The Medical Massage Question

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The question of what is Medical Massage has become the million dollar question in massage circles.  And the question I just received is this "Is there a difference between medical massage and clinical massage?"  For the first part of my answer I will defer to James Waslaski, a leader in the massage field, and a quote from his article in Massage Today from June 2004!

"The best short definition I gathered from medical massage therapists is: "Medical massage is performed with the intent of improving conditions or pathologies that have been diagnosed by a physician; a wide variety of modalities or procedures are utilized to focus the treatment based on the diagnosed condition." I was determined to prove that advanced disciplines, such as neuromuscular therapy, CranioSacral Therapy (CST), myofascial release, lymphatic drainage, massage for cancer patients, orthopedic massage, etc., fall under medical massage disciplines, and certification in many of these disciplines usually requires a minimum of 100 hours of training."    http://www.massagetoday.com/archives/2004/06/03.html

Waslaski teaches an Orthopedic Massage class and has a book from Elsevier called Clinical Massage Therapy: A Structural Approach to Pain Management.  I do not have this particular book but any other book from Elsevier is in the form of a textbook.  Elsevier is a company that I dealt with when I was the Massage Therapy Chairperson at a private school in Florida.  More about books in a bit.

So now that I have muddied the waters, let me address the Clinical Massage Therapist part of the question.  I found the following quote:

While a massage therapist can work with clients who have tension, stress and pain, "more serious issues are often treated by a clinical massage therapist. This practitioner uses techniques specifically designed to help injuries heal, improve range of motion, and increase muscle function. Also known as medical massage, therapists who perform this work generally do so by prescription from a doctor."        http://work.chron.com/clinical-massage-therapist-16412.html  Please note that this person is NOT a massage therapist, but that does not make her remarks any less true.

About 10 years ago, I was lucky to attend a seminar at the Florida Chiropractic Convention in Orlando.  This convention has in the past, and I would assume still does, hosted a Massage Therapist track as part of their training classes.  At this particular convention I attended a CE Class about Medical Massage by Sandy Fritz.  For those who do not know, Sandy is the main author of two textbooks by Elsevier/Mosby:  Fundamental of and Science of Therapeutic Massage.  In her lecture she feels the ALL massage is basically medical or clinical.  Her reasoning for this is that all massage has some sort of "medical" benefit to the client regardless of why they are on the table. 

But of course the massage industry as any other profession likes "labels".  It makes for great marketing and sales for massage schools and  continuing education providers.  Don't get me wrong, I do believe there is such a thing as Medical Massage but contrary to some advertisments it is not a required "certification" to do that type of massage.  (Disclaimer - My opinion and I do have a Medical Massage Certificate!)

The standard definition for Medical Massage is that it is an outcome-based, results-oriented specific treatment to a targeted area or problem.  The treatment is by diagnosis and prescription of a physician and may follow their specific instructions after a thorough assessment or evaluation of the problem.  It is also generally billable to insurance.  Be aware that not all states allow billing to insurance companies by massage therapists, licensed or not.  For more information about Insurance Billing for Massage Therapists please look up Vivian Madison Mahoney at www.massageinsurancebilling.com.  I was fortunate enough to take her class and received great documentation on the insurance billing process.  She does have an insurance billing seminar on DVD and if you take a class with Premier Continuing Education you can receive free CE hours from her.  (Shameless Plug)  www.premiercontinuingeducation.com

My personal opinion is that networking with a physician or chiropractor would be the best way to get into this type of massage.  Advertisment and marketing to a specific client base would be another way.  But first you need to have the training to do this type of work.  Clinical-based massage is much more specific and requires the therapist to have more specific training and understanding of the mechanics of the human body.  Back to that Anatomy and Physiology that you learned in school. 

My recommendation and that of James Waslaski in his article mentioned above is to have training in as many advanced disciplines as possible.  Recommendations include (but are not limited to):  Myofascial Release, Neuro-muscular Therapy (NMT), Trigger Point Therapy, Cranio-sacral Therapy and Sports Massage/Stretching.  Additionally more specialized Hydrotherapy applications, including Hot/Cold Stone and other more structurally-based modalities such as certain types of Lomi Lomi and Structural Integration techniques.  You also need to know how to explain why/what you are doing to your clients.

Recommendations for books include (but are definitely not limited to):  Anatomy Trains by Tom Myers, Kinesiology by Joseph E. Muscolino, A Massage Therapist's Guide to Pathology by Ruth Werner (who by the way will be teaching some classes at Sage Continuing Education in Lancaster, PA this fall! - www.sagecontinuinged.com), any of the textbooks by Sandy Fritz, Trail Guide to the Body by Andrew Biel, Basic Clinical Massage Therapy: Integrating Anatomy and Treatment by Clay and Pounds (an LWW textbook), and Fascial Release for Structural Balance by James Earls & Thomas Myers.  I am currently taking the online course by Niel Asher on Trigger Points that I highly recommend (NAT) and any of the books by Clair Davies on Trigger Points.

I hope this addresses the question posed by my Facebook reader this morning.  Obviously the best place to start is in the beginning and being a licensed massage therapist is that first step!  Having the desire to "make a difference in the pain and posture of the body" is the next step.  I hope this points you in the right direction.  Please feel free to comment here.

References used:  www.medicalmassage.com, www.massagetoday.com, www.mmpa.us

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