Published in Vol 1 Issue 26 The Art of Healing
Being a massage therapist is a unique experience. Aside from being able to help others, it gives you the opportunity to educate people about how their bodies function, as well as developing and maintaining a connection that supports and heals another human being.
As a massage therapist I am very passionate about what I do. For me it is an honour to be able to share my knowledge, skills and experience with my client base. Each client is not only an opportunity for me to give of myself and my knowledge, it is also an opportunity for me to learn more about the interplay between function and form, how our bodies react to overuse, under-use, stress, illness, injury, emotional upheaval and life in general. I feel privileged to have helped so many people over the last 11 years, and the knowledge that I have gained from these individuals has helped make me a better therapist.
Getting Real about Massage
Massage therapy is about more than simply putting your hands on a body. Few people understand the benefits of massage therapy and what regular massage can offer them. Fewer people again have any idea of what it takes to become a remedial massage therapist. Many people still view massage therapists as being somewhere between tree hugging, dolphin loving hippies and a salacious dominatrix from the adult film industry. Neither analogy is accurate. Both undermine our professionalism, dedication and training which we strive so hard to achieve. These backward concepts frustrate and anger me. It’s time for the industry to step out of the dark ages and take its place alongside other treatment modalities.
Historically, the massage industry has been deluged with unsavoury PR. For example, in 1894 a British Medical Association commission revealed many problems with the standards and practices of the massage industry of the day. Inconsistent training, giving untruthful information about education and experience, patient stealing, and increased fees for service, were a few of the issues that were uncovered. Improper recruitment tactics of students was another issue that had far-reaching consequences. These poorly trained students, once graduated found it difficult to find legitimate employment, and many turned to prostitution to repay their course fees. Hence the association of massage with "massage parlours".
The unfortunate thing is that even though this was over a century ago, the ‘taint’ of massage practice during these times still lingers today. One of the biggest day-to-day concerns we see from clients are their fears associated with receiving a massage treatment from a male therapist or anxiety about being undressed in front of a stranger, regardless of whether that stranger is male or female. Let me assure you that professional massage therapists do not see your body as big, thin, hairy, tall, short. We see form and shape. We also only see the parts of your body that we are working on. The remainder of your body should be covered by a towel or sheet.
What should you expect from a massage?
A professional massage therapist should direct you to dress and undress in the treatment room in private, and a towel/sheet should be made available for you to cover yourself with once you are on the table. Your therapist would normally not come back into the treatment room until you let them know you are ready. Mid-way through the massage when the therapist will request you turn over, the therapist should hold a sheet up to remove you from his/her view. At all times, the therapist should treat the client with the utmost discretion and respect.
Clients need to voice their concerns to the therapist, the business owner, and the relevant association if they feel that any behaviour is not professional or has made them feel uncomfortable. All massage associations have a ‘Code of Ethics’ which their members should abide by. Furthermore every massage course teaches students how to drape (covering body with towels) and manoeuvre clients on a table to protect the client from being unduly exposed.
More importantly if you feel that you have received any unwarranted or inappropriate attention, you need to let the relevant authorities know, such as business or clinic setup then let the business owner or other therapists on staff know, the therapist’s massage association should also be informed and perhaps the Police depending on the nature of the incident. Unfortunately like other professions there are a handful of male therapists whose behaviour and lack of professionalism bring the industry in to disrepute and only help to further the negative stereotypes of our industry. For those of us in the industry however who strive always to maintain our integrity and professionalism we do not and will not tolerate this behaviour!
Back in 1894 the Society of Trained Masseuses was formed which imposed rigorous standards, academic prerequisites, inspections, and examinations on both students and teachers. Similar standards are still upheld within the industry today. In Australia, massage training can be studied through private and public institutions (such as TAFE) and some Universities. National training standards have been implemented and individuals need to be fully qualified and have a current Senior First Aid Certificate before applying to a Professional Massage Association for membership. Only after membership has been granted are they then able to take out Professional Indemnity and Public Liability insurance, as well as be eligible to register as a Health Fund Provider. Massage therapists are also required to complete continuing education and training to retain continued access to professional membership and health fund registration.
When I undertook my course in remedial massage in 1997, I studied anatomy and physiology of the human body, as well as pharmacology, pathology, exercise physiology, and biomechanics. The course included study of the Range of Motion (ROM), gait, postural analyses, and assessment and treatment protocols. We were also trained in the physical application of a range of massage techniques such as trigger point therapy, myofascial release, shifting, digital ischaemic pressures (DIPs), deep transverse frictions (DTFs), effleurage and tapotements. We were also taught the physiological and mechanical effects that these techniques had on the body, and the potential emotional or psychological responses that the client might experience. However, training in massage does differ between institutions, with variations in length of time depending on the type and level of course being studied. For instance a Diploma course may take around 12 months to complete, while an Advanced Diploma or Bachelor may take as long as 3 years.
