Terminology in the world of massage therapy can be difficult
to navigate, even for an experienced massage therapist. Where does that leave
the customer? For example: if you know that you have persistent pain, and you
want someone to help you get rid of it, what type of therapy will get the best
results? Do you want sports massage, deep tissue, myofascial, or trigger point
therapy? What are the differences, and do any of them work better than others?
Believe it or not, there is no clear science on this. All the hype you see
spinning around a certain modality is anecdotal, and is usually created by the
people selling that style!
The truth of the matter is that the majority of these titles
are legally unregulated. I have a couple of these titles myself, which I earned
for completing long and complex continuing education programs. When such titles are proprietary,
it is because they are trademarked in order to make money, not help patients.
Anyone, even with the most basic education in massage, can brand themselves as
any of these things. This is a major problem in our industry, since the
customer is left guessing whether they are seeing someone with real practical
skills and knowledge. If I tell everyone to forget about these titles,
I'm going to have to attempt to give the customers (and anyone else) a little
guidance here.
...and this is often contrary to the way our (American)
culture looks at massage.
For one thing, you need to have good communication and
rapport with your massage therapist. This means finding someone whom you trust
and going to them regularly to build a strong therapeutic relationship. Massage
is a type of communication between the hands of the practitioner and the
nervous system of the recipient, and communication is always more difficult
with strangers. With the current focus on getting cheap massages (think
Internet deal sites like Groupon) we have started a race to the bottom in this
regard. The same goes for spas that focus on the trendy add-on services (think
foot scrubs, reflexology, or aromatherapy) rather than the building of
therapeutic relationships. The idea that providing more services creates a
better experience takes you directly into a quantity of quality model.
Also, massage shouldn't be painful. You have probably heard
the exact opposite, and it was probably couched in the myth that massage milks
lactic acid out of muscles, or physically breaks up tissue nodules (knots,
adhesions, trigger points) through deep pressure. This is simply not true. It
bears repeating, massage is a conversation, and painful massage is like trying
to improve a conversation through shouting and intimidation. New therapists are
often very soft in their approach, and after being reprimanded repeatedly, they
either quit massage or learn to give deeper work. If learning to give more
pressure is a good thing, when is there too much of a good thing? There is a
clear line, and when you have studied several dozen modalities as I have, it
begins to emerge as almost universal. Pressure should feel significant, relevant
to the goal, and should not exceed that line.
Science, art, or skill?
There are some basic necessities for any decent massage therapist. Every massage therapist should have a good working knowledge of anatomy, human physiology, and a decent grasp of basic science. Clinical reasoning is absolutely essential and often overlooked. They should have the confidence to evaluate themselves, their practices, and come to rational conclusions about different therapeutic approaches. Also, because our services involve physical touch, an understanding of ethics should not be forgotten once we get into practice. I am increasingly convinced that for best practices, a course in modern pain science should also be required!
I am often criticized for taking too clinical an approach to
massage. I am interested in getting a clearly trackable goal for each session
and keeping records to see progress. I am quick to read and report what the
science shows can and can't be done by massage. I am candid about what I know,
what I don’t know, and I am also very dismissive of the many myths and tropes
on which other massage therapists continue to cling. Massage is often sold as
an intuitive, natural healing art. Healing because it channels some ancient
pre-language energy that holistically guides the receiver to better health. I
think there is a nugget of truth to that idea. I also think it opens the door
to ignoring reality and therefore must be avoided.
Every good massage will have "non-specific
effects" which can cause the practitioner and the recipient to believe it
is magical. Research, however, shows that these effects are often fleeting,
unreliable, and temporary. One has to have something else behind their
approach, or failure and client-shaming are soon to follow. I've heard it said
by many other massage therapists. Calling their clients "energy
vampires." Saying "that client is so negative, he/she really drains
me." Or worse, telling the client that it is their negativity, their
inability to let go that prevents their symptoms from improving. This takes me
back to the conversation analogy, lousy conversations are not improved by
telling the other person that the lousy conversation is their fault. It is up
to us, the massage therapists, to guide that conversation back on track, to
change the subject when it is obviously causing strife, or to end it when there
is nothing to be gained.
I have seen some recent musing about whether we, as massage
therapists, have "patients," "clients," or
"customers." After 8 years in practice, I honestly don't know. I use
them interchangeably for that reason. Every person comes to me with a unique
story and a unique set of needs, and I do my best to provide the right service
to meet those needs. Some people have chronic pain, some have acute pain, some
have anxiety and/or depression, and some just want some time to feel good. None
of these are bad reasons to get a massage, and none of these have any greater
need for my services than any of the others. Our field has an identity crisis,
is it supposed to be a luxury service or a medical practice? I think it is both
and neither. Therapeutic touch is too essential to be called a luxury, and too
vague and unregulated to called medicine.
Another stumbling block is pricing and frequency. We, as a
field, really do not know how much to charge or how often you should get a
massage. For certain physical conditions, you have clear limits, but for most
people, the sky is the limit. Monthly, weekly, perhaps daily? My answer for
this is often, at least as often as you have the desire and the means. Let your
body be your guide. What then should it cost: $40, $60, $80 an hour, or more? I
value my work, and charge $75 an hour. But then I offer all kinds of
price-breaks and discounts and deals to first-time and regular customers. I
have often toyed with the idea of making my business a Pay-what-you-will model.
I would do it too, if I thought it wouldn't be alienating to those who have
been kind enough to see me regularly at full price.
