Wednesday, March 14, 2007

Things to never say to your Massage Therapist

Being a male Massage Therapist, I get a lot of conversation from my patients. Some are very supportive of my career choice (expecially once I get my hands on them), some are idiots (like any other profession), and some are just genuinely curious about what I do and what it's like to lift, press, crunch, stretch, and pop people's muscles for a living. I try to field all their questions and comments with as much objectivity, helpfulness, and good humor as possible. After all, many people are extremely self-conscious about others touching their bodies, and some hide it better than others. That being said, I feel like something in the order of a "how-to" pamphlet should be given to anyone who is going to get worked on in any massage-related environment. And the first thing people should know are:

By Mark Brand

1) "My ____ (friend, family, etc.) has been seeing a masseuse for years, and I finally decided to try it..."

In this list, this is the one that irks me the most. Not because I've heard the story a million times, but because literally no one understands the difference between the words "masseuse" and "Massage Therapist". A Massage Therapist (note the capitalization) is a healthcare professional who has undergone 1-2 years of training, typically after undergrad college, and has passed a national certification boards test. Most states also require Massage Therapists to be licensed and insured a-la physicians, dentists, optometrists, or physical therpists.

A Massage Therapist is not only a healthcare professional, they are considered a "practitioner," versus even "allied health" support staff like phelobotomists, x-ray techs (which I also am now, incidentally), and most nurses. This means two things: first, a Massage Therapist is qualified to evaluate a patient (or client in spa/gym settings) for musculoskeletal dysfunction and treat them accordingly within their scope of practice. Second, a Massage Therapist therefore carries his or her own malpractice insurance. And before you ask, no it's not comparitively expensive.

The word "masseuse" is an archaic holdover from the massage-parlor days when it might have meant a skilled massage professional or just as easily a prostitute. Or both. In any case, real Massage Therapists hate being referred to as "masseuses" or "masseurs," and it is actually illegal for anyone who is not a real Massage Therapist to refer to themselves as one. Just like it's illegal for a nurse to claim to be a doctor.

If you take nothing else away from this extended rant of mine, remember this: find out if the person you work with is a licensed Massage Therapist. If not, don't bother going back to them because they have no idea what they're doing and if they injure you they're not liable for it. If they are a Massage Therapist, do not ever refer to them as a "masseuse" or "masseur" or even use those words around them.

2) "Is it bad that my ____ (knuckles, knees, neck)__ cracks?"

This one I hate hearing because I've answered it more times than I care to remember, and it seems like I must have explained it to just about the entire human race by now. It is neither good or bad that you have popping or cracking in your joints or muscles. There are probably two dozen things that can cause noises from your joints in the form of various pops and crunches. Some of them are bad, some are good, and some are meaningless. Who knows the difference? Doctors! Should you waste their time by asking this question? No! How do I know if it's a bad popping/crunching? If it's accompanied by pain, swelling, stiffness, redness, or loss of motion, consult a physician. Otherwise crack the shit out of yourself for all I care, or better yet, go read a human physiology book and figure out why your body is doing what it's doing. Physiology's not that tough to grasp, I took my 400-level human physiology final half-drunk and I still passed.

3) "I love you."

You'd be surprised how often I hear this one. Yes, it is inevitibly from harmless people who are so stressed that they're just trying to release their anxiety and they are supremely grateful for the neck that no longer feels like they have a railroad spike driven into it. Just the same, it is an awkward thing to hear from someone whose body you just stretched and unwound for half an hour. Massage Therapists are not the sort of crazy, aloof, flashy, flesh-hungry people you would imagine us to be (though some of the energy work folks are whackjobs for sure). When someone says this to me, I usually respond "Well, not many people tell me they hate me." Just the same, I'd rather not have someone tell me they love me at my job. Happy to see me? Great. Don't know how you'd get by without me? Terrific. If you wouldn't say "I love you," to your personal trainer, don't say it to your Massage Therapist. We're happy to see you too, but let's not get carried away.

4) "You should try working in a _________ (spa/gym/doctor's office)."

