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Practice building: Designing your Technique: Ligamentous articular Outlook: Business technology trends for

treatment space p.14 strain technique p.22 2016 p.26

Winter 2016

From RMT to media
personality, Margaret
Wallis-Duffy takes practice
to a whole new level

All advertising is subject to the publisher’s approval. Massage Therapy Canada will mail information on behalf of industry-related groups whose products and services we believe may be of interest to you. November.Winter 2016 massagetherapycanada. massagetherapycanada. April. please contact our circulation department. No liability is assumed for errors or Winter 2016 Massage Therapy Canada 3 . Occasionally.. Published and printed by Annex Publishing & Printing Inc. Printed in Canada. If you prefer not to receive this information. Publisher reserves the right to refuse advertising that does not meet the standards of the publication. ON N3Y 4N5. COLUMNS this RMT takes 12 practice to a new Practice Points level Funny you should by Mari-Len De say that Guzman by Don Quinn Dillon 22 14 18 Few and Far LAST resort Between Dissecting the Room for evidence for movement ligamentous by Jules Torti articular strain techniques 26 by Robert Libbey RMT Tech Talk Business technology trends and outlook for 2016 14 by Jessica Foster ON THE COVER: Margaret Wallis-Duffy. Massage Therapy is published four times a year: January. Opinions expressed in this magazine are not necessarily those of the editor or the publisher. owner of Wallis and 16 22 Associates in Bramp- FEATURES DEPARTMENTS 16 04 From the editor Sticky ‘Tis the season situation Exploring more 06 effective Touch Points applications for News and events kinesiology tape by Conor Collins 06 Human Factor The lighter side of 18 things COVER Media savvy From treatment room to television. and host of WOW Living TV ISSN 1499-8084. Simcoe. Ont. Such approval does not imply any endorsement of the products or services advertised. All rights reserved. No part of the editorial content of this publication may be reprinted without the publisher’s written permission. July. 105 Donly Drive South.. ©2016. Annex Publishing & Printing Inc.

This would ensure the end-result is Fax: 416-510-5170 provincial regulation that conforms with nationally accepted norms. Printed in Canada While on the surface it looks like a provincial issue. and welcome the new year. (519) 429-5173 (888) 599-2228 ext. If you prefer not to receive this Last November. P. which can potentially have a big impact on massage Christine Livingstone therapists across the country. Simcoe. Box 530. Mail: 80 Valleybrook Drive. Toronto.O. Shortly. ON N3Y 4N5 holders to come together with a common PUBLICATION MAIL AGREEMENT goal of truly advancing the profession through regulation that is at par #40065710 with national standards. Ontario. It would be interesting to see how this truly advancing the profession. Massage Therapy will mail information on behalf of industry-related groups whose products and services we believe may be of interest to you.” story unfolds. however. the province’s health ministry announced it has ap. GROUP PUBLISHER Martin McAnulty Because of its potential national implica.95 On behalf of the staff at Massage Therapy Newfoundland.000 people. (905) 726-4659 This year is ending with a somewhat positive development from PUBLISHER Manitoba. I wish you good – 2 Years $ more about this development in our report on page 10. it would seem this an.95 (includes GST - #867172652RT0001) For USA and Foreign rates please call Circulation Manager Tel: 800-668-2374 MARI-LEN DE GUZMAN. (888) 599-2228 ext.FROM THE EDITOR Winter 2016 Volume 15 Issue 1 ‘Tis the season EDITOR Mari-Len De Guzman mdeguzman@annexweb. This latest story from Manitoba became the highest visited web page CIRCULATION MANAGER on the Massage Therapy Canada website in a matter of days. Barb Adelt badelt@annexbizmedia. it’s easy to see why this story gained MAILING ADDRESS come together with a common goal of so much attention. Manitoba will become the fifth Canadian province ACCOUNT CO-ORDINATOR Shannon Drumm to have a regulatory college and will effectively result in massage thera.C. 219 nouncement is only the first step of what could be a long and tedious MEDIA DESIGNER process toward establishing a regulatory body in Manitoba. SUBSCRIPTION RATES Canada – 1 Year $29. sdrumm@annexweb. Editor @MTCanadaMag 4 Massage Therapy Canada Winter 2016 massagetherapycanada. 239 proved regulation for massage therapists in Manitoba. . it was shared 88 times and was seen by nearly 11.95 tidings and all the best in 2016! – 3 Years $64. it would be prudent for existing massage therapy regulatory bodies in Canada (B. please contact our circulation department in any of the four ways listed above. even the new college in New Brunswick) to help guide Tel: 416-510-5189 Manitoba in the right direction. The hope is for all stake- 105 Donly Drive after the link was posted on our Facebook pists across Canada bidding farewell to GST/HST charges. Annex Privacy Officer “The hope is for all stakeholders to tions. CIRCULATION email: asingh@annexbizmedia. ON M3B 2S9 We might not be able to say goodbye to that pesky GST/HST just yet.You can read Emily Sun esun@annexweb. Once regulation is institutionalized. but we certainly bid farewell to 2015. (519) 429-5183 Before we start counting our chicks.


The CMTO puts from mas.” tion to seek in. the TRY IT accountable for acting in consultation is taking place Use the correct keywords to help search engines index your website patients’ best interest. outlined some of sage therapists. and appropri- for overseeing the workings ate access by the of clinics. without the practi- ploring the viability of a tioner’s knowledge clinic regulation model in • Billing system that Ontario. 6 Massage Therapy Canada Winter 2016 massagetherapycanada. appropriately.” said Flit. their workplaces. m o d e l wo u l d sionals and busi. for the proposed clinic reg- viding a public register of ulation. provide: nesses on the planned . as “crawlers” or “knowledge-bots.” activity. accurately reflects the Last spring. • Clinic policies that tablishment of a clinic allow the health pro- regulation model. without fear of reprisal “While many clinics oper- ate in the patients’ best in- terest. fessional to meet his In a letter to RMTs. on concerns about tection and strengthen the practices at the clinic health-care system. However. the CMTO services provided announced it was working • Maintenance of ade- with other health regulatory quate records for pa. search engines to roam the World page. They are also referred to relevance for a particular search her letter. clinic regulation would in. In Internet usage. TRENDING Spiders colleges to “explore options tients.” Flitton explained in professionals. use brought to our attention and fectively can be a challenge computer robot programs used by spiders to crawl a website or web a model to hold clinics ac. an increasing number “Health regulatory col- leges have a mandate to protect the public. or her professional CMTO registrar and CEO obligation Corinne Flitton said the • Safeguards in place consultation – which will to prevent profes- involve a preliminary draft sional credentials of the regulation model – from being misused will assist the college in ex. hold clinic owners According to Flitton. clinics. This helps your site to be ranked high in search results. the aspects a patients. guards against pists of Ontario fraud and other (CMTO) is em.TOUCH POINTS HUMAN FACTOR REGULATION CMTO conducts consultation on proposed clinic regulation The College of establish safe- Massage Thera. visit websites and page is about and determine its exist. and in the fall and winter. ton. tices.” These colleges RMT to those re- have since established a cords to facilitate “working group” to explore care whether pursuing a new • The ability of a RMT model for clinic regulation to notify the regulator would enhance public pro. such as Google. explaining the rationale (Source: UC Berkeley Library) Illustration: Brian Fray crease transparency by pro. which helps determine what a countable does not currently tions only on individual Wide Web. rather than databases. “In our view. in a system imposing obliga. inappropriate barking on a business prac- public consulta. other clinic regulation health profes. DEFINITION APPLICATION of troubling cases are being achieving that mandate ef. “spiders” are Search engines.

