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A Golfer’s Worst Nightmare Rehabilitated Through Massage

February 15, 2023 by Leave a Comment

For many golfers, the only meaningful way to spend a sunny day is out on the links. With 18 holes to look forward to — the sun’s rays caressing the greens, blue skies inviting deep breathes, and the warm leather grip of a favored club in hand — nothing much can break their joy of being alive.

Until, that is, pain strikes. Pain in the physical sense such as a muscle tear or unstable joint, or the pain they feel from a continually declining game performance. For a die-hard golfer, the two pains are equally worrisome. And, left unresolved, grow to become their worst nightmare: the end of their golfing and no more need for sunny days.

Massage therapists are all well aware that, as the human body ages: muscles atrophy, tissues lose elasticity and overall flexibility declines. What many therapists have yet to fully understand, however, is that static stretching of muscles is rarely enough to correct these affects (Siff and Verkhosansky 1993, Siff 1994, and 1998). And even dynamic stretching is an incomplete course of treatment for many of our clients — especially those who golf.

Kinematic Sequencing and Therapeutic Improvements

To effectively assess and treat the unique needs of a golf client requires that the therapist first acquire an advanced knowledge of body dynamics, namely, the kinematic sequencing of the golfer’s body.

Kinematic sequencing refers to the specific order that the body engages its muscles, bones, joints and balance to perform a movement. In our golfing clients, the movement is striking the ball.

For an efficient golf swing to take place, the process of kinematic sequencing looks like this:

  • First, the pelvis is engaged and rotates towards the ball.
  • Second, the trunk engages and follows the pelvis.
  • Third, the arms engage and follow the trunk.
  • Fourth, the hands and club follow the arms until the ball is struck.

Once the ball is struck, the body again engages in a kinematic sequence, this time of deceleration, with the pelvis engaging first, followed by the trunk, followed by the arms, followed by the hands and club. That is good sequencing.

As massage therapists, the better we understand kinematic sequencing — especially in our rotational athletes who play golf, tennis, baseball, bowling and soccer — the the better we become at assessing our clients’ pains, restrictions, limitations and frustrations.

And the first step to better assessing our clients is to perform better evaluations. Specifically, how they present when they take a static posture and when they take a dynamic posture as they describe their pains, restrictions and issues.

Static posture is, of course, the position of the body at rest, sitting, standing or lying down. This is typically what we see most often as massage therapists. Our clients sitting or standing before us or perhaps already laying on the table as they describe their pains and wait for us to treat them.

Dynamic posture, on the other hand, has the patient: move, twist, lift, pull, push and balance in order to reveal the likely causes of the client’s pain or imbalance. The difference in evaluating your client’s condition using dynamic posture as well as a static posture is often the critical and missing step in properly assessing and treating our patients (Doctor Vladimir Janda “Upper and Lower Cross Syndrome” 1979, cited in Lewitt 1999).

To only evaluate your client in a static posture would be missing the holistic nature of human dynamic motion and posture. Sure, you can look at a left hip internal rotation when your client is on the table and find a deficiency of say 15-20 degrees, but that won’t give you an accurate picture of what’s really affecting the golf swing until you ask your client to stand up and perform the very movement that causes the trouble. So to replicate the golf swing, you must ask your client to do an internal rotation so as to move the trunk over the hip.

Frankenstein on the Golf Course

Here’s an example from my own clinic. I recently had the opportunity to work with a golfer who had bilateral hip replacements, a right knee replacement, and a left shoulder injury that was never repaired. I hate to say it, but he walked like Frankenstein and, as you can predict, his traumas lead to a continuing decline in his game performance.

When golfers ready themselves to strike the ball they bend their knees into a semi-squat formation. So to properly assess my client’s condition, I asked him to squat, slowly, all the way into a chair. And as he did so, I observed his ankles, knees, hips, trunk and motor control. I then asked him to stand on one leg. His ability to maintain a one-legged posture lasted less than three seconds. I also noted that he could not even begin to touch his toes; and he had limited trunk control, pelvic and spinal rotation. He had a forward head posture, kyphosis, and evaluation of his left shoulder joint presented the arm well in front of his ear instead of the proper placement which is beside or behind the ear. As you might infer, he clearly needed better flexibility. But, because of his hip prosthetics, it would be inadvisable to stretch his hips into internal rotation.

For this client, I began by making a basic golf movement better. Namely, the squat. Simply by teaching him to use his hips better, it allowed him to stay in a golf posture longer which helped with his swing path, tempo and striking distance — and his enjoyment of the game. We always combined our sessions with manual therapy, focusing around the hip rotators, to help him improve his hip hinge.

If you are ever presented with a client suffering with similar impairments, begin by writing down your assessment of how each muscle is affecting the joints in the lower extremities. Look at the flexibility of the feet as they relate to overall stability during weight shifts. Create more ankle mobility by addressing the dorsiflexors and removing myofascial restrictions. Check the client for the ability to do inversion and eversion of the ankles. Attempt to lengthen the quads, hamstrings, adductors, IT band, gluteals and psoas. Your goal is to increase the length of the flexor chain and increase strength to the extensor chain.

