A Sermon on the Science of Massage

This isn’t one of my rants about massage research–although that’s definitely a sermon I plan to keep on preaching. It’s about the basic things that we all ought to know, if we’re calling ourselves massage therapists.

I love anatomy and physiology, and the study of pathology is fascinating to me. The human body is an amazing thing, and the more I know about the way it works, the more competent and empowered I feel to do a good job as a massage therapist. Sadly, that sentiment isn’t shared by everybody.

I’ve been tutoring students and teaching my class in how to pass the exams for over ten years. I can’t tell you the number of times someone has said to me “I just want to do massage. Why do I need to know this stuff?” A few weeks ago, I actually had someone who has graduated from massage school (but not yet passed their exam) ask me where the trapezius is located. I didn’t know whether I should feel sorry for them at their lack of education, or whether to give them a swift kick in the butt and point out how lazy they must be not to know this by this time.

Due to the lack of regulation in some places (there are still 8 states where anyone who wants to may call themselves a massage therapist with no education at all), and the time-honored tradition of grandfathering people when legislation does come in, there are thousands of people practicing massage who know nothing of the sciences associated with it.

Massage is an art form, to me anyway, as well as a science. And I’ll concede that there are people who can give an amazing massage that don’t know what the trapezius is. But the fact is, I don’t want a massage from any of those people.

If I go to get a massage and say “It hurts when I do this,” I feel much better about getting it from someone who knows what muscle does that. If I make an appointment for a hot stone massage, and then put on the intake form that I am suffering from a severe case of peripheral neuropathy, I’d like for that therapist to know that I shouldn’t be receiving that type of massage. If I’m taking muscle relaxers, I’d like for the therapist to know that my muscle reflexes are inhibited and my sense of pain tolerance is dulled, and that therefore a lot of deep thumb work could leave me bruised and feeling battered. If I have a raging case of shingles, I’d feel better knowing that the therapist would send me back home without a massage. I might have walked in the door as an uneducated member of the public thinking that a little cream spread around on me would make me feel better. I’ve had that happen during my career.

I don’t know everything there is to know–yet.  But I’m happy to say my education didn’t stop at the massage school door. It’s never over, and it will never be over. That doesn’t mean I’m sitting around reading an A&P book cover to cover for entertainment, but I figure the more I know about it, the better I become. When a client comes in and mentions a condition I’ve never heard of, or that they’re taking a drug I’ve never heard of, I’m going to take five minutes to look that up before I put my hands on them. When I can help someone by showing them a stretch, or giving them a few hints about how their body mechanics or the ergonomics in their work space can be involved in their pain, I’m empowering them to feel better and improve the quality of their daily living.

There are some brilliant minds in this profession, and the way I see it, they’ve gotten where they are not because they give a fabulous massage, but because they have knowledge. I made a FB comment one time about the way something works, and no less than Erik Dalton corrected me. I’ll defer to him in a heartbeat. It will take me years to know everything he knows, and he’s been at it a lot longer than I have. And even though he’s making a few noises about retiring to Costa Rica, I don’t think the day will come when he decides he knows enough. He’ll be basking in the tropical sun reading a fascia journal.

I’m never going to be the next Erik Dalton, and chances are you aren’t aspiring to that, either. But I think the burden is on us, as professionals, to soak up the science of massage like a sponge. At a minimum, knowing not just the names of a few major muscles but of all of them, along with their origins, their insertions, and the actions they perform. At a minimum, having an adequate pathology and drug reference handy or Internet access for looking those things up–and actually doing so–in our work spaces.That act alone will cause you to learn something new every day and it will only take a few minutes. That’s my sermon for today.

Get over the idea that only children should spend their time in study.  Be a student so long as you still have something to learn, and this will mean all your life. ~Henry L. Doherty

22 Replies to “A Sermon on the Science of Massage”

  1. To add to this Laura, I love when people say we are health care professionals and they don’t know their muscles or care to take another CE class!!! WT???

    I can’t get enough of knowledge and the more I begin to learn about the body, the less I realize I knew/know. 😉

    It is fascinating and complex – why wouldn’t you want to learn more?

    It also amazes me when I teach classes that students are not aware that certain strokes are ineffective for certain conditions. They just do them …..because (they like them).

    They also don’t realize how certain pharmaceuticals are reacting with our strokes. Many individuals are on multi-pharmacy ~ we better understand.

    And…to add to that I have had students in my classes that came from states that don’t require CE’s ~ then move to one that does and tell me they NEVER took another class since massage school (15 years ago). Simple techniques I was teaching for carpal tunnel relief they looked at me like I was a genius.

