resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Integrating Art with Clinical Practice for Patients with PTSD: The Artemis Project
Are you restricted by those one-on-one clinic dynamics? Why not join colleagues and clients in experimental group settings? Three of us volunteered to do just that in Austin on behalf of women veteranss from all branches of the service.
Medicine is Clumsy, Don't You Be
All medical systems have clumsiness in them. If the technique isn't, the practitioner is. Everyone in every form of medicine is striving to improve. That is why we call it practice.
First Do No Harm?
There's no questioning the frightening nature of breast cancer, which strikes one in eight women in the U.S. – eclipsed only by skin cancer in terms of prevalence.
A Poor Choice for Pain Relief
Acetaminophen is the most popular pain reliever in the U.S., accounting for an estimated 27 billion annual doses as of 2009. With 100,000-plus hospital visits a year by users, it's also the most likely to be taken inappropriately.
Reducing the Autogenic Inhibition Reflex: Making Weak Muscles Strong
The autogenic inhibition (AI) reflex is a sudden relaxation of a muscle in response to excess tension.
Leg-Length Inequality and Pelvic Fixation: A New Approach to the Negative Derifield (Part 2)
As we noted in our previous article, with a positive Derifield (+D), the doctor observes the reactive (shorter) leg in the prone position that becomes longer or "crosses over" in the flexed position.
5 Tips for Using Pinterest to Market Your Practice
Pinterest is a very popular, but often under-utilized, social media platform where people can bookmark, or "pin," fun and interesting things from all across the internet.
Spieth Thanks His Chiropractor After Historic Masters Win
Jordan Spieth didn't just capture the hearts of golf enthusiasts worldwide with his record-setting, wire-to-wire victory at the 79th Masters Tournament.
Professional Credentialing and Board Certification: An Ethical Faux Pas
Because of the Affordable Care Act, health care systems are coordinating care through accountable care organizations (ACOs) in order to reduce the cost of care and improve quality of care.
We Get Letters & Email
A House Divided? (May 1 issue) provoked significant response from readers. Here are several of the surprisingly similar comments we received.
Marijuana, Apathy and Chinese Medicine, Part 1
This article was written in response to the unheeded acceptance of marijuana as a harmless substance that potentially does good when used for the medical relief of pain.
Animal Acupuncture: A Case Study in the Treatment of Traumatic Injury in the Equine
The rise of animal acupuncture in the U.S. began in the early 1970's as a result of the work by members of the National Acupuncture Association in Westwood, Calif.
The Acupuncturist's Problem
I want share with you some observations and insights into what seems to be the most common problem my colleagues in the acupuncture profession struggles with. If you also struggle with this problem, I hope you get a valuable "aha" moment from reading this.
PCOM Granted Regional Accreditation
Pacific College of Oriental Medicine (PCOM) recently announce it has received regional accreditation from the Western Association of Schools and Colleges (WASC). This achievement reflects five years of hard work on the part of faculty, staff, and students.
Green Tea Improves Cognitive Function in Elderly Subjects
Publishing their results in the journal Nutrients in May 2014, researchers showed that drinking the equivalent of 2-4 cups of brewed green tea (or bottled tea) daily improved cognitive function or reduced the progression of cognitive dysfunction in elderly subjects.
The Tide is Rising in the Acupuncture Profession
Former President Ronald Regan said, "When the tide rises all boats float." The tide is rising for the acupuncture profession. Many forces outside the profession are helping the tides to rise.
Rethinking Musculoskeletal Pain – A Public Health Perspective
The American Public Health Association (APHA) is the world's oldest and largest association of its kind, founded more than 140 years ago and boasting over 25,000 members.
ACA or ICA: Which Best Represents You?
Last June, I was honored to represent Texas ICA members as their representative assemblyman at the ICA Annual Meeting in Kansas City.
5 Simple Steps to Create an Effective Marketing Calendar
In the educational experience of most healthcare practitioners, business and marketing are overlooked topics.
Giving Vets the Care They Deserve
The Department of Veterans Affairs (VA) administers the largest integrated health care system in the United States.
How Much Do You Know About the Benefits of Birds Nest?
Edible bird's nest is the nest made by the Swiftlet bird of Southeast Asia that is usually prepared as a soup and prized in Chinese culture as a healthful delicacy.
The Challenges of Integrating Eastern and Western Medicine
My Masters thesis was titled, "The Challenges of Integrating Eastern and Western Medicine," which highlighted several reasons why it is hard for these two worlds to mix.
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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