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RE: Can a PT provide massage for fee in NY as side- job
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RE: Can a PT provide massage for fee in NY as side- job - November 9, 2007 1:07:21 PM
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TLB
Posts: 350
Joined: September 13, 2002
From: Arizona
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quote:
ORIGINAL: pappawheelie
I didn't find anything(title and author search), but what exactly am I looking for? A technique, theory, arthrokinematic discription?
Go to the search box and type directional preference, centralization whatever you want and multilple articles will appear.
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RE: Can a PT provide massage for fee in NY as side- job - November 9, 2007 1:16:42 PM
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Shill
Posts: 1078
Joined: February 13, 2003
From: Madison WI USA
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TLB,
Have you actually tried the local plumber? You seem to already have come to your conclusion, without actually putting it to practice. How evidence based is that? I believe assumptions are lowest on the list. Incidently, when she (your massage therapist) describes you, does she include your national background/heritage as well? Nice cultural sensitivity.
< Message edited by Shill -- November 9, 2007 1:20:43 PM >
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RE: Can a PT provide massage for fee in NY as side- job - November 9, 2007 1:35:18 PM
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TLB
Posts: 350
Joined: September 13, 2002
From: Arizona
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quote:
ORIGINAL: Shill
TLB,
Have you actually tried the local plumber? You seem to already have come to your conclusion, without actually putting it to practice. How evidence based is that? I believe assumptions are lowest on the list. Incidently, when she (your massage therapist) describes you, does she include your national background/heritage as well? Nice cultural sensitivity.
Chill out, it's a joke of which you obviously don't get. There are multiple Asian rub and tugs around here and I imagine every major city in the US, so settle down just a bit. No I haven't tried the plumber it doen't sound like what I'm into but too each there own, think I'll stick with the rub and tug. Again Just joking don't get your panties in a wad.
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RE: Can a PT provide massage for fee in NY as side- job - November 9, 2007 2:04:28 PM
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smithcove
Posts: 44
Joined: February 11, 2007
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Wow
I hope you have bird flu
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RE: Can a PT provide massage for fee in NY as side- job - November 9, 2007 2:04:38 PM
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proud
Posts: 921
Joined: March 22, 2006
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quote:
ORIGINAL: Shill
There is a lot of needless and incorrect "education" about LBP, and about NMSK maladies in general, with that I agree.
Good
quote:
I do not see a practical way to undo the teachings of those who use unproven methods, treatments, causes, etc, beyond the one at a time re-education when they come to a clinic in which the practitioner teaches plausible approaches and methods.
Well shill, if we found a way to curb the mis-information in the first place....did you happen to read the Wall Street Journal article in Feb 2007?
quote:
Anyone can identify a problem, what we need is a solution.
I proposed a solution
quote:
What are you doing about this besides arguing on a forum? I ask in sincerity.
One person, one patient, one clinician at a time. I also am involved in educating government in Canada about some of the expert abilities Physiotherapists have. Key stakeholders need to be informed. Plug away is what I do. However as I read on these sites( Smithcove types make me nervous....sorry), the more I realize it's no wonder "key stakeholders" lump us in with witchcraft treatments like CST, MFR and yes....massage to cure LBP....
quote:
Massage takes some skill TLB. Go to a plumber and ask him to rub your back, after he punches you out, if you can get to your feet, and then convince him to actually rub your back, you will notice a distinct difference in his technique over a massage therapist.
All true shill. However if you actually attend a massage session you would discover than many of these clowns actually attempt to psuedo-diagnosis their clients. I would argue more than 75% do this. All mis-information. In Canada, somehow massage therapy gets reimbursed by insurance companies if prescribed by a physician.
No problem with a relaxing rub Shill. Buut not at the taxpayers expense....
< Message edited by proud -- November 9, 2007 2:12:46 PM >
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RE: Can a PT provide massage for fee in NY as side- job - November 9, 2007 2:21:53 PM
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TLB
Posts: 350
Joined: September 13, 2002
From: Arizona
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quote:
ORIGINAL: smithcove
Wow
I hope you have bird flu
If I do I'm sure my cranio sacral therapist can get rid of it for me. If not I'll run to Sedona and see if they can unwind it out.
