Each therapist, based on their background, will have different interpretations, ideas and uses of Medical Massage. My background comes from Massage School (CCMT), graduated 8/2002, straight into a Medical Massage Program at Hartford Hospital CT, after doing a clinical (field course) at the same place, graduating 1/2003, plus 30 years in Emergency Medicine, including working as a Paramedic.

My view of Medical Massage is to use massage techniques for medical purposes, to reduce or remove pain and disability. All massage work intends to increase health when possible. If one continues to receive massage after reaching some ‘health’ target, the client can become ‘healthier’, that means it takes longer for any harmful actions to manifest.

Ideally a person will notice signs or symptoms and take action then, before they turn into disability, which, if left untended, becomes diseased. Stretching out this decline allows more chance for an intervention to occur and succeed.

Before starting a program of medical massage, even if it is just one massage, a good medical history is advised, as the origin of the problem can come from many sources such as trauma, disease, nutrition, work history, sleep position, and more. Other pertinent factors are surgeries, medications (past and current), supplements taken, allergies and psychological values.

Some conditions preclude the application of specific massage techniques, others must be used with caution, such as diabetes or stroke, where the client’s sensitivity can be impaired. Some require shorter massage sessions.

Unlike most regular massages, pain may occur despite efforts to proceed slower and gentler, the client may be actively involved rather than lie passive on the table, a relaxation may occur as a side effect of regained mobility rather than the application of soothing strokes.

Often a client shows up because the regular medical system has not succeeded, as when it does succeed, there’s no reason to seek a medical massage. Sometimes a client shows up because they can’t afford a regular medical treatment or can’t afford the insurance, but that’s different. Sometimes a person is told by a doctor to ‘live with it’. Such situations can be challenging, the solution not obvious, else it would have been tried before in physical therapy. Being a medical massage therapist can then be like a detective, hands-on, finding clues, keeping an open mind, trying and evaluating results, seeking an ‘ah-ha!’ moment. Sometimes it’s just a long series of incremental steps, recovering from years of dysfunction, slowly passing through ever healthier states, maybe some plateaus.

A better medical massage therapist will have taken classes, learned modalities beyond what is taught at school. I have taken 4 Visceral Manipulation courses (Abdomen I and II, Thorax and Pelvic), Craniosacral and a couple of myofascial classes. Self-taught Nerve techniques for the upper and lower extremities. There are many courses out there, many modalities, go on-line and read about them to find out what might work for you, or, call a therapist and ask. One web-site is iahp.com which lists about 20 modalities and lists those therapists nearby to your zipcode. Call and ask, get a second opinion.

Energy work is also a massage category, with many variations, most people will have heard of Reiki, my version takes many forms, mostly in the area of ‘listening’ or ‘feeling’ what a client is experiencing and communicating with an injured body part. There can also be a Shamanic component, one more activity I’ve taken classes in.

And then there’s the clients. They teach us. We solve new problems, rare problems, and sometimes stumble into solutions. Each therapist has unique work experiences. One of my clients was trying to avoid neck surgery. After months of work the client decided to go for surgery. What might have been viewed as a failure was not, as the client was described as ‘the poster child’ by her doctor for that surgery, recovering in one third of the time most people took. Everything around the problem site was so healthier it didn’t take long to heal. Another client came to me expecting to be wheel-chair bound within 6 months. Eight years later she was still walking, no cane needed, and no expectation of needing a wheel-chair.

It’s all fascinating work, and when I’ve done my job right, you don’t need me, don’t need to keep coming back. Maybe you’ll be doing the occasional stretch when a symptom pops up, but I’ll have educated you as to simple things to do to stay healthy.

P.S. Craniosacral as a modality usually takes longer to do, 75 minutes rather than 60 minutes, so the charge for that is higher.

Paul Rice

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