resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
A Major Role in Back Pain: The Multifidus
Back pain affects roughly 80 percent of the population at one time or another and is one of the leading causes of doctor visits.
A Daily Strategy for Heavy-Metal Detox
In modern society, we are constantly exposed to heavy metals such as cadmium, lead and mercury. These heavy metals have no essential biochemical roles in our body, and conversely, can cause us a great deal of harm if they build up to toxic levels.
News in Brief
ACA Adopts New Governance Model; ACA 2017 Awards; CCA Helps Calif. DCs "Share the Love"; $1 Million to Help Advance the Profession; D'Youville Raises the Bar on Anatomy Education; ErRatum.
Raditation & Your Smartphone: Is it Worth the Risk?
If radial arteries could talk (and in my experience they can to some extent), they would say, "Step away from the smartphone." At least that is the message I am receiving loud and clear as I feel the pulses of many patients.
Taking the Chiropractic Message to the Press
"There is no better place on earth to have a news event," the National Press Club boasts, and it's easy to understand why: Every year, the 108-year-old Washington, D.C.-based organization hosts countless press conferences on the hottest topics impacting America and often the world.
Clearing Blocks: A Way to Improve Cosmetic Acupuncture
As a Five Element acupuncturist who teaches facial acupuncture classes nationally, I was surprised to learn that one of the basic principles I was taught in school is unfamiliar to most acupuncturists.
Is It Time to Rethink Mental Illness? (Pt. 1)
Invariably, patients will ask their chiropractor about depression or various mental illnesses. Some practitioners will reflexively offer a cervical adjustment, suggest St. John's wort or contemplate a referral to a specialist.
Creating Good Business Buzz
What do patients really think about working with you? Rarely do you hear the whole truth. Those who improve may be candid in their gratitude.
Is the New Medicare Reporting Exemption Right for You?
What you've heard is not a rumor – there will be exemptions for providers of Medicare patients, with no penalties assessed for offices that do not do Quality Payment Program (EHR, PQRS, MACRA and MIPS) reporting.
Give Yourself the Digital Advantage
When you see this article in the print version of this issue and swear you read it already, don't be alarmed: you probably did. That's because by that time, the May issue will have been available online in digital format for three weeks.
An Integrated Approach to Chronic Pain
Findings from a unique Medicaid pilot project in Rhode Island involving high-use Medicaid recipients from two health plans were recently presented to the state's Department of Health, demonstrating stellar outcomes with regard to medication use, ER visits, health care costs and patient satisfaction.
Balancing Spring Challenges
As the winter months come to a close and warmer spring weather appears, patients may begin to present with new challenging pattern presentations.
Universal Design: Principles & Practice
In many respects, universal design serves as the core of ergonomics. It's also a good tool to use when designing a return-to-work program for injured and/or ill patients. Let's take a closer look at universal design and why it should matter to you and your patients.
Women's Hormones: A Western & Eastern Perspective
Sometimes it may seem that you require a degree in medicine to understand hormones and how they function.
New Relationships, Old Trauma: AOM & Other Healing Strategies
Being in love is one the most beautiful and enjoyable experiences. Most of us are willing to pay almost any price to have that experience, and still often find it elusive or fleeting. Navigating the ups and downs of loving relationships are often challenging — even for the most psychologically balanced among us.
Bill With Confidence: Learn What to Collect
Q: I am trying to understand what I may collect from my patient when there is insurance. Do I have to accept the amount allowed by the plan or may I collect up to my billed amount? Please note, I am not a member of any insurance plan.
Eczema & Acupuncture: A Sound Solution (Part 1)
Eczema affects approximately 3.5 percent of the global population and is one of the most common skin complaints seen by dermatologists.
The Visual Error Scoring System: A Concussion Tool
Postural stability and oculomotor function are the most easily recognized physical indicators of neurologic motor dysfunction associated with concussions.
Why I Quit Doing House Calls
My father was a chiropractor who did house calls, so when I became a DC, I figured doing house calls was part of the job. My March article recalled my experience as a small boy, accompanying my dad while he went to patients' homes to treat them.
April, 2002, Vol. 02, Issue 04
Scope (Not the Mouthwash)
By Cliff Korn, BS, LMT, NCTMB
"Scope of Practice" is a term that, like many others, seems obvious, but means different things to different people. Strictly speaking, a scope of practice is the legal limit of practice options available to a regulated practitioner.However, in common usage, associations develop scope-of-practice guidelines for professionals in a field independent of regulation. A practitioner's scope of practice is predominantly measured by definition, and definitions change depending on who is doing the defining. Laypersons and regulators may define terms we use internal to our work differently than we do.
