Washington state a leader when it comes to medical massage


Diane Maurer was swooshing down a run at Mt. Baker Ski Area when she took a wrong turn, caught her skis on small treetops sticking out of the snow and cartwheeled down the slope.

The fall resulted in a severe calf muscle injury for Maurer, a former ski instructor and the mother of two Bellingham teens. To help her recover, she had two massages.

"After massage I could feel the stretch along the entire calf muscle, because it wasn't tight anymore," she says.

More people are getting massages these days, and the reason they're getting them is changing.

According to the American Massage Therapy Association, 16 percent of adult Americans had at least one massage between July 2011 and July 2012. That's well above the rate for the previous five years. Of those people getting a massage, 43 percent did so for medical or health reasons, not mere recreation.

That growth and change is evident in Whatcom County.

"We have a thriving business," says Tanja Kanoa, a licensed massage practitioner and the owner of Advanced Medical Massage. Kanoa opened her business in Bellingham in 2001 and moved to its current Fairhaven location in 2006. She employs 12 therapists, with 90 percent of their business coming from doctors' referrals.

"What's remarkable is that Washington recognizes massage therapists more than any other state," Kanoa says. "In this state, insurance has to offer a plan that includes alternative care."

Sally Ledgerwood, another massage practitioner in Bellingham, agrees that Washington sets the insurance standard for reimbursable medical massage.

"Massage is coming into its own," she says. "We're stepping into full partnership with the medical profession."

Ledgerwood has practiced in Bellingham since 1999, and, like Kanoa, helped launch the associate's degree massage program at Whatcom Community College. She also volunteers as a massage therapist at Whatcom Hospice.

At hospices, massage is purely for comfort.

"It's very gentle, and not usually full body, since the patient may be in a hospital bed," Ledgerwood says. "Anyone who's ever had even a shoulder rub knows it feels good. There are fewer and fewer skeptics about massage having an effect on the body."

At the new PeaceHealth St. Joseph Cancer Center, outreach coordinator Carol Brumet oversees massage and other free complementary therapies for patients.

Massage helps diminish the stress of diagnosis, and the side effects of chemotherapy and radiation, such as nausea, fatigue and body aches. Each year, six licensed volunteers deliver four massage sessions each to a total of 150 patients at the center.

"You never see anybody walk out of that massage room grumpy," Brumet says. "They're grateful for the volunteers' time, grateful that the service is offered."


Massage can be categorized into main arenas: medical and spa. Medical massage is reimbursed by insurance; spa massage is not. In both cases, providers are licensed, and both provide health benefits.

Medical massage treats a specific condition diagnosed by a primary care provider. Spa massage often treats a specific condition, but without a prescription or insurance. An hour massage at a spa ranges from $50 to $90; insurance-reimbursed medical massage can cost up to $150 an hour.

Medical and spa often use the same techniques. Massage encompasses nearly 100 different methods. The most common include Swedish, deep tissue, shiatsu, hot stone and chair massage.

"They're just different modalities," Ledgerwood says. "The end result is the same. You get the body to return to its holistic state."

Karen Moore, the owner of Zazen Salon Spa in Bellingham, says the growing popularity of massage prompted an addition to their Bellwether operation in 2008. At Zazen, massages are oriented to what the client wants, rather than what a doctor prescribes.

Salon massage includes a sauna, showers, robes and slippers, and drinks and snacks.

"Once they walk in the door, they shut the rest of the world out," Moore says. "Taking time to fully relax results in health benefits. You have to schedule it if you want it to happen."


First, check whether the massage provider is licensed by the state.

Second, know what you are looking for.

"What is the consumer's intention?" ask Tanja Kanoa, the owner of Advanced Medical Massage in Fairhaven. "To help release a frozen shoulder? Then going to a spa might not be best. If the intention is to have a full, sensational experience with robe, steam bath, and the full package, don't come to a medical massage clinic."


Anxiety: Massage can lower the amount of "fight-or-flight" cortisol in your body, and increase neurotransmitters that help reduce depression.

Cancer care: When used with standard care, massage can reduce stress, anxiety, pain and fatigue for people undergoing cancer treatment.

High blood pressure, poor balance: Massage can decrease blood pressure and improve stability for older people.

Sore backs: Regular massage can reduce pain and improve function for people with low-back pain.

Sore knees: Massage can significantly reduce pain from osteoarthritis of the knee.

Sore muscles: Massage can reduce inflammation in muscles damaged during exercise.

Source: American Massage Therapy Association


Massage encompasses nearly 100 varieties. Here's a guide to the most common.

Acupressure, or shiatsu: Massage that uses fingers and thumbs especially to focus treatment on the same points of the body as acupuncture.

Aromatherapy: Essential oils, often derived from medicinal plants, are mixed into massage oil to deliver a relaxing effect.

Chair: Typically 20 minutes of massage focusing on the neck, shoulders, back, arms and hands. Some employers, such as accounting firms during tax season, offer chair massage as a benefit

Craniosacral: Gentle noninvasive manipulation of the skull, to release tension.

Deep tissue: Detailed therapeutic massage with strong pressure on target areas to achieve a specific result.

Hot stone: The therapist holds a warm stone as a tool to massage, or places warm stones on specific sites on the body. The heat penetrates muscles more deeply.

Manual lymphatic drainage: Light massage focusing on the lymph system just under the skin, often used after surgery to reduce swelling.

Pregnancy massage: Often addressing low-back pain, this accommodates a pregnant belly and can involve a specially designed table.

Reiki: A Japanese massage in which practitioners believe they tap into universal energy to combine with a client's own energy to promote relaxation and healing.

Sports massage: A variety of approaches to help athletes before, during, and after events to promote flexibility, prevent injuries, help muscle strains and aid healing after injury.

Swedish: A classic massage that uses long strokes and light or medium pressure to promote relaxation, relieve tension and stress, improve circulation and soothe aches.

Cheryl Stritzel McCarthy is a Bellingham freelance writer.

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