    That’s my rant for the day 😉

  2. I learned a very long time ago to never be afraid to empty my cup and fill it up again, and again with knowledge. Laura, I love everything you said. I have done school visits here in Ga. and it just takes my breath away when I see in their first two weeks of school they have a study sheet for the state board. The instructor is having them study the sheet and test, day in and out. Needless to say when I asked an A&P question, after being in school for three months, to give them a prize, no one knew the answer. Please, I do not ever want to see these folks in practice any where at any time.

  3. my sentiments exactly. you could have read my mind. When i was in school I wanted to be a sponge, because I knew I would only have this opportunity one time (to get it ). I take every class I can find that leads me to better understand the body and how we can help to heal it. Including the aforementioned erik dalton. I love educating clients and listening to their complaints and finding ways to listen to their body and unravel the problem. the more I know about massage, the more I learn about anatomy and physiology. the more I love what I do.

    And I am passionate about massage. Thank You Laura for sharing

  4. Simply put, the more I learn, the less I know…. awareness is amazing…

    Laura, thank you for speaking for so many of us! Some days I just almost panic – so much to learn, so much to experience, not enough hours in the day, not enough days in the year, not enough years left??? Not enough funds fast enough??? Oh Dear Lord, please let me live long enough to make a dent in it, to be almost good enough, to get a glimmer of how wondrously we are made!!!
    I am deeply, deeply grateful for all of the amazing teachers that have crossed my path. So grateful to have been blessed with a hunger to know..
    So thankful for all who share with us..
    Keep writing!!!

  5. Hey there Laura:

    Love your blogs…quite a way with words…and guitars. Although I’m flattered by your comments, I never recall correcting you on anything therapeutic. Not saying I didn’t…seems I’m often afflicted with ‘adult moments’ that last for days.

    The theme of this blog highlights a critically important issue for bodyworkers…PASSION…how to get it and how to keep it? Not sure it can be legislated but it can be cultivated. Most of us bodywork junkies are driven to be better educated so we can be the best “in-the-trenches” therapist we can be.

    The more we learn, the more we want to learn, and the more we realize we don’t know crap. But we don’t care because we’re totally inspired by all the wonderful things out there left to learn. I concluded my 1998 Myoskeletal Alignment Techniques manual with a favorite quote by an unknown author that simply states: “Truly Educated Never Graduate.”

    Although I have no plans to completely retire, I’m not teaching in 2011 to allow time to promote my upcoming Dynamic Body book. See preview @ http://www.daltonarticles.com/dynamicbody.html
    Also want to finish a couple of home-study courses and attend more research conferences. Really excited about the March Fascial Congress in Vancouver…word is leaking of some intriguing new neurofascial findings and treatments. Hope to see y’all there….much love amigos >>Erik

  6. In my travels as an army wife and therapist, I’ve discovered most therapists dont know a trap from their elbow. Nor do they know the difference between a muscle and a bone. I blame the massage schools for this. The state board I took, we had to know the major bones and muscles, guess I was one of the lucky ones. There seems to be a theme with massage school, to make money, instead of train people to be good therapists. I attended three different schools due to having to quit in order to support myself, and then go back. So I saw some scary things being taught, saw therapists being thrown to the wolves giving practice massage with no instruction at all. Had the worst anatomy teacher who had no business teaching how to kill a fly let alone A&P. It is the massage education system as a whole that needs to clean house, & start from scratch, filling positions with qualified teachers who care about the public and the future of massage. Ok, Im off my soapbox now, Laura, keep the flame going….

  7. Uhm, Its not that I disagree with everyone in here..No matter what profession, its good to be educated. And after 26 years of being a massage therapist. I have to admit, I’m a bit weak on anatomy and physiology…Im not nationally certified or anything…No CE classes for years. ..Ive taken some practice exams for the various certifications out there. And flunked them…Ive been asked to teach at a local massage school..I looked over the curriculum and told the lead instructor that I cant teach this… She asked why, and I told her that I dont know any of this stuff.. She looked at me puzzled and said..But you are a professional massage therapist? And I said. Well apparently you dont need to know any of this stuff to be a professional massage therapist..At the same time, I study all the time. Its just not what they teach in massage schools or have on those exams…I feel very comfortable in my work. Im not quite sure how to say what I want to in here?? uhm.. Ok I’ll try. If you take a yoga class. Its complicated. There is a way to do it right. Breathing, posture, position and so on. The instructors are experts and you arnt..It takes quite a bit of training to be a yoga instructor. But cats stretch.. They dont know anything or worry about all that stuff and dont take classes.. They just stretch. Uhm, one time I found myself in a room full of medical doctors . They were discussing herniated discs…I have a herniated disc…Unless any of those doctors has a herniated disc themselves. I was the only expert in that room.. I am the herniated disc..I look at the schools now..There is just too much time spent on teaching how to pass exams…and not how to be a massage therapist..Too me, its an obvious fact…I cant pass a test.. But Ive been working as a massage therapist for 26 years successfully. The career span for this industry is six years now. Im not arguing with anyone in here..Education is important…But something is wrong you guys..And it wont be corrected with ever more or stringent testing.