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disorder.” bination of light and drug antidepressant treatment study co-author Dr. dummy pill. a psychiatrist at The study was published symptoms. Ray. Levitt said 75 per cent of ing to us. of the difference was .TOUCH POINTS TREATMENT Light therapy eases symptoms of seasonal. “It’s important to find . antidepressant were treated “We don’t usually get re. during the winter months can also ease symptoms of depression that occur throughout the rest of the year.” sion.” said Levitt. therapy saw an easing of also reduced symptoms mond Lam. or SAD. non-seasonal depression: study Light-box therapy typi- cally used to treat people with seasonal affective disor- der. the University of British recently in the journal About half of the patients “In the combination Columbia. a study suggests. experienced similar im.Sheryl Ubelacker. Anthony Lev- itt. JAMA Psychiatry. treated with active light ther. he said. “What we’re showing here said Levitt. chief of it works at any time of the front of a light box. saying their find- sant with exposure to a sham That 30 per cent response Light therapy has long ings need to be replicated by light box. should those with bipolar minutes each day during the program. group what we saw was con. Those with reti- with fluoxetine (sold under sponse rates in the range of is that light works in nal and certain other eye the brand name Prozac). apy and a placebo pill tinued improvement each new treatments because our The Canadian Press 8 Massage Therapy Canada Winter 2016 massagetherapycanada. but other scientists in trials in- a sham light box and a placebo effect – is typical in its effects in patients with volving more patients. or the sant trials – but improve.” said Levitt. equal numbers to receive 30 per cent of those given the first one to two weeks – However. ment continued even up depression self-treat with placebo pill. as exposure could eight-week study. an antidepres.” said study co-author Dr. until eight weeks. said scribed by a physician. he said. The clinical trial involved 122 patients who were ran. the researchers one of four treatments: light the active antidepressant that’s true of all antidepres. with a sham light. set off an episode of mania. Researchers found that patients with non-seasonal major depressive disorder (MDD) who received both light therapy and an antide- pressant improved more than those given just one therapy. while only about The greatest reduction is in for everyone. fective in treating depres. were not well-known. and both access to for the latter – called the been used to treat SAD. mending that people with sant. should not use light therapy. week across the eight weeks. stopped short of recom- therapy and an antidepres. nor therapy were exposed for 30 Sunnybrook’s brain sciences year. current therapies don’t work domly assigned in roughly provement. much more quickly. “So the magnitude While medications are ef. and our findings show it could bene- fit many patients. got better. a psychiatrist at Sunny- brook Health Sciences Centre in Toronto. 75 per cent in any depression non-seasonal depression and disorders should not sit in and those given light-box trials. Adding light therapy to 60 per cent of cases. any clinical trial testing a non-seasonal depression As well. Levitt said. some people Patients who received an drug or another therapy. they work in only about “It still should be pre- the patients given the com. light therapy and a sham light and dummy pill.” light boxes. “Light therapy is a low- cost treatment option with few side-effects.” Lam said.

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as I’m finding out.TOUCH POINTS SPORT REGULATION Ontario introduces Massage therapy regulation concussion bill named after gets nod in Manitoba teen rugby player who died Manitoba has approved • considering the devel- regulation of massage ther. opment of a bridging almost 89. ciation in Manitoba – to The MTAM and NHPC after the bill was announced. Stringer’s parents say. It doesn’t need a • determining if a single province’s relatively new er child in Canada dies from sec. • conducting a review of girls. of all health professions in the This milestone recognizes being injured while playing high plemented within a year. in Canada.” minister. should be imple. the Ottawa-area riding where the cil’s recommendation. Both She was a nurturing person who Stringers live. cants whose knowl- emergency department or a phy. tion of Manitoba (MTAM) the anticipated costs It’s not about banning contact officially applied for self-reg. as she died in Lisa MacLeod. and it this again and I would be just a health and safety issue. who represents and I have accepted the coun.” A previous attempt at concus. apists. Sheila Molloy. Natural Health Practitioners ment to determine timelines said her mother. Those province. ing assessments that get in line with the rest of the risen significantly. sion is suspected and that they recommended the profession MTAM and NHPC will be cepted to the University of not return to play until receiving of massage therapy be granted forming a review committee Ottawa’s nursing program. will have to and doctors’ offices in Ontario has fail. Between 2003 and 2011. A number of them are found that the number of children “It would be a terrible tragedy levels of competency currently still transitioning and youth treated for concussions to have another opportunity to get • determining creden. not long sion or whether there ince’s 22 health-care profes- for Clinical Evaluative Sciences before Rowan died.” ture with rare all-party support. actually doesn’t really end.” said Gord Stringer. massage therapy is finally other family to have to experience “This isn’t a political issue. bling the consistent regulation waited a long time for this. grief journey.Allison Jones. “The Health Profes. said Molloy. • developing an educa. recommending regulation. tragic loss and the said his daughter was a person sues that will suppor t sage therapists in Manitoba. new regulatory college. a law passed more ond impact syndrome. . than five years ago that aims A study last year from Toronto’s sion legislation was left on the mented for the . profession in the province. “It’s Rowan’s father. Kathleen. for now. “The Rowan’s Law would establish a Professions Act supports massage therapy association committee to get the recommen.” he said. apy following the release of program for appli- sions were treated in either an a report by the Health Pro. and expenses and de- sports. sions Advisory Council has Representatives from Rowan Stringer had been ac. Gord Stringer. so self-regulation. together represent 1. should be different sions. The bill was co-sponsored by of Canada (NHPC) – the for the development of the “It’s almost impossible to de. plicants and members has more to do with the devastated to find out that anoth. address some of the key is.” Health Minister the importance of massage school rugby was introduced late recommendations include estab. action to happen. it just this is the way she would want these issues include: before actual regulation for changes.” said from children falling from the sions Act in 2012. to the RHPA. but medical clearance. 17-year-old girl who died after oner’s inquest into her death im. scribe losing a child.000 pediatric concus. is removed from play if a concus. Massage ther- in both emergency departments concussion legislation in place tials and prior learn. and to than three years after the educational standards 440 from 208 per 100. executive di- monkey bars. said Rowan’s Law Blady instr ucted the associations will also be would have wanted her memory would be the first concussion law MTAM to work with the working with the govern- to be used to help other children. “We’re delighted. may be needed for health professions. realized in Manitoba. The Canadian Press membership “It’s a little more than just 10 Massage Therapy Canada Winter 2016 massagetherapycanada. self-regulation under the act to explore and resolve the never got to attend. assessed as not equiv- sions jumped to 754 from 466 The report comes more alent to Manitoba per 100. therapy as a health-care November in the Ontario legisla. lishing guidelines to ensure a child ment. to govern all of the prov- York University and the Institute table in the fall of 2012. who brought people together. political stripe on it. Some of It may be years. Sharon Blady said in a state. I would never want an. The rate of concus.000 for Massage Therapy Associa. fessions Advisory Council edge and skills are sician’s office. has worked a long time and A concussion bill named for a dations that came out of the cor. key issues outlined by the 2013 from multiple concussions.000 for boys. it’s tional standard for ap.” she said Democrat Catherine Fife. however.325 mas- a devastating.” standard education RHPA. Liberal John Fraser and New other massage therapy asso. “The Regulated Health rector of the MTAM. Concussions will happen even Regulated Health Profes. quality patient care by ena. ulation under the province’s termining fee structure. “It’s for kids.

