The recognition of massage therapy as healthcare methods of treatment
Recently I have had communication with LMT, who in the past took my CE classes.
In the middle of our discussion she said:” you Boris are a very advanced massage therapist, if all of us would be as advance as you are, massage therapists might be recognized as a healthcare provider. “
“Of course,” I said, “thank you for the compliment, but what does it mean to be advanced massage therapist, and what does it mean to be recognized as a healthcare provider?”
Somehow she had had difficulties to provide a clear definition of what “advanced massage therapist” is, as well as to describe the meaning of being a healthcare provider. I have comforted her, saying:” some time ago, our professional community was involved in vigorous discussions on the subject: What does it take to be a recognized healthcare provider?”
Many talked about the necessity of extended academic education, some expressed the opinion that in order to be recognized as healthcare professionals we must have a degree; a lot of discussions were about science, more research, about getting scientific … whatever it implied. Many community members, believed in an advanced massage program.
Some of my colleagues defined “advance,” as being able to successfully treat painful back and limp disorders.
At the time, I didn’t have a strong opinion. However, I believed then and believe now, that no matter what protocols of massage therapy one practices, first and foremost they must be efficient clinically, capable to deliver faster and sustainable results. Only then one can talk about the recognition of the healthcare profession or being called advanced MT.
A few times during these discussions, I asked for a clear definition in regards to:” What does it mean to be recognized as a healthcare provider?”
I received many variegated answers. Mainly my colleagues expressed beliefs, that to be recognized as healthcare professionals, meant to be paid by insurance.
I didn’t know much about US massage fields
When I arrived in America, I was under the impression that everyone practiced the same kind of massage therapy. Little by little I understood that this wasn’t exactly true. This unfamiliarity with what other massage therapists were doing made it difficult for me to come up with the aforementioned definition.
Most of the students who graduated from my massage school also took my CE classes perusing their interest in learning additional protocols. However, that exposure didn’t get me any closer to realizing the entire gamut of what went on in the field.
However, since taught classes at the World Massage Festival, I am not only met hundreds of massage therapists but could see them working on tables and exchange ideas. That was enough to paint the general picture.
I had a great impression. In other words, first-time I have got the opportunity to see and understand what other people did. This experience allowed me to arrive at the conclusion that as a professional community, we are good at what we do. Being a presenter at the World Massage Festival convention, I had the opportunity to express my opinion:” We are good in what we do but the sky is limit when coming to developments of skills.” Most if not all, agreed with me.
Again, back then I didn’t have an opinion on the subject, but now I do and would like to share it with you in this article.
The overview of massage therapy fields.
As a matter of fact, we are the front door providers of therapies by means of massage. We are seeing patients in our own offices and answering house calls.
Also, we are practice at doctor’s offices, including and not limited to chiropractors and physical therapy offices, as well as we are practicing at spas and massage centers.
To be an advanced massage therapist
In general, Medical Massage contains more than 65 protocols for treatment of different disorders including protocols for neck and upper back disorders, not limited to thoracic outlet syndrome, lower back disorders, including sciatica, lumbalgia, myofascial syndromes like piriformis muscular syndrome, hip, knee, and other joints disorders. It also includes protocols for treatment of sprain strain type of injuries, pregnancy massage, Postpartum rehab massage, protocols for fibromyalgia, stress management massage, tension headaches, TMJ disorders, migraines headaches, sleep disorders, post concussions rehab massage, and much more.
Who of us is trained and to perform all these protocols?
Are there massage practitioners who practice all the mentioned protocols? If so, would they be considered advanced? We all have our own specialties, and in my opinion, if applying particular protocols one is capable of delivering sustainable results, they should be considered advanced and good massage therapists. If one to define what“advanced massage therapist” is, they must pose a question “compared to whom?”
This discussion started 15 years ago, and I have submitted my commentary to Massage Today August 2005, Vol. 05, Issue 08
These are a few sentences from this article:” Modern society as a whole is susceptible to stress. Stress-related illnesses include heart attacks, strokes, high blood pressure, diabetes, anxiety, clinical depression, and more (and it should be noted that the American economy is losing $300 billion annually due to stress-related illnesses). Full-body stress management massage is scientifically and clinically proven as a powerful method for managing stress.
There is little doubt that those suffering from back pain have a disrupted quality of life. However, people are not dying from back or joint pain. People are dying from stress-related heart attacks, strokes, and diabetes; therefore, how can we consider therapists who perform full-body stress management massage anything less than advanced massage practitioners?”