Once you’ve completed all of the above, recheck the client’s movement by asking your client to perform another squat or the movement pattern that is causing the concern. If your client has yet to improve, it may indicate that just stretching the lower extremity is not enough. Adding mobility without adding stability may not change the movement pattern. You may need to become a teacher of the squat. Put a chair behind the client, have them do an isometric press into their hands to activate the core, and teach them to hip-hinge back into the chair. Then repeat your manual therapy and re-check your client’s range-of-motion. Continue to do this as many times as necessary throughout the session to reveal how much your client’s motor control is improving. You will often see minor improvements during the first session and noticeably bigger improvements during subsequent appointments.

This is the protocol I implemented with my own client and he improved dramatically. In just three months, I had him transform his gate from that of a B-movie monster to that of a young man walking with a kick in his step. He also lowered his golf handicap, feels younger, stands taller and more importantly . . . he is now free of his worst fear — that of believing that he’d never again enjoy playing 18 rounds of the great game of golf.

References

  1. Supertraining: Yuri Verkhoshansky and Mel Siff.
  2. Manipulative Therapy in the Rehabilitation of the Locomotor System: Karel Lewit, Third Edition 1999.
  3. Superstretch : Mel Siff 1994.
  4. Facts and Fallacies of Fitness : Mel Siff 1998.
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Why Do My Muscles Feel Tight?

February 13, 2023 by Leave a Comment

Why do muscles feel tight? Does that mean they are short? That they can’t relax? And what can you do about it?

Here are some of my thoughts about why muscles feel tight and what to do about it.

Tightness is a Feeling, Not Just a Mechanical Condition
If you say you feel “tight” in a particular area, that might mean several different things:

Poor range of motion.

Or maybe range of motion is fine, but movement to the end range feels uncomfortable or takes excess effort.

Or maybe the problem isn’t really with movement, but just that the area never reels feels relaxed.

Or maybe the area feels basically relaxed, but has some vague sense of discomfort – a feeling that is unpleasant but too mild to be called pain.

This ambiguity means that the feeling of tightness is just that – a feeling – which is not the same thing as the physical or mechanical property of excess tension, or stiffness, or shortness. You can have one without the other.

For example, I have many clients tell me their hamstrings feel tight, but they can easily put their palms to the floor in a forward bend. I also have clients whose hamstrings don’t feel tight at all, and they can barely get their hands past their knees. So the feeling of tightness is not an accurate measurement of range of motion.

Nor is it an accurate reflection of the actual tension or hardness of a muscle, or the existence of “knots.” When I palpate an area that feels tight to a client (let’s say the upper traps), they often ask – can you feel how tight that is?!

I often say something like:

Ummmmmm …… no. It feels just like the surrounding tissues.

But I completely understand that it FEELS tight in this area and you don’t like it.

I don’t like the feeling of tightness either so I want to help you get rid of it. But the feeling of being tight isn’t the same thing as that area actually being physically tight. Make sense?

This actually does make sense to most people, and they find it mildly interesting. I want people to understand this because it might help them reconsider a misconceived plan they may have already developed for curing their tightness – such as aggressive stretching, fascia smashing, or adhesion breaking. So now they are willing to consider an approach that is a bit more subtle than driving a lacrosse ball halfway through their ribcage.

Why do muscles feel tight if they are not actually tight?
So why would a muscle feel tight even if it physically loose?

I think we can use pain as an analogy. Pain can exist even in the absence of tissue damage, because pain results from perception of threat, and perception does not always match reality. Pain is essentially an alarm, and alarms sometimes go off even when there is no real danger.

Perhaps a similar logic is involved in the feeling of tightness. The feeling happens when we unconsciously perceive (rightly or wrongly) that there is threatening condition in the muscles that needs a movement correction.

So what is the threatening condition that a feeling of tightness is trying to warn us about? Surely it is not just the presence of tension – muscles are made to create tension and we often feel tightness in muscles even when they are almost completely relaxed.

So tension is not a threat, but the absence of adequate rest or blood flow is a threat, which could cause metabolic stress and activate chemical nociceptors. So the problem that a feeling of tightness is trying to warn us about is not the existence of tension, but the frequency of tension or the lack of blood flow (especially to nerves, which are very blood thirsty.)

With this in mind, I think of the feeling of tightness as a variety of pain, perhaps a pain too mild to deserve being called pain. But it is definitely bothersome. And it has a certain flavor or character that motivates an interest in changing resting posture, or moving around or stretching. Which is different from certain pains, which often make you want to keep still. Maybe we could say that pain is warning us to not move a certain area, while tightness is warning us to get moving.

https://www.bettermovement.org/blog/2015/why-do-muscles-feel-tight

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3 Tips To Foam Rolling Success

February 10, 2023 by Leave a Comment

Foam rolling is very popular. Athletic trainers use it as a part of the warm-up. Physical therapists use it as part of their treatment strategy, often to improve extensibility of “short” tissues. There is very limited evidence about what benefit, if any, foam rolling confers. But there are a few studies showing it leads to short term increases in range of motion that are not accompanied by strength loss. (This is interesting because stretching interventions tend to show increased range of motion that are associated with a loss of strength and power.)

