A Medical Massage Might Just Be What the Doctor Ordered

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Literally! It could be what the doctor, physical therapist or even the dentist ordered. In most cases, you do not need an order from a healthcare provider to receive treatment from a medical massage therapist (MMT).

There are many benefits of massage and it is being used more often in the medical setting as additional research is being done on the effects when used in combination with other treatments and alternative therapies. The Mayo Clinic College of Medicine and Science also discusses the increase in use of massage therapy in the medical field.

In the hospital setting, a medical massage therapist may treat patients with conditions such as fibromyalgia pain, cancer, and patients on hospice.

Read on to learn how medical massage (A.K.A. therapeutic massage) is different from other types of massage. It might be a game-changer for you.

More than a massage

How is this type of treatment different from the other types of massage such as those discussed in this Health Line article?

This is a more specialized form of massage where specific conditions are treated using a combination of techniques to help correct the problem. It usually isn’t just for relaxation or relief of tension, although, some conditions like anxiety, depression and insomnia may benefit from these as well.  

The licensed massage therapist (LMT) will talk to the patient about why they are there and ask specific questions about the pain, discomfort, or other reasons for the appointment. The LMT will perform a physical assessment and develop a treatment plan.

This probably sounds very different from what you may know about getting a massage. Pain, discomfort, and limited mobility have a significant impact on our lives and need special attention and care. Some rely on these treatments to function in their everyday lives.

Do you have to see a doctor first?

There are times when you know you should seek medical attention first. If you are in serious pain, you should see a doctor. If there is a wound, discoloration, or something that just does not look or feel right then you should see a physician.

You may have already seen a doctor, chiropractor, or physical therapist. That’s great! When you have an appointment, ask while you are there. However, for many common issues, you do not need to be evaluated by another healthcare provider before seeking treatment from an MMT.

Maybe you already know that you carry a lot of tension in your back, shoulders and neck that causes headaches. You might have plantar fasciitis that causes sharp shooting pain in the heel of your foot in the first few steps of the morning. Back and neck pain are very common. These are just a few very common issues that can be taken care of without a trip to the doctor every time.

When in doubt, ask.

Conditions that can be treated

There are quite a few conditions that can be treated with the many techniques that have been developed over the years and around the world.

Here are some common issues that can be treated with massage:

  • Tension headaches
  • Plantar Fasciitis
  • Thoracic Outlet Syndrome (TOS)
  • Temporomandibular Dysfunction (TMJ Dysfunction)
  • Sciatica
  • Carpal tunnel syndrome
  • Certain types of swelling
  • Scar tissue restriction and pain
  • Back pain
  • Neck pain
  • And the list goes on

If you have questions about whether therapeutic massage is right for you, contact a medical massage therapist near you and just ask.

Treatment options

You have heard of Swedish, deep tissue and Thai massage as well as some others. Each has their own techniques and purpose. There are many ways to achieve similar effects and thank goodness! Some people have sensitivities to pressure, heat or cold, range of motion limitations and more.

Here are just ten of the techniques that can be used in medical massage:

  • Swedish
  • Deep tissue
  • Trigger point therapy
  • Myofascial release
  • Cupping (static and cupping massage)
  • Gua Sha (A.K.A. scraping or coining)
  • Active and passive stretching
  • Post isometric stretching
  • Pin & stretch
  • Muscle Energy Techniques (MET)
  • And so many more

Depending on the problem to be addressed, one or several of these techniques may be used. Treatment should always be specific to the individual patient’s needs.

Where to find them

This specialty of massage therapy can be found in the hospitalist setting, clinics, nursing home facilities or in private practice.

Chances are that you will be looking for one that is in a private practice or works in a clinic. If your healthcare provider doesn’t know of one to refer you to, here are a couple of options.

You can check online directories such as these:

Otherwise, Google will likely have the answer.

Try searching for “massage therapy near me” or massage therapy + your city/town. If you live in a city, then the chances are that you will have at least a few to choose from. Smaller towns may not have exactly what you need, and you may have to look at surrounding towns as well.

From there you can review the results to see if they might provide the services you are looking for. You may need to call and ask them. If they don’t, ask them if they know someone in the area who does.  

Does insurance cover medical massage?

