Therapeutic Massage
With the implementing of the two-year training programme and the discrimination between therapeutic and non-therapeutic massage, the question "What is Therapeutic Massage?" is often posed. Along with this question goes the assumption that it is a recent development that 'massage' has been elevated to the status of a recognized health profession with the new amended Allied Health Professions Act.
This could not be further from the truth. A series of quotes from serious literature, written with a focus on the underpinning training of the therapeutic massage therapist in the sciences, with an understanding of the effects of the techniques on the anatomical structure and physiological function, and specifically aiming the applications of techniques and end results of a treatment towards a specific outcome came to light recently. What makes this so remarkable is that the books were published respectively in 1889 and 1920. Looking at the depth of the profession revealed in these quotes, the conclusion that can be drawn is that Therapeutic Massage formerly occupied an esteemed position in the health sector and like many other non-invasive health professions, lost ground with the rise of allopathic (modern) medicine and introduction of drug therapy.
Dr James B Mennel wrote in his book "Massage Principles and Practice" (Philidelphia: Blakistons, 1920:4) "To use massage aright, we must consider it entirely as a means to an end, the end being the restoration of function. Every movement performed should have it's end view; and the masseur should be able to show in reasoned detail, what effect it is hoped will result from each movement of the hand or finger, what part this effect is expected to play in the restoration of function." This suggests that way back in the 1920's the training of masseur's was underpinned by a strong foundation of understanding of normal and abnormal structure and function of the human body. It also suggests that there was a great deal of predictability in the likely results of the treatment in relation to the techniques applied. Today this forms a large part of the clinical reasoning and clinical decision-making phases of the therapeutic massage treatment and is the cornerstone of acknowledgement of the credibility and validity of the profession. If the same results can be achieved under controlled situations with repeated applications in a variety of situations, then the predictability of the techniques applied can be validated and claimed.
The following definition was recently proposed for therapeutic massage: "The manual application of mechanical, reflexive, connective tissue, fluid moving and percussive techniques to soft tissue to directly or indirectly influence normal or abnormal anatomical structure, physiological function, psychological state, emotional health and / or well-being for health maintenance, restoration, palliative care and / or condition management." This definition relates the therapeutic massage techniques to the desired therapeutic changes within human structure and function and the required outcome of the application of the technique or the treatment. This definition is closer to Dr Mennel's interpretation of therapeutic massage than most of the definitions used in the recent history of therapeutic massage in South Africa.
Dr William Murrell, MD published a book called "Massotherapeutics or Massage as a Mode of Treatment" (London: H K Lewis, 1889:2, 65) from which the following extract is taken "Another common mistake is to suppose that anyone can 'do massage', and that the whole art can be acquired in one or two easy lessons. Applicants for employment are anything but pleased when they are told that it takes nearly two years to learn, and that many people, from the lack of aptitude or defective general education never succeed in acquiring it … Anyone can rub mechanically, but that is of no earthly use; a masseuse must work with her brain as well as her hands."
This quote particularly tickled me as a friend recently phoned me and said "…. will you consider 'so and so's' daughter for training as she is not a rocket scientist ….". After picking myself up off the floor I tactfully explained that the course was pitched at a higher education level and that it required a mixture of acumen and hard work to succeed. I was relieved that this conversation was taking place over the phone and she could not see the shock registered on my face. Dr Murrell highlights in the above quote the perception that if a few moves are taught and are applied to the body, you have a job. Unbelievably this conversation proves that this perception still exists just over 113 years on. To think that we considered that we were elevating the profession to new heights with our two-year training programme, when in fact the training was being restored to it's former position.
Today, we prefer to be called Massage Therapists practicing Therapeutic Massage as the words masseuse and masseur are associated with the cosmetic (non-therapeutic) industry.
In conclusion, the therapeutic massage therapist's training is underpinned by in-depth training in the anatomical structures and the sciences (of physiology and pathology) and the application of the techniques are calculated to achieve predictable results. Knowledge and discrimination skills take time to master, hence the two-year training programme. Non-therapeutic massage on the other hand focuses on the feel good factor and techniques are applied because they are enjoyable. There is a huge chasm between the two approaches as they are diametrically opposed. Once the intention of both groups is understood clearly "never the twain shall meet."