The purpose of this article is not to question whether foam rolling is effective for anything. I’m willing to assume it works in some way for some people. It is hard for me to believe that so many intelligent trainers such as Mike Boyle would be singing its praises unless it was good for something. So I’ll give it the benefit of the doubt for purposes of this article.

The question for this post is the following: if foam rolling can actually reduce pain or improve mobility, what is the mechanism? I do not find the common explanations very convincing. But there is one (less commonly heard) explanation which I really like. Here’s my critical analysis of the different theories for why foam rolling works, including my favorite one.

1. Does foam rolling “improve tissue quality”?

This is one we hear quite frequently, usually without any specifics as to which “qualities” are at issue. I think some people imagine that foam rolling can smooth out bumps in their tissues like a rolling pin over pizza dough. To be fair, this explanation is usually intended for lay people and not scientists, so we can cut some slack about the lack of specifics. Perhaps the qualities to be improved involve the presence of fascial adhesions or trigger points. I’ll address those claims specifically below.

2. Does foam rolling lengthen or “melt” fascia?

For some reason people just tend to assume that foam rolling works by changing the fascia. I honestly have no idea why. A foam roller puts pressure on all the other tissues in the body, and they all communicate with the CNS, which controls how we move and feel. Isn’t the CNS the most obvious place to look for changes after foam rolling?

No, it always has to be the fascia.

But fascia is tough stuff. Sure it has some interesting adaptive properties, but at the end of the day its purpose is to form a solid structure for the body. Is it really plausible that we can significantly change our structure just by leaning on a foam roller a little bit? We must be made of stronger stuff than that. If fascia started to break down, or elongate, or “melt” every time it felt a little sustained pressure, we would be pretty fragile creatures. Every time we sat on a rock our posterior chain would lengthen. So for me the idea that foam rolling lengthens or melts some important structural stuff in our body does not pass the common sense test.

And, more importantly, the research does not support this idea either. There are a few research studies which try to determine the degree of pressure necessary to cause permanent deformation in mature human connective tissue. The upshot is that if you want permanent change, you better be prepared (as Paul Ingraham notes) to “get medieval.” Steam roller maybe, foam roller, no. It’s not going to happen in any of the places where the roller is most commonly applied, which are usually the strongest parts of the body – the ITB band, lumbar fascia, plantar fascia, etc.

 3. Does foam rolling break up fascial adhesions?

Maybe a foam roller can’t lengthen the IT band, which is stronger than steel, but could it break up some little fascial adhesions that prevent sliding between different muscle groups? One of the studies I referenced above show that manual pressure might be enough to deform nasal fascia. Now I don’t see many people foam rolling their nose, but maybe there are tiny little adhesions between large muscles groups that are as weak and deformable as nasal fascia.

Again this seems highly speculative to me. How do we know where these adhesions are, or what angle will help break them? A foam roller is a blunt non specific instrument that delivers force in a diffuse manner into the tissue. Smash! Part of the job of fascia is to diffuse force, so it would be hard to target a specific point here. Also, the angle of pressure is always straight in. The foam roller would have limited ability to provide the kind of precise oblique force that might be able to slide one layer of tissue with respect to the other.

Another problem I have with the idea that foam rolling breaks up fascial adhesions is that the effects are often temporary. People do some foam rolling, they feel better for a while, and then tomorrow or even later that same day, they feel the need to roll the same area again. If the mechanism of effect is breaking fascial adhesions, then why do we need to repeat the process? Did the fascia knit itself back together again? The temporary nature of the results strongly suggests a nervous system mediated mechanism for efficacy, not a structural one.

3.  Does foam rolling get rid of trigger points?

Many foam rolling proponents explain that proper procedure involves finding a “trigger point” and staying on that point for a while. Is foam rolling a way to treat trigger points?

It should be noted that the term trigger point means different things to different people. For some it just means a sore spot, but for others it refers to a specific pathology. The technical definition involves several elements such as a hyperirritable nodule within a palpably taut band that elicits a twitching response to snapping palpation. Trigger points are thought to be caused by some sort of metabolic crisis in the muscle cells which causes chemical irritation in the local area and for some unknown reason refer pain to other areas when pressed.

Trigger points are controversial to say the least. There is substantial debate as to whether they even exist. Whether they can be reliably identified is another debate. And whether they can be effectively treated is another. There are many recommended treatments – stretching, post-isometric relaxation, sticking needles into them, pressing on them, etc. I definitely don’t have the time or anything approaching the knowledge to address all these debates.

But given all these uncertainties, I’m disinclined to believe that foam rolling works by getting rid of a trigger point. There are just too many unanswered questions here. The experts in trigger point therapy will tell you that not every sore spot is a trigger point, that not all trigger points are clinically relevant, and that their identification and treatment takes practice and expertise. So I don’t think shotgun fascia smashing with a foam roller is a plausible trigger point treatment (assuming they exist and can be treated with pressure.)

This article was taken in part from https://www.bettermovement.org/blog/2013/how-does-foam-rolling-work

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Massage for Cancer Patients in the News

January 30, 2023 by Leave a Comment

The benefits of massage therapy for cancer patients were communicated by an ABC affiliate serving Virginia, on March 5.