Some physicians are familiar with the benefits of massage and may even write a prescription for treatment of a specific condition. This prescription is needed if you would like your insurance to cover the cost. Not all insurance companies cover massage therapy, however.

Because of this, many massage therapy practices are private pay only and do not accept insurance. There are often requirements and restrictions (including time restrictions) by insurance companies. Even if your insurance doesn’t cover the treatment, it may still save you some money in sales tax.

Conclusion

Medical massage therapy is there to help decrease or relieve tension, pain, and improve the quality of life for the patient. It is the specialized study conditions and practice of using techniques to achieve a therapeutic outcome. These therapists are focused on providing a service and caring for their patients.

They study and apply many different techniques to achieve the treatment goals of their patients. They may use many tools of the trade as allowed by their scope of practice in addition to their fingers, hands, fists, forearms, elbows, etc. Be curious and ask questions.

About the author

Ethan Pariseau is a licensed massage therapist, Registered Nurse, and a freelance health writer. He is passionate about health-related topics and educating others so they can better understand their conditions and take an active role in their own health journey.

Links and resources used in this article

The Mayo Clinic College of Medicine and Science – https://college.mayo.edu/academics/explore-health-care-careers/careers-a-z/medical-massage-therapist/

Health Line article “What Are the Different Types of Massage?” – https://www.healthline.com/health/types-of-massage  

The Mayo Clinic – Benefits of Massage – https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/benefits-of-massage-therapy

American Massage Therapy Association – Find A Massage Therapist – https://www.amtamassage.org/find-massage-therapist/?utm_source=radio&utm_medium=cpc&utm_campaign=famt

Massage Book directory – Massage Book Health Grades directory – https://www.healthgrades.com/massage-therapy-directory

Why I Call You My “Patients” and not “Clients”

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I’ve been a nurse for 15 years. So, I’m sure that has a lot to do with it. But, in my mind, a “patient” is someone you have a different connection with than a “client”. It feels like it’s a cold and distant relationship to me. There’s nothing wrong with massage therapists or other businesses calling them “clients”. They may feel the same way about using the term “client” as I do about “patient”. 

As a nurse, I have taken care of patients who were coming to the end of their lives. Others who were dealing with the worst health crisis they had ever experienced. I have listened to the life stories of the elderly because they were lonely in the middle of the night with no family around to keep them company. I have dealt with many situations from the nurse/patient perspective. I have been the one providing the care.

I’m not a physician but I have had patients, both as a nurse and as a massage therapist, call me “Doc”. They knew I wasn’t a doctor but I didn’t correct them. It was their way of showing me that they respected what I was doing for them. Sometimes, you just have to go with it. 

As a licensed massage therapist, I see people in various stages of health as well. They come to me when they’re in pain and have tried everything else that they can think of. Other times, they’re just so uncomfortable and have so much tension built up that they need a professional to work it out. Physicians, physical therapists and other health professionals may also refer them to see a massage therapist so they search on Google and find me. 

To me, the term “patient” is an endearing term. Referring to those who come to me as “my patients” carries with it a sense of weight and responsibility, on my part, to the person seeking treatment. They’re coming to me in hopes, trusting, that I can help them. I don’t take it lightly and I appreciate each person that comes to see me in my humble “residential practice”, as they call it. It’s a start.

This is the reason I call them my “patients” instead of my “clients”. It’s a personal and professional preference of mine. 

About the author: Ethan Pariseau is a registered nurse with a bachelor of science in nursing and is licensed by the state medical board of Ohio to practice massage therapy.

A Pain in the Tooth Can Become A Pain in the Backside for Dental Professionals

A Pain in the Tooth Can Become A Pain in the Backside for Dental Professionals

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Dental professionals are at a higher risk of developing musculoskeletal disorders. To a patient laid back in the chair with their mouth agape it may just be a fleeting thought but if they take a minute and think about it, bending and leaning over like that’s gotta hurt. Then, the patient returns back to focusing on anything but what’s being done to their mouth.

Neck, shoulder, upper and lower back pain all contribute to early departure from the dental profession. Those of you who work in dental offices have to contort your bodies to get the angle needed to take care of your patients. You have to hold those positions while you carefully, meticulously and methodically work to take care of your patients throughout the day.