Manitoba Minister of Health recommendation. At minimum.” Melynyk said in a “The minister has to re. a massage sage therapy – the standard therapist and past-president implemented across all reg- of the MTAM.” Fraser said in a state. pleted 2. Advocates for na.” Sloan minister determines that a the college. been thrown out the window issues to be addressed under profession. George rector Kelly Sloan allayed the constructive working re- now cooperate in the so. the minister should as Manitoba. of ethics and continuing According to the national competency requirements as competency standards for regulations under the act. positions of the various par- The RHPA replaced 21 ties to the application. of 2.200 hours of massage sions Advisory Council’s therapy Winter 2016 Massage Therapy Canada 11 .” statutes dealing with the added Melnyk.TOUCH POINTS establishing the college be. 2. therapists are able to prac. NHPC’s execitive di. and that we will these last-minute diversions correctly based upon the members have also com. regulation should look in “The problem with all of better advice and proceed ulation. that lated. therapy students graduating fused the process by not from regulated provinces collaboration is a waste of cording to Sloan. I have Alberta-based NHPC who actions regarding the HPAC the majority of the 350 absolute confidence that we aggressively opposes regula. expressed ulated provinces – registered disappointment that the massage therapists must health minister. be able to do that very is that the applicant (the Act. ization actively advocating latory bodies to establish for regulation of massage standards of practice. ac. it members of the other asso- cording to the Act. “The proposed flawed sage therapy education. requirement. who is now regulation of 22 different president of the recently es- health professions in Mani. regulatory college. “The MTAM then went The RMTSMB’s new ex. Massage Sharon Blady. among other the minister. MTAM and NHPC.200 hours of education. tablished Remedial Massage toba. members in Manitoba are in through the details of how statement. months and months away. recommendations NHPC massage therapist are going to be able to work tion. Fraser. given further to indicate it would ecutive director. entry-to-practice for mas- Garry Melnyk. Majority of its Manitoba. however. The toba (RMTSMB). However. an organ- legislation requires all regu. Blady tional competency standards – it could have tragic results the health minister’s direc- had instructed the MTAM in Manitoba want to bring for the profession Canada tive – will have to be settled and NHPC to work together all massage therapists up to wide. some massage tional council’ will be the question of whether to recommend to the Lieuten. read the Act – get some support of professional reg. sage Therapy Canada Maga.” Sloan said. while ac. She noted. Alberta-based NHPC. If have a single standard of ant Governor that such tice with as little as 250 not revisited. noting and the MTAM have. appear to gover nment is working have now become mandated through a list of a number of criteria to establish the new other health-care profes.Mari-Len De Guzman massagetherapycanada. have completed a minimum cepting the Health Profes. health profession be regu. This is sions. in process and the required said. Instead. . MTAM) and specifically the ment. all the effort of education or different levels health profession be desig. unregulated provinces such establishment of the ‘transi.200 hours of mas. and outlined above. following the provisions of such as Ontario and British valuable time and will end “Our members have been the Regulated Health Pro. quickly. among stakeholders as well. urged the health concerns the association is lationship that the NHPC called ‘next step’ with the minister to reconsider her against regulation. so that may end up very misleading to RMTs taking us a little more time. Ac. zine. who cause right now the thing also does not support the that complicates this is that national competencies for with the new Health Act the the profession. had con.” in discussions between to address the key issues par with a minimum of In an interview with Mas. bringing all under one Therapists Society of Mani- piece of legislation. codes therapists in the province. to be registered with will add lengthy delays to the ciations have been to. Columbia must meet this poorly for the profession and to the same schools that the fession’s Act (RHPA).” who understand clearly the Molloy explained. hours of education and application and review has of competency – one of the nated as a regulated health training. once the things. “I am very confident.

the health-care plan for persons with low income. charging too much rent. lecturer. RMTs vices are still covered under British Columbia’s provincial have been told to “…avoid working cross-body.” Massage thera- appreciate the true costs of running a business. Despite almost 90 years of regulation in Ontario – the last 12 Massage Therapy Canada Winter 2016 massagetherapycanada. reflect these assertions. Their opportunity they’re providing. the College of Massage Therapists of Ontario table to expect more. ness open to risk and financial instability.. services are not funded in any of the provincial govern- “The CMTO says. The person brokering the practice opportunity may be painted as a money-grabbing exploiter. It’s understandable the student or unseasoned practitioner would accept the information passed down by a mentor or the RMT culture as hard fact without much reflection. tice/code of ethics.” Yet. Whatever the practitioner doesn’t possess they CMTO. pists are currently regulated in four Canadian I have seen convictions RMTs treat as factual – even gospel – with- out critically examining their plausibility. was cut back in 2004. dition.. res- DON QUINN DILLON. speaker and mentor. Photo: Fotolia which previously covered massage therapy for all B. and RMTs. policies and position statements. idents.) Find him at MassageTherapistPractice. “Don’t pay more than ‘x’ per cent. In my experience. You don’t need to fear the operations. is a registered massage therapist. If you wonder about the validity of something you’ve Practitioners must realize they need to bring value to the heard or read.C. but turned-practice-brokers don’t appreciate the value of the are not typically employed in health-care facilities. It works hard to help you attain compliance with must pay for. I have found that many regulations and continues to do so.” Practitioners are often counselled they should expect and demand the lion’s share of the service fee. policies or position statements don’t is squeezed when rent paid is insufficient – leaving the busi. it’s the business owner who college’s standards. Because these convictions can have seri- ous implications for the business of practice. The plan.” The regulatory body gets shoul. ment-sanctioned health-care plans (Massage therapy ser- dered with many imagined policies. actual business compe.COLUMN PRACTICE POINTS Funny you should say that Massage therapy myths that persist BY DON QUINN DILLON O ur profession can be guilty of floating some pretty novel no- tions. con. For example. trainer and previous assessor in the au- to-insurance realm. carrying over ideas passed down to me by well-meaning colleagues who probably didn’t think them through when they adopted them from other prede- cessors. As a . practitioners who work as employee or contractors fail to “Massage therapy is ‘health care’. the professional practice advisor is available by phone tence. practice manager. I have contributed to that culture of con- victions myself. In my consultations with many RMTs-turned-practice-brokers. A practitioner is more valuable if she (CMTO) provides online resources for standards of prac- possesses the four Cs: capital to invest in the business. In ad- tacts to solicit for appointments. and the commitment to manage or contribute to or email and is very helpful. I tackle a few in this column.

. in private practice. massage therapy remains adjunctive – ers using considerable professional resources to incur influ- even alternative – funded out-of-pocket or by employers ence and upgrade the profession’s position. kets demonstrate the diversity that massage is delivered. on resorts regulatory colleges were still forming in Ontario. HST exemp. and disciplines in provincial health care funding. ful in positioning massage therapists alongside other health Write me at don@MassageTherapistPractice. The call for accreditation of massage training providers. victory required cross-profession collaboration. adopt practical applications only when you prove them the profession and its practitioners. they cannot by desired objective for many massage massagetherapycanada.. Practitioners work in massage therapy – zoomed past our profession in 2014 to spas. Generate discus- problems. Massage therapy is subject to the goods and schools and research literacy have also promised credibility services tax HST (many other health professions are Winter 2016 Massage Therapy Canada 13 . I encourage you to critically ex- “Regulation/accreditation/research will solve all our amine adopted RMT cultural convictions. Observe how the naturopathic and acupuncture profes- By extension.” While regulation has provided some value to sion. it has not been success. school accreditation and research liter- While being perceived as working within health care is a acy are important and necessary objectives. insurers. rehab or multidisciplinary centres. athletic/fitness facilities. Such a and cruise ships. time and money. isolation of your practice. through workplace benefit plans. to be true yourself. We should emulate their example. gatekeeper health disciplines and the (RHPA) – massage therapists are not treated as health-care public/media. These mar. Rela- ernment. insurer. Help people. in the eyes of these aforementioned authorities. gatekeeper health discipline and public/ tionships must be cultivated with the mentioned stakehold- media perspective. themselves achieve the credibility assigned to them. We’ll handle the rest. thus Before you adopt or support anything you hear in the massage cannot be relegated to a health care context alone. nor provided the hoped-for legitimacy with out to pasture. from a gov. even while their on-site in corporate workplace wellness programs. acquire regulation and HST exemption. “health care” represents only part of the sions – both smaller and arguably more alternative than marketplace massage therapists serve. Attractive.quarter century under the Regulated Health Professions Act government. and other situa.  While | For more information or to apply email careers@massageaddict. empt) and there remains no Medicare funding. a clear tar- tions where people use massage for well-being. Join our team of like-minded professionals improving the health of Canadians through massage therapy. predictable income Flexible scheduling Professional development Steady clientele Tools and support Recognition and rewards Canada’s largest and fastest growing massage therapy company. Opportunities across Canada Do what you love. share what antiquated convictions you would like to see put tion. get.