In “Cancer Patients Get Boost from Massage Therapy,” breast-cancer patient Sandy Briggs’ journey through chemotherapy—a journey on which she discovered massage—is detailed.
“After a successful lumpectomy, doctors told Briggs she’d need chemotherapy and it was at that time that she discovered massages at Rockingham Memorial Hospital’s Image Recovery Center,” the article noted.

“As a retired teacher, Briggs had read book after book about cancer, but never did she think massage therapy would play a role in her treatment … [b]ut the massages helped Briggs through her 7 months of treatment and she says now as a cancer survivor, life has so much more meaning.”

Read the article at www.whsv.com.

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Massage Therapy Research

January 25, 2023 by Leave a Comment

Over the past several years, research on massage therapy and bodywork has been conducted in isolated studies throughout the country. For the most part, these research studies are funded for the purpose of publishing the results in medical and similar style journals.

In other words, the promotion and facilitation of research on various massage therapy and bodywork modalities seems to be targeted at proving the validity of our profession to the wider allopathic and complementary medical communities. While this is a fine and respected endeavor, the positive results of these research studies are getting filed in medical journals and talked about in medical venues but fail to reach the people who could use it the most: massage therapists and consumers.

Why Should You Care?

Why should research and its results be important to massage therapists? Massage therapists educating themselves on research results are able to take that information and share it with their clients. Having that research knowledge gives us a logical platform to stand on when talking about the benefits of our work. Imagine showing your client, through research, that the very disorders and conditions they (or their loved ones) suffer from can be addressed through therapeutic touch. Think of the vast opportunities that will open up to reach a much wider audience.

Results of massage studies show valuable information on how therapeutic massage and bodywork can provide relief and healing to those suffering from chronic pain, emotional distress and various debilitating diseases and disorders. In other words, it gives all of us power behind our long-held beliefs that massage does impact the human body and psyche on so many levels.

Research Resources

Through the work of the Massage Therapy Foundation (MTF), information about proven benefits of massage has begun to trickle down to the national therapist community and a small percentage of the American population. The Massage Therapy Foundation has a research database of 4,800 records on massage research and projects. The institutions that have conducted some of these projects include:

Mayo Clinic
Boston Medical Center
Yale University
Children’s Memorial Hospital
St. Jude Children’s Research Hospital
Harvard Medical School
Children’s Hospital Los Angeles
Touch Research Institute
The Touch Research Institute (TRI) has more than 100 studies on massage and its effects on several disorders and conditions including anorexia, bulimia, arthritis, carpal tunnel syndrome, depression, diabetes, fibromyalgia, insomnia, and post-traumatic stress disorder. Many results showed a decrease in stress, increase in immune function and decrease in pain created by the above conditions. The results of these studies are available to anyone by simply visiting the TRI Web site.

Call to Action

For massage therapists, understanding research study results is powerful in several ways. The knowledge makes you personally aware of how your profession is growing and expanding. It gives you something to share with new folks to build your practice. With this knowledge, you can further serve your existing clients as well.

So, the call to action is this: make a commitment today to developing your awareness of research studies and learn how you can personally support future studies. Learn where to access this information (such as the resources mentioned) and commit to reading and understanding a study each month. Then, find a way to communicate to existing and potential clients what you learned from the study.

One way you can do this is to find a piece of research that fits a specific disorder/disease connected with a support group. Once you thoroughly understand the research study, reach out to a local chapter of the support group and offer to speak on the information you have.

You can be the conduit between research and consumers. The valuable information you share can help those folks live with less pain and stress. Remember, because of our education in various sciences of the body, we have an easier time reading and disseminating medically written papers. We have the ability of taking the language of research and boiling it down into simple and understandable terms.

On a more personal note: I encourage you to support the Massage Therapy Foundation. Pledge a donation to help MTF continue its valuable work in supporting research and community outreach projects. Even a small annual donation of $20 will have an impact, so give what fits your budget. Visit MassageTherapyFoundation.org for instructions on donations and to discover how you can become personally involved as well.

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Massage Education’s Future

January 19, 2023 by Leave a Comment

Education is a sensitive and divisive topic within the massage therapy profession.

On one side of the argument are those who believe that today’s non-degree vocational school system is both egalitarian and in line with traditional massage therapy practices.

On the other are those who believe the current system penalizes those who want to become full participants in the health care industry. They advocate for an educational spectrum that also includes bachelors and advanced degrees. But while some form of tiered credentialing seems to be the preferred solution on both sides of this argument, it seems there are many directions for that path to take.

“I know there’s a segment of the massage population that wants to increase the hours and scope of practice for massage therapists. They want to see more evidence-based massage research and more acceptance by the allopathic medical field,” said Cherie Sohnen-Moe, WIBB blogger, author and business coach. “While I would like to see this as an option, I don’t want to see it as the main path for massage. If we do this, we will be pricing massage out of the range of the average person. As it is, most people claim they can’t afford a massage on a regular basis, if at all.”

massage education Monetary arguments can be powerfully persuasive in a profession where the average salary can hover around $30,000 per year for experienced therapists and around $10,000 per year for a first-year therapist.

“The more training you require for entry, the higher the cost of the training, the more evidenced-based you need to be to justify it, the more people you eliminate from practice and the higher the cost to the consumer,” said Keith Eric Grant, senior instructor of sports and deep tissue massage at the McKinnon Institute in Oakland, Calif., and a board member of the California Massage Therapy Council.

