Massage Training Controversy

One of the big issues in the massage profession has to do with the number of hours of education that one needs to become a professional, licensed massage therapist. While many states have adopted 500 hours of training as the basic amount of hours of massage school, there doesn’t seem to be any proof of what is really needed.

There seems to be two schools and probably many in between but the two basic versions are:

• 100 hours of basic massage training focusing on giving massage
• 500+ hours of extensive training in anatomy, physiology, orthopedic massage or some advanced systems of massage

When I went to massage school back in 1987, the basic requirements in WA State were 250 hours of massage school which did include anatomy, physiology, pathology and treatment massage for working with various basic conditions such as sprains/strains, headaches and common conditions. I was in the last group that was let in under those requirements of 250 hours. The number of hours of training that was required was going up to 500 hour of massage school where it stands now. I was very glad to be in the last class at 250 hours because I didn’t want to spend the extra time and money. The reasons for the increase in the number of hours of training was just an arbitrary thing that the state board seemed to come up with at the time. The massage schools were actually requesting it for no other reason than that they could make more money by getting students to stay longer. Keith Grant in his white paper on “Issues in Massage Governance” which he wrote in 2002 described this situation exactly. I have spoken about it here and really recommend that anyone who is interested in the future of the massage profession read it. It is quite lengthy and I have summarized this before on the blog.

Basically what he says is the same thing - that 100 hours of massage school is enough training to do massage and become a massage therapist.

People who think differently seem to have such an extreme reaction to this statement but don’t seem to have any proof or references to back themselves up other than statements like:

• People can’t do medical massage with only 100 hours of training
• People can’t give a good massage with only 100 hours of training
• People need much more anatomy and physiology than could be fit into a 100 hour training class

There is a whole other controversy over the issue of medical massage. Does medical massage require extra training or is it just the ability to be able to bill an insurance company for massage services which only requires knowing what paperwork is needed and how to show improvement in a massage session. Anyone who can do basic massage and can create a change in a muscle can show improvement in a condition.

I guess I must have my own personal definition of medical massage because I have been doing it since 1989 when I started my practice with 250 hours of massage school. From the very beginning I was able to bill insurance companies and be paid and was also very successful in working with clients. That doesn’t mean I didn’t get more training through the 20 years of being a massage therapist.

I am not saying that having more training is not good and that all of those years and thousands of dollars that are spent are not worthwhile. I am not saying that more education can improve your chances of being successful.

What I am saying that anyone can be taught to do a basic massage in 100 hours of training. How successful they will be depends on them, just as it does with someone with 1000 hours of training. There are so many massage therapists that do have training and still are not successful. ABMP reports that about 50,000 massage therapists leave the field each year and though they don’t say why, I would guess that most are due to being unable to make a living whether that involves getting injured or sick or what.

The thing is that we really don’t know what is required as far as education in creating a massage therapist who can be effective and successful. As a profession we have not created any studies that show that 100 hours or that 1000 hours is the best.

I don’t really know what the answer is to the issue but am really open to hearing about solutions such as studies that could help create more successful massage therapists. Keith Grant’s solution is apprenticeship programs which seem to be put on the wayside to make room for the big massage school conglomerates such as Cortiva, Corinthian Colleges and the like. And with the increase in massage franchises that only pay massage therapists $15 an hour, I just have to wonder what exactly is going on.

Posted in Massage Research, Massage Schools/Students, Massage Therapy Jobs | 4 Comments »

Evidence Based Massage

I have been trying to understand what this new call for evidence based massage is all about. There is a research Yahoo Group called the journalclubonline where I am learning about this.

The massage profession is just starting to understand the significance of research - doing research and understanding research. Most massage therapists lack the basic underlying knowledge and are unable to understand research and why it is important to the profession. Because of their focus on touch and the kinesthetic world, research that focuses on the techniques and science seem skewed and unimportant. With the world so focused on knowing more about something before trying it, how can we educate clients as to what massage can really do for them and build their trust in the massage profession?

Funded by big companies and flawed by researchers bias and filled with too many terms we can’t even begin to comprehend, how do we combine our love for the art of massage, the therapeutic relationship and the science of research into an understandable body of knowledge?

Confronted with clients who have herniated discs, muscle spasms, tendon tears and very stressful lives, we need to share what we know about massage and find out what they think is needed to heal their condition and create a plan that supports the client in their healing process.

