It’s unpopular to say, but being human is a chronic condition.
All humans, even the most fit and healthy of us, are living in bodies that are will break down eventually.
Some bodies will break down more slowly than others and all will do so in different ways, but whether you provide massage in a nicely outfitted corner of your basement or in the fanciest of the fancy hospitals, you are working with people who are either in a state of disease or who will be at some point. That is simply the truth.
If you are occupying a professional space — and I’m not talking about your practice space, I’m talking about how you present yourself to your clients and how you think about yourself as a practitioner — as a massage therapist, you are providing health care. As such, your clients’ expectations of your ethical standards and behavior should be high.
What do you expect in terms of communication, safety, privacy, ethics when you see a doctor? How about a psychotherapist or a dentist?
Do you want them to know about and understand the latest science and research about their discipline — or do you want them to guess and tell you what worked for them when they had a stomach problem?
Think about this.
Are you providing the same level of professionalism and responsible attention that you expect of others you trust with your health?
Stay in Your Scope
Your clients may not know it, but they want you to behave like a health care provider and to treat them as the most trusted of their providers would. Which means, if you are a massage therapist, your clients are paying you to do a lot.
They certainly want you to make them feel better.
They want you to listen and to care about what they’re saying and even about what they’re not saying.
They want you to be perceptive and curious and, possibly above all else, to know what you don’t know.
This last bit is a place where massage therapists really fall down. Our clients want a lot from us, but they do not want us to be dieticians or personal trainers or life coaches; at least, not while they’re on our massage tables, interacting with us as their massage therapist. They may think they want these other things, but they don’t realize that armchair dietary advice, life advice and workout tips are things best delivered by their nosy neighbor … and then forgotten.
We do this thing where we decide that our “n of 1” which means, “It worked for me, so that’s proof it works,” is enough to empower us to share our lived wisdom about carbs, keto, ballistic stretching, circuit training, aromatherapy alarm clocks or whatever else.
We are not Louise Hay. We are not Dr. Oz. Let’s just feel the relief in that.
Just Be Good at Massage
As massage therapists, we often become very familiar and comfortable with our clients over time. This trust is actually part of what’s therapeutic about massage therapy, but this also makes it easy to think, “Well, I wasn’t telling them about kale smoothies as a massage therapist. I was just telling them as ‘me.’”
The fact that we are their massage therapist lends a sometimes unintended weight to any health-related advice we offer. We have to know this and it has to matter.
We dilute our effect when we creep out of our scope. Let’s just be good at massage therapy when we’re in the role of massage therapist. When we are good at massage therapy, we are doing so much more than we may think.
We are supporting one of those humans I mentioned earlier; the ones in the breakable bodies.
We are speaking kindly (I hope) to the nervous system in a way that allows the whole body to simply “do better.” We are spending an hour of our time easing the experience of another person.
All of this happens, even if (and maybe especially if) we hardly open our mouths and definitely if we stay solidly within the bounds of massage therapy’s scope.
Let that be enough. It’s a lot.
Let’s make a pact today to stop doing some really common things that are hurting our profession and our clients:
• Making claims for which we have no scientific proof: “massage releases toxins”; “I’m lengthening your IT band.”
• Blaming the lack of research on big pharma: “The pharmaceutical companies don’t want people to know how effective massage is, but we wouldn’t even need pain medicine if massage was available to everyone the way medicines are.”
• Making treatment plan recommendations with our wallets instead of our brains: You have a client who has chronic shoulder pain. After the first session, they ask you when they should come back. You think two weeks or even three is probably a good starting place, but rent is due at the end of next week, so you tell them to come next week … before your rent is due.
• Repeating advice we read on Facebook: “If you rub your arthritic knee with turmeric, you won’t need surgery”; “A pickle a day will prevent Alzheimer’s disease.”
• Saying, “That’s what I learned in massage school” as a rationale for treatment plans or in support of outdated and inaccurate physiological explanations. Such as: “Never massage a woman in the first trimester of pregnancy” and “clients are sore after a massage because your work released lactic acid in their muscles”
Watch What You Say
What happens in our offices is not research. The successes and failures on our tables are useful and they will help us build a body of knowledge that will, indeed, support us in making better and more effective treatment choices over time, but we have to be responsible in how we employ this knowledge and certainly in how we talk about it.
Maybe you do a thing that “always” helps people with hip pain. This could be the beginning of a case series. It could be the beginning of a hypothesis or an actual research question, but it leads very easily to what’s called specious reasoning.
Merriam Webster defines specious as “superficially plausible, but actually wrong. Misleading in appearance, especially misleadingly attractive.” When the “evidence” makes us look good or feel good, it’s tempting to just run with it, but this is not a responsible way to understand our work.
In the classes I teach, I sometimes illustrate this point with what might seem like a silly trope. I point at my wristwatch and I say, “This watch repels tigers.” As you might expect, students laugh, but they laugh uneasily because it’s obviously a setup of some kind.
They just can’t tell what kind exactly, so they wait.
After a few moments, I lean in, smile and say, “Wanna know how I know?” I wait just a second or two longer and then motion around the surrounding area triumphantly, “See any tigers?” They all laugh because clearly the absence of tigers proves nothing in this fourth-floor classroom in a suburban city in the Midwest, but this is what we’re doing when we tell clients about the results they can expect based on our experience with our own injuries or with the bodies of other people we’ve touched.
Our office is not a place where strictly scientific evidence can be gathered, so share the data you gather in a way that leaves room for discovery and question.
You Should Already be Busy
If the body is our scope, we must commit to learning all of the body’s systems in functional, contextual, relevant and factual detail. That will keep us plenty busy without ever mentioning the wonders of asparagus or cayenne lemon water.
If you’ll excuse the cliché, we are the ones we’ve been waiting for.
We will not transform health through policy; not by creating it and not by hating it. Nobody else cares about massage therapy enough to save us from ourselves. The kind of change that will elevate this profession and the opinion of this profession that is held by those outside of it will be the result of collective action, individual investment and empowerment to create and hold a high standard.
It’s unlikely that we’re gravely injuring anyone with our lay advice and flimsy theories, but to assume that we’re not harming people, or better yet, to assume that we’re actually caring for them responsibly and ethically is myopic at best.
Please consider that what we’re really harming is the massage profession.
About the Author: Lauren Cates is a massage therapist and executive director of Healwell, which provides massage therapy in hospitals, conducts research and provides advanced, clinical education. Experience in hospitals around the U.S. has informed their blend of nerdiness and authenticity to create opportunities to be more effective, more human and more flexible. (Lauren is gender fluid and uses the pronouns they, their and them.)