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SUMMER 2014 ISSUE

CONTENTS
Features
COVER
Focus: Ontario
14
p14
Onward and upward

Breath of life 18

Coming out 22
of the shadows

Separating fact 24
from fiction

p18
Departments
p24 From the editor 5
Touch Points 6
Industry news and events

RMT Tech Talk 30
Reading the fine print

Columns
The learning curve 10 On the Cover:
Our stories matter Andrew Lewarne, executive direc-
tor and CEO, Registered Massage
Therapists’ Association of Ontario
Few and far between 12
Under the sea

MASSAGE THERAPY CANADA • SUMMER 2014 3

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An undertaking as big as this needs the support of all stakeholders involved. RETURN UNDELIVERABLE CANADIAN ADDRESSES TO CIRCULATION DEPT. President and developing a nomination process for the appointment of the initial board of Mike Fredericks • mfredericks@annexweb.O.com Mari-Len De Guzman Editor @MTCanadaMag MASSAGE THERAPY CANADA • SUMMER 2014 5 . it also compels educational institutions to raise the standards of their – 2 Years $49. All advertising is subject to the publisher’s approval. Opinions expressed in this magazine are not necessarily those of the editor education. Published and printed by planning committee. 105 Donly Drive South. Early this year. the MTCFA is expected to begin the accreditation process Annex Publishing & Printing Inc. – 3 Years $64.” has commenced the work of incorporating Account Co-ordinator the MTCFA under the Not For Profit Corporations Act.com (519) 429-5173 • (888) 599-2228 ext. responsibilities and qualifications of board members.O.com I (905) 726-5445 t looks like national accreditation for massage therapy Publisher education will be commencing as early as 2015. ON N3Y 4N5 non-regulated province. BOX 530. Box 530.. If you it looks like the entire profession is rallying behind this – and why not? A national prefer not to receive this information.com directors of the MTCFA. Box 530.95 This will also open up more opportunities for massage therapists as practice (includes GST . Massage Therapy Canada will mail informa. currently led by the “founders’ group. ON N3Y 4N5 and appointments to the first MTCFA board. please contact our accreditation body for massage therapy education signifies that the profession is all circulation department in any of the four ways listed above. All rights reserved. the MTCFA launched the council website. SIMCOE. 239 The newly established Massage Therapy Council for Accreditation (MTCFA). criteria and process for selecting board PUBLICATION MAIL AGREEMENT #40065710 members. Group Publisher The founders’ group is also tasked with drafting the by-laws.com and updates on the progress of the founders’ group.ca. reprinted without the publisher’s written permission. ON N3Y 4N5 accreditation. nationally. or the publisher. and tion on behalf of industry-related groups whose products and services we believe may be of interest to you. developing the Martin McAnulty • mmcanulty@annexweb. and elevates the level of competencies of Tel: (866) 790-6070 ext. ISSN 1499-8084 National accreditation is the next best thing to massage therapy regulation. ISSue 3 from the editor Mari-Len DeGuzman • mdeguzman@annexweb. www. the Printed in Canada council will have accredited a total of 74 programs.. No liability is assumed for errors or omissions. The founders’ group Shannon Drumm • sdrumm@annexweb.com descriptions for the roles.O.massagetherapycanada.#867172652RT0001) mobility gets easier and recognition of their high standard of education becomes For USA and Foreign rates please contact Cheryl Nowe more pronounced. Mailing Address As of this writing.mtcfa. visit the MTCFA website at www. 105 Donly Drive South. Occasionally. April. Christine Livingstone • clivingstone@annexweb. July. Publisher reserves the right to refuse advertising that does not meet the standards of the publication.Editor Summer 2014 . ©2013 For updates on the development of the national accreditation for massage therapy Annex Publishing & Printing Inc. and Media Designer Brooke Shaw Corinne Flitton for the Federation of Massage Therapy Regulatory Authorities of Canada. As national accreditation elevates the level of education for would-be massage Subscription Rates Canada – 1 Year $29. ON N3Y 4N5 information about the planned national accreditation for massage therapy education.Volume 13. 219 consists of three stakeholder representatives: Randy Ellingson for the Canadian Council of Schools. Simcoe. the founders’ group is consulting with the massage therapy P. on its second year of operation in 2015 – starting with four program reviews and Simcoe. Such approval does not imply any endorsement of the products or services advertised.com (519) 429-5183 • (888) 599-2228 ext. community about a number of proposed documents: the process for nomination Simcoe.95 curriculum and effectively weed out the uncommitted and underperformers. 207 practitioners across Canada – regardless of whether they come from a regulated or Fax: (877) 624-1940 Mail: P. email: cnowe@annexweb.com par with nationally accepted standards. Lori Green for the Canadian Massage Therapist Alliance. November. and the description of the board members’ roles and responsibilities. It Circulation ensures that educational institutions teaching massage therapy programs are at email: cnowe@annexweb. which contains P. Massage Therapy is published four times a year: According to the October 2013 report released by the national accreditation January. grown up and is poised to become a significant player in the health-care realm – as it No part of the editorial content of this publication may be should be.95 therapists. The number of reviews will increase each year and by 2020.

Commenting on RMTAO’s ciation as part of the overall positive ment that there is a clear and unde. in this capacity. improve the quality of life and they will be led by the Rodney. our province is our people and Early Childhood and share their wellness pri. I encourage all Albertans to and wellness. ernments. the reason for the a part of the CMTA. tors that contribute to health – promoting the wellness of Development. together with the Ontario asso- “The RMTAO is in full agree.” compliant with the implementation tant part of the health-care sector in RMTAO. very much look forward to working sage therapy associations.” ticipation and membership in the for a unified national approach for withdrawal as “due to the amount “As well. initiatives. Let’s Talk about so much more that we can Wellness. Albertans is essential to our ness and shift conversations think about the possibilities “Wellness is more than not future. interest in taking part. a national Then RMTAO chair Amanda would like to move the profession comes the RMTAO’s decision to alliance of massage therapist Baskwill cited. of financial and human resources RMTAO would like to work MTC in an email. com. which all of us to work together as Wellness. compliance with the Not-For. Participants will have an addressing the social. Albertans can visit Approach to Wellness. for a unified national approach. families. in communities across the “Alberta has become a province.Touch Points INDUSTRY NEWS AND EVENTS Ontario rejoins national massage therapist alliance T he Registered Therapists’ of (RMTAO) has rejoined the Massage Ontario therapy presence. chair of the participate in this organization. James ports Alberta’s Strategic in our communities requires International Symposium on Talbot. Sparling said the dialogue within the profession. leader in disease prevention The province’s new and wellness. The Let’s Talk about we breathe and the choices Tobacco Reduction Strategy. Healthy U talkwellness. expressed the Ontario In deliberating to rejoin the of the Not-For-Profit Act as well as Canada and there is a clear need for association’s commitment to sup. including: associate minister of wellness. business and gov. The Government of care to the factors that con.” Sparling told the profession. schools. The true wealth of Poverty Reduction Strategy. Dave Rodney. 5&1 Experiment. standing of health and well. number of initiatives over Let’s Talk about Wellness Albertans to enjoy a greater munities and workplaces.” Bokalo on behalf of the profession. degree of wellness.” said Talbot. Bokalo said some of the any other necessary amendments national coordination to advocate porting and maintaining an open concerns voiced in recent board to its financial structure.” Bokalo said. the amazing opportunities for our families. and “The CMTA very much wel- Alliance (CMTA). engages resi. The RMTAO was previously a member of the CMTA until it Act to the alliance’s by-laws.” Canadian Massage Therapist withdrew its membership in 2011. in the past few years to help conversations begin this fall. cal officer of health. opportunity to join together nomic and environmental fac. “The massage In a letter sent to the CMTA. 6 MASSAGE THERAPY CANADA • SUMMER 2014 .” niable need for a national massage any future amendments to the CMTA is currently in the process of – Mari-Len De Guzman Alberta wants residents to talk about wellness A lbertans are invited to share ideas and inspire new ways to improve wellness orities this fall through local community events and online conversations. and chief medi. we make. “At this time. from the delivery of health we have to strengthen our being sick or hurt – it is some. We dialogue with other provincial mas. Profit Act and the integration of recent decision.” said our parks and playgrounds. the places we live. the air for Albertans. Dr. this important conversation. the RMTAO board of directors sees the necessity integrating the Ontario association with the national alliance and “will be proceeding as soon as possible. U-Walk. do – that’s why we’re asking dents and aims to broaden Albertans to participate in Albertans’ collective under. Wellness engagement sup. discussions had to do with the wrote in the letter to CMTA chair. Promoting wellness Get Outdoors Weekend. Social Policy Framework. outcomes for Albertans by munities. CMTA’s financial structure and Marilyn Sparling. the National Alliance. com. citing the necessity annual report. in the RMTAO forward by joining the discussion as enter negotiations for full par- associations.ca to express their aims to improve health individuals. collaboration and broaden thing we build together with Alberta has undertaken a tribute to wellness. that would have been required to towards ensuring the CMTA is fully therapy profession is now an impor- Krystin Bokalo. but there is program. CMTA. eco.

