A gentle but powerful type of massage that focuses on the movement of fluids around the brain and spinal cord. Light pressure is applied to address medical problems ranging from migraines to cerebral palsy.

Faced with a painful operation for a shoulder problem, Hal Robinson found an alternative that he says helped him avoid surgery. "Massage therapy was, for me, almost a salvation," Robinson says.

Arthritis caused cartilage in his shoulder to wear away and caused pain and difficulty with everyday activities like sports. After trying physical therapy for the 12 visits covered by Blue Cross/Blue Shield, an MRI showed the therapy hadn't worked.

"I went to two other doctors for a second and third opinion, and one of them said massage therapy will help you," he says. "I didn't know the difference between physical therapy and massage therapy at the time."

After about a dozen visits with massage therapist Phil Cutrell of Touch Therapy Associates in Southfield, Robinson says he is able to throw a ball again and sleep on his left side.

Massage has also been plagued with the stigma brought about by the adult entertainment industry. Therefore, massage practitioners in Michigan have been pushing for almost three years for legislation that will regulate use of the title "massage therapist."

If passed, the law would create a state board for massage therapy and require massage therapists to be licensed. To be eligible for a Michigan license, therapists would have to have graduated from a state-licensed school or have passed a national certification exam.

more and more people seeking alternative health services. It used to be viewed as something to pamper oneself with; now everyday people are getting massage and seeing how it makes them feel better," says Kathy Gauthier, executive director and daughter of the namesake of Irene's Myomassology Institute in Southfield.

A survey commissioned by the American Massage Therapy Association estimated that 47 million Americans received a massage in 2005 -- up 2 million from the previous year. The Centers for Disease Control and Prevention's 2002 National Health Interview Survey found that 9% of American adults had a massage at some point for help with a medical problem, and that hospitals are increasing their use of massage for pain relief, stress management and help with cancer symptoms.

Some plans offer a discount at designated centers, but few cover the treatment. Robinson paid for the therapy himself, and estimates he saved his insurance plan the $120,000 or so it would have cost for a shoulder replacement.

Even though Michigan doesn't currently require massage therapists to be licensed, David Winkler, 51, of Farmington Hills chose to spend thousands of dollars for classes at Irene's Myomassology Institute.

Without training, he says, "I could make you feel better, but I wouldn't know how to incorporate general health. Here, we learn more than just massage," including etiquette, draping techniques and how to take a health history.

Winkler is ambivalent about the licensing bill because he feels word-of-mouth brings back clients if a therapist is good, and "if someone goes to someone shady, they don't go back. I don't think licensing will change that."

massage proponents tout -- some confimed by medical studies, some not -- are physical relaxation, relief of stress and anxiety, better blood circulation and a heightened sense of well-being.

In one study from the University of Miami School of Medicine, babies who were born prematurely because of cocaine exposure were massaged for 15 minutes three times a day. They averaged a 28% greater increase in weight each day over babies who weren't massaged, and had fewer complications.

Gauthier says that people who get frequent massages take better care of their bodies and health. "It's like if you do an exercise class, you don't go out and eat a Big Mac."

Other enthusiasts trumpet the physical contact of massage. The energy from a human touch can stimulate self-confidence and even help victims of sexual abuse reconnect with a "safe touch," Gauthier says.

At the very least, massage doesn't do any harm, says Dr. David Janda, an orthopedic surgeon and director of the Institute for Preventative Sports Medicine in Ann Arbor. He recommends massage for both prevention and treatment of injury.

"We find that if folks after a shoulder injury integrate massage, they get better quicker, so the health care costs they generate are less because they get back to their activities quicker."

Joe Rayl of Monroe is someone who did consider it. She was in two rear-end car accidents and her shoulder was bothering her. Her chiropractor couldn't help. Her doctor prescribed massage therapy, and car insurance paid for it.

"It was getting to the point where I was having a hard time sleeping at night; my shoulder pain would wake me up," she says. "It was wonderful because I didn't realize how much my range of motion was limited by the accident. Until you actually experience the treatment, you don't realize what a difference it can make.

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