Every massage therapy student should have to read at least one textbook.

I was required to take a minimum of 750 hours of schooling to become a licensed massage therapist in the state of Arizona. Roughly translated, that’s nine months of school four full days a week. Most of the curricula focused on anatomy, pathology, practical application, and ethical considerations. In order to maintain my license,  I need to take 25 hours of continuing education classes every two years.

If I had still been living in San Francisco when I decided to get a license, I could have been granted a “General Practitioner Permit” with 100 hours of training, or an “Advanced Practitioner Permit” with 200 hours of training.  In other words, if I go back to California and prove that I meet those minimum requirements, I would basically be a   General+Advanced-Advanced-Advanced Practitioner.

Somehow, I don’t think I qualify to be considered a massage therapy superhero. I also don’t think that each California school hour is twice as educational as an Arizona school hour.

What’s even more confusing: California, like some other states, doesn’t have set of statewide regulations. Even worse is that some states do have a set of regulations, but they allow their cities to impose separate regulations that therapists must adhere to. If a massage therapist wants to move over to a neighboring city, she might have to change her policy or even take an extra exam. (Of course, if that therapist moves to a different state, she might have to take an extra 900 hours’ worth of classes.)

Certain cities’ regulations are downright offensive. While I was sitting in a Scottsdale, Arizona cadaver lab to learn the ins-and-outs of human anatomy, some California would-be massage therapists were submitting to STD tests in order to become certified. Massage licensing regulations are all over the place (or for some states, nonexistent.)

The American Massage Therapy Association (AMTA) estimated in 2008 that there were between 265,000 and 300,000 massage therapists and massage therapy students in just the United States. The U.S. Department of Labor estimated that the massage therapy field would see a rapid 20 percent increase in employment from 2006-2016.

I think it’s laughable, yet also sad, that such a booming industry hasn’t yet found a way to establish a cohesive set of strict regulations. I don’t necessarily think that massage therapy should be formally standardized across the United States, but I do think that all states should establish their own regulations. I also think that all states should set similar standards.

It just doesn’t seem right to me that, while I provide injury treatments and while therapists in New York are working to obtain 1,000+ hours of training, massage therapists in some parts of the country are still called “masseuses” in the way that strippers are called “exotic dancers.”

Regulating massage therapy will:

1. Help ensure that all clients are safer because all therapists will have been background checked.
2. Ensure that all therapists have met a minimum set of educational requirements so that clients will be able trust who is treating them.
3. Set ethical standards and allow the law to apply appropriate punishments to those who break those standards.
4. Increase the amount of clinical studies performed in regard to massage therapy and encourage insurance companies to cover massage as a result of proven results.
5. Encourage massage therapists across the country to feel more united as a team.

It’s time to get the ball rolling.

If you’re interested in finding out more about regulations in your state or city, check out the following links:
Massage Therapy State Boards and Licensure
Massage Laws and Legislation in the United States and Canada

Legitimate massage therapy businesses shouldn't display this sign.

“You do massage therapy? Do you like being a masseuse?”

Well, I wouldn’t really know what it’s like to be a masseuse because I’m a licensed massage therapist (L.M.T.) in the state of Arizona. Unfortunately, that statement almost makes me sound like I add the fancy acronym to all of my magazine subscriptions as if I were a doctor. I’m not really that uptight, but I do have a legitimate reason to squirm away from the “masseuse” title.

The word “masseuse” originated in French to describe a female who gives massages and “masseur” describes a male who gives massages. “Masseuse” describes me, right?

Yes and no.

A licensed massage therapist can always be considered a masseuse/masseur but a masseuse/masseur isn’t always a licensed massage therapist. Now that massage therapy has started to become regulated in this country, most states won’t allow unlicensed individuals to charge for massage. People who aren’t licensed, certified, registered, etc. in their states do give massages on the sly, but they can’t profess that they meet state or city requirements.

Some masseuses/masseurs may be self-taught experts of anatomy and physiology. They may be better at my job than I am. (I suppose they can call themselves massage therapists as long as they don’t purport to be licensed.) Others just hand out business cards that say, “I’ll rub you the right way,” and, “Feeling knotty?” They will give you a back rub. Some masseuses/masseurs may work out of their homes, others may do outcalls, but many of them work at massage parlors, where the clientele expect a little more than a massage.

The terms “masseuse” and “masseur” were used on a regular basis in the United States for so long that it is still normal for anyone to use them interchangeably with “certified massage therapist,” “licensed massage therapist,” or “registered massage therapist.” But, as one who went through the 750 hours of schooling to obtain a license, I’d prefer not to be linked to a name which indicates that I may wear stilettos and a tube top on the job.

