When To Choose Massage Therapy As Primary Health Care Modality

When would someone choose massage therapy as a remedial therapeutic healing modality?

The intent of this article is to provide insights to consumers when choosing a health provider. When is it appropriate to choose massage therapy. My motives are to market my clnic because I am a massage therapist, and partly to be helpful because the public doesn't know what services massage therapists provide. I also wish to take the burden off physicians, chiropractors, and physiotherapists who are being overtaxed for their services for some treatments which can best be perfomed by massage therapists.

When is it appropriate to go to the massage therapist?

For most muscular and joint aches and pains.

Some doctors don't think of massage therapy as a healing modality when they have a patient come into their office who may have other more serious symptoms.

Massage therapy has been shown to be beneficial in treating injuries which result from trauma, surgery, or workplace and vehicle accidents. The rehabilitation protocol for restoring full range of motion and strength to muscles and joints is practiced by qualified therapeutic massage therapists. Massage therapists have thorough training in assessment of muscle and joint imbalances and can successfully treat these dysfunctions and restrictions.

Massage therapy has its place in the healing forum. So How to Choose?

There are some healing techniques which physiotherapy performs better and some which massage therapy performs better.

How will you know which treatment is better at the time of rehabilitation? Massage therapy or physiotherapy?

Ask your local professional massage therapist and physiotherapist for a description of their different treatments.Then you can make an informed choice.

How will you know which treatment is for you?

It's sometimes difficult to decide. So trusting your professionals requries asking some questions!

Sometimes it comes down to training and experience with your particular condition!

Ask your health provider whether they've treated this condition before and what the results were.

Why should a consumer choose massage therapy as a healing modality?

Because it is a scientifically proven method of healing. Because it is established fact that massage therapies

are capable of providing relief from pain, relieving the patient of symptoms which either restrict movement

or limit range of motion of a particular extremity or body part. Because massage therapies are capable of restorative and maintenance functions in sustaining wellness. Because massage therapists are capable to treat patients in acute, sub-acute, and chronic stages of injury and healing. Because some massage therapists are trained in various modalities of hydrotherapy treatments which complement massage therapy and can be used integrally.

The health consumer's choice of healing modality depends on many variables.

The three most important factors which I will focus on are:

1. Time spent between the healer and the patient.

How much time does it take you to tell your health provider about your complete medical history?

Fifteen minutes!

Doctors, chiropractors, physiotheraists, massage therapists; all ask approximately the same questions, but each specialist goes about it with different means yet with the desire to achieve the same goal: to restore the patient to a state of health, balance or equilibrium.

Because of the ways in which doctors and chiropractors are paid, by billing the medical health authorities, contributes to the length of time which they spend with the patient: statistically an average of ten(10) minutes per patient. The massage therapist, on the other hand, is not paid by the provincial health authorities, but usually contracts with their patients for periods of a half-hour or hour appointments. These are either paid in cash or billed to a group insurance plan which covers massage therapies. It's not that they work by the hour, or for an hourly rate, but the therapist books that time slot with the patient to allow the necessary time for appropriate and adequate assessment and treatments. The patient pays for the therapist's training and expertise and for their manipulations, mobilizations, and other corrective techniques.

2. Determination of the most appropriate modality of healing for a particular condition, ailment, or pathology.

Another important feature in selecting a healing option is the determination of what type of healer is best suited for a particular type of dysfunction.Because each specialist has their different protocols, each will have a different set of ojbectives and tools with which to work.

a)The doctor examines the body from a systemic approach, examining the skin, circulation, respiration, eye/ear/nose complex, digestion, etc., reduces the symptoms to a limited number of likely pathologies, then prescribes appropriate medications which will help to eliminate pain and relieve symptoms, and hopefully restore systemic homeostasis or equilibrium. " If the pain persists past a week, come back and see me", is the common refrain. With a return visit the physician then proceed to perform a more lengthy and detailed examination and testing until a more particular diagnosis is obtained and a more specific prescription of medications can be given.

b)The chiropractor will manipulate the spine or joints to restore neurological functioning by re-aligning vertebrae which were subluxated, and restoring nutritional and circulatory pathways to the body parts being served by those spinal nerve roots. They will assess muscle texture abnormalities before and after manipulations to determine whether the treatments have been effective.

c)The massage therapist will ,like the doctors and chiropractors, take a detailed medical patient history, eliminate possible pathologies which the patient is known to have and claims to not have, performs assessment of joints and muscles to ascertain restrictions; utilizes deep tissue and peripheral joint manipulations as well as active and passive stretches and neural inhibition and stimulation techniques to help restore bilateral symmetry and restore tissue texture normality.

