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December, 2005, Vol. 05, Issue 12
Chair Massage Redux
By Cliff Korn, BS, LMT, NCTMB
I recently received a letter concerning an article I wrote about an international chair massage conference in Toronto (www.massagetoday.com/archives/2005/09/01.html).The author was Russ Borner, a well known senior instructor of David Palmer's TouchPro Institute.
Russ expressed confusion over several parts of my article that were perhaps overstated, so I undertook a bit more research. His concerns were that I reported the Toronto event as the 1st International Chair Massage conference. His email to me said, "[I] was part of David Palmer's TouchPro Institute's 'First International Chair Massage Conference' held in San Francisco on June 22-25, 1998, where over a hundred chair massage practitioners gathered for what seems to be the same purpose advertised by Eric. As I remember, there were practitioners from all over the U.S., Canada, UK, the Netherlands, among others." He further said, "In addition, this comment [in your article] was particularly confusing "Eric Brown of BodyworkBiz described for the first time the physiological mechanisms involved in the unique fainting phenomenon that sometimes occurs with chair massage, and gave participants guidelines in preventing this from happening."
David Palmer's TouchPro Seminar, since the summer of 1986, has been highlighting and covering the fainting phenomenon in course materials and instructor presentation in a very complete and understandable manner. Some 11,000 massage practitioners have been trained in this matter, including Eric Brown."
My additional research indicates that I was incorrect in my statement about the Toronto venue being the 1st, but so were the event sponsors and Russ. The event Russ mentioned was not open to the trade, but was designed for graduates of the TouchPro program only. The actual "1st International Chair Massage Conference" was a conference held in France in 2002, sponsored by Tony Neuman of Touchline, based in Switzerland.
To me, the issue of which was "1st" is much less important than the issue of the fainting episodes in chair massage. Here we find some real differences of opinion on an issue that can be crucial to any of us who owns a massage chair! When I questioned Eric he said, "as a sponsor of TouchPro workshops and a participant, I can honestly say that the issue of fainting has never been fully addressed by TouchPro or others. The techniques taught by Russ and the TouchPro instructors are very traditional Japanese acupressure techniques. There has been some attempt to correlate the fainting episodes to acupressure points in the arm. Since 1998, we have tracked dozens of fainting reports looking for co-relating factors. I can honestly say that there is no correlation between the part of the body being massaged and the fainting episodes. The only plausible explanation for the rapid fainting episodes is the elicitation of the carotid sinus reflex. I developed the hypothesis in 1999, and it has held true over the years. I outlined the physiological mechanisms in detail at the conference, and to the best of my knowledge, that is the first time anyone has publicly given a scientifically sound rationale for the physiology behind the phenomenon. If anyone has other tenable theories, I would certainly be interested in hearing them."
David Palmer wrote an article entitled "Fainting and Chair Massage" first published in the June/July 2000 issue of Massage and Bodywork magazine (for ABMP members only: www.abmp.com/members/login.html?article_id=310). David's response to Eric's information was that Chronic Sinus Hypersensitivity (CSH) is what Eric names as the cause of the fainting. In an email he said, [Eric] "believes that this rare condition is the cause of all syncope and pre-syncope episodes in the chair. That seems highly unlikely. As noted in my article, there are a vast range of possible causes of syncope and pre-syncope events and it seems a great leap to presume that one condition that primarily appears in older men is the cause of all of them.
"As you also will note in reviewing my article, I never highlighted work on any particular part of the body as the primary cause of these occurrences." Since Eric has the article, I am uncertain as to why he would make this claim. To the contrary, the two most common correlations that we have discovered are low blood sugar (caused by skipping a meal) and a history of fainting (which would include CSH conditions), both of which we screen for before each massage. In addition, I pointed out that the most common reason in the medical literature given for Syncope episodes is a triggering of the vasovagal nerve reflex. I have no idea why Eric would suggest that CSH is the only credible hypothesis. The full protocol outlined in the article has reduced the number of syncope events in the massage chair to zero, and sharply reduced the number of pre-syncope events. We also train practitioners to be aware of the possibility of carotid impingement with the ends of the face cradle when we discuss positioning of the client in the massage chair."
Eric responded back that David was confused between Carotid Sinus Hypersensitivity and the Carotid Sinus Reflex, and that the two are not correlated.
Eric in short order provided me with several pages of as yet unpublished information concerning this fainting phenomenon, much too much to include in this editorial. From the chair of this massage therapist, both the hypotheses of David Palmer and Eric Brown make sense. But there certainly is a division of thought here - and this is an issue that can be absolutely crucial to any of us who use a massage chair in our practice. I am looking forward to Eric publishing his information so that the two divergent theories can be compared side-by-side, so that we all are practicing more safely.
So, where does all this leave you and me? I guess I have been most fortunate that I have never had anyone faint during or after chair massage. I would guess that someone who did might not be inclined to return to my practice for additional types of massage! There are few massage therapists who don't agree that chair massage is not only a tremendous intervention in it's own right, but also a marvelous, non-intimidating tool for introducing new people to all forms of massage and bodywork. We need answers!
I hope this editorial is not taken as a point/counterpoint discussion, in a negative sense, between two individuals. Both David Palmer and Eric Brown are true pioneers in the development of the chair massage industry and they certainly deserve a huge thank you from all of us! May we all learn and grow from this, and may the discussion continue.
Thanks for listening!
Massage Today encourages letters to the editor to discuss matters related to the publication's content. Letters may be published in a future issue or online. Please send all correspondence by e-mail to , or by regular mail to:
Former editor of Massage Today, Cliff is owner of Windham Health Center Neuromuscular Therapy LLC. He is nationally certified in therapeutic massage & bodywork and is licensed as a massage therapist by the states of New Hampshire and Florida. Cliff is a member of the International Association of Healthcare Practitioners; a professional member and past president of the New Hampshire chapter of the American Massage Therapy Association; a certified member of the Associated Bodywork & Massage Professionals, Inc.; and a past chairman of the board of directors of the National Certification Board for Therapeutic Massage & Bodywork.
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