Beyond Technique: Safety, Specialization, and the Future of Medical Massage

Reality Check:
Medical schools as well as massage schools prepare students for clinical practice, generally focusing on building a solid foundation. Students then choose their specializations—MDs select different residency programs. In contrast, massage therapy school graduates do not require residency studies; they simply choose relevant continuing education programs to prepare for their desired careers.

From the Author
Science-based medical and sports massage is not rocket science. To become a skilled hands-on practitioner, one must not simply memorize but understand the essence of the abnormalities being addressed—and, of course, learn and remember the step-by-step massage techniques applications.It is impossible to learn medical and sports massage in the “Instagram style,” where you watch a few seconds and think you know it. True understanding often requires rereading related material and then learning directly from a presenter through hands-on practice. Hands are guided by the brain, and the brain carries the understanding of the material learned.

No matter how many words educational materials are provided, if one wants to truly learn medical and sports massage, one must invest time in reading in order to grasp the message, the idea, and the essence.

Professional discussions in Facebook groups are a great way to learn, share perspectives, and sharpen our clinical thinking.

Below, I’m sharing the text of my post exchange from one of these groups. I invite you to take a few minutes to read—it might spark new insights, ideas, or even a shift in how you see clinical practice.

In summary, I would like to extend the Reality Check: I recommend reading carefully, as this post reflects an exchange between two educators in the field of massage who hold different professional views on specialties within the field. In my view, the goal is to choose a specialty that is truly needed. Careful reading of this exchange may help you decide on your direction. Both perspectives can be valuable—it ultimately comes down to individual preference.

I posted the following:

Hello members

Below is the link to my new article: “Danger of Overstimulation.”
I believe I have presented important information to consider.

Additionally, I would like to hear your opinion on my correspondence with an MD who refers patients to me and seems to be following my writings.

He texted me, and my reply was: I have come across your article. “Danger of Overstimulation.” Very good and informative presentation .I would avoid saying that your treatments are " 100%" if I didn't know you, it sounds like BS even if it's true so I would change it to " consistent results" Or " highly reliable and effective" or " effective results with remarkable consistency"

my reply.

“I’m not a scientist, I am a clinician, and based on many years of experience, I feel comfortable claiming that if applied correctly, massage procedures are 100% free of side effects. Yes, this is true—it is completely side-effect free. In some cases, we may not be able to help, but when performed correctly, massage cannot cause harm.”

He replied afterwards.

I still wouldn't say it like that but that's my opinion.Any scientist knows nothing is 100%, so you're claiming an impossibility.And that loses credibility .

“Please advise: should I follow his advice and change my claim, or should I leave it as is?

Best wishes,

Boris

https://www.medicalmassage-edu.com/blog/danger-of-overstimulation.htm

immediately educator replied: Thanks for bringing attention to safety in practice.

Your article highlights that massage should be both safe and effective, but seems to contradict itself beginning by suggesting that massage, if done appropriately , is 100% free of side effects, but later clarifies that even relaxation massage can cause harm if not applied properly.

In my opinion, most therapists are already at a disadvantage because they often haven’t been trained to properly assess a client’s condition or fully interpret medical diagnoses. (This makes it tough for them to know what “appropriate” treatment actually is for their client )

In our AMT classes, we emphasize the need for structured assessment, therapy planning and goal setting, so therapists can confidently tailor their approach to each client’s presentation.

I think the doctor is accurate that “100% safe” diminishes credibility as a blanket statement, but in individual cases — IN RETROSPECT— it can be stated “the application was 100% safe” but that could only be determined after the fact.

Together, we’re even more brilliant! ~Irene

This is my reply.

In my article, I am claiming that massage therapy is 100% safe when applied appropriately. As I have stated, prolonged full-body relaxation massage can be dangerous due to overstimulation and may cause harm. I also explained, using research-based data, the importance of treatment duration in both full-body medical stress management massage and regional medical massage protocols.

All of the data I presented in the article have been clinically proven over many years to be 100% safe. Of course, we cannot always help in every case, but when applied correctly, our procedures are completely free of side effects.

It would actually be better, if you find anything in my article that seems controversial, to copy and paste my exact words so I can clarify if I contradicted myself. Please use full sentences.

Thank you, and I agree: “Together, we’re even more brilliant!” ~Irene

Best,

Then I continued

I have a habit of rereading posts, and your post is excellent in extending educational discussion and promoting learning. Somehow, I immediately focused on your mention of “controversial,” which I believe is important to clarify. If something is controversial, then where is the truth? Your post goes beyond that.

