What is Orthopedic Massage?

What is orthopedic Massage exactly? Well, to be honest, that is a hard question. I have heard it described multiple ways, such as it is a combination of medical and sports massage, or a way of treating soft tissue injury which is its own style. 

Truthfully, the answer is an issue I also struggle with because my training is different from anyone trained in NY who is doing ortho work, and at first I did not realize that my training was any different because, in Ontario, where I went to school, everyone works the same way. I  was aware that I had gone to school nearly twice as long as the  New York program , but I never thought that what I  was being taught was entirely different that what was being taught here.

Lake Ontario- Toronto, Ontario

I suppose I should go back a bit and explain that in Ontario massage is covered by the National Health System.  Canadian massage therapists operate in a very different capacity than in New York. Massage is not seen as a luxury but as affordable basic health care for physical problems that do not require a prescription.  Canadian therapists might work in conjunction with a doctor or physical therapist, or entirely alone. The entire attitude towards the profession is different.

Here is what I learned about the difference:  In the first year of school in Canada we learn the basic concepts of Swedish massage, which is essentially the same as the training here in New York. It is the second year in Canada--where we only treat dysfunction,  go through an internships plus the continuing education-- is where things take a turn. The second year of massage in Canada is solely ortho. The therapists learn every single thing that could possibly go wrong physically (within reason, ie we are not studying super-rare subsets of infections and disease)  in each part of the body, including those things that we are NOT able or licensed to treat, and you are drilled on it...over and over. We are run through literally thousands of scenarios, good, bad and ugly, and graded on them. The drills are run like real live client interactions where we assess, interview, decide to treat or refer out to higher care, and then provide home care.  When the school thinks we have done enough ground work we are sent to practice on real assessments for real conditions. It is essentially our residency.  I was sent to a Parkinson's clinic, and an AIDs hospice for 3 month stints. By that time, organizing a treatment for someone with a physical problem is not really a challenge, however, reading about someone who is dealing with the possibility of death or disease is entirely different than caring for someone who is dealing with it. This part of the program gives us essential real life clinical experience, and it‘s pretty tough. Incidentally, they also make us intern in an office as a lesson in how not to ruin a business. 

From what I have understood from therapists here, they touch on ortho. The class might visit a Parkinson clinic here, and they might learn the techniques from a book just as we did, but they don't have the time to work in those environments.  In essence, the program here is a tasting platter and the Canadian is a full 6 course dinner. There is nothing wrong with the program here, it is just different. It is designed to give a great relaxation massage and show the therapists IF they wanted to learn more that there is more out there. Many, of course, have learned more, and are working in hospitals, teaching throughout NY and generally doing great work. Many therapists never move beyond working in a spa however. But why the difference? Why educate all therapists to work in a way only a handful do in NYC?

Massage Therapy in Canada is covered by the NHS, and since the insurance  is paying, they are invested in the product. The massage therapy program in Ontario fills the gap between physical therapy and your doctor. We handle the manual therapy components that often pt's are uninterested in, pain management, and the physical components of stress-related problems,  while keeping the doctors’ offices clear of minor bumps, sprains and strains. My days were filled with never ending streams of very normal problems ranging from headaches, surgery recovery, car accidents, over training, back pain and fibromyalgia. The end result is less people in the doctor’s office, less prescriptions for pain relief, and more problems caught before they become serious. 

You might pose the question of litigation. Here in NY we worry about litigation a lot. Therapists here are trained to explain that their care is not a substitute for medical care, which is really confusing as we are listed as medical professionals. You might think that, because we more frequently work with injured in Canada that the risk would be higher, however it is the opposite. Canadian therapists are far more likely to stay out of trouble by being able to accurately identify problems before they start. We have the extra training to understand when a problem is too big for us, and our training prepares us to work in emotionally difficult scenarios. 

So what is Orthopedic Massage? For me it’s being a trained professional, knowing what I can provide, and understanding my limits so I can make available the best care possible to the people seeking me out. Good care comes from understanding and pulling in the right resources, not from being the only stop in health care. Orthopedic treatment means I can pull from lots of sources and work in conjunction with trainers, and other health care providers to get the best.

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