Keep it Simple
By Boris Prilutsky, M.A.

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Nowadays, we are witnessing many heated debates in the massage therapy community about various topics. These include issues like “who among practitioners are allowed to call themselves medical massage therapists?” or “how many hours of training should be required?” and “is national certification necessary for medical massage therapists?” Many colleagues are calling for a college degree as a minimum to become a massage therapist. Others suggest that hundreds of hours of anatomy and physiology be included in training programs.

My opinion is that we should keep it simple. I graduated from two professional schools, and like in any area of academic study, I was overloaded and over-bored with anatomy, physiology and pathology studies. Being in practice for more than 30 years, I can tell you that this pure memorization that takes place in the study of gross anatomy and physiology (including dissection sessions in the anatomy lab) is absolutely not useful in daily practice.

In search of evidence that might support my outlook on academic studies, I once asked my brother in law, a cardiologist with more than 30 years of clinical experience, to answer questions on the anatomical names of bones, ligaments, and muscles of the foot. He couldn’t answer. In response, he said “Boris, what do you want? The last time I was involved in this kind of anatomy was when I took the National Board Exam, but in my daily practice I am dealing with pathologies of the heart.” At the same time, ask orthopedic surgeons with many years of experience to name the anatomical components of the heart and to answer questions on the electrophysiology of the heart. In most cases, I can assure you they will have difficulty completing this task. Again, this is because in daily practice, they do not need this kind of knowledge.

Two of the most difficult pathologies of the support and movement system are sciatic nerve neuralgia and thoracic outlet syndrome. In many cases physicians choose to perform surgeries. The bottom line is that sciatic neuralgia and thoracic outlet syndrome very often are results of muscular syndromes. For example, thoracic outlet syndrome is the result of over-tensed anterior scalene muscles that compress the brachial plexus as well as the subclavian artery and vein, evoking a difficult neurological picture such as irradiating pain to the upper extremities, obstructing vessels (which adds to the pain), color change, etc. The anterior scalene muscles originate from the transverse processes of C3-C6 and insert into the first rib. The space between the anterior and middle scalenes is called the outlet.

As you can see, it takes very little to teach basic anatomy and pathology as I just described of thoracic outlet syndrome. What is important in continuing education training as well as in instructional DVD’s of medical massage is not only to explain the anatomy physiology and pathology, which as you understand does not take 100 classroom hours, but how to safely perform the medical massage protocol step by step, including connective tissue massage, muscular mobilization (myofascial tissue release), trigger point therapy, etc.

Today, the massage therapy industry is booming. The general public spends $5 billion annually on massage therapy. Many current surveys indicate that massage therapy is one of the most effective methods in the treatment of back disorders, stress management, and other disorders. I would like to use this opportunity to remind those who are calling for increasing massage therapy training to the college degree level that these surveys have been completed by massage therapists who do not have any degree in massage therapy (except their training in massage therapy schools).

Make no mistake, I do support real education in massage therapy, but this education must have a practical structure. Massage therapists graduating from schools must have hands-on skills to deliver results. In order to deliver results such as decreased pain, increased range of motion, and decreased stress, anxiety, depression, and high blood pressure, massage therapists have to understand the structure instead of memorizing anatomical names and terms. Most importantly, a therapist must understand what every second of touch causes.

I passionately love massage therapy because of the simplicity of this therapeutic method and its significant therapeutic power. So be it teaching live workshops or making instructional medical massage DVD’s, I keep it simple and teach the material in a practical way. In my workshops as well as in my instructional DVD’s I share with you more than 3 decades of clinical, academic, and research experience.

I hope that as practitioners you will find my instructional material to be a good source of education in the medical massage therapy field.

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