A high percentage of new massage therapists leave the profession in the first five years of practice because of occupational strain and injury. Clearly, practitioners need to be able to provide patients with the benefits of massage therapy without harming their own bodies in the process.
October 1, 2009 By Marilyn Chapman PHD
A high percentage of new massage therapists leave the profession in the first five years of practice because of occupational strain and injury. Clearly, practitioners need to be able to provide patients with the benefits of massage therapy without harming their own bodies in the process. Gary Schweitzer, RMT in Vancouver, has learned to do just this, and is now sharing his knowledge and techniques in hands-on workshops for colleagues.
Gary’s journey began when he was a student at the West Coast College of Massage Therapy.
In his own words: “As I was falling through the air I thought it was but a dream and when I hit the ground I would awake and find myself comfortably in my bed. Was I ever wrong! I had been sleep walking – right out of a third story window – and now found myself on the concrete floor below, with bilateral foot fractures and a broken back. I was quickly surrounded by paramedics, who took me to the nearby hospital where I spent 17 days. I came very close to death on two occasions, having suffered hypovolemic shock and respiratory distress.”
Overjoyed that he had survived the accident and was not a quadriplegic, Gary finished the last two semesters in a wheelchair due to the injuries he had sustained. He was determined to finish the program. The word “fail” was not in his vocabulary. In 1993, after completing his training and becoming a registrant with the B.C. College of Massage Therapists, he began his clinical practice in Kitsilano, a trendy Vancouver neighborhood.
Little did Gary’s clients know that he was in pain for the first three years of his practice. Constantly aware of his now-healed broken back, he found that he could manage the pain when he kept his back straight and bent his forward knee when attempting to create movement. By shifting his attention to the core and not being overly concerned with what his hands were doing, he could get through the day with little discomfort. The upright
posture he assumed served him well.
Gary concluded that keeping a strong biomechanical presence was critical. The insights Gary gleaned from these early experiences eventually found their way into his workshops, and have had a profound effect on his students.
At The Crossroads
Gary found that he attracted clients who had an appetite for deep treatments. Often, the clients would comment that they didn’t care how uncomfortable their treatment was because they knew that it would be beneficial to them in their efforts to resolve their body-based issues.
Puzzled by this, and wondering if his clients were masochists because they had such a high tolerance for the discomfort often associated with deep treatments, he tried to work at a level that gave them what they needed while at the same time staying within his own comfort level.
A turning point came when a client pointed her finger at Gary, proclaiming that he wasn’t working deeply enough and that she would be looking elsewhere. With a sore ego, he realized that if he were to maintain a healthy business practice as well as his own physical health, he would need to find someone who could teach him how to work deeper and provide his clients what they needed. A colleague suggested a well-known therapist in North Vancouver. After discussing Gary’s predicament, the therapist suggested he take his workshop.
From the moment he began this intensive study, Gary was hooked. He studied this work for six years. During this time he became aware of some of the shortcomings in the ways in which massage therapy was being taught. For example, the emphasis was on clients’ comfort or discomfort: what was missing was a system of treatment that cared for and supported the practitioner. His mentor would often say, “If the treatments we are giving are at the expense of the therapist, the therapist soon becomes the patient.”
With his mentor, Gary learned how to work with the client as a willing participant to meet clearly defined therapeutic objectives. His clients had looked very hard to find a treatment approach that dealt specifically with soft tissue pain and dysfunction. They had been looking for a practitioner who would work with them and give them a deep treatment as well as allow them to guide the process with respect to their discomfort rather than simply offering comfort massage.
After several years of intensive study Gary decided to develop a workshop of his own. He created a three-day course of study called Schweitzer’s Deep Tissue Therapy (SDTT). It incorporated the technical aspects of his mentor’s work together with a biomechanical focus that had become the foundation of his early experiences in practice. The combination of biomechanics and unique and innovative techniques that allow the practitioner greater access to the deeper muscle tissue form the basis of his two-pillar approach. Gary designed a workshop that offered a step-by-step approach to learning. He realized that most massage therapists are either tactile or visual learners. They want to start working in a hands-on way from the outset, and dislike having to listen to lectures. They also want to learn something they can use immediately. Being attuned to students’ needs, he decided to teach through demonstration, hands-on practice, coaching, and corrective feedback.
A New Direction
Gary begins his workshops by showing therapists how to get their whole body working as one unit and creating movement from their core. Once they accomplish this, he introduces the deep tissue techniques.
