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What is Medical Massage


By W.D. ‘Peter’ Lane, BA, LMT, CNMT, NCBTMB
There is a need to define the frequently used term “medical massage.”
One proposed definition would require a medical massage therapist to have significantly more training to qualify for licensure.
The curriculum for medical massage would include cadaver studies, chemistry and nutrition, as well as an internship.
The state would provide a separate license for a medical massage therapist, which would allow the practitioner to bill insurance. The insurance component would compensate a therapist for the additional required education.
A medical massage therapist would work with a patient’s primary care physician or specialist to provide optimum health for the patient.
One of the most vexing issues facing the massage therapy industry today concerns the term “medical massage.” All healthcare professionals know what it is, yet few are able to define it. Yet, when we as body work practitioners, answer the question of what medical massage is, we will further the goal of legitimizing and establishing advanced body work in the healthcare environment.
Why is “medical massage” creating such a stir in the massage and medical community at large? Who should be allowed to practice medical massage and how? When is it indicated and when is it not?
I attempt to answer these questions from the standpoint of a Licensed Massage Therapist and a Certified NeuroMuscular Therapist who has been treating patients in New Mexico for the past 15 years. My opinions are based upon practicing in both the massage and medical environments. I have come to these opinions based upon a sincere desire to see the perception, understanding and appreciation of bodywork advanced throughout the United States with some degree of uniformity. More importantly, the body work industry needs a universal definition so that when a patient seeks out the services of a medical massage therapist he or she will know that a LMMT is licensed and properly trained to treat their pathology. It’s important to define medical massage to both eliminate imposters and to protect legitimate medical massage therapists.
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In my opinion, medical massage should be:
· An accepted part of allied health care and physical medicine.
· It should be a system of patient care and treatment based on a medical model that is scientific, hands-on, and results-oriented.
· Medical massage is derived from a specific diagnosis that requires certain specific techniques or procedures to bring about a specific measurable response from the patient.
· Medical massage should be a discipline that operates as a scientific system utilizing universally accepted medical terminology.
· Medical massage practitioners should participate in scientific research that demonstrates a measurable response to a patient’s chief medical problem.
· It should treat a variety of specific musculoskeletal indications with an educated understanding of how every system of the body is affected by every other system.
· There should also be a comprehensive set of contraindications for the modality as well.
· Medical massage should NOT be a system of diagnosis and treatment that relies upon the use of prescription medication to treat musculoskeletal related dysfunctions.
These days, many other definitions of medical massage are floating around the country. Some serve the limited financial gain of a person or organization promoting a particular definition. Some definitions state that medical massage should only be practiced in a doctor’s office under the absolute control of an MD or DC. If practiced in a PT clinic, it must be under the domain of a PT. One organization states that only students who take their “national certification examination” in medical massage should be recognized as a medical massage therapist. From an insurance billing perspective, there has been recent litigation attempting to prevent a body worker from filing insurance unless they are a “medical massage therapist.” Fortunately, when the judge asked for a definition of medical massage and none could be offered, he ruled in favor of the massage therapist. It has become quite clear that these definitions do not have at their core the benefit of the patient.
Under the definition that I propose, a LMMT (licensed medical massage therapist) should be someone who has received training requiring more than the universal 500 hour training threshold that has become the norm for massage therapists. The curriculum should require more hours in anatomy and physiology, pathology, patient assessment, kinesiology, musculoskeletal anatomy, including cadaver studies, chemistry and nutrition. The curriculum would include alternative therapy electives, a segment on business and ethics, practice management and insurance billing. I also propose a significant clinical practicum and internship.
Included in this formula is a continuing education requirement that exceeds the current eight to 16 continuing education units required biannually by many states. The extra
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education can be accomplished within the context of a 2000 to 2400-hour program similar to the structure of training programs in place in Canada where 2200-3000 hour programs are standard. A Licensed Medical Massage Therapist would have the option of practicing in a controlled environment such as an HMO, working in private practice or something in between. The state would be required adopt separate licensure for Licensed Medical Massage Therapists. Furthermore, the LMMT should automatically be included in the mix of approved therapies for insurance billing.
The benefits for patients and therapists are obvious. The patient will know his or her therapist is properly trained, qualified and competent to treat the condition that they have been referred for. The therapist will have the satisfaction of knowing that their training will bring measurable results to the patient and they will be compensated for their work by insurance. The insurance industry benefits by knowing that a Licensed Medical Massage Therapist is ethically and legally following a standard of treatment and documentation. By arriving at a national consensus about the definition and training of a Licensed Medical Massage Therapist, the Unites States will have gained a cost-effective tool in containing spiraling healthcare costs.
A quality driven, credible medical massage therapy program should be predicated on proper program development and organization complimented by a competent and experienced teaching staff and utilized in an active clinical environment. Too often education and competency have not paralleled each other and curriculum has not been problem centered and patient based.
The following curriculum outline is designed to assist preeminent institutes for higher education in the medical massage industry. The medical massage program can be implemented in stages as instructors are trained and certified or offered as a comprehensive second-tiered advanced program.
W.D. ‘Peter’ Lane is a LMT , LMTI and Certified NeuroMuscular Therapist practicing in Albuquerque. He teaches anatomy and physiology and certifies and trains a variety of licensed healthcare practitioners in NeuroMuscular Therapy.  He most recently has been the chairman of the New Mexico Board of Massage Therapy. His e-mail address is wdlane@salubria.org
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