” said Massage in Fredericton. including in Moncton. the out that there are many who probably one of the biggest Act outlines the participation may fall just outside of college highlights that we’re working of all three associations and requirements. so we meet the work together and we had to province takes regulation of a requirements for the CMTO go in and accommodate the health profession they do that (College of Massage Therapists third. and that’s just a matter of economics. “So their The college is still in its early the same page. and in 2004 the two Canada. The Brunswick Massage Therapists Schools. Watson points to do college exams.” province. they’re well pre- get on board. or who may not with the college on right now. New Brunswick Massotherapy guess the timing was finally Atlantic College of Therapeutic “The future of the massage Association (NBMA) first decid. member in good standing of to take the entry exam with He said there are only four an association would become the new college. “We’re putting things to change and ratify things in efits to massage therapists. Health Practitioners of Canada there. And while it incorporated into the Act in education with locations across school because ACTM already will be actively trying to main- 1994. from being harmed. progress was halted relations advisor for the Natural Ontario and write exams tions. schools for the International dents at her school have noth. present and future stu. standard. what regulation means for pared. process as a “slow go.B. standards.” he explained. requiring an entry exam to the who are going to find the most of the other three provinces. in the air following regulation.New Brunswick gears up for regulation N ew Brunswick is now in full swing to establish the new college of massage Brunswick is still fresh and noth- ing has been set in stone as of yet. “Right is presently not interested in a legislative committee (JLC).” acknowledges that any current be able to go back to school MacKenney said. bers of the profession. president practitioners in the province.” John MacKenny. meets the national competency tain membership. right for it to go through. has weighed in on prepared. and their of the required six committee grandfathered into the new practice will now be set at a members in place now. therapy would be formed in a minimum amount of hours school and learn how to qualify The fate of the three pro- order to protect the public needed to reach the provincial for college entry are most likely vincial associations is also up and govern regulated mem. director of the past. to go in and be able According to Pierre Wust. before it’s fully functioning like the province’s massage ulated provinces. but speculation is that New going to choose not to be part of the college. see one association for the a lengthy process. outside of the college boundar. but not every- began in 1990 when the many years as I know. which they’ve been trying for as But Candace Gilmore. disadvantage. described the “I think it’s probably both ment in regards to ICT Schools. after its passage of Brunswick will operate along retire. government now our students can go to merger with the other associa- However. an institution special.” she said. the ANBMT associations formed the joint N. stages. So. because the third and final pro. the people one of the other colleges in one therapy profession. their together right now for new stu- order to make the third associa. So we had focus isn’t to provide better ben. ANBMT has currently over 400 (ANBMT) was then officially izing in massage therapy “This shouldn’t affect my active members. membership fees and trouble trying to go back to he said.” Watson said. These include: ies. some will try to practice be another 12 to 18 months Bill 25 last winter regulating the same lines as the other reg. The college. but I academic director for the one shares this sentiment. Brunswick is uncertain as there Act. entire province. because the government with the idea of protecting the of Ontario). Kathy Watson. New Brunswick Ministry of New Brunswick legislative assembly The situation in New “Some practitioners are Health has yet to put forward building in Fredericton MASSAGE THERAPY CANADA • SUMMER 2014 7 . our curriculum is established the two of us really needed to pists to understand that when a in Ontario.” positive and negative and it’s “It won’t affect us because “What had to happen was important for massage thera. is no requirement to remain a The Association of New Complementary Therapy (ICT) ing to worry about in regards member in any of them.” wanted everybody to be on public.” The college of massage college. Some will the final two people to be a part of the founding committee. ing and working in outlying MacKenney said he’d like to This legislation came after what of a surprise because communities. it’s going to therapy.” Wust said. That’s president of the ANBMT. Villeneuve echoed that state- of the NBMA. and very likely. However. to be the ones that are function. as far as them being – Jessica Beaulieu vincial association refused to (NHPC). “New Brunswick was some. said therapy associations in New ed to write the Massotherapy Florent Villeneuve. to passing the entry exam. focus is to protect the public dents and people entering the tion accept it. “Realistically.” Watson said.

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We need not just data. they too express reading journals and professional of other therapists. my clients. Yet. to evaluate. adapt and utilize the practices therapists tell me that those interactions our assessments of clients and. Canada is central and helpful. I have had many of the theories about how massage works. These learn the art of modifying these various CEU courses. We can the Registered Massage Therapists surprising. Most importantly. most theory and modalities. or adaptations that occur with various on occasion with those near to them Online searches can lead us to research impairments we see. who circumscribed explorations of technique. I know that without these conversations I would not be treating clients with all the tools I now have at my disposal.C. Learning about how other therapists practice in their clinical settings is without a doubt one of the most potent ways of motivating me to explore new approaches to treatment and to seek out new information. to the treatment plans we negotiate. case studies and the like. about such interactions. hence. with respect to what we do day-to-day therapists. and require seeing many of the same MTs. case studies wide range of national knowledge. Many more find that aspects of how we choose and perform so we can still see the unique inter- outside of fulfilling the requisite number an assessment. add this data to the mix of our current Association of B. most massage therapists for learning about what it is that others to learn to recognize the patterns that do not get such a wide and diverse are doing in our profession is what clients present with. This careful (For examples visit the Student Case will tell you that this collegial exchange collection of evidence brings about the Study Award page on the website of is one of the benefits. a treatment relationships of adaptations of each of CEU hours they have little contact plan and the like. individual client. learn to recognize sampling of what other therapists are sustains professional journals like this common patterns of compensations up to. a technique. in certain circumstances) when possible. I am fortunate to have this I have been wondering how we could But from research and its evidence we opportunity for collegial interaction and expand our contact with each other cannot get what we need most to be ongoing learning. Meeting with massage therapists from around the country and talking about clinical practice has always inspired me to read up on the various modalities and techniques they use. It is one of publications like Massage Therapy own clinical experience of trial and the perks that we get from travelling. attending annual provide us with valuable information commonalities (or to know when to general meetings or going to conferences with which we can re-evaluate certain abandon them. a good deal of time to put together. and/or get to meet others when taking articles.The learning curve BY DAVID ZULAK Our stories matter Creating knowledge-sharing opportunities for massage therapists I am fortunate that teaching continuing education unit (CEU) courses gives me the opportunity to travel throughout Ontario and the rest of Canada during the year. When speaking with other presenters in our clinical practices. Even varying degrees of evidence concerning are quite formal in nature. We need to learn from the experiences that I meet on the road. Certainly. with the diverse number of those in The formality inherent in research Case studies might come to mind as our profession and therefore miss the studies and case reports can present possible sources. we need However. This helps me Unfortunately. Many therapists may interact publication. often hidden or science of massage therapy. However. and techniques that I feel will benefit seem few and far between.) They do take place 10 MASSAGE THERAPY CANADA • SUMMER 2014 . lengthy when taking CEU courses they are often causative certainty within very (20 to 40+ typed pages). This need error. already share their interests. along with our much the same sentiment.