So, if someone ever calls me a masseuse, I don’t get huffy and say, “I can’t believe you just called me that!” I might, however, offer a gentle nudge in a more affirmative direction by nodding and saying, “Yes, I am a licensed massage therapist.”

Massage minutes go by faster than the rest.

If you’ve ever been to a spa or any other place where massage therapy is offered, you probably know that massage therapists provide treatments for assorted lengths of time. Three typical massage lengths are 30 minutes, 60 minutes, and 90 minutes.

The most common massage in a spa environment is a 60-minute massage. As a massage therapist at a chiropractic office, I’d say I give about an equal amount of 30-minute and 60-minute massages. I give occasional 90-minute massages and have only given a single two-hour massage.

Which should you choose? The one that’s best for you depends on what you expect to get out of your massage.

30-minute Massage

• What it is:A 30-minute massage is a great maintenance massage for one area of the body. (Most of my 30-minute clients enjoy my combination shoulder, low-back, neck, and scalp massage.) It can also offer you a quick breather in the midst of a stressful day. Another major “pro” of a 30-minute massage is that it’s usually pretty cheap.

• What it isn’t: 30 minutes isn’t the intended length of time for a full body massage; it simply isn’t enough time to adequately address all areas of the body. If I were to break down a general full body massage into 30 minutes, I wouldn’t have enough time to do extra work on any of the muscles after I warmed them up.

60-Minute Massage

• What it is: 60 minutes is enough time to fit in a relaxing full body massage. An hour gives me time to warm up muscles pay a little extra special attention to problem areas. A 60-minute massage will be more expensive than a 30-minute massage, but many massage therapist offices and spas won’t actually double the cost for double the time. Generally, you’ll get more massage for your buck if you choose a longer massage. (For example, if a chiropractic office charged $40 for 30 minutes, it might charge $65 for 60 minutes.)

• What it isn’t: Some clients don’t feel that 60 minutes is quite enough time for them to be on the table when they want a well-rounded treatment. As a therapist, I agree. I can give a full-body massage in 60 minutes but I still feel rushed. For example, sometimes I’ll have already worked on a person’s back for 20 minutes but then run across a problem area right before I go onto the next body part. I have no choice but to tell my client something like, “I can continue to work on this spot and not work on your arms and legs, or I can just continue on

90-minute+ Massage

• What it is: 90 minutes is blissful. It’s enough time for me to slow down, ignore the clock a bit, and listen closely to what a client’s body is telling me. It’s also enough time for me to try out new massage techniques. Some of my clients say, “Once you try a 90-minute massage, you will never want to go back to shorter ones.” A 90-minute massage is naturally more expensive than your other options, but it also is usually cheapest per minute. I couldn’t say whether you should get a 30-minute massage every two weeks or one 90-minute massage every six weeks; that really depends on how often your body needs maintenance.

• What it isn’t: A 90-minute massage isn’t for people who have trouble lying in one position for extended periods of time. It also isn’t a frequent treatment option for people who are on a tight budget. However, I urge you to try it once to decide whether it suits you.

"Are you ready for your massage?"

I love stopping by places like Brookstone whenever I go to the mall because I get the chance to sit in one of those nifty massage chairs for free. If I’m lucky, the chair will find the areas in my neck and back that even most of my massage therapists can’t seem to access. If I’m not so lucky, the rumbling heat being sent up my back will still induce relaxation. It’s a win-win situation.

Robots are getting so high-tech these days that they’ve begun to replace humans, but I’m not too concerned that massage therapists will end up needing to switch careers. Even when I read stories like this one, I think, “Wow! Technology is amazing!” but I can’t say I ever really worry that my position will be filled in by something that runs on batteries and sleeps in a closet.

Humans will always need each other because there can never be such a thing as synthetic genuine touch.

When I accidentally smack my foot into a door, one of the first things I do (after I scream a couple of expletives) is I grab my foot with my hands to soothe my injury. That instinct is not unique to me. All humans do it because it causes the pain to subside. Touching the pain and rubbing or pressing it will stimulate other nerve fibers and cause the spinal cord and brain to “forget” about the painful nerves. But could I really imagine just grabbing a spoon to do the work of my hands?

No.

There’s something lovely about the heat of hands, the feeling of flesh on flesh, and the tingling sensation of human energy. Even premature babies know what I mean.

One study showed that premature infants who received three 15-minute human massages every day for 10 days gained almost 50 percent more weight than infants who took in the same amount of calories but received no massage. I guess one could argue that it’s the extra attention rather than the physical touch itself that led to this weight gain, but I wouldn’t be willing to bet on that. Babies often cry until they are held by another person; they don’t always stop crying when their mothers come into the room and talk to them from two feet away.