However, others suggest that advanced degrees can present new and important opportunities for therapists and consumers.

“Having advanced degrees available in massage therapy will open many doors for us in the research world and in the public health policy world,” said Ruth Werner, President of the Massage Therapy Foundation. “It is so frustrating to realize that right now we are missing out on a once in a lifetime opportunity to be in on the beginning of a new health care paradigm that encompasses preventive care and wellness. We’re doing our best, but it is an uphill battle largely because of this educational disparity.”

Portrait of the Profession

Most therapists today are female, in their early 40s and enter the profession as a second career, according to recent studies by the American Massage Therapy Association (AMTA) and market research done by Massage Today. The industry itself was estimated to be $12 to $17 billion in 2010. According to a 2010 U.S. Department of Labor estimate, employment for massage therapists is expected to increase 19 percent from 2008-2018, faster than average for all occupations. According to the AMTA study, between July 2009 and July 2010, approximately 48 million adults received a massage at least once.

Most therapists work an average of 15 hours a week providing massage (this includes time spent on other business related tasks). Therapists charge an average of $60 for a one-hour massage and earn an average wage of $41 an hour (including tips) for all massage-related work. The AMTA study also found that today’s therapists are heavily reliant on repeat business. The average annual income for a massage therapist in 2010 (including tips and working approximately 15 hours per week) was estimated to be $31,980.

Current Education and State Regulation

According to the AMTA survey, there are more than 300 accredited massage therapy schools nationwide and nearly 90,000 nationally certified therapists. What does it mean to be nationally certified? According to the National Certification Board for Therapeutic Massage and Bodywork (NCBTMB), to meet this standard, a therapist must demonstrate a mastery of core skills and knowledge, pass an exam, adhere to a code of ethics and established standards of practice and take part in established continuing education standards.

Massage therapists have an average of 660 hours of initial training and take an average of 22 hours of continuing education per year. Perhaps the most interesting piece of information from the AMTA study was that 92 percent of massage therapists strongly or somewhat agree there should be minimum education standards for massage therapists.

An argument can be made that you really can’t look at massage education without looking at the regulation of the industry, as the regulation generally set the educational criteria that must be met. Currently, 43 states and the District of Columbia regulate massage therapists or provide voluntary state certification. And with that certification, a specific educational requirement must be met. However, each state is different in what they require to be considered certified or licensed. For example, the state of Texas requires 500 hours of board-approved education, while Alabama requires 650 hours, Arizona requires 700 hours and the state of New York requires 1000 hours.

Not only are the number of hours different, so too is the mix of classes the various states require. For example, according to the Texas Department of State Health Services, its 500 hours of massage therapy course work must be “directly related to the theory or clinical application of theory pertaining to the practice of massage therapy and the manipulation of soft tissue, massage therapy laws and rules, business practices, professional ethics, anatomy, physiology, hydrotherapy, kinesiology, pathology or health and hygiene.” While the New York State Education Department requires its 1000 hours to be “complete coursework in anatomy, physiology, neurology, myology or kinesiology, pathology, hygiene, first aid, CPR, infection control procedures, the chemical ingredients of products that are used and their effects, as well as the theory, technique and practice of both oriental and Western massage/bodywork therapy. Within the 1000 hours of education, you will have to complete a minimum of 150 hours of practice on a person.”

“I think massage therapy education the way it is today is a natural outgrowth of many factors,” said Werner. “The advent of Title IV funding was, predictably, a blessing and a curse. It actually made massage school more expensive, but also made it more accessible to a wider market. You can also argue that it raised the bar for minimum expectations above what people in my generation of students got from one teacher teaching every aspect of a course.”

It can be argued that with so many accredited schools nationwide and requirements varying from state to state, that this educational environment only seems to perpetuate the problems involved in portability and the perception among other health care professionals that massage therapists might not be qualified to be a contributor on the health care team.

Grant believes more needs to be done in the current system before degree programs should be considered. “Current 500-hour requirements are very vaguely defined in terms of evidence-based outcomes. If we are truly interested in credibility, then we have a lot more that can be done in terms of validity and reliability (consistency) within the hours we already are requiring,” Grant said.

Werner agrees that standardization is important. “One major factor is that each accrediting agency has different standards and schools often choose whichever is the least expensive to work with, or the least expensive to comply with. I don’t know much about the accrediting process, but I know that some accredited secondary or vocational school systems don’t have requirements about the order in which people take classes — they just put people in the stream and hope for the best — then you get students who are learning deep tissue massage before they learn anatomy. Who thinks that’s a good idea? But the institution is accredited and it’s the cheapest way to put people through the system, and who gets short-changed? The student.”

Ralph Stephens, a nationally recognized massage therapist, author, and continuing education provider believes that, “until we have standards for massage therapy instructors, degrees will not in and of themselves accomplish much of anything.” Stephens thinks any changes made in education must be done with one question in mind, “what will provide the public with a better massage?”

The Debate

The issue of portability has been a longstanding thorn in the profession’s side for many years now. One possible solution being considered is tiered credentialing, that is, a system that includes college baccalaureate degrees and beyond.

