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Massage Today
May, 2004, Vol. 04, Issue 05

Is It Time to Implement Levels of Education?

By Ralph Stephens, BS, LMT, NCBTMB

In my previous article, the question of whether massage is a trade or a profession generated many interesting responses (

One came from a person on the trade side: She claimed to be a "multiple-degreed professional" who teaches massage at the continuing education level, but misspelled many words, including "therapeutic." She informed me, "It is a massage, not brain surgery!" and indicated that she is part of a group that will "file a class-action lawsuit over any attempt to raise core requirements for massage therapists" in her state. She feels massage is nothing more than a trade, and "how dare anyone try to professionalize it," especially through education. This supports my theory that the status quo will always defend its cash flow.

From the professional side, a therapist from Canada held up his country's 3,000-hour model, which has a bachelor's program on the way. He wondered when the United States would catch up. Those are the extremes. They are far apart. David Palmer and others have promoted the idea of a multi-level profession for a long time. I have always resisted the idea of a tiered profession. The professional boundaries and scope-of-practice issues between each of the levels would be one of those proverbial "sticky wickets." The challenge is in defining where relaxation ends and therapy begins, and the entry-level education requirements for each level will undoubtedly create interesting discussion. I am beginning to think it may be the best idea after all. Is it time to establish and recognize a trade level and professional level of massage?

The trade level would be chair and table relaxation massage routines only; the professional level would include wellness enhancement and therapy. I'm just asking - not advocating. It's a discussion that needs to take place again. It was discussed and rejected in the early 1990s, but things have changed a lot since then. From my view, it is beginning to appear inevitable that some sort of split must occur. However, it will require a dramatic change in our current educational structure, which leads me to the next point: how to increase the quantity of skilled massage educators.

What's a School Without Instructors?

A fellow philosopher went beyond the trade/profession argument to point out that it will be very difficult to raise the educational component of our profession, unless we raise the competency of massage educators in entry-level programs. He is working on developing innovative programs that will accomplish that. He said:

"Schools are just buildings and businesses that push paper around for money. They don't educate. Great schools are great because of their instructors (which are sometimes the owners), and they usually degrade if they lose those instructors, or expand beyond their qualified instructor base.

"Teachers make or break a profession. They actually influence strongly the entire profession's practice methods from technical skills to ethics. They also influence the demands that the profession places on the educational system, which supplies future professionals. If they are minimally qualified, they will project an attitude that minimal qualifications are all that is necessary."


The Council of Schools has been sponsoring massage instructor conferences for the last few years. This program needs to be expanded. Our educators need more training, especially in teaching psychomotor skills to adult learners. In regulated states, massage boards need to lead the way in establishing instructor credentials.

Do we need to create an instructor level or class within our profession? Of course, this would require determining what the requirements should be to become a professional massage educator. It needs to include more than just being a practicing therapist. (Last year's graduates are not acceptable as instructors.) It especially needs to be more than a therapist who cannot make a living doing massage or has destroyed their own body doing massage. Such incompetence does not need to be passed along. Whatever change happens in massage education, it will occur as a slow, evolutionary process...In the meantime, how about something useful, instead of philosophical?

The Deltoid Trap

Most of you only know me as a controversial columnist. While I enjoy sharing my views on the politics and philosophies of our profession in order to motivate people to think (and hopefully act), my first love is massage therapy and helping people find relief from their pain. To make my column more immediately useful, I plan to include a short, practical, clinical tip occasionally. The following relates to the upper trapezius muscle generally thought to elevate the shoulder, which is really more of a stabilizer that holds the clavicle against the sternum (

This muscle often harbors trigger points that cause headache-like pain from the base of the skull, up around the ear to the temple. I often find it difficult to get this muscle to relax, and the trigger points refuse to deactivate. Look at "The Musculature System" wall chart from the Chicago Anatomical Chart Company, drawn by Dr. Peter Bachin. Notice the trapezius fibers share a common fascial attachment with the deltoid at the acromion process.

"Ah- ha!" I exclaimed when I noticed that. I treated and stretched the deltoid and went back to the upper trapezius, treated it again - and it melted into my hand - the trigger points reducing in 10 seconds of sustained pressure. Headache gone! This has worked hundreds of times for me. Think about it. Look at it. Try it. Your patients might like it!

Until next time, remember: A bad law is worse than no law at all, and no matter what you choose to call it, to the public it's all just massage.

Click here for more information about Ralph Stephens, BS, LMT, NCBTMB.


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