Thursday, June 11, 2009

Historical, Cultural and Philosopical approaches to Massage

Massage has been round for thousands of years. Although there are many different forms of massage, they all have the same end goal. “Massage therapy has been in existence for one purpose and one purpose only: to aid human beings in their pursuit of pain management and take away their stress. From the paintings in ancient caves depicting one person rubbing another's foot to ancient Egyptian artwork often found in temples and pyramids showing foot, hand, and head massages, all have one thing in common, the universal language of therapeutic touch.” (Fernandez, E. 2005). There has been many influences from various cultures throughout history. There has been a lot of research into the benefits of massage and surprisingly knowledge that has been pasted down through the generations still in use today.

Asian bodywork therapy which we see today is based on traditional Chinese medicine and Ayurvedic medicine (India), which is 2500-4000 years old. “Traditional Asian techniques and treatment strategies to affect and balance primarily the energetic system for the purpose of treating the human body, emotions, mind, energyfield, and spirit for the promotion, maintenance, and restoration of health.” (Salvo, 2007, p755-756). These Eastern traditions developed to maintain a persons health looking at the overall picture of their health. Concentrating on their energy and correcting stagnation in energy. The body maps for energy involving meridians or chakras. In these traditions is where the five element theory was developed. These elements, fire, water, wood, earth and metal relating to different body organs. Acupuncture and use of hot stones and various herbs was also developed in eastern tradition. Eastern tradition is very natural and spiritual. The western traditions however have a little more tunnel vision to them. They have taken a very medical approach usually with scientific evidence to support their theories. Many great names of history in the western traditions are responsible for the medical knowledge that we have developed.


Some of the great names in western history are as follows:
Hippocrates of Cos (460-375 BC) is considered to be the 'father of modern western medicine'. He was the founder of a Hippocratic Medical School. Numerous books were published about medial techniques and practices from the school.
Galen of Pergamon (A 130-200) was a Roman physician who studied medicine in Egypt. He became the personal physician to the Roman Empire Marcus Aurelius. Galen combined the Greek knowledge of anatomy and medicine.
After the collapse of the Roman Empire the western medical knowledge that had been previously advancing stopped. It is only thanks to some western physicians who recorded the medial knowledge of the Greeks and Romans that it was not lost.
Pehr Henrik Ling (1776-1839) was a Swedish physiologist and gymnastics instructor. He is regarded the 'father of swedish massage'. Ling developed his own system of medical gymnastics and exercise. His main focus was to treat disease and injury. Sadly because Ling was not a physician it took a long time before his work was appreciated.
However, Johann Mezger (1817-1893) was a physician. Because of this he had the medical and scientific knowledge to promote massage. He is thought to have introduced the French terminology such as effleurage.
John Harvey Kellogg (1852- 1943) published a 'Good Health' magazine in the United States. This helped make massage popular to the public.
James Cyriax (1907-1947) influenced the range of motion assessment and deep transverse friction.
Janet Travell published many papers regarding the understanding of trigger points.
Emil and Estrid Vodder developed the manual lymph drainage in the 1930's. Otherwise recognised as the Vodder technique.


A part of history in New Zealand is the influence of Maori techniques on massage. Traditional Maori healing takes a mind-body-spirit approach. There are four cornerstones of Mirimiri. These are family health, physical health, mental health and spiritual health. The focus is on physical growth and development, faith, belonging, caring and communicating. Health in ones entire being. Romiromi is the use of the therapists elbows, hands, knees and feet as well as wood, stones and seawater. Traditional Maori healing is similar to the eastern traditions with the use of nature and spiritual well being. The western tradition being different in that it has more the body approach with a lack of spiritual treatment.

