Are We Afraid to Learn? Medical Massage, Evidence-Based Practice, and the Future of Our Profession

From the Author

After publishing “Fascial Tensions from a Massage Therapist’s Point of View — Part Two” , I had a conversation with a longtime friend of mine who is a mechanical engineer and, I would say, one of my biggest fans. He reads practically every article I publish.

This time, however, he made an interesting comment:

I found that statement curious, so I asked him to explain what he meant.

Before this article, I had published articles discussing medical massage protocols for post-concussion rehabilitation and prevention of encephalopathy. I had also presented a pilot study concerning hypertension associated with vertebral artery compromise.

I explained to him that I believe in a relatively simple approach to medical massage: teach the science behind massage in a clinically oriented way, using language that massage therapists can understand and apply.

So I asked him:

He admitted that he could not say exactly. In his opinion, this article was written in more complicated professional language and perhaps presented a more complex concept. His feeling was simply that many massage therapists might not like the article—or might not even read it.

I laughed and told him:

What I meant was not that massage therapy is simple or unimportant. Quite the opposite.

Massage therapy requires knowledge, skill, clinical reasoning, anatomy, physiology, observation, communication, and hands-on experience. But I believe that the science behind what we do should be presented in a way that makes it understandable rather than intimidating.

That conversation also brought me back to the history and development of the evidence-based massage practice movement, which I discussed in the article.

Be Informed — or Else

The purpose of this article is not to tell massage therapists what they must believe.

It is an invitation to become informed.

Below is an overview of my perspective. Some of my conclusions are based on published scientific information; others represent my personal clinical observations and professional opinions.

Read “Be Informed — or Else”

An Important Clarification About “Medical Massage”

In this discussion, “medical massage” refers strictly to a systemized combination of massage modalities performed within the licensed scope of massage therapy practice and regulated in the same manner as other professional massage services.

I am not suggesting that the term “medical massage” gives a massage therapist permission to diagnose or treat medical conditions outside the therapist’s legal scope of practice.

For curious minds only: What Is Medical Massage?

My use of the term refers primarily to the clinical organization, purpose, sequencing, and application of massage techniques, rather than to practicing medicine.

Throughout my career, I have had the opportunity to observe and work with many massage therapists performing Swedish massage and other forms of massage.

Based on my experience, I believe that the strategic sequencing and application of specific techniques within a structured medical massage protocol can make the therapist’s physical work considerably more efficient and, in some circumstances, less physically demanding.

Where Do We Go as a Profession?

Our professional community is large and diverse.

Just as in medicine, physical therapy, chiropractic care, and other healthcare professions, massage therapists have different philosophies, educational backgrounds, clinical interests, and professional goals.

Some practitioners place strong emphasis on evidence-based massage practice.

Others are particularly interested in developing massage into a more clinically oriented therapeutic profession and in using massage techniques to produce meaningful functional and health-related outcomes within their scope of practice.

I do not believe these two approaches necessarily have to be enemies.

• Evidence matters.
• Scientific research matters.
• Clinical experience matters.
• The ability to apply hands-on skills effectively matters.

Ideally, these elements should strengthen one another.

For me, the term “medical massage” represents an approach in which massage techniques are organized around a specific clinical objective while remaining within the therapist’s legal scope of practice.

The word “therapist” itself is also meaningful to me.

We call ourselves massage therapists.

That means we should take seriously the responsibility to develop our therapeutic knowledge and skills.

It means continuing to learn how our profession can provide the most effective, responsible, and useful therapeutic services possible.

The Sky Is the Limit

After many years in this profession, I continue to learn.

And I continue to believe that the sky is the limit when it comes to developing our skills.

There is always another technique to learn, another physiological mechanism to understand, another clinical observation to investigate, and another opportunity to improve what we do.

In one of my previous writings, I said that I should not apologize for the knowledge I have accumulated or for my ability to produce clinical results.

I still believe that.

At the same time, I do not expect anyone to accept my conclusions simply because I have been practicing for more than 50 years.

Everything I write about comes from my personal clinical experience, my continuing education, my study of science, and my attempt to explain complex subjects in language that everyone can understand.

Honestly, I do not believe there is any reason for a massage therapist to be afraid of learning something new.

Our profession can only become stronger when we are willing to learn, question, investigate, and continue developing our skills.

Best wishes,
Boris Prilutsky