Medical Massage – ANY type of massage technique/modality that is used in a way that shows improvement in a clients health condition. There is not any one technique or method that IS medical massage. ALL massage is medical really.
Integrative Massage Therapy – Integrative seems to be the new buzz word. Complementary and Alternative have been previously used to describe treatments and services that are outside the mainstream medical profession also knows as conventional medicine. The National Center for Complementary and Integrative Health (previously National Center for Complementary and Alternative Medicine (NCCAM) defines integrative as:
We use “integrative health” when we talk about incorporating complementary approaches into mainstream health care.
Massage Therapists – “In our profession we are all massage therapists—not service providers—and we should all possess the skills necessary to assess a client and choose appropriate massage and bodywork application methods to benefit that client’s unique health picture. A meaningful massage should happen in every environment where massage therapy is offered, be it a cruise ship, spa,salon, massage clinic, or hospital. Clearly, based on this feedback, this is an area where a significant knowledge and skill gap may exist in our profession. More must be done to educate employers and also some schools, instructors, and professional therapists about the benefits of organized, comprehensive, and meaningful assessment to customize sessions based on a client’s unique health care needs.
Body of Knowledge Definitions
Description of Massage Therapy and Scope of Practice
Description of the Massage Therapy Profession Massage therapy is a healthcare and wellness profession. The practice of massage
therapy involves a client/patient-centered session, intended to support therapeutic goals, with the therapist being free of personal agenda. Massage therapy also meets the well-researched need for touch and human connection. Massage therapy at its essence is human touch with clear intention, focused attention and the attitudes of compassion and non-judgment
During a session,a massage therapist incorporates a wide variety of techniques and approaches. They design the session to address the goals of the client/patient, which may include, but is not limited to, the following:
•Treatment of pain, injury or conditions
•Balance and connection of body, mind and spirit.
Massage therapy is performed in a variety of practice settings designed to meet a
multitude of client/patient needs. Examples of the many possibilities include
•In independent offices serving community needs.
•In an athletic training facility working with both amateur and professional athletes to improve performance.
•In hospitals, providing massage therapy for patients.
•In a massage clinic working on injury rehabilitation.
•In multidisciplinary clinics with acupuncturists, medical doctors, physical therapists and naturopathic physicians as part of a healthcare team, providing integrated healthcare.
•In oncology clinics, providing palliative care.
•In chiropractic clinics, doing massage therapy treatments that support chiropractic care.
•As an onsite practitioner going to client homes or offices
•In airports, doing seated massage therapy on travelers.
•In spas, offering stress-reducing time away from the hectic pace of life.
With psychotherapists, focusing on mind-body connections that help heal past trauma.
•In retreat centers with clients/patients on a self-actualization path, focusing on mind-body awareness or creating a meditative state for the whole body.
•In a stable, helping the dressage horse and rider work together with ease,
addressing the individual body issues that each may have.
Many people who have received massage therapy can attest to the emotional, mental
and physical benefits. The physiological mechanisms that create these benefits have
been the focus of a growing body of research over the last twenty
. Research confirms that massage therapy reduces pain relieves anxiety levelsdecreases blood pressure lessens depression and
gain in premature infants
As research increases our understanding of how this therapy improves health and wellness, it will help guide the teaching, practice andutilization of massage therapy in order to achieve the greatest benefit to the client/patient.
Massage Therapy Definition and Scope of Practice Statement
Massage therapy is a healthcare and wellness profession involving manipulation of soft tissue
. The practice of massage therapy includes assessment, treatment planning and treatment through the manipulation of soft tissue, circulatory fluids and energy fields, affecting and benefiting all of the body systems, for therapeutic purposes including, but not limited to, enhancing health and wellbeing, providing emotional and physical relaxation, reducing stress, improving posture, facilitating circulation of blood, lymph and interstitial fluids,balancing energy, remediating, relieving pain, repairing and preventing injuryand rehabilitating. Massage therapy treatment includes a hands-on
component, as well as providing information, education and non-strenuous activities for the purposes of selfcare and health maintenance. The hands-on component of massage therapy is accomplished by use of digits, hands, forearms, elbows, knees and feet with or without the use of emollients, liniments, heat and cold, hand-held tools or other external apparatus. It is performed in a variety of employment and practice settings.
What IsIncluded in the Scope of Practice
The preceding Sections 110 and 120, “Description of the Massage Therapy Field” and “The Massage Therapy Scope of Practice Statement,” were specifically intended and drafted to describe and define the entire field of practice of massage therapy as it presently exists while recognizing, respecting and excluding the different and distinct identities of other forms of touch therapies within the broader industry (including, but not
limited to, other bodywork and somatic practices with their own separately developed systems and philosophies, scopes of practice and educational requirements).