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RE: Can a PT provide massage for fee in NY as side- job - November 9, 2007 2:22:53 PM
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pappawheelie
Posts: 40
Joined: September 19, 2007
From: Vermont
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Ok. I wasn't looking beyond the titles.
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RE: Can a PT provide massage for fee in NY as side- job - November 9, 2007 5:27:06 PM
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pappawheelie
Posts: 40
Joined: September 19, 2007
From: Vermont
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quote:
Chill out, it's a joke of which you obviously don't get. There are multiple Asian rub and tugs around here and I imagine every major city in the US, so settle down just a bit. No I haven't tried the plumber it doen't sound like what I'm into but too each there own, think I'll stick with the rub and tug. Again Just joking don't get your panties in a wad.
It may be this type of apparent insensitivity that keeps people from paying cash for physical therapy and willing to pay a massage therapist $120.
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RE: Can a PT provide massage for fee in NY as side- job - November 9, 2007 9:14:50 PM
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PTupdate.com
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Joined: October 8, 2001
From: Pittsburgh, PA USA
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Perhaps the major problem is how many PT's treat their patients. When someone in pain comes to a massage therapist, and many many times even a chiro, they usualy leave with pain relief. Unfortunately, when many leave the AVERAGE physical therapy clinic, they do not feel better. Many times, they feel worse.
I'll often get these patients, and after asking what happened at "the other place", I can piece together the process. Someone comes in with a problem, and they are shown exercises that appear to be purely "guessed", often they are never even manually worked on (or, when they are, it's a procedure that may be in a recent journal, but often exacerbates the symptoms), and they don't leave feeling very good. The McKenzie maniacs are best with screwy business plan
When someone comes to us PT's in pain, why is it so hard to try and aleviate that pain? Can't we make them feel good for a few days, earn their trust and respect, and then work on the original source of the problem?
This is how I treat, and why I am packed to the rafters. Most others in my area (now 27 clinics within 5-10 minutes drive) don't treat with this simple common sense idea. and for the sake of my pocketbook that's fine with me (but not for the sake of our profession).
_____________________________
John M. Duffy, PT
Board Certified Orthopaedic Clinical Specialist
www.PTupdate.com
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RE: Can a PT provide massage for fee in NY as side- job - November 9, 2007 9:45:37 PM
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smithcove
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I agree, John.
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RE: Can a PT provide massage for fee in NY as side- job - November 9, 2007 10:18:36 PM
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proud
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quote:
ORIGINAL: PTupdate.com
Unfortunately, when many leave the AVERAGE physical therapy clinic, they do not feel better. Many times, they feel worse.
If patients leave feeling worse, then I agree....that PT did the wrong thing usually. Although it does depend on the diagnosis. "osis" for example requires a bit of post exercise pain( Khan et al etc).
quote:
often they are never even manually worked on (or, when they are, it's a procedure that may be in a recent journal, but often exacerbates the symptoms), and they don't leave feeling very good. The McKenzie maniacs are best with screwy business plan
Hopefully PT's are not just throwing a recent journal technique at a patient without understanding the how and when of that technique. Most PT's that actually read journals are not so silly John. It's the ones that DONT read journals that scare me.
quote:
When someone comes to us PT's in pain, why is it so hard to try and aleviate that pain? Can't we make them feel good for a few days, earn their trust and respect, and then work on the original source of the problem?
I agree. But it all depends on how you "gain that trust" John. Chiropractors are great at gaining trust but often are also great at creating dependance and patients completely confused with a fired up insular cortex....if you know what I mean...
As far as massage goes, as stated before, I have no problem with someone getting a rub if it makes them feel all warm and fuzzy. No problem. But that is not reality John. In reality many if not most massuers attempt to pseudo-diagnosis people which really does not help matters in the long run. Back pain is typically a recurring and often worsening problem. Underlying causes, either patho-anatomical or psycho-social need to be addressed properly. Massuers are not equiped to understand the complex science and research that goes along with this stuff. If they were, I imagine they would have applied and been accepted to an acedemic insitution of higher learning. Most masseurs I know are high school graduates only or arts degree drop outs. That is not by accident of course.
PT's on the other hand are equiped as evidenced by stringent entrance standards...unfortunately it seems, too many do not use the intellectual skills they have.
