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Pro-Con: Swaddling for Newborns
The practice of swaddling has been used for thousands of years and was popular until the 1700s, when it was slowly abandoned by many cultures that considered it old-fashioned or barbaric.
F4CP Making a High-Impact Impression
The Foundation for Chiropractic Progress has released details of its 2016 strategy, certain elements of which are already in play. The strategy includes ads, posters and other resources available to all F4CP members.
The Concussion-Subluxation Complex
In the Aug. 1, 2014 issue of Dynamic Chiropractic, I reviewed some of the literature demonstrating the role of the chiropractic adjustment in post-concussive care.
Targeting the Bad Apples in the Bunch
While everyone was focused on the conversion to ICD-10, the Office of Inspector General for Health and Human Services released a new report on chiropractic titled "CMS Should Use Targeted Tactics to Curb Questionable and Inappropriate Payments for Chiropractic Services."
Born to Energize the Human Spirit: Recollections of Sig Miller
Sig Miller, longtime executive director of the Association of New Jersey Chiropractors (ANJC), passed away on Sept. 17 after a long battle with cancer.
Create Community and Grow Your Practice
Many healthcare providers are fortunate to enjoy the freedom and independence of owning their own businesses. However, the constant demands can lead to a lonely and isolating experience unless you make an effort to get out of your office.
Suffering Makes Us Human
It is possible that suffering, instead of being something negative, can be one of the greatest gifts to bring out one's humanity — if we allow it to be.
Cold and Flu Season: Expanding the Repertoire
As we move into the winter months, it is important for clinicians to have a solid working knowledge of effective herbal protocols for treating and managing clinical cold and flu presentations.
Breech Baby: A Scientific Approach
You learned a classic cookbook style treatment strategy in college for treating breech baby presentation. I'm sure you've used it. The main ingredient: moxa at Urinary Bladder 67.
When I started to think about what I wanted to do, I toured different schools to choose where to pursue my original chiropractic education.
Building Community: A New Way to Socialize Your Practice
Social Media can seem like a slippery slope when, in fact, it is fairly easy to understand. With social media platforms, you can connect with current and potential new clients, build strong customer loyalty and increase brand awareness.
The 2015 Nobel Prize Shines a Spotlight on TCM Research
Traditional Chinese Medicine continues to make it's presence felt on the world stage as the 2015 Nobel Prize in Physiology or Medicine was jointly awarded to William C. Campbell and Satoshi Omura for their work on combating parasites and YouYou Tu for her discoveries in combating Malaria.
Designing a Fitness Plan (Part 1)
It doesn't matter if you come to my practice for pain relief, weight loss, healthy aging or something else. The formula I talk about for each patient's fitness strategy is pretty much the same.
Are You a Stakeholder?
In today's world many new things are occurring, especially in the world of information technology. With these changes, comes an entire new set of vocabulary words and definitions.
Too Many to Remember: Tips to Revive Your Ortho / Neuro Test Skills
When I was at Palmer in the mid-1980s, we were given a set of notes in one of our diagnostic courses. The notes covered approximately 70 orthopedic and neurological tests for various regions of the body.
How to Market to the Medical Profession
The world of health care is changing dramatically. When situations occur that cause expenses to increase, it is time for you to develop strategies that maintain and grow revenue.
Detoxification Demystified and the Crucifers that Help
"Let food be your medicine and medicine be your food," is a quote often attributed to Hippocrates, a philosopher of the 5th century BC.
Diagnose Sprain Injuries in MVA Cases With Dynamic X-Rays (Pt. 1)
Am I the only person to notice hospitals are doing a seemingly insufficient job lately in their initial radiological workup of motor vehicle accident (MVA) victims?
Yo San University Receives $1 Million Gift
Long-time Yo San University supporter Thomas S. Blount recently gave a $1 million dollar gift to the University, it's largest charitable gift to date. Mr. Blount was a retired naval officer, aerospace consultant and philanthropist.
Making Sense of an Increasingly Obvious Conclusion
Where's U.S. health care heading? Like it or not, the list of telltale signs is growing to a point that stands out to even the most myopic observer. Consider this list of facts as you look into the future of health care in the United States:
October, 2012, Vol. 12, Issue 10
Understanding the Difference Between Clinical and Spa Massage
By Christy Schumacher, NCTMB
As most of us in the massage profession recognize of late, we are splitting into two fairly divergent, yet equally important industries. The most prominent and popular industry is the personal services massage industry.Many refer to this as "spa" or "relaxation" massage (for the purposes of this article I will refer to this as spa massage). The second and more recently emerging industry is "clinical" (or medical) massage therapy. These and other terms get thrown around a lot, and can cause a tremendous amount of confusion for massage therapists, but more importantly, for consumers. I hear many massage therapists and consumers denigrate spa massage as lesser than clinical massage, and each time it makes me cringe; all professional massage has therapeutic value! However, I also hear an equal number of therapists misrepresent clinical massage. I would like to provide clear and reasonable distinctions to these two types of massage, and hopefully help move both industries forward in a productive way.
