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My View From Here

By Ralph Stephens, BS, LMT, NCTMB

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It Is Time

This column is in two parts, one more political about education and the other about how to bring about inhibition (relaxation) easier and faster. Hopefully, there is something for every body.

Sadly, the movement toward energetic (subtle) forms of therapy within our profession lead to a significant percentage of instructors, and the therapists they trained, who discounted the need to study, learn and apply anatomy. This intellectual laziness still exists and handicaps our profession. The late, great Barbara Brennan, an RN who was a pioneer in energy healing, essentially told a group; you intuitive people with your great intentions really need to learn anatomy, because that growth you think you see on the liver is really a vital organ called the gall bladder.

We have severely limited ourselves, both in our abilities to help our patients and in our being accepted as creditable by other providers through our avoidance of learning anatomy, physiology, and kinesiology. We are addressing a physical body - a physical manifestation of a thought form maybe, but it is in the physical now - and to avoid learning the names and functions of its parts is negligence and incompetence. It is a disservice to those who come to us for help. It is arrogance and egotism. If you really want to help people, you should care enough to learn the language of the health professions and as much as you can about the human body. What is more fascinating than the study of the human body and mind? No one has ever learned all there is to know about them. Shouldn't your study be ongoing, as in regular continuing education activities, beyond the minimum required? For those who seek acceptance by the allopathic (medical) system, let me assure you, it will never be gained through ignorance.

It Is Time - Copyright – Stock Photo / Register Mark Would you hire someone to fix your car that didn't know the names or location of the engine parts? I grew up around machinery mechanics, most of whom did not have an eighth grade education, but they knew the name of every part of every machine. They learned and spoke the language of their profession. We "work" on the most complicated "machine" known, the human body, and some don't think it important to know the names of the tissues that are being manipulated (touched).

It is high time our beloved "stakeholders" established standards and qualifications for entry level massage instructors and institute competency based requirements for graduation and licensing. We must ban the educational practice of "wheel"/"spoke"/"modular" massage education where students are plugged into a program at wherever the program is in its cycle. Students get dumped into the last two months of a program and then get the basics later. Or, some get a brief introductory class and then get dumped into the rotation, wherever it is at the time. That is no way to train competent, confident, professional massage therapists. Physicians are not taught surgery before they learn anatomy. Nothing is going to gain us acceptance as a profession until we have a consistent deliverable. We will not have that until we significantly change our entry-level educational practices. (Of course not all schools teach this way, but those that do must be required to change, and soon – for the sake of the public.)

Individual therapists who have learned their "stuff" are making good inroads into the "system." However, I talk with physicians regularly who tell me they would love to refer to massage therapists but they cannot find one who knows a fibula from a fender or will show up on schedule. Our average is way too low. It will take a long time to bring it up. The sooner we start the better. It is time.

Lighten Up!

If you have not already, it is time to come to the realization that one cannot drive pain out of the body with painful physical force. Therapeutically caused pain does not necessarily mean gain or bring about "healing." My good friend, colleague, and educator Mike McAleese recently posted, "Bodywork is a physical conversation with the body. Some people think that deep, painful pressure is helpful. This is akin to yelling at someone who is injured."

Our window to the body is not through the skin and muscles as much as it is through the nervous system. The results we achieve from massage are actually a stimulus-response loop. We apply a stimulus and the nervous system responds. If we apply the correct stimulus, we get the desired response, which is generally a relaxation (inhibition) response and a lessening of soft-tissue pain, often increasing range of motion. If we apply the wrong stimulus, we get a less than desired response.

Our touch triggers mechanoreceptors that are embedded in the soft-tissues. These receptors respond to mechanical stimulation such as massage. If properly stimulated, these mechanoreceptors elicit an inhibition (relaxation) response from the central nervous system (CNS) back to the local area of the stimulation. Different mechanical stimulus (massage strokes and techniques) stimulate different types of mechanoreceptors. The more mechanoreceptors stimulated, generally speaking, the more inhibition that is returned to the stimulated area.

However, if the stimulation is too intense and causes pain, a contractile response is sent by the CNS to the stimulated area. This is generally counterproductive to our goal of relaxation. Sadly, some patients seem to enjoy this pain and ask for it with the line "I can take it," or "I like it deep/hard, etc." They seem to equate the endorphin response elicited by the pain as relaxation, and the endorphins reduce the local pain, so they think they are receiving benefit. While such aggressive treatment may help some, even to a great degree, a more appropriate, non-painful stimulus would help them even more if they would let go of their association of pain equals healing.

Working hard and deep has destroyed many a therapist's body and thus their career. It is not necessary to "yell" at someone to get him or her to relax. In fact, deeper and more profound relaxation can be achieved by proper stimulation of mechanoreceptors that causes absolutely no pain to the patient, not even the hurts so good pain, and puts very little, if any, strain on the therapist's body. An elegant system has been developed by Lawrence Woods, a therapist from Indianapolis. Called Neural Reset Therapy (NRT) the system applies precise, gentle stimulus to mechanoreceptors in a way that almost instantly relaxes the muscle and relieves tickle, excess tension, and tenderness. Easy on the therapists, NRT can allow you to "reset" the tonus of 321 muscles in 45 minutes. It is time to learn a better way.

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