GRADUATION & FRUSTRATION

Health Enrichment Center had a graduation yesterday. Graduations are important.  They mark a time when a level of learning is completed and a new one begins.  I told the graduates yesterday that the education they received ultimately taught them to be their own teacher and every client they worked with would be an important point of learning.  People often ask me how I know so much.  Sometimes I even ask myself that but I do know the answer.  I have been a massage therapist a long time with hundreds of clients, most long term, I write textbooks and I teach.  These activities keep me current, fresh and challenged.  Every time there is a graduation I find myself reflecting on massage as a profession. I will admit that I am a bit frustrated with us. I think the massage profession needs to graduate and get on with it.  I told the graduates yesterday that the world of massage therapy they are entering is different than the one I began some 30 years ago. Yet later last night I wondered if that was an accurate statement.  Here is what is different:

Massage therapy is now a licensed occupation
The massage community is actively engaged and being supported by high quality research.
The massage community has an acceptable formal body of knowledge- the MTBOK
Support for employment primarily from the growing franchise sector

What hasn't changed:

Educational standards -we are still stuck around with number of hours instead of competencies to practice

Educational excellence- buyer beware when it comes to massage schools and continuing education

Bickering, infighting and lack of cooperation among professional organizations- I am really getting tired of this

An agreed upon entry level competency base and educational platform- This is becoming ridiculous

A scope of practice that is realistic and attainable with formal education and  professional experience

Very little research on ergonomics and biomechanics--this has got to change.  The profession has to support independent evaluation and assessment of how we do massage. We cannot do this ourselves and be objective. The injury rate is unacceptable and massage therapists are not able to perform enough massage to generate a sustainable income.

There is more but I am beginning to get frustrated.  How can I send my graduates into this professional world confident that they will receive the support they need as they grow into real massage therapists.  I am on a bunch of committees with a variety of different organizations.  I know that there are many who are trying to resolve these issues however------

I am angry with myself as well. Last week when discussing a model curriculum in a competency based platform -both of which I have already done  in conjunction with my textbooks specifically but also much broader with the entire Elsevier massage educational line- I recommended that an independent group outside of massage be found to actually develop the document.  This is an excellent recommendation by the way and is not why I am angry and disappointed with myself.  What I did that bothers me is saying that at this point I personally was unwilling to  lead this process because I did not want to put myself up for all the infighting, criticism and opinion based comments that I think would occur.  Shame on me.  Jan Schwartz made a comment and recommendation on one of the other discussion boards that leading educators need to be brought together and get this thing done.  I agree! I also recognize that the massage profession has a huge learning curve to deal with concerning educational design and we need to admit it and commit to paying consultants and collaborators to do this for us with guidance from the profession.   Once we have this document-based on the MTBOK-the next challenge will be to bring instructing staff up to speed. 

The ABMP is going around the country presenting instructor training workshops for FREE.  Myself and my instructors attended the one that was just presented in Detroit.  Yes, there is promotional aspect for ABMP and I believe this is one of the greatest marketing campaigns I have seen. Regardless  the presenters did a fantastic job as did the course developers. On the way back in the car my instructors said--"We already do most of that stuff". Proudly patting myself on my back I agreed.  What struck me however during the workshop and the interaction is that the broad spectrum of instructors from many schools in attendance really want to do a great job and the skills provided were very new and unfamiliar to many. There was nothing unique about what was presented in the workshop. The observation that the information was unfamiliar with many was sad.  Massage therapy instructors want to do a good job but the massage profession is not working together well enough to give them the tools they need. It is time to graduate and get on with it. None of the information and skills the profession needs is different than other groups.  It is all out there and successfully being done and implemented by other professions.  I can't imagine having the recreate the wheel again and to do so is a waste of time and a disgrace to those entering the massage profession.  So now I think I want to cry but will go walk around my garden and commit to being part of this process even if I am personally and professionally vulnerable. I owe it to my graduates.

