This FAQ started out as a post in my blog, but I’ve decided to make it a link from the main page. I think some may find it useful.
Some time ago I asked some online acquaintances what questions or concerns they had about Massage Therapy, both as a potential client and just for the sake of curiosity. Here are a few of their questions, along with my answers. Do note I’m speaking from the point-of-view as a newer RMT in Ontario. While some information will apply in any province or country, other information is fairly specific to Ontario, or at least to Canada.
If you’re reading this and have questions of your own, feel free to comment and ask them.
What is Massage Therapy?
I’m going to answer that question by copying the Massage Therapy Scope of Practice directly from the College of Massage Therapists of Ontario Website (http://www.cmto.com):
The practice of massage therapy is the assessment of the soft tissue and joints of the body and the treatment and prevention of physical dysfunction and pain of the soft tissue and joints by manipulation to develop, maintain, rehabilitate or augment physical function, or relieve pain.
(Massage Therapy Act, 1991)
Generally, people doing massage who say they’re “certified” or “licensed” but who aren’t “registered” with the CMTO - are they fake/legit, etc.
This issue is a bit of a tricky one. You’ll get a slightly different answer to it with each Massage Therapist you speak to.
From an objective point of view, the difference is in legal structure and protection of the public interest. A Registered Massage Therapist is required to complete a minimum number of hours of schooling in a specific spread of topics. In Ontario, this requirement is 2200 hours, which must include not only classes on how to massage someone, but also classes in anatomy, physiology, pathology, kinesiology, hydrotherapy, and remedial exercise. After completing school, two exams must be completed in order to receive your license to practice: one written, one hands-on. Registered Massage Therapists are regulated by the CMTO under the Regulated Health Professions Act, 1991 and the Massage Therapy Act, 1991 as they pertain to the practice of the profession. The RHPA regulates all licensed health care providers in Ontario, including Doctors, Nurses, Physiotherapists, and Chiropractors, among many others. Also good to note: While the CMTO does help promote the profession of Massage Therapy in its own way, it ultimately is there for one reason only: to protect the public.
Those that do massage under some other title (for example, bodyworker, orthotherapist, esthetician, thai massage) will have a variety of different levels of education, some as low as a few-hour weekend course. If they say they are certified (but not by the CMTO), it means they have joined an association and received certification through them. The associations are not working under any specific health care regulations and are there to promote their own cause, not really to protect the public.
That said, can you get a good massage from a non-RMT? Sure. I’m not about to try to claim that all RMTs are better at massage than all non-RMTs. It’s really a case-by-case situation, where the talent, personality and education (including extra courses outside of the core education) really determine how good the practitioner will be. I’ve had some great massages by shiatsu therapists and estheticians, and neither of them are regulated under any legal body.
Why choose the RMT over the non-RMT? If you are going for a health-related issue, be it sore muscles, tendonitis, arthritis, or any number of other conditions, you are going to want a regulated health care professional. Anyone who holds the title of RMT has gone through extensive schooling and actually knows how to assess and treat a variety of conditions. Also, as a member of the public, you have someone to go to should the RMT abuse you in any way (a rare situation, but it does happen). If you choose the non-RMT, you may be dealing with someone who has very little education, has no knowledge of pathology, and is not able to properly assess and treat your condition. Also, if the non-RMT abuses you, you will not be able to report them to any regulatory body, as there is not one. You may be able to report them to their association, but ultimately any legal action against them would have to be undertaken by you reporting them to the police and/or suing them at your own expense.
Can I just set up an appointment or do I need any sort of referral?
You can just call and set up an appointment. I’ve heard of a few therapists who only see clients by referral, but that’s generally due to having a limited practice (for example, they only massage once or twice a week and do something else the rest of the week). But in 99% of cases, you can just call and book.
Is there any risk that the place I see advertised/see a sign for isn’t really about massage? (Or, more broadly, how do I find a massage therapist?)