And....smithcove...you agree with what exactly?
< Message edited by proud -- November 9, 2007 10:36:05 PM >
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RE: Can a PT provide massage for fee in NY as side- job - November 9, 2007 11:49:52 PM
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PTupdate.com
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Joined: October 8, 2001
From: Pittsburgh, PA USA
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Proud says: "As far as massage goes, as stated before, I have no problem with someone getting a rub if it makes them feel all warm and fuzzy. No problem. But that is not reality John"
But, remember that the "rub" sometimes is all they need to get rid of a pain/ache/tension...either from me or a massage therapist.
I do agree that massage therapists far too often tell people all kinds of weird things, and then send them to a chiro as well. My wife has strict instructions to never ever never ever ever do that.
The PT's that don't read journals, which is the majority, scare me too. Others read just the abstracts. Others read the whole thing and don't have a clue how to integrate that into treatment. Others are just too plain stupid to figure out anything. That leaves probably 1% of the practicing PT's in this country worth something. Thus, a good massage therapist probably does a better job of improving a lot of conditions compared to the AVERAGE therapist....and that is quite a shame.
Guess what? Tomorrow, at 1:15, I have a 1 hour massage scheduled! Isn't it a shame that I'd rather go drop $60 bucks and not even get a happy ending, instead of going to some PT? Why is that?
_____________________________
John M. Duffy, PT
Board Certified Orthopaedic Clinical Specialist
www.PTupdate.com
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RE: Can a PT provide massage for fee in NY as side- job - November 10, 2007 11:25:58 AM
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proud
Posts: 921
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quote:
ORIGINAL: PTupdate.com
Proud says: "As far as massage goes, as stated before, I have no problem with someone getting a rub if it makes them feel all warm and fuzzy. No problem. But that is not reality John"
But, remember that the "rub" sometimes is all they need to get rid of a pain/ache/tension...either from me or a massage therapist.
Well the problem with the above statement is that it completely ignores the available evidence John. As it stands now there is NO evidence( Level D) that massage "gets rid" of pain. Reseach repeatedly shows it does not in any way expediate recovery. So what on earth are you saying?
I reiterate: No problem with someone getting a rub down. However for insurance companies to reimbrse for it and ultimately increase premiums for everyone is a foolish waste of precious healthcare dollers.
I reiterate for emphasis: Level D John( actually below level D depending on what guidelines you use...)
< Message edited by proud -- November 10, 2007 11:31:13 AM >
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RE: Can a PT provide massage for fee in NY as side- job - November 10, 2007 4:28:49 PM
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PTupdate.com
Posts: 1468
Joined: October 8, 2001
From: Pittsburgh, PA USA
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OK, I just got back from my massage, and I feel pretty damn good. Wife says I look very relaxed, and for the first time in a week I have no scapular pain while sitting at the computer.
Proud...you note above that my statement ignores all the available evidence. What evidence are you citing? I jumped online and very quickly found these two, and there appear to be many more:
Ann Intern Med. 2003 Jun 3;138(11):898-906. A review of the evidence for the effectiveness, safety, and cost of acupuncture, massage therapy, and spinal manipulation for back pain: "The three RCTs that evaluated massage reported that this therapy is effective for subacute and chronic back pain. Preliminary evidence suggests that massage, but not acupuncture or spinal manipulation, may reduce the costs of care after an initial course of therapy"
A Meta-Analysis of Massage Therapy Research: Psychological Bulletin, v130 n1 p3-18 Jan 2004 "Single applications of MT reduced state anxiety, blood pressure, and heart rate but not negative mood, immediate assessment of pain, and cortisol level. Multiple applications reduced delayed assessment of pain. Reductions of trait anxiety and depression were MT's largest effects, with a course of treatment providing benefits similar in magnitude to those of psychotherapy" Perhaps I'll get the full versions of these, and the others, and see how well they were done
Looks like some positive support to me! And where did the major issue of insurance paying for this arise? Are you stating that even when a PT does "massage", or some other form of soft tissue work, that it not be paid for? Or, are you stating they should not pay for outside massage therapists? In this country, that rarely happens.
