Per definition massage could be defined as manipulation of soft tissue which includes musculature and connective tissue. Another more detailed definition of massage is stroking, pressure and stretching of the skin and skeletal muscles.First, one has to remember that there is an overlap between different massage methods. Some of techniques are more or less the same independently of the name of the therapist educational background or of the main philosophy of a particular school.The Swedish massage I have my training in is systematically focused on working on the soft tissue and specifically on the skeletal muscles. But it must be emphasized that there is a difference between schools in Sweden how the Swedish massage is performed. This is by no means unusual in the case of manual therapy in general. For instance chiropractic and physiotherapy colleges can differ quite much in curriculum between each other. In Sweden every school has its own curriculum and will teach their students massage according to the schools on literature. In Sweden predominantly the schools that have Swedish massage on the curriculum are private. Although some state-owned university programs like physiotherapy has a few hours of massage in their curriculum it is not any complete massage course compared to many of the private massage school. Before the 1970’s physiotherapists in Sweden were well trained in massage but when physiotherapy became a more academic subject and programs were integrated within medical or health faculties there were a stronger demand that everything should be scientific based or evidence based. So the paradox today is that many of the private schools with no affiliation to university have the comprehensive programs in hands on massage training. But university programs in health and medicine are generally more extensive in science, medicine and human biology. Many of the private massage schools are under state supervision but this more a bureaucratic formality and the authority really has no knowledge in manual therapy in general or massages therapy particularly. In Sweden the quality assurance of a massage curriculum is done internally by the school itself. But there are about ten schools today that formed the Swedish Massage Advisory Council.The main aim of the Swedish Massage Advisory Council is to uphold the professional skills of a masseur or masseuse and the credibility of the business. The council quality assures schools. This is achieved by all students who are enrolled in a member schools can undergo a national test and receive certification as masseur. When council was formed 1998 there were an agreement that the title masseur or masseuse was the most commonly known title among the clients. This was the reason for that the title certified masseur or masseuse (in Swedish the word is the same for both gender) was established and marketed. Although today massage therapist is maybe has higher credibility as a title. Massage therapy diploma is a title that every school or course provider can give without any reservation. The Swedish Massage Advisory Council has through it years established guidelines and minimum level of what a massage therapist needs to know and how many hours of tuition is required in human biology, medicine, and massage and stretching. There are also requirements of clinical practice both supervised and done independently. All together there should a minimum of 390 hours of tuition and clinical practice. This is then examined when the students of the member school have passed a national theoretical certification exam. This exam is a multiple choice quiz with most questions is regarding the students’ proficiency in anatomy. There is also a national practical exam on the students’ skills in surface anatomy, massage and manual stretching. However we in the Swedish Massage Advisory Council has agreed on which muscles and their insertion and functions a massage therapist need to know there is really no consensus on the practical massage. There is also an agreement on which muscles a massage therapist should be able to passively stretch a patient but exactly how this is done regarding the position of the patient and therapist is something each school will decide. When it comes to the practical massage the guidelines is more indistinct.According to the Swedish Massage Advisory Council a certified masseur or masseuse should have a good working and theoretical knowledge of the massage techniques effleurage, petrissage, frictions (circulatory motions with the tip of the fingers), vibration and tapotement. The therapist should be able to apply these techniques on an individual basis regarding the patients or clients requests, health, physical constitution and any contraindications that might exist. But how the therapist adapts the massage techniques regarding depth and rhythm each member school will decide. Even the length of treatment session and the sequence of the techniques differ.The purpose is that certified masseur or masseuse can give massage for pure relaxation as in a whole body treatment but the therapist should also be able to treat minor musculoskeletal disorders or rather muscle dysfunctions with more localized massage in combination with manual stretching techniques and advise in basic exercise and stretching. The predicament is that the definition of the classical massage techniques is not universal. For example petrissage could be one technique with circulatory movement with the contact of the palm but petrissage is also mentioned as an overall technique that includes variations of kneading or compressions. Another dilemma is that many schools have included other soft tissue or myofascial release techniques in the massage routine. And to make even more diverse every school make their own routine and there is no consensus on which massage techniques should be done on what body region. One example is that some schools teach their students tapotement