Physical Therapy, Massage

Massage therapy and physical therapy are practices that aim for similar goals; to aid in healing, relieve pain and restore function. Massage therapy has more of a holistic approach where mind and body are one and the focus is primarily on the soft tissues. Physical therapy usually focuses one body part at a time, providing rehabilitation to improve strength for it to work properly. The education level of each practice and tools utilized makes them different.

First I’d like to mention how Massage and Physical Therapy came about. Massage therapy has been practiced since cave dwellers would rub their bruises. The art of massage was first mentioned in writing about 200 B.C. Hippocrates learned massage as well as gymnastics. Julius Cesar had himself pinched everyday for neuralgia.

In the 16th century, a Swedish fencer by the name of Per Henrink Ling was dedicated with the study of massage after curing himself of rheumatism with a technique called percussion (tapotement). He then merged the practice of passive gymnastics and massage through the study of physiology. Ling’s dedication won him the acceptance of “The Ling system” also known as a popular technique used today “Swedish massage”. Between 1854 -1918, massage became from a doubtful, unskilled trade to a medical field of profession, Physical therapy. Physical therapy had it’s full emergence during WWI and WWII helping injured soldiers.

Massage Therapy today is most popular and utilized for relaxation, where you can go to a professional and have a sixty to ninety minute massage. This usually entails relaxing music, one on one attention and a serene environment. Massage therapy may be used for many situations that cause imbalance within the soft tissue. Massage increases circulation, breaks down scar tissue or “knots”, realigns muscle fibers, and gets rid of lactic acid especially after vigorous activity. The purpose of massage is to bring change and balance to the physiologic, mechanical, or psychological effect from the application of various techniques. Some techniques derived from the Swedish language are effleurage, strokes that glide; those that knead are petrissage; those that compress are friction, those that strike are tapotement; and vibrate are vibration.

Massage Therapist’s (MT) have an understanding of Anatomy and Physiology, basic knowledge of mechanics and fundamentals of disease. MT’s are also taught when massage is indicated or contraindicated for an individual with specific diseases or illnesses. However MT’s have up to one year of education in comparison to Physical therapists (PT) - who now attend of what many institutions provide a six year competitive program. PT’s undergo a curriculum that gives the knowledge to recognize disease, asses and provide treatment plans of impairments and disabilities. PT’s become efficient with practice within rotations in various internship settings learning the promotion of mobility, functional ability, quality of life and movement for physical intervention.

Some common areas of specialization for PT’s are orthopedics, cardiopulmonary, pediatrics, women’s health, geriatric and neurology. PT’s practice in many settings such as outpatient, inpatient (hospital), skilled nursing facilities, schools, occupational environments, etc. Massage therapy has evolved over the years and has increased it’s acceptance within the healthcare system. Research has provided evidence for MT’s to share some of the specialties and work out of some of the above settings as the PT.

Physical therapy may include massage as a tool but often times the soft tissue is manipulated with techniques that are less time consuming. Depending on the need of the patient, a PT may use muscle energy techniques, myofascial release, proprioceptive neuromuscular facilitation (PNF) and/or active release techniques. There are many other techniques PT’s may use to manipulate soft tissue. Without a profound and good understanding of the physiology, one would not understand how and when they can help.

An example on how MT combined with PT may be beneficial. The muscles exert pushing and pulling forces about joints to create and control movement. As the muscle tone (muscle resistance to passive stretch) is in its rest position, it’s positioned for free movement and balanced structure. The tone of your muscle is set by your nervous system. If your muscle has too little tone, your body’s ability to generate strength and power is minimal if not absent and the muscle becomes flacid. If the muscle has too much muscle tone the muscle is too excited. The muscles lack the ability to relax and are in constant contraction, deficient in the capacity to return to its resting length. This constant contraction or tone makes the body or muscle group rigid. In order to re-set your muscle tone and have a structural balance, you need to work with the nervous system.

As a practicing massage therapist of 15 years, I found massage to be most beneficial when combined with other therapeutic measures. One of the greatest outcomes for prevention of injury and/or recovery is when massage is combined with skilled flexibility and exercise program. Massage Therapy integrated with Physical Therapy would give you optimal results in restoring balance within your nervous system, recovery and prevention of injury and an overall healthy state of well being.