I believe that what we also need is summary of several – all to sketch out Or. “Field notes record feelings and intuitive hunches. that may show with experience in the field that we is pertinent to the story). Yet. it could be a place to just find something a little more grass roots. what it is that many of us are up problem or question that keeps to. to do such a project as part of their abroad could contribute to and access.A. and when? Do others also use. All of us need to hear how others interesting events that happen in the treatment and advanced make their treatment choices. how we put it all together in the Posts in this online community majority of his teachings moment. and no comment on another limit variables. do they use one model. While I believe it would be good for all questions. could also include a collection of those focus on clinical assessment. speaks to the art of massage therapy. for example.” So many massage therapists work on their own and do not often have opportunities to consult with peers. mind-boggling or inspiring book Comprehensive Assessment for to supply the context for assessing stories about our work occurrences Massage Therapists. He is the author of the text- theories or models do they draw on amazing. a the context – and then a short write-up out that there are others who have little more accessible. judgement. it is a lot to expect from most A submission could include a few Such a site could be a place to hear practicing therapists. training. or topics of research for those so inclined.in a clinical situation. If not. Something that popping up but for which one seeks an David Zulak is a RMT. They record testimonies. They Having a place online where other These stories will require no review. techniques. They can be great sources field notes could possibly help provide field report. experienced the same thing – a place which any MT could contribute to in a lesson learned. on occasion) to treat trigger points? What are the innovative and creative approaches that others have found to work in specific situations? What I have in mind is a database that contains what would technically be called “field notes. frustrating. we do. The only restriction is that of ideas for potential research projects. S. and suggest would hope to hear. and document the work in progress. Ont. by Susan Soy. What clinical setting – humorous. leave an email address. but they are insulated by distance from more diverse about.” Field notes are defined in The Case Study of a Research Method. and something in of an “experiment. no remain constructed scenarios that try to therapist can send informal reports or critique. a reservoir of stories. He works in a busy and treating. or give an early signal that a pattern is emerging.O. They assist in determining whether or not the inquiry needs to be reformulated or redefined based on what is being observed. explore it and report the results. experiences. 1997. they not be of professional misconduct. it is from those sketches of the client (especially what what others are up to.P notes of a treatment. Strain Counterstrain followed by stretching (employing contract-relax. or several. answer. the brief trends in our profession. stories put out there without required to articulate a specific thesis. The That is. Others may have small informal groups they can consult with but may be MASSAGE THERAPY CANADA • SUMMER 2014 11 . contact. an observation that for stories that we can share with fellow order to share the stories of what it is changes one’s perspective or a persistent massage therapists.” a novel approach. stories. If massage therapy students to be required therapists across the country and a therapist wants feedback or a debate. and illustrations which can be used in later reports. author and educator. across the country. that’s ok. that we just would like to tell someone group clinic in Brantford. They may warn of impending bias because of the detailed exposure of the client to special attention. pose questions. and suggestions that either in the content or in the telling.

And then there’s seaweed. edible seaweed extract used as a thickening and gelling agent in dairy products like ice cream. I expected a woodsy-chalky. one can find the likes of Irish seaweed scrub. The spa menu is delicious: a spruce and pine-scented relaxing and calming sensations. There are also algae body polishes with pine oil. salt and almond oil Beauty in Ireland. maple sugar scrubs and detox seaweed foot rescue balms. and Nova Scotia. Aqua Mer beeswax. there is a name and science behind seaweed. La Fille de la Mer on Gurney’s Montauk Resort & Seawater Spa in Montauk. for calming itch and serving as a protectant. is the only authentic thalasso centre in the United oil with ylang ylang – an essential oil known to stimulate States. and the amino acids boost protein synthesis and Wherever I travel. BOTTOMS UP When visiting Placencia. antioxidants. This summer. For an extra hit of sea serendipity. For east coast centurions. diet could be the underwater miracle. marine-focused spa offers niche treatments for nasal hygiene. the itinerary is not just about landmarks skin elasticity. anti-inflammatory battles. seawater hydrotherapy baths. Sometimes the seaweed is harvested in fresh water 12 MASSAGE THERAPY CANADA • SUMMER 2014 . B. known as the seaweed lady of Sooke Harbour. organic sunflower oil and pure organic Canada’s largest thalassotherapy spa. in Quebec’s Magdalen Islands. perhaps it’s time to take a deeper look at their origins. frankincense. Sea vegetables able to add to my seaweed aficionado repertoire by sampling were among the seven to 10 servings of fruit and vegetables “sea tea. Quebec. Magdalen makes handmade sea soaps and a Sea Kelp massage New York. and scenic vistas but also a carefully researched list of things to Seaweed products have also been linked to the longest-living sip and eat. Japan. The moss shakes are derived from carrageenan. warm spaghetti harvested from the island’s west coast. The SEAWEED 101 presence of copper. but with all of the recent hype surrounding the benefits of natural products. if you can’t get enough dulse. a red. viscosity. made from seaweed. a dulse-dense seafood cooked in seaweed-lined pots. it’s trending now. The too. they make a seaweed lip balm Thalassotherapie. Fresh brown commitment to 34 treatments in that time span. There are algae-based THALASSOTHERAPY cryotherapy sessions. anti-infection and speedy healing. is in Carleton-sur-Mer. it’s spaghetti. our daily routine involved stacks PHOTO CREDIT: JULES TORTI of banana pancakes and thick Irish moss shakes offered at The Shak. Two major products that massage therapists use – coconut oil and Dead Sea salts – rely on a geographically limited bounty. soak in a 94-degree sea water hydro massage thalasso tub after At Algaran Organic Irish Seaweed Products for Health and an invigorating coffee bean. are baths. zinc and iron gang up as a task force for Diane Bernard.C. seawater rain Yes. Belize. Their skin seaweed wraps.” The Magdalen sea tea is the leftover liquid slop from eaten on a daily basis.Few and far between BY JULES TORTI Under the sea Tracing the origins of ingredients in body products used in practice It’s easy to buy and use body products without considering the source. I’ll be populations in Okinawa. It’s a shake.. and for kissy-cool lips. seaweed and warm salt water are the authentic ingredients of thalassotherapy (“therapy with seawater”) elixirs. peanut butter concoction but was pleasantly surprised with the pleasing soy overtones and eggnog Seaweed farming is a huge industry for the women of Zanzibar. suggests a skeptical and informed approach to seaweed spa The vitamin compounds stimulate cell growth and act as treatments. a recent tonic that is making big waves in different parts of the world. cellulite and anti-tobacco management. a local beach café. massages and an intense itinerary for a five-day rehab requiring a it’s a moisturizer. After a chance encounter at a gas station off the Hummingbird Highway where I opted for the most radical choice in the cooler – a peanut sea moss drink – I was hooked.

