Understanding "MEDICAL MASSAGE" & How Massage Therapy Can Help You...
What is "Medical Massage"?
In some circles, the term is used to suggest that the person or clinic employing medical massage has a more "clinical", "technical" or "insurance-compliant" approach to massage than their relaxation or stress management therapy counterparts.
A cohesive and objective definition of the term "medical massage" can be derived by examining each word.
Let's start with the word medical...
Medical = Of or relating to the study or practice of medicine. The word medicine refers to something that treats or prevents or alleviates the symptoms of disease. The term is derived from the Latin ars medicina, meaning the art of healing.
Medicine has several branches such as "Preventive medicine" which focuses on preventing disease. Alternative medicine treats disease without the use of drugs. Complementary medicine combines traditional medicine with alternative medicine.
My view is that Massage is most effective when it is part of an integrative approach to disease treatment and prevention. Our approach looks at addressing the cause of the disease in addition to treating or simply masking the signs or symptoms of the disease (although pain management is critical if we expect to function normally throughout the day).
What does Massage really mean then?
The term "massage" has several origins. The most direct origin comes from the French word, massage, meaning "friction or kneading," or from Arabic massa meaning "to touch, feel or handle" or from Latin massa meaning "mass, dough". An older etymology may even have been the Hebrew me-sakj "to anoint with oil". In distinction the ancient Greek word for massage was anatripsis, and the Latin was frictio.
In a more technical perspective, "Massage therapy or bodywork" means the science and healing art that uses manual actions to:
1) Palpate; Palpation is the assessment (usually with the hands of a healthcare practitioner) of a patient's or client's tissues to identify swelling or muscle tone, to assess range and quality of joint motion, and provoking or qualifying pain with pressure or stretching.
2) Manipulate; Massage use various pressures (deep to light, structured to unstructured, stationary, or moving) and techniques (tension, motion, or vibration, done manually or with mechanical aids) to act on and manipulate the body. The massage is applied with the hands, fingers, elbows, forearm, and feet.
3) The soft tissue; Soft tissue includes tendons, ligaments, fascia, fibrous tissues, fat, and synovial membranes, and muscles, nerves and blood vessels of the human body.
4) To create a positive outcome for the client. The immediate outcomes improve circulation, reduce tension, relieve soft tissue pain, or increase flexibility.
"Massage therapy or bodywork" also includes the process of determining whether massage therapy or bodywork is appropriate or contraindicated, or whether a referral to another health care practitioner is appropriate.
As trained therapists, we use intake forms and interviewing skills to learn about a client's health history and current state of wellness, pain or discomfort, and goals. For clients who need several sessions to get measurable results we will also keep SOAP notes (ongoing clinical notes and reports to track session results) and perform walking and postural assessments to identify potential roots of the pain or discomfort.
It is important to note that "Massage therapy or bodywork" does not include making a medical or chiropractic diagnosis.
So, to answer the original question of "what is medical massage?" the most concise definition is:
Medical Massage is using the science and art of treating soft tissue via palpation and manipulation to treat, alleviate or prevent disease (without diagnosing or prescribing).
Medical massage combines advanced soft-tissue techniques with patient-specific treatment plans. Here at Milwaukee's Best Massage, our therapists also integrate relaxation massage, and use the session to reduce stress, thus maximizing the client's ability to heal.
After completing a functional assessment and using the intake form and initial interview to assess the client's health, the effective massage practitioner uses a variety of proven modalities to treat the patient or client.
It is critical to realize that invoking a relaxation response is just as medically important as is using other techniques such as:
- myofascial release
- neuromuscular therapy
- scar tissue mobilization
- neuromuscular re-education
- PNF stretching
The effective therapist also adapts their treatment plan to reflect the needs of the client. Gone are the days when a standard massage routine or single modality is effective.
It's wise to treat the whole body. The body seeks balance and will do whatever it has to function properly, if it means creating less than optimal posture or walking patterns or throwing the muscles out of whack to create the illusion of balance.
Furthermore, since every part of the body is somehow affected by every other part of the body (like ankle pain affecting lower back pain and shoulder and neck pain), full-body treatments are often the best approach to achieving results.
At times, (where time is at a premium or insurance only covers specific types of treatment) the massage therapist focuses primarily on areas that are specific to injury or disease.
Consequently the length of the session may last from 15 minutes up to two hours. Three or four hour sessions are also possible, especially where Myofascial release is part of the massage therapy regimen.
These shorter sessions use massage therapy to treat specific injuries, such as whiplash, or specific regions, such as the lumbar-pelvic region.
Cumulatively, repeated massage sessions can help relax the muscles, increase and maintain range of motion, decrease stress and tension, increase circulation, and prevent and breakdown scar tissue formation.
