What is a modality?
Taber’s Cyclopedic Medical Dictionary defines a modality like this:
1. method of application or the employment of any therapeutic agent, device, or treatment.
2. Any specific sensory stimulus such as taste, touch, vision, pressure, or hearing.
physical agent modality
A form of therapy used in rehabilitation that produces a change in soft tissue through light, water, temperature, sound, or electricity. It includes transcutaneous electrical nerve stimulation units, ultrasound, whirlpool, hot and cold packs, and other medical devices.
Sandy Fritz defines it as this in her book:
modality- A method of application or the employment of any physical agents and devices. The term is commonly misused to describe forms of massage (e.g., NMT, myofascial, Swedish).
Fritz, Sandy; Fritz, Luke. Mosby’s Fundamentals of Therapeutic Massage – E-Book (Kindle Locations 39249-39250). Elsevier Health Sciences. Kindle Edition.
Massage therapy is a modality. Chiropractic is a modality. Acupuncture is a modality.
Types of Massage
There are many types of massage within the modality of massage therapy. How many are there now? Hundreds? Many with a long history, many made from other therapies, many based on tradition and some based on evidence/science. No matter what their roots or evolution, learning different types of massage has become another myth in the massage therapy profession.
Massage therapists flock to CE classes on various types of massage, thinking it will be another tool in their toolbox or thinking it will be the next big thing and will help them to be successful in building their business or wherever they are in their careers.
Modalities are tools at best, brainwashing at worst. ~ David Lauterstein, The Deep Massage Book
History of various types of massage
When you start really researching the various types of massage and look into their history you will find common themes emerging. Many are created as a result of the person having a disease or condition that they could not find any help for or like with Connective Tissue Massage (Bindgewebs Massage) created by Elizabeth Dicke who was told her leg would have to be amputated.
Many other types of massage are created by people after learning specific methods and then either not agreeing with the theories or practices or expanding on them. Ida Rolf who created Rolfing had many students who branched off into their own things – Hellerwork, Zentherapy and more.
The Other Side of Modalities
As massage therapists, we study and learn as many different types of massage as we can. Everyone becomes an expert over night calling themselves a cranio-sacral therapist after a weekend workshop or whatever type of massage that was studied.
Poorly defined types of massage have created even more confusion. What is Deep Tissue Massage exactly? What is medical Massage anyways? There isn’t any such thing as Medical Massage. The draw of getting a “Certification” is misused over and over, with many teachers saying that you can get a certification in their specific method or type of massage when the only True certifications are from the NCBTMB and a few other certifying agencies like the Lymphatic Drainage Certification, Triggerpoint Certification.
All of these specific recipes just provide a framework for working with people. The true power of applying these hand movements requires assessing each persons needs and developing a plan of care. That also requires basic knowledge in Science Literacy and Critical thinking. Your ability to be successful has little to do with the type of massage you learn or give. It has to do with who you are and developing a therapeutic relationship with clients.
Massage therapy is 10% technique and 90% You ~ Unknown, many massage teachers.
Moving to Outcome Based Massage
So many different types of massage…so much confusion. What to study? What type should you get?
It doesn’t really matter. What matters is the outcome or results that are achieved with each session. The type of massage does not matter. Sandy Fritz, in her book Mosby’s Fundamentals of Therapeutic Massage outlines the 4 main outcomes of massage which are:
Relaxation, stress management, pain management, and support for functional mobility.
Fritz, Sandy; Fritz, Luke. Mosby’s Fundamentals of Therapeutic Massage – E-Book (Kindle Locations 12518-12519). Elsevier Health Sciences. Kindle Edition.
When people look to get a massage, they usually have some problem that they need a solution for…stress, pain or they just need a break. They don’t care what type of massage they get and they often do not understand the various types of massage and quite frankly…it does not matter. What they want is to feel better. They want to be able to work in the garden longer, work at their desk without pain in their neck/arms/back or whatever their reason for seeking massage.
When clients feel the touch of massage, they don’t know if you are doing Swedish Massage, Pfrimmer Massage or whatever modality you just spent time and money learning. What they feel is being held, nurtured, valued and supported.
Bevis Natan in his book Touch and Emotion in Manual Therapy asks: What is it that primarily heals – the technique and its tissue-specific physiological effects or the experience of being held/healed?
See also: Are we the modality by Walt Fritz
Modality Empires: The trouble with the toxic tradition of ego-driven, trademarked treatment methods in massage therapy, chiropractic, and physiotherapy. Paul Ingram. www.painscience.com