About the Author
Sandy Fritz helped found the Alliance for Massage Therapy Education. She also wrote massage textbooks, including “Mosby’s Fundamentals of Therapeutic Massage,” “Mosby’s Essential Sciences for Therapeutic Massage: Anatomy, Physiology, Biomechanics, and Pathology,” and “Sports & Exercise Massage: Comprehensive Care for Athletics, Fitness, & Rehabilitation.” Her articles for MASSAGE Magazine include “Old Myths Die Hard: The Truth About Toxins” and “The Massage Profession Needs to Face the Future—United.”
I write textbooks for massage therapy education. For years, I have struggled with massage terminology. Even a discussion of terminology has terminology issues:
• Terminology: the system of terms belonging or peculiar to a specialized subject; nomenclature.
• Nomenclature: a system of names used in the classification of an art or science or other field or subject.
• Taxonomy: the science or technique of classification.
The best word to use for this discussion is nomenclature. The lack of agreed-upon massage therapy terms makes it hard to guarantee solid entry-level education. It also makes it hard for graduates to be ready to succeed in licensing exams.
Often, massage styles with different names are essentially the same. The unusual language in massage therapy is not descriptive. It confuses massage therapists, other health and medical professionals, and the public.
This issue plagues manual therapy overall. It affects osteopathy, chiropractic, physical therapy, and massage therapy. Each discipline has created its own language.
To add to the confusion, groups within an individual discipline use unique terms. This is common in the continuing education market for massage therapy. Many styles of massage have been developed. Individuals who use specialized language have taught them to others.
Also, other disciplines have many manual therapy methods. These come primarily from osteopathy and different cultural healing systems. Massage therapy has been taken, renamed, and included. This practice prevents meaningful discussion. It makes discussing massage difficult and confuses communication between different fields.
Attempts at Definitions
Two profession-based attempts have been made to describe massage therapy:
- Massage Therapy Body of Knowledge (MTBOK) in 2010
- Entry-level Analysis Project (ELAP) in 2012
Both projects led to recommendations. The recommendations were for a single definition of massage therapy and a suggested naming system. But the massage community has not supported either. Even though, massage therapy organizations funded both.
Another issue is that the massage therapy community does not have a single, clear definition of massage. I recommend the following, based on the article, “Clarifying Definitions for the Massage Therapy Profession: the Results of the Best Practices Symposium,” by Ann B. Kennedy et. al., published in the International Journal of Therapeutic Massage & Bodywork:
- Massage is a patterned and purposeful manipulation of soft tissue by using body parts. It can include emollients, liniments, heat, cold, and tools. It is for the intent of therapeutic change.
Massage therapy involves the use of massage and non-hands-on parts. These parts include health promotion and education messages for self-care and health maintenance. Therapy outcomes can be influenced by:
- Therapeutic relationships and communication
- The therapist’s education, skill level, and experience
- The therapeutic setting.
Massage therapy practice is client-centered. It provides massage through assessment. It uses a care plan, treatment, and reassessment. It also gives health advice, documentation, and closure. The goal is to improve health and well-being. Massage therapy practice is influenced by scope of practice. It is also influenced by professional standards and ethics.
No One Knows What We’re Talking About
For years, the massage therapy community has talked about being part of healthcare teams. They want to be part of both medical care and other health services. The Massage Therapy Foundation’s research agenda and funding have supported progress. They back the science of massage therapy.
Research in massage and all manual therapy professions faces a challenge. The problem is the lack of consistent terminology. Multiple researchers have told me they have little to no idea what massage therapists are talking about when they describe their work.
The terminology must unite professionals from many backgrounds. It should not reflect a specific history. The ability to communicate clearly and accurately is essential. It is needed for the variety of manual therapy practitioners to use shared research in practice. They also need it to work successfully together.
A New Approach: The ICMT
There are some encouraging developments. The International Consortium on Manual Therapies (ICMT) is tackling this issue. Over two years ago, when I was recruited to be part of this group, I felt that this was the chance to make something positive happen.
We don’t need to prove massage has benefits. We don’t need to prove ourselves to other professions. The research that exists has done that. Collaborative research will increase the information base. That is a huge focus of the ICMT—shared language so scientists can expand on research that benefits us all.
This cannot happen without collaboration. Massage therapists are equals at this table. Shifts in belief are rare, but I think the International Consortium on Manual Therapies is important. We must not miss this opportunity.
The massage community must join the ICMT initiatives. They must not ignore the impact of this global collaboration among manual therapists. Brian Degenhardt, DO, Paul Standley, PhD, and Francesco Cerritelli, PhD, DO(Europe) founded the ICMT. They met at several osteopathic manipulative medicine conferences.
Standley made a huge impact on me. He presented at the 2007 Fascial Research Congress at Harvard University. He described the problems with unclear terms in massage therapy and other manual therapy.
Standley is one of a select group of people around the world studying how manual therapy affects gene expression. He researches at the College of Medicine-Phoenix. He studies how biomechanics regulate gene and cell growth in bioengineered tendons, fascia, and muscle cells.
Degenhardt, Standley, and Cerritelli know that to improve manual therapy, the old walls between professions must fall. They need to remove the silos and build communication and collaboration. First, they decided that big issues must be overcome. These include variations in naming systems within and across professions. They also include the need to build a platform to improve communication between clinicians and basic scientists. It is from this perspective that ICMT’s first conference program was developed.
The ICMT Massage Therapy Working Group worked with the other ICMT working groups. These include structural integration, physical therapy, osteopathy, and chiropractic. They made documents to start an interdisciplinary conversation. The goal is to create understanding among manual therapy professionals. We also want to move toward a language that scientists can use in research. This will benefit all involved in the practice of manual therapy.
The foundational language for massage therapy can be used to describe how to apply and describe massage methods. This language is taken from the Entry Level Analysis Project (ELAP). This document can be found at elapmassage.org. Only the recommended language was used to create the ICMT documents.
Other factors related to curriculum recommendations were not relevant for the ICMT project. The document’s scope of practice comes from many sources. It reflects the scope described in most state licenses. It also reflects the scope in the Model Practice Act from the Federation of State Massage Therapy Boards.
The goal is to simplify massage therapy terms to basic, clear, and repeatable words. We will avoid the specific terms for the different styles of massage. These terms are named using cultural or historical terms, eponyms, and brand-based or short names. The other involved occupations are working toward the same goal. The vision is to identify a nomenclature that researchers can use across disciplines. The massage therapy community is invited to view and comment on these documents.
Get Engaged
The ICMT conference will be interactive. In most conferences, participants watch and listen to lectures. However, at ICMT, they will fully engage in the program. You will work with respected colleagues and peers from many manual therapy disciplines. You will discuss the latest insights into manual therapies together. You will also help shape future collaboration and research. Importantly, scientists will be involved. They will support evidence-based practice and find gaps for future research.
[Click here to visit the ICMT Discussion Forum video presentation.]
Explaining what we do as massage therapists can be hard. But, I believe we can do it in a way that will grow the profession. We can build a clear message about our nature and value. I urge you to join the conversation. Register for the virtual conference. It will be presented uniquely over 30 days. Learn more and register for the conference here.Protect your massage therapy practice. Get insurance from Massage Magazine Insurance Plus. We have comprehensive coverage for you. Don’t wait until it’s too late—ensure you’re covered today. Get insured now!