- Making Sense of Medicine by Bob Keller
- When one thinks about massage, one imagines lying on a massage table for an hour or so, undressed but covered by a drape, and having the pleasing experience of being rubbed with massage oil by a professional therapist: head and neck, arms and hands, legs and feet, and, of course, your back. The best result of such a classic or Swedish massage is to feel relaxed all over, to be relieved of stress and to feel ready to take on the world.
Here is a laundry list of some of the more common approaches: deep tissue massage, sports massage, hot stone massage, trigger point, reflexology, craniosacral, zero balancing, Feldenkrais, acupressure, Alexander, Jin Shin Do, Thai massage, neuromuscular, polarity, reiki, Rolfing and even more. These are all effective techniques when applied in the context they address.
What is medical massage?
Of particular interest to me is what’s called medical massage therapy. Medical massage therapy is a broad category that uses soft tissue manipulation to relieve specific medical conditions. In other words, medical massage therapy is outcome-based and is sometimes called clinical massage or treatment massage.
There are now numerous schools that claim to teach medical massage therapy, and even award a certificate. But there is no one set of techniques to be taught nor certified. Rather, whatever techniques a particular therapist uses become medical massage when applied to relieve a specific condition, like low back pain.
Every licensed, professional massage therapist acts in some cases to perform medical massage. That is, anyone who successfully treats specific conditions is free to print up and legitimately display a medical massage certificate.
That said, there are some therapists, myself included, whose practice is focused mainly on medical massage.
Is medical massage new?
Massage has been used as a medical treatment at least as far back as China 5,000 years ago. And as recently as the last few centuries, there are books and papers, often by physicians, explaining the clinical application of massage. Among the most influential practitioners in this area was 20th-century doctor Janet Travell, whose work with trigger points and referred pain fueled an explosion of information in the area of neuromuscular rehabilitation.
An example of medical massage
I don’t usually write much about my own practice in these columns, but the myokinesthetic system I use, MYK for short, is a good example of medical massage therapy.
MYK uses very precise, gentle muscle movement and stimulation to address a wide variety of specific medical conditions. These include migraine headaches, sciatica, carpal tunnel, knee pain, hemorrhoids, tennis elbow, low back pain, plantar fasciitis and many more.
What I do
At every vertebra in your spine, from your head to your tailbone, there emerges a big pair of nerves from your central nervous system that we call the nerve root. The nerve roots branch out to innervate every part of your body: muscles, organs and more. That is to say, every part of your body is hard-wired to your CNS through one or more nerves.
If you visit as a patient, my first priority is to determine which nerve root is primarily responsible for whatever pain or other condition you are experiencing. In order to do this, I listen to your symptoms, perform a posture analysis, do some muscle testing and arrive at a conclusion. If there is more than one nerve root involved, then I will usually prefer to treat the one responsible for your oldest pain.
Next, using very gentle stretch and stimulation, I treat every muscle in your body that’s innervated by that nerve root, and only those muscles. In so doing, a focused neurological signal is sent to that nerve root, and on to the CNS.
The CNS then perceives that there is some imbalance in the signals between the right side and left side of the nerve root, and being determined to enforce balance in your nervous system, it sends signals down to adjust the postures in your body. When balance is achieved, your pain or numbness is generally relieved.
How it works
The effect of MYK treatments is very similar to what your surgeon may do in implanting a nerve root stimulator in your spine. I would love to tell you how and why the NRS works. Alas, however, no one seems to be quite sure why this works. And the same applies to MYK.
MYK has worked in about 80 percent of my cases, and it seems to have an effect better than the NRS. As I understand the research, the NRS generally has the effect of changing pain into numbness, whereas with MYK, I generally expect a return to normal sensation.
The point of this is to illustrate some differences between medical massage and classic massage. For example, MYK uses no oils nor creams, you are fully dressed, and the treatment is 10 to 20 minutes. In addition, results are achieved through focus on a specific nerve root, while in a classic massage, most of your nerve roots are stimulated randomly, leaving the CNS with no clear direction as to what to do.
I recommend getting a regular classic massage for your general well-being, but if you have specific pains or other conditions, I urge you to consider medical massage.
Bob Keller maintains a holistic practice in Newburyport, MA.