There’s a few things to look for to make sure the person is a true massage therapist and not advertising for ‘other’ services:
1) If they’re calling themselves a Registered Massage Therapist. In Canada, this is a protected term, so only real RMTs can call themselves that. In other countries, the terms vary. For example, parts of the USA use ‘Licensed Massage Therapist’ or ‘Certified Massage Therapist’.
2) If the clinic seems medical in nature, it’s very likely legit. (For example, they require you fill out a medical history, they ask you questions about your condition, they mention the service may be covered by insurance policies, it feels and looks clean, they actually keep records, there are diagrams of skeletons/muscles/etc on the walls…)
3) If a spa: Again, look for the ‘RMT’ designation. Sometimes Estheticians give massages in spas; while they’re probably great at a very general relaxing treatment, they aren’t qualified to deal with anything beyond that.
To find a therapist in your area (Ontario), there are several search engines. Two of them are:
How much would I expect to pay for a session? And how long would a session normally be?
This depends on your condition, but typically a first session would be 45 min to an hour. This allows the RMT to have time to review your medical history with you, discuss your condition and your expectations from massage, do an orthopedic assessment of some type, discuss the treatment with you, and actually do the treatment. Prices for an hour treatment vary from clinic to clinic, but typically you’d pay somewhere between 70 and 90 dollars.
That, by the way, is another hint that you’re getting a legit RMT. If someone is advertising massages for 40 dollars/hour (or something of that sort), they probably aren’t really an RMT.
Anything I can do in preparing for my appointment to make things better/easier/less of a pain for my massage therapist?
Show up on time, and if you need to cancel, please give us at least 24 hours notice. I know the majority of people don’t need me to say this, but for the few that do, take note. If you show up late, you will receive only the amount of time remaining in your appointment. If you don’t cancel with good notice, you may end up paying a fee.
Wear loose, comfortable clothing, so that the therapist will be able to assess you easier. For guys who need lower-body work, it’s usually better not to wear boxer-briefs, because they tend to restrict how much of the leg we’re able to fully work on. (Of course, if they’re all you’ve got, that’s fine too, we can work with that).
It probably goes without saying for most people, but I’ll say it anyway: shower before you come (earlier that day is fine, of course), wear deodorant, and if you’re having your legs or feet worked on, wash your feet well. Sure, we can work on someone who’s all sweaty from just having come from the gym, or who didn’t bother to shower that morning before coming to see us, but if we have the choice, we’d really rather not.
Please do not wear any scented products, including perfume, after-shave, or body spray. Many people are sensitive to scents, and this includes some RMTs. Think of it this way: If you touch someone for a full hour while giving them a treatment, any scented products they have on their body tend to get on you and linger for hours later. Even if you aren’t scent-sensitive, this isn’t all that nice. Further, the perfume/spray/etc tends to linger in the treatment room after, meaning the next client has to smell it. If they’re sensitive to scents, it could cause them to feel ill or get a migraine.
Can a massage actually get rid of knots (what are they anyway? do massage therapists call them that?)? what about the ones everyone has in their shoulders — does everyone have them, and can/should they be gotten rid of with enough massage?
Yes and no. So-called knots can be a variety of things. Sometimes they are an overtight muscle. Sometimes they are an adhesion within a muscle or fascia or other tissue layers. Often, however, they are what are called Trigger Points. An RMT is trained to treat trigger points by essentially ’squishing them out’, then applying a good stretch and heat to the muscle. Usually it takes multiple treatments to get rid of a trigger point, as they generally aren’t something you got overnight. Years of muscle strain, improper posture, overuse, and other factors cause the trigger points in the first place. Years of over-working a muscle usually take multiple treatments to get rid of.
So why did I say yes and no? Well, the thing is, once a person leaves the treatment room, they resume their normal daily life. We can educate them about proper posture, we can tell them exercises to do at home to help their body be healthier, we can mention things about proper sleeping and working habits, but we can’t force them to do anything. Posture is not something easy to correct; most people take months of work to make any really good progress. So someone with trigger points in their neck muscles, who has them fully treated by a massage therapist, may find they come back a few weeks later. It’s all how the muscles are being used.