The following excerpt is also from the same 15 years ago article:” For the past 40 years in Europe, the educational training in full-body stress management massage has stayed between 120-200 hours. I strongly believe that 120 hours for full-body medical massage training is enough. Therapists who would like to be involved in the treatment of specific disorders should have additional specialized training. And therapists not trained in how to treat particular disorders should not attempt to treat them.
Consider this: The credential “DDS” stands for “Doctor of Dental Surgery.” This type of doctor is qualified to legally perform surgery in the cavity of the mouth; however, if this dentist evaluates a patient and discovers a tumor or difficult tooth extraction, he/she will refer the patient to an oral surgeon. An oral surgeon is also a DDS but has had special training in oral surgery. Suppose a dentist who can legally perform extractions causes harm to a patient and is sued for malpractice. The plaintiff will inevitably demand proof that the dentist has had additional training/continuing education to treat the plaintiff’s specific complication. Professional difficulties are sure to arise for the dentist who lacks the proper training needed to perform a procedure. This analogy pertains to massage therapists, as well. Just because a dentist is not an oral surgeon, does not mean that he/she is not a qualified dentist. And so it is in our profession. Not being a specialist in a particular discipline or, conversely, having hundreds or thousands of hours of training, does not make one therapist better than another.”
Nowadays, especially in 2020, exposure to stress grew in pandemic proportions and really destroys lives. If one’s specialty is stress management massage protocol and they deliver great outcomes, I personally would consider them advanced massage therapists.
Here is the link to my video where I’m explaining debilitation of stress on our health
I receive training to perform 65 + protocols, but I don’t practice them routinely. There was a period in my career when the main emphasis of my practice was placed on pre-event and post-event sports massage and treatment of sports-related sprain/strain type injuries. Then there was a period I was more interested in treating painful lower back neck and upper back chronic disorders. After that, I switched to the treatment of fibromyalgia patients. Then my main interest changed to treating patients with concussions. Lately, it’s extended to the treatment of patients with bronchial asthma and boosting or balancing patients’ immune systems. I talked about it in this article. If some of you missed it or will have an interest you’re welcome to click.
My treatment interests often changed reflecting the referrals that I received.
When rheumatologists, massively used to refer to me fibromyalgia patients, it was exhausting work, but I enjoyed it, as well as treating those patients suffering from concussions, or bronchial asthma patients or those who needed boosting of their immune system. I was trained on how to perform these protocols, and perfected them, performing them on hundreds of patients.
The stress management protocol was always my main interest. I consider stress management massage a fundamental for all types of massage procedures. Actually, any medical massage protocol should be started with the introductory massage, aiming at increasing the threshold of pain, then fifty percent of procedure time must be spent on kneading. Of course, one must perform introductory massage on a particular body part. If to address full-body by spending fifty percent of the time on kneading, as well as performing circulatory techniques, movement directions to the heart, to accelerate the drainage of vines blood, one can call it Swedish full body stress management massage, or medical full-body stress management massage protocol. The bottom line is, you are addressing and balancing autonomic activities.
Friends, I’m encouraging everyone to learn and study from good sources.
If one would have a desire to learn many protocols, go for it. Here in the US, having my own massage – school for more than 20 years, most of my graduates took the main school program, and then continuing taking CEs programs of their interest, accumulated 800 + hours of training .it was paid off, tremendously advance their career. Don’t get me wrong, I am for education. Though, in my opinion, we can consider a one to be advanced if they are excellent in stress management, or specializing and perfecting skills, and successfully reproducing outcomes treating some particular disorders. Advance is the ability to deliver faster and sustainable results.
In order to be recognized as healthcare professionals we must have a degree?
In my opinion, this depends on the particular circumstances. As I have said, regardless of all the available education, a clinician must be able to deliver results.
Let’s say if you are an RMT and or DMT. The process is similar in the physical therapy field.
How would it make one recognized as a healthcare provider? Would Medicare start paying us for treatments? And why? Only because we are holding a Master’s degree in massage therapy, or we extended our training to Dr. in massage therapy DMT? I don’t believe Medicare or any insurance for that matter would cover our services because of RMT or DMT after our names.
Also placing a diploma against painful spots won’t make any difference in the condition of our patient. When we placing our well-trained hands on a patient we make a difference, receive the recognition from that patient; this patient then introduces us to doctors and refers other people to us.