As I stated, yes, I agree with what you said: “Together, we’re even more brilliant! ~Irene” — without question. In the past, I have offered to teach together in order to create a more universal approach to understanding massage. I am still offering this today — to you and to other educators and/or schools. I am ready to come and teach, to share my knowledge, and I believe we can blend many valuable understandings.

However, with this sentence, I disagree:

“I think the doctor is accurate that ‘100% safe’ diminishes credibility as a blanket statement, but in individual cases — IN RETROSPECT — it can be stated ‘the application was 100% safe,’ but that could only be determined after the fact.”

I mean, in principle — why should it only be determined after the fact? I don’t want to repeat myself, but in both my reply and my article, I provided enough points to support my claim.

Regarding your statement:

“In my opinion, most therapists are already at a disadvantage because they often haven’t been trained to properly assess a client’s condition or fully interpret medical diagnoses. (This makes it tough for them to know what ‘appropriate’ treatment actually is for their client.)”

My reply :”In my opinion, we cannot make such general statements. There are 60 developed protocols of medical massage, and it is not possible to teach all of them within the framework of a school curriculum — just as in medical school, not all specialties can be taught in detail. In both medical and massage schools, students receive foundational knowledge and clinical experience. Later, medical doctors choose a specialty and apply for residency. Similarly, massage therapists, after graduation, select continuing education classes in the specialties they wish to pursue. This is exactly what continuing education is for.

For example, if someone does not plan to practice pregnancy massage, they will not choose that class, but instead, they will choose CE classes relevant to their interests and professional goals.

You wrote:

“In our AMT classes, we emphasize the need for structured assessment, therapy planning and goal setting, so therapists can confidently tailor their approach to each client’s presentation.” My question is — are you teaching all 60 massage protocols within one program so that therapists can truly “tailor their approach to each client’s presentation”? And if not, in which cases do you believe this applies? Best wishes,

she replied

I’m not following your question regarding “the 60 developed protocols”. I specifically only teach The Diamond Method’s client activated approach. Depending on the clients goals/needs, we address reducing symptoms of stress, orthopedic/myofascial pain, migraine, and fibromyalgia and improving function and mobility. In the Active Modulation Therapy course, we briefly include assessments and highly encourage more comprehensive study so the therapist has a more foundational understanding of their client’s presentation.

My reply.

Hi Irene,

Regarding the “60 developed protocols” — this means that scientists researched and created step-by-step medical and sports massage protocols. Please click this link, https://www.medicalmassage-edu.com/instructional-massage-programs/ and if you carefully read the content of each program and count them, you will find more than 60 different protocols for specific disorders. We are all talking about being recognized as healthcare professionals. But can you imagine if medical doctors — including those in the emergency room — acted only “depending on the client’s goals/needs”? I’m sorry, but I cannot follow your reasoning. To me, it doesn’t make sense. As I often say in such cases: not applicable. Best wishes,

Dear followers,

I have always advocated for specialties such as stress management massage—not to be confused with simple relaxation massage.

This article of mine was published in Massage Today (August 2005, Vol. 05, Issue 08). Twenty years ago, when I wrote it, there was already a crucial need for a true specialty in stress management massage—real, medical stress management.
Read the article here

Today, the situation is even more urgent. Public health has been deeply affected by the post-COVID pandemic of stress-related illnesses. Unlike 20 years ago—or even just before the pandemic—the impact of stress is now far more complex and severe.

Many data, statistics show that about 90% of doctor visits are stress-related. What they often fail to clarify is that post-COVID stress disorders affect patients in multiple, overlapping ways. Most sufferers present with two or three symptoms—such as tension headaches, sleep disturbances, or muscle pain—and nearly all experience cognitive decline.

In the last two years, , I treated patients in serious decline. During the COVID pandemic, media coverage, government policies, and regulations all contributed to chronic stress. Chronic stress is particularly dangerous because it triggers widespread cognitive decline. If untreated, it can pave the way for a future dementia pandemic.

I recently presented these concerns to a group of neurologists. Together, we analyzed 20 documented cases they referred to me. The conclusion was clear: without intervention, every patient would have continued cognitive decline including but not limited to degenerative brain changes.I am now preparing detailed materials, as well as upcoming webinars and live seminars on this topic. My advice: reread this carefully. If you feel convinced and would like to develop skills in this specialty, I will be glad to share my extensive clinical experience. Those who know me understand that I never make claims unless they are backed by clinical evidence—and I have personally treated hundreds of post-COVID stress-related cases.

In the meantime, you are welcome to share your questions, agreements, disagreements, and opinions.

Best wishes,