Tuesday, June 16, 2009

Thursday, June 11, 2009

Historical, cultural and philosophical approaches to massage

Fundamentals, task 6. Due date: June 12, 2009

Barbara Newton

Historical, cultural and philosophical approaches to massage.

“Massage is a very ancient form of treatment, so ancient that one may consider its history to be as old as mankind, and its beginning prehistoric.” (Emil and Kleen, 1921 as cited in Calvert, 2002, p.1)

As we look to the future of massage therapy and its position in the health care profession it is important to have an idea and basic understanding of the history of the different cultural and philosophical approaches, and of its evolution to the present state.

Massage has developed from the most primitive of all sensations, that of touch (Salvo, 2007, p. 82) in three main streams: that of the traditional healer, eastern massage, and western massage. This development has occurred in a cyclic manner with regard to massage usage and in general the ebb and flow of its popularity following new knowledge and technique developments.

Traditional massage (holistic)
The traditional massage had its beginning with the village healer whose modem was based around a holistic approach: physical, emotional and spiritual, with treatment incorporating herbal remedies, manipulations, energy work and calling on the spirits.

Eastern massage (holistic + energy)
Eastern massage in the ancient cultures of China, Japan, India, Persia, Arabia, Greece and Egypt (American Cancer Society, 2009) was also developed from the traditional holistic methods but from an energy movement system approach, and incorporating massage without the use of lubricants but using compression, stroking and stretching. These include: the Chinese methods of Amma/An-mo, Tai Chi and acupuncture; Japanese Shiatsu; Thai massage; and the Indian head and Ayurvedic massage.

Western massage (body, scientific)
On a completely different track western massage on the other hand has developed from the traditional techniques wholly on the physical and physiological theory. This evolved under the influence of the scientific approach to modern medicine, and the increased awareness of the human anatomy resulting in the development and basis of what is one of the most common forms of massage used and known today as Swedish massage.
Its development was started by Geek physician Hippocrates of Cos (460-375 BC) who is generally recognized as the father of Western medicine, who set in place the practice of looking at techniques, figured out how they worked and analyzed and recorded the results. He was a proponent of massage (Salvo 2007, p.14) based on scientific and physical ideas.
These ideas of Hippocrates were advanced by the efforts of Galen of Pergamon (c. AD 130-200), another Greek physician whose writings and dissections greatly improved anatomical understandings enabling the relationship of anatomy to physiology to be made.
This early development and association of massage with healing by Hippocrates and Galen happened during the peak of the Roman Empire until its collapse and the period known as the “Dark Ages” or devolution of civilization came about. A resurgence occurred in the Renaissance or enlightenment period( or 2nd cycle of popularity) when Swedish physiologist and gym instructor Pehr Ling ( 1776-1839) revived massage practice using physiological principles to explain why his “gymnastics” had health benefits. While his efforts, based on active exercises, passive stretches combined with massage, were sound, innovative and successful he failed to gain credibility from the medical fraternity due to his of lack of medical training. Despite this he gained world wide recognition of his techniques and systems through his widespread teachings in Europe.
It was Dutch physician Johann Metzger (c 1817-1893) who took massage to the next level by establishing massage as part of medical practice. Around this time French names and terms were used in massage by Metzger’s followers.

With all this growth and the favourable acceptance and use of massage from the medical fraternity massage became a victim of its own success (Fritz, 2009, p. 16) during the 1890’s with an increase in demand for trained therapists. Consequently it was necessary to establish more training facilities and this in turn resulted in a flood of therapists on the market.
Unfortunately the standards and levels of training were not always of a high quality, and dubious massage parlours recruited and exploited those from poor neighborhoods, who in turn under the guise of “massage” turned to prostitution in an effort to repay the debt incurred in their training. In addition outlandish claims were made as to what they could do, scandals abounded and the combined effects resulted in a massive negative impact on the industry, (McQuillan, 2009). And so the second trough in the industry occurred. That downward period was relatively short-lived until the early twentieth century when a number of new exciting techniques were introduced, (resulting in a resurgence occurring in massage), and in particular, among others, those by Kellogg, Vodder, Travell and Cyriax.
The American John H Kellogg (1852-1943, Sanitarium founder) developed a combination of massage therapy techniques consisting of “seven types of basic manipulations: touch, stroking, friction, kneading, vibration, percussion, and joint movements” (Wakuda, T., Wada, T., Noguchi, E., Saijo, K., 1999). He also helped popularize massage to the general public in the USA through his numerous writings (Salvo, 2007, p.9), and interests in the fledgling spa industry.
A technique called massage lymph drainage that moves the skin over the underlying tissues using repetitive and circular movements was discovered and developed by Danish practitioners Dr. Emil and Estrid Vodder and which they went on to train others in. Shortly afterwards Janet Travell pioneered a technique known as trigger point release “for treating and controlling [myofascial] muscular pain”, (Pain education, 1998). She also published a huge volume of material on her work. James Cyriax was an orthopedic surgeon, who devised a specific massage technique, called deep transverse friction, for the treatment of muscles, tendons, ligaments, joint capsules and tendonitis scar tissue (Yaaqoubi, 2006). He also introduced the range of motion assessment which today is a big part of massage assessment (McQuillan, 2009).