An instructor from my school once said that he could find a trigger point on anyone pretty easily, and that he has never worked on a single person who was trigger point free. The upper body tends to have a lot of them, due to our jobs and our daily lives. Also, people tend to ‘carry their stress’ in the upper body, meaning your neck and upper back muscles will be prone to having trigger points.
About the profession, I guess I wonder whether massage therapists think of themselves as being in a medical field or in a “pampering” field, or if that depends on the therapist. And I wonder if it’s really as much fun as it seems like to me, to get to give massages all day.
It does depend on the therapist. In my experience, most Massage Therapists do think of themselves as part of the medical model. We are trained in many different pathologies and anatomy. Most Massage Therapists would correct anyone who considers the profession to be one of pampering and beauty.
I’d mentioned previously about estheticians who do massage (and aren’t Massage Therapists, but just do relaxation massage as part of their skin and beauty treatments). Their existance tends to be a big part of why people still think massage is all about beauty and spas and skin treatments and little else. People who want that kind of treatment; all the power to them. There are some awesome estheticians out there. It’s just that relaxation is a very small part of what a Registered Massage Therapist is trained to deal with.
Most Massage Therapists I’ve spoken to do love their jobs. It really is great to help people all day long and give them massages. The job does have its pros and cons like any job, but it is a very rewarding profession.
What are the cons of being a Massage Therapist?
These are the ones that pop into my head right now. Like any job, the list of cons are going to be different depending on who you ask.
* In most cases, you are an independent contractor, which means you get paid for how many clients you see. This is a good thing if you’re a busy therapist, as you’ll end up making more money and have more control on how many people you see per week, how many hours you need to work, what days you work, etc. However, with that comes a price — you don’t get benefits, you don’t get sick days, you don’t get vacation days, you don’t get vacation pay, you need to keep track of your income for income tax purposes, etc. So if you want to take time off, you need to save money and plan for it. If you want benefits, you need to go to the insurance companies yourself and buy a policy. If you take a sick day, there usually isn’t someone to cover for you, and you may end up working extra days to make it up to the clients you had to cancel because you were sick. And if you have a slow day, you make less money. If you only see one client in six hours, you only get paid for that one client. So you can see how some Massage Therapists might wish they got a steady salary with benefits.
* It’s hard on your body. We are taught to use proper body mechanics while in school, but even so, after a few years you tend to start to get aches and pains and need treatments yourself.
* We have ethical rules we need to follow. While this is usually a good thing (we have to treat everyone equally and cannot refuse anyone treatment unless it is because their health would be at risk if they did get treated), it does make for some uncomfortable situations sometimes. Say, for example, someone came into your office who was extremely anti-abortion, and say you were pro-choice. Imagine how hard it would be to give that person a good treatment, if they were going on and on about it. In another environment, such as a restaurant or retail, you would be able to simply ask the person to leave if you wanted. Regulated health professionals cannot simply ask the person to leave. These issues are the kind of stuff all medical professions face, but it tends to be even weirder for an RMT, since usually our treatments are 45 min or more. You do learn ways to deal with these things while in school, but it still can be pretty darn uncomfortable when they do happen.
* People can smell. People can use too much perfume and make you want to gag.
* There are still a lot of people who aren’t aware of all that Massage Therapists can do. While it can be fun educating people, it isn’t all that fun when you’re trying to find a job to convince someone that they would be benefitted by hiring you, all while they’re going ‘but massage is just about beauty and relaxing, right? Why would I hire someone to help my clients with [condition]?’
* Some people aren’t looking for a therapeutic massage, they’re looking for a ‘massage with extras’ or what we tend to call a ‘rub and tug’. While most therapists who work at good clinics or reputable spas don’t have many problems, some therapists who work out of their homes or have a travelling business find that sometimes they get calls from people looking for ’special services’. Ahem.