What about the fact that there are massage therapy services everywhere, and people pay cash out of their pocket for this service? When is the last time someone said they didn't like getting one? It is obviously doing some good for people, be it pain reduction, stress reduction (and guess what, we get patients with purely stress problems ALL THE TIME). Are we to tell all of them "stop going there! There is no evidence to support what you are going to have done to you!!!!!
Since Budweister is the "King of Beers", should I stop drinking Guinness? Even though Bud gives me the poops? The last time someone someone suggested they know what's best for me, she was wearing a name tag that said HILLARY CLINTON
You also say "Reseach repeatedly shows it does not in any way expediate recovery" What is the research that "repeatedly" shows this?
_____________________________
John M. Duffy, PT
Board Certified Orthopaedic Clinical Specialist
www.PTupdate.com
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RE: Can a PT provide massage for fee in NY as side- job - November 10, 2007 5:43:34 PM
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proud
Posts: 921
Joined: March 22, 2006
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Sure John,
Furlan etal 2005: Cochrane library. This being the most prestigious of all systematic reviews. It seems massage combines with exercise and education CAN be beneficial. Massage alone....nope.
Which is why I have no problem with A PT hiring a massuer to work with some chronic LBP patients. Your set up sounds that way.
But no way can a massuer understand the complex pain physiology etc that would allow them to dispense the RIGHT exercise to the RIGHT subset of patients. And certainly not qualified both clinically or acedemically to provide education.
So....reimbursment for massage without direct supervison by a PT....is foolish.
< Message edited by proud -- November 10, 2007 5:50:52 PM >
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RE: Can a PT provide massage for fee in NY as side- job - November 10, 2007 7:10:50 PM
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Sebastian Asselbergs
Posts: 1155
Joined: September 29, 1999
From: Barrie, Canada
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As most of you know, I am a science-oriented amateur. I was trained as a combination PT/MT in the late 70's early 80's. I have a feeling that massage, when done correctly, can have a huge impact on human function. Picture the quiet, warm room, a comfortable position, and warm human contact on your skin. Relaxing to Nth degree when done right; during the relaxation, all kinds of stuff is happening in the brain and body - neurophysiological. Very helpful for westerners to get "in touch" with their own body and the deeper sense of their own neuroanatomy. Interesting work being done on infant massage too - can't find the reference.
I agree with proud about the diagnostic baloney some (quite a few) get into, but even despite our so-called extensive education we have PTs regularly "concluding" problems with fascial restriction, cerebro-spinal fluid dysfunctions, tilted livers, slipped discs, parietal bone displacements etc etc.....Then we have those who blatantly ignore any pain research and blindly focus (pun intended) on "function".
I think we are in waaay too fragile a glass house to even start throwing bricks at massage therapists.
_____________________________
Mundi vult decipi
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RE: Can a PT provide massage for fee in NY as side- job - November 10, 2007 9:51:32 PM
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PTupdate.com
Posts: 1468
Joined: October 8, 2001
From: Pittsburgh, PA USA
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Sebastian is so very correct....those in our profession are in no way situated to critique another profession. A very good PT could easily provide a better quality treatment to a patient than an average massage therapist. However, a good massage therapist could probably do a better job of relieving pain than the average PT (which is most of the PT's).
Again, nobody said anything about MTs providing exercise or anyting else. Few do this, so it's a non-issue for me. Some people simply need soft tissue treatment to alleviate their problem, and this is a niche profession that can do it. Others need the relief of the symptom,which can be provided by a PT or MT, but also need to figure out what caused the problem in the first place (thus a good PT is needed)
If a MT, or even PT is treating a "symptom", be it spasm, trigger point, knot, etc. Is there anything wrong with that? Medicine routinely advocates treatment of symptoms as part of a comprehensive treatment plan....meds to treat inflammation and/or pain, injections to treat inflammation, bracing to support instability, etc. Providing relief of symptoms while also tackling the root cause of the problem is what we are supposed to do. Far too many PT's are too clueless to figure out the cause of many problems, and most too egotistic to help alleviate pain, which is usually what brings the patient to therapy in the first place. Again, that's fine.....their failure sends more people my way, but degrades our profession
_____________________________
John M. Duffy, PT
Board Certified Orthopaedic Clinical Specialist
www.PTupdate.com
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