-or- Allissa wanted to know what medical massage really is, but didn’t want to do the research so she begged Mr. Stephens to guest-post.
(When you’re done here, Kelli Wise over at Massage Therapy World has some great thoughts, too.)
By Ralph R. Stephens, BS, LMT, NCTMB
Just what is medical massage and why should I study it? This is a common question asked by many therapists considering their continuing education options.
Medical massage is not a unique method in and of itself. Instead, it is a combination of advanced soft-tissue techniques, organized to address the particular complaints or needs of each individual being seen by the therapist. In reality, it is more of an orientation whose focus is to work with clients that have medical or rehabilitative considerations. This approach is a synthesis of education, training, experience, dedication, humility, and intuition. Medical massage is not relaxation or stress reduction massage. It is tissue and body region specific based on the individual’s complaints, primary pathology, and the therapist’s findings. Medical massage is seldom a “full-body” treatment, but it could be. It is usually a focused treatment on the lumbar-pelvis region, or the cervical region for example. Often sessions are shorter and more frequent, sometimes as short as 15 minutes. However, extended sessions (90 minutes) can be appropriate depending on the patient’s needs.
Medical massage does not have to be done in a hospital. It can be done in your private office or even on-site. It does not have to be a referral from a physician, but it could be. It does not have to be covered by insurance, but it could be. It is not the venue or who pays the bill; it is the nature of the treatment that makes it medical massage. If the treatment is specifically focused on the pain, complaint, injury, condition, or need of the patient and is not a choreographed, one size fits all, or non-specific, full body, relaxation massage it could be medical massage.
To make it very simple, medical massage is a term being used to differentiate advanced, condition specific, individualized massage from general relaxation massage. The medical massage therapist has advanced training in anatomically specific assessment, palpation, and treatment of soft-tissue. Many existing modalities of soft tissue manipulation and body/mind support effectively support these goals. Medical massage is a very clear term that is not confused with relaxation massage or adult entertainment. The term is clear to the public and to other health care providers.
The protocol for medical massage is:
- Taking a complete, detailed case history (patient intake)
- Assessment of posture, movement, and soft tissue
- Treatment of abnormal tissues
- Re-assessment
- Additional treatment.
The most common forms of assessment are:
- Posture and gait assessment
- Orthopedic muscle testing
- Range of motion (ROM) assessment
- Palpatory assessment of soft tissue (examination)
Based on the findings, a treatment protocol (treatment plan) is developed for each individual. This is really fun, challenging, and exciting for the therapist. No more boring massage routines done almost the same way over and over. Every treatment is slightly or maybe dramatically different and changes as the patient’s condition improves. This reduces therapist burnout and helps prevent repetitive strain injuries.
A medical massage treatment is any one of or a combination of 9 massage types:
- Neuromuscular
- Connective Tissue
- Myofascial
- Periostial and Segmental Reflex (Russian techniques)
- Lymphatic
- Stretching and Movement
- Joint mobilization
- Orthopedic
- Sports (but not Event Sports Massage)
- Some might argue that cranial sacral could be done in a medical massage depending on the application.
- Note: Trigger point therapy is part of several of the above technique types.
Each of these massage systems are very specific and can be easily combined by the therapist to make a powerful therapeutic impact. Obviously, no one instructor or class will teach all of these massage techniques at once. It is a career-long study.
To quote my two favorite medical massage colleagues,
“Medical massage therapy procedure consists of mobilization of skin, fascia, muscular tissue, trigger point therapy, and post-isometric relaxation techniques. Each of the above mentioned modalities is equally important in order to reach sustained and rapid results. For many decades, massive utilization of medical massage has proven to be a safe and very effective method of treatment for support and movement system disorders, inner organ disorders, stress management, etc.”
-Boris Prilutsky, MA & Ross Turchaninov, MD, PhD
Medical Massage is an advanced discipline of massage therapy/bodywork.
What distinguishes medical massage therapists is additional knowledge of techniques, injuries, pathologies, medical terminology, equipment, and procedures. This expanded knowledge is generally taught in post entry-level continuing education programs.
Why study medical massage?
To help you learn more and better ways to help more people efficiently and effectively. Medical massage courses will improve your palpatory literacy. You will gain a better understanding of soft tissue dysfunctions and injuries, from a holistic, soft tissue perspective. While medical massage addresses specific areas, it also recognizes the interconnectedness of the entire body. “Where it hurts is where it ain’t” – Ida Rolf. You will learn to find and work the other side of the pain along with how to lengthen and strengthen specific muscles to bring the patient’s body into better alignment and functioning.
As the massage field becomes more competitive, with more and more therapists entering the marketplace, you need the skills that set you apart and make your services more essential and valuable to the public. Relaxation is wonderful and people will pay for it when they have the disposable time and money available. It will be cut from their budget when times get tough. They will also be easily lured to a cheaper venue. However, if you are providing pain relief and performance enhancement, you are much more unique. Relief from pain is a necessity. People will pay more for it and will be much more loyal to a therapist who is actually helping them. If you can help people get out of pain, you will get busy rapidly and stay that way, because you will never run out of people in pain. People in pain know other people in pain and your practice will grow by referral, the most effective and cost efficient form of advertising.
(Consumed while writing this post: breakfast smoothie made with bananas , pear juice and supplements. Later over organic O’s, almonds, raisins, and Naked Juice Mighty Mango juice. Finally, 88% organic dark chocolate and macadamia nuts.)
More about Ralph
Internationally recognized instructor, therapist, and author; 2008 Inductee – Massage Therapy Hall of Fame; all around nice guy, great dance partner and cool enough to hang out and drink scotch with Allissa. Ralph is known for sharing his 24 years of experience in an entertaining, inspiring style that makes advanced techniques fun to learn and easy to remember and apply. His goal is to help you help more people.
If you want to help more people, grow your practice, increase your income, improve patient loyalty, and move beyond the relaxation routine, medical massage training can be an excellent investment that can bring a huge return in your job satisfaction and your income. Check out his continuing education schedule here.
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