resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Universal Design: Principles & Practice
In many respects, universal design serves as the core of ergonomics. It's also a good tool to use when designing a return-to-work program for injured and/or ill patients. Let's take a closer look at universal design and why it should matter to you and your patients.
An Unexpected Diagnosis: The Result of Lacking Communication
A couple years ago I had a case that showed me the importance of open communication between health practitioners. We need to show up with less fear, and let go of our judgments so we can do better for the patient.
Bill With Confidence: Learn What to Collect
Q: I am trying to understand what I may collect from my patient when there is insurance. Do I have to accept the amount allowed by the plan or may I collect up to my billed amount? Please note, I am not a member of any insurance plan.
Creating Good Business Buzz
What do patients really think about working with you? Rarely do you hear the whole truth. Those who improve may be candid in their gratitude.
A Major Role in Back Pain: The Multifidus
Back pain affects roughly 80 percent of the population at one time or another and is one of the leading causes of doctor visits.
Is It Time to Rethink Mental Illness? (Pt. 1)
Invariably, patients will ask their chiropractor about depression or various mental illnesses. Some practitioners will reflexively offer a cervical adjustment, suggest St. John's wort or contemplate a referral to a specialist.
Why I Quit Doing House Calls
My father was a chiropractor who did house calls, so when I became a DC, I figured doing house calls was part of the job. My March article recalled my experience as a small boy, accompanying my dad while he went to patients' homes to treat them.
Balancing Spring Challenges
As the winter months come to a close and warmer spring weather appears, patients may begin to present with new challenging pattern presentations.
Eczema & Acupuncture: A Sound Solution (Part 1)
Eczema affects approximately 3.5 percent of the global population and is one of the most common skin complaints seen by dermatologists.
Clearing Blocks: A Way to Improve Cosmetic Acupuncture
As a Five Element acupuncturist who teaches facial acupuncture classes nationally, I was surprised to learn that one of the basic principles I was taught in school is unfamiliar to most acupuncturists.
Taking the Chiropractic Message to the Press
"There is no better place on earth to have a news event," the National Press Club boasts, and it's easy to understand why: Every year, the 108-year-old Washington, D.C.-based organization hosts countless press conferences on the hottest topics impacting America and often the world.
Give Yourself the Digital Advantage
When you see this article in the print version of this issue and swear you read it already, don't be alarmed: you probably did. That's because by that time, the May issue will have been available online in digital format for three weeks.
Women's Hormones: A Western & Eastern Perspective
Sometimes it may seem that you require a degree in medicine to understand hormones and how they function.
News in Brief
ACA Adopts New Governance Model; ACA 2017 Awards; CCA Helps Calif. DCs "Share the Love"; $1 Million to Help Advance the Profession; D'Youville Raises the Bar on Anatomy Education; ErRatum.
The Visual Error Scoring System: A Concussion Tool
Postural stability and oculomotor function are the most easily recognized physical indicators of neurologic motor dysfunction associated with concussions.
An Integrated Approach to Chronic Pain
Findings from a unique Medicaid pilot project in Rhode Island involving high-use Medicaid recipients from two health plans were recently presented to the state's Department of Health, demonstrating stellar outcomes with regard to medication use, ER visits, health care costs and patient satisfaction.
A Daily Strategy for Heavy-Metal Detox
In modern society, we are constantly exposed to heavy metals such as cadmium, lead and mercury. These heavy metals have no essential biochemical roles in our body, and conversely, can cause us a great deal of harm if they build up to toxic levels.
Raditation & Your Smartphone: Is it Worth the Risk?
If radial arteries could talk (and in my experience they can to some extent), they would say, "Step away from the smartphone." At least that is the message I am receiving loud and clear as I feel the pulses of many patients.
New Relationships, Old Trauma: AOM & Other Healing Strategies
Being in love is one the most beautiful and enjoyable experiences. Most of us are willing to pay almost any price to have that experience, and still often find it elusive or fleeting. Navigating the ups and downs of loving relationships are often challenging — even for the most psychologically balanced among us.
June, 2008, Vol. 08, Issue 06
Contemplating Thai Massage Regulation
By Nephyr Jacobsen, LMT
I've done deep-tissue Swedish massage for 17 years. I mean really deep; no fluff-and-buff stuff here. But it doesn't come close to Thai massage, and nothing I've seen does. It's yoga and Rolfing and acupressure and tapotment and chiropractic and reiki and deep compression work and myofacial release and hydrotherapy with herbs and the power of spirit, all rolled into one.At the same time, it's none of those things because those aren't Thai and the truth is, Thai massage really is Thai. It's not a new brand of ayurvedic medicine or a twist on Chinese meridians, it's seriously Thai and it's serious medicine.
And here in the U.S., you can practice it after watching a do-it-yourself video, taking a two-day workshop or reading a book. And you can teach it after going to Thailand and taking a five-week course, a two-week course or a one-week course, never having actually had a working practice of it in your life. And people do. So long as you meet the regulatory professional massage laws of your state (which are all written with Swedish massage in mind), you can practice and teach Thai massage without a day of training if you so choose. And in some states, you don't even have to be a licensed massage therapist because you can claim this extremely physically intensive bodywork modality is technically energy work.