It’s just not socially acceptable for mothers to continue cuddling their children past a certain age. Despite that reality, people of all ages can still experience that simple, soothing, healing touch when they hop onto a human massage therapist’s table.

Sorry, robots.

This duck is riddled with quackery.

Foreword: Science wasn’t my favorite subject in school. In fact, sometimes I hated science class. Gathering specimens and making notes, then comparing those notes and making more notes for the sake of ensuring accuracy was exhausting to me. So when I say what I’m about to say, I must preface it by emphasizing that I’m humbled by all of the folks who spend their lives trying to make healthcare legitimate and safe for the masses.

I recently ran across an article entitled “How to Spot a ‘Quacky’ website”. It warned people to steer clear from any website that:

-Generally promotes “alternative,” “complementary,” and/or “integrative” methods of treatment

and/or

-promotes  “nontoxic,” “natural,” “holistic,” or “miraculous” treatments.

While I can’t say that I promote miraculous treatments–and, indeed, I’m also sometimes a bit of a skeptic—I do wholeheartedly promote many holistic therapies relating to complementary and alternative medicine (CAM). Yet, according to some of these rules, I’m a sort of quack running a “quacky” website.

In this short essay, I plan to a) Examine the reasons why I’m called a quack and b) Explain why I stand wholeheartedly by what I write, whether or not it makes me a quack.

According to the Quackwatch website, science demands that people who make claims must provide substantial proof to back up those claims. That proof must come by way of sound studies, a well-balanced evaluation, and confirmation by other knowledgeable people. However, not all promoters of complementary and alternative medicine stand by the same rules.

Some complementary and alternative treatments rely mostly upon anecdotal evidence and so-called “sloppy” facts such as, “This medicine has been successful for thousands of years.” Also, the placebo effect is so potent that people, not the treatments, could really be the ones healing their own abnormal physiologies just by believing that they are supposed to be cured.

People who adhere to the strict standards of scientific proof assume that this translates to complete quackery. After all, where are the regulations? They don’t want anyone getting ripped off or, worse, killed by peddlers of fake medicine.

So, what do science sticklers propose we do to provide substantial proof? They don’t just want us to come up with studies; they want us to construct sturdy double-blind tests. In a double-blind test, neither the people administering a study nor the study’s participants know who’s getting the real drug/treatment and who’s getting the placebo. Only at the end of the trial, when results are being collected, will the truth be revealed. This brilliant method of research aims to eliminate any sort of bias on either side of the spectrum.

I appreciate the idea of studying and standardizing all medicine in order to make it safe and reliable. Maybe then more insurance companies would cover more of it. However, I have two major concerns with the demands for double-blind tests:

Concern Number One: Double-blind studies aren’t infallible, not even when they’re designed properly (randomized and placebo-controlled.) Firstly, the people willing to participate may not be perfect representatives of a whole population. Additionally, some studies—even double-blind studies—rely on subjective responses. Take anti-depressant medications, for example: In the course of a study, both the participants who take the placebo and the participants who take the actual test drug will need to interpret a questionnaire and then offer a subjective analysis of how depressed they feel. The study could look at literal factors such as presence of chemicals in the brain, but such hard facts don’t necessarily prove that someone is or isn’t feeling depressed.

Concern Number Two: Applying double-blind studies to complementary and alternative medicine is often impossible. How can a practitioner such as an acupuncturist be blinded to the treatment he is offering to study participants? He either knows he’s doing it properly or he knows he’s giving a placebo treatment.

Science has its limits, no matter what it is attempting to etch in stone. That is why facts change. (Remember when Earth was flat and in the center of the Universe?)

Sometimes the subject of study far transcends the capacity of a pen, paper, and microscope. When it comes to the study of love, for example, science gurus examine alleged “love chemicals” that flow in the brain such as serotonin, oxytocin, vasopressin, and norepinephrine. They investigate areas in the brain that are thought to light up when a person has loving feelings.

Psychologists go to great lengths to organize love into categories such as romantic love and platonic love. American psychologist R.J. Sternberg said that interpersonal love requires a combination of intimacy, passion, and commitment. Some psychology experts even break down love into stages: first lust, then attraction, and finally attachment.

But none of that encapsulates love. No one—not even scientists who live with their eyes glued hard facts—could truthfully say that the love they have for their families and friends can be quantified by science. Love is love.

I’m not suggesting that complementary and alternative medicine or holistic approaches to health are equivalent to love, but some of their components are similar. For example, the idea of body energy (also called Qi and Prana) may not be entirely understood, but I know it exists when I close my eyes and feel it flowing through my body.

Does that make me a quack? If so, I’m proud to be one.