“Their was a time when I felt like our profession could not handle tiered credentialing because it is just so hard to organize massage therapists,” Werner said. “But as I have seen more [through my work with the Massage Therapy Foundation] about what the potential for our profession is if we make the opportunity for people who want to pursue advanced education — but we should not require it.

“I’m determined that however our profession moves forward when we think about the evolution of our education, there needs to be space for people who are not bookish, but do their work and they do it brilliantly, as long as they do it safely. But what we’re missing now is space for people who are bookish.

“Right now, if you want to get an advanced degree in massage, what we’re talking about is a master’s or PhD in public health, nursing, psychiatry or gerontology. Those are the only advanced degrees I know of. It’s time for us to have bachelors, masters and doctoral degrees in massage therapy — and not for everybody — but for the people who want to do it,” Werner said.

However, not everyone feels this is the best move forward for the profession.

“Our traditional medical system is a failure, why jump on that boat when it’s sinking?” asks Sohen-Moe. “In terms of baseline requirements, it does not take a rocket scientist to perform a safe, effective massage. While I am personally an advocate of lifelong learning and would hope that practitioners would choose programs that offer some depth as well as breadth, basic programs need to be offered.”

Stephens wholeheartedly agrees. “We need to reach the public with a better product as an alternative to the allopaths, working with other alternative providers to challenge the monopoly of the pharmaceutical-allopathic cartel.”

However, this leads to the question, if an expanded scope of practice were offered with degree-level training, which theoretically leads to more acceptance by the allopathic medical field, would more patients seek out massage as an option for care of pain management or musculoskeletal issues as opposed to seeking out a prescription for drugs? Ultimately, would this type of program lead to more acceptance in the mainstream health care community and are massage therapists ready to play in that field?

Ruth Werner absolutely thinks so. “There is a new emphasis on wellness and prevention and massage deserves a seat at that table and can absolutely play in that playing field, but if we scream and kick and pound our fists and demand a seat at that table, people with doctorates will look at us and say, ‘500 hours? Really?’

“The amount of money spent on massage therapy research is not commensurate with the amount of money the public spends on it and the reason for that is that there are not enough people who know how to write a good grant proposal,” Werner said. She continues, “the reason there aren’t enough people who know how to write a good grant proposal is because there is not a good degree program for massage therapists.”

Those that feel massage therapy is generally less scientific and more about the art of touch, say that something important will be lost if the profession pushes ahead with an advanced degree program.

“I fear the loss of the art of massage as we swing the pendulum to the scientific aspect of massage,” said Sohnen-Moe. “I’ve already witnessed a lot of that change in the past 15 years. Less and less people get into this field as a calling. I’ve had many technically accurate massages, but the newer practitioners seem to have something missing in their work.

“I think the way to go about addressing the education issue is to have specialty national certifications rather than advanced degrees. While I know this is a difficult and expensive process, I really think it’s the way to go,” said Sohnen-Moe. “We need to make sure our core competencies are there. Board certification is more valuable and gives us much more credibility. Doesn’t it sound better to say, ‘I am a massage therapist board certified in…whatever your specialty is.'”

And yet there are still others who feel the time for action in this area is now.

“There are enough of us who are standing up and saying there is a segment of our profession that needs to step it up and accept those higher standards and stop trying to get everyone to agree because we’re not going to agree,” said Lisa Curran-Parenteau, WIBB blogger and marketing and practice development specialist. “Let that natural separation happen. I love the nursing model. You’ve got nurse practitioners, registered nurses and licensed nurse practitioners and they all have a great vocational opportunity for themselves and they all spent different amounts of money for their education. They have a structure and everybody knows that it is and it’s portable.”

Is it now time for the profession to take responsibility for itself and the direction it wants to go? Is it time for therapists to “step it up” to market themselves and effectively communicate their experience and education? With licensure not required in all states, no portability, no defined education standards or consistent school requirements, does moving to a degree program make the most sense in providing a legitimate platform for qualified and motivated therapists to compete in this evolving health care landscape?

Where do you stand in this debate? Do you think that more people will be dissuaded from entering the profession because of the increase in educational costs if the profession required a degree? Do you think there should be a tier system with a college-level degree as an option? If there was a degree option, do you think more people would choose massage therapy as a first career rather than a second? Do you think a degree would provide more legitimacy in the mainstream health care system?

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Freedom Comes To Massage Therapist

January 15, 2023 by Leave a Comment

Finally… FREEDOM!

To be a professional. Thanks to CAMTC.

Moving to Los Angeles from New York in 2001, had me very excited about my career as a massage therapist. I had just completed two years of massage school in NY and was eager to embark on a new chapter in my life; one of professionalism and compassionate healing. I had envisioned a healthy balance of house calls, with perhaps one or two days per week in a health care setting to supplement my private practice.

 

This daydream came to a screeching halt soon after my arrival in L.A., upon learning that the licensing process was going to be much more complicated and dollar-consuming than I could have ever imagined. I quickly learned that in addition to a business permit, I would need to obtain a massage permit for each city or county in which I planned to treat clients. Each had its own set of fees, regulations, and level of scrutiny. (By ‘scrutiny’ I mean, a lack of respect as a health care provider.) The city of Los Angeles classifies massage therapy as ‘adult entertainment’ under the city zoning laws, and therefore by default, gives as much respect to massage therapists as it does prostitutes. This was a huge eye-opener, after coming from a state where massage licenses are granted by the Department of Education (the same entity which grants medical and teaching licenses). There are some cities in California that require nothing more than an application fee and your signature, without so much as a minimum education requirement! How’s that for professional standards?

