Dear reader,
We will choose the most interesting personal stories associated with massage therapy for the this part of our journal to inspire you and show you larger picture of massage therapy profession. We believe that the personal experiences are the most fascinating part of the life.
Our first Person of the Month is Stephen Ryason, LMT, MMT. I met Stephen several years ago when he was freshly from the massage therapy school with very basic skills and knowledge. He never was exposed to the medical massage concept but he was a very dedicated to his new profession. For couple years I had a privilege to observe Stephen’s professional growth and his deep understanding of the science of medical massage. Currently Stephen built up his medical massage practice and he enjoys fruits of his labor as well as respect in the local community.
Stephen’s story is a great example of healing power of medical massage and its crucial impact on the practitioner’s practice. This is why we choose the Stephen Ryason as Person of the Month for the first issue of Journal of Massage Science.
Here is our interview with
MEDICAL MASSAGE PRACTITIONER
Stephen Ryason, LMT
Journal of Massage Science (JMS): How did you get into the M.T. field?
Mr. Ryason: Back in the 80’s, I was living in Lake Tahoe, working as a stone mason. One day, as I was attempting to move a very large stone into place, I slipped and hurt my back. The pain was terrible, some of the worst I’ve experienced. I couldn’t bend over, sit down, or turn my head without pain sensations shooting up and down my spine and into my extremities. I went home, took lots of painkillers, used ice, heat, bed rest, etc… all to no avail. After 3 days I went to see a chiropractor that I knew. He took X-Rays of my spine, which showed my right iliac crest was almost touching my ribs. He attempted an adjustment, but I couldn’t tolerate the pain. He said I would need to alleviate the spasm before he could adjust me and recommended I see a Massage Therapist. I knew an M.T. who worked with a lot of athletes in the area, so I contacted him. He gave me 3 treatments in 7 days. I returned to the chiropractor and he was able to realign me well enough to stop the shooting pain. It took several more trips to the M.T. and the chiropractor, along with remedial stretching and exercise, before I was able to return to work. The experience left a lasting impression on me of the value of manual therapy. I left Lake Tahoe in 1992 to return to Arizona. Once here, I began researching Massage Therapy colleges. I enrolled in Phoenix Therapeutic Massage College and graduated at the end of 1995. I received my license in January 1996 and have worked as an M.T. ever since.
JMS: At a time when the AMTA does not have a clear position on Medical Massage, your business card states that you are a Medical Massage Practitioner. How do you define Medical Massage?
Mr. Ryason: First, let’s review the American Medical Association’s definitions:
Massage: “includes effleurage, petrissage, and/or tapotement.”
Medical Massage:
1. The application of “physical medicine” by a “massage therapist.”
2. Must be “medically necessary” and prescribed by a “doctor.”
This seems to be a generally accepted view of Medical Massage by medical community. However, among the massage practitioners as well as in massage journals, one other criteria comes up frequently in the discussion of determining what is or isn’t Medical Massage, and that is payment. Practitioners frequently think that the treatment may be considered to be Medical Massage if it is reimbursed by insurance companies. I think this is a grave professional mistake.
I practice Medical Massage (MM) for almost 13 years and I believe these criteria constitute Medical Massage:
1. MM requires a prescription and a diagnosis from a client’s physician.
2. MM requires a treatment plan.
3. MM uses specific MEDICAL MASSAGE PROTOCOLs in the assessment and treatment of specific pathologies and/or dysfunction.
4. MM requires a specific number (or course) of treatments.
5. MM is documented in SOAP note format.
6. MM requires a higher level of competency and understanding, through education, of the therapist, and the patient.
Note that I have left method of payment off the list. This is why: Insurance reimbursement can be a slippery slope. I have found that direct payment to the MT by insurance companies is inconsistent. Generally speaking, direct insurance reimbursement to the MT is expedited relatively easily in two situations:
1. Treatment to injury incurred in an automobile accident (Auto Insurance);
2. Treatment to injury incurred in the workplace environment (Workers Compensation).
Insurance reimbursement from Medical or Health Insurance can be much more difficult. Due to my frustration with the insurance industry, I insist on payment at the time service is rendered, and I provide all documentation so the patient can pursue reimbursement from the insurance company.
JMS: You told us you don’t advertise your services, but you have built a thriving practice. What do you think has been the secret of your success?