The massage therapist have their place in the medical professional community of healing. Their focus is both systemic and specific. It specializes upon the musculo-skeletal aspect of the patient but not excluding the other aspects which the doctor or chiropractor takes into consideration when assessing the patient. The massage therapist includes the medical pathologies which the patient reports into their patient history. The massage therapist takes into consideration the spinal and neurological dysfunctions which may be reported by the patient when assessing the patient and setting up a treatment protocol. The massage therapist then proceeds to perform a series of visual and palpatory examination of muscles and joints mobilizations and range of motions to discover restrictions and asymmetries, which many times are the causes of the aches or pains and the consequences of hypertonic muscles, restricted joints, or weak muscles having either a muscular or a neurological cause or origin. The massage therapist is capable through a range of techniques to restore normal resting tone and function to the muscles and joints while providing the patient with appropriate stretching and strenghening of muscles which are involved.

3. Cost of treatment or service to consumer

The method of billing and payment determines to a large extent when a consumer will choose their healing modality. The cost to the health consumer of the visit to the doctor is hidden in the provincial tax structure. The health consumer also gets a fixed nunmber of 'free' visits to the chiropractor with a 'topping-up' fee which chiropractors charge without which they would not be able to operate their clinics profitably. The massage therapist charges between $40.00 and $60.00 for consulation, assessment, and treatments which usually take between a half-hour to an hour, averaging 45 minutes.

This cost is borne by the patient and/or partially subsidized by a personal group insurance plan. Some of these plans such as Blue Cross, or Great West Life, Sun LIfe, Mutual Life, cover from 80%-100% of massage therapy treatments if covered in their particular employee plans.

The big difference in choosing a healing modality comes when one is involved in a motor vehicle accident"MVA".

In Manitoba only chiropractors and physiotherapists are able to obtain coverage for patients from either Autopac or

Workers Compensation in the event of a workplace injury. Therefore it is cheaper, much cheaper to visit a chiropractor or physiotherapist in these instances.

Therefore most of patients involved in these types of injuries choose the physiotherapy or chiropractic healing modality when in many instances massage and hydrotherapies would be beneficial in assisting healing and shorten the healing time with restrictions to muscles and limited range of motions to joints.

STANDARDS FOR MASSAGE THERAPISTS AND REGULATION OF THE MEMBERSHIP

In Manitoba massage therapists may work professionally once they belong to an association and obtain the appropriate licenses and permits which vary between municipalities and urban jurisdictions.

The minimum requirement in rural Manitoba is membership to an association. The three main associations which regulate massage therapists vary as to their requirements for membership. The London County Society of Physiologists and the Massage Therapists of Manitoba both require a 2200 hour course to qualify for their membership. The Association of Massage Therapists and Wholistic Practitioners requires a minimum 1000 hour course to qualify for membership.

The City of Winnipeg recognizes this minimum standard and provides licenses to massage therapists with this level of training.

Any complaints about professional conduct can be reported to the various associations and the discipline which will be enforced varies between associations. At the time of writing of this article there is not a provincial standard for massage therapists and there doesn't exist the political will at this time to enforce one.

There exists a national body which is attempting to consolidate the various provincial massage associations and the federal government has indicated that there is a desire federally to institute a national standard within the near future to allow for the movement of labour interprovincially. Currently a massage therapist may operate with a 400 hour course in Quebec, a 1000 hour course in Manitoba, and a 3000 hour course in British Colombia.

The standard will probably become the 2200 hour course nationally which approximates a two year full time or three year part-time curriculum.

So how does a health consumer know how to recognize the qualifications of a massage therapist in Manitoba:

Only by asking individual professionals with which association they are affiliated and what length of course have they achieved.

Roger Fontaine is a registered massage therapist who is operating a massage clinic offering therapeutic and stress-reduction table services and mobile service for chair massage in the workplace for special events, fundraisers, tournaments, celebrations, and any other function which requires a unique special feature. I have been operating at Shapes Fitness Centre at 12-1150 Nairn Avenue in Elmwood Winnipeg since 2004, previously having operated a home residential clinic since 1999.

WHEN TO CHOOSE MASSAGE THERAPY AS A HEALING MODALITY?
by Roger Fontaine, B.A., r.m.t.
http://www.healingmassage.ca/
204-799-3663

Health and Massage

Massage affects the body as a whole. To understand how massage therapy works, some of the physiological effects of massage need to be briefly examined.

Massage is known to increase the circulation of blood and flow of lymph. The direct mechanical effect of rhythmically applied manual pressure and movement used in massage can dramatically increase the rate of blood flow. Also, the stimulation of nerve receptors causes the blood vessels (by reflex action) to dilate, which also facilitates blood flow.

A milky white fluid called lymph carries impurities and waste away from the tissues and passes through gland-like structures spaced throughout the lymphatic system that act as filtering valves. The lymph does not circulate as blood does, so its movement depends largely on the squeezing effect of muscle contractions. Consequently, inactive people fail to stimulate lymph flow. On the other hand, the stimulation caused by vigorous activity can be outstripped by the increased waste produced by that activity. Massage can dramatically aid the movement of lymph in either case.