There are a lot of talks was about science, about doing more research, about getting “scientific” in order to be recognized as a healthcare provider.
At this point, I know, the sentence above, doesn’t make much sense, as it won’t lead us to the recognition as healthcare providers.
Not long ago Dr. Ross, participated in clinical scientific research/trial, the effect of medical massage in cases of tension headaches. I would classify tension headaches as say pandemics.
It was done by a US neurological clinical and research Center. The outcomes were tremendous. How did it help us to be nationally recognized as healthcare providers? Who studied from his clinically and scientifically proven protocols, capable to deliver results in cases of tension headaches, got the recognition as a healthcare provider, they were recognized by patients, who terribly suffered from tension headaches, and got their lives back.
This scientifically and clinically proven protocol for hypertension. Link below. Until the day of today, I am reproducing outcome, getting recognitions from my patients, by physicians who are referring to me in these cases. This is clinically oriented science. Science has to work in the treatment room.
Please read carefully about scientific experiments I have repeated here in the US.
Professor Zabludovsly (1913) was the first one who explained the reflex effect on arterial circulation in non-massaged extremity. The phenomenon was confirmed later by many experimental and clinical studies (Guthberson, 1933; Ebel and Wisham, 1952; Belaya, 1974; Shtergertz, 1985, etc.)
In 2003, at Beverly laboratory of Vascular Studies, I repeated Professor Zabludovsly’s protocol. In Medical Massage Vol.2 text, Dr.Ross Turchaninov extended on this experiment. We have provided him with all the post-experimental data. In fact, a qualified massage therapist can reproduce the same outcome every time. To study this 15-25 minute protocol is simpler than studying many other simple step-by-step hands-on medical massage protocols.
The Beverly laboratory of Vascular Studies in California examined the effect of medical massage therapy on arterial blood circulation in lower extremities of healthy adults by using Pulse Volume Recording (PVR), Photoplethysmology (PPG) and Thermography (TMG). All these tests measured blood circulation on the opposite lower extremity, i.e. practitioners worked on the left extremity while circulation was measured on the right extremity. Peripheral circulation was measured before the experiment and after the application of Medical Massage. Major changes were registered in PVR, which is a pulsate volume of perfusion through the extremity.
Let’s briefly review the results of this study. The initial PVR registered on the right lower extremity was 0.81. After this parameter was registered, a medical massage practitioner applied the treatment of the lower extremity for 15 minutes. After 15 minutes of medical massage, PVR increased to 1.22 and continued to climb during the next 2 hours after the medical massage was over. At the end of the second hour, PVR value was 1.63, i.e. blood perfusion through the contralateral lower extremity showed a double increase even after the medical massage was over.
This study is a great example of the valuable effect of medical massage on peripheral blood circulation (Prilutsky, 2003). This is why patients with arterial circulation disturbances respond so well to Medical Massage.
It’s hard to overestimate the importance of contralateral extremities massage, in cases of fractures, surgeries, and significant other types of injuries when we cannot apply the massage techniques directly to the injured area. More than that, at the time of the experiment described above, my models agreed to wait only two hours in order, to allow us to perform PVR measurements. Two hours after the stopping treatment, it continued to increase PVR.
Back in the Soviet Union, we have repeatedly described protocols many times, and the reflex of increasing blood supply is sustained for an average of 15-18 hours. Isn’t this exciting? The stimulation by massage is already stopped, but during 15-18 hours after it is stopped, the body continues intensive healing! Remember after significant blood supply increase, abnormalities never come back to initial conditions, but after every treatment continues to improve.
Everyone who learned about the outcome of contralateral leg massage was amazed. I’m talking on the medical community, more than 30 of them. They praised me. If I’ve got a recognition, of course. Still, we aren’t talking about some form of national recognition whatever it might be.
Thus, here is my last point. Why more research won’t contribute to usual, Medicare/health insurance covered recognition of massage therapists?
Let’s note that practically all medical doctors read “Science Translational Medicine.” The reputation of this publication is not less than the reputation of the New England Journal of Medicine.
The entire medical community, it’s something published at these publications, considering and accepting as written in stone.
On February 2nd, 2012 we witnessed a press release, a grand recognitions of massage therapy, recognition of its extreme healing power. Below are the few samples of this release. In reality, however, it was much broader publicized, including TV reports.