Do you need a ligations. Peer assessors will be actively looking easiest part. of aromatherapy products. Or. clinical. individual treatment. Down- cycles to avoid the whirr and buzzer comfortable and in control. to all the elements of the experience that 14 Massage Therapy Canada Winter 2016 massagetherapycanada. the Now. Clients should furnishing your space). addressed. There Cedars Spa offers “aromatic journeys” on display that might cause an allergic should be adequate space for: reception. massage engagements. In between or sesame seed. can quickly translate (also speaking from experience). sensory appeal and palette of you wish to promote yourself as a scent. kitchen? Do you have stairs that might be offered choices regarding the use.” you can certainly tial allergies. she travels to Africa to be with chimpanzees and writes about her zany travels for Schedule a massage and pay attention Matador Network. also has its checklist that needs to be retreats online. adjacent to the wave experience here)? If you do have pets been established to promote and it will help dashed-rocks looking out to the you’ll have to inform clients with poten. sanitizer. Offer your own reaction? Any nut-based oils? Is there a waiting area. writing out rent cheques if your husband or wife wants to make lit. you have free reign over a are on a massage table – in a positive and cots and face masks. Can you time your laundry spaces where the client feels on the secrets attempt to recreate it. welcom. client-centred treatment you to hone in open Pacific. there barking dogs next door? Do you tice. Anything fancy. the first obsta. Everything becomes amplified when you cords of equipment maintenance. search: “conducting a Try different prime real estate location of the course of your intended work day. years – a makeshift clinic in the basement ing and not a potential Dino-welcoming. walk through your house and the sound. Think temperature. Do you want to be viewed as online. the design fun begins. de. focus on the nearby road or house construction? Do be consistent with the public’s expectation. well ing. If you are in the preliminary stages of and ensure quality of care. but. measures have fringe. French Parisian glamour? Easy research into lost clientele. necessary items like tissue. On the CMTO While you might not have the sounds and smells that evolve over the website.COLUMN FEW AND FAR BETWEEN Room for movement Put some serious thought to designing your treatment space BY JULES TORTI R egardless of what planning bathroom that is accessible without cli.. obvious and searchable aren’t going to pull out the drywall when to and washroom facilities. Houzz or looking at are considering a home-based . Maybe you share a room Fred-Flintstone-home-from-work scene. industrial. for exceeding town Toronto might present a sounding off during treatments? Is there “The physical setting should client challenge. to guests. gyms. client’s privacy and comfort level? Do At home or in a rented space it’s essential cle is choosing a business name that’s you have secure hooks in the wall that to determine the overall “feel” you want memorable. has been in practice since 1999 and a freelance writer since age six. if signing your treatment room can be be an issue for an injured client? Do you proposed. with a German someone uses them to steady themselves a zen zone sanctuary. ents traipsing through your house? What fice must be clean.” hands-on massage would seem like the intended treatment space and observe.icate (if it’s your primary workplace).filing cabinets that can be locked and of your house. where the Ancient Cedars have a curious cat who might suddenly both traditional and nontradi. your certif- Maybe you’ve had a space for a few to ensure the space is suitable. “O” and umlaut.C. finger better yet. you can too. RMT. make sure you are aware of all the sights. oils daunting. custom essential oil blends and experi- ment with different carriers like avocado JULES TORTI. Are clinical massage therapy prac. well maintained. the College of your colleagues’ workplaces. Spa is “sheltered by the forest environments leap up on the table (I’m speaking from tional settings. bricks and mortar storefront with your not-so-affirmative way. expectations for an encounter your room. Once you’ve fulfilled the CMTO ob- name on an elegant looking signage. While the Ancient free clinic? Do you have fresh cut flowers with a health-care professional. The of- stage you are at (daydream. In ongoing efforts to protect the public can involve road trips to visit hotel spas. Though “Knots Landing” or “The Back portable heater or fan for the space? Are Alley” might seem clever after a few there blinds on the window to ensure a Mind your space cocktails with colleagues. Walk through as a first-time client would for visible fire extinguishers. Pin- deciding where to begin your career and Massage Therapists of Ontario (CMTO) terest. Instagram. and arranged to allow sufficient pri- or already in the aisles of Ikea butter chicken or fry up tilapia in the vacy for clients and staff. styles of Wickaninnish Inn in Tofino. re- with a team of massage therapists. When you begin taking all the have available parking? or lotions and/or background audio critical elements into consideration.” Because RMTs work in massage in all B.

rosemary and eucalyp. retreats. but. run all day long. it’s not wise to share space tus. Howatt set herself apart in Hess Village in a salon? Prepare for hot. Fifteenth century French grave with someone who is instructing dragon Words from the wise robbers armed themselves with this breathing techniques to yoga students in Designer Debbie Travis advises. Recreate the best of all your favourite by having her dog at her clinic.. but unique. I knew I could always expect a whirring treadmills. For instance. Ont.” Sage is the author of the book. “Design is absolutely Shannon Earnshaw’s style at Sentio. signifying clear great soundtrack – most often Natalie Are you in a lower level office close to skies and cleansing water and produces Merchant. I will remember with partitions instead of walls wasn’t in simplicity and rustic allure of the setting. I instantly appreciated owner ents. black and white When I lived in Abbotsford. for our own space and where the next client’s name is written. clinic) and it will ginger tea or a Clif bar after a treatment. There’s always room for movement in list of things you’ve loved and loathed? I prints trailing around your room. of us.” author Sessions. a unique worked in my practice in the last 16 years. rate your space to help you grow. Toronto. If you find work at a Natural materials and uncomplicated work. and most expensive cleaning product e-mail to the editor. “Wood blend believing it would ward off disease. B. If you rent a space in a hair salon. “Blue is a soothing shade. also offers therapeutic baths like a 25-minute beer soak you love – or don’t. home. Are you compiling your own mental option because you will have oily foot.C. in his cozy Cabbagetown home in weight stacks. The from the in-room electric fireplaces to prepared for the powerful smell of perm intentional and mindful creation of the little blackboards on the clinic doors solution on a daily basis. looks different for all liked that Brad Payne had a burbling fish room beside a public use toilet? Stair. massagetherapycanada. I like being offered purchase battery-operated votives. again. Invest hotel. are purposeful and practical. gym.” Whenever I booked with Rodney Osi. Looking for colour ideas? In a recent gna. in your ambience.” Look for Friday with MT Doug Sutherland. Is your treatment for those we love. beeping stair masters and House to Home article. Choose chairs that introduced me to Thieves Oil. Poll your photos of sand dunes or isolated beach- booked recalibrating massages every friends—what stands out for them? Winter 2016 Massage Therapy Canada 15 . “Deco- it’s the music: Sirius XM Coffee House utes. coco. make the space “you. I loved nut-scented wafts every 15 to 20 minutes. If a a massage clinic. the Grand Wellness Centre spa in Brantford. He I can tell you all the things that haven’t linens with texture. every three to five min. You can issue ear plugs to your cli. be another avenue for self-realization. of massage in all environments (spa. be a soundtrack of dropped barbells. keep in mind your entire day will style lines soothe and refresh. what about you? Anne Sage said. blend of cloves. Travis explained. serene spaces in your practice and share that pre-massage interaction – it con. but also for the Thieves oil. help you to hone in on the secrets for Or a hot citrus-scented towel (it’s just as Whether you choose to hang vintage exceeding client expectation.When I go to the Sentio Clinic a subway tunnel? Those subway trains a spa-like feel when coupled with white.In addition to massage therapy. I end of a long haul flight). In her Los Angeles Times piece. Try different styles like places that have good. zines on the table. If you’re investing in flooring and your images and ideas with Massage firmed the power of animals in instilling thinking laminate – investigate your best Therapy Canada readers by sending an calm. rewarding as being handed one near the anatomical drawings. tank in his Yonge street space. Martha well? Are you across from a tanning bed Sage Living: Decorate for the LifeYouWant. and hair dryers.” at the Bread Factory in West Galt. him most for his killer sacroiliac joint my comfort zone. I running constantly.. recent maga. beauty around us. the room beside you. landlord is concerned about candle use. Working in a space is a natural element that maintains the especially the plague.