For the whole body to be healthy, the sum of its parts - the cells - must be healthy. The individual cells of the body are dependent on an abundant supply of blood and lymph because these fluids supply nutrients and oxygen and carry away wastes and toxins. So, it is easy to understand why good circulation is so important for the entire body, due to its effect on the circulation alone.

Massage is also known to:

- Cause changes in the blood. The oxygen capacity of the blood can increase 10-15% after massage

- Affect muscles throughout the body. Massage can help loosen contracted, shortened muscles and can stimulate weak, flaccid muscles. This muscle "balancing" can help posture and promote more efficient movement. Massage does not directly increase muscle strength, but it can speed recovery from fatigue that occurs after exercise. In this way, it can be possible to do more exercise and training, which in the long run strengthens muscles and improves conditioning. Massage also provides a gentle stretching action to both the muscles and connective tissues that surround and support the muscles and many other parts of the body, which helps keep these tissues elastic.

- Increase the body's secretions and excretions. There is a proven increase in the production of gastric juices, saliva, and urine after massage. There is also increased excretion of nitrogen, inorganic phosphorous, and sodium chloride (salt). This suggests that the metabolic rate (the utilization of absorbed material by the body's cells) increases.

- Affect the nervous system. Massage balances the nervous system by soothing or stimulating it, depending on which effect is needed by the individual at the time of massage.

- Enhance skin condition. Massage directly improves the function of the sebaceous (oil) and sweat glands which keep the skin lubricated, clean and cooled. Tough, inflexible skin can become softer and more supple.

- Affect internal organs. By indirectly stimulating nerves that supply internal organs, blood vessels of these organs dilate and allow greater blood supply to them.

Knowing about the physiological effects of massage makes it possible to better understand the health and fitness benefits of massage. What takes place under the massage therapists hands has profound importance for those interested in health and fitness in tuning up their bodies. In every sport or form of exercise, massage can help. By helping to reduce physiological fatigue and aid recovery from the exertion of working out or playing, massage enables better training, with longer, more effective workouts, thus facilitating better performance and preventing injury.

The people of ancient Mediterranean civilizations knew this. After bathing exercise, they included a full body massage. The ancients understood that education involves equal development of the mind and body. The modern publics interest in physical fitness, holistic health, wellness and human potential represents a bid to revive a time honoured philosophy.

For most people embarking on a fitness program, often the spirit is willing but the flesh is not. When regular exercise is begun almost every part of the body changes. Of interest to massage therapists is the way blood vessels become more intricate in order the meet the body's demand for more oxygen, to supply more nutrients, to permit more elimination. This takes time. While the muscles are getting into shape, they have trouble getting enough oxygen and nutrient and wastes back up and stagnate.

Unfortunately, many exercise programs regard aches and pains as the inevitable price to be paid. This is simply not true. Massage can be used as the Greeks and Romans used it - to increase endurance, control fatigue and feel better as part of a regular health program.

Massage acts to disperse the accumulated by-products of muscle action that irritate muscles and nerve endings. Lactic and carbonic acids build up in muscle tissue shortly after exercise begins. These acids are waste products that contribute to the causation of the pain and occasional cramping that exercisers, athletes, dancers, etc. suffer during and/or after workouts or performing. These acids are formed when the glycogen stored in the liver and muscles in burned to produce the energy expended during exercise. The acids must eventually be reconverted to glycogen and stored again, or drained out via the lymph and circulatory systems. Pain and fatigue persist until this process of reconverting or excreting is completed. Massage can help eliminate the irritation caused by these wastes, thus increasing muscle recovery rates. When massage has been substituted for rest, an increase from 20-75%, even 100% muscle recovery has been recorded. For example, this is why boxers are massaged rather than rested between rounds.

Joints are critical to exercise because joints are moved by the muscles to produce movement. All joints are complicated, and their parts have a way of settling and stiffening when not used. A sluggish, numbed feeling in the joints discourages exercise. A massage therapist counteracts this by using massage strokes and passive movement to release the muscle tension and free the connective tissue found around the joints that can bind the joints.

Massage also aids recovery from soft tissues injuries such as sprains and strains. This is possible because the growth and repair of tissue are accelerated by efficient circulation in the injured areas and appropriate stimulation of the healing tissues. Many soft tissue injuries are not serious enough to necessitate a visit to the doctor or hospital, or are only treated with some first-aid, but still cause some discomfort and disability. Massage therapy can often help speed and improve recovery and reduce discomfort from such mishaps. In this way, massage helps bridge the gap between common neglect of injury and major medical intervention.

