Aug. 2, 2021

David Morin & Sam Small: A Clinical Approach to Massage Therapy

The following material has been edited for clarity and brevity.

In this episode of Alternative Health Tools, Kim Shea spoke with David Morin and Sam Small. David Morin has worked as a licensed massage therapist for over 40 years and has provided care to Olympic athletes at two Olympic games.

Sam Small is a content producer, who has personally benefited from David’s treatment and leads the marketing for David’s practice and courses. Their goal is to utilize client-centered, results-oriented massage therapy to treat specific soft tissue injuries and conditions. Drawing on David’s expertise, they have created courses so that massage therapists can develop their clinical skills. They focus on ensuring patients get well and therapists have a healthier experience so they can serve their clients for a longer period of time.

David Morin: The Instigator of Healing

Kim: David, do you want to tell us about your background and how you got into this?

David: I suffered from a good education. I've been to four undergraduate schools and four graduate schools. When I finally entered massage therapy at the age of 36, I had a degree in biological sciences with a minor in chemistry. I had done graduate work in anatomy, physiology, vertebrate anatomy and physiology, and had been a medical photographer in Vietnam.

I had done a variety of medically-oriented things, including being an ambulance driver and other roles in the medical realm. When I got into massage therapy, I just naturally gravitated toward the most technical, the most clinical, and the most anatomically and physiologically connected type of work.

It was boring for me to do a full-body massage where the person would just take a deep breath and go to sleep. What I found to be much more demanding and engaging was to become more clinically-oriented. And as I did that, I began to have people coming in, asking for specific work on specific problems. That's the way my practice changed. They weren't coming in anymore and saying, “I want a nice, full-body massage, as deep as you can deliver it on every aspect of my muscle groups.”

I found that when a person came in with carpal tunnel syndrome, or plantar fasciitis, or a whiplash injury, I just got very excited about the ways could I help them in addition to what their physician, their chiropractor, or their physical therapist might be doing. I’m not trying to replace those roles, because that's clearly not what I'm prepared or trained to do, but I am trained as a soft tissue specialist. That means I know the 200 bones and the 600 muscles and where they interact, intersect, and attach. All that is in my wheelhouse.

It turns out that in almost every kind of syndrome or problem that a person might be suffering with—like carpal tunnel syndrome—there is always something that can be done with the muscles and the myofascial structures of the body.

That's where I focused my energy. I had the technical background that so many people coming into massage therapy don't have, so I was really prepared for clinical work. I began traveling with my university track and field team at the University of Texas El Paso.

I traveled with the men’s and women's track and field team for eight years. Along the way, we had some very fine, world-class sprinters who hired me to go to the 1996 Olympics in Atlanta. Then, I was hired again to go to the 2000 Olympics in Sydney, Australia, where my athletes took a gold medal in the 100-meter relay and a bronze in 100 meters.

I came back to my practice realizing that everybody is the same. We’re a little bit removed from being the quality of an Olympic athlete, but you or I can have all manner of difficulties. That's what I've dedicated my practice to. I just retired last year after working for 42 years and it has been a wonderful journey.

I started teaching what I was doing because so many people said, “David, I've never had anything like this.” I'm not saying I created or developed anything new. I studied with every master I could. Anyone that had anything going, I was going to go get treatment from them and read their book or take their class and incorporate that into my background, which is now quite broad. So, I'm bringing a lot to the table academically, historically, and experientially, as well. We want people to sign up for these courses and use them effectively and get really great results with them. The market that we have for our courses is any licensed massage therapist who would like to become more clinical in their work.

Now, there are lots of conditions for which a relaxing full-body massage is the ideal treatment. Think of someone who's recently had a loss in the family, or who has anxiety or depression. A properly delivered full-body massage is perhaps the very best treatment that anyone could possibly deliver for certain maladies and certain conditions.

However, for whiplash, not so much. We need to do specific and detailed work on the neck and all the 16 muscle groups that interact with the neck. It can get very technical and very comprehensive, so that takes a very special set of skills.