He finds it rewarding to see how his methods transform the ways in which practitioners work and help them realize how much unnecessary effort they had been exerting.
Gary teaches six foundational techniques, covering the entire body in three days. The first and most challenging technique is called the fist and hand technique. Just as it implies, the fist is coupled with the hand. While this hand position is very foreign to most, when done correctly, it allows the practitioner to work at a deep level while making it virtually impossible to hurt oneself.
The fist and hand technique is also the most difficult to master because it involves a fundamental shift from using strength to using power from the core. This power-versus-force concept can often create anxiety because it disrupts habitual patterns.
Teaching practitioners how to consistently produce physiological and structural change adds value to their experience. The external stimulus has to create the greatest internal change of the muscle tissue with the least amount of effort.
This is a value-added concept for the practitioner and the client. Using strength forces the therapist’s way into the tissue.
Working from the centre, on the other hand, enables practitioners to step into their power base and expend less effort. Changing the neurological pathways that have been firmly fixed in a therapist’s treatment approach, however, is a challenging process over the course of the three days.
Gary taught his first workshops in the United States. In an interview with the Brenneke School of Massage in Seattle, he
discovered that deep tissue work had a bad name. Gary surmised this reputation was due to its association with pain and discomfort.
This may in part be due to media portrayals of massage therapy as relaxation and more relaxation.
It is almost as if massage therapy and its therapeutic intention have been diluted to an experience of relaxing the mind instead of the effective treatment of identifiable pathological processes and the elimination of pain and dysfunction.
After some convincing, the school allowed Gary to teach his three-day workshop at the post-graduate level.
Academic standards in Washington State require 1,000 hours of study.
Gary found that the participants had a lot of trepidation and anxiety about working deeply, and had many fears about what was being taught around this body of work.
Gary had introduced the use of elbows, fists and hand, grasping and independent fists techniques, which minimize the discomfort of the person on the table. The therapists were quite amazed at the level of depth they could achieve with the least amount of effort, and how acceptable it was for the person receiving the work.
The combination of this technical approach, biomechanical postures that activate the core and distraction techniques that minimize the client’s discomfort, dispelled his students’ long-held conceptions of deep tissue therapy massage. They were very excited about these new possibilities.
In the early years of teaching his workshops, Gary discovered that over 85 per cent of his students were hurting as a result of their treatments styles. This figure is both surprising and alarming. Why are so many massage therapists harming their bodies every day with their own therapeutic techniques? How can they continue to work under these painful conditions?
Participants in Gary’s workshops who incorporated the biomechanical postures with Schweitzer’s Deep Tissue Therapy (SDTT) approach reported their own body-based issues disappear within the three days of the workshop. Much to Gary’s delight, he realized how he could serve his profession and contribute to his colleagues’ longevity.
Finding New Ways
Gary currently teaches in the U.S., Canada and Europe. He has found that in each region of the world the standards of education vary from as low as three hundred hours to three thousand hours in the province of British Columbia.
Gary’s experiences with over 500 students have led him to conclude that most educational programs have not addressed the need to incorporate techniques that serve the practitioner as well as the client. He believes that a fundamental shift needs to take place to examine whether the techniques and approaches that are being taught contribute to occupational strain and injury.
Techniques that tax the practitioner, such as using the thumb, and pointed fingers coupled with poor biomechanics, ultimately lead to overuse injuries. Each educational institution has its own philosophy for effective treatment based on the faculties experience and belief systems.
At present, massage therapy education is fragmented and lacks a cohesiveness that other professions seem to possess. Gary strongly believes that the profession as a whole is lacking a core philosophy.
Over 90 per cent of workshop participants who experienced pain before taking Gary’s three-day workshop have reported a complete elimination of painful symptoms.
Gary is now considering working with a researcher from the University of British Columbia to investigate systematically the effects of his methods on therapists who have participated in his workshops. He is hoping to acquire objective data on the effects of correctly articulated biomechanical techniques and SDTT techniques in eliminating occupational strain or reversing existing pain profiles.
An independent research project would be important for validating his approach. If the results of this independent study support his observations, he plans to present the research to massage therapy educators and suggest ways of teaching this methodology in the core curriculum of massage therapy programs in Canada and abroad.
• For more information, see www.sdtt.com. Gary Schweitzer can be reached at firstname.lastname@example.org Author Information
• Marilyn Chapman is a Professor in the Faculty of Education at the University of British Columbia.
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