comes scep. the While creating treatment plans to return patients to prior body’s largest exteroreceptor synapsing with the central injury status is complicated and multifactorial. the skin there are a number of mechanoreceptors which help tissue quality and improvement in activities of daily living to facilitate sensory processing. massage therapists are looking for new modalities to help re-enforce treatment strategies outside of the clinical Lymphatic draining application: Long anchors of tape are cut into space. settings.FEATURE MODALITY STICKY SITUATION Exploring effective applications for kinesiology tape F BY CONOR COLLINS or many massage therapists. No tension whatsoever is pulled on the tape. respectively. Within the epidermal and dermal layers of common goals all massage therapists have. Pain. With current research advocating for active recovery programs. there is an endless quest to improve patient care and decrease the time frame by which patients have to deal with acute or chronic conditions. 16 Massage Therapy Canada Winter 2016 massagetherapycanada. This is done through utilizing the power of touch. the easier pattern. swelling. The effects of tactile stimulus is kinesiology taping. In general. You can reach him at www. it has increased in popularity in a number of Australia.conorpcollins. and more an integral role in pain reduction in both acute and chronic recently in including track and field. Kenzo Kase. one thing will al- ways remain the same: A massage therapist will not fix every patient they treat. Slow adapting mechanoreceptors continue to send information to the CONOR COLLINS is a massage therapist and sports injury therapist based in central nervous system as long as they are being stimulated. there are nervous system. Kinesiology tape was developed in on pain reduction have been well researched by both the Japan in the mid 1970s by Dr. With any new modality there are both benefits and strips of four and laid over top of each other in a basket weave style risks associated with the intervention. Massage therapists apply these principles and play athletic environments. “How does kinesiology tape in an attempt to modulate signals from the peripheral and work?” and “Can it be used as part of a treatment plan in a central nervous system. a modality is for a patient to understand. A massage therapist’s first point of contact is the skin. runners and similar continuous. Ont. While the profession moves forward and makes advances in research. ing to skin shear and light touch. Ancaster. and made its Body in Mind Organization of the University of South first mainstream appearance in the 1988 Seoul Olympics. tactile stimulus to the central injuries to the foot and ankle. With popularity. massage therapy practice?”.com . He has been using kinesiology taping in his practice for almost Through its elastic properties kinesiology tape provides a decade. ticism and the question of. He has a special clinical interest in treating triathletes. After the patient leaves the treatment space. The ruffini endings and are measures that can be followed both subjectively and merkels discs are slow adapting mechanoreceptors respond- objectively throughout patient recovery. also in Since then. the more compli- ant the patient will be with the instructions surrounding it. Australia and the Neuro Orthopaedic Institute. low grade. nervous system. Pain is the most common stress response due to injury One modality that more massage therapists are turning to that patients associate with. however.

kinesiology tape does not yield a shown to have a better opportunity to recover. when tissue is loaded and manipulated over time. Early stage intervention through both manipulation and taping may help facilitate the healing process and lead to less complication from scars long-term. In the past. SWELLING In acute scenarios the cardinal signs of inflammation are often seen as a by-product of pathological response. compres- clearly understood is that both manual therapy and exercise sion-based therapies. research exploring fluid management and kinesiology tape examined whether it directly influenced perfusion to an injured area. Models of treatment are based predominantly on the anatomical organization of tissue. but research on its ap- Less understood is the influence that superficial healing plication continues. cally sensitive in creating a painful stimulus. one topic that appears to be unable to tolerate. it has been As with all modalities. fascia and muscle deep to it. An example of this is the onset of lymph oedema following the removal of ax- illary lymphatic nodes post Winter 2016 Massage Therapy Canada 17 . fluid accumulation may be present due to poor tissue quality or a change in the anatomy of the systems responsible for fluid clearance. Tape is ap- plied to create low-grade shear force on the skin during the healing process. This is done in an attempt to influence ing pain perception and fatigue often associated with injury. A benefit is that this force can be applied to the skin for significantly longer periods of time than a typical manual therapy treatment. the space between the dermis and superficial fascial layer. and allows the therapist to treat tissue in a stage of the healing process that is often ignored. dysfunction and lifestyle. research has refuted this with each individual piece of tape pulled (at 50 to 60 per cent of its claim. Tissue quality is always a topic of discussion in the field of For massage therapists practising lymphatic drainage. While the field still apy. may help re-enforce the massage therapist’s treatment goals. In 2004. negative side affects to this modality. and may offer additional modality where patients are awaits definitive research. If the patient is unhappy tion to myofascial pain syndromes. complications and symptom presentation. plays in this process. Lymphatic kinesiology tape applications are applied in a tactile stimulus produced by the tape may assist in decreas. the therapist attempts to increase a superficial scar’s mobility on the layers of fat. system in fluid management. while new research explores the role of the lymphatic tension) in opposite directions. or were unsuccessful with. Through the work of Lewitt and others. the tape is thought to assist the otherwise passive SCAR TISSUE lymphatic system in clearing fluid from the interstitial space. In these cases and serve as a viable adjunct to a manual therapy practice. “web-like” fashion. Taping offers the massage therapist a therapeutic modality that may be of benefit. desired clinical result in every case. Taping was thought to increase or decrease blood flow through mechanisms similar to com- Scar taping application: Tension is applied over. More recently. Overtime. superficial scar manipulation has become more clinically relevant in mas- sage therapy. He encouraged the early with the tape application. massagetherapycanada. Force is applied in an attempt to improve tissue quality of the scar as granular tissue proliferates within the injury site. examined the What does remain to be true is that there are very few clinical importance of superficial scarring and it’s contribu. Kinesiology tape is used in a similar fashion. By manipulating tissue in the early stages of healing. Karl Lewitt. In chronic conditions. the quality of collagen laid down tape offers a low-cost and minimally invasive modality that has been shown to be less functional and more neurologi. or beside the scar pression therapies. ki- massage therapy and the debate continues as to whether nesiology tape may be an excellent adjunct to manual ther- therapists can “break down” scar tissue. they simply remove the tape from manipulation of superficial scars to prevent long-term the skin. responses of injury. Kinesiology In chronic conditions. can control and increase the function of tissue during the The ultimate goal of the therapist is to manage the stress scarring process.

