Why massage therapists need to change.
Are you one of those massage therapists that are dreading the fully booked day the next day? Are you exhausted physically, spiritually, and emotionally of giving full body one hour massages? Feel like a mindless muscle kneading zombie listening to waterfall sounds all day long?
I feel you my brothers and sisters. I really do. I’ve been there.
As a male registered massage therapist practicing in various health clinic environments and spas in Toronto for the last couple of years, I’ve come to understand why we feel this way.
Let me give it to you straight.
“Relaxation massage” = Palpate the muscles that feel tight and keep holding it, kneading it, compressing it until it relaxes. Lots of lotion or oil. Make it rhythmic and work hard and fast to finish the whole body under the time limit the person paid for.
“Treatment massage” = Assess and plan to balance the RELATIONSHIP between the underlying dysfunctional soft tissue structures (tendons, capsules, ligaments, lymphatic nodules, peripheral nerves, muscle fibres, ACTUAL workable acute scar tissue, trigger points, et cetera). Give appropriate self care practices that are safe and relevant to their chief complaint. Also understanding that not all musculoskeletal conditions can be fixed through soft tissue manipulation alone and accordingly refer patients to appropriate and competent chiropractors, physiotherapists, and other specialists.
Continuing from above , Massage therapists in Ontario are NOT permitted to perform grade 5 joint (High Velocity Low Amplitude) adjustments/mobilizations on patients as it is out of scope of our practice. Yes, it is frustrating and very tempting to crack and pop those thoracic joints but like I said, it is not up to us to fix subluxations or misalignments. Recognize that you could be further mobilizing hypermobile joints and leaving the hypomobile segment still “stuck” – while there may be some muscular relief immediately as the muscle tension resets, the surrounding musculature will become hypertonic in the near future due to the compensatory guarding mechanism (to prevent further misalignment). As the highly skilled father of Gonstead Chiropractor, Clarence Gonstead, once said, “Only fix the subluxations and leave rest of the spine alone. If it ain’t broken, don’t fix it”. I see and hear about too many therapists attempting to perform HVLA techniques on patients & clients, only to leave them in more pain couple of hours later and only to have them afraid of highly effective manual treatment techniques.
We need to be less time = money oriented, more neuromuscular relationship focused, and learn to distinguish through proper and efficient assessment if the cause of the pain or dysfunctional is a mechanical issue or a nervous system issues. If it’s a neuromuscular dysfunction, no amount of external elbow pressure will fix it, in fact I strongly believe this is why some massage treatments are not effective and very painfully forced upon the patient. As Dr. Andreo Spina said in his Functional Anatomy Seminars, “No permanent lasting change can be created with a single input. It needs to be repeated and reinforced over a long duration to make effective, lasting changes that sticks.” It needs to come from the human body itself, internally.
As we are trusted to know and understand how the body’s musculoskeletal operates by the general public, we need to hold ourselves to a higher standard and rise above and beyond the basic standards of soft tissue massage. Only in this way will we be able to gain the respect and the trust of our fellow health professionals (physiotherapists, chiropractors) as well.
Let me know if you agree, disagree, or have any comments! Even just want to say hi 🙂
Until next time,
Brian Donghui Rim, RMT