They know hardship all too well.000. Low world prices made for an unsustainable market. striding with buckets on their heads. Bernard is picky for capsules and a bevy of spa indulgences. many have only elementary school education. each has Reading about the entrepreneurial spirit of the seaweed ladies an admirable story of perseverance. which was remarkable lance writer since age six. medicinal As president of Outer Coast Seaweeds.C. soap and moisturizing creams. In 1973. good reason: she supplies high-end restaurant kitchens across Seeing the women pass by daily as the tide came in and Canada and her product is served within 24 hours. which were more the shore in a washed-up composting clump). furniture polish. and high tide signals the day’s end. plans to introduce seaweed to Tanzania to create www. premium PROFESSIONAL Liability On the east coast. antibiotics. There. It should smell like the ocean but not for survival and fresh water is a fast and efficient destroyer).000 residents find steady employment harvesting Matador Network. negotiation. a seaweed grinder was acquired to enable the women to produce and sell their first soaps. If anything. In terms Next time you warm that oil in your hands and “suds up” of our own health and well-being. we had front-row seats to client’s massage experience to a new and educated level. Her seaweed engaging in conversation with them made the tangible final body products are hand-harvested and free of dyes. Irish seaweed lip balm or the ROAD TRIP TO ZANZIBAR ambitions of the seaweed lady of B. making it void of the inherent benefits found in destroyed the sensitive seaweed environment (salinity is critical naturally sourced seaweed. we have an underlying commitment to provide safe. As massage made me think about the origins of our body products at home therapists. seaweed. agar.000. and globally. 322 and how networking can attribute to distribution. Whether it’s a clove bar from Zanzibar. prior to ending up in your treatment room. we must also consider the post-treatment with soap. farmers. work is full force. Some of these women are single and LIABILITY (PLI) struggling to support a family. of Zanzibar was definitely part of the lure of visiting the Maybe you are already tuned in to the local scene and have archipelago off the coast of Tanzania. Africa.com • elisa@rmtinsurance. fishy (since this indicates that it may have been harvested from Two new species of seaweed were introduced. we would see the seaweed ladies pass by.000 metric tonnes of seaweed a year – all picked by hand. locally the tide tables. coverage we have ever offered! Seaweed can grow rapidly. Zanzibar produces 5. she travels to Africa to be with chim- Seaweed farming in Zanzibar is a huge industry for women panzees and writes about her zany travels for – over 12. The Seaweed Centre is the hotbed for drying and processing collected seaweed for juice.tanks or lakes. It certainly by-products. producers. buyers and packers and visualize their soaps and spa $25. and should not be resilient and gained better market prices for world consumption perfumed. in toothpaste. Like clockwork. origin. OFFICE PROTECTION Many women carry buckets or sacks weighing in at 10 kilograms – not an easy feat especially if you add a broiling 48-degrees Celsius to that weight. uneven footing and a four- $5.000 0 PROFESSIONAL kilometre picking route. consider these products’ path and products that we are exposing ourselves to on a daily basis. 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In 2010-2011. debate over professional identity still remains: made to improve the health-care system today. health-care relaxation versus therapeutic massage. it was in recognition of massage therapy as a form of health care. costs are due to preventable illnesses.” walking into your office. RMTAO believes massage therapy needs to opposed to proactive. “At the moment tem – as preventative health care will become more accessible we’re reactive. more “Massage therapy. be part of a larger conversation on improving Ontario’s overall such as what the RMTAO proposes. refer them to me. is more proactive and less health-care system – one that focuses on proactive prevention costly. tary and alternative health practitioners – covered under the Health Professions Act – for preventative health care. Ontario continues to play a leadership role in propelling the profession further up in the health-care chain. by government. Massage therapists and other alternative remains within the health-care realm.’” Despite being one of the most highly utilized forms of com.” for Ontarians. massage therapy’s complementary health services need to be partially supported recognition as a necessary component of the overall health. and those in the leadership roles RMTAO is engaging the legislative leadership to propose a within the profession are continuously trying to change that tax credit for Ontarians who use the services of complemen- for the better. cash-strapped health-care system in the long run. so we expect our vision is that it and if you want to get some really good responses to what’s they should enter the current health-care system. nearly a century later.000 hospital emergency room visits could have been among the complementary therapies. if you make it more treated in alternative primary care settings – at lower costs. PROACTIVE APPROACH Under the current system. (RMTAO). available then you know that people are going to use it and 14 MASSAGE THERAPY CANADA • SUMMER 2014 . massage therapy health-care model. Although massage therapy has evolved significantly through The Ontario government estimates that if no changes are the decades. putting less strain on hospitals and acute care Ontario Ministry of Health says 25 per cent of health-care services. Every provincial health plan seems reactive. professionals in Ontario and the provincial health-care sys- executive director and CEO of the RMTAO. and say. only health expense receipts in The Registered Massage Therapists’ Association of Ontario excess of $2. care system remains wanting. for this to succeed. spa setting versus health costs will increase by $24 billion by the year 2030. care setting. an organization of about 5. However.” says “That means we need to be partnering up.” says Andrew Lewarne. the profession as to how they identify themselves. and complementary health practitioners will be the ideal part- “I think there are still some conversations going on within ners for pursuing this goal of wellness and prevention.000 registered massage whichever is lesser. Disagreements notwithstanding. can be claimed for federal tax credit therapists. which is one of the most widely used than 271. registrar and CEO at the College of Massage able to turn around to the gatekeeper physicians.Focus: Ontario BY MARI-LEN DE GUZMAN Onward and upward Massage professionals’ push to take their place in health care W hen the Ontario Board of Regents first regulated the practice of massage in the province of Ontario in 1919.” A tax credit for preventative health care. the family Therapists of Ontario (CMTO). Today. effectively easing the financial pressure on an already and wellness promotion. here’s how we can do regulated health professionals. “What needs to be talked about in Ontario is that we need Lewarne sees this as a win-win for both massage therapy to look at a new health-care model.171 (for 2014) or three per cent of net income. is among those working to elevate the profession. Lewarne says alternative and plementary and alternative health services. we need to be Corinne Flitton. “The college sees them as doctor. and as far as Lewarne believes prevention is key to sustaining the country’s the Ontario regulatory college is concerned. To The RMTAO believes this current system is “reactionary as accomplish this. ‘here’s what we can do.

more than 11. will allow practitio.” tuting a degree program as of yet.000 RMTs. In response to aged to stain the profession in the eyes of insurers. and an easier way to determine potential fraud.” Lewarne says. coordinator at Centennial’s faculty of mas- prevent fraud. the curriculum was expanded to tion has been improving significantly in recent years. “And as that happens. you will map in health care. when implemented. as it is faced by practitioners in other provinces. “I suggested to the insurance industry that (the professional CREDIBILITY credential tracker) might not be a bad idea to put in place for A constant challenge that is certainly not unique to Ontario’s the extended health-care industry. fraud. Health Care Anti-fraud Association to ensure the insurance “(A degree program) is certainly a direction for our future. the MASSAGE THERAPY CANADA • SUMMER 2014 15 .” says Lewarne.” Lewarne points out. is a bruised credibility with the insurance EDUCATION industry. “Ontario is working as one stakeholder from the Federation This new system. Centennial offers a three-year Most recently. College is one of them. schools and was completed in less than a year. The situa. the profession is currently Ontario is also pursuing means of enabling regulated health. I think (having a degree) puts us on the need to happen. the RMTAO has engaged the Canadian advanced diploma program in massage therapy. to help prevent massage therapy education. It’s the consequence of malicious and fraudulent acts Massage therapy training in 1935 was only offered in private of a few unscrupulous practitioners that have effectively man.Massage therapists have a role to play in overall efforts toward disease prevention. a two-year program in 1987. sage therapy program. when they use it… the credibility of the profession is going to ners to have better control of their professional information go up. “We’re a regulated profession but we “These kinds of clarifications are really important and they don’t need a degree. of Massage Therapy Regulatory Authorities of Canada.” find that the responsiveness both to the insurance industry and Although there has been no concrete advancement in insti- from the insurance industry is going to go up. to submit auto insurance claims. in an effort to bring Canadian massage see which clinics or health facilities are using their information therapy schools up to national standards. advances in medical trends. The Financial Services Commission of Ontario is get. working on the next big thing: national accreditation for care practitioners. have taken an active role in engaging Many in the profession would like to see education evolve the insurance industry and educating them on professional even further into a degree program. and then further expanded to a as practitioners across the country. professional associations.” industry is aware of the steps and systems in place to help says Lori Copeland. including massage therapists. however. The recently formed Massage Therapy Council for ting ready to implement a professional credential tracker tool Accreditation seeks to establish national accreditation for mas- that allows health-care practitioners to do an online check to sage therapy programs. Toronto’s Centennial practices in hopes of aiding the reduction of insurance fraud. through their respective three-year program in the mid-90s.

” he explains. “CMTO wishes to encourage high quality research in mas- sage therapy.C. among other things. Mari-Len De Guzman is the editor of Massage Enabling professional mobility for massage therapists in Therapy Canada and Canadian Chiropractor the regulated provinces of Ontario. “It’s just becoming clear that we need to make that step. but the research needs to support the touch. because I want to have practitioners that are mature right out Centennial has been adjusting its massage therapy curricu. 16 MASSAGE THERAPY CANADA • SUMMER 2014 . and provide the foun- fident the graduates will be able to write the new registration dation for advancing the profession’s role in disease prevention. for example. be accepted and recognized across the country once the word gets out there. RESEARCH Research is another front that Ontario is actively pursuing. and has really taught to the inter-jurisdictional competencies will that’s higher up in the health-care field. according to Flitton. the labour mobility provisions in Ontario’s Regulated Health Professions Act. and Newfoundland magazines. Competencies and Performance Indicators.C. evaluation of MT practices. research should not be done at the expense of The accreditation council expects to commence the accredi. vital as the research itself. efficacy and safety. CMTO facilitates the registration of RMTs coming to practice in Ontario from other regulated Canadian provinces. exam with success. research literacy – that’s what needs to happen. one of the stand and evaluate the quality of scientific studies. fession forward. an annual national level research competi- tion administered through the Canadian Interdisciplinary Network for Complementary and Alternative Medicine Research. and sage therapy schools in Ontario begun mapping their curricu. developed and Expanding and developing massage therapy research will approved in 2012 by the three regulatory bodies for massage directly influence the profession’s credibility in the health-care therapy: Ontario. When the competency document was released in 2012.” says Lewarne.” Copeland says. without any need for further assessment of their program of study in massage therapy. Contact her at and Labrador has already been in place since 2009. field of massage therapy.” says Flitton. who is also a RMT. and Newfoundland and Labrador arena. part of the reason that I would like that step to be in place is lum to the new competency standards. However. tion a degree program. Canadian Massage Therapist Alliance and Canadian Council It is not just being able conduct research that is in vital of Massage Therapy Schools to establish the accreditation need for the profession. Copeland says it has not been A degreed program would also propel more research in the a huge adjustment on the part of the school and she is con. dition based on trust. B. notes Lewarne. but many schools in Ontario have “We have a huge tradition in massage therapy and it’s a tra- already began mapping their curriculum to the new entry. laboration with other health-care professionals. and massage therapy effectiveness. it’s the ability to under- agency and process. and so would making massage therapy educa- ment in 2015. This is about touch. of the gate. particularly in relation to professionalization of massage therapy. lum to meet the new standards. tation process by 2015. however.” he says.” largely due to the fact CMTO has announced it will begin Copeland and Lewarne agree that research will drive the pro- testing for registration based on the new competency docu. Practice mobility is expected to further expand to other juris- dictions as national accreditation becomes fully operational. The CMTO provides funding for the Massage Therapy Research Fund. “We need to actually have the The standards to be instituted by the national accredita. “At the end of the day it’s to-practice competencies document as early as 2013. according to RMTAO’s Lewarne. is as council.com. And that’s an tion council will be based on the Inter-jurisdictional Practice educational component. under mdeguzman@annexweb.” Copeland says.” explains CMTO’s Flitton. says Copeland. B. The only thing that will be required of massage therapists from another province seeking registration in Ontario is evi- dence of good character from the Canadian jurisdiction where they practiced and successful completion of the CMTO’s juris- prudence examination. mas. col- As the new president and CEO of the RMTAO. council “founders” tasked with incorporating the accreditation Research literacy. evidence based practice. tradition. Andrew Lewarne engages stakeholders in an effort to propel the profession forward. “As we get stronger in research and recognized as a degreed “The students and graduates who come from a program that profession. then we start moving where we need to go.

