resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Weighing in on Weight Loss
If your practice trends anything like the U.S. population, you are probably noticing over two-thirds of your patients could benefit from weight reduction, particularly if their main complaints include chronic back or joint pain.
Qigong to Empower Our Youth
Qigong is an ancient form of exercise and meditation used to promote longevity and health. This practice has traditionally been used by adults to balance the body through mindfulness, focused breathing and gentle movements.
Common Disorders of the Temporomandibular Joint
The evaluation and management of craniofacial pain is a complex endeavor, which often encompasses the presence of temporomandibular joint disorders.
Grape Seed Extract: A Multifaceted Herb for Promoting Healthy Circulation
One of my favorite herbs is grape seed. Modern research has identified some intriguing health benefits attributable to the seed of this ancient fruit. I particularly use grape seed as an extract standardized for OPCs (oligomeric procyanidins).
Peer Points: Spreading The Word
Pedram Shojai describes his venture into Traditional Chinese Medicine as a journey led by various "mystical experiences." Shojai decided to change the course of his career when he looked deeper into the basics of TCM.
Gaining an Independent Occupational Code with the U.S. Bureau of Labor Statistics
One of the most important national activities currently taking place in relation to the development of the field of AOM profession is the Department of Labor's Bureau of Labor Statistics' (BLS) revision of the 2010 Standard Occupational Classification (SOC) system.
The Urinary Bladder Official
The Bladder Official is known as the Official Who Controls the Storage of Water. In Western medical terms, this organ collects the urine excreted by the kidneys.
Don't Believe It
One of our staff came into my office last week, very concerned about an article she had just read on a news media website. The article suggested researchers found "no health benefits" associated with taking multivitamins.
Asymmetrical Pronation: Effect on Adjustments
When your patients don't respond as well as expected to their chiropractic adjustments, oftentimes there is a source of interference in the pedal foundation – asymmetrical pronation.
Acupuncture Ambassadors: A Chat with Leader Anthony M. Giovanniello, MSAc,LAc
When you first meet Anthony Giovanniello, you realize he's a humble practitioner, yet is bursting with a type of dedication that you can't help but be overwhelmingly inspired by.
The Power of Words: DCs Share Drug-Free Approach
There's no doubt that words are powerful and important – especially in the chiropractic profession, where we have been struggling for years to find the right words to describe who we are and what we do.
Diagnosing Flexion-Intolerant Lower Back Pain (Part 2): Exercise Rehab
One of the things that has puzzled us for years is the presentation of the flexion-intolerant patient. We have realized there is a large overlap with sacroiliac indicators. In acute lumbar pain, the SI often twists, subluxes, goes haywire.
Preserving the Natural Resources and Culture of Chinese Herbal Medicine
As the world experiences unprecedented population growth and ever-increasing ecological pressures, the topic of preserving Chinese medicine's natural resources has attracted steadily increasing attention from practitioners.
Using Facial and Scalp Acupuncture To Treat Neuromuscular Facial Conditions
As a practitioner and instructor of facial rejuvenation acupuncture I have gotten many calls over the past 10 years from individuals seeking help for various conditions affecting the facial muscles, nerves, and overall function of the face.
VA Names Sites for Pilot Chiropractic Residency Program
The Veterans Administration has announced the five VA medical facilities that will serve as initial sites for the administration's recently established pilot chiropractic residency program.
Giving Testosterone Levels a Boost (Part 3)
Since testosterone and insulin status are inversely correlated, it's important to keep insulin low so testosterone will remain high.
News in Brief
Patriot Project: Serving Those Who Served; CTCA Chiropractor Receives Clinical Innovation Award.
The Deficiency Myth
If you went to the same kind of medical school I did and took the same kind of licensing exam I took, you were trained to seek out and expect to find primary deficiencies here in the U.S.
Managing Hallux Hypomobility Disorders (Part 2)
In part one of this series we discussed the unique properties and significance of the first toe in the propulsive phase of gait. In particular, we discussed the importance of the first metatarsophalangeal joint (MPJ).
Embracing the Light
Four years, ago I was diagnosed with a labral tear in my hip that was excruciating and "required surgery" according to an orthopedic surgeon. I tried everything and although the symptoms had mostly abated, I had to give up Yoga practice and everything that could exacerbate the tear.
Eucommia Bark Helps Maintain Strong Bones
Eucommia bark is a major tonic herb used in Asia, and now throughout the world, that supports and helps mend the skeletal structure and its related tissues. Eucommia bark is collected from Eucommia ulmoides trees that are more than 10 years old.
An Alternate Method For Choosing The Right Formula For Your Patients
A constant question for us in the clinic is when to make adjustments and when to stay the course. A patient comes in and says, "Things are the same as last week."
Gallop Confidently Into The New Year
Happy New Year! As you may know, this is the year of the Wooden Horse. I received a wonderful gift for Christmas. It is a beautiful glass sculpture of a horse, by Luili Gong Fong, a Chinese artist.
Ever Heard of the Lateral Raphé?
We have all had acute patients enter our offices listing laterally to the side at the level of the lumbar spine or expressing pain on lateral lumbar bending.
March, 2005, Vol. 05, Issue 03
What Scope of Practice?