There is no regulation of Thai massage outside of the Swedish massage laws in the U.S., and I'm not even sure if there should be. Regulation is a sticky subject and with Thai massage, it gets complicated very quickly. At this time, the majority of states have some sort of regulatory agency that establishes the specific requirements to practice bodywork professionally and governs all massage modalities. A few states have no massage oversight at all and little to no requirements concerning practice. In those states with explicit oversight, all massage modalities are grouped together and have the same requirements. There are no specific laws for specific modalities. At this time, no organization in the U.S. has the authority to specifically regulate, certify, register or accredit Thai massage practitioners, therapists, bodyworkers, instructors or schools.
A Case for Thai Massage Regulation
Thai massage has the potential to cause injury if not done correctly. This applies both to the therapist and the receiver. Thai massage is a far more dangerous modality than Swedish massage could ever be. With proper training, it's amazingly therapeutic. And knowing effleurage, petrissage, cross-fiber friction and the diaper drape doesn't prepare anyone for practicing Thai massage. That's like saying if you're a highly trained golfer, it follows that you are qualified to play professional basketball. It's apples and oranges.
What this means is that states requiring that Thai massage practitioners be licensed massage therapists have really not done anything to protect the public safety in regard to Thai techniques. Because none of the required massage training (I'm not talking about the sciences of anatomy/physiology here) has anything to do with what you must know to practice Thai massage. It is left up to the practitioner to voluntarily seek out quality instruction.
This is why the regulation of Thai massage by a body of professional practitioners can be seen as necessary. In this case, oversight must come from within the community of Thai massage practitioners, because these are the individuals who truly understand the techniques and the proper methods of training. Of course, these individuals also would have to be professional licensed massage therapists, in order to comply with state laws.
A Case Against Regulation
And here is where I start to sound a bit inconsistent, because a part of me believes the way one trains should be voluntary. I have always felt that massage, as with herbalism and midwifery, belongs in the layperson's hands, where some of the best teachers are quietly hidden and carry no state-governed credentials. I am deeply suspicious of massage regulation, with its pandering to large corporate schools and its focus on written exams for a field that involves the unmeasurable ability to touch and feel with intuition and competence.
In the world of Thai massage, regulation is nearly impossible. While schools and practitioners have begun to be regulated by the Ministries of Education and Public Health in Thailand, it remains a fact that some of the most proficient therapists in Thailand are unlicensed, unrecognized and unofficial. Some of these practitioners are masters of hereditary methods; some live in the far-out villages where licensure is not possible.
Maintaining the Status Quo
There are some who suggest Thai massage practitioners should not have to be licensed massage therapists at all, meaning they should not have to meet any existing state requirements in order to practice their profession. This position holds that Thai massage is not the same as other bodywork modalities and should have either no requirements or only those of our own regulatory agencies. They propose that we should not even call it Thai massage, suggesting instead names such as Thai Yoga Therapy or Thai Intensive Stretching. It's as if a change in semantics will change the fact we are "manipulating soft tissue," the common definition of massage in most states. While I agree Swedish massage licensure does not qualify one to practice Thai massage, I do not think it hurts.
Another factor in this issue of creating regulatory agencies specifically for Thai massage is the need to be wary of self-absorption - to the point of forgetting the public we serve. So, how do we regulate Thai massage? We set the standards not by creating more regulatory agencies and attempting to separate ourselves from the rest of the massage world, but by creating classes and schools with a high bar and by being practitioners who don't balk at training. What if, instead of using our energies to fight the existing system and create new regulating agencies, we were to work together within the system? This could be the best of both worlds. Thai massage does not become regulated unto itself (hopefully avoiding homogenization), and by following state requirements of licensure, at least in states that have requirements, the people who can practice will by default be those who are willing to put in a little extra work.
I have looked through both lenses and agreed with what I saw. In the end, I have come to a place at which I accept things the way they are. It's not perfect, but I know the things that bother me most about the present and likely future of Thai massage are not actually going to be fixed by less or more regulation. They are not being fixed by the states that don't require Thai massage therapists be licensed in massage and they are not being fixed in Thailand, where there is very specific government regulation of Thai massage. What bothers me are things like gaps in integrity and the need for better understanding. Things like the tendency to call Thai medicine ayurvedic or Chinese because we don't understand it enough or respect it enough to grant it its own standing. Things like infighting among practitioners and teachers. More importantly, I am bothered by the actual danger of an ancient art becoming watered down and distorted until it no longer exists in its true form.
Luckily, these are things we can change without having to restructure the system. These are things we change through personal commitment. As we teach our students and teach each other, we set the bar higher and encourage quality in the Thai massage community. I believe it's up to us as individuals, not laws, to keep Thai massage safe and authentic. Those who do will shine brightly.
Nephyr Jacobsen is the founder and director of The Naga Center School of Traditional Thai Medicine in Portland Ore. She has been a massage therapist for 17 years and has spent extensive time studying Thai massage, both domestically and in Thailand.
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