 

I realized there would be no point in wasting my energy on wishing that things were different. I simply had to suck it up and choose one city to become licensed in, and accept the fact that I could only practice massage within that city. If I had a larger bank account at that time, I might have chosen to hold licenses in several cities so I could have a broader client base, but I simply could not afford it. Although I felt frustrated and limited within my profession, I conceded to the regulations set upon me and my peers. The house call aspect of my business was quickly hindered, since many of my prospective clients lived outside the geographical limits of my L.A. license. A weekly client of mine, who I used to treat in her L.A. office, asked me if I could come to her house to treat her husband. I had to decline because their home was (a mere 3 miles away) in Beverly Hills, and I did not hold a Beverly Hills massage license. And so it went…

 

I decided to shift gears a bit and rent space in a wellness center full-time, rather than try and navigate the restrictive house-call path. After some time, I began to feel comfortable and more confident as a well-respected bodyworker, establishing a nice following at the center. Then one day, in mid-session with a client who I’d been working with regularly to alleviate chronic sciatica pain, the door to my treatment room suddenly opened as I was momentarily blinded by a sharp beam of light from the vice officer’s flashlight. He demanded to know, “Is that person wearing underwear?” It took me a moment to comprehend what was happening, and another moment to compose myself, after realizing that he assumed something inappropriate was taking place. This was not the last time I would experience this degrading interaction in such a potentially professional setting.

 

It goes without saying, that I was feeling quite disheartened and disrespected as a therapist, when suddenly one day, the sun came out! In September 2008, Senate Bill 731 was passed, which resulted in the formation of the California Massage Therapy Council (CAMTC). I couldn’t believe my ears… I would finally be able to practice anywhere in the state of California once I obtained certification through CAMTC! The application process was simple, and I did not feel like I had to prove to law enforcement that I am NOT a prostitute. This is what I and my fellow massage therapists have been waiting for. With CAMTC statewide certification, we now have the right to practice our profession within the standards set by our fellow professionals, not by the city vice squad. My clients feel more confident knowing their safety is being overlooked by an entity suited to do so; a group of professionals who embody the professional standards required of one to call themselves a massage therapist. Certification renewal with CAMTC takes place every other year, as opposed to annually like most cities/counties. The application process is streamlined and simple to understand, and about half the price of what I was paying annually for renewal.

 

My faith in the integrity of this profession within the state of California has finally been restored. My CAMTC certification boasts much more credibility among my prospective clients than my city permit ever did. I am so proud of what our profession stands for and I display my CAMTC certificate on my office wall with an enormous amount of pride. For those of my fellow massage therapists who are considering CAMTC certification, I can’t recommend it strongly enough. It affords each of us the freedom we need to practice our profession, along with the respect we deserve as health care practitioners. Thank you CAMTC!


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Prevent back, neck and shoulder pain

January 12, 2023 by Leave a Comment

Back, neck and shoulder pain is the natural result of prolonged sitting at work behind a computer, as is bad posture. This can cause headaches and excessive tension in neck, shoulders, arms, forearms, wrists, back, hips, thighs and legs. The result is increased fatigue to the muscles and ligaments supporting the lower back and this can eventually lead to tissue injury and spinal joint dysfunction. Avoid these problems by posture correction, exercise and correct use of equipment.

Symptoms of back problems due to excessive computer use include:

* Back and neck muscle spasm and pain
* Back and neck soft tissue inflammation
* Back, neck and shoulder pain on movement and involvement of other muscles as a reaction
* Referred pain to buttocks and thighs or up the spine

Preventing back and neck pain while sitting is not an exact science as there are many differing opinions on the subject. However, there are some common denominators on which most chiropractors and other medical professionals agree:

Tips to Prevent Computer Related Neck and Shoulder Pain

Do not slouch in front of the computer or lie in bed and work on a laptop.

Do not work for hours in front of a computer without breaks.

Do not ignore back twinges and back pain, hoping that the problem will resolve itself.

Avoid taking pain or anti-inflammatory medication when in pain from using a computer. This will serve to mask the symptoms but can lead to serious injury or permanent nerve damage in the long term.

Do not sit on one leg or sit with legs crossed as this causes additional strain to the back.

Do not perch a laptop on the lap and stare down at the screen – this places extra strain on the neck, spine and arms.

Buy a chair that encourages you to use your back muscles, such as a stool chair with no back or arm rests. Lower back pain can be reduced or eliminated by strengthening the lower back muscles through active sitting exercises.

Buy an ergonomic keyboard and mouse and ensure that the height is adjusted appropriately.

Have a break every hour and do stretching exercises like neck rolls, chin tucks, cupping head in hands behind the head and extension exercises.

Visiting a Chiropractic Clinic

A chiropractor is a medical professional who treats spinal column dysfunction. Back and neck pain may be the result of the back being badly aligned and the chiropractor sets out to relieve the problem by manual manipulation, exercise, massage and the application of heat, cold and light.

