What is in a name? Why does the confusion persist?

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One has to concede that therapists who complain that in practice the profession of massage in South Africa has so far not benefited much from having been absorbed into the national healthcare system, have a point. Although it is increasingly being taken seriously by the public and other health professionals a number of factors are hindering the establishment of massage as a health profession:  A lack of capacity exists in both the Department of Health and the AHPCSA, to bring unregistered therapists and training institutions to book.  The massive marketing machine of the spa and beauty industry perpetuates the image of massage as part of the leisure and recreation industry only. MTA’s valiant and on the whole successful attempts at awareness raising campaigns has to compete with the spa and beauty industry’s slick and sponsored marketing campaigns put together by full-time professional PROs. Misinformation about the South African massage profession published in the media. Journalists interpret information available to them and most of the time the spa and beauty industry’s is more visible, glamorous and ‘sexy’. A young, attractive model having a massage in luxurious surroundings always makes for better photos than that of an elderly patient in a therapy room. Often articles are also based on information gained from the American websites, and do not resemble the South African context and legislation at all e.g. listing even reflexology and aromatherapy as types of massage. As registered massage therapists we often forget that we are the custodians of our own profession. Instead of actively taking charge of massage therapy by protecting and promoting it, we place our hopes for survival as a profession in the official structures. Rather we should rely on our collective voice and resources. MTA after all exists solely through and for those massage therapists who take their profession...

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What is in a name? The South African context: Official designation or style of massage?

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It is important to understand that the term Therapeutic Massage Therapy as used in this country refers to the description of massage as published in the amendments to the Allied Health Professions Act No 63 of 1982 tabled in parliament in 2001. Unlike in certain quarters in the , this term does not imply that therapeutic massage therapy is a particular style or type of massage. It is the designation adopted to distinguish the practise of stand-alone massage from beauty therapy and somatology and the application of massage as a technique to warm muscles prior to e.g. physiotherapy or chiropractic treatment.  Already we can differentiate four types of massage applications: massage as part of the menu of services offered by a beauty therapist or somatologist; massage as preparation for other profession specific treatments e.g. physiotherapy; massage as part of an alternative healthcare system e.g. Ayurveda and Traditional Chinese Medicine (tui-na massage) and massage as an independent and autonomous health profession. As MTA chairperson, Sandra Williams pointed out in a recent article that appeared in a popular magazine, the implication of this piece of legislation is that it regulates not the term Therapeutic Massage Therapy but the act of laying hands on a body with the intention of achieving therapeutic change. Off course the following question arises: What is therapeutic change? Therapeutic change can be described as actions that restore or maintain health. The next important question is whether it is possible to massage a person and not effect therapeutic change? For the most part, this is the line of reasoning proposed by those who prefer to sidestep the law – that they do not practise Therapeutic Massage Therapy. They describe what they do as a different method, type or style of massage e.g. relaxation massage or rebalancing massage or just plain massage. The aim is to relax, de-stress the patient, to make them feel good, not to achieve therapeutic outcomes, the argument goes. The fact is that whether it is a slow rhythmic massage, merely rocking the body to achieve a state of relaxation or whether more invasive connective tissue techniques are used, the person who touches the body acts as a catalyst to attain structural and physiological changes in the body. Even a mother rubbing her baby’s back to sooth and comfort, causes physical and chemical changes in the body. Imagine then, the profound influence informed touch performed by a massage therapist can have on the physical and emotional wellbeing of a person. How is it possible then to distinguish between massage that is therapeutic and massage that is not? There is no difference. The argument that some types of massage are therapeutic and others are not and...

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What is in a name? Styles of therapeutic massage therapy

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CHAIR MASSAGE Also known as seated massage or on-site massage. Includes massage and stretching techniques. Patient is fully clothed . Is done in variety of settings e.g. businesses and airports. May involve the use of a specially designed massage chair in which the patient sits comfortably (A pillow can also be used). DEEP TISSUE MASSAGE Techniques that utilise deep-muscle massage are administered to affect the sub-layer of musculature and fascia. These techniques require a thorough understanding of anatomy and physiology. The muscles must be relaxed in order to effectively perform deep-tissue massage, otherwise tight surface muscles prevent the therapist from reaching deeper musculature. ORTHOPAEDIC MASSAGE It aims to induce a change in structure and function of the neuromusculoskeletal soft tissue to promote healing of the whole person. Emphasis is placed on understanding both the injury and its rehabilitation criteria. Three basic elements are adhered to, despite the technical diversity in treatment: assessment, matching the treatment to the injury, and adaptability of treatment. HOLISTIC MASSAGE Emphasises psychological benefits such as stress reduction, relaxation and promotion of general well-being as much as physical benefits. It treats the whole person and often incorporates energy medicine into its practice RUSSIAN MASSAGE / RUSSIAN SPORTS MASSAGE It is a system of massage developed in the former Soviet Union that alters the basic strokes of classical massage so each stroke provides the patient with the least invasive and most comfortable treatment. Each stroke has a known physiological effect on a healthy or dysfunctional body. Therapists don’t use their wrists or single digit pressure, rather shoulders or elbows as the primary sources of strength for deep work. MANUAL LYMPH DRAINAGE The strokes applied in manual lymph drainage are intended to stimulate the movement of the lymphatic fluids in order to assist the body in cleansing. This is a gentle, rhythmical technique that cleanses the connective tissue of inflammatory materials and toxins, enhances the activity of the immune system, reduces pain, and lowers the activity of the sympathetic nervous system. The most widely taught version of this technique was created by Dr. Vodder. SPORTS MASSAGE Sports massage is designed to enhance athletic performance and recovery. There are three contexts in which sports massage can be useful to an athlete: pre-event, post-event, and injury treatment. When an athlete sustains an injury, skillful massage therapy can often speed up and improve the quality of healing. RELAXATION MASSAGE This method is applied primarily by massage therapists working in resorts, spas, and health clubs. Students learn a one-hour, full-body massage that provides patients with the relaxation and enjoyment of a Swedish massage with the deeper release of deep-tissue work. SWEDISH MASSAGE It was developed by Per Henrik Ling in early 1800s...

