise under the heading of massage. I have received many e-mails from Texas in response to my two columns that referenced prostitution and massage. Ninety percent of the comments are positive, grateful and supportive. Many have sent additional disgusting stories and ads. I find it interesting that you seem to indicate there is not a problem. So, how do all those people who place erotic ads for massage get their RMT credentials, if they are not being graduated from schools in Texas? Oh, the other 10 percent of e-mails on this subject all admitted eventually that the problem does exist; they are just unhappy I mentioned it in a public forum.
  3. Yes, I could file reports with the Texas Dept. of Health. I am sure they would get the same attention given to numerous other complaints filed by Texas therapists I have interviewed: little to none. I also am well-aware of the complaint process and the ultimate hearings. If there is no witness, the case is dismissed. I do not have the resources to travel to Texas to appear at dozens of hearings a year. I do care about this situation, and am investing considerable time in it, but quite frankly, I am not going to dedicate my life to it.
  4. I do not understand how you can claim I am "aiding and abetting" a situation by pointing it out and encouraging the people who live where the problem exists to do something about it. I find it quite interesting that you say, "Your irresponsible comments jeopardized a practice we have spent years building. Our most difficult struggle with our clients is in helping them get past the notion that massage is about sex" If there is no problem with massage being used as a cover for prostitution, why have you had such a difficult struggle with the massage/sex issue? Where have people been getting this notion? Since you say you have been struggling with massage/sex issue for years, your clientele could not have gotten "the notion" from my column, which appeared in Massage Today only a few months ago.
  5. My columns are not written for the general public. Massage Today is sent primarily to practicing massage therapists, students, schools. My comments are not going to affect your clients one way or the other. If clients pick up copies of the publication in your waiting room and dig deep enough to find my article (and remember, I won't write about this issue again), I don't believe my comments will suddenly change their opinions of you. To the contrary, my comments should inspire clients to help you clean up the situation and protect you, so they can continue to receive safe, ethical massage. I would think you would be concerned about the situation, and want any help available to clean it up. I am trying to offer some help because if the problem is not addressed, it will soon spread to other states, and our entire profession will suffer greatly. Ignoring the problem, denying its existence, and not talking openly about it within our profession, will not make it go away. Denial will only allow it to grow.

I suggest you invest your energy into working to eliminate the problem, not the messenger. Since you are from Austin, I suggest you join forces with the Austin Bodywork Cooperative. Its members are trying to clean up some of the dubious advertising that appears in the Yellow Pages. That would be a good start. Come to Houston on May 17, and join with others who want to clean up the image of massage in Texas. Support changes in the law to raise standards and bring about more effective enforcement.

I sincerely apologize if you construed my comments as a personal attack on you or your practice. That was not my intention. I hope you feel you can again leave Massage Today in your waiting room, and I hope you will join other Texas RMTs who are working to remove the prostitutes from the massage profession.

Ralph R. Stephens
Cedar Rapids, Iowa

Getting the Toxins Out of Massage

Dear Editor:

Many thanks to Keith Eric Grant for his article, "Flushing Out Myths" (MT, Dec. 2002). For 10 years, I have heard from clients that they are "full of toxins"; most of them have this impression because they heard it from massage therapists, or from others who heard it from massage therapists. I think it is a disservice to encourage people to think they need massage because they are "toxic," and that massage therapy helps correct this problem. People who already may be anxious or uncertain about their health status do not benefit from the erroneous, alarming image that they are being poisoned by metabolic sludge. I also think some massage therapists may avoid taking responsibility for using inappropriate depth of pressure on sensitive clients by explaining that postmassage discomfort is merely from "getting the toxins out."

I'd like to see more honest and responsible discussion of the role of massage in cellular metabolism. I think we should share accurate information with our clients on the known, positive effects of massage, and we should not be afraid to say, "We don't know yet" in response to some questions. We will all benefit if we eliminate misleading, toxic claims from our interactions with the people we serve.

Margaret Caro, LMT
Corvallis, Oregon

Editor's note: James (Doc) Clay's January 2003 column, "The Clinical Track: Introduction, With a Response to AMMA," inspired considerable letters to the editor, one of which is printed below. Massage Today regrets that it cannot publish all of the letters we received. The complete text of Mr. Clay's article appears online at

"Medical massage truly is holistic medicine"

Dear Editor:

