A gift certificate granted Karen Lafitte her first spa massage, a "wonderful" experience that she otherwise considered beyond her monetary means.

A gift certificate granted Karen Lafitte her first spa massage, a "wonderful" experience that she otherwise considered beyond her monetary means.

That was before Lafitte was stricken in 2002 with Parsonage-Turner syndrome, a rare nervous-system condition that crippled muscles in her neck and shoulders. Building on three years of intense physical rehabilitation, her therapist recommended acupuncture and massage.

"It keeps me stretched out," Lafitte says. "When I leave, I'm like Gumby-legs. I think it works out a lot of toxic stuff."

Although massage therapist Lori Katzen charges $135 for a two-hour session that combines acupressure and deep-tissue techniques, working the expense into her budget is now a priority, Lafitte says. After benefiting from weekly treatments, the 52-year-old Medford resident gradually decreased visits with Katzen to monthly maintenance massages.

"This healing process has made it very apparent to me how important it is to take care of oneself," she says.

Lafitte is among the nearly 40 percent of American adults who have visited a massage therapist at some point in their lives, according to 2006 statistics released by Associated Bodywork and Massage Professionals. With as many as 250 known types of massage and bodywork, the industry sees new modalities emerge every year. But the most important trend of the past two decades, massage professionals say, is steadily mounting awareness of massage as a legitimate form of health care.

"I think there's a profound shift in how people are thinking about health and healing ... People are really starting to look outside the box," says Janie Chandler, a massage therapist and instructor at Ashland Massage Institute (AIM).

In response to a growing population of massage clients who have injuries and chronic pain, Genna Southworth introduced a more clinical approach in AIM's curriculum when she and husband David Frederickson purchased the 20-year-old school five years ago. However, one-third of all hands-on classes at AIM stem from Eastern philosophy and "energetic" philosophies, including the workings of meridians and chakras.

"It's kind of like the 'woo-woo' meets the West," Southworth says. "A clinical approach doesn't fit all practitioners, and it doesn't fit all clients."

Neither a pediatrician nor a homeopathic practitioner could help Ella Lovett who, at almost 2 years of age, was unable to sleep like an

active toddler should and woke up every couple of hours.

"Nobody really gave me an explanation," says Ella's mother, 32-year-old Kalle Lovett, of Ashland.

A friend suggested mother and daughter visit Ashland craniosacral therapist Judith Sanford, as a last-ditch effort to improve the family's exhausting nighttime routine.

"I had very low expectations," Lovett says, adding that Sanford told her she didn't know whether she'd be able to help. But as soon as Sanford put her hands on Ella, the girl "melted," her mother says.

Treating the body's craniosacral system, which consists of membranes and fluid that surround the brain and spinal cord, Sanford says she uses a very light touch and the body's own "craniosacral rhythms" to open circulation and help muscles to relax. The nontraditional technique that developed out of osteopathy has been practiced since the early 1900s, Sanford says. Massage therapists, she adds, have been using it since the 1980s.

"It's a physiological system," Sanford says. "It's not a new-age, 'woo-woo' kind of thing."

While admitting that craniosacral therapy can be difficult to explain, Sanford says it can address latent symptoms that may not show up for 20 years following an injury. And it can be particularly helpful for children, she adds.

"This can often be the missing piece," Sanford says, referring to people who have undergone other bodywork without the desired results.

In Ella's case, Sanford guessed her birth had been difficult and that Lovett had delivered by Caesarean section. During four consecutive months of biweekly appointments with Sanford, Ella progressively slept better until the first week of June when she started sleeping through the night, Lovett says.

"Judith was able to connect with her on some level and just really healed her," Lovett says. "It wasn't a prescription or a remedy; it was just a healing touch that she needed."

Whether it's just a few grams of pressure or the intense penetration of deep-tissue massage, many local practitioners say they integrate several techniques in a single session.

And numerous massage disciplines overlap, says Chandler, who started her career more than two decades ago at a chronic pain clinic practicing neuromuscular therapy. After moving to Ashland, she incorporated more "energy medicine" — akin to acupuncture.

"I believe that all massage therapists are doing energy work whether they know it or not," Chandler says.

Connie Shields focused her Medford business exclusively on energy work for 10 years but became licensed in massage therapy three years ago to appeal to a wider range of clients.

"The massage is much more popular ... and people understand it," Shields says.

When she launched her new practice last year, Shields realized a lot of potential clients neither had health insurance nor incomes that would accommodate regular massage therapy. Dubbing her endeavor Affordable Massage, Shields set her base price at $50 for an hour but also considers trading services, like the deal she struck with a male client who washed her windows.

"If you have absolutely no money, but you are serious about your health, come see me," she says.

Improving posture, digestion, flexibility, mobility, as well as alleviating a host of aches and pains, monthly massage should be part of everyone's wellness program, Shields says. Reducing stress, she adds, is among the most valuable benefits of massage.

"Why wouldn't you want to feel better?" she asks

Trends show that plenty of people do, Southworth says. Just as the number of licensed massage therapists in the Rogue Valley has rapidly increased over the past two decades — a number some say has doubled — Oregon's projected need for therapists is among the state's highest for health- care practitioners, Southworth says.

"There are very few places in our culture, our lives, where we give ourselves permission ... just to be," Southworth says of experiencing massage.

"Most people are really hungry for that."