  8. Laura, I love your blog posts. I totally agree that massage is an art form and a science. I work hard to improve my knowledge and skills in both. I live in one of those states (Oklahoma) where you don’t have to be trained or licensed or certified to practice massage. My city is the only one in the state that required licensing (and entertainingly the licenses have a deer head embossed on them! Maybe deer hunting is more of a priority than we are!). I went to a really good school (graduated 3 years ago) and got good training, which I’m thankful for. But because I’m a perpetual student I’ve really pushed to go to CE classes (I’ve done through SomatoEmotional Release 2 in Upledger’s program), and I buy DVD’s to further educate myself about massage and Myofascial Release.

    I think it’s really important that we have a passion for what we do. I am always concerned when the focus of an educational system is passing an exam whether it’s massage school or our school system in general. I so agree with you Gordon that more stringent testing won’t create better MT’s.

    I think I’m having the same issue Gordon did – having trouble saying what I want to say!

    Laura, I don’t know if you have time to read these comments but if you do I think you might like to know about the person who went through school ahead of me who told the instructor “I don’t have to know about anatomy and physiology. My ability to massage people is a gift from God.” The instructor didn’t sign her diploma…

  9. Great post Laura!
    I’ve never understood why folks want to separate art & science when they are both one and the same. Change is quite difficult, especially when it’s time to overhaul old ideas and replace them with new. Most are scared of that process, but there need not be any fear, so much more can be accomplished when we let go of our egos.

    Rajam Roose, HHP

  10. i agree laura, the more i learn the more need to know. from what i have experienced the schools hear in Oz are focused more on making money than educating the student, and we are battling for recognition from the government and medical profession also.

    Terry RMT

  11. I hope I dont come across as a Mr. Know it all… Because Im not…I’m on my 3rd wife and Im broke all the time.. But I know my work…Everything i do with my massage work has nothing to do with what I learned in school or on any exam. I just dont wanna be forced to memorize a bunch of stuff that has relatively no importance to my work. And pay money on top of it.. Ok here is an example.. A lady came into see me a few weeks ago. Sever pain in her shoulder. She couldnt abduct her arm very far at all without experiencing pain…Range of motoin was very restricted. She had seen a medical doctor that said she had a rotator cuff injury, and may need surgery. I asked her where it hurt.. she touched her deltoid…I palpated her deltoid, but couldnt elicit any soreness in her deltoid. She said it hurt deep inside the joint..Well maybe, but I doubt it.. I figured that it was referred pain from somewhere else.. I know that 85% of pain comes directly from trigger points. Not joint or nerve or all this other stuff…I know that a trigger point in the infraspinatus refers pain to the deltoid… So sure enough I palpated a massively sore trigger point in her infraspinatus. Then I initiated a clasp knife reflex in her infraspinatus muscle…and in 20 seconds her pain was gone. She had full pain free range of motion in her arm. Total time , maybe five minutes. Sorry for any misspelled words.. Im not good at spelling either.

  12. No rant at all Laura,
    Well put, and Thank You for upping the ante for learning more… and more.. and MORE!
    I’m a transplant to GA from FL, and was glad when GA decided to go hands-on for renewal. Even before FL did, I’ve always taken hands-on courses and have always been “on the learn” for new (and older) things related to massage, and the all of the healing arts.
    As an instructor for “Tian Di Bamboo Massage”, it always shocks me to see how so many of my LMT students do not know their A&P! This NCBTMB approved course is distinctly different and involves very precise work with cutom-made bamboo tools specifially designed for their application for therapeutic value. Therapists MUST know their A&P in order to learn this technique, and it distresses me to routinely hear ” oh I forgot that as soon as I left school and passed the test!” Sadly, with the schools being so focused on passing the exams I see a lot of memorization without understanding going on. So I show these students on the exact way to utilize the bamboo sticks and refresh their A&P — and although it takes a bit longer in the class, I make absolutely sure they are correct in what they are doing, and can guarantee that not one student leaves without learning it right.
    Like you, I encourage my students to broaden their scope of knowledge to include an endless appetite for learning more!
    Thank you again for bringing this to up to more attention!

  13. Accumulation of information, is not the same as real knowledge. And thats the problem with how massage is being taught today. I seem to be the only one that feels that way though..Well its ok.

  14. brilliant article Lauren – hits the nail on the head. I keep telling massage students that once they think they know it all to then get out of the industry. Massage is a journey for all – it never ends – enjoy it & feed the mind – there’s always something new to learn. Plus your clients will be only to grateful for what you bring to the table.

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