Inevitibly the people I work on have had experiences with other Massage Therapists at different venues than a physical therapy office. I mentioned above that Massage Therapists are healthcare professionals. This holds true even if they're smothering you in shea butter, working your sweaty traps after a workout, lighting candles and incense in their Zen sanctum, or relieving scar-tissue adhesions from a whiplash injury at your Chiropractor's office. Just the same, most Massage Therapists get into the business with a particular venue in mind, and there is an unspoken but relatively reliable hierarchy of talent and experience that goes along with where you find Massage Therapists in their respective workplaces. It goes as follows:

At the bottom are the spa folks. Not that many of them aren't terrific therapists, or that they aren't just as well trained initially as their superior cousins, but their downfall is the relatively limited leash that they keep themselves on in terms of treatment and expectations. They tend to use techniques that last only hours, or maybe days at most, and focus on single-treatment relaxation for the maximum stress-relief effect. Often these folks are cross-trained in cosmetology and aesthetics for facials, skin peels, etc. On the plus side, all the Quaaludes in the universe won't relax you the way a good spa therapist can.

Somewhat above them are the private in-home or in-studio therapists. I rate them third best because their quality varies so significantly. Some of the best and worst therapists you'll find are in this range, but you'll have to try a few to find one that will click with you. You might get someone like my teacher Bobbi who makes me look like a very poor example of what I do, or you might get a spiritual crystal energy reader who will give you a handjob for an extra $10. If you're going to go with someone in a private studio or home, get references.

Second best is probably the gym/health club people. If you're looking for massage for a specific problem, or you want that nagging shoulder pain to go away, these folks know more than most about bodies and muscles. Also, they tend to be older, more established, and better paid, which translates into stable, normal people. Always a good thing if you plan on taking your clothes off around them.

At the top of the heap are the true medical people. I am one of these. My actual title is Manual Therapy Specialist. This is an elite sub-set of Massage Therapists that work under physicians and physical therapists and provide specialized forms of massage that are recognized as actually treating diseases and musculoskeletal disorders. One thing that private Massage Therapists, health-club people, and spa therapists cannot claim to do is to treat specific diseases or disorders. They can all recognize musculoskeletal pathologies because that's part of our training, but in the actual office environment, only the medical people are qualified enough that their intake forms do not include the "please sign here if you understand that we do not claim to heal X disease" clauses. Not only can I perform advanced technigues under physician supervision, but my work is billable to medical insurances as standard-of-care treatment for things like repetative stress injuries, auto-accidents, frozen shoulders, sciatica, fibromyalgia, sports injuries, etc. Manual Therapy Specialists like myself often have extensive backgrounds in medicine that extend well beyond the standard massage school training. Many were nurses, x-ray techs, kinesiologists, physical trainers, etc, or other medical office staff before making the switch. Often these people perform duties similar to physical therapy assistants or aides in addition to their massage work. For example, I am also qualified to use theraputic ultrasound and electric muscle stim machines. And I'm an X-ray tech. And I do the computerized range of motion and muscle testing. And...

The quality of work you will recieve from Massage Therapists that work for medical groups is almost universally high, though you will not get the same sort of individualized attention from someone in a physical therapy office that you will get in a spa or studio.

There are certainly advantages and disadvantages to each type of massage. Personally, I love working most in the studio environment because you can focus on your patient more intensely than any other venue, but if I had my choice of who to go to, I'd likely pick either a spa therapist or a medical therapist depending on whether I was stressed out over life or back pain, respectively. Spa type and medical type massages are vastly different and both can be mind-bendingly awesome or dismally awful depending on who you get for a therapist. I'd say you have a slightly better chance of getting a lousy therapist in a spa, but maybe I'm biased. I have never had a massage in the health club environment or worked in one, other than as a student, and I didn't care for it at all. Just the same, if you're working out you can buy yourself literally days of painless workout recovery with massage.

1 comment:

Sean Haber said...

Awesome blog. I enjoyed reading your articles. This is truly a great read for me. I have bookmarked it and I am looking forward to reading new articles. Keep up the good work!

Sean Haber is a member in good College of Massage Therapists of Ontario and the RMTAO