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Massage Today
May, 2003, Vol. 03, Issue 05

Who Owns 'Manual Therapy?'

By Cliff Korn, BS, LMT, NCTMB

I just read an article in Dynamic Chiropractic, the sister publication of Massage Today, that sent chills down my spine. The article, "Can Kansas PTs Perform 'Manual Therapy'?" [] reports on a Kansas PT bill many DCs believe will usurp the chiropractic scope of practice if passed.

According to the article, "The bill, which has already passed the state Senate, includes language that could allow physical therapists to perform manipulations on patients," and "Of importance to the chiropractic profession is an amendment that would revise Kansas law and add 'manual therapy' to physical therapists' scope of practice." The article notes that the Kansas Chiropractic Association is working feverishly to defeat the bill.

I'm sure regular readers of this column see the implications of this unfortunate chiropractic grab for power.

It underscores the need for broad scope-of-practice language in massage therapy practice laws. Can the chiropractic profession be so self-conscious and unsure of its abilities that it feels threatened if it can't completely block any other profession from the use of "manual therapy?" Can it not recall the restrictions put on it by the allopathic community just a few decades ago? Now that it has won that war, is it adopting the posture of its former adversaries?

The argument supporting this unfortunate abuse of power is a Kansas statute that states individuals who "adjust any misplaced tissue of any kind or nature, manipulate or treat the human body by manual, mechanical, electrical or natural methods" are engaged in the practice of chiropractic. In discussing the term "manual therapy," a Kansas chiropractor noted, "The current definition for the treatment called physical therapy does not include this term. The reason seems obvious - it is included in the exclusive scope of practice for chiropractors." [My emphasis added.]

I see a real danger here. If one assumes Kansas chiropractors are not operating in a vacuum, it is apparent that massage therapists in all states must be vigilant in ensuring their right to work. A title-protection or freedom-of-access law won't necessarily keep the lawyers from having a field day if onerous language supported by Kansas chiropractors affects you. Only a practice act that guarantees scope of practice will provide any protection at all. Who in the world do these people think they are? Have they never heard of overlapping scopes of practice? They don't own the words "manual," "manipulation" and "therapy," any more than any other caregiver does. In my own practice, I "adjust misplaced tissue" daily, and so does every massage therapist I know. We all use manual therapy, manipulate soft tissue and mobilize joints. If the chiropractors want to protect their turf by excluding high-velocity, low-amplitude (HVLA) thrust techniques from other practitioners' scopes of practice, they operate from a position of strength. If they want to restrict the use of manual therapies from other scopes of practice, they operate from a position of folly.

I sincerely hope Kansas chiropractors are operating independently of their associates in other states. I also hope the average chiropractor is confident in the capabilities and benefits of chiropractic, and finds it unnecessary to deny other professions their overlapping scopes of practice. However, as long as stories such as this keep surfacing, we must remain vigilant in protecting our right to practice. It's hard enough fighting city and state officials who can't get it out of their heads that massage and adult entertainment are not synonymous, but now it appears we also need to fight other health-care professionals who appear threatened that we may bring more cost- and result-effective therapies to the marketplace.

With all the fighting going on in our nation and the world, I would prefer we come to an understanding between professional therapists and the different modalities we have available. We all have something to offer, and we may overlap at times, but our differences make our professions unique, and our similarities should keep us working together, not against each other.

Thanks for listening!

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:

Massage Today
P.O. Box 4139
Huntington Beach, CA 92605

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.


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