Check out this article I found.

Massage outperforms meds for low back pain, study finds

Monday, July 25, 2011 by: Mary WestSee all articles by this author
Email this author

Is it conceivable that massage can provide more effective relief from low back pain than medication? A new study published in the Annals of Internal Medicine suggests this therapy might indeed alleviate back pain better in the short term than traditional interventions of medicine, bed rest or exercise: Healthday reports.

The investigation conducted by the Group Health Research Institute in Seattle involved 400 patients who had low back pain, the majority of which were middle aged, Caucasian and female. Researchers found those who were given a series of relaxation massage or structural massage were better able to work and be active than those who were given traditional medical care, such as pain pills, muscle relaxants or physical therapy.

According to The New York Times, the study's participants were randomly divided into three groups: structural massage, relaxation massage and traditional care. Patients in the massage groups received one hour of therapy weekly for 10 weeks.

At the conclusion of the 10 week period, over one-third of the patients who were given massage therapy reported their pain was much improved or eliminated completely, as opposed to only one in 25 patients who were given traditional care. Furthermore, patients in the massage groups were twice as likely to have spent fewer days in bed rest, used less pain pills and participated in more activity than the traditional care group.

Lead author Daniel Cherkin was surprised by the fact that structural massage did not prove superior to relaxation massage in relieving pain. Structural massage involves manipulating specific back pain related muscles and ligaments, while relaxation massage, otherwise known as Swedish massage, involves inducing body-wide relaxation.

The beneficial effects of the massage seemed not only to be experienced during the 10-week therapy period, but also to linger for a time following the cessation of therapy. Evidence of this lingering effect was manifested by the fact that the massage groups continued to display improved function six months after the study's onset. At the one year mark, however, no significant differences were found in the three groups.

Although the researchers were uncertain of massage therapy's exact mechanism of action for easing back pain, they voiced several theories. One suggestion was that it either stimulated tissue locally or produced a general central nervous system response. Another speculation was that merely spending time in a relaxing environment and feeling cared for might have been responsible for the improvement. An additional factor to consider is the subjectivity that is impossible to eliminate in such studies. Patients in the control group were aware that the other groups were receiving massage and this knowledge may have caused them to discount their own progress.

It should be reiterated that the study suggests rather than proves the benefit of massage for back pain. Also, some members of the American medical community not associated with the research have expressed reluctance to accept the suggested benefits as being valid.

Conversely, the study's authors offered their assessments of its import. Cherkin characterizes the results as being "pretty strong." He states the massage was tested on patients who did not improve using the standard medical approach to back pain treatment. He feels that massage therapy is a reasonable thing to try for anyone getting insufficient relief from this malady. The coauthor, Dr. Richard Deyo, feels that massage appears to provide clinicians with another choice for managing the challenging medical problem of chronic low back pain.http://health.usnews.com/health-new...
http://well.blogs.nytimes.com/2011/...
http://abcnews.go.com/Health/PainMa...

About the author

Mary West is the creator of a natural healing website where she focuses on solutions to health problems that work without side effects. You may visit her website to learn more at http://www.alternativemedicinetruth.com.
Learn more: http://www.naturalnews.com/033113_low_back_pain_massage_therapy.html#ixzz1TMfXMT6p

Stages of learning

I received this yesterday. It made my day. It has been edited some to maintain confidentially.