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If supine. the therapist inserts curled fingers along the inferior rib patient’s quality of life. to move on. inferior edge of the ribs. By curling their fingers and slowly leaning forward allowing their NEUROLOGICAL APPROACH ribcage to slip slowly over their fingertips. The best location to As with any extreme and prolonged physical effort. the the hip flexors. but each release may take upwards of two minutes. As the diaphragm further damage. Consequent muscle pain referral can result in low time and treatment are enhanced. they will achieve An effective method of reducing diaphragm holding can be results. With contraction. repeat the moderate involuntary sustained contraction of parts or all of the process laterally along the ribcage. we can make a difference for patients suffering from a respiratory condition. treatment is uni- diaphragm holding will pressure these structures. Because the liver sits compounding the patient’s misery.g. Self-treatment by the patient is best accomplished seated. However. the chitis. muscles commence is the lowest anterior edge of the ribcage. nate stress on muscles such as the scalenes. As with asthma. Struggling for breath is surely the most inca- pacitating and soul-destroying aspect of any illness. the therapist’s efficiency of diaphragm. as well as medially toward the muscle. The posterior COPD indicates disease that blocks airflow (e. especially the lateral after which the therapist switches sides. breaks for the therapist may be needed as this technique can cause lactic acid in the hands. This article does not pretend to teach a cure for asthma or the patient should keep the knees and hips flexed. thorax facing the patient’s feet. With the patient seated. which on the inside edge of the thorax. This can be described as a low to site responds and further penetration has plateaued. thoraco-lumbar junction. Regardless. However. I would assure patients and therapists alike that 18 MASSAGE THERAPY CANADA • SUMMER 2014 . at the very least. but medi. Chronic positioning along the ribcage. Chronic. symptoms include shortness slowly relaxes. Periodic seen symptoms. as with any muscle. In this instance. emphysema). Obstinate areas respond better back pain (diaphragm) and chest pain (intercostals and scalenes). The seated patient may lean exacerbates respiratory muscle tightness. oesophagus which can affect digestion. Done supine. the gratitude of your TREATING THE DIAPHRAGM patients will cause you to persevere and continue to produce The diaphragm is an umbrella-shaped muscle spanning the results. work with the patient’s cal treatment is aimed at treating symptoms and minimizing respiration to allow further penetration. This is also true for the respiratory muscles. This will enable the curled finger The aorta and oesophagus penetrate the diaphragm. their own. xiphoid process. when the rest of the muscle has released. This reduces abdominal tension and enables the important role of muscle tissue in respiration is without dispute. the latter with a pillow Ten minutes in one location with no response is an indication between the therapist’s torso and the patient’s back. by treating the muscles of respiration. chest tightness and chronic cough. It is gratifying to know that as massage thera- pists. chronic bron. be gentle and patient. laboured breathing compounded with coughing will put inordi.Technique BY JONATHAN MAISTER Breath of life Treating the respiratory musculature R espiration is arguably the most vital human function. Seated or Hence. intercostals and the By moving to areas that do respond. we can improve a supine. margin and takes up the slack of the soft tissue. The body does performed by the massage therapist as well as the patient on respond. edge of the lower ribs may be accessed. Experience suggests that unresponsive areas be left for later. that diaphragm region a myriad of conditions and result in extreme and often unfore. In all instances. treatment is bilateral. therapist to access the diaphragm via the abdomen. does tend to hold. and more patience may be required. This is done supine or seated. marginally forward to facilitate this process. The dome flattens and air is drawn into the lungs. the therapist’s curled fingers will creep superior of breath. Respiratory illness can cause in the upper right abdominal quadrant. shortening chronic obstructive pulmonary disease (COPD). Once that develop holding patterns. wheezing. the therapist is positioned beside the patient’s it shortens. Lung damage cannot be reversed.

Bear in mind that respiratory chal- lenges of the patient may preclude prone lying. but the patient will need to elevate his or her shirt above the inferior ribs in order to allow contact. Once again. Challenge the tissue a level deeper than the skin. Forewarn the patient that feeling tender is likely the day after treatment. Keep your fingers and wrist straight. preferably leaning forward. In all instances. The tissue will allow you to stretch it. feel the holding of the tissue on the ribs’ inferior edge. this is not ideal for the therapist since you may have to torque your wrist and body to achieve the correct angle. Repositioning yourself around your patient. TREATING THE INTERCOSTALS These muscles had best be treated fascially. If it resists. Fascial work can be challenging because it is associated with Diaphragm release with the patient supine pressure that may be uncomfortable for the patient. this will allow a prone position. So long as the therapist works slowly. but rather as an indication of our versatility as massage therapists to adapt and make a difference. so do diagnostic pal- pation to determine this. The “plastic” quality of the fascia is what you are stretching. This should be done engaging laterally or medi- ally depending where resistance is greater.a release in one area alone provides some relief and should be deemed a success on which to build. in this instance we are dealing with tissue that is sensitive and with patients that may be seriously ill. Generate the force. This order of treatment is less bothersome to the patient and makes the physicality of the fascial release easier for you as a therapist. you will have to treat supine and prone. But persevere if you can. Ergonomically. as gentle as it can be. Disrobing is not essential. Fascial work does require access to the tissue. change the angle of attack by a few degrees. He or she can be treated through the fabric of a loose-fitting shirt. it’s the resistance you feel once the “elastic” quality is at its end-feel. Treatment has to be modulated in accordance with the patients’ and tissues’ status. you will address all the restricted areas along the inferior ribcage. the patient need not disrobe. Your own body should be positioned to allow you to engage the tissue pushing away from you. bruising should not occur. precludes other techniques. supine MASSAGE THERAPY CANADA • SUMMER 2014 19 . Another possibility for treating poste- riorly is having the patient seated. The ribcage spans almost the entire thorax. or change position a few fingertips further and retry. I see this not as an impediment. Their anatomical position. This will save your fingers. Bear in mind. and this should determine how slowly you proceed. but don’t force it. as relief is achieved. wedged between the ribs. In essence. Disrobing and appropriate draping will be necessary. Pressure should be firm and movement slow to avoid bruising. In this instance treat supine only. FASCIAL APPROACH Fascial release in the same region will augment treatment and should be done after the diaphragm has been released. use your body leverage to Fascial work to the intercostal muscles. The therapist’s fingertips or thumb engage tissue along the inferior thorax. In order to address as much of the intercostal muscles as possible. usu- ally beside the patient’s abdomen or thorax. Hopefully. from your elbow or body.