The purpose of remedial massage is to correct soft tissue (i.e. muscle tissue, ligament, tendon and fascia/connective tissue) dysfunction. Generally, dysfunction arises from overuse (eg. excessive gardening), poor posture (eg. sitting slumped over a desk) or an injury (eg. spraining an ankle). A client will often present with pain (eg. headache), loss of range (eg. stiff neck), poor coordination (eg. walking awkwardly) or muscle weakness (eg. can't lift or carry), or a combination of these symptoms. A remedial massage uses specific techniques designed to affect soft tissue at a physiological level. Often a variety of treatment disciplines including physiotherapy, chiropractic, osteopathy, acupuncture or Pilates may be required, in conjunction with remedial massage, to assist the client back to full health.
For those of us who are charged with bringing our industry out of the dark ages and want to educate the general populace on the benefits of massage therapy, we need the assistance of both lay people and other professionals within the medical community. We need people to support professional massage therapists. So how can you identify a professional therapist I hear you ask? Professional massage therapists will hold the correct qualifications for the massage treatments they provide. For example, a remedial qualification for a remedial treatment, Thai qualification for a Thai massage etc. They should also be members of a professional Massage Association, and someone you ultimately feel safe with and who educates you about your body and the way it functions. A good therapist will tailor the treatment to best meet your needs and will be happy to provide information about previous experience and qualifications.
When you initially visit a remedial massage therapist you should complete a questionnaire or client intake form. This will ask you to outline your previous medical history, any recent surgeries or illnesses, current medications, and your reason for coming for a massage treatment. Over the years so many people have asked – ‘do I need to fill all of this form in?’ or ‘why do you need to know this?’ or simply leave sections blank that they don’t believe is relevant to our work.
People have to understand that massage therapy has the ability to affect every part of the body. While massage therapy is applied directly to the soft tissue of the body (remember soft tissue is muscle, connective tissue/fascia, tendon, and ligament), ultimately the one thing we affect is blood flow and circulation. A massage improves blood flow to the area being treated and also aids blood flow returning to the heart (also known as venous return). Blood flows through every cell in your body. Therefore we have the potential to affect every cell in your body. That is why you are asked the questions you are asked. You may not see the relevance or understand the connection but your massage therapist does.
Over the years I have amazed a lot of clients by being able to describe to them how they use their bodies on a day-to-day basis. Headaches may indicate too much time over a computer with few breaks and poor posture. Tingling or numbness in the toes may be indicative of a lower back injury. The lay person often doesn’t see or understand the connections between the different areas of their bodies. They not only lack understanding about how their body functions but also lack any body awareness. These are the fundamentals of what a quality massage therapist can share with you and teach you.
Not only are we able to surprise you with insight into your regular habits, but a good massage therapist will want to have an understanding of your day-to-day activities, your stress levels and coping mechanisms, as well as your medical history. Personally, I view being a remedial massage therapist as being a “body detective”. I’m forever learning about the relationship between form and biomechanics. At times over the years when I’ve had a particularly strange set of symptoms or patterns of muscle tightness I wish I could follow the client around for the day to help me determine the odd habit that is causing their muscular dysfunction. Did you know that the fall you had skiing 10 years ago where you twisted your ankle and never sought treatment may be the reason you are now having problems with your knee? Or the persistent headaches you’ve had since the death of a loved one could be your body’s way of coping with your grief? Or perhaps your shoulder pain is caused from the ten tonne handbag you lug around on your shoulder every day. A good therapist makes these connections and can educate you on how to better utilise your body to stop causing yourself more harm, pain and injury.
As I’ve already stated massage therapy is about more than just the placing of hands on a body. The body functions as a complete unit and to neglect part of this unit is naïve and potentially undermines the return to wellness or healing of the client. Unfortunately, there have been times when other health professionals have referred clients to me because they have seen massage therapy as their final option. Had I seen the client and their injury when they were first diagnosed, I believe the client would have been returned to wellness at a much faster rate. Luckily we are seeing an increasing number of clients referred from other health professionals and in these cases we are able to work together to help the client achieve the best outcome.
What I also see is that many people give away their power to self-heal to the medical profession. They actually believe something is wrong with them – only because ‘so-and-so’ said so. What I would like to see - and hear, is that other health professionals are explaining the reason for a particular diagnoses to their patients, and that patients are asking questions of their health professional. As professional massage therapists, we are taught to explain how the body works, what treatments we are going to apply, and to what areas of the body. We give our clients post-treatment recommendations and we refer them to other health professionals when we feel that our skills and experience are not going to be enough to return them to wellness.
The medical community needs to appreciate, understand and utilise the skill-set that is available to them from their massage therapy colleagues. I know that going forward we, the massage industry, need to keep educating both the medical community and the lay person about the benefits of massage therapy. I look forward to the day when clients are more often referred for massage treatments than prescribed pharmaceuticals.
About the author:
Lisa Allmey-LaMaitre holds a Bachelor of Science degree (ANU) and an Advanced Diploma in Remedial Massage (CIT). Lisa has been a massage therapist for over 11 years and is the Managing Director of Therapy Masters located in Canberra City. Please visit www.therapymasters.com.au.