By Ralph Stephens, BS, LMT, NCTMB
Most professions clearly stake out a scope of practice and then work to expand it. They work to plant it into law in each state and then grow it at every opportunity. Not the massage profession.We have consistently avoided defining our scope of practice. Our national leadership has consistently refused to draft model legislation and work to pass a standard law in every state so practitioners can have mobility, and the public can depend on a massage professional to meet consistent competency standards. Instead, volunteer therapists in each state have written their own laws from scratch, with minimal, if any, guidance. In the last two years, both the AMTA and ABMP have published some models, but they are suggestions - more guidelines than goals to accomplish.
Most massage therapists do not understand the legislative process and the nuances of drafting practice legislation where words mean something and a lack of words means something; mistakes have been made, not learned from, and made over and over, wasting years, thousands of dollars, and countless hours of effort. For proof of this, consider the hodgepodge of inconsistent licensing laws that have been passed, some of which are more of an impediment than benefit to practicing professionals.
In some states, teaching a seminar entitled "Medical Massage" is against licensing regulations. Due to poorly written laws, in some states, massage therapists cannot practice CranialSacral Therapy; in other states, stretching and exercises have been removed from our scope of practice. Some of our best educators cannot teach in some states because the way they practice the strokes (the same used by all forms of touch therapy) is not described or titled "correctly." Quite honestly, this is an embarrassment.
Whenever we have been challenged, we have given up scope of practice. Our scope is now more restrictive than it was 20 years ago. Some of our licensing efforts have become nothing more than a tax to practice, in some cases a voluntary tax. Want a license? Here you go. Don't want one? Fine - do your thing. The few good state licensing laws are constantly under attack, and there appears to be little effort by the professional associations to defend what we have, much less go for more.
Unfortunately, we are so politically correct that we dare not offend anyone. Since any time a group takes a stand on something - right or wrong - it offends someone or some other group, the massage profession has been very careful not to declare a meaningful scope of practice, a meaningful definition of our profession, or a meaningful piece of model legislation. The absence of leadership is not due to incompetence. Consciously or unconsciously, it is driven by money.
Nothing had better get in the way of the cash flow. The cash flow comes from anyone and everyone getting in easily and quickly. Zip them through school, sign them up in some association, sell them an insurance policy and maybe a license. In a few years most fail because of a lack of skills in both technique and business management; however, they are replaced by even more, quickly trained therapists.
The legal environment does not really matter; in fact, better for it to be muddled. As long as we can push some oil around and use the word "therapeutic," the system works very well for the system. "The mill" grinds up therapists, while the regulators, insurance vendors and associations fleece them. The 500-hour standard is a joke - it's not even long enough to be recognized as a profession by the government, which always sets the lowest possible standards for everything (well, except for taxes). Yet, a significant number of people in this profession feel 500 hours is too high.
The only thing saving this profession is the incredible power of caring touch, the good hearts and intentions of the majority of the people entering this profession, and the far too few excellent schools, whose owners really are dedicated to quality training and to the profession. Sadly, most of these owners have been therapist/educators for a long time and they are nearing retirement. When that generation hangs up their towels, I wonder who will carry on? Oh well, the cash flow won't go down without a fight. Corporations and bureaucracies are very good at maintaining the status quo. That said, may I suggest what I think our scope of practice should be? (Since it is my column, of course I can!)
The scope of the medical massage therapist or any massage therapist/bodyworker is simple. We should have the scope of practice to assess and treat - yes, treat - minor myofascial complaints. "Minor" meaning surgery is not required. (So the complaint can be major to the person with it! But surgical intervention is elective, not required.) Myofascial - meaning muscles, tendons, ligaments and fascia.
To do this we treat (there's that "T" word again) the soft tissues and the tonus mechanism (system) of the body using manual manipulation methods; stretching and movement; hydrotherapy; mechanical/electrical devices, which effect muscle tonus; nonprescription medications (homeopathy, herbals, supplements, etc.); and nonprescription topical applications. This is clear, simple, concise, and very open. If you think about this, you will realize what an incredible scope this would give us. I'll bet we could get that (and more) in every state with well-written legislation and the support of our patient base. Of course, to get it, we may have to increase training and competency. (Uh-oh. That will threaten cash flow. Sigh.)
Yes, this would probably mean a split in the profession to separate the amateurs from the professionals at both the school and therapist levels. The professionals might have to be divided into relaxation and therapeutic levels. Not necessarily, but probably. More training coupled to competencies, not just hours, will likely be required.
Obviously, this is an editorial / philosophy column. It is not intended to impose anything on anyone but to create awareness, plant seeds and encourage you to think. Keep thinking. I'll be back with more for May Day.
Try This: When faced with a complicated or seemingly difficult patient complaint with an intimidating diagnosis, approach the patient lovingly and respectfully, giving him/her your undivided attention. Respecting all applicable contraindications without causing pain (discomfort is ok, but pain is not), work to reduce muscle tone, ischemia and trigger points, increase circulation, and restore range of motion. By normalizing soft-tissue and movement, it is amazing how many complaints quickly lessen or go away.
Click here for more information about Ralph Stephens, BS, LMT, NCTMB.
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