While massage therapy can do wonders for those who receive it on an ongoing basis, massage therapists are NOT doctors. In school, we learn the language used by medical professionals to help communicate with each other, and the insurance industry. Still, the massage practitioner provides a different experience than doctors.
Instead of aspiring to be or to compete with doctors, today's massage therapist should aspire to be exceptional at what - in my opinion - makes a good massage practitioner and massage therapy so effective. These attributes include:
- Having a thorough understanding of the human body and how the muscular system affects health, comfort, longevity and overall client wellness
- Serving as a provider of humane, positive, supportive touch
- Being an empathic listener
- Delivering a non-judgmental assessment and session(s) to provide pain relief
- Improving a client's condition through their practice or palpation and muscle work and basic recommendations for optimal wellness
- Remaining a humble, yet professional practitioners who happily makes referrals to others trained specifically to treat the client for the problems that are beyond the scope of massage therapy
Massage therapy allows us to treat pain quickly and without drugs (and the side effects that many prescription or over-the-counter drugs deliver). There are so many positive, documented benefits to receiving massage on a regular basis
Physical Benefits of Therapeutic Massage
- Helps relieve stress and aids relaxation
- Helps relieve muscle tension and stiffness
- Alleviates discomfort during pregnancy
- Fosters faster healing of strained muscles and sprained ligaments; reduces pain and swelling; reduces formation of excessive scar tissue
- Reduces muscle spasms
- Provides greater joint flexibility and range of motion
- Enhances athletic performance; Treats injuries caused during sport or work
- Promotes deeper and easier breathing
- Improves circulation of blood and movement of lymph fluids
- Reduces blood pressure
- Helps relieve tension-related headaches and effects of eye-strain
- Enhances the health and nourishment of skin
- Improves posture
- Strengthens the immune system
- Treats musculoskeletal problems
- Rehabilitation post operative
- Rehabilitation after injury
Mental Benefits of Massage Therapy
- Fosters peace of mind
- Promotes a relaxed state of mental alertness
- Helps relieve mental stress
- Improves ability to monitor stress signals and respond appropriately
- Enhances capacity for calm thinking and creativity
- Satisfies needs for caring nurturing touch
- Fosters a feeling of well-being
- Reduces levels of anxiety
- Creates body awareness
- Increases awareness of mind-body connection
How massage helps relieve pain...
Touch is the most powerful tool in the world. The simple laying of hands on the sick is an ancient tradition that is as effective today as it was thousands or tens of thousands of years ago. When you combine light, loving, non-judgmental touch with specific massage techniques, the ability to relief pain and create a sense of prolonged wellness is magnified dramatically.
Another way that massage helps is through the physical removal of the waste products from the muscle tissue. As the body is kneaded, stroked and heated, blood flow is increased, taking oxygen and nutrients into the area. Lymphatic (the lymphatic system itself is responsible for optimum functioning of the water circulation and immune system) drainage is enhanced, thereby removing waste products and reducing the affects of the pain inducing chemicals.
Other ways in which pain is decreased by massage...
The ground substance of the fascial casing of the muscle and muscle fibers (a web-like matrix) varies from a thin, fluid (sol) state to a thick, solid (gel) state. The consistency of the ground substance can be influenced by heat, pressure, vibration, elongation and other mechanical distortions.
When the muscle becomes warm from the blood flow, frictional stimulation, and other mechanical pressures, the fascia will become more liquid and malleable. The physical pressure on the muscles will be lessened as the fascia softens and the muscular contractions reduced. With the fascia in a more liquid state, the muscle may also be more easily lengthened, thereby decreasing intrajoint pressure and further reducing neurostimulating input into the cord.
As the body is touched, the pain control (analgesia) system of the brain and spinal cord can be activated. This system affects both fast (sharp) pain signals and slow (burning) pain signals, thereby influencing both acute (short term) and chronic (long standing) pain.
Inhibition of pain transmission may be evoked by the release of chemicals, such as enkephalin and serotonin. These chemicals are believed to cause presynaptic inhibition of neurostimulation, that is, stopping transmission before the nerve fires to the next nerve. Other analgesic chemicals resembling opiate-like substances, such as endorphin and dynorphin, may also be released.
Inhibition of pain receptor firing can also be caused by the brain itself. In the 'gate-control theory', it is postulated that a modulating gate mechanism exists within the nervous system which controls the transmission of impulses into the cord. It is thought that incoming impulses can be overridden by other impulses, sort of like a train track which can be switched; where the tracks merge, only one train can travel at a time.
When the secondary stimulation travels faster or stronger than the established reflex circuit, it can override the reflex arc, which is transmitting the pain signals. Massage is one of several stimulants which can override pain transmissions.