As written, Sections 110 and 120 define the full scope of practice of the massage therapy profession, one that goes beyond the minimum entry-level “Competency Requirements for a Massage Therapist in Terms of Knowledge, Skills and
Abilities (KSAs)” presented in Section 200. Therefore, it should be understood that not all items mentioned or implied in the above descriptions of the field and its full scope of practice are entry level and that not all of the items would be expected to be included in Section 200 KSAs or in basic entry-level massage therapy training.
The following list of what is included in the scope of practice of massage therapists assumes, at least, the minimum entry-level training in massage therapy and specific post- graduate training where necessary or required:
•The use of touch through pressure, stroking/gliding (effleurage),kneading (petrissage) ,lifting,
percussion (tapotement), compression, holding, vibration, friction, pulling, movement and stretching (see below) by the digits, hand, forearm, elbow,knee, foot or mechanical appliances which enhance massage therapy techniques
•Techniques to enhance wellness and facilitate mind, body and spirit connections
•The use of active/passive movement within the normal physiologic range of motion, active assisted and resistive movement and stretching.
•Neuromuscular re-education and soft tissuemobilization
•Energy work, which includes treatment of the energy field through the use of touch or through the use of non-contact techniques
•Client/patient assessment by health history and intake interview, observation of posture and movement, palpation, range of motion assessment,special tests and, with permission, consultation with the client’s/patient’s other healthcare providers
•The determination of whether massage therapy is indicated or contraindicated for the client/patient
•The determination of whether referralto another healthcare practitioner is appropriate or necessary when the client’s/patient’s condition is determined by the massage therapist to be beyond his or her scope of practice, skills and training
•Formulation of an individualized treatment plan based on client/patient assessment findings
•Application of therapeutic modalities that include hot and cold applications (such as heat lamps, compresses, ice or hot packs, stones, etc.), hydrotherapy.
•Application of therapeutic procedures that include topical nonprescription applications (herbs, salts, sugars, poultices, muds, packs, etc.), body wraps (for therapeutic musculoskeletal and wellness/constitutional intentions), tools, electric massagers, aromatherapy and application of tape for the purpose of therapeutic benefit that does not restrict joint movement
•Using emollients, lubricants and friction-reducing products, such as oils, gels, lotions, creams, powders, rubbing alcohol, liniments, antiseptics, ointments and other similar preparations
•Documenting a client’s health history, intake interview, assessment findings, treatment and treatment outcomes, as appropriate.
•Obtaining a client’s/patient’s informed consentprior to initiating treatment
•Using guided relaxation techniques for the intention of facilitating and enhancing application of massage therapy
•Offering specific suggestions and recommendations of selfcare and health-maintenance activities including, but not limited to, self-massage, movement, self- administered hydrotherapy applications, stress reduction and stress management techniques, stretching activities, structured breathing techniques, progressive relaxation and meditation.
•Ethical business practices, which shall include,but not be limited to,full disclosure of fees and payment policies with the client/patient prior to providing massage therapy
•Intra-oral and intra-nasal work with separate informed consent to address the specific considerations (All other manipulation of soft tissue is limited to external tissues.)
•Female breast massage, with separate nformed consent to address the specific considerations
What Is Not Included in the Scope of Practice
The following are NOT included in the Scope ofPractice of Massage Therapists:
•Diagnosis of medical or orthopedic conditions or illnesses
•The performing of surgery or other procedures requiring a medical license.
•The prescribing, changing, dispensing and administering of legendor over the counter drugs orherbal medication
•Genital, intra-anal, intra-vaginal manipulation or applications
•Manipulation of any body structure for the purpose of sexual arousal or gratification
of either the client/patient or therapist regardless of who initiates such activity
•High velocity/low amplitude
thrust force to any articulation of the human body as
performed in chiropractic, osteopathic or naturopathic adjustments
•Application of ultrasound, electrotherapy, laser therapy, microwave therapy, injection therapy, diathermy or electronicnerve stimulation.
•Depilation, waxing, hair extractions and electrolysis
•Acupuncture and Chinese Pharmacology.
•Moxibustion through the use of needles.
•Diet and nutritional counseling, including the recommendation of vitamins, supplements and other neutraceuticals
•Prescription of therapeutic strengthening exercises, including Personal Fitness Training, Tai Ji Quan (T’ai Ch’i Ch’uan), Qi Gong (Ch’i Kung), Yoga Instructor Training.
• Psychological counseling
•Guided imagery intended for counseling or psychotherapeutic processing
•Homeopathy, which includes Bach Flower Remedies
•Cosmetology or the specific practices intended to beautify the skin.
•Colonic irrigation and other methods of internal hydrotherapy
•Intentional use of techniques to evoke an emotional response in the client
The list of therapies and disciplines described above is not exhaustive.
represents practices that are not within the scope of practice for massage therapy, they
may provide benefit for
. Massage therapists can and often do learn
and obtain appropriate licensing and certification to practice and add these disciplines to
their “tool bags” within their practice. Massage therapists are expected to meet all legal
expectations and requirements of the jurisdiction in which they practice their disciplines
prior to implementing them in practice