Doing this day after day and year after year can lead to the inability to continue working in this capacity. It’s just too damaging and too painful to continue on after so long. If you don’t find ways to make your work practices more ergonomic and really pay attention to your body you may find yourself looking for a new position in the dental field or for another line of work altogether.

  • Here are a few ideas for things that could help relieve or even prevent pain/discomfort while at work in the office:
    • Make it a point to stretch periodically throughout the day.
    • Use a tennis ball between yourself and the wall to roll out tense and aching back muscles.
    • Keep a massage gun in the office for a quick tune up. You may need a hand from a coworker if you can’t seem to get the massage gun
    • to the right spot or hit the tissues at the right angle.
    • Schedule a massage therapist who will come to the office with their massage chair and give 10-15 minute massages to each of the staff as they rotate out for their lunch break.

Injuries can be short or long term but chronic injuries are more common. With chronic injuries, it increases the likelihood that you won’t be able to continue working in the dental field as you are. As a result of these injuries, the dental practice will see an increase in sick leave, decreased quality of work and increased work-related accidents. These can cost you considerably and in more than one way.

When able, try to find different positions to perform the same tasks and vary them throughout your workday. Find ones that work for you and place less strain on your body. Take a minute here and there to move and stretch those muscles, tendons, ligaments and structures that are pushed, pulled and cramped while working with patients.

About the author: Ethan Pariseau is a registered nurse with a bachelor of science in nursing and is licensed by the state medical board of Ohio to practice massage therapy.

Do You Have Tennis Elbow?

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Also known as “lateral epicondylitis”, tennis elbow doesn’t just develop in tennis players. You don’t even have to be an athlete or play sports at all. I’ve personally treated nurses and those who work in the construction industry who have had it.

What is it?

Lateral epicondylitis is basically inflammation at the site where the muscles and tissues of the top of the forearm, wrist and hand attach to the outside bony structure of the elbow. It’s painful and can make everyday tasks a challenge. It may be painful to turn a doorknob, a screwdriver, wring out a washcloth, etc. Even holding a cup might be painful. Many things that require the use of the muscles on the top side of your forearm can cause this pain. The pain can also be located in the forearm or wrist, although this seems to be less common in my own professional experience. Muscles knots (a.k.a. trigger points) may also be a factor contributing to pain in the forearm.

Causes and risk factors

Basically, overuse and straining of the muscles are the cause. Anything that causes repeated contraction of the forearm muscles that are involved in straightening your hand and raising your wrist can lead to tennis elbow. These repetitive and straining activities put extra stress on the muscles and connective tissues, such as tendons, and their attachment site. Think about using a computer mouse and pulling your fingers up away from the mouse after clicking or using the scroll wheel. Maybe you’re a writer, editor, graphic designer, secretary at a school or a nurse who documents on your patients repeatedly throughout an eight or 12 hour shift. There is repetitive stress placed on the structures mentioned previously that contribute to the development of lateral epicondylitis.

Maybe you’re fiercely competitive when it comes to ping pong, tennis, racket ball, badminton or another sport that uses a racket.

The backswing specifically is what may contribute to the development of tennis elbow. Also age. If you happen to be between the ages of 30 and 50 you may be at a higher risk. I’m smack dab in the middle here.

Treatment

Rest, ice and over-the-counter pain relievers according to the Mayo Clinic. Massage can help to alleviate tension in the muscles, on the tendons and in other connective tissues. This can speed the recovery from tennis elbow. One thing that I incorporate is ice massage at the beginning of the treatment session. I may use a dixie cup with ice and massage the attachment site at the elbow. This helps calm the irritated and inflamed tissues before I work with them. I then apply Swedish techniques, deep tissue, pin and stretch, a few other techniques depending on the situation and then back to Swedish to make nice with the tissues to finish.

You may also try using a tennis elbow brace to decrease tension on the attachment site. If the pain persists past what seems to be a reasonable period of time then you may want to consider making an appointment with your family doctor.

About the author: Ethan Pariseau is a registered nurse with a bachelor of science in nursing and is licensed by the state medical board of Ohio to practice massage therapy.

