Massage & Bodywork

November/December 2009

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reader forum WHAT YOU ARE SAYING Scope of Practice I look forward to every edition of Massage & Bodywork magazine. However, the September/October 2009 issue contains information in two articles by Christy Cael that seems contradictory. In her article, "Scope of Practice" (page 56) Cael states, "It is tempting to encourage your client to do shoulder rolls to relieve their neck tension between appointments or to stretch their wrist fl exors after heavy computer use. Be clear that this is not within your scope of practice as a massage professional and may actually be excluded by your state law." In her second article in the column Functional Anatomy ("Quadratus Lumborum," page 97) Cael writes a sidebar called Client Homework— Stretching and proceeds to explain how to stretch these muscles. How can she advocate giving a client homework in one article, when she clearly states in the other article that it is not within our scope of practice to do so? DONNA BYLINA TINLEY PARK, ILLINOIS AUTHOR RESPONSE Thank you so much for your question. The information in the two articles does seem to be contradictory, and I appreciate the opportunity to clarify. Though our scope of practice as massage therapists is limited, our clients may ask for educational resources. The Client Homework—Stretching element in the Functional Anatomy article is intended as a take-home resource for clients experiencing issues with the profi led muscle. The intention is not to teach clients to exercise or perform stretches as an integral part of a massage session. The identifi ed stretches are intended as self- care to be done by the client outside of the massage session. Offering a resource is different than structuring and overseeing a program of therapeutic exercise. The article "Scope of Practice" stated that massage therapists are "working outside of their scope of practice if they integrate therapeutic exercises, or any exercise for that matter, into their massage practice." The stretches identifi ed in Functional Anatomy should not be performed within massage sessions or progressed by massage therapists. Additionally, many states limit a massage therapist's ability to assign specifi c therapeutic exercises, volumes of exercise (reps and sets), and exercise progressions. It is important that massage therapists work within these boundaries. The Client Homework—Stretching segment in Functional Anatomy specifi cally excludes duration of stretches (time), number of repetitions (volume), and frequency of stretching in an effort to comply with state laws and maintain your scope of practice. I hope this clarifi es the issue. If not, please feel free to contact me at functionalbook@hotmail.com. Sincerely, Christy Cael 12 massage & bodywork november/december 2009

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