 " I graduated from Health Enrichment in 1996!  I was doing some research on massage schools for my aunt, and of course I started with you J  I read through your website and I am glad to see that you are continuing to move massage therapy into the future.  I wanted to take a moment to thank you for all you do, have done and will do.  Massage has forever changed my life and the lives of those I have been blessed to touch.   It all started with a friend of mine that was attending Health Enrichment in 1994.  I had a bad car accident that totally changed the way my body worked.  I was on many pain meds to cope with my injuries.  My friend used me for her log hours.  I was so profoundly affected by the massage that I had to tell people all about it!!!!  I quit my 9-5 job and enrolled in Health Enrichment J. Since graduation I have achieved all the goals that we set for ourselves as a part of our training.  I have worked with physical therapists, chiropractors and at a salon/spa.  About 4 yrs into my massage therapy career, I brought my clients to my home (this was a set goal).  My husband built me a massage room with private entrance and bathroom.  I was able to have an at home business for 8 yrs while birthing babies and homeschooling!   I am studying for the MBLEx (using your massage books to study) so I can be licensed here in SC and I am actively taking classes towards my bachelors in science.   I really wanted you to know how the education you provided me has always been a great part of who I have become and where I am going.  Again I say Thank You!  Because of you and your vision, I am blessed."


As an educator these types of messages make it all worth while.  Wednesday I was in the classroom with my newest group of students and we were beginning our overview of muscles.  This is really hard for me because the newest information supports the concept that there really  are not such thing as individual muscles but instead interconnected structures that produce functional units.  If you really want to understand that go the Gill Hedley's web site and purchase his DVD's and watch them over and over and over     http://www.gilhedley.com/

. My student's idea of what the muscles look like
. 

Anyway, learning occurs in stages .One of the pictures posted is of a swallowtail butterfly caterpillar on some dill in my garden. A caterpillar's main job is to eat and not be eaten.  An entry level student's job is to learn to establish a foundation and not give up.  In my opinion entry level education is the most difficult.  I appreciate the frustration and overwhelm that occurs as new students realize that - yup they do have to know all that stuff - and as a teacher I have to remember that they don't know all that stuff yet.  It is my job to get them through the caterpillar stage so they can become a butterfly.

I always have a couple of students that by their nature easily understand the concepts and application. The fundamental details and the repetition required to own the information is so tedious for them. I listen as they describe how frustrating it is for them to do all the homework and take all the multiple choice tests and do on the activities in the textbooks.  Now online learning is being integrated into the classroom.  Actually in many ways a well done, comprehensive online learning platform such as provided by my publisher Elsevier/Mosby for the Essential Sciences textbook is truly a better way to learn fundamentals such as anatomy and physiology ( coupled with a teacher that knows how to manage online learning). Tons of different learning elements can be used to repeat the same information over and over but in novel and unique ways and the student can review as much as they need to. But and this is a very big BUT- students have to be  motivate and discipline themselves to do that.  I have a group that is getting ready to graduate soon.  Many of them got behind on all the stuff necessary for obtaining as solid entry level education which includes completing lots of multiple choice exams in preparation for taking what ever licensing exams Michigan approves.  Now they are stressed because they procrastinated. I am ok with that.  This is another learning stage. Besides as they are getting caught up they are reviewing and that is a good thing. One of my recent graduates just informed me that she passed the National Certification Exam. Excellent- to me that means we both did our job!
It is ok if students get a little grumpy.  Butterflies are beautiful. Caterpillars are not always so lovely. Lots of people get squeamish about the uckiness of some caterpillars. Well butterflies start as crawling creeping creatures and it is a necessary stage. Personally I really like caterpillars (well most of them-tent caterpillars and tomato hornworms give me the willies). I don't give up on a student until they quit and give up on themselves. I am a teacher. My job is to get them out of the cocoon (chrysalis) and ready to fly. 

Abrupt Post

The research is excellent for massage therapists. For you garden lovers, here is one for ya

New research

http://www.linkedin.com/news?viewArticle=&articleID=616358139&gid=2745947&type=member&item=60551126&articleURL=http%3A%2F%2Fwww%2Enpr%2Eorg%2F2011%2F07%2F04%2F137609072%2Fgot-low-back-pain-massage-therapy-may-rub-it-out&urlhash=UK6U&goback=%2Egde_2745947_member_60551126

This is a link to a discussion about research that shows massage better for lowback pain than other forms of care.  What interested me was that general massage was as effective as specific deep tissue methods. Interesting.