Plantar Fasciitis – A Pain in Your Heel

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You may have heard of it. It’s painful. Imagine trying to get out of bed in the morning to get yourself ready for the day and you can barely stand or walk around your bedroom because it’s too painful. Or when you get up after sitting for a while like after sitting at a computer for work or after a car ride. Even more pain following certain exercises like running. The good news is that it’s treatable. There are several things that can be done that are natural and without medications, injections or minor surgical procedures.

Who Does It Affect?

Plantar Fasciitis is one of the most common causes of heel pain. Approximately 2 million adults are treated for this condition each year. The number of those affected is certainly higher than those reported as having been treated for it. I’ve known people personally who have been affected by it but they just toughed it out until it went away, which took a while and I would not recommend doing. It can affect those who aren’t very active in their daily lives but also those who are very active and athletic. Some of the causes are overpronation of the foot (your feet roll inward toward the arch of your foot as you walk), excessive running and standing for extended periods of time. It usually affects both feet at the same time.

What Is It Exactly?

Sometimes referred to as “plantar heel pain syndrome”, plantar fasciitis can be related to the degeneration, or breakdown, of the collogen in the tough band of connective tissue that runs along the bottom of the foot and connects the heel bone (the calcaneus) to the first set of bones of the toes (the proximal phalanges). It can also be related to bone spurs and/or inflammation as the “-itis” at the end of the term suggests.

What Causes It?

  • Excessive Running

Even more so if the runner wears worn down shoes. I’m a long distance runner myself so this is a concern anytime I start to feel similar symptoms. I’m also always conscious of the mileage and wear and tear on my running shoes.

  • Being Overweight

Also guilty. In September of 2017 I began gaining weight. I gained 70 pounds of unwanted weight and I’m still working on getting rid of it. Genetics, life situations that are out of our control, poor dietary choices…the list goes on. But our connective tissue doesn’t care what the reason is for the added stress.

  • Sudden Changes in Activity

Even running 5-6 days a week and long distances hasn’t worked on it’s own. I’m changing my eating habits, exercising more with bodyweight and strength training. Fortunately I haven’t had to deal with PF. I am very conscious about gradually increasing the amount of activity I do and paying attention to lingering tightness, soreness and anything else that might lead to an injury of some kind.

Uneven Leg Length

This creates an imbalance of pressure, movement and stress on the lower extremities.

Flat or Pronated Feet

Also creates an imbalance of pressure, movement and stress on the lower extremities.

Arches of the Feet that are higher than average

Ditto as the two previous potential causes.

This tough band of connective tissue acts as a shock absorber and spring in the foot. But these functions are hindered when the fibers of the connective tissue fray from overuse and stress and isn’t repaired properly. PF may also occur because of other disorders like gout, rheumatoid arthritis or diabetes.

How Do You Know If You Have PF?

The signs and symptoms of PF are pretty consistent which make it easier to identify.

  • Acute pain in the first few steps after having been off your feet for a while
  • The pain is located just in front of the heel on the bottom of the foot or deep in the arch of the foot
  • Pain eases or goes away after a few steps
  • Pain comes back (possibly more intensely after prolonged standing, walking or running

There is a simple test that I do on my patients who believe they may have plantar fasciitis. This test is called the Windlass Test and it is done with the patient sitting on the table and I brace the heel of the foot with one hand and apply upward pressure on the toes to tighten the tissues on the bottom of the foot. The test is positive if this produces pain between the arch and where the connective tissue attaches to the heel.

How Is It Treated?

Here we go…onto the stuff you’ve been waiting for. Most people don’t want to jump right into steroid or Botox injections. Steroid injections can cause damage to the fat pads on the heels of the foot and can also cause the collagen fibers to become weak and the tissue to possibly rupture. There is also a focused ultrasound therapy (extracorporeal shockwave therapy) that has shown some effectiveness in treating PF.

Let’s talk about what can be done without needles, medications and ultrasound machines. The first thing to focus on is decreasing the amount of tension in the muscles and tissues that cause PF and the pain. First thing in the morning, before you even get out of bed, massage your calf muscles and feet. Get the blood flowing. Warm the tissues. Do some stretches on the calf muscles and get the tissues in your feet moving. This doesn’t have to be an extensive process. Just a couple of minutes.

