Massage Therapy

- From St. Louis Post Dispatch-
By Harry Jackson Jr.

Two years ago, Jeni Widerman, 29, of Oakville, Injured her neck in a traffic accident..
The injury became another layer of pain atop her diagnosis of migraine and cluster headaches. "I had a migraine that lasted for three weeks," says Wilderman, a middle school teacher. Making matters worse, she found that she was allergic to one of the medicines.
Dr. David H Jansen, a chiropractor with offices in Creve Coeur, had suggested visits to a massage therapist who works in his office.
"I'd been reading up on massage therapy for some time, looking for different ways to deal with migraines," Widerman saud. So when the accident happened, she visited the therapist that same day. She was hooked and has been visiting about once a week since then.
"I rarely have to take my migraine medicine any more," she said. "I'd read that a lot of people had success controlling migraines through massage therapy without medicine. It was just a coincidence that I got into a car accident and needed massage therapy eveb more than I had previously."

What's New
Massage therapy has rapidly become a popular alternative treatment for everything from stress to pain relief to rehabilitation.
According to American Massage Therapy Association's 2005 fact sheet, one in five people surveyed said they had receibed a massage of some sort in 2005 - about 5 percent more than in 2004. It is estimated that by 2012, the number of massagetherapists will have increased by 20 to 35 percent.
The upswing in the popularity of massage has followed two decades of newly enacted state laws that recognize massage therapists as allied health practitioners.
Nowadays the occupation, whose services were once seen as a luxury on country clucb locker rooms (or a front for prostitution), is among the fasted-growing vocations of young people seeking their first career, as well as for those who want to start second or supplementary careers.
"In the last 20 years, it's become a part of the medical community," said Matt Meyers, a licensed massage therapist with Barnes-Jewish Hospital. "But it had such a terrible stigma, with massage parlors being a cover for everything else, and that's not what it is."
Modern therapists, he said, "have gone through the trouble to take the training and the trouble to pass that state board's test - it's grueling."
Missouri and Illinois enacted licensing within the past six years.
"As massage therapists, we own the name now; we own the word," said Joe Horn, program chairman at Missouri College, a school in west St. Louis County that prepares students to take the licensed massage therapist certification exams in Missouri. "That's the first step toward getting your profession into a better light."

What is MassageTherapy?
Massage therapy is the practice of manipulation - kneading, stroking, pounding - of muscles, skin, anything that's not bone or connective tissue. The purpose of the manipulation ranges from simply making a client feel good up to helping to aid in the rehabilitation of injuries.
"What used to be a feel-good practice that only people with money could indulge and afford," Meyers said, is now "more mainstream, more of a necessity than a luxury."
"By relaxing someone, you lower their blood pressure and their heart rate, things of that nature. But there are parts of the body, positions, strokes and different types of maneuvers to create ... to get the desired effects."
Trisha Becker teaches massage therapy at St. Louis University. She's a physical therapist who specializes in orthopedic therapy and is a licensed massage therapist.
She practices and teaches "outcome-based" massage, meaning she uses massage for the rehabilitation of physical problems.
Becker's area is one of a myriad of specialties for massage therapists. There are hundreds of different types of massage, she says. The techniques and methods can range from:

-- Massage that makes you feel good - usually found at spas or advertised by private practitioners who'll bring the spa to your home. These are often called Swedish massages.

-- Sports-based - relieving sore muscles after hard physical activity.

-- Outcome-based - massage based on physical therapy, aimed at specific physical conditions.

Massage comes in more than 100 forms, maybe more if you take into account that some form of massage has been identified in every culture and country that has pocked the earth.
The federal government and medical community consider it complementary and alternative medicine.
The most basic massage, the Swedish massage, is the grandparent of all massages in the West.

What happens

The licensed massage therapist will squeeze, stroke, bend, wring and manipulate muscles. The method produces a series of effects.
"Physically, you are moving fluid," Becker said. "That produces physiological effects, which changes the biomechanical effects, which causes psychological effects, reflex effects because you change the nervous systems and psychoneuro-immunological effects, which enhance your immune system.
"When you contract a muscle, you have waste products - oxidants, lactic acid, irritants. If you have a lot of tightness in a muscle, that stuff doesn't go anywhere," she says. Massage basically wrings the muscles out as you would a sponge, she says. The waste products go into the lymphatic system and then are flushed from the body, she said.
The release of waste materials can be so effective that it sometimes can cause nausea when the massage is complete, Becker says, which is why once a massage is over, clients sit quietly for a while and drink a lot of water to help flush their systems.