As I've gotten older, I'm not as athletic as I used to be. I'll be 80 on my next birthday, and I'm just not able to lift those heavy bodies and legs and arms and move them all around as easily and freely. So, I've converted my practice to one that is mostly seated but still getting very good, specific results. I can be seated on a stool and deliver marvelous therapy over a period of time. I do not have to stand or lift, and I’m still able to do the work that I know how to do.

I had someone call me when I was doing live classes and said, “David, I'm 60 years old. I've been a massage therapist for 20 years, and I'm just having great difficulty getting around to deliver these deep tissue massages that these people want.”

Deep tissues massages are when you press as deep as you can and as far as you can. The client walks out hurting, but happy, so to speak.

This woman told me, “I just can't do it anymore. Plus, I now have a herniated disc in my back and I'm thinking about retiring.”

I said to her that the class coming up was the head and neck class. I told her, “Ma'am, you come to that class and you get real good at neck and jaw treatment. You can literally be seated and become a neck and jaw specialist. You can get referrals from dentists with restricted jaw opening or problems around the mouth; from speech therapists with people with lazy tongue and inability to use their maxillofacial muscles; and also from physicians. You could become a literal specialist. You'd be seated and it wouldn't put that pressure on that herniated disc in your back.”

She came to the class and she's now doing that. That's rewarding to me. That's what I’m about. That's what this whole thing is about: people being able to continue doing what they love to do. They’re not having to stand up all the time, not having to lift heavy bodies, and not having to answer the demands of a client who would be saying, “Can you go deeper, please? My last therapist could go deeper than that. If you want me to come back, you've got to really beat me up a little more.”

Massage therapists are tired of hearing that. We really are tired of hearing that because the healing comes from within, not from us. We're not healers, but healing is there. It's there for all of us.

Sam Small: The Magnifying Force

Kim: So Sam, tell me about you. What's your background here? How'd you get involved in all this?

Sam: Well, I have a degenerative disc disease. I'm 64 years old now. Over 30 years ago, I had my first surgery and had muscle spasms, pain, and discomfort resulting from that. So, I went on a quest looking for massage therapists who could help me.

Everything that David has been talking about is absolutely true. You know, a gentle, relaxing massage was not what I needed. I needed very specific work and I had a really hard time finding therapists who understood that and who had the kinds of skills that could help me.

Life went on and I've had four major surgeries now. I still get a very targeted massage on a regular basis. I found David. Life introduced us to one another and I was absolutely smitten with the quality of the work and the approach that David takes to a massage. I immediately recognized the difference and that it was what I needed.

I also happen to be a content producer. I'm a director and an editor. I was just so taken with what David was doing as a therapist, and that he was also traveling the country and teaching this work.

I realized that this is something that the world needs. Everybody needs to have access to manual therapy and manual therapists who can do this. You know, the opioid epidemic that we're still reeling from was using pharmaceuticals to treat pain. There are other ways to treat pain. The work that David and Wanita have put together teaches therapists to be able to serve their clients and resolve pain without pharmaceuticals. I just saw my opportunity as a content producer to be able to document what David does and what he teaches, and be able to turn that into an online video-based Master Class for as many people as possible. It helps the therapists and, in turn, each therapist helps their clients. If I can produce media content that helps people in that kind of way, I'm there.

Kim: That's great. It sounds like you're living your purpose too, Sam. If you had not found David, where do you feel that you would be? Do you feel that there's a marked difference that you've achieved in the quality of your life?

Sam: Yeah. Especially post-surgically. I've been fortunate in that I've had four catastrophic disk failures spread apart by five or six years each. I've been able—with the help of massage and trigger point acupuncture—to have been able to live comfortably and have good mobility in those intervals. I'm hopeful I can avoid a fifth surgery. Because of the work David does, I do live comfortably.

As David says, he doesn’t heal my body—the work he does allows my body to reach its homeostasis and heal myself. My body does the healing. David does the facilitating to remove the barriers that are keeping my nerves inflamed or keeping a disc inflamed. The body is the healer. The therapist is just the facilitator.

