In the massage therapy profession, the inconsistent and often confusing use of massage therapy terminology has led to challenges in communication, both within the field and with clients and other healthcare professionals. The lack of standardized language, particularly in defining different types of massage, complicates the understanding of what services are offered and their intended outcomes. To address this issue, there is a growing call for clearer, more unified terminology that accurately reflects the diverse modalities and practices within the profession, ultimately aiming to enhance clarity and professionalism.
Key Takeaways
- Massage therapy can be broadly categorized into personal care services for relaxation and health care massage for addressing specific health conditions, both of which are equally valuable but distinctly different.
- Broad, umbrella terms for massage should not be based on factors like referral source, setting, payment type, or specific modalities, as these can oversimplify and misrepresent the diverse and specialized nature of massage therapy.
- There is a pressing need for the massage therapy profession to establish standardized terminology to enhance clarity, reduce client confusion, and improve the profession’s overall image.
Unraveling Our Tangled Web of Massage Therapy Terminology
As a 35-year veteran in the world of massage therapy, I have often found myself bewildered by the plethora of names and labels attached to various categories and types of massage. I’m not alone in this sentiment. Many professionals, from beginners to experts, feel the same confusion.
For this article, I initially aimed to shed light on the term clinical massage; yet, as I delved into the topic, I uncovered a complex web of challenges surrounding our massage therapy terminology. In this article, we’ll address these key issues and hope to initiate a conversation about possible solutions.
Before delving into the complex terminology of the massage profession, we must address a fundamental question: Do names matter, and if so, why? There are evident problems when a profession cannot agree on how to refer to even its major overarching categories, much less the specific modalities or techniques used.
In the massage profession, marketing opportunities are motivators for naming. This wild west of terminology confuses other health care professionals and clients. What is more problematic is when the field’s professionals use various terms inconsistently and in very different ways. While we will always have a diverse and colorful selection of modalities, we would be wise to agree on our broadest categories as a profession.
Massage therapy can be divided into two primary types: personal care services and health care massage. It’s essential to note that neither type is superior to the other; both have unique merits.
Personal care massage focuses primarily on general relaxation and stress reduction. This is treatment delivered in spas, salons, franchises, private offices or other environments where the primary goal is general stress reduction and relaxation. The practitioners in this track are not acting primarily as health care providers.
The second category of health care massage specifically focuses on using massage to address compromised health conditions. It is in this overarching group where nomenclature becomes a real issue. In this article, we will explore the challenging terminology revolving around health care massage.
What Should Health Care Massage be Called?
Historically, the term clinical massage was used to denote the vast and diverse world of health care massage. The profession has a history with this referent, so definitions that closely resemble each other exist. In its broadest sense, clinical massage has been used vaguely to portray the idea that the massage was more than basic Swedish massage learned in entry-level education.
Because of its all-encompassing reach, clinical massage can include any number of modalities, settings, client populations and approaches. Practitioners who call their work clinical massage usually provide more detail about their therapeutic approach.
However, clinical massage is also more specifically characterized, particularly in entry-level textbooks. These definitions highlight that clinical massage is outcome-based, with defined goals established either with the oversight of a physician and/or in consultation with the client. It is care directed toward therapeutic purposes, such as injury recovery, medical-condition management and improving function.
To be outcome-based, clinical massage requires various degrees and types of assessment depending on the client/patient’s medical condition. Clinical massage includes condition or population-specific care, such as oncology or geriatric massage. At its core, the term is broad to represent the diversity of settings, clients and goals that comprise this body of massage.
Today, the term medical massage is widely recognized throughout the massage profession. Some people use the terms medical and clinical massage interchangeably. However, there is more significant confusion around medical massage because other concepts are often interjected into the definition.
While this term is broad, it predominantly relates to patients with compromised health conditions. Challenges arise when trying to define medical massage, as evident in the varied and sometimes unclear definitions provided by major health care institutions such as the Cleveland and Mayo Clinics.