What massage isn't
A massage therapist brings relief, not cure.
"Be careful to know that we don't cure anything," Meyers said. "We assist; we help alleviate pain."
So if a massage therapist claims to be able to cure an illness or a disease, run in the other direction, he says.
Also, don't confuse massage with "reflexology," the practice of massaging feet and palms to affect other parts of the body. People with the placard of reflexologist do not have to be licensed by the state, although a licensed massage therapist may know reflexology and any number of Eastern techniques through his or her continuing education.

When do you need one?
If you just need to relax, a therapist working in a spa is fine, Becker said. If you have something really ailing you, especially pain, you need to start with your physician and either get a referral or get an OK to visit a licensed massage therapist. Therapists aren't trained to recognize diseases and other conditions that require a physician's diagnosis.
Otherwise, "if you just want a massage, you need to find a good massage therapist," Becker said. Go by recommendations from friends, she suggested. "Find one in a spa or one who has a private practice."
If you don't feel comfortable with a stranger's hands all over you, Becker says that's OK.
"Touch is very powerful," she said. "It can bring back memories; it can cause certain things to happen within your body that you don't like. So (if that's the case), don't get a massage because you won't get the effects that you need."

What to expect from a licensed massage therapist and your first massage:

-- First visit: When arranging for your first massage, the staff of an office will explain the options and ask what you want. An assessment will involve either a questionnaire or a conversation so that the therapist can watch for special physical problems. Use the first visit as if you're interviewing a new employee. Look at the surroundings, the equipment and the professionalism of the office. Even watch for cleanliness; Missouri requires that equipment - even upright chairs used for shoulder massages - be disinfected after each use. Meet the person who'll be doing your massage. If you're uncomfortable, leave.

-- Cost: Expect to pay about $50 an hour if you seek out a massage therapist for a basic massage for relaxation. The price goes up, depending on what you want - for example, deep tissue massage, pain relief or home visits. Insurance may cover massage therapy if you're referred by a physician or a physical therapist for specific therapy, such as therapy for an injury or physical condition that's under a doctor's care.

-- Time: Most head-to-toe massages take 45 minutes to an hour.

-- Clothing optional: After the initial interview, the first source of anxiety may be how much of your clothing you may need to remove. A professional therapist will make suggestions but not urge you one way or another. He or she will leave the room while you disrobe. Then you're covered with a sheet and the therapist removes the sheet only from the parts of your body he or she is massaging. If you're uncomfortable with disrobing, wear light, loose clothes of thin material. Some therapists will provide modest garments.

-- Man or woman therapist: That depends on your comfort level. Some religious practices have strict guidelines on unmarried couples touching. Feel free to ask the gender of the therapist when calling for an appointment.

-- Lights, music, scents: Amenities often depend on the purpose of the massage. To promote relaxation, a therapist may use low lights, scented oil and soothing music. Therapists providing massage as physical therapy may not provide this. The amenities have nothing to do with the experience or skill of the therapist.

-- Sleeping: That's fine. People react differently to massages. Some go into deep sleep; others become energized. The therapist will finish and awaken you when your time is complete.

-- Painful massage: Deep tissue massage can hurt when you first start and lessen with ensuing visits. Tell the therapist if the massage hurts. Swedish massage, the basic, shouldn't hurt at all.

-- Inappropriate behavior: Any conduct that makes you feel uncomfortable should be reported to a supervisor or to the state. This includes inappropriate touching or suggestive language. It also includes making inaccurate promises about the therapeutic value of massage. Massage cures nothing. It relieves symptoms for a number of conditions.

-- Talking with the therapist: Massage can take you to a nearly hypnotic - and chatty - state of mind. Can you tell too much? Missouri law and federal privacy guidelines protect most conversations between licensed medical practitioners and patients. But there are some gray areas, and the law requires medical practitioners to report dangerous information to police. So remember: You're talking to a medical practitioner, not a priest.

Fit to the core
By Harry Jackson Jr.
ST. LOUIS POST-DISPATCH
08/28/2006

hjaxson@post-dispatch.com 314-340-8234

Sources: American Massage Therapy Association, State of Missouri, U.S. Department of Health and Human Services, area massage therapists.