Wanita Thompson: The Tower of Knowledge

Kim: Let me ask you, David, about Wanita. She's your partner in all this and in doing the online instruction, is that correct?

David: Totally. We met in massage school in 1978. Prior to that, she was a cardiac nurse at the Miami Heart Institute, as well as other places, so she had a tremendous background in cardiac work. She had a clinical background and it meshed rather well professionally, as well as personally. We became very close. Right after massage school, we moved to Sarasota and set up a booming practice. We started teaching at the local junior college. We met some physicians, talked about what we're doing, and invited them to have a session or send their head nurse to us, so we could get the credibility that we desperately needed in the professional area.

After five years there, we moved to Ruidoso, New Mexico, where we started the first massage school in Southern New Mexico in 1987. Wanita continued that school for another 23 years. She was the mistress of the best massage school there in Southern New Mexico and had a fantastic experience. We have taught together for many years and I have taught in her school at times. We have a son together. We divorced in 1990, but now we've progressed all the way to friendship and we share a property in New Mexico.

She is a tower of knowledge. She has a background in being a midwife, as well as a nurse, a school owner, and a massage therapist. She is a tremendous source to this program. The manuals are compiled and presented by both of us. Her name is on everything because she has added so much. She made our five courses into six by adding a very wonderful course that everyone likes. She has 42 years of experience, so we literally have 84 years of experience between us.

Sam: They are both rock stars when it comes to massage. They were acknowledged at the World Massage Festival and were inducted into the Massage Hall of Fame in 2009.

The Medical Massage Therapy Program

Kim: If a student was to contact you, somebody who is already a licensed massage therapist, how long will it take them to complete your program?

Sam: Massage therapists can find us at The basic course is a very comprehensive online masterclass. Typically, we advise that a working therapist spends at least five hours a week dedicating themselves to watching the videos, reading the 360-page course manual, and practicing the techniques on very lucky friends and family. If they follow that pace, they'll be able to complete our course comfortably in five months’ time.

There are six modules, because the body is broken into different body parts. We also have an extensive course on documentation, which is a big part of the clinical aspect. The record-keeping and the clinical protocols that we encourage our therapists to follow are essentially the same medical protocols that a doctor's office keep, so that there is an accurate record of the patient's progress. That affords an opportunity for our therapists to be extraordinarily client-centered and results-oriented.

Your first session with a medical massage therapist is an extensive assessment with physical movements that we teach our therapists how to measure. We have a little protractor device so that they can know how far you can move your right arm, for example. What's the limitation that you're experiencing? That gets recorded. That gives a benchmark for progress for the therapist and for the client, which drives people because there’s a demonstration of healing that takes place along the way. When they've improved their health from this work, that's encouraging, you know? People just light up when they see that kind of result.

It translates into pain remediation, as well, because what's stopping them is pain. So, suddenly they're pain-free and they have their full range of motion back or whatever they're going to be able to get if there's an injury or condition that's stopping it.

Our therapists know how to do that. This is a very comprehensive course because there's a lot of different body parts and there are a lot of specific injuries and medical conditions that massage can have an impact on. All of them are included in the research and the courses that David and Wanita have done. They also include the pains, conditions, and injuries that we know that massage cannot have an impact on. Nobody's time should be wasted and they shouldn’t have false hope. All of that is included in the course. In medical terminology, it's called “indications” and “contraindications.”

We're teaching our therapists how to have the critical thinking skills, how to do the assessments, how to observe their client's posture and their movement, how to measure their range of motion, how to work with them on discerning their pain level so that they know how to progress, and how to build a treatment plan for that client.

As David aged, he blew his thumbs out. He is not able to apply sustained pressure using his thumbs, so to be able to stay in this industry that he loved so much, he had to find another way to work. He has developed hand tools, which we teach therapists to use. They are wooden hand tools that have rubber tips. We call them “thumb savers.” You can apply that sustained, focused pressure on a muscle or a trigger point that is locked up. The idea is that with the right sustained pressure that muscle will release. It's like the reset button on a computer.