Increased health awareness has also increased nutrition awareness. The most carefully planned diet is partly wasted if blood vessels are not developed an open so that nutrition can reach the cells. Massage can aid internal nutrition rates by improving circulation.

The relationship of stress and illness is of interest to anyone maintaining their health. We all have stress in our daily lives relating to work, family, environment, society. Mental tensions, frustrations and insecurity are among the most damaging. Stress causes the release of hormones that create vasoconstriction - vessel shrinking - and reduced circulation Affected by stress, the heart works harder, breathing becomes rapid and shallow, and digestion slows. Nearly every body process is degraded. Psychosomatic studies show how stress factors can cause migraines, hypertension, depression, some peptic ulcers, etc. Researchers have estimated that 80% of disease is stress-related. Soothing and relaxing massage therapy can help counteract stressing effects.

Massage has a definite psychological effect. Since massage animates the tactile sense, the body's primary sense, it brings people into the here and now and away from tension generated by constant preoccupation with problems. Also, loosening of muscle tension or armouring - the physical counterpart to how we defend and protect ourselves from psychological pain - can lead to freeing of repressed emotions.

Users of massage therapy as a healing tool quickly realise that they have found a form of drugless therapy. Headaches, insomnia, digestive disorders including constipation and spastic colon, arthritis, asthma, carpal tunnel syndrome, sinusitis and minor aches and pains are some of the problems that can respond to massage therapy. Massage can have an excellent effect on nervous people who have been dependent on their pharmacy for rest and relaxation.

Simply stated, the foundation stone of the therapeutic effect of massage is what Hippocrates, the Father of Medicine and an advocate of massage, defined as vis medicatrix naturae, or the body's natural recuperative powers, the life force. Massage therapy essentially promotes health by boosting the body's own processes.

While this article has focused on how massage can help tune the body and on the concrete scientific effects of massage, it should also be mentioned that massage can be seen as a healing art as well as a science. The theories of therapeutic massage are scientific in character, but the actual application of these theories is an art, for it involves the healing sense, sensitivity of touch, insight and intuition. It is a unique way of communicating without words, sharing energy, enjoying pleasurable relaxation, and experiencing peace of mind. Massage is often attributed to have ethereal spiritual effects akin to those of meditation.

The past ten years or so have been seen a proliferation of different terms, titles, and systems of massage such as: Therapeutic, Holistic, Swedish, Sports, Neuromuscular, Bodywork, Oriental, Shiatsu, Acupressure, Esalen, Reichian, Polarity, Reflexology, etc. For the sake of clarity, the term amssage or massage therapy as used in this article refers to the scientific manipulation of the soft tissues. The thing to keep in mind is that every healing art that employs massage therapy should include some form of kneading, pressing, or stroking with the use of pressure and movement, no matter how slight the touch or how often it is used.

The best way to find a massage therapist is to get a referral from a friend who gets massage therapy or a health professional who is knowledgeable about forms of complementary and alternative health care such as massage therapy. Or you can contact Queensland Association of Massage Therapists and the Australian Massage Therapists Association for names of qualified massage therapists in your area.

Since there are many styles of massage, you may want to shop around to find someone who practices the style of massage most suited to your needs. You should be able to find a massage therapist who is right for you., though you may or may not need to try a few massage therapists to do so.

Whenever interviewing a massage therapist you should always feel comfortable asking if they have graduated from a school that is accredited or approved by a credible accrediting agency, belong to a credible professional association such as the Q.A.M.T or A.M.T.A, and also their amount of experience and styles of massage.

In terms of what to expect during a massage therapy session, they generally are an hour in length. Clients are usually asked to remove as much clothing as they are comfortable with and rest on a padded massage table. To respect personal privacy and provide adequate warmth, the client is covered or draped with a sheet or towel so that only the part of the body worked on is exposed at any given time.

Whether or not you would expect to talk during a session depends on your needs at the time. Some clients need to talk. Some need silence. Massage therapists will usually try to accommodate what the client needs. However, sometimes talking detracts from entering a state of relaxation or experiencing the physical, nonverbal dimensions of the massage. In any case, feel comfortable giving feedback about your needs and what you like or do not like during the session. Good communication enhances the massage session.

There are a few other key points to note regarding your massage therapy session. The massage therapist will likely use a high quality oil or lotion, but if you have an allergic reaction you should let the massage therapist know. Some massage therapists offer to play music during a session, others may feel it distracting. It is best not to have eaten just before a session. Your massage therapist can answer many other questions you may have. If for any other reason you must miss a massage appointment, your massage therapist will surely appreciate being notified as soon as possible.

To enjoy the benefits of massage which have been discussed, it is best to receive a therapeutic massage from a practitioner who has blended a thorough knowledge of anatomy, physiology, kinesiology, and massage technique with a sensitive, powerful touch and healing sense. Yours in health!

(c) Professional Therapist

Lynne O'Brien
Professional Therapist