Massage therapists have a scope of practice, which is the legal limit of what we can do and say professionally. It differs somewhat from state to state because of variations in licensing laws but in general it’s limited to working on muscles, tendons, ligaments, and other connective tissue (generally referred to as fascia), and giving you guidance to maintain the progress we’ve made in our sessions.
It prevents us from:
Diagnosing – We can’t tell you that your wrist pain is carpal tunnel syndrome, even if it’s a textbook case. Nor can we tell you that your one-sided headache that makes you nauseous and sensitive to light and sound is a migraine. Why? 1st – It’s illegal. 2nd – There’s a good reason it’s illegal… there are other conditions with the same or similar symptoms. Doctors go to school for 8 years to learn how to differentiate one disease or condition from other similar ones. A massage therapist goes to school for anywhere from 6 months to 2 years to primarily learn about the musculoskeletal system and how to treat it. Who do you want diagnosing you? Someone with 2 years education or someone with 8?
Prescribing – We cannot “advise and authorize the use of a medicine or treatment.” This means that we cannot tell you whether you should take ibuprofen or tylenol for your pain, and we certainly can’t tell you how much or how often to take it. We definitely cannot tell you to discontinue taking meds that your doctor has prescribed. We also cannot prescribe exercises or even stretches. We CAN recommend stretches and show you the proper form for each stretch but we’re not supposed to tell you how long to hold the stretches or how often to do them. That last part is a bit frustrating, I know; but I’m totally behind the rest of it (and I abide by the frustrating part).
Adjusting – We cannot move the bones the way a chiropractor or D.O. does. Sometimes releasing muscles allows the bones to move back into place of their own accord, and that’s ok because that’s an unintended result. We cannot, however, intentionally “crack your back” for you, no matter how much you beg or plead. Even if your last massage therapist did it or you promise not to tell anyone. Why? Because it’s illegal. Oh yeah, and they don’t train you how to make chiropractic or osteopathic adjustments in massage school.
Many massage therapists lead a healthy lifestyle and are very knowledgable about healthy food and supplement choices. Naturally they want to share this knowledge with you because they want you to be as healthy as possible. And you want to take their advice because there’s so much conflicting information out there on how to eat, what supplements to take, and how to exercise in order to be healthy. It’s great to know someone who’s looked at it all and taken the time to figure out what’s what, right?
Unfortunately, it’s not that simple because all of that stuff also falls under Scope of Practice. You see, unless someone has gone to school to study dietary nutrition &/or supplements, legally they cannot give clients advice about it in a professional capacity. While that may seem like a real drag, there’s good reason for it.
Here are the two most “popular” types of advice I see/hear dispensed by massage therapists along with the reason they’re out of our scope of practice:
Supplements – The human body has an optimal range for vitamins and minerals. Too much or too little can lead to real problems. For instance, magnesium is a necessary nutrient for muscle health and muscles often hurt when you’re deficient in magnesium. But there are many reasons your muscles could hurt, not just a magnesium deficiency. Plus, magnesium acts as a laxative AND can interfere with certain types of prescription medication. If you want guidance on which supplements to take, I recommend seeing a naturopathic doctor. They can test your blood levels of what ever you might be considering and find out whether you really need it. So even if it wouldn’t cause a problem if you got too much, you don’t want to waste your money on something you don’t need.
Nutrition/Diet – Only dieticians, nutritionists, and doctors can dispense dietary advice professionally. Your friends and family can give you dietary advice all day long (and sometimes they do), but that’s different. They’re not acting in a professional capacity with you. The wrong diet for you could be disastrous. For instance, back in the 90’s 2 friends of mine who were also coworkers went on the carb-restrictive Atkins diet at roughly the same time. Friend 1 had lots of energy and lost about 25 pounds. Friend 2 didn’t lose any weight, could barely get out of bed in the morning, and could barely function at work because of her low energy. It’s just not true that EVERYONE needs to eat a carb restrictive diet, or avoid gluten, or avoid all forms of sugar, be vegetarian, or eat ginormous amounts of protein, or whatever the latest diet trend happens to be.
PS be wary if they say “everyone…” Everyone is No one. There is no one thing that every single person either needs or is lacking.
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