FITNESS : Therapist Hopes the Public Will Get His Massage

Michael B. Epstein would like a little respect, please, not just for himself but for his chosen profession.

He’s a licensed, trained, experienced massage therapist, a practitioner of the healing arts. He works independently and with doctors to help knead the kinks out of injured muscles, restore movement to frozen joints, and melt away the effects of stress.

He does not, however, provide sexual services to his clients. And he’s sick of the assumption, in governmental regulations as well as popular misconceptions, that his profession is merely a legitimate-looking front for prostitution.

“We’re health care professionals,” says Epstein, the newly elected president of the Orange County chapter of the American Massage Therapy Assn.

Epstein, who lives in Laguna Beach and has practiced massage therapy for eight years, says the problem of inappropriate assumptions about massage is so bad that he won’t even advertise in the local phone book.

“The massage therapists who do advertise get the weirdest calls,” he says.

To illustrate his point, Epstein opens his own phone book and peruses the yellow page ads. “Look at this!” he says, pointing to a drawing of an attractive woman in a tight miniskirt used to advertise a business that provides “massage” on 24-hour call. “What does this have to do with health care?”

Even the licenses he carries enabling him to practice in the cities of Laguna Beach, Newport Beach and Irvine seem a bit ambiguous.

“For Irvine, I have to get a venereal disease test every year,” he says. “But I don’t have sexual contact with my clients.”

Epstein campaigned for the local association presidency on a reform platform, vowing to work toward standard training and licensing for massage therapists not only in Orange County, but statewide.

The other misconception many people have about massage, he says, is the assumption that it’s a self-indulgent luxury for the rich, something that feels good but has no real medical benefit.

To help dispel that notion, he’s also trying to get more doctors--and insurance carriers--to recognize the therapeutic benefit of massage.

“I put in 1,000 hours of study at a school in San Diego,” Epstein says. “I use 10 different modalities, from deep muscle work to reflexology to cross-fiber to acupressure and other therapies, depending on what is appropriate for the situation. And it really does help.”

He gets no argument on that point from local doctors, although they don’t always agree on when to prescribe massage therapy.

Massage is indeed an “extremely valuable” health care tool, says Alan M. Strizak, a Tustin orthopedic surgeon and sports medicine specialist. “I prescribe it very often,” he says.

“We’re way behind in this country when it comes to massage,” Strizak says. “For European athletes, massage is one of the most accepted ways of taking care of their bodies. But for Americans, I think it’s a combination of the old Puritan ethic and just a shortage of manpower. If a football team of 40 players has one or two athletic trainers, they’re not going to be able to do much in the way of massage. But when a European team travels, everyone on their support staff--doctors, coaches, mechanics--they all do massage.

“Athletes from the Far East also have their own kind of massage, and they consider it very important,” says Strizak, who has traveled with American cyclists and other athletic teams to the Goodwill Games in Moscow and other international competitions.

“For the other teams, massage is almost taken for granted. But if an American athlete asks for a massage, the trainer will probably say, ‘If you can reach it, you can rub it.’ Or, ‘Sure, I’ll do you if you do me.’ ”

Strizak says that although different forms of massage work in different ways, the general principle is the same. “When a muscle works, it builds up byproducts of metabolism such as lactic acid, which causes soreness. Massage invigorates the muscle and squeezes out the lactic acid, while allowing blood to circulate through it.

“The more oxygen you can get to a muscle, the better it works. Massage can also break up scar tissue and help keep the muscle supple and stretched to its proper length so it can function better mechanically.”

Irvine orthopedic surgeon Stephen Weiss says he, too, prescribes massage, “in conjunction with a multimodality physical therapy program for acute treatment of a muscle injury. The therapeutic effects are usually right after the injury, up to two to three weeks. After that point, the most effective therapy is exercise.

“You can still have a massage for comfort, but it isn’t medically necessary,” Weiss says.

“I like a massage as well as anyone,” he says. “But really for the everyday person, it’s more of a feel-good type of thing. I’m not saying it doesn’t provide some benefit, but it’s not necessary.”

Strizak agrees--up to a point.

“We all know that a massage is going to make us feel better when our muscles feel tense, but those benefits are relatively short-lived. A day or two later, you’re back in the same situation. But there are other kinds of massage--which doesn’t necessarily feel good--for muscle spasms, injured tendons or muscles--that does have a lasting effect.”

Gordon Grannis, a Laguna Beach chiropractor, says he rarely prescribes massage therapy immediately after an injury. “From what I’ve seen, it works best in chronic pain situations.”

A soft, gentle massage “may feel nice, but five minutes later you’ll forget you had it. You have to get rid of the aberrant adhesions in the muscle if it’s going to heal,” he says. “And that doesn’t feel very good while it’s happening. It can be painful, and then the soreness may last for several days afterward. But then the problem does go away, and you don’t have to keep getting massaged every week.”

Grannis says he sees more and more patients in need of massage because of injuries related to the lifestyle here in Orange County.

“We see a lot of auto-accident related injuries, because people spend so much time on the road, problems with job stress, or people who try to get in shape and end up injuring themselves,” he says.

“I’ve learned over the years that massage is really the best treatment for those soft tissue injuries. But you do need a therapist who is trained,” he says. “To accomplish anything, they have to go deep, and they have to know where the muscles lie and what other structures lie nearby.”

State and county AMTA members still haven’t agreed on the details they’d like to see for standard licensing, such as the amount of training required, Epstein said. “Right now it varies. For Irvine, it’s 500 hours, and in Huntington Beach it’s 100 hours. In San Diego County, it’s 1,000 hours.”