Massage Therapy is still a growing industry in New Zealand. In the early 1900's there was over 300 massage therapists. In 1985 Bill Wareham helped form Massage Institute of New Zealand (MINZI) with a focus on education for therapists, standards for teachers and conferences for skill development. In 1989 Jim Sanford established the New Zealand Association of Therapeutic Massage Practitioners (NZATMP). His focus was not only on education but also promoting a professional image and increasing public awareness of massage therapy. In the late 1990's NZATMP changed its name to the Therapeutic Massage Association (TMA). Its new focus was to be a voice for the massage industry and to support and represent those who were qualified therapists. In 2007 MINZI and TMA joined together to form Massage New Zealand (MNZ). Although this seems to be a positive step for the professional development of massage in New Zealand, MNZ has been struggling ever since the merger. MINZI and TMA have disagreed over some issues but also there has been a lack of new members joining. Its the same old story with voluntary organizations. Always the same few people doing all the work. Some people can be selfish and if they can't see immediate benefit to themselves and their career they are not prepared to put the work in. Hopefully MNZ will become better supported as it provides a good professional base by providing such things as code of ethics and scope of practise on which to base our practises. Unfortunately it would have much more of a voice if it was compulsory to join. But with all the past stigma regarding prostitution it is important to support professionalism.

In the 1890's is where the massage scandals took place. Massage had become well recognised and with the increased numbers of therapists some had resorted to prostitution. Massage parlours were sometimes just another place for prostitution. This is a terrible stigma. People can be conservative at the best of times. It is a big deal to be unclothed on a table for a massage. No wonder people that are uneducated about massage would think it is still linked to prostitution. Even now, 2009, when I have told some people about what I am studying they are associating it with prostitution. That is why education standards need to be in place so massage therapists have some sort of uniform. So the public is aware what will be expected when going to see one. I know if I was unaware of what a massage therapist did and my partner wanted to go, I would be a little hesitate about him going to see a practitioner where he was going to take his clothes off!

Today contemporary massage is a growing industry beginning to get recognition from other healthcare professionals. With research supporting lymphatic drainage, injury rehabilitation, myofascial release, stress management etc. It is becoming very complimentary to use massage in association with other healthcare providers. There is developing education opportunities for massage ranging from certificates to degrees. Also membership, as previously mentioned, is not compulsory in massage organizations such as MNZ, massage has more of a professional voice now. There is still a lot of educating to be done as there is a lot of untouched clientèle out there. But hopefully with this continuing education to the public, and the acceptance and recognition of the benefits massage provides the stigmas associated with massage will soon be a thing of the past.

There are different approaches to massage. The western tradition has focused mostly on the body-mind approach, the direct effects massage has on the body and the mind. The western tradition although very effective can be a little clinical in that everything needs to be proved or measured. This is effective for many people who are 'closed book', who are in pain in an area of their body but are not ready to open up emotionally or spiritually. For a treatment to be effective you have to believe in it. For example it is easy to believe that massage has a positive effect on your injured hamstring as your range of motion begins to increase. It is harder to believe that you have stagnant energy because there is nothing to measure. The eastern tradition has a focus on the body, mind and spirit. These could be viewed as the unexplained health benefits. Although science can not yet explain it doesn't mean it doesn't have an effect. You hear of stories of somebody being diagnosed with an incurable disease, yet by some sort of alternate treatment they get better. The mind is very powerful tool and maybe diseases are just an unbalance in our body-mind-spiritual health. As a massage therapist we can then chose if we would like to be a therapist or a facilitator. Therapists have a massive role in society, but their primary focus is on the body. They can alleviate pain and stress. A more holistic approach however would look at the whole picture, body, mind, spirit. This is the facilitator.

So it is no surprise that massage has been going on for thousands of years. “It is a natural response to rub our aches and pains, whether or not we are familiar with the medical knowledge behind these actions.” (Salvo, S. 2007 p4). Massage is getting more and more proven and recognised thanks to the research of people going back hundreds of years. There has been many historical and cultural influences to give us the different variations of massage therapy. Different styles will suit different people but at the end of the day if it feels good to you, keep doing it! There will always be varying types of therapists, with different specialities in different areas but hopefully massage will keep pushing forward to give that professionalism as a healthcare provider.


References:

Fernandez, E. (2005) Massage Therapy Licensing: An In-Depth Look retrieved June 6, 2009 from www.massagetoday.com/mpacms/mt/article.php?id=13608

McQuillan, D. (2009) Energetic Approaches. Dunedin, New Zealand: Otago Polytechnic

McQuillan, D. (2009) Recent Advances. Dunedin, New Zealand: Otago Polytechnic

McQuillan, D. (2009) The roots of massage therapy. Dunedin, New Zealand: Otago Polytechnic

Salvo, S. (2007) Massage Therapy Principles and Practice (3rd Edition) Missouri: Saunders Elsevier