Evidence Based Medicine uses the results of research to use as a guideline when forming a treatment plan in the medical setting. As more massage research is done we can start to apply it in our everyday practices and also educate the public as to what massage can do. While there are many aspects of massage that are immeasurable such as the relationship of the mind-body connection and healing, we can begin to teach people about the uses and benefits of massage from this totally physical, scientific manner as people usually like to base their first opinions on proof. It can also be of use in building a practice. By providing supporting evidence you may be able to work more with hospitals, corporations and other businesses who need more proof to be spending their money on massage.

From what I understand so far - evidence based massage is being able to provide research that will back up our claims that massage is effective for various conditions. Sean Slovik has created this website -www.massage-therapy-research.com to try to help explain it all.

I have also just read another article in the Massage Therapy Journal called Care With Confidence By Rebecca Birr, MSLIS, AHIP / Kathy Zeblisky, MLS, AHIP that also is helpful in explaining research and why we need it.

So much of what we learn in massage school is not really evidence based. We think it works because it has worked for us and we see it work for others. Our claims that massage and other modalities work seem to be mainly from our personal experiences which is often just that -personal.

From what I have been able to discern from all of this is that we need research if we want to have some credibility in the medial profession. Clients may also even be skeptical of massage and its usefulness for various conditions. People usually need proof that something works. They are skeptical to try things that may me unknown to them without evidence. One of the best methods of building a massage practice depends on getting current clients to refer their friends and family members. That is enough evidence for some people.

The problem is that most massage therapists are not versed in being able to interpret or understand research papers. Ted Nissen author of (anatomyfacts.com ) also working to make massage research more understandable and he says research should have some kind of rating system that can tell us more about the research - is is valid and how did they come to their conclusions.

The things I struggle with are how do we know how research is done. How do we actually measure what really happens in a session? I had a client who had a headache for a year and it went away the day she quit her job. I had a woman who was trying to get pregnant for a few years with no luck and then after 6 weeks of massage for back pain she is pregnant.
What does massage really do? Is it the technique we do? The relationship we develop with the client? The client finally being able to feel themselves more? What is it that happens in a massage session?

Posted in Massage Research, Recommended Reading | 1 Comment »

Massage Better than Psychotherapy?

Interesting Study on the effects of massage.
A Meta-Analysis of Massage Therapy Research
Christopher A. Moyer, James Rounds, and James W. Hannum

Originally published in Massage and Bodywork magazine, June/July 2004. Massage Today New Study Reviews Effectiveness of Massage Therapy: Researchers Draw Interesting Parallels Between Massage and Psychotherapy
By Michael Devitt, senior associate editor

Massage Magazine - Overall, Massage Is Effective

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Massage Research Resources

I have been redoing the pathology section on my website www.thebodyworker.com to reflect some of the research and other articles that are being written on various ways to work with different conditions.

If you come across any that are of interest please let me know so I can add them to the pathology section. My pathology section comes up in the number one page of results with google for almost every condition. This could be a big plus for the massage profession as I talk about whether or not massage can be helpful for these various things or not. For example search using google for “carpal tunnel” or “pregnancy trimester information” and my site comes up.

There is a new Yahoo Group online called journalclubonline that was just started by Ted Nissen from anatomyfacts.com

“The latest massage and related research delivered directly to you for discussion, analysis, and review. Want to quote research studies like a pro and learn how to understand scientific literature while cross talking with other massage therapists online? Learn what massage techniques are scientifically effective and take these good ideas from the research lab to your massage client. We welcome massage therapists, aromatherapists, reflexologists, Energy Workers (Reiki ect), and other touch therapists. It’s a hassle free, no cost, way to keep informed.”

Background Papers by Ted Nissen - Anatomyfacts.com

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Massage Research

Research in and about the massage profession is becoming more available.

The Touch Research Institute (TRI) is the most popular source of research along

with the Massage Therapy Foundation.

TRI is funded by Johnson & Johnson Pediatric Institutes, National Institutes of Health, March of Dimes, Biotone and other companies

But how effective or accurate can massage research really be (or any research for that matter?) How can you control a technique and find people with the same exact fiber of muscle that is in spasm or injured to prove anything anyways.

I think we may be too caught up in trying to prove what it is that we do with massage and bodywork to somehow impress the medical profession or whoever or to make the public think we are more credible. I think the only way to achieve credibility is to be more credible.

And after all of the research why can we not cure cancer yet? and look what happened to poor Pluto after all of these years¦

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