” massage therapists. a physiotherapist. You gradually built a network of multidisciplinary prac- may contact her at mdeguzman@annexweb. says Wallis-Duffy.000-square-foot upstairs level of the the rest is history. She has been a journalist for more than 15 years. had a vision. Turn wanted to earn the respect of medical professionals. titioners providing a whole range of health and 18 Massage Therapy Canada Winter 2016 massagetherapycanada. she has worn many hats – regis. “The other reason: I used ‘associates’ because I osteopath (who is also a RMT). and media practitioner. “I was she received the 2015 Brampton Board of Trade nervous because it matters.” Wallis-Duffy explains. They are all operating under the pregnancy to palliative care.” In the 24 years since Wallis-Duffy graduated from Begin with the end in mind Sutherland Chan. an moments.300-square-foot midwifery The vision was to establish a diverse health and and breastfeeding clinic. this RMT takes practice to a new level S by Mari-Len De GuzMan he is the recipient of several business Wallis and Associates umbrella. Within six weeks (of opening). throughout her 24-year career. Most recently. She started as a solo practitioner and magazine. a family counselor. and a me. FAILING Wallis-Duffy could have been taking a page from tered massage therapist. clinic. she won the Small Business of tion to attendees at the Massage the Month award from the Brampton Board of Therapy Canada Business Forum last September. And ing in the 2. “It sounded nary practice in Brampton.” she smiles. two naturopathic doctors. a registered dieti. because I believe in this Award of Excellence in Communication. Downstairs is a 1. Ont. years into practice. and within eight weeks I had two. which houses eight teachable professional. therapist. Women of Achievement award in the category of “I was nervous speaking in front of a small group sports. but Her efforts in the community have been recog- when Margaret Wallis-Duffy was nized through the years as well. of massage therapists. failures into It sounded like a law firm. I wanted there to be more than just cian.. learning. but it was done with a purpose. Wallis-Duffy has built a successful multidiscipli.COVER PROFILE Media savvy From treatment room to television. I had one other pedorthist. multidisciplinary clinic FORWARD Stephen Covey’s Seven Habits when she opened her owner.” Wallis-Duffy admits. profession. wellness and healthy living. entrepreneur. just five about to deliver a keynote presenta. and it is no coin- awards and has spoken confidently at cidence that Wallis-Duffy is at the heart of this community and health-care events operation. These are just the professionals practic. from medical . She named her practice Wallis feels it is time to give back to the massage therapy learn from one’s and Associates – a seemingly unusual name for a profession and share two decades of accumulated mistakes and health practice. In 1997. She is the 2008 recipient of the Zonta her hands were shaking. who is also an internationally certified infant massage MARI-LEN DE GUZMAN is the editor of Massage Therapy Canada instructor. knowledge and experience in the hopes of helping moving forward “It was a deliberate name I chose for two reasons: other RMTs make sense of the business side of from that I wanted to (show) our power as a therapist and I practice. She The ability to own clinic in 1992. with five midwives and a wellness practice focused on holistic health.

the belief has to be there. I could have my own vision. believing in that vision and sticking of the doctor. sitting in the clinic and waiting for people to show up at the door is not always the best way to grow a practice.” opportunity to educate – It’s not just about bringing food and referral pads and that is what I am that got medical professionals referring patients to Wallis-Duffy’s clinic. I love people and I wanted to have diversity in what I do. “What I did see from and earning people’s respect. For starters.” Wallis-Duffy cost a fortune.” outreach or volunteer work can be more valuable Before vision. she says. Her passion for the power of touch on people’s health was the fuel behind the growth of her prac- tice. Business Forum. “You need to be thinking while you’re still in Marketing your clinic to the community need not school about where you’re going.” Wallis-Duffy says. After witnessing how the therapist conducted postural assessment and neurological testing. however. and that I could really see people from pregnancy through to palliative care. take care of the caregivers?” Wallis-Duffy says. Wal- lis-Duffy was convinced massage therapy was the career for her. massage therapy treatment as a student in the ki- nesiology program at the University of Waterloo. but the owner of Wallis and Associates admits it took time. volunteering wellness dawned on her when she went for a your services at the community hospital or massagetherapycanada. the physio- wellness services. she conveyed the importance of “We had to go in and prove and earn the respect having a vision. Is yours worth catching?” embodies her belief in massage therapy and in elevating the profession. who says Photo credit: Mari-Len De Guzman notes. “Attitudes are contagious. effort and lots of creativity to get to where the practice is today. The regular visits of the Wal- passionate about. “I always knew that I was interested in the human body and health care. Wallis-Duffy is as passionate about the massage therapy profession as she was 24 years ago when she decided to pursue it as a career. she never spent money on traditional advertising. potential to significantly affect people’s health and Participating in local health fairs. “What really attracted me (to massage therapy) was that I could be an entrepreneur.” lis team to doctors’ offices included spending time to provide complimentary health-care services to the physicians’ clinic staff – it could be a massage therapist providing in-chair massage. according to Wallis-Duffy.” she recalls. but you really have to think about being ahead of Spending time in the community through various the curve. for the practice than thousands of dollars spent on she adds. therapist showing some stretches or naturopath Talking to massage therapists at last September’s offering some advice on health.” Beyond the treatment room Today. television was my It just cost time outside of the treatment room walls so that I could build a business. What physicians’ office does not like to it – and the journey toward that vision begins way the idea of having a group of therapists coming to before the RMT’s certification and registration. That I could own a business and a clinic. “I was visiting doctors and bringing banana breads – that our team baked – and referral pads. The belief in massage therapy and its a newspaper or radio ad to promote one’s clinic. that I could work in a hospital but didn’t have to. “I found creative ways that didn’t have to cost Winter 2016 Massage Therapy Canada 19 . Her motto. “I know you have to focus on your studies.

featuring various health and wellness Camera-ready ing course. but it’s not money you spend out of your pocket.” Johnson brand. Wallis-Duffy says one must learn to pay attention. was a huge opportunity for marketing. “I wanted to have a broad- treat everything as a learning experi. as called.” she says. The company paid for video series on several health topics Wallis-Duffy to undergo a media-train. there Naturally. every therapist is encouraged to offer a maximum of five complimen- tary treatments a year. even conducting free health information sessions for the community – these are some of the things a therapist can do to raise the clinic’s profile and. WOW how we can do it better. what we did wrong and nities was an offer to be a media Since it launched in 2010. opportunity.Wallis-Duffy points out. which had a segment that is what I am passionate about – marketing then comes into play. evaluating what professionally.” Her television stints led to more be a two-way communication tool us- “A lot about this business is trial and opportunities for her practice to gain ing social media. “What I did see from television therapist. likely to develop a lasting relationship was followed by several more guest Wallis-Duffy describes WOW Media with medical doctors once trust and appearances on Cityline. at the same time. that makes up to 40 treatments that the clinic is giving out to the community for free. In addition to running a tandem with referrals: Communicate.” She recalls watching an episode of was my opportunity to educate and The principle of word-of-mouth Cityline years ago. One of those opportu. Years later. for example. as it likely it certainly opens the door for people show that would bridge the gap. This health and wellness topics. educating people on would likely refer patients to a therapist the program’s “wellness experts. happy clients and positive outcomes started faxing the TV show (this was Massage therapy absolutely deserves to lead to the all-important referrals. web-based.” we did right. “Yes. She educating people on integrated health. educate the community about the benefits of massage therapy. It would to “fail forward. one-on-one. At Wallis and Associates.” result in success. it’s money out of your time. Should it? Not necessarily… but cast-quality online television and radio ence. related to massage therapy to Cityline clinic and treating patients. “I knew that with the Internet.” she educating people about evidence-based 20 Massage Therapy Canada Winter 2016 massagetherapycanada. offering free treat- ment or fundraising for a good cause. Wallis-Duffy adds “exec- Associates. Health and Family Day. before the time of computers and play an intricate role in the integrated Doctor referrals comprise 80 per cent e-mails) offering her expertise as a mas. “But that Margaret Wallis-Duffy shows off a quote that has served as a guiding principle in all she does. gage the community and get their up. they feel confident about. but it builds a stronger foundation for the practice. Every day for one year.” would be in educational form. a multimedia business etiquette to follow-up and colic to the latest research on reducing production company that produces thank the referring physician. picking myself traction and for Wallis-Duffy to grow. recalls. feedback. not every endeavour will keting tool. “Being on Cityline was a great mar. does.” Wallis-Duffy says. It takes time. to prove to your patient that you should be their into unknown territory: television. and estab. “By the end of that course I knew I production company as a platform for apy also led Wallis-Duffy to venture was bitten by the media bug. dusting myself off. The therapist is segment at Wallis-Duffy’s clinic. she also Wallis-Duffy says it is always good – from growing pains and babies with spearheads WOW Media. and moving spokesperson for the Johnson and Media has produced a number of web forward each time. but it’s important to evision brings credibility? Maybe it she says. as a one-stop health and wellness “desti- respect are earned – and the doctor lished the Brampton RMT as one of nation” for families.” of the people who walk into Wallis and sage therapist on various health topics. Update chronic pain in adults. experts. because we can en- error – failing forward. “Do I think tel. When things go south. it works. wanting to do a taped podcasts – focused on integrative back to the doctor. medical model.” holistic health and integrative medicine. Wallis-Duffy wants to use her Belief and confidence in massage ther. It will. “broadcast-quality” educa- them on the treatment plan for the Finally.Wallis-Duffy was utive producer and host” to her profes- Another best practice that goes in pitching story ideas on health topics sional titles. the call from the TV show’s tional programming – videos and patient and communicate the results producers .health-care centre. With eight mas- sage therapists at the clinic.

