THE JOURNEY OUT OF PAIN
There is more than one way out of Pain
Oftentimes, injuries are caused or exacerbated by musculoskeletal compensations that compromise our inherent structural integrity. While advances in medicine reliably treat serious injury and pain, optimizing inefficiencies in our posture and movement could avoid it altogether.
PAIN AS AN INDICATOR
Pain is not the enemy
Non-pathological pain is neither arbitrary nor coincidental. It is an indicator that something in our posture and/or movement is suboptimal. Physiological factors compound and shape our experience of pain. It is important to understand what they are and the role that each plays in the presentation of our symptoms.
REDEFINING PROGRESS
Anticipating and being patient navigating the space in between
Musculoskeletal imbalances are not corrected overnight. In the early stages, just ‘feeling’ imbalances more clearly is a sign of progress. Shifts, tilts, bends, rotations, and other postural compensations suddenly come into one’s awareness. This feedback allows us to move differently, both consciously and unconsciously, and deconstruct habitual postural and movement patterns. Anticipating and being patient navigating the ‘space between’ awkward and easeful posture and movement can be instrumental on the path to recovery.
PERSPECTIVE ON MASSAGE
Massage has a history that spans both the broad spectrum of time and places.
Massage has a history that spans the broad spectrum of time and place- far beyond what is suitable to share here. Fast forward to the 20th century in the United States, massage “masseurs” and “masseuses” worked as physiotherapists in conjunction with conventional medicine. This changed in the 1950s, with the development of the physical therapy profession and licensing. (Massage Therapy Journal, “Brush Up on the History of the Massage Therapy Professional”, April 2017) In the 1970s, massage saw a resurgence in popularity with the onset of the alternative medicine and holistic health movement, still ongoing today. (Massage Therapy Journal, “Brush Up on the History of the Massage Therapy Professional”, April 2017) 50 years later, with the current surge of new massage businesses and membership models, massage has crossed over from the movement into the mainstream. PROFESSION Despite a long tradition, the profession of massage therapy is in the early stages. Standardization in education and regulation in licensure is still taking shape. Not until 2005 was the national Massage and Bodywork Licensing Examination (MBLEx) established and widely adopted. Even today, there are a few state hold-outs where licensure requirements are either laxed or more robust to the detriment of an industry standard. Disparities in state massage education requirements and curriculum further complicate matters. Hour requirements vary state by state, ranging from 500 to 1000 classroom hours. Given current disparities in education and licensure requirements, core competencies and job proficiency can vary therapist to therapist. In the workplace, mentorship and professional development is further complicated by lack of structure and guidance in an industry where 75% of therapists work independently as sole practitioners or as independent contractors. (AMTA, 2024 Massage Profession Research Report) Despite these challenges, demand for the profession and in the industry still grows. I believe this is a testament to the need for manual therapy and the greater potential for this work. MARKETPLACE The 2000s has seen rapid growth in the massage industry thanks to the establishment of many new massage businesses and franchises. Today, 39% of all Americans report having received a massage before, with 25% reporting receiving an average of 3.3 massages in 2023. (“The 2024 Massage Therapy Profession Research Report”, AMTA 2024) The top reasons for a visit: medical/physical health (61%), mental health/stress (56%), and special occasion/other (32%). (“The 2024 Massage Therapy Profession Research Report”, AMTA 2024) The most common and accessible type of massage is relaxation. Relaxation includes Swedish and deep tissue Swedish. Relaxation is the most easily scalable because of its marketability and adaptability, addressing both physical and mental health concerns. Despite the current relaxation-fits-all approach, there are other massage styles with more specific therapeutic intent and outcomes. These styles and practitioners are best understood on a continuum, from general to specialized. The more specialized the service and massage type, the more indepth and precise the approach. These therapies combine broader healthcare knowledge, protocols, assessments, with more focused manual techniques. Often they are offered in medical clinics, specialized therapeutic centers, or as specialty services in select spas. An unofficial overview is below:
MY PERSONAL EXPERIENCE
On My Therapeutic Approach
As an adult, I have remained active for health and fitness. During this time, I have seen various doctors for musculoskeletal dysfunction and discomfort. Aside from ruling out serious injury, there was nothing they could offer. It is no small accomplishment that our healthcare system is so well-equipped to respond to serious orthopedic injury; however, it is not unreasonable that the public also have access to preventative therapies that optimize musculoskeletal health. My search for an ‘optimizing’ manual therapy approach led me to clinical massage and bodywork. Bodywork is a general term used to describe functional massage, which includes clinical massage. Clinical massage is differentiated from general massage by its application of orthopedic assessments, specialized techniques, and particular research and clinical findings in its treatment. Given its scope and specialization, there is a shortage of clinical therapists, teachers, and programs nationwide. Three programs standout to me that are arguably the pioneers of this advanced style of massage: Anatomy Trains Structural Integration, Advanced Myofascial Techniques, and Precision Neuromuscular Therapy. Although there is overlap, each applies a unique neuromuscular myofascial approach to make more of an imprint on the nervous system to create more lasting change. My perspective on each is as follows: