Breaks some of our little hearts.

 

This post evolved from a response to Ryan Hoyme   (the MassageNerd)  http://theyoungthumbs.com/why-all-the-hate/.

Ryan is one of the gentlest, most compassionate people I know and I believe the controversy in our community is breaking a piece of his little heart.  Mine too Ryan. And I think there is a solution.  

Having grappled with this issue for many years I have come to a bit of peace about it. There is massage as a system. It is whole in and of itself. It does not need anything added to be complete.  While a definition eludes us, we can recognize massage regardless of what someone is calling it. There is a  logical benefit of seeking to understand the value of a system through research and other forms of evidence.  Massage as a system is getting there but high quality research remains scant. Many of the “claims “ people make about massage are opinion at best and some are outright wrong.  We –the massage therapy community need to stop perpetuating the myths and continue to seek understanding.  But-I say again- I believe we have enough evidence to claim valid benefit for those seeking our services.

 Massage as a unique system has limitations and these also need to be recognized.  Massage as a health approach only targets part of the wellness continuum.  That’s ok.  There is just too much to know and I am just fine being competent in my area. I know that wellness is a multifaceted process.  I don’t have to be a counselor, nutritionist, exercise expert, chiropractor, physical therapist, or spiritual support for example.  There are other professionals that are skilled in these areas. We can all work together even when there may be some overlap in some skills.  A physical therapist for example can so some massage but it is a minor element of the practice.  Massage is my thing-it is what I do. I can suggest some simple exercises but I just don’t have the training to develop a rehab program.  And I don’t want to.  Massage is essential, I have been learning about it for almost 35 years now and I am excellent at it.  I can be a team player. 

There are other systems that can also stand alone in the sense that a client's issue can be addressed with the methods of the system.   I think of hydrotherapy as an example. As a massage therapist I don't have to incorporate hydrotherapy for the application of massage to be complete. However there are elements of hydrotherapy that compliment massage (and vise versa). I can even use elements of hydrotherapy as a massage tool.  Think of an ice cup as an implement for massage. 

Essential oils/aromatherapy is another example.  In the research you will find studies that combined the two independent methods such as massage used to apply the oil.  However, essential oils have an independent body of knowledge and can function without massage. Massage has an independent body of knowledge and can function without essential oils.

 Specific forms of movement and exercise are stand-alone methods. Many are named for the individual that organized the concepts into a system such as Pilates. Some are cultural such as yoga but these systems share fundamental observable elements regardless of the name.

Energy based systems while varied, multicultural and attributed to individuals that formalized the systems fit into this type of explanation. If you observe a variety of styles you will recognize a fundamental sameness.

None of the unique systems provide the whole answer to health and wellness.  Just like massage, there is plenty to know, learn and practice within the system.  Each can be a life time of learning. And just like massage the client benefits with a team assisting them.

Regardless of the system-it is the responsibility of the practitioners of the methods to be seeking evidence for value and practice in an ethical manner.  However, I do not have to prove or disprove any other system.  I just don’t want the practice of what is massage and what is not massage to further confusing  us and other health care professions and clients. Even when multiple systems  become blended in a individuals personal practice each can be described and validated (or not) based on itself-not as the blend.  You can be multiple trained. You can be a massage therapist and a yoga teacher. Just present as such.  If I come in for a massage- I do not want a yoga lesson.

I am going to cap this so it does not get lost ok--ALL THERAPEUTIC INTERACTION, REGARDLESS OF SYSTEM, IS MORE EFFECTIVE WHEN THE CLIENT AND PRACTITIONER SHARE AN EMPATHETIC, COMPASSIONATE, ETHICAL THERAPEUTIC RELATIONSHIP WITH INTENTION, ATTENTION AND WITH PRACTITIONER EXPERIENCE TO DRAW ON-INTUITION.  ------so don’t get your fascia in a twist around some nerve with dermal branches ok.

Now I do get frustrated when a method is presented as different than massage when actually massage application has been adapted to target a tissue, function or outcome.  The whole concept of "fascia, myofascial " methods is an example. Another set of  currently popular approaches right now involves specific skin massage under the term dermal --------.  Another example is when a method that is essentially massage gets separated out of the massage system because of some sort of claim that it interfaces uniquely with a particular anatomical or physiological function. You can recognize these approaches because  neuro ----- or some body fluid shows up in the name.  I also think of methods such as nerve stretching or flossing and lymphatic drain as examples. All of these types of methods fundamentally use physical contact to create a mechanical force into the body tissues. –massage.  To me they are massage adaptation and not unique systems. Yes there can be expanded learning in these areas (and should be) but fundamentally massage is being use as the approach. Those teaching should be ethical about explaining this.

This next paragraph is bolded because I think it explains a lot of the problem.

So now here is where I think it all got confused.  The massage community in the past , in an attempt to legitimize itself, somehow decided that massage in and of itself was not enough. Massage was incomplete.  Therefore many systems of health practice got all jumbled in. And we ended up with the whole massage and bodywork  debacle.   

 Even more confusion occurred as multiple names for massage evolved--manual therapy, myotherapy, massotherapy,  medical massage, western massage, eastern massage, and all  you have to do is look at a list of forms and styles. 

Education for massage then began to include bits and pieces of all the individual systems diluting massage and doing a disservice to other systems that require unique knowledge and skills.  What a mess.

My recommendation  is-------------------------TA DA

The massage community needs to reclaim massage therapy as a whole approach.

If an individual practitioner wants to blend systems in their professional practice then they should commit to comprehensive study of that system and then openly present to clients and the larger community that they combine multiple approaches. The client has the right to be informed.

WE DO NOT NEED TO FIGHT. WE DO NEED TO CLARIFY.