Massage Therapy to Relieve Back and Neck Pain

If done correctly, massage therapy can help to relieve back pain and tension. It is best to find a therapist trained in techniques that address back pain issues and has a knowledge of muscle imbalances relating to back pain, such as sports injuries. Massage therapy should never be considered a substitute for proper medical attention where there are serious back problems.

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Learn about the Importance of a Healthy Lymphatic System

January 1, 2023 by Leave a Comment

The lymphatic system is one of the most overlooked systems in the body, despite the fact it plays a central role in your overall health. Keeping your lymphatic system in top shape is an important aspect in maintaining a healthy life.

What is the lymphatic system?

The lymphatic system is a network of vessels that runs through your entire body. Lymph nodes are strategically located throughout the system for optimal performance, and are clustered in areas like the underarms, abdomen and neck.

What does the lymphatic system do?

Your lymphatic system performs the vital function of cleansing the fluid that surrounds the cells in your body by removing impurities and waste products. This process not only protects your body from toxins, but also allows cells in the body to function at their best.

What happens when the lymphatic system can’t function properly?

An unhealthy lymphatic system can have a serious impact on your health. Poor lymph function is associated with fibromyalgia, multiple sclerosis, chronic fatigue syndrome, aches and pains, bloating and poor digestion. Studies have shown that an unhealthy lymph system can contribute to cellulite, fat deposits and obesity as well.

How can you keep your lymphatic system healthy?

Drink plenty of water. The lymphatic system depends on a constant supply of fluid, so it’s very important to drink at least eight glasses of water a day to keep it functioning at its best. Purified or filtered water is the best choice.

Choose healthy foods. Preservatives, artificial sweeteners, refined grains, excess sugar, chemicals and processed foods all put strain on the lymphatic system. Choose foods that are organic, whole and natural as much as possible.

Eat your fruits and veggies. Fruits and vegetables supply the lymphatic system with important vitamins, minerals, antioxidants and phytonutrients. The chlorophyll in green vegetables is especially beneficial to the lymphatic system.

Get your essential fatty acids. Healthy fats are necessary for the proper function of the lymphatic system. Good sources of essential fatty acids include pumpkin seeds, flax seeds, walnuts, almonds and avocados.

Stay active. When your muscles move, they essentially massage the lymphatic system and promote the flow of fluid through your lymph vessels. Regular exercise like stretching, yoga, daily walks and strength training are all great ways to keep those lymph juices flowing.

Practice deep breathing. Like exercise, deep breathing promotes the movement of fluid through the lymphatic system while providing it with fresh oxygen.

Take echinacea, wild indigo and goldenseal. These herbs support immunity and help cleanse the lymphatic system. These should be used as part of a cleansing period lasting for about 2-4 weeks, one to three times per year.

Get a massage. Massage stimulates the lymph nodes and helps promote fluid movement in lymph vessels. Lymph drainage massage is especially supportive of the lymphatic system.

Relax in a sauna.A weekly hour in the sauna or steam bath can facilitate detoxification and take some pressure off the lymphatic system.

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Discover the Therapeutic Benefits of Massage

December 26, 2022 by Leave a Comment

The health and wellness benefits that massage offers are more abundant than once thought. Emerging research points to a growing list of advantages that range far wider than simple anxiety, tension, and pain relief.

One of the most interesting benefits uncovered is a possible link to improved immunity. Studies have shown that those who receive regular massage have lower cortisol levels in their saliva. Cortisol is the “stress” hormone, and it is linked to a lower immune function.

Cortisol actually kills off the cells that are necessary for healthy immunity. Lowering this hormone in the body not only can lead to greater immune response to foreign invaders, but it also leads to lower stress and anxiety levels. Lowering cortisol levels has also been linked to a greater ease in losing weight and keeping it at a healthy level.

The mental health benefits from lowered stress levels and regulated anxiety are probably worth it alone. However, there are even more advantages your body reaps from getting massaged regularly.

Studies have indicated that regular massage helps with hypertension. Massage helps reduce anxiety, which contributes to high blood pressure. This is probably a part of the reason that it helps to regulate blood pressure.

However, there is also another factor that contributes to this function. The vagus nerve actually helps regulate a person’s blood pressure, and massage helps to stimulate this nerve into action.

The more obvious benefits of massage are its excellent ability to temporarily reduce and manage pain. It can be used to relieve muscle pain, pain associated with nerve damage, and even joint pain. The manipulation of the soft tissues helps increase circulation, which may aid in healing as well.

Enhanced circulation also leads to better skin tone and healthier soft tissue. This enhanced circulation and manual pressure also helps to deliver oxygen and vital nutrients to the cells.

Massage is even believed to help enhance the elimination of toxic substances which are transported out of the body by the lymphatic system. This lymphatic drainage, while beneficial, needs to be helped along by you. Hence, it is always recommended that one drink plenty of purified water after a massage, to push the toxins through the elimination process quicker.

Overall, massage is a great way to reduce stress, unwind, and enjoy some “you” time. It’s important to remind yourself of the other benefits that massage offers if you start to feel a little guilty about it. Massage can be an excellent complement to an otherwise healthy lifestyle and diet.

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