Muscles are stupid. They only have one response. They either tighten or they let go. Sometimes, they tighten and they forget how to let go. This trigger point work delivers a very similar result to trigger point acupuncture, which delivers a stimulus that gives the muscles a reset. The sustained pressure from a massage therapist can do that as well.

All of that has been incorporated into the coursework that we have. David has close to 200 different techniques and massage treatments that he demonstrates in this course to treat various muscle injuries or conditions. The course also incorporates how to deliver treatment in a way that protects the therapist. It's self-care, which contributes to longevity and interests our students. Probably more than half of our students are 65 or older. They come to this work because they are experienced therapists, or they're new and they recognize, “I can't deliver that sustained pressure. I can't do that without hurting myself.”

Another thing that makes clinical massage therapy different is that our clients don't get undressed. This is a clinical approach where the client stays clothed. We're teaching our therapists to be able to deliver massage through clothing. They learn how to feel what the client's muscles are doing and be able to deliver the right pressure in the right place. You can do that through clothing—just a simple cotton shirt or lightweight sweatpants.

You have the front, the back, the left side, and the right side. But most massage therapists don’t use that sideline position. When you're practically naked on a table, massage therapists give treatment so the client is either face-down or face-up with a drape over them. If you put somebody on their side, the drape tends to fall off and suddenly they're exposed. We are offering to double the amount of access that a therapist has to a client's body.

It’s kinda counterintuitive, but our therapists take the approach of getting the client back to being pain-free and having a full range of motion as quickly as possible, so that you do not have to come back to us.

David: We still do operate a monthly maintenance program. There are times when folks come in and have gotten better, but they do want to be placed on some sort of maintenance.

So, I'd say to have a check-in once a month for a while and see how that goes. If they've been referred by another massage therapist to me and to our practice, it would be a matter of returning to their regular massage therapist because I've not done any full-body massage for years.

I get lots of referrals and our graduates, I would hope, get lots of referrals from massage therapists who know that they are not going to take their clients, because they're there to work on their carpal tunnel or their plantar fasciitis or their knee problem. Then, those clients will return to their therapist for their full-body massage.

Kim: You're not stealing the client. You're just helping them with a particular problem.

David: Yes. After our graduates complete our course, we don't require them to let go of doing full-body massages. It's up to them completely because they're the manager of their own world. However, I will say that there are some distinct advantages health-wise if they don’t continue doing full-body massages. The specialist will work on a specific syndrome or injury, and the client’s regular generalist does their maintenance work. That's the niche that I have carved out for myself over the years. I certainly present that to folks and encourage them to give that every consideration because that's what's lacking.

My comment is that doctors give drugs, chiropractors adjust, physical therapists give exercise, and massage therapists do a nice, full-body massage, but who's going to do that specific work? Who's going to help that person who has a traumatic brain injury and no one will work on their neck because they're scared to, or because they don't think it'll help? Who is going to do that? Well, there are those of us that really enjoy this kind of work and are available to do that. That's the word we want to get out.

Kim: I think it'd be very satisfying to see somebody come in with one of those conditions and then watch the progress.

David: Thank you for saying that. I know that every massage therapist has heard from a client, “Oh, that was a tremendous massage. One of the best I've ever had.” It meant a lot to me when they said that. However, it all changed when a person would come out and say something like, “Four visits with you have helped me more than 12 weeks of that other therapy. It's changed my life.”

That's a different story. When I began hearing that, that's what changed my life. I knew it wasn't me. It was partly me, partly them, and partly the work. It's not about me. It's about the work and the work carries the day.

Opportunities for Clinical Massage Therapists

Kim: Are there other job opportunities for people who have become specialists? What else can they do now?

David: The beauty of this experience for me, Kim, has been that with the work that Sam has done to present this course online, we have students from countries that I can't even pronounce. It's amazing. After their first course, the students have to evaluate each segment. They cover the module, take a test on it, then evaluate it and tell us what they think.