It is important to understand that the type of modality that is practiced, from Swedish to Myofacial Release, from Cranio Sacral to Proprioceptive Neuromuscular Facilitation, or from Trigger Point Therapy to Lymphatic Drainage, in no way puts a massage therapist in one category versus another. A spa massage therapist and a clinical massage therapist can, and do, practice all types of modalities in both industries. The ultimate difference is the focus. In spa massage, the therapist is ultimately focused on the satisfaction of the client. The session is often intuitive and compassionate. The environment is private and often includes luxuries that put the client at ease. essions are defined and charged by a set number of minutes the hands are on the body, and tipping is expected. Attention to details such as music, table warmers, aromatherapy and high-end linens is common, and often required to stand out to consumers to get them to return.
In clinical massage, the ultimate focus is on functional outcomes. There is an evidence-based reason why a therapist applies one modality over another and most importantly, results must be measurable. Client satisfaction is often not assessed until the completion of a limited number of treatments, referred to as "treat and release," or the achievement of a specific therapeutic outcome. Finally, the length of the session is often shorter and the number of minutes that are spent with the hands on the body is not a focus point for the session (no more clock watchers!). Prices are defined more often by third party payers (insurance companies), in 15-20 minute increments, and tipping is rarely involved.
Training is another important difference between clinical and spa massage. Basic massage education (often around 500 hours) rarely provides the education required to practice in a clinical setting as a new graduate, but is sufficient for many spa settings. This allows for a new therapist to begin practicing, build their skill set, and most importantly, make money! A new therapist can get a spa massage job and gain the necessary experience and continuing education to tailor their future career to what works best for them. A typical massage graduate requires a period of professional practice and substantial continuing education to be qualified to practice in a clinical setting. Knowledge must be gained that includes assessment and proper documentation of functional pain, lifestyle and ranges of motion. Advanced understanding of pathology and kinesiology also is important.
Credentialing is another important distinction. To practice spa massage, a therapist often is required to be licensed and carry liability insurance. In many clinical settings, additional credentialing is often required such as National Certification, additional professional certificates, continuing education hours and sometimes even professional licenses such as nursing or physical therapy may be helpful to bill insurance (in the interest of full disclosure, I have been a Director for National Certification for Therapeutic Massage and Bodywork since 2009).
Most importantly, various details of ethics must be observed and practiced with care. This includes knowing not just your scope of practice as a massage therapist, but also the scopes of practice of your fellow allied health professionals. Clinical massage is often practiced in team-based settings that include colleagues such as physical therapists, occupational therapists, acupuncturists, psychologists and orthopedic physicians. Referrals are important. Knowing when to refer your client out and how to communicate that effectively is an important part of clinical massage. Likewise, communicating to allied health colleagues about their patients, and when your skill set may be a more suitable therapy, takes time and patience to develop.
This is certainly not to say that a spa massage therapist does not require proper ethics training to ensure public trust and safety. Basic massage education will include training on maintaining proper records of informed consent, contraindications and limited SOAP note documentation. However, for spa massage, documentation of time and place of a session is often ethically sufficient. When the focus is on measurable outcomes, documentation is just as important as the session itself.
The Bottom Line
I come in contact with numerous massage students and recent graduates at my integrative health clinic. Almost universally, these students and professionals will tell me that they have no interest in working at a spa and want to practice massage that actually "does something." Spa massage does accomplish something! The ability to provide essential relaxation and stress relief is a powerful therapeutic tool. In fact, stress and tension is often the root of physical pain, and needs to be addressed concurrently with any clinical or spa massage.
As a new massage graduate, it is important to recognize that the differences between spa and clinical massage are quite muddy for consumers. If you want to develop your career as a clinical massage therapist, there are important steps to take. First of all, recognize that the best way to get there is getting your hands on as many bodies as possible to develop your skills. A job at a spa is a great place to do this.
Communicate with your clients about why they are on your table and track lifestyle or stress outcomes. If a client comes in with low back pain, ask them on a scale of 1 to 10, how bad is it now? How bad does it get when it’s at its worst? Ask them what number they are at after your session. If they are coming in for overall stress relief, ask them what their stress does to restrict or impede their lifestyle. How is their sleep, anxiety levels and depression levels? Assign a numeric scale to these questions, document your findings and ask these same questions again on a follow-up visit. Upon their return, ask them the same question and remind them of their previous answers. And above all, DOCUMENT.
Those of us who have been in this industry for a long time recognize that a lot of massage therapists want to be a part of clinical health care teams. More and more opportunities are becoming available, but will require dedication and commitment from the next generation of massage therapists if they are to grow in number. Continue your education. Learn what your allied health colleagues can do to further improve your client’s pain, lifestyle and range of motion limitations. And above all, recognize that any massage you provide for your clients, whether it’s at a fancy spa or in a semi-private clinical setting with bright lights, you are providing them with an invaluable tool to improve their lives.
Christy Schumacher is a medical ethicist and massage therapist who works with integrative health care practitioners to improve access to and utilization of professional massage therapy within conventional medicine. She has a strong background in public health, evidence-based medicine and outcomes-based models of care.
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