Keep it Simple
By Boris Prilutsky, MA

therapists, etc. Many colleagues are calling for a college degree minimum in order to be a massage therapist, and/or the inclusion of hundreds of hours of anatomy and physiology in training. My opinion is that we should keep it simple. I graduated from two professional schools, and like in any academic study, I was overloaded and over bored with anatomy, physiology and pathology studies, including all finals etc. Being in practice for more than 30 years, I can tell you that all this pure memorization that takes place in the study of gross anatomy and physiology (including dissection sessions in anatomical theatre) 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 in 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 as well as thoracic outlet syndrome. In many cases of these aforementioned pathologies, doctors are performing surgeries. The bottom line is that sciatica 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 anatomy and pathology such as that which I described of thoracic outlet syndrome. What is important in continuing education training as well as in instructional DVDs of medical massage is not only explaining the anatomy physiology and pathology which as you understand does not take 100 classroom hours, but how safely step by step to perform medical massage protocol, including connective tissue massage, muscular mobilization (myofascial tissue release), trigger point therapy, etc. To perform, with precaution, step by step, the above mentioned modalities it is possible to reach rapid and sustained results in pathologies such as sciatica neuralgia, thoracic outlet syndrome and in many other cases. 

Today, the massage therapy industry is booming. The general public spent $5 billion annually on massage therapy. Many surveys recently indicated that massage therapy is one of the most effective methods in the treatment of back disorders, stress management, etc. I would like to use this opportunity to remind those people who are calling for the raise massage therapy training to college education that all these surveys results have been delivered 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 practical structure. Massage therapists who will graduate from schools must have hands-on skills to deliver results. In order to deliver results such as less pain, more range of motion, less stress related phenomena such as anxiety, depression, high blood pressure, etc, massage therapists have to understand the structure instead of memorizing anatomical names and terms. The most important thing is to understand what every second of touch is causing. My grandpa was MD, Ph.D., and massage therapist. In eastern European countries it was a common phenomenon to find medical doctors with training in medical massage and who incorporated hands-on treatment into the other conventional medicine treatments. More than once he said to me, "Boris, look at the simple and beautiful method of medical massage. After all, when it comes to delivering results I have to put my hands to make a difference." The founder of medical massage, Anatoli Sherbak MD, Ph.D., in most of his works would often refer to terms such as "nature of the human body" instead of conventional medical terms. 

I passionately love massage therapy because of the simplicity of this therapeutic method and significant therapeutic power. Therefore, when I teach workshops or on my instructional medical massage DVD series I keep it simple and teach the material in a practical way. At the time of my workshops as well as on my instructional DVDs I share with you my more than 3 decades of clinical academic and research experience. I hope that as practitioners you will find my instructional material as a good source of education in medical massage therapy field.

Sincerely,

Boris Prilutsky, MA
Director of Institute of Professional Practical Therapy
School of Massage, Los Angeles, CA
www.ippt.com