This acclaimed book delivers beautifully illustrated information for learning palpatation and the musculoskeletal system. and what we do in our profession. It circle to expand her learning. Continuous learning want to be able to make sure that when and how it can help with lymph drainage.” she says. in the hope of engaging an audi- “We have an aging population. series of Tweets around a particular she says. I ence. 206 bones. but provide the best service from a Wallis-Duffy’s clinic waiting to see the ness. picking more of the profession in these educa- tion videos.indd 1 2015-12-02 4:23 PM . The storyline was on osteopathy. sional Consultant on Aging. dusting myself off. myself up. “What should be happening is an on-going series on the power of touch evaluating what we did right. With 504 pages and 1.” business through the Certified Profes. Although she has been in practice for 24 I am seeing patients that are seniors. She and saw our storyline on osteopathy. but what did certification to become an age-friendly She recalls doing a Twitter storyline – a we do first? We educated. “It’s a remarkable tool. It makes mastering the essential manual therapy skills interesting. massagetherapycanada.integrative health care and more im- portantly. as well as practice building. This edition includes an extensive appendix that describes the common trigger point locations and pain pattern of 100 muscles. She regularly attends Winter 2016 Massage Therapy Canada 21 MTC_TrailGuideToTheBody_BookAd_Dec2015. uses Twitter to drum up conversations converted to business four days later. a mother and daughter showed up at her knowledge about health and well.Wallis-Duffy continues to broaden that I am not only able to treat them. Wallis-Duffy is currently undergoing on various health topics. Her hope is to be able to highlight error – failing forward. memorable and easy. about the role the massage therapy profession plays in wellness A lot about this business is trial and promotion. from pregnancy through to palliative care.” TRAIL GUIDE TO THE BODY. She has also taken social media “How did they hear about us? Twit- even speaks at many of them. years. The mom had lymphedema from makes it a point to go to conferences new concepts around social media cancer and the daughter was on Twitter that are outside the massage therapy marketing to her own practice. Before you can assess or treat a muscle. you first must be able to locate it. business perspective. 33 ligaments and 110 bony landmarks. osteopath.400 illustrations covering more than 162 muscles. She courses and has applied many of the ter. as well. topic. REVISED 5TH ED. this text provides an invaluable map of the body. A few days after posting the Tweets.

There is maintain joint stability. TECHNIQUE Like the reins on a horse. not parallel. For more information on LAST visit lastsite. inhibiting mus- patients in mind at all times a paper in which he stated that liga. wide collagenous. I’ll pro.” was published in the Interna- tional Journal of Therapeutic Massage and Bodywork. and improve the quality of life of your a joint stability system in which mus. are inseparable. tomuscular reflex activation of associ- In an This reflex has been formed practice. practices full time and instructs LAST courses across Canada. ligaments LAST resort constantly assist in the stabilization of a joint. rounding tissues. aments and joint capsules are now seen the research supporting the theory for weave and function mainly in an not as completely separate structures ligamentous articular strain technique “in-series” situation rather than an but they are embedded. clini. When you contract a muscle. “Fascia and Sports patients – it has for mine.” This ligamentous system is part of ROBERT LIBBEY. They are in espe- BY ROBERT LIBBEY cially high concentrations at the ten- operiosteal and ligamentoperiosteal oday’s massage therapy WHAT WE KNOW NOW enthuses. local densifi- (LAST). during both concentric and eccentric muscu- lar . ated muscles. Many anatomy texts ceptors in ligaments trigger a ligamen- and evidence. these and the surrounding tissues Muscular activity elicited by this tion into their clinical reasoning. dynamic absorbing system. reflex allows muscles and ligaments to ing the best interests and goals of their In 2009. keep. However. I explore ous connective tissue (RDCT) inter. Jaap van der Wal published work together as a unit. 22 Massage Therapy Canada Winter 2016 massagetherapycanada. fibrous mostly ten- of LAST in treatment. These mechanore- techniques ceptors are everywhere throughout our T connective tissues. non-stationary organs. the ligaments are automatically engaged.FEATURE Annular ligament and radial collateral ligament the musculoskeletal system – an often overlooked functional parameter as to proprioception in the locomotor appa- ratus. shown to exist in most joints of the cians are aware of emerging evidence. portray ligaments. “The ar. chitecture of the connective tissue in sion driven interconnected system. Thus. cations. In the second article. regardless of its position. Medicine. in vivo. fact. Ligaments are considered RDCTs. sules and muscles as separate tissues. “in-parallel” situation. local specifications of a body- vide case studies documenting the use Van der Wal’s paper titled. the periarticular con- nective tissue is loaded and stretched both by the movement of related skel- etal parts and by the tension of the muscle tissue inserting to this connec- tive tissue. in actual extremities and in the spine. profession is committed For many years we have been taught Ligaments are highly dynamic and to utilizing techniques that ligaments and muscles were sepa. “Lig- In this first of two articles.” Robert Schleip states. and rationally integrate new informa. cular tissue and regular dense collagen. They are responsible for kinesthetic and propri- ligamentous articular strain oceptive sensation. joint cap. Both live and online the fascial connective tissue referred to courses are accredited for CECs by all Canadian provincial massage therapy regulatory bodies and also as the multimicrovacular collagenic the NCBTMB in the USA. which are not connected to the sur. cles that destabilize the joint and in- Practicing in this manner has the ments are mostly arranged in series creasing antagonist co-activation to potential to transform your practice with the muscles. cartilage. Mechanore- informed from research rate structures. In the DVD. Afferent mechanoreceptors in liga- ments provide significant input to sensation and contribute to the syner- Dissecting the evidence for gistic activation of muscles. RMT.

