I have been doing massage therapy now for nearly 39 years and it has always been not only my profession, but also my passion. In many ways, it seems as though the profession of massage therapy is at a crossroads. This has me really concerned for the future of this field which I love so much. Growth in the number of therapists has leveled off. Many schools have closed. Listening to many school owners, they are very concerned about the number of prospective students looking at the profession. Where the profession is headed is far from clear. Leaders in the field paint a fairly rosy picture of the profession, understandably so. But does that really reflect the state of the average therapist?
These are big issues and I do not pretend to have answers to these very complex problems. What I am sure about is this; the need for rock solid work that gets results for clients is greater now than it has ever been. My observation is that massage therapy fills a role that no other health care profession can provide. Most importantly, the cost savings to the client and to the health care system in general is substantial.
As the world moves faster and faster, there will always be a need for massage therapy for relaxation. Stress is more of an issue now than it was when I started my career. That need will probably grow but is vulnerable to the disposable income of the client. The need for manual therapy targeted to specific muscular conditions is an area of immense need and one that I see our field in the perfect position to fill. Other professions, such as physical therapy and chiropractic do not have the time to spend with each patient. Their services are also comparatively much more expensive.
For the bulk of the clients that my office sees, the discomfort they have does not keep them from going to work or continuing to function in daily life. It does however, make doing so a difficult affair. I think that is our niche; the people who function (often courageously) but live their life with nagging and annoying pain.
Out health care system does not serve these people well. I do not find it within economic reality that people like this will be able to pay for the physician visit, get an X-ray or MRI, and then be referred to physical therapy for a round of treatments. The cost to the system is enormous and simply not sustainable. As people will be asked to shoulder more of the economic burden, such as with high deductibles, the choice they will probably make is to do nothing. That isn’t health care. Massage therapy could efficiently and effectively serve that need.
Here is a case in point. A few weeks ago a man came to see me because of pain in his mid-scapular area and also resultant numbness in his arm and hand. This numbness did not follow a specific nerve pathway, which is an important detail. (My experience is that if you present with numbness, providers are immediately going to suspect cervical involvement, even if the pathway does not follow the typical distribution. I’d bet a lot that he would have been prescribed an MRI, which would find some degenerative changes.) He could go to work, but this was very difficult with his pain. He did his best to keep up with work because he was self-employed, but he was falling behind in his work schedule. He had already gone to see a chiropractor who adjusted him multiple times and a massage therapist who did deep tissue work on his mid-scapular area, which did not help and made him really sore. What was ahead for him was a long and very expensive road. Complaining to a friend about his plight, that friend suggested a call to my office.
I saw him for three sessions, each 30 minutes in length. As usual, I decided to pursue two possible treatment threads, as I wasn’t completely sure which was the source of his symptoms. One involved the upper thoracic vertebra, the other a trigger point issue in the Teres Major muscle. Both were reasonable and neither conflicted with each other. Treatments were quick and efficient so he could get back to work. I keep notes to myself to check on clients if I have not heard from them in a bit; he has been symptom free for several weeks. In fact, when I last texted him, he just played 45 holes of golf over the last two days. Think of the impact, emotionally and financially, of the success of PNMT with this person. Also, think of the money saved to the health care system in general.
I must point out that this person had already tried other approaches, both chiropractic and deep tissue massage. PNMT and deep tissue are not the same thing. The skill set from the assessment and palpation side for PNMT is much different. As with all things there is a place for both, just as there is a place for general massage for relaxation. They cannot however, be used interchangeably. You cannot use one approach to achieve the goals best suited by the other.
This demands a little clarity on the part of both the therapist and the client. PNMT isn’t for every therapist. Not everyone likes to solve problems or is interested in the application of massage to very specific issues. That’s a good thing. Therapists should pursue a style of work that resonates with who they are. Similarly, clients should seek out therapists who practice a form of massage therapy that is best suited to their needs and goals. Clients need to understand that there are different forms of massage out there. This can, however, be very confusing to the general public. If they get a massage in any one context, the whole of the profession is often lumped under that umbrella. That can be a problem for client and therapist alike. We have to do a better job of matching people to the right therapeutic approach.
These are all big issues and I don't know a better way to serve the profession and the public than to continue teaching PNMT. The work certainly isn't flashy and definitely isn't a marketer's dream. We don't make big promises or claim to solve all pain known to man. We don’t market a four step protocol to solving back pain; we teach therapists how to navigate through the maze of a complexity and design fluid and flexible treatment approaches. Mastering PNMT takes work and study; so does everything worth doing in life. In the end, what you will create is a practice that will make a major difference in the lives of those you touch. You will fill a niche for clients that few other approaches can offer. In return, your practice will thrive as people reward you for the good work you do. Word of mouth will spread quickly. Clients will trust you precisely because they see you adapting what you do to meet their individual needs. You will gain their trust and because you have earned it. It is a deep and profound privilege to do so.
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