Mr. Ryason: My practice has been built solely on word of mouth and referral. I attribute my success to the following:
– I conduct a thorough interview with all clients before I begin initial treatment.
– I explain in detail, and in layman’s terms, the nature of the pathology and/or dysfunction, and what can reasonably be expected from treatment.
– I make a “connection” with my client by listening attentively to them as they describe theirsymptoms, and by asking specific questions.
– I use MEDICAL MASSAGE PROTOCOLs which are strictly based on science
– I encourage feedback from my clients before, during, and after each treatment.
– Lastly, I deliver results I’ve promised.
Many times my clients come to me as a last resort. They have already exhausted more traditional treatments (surgery, drugs, PT, pain management, etc…). They are in pain and the medical community has not been able to help them. They hear about me from a friend or an existing or former client and think, “Why not? I’ve tried everything else!”
My approach is to determine what abnormality in the soft tissue structure or structures is contributing to or causing the symptoms, and to normalize them. As the soft tissue returns to its normal state, pain and dysfunction disappear and normal function and sensation return.
If you have a client in chronic pain that no one in the medical community has been able to help, and you are able to help them, not only do you have a client for life, you have a constant source of referral. Multiply this situation by a continually growing number of clients, and advertising becomes unnecessary.
JMS: Would you like to share with our readers stories of clients of yours whom you were able to help?
Mr. Ryason: I am blessed to have been able to help many people with their problems over the course of my career. In many cases I was the only person who was able to do so. Rather than go on about all the different people and different situations that I have been successful with, I will tell you one story:
I was working with a female client in her 40’s who had some neck and shoulder problems. We were able to resolve her issues relatively quickly (less than 6 treatments) and she was very grateful. During one of the treatment sessions, she began telling me about her mother. Her mother was in her late 60’s, she suffered from osteoporosis, arthritis, she had a pronounced dowager’s hump, and bilateral torticollis. She was unable to raise her head to look directly forward or turn her head much. She was in constant pain which was no longer being adequately managed by her pain medication. She had been through the PT, acupuncture, drugs, routine and had even looked into surgery, which was deemed too dangerous. Her daughter asked me if I could help her. I said I didn’t know, but would try if her mother was willing. She began bringing her mother to see me once a week. Her mother was a challenging case. She was hypersensitive and due to the deformity of her spine and neck, it required some creative bolstering with several pillows to allow her some comfort on my table. Treatment was uncomfortable for her, and I was careful only to do what she could comfortably tolerate. Over the course of several treatments, her pain began to diminish, and she was feeling much better. One day, after her treatment, she came out to the lobby and said she needed to thank me. This was something she did after each treatment, and I always responded with something like, “You’re welcome, I’m glad you are feeling better,” or something similar. She then said something I will never forget. She said, “You know, I have not been able to see the sky when I am walking for the last 5 years, but when I left here last week, I could see the sky! Thank you!” That statement was more rewarding than any paycheck I ever received, and is an excellent example of why I love this work.
JMS: Is your practice being adversely affected by the present difficulties the economy is experiencing?
Mr. Ryason: No. I am working with clients who are in pain and frequently they rely on my treatments as a last resort. I think that professional niche of medical massage is still wide open for those who would like to learn and practice it. This is one more reason why Medical Massage is such great field of massage therapy.
JMS: If you are willing to share this information with us, may we ask what approximate income your practice generates per year?
Mr. Ryason: I charge $110 an hour. I average between 30 to 40 treatments per week for about 48 weeks a year, so my practice generates between $158,000 to $200,000 in revenue a year, before taxes and expenses.
JMS: What advice or other words do you have for our readers?
Mr. Ryason: I cannot adequately express how learning the theory of Medical Massage and using the MEDICAL MASSAGE PROTOCOLs has changed my practice, and my life. It is not difficult to learn or apply. What is difficult is that you are required to step out of your “comfort zone.” By no means do all my clients come to me with a doctor’s diagnosis, prescription, or treatment plan. If they do, I am equipped with the knowledge and ability to work within those parameters. Understanding the scientific principles of MM and being able to apply them successfully has been immeasurably helpful in the treatment of ALL my clients. I strongly believe that graduation of massage therapy school is just beginning of continuous process of professional growth. I encourage all therapists to educate themselves about Medical Massage, and to that end, this website is a collection indispensable tools.
Category: Person of the Month