lymphatic and blood flow. Movement. mainly ligaments.“Manual techniques that target mechanoreceptors have been proven to affect autonomic functions.. prevent and/or ameliorate soft tissue adhesions. found everywhere in our organism. ligamen- tous and periosteal fibrous tissues to the axial fibrous tissues. tendons and indirectly. and thus. increasing local proprioceptive attention. They suggested that “therapists might be encouraged to aim their soft tissue techniques to a lesser area where there is known to be high density of mechanoreceptors. J. connecting not just the vertebral column to the sacrum. I see this “ligamentous stocking” as being organ- ism-wide. MECHANORECEPTOR-SPECIFIC TECHNIQUES LAST affects the connective tissues of the body. leading to injury. capsular.” HM Langevin and his colleagues proposed that ther- apies which briefly stretch tissues beyond the habitual range of motion (massage) locally inhibit new collagen formation for several days. In 2014.. such as low- ering sympathetic nervous system activity. joint capsules.” Guimberteau. but also connecting the various appendicu- lar interdigitations of membranous. causing a decrease in active muscle tone and affecting both the local blood supply and the local tissue viscosity. Andry Vleeming uses the term “ligamentous stocking” to describe the connectedness of fibrous soft-tissue structures of the lumbar vertebrae to the sacrum. fascia. C.” In the DVD. and the autonomic nervous system. concluded that spe- cific myofascial receptor techniques might not only im- prove ROM but also have a longer lasting effect than classical (Swedish) massage techniques. Manual techniques that target mechanoreceptors have been proven to affect autonomic functions. Min-yeong Kim and colleagues from the . In a study presented at the Third International Fascia Research Congress. Stability & Lumbopelvic Pain. is to prevent a level of resistance that would permit the collagen to shear. “Strolling Under the Skin. Viklund.” In the book. et al. states that “the role of this rubbery elastic shock absorbing system. muscles. Manual therapy has been shown to affect the fibrosis and densification of fascia by changing its tensile status and sliding components.

proaches incorporating mechanore. 1800s.” Several of these were lig. tissues into the direction of ease. leading to “Indirect techniques” follow the tute. search and advance this technique and discharge for visual analogue scale Ligamentous articular strain tech. local and systemic effects on our phys. many of the tech. velocity low-amplitude techniques. taking the tissues to the first tissue re- The authors stated. traction methods. These “direct tech. therapy profession. the ligamentous articular tissues. our understanding of all tissues not just agement of cervical disc herniation In the early 1900s. permitted motions of the dysfunctional observation of muscle energy tech. techniques. when Still was innovating man. This has the suit the scope of practice for massage of this article at www. searching for a more precise and spe. I will (TOS). I have For a complete list of references. All these research directly affect contributing to the conservative man. improvements were reported in the tissues. niques initially developed were called published from the fascial community ment focused on muscle energy tech.” became known primarily as high into practice. “The successful outcomes suggest ual therapy. “Significant cific technique that targeted the joint sistance barrier. The majority of the . “Di- niques and ligamentous articular strain HISTORY rect techniques” match the reciprocal in two cases of cervical disc herniation In the beginning of my career. redefined the techniques of LAST to check out the online version iological environment. niques. and various myofascial techniques. bring it into today’s evidence-informed (VAS) and neck disability index (NDI) niques (LAST) originated in the late practice standards for the massage scores and physical examinations. My journey led me to Andrew It has been a passion of mine to re- outcome measures at admission and at Taylor Still. I began tension of the dysfunctional tissues with thoracic outlet syndrome. (CDH) with thoracic outlet syndrome niques were modified by therapists that In the next article in this series. potential to positively affect the therapists. massagetherapycanada. ceptor-specific techniques have both Over the course of my career.” wanted to focus on a 24 Massage Therapy Canada Winter 2016 massagetherapycanada. cus on the ligamentous articular tis- ular strain (LAS) are effective in amentous articular strain techniques sues. New research is continually being that integrative conservative manage. LAST and evidence-informed research clinical finding that treatment ap. more direct present case studies that incorporate Research confirms the common method of treating. known as “indirect and from leading researchers who fo- niques (MET) and ligamentous artic. functionality of the patient.Technique for long head biceps and Technique for coracoid ligament glenohumeral capsule Jaseng Spine and Joint Research Insti. published research on the “clinical an improved quality of life. a doctor of osteopathy.

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these online ser. it also cess online. Most massage therapists accept credit to distribute this knowledge. fective collaboration amongst geo- ing-down” these devices when they are device-responsive website. and worth their while to leave these matters to their trusted IT advisor. Smart phones are they address both your in-person and Smart tablets are in. taining their computers and Internet there are substantial benefits to a sys. treatments. be well. associations and related or- venient than traditional laptops. these tablets are more con. no matter what de. client needs with a mobile-friendly. This need assistance setting up and main- practices to large clinics. their computing devices are available other for charting. provider of massage therapy websites and The very best to you in 2016. yet an. run inquiries immediately and from any. ranging from individual solo line through the RMT’s website. to utilize these organizations’ online the Internet and are compatible with Savvy RMTs will also continue to learning resources to their fullest ex- advanced RMT practice management recognize that their clients are also tent. findings. Just like the in-person infrequent occasions when help is provides therapists a single point of merchant accounts. most of these merchants offer foresee affecting RMTs in 2016 Realizing smart phone technol. This trend encompasses research services. smart tablets are now legitimate screens. RMTs are adopting the Internet business tools with fully featured oper. vice they are using. They are finding it keeps their user support and the benefits of an vices charge a fee based on a small practice running smoothly and is well integrated system to manage their percentage of each transaction. RMT prac. RMTs need to use best There is a growing trend to fulfill these The Internet affords time and cost-ef- practices with respect to “lock. They see the benefit of colleges. Not only does this your website that your clients can ac. that a growth in Masters and PhD level records. or products (gift certificates. Mas. see more RMTs moving to these ser- entertainment devices they once were. and the list goes on. professional social media sites As a cautionary note. JESSICA FOSTER writes on behalf of mindZplay Solutions. 26 Massage Therapy Canada Winter 2016 massagetherapycanada. visit www. such as client knowledge they employ in practice and top computer. as well as private online user groups. We increasing the body of evidence-based services to manage practice. Should your tablet get lost site visitors to access the information and alternative medicine (CAM) or- or stolen you do not want anyone to on their site and hopefully create online ganizations. clearly mainstream communication online payment transactions. RMTs will continue to adopt study. they do not replace full-fea. research and . they are devel- tem that combines all these tools into processing services that integrate into oping business relationships with local a single solution. As a result. that in turn uses the Internet sage therapists historically used sepa. We see this trend continuing possibly a nominal monthly fee. it is critical that another for treatment billing. card payment as an option in the form Use of IT professionals. vices in the coming year. creasingly wishing to pay for services when they are due to their importance of catering to their needs. provide access to where with a cell/Internet connection. mobile-centric and understand the websites. However. their practice activities. recognizing that from time to time they tices. research into CAM specializations is Continuing trend in use of online Online merchant accounts. One could also speculate have access to your clinic and personal booking requests. RMTs ogy in their practice. In ness technology trends that we into 2016 and beyond. addition. smart phones to keep in touch with for research to aid in increasing the ating systems that perform like a desk. traditional card swiping devices. needed. As RMTs age various aspects of their practice: of “in-person” payment systems via become increasingly reliant on technol- one solution for schedule management. next time.) on. portability. etc.COLUMN RMT TECH TALK Business technology trends and outlook for 2016 I BY JESSICA FOSTER n this issue we review some busi.massagemanedger. They using smart phones to respond to client ganizations encourage practitioners to are lightweight. For both in-clinic and mobile therapy tured computing devices and larger Online search. Therapists are Over the past few years. practice. are now finding their clients are in. provide clinically useful feedback and business applications. Many merchant account vendors offer appliances. in-person card swipe terminals so that and beyond. Until practice management solutions. To learn more. ing schedule. have realized is a client preference worth noting. More and more. ogy limitations. Smart tab. rate vendor specific solutions to man. This allows graphically dispersed complementary not in use. IT professionals to assist them on those approach offer cost savings. RMT viewpoint. From the practitioner’s booking requests and viewing upcom. are living in a plastic payment world. We fore- lets today are no longer the simple tools and are a valuable business asset. very portable.