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Massage Today
November, 2004, Vol. 04, Issue 11

Medical Massage and More, Part I

By Ralph Stephens, BS, LMT, NCBTMB

I believe medical massage is an advanced discipline of massage therapy. In reality, medical massage is more of an orientation than a particular set of techniques. It is not general relaxation massage; it is anatomically precise and patient specific.

The medical massage therapist combines education, training, experience, dedication, humility and intuition to create an integrative manual-therapy approach to reducing the patient's soft-tissue related complaint(s).

Initially, I resisted the term "medical massage;" however, I realized that as massage therapists we do treat medical conditions when they are soft-tissue related. Of course, we cannot say we do - we have to play little word games, more in some states than others - but the truth is we do treat medically related conditions like "frozen shoulder" and "medial epicondylitis." So, why not call it what it is: medical massage? If we stay within the scope of soft-tissue manipulation and joint mobilization there is no reason not to call it medical massage. It seems to be accepted without protest from the allopaths. Hopefully, using the term is the first step toward openly and honestly describing what we do when we move from a relaxation paradigm to a therapeutic, corrective and restorative paradigm.

Actually, the term "therapeutic" massage says it all, but it is an old term that no one attaches any significance to these days. And the public does not understand terms that have been coined to describe massage if the word "massage" is not included (terms like somatic re-education, bodywork, structured touch, neuromuscular therapy, myo-skeletal-kinestic-neuro-biological-rearrangement, blah, blah, blah). But it is clear to the public that medical massage will address their pain or problem. It doesn't sound relaxing, and it doesn't sound like adult entertainment. It is a term that allows us to better reach the public and our allopathic colleagues. Isn't that the idea - to help more people? If this is the term that facilitates the needed communication to bring us together with the public and the health care community, then it is the term to use.

Got Diagnosis?

Some authors who have recently written about medical massage believe a physician's diagnosis is a requirement to perform medical massage. I strongly disagree. Do you realize where this will lead us? Do you want to be a slave in a physical therapy department for $10 an hour and maybe benefits? Not me!

Massage therapists are currently first-door providers. This means that the public can come directly to us for help first, and we can do whatever we know within certain limits to help them. This is the same privilege and patient-provider relationship that physicians have. We do not need a physician's permission to help someone. Most PTs, OTs, ATCs, nurses, etc., do not have first-door access to patients. They only see a patient after a physician says they can, and then they can only do what the physician says they can do - their hands are tied. They cannot use all of their skills and resources to help the patient. They cannot treat the whole person; they can only treat a knee or an elbow for a set period of time, and in a certain number of visits.

We do not need gatekeepers (physicians) to control the flow of people to our practices. First-door providership gives us an incredible opportunity to help people. We need to defend this privilege above all else. Never surrender it! If we do, patients will only be allowed to get massage if it is prescribed, which will prevent many of the people we now help from having access to our services.

This is not to say that we should not work with physicians, or that patients should not get a diagnosis and/or a referral and bring it to us. The more information we have, the better we can help; however, we should work with doctors as colleagues, as fellow first-door providers, not as subservient slaves. First-door providership is an incredible opportunity, but it is an equally incredible responsibility. We need higher quality entry-level education, including more assessment skills and standard terminology for strokes and techniques so we can communicate better among ourselves and with other disciplines. We need to take advantage of this privilege to help more people. You do not need a physician's diagnosis or referral to perform medical massage, but if the patient has it, so much the better. More on this in my next column.

Got Impressive Credentials?

I get some great mail in response to this column. Here's some recent feedback that I hope will inspire you to personal excellence:

"I worked with a chiropractor who advised me to get a degree from Harvard to impress people, i.e. get more clients. I told him at the time that if a Harvard degree is what is takes to impress people, I'd rather remain my, apparently, 'unimpressive' self. (Shortly thereafter, this chiropractor declared bankruptcy and lost his home. So much for impressing people.) My clients come to me for my personality and the results they receive from my massage skills. Referred clients don't come to me for any degree that hangs on my wall, or any fancy initials or titles after my name. They come to me because another client got the results she/he wanted and they believe I can help them, too."

Amen. Become the best you can be. Learn to help people get out of pain, and you will always be busy.

Despair Not

If the presidential elections are not over by the time you read this, hopefully they will be shortly. It's been a long and entertaining campaign. Whichever way it turns out, we will go to work on Wednesday morning. Let go of it. We survived the last four years and the eight before that. Our politicians are merely a reflection of our society.

What's really important is the difference each of us makes in the lives of those we directly interact with. Each one of us has control of what we do. So get good and do good. As massage therapists, we have a unique opportunity to change the awareness and lives of everyone we touch. May our efforts bring about a healthier and more peaceful world.

Happy "Holidaze!" My best wishes for success, health, happiness and prosperity to you all. Thanks for your continued support. May you sell lots of gift certificates and have a joyous holiday season. See you next year!

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


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