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What is in a name? Massage therapy or Therapeutic Massage Therapy?

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On several occasions in the past, InTouch has reported on the issue of what we, as registered massage therapists, should be called. Thanks to the official structures we have been saddled with the unwieldy title of Therapeutic Massage Therapy (What would we do without the autotext facility on Word!). In everyday speech we mostly refer to ourselves as massage therapists and this is not incorrect as these two terms actually refer to the same thing – the action of using ones hands to stroke or knead the body. But here lies the rub – so do beauty therapists and everyone else who does stand-alone massage treatments but has not necessarily submitted to the scrutiny of the Allied Health Professions Council of South Africa as regulator of the profession. Many registered therapists feel our profession, and often our income, is being undermined by people who are not accountable to anyone and whose actions are not regulated and certainly not curtailed by council. Members often complain to MTA that these people can practise where they please, they can advertise as they please. Meanwhile the law abiding ones are restricted by rules and regulations that limit the way we ply our trade and market ourselves. And for this we have to pay a fortune in registration fees! AMBIGUITY MTA as the only professional association representing massage therapists has often aired its members’ reservations about the term therapeutic massage therapy to the council and at other relevant forums. MTA is of the opinion that the distinction between a massage therapist and a therapeutic massage therapist presents a loophole for therapists to practise massage without being accountable to the Department of Health, the council and by implication to the public. This ambiguity around what exactly therapeutic massage therapy is, is magnified by the large numbers of massage therapy students that graduate at the end of an academic year yet do not apply for registration with the council. RESULT There is a glut of advertising in the print and electronic media for massage therapists, massage courses that allow you to earn immediately on completion of the course as well as franchise opportunities for massage training programmes. Yet there are less than 300 registered therapeutic massage therapists in the country. More and more members of the public and sports groupings are showing interest in massage yet one of South Africa’s most successful national sports teams employs a non-registered person (At least on national television he is referred to as a masseur and not a massage therapist!) CHANGE THE LABEL This anomaly exists as individuals are under the mistaken belief that registering with the AHPCSA is a matter of choice. Unfortunately training institutions perpetuate this misreading of...

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Understanding the body-mechanics of a cyclist

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Massage has a long and proud association with the sport of cycling, with the soigneur (pronounced ‘swan-year’) being an integral member of the professional cycling team. As a recreational sport, cycling is experiencing rapid growth, with an ever increasing number of people taking up the sport, both on-road and off-road (in the form of mountain biking). This has been partly due to the extensive media coverage given to events like the Tour de France (especially with the phenomenal success of Lance Armstrong). The other reason is that, being non-weight bearing, it has allowed many people who otherwise may have struggled to take part in regular exercise, to do so with little risk of injury. However, injuries do occur, and therapeutic massage therapy can be a valuable tool in ensuring that these injuries are kept to a minimum. When one considers the high speeds that are attainable on a bicycle, as well as the added danger of motor cars, pedestrians and other obstacles, it is easy to see that by far the most significant injuries are of a traumatic nature. These range from skin abrasions and lacerations, through fractures and sprains, to the more serious head injuries. For these reasons, any massage therapist that is involved with a cycling team needs to be highly competent with basic first aid techniques, and to ensure that the first aid kit is adequately stocked. Furthermore it is important that the massage therapist is also aware of past accidents, as these may have resulted in altered biomechanics, as well as possibly being the source of the presenting symptom e.g. headaches and/or muscle spasm due to whiplash. However, for most massage therapists the problems that the cyclist brings into our practice is of a more chronic nature. These can be sub-divided into complaints that are due to the specific posture associated with cycling, and those that are due to overuse of particular musculo-tendonous units. In order to better understand these injury patterns we need to understand the biomechanics of cycling. The legs The power required to propel a bicycle forward is generated primarily by the gluteus maximus and quadriceps muscles, with added power coming from the hamstrings, gastrocnemius and soleus myscles, as well as the iliopsoas. It is worth noting that whilst recreational cyclists rely on a downward push on the pedals, the elite cyclist also pulls the pedal back up, thereby substantially increasing the total power output. Unfortunately, this also means that there is little chance of recovery for the muscles. Because of the cyclist’s position on the bicycle, the leg muscles are unable to work through their full range of motion, and are forced to operate mainly in their middle and inner range....

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