woman holding red ceramic heart over her chest.

Massage therapists tend to be people who are deeply dedicated to independence and autonomy. That trait is laudable in many situations, but it can also blind some of us to the realities of our responsibilities as health care providers.

In light of the recent debates in the profession about staying open or not during the early days of the COVID-19 lockdown, I want to talk about what COVID-19 exposed about many massage therapists and why this matters to the future of massage therapy in health care.

I’m not interested in re-hashing the heated and polarizing debate about who closed, who didn’t, who closed too late or who kept working because the chiropractic practice they work with stayed open.

As a profession, as a body of providers, massage therapy didn’t respond quickly enough.

Looking at why that happened will help give us a roadmap going forward as we continue on our path of becoming true partners in the larger health care arena.

My own organization, Healwell, definitely got it wrong. When hospitals and other clinical organizations started asking non-essential providers to stay home, we reached out to our donors and thanked them for their ongoing support.

“Everybody wants us to stay! They like us! They really, really like us!”, we proudly announced. This is what Healwell works for every day, right? For massage therapists to be accepted as members of a health care team. To be deemed essential.

“See? Your dollars are working,” we said. “You did it!”

Difficult Decisions

When we realized what was really happening and how every additional mouth and every additional set of hands, not to mention medical facility, was a vector for infection, we were faced with a very hard decision.

We were actually faced with a tangled snake of hard decisions.

If we suspend our hands-on services, are we saying we are not essential?

If we let down our clinical partners, are we proving the long-held bias that massage therapists can’t take the heat in the kitchen?

If we suspend our services, what will happen to the 14 massage therapists who aren’t going to have jobs — not to mention the large percentage of our operating revenue that will disappear?

At the end of the day, the decision was difficult but clear.

This was so much bigger than Healwell or any of our individual therapists, our bank account or whether or not massage therapy was getting its due. If we kept working, people could die. We had to thank the hospitals for loving us and then tell them our oath to do no harm would have to win out on this one.

We knew the science weeks before. The dangerous game of chicken we had all been playing had to end.

The behavior on the part of some massage therapists during the COVID-19 lockdown demonstrated two things that have already made massage therapists unwelcome in some health care circles — long before COVID-19, actually.

Collaborating By Leaving

The first is a clear lack of understanding of science. While the specifics of COVID-19 continued to emerge in the days and weeks when we were all having our debates about staying open or not, what was not unclear is germs spread quickly and easily and a largely unknown, novel virus needs to be treated with uncommon caution.

We also had clear data from Wuhan, China, that social distancing, a thing that is impossible to adhere to while providing massage, is the thing we could do to limit spread. Hospitals were telling hospice nurses, social workers and other direct care providers that could certainly be argued to be essential to please stay home.

It was clear that every person is a vector for infection and people could be infected for many days before manifesting symptoms — and still massage therapists made claims about the value of verbal pre-screening and handwashing, blatantly ignoring the scientific evidence that social distancing is key.

The second thing that emerged is a sense that many massage therapists believe the care we provide is on par with that of cardiac surgeons and emergency department staff. I will be among the loudest to shout about the place of massage therapy in mainstream and even frontline health care, but COVID-19 is a place where it was clear we needed to stand down and notice our egos were getting in the way of meaningful collaboration.

It’s hard to think about the act of removing ourselves from health care as an act of collaboration, but in this instance, removing ourselves was a beautiful place to show we really got it. Still, we didn’t.

The Right Thing

I am a person who does most of their massage work inside hospitals, literally next to doctors and nurses. It was deeply sad to make the decision to remove our therapists from the clinical care setting at all of our partner sites (seven hospitals and two continuing care facilities).

Every single one of our clinical partners responded to our announcement with a combination of sadness — because they, too, believe what we do is so important to their patients — and gratitude.

They were sad to lose us at a time when the kind of support we provide would undoubtedly be needed. They were grateful they didn’t have to ask us to leave, because they really didn’t want us to leave, but they also knew it was the right thing to do.

Massage therapists do what we do because we want to lessen suffering and pain. We hate to see it. When we see it, we want to help. We want to show up and massage it away. We just can’t seem to figure out how to own and claim our value without missing the forest for the trees.

We cite our clients who have migraines or lymphedema or arthritis or an anxiety disorder or who are dying and we are sure everyone will agree the need for massage and really for me to get in there to massage people supersedes the demands of basic safety, because what we do is so essential.

Viruses are not thwarted by the benevolence of our intentions.

The people you serve who have chronic and inflammatory conditions, who need massage the most, are also the people who are the greatest risk of dying from COVID-19. Some of us chose not to see that. We couldn’t see it around our stories of self-importance.

The continuation of that mentality will continue to make us a liability to health care.

How do we keep our heads up while we’re being asked to stand aside for an unspecified amount of time, during COVID-19 shutdowns or anytime similar time in the future? Easily. We do it with the pride of knowing that we’re doing the most healing and compassionate thing we can do when our very presence can be harmful.

We’re holding people in our hearts until we can hold them in our hands again.

Editor’s note: This is an opinion piece.

About the Author

Lauren Cal 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.) They regularly contribute articles and guest editorials to MASSAGE Magazine, including “Massage Therapy is Health Care. Start Acting Like It.”