DC. to ribs 1 and 2. Unknowingly. Ont. you will palpate deep to the skin level. (Special thanks to Dr. for their kind assistance with the accompanying photographs. posterior and laterally. if necessary. Treatment in this region is not possible. sport mas- sage therapist and athletic therapist. RMT. combining manual techniques for the muscular system. slowly and gently as with the intercostals – or even more so. the intercostals and then the scalenes will respond more willingly. Treatment order should follow as presented. medius and posterior) con- nect the transverse processes of the cervical spine (C2 – C7). slide your finger- tips along the transverse processes. Fascial work to the intercostal muscles. Usually. Challenge the soft tissue infe- riorly. One treatment may suffice for a patient recovering from a cold or cough. Engage your thumb or finger in the intercostal space. gently stretching the tissue as slow and as far as it allows. severe chronic cases may need regular attention to ease their ongoing symptoms. sport medicine and related topics.) Jonathan Maister is a massage therapist. He has taught across Canada and written extensively on a variety of ortho- pedic. I would hope that once the diaphragm has released. Once again. These are treated supine with gentle direct fascial release. mucosal drainage. they are stabilizing their upper body to facilitate scalene contraction and its action in elevating the ribs. with a private practice in Markham. Fascial work to the scalene muscles Bypassing the sternocleidomastoid (SCM). and correcting elevated ribs. Patients with chronic severe respiratory distress will need more sessions. This technique is performed specifically with the fingertips. Fine-tuning these techniques makes for a set of skills that both patients and therapists consider to be priceless. TREATING THE SCALENES The three scalene muscles (anterior. The diaphragm is by far the major respiratory muscle. You can probably achieve results with one to three thorough passes over one area of tissue. The pectorals and breast tissue lie superficial to the superior anterior intercostals. you will feel the resistance of the fascia between the ribs.exert pressure. they activate. standard trigger point techniques may precede fascial work to address areas of particular tender- ness first. CHA. and. and Melanie Tinianov. Addressing the entire intercostal region.com. Should the therapist so choose. does require time. Marco Caravaggio. Many athletes breathing heavily have felt compelled to clasp a fence to assist breathing. seated 20 MASSAGE THERAPY CANADA • SUMMER 2014 . He can be contacted at jmtherapy@JonathanMaister. Conceivably. anterior. Regardless. engage the tissue and slide with it. not your fingers. The neck is very sensitive and is a hotbed of pain referral. He assists at the committee level for the Canadian Athletic Therapists Association and the Canadian Sport Massage Therapists Association. this will be laterally. so consistent patient feedback is essential as you stretch the fascia. Especially with laboured breathing. Restoration of a patient’s respiratory comfort is invaluable. You might be able to distribute two or three fingers among the inter-rib spaces and address more than one intercostal space simultaneously. Massage therapists can offer extraordinary abilities. and take up the slack in the tissue.

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seems higher in cases where lymphedema onset was early in Secondary lymphedema is acquired. In this stage we also see skin changes occurring. The Complex Decongestive Physiotherapy system was 22 MASSAGE THERAPY CANADA • SUMMER 2014 . It is called spontaneously THE GOLD STANDARD reversible because the swelling is mild and will reduce during In Europe. the skin Robert Lerner. as many variables affect the devel. important for patients to know that Stage 3 is rare. ized. Stage 2 (spontaneously irreversible).S. under the auspices of Dr. Stage 1 (spontaneously reversible).Health care BY JOHN MULLIGAN Coming out of the shadows Giving hope for patients living with lymphedema L ymphedema is a condition of chronic and progressive swelling that can be inherited or acquired. BCRL can The tools for treating lymphedema were developed by range from mild to severe. This is partly due to time. the Vodder School North America can develop papillomas (tissue blisters). Lymphedema is puberty or even later. The swelling that there was nothing that could be done for patients with increases and there is evident and palpable tissue thickening.C. It can be very serious if characterized by a slow onset and it takes a very long time to left untreated for a number of years. It may be present at cases of lymphedema will plateau in Stage 2. These physicians and researchers worked with highly Stage 0 (latent). lymphedema treatment was becoming standard- overnight sleep or on elevation. Often. in adulthood. There are two kinds of lymphedema: primary lymphedema While lymphedema progresses through these stages it is and secondary lymphedema. Danish massage therapists (Emil and Astrid Vodder) in the opment of the swelling. tion and increased skin folds. This interest in lymphology in the affected limb. resulting in lymphedema. at ress to Stage 3. ficient impact on medical training in North America. then the lymphedema is referred the patient compliant. the first Complex Decongestive Therapy that is classified as non-pitting due to the density of the tis- (CDT) clinic opened in the U. In 1989. did not occur to stage may continue for months or years before the edema the same degree in North America. In Stage 2. affected the lymph system. This and applied lymphatic treatments. to name a few. sue. Lymphedema is a chronic condition. This initial stage of lymphedema has no trained European massage therapists and physiotherapists visible signs. possibly. Historically – as recently as the 1980s – the general con. Signs of elephantiasis are gross 1987. as well as tissue fibrosis patients. the condition does respond very well to lymph nodes for staging the spread of cancer. It no longer reduces with overnight rest. Symptoms are a feeling of heaviness or achiness who administered the therapy. This clinic primarily used compression pumps to treat swelling leading to limb deformation. eleva- sensus in the North American medical community was tion no longer has any effect on the swelling. and still has not had suf- becomes evident. 1930s and by German physicians and researchers in the Lymphedema has four stages: 1960s. There is no cure at in North America. In Stage 1 lymph- edema there is evident swelling. If it is left untreated it can become disfiguring. changes in pigmenta- was established in Victoria. even life-threatening. With early intervention develop into Stage 3. lymphedema. B. There is no measurable swelling. and not prog- birth or it may show up later in infancy. If the cancer treatment and management – if the therapist is diligent and in question is breast cancer. Many Primary lymphedema is inherited. The incidence of Stage 3 lymphedema it can be successfully managed over a lifetime. In 1993. The first lymphedema clinic in North America opened in Stage 3 (elephantiasis). potentially disabling and. the cause will be the surgical removal of this time. to as breast cancer-related lymphedema (BCRL). Some trauma has life and went untreated well into adulthood. however. childhood. However.

lympho. The risk of developing lymphedema is not the same for everyone. If the therapist and the patient do every- thing that is needed. If patients have concerns about their condition. Do not mistake post-surgical swelling with lymph- edema. they should talk to their physicians about it. Patients who have had lymph nodes removed. risk can be related to these factors. When patients have had lymph nodes surgically removed for any reason. Depot. the largest lymphedema. but may take longer in some cases. aimed at decongesting the tissues and promoting lymphatic Patients who have had lymph nodes removed and have function. Post-surgical swelling should resolve in six to eight weeks. offers established international guidelines for that treatment. received dard of treatment for lymphedema and related conditions. then lymphedema can be reduced and managed. He sits on the Education into the maintenance phase. Once the swelling is reduced.lymphedemadepot. with time off for showering and treatment.php. The patient is treated with manual lymph drainage and www. Removing them. researchers and leaders in the field of somewhat elevated risk of developing lymphedema. lymphology recognized and supported CDT as the gold stan. The document supports compression bandaging. management of lymphedema becomes easier. This brings the patient therapist and educator. even com. In this phase the patient is self. the patient may transition into daytime compression garments and nighttime bandaging John Mulligan is a RMT and certified lymphedema or nighttime therapeutic garments. Patients who have had lymph nodes surgically removed are MASSAGE THERAPY CANADA • SUMMER 2014 23 .org/resources. This is a commercial website that maintains these listings patients with advanced longstanding lymphedema respond as a service to the lymphedema community. These wonderful results are gained through hard work and compliance with the established standards of treatment and self-management. There are instances when the results seem almost miraculous. simpler and more routine. a company that offers advanced options in If properly applied. • compression therapy (bandaging and compression gar- ments) RESOURCES • decongestive exercise Find a provincial lymphedema organization by visiting the • skin care (lymphedema patients are prone to cellulitis) Lymphedema Depot website where lymphedema organizations • patient education and other support networks are listed: www. well. Framework and is also co-owner of Lymphedema pression and exercise protocols. While there are exceptions to every rule. This multi-faceted approach yields tremendous results. The lymph nodes are required to process and purify the lymph fluid that enters into them from the lymph vessels. while necessary in fighting cancer. Working Group of the Canadian Lymphedema managing the lymphedema through compliance with com. CDT can reduce the swelling of even the management of lymphedema. all of which were at risk of developing lymphedema. proved to be a very effective treatment with no received radiation therapy as part of their treatment are at a side-effects. The treatment approach is to have an intensive phase A document called Best Practices in Lymphoedema of treatment. leaves some of the lymph vessels with dead ends. radiation. where the therapist is seen as frequently as pos. the transport capacity of the lymph system has been reduced and they are at risk of developing lymph- edema for the rest of their lives. BREAST CANCER-RELATED LYMPHEDEMA Patients who have had lymph nodes removed – to determine if the cancer is spreading or still contained – are at risk of developing lymphedema. Over time. and then experienced significant weight gain after CDT consists of: their surgery and subsequent treatments have an even higher • manual lymph drainage risk of developing lymphedema. Eventually. and the fluid they would have carried to the nodes becomes excess fluid that is left in the tissues of the limb. Management is freely available for download at this site: sible.developed. This combination of therapies. The bandaging must be worn 23 CDT as the standard of treatment for lymphedema and hours a day.