I am a graduate and a student of the Blue Heron Academy of Healing Arts and Sciences [Grand Rapids, Mich.]. In addition, I maintain a private practice in the Blue Heron Clinic and have been a member of the American Medical/Manual Massage Association (AMMA) for three years. I am a medical massage therapist, but more accurately, a manual therapist. In the article, Mr. Clay states, "We do not treat conditions according to medical diagnostic criteria, but according to clinical massage therapy assessment criteria"... and then says how he would treat it. As a Blue Heron graduate and a medical massage therapist, I treat according to medical diagnostic criteria, not the way either an medical doctor or you would treat. That being said, I'm sure there are plenty of similarities too. Tendonitis (can also be spelled correctly as tendinitis) also is called "medial epicondylitis" or "golfer's elbow." It results from injury to the common flexor tendon. A simple test for this condition is active wrist flexion against resistance. I palpate the affected area; fold the tissue; perform deep tissue to periosteum massage (not painful, because the tissue is folded and because I use a soft-hand technique); note adhesions and fibrosis; do joint physics;bony lever at the joint junctions; etc. If you could watch me, or any of my peers, do this, I suggest you would be witnessing something you have never seen anyone do, anywhere. We use a dry-hand technique and achieve unique results. Some of these techniques are original, courtesy of Dr. Gregory Lawton, DC, DN; some are 100-year-old naprapathic techniques. It's medical massage/manual therapy - what soft tissue work was meant to be before the advent of "swedish massage." It's our heritage as massage therapists.

Mr. Clay also says problems with the wrist and hand are traceable to the forearm, elbow, shoulder or chest. The first thing I do when a patient tells me he or she has wrist and hand pain is inquire about any recent or old neck injuries. If not localized fibrosis (wrist, hand, forearm, or just above the elbow), this type of pain is usually indicative of brachial plexus nerve impingement. The brachial plexus is a plexus of five nerves that grow out of the spinal cord at C5-T1and innervate the neck, shoulder, arm and hand. Pain is on the ulnar or radial side of the limb helps differentiate which of the five nerves is involved. My point here is that medical massage therapists who graduate from Blue Heron know neurology: We know where the nerves track, and what soft tissues the nerves innervate. If there is a problem with that soft tissue, we go to the nerve root at the joint and work there. We work at the nerve root. If I find adhesions in the neck related to a patient's pain, that's the area I'm going to focus on. Do you see my point? This is all medically based. You pointed out the incorrect spelling of "biceps," but more important than that, do you know that is does little good to do considerable soft tissue work on any biceps muscle belly? If a patient has pain in a biceps muscle, you would best spend your time and your patient's money by working at the joint at which the biceps attach/insert.

One hundred years ago, MDs touched their patients, and did so based on scientific findings. They were physicians, and they did soft tissue work - imagine that. In fact, some of them wrote a book called, Medical Massage. Dr. Lawton didn't just dream this stuff up; we have the book to prove it. This is what medicine used to be.

Mr. Clay also states, "I can't help feeling that the use of the word "medical" in designating our profession betrays a desire to enhance our prestige ..." As far as I'm concerned, there is nothing prestigious about being an MD these days. Certainly they want to practice medicine well, but their training has steered them far afield. If you have consulted with or been referred patients by an MD, you know it's not a real pleasant experience, but nevertheless a necessary one. I'm ashamed and embarassed by the MDs and DCs who refer patients to me. What passes for a physician is in shambles, and so are patients' bodies. The MD sends me the people he's poisoned, cut and burned, and the DC sends me the patients he's used his newfangled hammer on. They wonder if there is anything I can do for them; yes there is, thanks to my training. encourages us to get out into "the field" and deal with these real clinical issues based on our holistic training. You can call it "clinical" or "medical," but I prefer the latter term because that's what it is: medicine.

The allopaths took the word medical from us. Holistic treatment was considered medical before most of us were born. All soft tissue workers who want to practice noninvasive, holistic medicine by touching people based on the modern discoveries of science and anatomy are denied this privilege by the modern allopaths and some chiropractors.

Mr Clay says, "We would do well to maintain our independence from more traditional disciplines." Allopathic medicine is more accurately called modern medicine. What we do, as soft tissue workers and as massage therapists, is traditional medicine. We are holistic. Medical massage is science-based, holistic ... and it works. It's the way medicine used to be, and the way it will be in the future, including new techniques based on new research. What goes around, comes around.

Mr Clay says, "Massage is not inherently holistic." If it's not, then what is it? In my opinion, medical massage truly is holistic medicine. The AMMA is not frozen, petrified, closed-minded or institutionalized. We simply approach soft tissue work/massage based on the most up-to-date knowledge of anatomy, physiology, etc., the way the serious medical practitioners of old practiced.

This discussion is worth having. I enjoyed Mr. Clay's article. Thank you for providing a venue to voice our opinions.

Lisa Townsend, PMT (Professional Manual Therapist)
Grand Rapids, Michigan


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