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

Continuing Education Providers: Sink or Swim

Every time I turn around, it seems that something is on the horizon that affects CE providers–and the therapists who are obligated to get CE in order to maintain their license.  The latest salvo has been fired from the state of Maryland, where legislation is afoot with big changes in the CE environment. According to the Maryland Chapter of AMTA, the proposed regulations mean that NCBTMB-Approved Providers can no longer offer classes in Maryland unless they have been pre-approved by the Maryland Board of Chiropractic and Massage Therapy Examiners at least 90 days in advance; CE offered by community colleges and online classes will be subject to the same rules, and providers will have to pay $25 per course unit for approval. CE hours earned at AMTA conferences won’t fly unless they have been pre-approved and the fees paid. This is going to be voted on this coming week and the MD Chapter has been making a big effort to drum up enough support to kill the changes. If you haven’t weighed in yet, you’ve got until the 18th of January to call your legislators and protest. Every time something like this happens, I get a lot of email from people asking me what they can do about it. The short answer is do it right now–don’t wait until the bill is passed to complain. You can send your comments and questions to vallonej@dhmh.state.md.us

As a provider myself, there are certain states I’ve never visited because of the hoops you have to jump through. New York, as I reported last year, requires a fat fee of $900 to be a provider, and a New York-licensed massage therapist has to perform the hands-on portion of any CE training. I don’t pretend to hold myself in the same class as Erik Dalton or Ben Benjamin, but it does seem strange to me that someone with a PhD can’t perform the hands-on portion of their own class unless they have gotten themselves licensed in NY.

If you want to be a provider in the state of Texas, you must get yourself pre-approved, reapply and pay a $200 fee every two years. I just looked at their list and there are 549 providers currently approved there. That’s a tidy chunk of change for their board.

Florida also has their own process. I got their approval last year, and while it didn’t cost me any money, I did find their process a little confusing to go through. I actually sent them $250 because I thought I had to after muddling through their directions for applying. My money was refunded.

The Chair and Vice Chair of the North Carolina Board of Massage & Bodywork Therapy reported upon their return from attending the Federation of State Massage Therapy Boards meeting in 2010 that the Federation was investigating the possibility of approving continuing education. Recently, the Alliance for Massage Therapy Education has also been making noises about national teacher standards as well. Alexa Zaledonis, the new Chair of the National Certification Board for Therapeutic Massage & Bodywork, has also put up a statement on the NCB website that they are about to undertake new initiatives in the CE provider program.

The opportunity for continuing education here in North Carolina is so competitive, it’s almost overwhelming. We have about 8000 active licensees, and 145  CE providers who live in the state…that doesn’t count the folks who are traveling in from elsewhere to teach. If you only count the ones who actually live here, that breaks down to 55 students per provider per renewal period, so if you’re wondering why it seems to get tougher to attract students, basically it’s because there’s a CE provider on every corner. While some students will seek you out because of what you teach or who you are, there are hundreds of others who are just looking for the closest class so they don’t have to travel, or the cheapest class they can get due to their finances, or they’ve procrastinated so that they just take the first thing that comes along when it’s time (or past time) to renew.

I love teaching. It isn’t my primary source of income, but it’s important to me to get that interaction. I feel energized after I’ve spent the day in a class with a bunch of people who actually care about learning something.

The CE river is rolling along, the water is getting pretty muddy, and we’re all going to have to sink or swim.

ADDENDUM: After I finished this blog, MK Brennan brought to my attention the following post from the MD Board:At its General Session Meeting of 1/13/2011, the Board of Chiropractic & Massage Therapy Examiners announced that it would forthwith withdraw from the rulemaking proposal Chapter 16 (Recordkeeping) and Chapter 20 (Continuing Education) pending further review and study. Both of these chapters were contested in comments received to date. This means that Chapters 16 and 20 will not be processed further in the current rulemaking proposal.

When further review and study of Chapters 16 and 20 is scheduled, details shall be posted on this website and in the Maryland Register.

That is the best demonstration of what can happen when MTs rise up and take ACTION! Legislators are forced to LISTEN! Kudos to Maryland Chapter of AMTA and all the MTs who protested this move!

Male Massage Therapists: Survival of the Fittest

According to surveys by our professional associations, males account for less than 20% of massage therapists. From the personal experiences I’ve had with teaching male students, having male therapists in my own practice, and serving on a state board, I’ve made a few observations. I think males definitely have a harder row to hoe when it comes to making a living in massage therapy.

I’ve employed a couple of male therapists over the years who practiced advanced modalities. I’ve had a therapist who practices Structural Integration traveling from out of town to work at my place for six years. I’ve also in times gone by employed a male who did orthopedic massage. Both of them had a much easier time getting new clients than did the male therapist who didn’t have a specialty.

I live in a small town, and have found that many women don’t feel comfortable getting massage from a male; many women wouldn’t mind getting massaged by a male, but their spouse doesn’t want them to, and a whole lot of homophobic males won’t get a massage from a male.

As for male therapists getting in trouble with the board, in the past four years that I have served our state board, only one woman that I can recall has been brought in for a hearing on an ethics charge, but there are males having disciplinary hearings at nearly every meeting.

There have been several times when I didn’t think a male therapist who had been accused of something was guilty, but I was voted down by other board members. When it’s a sexual offense, I believe there is a tendency to err on the side of caution, and the standard of proof is not what it is in a regular court of law. I also believe there are plenty of women out there who are violating the code of ethics, but a lot of men won’t complain about being offered sex along with their massage.

All that being said, I look at some of the people who are at the top in this profession, and many of them are men. Erik Dalton,Whitney Lowe, James Waslaski, Tom Myers, Benny Vaughan, John Barnes, John Upledger…the list goes on, and if you stack up the women who have that same kind of name recognition, it’s probably about equal–amazing since over 80% of the profession is comprised of women. Maybe there’s a glass ceiling in massage. If you look at their class schedules, a lot of those esteemed fellows are on the road more than they’re at home. We women tend to nest a little more. Somebody has to keep the home fires burning!

I wonder about the percentage of males who leave the profession because they can’t make a living as opposed to the number of females who do that. I feel for them. The males I’m acquainted with who are successful have had a lot of perseverance. I recently had a black gentleman in one of my classes who has been practicing more than 40. I told him I bet he was the first one in North Carolina. I was thrilled he came to my class. After 40 years, you’d think our state board could lighten up on the continuing ed requirement!

To all the male therapists who are trying to contribute to this profession, I salute you. If you really want to do this, I believe you can make your way. Professionalism will eventually overcome outdated perceptions.  Don’t give up too soon.

Peace & Prosperity,

Laura Allen