Most current medical massage curricula that I am aware of focus on the clinical practice of medical massage. There are a few books (notably Thompson’s “Hands Heal” and Luther’s “Medical Massage Office”) and courses that cover the business aspects of delivering medical massage. But I am not aware of a comprehensive program that addresses all of the clinical, business, ethical, professional, and other aspects of being a medical massage therapist.
This draft of a medical massage curriculum is informed by several continuing education courses, extensive reading on the subject, other massage curriculum projects that I have undertaken, my medical massage practice, and many conversations with massage practitioners and educators.
A medical massage curriculum needs to be focused, precise, detailed, and thorough – much more so than a basic massage licensing course – so a good medical massage program should probably be at least 500 hours long (on top of a basic massage licensing program) but could easily be over 1,000 hours.
I. Medical Massage Ethics
When you’re putting a square peg (holistic massage care) in round hole (allopathic medical system), you’d better have your ethical principles clearly articulated before you start practicing.
A. Developing an ethical approach to medical massage
B. Ethics topics:
- Delivering holistic care in an allopathic system
- Medical necessity for a massage prescription
- When to terminate care
- Distinguishing medical work from wellness work
- [many more ethics topics to come]
II. Medical Professionalism
If you’re going to work in a medical setting, you’d better act like a medical professional.
A. Medical Terminology
1. Clinical Terms
2. ICD Codes
3. CPT Codes
B. Documentation & Communication
1. HIPAA compliance
2. SOAP Charting
3. Report Writing
4. Understanding Medical Reports
C. Medical Imaging
1. Understanding x-rays
2. Understanding MRIs
D. CAM in Medical Context
E. First Aid/CPR
F. HIV/AIDS
III. Anatomy & Physiology
Medical massage requires more precise anatomical knowledge and a deeper understanding of physiology and kinesiology than wellness massage.
A. Advanced Anatomy & Physiology
B. Muscle Identification, Palpation, and Testing
C. Kinesiology
IV. Pathologies / Medical Conditions
Medical massage is by definition (since a prescription – a statement of medical necessity – is required) the treatment of pathologies.
- whiplash
- neck pain
- low-back pain
- tendonitis, tenosynovitis, and other tendon injuries
- myofascial pain
- sprain/strain
- fibromyalgia/fibrositis
- trigger points
- osteoarthritis
- repetitive strain injuries
- athletic injuries
- post-injury rehabilitation
- sciatica
- carpal tunnel syndrome/CTS
- thoracic outlet syndrome/TOS
- etc.
V. Clinical Skills
Hands-on manual skills are the root of any massage practice, but the standards are higher, the precision greater, and the consequences of poor technique greater in the practice of medical massage.
A. Indications & Contraindications for Massage
B. Assessment & Evaluation
1. Muscle, tendon & ligament tests
2. Postural analysis
3. Gait analysis
etc.
C. Treatment Techniques
1. Muscle Energy Technique (Phaigh/Onsen, et al.)
2. Neuromuscular Technique (St. John, Travel/Simons, et al.)
3. Myofascial Release & other fascial treatments (King, et al.)
4. Deep Tissue
5. Lymph Techniques
6. PNF
7. Neuromuscular Re-Education
8. Structural Integration (Rolf, Heller, Myers, et al.)
9. Taping, Bandaging
etc.
D. Treatment Protocols
[for each of the pathologies/conditions listed above.]
E. Clinical Practice
1. Student Clinic
2. Internship(s)
VI. Business Skills
It is the business context for medical massage that distinguishes it from wellness massage, so – while they need to stay focused on the clinical aspects of their work – medical massage practitioners need to understand the business setting for their work.
A. Patient Management
1. Policies
a) Insurance verification before treatment
b) Late/missed appointment fees
etc.
B. Insurance Billing
1. Verifying coverage
2. HCFA form
3. Follow-up & Collections
4. Billing Software
C. Office Administration
1. Internal reports
2. Practice management software
3. HIPAA
D. Patient files
1. HIPAA
E. Marketing
1. Marketing strategy & planning
2. Service offerings
3. Setting prices/rates
4. Practice type/location
Owner/operator of clinic; independent practitioner (on own, in holistic clinic, in medical clinic, in chiropractic office); employee of clinic, hospital, etc.; independent contractor
5. Promotion tactics
6. Marketing to physicians, chiropractors, physical therapists, naturopaths, acupuncturists, other health care practitioners
F. Accounting
1. A/R management
2. A/P management
VII. Research Skills
Medical work is evidence-based, so medical massage practitioners need to know how to read, use, and possibly even conduct massage research.
A. Consuming massage research
B. Conducting massage research