Massage Therapy

Scope of Practice
The practice of Massage Therapy is the assessment of the soft tissue and joints of the body and the treatment and prevention of physical
dysfunction and pain of the soft tissue and joints by manipulation to develop, maintain, rehabilitate or augment physical function, or relieve pain.
(Massage Therapy Act, 1991)
Standards of Practice and Encompassing Statements
The Client understands the Registered Massage Therapist (RMT) is providing service within their scope of practice as defined by the
College of Massage Therapists of Ontario (CMTO).
The Client acknowledges that the RMT is not a Physician and does not diagnose illness or disease or any other physical or mental
condition. The Client understands that the RMT is not a substitute for a medical examination. It is recommended that the Client attend their personal
physician for any aliments that they may be experiencing.
The Clients Health History provided is accurate, complete and up-to-date. It is the Clients personal responsibility to keep the RMT updated
on their prudent information, medical history and immediate family association along with any future changes, and is aware it is used to treat them
safely and that not providing such could lead to unforeseen risks, consequences and side effects.
Client is aware of the nature, purpose, clinical reason(s), benefit(s), risk(s), consequence(s) and contraindication(s) of the Assessment(s)
and/or Treatment
The Client is aware they have the opportunity to discuss and question their RMT about any of the components of Massage Therapy as
outlined by the CMTO.
The Client accepts that there is no guarantee of the effectiveness of the Treatment.
The Client may experience some discomfort or pain, emotional or physical release, coldness or heat, and/or a burning or tingling sensation
from some of the Techniques, Modalities and/or Tools being used and in the following days. The Techniques, Modalities and/or Tools being used will
follow all protocols as outlined by the CMTO in there application.
The Client is aware of the comfort/pain scale—1-to-10, 6-and-7 being the difference between pressure and pain—and despite frequent
inquiries by the RMT of their comfort/pain during Assessments and/or Treatment it is the responsibility of the Client to inform the RMT of their
status.
The Client is aware that they may alter and/or stop any of the related components of their Assessments and/or Treatment at any time, and
takes responsibility to inform the RMT.
The Client is aware and does not expect the RMT to anticipate all the risks, consequences and side effects. The Client wishes to rely on
their Registered Massage Therapist to exercise proper judgement and make decisions based upon their best interest.
If the Clients experiences any improvements, it is good to use and maintain them, but don’t overuse; allow for adequate recovery time,
which is typically 24-48 hours.
Assessments
The nature and purpose of Assessments is to have a better clinical understanding of the symptoms the Client is presenting with. The
benefits is so the RMT and Client can make a safe and effective Treatment Plan. The consequence of not going through with Assessments is we may
not see something potentially harmful to the Client. In the case of a medical emergency being present, the client will be immediately referred out. The
RMT may need to touch and move the Client throughout these assessments. These Assessments are meant to provoke or intensify symptoms and pain
and may continue to do so in the following days.
Treatment Plan
The nature and purpose of a Treatment Plan is to address the Clients goals. Not continuing with this Treatment Plan may result in the
Clients condition staying the same or worsening as a consequence. If the Client or RMT wants to stop the Treatment Plan or believe it would be
better continued with another healthcare professional, the RMT will refer and discharge the Client. The Client will also be discharged in the case of
inappropriate and abusive behavior and/or comments.
Remedial Exercises
The nature and purpose of Remedial Exercise is to address the Clients goals. The benefits are to increase strength, length, endurance,
balance, coordination and/or agility. The consequence of not doing these Exercises is it may affect the Clients overall health and lengthen the duration
of the Treatment Plan. Not everyone is the same and therefore cannot perform the same exercises. If the Clients feels they cannot do an Exercise
safely after the RMTs demonstration, the Client should inform the RMT and the RMT will stop and modify the Exercise for the Client. If the Client
experiences any adverse reactions—such as shortness of breath or dizziness—the Exercise will stop and not be used. There should be no pain or
muscle fatigue during these Exercises. This can lead to substitute motions, disrupt the healing process and increase inflammation, and we are trying
to target specific tissues and progress safely towards the Clients goals. And if this occurs beyond 3 days, which is delayed onset muscle soreness,
contact the RMT and the RMT will make adjustments to the determinants—sets, repetitions or duration.
1. Each exercise program requires the Client to start with a warm-up and finish with a cool-down. This ranges from 5-10 minutes. Ex. are
walking, a warm shower, active range of motion, loose stretching, etc., but stretching should not be the first done because cold tissues are
easier to injure.
2. Rest intervals are taken after every exercise or set for 2 minutes or more.
3. The area should be safe and clear to move in, and not distracting.
4. Client and/or RMT should inspect the equipment for integrity prior so neither hurt themselves.
5. The Client should breathe throughout these activities, so they do not cause internal pressure on their organs—this is called the Valsalva
maneuver and can be harmful.
6. These activities should be done in a slow and controlled manner.

Client Name (print): _______________________________________ Substitute Decision Maker Name (print): ________________________

Client Signature: __________________________________________ Substitute Decision Makers Signature: __________________________

Date: ___________________________________________________ Date: _____________________________________________________