In fact, the term medical massage has become a focal point of discussion and frustration.
Numerous practitioners highlight a missed opportunity in how the label medical massage is used. If a practitioner is trained in medical massage, should they not be familiar with common medical conditions beyond musculoskeletal complaints? Should they know the difference between conditions that may seem like musculoskeletal injuries yet are severe systemic medical conditions?
The waters are even more muddied when other specific elements are included in the definition.
Some professionals insist that medical massage should be exclusive to treatments prescribed by a physician. Others have gone further to say it is a massage paid for by medical insurance. The medical classification also risks being pigeonholed by where the treatment takes place.
Then, there are those who view medical massage as a specific collection of techniques, narrowing what medical massage represents substantially.
What all these various definitions of medical massage miss is a description of the practitioner’s training, skillset and knowledge. Medical massage descriptions increasingly borrow heavily from the definitions of clinical and, in some cases, orthopedic massage. This causes confusion across the profession.
What Umbrella Massage Terminology Categories Should Not Be
Umbrella concepts or categories—those overarching definitions used to name types of massage therapy—can lead to confusion among consumers. Here we will look at what such categories should not be based on:
• Referral Source Based: Relying on the referral source, specifically a physician’s prescription, as the determinant for defining a large umbrella concept like medical or clinical massage poses a fundamental challenge. By this definition, the intrinsic characteristics of the massage—the techniques used, the specific health conditions addressed, and the intended therapeutic outcomes—are overshadowed by the mere act of physician referral.
Such a narrow lens overlooks the fact that many massages, even without a physician’s directive, can address and alleviate specific medical conditions with significant efficacy.
Moreover, a physician’s referral-based definition could inadvertently discount the expertise of seasoned massage therapists who, through years of practice and continuing education, possess a deep understanding of complex health issues and provide highly therapeutic massages without a direct doctor’s prescription. Simply put, tying massage solely to the referral source reduces the richness and diversity of the therapeutic encounter.
• Setting Focused: Defining massage based solely on the setting in which it is performed, such as a medical clinic or hospital, oversimplifies the nature of the therapeutic process. Such a definition may exclude specialized treatments delivered outside traditional medical environments, like home-based care or athletic training facilities.
A setting-based definition neglects the core essence of the treatment, which is rooted in its therapeutic objectives, the specific health conditions addressed, and the expertise of the therapist rather than the location where it is administered.
• Payment Type: Defining massage based solely on the method of payment, specifically third-party reimbursement like insurance, is an oversimplification that sidelines the core principles and objectives of the therapy, reducing it to a mere economic transaction. Such a definition fails to consider the diverse techniques, specialized training, specific health conditions addressed and the desired therapeutic outcomes of the care.
Additionally, many therapeutic massages are self-funded by clients.
• Modality Focused: Borrowing large umbrella categories and attributing specific techniques or modalities to them is problematic. Confusion will result if the client sees these terms used in other, more broad ways. Both clinical and medical massage, by definition, are not specific modalities.
Proposed Best Practices Umbrella Terms
The profession faces a labyrinth of terminology to refer to the endless spins on modalities. Clients face a mind-numbing number of massage types with no clear understanding of what the neuro/myo/kineto/wawa/dodo terms actually mean.
Our overarching, profession-wide classifications should not further the client’s distress and confusion.
While diversity and innovation are welcome in the field, practitioners, educators and organizations need to work toward a more standardized terminology. This would simplify communication, reduce client confusion, and ultimately result in a more professional image of massage therapy. Our profession must have strong leadership in this matter. I urge our professional associations and organizations to establish a dedicated task force to develop consistent terminology. This task force can address the current dilemma and provide us with precise language to better describe our practices.
About the Author
Whitney Lowe, LMT, directs the Academy of Clinical Massage. He teaches continuing education in advanced clinical massage through the academy, and offers an online training program in orthopedic massage.