who to engage. at the very least. this means being able to incorporate the information found By educating the client on the difference between what seems from reliable studies into your massage practice and to communi. interpret and criticize research articles. No one is expecting massage therapists to wear lab coats and modality works can open the door to many new markets. tion. defining research literacy as the “ability to locate. consumers these days as they are becoming more familiar with the Susan Salvo’s book. such as marketing. It is becoming increas- research findings related to massage therapy to physicians. believed were off-limits to massage. how to read it. ing their clients to become better consumers of their health care. research literacy has become a mandatory part of curricula for RMTs. People may be more willing cited Dr. believe there is no room for anecdotal data. “evidence-based practice” movement. pists.Education BY JENNIFER BLOCH Separating fact from fiction How research literacy can benefit you. trustworthy sources of massage informa. they think their therapists are familiar with the latest information understand. and how to ask the right questions to determine the study’s cred. and evaluate research literature. Research literacy. Being able to explain physicians) on research in this profession. is an important part of upholding therapists’ commitment to ethics and profes- sionalism. and independent lifelong learners. On the other side way our profession is viewed by the insurance companies. On the one side are massage therapists insurance companies who are often hesitant to cover massage who believe the proof of effective practice lies in the results therapy. read. For massage thera.” Clients will appreciate this and may even respect their practitio- By learning how to find. to work based on experience versus what has been shown to work cate research findings to others. Great strides have been made in the last few years with respect to evidence-based practice in massage therapy and. coming for massage simply for relaxation may decide to increase The expectation for the research literacy of massage therapists is the frequency of their visits to help treat symptoms they previously simply to: know where to find it. about massage therapy. clients (including By becoming research literate. your business and your profession M any massage therapists push research literacy to the bottom of their list of selected continuing education units (CEUs) due to its complexity or a preference to pursue courses that enhance practical techniques or skills to drive in more business. potential clients) and other health-care professionals (including guage of other health-care practitioners. massage therapists are empower- become good consumers. Clients are increasingly becoming better responsibly educate clients about the results the research identifies. people will recognize you as a well- ibility. author of Research Literacy and Massage to tell their friends and family about their massage therapists if Therapy. ners’ opinions that much more because of it. Through word of mouth. Research literate massage therapists can help change the they have witnessed in their own experiences. MAKING A DIFFERENCE IN THE PROFESSION I spent the last few months reviewing articles and obtaining the GROW YOUR BUSINESS opinions of colleagues (including students). ity and the likelihood that they will send you referrals. you are enhancing your knowledge on that particular topic. indi- rectly impacting your skills in a positive way. JoEllen Sefton. you will be able to speak the lan. for ingly clear that we need to do more to improve our credibility example. Clients evaluate the statistical significance of the results of their practice. thereby are those who exclusively support evidence-based practice and creating less resistance to coverage for your clients. Massage Therapy Principles and Practice. It gives you the skills necessary to based on scientific evidence. Having an ability to understand and to explain how a particular These two extremes make it difficult to unite as a profession in 24 MASSAGE THERAPY CANADA • SUMMER 2014 . Another important expectation of massage therapists is to informed practitioner. in a way that they understand can increase your credibil. more recently. within the health-care community. The results of my informal investigation revealed a divide Our profession is always justifying our role in health care to amongst the profession.

ca specialization in certain aspects of the program to ensure that the knowledge passed on is of the highest quality. ™ and may be eligible to enrol in a B.osteopathie-canada. . Osteopathic (Ost).M. scientific and research Family knowledge with our strong foundation in clinical expertise that our graduates are recognized for. Vancouver (english) The Canadian College of Osteopathy offers: Quebec City (francais) • An experienced and broad faculty with many years of clinical practice • A student clinic that will enhance your clinical skills and confidence Montreal (francais) • A professional campus setting to enrich your educational experience 800-263-2816 • Additional support to students to learn and increase competencies outside of scheduled classes 514-342-2816 The practice of traditional manual osteopathy requires a fine touch. If you are looking for a college to provide you with the highest educational stan- dard in Osteopathic training.6 Canadian Campuses Toronto (english) Providing the highest standard in osteopathic Winnipeg (english) education in Canada for over 30 years 877-893-0367 Study with us and grow your practice! 416-597-0367 Our 5 year part time program is designed for health-care professionals to gain experience and evolve their practices while studying. and a desire to learn. D.P.O. This ensures that our graduates continue to be leaders within the profession of Osteopathy throughout Canada by combining academic. Our lead instructors hold www. Successful graduates of the Canadian College of Osteopathy will receive a Diploma Join our in Osteopathic Manual Practice.osteopathy-canada. with Halifax (english) a program that is internationally recognized and accredited for its excellence. The Canadian College of Osteopathy continues to be at the forefront of Osteopathic training in Canada. The emphasis at the College is to ensure that the hand-to- www.Sc.com hand transmission of traditional Osteopathy is preserved. then the Canadian College of Osteopathy is your best choice. a gentle heart.

Most clients are not aware of the extent of our tests the many hypotheses we have developed over more than a knowledge and skills. the mood and lighting in the the face of how we practice. research director with the Massage My discussions with clients and other health-care practitio. ‘I see it work in my provides us with more funding. need to have a basic understanding of how to seek out research to stay current with the latest informa- tion and identify red flags and know what questions to ask to critically evaluate an article. There are other possibilities too. however. it is the office every day. We cannot just say. There is. ‘we’ve been doing association to do this advertising for us or wait until someone this. It is easy to believe the ischemic com- helps us be more effective. The trick is how we are conveying the ing. Our peers. context and faith in us. and in every we already do. Author Susan Salvo says. actually due to what we do.” If we inform our clients that a modality or technique will decrease their pain when we are basing it on anecdotal data. Without anecdotal information.” Haraldsson previously sat on the board of the College of Massage Therapists of British Columbia and served as vice- president at the MTABC. we room. no way to be our own agendas. Bodhi Haraldsson. Sure. On the flip side. Anecdotal information is. we have the duty to conduct the research that are capable of. This is a moral duty PROFESSIONAL ETHICS IN RESEARCH of our profession to ensure that those things we profess (to The problem with relying solely on anecdotal information is profess expertise is where the word profession comes from) have validity. but that doesn’t mean they were conducted properly. clients and other health-care professionals expect massage therapists to have a basic understanding of what to look for in determining the credibility of evidence- based therapy. the lotion all. the warm up of effleurage.’ We can’t just say. “Some MTs do not understand the For example. by its very nature.” certain the clients’ breathing habits. Massage therapists. unreliable. Therapists’ Association of British Columbia (MTABC) said. Any one of these factors leaves room for wouldn’t have research.” Do we define the highest possible 26 MASSAGE THERAPY CANADA • SUMMER 2014 . The Respect for Persons principle includes “ensuring that clients are as fully involved as possible in the planning and implementation of their own health care. Let us reflect on our Code of Ethics principles put forth by the College of Massage Therapists of Ontario and how being research literate is a basic requirement to adhere to our Ethical principles. through the highest possible standard of professional practice. at the very least. the possibility that the ischemic compression alone was not the There is room for both schools of thought: the therapists who main contributor to pain reduction among clients. the positioning of the client. then our clients are planning their health-care based on misleading information.’ The lack of control makes it impossible to individual interactions that massage therapists have day-after-day determine if the positive outcome we all see with our patients is that will make or break our credibility. let’s keep doing it. we should use our pressions caused the decreased pain given that all of the clients knowledge and skills to best serve client goals without inserting responded in the same way. yet more and more massage therapists are using these studies to support their claims that a particular technique will yield a particular result.our goal to adhere to our commitment to responsible health-care that there are many other factors that can disprove a direct practices. the pain decreased. it can form the basis for a research question that can change used. not factoring in the other potential contributors. you may have experience treating a hundred clients role of research. the music used. cause-effect relationship of a particular modality or technique. Good research improves our understanding and case. “Ischemic compressions will reduce your pain. rather than the other non-specific effects of placebo. or the flushing of petrissage weren’t what actually contributed to However. Responsible Caring includes “promoting the client’s best interest and well-being. After the decrease of pain. we can expect our professional century of our existence. So many clinical trials exist today. Factual statements should not be made on the basis of studies that are invalid or unreliable. and those who are us feel confident enough to make a statement to our clients say- dedicated to research. yet many of are dedicated to their personal experiences.” information to our clients. ners revealed a gap in the perception of what massage therapists “As a profession. It should inform our practice – enrich what with trigger points using ischemic compressions. that is not to say it is not extremely important. At the end of the day. or any information suggesting a cause-effect relationship.