could be performed on the lower body but other teach that tapotement can be done on the upper body as well.All of the member schools of Swedish Massage Advisory Council have their own profile and specialization and most schools also graduate their students on a higher level than what is required. But unfortunately there are a lot of schools that are not members of the Swedish Massage Advisory Council. Some of these schools are still professional but others give away diploma after s few days’ courses without any examination. It is of course one thing to have shorter course for non professional use however it is not very serious if it is meant as course for professional use.I have some experience of examination massage therapist who has been enrolled in other schools in Sweden than where I work and I have also had examinations of a few therapists from other countries. The therapist will be very good in the specific technique but it always looked more like an unspecific whole body treatment and the routine less rational with alternating from different regions. It is a vast difference in how the Swedish massage is performed. Nevertheless a legitimate question is what is the difference between what the schools teaches and what the individual therapists do. When I watch learning videos on Swedish massage I see the same thing the massage techniques is seldom systematically performed on specific muscles. It looks more like an unspecific whole body treatment. I am not saying this is wrong or bad. All touch therapy will generate physiological responses of the client or patient.In conclusion Swedish massage is not as standardized as one could expect. This is also the fascination with massage despite that it from a scientific perspective is a disadvantage.
Massage for Whiplash: How to Find the Right Massage Therapist to Treat your Whiplash InjuryWhiplash is also known as cervical acceleration/deceleration injury, and hyperextension/hyperflexion injury. We will assume for this article that you are already aware of the symptoms of whiplash and that you have an idea of the most common causes of whiplash. Massage has a proven track record in helping people heal from whiplash injuries and ongoing research in this arena is promising.The 4 Main Hurdles to Overcome in Utilizing Massage Treatment for Whiplash are:Many physicians still have limited knowledge about the usefulness of massage and bodywork. Massage and bodywork for medical conditions and injuries are still in the process of gaining acceptance by the medical community at large. The good news is that more physicians everyday are opening up to, and recognizing the benefits of, utilizing massage and bodywork for injury treatment.
The training for massage therapists and bodyworkers is not standardized and there can be a great disparity in knowledge and training among graduates from different programs. Some states still have no licensing requirements. Fortunately, there is a growing movement advocating for advanced training for massage therapists and bodyworkers who specialize in treating injuries and managing pain associated with chronic medical conditions.
You may live in a state where massage is not a licensed healthcare profession and auto insurance companies may balk at paying for massage for whiplash treatment.
The knowledge base of the public. Most lay persons, and whiplash sufferers, may not know there is a difference between spa massage, and massage and bodyworking techniques that can be effectively utilized to speed healing from whiplash. I am not slighting the spa industry. Massage for relaxation has its own therapeutic value, although it is not well suited for site specific injury treatment. What’s the difference between spa massage and medical or therapeutic massage? Spa massage tends to be a more generalized effort to calm the nervous system and reduce general tension in the structure. Medical massage, or therapeutic massage, is more focused and endeavors to address trauma and to alleviate pain in the short term. The long term goals are to effect mechanical changes, make histological improvements (effect changes in the characteristics of the tissues involved), and to restore function and balance to the structure.Tried and True Methods of Finding the Right Therapist or OrganizationThere are some tried and true ways of finding a massage therapist to treat whiplash. If you are fortunate enough to have a physician who is already aware of the usefulness of manual therapies, he/she may have a clinic or list of medical massage establishments that are reputable and can render effective massage treatment for whiplash. If not, there are other avenues such as friends, coworkers, and online rating sites. The problem here is, unknown to each of these sources, treating whiplash requires higher levels of training and skill. Finding someone to perform effective massage treatment for whiplash is different from finding a massage practitioner who performs great well-body massage. The problem with relying on word-of-mouth referrals from people who may not have had massage for the treatment of whiplash, is that they may not know the difference between the use of relaxation techniques and the use of more advanced theories and techniques which are used to treat significant soft tissue injuries. It is often necessary to take things into your own hands and do your own research.Finding Massage for Whiplash On Your OwnThings to look for:A clinical setting with a therapist or therapists who have a higher level of training. It is possible to find a clinic that has many excellent therapists. Excellent professionals seek out associates of equal caliber to stay challenged, and up to date, so they can continue to grow their skill-sets. Collaboration between colleagues can offer advantages for patients and massage therapists alike. These are just points to consider. It is also possible to find an exceptional practitioner who operates a solo practice.
