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What's the difference between STM and massage?
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What's the difference between STM and massage? - May 21, 2004 4:19:00 AM
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chiroortho
Posts: 655
Joined: February 18, 2004
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Hi folks, hope all is well with you and yours.
I am starting this thread not to cause trouble, but because I am sincerely interested in your input.
I've seen folks on this board make the distinction on a few occasions between STM and massage, and I am curious as to the technical differences. As PTs are well trained in this area, I thought I'd ask your opinions.
BTW, in my area it has become fashionable for some LMTs to advertise that they do 'medical massage', 'sports massage', 'neuromuscular therapy', and such all in the same advertisement. An LMT that used to work in my office years ago started a massage therapy school, and we've maintained good rapport, so one day I called her and asked her about the different types of massage therapy techniques being advertised, such as 'medical massage'. In essence, she said that there wasn't any difference between 'medical massage' and 'neuromuscular therapy'; it was more of an advertising concept to help with the medical referrals. If true, I don't blame the LMTs, and I certainly don't spend any time worrying about what the LMTs call their procedures. I just thought it was interesting.
What do you think?
Respectfully,
Greg
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Greg Priest, DC, DABCO
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Re: What's the difference between STM and massage? - May 21, 2004 11:09:00 PM
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nari
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Joined: November 14, 2003
From: Australia
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Hi Greg
I spent, many years ago, as part of my undergrad course, 18 months learning remedial massage. I don't know what that is; nor do I know what neuromuscular massage or sports massage is.
Straight 'massage' suggests anyone can do it, so I think the different names spring up to make it sound more credible.
Massage is pleasant, its placebo effect is powerful, it does no harm, and may even send appropriate impulses to the anterior cingulate.
I do not practise it, per se. It is not generally recognised as 'appropriate' physiotherapy where the aim is to assess and treat what you find in relation to the complaint the patient presents.
But in the light of the updated neurobiology, it may well have a true therapeutic function.
Physios can choose what they wish to achieve the outcome they and their patients want; I have no issue for PTs to choose massage as a treatment.
Until there is some evidence that it does more than 'feel nice' for a day', I choose not to use it.
Nari
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Re: What's the difference between STM and massage? - May 21, 2004 11:50:00 PM
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nrl
Posts: 121
Joined: May 23, 2002
From: israel
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hi nari,
there is some evidence of effectiveness of massage.
one i had in my files is : review of the evidence for the effectiveness, safety, and cost of acupuncture, massage therapy, and spinal manipulation for back pain.
Ann Intern Med. june 2003.
i remember seeing other articles with about the same conclusion
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Re: What's the difference between STM and massage? - May 22, 2004 3:34:00 AM
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chiroortho
Posts: 655
Joined: February 18, 2004
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nari,
Very well put. We have 2 LMTs in our practice, and our patients just love them! Since our practice sees so many folks that have what I might describe as 'muscular pain', as opposed to true joint dysfunction that would require SMT, we added therapeutic massage so that we could offer this particular group of patients some help.
It is very interesting to hear that a lot of PTs don't perform massage, as noted on another thread here. I think PTs are actually the best folks to perform massage therapy due to your extensive training in anatomy, biomechanics, etc. and although I understand that some might not do it out of concern that they might be viewed as a 'masseuse', IMO that's a shame because you're the folks that I think would benefit most from adding it to your list of services (of course, if you're comfortable with the efficacy data; I understand completely if you're not).
I'm not slamming LMTs here, as my profession has more than it's share of issues to deal with, but unfortunately one of the main reasons that we decided to add LMTs to our practice is that when we referred patients out for massage therapy, a few would come back to me and describe some very questionable things going on, e.g. strange metaphysical comments having been made, burning of incense, 'moxibustion'-type procedures and the like. I fully realize that it would be wrong of me to generalize about LMTs or any other profession for that matter, but I just decided that it would be preferable for me to hire my own LMTs which allows us to supervise them and let them know what we feel is/is not acceptable. Our LMTs are very professional, and have done an excellent job with our patients.
At least one PT in our area advertises therapeutic massage as a service that he offers, which I think is great! I don't recall if we've sent him any folks for massage per se, but I do think we've sent him patients for PT rehab services.
I also think that you hit the nail on the head about the different names springing up to make the procedure sound more credible. But I suppose I understand why the LMTs do that; they're working against many years of old perceptions and desire to distance themselves from those 'masseuse' perceptions. Can't blame them.