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And finally. my clients seem to experience a reduction in pain. while providing responsible. “Some small studies have shown that isch- emic compressions may result in the reduction of pain. If you are willing to try it. we can continue to practice modalities and techniques that are safe and seemingly effective provided that we educate our clients responsibly about the differences M between anecdotal information and evidence-based practice. you can say for example. We can always try this technique and see if it works for you. In the meantime.” Or. We can- not stop our careers while advances in science are still being hypothesized. however more research still needs to be conducted. however. RESPONSIBLE COMMUNICATION When communicating with our clients. but there is no evidence that I am aware of to support that this is what causes the reduction of pain. Once you are familiar with what is out there in terms of trustworthy research. honesty and diligence in our professional relationships. 28 MASSAGE THERAPY CANADA • SUMMER 2014 .” encouraging those practitioners who are interested in pursuing their careers in research to answer these questions for us. we know that there may be other factors contrib- uting to someone’s pain reduction yet we say it is definitely due to the ischemic compression. Jennifer is the owner of BusyBodies Health. Responsibility to Society not only dictates our “commitment to continuous improvement”. She was a recipient of the 2013 Award for Excellence in Research and Interpretive Studies by the Canadian Council of Massage Therapy Schools. there are ways to edu- cate them about the difference between anecdotal information and evidence-based practice. change our thinking about the effects of our work by becoming curious and skeptical – continuing to ask ourselves “why the result is the way it is. RMT.” These types of responses allow the therapist to continue practicing a modality or technique that they believe works. is dedicated to research and supporting the integrity of the massage therapy profession. Jennifer Bloch.” Unless we are using sci- entific evidence to support our claims of cause-effect relation- ships. We can. it also expects us to participate in “the promotion of the profession of massage therapy through advocacy. our professional col- leagues and society. with ourselves. we are not fulfilling our responsibility to society using the highest possible standards of practice. standards by providing the client with information that leaves room for error? The definition of Integrity in Relationships is “to practice with integrity. research and maintenance of the highest possible standards of practice.” We are not acting with integrity when. “In my experience. whenever I perform ischemic com- pressions. so they can make an informed decision about their own health-care treatment plan. informed information to the cli- ent who now fully understands that ischemic compressions may not actually cause a reduction in pain before they provide consent to treatment. we can get started. a mobile massage company that provides other health-care services in the interest of saving people time to focus on their healthy lifestyle. for example. our clients. Research in massage therapy is still in its infancy.

seminar participant practicing massage therapist. Fascial Release for Structural Balance provides the information therapists need to give effective treatments and create long-lasting.. authors James Earls and Thomas Meyers—both respected bodywork professionals—argue that approaching the fascia requires “a different eye. affordable Advanced Placement options for RMTs who want Bring Don back anytime!” to enhance their training. and tissue-specific techniques. Fascial Release FoR stRuctuRal Balance Fascia. providing immediate pain relief as well as reducing ongoing aches and pains.” This book offers a detailed introduction to structural anatomy and fascial release therapy. complete technique descriptions.com Call 1-866-491-0574 MASSAGE THERAPY CANADA • SUMMER 2014 29 .” Featuring 150 black-and-white photographs. which will become the new standard in all regulated provinces. If you are a . We are excited that our new 2013-14 curriculum meets or exceeds the Canadian inter-jurisdictional entry- to-practice standard for massage therapists. a bodyworker or therapist can help clients with many chronic conditions. including postural analysis. and organs. the soft tissue surrounding muscles. informative. Call us today to learn more. a different touch. Speaker & Mentor Be Regulation-ready! “Don Dillon was very You deserve credit for the experience you have. rmt Practitioner. Donald Q. Dillon.indd 2 2014-04-01 2:08 PM you re-learn skills and knowledge that you already have. bones.should speak in RMT schools to MH Vicars School of Massage Therapy get us all off to a good start. we will respectfully assess both your experience MassageTherapistPractice. In Fascial Release for Structural Balance. We won’t waste your time or money by making Massage_DonDillon_Bizcard_Mar2014.com and your previous training and place you in the right class to earn our 2200-hour diploma in less than a year.. systemic change in clients’ shape and structure. MHVicarsSchool. By learning to intelligently manipulate it. plays a crucial role in supporting the body. and the art of proper assessment of a patient through “bodyreading. has convenient.

• Upon termination of services the service provider shall return It is extremely important that you fully read and understand all data to the registered user when requested and all data is what you are agreeing to. a provider of massage therapy contained in the records. online systems you are presently using. this is unacceptable when the health-care providers (again. storage or possible sale of the client data Solutions Inc. don’t walk.A. to review the terms of service on the – permanently. This can save contact information. 30 MASSAGE THERAPY CANADA • SUMMER 2014 . by the associations have already researched solutions and can advise you online service provider.massagemanedger. with respect to your clients’ data. we do not even read size-fits-all” online data services. at anytime and without notice to or committing to. or European countries. Your agreement is subject to the privacy laws of foreign To learn more about mindZplay solutions countries. online service providers (note that they have been summarized in As a regulated health-care professional you are obligated to plain English for clarity). to do so. shall at all times be owned by the registered user. There are service providers out there that specialize agreement by you. account details. you a lot of time and potential problems. They may also rent or sell your clients’ on recommended practice management systems. Clearly. be well. Run. them here. The thinking is that there is very little to worry about since booking and data service providers offer their same services to we are simply sharing photos and personal experiences with family businesses ranging from hair stylists to lawn care companies – and friends. and for massage therapists visit Why would a health-care professional agree to these types www. websites and practice management solutions. right service provider to partner with is key. However. Often.. to offer you legal advice. on the “I agree” to the terms of service button when signing up These sorts of terms of service clauses are often found in “one- for our favorite social media sites. health-care data will be cared for. condition. Often. or even another unnamed third. You have given your legal power-of-attorney over the health-care There are other very important data privacy considerations data to your service provider. the Jessica Foster writes on behalf of mindZplay disposition. provincial Your clients’ health-care records may be subject to sale. as it will directly affect how your clients’ then removed from the system. you can be denied access to the health-care files needs. you communicate with is not authorized to advise you in any manner with respect to your terms of service. often the U. • All data created or stored on the service provider’s system Using web-based appointment booking and practice. when you subscribe to an online only authorized service provider personnel will access the data service. stake. in the health-care industry with solutions that will meet your Without notice. it will give you some helpful insight into disseminate or transfer any user data. Below are examples of some of the terms of service that The terms of service are subject to the laws of the (XYZ) Canadian massage therapists could be agreeing to with some province in Canada. This column has detailed these party company that provides aspects of your service provider’s data concerns and remedies in past issues so there is no need to restate management services.RMT Tech Talk BY JESSICA FOSTER Reading the fine print In today’s digital world where many of us have a personal social of terms? One can only assume that they were never read or media presence. everyone is doing it – so it must be ok. these have been summarized in plain ownership and treatment of your clients’ health-care data is at English for clarity). The health-care records may be stored or transferred to any The bottom line is to read and understand what you are third-party company. “terms of service”. often their data management policies do not account for the While this approach may be fine for personal web services – special needs of health-care professionals. While this article is not intended • The service provider will not. After all. it becomes concerning if this thought process is brought into Below are some terms of service that are more appropriate for your business practices. including their Your clients’ stored personal health-care data is the legal property contact information and appointment records. These generic online appointment them.S. securely manage your clients’ health-care data. You agree that any employee of the service provider that Until next time. management services has now become mainstream for massage • All created and stored data will be treated as confidential and therapists in Canada.com or call toll free 888-373-6996. unless required by law the importance of understanding what you agree to online. under any circumstances. we have become accustomed to simply clicking understood by the practitioner. Finding the of the software service provider – not your client nor you. use. you are accepting to be bound by that service provider’s – upon the request of the registered user.

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