An experienced therapist or therapists who have worked with many whiplash cases. Less experienced massage therapists can render excellent advanced work as well, when properly mentored. Seek a therapist or organization where whiplash is one of the primary conditions they treat.
Therapists who are in the practice of keeping professional chart notes (also called SOAP notes) and who can write accurate reports containing important information for physicians, claim adjusters and lawyers. You will want excellent documentation of your injuries and treatment in order to establish the medical necessity for the treatment. In addition, complete and accurate documentation of your treatment is essential should your case need to be argued in court.
Location. Is it in a reasonable location for you? Are you willing to drive longer distances to see more experienced specialists? Depending on the specifics of your case, the treatment period could be weeks or months. This makes distance and the convenience of getting to your therapist’s location an obvious consideration.Questions to ask of a prospective therapist or organization:Do they specialize in whiplash? Are they comfortable working in the anterior triangle of the neck? Many therapists are not comfortable working the entire neck because they have not been trained to work the front of the neck, known as the anterior triangle. Treating this area of the body is not taught in many basic licensing courses and the therapists without this training will not want to work this area, nor should they. It is important to note that, although most whiplash pain is felt in the back of the neck and upperback, it is usually perpetuated by post-traumatic muscle guarding in the anterior (front side of) the neck. Alleviating whiplash pain is only the initial concern. Restoring function and the proper anterior/posterior postural balance (holding your head well balanced on top of your neck and shoulders) is imperative for long-term health and the avoidance of serious residual problems down the road. Properly treating the anterior triangle is an important part of restoring that balance.
How much experience do they have as an individual or as a group? How much knowledge is under one roof? This is an important consideration, because inexperienced therapists who are not being supervised or mentored, may miss problems common to a whiplash injury. There are problems of which the patient may not be aware. For example: a patient was rear-ended while sitting at a traffic light. It is common for a person holding the steering wheel in this situation to have shoulder joint injuries which are masked by the overwhelming neck pain. An inexperienced therapist may neglect to do simple palpation of the shoulder, which would be surprisingly tender to the patient, and confirm the injury. A missed condition that will become more evident as the inflammation in the neck subsides. This shoulder injury could be unnecessarily challenged by the insurance company responsible for payment. The insurance company would argue that the shoulder injury was not from the accident, since it was not charted on the initial visit. I understand that this is unfair, but it is how insurance companies usually behave. The point here is that massage therapists who are experienced in treating whiplash know what to look for and how to treat it.
How long have they been in business? Again this speaks to the level of experience. Seasoned therapists, or clinics with multiple therapists and a large collective body of knowledge, understand the intricacies of treating serious injuries such as whiplash. Just as important is an understanding of proper documentation and dealing with insurance companies, which leads us to number 4…
Do they do the insurance billing for you? Or will they require you to pay at the time of service and leave you to bill your own insurance company? Billing is a valuable service provided by well established practices. It can take a lot of the paperwork load and hassle off of you while you are healing.As mentioned before not all states regulate the practice of massage. Alaska, Idaho, Kansas, Minnesota, Oklahoma, Vermont, and Wyoming are the states where massage is currently unregulated. Check the American Massage Therapy Association website for the latest update.While this article is not meant to answer all of your questions on how to find the right massage therapist or organization, I hope it gets you well on the way to finding the person or persons who can render the most effective massage for your whiplash treatment, and help you fully heal from your injuries.