Thank you Nari for your comments. Good to hear from you.
Greg
_____________________________
Greg Priest, DC, DABCO
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Re: What's the difference between STM and massage? - May 22, 2004 1:52:00 PM
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rolf-inge
Posts: 23
Joined: May 10, 2004
From: norway
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Hi all!
Sometimes massage is nesessery alone or together with other Mt/PT treatment.
BUT there are no sientific evidens what so ever to say that massage therapy is less effective than other classical MT/PT treaments in treating chronic or acute pain conditions.SORRY!This is EBS.
What you experience in you clinical pratice might
be another world!
BUT cognitiv behavior therapy seems to be moore effective in the long run compared to other treatments!
RIN
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RIN
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Re: What's the difference between STM and massage? - May 22, 2004 4:20:00 PM
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nari
Posts: 1568
Joined: November 14, 2003
From: Australia
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Rin
I agree; there are many other methods we could use that may be just as effective, or better.
I hesitate over physios saying they practise CBT, as that strictly belongs to the psychologists' arena - but we can still educate, understand the real reason (cognitive)behind many pain complaints, and deal with these issues.
I notice that on this forum, and in another, there is a tendency for more physios to take on this role; but the need for it has to be recognised first.
Nari
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Re: What's the difference between STM and massage? - May 23, 2004 11:42:00 AM
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nrl
Posts: 121
Joined: May 23, 2002
From: israel
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"that strictly belongs to the psychologists' arena" i don't fully agree.
guiding patients to full function (using exercise, gradual return etc.) is behavioral therapy ,as i understand it. i believe we have to learn from the psychologists how to do it correctly. we need to be better educated about how to do do this intervention.
cognetive intervention as well. educating patients, teaching them strategies that will help them cope.
this is not to say we should not attempt to do the psychologists job. but i think CBT is a part of what we do.
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Re: What's the difference between STM and massage? - May 24, 2004 4:25:00 AM
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Jon Newman
Posts: 1711
Joined: April 24, 2004
From: Amherst, WI
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Greg,
Your question is a good one. I believe the diffence in most forms of therapeutic touching is the therapist's intent (versus actual effect). However, multiple ways to bill for this type of touching exist as if there is some important and meaningful distinction. I am interested to see if this thread develops.
jon
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[URL=http://www.sonymusic.com/clips/selection/30/064887/064887_03_03_30.wav]Evidence[/URL]
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Re: What's the difference between STM and massage? - May 24, 2004 1:09:00 PM
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Diane
Posts: 1507
Joined: March 9, 2001
From: Vancouver, B.C., Canada
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Hi Greg, others,
I just returned from a somatics hands-on workshop taught by Servaas Mes, PT, and Hanna Somatics practitioner. ( [URL=http://www.somatichealthcenter.com]www.somatichealthcenter.com[/URL] )It added a new piece of handling to my repetoire, briefly: have a patient contract a muscle against a little bit of manual resistance, then ask them to slowly relax while continuing to load them, eccentrically.
I never learned this in PT school; maybe it has been added since, but in my class(way back when) we were taught to only contact/resist concentrically contracting agonists.
This somatics type of handling, makes the agonist stay active and engaged while it lengthens, a lengthening 'agonist' in contact with some resistance that would passively lengthen it if it just "let go"... but the whole point of the work is to teach the muscle to lengthen under conscious control, and while loaded. Very interesting to feel this at a workshop model. Certainly does expand functional range in all six directions, immediately, painlessly etc... (very nice for aging babyboomer bodies..) The beauty of this system is, there is a simple set of exercises that once learned by one's own body, can be taught to other people and their bodies, to maintain the new found freedom to move fully, painlessly.
I use various forms of soft tissue work as a primary tool all the time, everything from muscle energy technique for joints to positional release for pain to light skin stretching for increasing range. I don't however, ruin my hands doing "massage" to try to "break up" imaginary "scar tissue" etc. To me that's a waste of time and energy. Especially when the other more neurological techniques work better (i.e.: through kinesthetic feedback/afferent input, persuade the patient's brain to change the patient's function.)
I consider work with patients' nervous systems facilitated by hands-on, basic PT. I think PT got way off track by dividing off into "ortho" specialties, then the 'bone&joint' mentality took over..
Diane
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