resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
It's Time to Create a Strong Acupuncture Footprint
Footprints in the sand. Footprints in the snow. Where do these footprints go? Some are big, some are small, but footprints are made by all.
Put the Social Back Into Social Media
Social media is more than a passing fad, it is definitely here to stay. Social media apps and channels of distribution may evolve, but the concept of social media is now big business and a part of all our lives.
It might have been a miserable start to the day in the heart of downtown San Diego. A heavy rain had soaked the large homeless population congregating near the intersection of Third Avenue and Ash Street as they waited for a free breakfast to be served at the First Lutheran Church on the corner.
The CDC came out with a report in March 2013 that suggests 1 in 50 children will be diagnosed somewhere on the autism spectrum – significantly higher than the 1 in 86 figure that came out in 2007. What does this mean moving forward, particularly for children?
The Top Seven Website Mistakes Clinics Make
The majority of acupuncture clinics finally have a website for their business. Having a website is crucial for being found online through Google, Facebook and review sites like Yelp.
Help Your Parents Stay Engaged
As much as parents may wish it were so, children do not come with an instruction manual. There's no "how to" that can be followed and no two children are alike, so what works with one generally won't work with the next.
Acupuncture and Homeopathy: Bioenergetic Brothers
Acupuncture and homeopathy share an important healing principle: bioenergetics. "Bio" means "life," so bioenergetics is literally "life energy."
The Conscious Evolution of Healing, Part 2
The idea of transmission is very important in the Chinese medical classics. According to author Claude Larre, the ancient Chinese were highly interested in the connection between things. Nothing was looked at as an isolated entity.
Reflections: The Art of Teaching Asian Medicine
Over the past three decades, my global workshops have been translated into German, Swiss German, French, Romansch, Spanish, Lithuanian and Xhosa. Time to offer you new teachers a few tips!
Cell Health (Part 2)
Dr. Barsten, your book is about restoring "cell vitality." Can you briefly define the term? Cell vitality is more than the mere absence of symptoms or pathology, but optimum structural, physiological and energetic health.
Neuroscience: Where Western Medicine and Chinese Medicine Can Come Together
The recent advances in neuroscience are truly incredible. With this expansion of scientific knowledge, I would like to see even more research into the neuroscientific basic of acupuncture and Chinese Medicine.
Finding Balance in the Clinic
This past December, I celebrated 11 years in practice. I seriously don't know where the time went. I feel beyond blessed and grateful to be practicing our profound and beautiful medicine and to be helping guide my patients restore a state of optimal health.
Mind-Body in Motion
A central goal of low back pain treatment involves the correction of dysfunctional movement patterns believed to be responsible for spinal overload.
Unlevel Pelvis in the High-School Athlete: Exploring Causes and Effects
The unlevel pelvis is all too common in the high-school athlete and if not detected, will likely cause a lifetime of musculoskeletal issues. Any provider who doesn't look for this common finding is missing critical information.
Leaving Footprints on Capitol Hill: Tribute to Dr. Kenneth Luedtke (1930-2014)
It was with great sadness that I heard of the passing of Dr. Ken Luedtke.
Are You Really a Healthy Eater?
I always giggle a little bit (to myself) when someone comes into my office and informs me that they are a healthy eater. What exactly does that mean? Does that mean they eat sugar in moderation? And what's that, exactly?
News in Brief
An Encouraging Sign at Palmer; NBCE Announces Retirement of Longtime Director of Testing.
Let's Speak With One Voice in 2015
For the longest time, the chiropractic profession has attempted to achieve some form of unity. On a political level, this was characterized by an ultimately unsuccessful two-year merger effort between ACA and ICA leadership from 1986-1988.
Old TCM Sayings: Treat the Front to Treat the Back
Chinese medicine college was, and always will be, a memorable time. It was a time of massive personal and professional growth.
Connecting the Dots
In 2002, I published a book on patient examination procedures that included information on the procedural coding of the recommended examinations. The book should have been published in 2000, but I had trouble finding a publisher. Why?
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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