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Perhaps each could have its advanced credentialing, but I believe the benefit to the client of having one cohesive approach of manual and movement therapy is clear. Merging Manual and Movement Therapies Ideally, there would be a meeting of the minds of the professions that would allow for a kind of reciprocity, or a bridge program that would allow a merging of the fields. Until then, this integrated world can exist only by having a massage therapist that is also certified as a fitness trainer (or Pilates or yoga instructor) or by having a fitness trainer (or Pilates or yoga instructor) who has also attended massage therapy school. The logistics of this are challenging, and a bit expensive, but I do believe that the benefits make this a worthy pursuit. Three Keys to Musculoskeletal Health I prefaced that the keys to improved musculoskeletal health (perhaps better stated as myofascioskeletal health) are strength and flexibility of myofascial tissue. Let's expand the term to "neuro-myo-fascio-skeletal" instead, which adds in the incredibly important concept of nervous system control. Proper neural control addresses the nervous system's ability to order and co-order (coordinate) various synergistic groups of muscles for healthy posture and movement patterns. Thus, the strength and flexibility of myofascial tissues plus proper neural control by the nervous system might be the three major factors needed for healthy somatic functioning (Image 2). Movement Professions to Include So, which field might a massage therapist add to their education and skill set? When looking at the world of movement therapies, the three biggest choices are fitness strength training, yoga, and Pilates. The starkest counterpoint to massage therapy's focus on loosening taut myofascial tissue is likely fitness training, so if the massage therapist is looking to complement their base with the other end of the spectrum, fitness training would be the obvious choice. Choosing yoga or Pilates, however, might be the more natural step away from manual therapy. These methods of body conditioning have a dual focus on strengthening and stretching. Another choice would be Feldenkrais, which concerns itself with neural control. Expand Your Skill Set . . . or Partner Up Of course, my intent with this article is not to try to convince each and every manual therapist to train to be a movement therapist. One can believe in the efficacy of movement therapy without having to enter the field. The alternative is to build a network of movement professionals to whom you can refer clients. But if adding in movement therapy to your practice does interest you, then it would round out your practice and allow for a greater, more comprehensive care of your clients. Dr. Joe Muscolino has been a manual and movement therapy educator for more than 30 years. He is the author of multiple textbooks, including The Muscular System Manual: The Skeletal Muscles of the Human Body (Elsevier, 2017); The Muscle and Bone Palpation Manual with Trigger Points, Referral Patterns, and Stretching (Elsevier, 2016); and Kinesiology: The Skeletal System and Muscle Function (Elsevier, 2017). He teaches continuing education workshops around the world, including a certification in Clinical Orthopedic Manual Therapy (COMT), and has created LearnMuscles Continuing Education (LMCE), a video streaming subscription service for manual and movement professionals, with seven new video lessons added each and every week. And he has created Muscle Anatomy Master Class (MAMC), the most comprehensive and detailed muscle anatomy online class in the world, with each muscle taught in five distinct video lessons. Visit www.learnmuscles. com for more information or reach him directly at C h e c k o u t A B M P P o c k e t P a t h o l o g y a t w w w. a b m p . c o m / a b m p - p o c k e t - p a t h o l o g y - a p p . 61 2 The three keys to musculoskeletal health. Permission Dr. Joe Muscolino (

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