You can get orthotics or heel cups to put in your shoes that help decrease the amount of movement in your feet that causes the pain. Some people even use night splints that keep the feet in a position slightly pulled back like when you pull your toes up toward you.

  • Ice

Using ice at the site of pain can help to lessen the pain. Try using a frozen water bottle and rolling your foot on the bottle against the floor. Even though you won’t be keeping the bottle in a single place on your foot, make sure to keep a cloth barrier (like a sock or washcloth) between your foot and the frozen bottle to prevent injury to the tissues.

  • Stretching

Stretch your foot and calf muscles, as I mentioned above. Why the calf muscles? There are two of them (the soleus, and gastrocnemius) that come together and form the Achilles tendon which connects to the same heel bone of the foot (the calcaneus) and continues on to form the tough connective tissue that runs along the bottom of the foot. If the calf muscles are overly tense they pull on the connective tissue and that tension translates down the lower leg and into the bottom of the foot.

  • Deep Tissue Massage

Deep tissue work of the calf muscles and bottom of the foot can help to release that tension I mentioned in the previous section. A licensed massage therapist who is knowledgeable about plantar fasciitis will know where to work and why. Only working at the site of pain won’t treat the cause of the pain. It’s like if you take Tylenol or Motrin for a fever…it won’t treat what’s causing the fever, just the fever that your body is producing to try and fight the cause. So, in plantar fasciitis, we have to treat not only the site of pain but also the other structures that are contributing to the issue.

These three are the least invasive and first line of treatment. After these have been done and if they have been unsuccessful then the injections and ultrasound may be an option. If those don’t get the job done then surgery may be the last option. This procedure usually involves dividing some of the connective tissue in the bottom of the foot that is causing the issue.

Non-Steroidal Anti-inflammatory Drugs (NSAIDs) might be used to help with the pain and Cortisone injections may also be used to help with anti-inflammatory and collagen-dissolving effects.

How Long Does PF Last?

Plantar Fasciitis can last anywhere from 6 months to 18 months before it’s all said and done.

I hope that this article has helped you get a basic understanding of Plantar Fasciitis. It’s not an exhaustive explanation but it should get you started. I didn’t want it to be too long and overwhelming to read. Remember to treat your calf muscles as well as your foot! The cause of pain is not always at the site where the pain actually is.

With all of that being said, find a massage therapist who is comfortable assessing and treating plantar fasciitis. Do some more research, talk to your massage therapist, physical therapist and/or primary care physician.

Also see the following references for more information:

The Mayo Clinic

OrthoInfo from the American Academy of Orthopaedic Surgeons

John Hopkins Medicine

About the author: Ethan Pariseau is a registered nurse with a bachelor of science in nursing and is licensed by the state medical board of Ohio to practice massage therapy.

Expressing Appreciation for My Patients

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A big Thank You to my patients

As a new small service based business owner in my small community I am very grateful for those in my town and the surrounding small towns that have come to see me and have trusted me with taking care of them. Allowing me to interview them, assess them, develop a plan of care with them and then follow through with that plan. 

I appreciate each and every patient that I have seen. And those who allowed me to work on them while I was still in school. Without those who allow students to practice on them the students wouldn’t be able to gain valuable experience and learn what different tissues feel like on different people. There is only so much one can learn from treating their classmates who don’t actually have any issues with their tissues. 

 I have learned something each time I’ve worked on someone. It may have been a new technique that I wanted to try out. Or maybe I just came up with a different way to accomplish the same goal but it helped to give variety to the treatment. I’ve learned which techniques are more effective for certain body types, pains, sensitivities and more. 

My experience so far has taught me something about myself. I’ve learned several problems I like to work on and it has helped me better define the type of patients I want to work with. There are still so many things I want to try and be a part of relieving and that just shows me that I have a long career ahead of me. I enjoy a challenge. I love to teach people about the body and what I’m doing so they can have a better understanding of themselves and take some control back. 

I will continue to look for different ways to show my appreciation for each of my patients whether they only see me once or become a regular who comes to see me for years to come. Getting creative in many aspects of my practice is one of the things I look forward to having the opportunity to do.

I hope that if I have treated you that you were able to get some relief and learn something from me. I appreciate the time you took to contact and come and work with me. Maybe we’ll work together again in the future. I thank you for giving me the opportunity.