Massaging muscles may reduce inflammation, spur mitochondria formation. USA Today (2/2, Vergano) reports in “Science Fair” that according to a study in Science Translational Medicine, “kneading muscles reduces inflammation and spurs cellular energy production.” In the experiments, researchers found that “massaged muscle cells had higher activation of gene pathways that spur mitochondria,” as well as “fewer signs of painful inflammation.” However, “massage didn’t lower levels of lactic acid build-up in muscles often blamed for the ‘burn’ in exercise.”
The Los Angeles Times (2/2, Brown) reports
“Massage also seemed to help cells recover by boosting amounts of another protein called PGC-1alpha, which spurs the production of new mitochondria.” The Times adds that according to researcher Dr. Mark Tarnopolsky, “exercise is the best way to reverse damage caused by common conditions including diabetes, obesity, and aging.”
Bloomberg News (2/2, Lopatto) reports that in the study.
“subjects were exercised to exhaustion, which took about 70 minutes. One leg was massaged; the other wasn’t. Both were biopsied immediately after the therapy and 2.5 hours later. The massaged leg showed slower production of interleukin-6 and tumor necrosis factor-alpha, both linked to inflammation.”
According to the Wall Street Journal (2/2, Hobson) “Health
“the researchers hypothesized that reducing the production of molecules linked to inflammation may be similar to the action mechanisms of aspirin and ibuprofen, both anti-inflammatory drugs.”
WebMD (2/2, Goodman) reports
“In recent years, a number of studies have shown that remedies for muscle soreness that work by turning down inflammation — things like ice baths or anti-inflammatory medications — may also have a downside. They may also block muscle repair and growth, which depends on inflammation.” However, according to Tarnopolsky, this study suggests that massage may be “an intervention that suppresses the inflammatory response but still allows, and actually enhances the [recovery] response.”
Also covering the story are HealthDay (2/2, Preidt) and the UK’s Daily Mail(2/2).
It is a very valuable data. I’m positive that the same research team soon will come forward with additional and even more significant data. The value of this research is not only in the importance of the exposed data but also because this study was published at “Science Translational Medicine.”
Because this paper was accepted and published by Science Translational Medicine, many medical doctors had the opportunity to read it. Should these materials be published by any other publications, excluding the New England Journal of Medicine, it wouldn’t have made such an effect, let alone it might not be taken seriously. Luckily, the materials published at Science Translational Medicine, are perceived as “written in stone.”
This is the nature of acceptance by medical doctors. It has to be published in a certain publication, where the editorial board will protect a publication from weak and not reliable study reports. Science Translational Medicine is one such publishing authority.
Because the results of a massage procedure were so highly acclaimed by a reputable publication, did massage therapists received recognitions? Yes, many medical doctors congratulated me on the science behind massage. “Wow!” they said, ”It looks like have a real science supporting and explaining what you are doing!”
In discussions, a lot of people claimed:” To go scientific in order to be recognized as a healthcare provider?”
Friends, in summary, I will be able to express my opinion in regards to recognition. Actually I did it in my article but will do it differently in summary.
What I have learned, at the World Massage Festival Convention, is that many performed excellently but not many could explain the scientific side of massage procedure. During my career I knew many people, even worked with some, who had used extensions after their names such as MD or Ph.D. These educated people could explain most of the science behind massage, but their hands-on performance was terrible. When it comes to the subject of massage, I prefer good hands-on work to excellent academic background and impressive title but a terrible hands-on work. Having said that, I highly recommend studying the science behind massage.
There is no better textbook, than the one written by Dr.Ross Turchaninov
The links are below.
Some might say that Boris is biased and has a financial interest.
Friends, if you won’t buy this text from me, it won’t upset me. I’m not making living from distributing his books only. If you will purchase this book from other distributors, and little by little will learn on the science of massage, it would make me happy, it would unify us, it would allow you to talk to doctors on a different level. This knowledge would empower your human factor, which is science-based energy healing. All that I wrote about Dr. Ross and his textbook, I’m not only believe, I know this is the real source of Medical Massage.
There is a difference in the definition of what healthcare providers are depending on who is using this term. It has one implication when used by medical bureaucrats and a different one when it stems from providing a cure for patients.
I consider myself, a hundred percent healthcare provider. I feel this way. As far as I know, my patients and referring physicians, recognizing me as a healthcare provider. Reiterating was said above, the capability to reproduce the outcome of massage procedure, make your healthcare provider.