New Zealand’s own indigenous massage is based around the traditional holistic healing approach in two main methods: Mirimiri and Romiromi.
Mirimiri is based on the four dimensions of physical, family, mental and spiritual health with emphasis on the later with regard to faith; who and what we are; where we are from and where we are going to.( Durie, n.d.) On the other hand Romiromi is a more physical technique using parts of the body: the elbows, hands, knees, feet, and tools: such as raakan (wood/stick), kohatu /toka (stones), and moana (seawater). This method is similar to the western massage deep tissue work, whereas as Mirimiri is similar to the relaxation massage. (McQuillan, 2009).

Massage New Zealand ( MNZ) evolved in 2006 out of the Therapeutic Massage Association (TMA) which had been formed following the merger in the late 1990’s of two separate professional organizations ( MNZ,2009): Massage Institute of NZ (MINZ), the first professional organization established in 1985 & the NZ Association of Therapeutic Massage Practitioners (NZATMP), established in 1989 by Jim Sanford. The main focus of this organization is on raising education standards and promoting professionalism in the industry for the whole industry (McQuillan, 2009).

Western massage had a hands on focus based loosely around biomedical and physiological models with a Swedish massage base. But contemporary massage is not just hands on massage. With recent advances it has diversified and encompasses strong elements of orthopedic assessment, and effective advanced soft tissue approaches, such as myofascial, neuro muscular, lymphatic drainage techniques.

According to Fritz (2009, p. 39) “in reality the body, mind and spirit cannot be separated” and this is born out by traditional massage which encompasses all three elements. The eastern massage in particular had its focus on the mind and /or energy work which were largely ignored by the West.
The advent of knowledge, anatomical understanding, from a medical and scientific background developed the Western focus to that of the body or physiological perspective.
Subsequent research and advancement in new techniques and therapies has edged the focus back to that of body/mind, with many of the touch therapies now combining ancient and modern techniques from both the East and West.
In essence the philosophical approaches to massage since its inception you could say have literally gone in a circle. From the traditional beginnings of a holistic approach to body / mind/spirit by healers or Shamans, and the Eastern world with more emphasis on the energy interaction component ( body /mind), to that of Western contemporary massage which had a physiological focus as the more skeptical western man obtained more medical knowledge.

With the cumulative knowledge built on from the past; research; education; complimentary and alternative medicine; and more integrative approaches to healthcare all combine to feed the current growth of the massage industry worldwide (McQuillan, 2009). At present the industry is undergoing an upward trend as “the credibility and acceptance of natural approaches to health and illness are developing, and knowledge bases are beginning to overlap” (Fritz, 2009, p.20).

In order to better understand where we are headed we definitely need to comprehend the past.

Personal thoughts
Class notes
Text books

American Cancer Society. Massage. Retrieved May 28, 2009 from http://www.cancer.org/docroot/ETO/content/ETO_5_3X_Massage.asp

Calvert, R., (2002). The history of massage: an illustrated survey from around the world.(illust.ed.). Inner Traditions / Bear & Company.

Durie, M. Maori health models. Retrieved May 24, 2009 from http://www.maorihealth.govt.nz/moh.nsf/pagesma/445

Fritz, S. (2009). Mosby's Fundamental of therapeutic massage, (4th ed.). Missouri: Mosby Elsevire.

McQuillan, D., (2009). Fundaments- history of massage. Retrieved June 9, 2009 from http://elluminate.tekotago.ac.nz/play_recording_confirmation.html

Massage New Zealand, (2009). How Massage New Zealand was formed. Retrieved June 8, 2009, from http://massagenewzealand.org.nz/

Massage World. Manual lymphatic drainage- Vodder method. Retrieved June 2, 2009 from http://www.massageworld.co.uk/articles/manual-lymphatic-drainage-vodder-method

Pain Education.com. (1998). Janet Travell, M.D. “Mother of myofascial –trigger point knowledge. Retrieved June 8, 2009 from http://www.pain-education.com/100143.php

Salvo, S., (2007). Massage therapy, principles and practice, (3rd ed.). Missouri: Saunders.

Wakuda, T., Wada, T., Noguchie, E., Saijo, K., (1999). Journal of Japanese Association of Physical Medicine Balneology and Climatology, 1999. The theory and methods of massage by JH Kellogg, Vol.62, no. 2, p.80-86. Retrieved June 2, 2009 from http://sciencelinks.jp/j-east/article/199911/000019991199A0269840.php

Yaaqoubi, S.,(2006). Cyriax massage. Retrieved May 28, 2009 from http://www.yaaqo.com/th_te_cyriax.html