MANUAL THERAPY

MASSAGE TERMINOLOGY

IT’S ALL IN THE NAME

By Marian W Dixon, Karen J Sherman, Diana Thompson and Daniel C Cherkin

THE STUDY Background Today, more than 80 types of treatment have been identified as “massage". Massage is used for relaxation, pain reduc- tion, comfort at the end of life, enhanced athletic performance, and many other therapeutic reasons (1). Touch given with the intention of healing is believed to have beneficial effects on tissue, body flu- ids and other bodily systems as well as communicating caring with another human being (2,3). Massage therapists believe the healing power of touch is a fundamental factor in successfully facili- tating their clients’ goals for health.

The absence of a common language makes it difficult to ensure that different massage therapists are consistently describing what they are actually doing in treatment ses- sions and that research protocols for mas- sage studies are reproducible.

Conflicting

or confusing terminology results, at least in part, from the numerous trademarked styles of massage that have developed and been taught along with specialised language to describe their component techniques and from techniques developed and named by other disciplines.

Some massage styles with different names may be essentially the same (eg. structur-

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Massage treatments in research and treatment descriptions even within the mas- sage literature do not have consistent terminology. The authors wished to devel- op a taxonomy to describe what massage therapists actually did when giving a massage to patients with musculoskeletal neck pain. After conducting a review of the massage treatment literature for musculoskeletal pain, a list of candidate techniques was generated for possible inclusion in the taxonomy. This list was modified after discussions between two senior massage therapist educators and with seven experienced and licensed massage therapists participating in a study of massage for neck pain. A three level classification system was conceptualised, made up of primary treatment goals (intent), styles, and techniques. The pri- mary treatment goal could be ordered into four categories: relaxation massage, clinical massage, movement re-education, and energy work. Each treatment goal could be met using a number of different styles, with each style consisting of a number of specific techniques. A total of 36 distinct techniques were identified and described, and many techniques could be ascribed to multiple styles. A pre- liminary classification system is presented whereby practitioners using different styles of massage could consistently describe the techniques they employ. This system is hoped to provide a forum for discussions to help create a common lan- guage among researchers and practitioners and to assist with selecting tech- niques appropriate to their research questions.

al integration and Rolfing®). In addition, some commonly used styles of massage therapy, including “deep tissue” and neu- romuscular therapy, are not consistently defined. For example, some practitioners consider “deep tissue” work to be a syn- onym for neuromuscular therapy, while others consider “deep tissue” to mean the application of Swedish massage strokes with strong pressure, the application of acupressure, or the use of myofascial release (4). Finally, the same technique or stroke is often given different names in different styles (eg. deep effleurage, mus- cle sculpting and longitudinal friction are the same), so massage therapists with dif- ferent training may not realise when they are applying the same technique.

As part of this study we surveyed the mas- sage treatment literature and developed a

taxonomy of techniques using neutral lan- guage to describe what is being done to the body. This report describes the devel- opment of our taxonomy, including the application of “intent” or purpose in rela- tion to massage for neck pain. Finally, we discuss the strengths and weaknesses of our taxonomy and provide suggestions for future refinement.

Methods One author, an experienced massage ther- apist/educator, reviewed 18 textbooks (1,3,5-20) and three databases (Massage Therapy Foundation database, Bodywork Knowledgebase and MEDLINE) that include descriptions of commonly used styles of massage and their component techniques used to treat patients with musculoskele- tal pain. Using those sources and her gen- eral knowledge of the field, she generated

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