If something that’s not right, they'll say so. They need to say so. However, what I'm hearing is excitement—and that's from doing this online. They've never met me. They've seen me in countless videos and through the course manual.

They're able to get jobs in hospitals and sometimes working on staff in a hospital. Other times, they get to work on certain patients in the orthopedic ward, for instance, and non-communicative wards, et cetera. In medical clinics, DC (doctor chiropractic clinics), and physical therapy classes. Then, there are massage therapists gathering among themselves and creating their own clinic or individual private practice.

There are many avenues for them to practice. I love to say to students that the future is so bright, they have to wear shades. It’s that much of an opportunity. I don't mean that there are ads in the paper every day. There are some, but it's often a matter of creating your future.

Kim: How do we find people who have graduated from your program?

Sam: There's a “find a therapist” link on our website where people will be able to search by their state and city to be able to find a graduate of our program.

Kim: Perfect. And you said you have people all over the world.

David: Yes, in many countries. I would say most states. I can't think of a state right now that we haven't had any students from. I think every state, Canada, Australia, and many other countries.

Kim: Okay. That's great. That opens up opportunities for everybody here.

Sam: For the graduates of our online masterclass, David teaches a live four-day class at least twice a year. This is a demonstration of the specific techniques that he has modified and designed to protect the therapist.

Students see them in the videos, but in the live setting, he demonstrates them in the classroom, then everybody breaks up into pairs and they start implementing it in person. David and the teaching assistants wander the room, give remediation, offer coaching, and evaluate each individual.

At the end of the online course, they will earn a certification as a medical massage therapist, but in the live classes, they earn a certificate of achievement with continuing education hours. Both certificates are NCBTMB-approved. The online class has 72 continuing education hours. In the live class—which is only available to graduates of the online course—students earn another 28 live CE hours. If they're good enough, they earn David's certification as medical massage therapists.

A Winning Team: A Medical Massage Therapist + An Informed Client

David: I had a call come in from a therapist in Berkeley, California, and she said, “David, I'm 63 years old. I've been a massage therapist for 25 years. I've studied with just about everybody. Why should I take your class? What am I going to learn?”

That was a pretty good question. I thought for a moment and said, “Well, the difference in my class will be the techniques. I'm a collector. I've been at it for 30 years and I've collected all manner of techniques and approaches from a variety of sources.”

She said, “You got me, I'll be there.” And she showed up.

Kim: Is she doing what you said?

David: Yes. In fact, she responded in a way that many other very knowledgeable therapists have. I've had some really top-notch people take my class and they have said things like, “David, let me be clear with you. A third of what you presented I'm doing already, so it was validating for me. A third of what you presented is stuff that I already knew about, but I'm not using and I said to myself, ‘Why am I not using it? David inspired me to go back to my routine.’ The last third is new stuff that I had no idea about.”

So, it's not a matter of a therapist coming in and having to get rid of everything they already know. We build on the foundation that was built in massage therapy school. We want to expand that foundation to include more anatomy, more physiology, more pathology, and more kinesiology. Then, they can feel confident when that person comes in and says, “I was injured in an automobile accident and I can't turn my head. My doctor (or whoever) sent me to you and said that you would know how to proceed.”

Our graduates know how to proceed. It's not always a matter of snapping your fingers and fixing something. It's a matter of doing what we can do today and incorporating everything so that we empower the client.

I am encouraging the client to do all they can on a daily basis. They're with themselves every day and we are only seeing them twice a week. It’s a matter of empowering them to become the driver of their own health bus. It's teaching them how to do it for themselves. That's why we start out with the assessment. The therapist plus an informed client is a winning team. We want to inform them, empower them, and support them. I always say, “I want to be your coach, your cheerleader, and your consultant. I'm not your healer. I don't fix anything. I set the stage where you can manifest that for yourself.”

Interview Links

Check out David Morin’s website here.

Find a certified therapist near you.

Look at David’s courses here.

Chat with Sam.

Send David a message.

Friend David on Facebook.

Connect with David on LinkedIn.

Follow David on Instagram.


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