An example of this can be found with the term "massotherapy." From a school website comes this definition: "Massotherapy is a scientific method for treating disorders of the human body through manipulating the soft tissue, by hand or other modality, to affect relaxation, relieve pain, increase range and mobility of joints and ligaments, reduce certain types of edemas, affect blood and nutrition, improve metabolism, promote circulation, and beneficially influence the nervous system." Another school's site defines the same term as: "Massotherapy is a hands-on application that consists of a number of techniques executed on living tissue with the objective of promoting a general well-being. This type of therapy has an effect on the skin, muscles, tendons and ligaments (referred to sometimes as soft tissue) and aims for a physical as well as a psychic well-being since the last two are closely related." Yet a third defines it as the following: "Massotherapy is massage therapy or a systematic and scientific manipulation of the soft tissues of the body."
They all make the term seem pretty synonymous with "massage," don't they? My favorite choice for definitions is Webster's New World College Dictionary, Fourth Edition. My copy defines massotherapy as "a physical therapy by means of massage." My guess is that individuals looking to initiate state regulation/licensing of massage would get fewer objections from the physical therapists if they studiously avoided Webster's definition!
Individual state regulators can and do choose how they wish to define terms and scopes of practice. This can drastically affect a scope of practice from one jurisdiction to another. A classic example of this is colon hydrotherapy, which until recently was (in one state) not allowed in a licensed massage establishment, while in a different state required those performing colon hydrotherapy to also be licensed massage therapists. In another state, a practitioner of massage may treat temporomandibular joint dysfunction only if a physician has directly referred the patient in writing for such treatment. One state allows the application of non-prescription topical substances on the body within its scope of practice. This has led massage therapists there to offer facial massage, which really irritates the estheticians, who consider the word "facial" to be theirs alone.
Certainly massage therapists deal with overlapping scopes of practice all the time, but regulatory definitions, scope limitations and educational requirements make it particularly difficult within the broad umbrella of massage therapy. Many well-meaning massage boards have developed broad massage definitions so that other professions aren't able to exclude massage therapists from the conduct of emerging advances in the field. A side-effect of this is that many people get swept up in the regulations that feel like they don't fit a definition of massage. Reiki practitioners in all but the most hard-nosed jurisdictions have been able to exempt themselves from most massage definitions. Other methodologies, which frequently wish to opt out of massage regulation, are reflexology and polarity. They make strong cases for not fitting the definitions of massage in many instances, but my trusty Webster's defines reflexology as "a practice involving the use of acupressure or massage of the hands or feet to relieve pain in other parts of the body, reduce tension, etc." The International Institute of Reflexology also lists itself as approved for continuing education by both the Florida Board of Massage and the NCBTMB. Do you think a regulator or layperson reading that definition and noting those approvals would see the merit in granting reflexology an "out"?
Similar difficulty with structural integration, Bowen technique, Asian bodywork, Trager, watsu, CranioSacral Therapy, etc., stems from differences in definition. One I found humorous was Webster's definition of Rolfing. It states, "service mark for a form of painful massage intended to relieve emotional tensions by relaxing and repositioning the muscles." My guess is that the Rolf Institute's public relations team will soon be petitioning Webster's publisher for a definition change!
The differences in state-by-state definitions and scopes of practice are particularly stressing to massage therapists. As a group massage therapists tend to be a mobile lot and the ability to cross state borders relatively seamlessly should be a boon. An organization had been in place to attempt to find common ground in regulatory language. Unfortunately, the National Alliance of State Massage Therapy Boards is all but dead. It has no leadership and no plans to meet again. Perhaps there can be a grassroots effort to get it re-established.
Thoughts on scope of practice are always affected by definitions. Here are a few (from Webster's, of course!) to ruminate on when next you are discussing the benefits of accepting or rejecting regulation, embracing or delaying continuing education, or contemplating whether you are a professional or a hobbyist in massage:
My high-school biology teacher used to use a phrase that still stays with me: "Ontogeny recapitulates Phylogeny." It refers to life cycles of individual organisms affecting the life cycles of groups of organisms. When we choose to define our scopes of practice, we affect more than just ourselves. As that teacher was alluding to with his jargon, what happens to one is indicative of what happens to many!
Massage Today encourages letters to the editor to discuss matters relating to the publication's content. Letters may be published in a future issue of Massage Today. Please send all correspondence by e-mail to , or by regular mail to the address listed below:
Former editor of Massage Today, Cliff is owner of Windham Health Center Neuromuscular Therapy LLC. He is nationally certified in therapeutic massage & bodywork and is licensed as a massage therapist by the states of New Hampshire and Florida. Cliff is a member of the International Association of Healthcare Practitioners; a professional member and past president of the New Hampshire chapter of the American Massage Therapy Association; a certified member of the Associated Bodywork & Massage Professionals, Inc.; and a past chairman of the board of directors of the National Certification Board for Therapeutic Massage & Bodywork.
Join the conversation
Comments are encouraged, but you must follow our User Agreementcomments powered by Disqus
Keep it civil and stay on topic. No profanity, vulgar, racist or hateful comments or personal attacks. Anyone who chooses to exercise poor judgement will be blocked. By posting your comment, you agree to allow MPA Media the right to republish your name and comment in additional MPA Media publications without any notification or payment.