Massage Matters, Fall 2013

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FALL 2013 VOL 6 ISSUE 2

M AT T E R S M A SSAG E TH E R A PIST S’ A SSOC IATIO N O F B RITISH CO LU M BIA

A DIFFERENT APPROACH TO STRETCHING

DISCOVER THE MANY BENEFITS OF A TWO-SECOND STRETCH | 5 THE BEST FROM BOSTON: HIGHLIGHTS FROM THE IMTR CONFERENCE | 7 ENTER OUR RMT Matters_Fall 2013_Gill Sans.indd 1

LET’S TALK ABOUT TAPE: INTERVIEW WITH RON ALEXANDER | 13

LEGAL MATTERS: PROPER DISCLOSURE OF MEDICAL RECORDS | 12

CONTEST FOR A CHANCE TO WIN! | PAGE 21 9/6/13 10:34:46 AM

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CONTENTS | FALL 2013 PRESIDENT’S MESSAGE CLASSIFIEDS

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5

COVER STORY A DIFFERENT APPROACH TO STRETCHING

The physiological benefits of a two-second active isolated or active therapeutic stretch are diverse

12 FUNCTIONAL FASCIAL TAPING

Our interview with Ron Alexander reveals how therapists can help patients heal using his innovative taping technique

THE BEST FROM BOSTON

Cathy Ryan reports from the International Massage Therapy Research Conference, April 25-27, 2013, at the Seaport Hotel and World Trade Center in historic Boston, Massachusetts

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RECEIVING A REQUEST FOR RECORDS

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Scott Marcinkow discusses how RMTs should respond to a lawyer’s request for their patient’s records

Industry updates and the latest news from the MTABC

NEWS & BRIEFS

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PRESIDENT’S MESSAGE MASSAGE THERAPISTS’ ASSOCIATION OF BRITISH COLUMBIA

MEETING THE SOCIAL MEDIA CHALLENGE

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s we ease into fall, I hope everyone took time to enjoy the amazing summer weather experienced by the entire province this year. (Yes, even the North Coast folks had some postcard-perfect days!) Too often, as self-employed professionals, we forget that keeping a work-life balance is important to making us better therapists and better professionals. Like many of you, I love what I do; I often say that I’ve never worked a day since becoming an RMT. But that doesn’t mean work should become my life. In fact, finding a healthy balance between our professional and personal lives is a worthy challenge. We must also be aware of our obligations within our professional lives, especially when it comes to boundaries. What we learned in school regarding appropriate versus inappropriate conduct seemed obvious on paper. But, in the work we do, the line can easily get blurred – particularly when it comes to how we communicate with patients. Frankly, it’s easy to become casual and complacent about our communication style or manner with patients. After all, we’re human beings dealing with very human situations. Social media is a space where the line not only gets blurred but stepped over far too often. And a social media misstep is not just an issue faced by

RMTs. In fact, many professions are working to adapt to the new reality of Facebook, Twitter, etc. Don’t get me wrong – social media can be a great tool for marketing and communicating our business to our patients. But Facebook in particular has become a place where RMTs need to take care that their personal and professional lives are kept separate, and that any publicly posted items do not step over the line. Thoughtful consideration must be given to any news item, joke or video that we as RMTs decide to post online. The professional title of RMT is always a part of who we are, and our title is seen in a very public way on the social media sites. Further, the explosion of social media over the last 10 years coupled with the extraordinary growth in our profession have magnified the challenge of appropriate posts. To meet this challenge, the MTABC will be focusing its efforts over the next year on educating, supporting and communicating professional best practices for RMTs. At the end of the day, we’re all in this together: the RMT profession, the MTABC and the world of health care. None of us can do it alone, and we are doing everything we can to support individual practitioners while promoting the profession, which is honourable, time-consuming and, often, fun work. Come join us. Damon Marchand, president, MTABC

LAYAR THIS MAGAZINE’S PAGES “TO LIFE” IN FOUR EASY STEPS RMT Matters is now using “augmented reality” to further improve the contents of our magazine. This exciting new technology allows users of Apple and Android mobile devices to scan specifically created pages within this book to

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ADDITIONAL EDITORIAL AND ADVERTISING CONTENT AVAILABLE VIA YOUR MOBILE DEVICE’S LAYAR APP

EDITORIAL Two-second stretch Boston highlights Functional taping Contest

5 7 12 21

1

2 Go to get.layar.com to install the app on your smartphone

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see additional “pop-up” content, like videos related to a story, relevant websites or background material, and information about the MT experts we interview. Just look for the Layar logo on the top of the page!

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RMT Matters is published three times a year for Registered Massage Therapists. This publication is intended to provide a voice for B.C.’s RMTs, a source for the latest research and a vehicle for the general population to understand and respect the valuable work of our RMTs. Funding is provided by MTABC and advertising revenue. Editor in Chief Noa Glouberman 604-608-5179 nglouberman@biv.com Managing Editor David DeWitt 604-873-4467 dave@massagetherapy.bc.ca Sales Victoria Chapman 604-741-4189 vchapman@biv.com Design Randy Pearsall, Soraya Romano Editorial Contributors Paul Elliott, Scott Marcinkow, Cathy Ryan, Michael Slobodian Cover Image Michael Slobodian Editorial Board Bodhi Haraldsson, Brenda Locke, Dee Willock, Damon Marchand, Michael Reoch Copyright © 2013 by BIV Media Group. No part of this publication may be duplicated or reproduced in any manner without the prior written permission of the publisher. All efforts have been made to ensure the accuracy of information in this publication; however, the publisher accepts no responsibility for errors or omissions. BIV Media Group 102 East 4th Avenue Vancouver, B.C. V5T 1G2 Tel: 604-688-2398 Fax: 604-688-1963 www.biv.com Massage Therapists’ Association of BC Suite 180 – 1200 West 73rd Avenue Vancouver, B.C. V6P 6G5 Tel: 604-873-4467 Fax: 604-873-6211 Toll Free: 1-888-413-4467 mta@massagetherapy.bc.ca www.massagetherapy.bc.ca

Discover an amazing extra layer of related content

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ON THE COVER

A DIFFERENT APPROACH TO STRETCHING The physiological benefits of a two-second active isolated or active therapeutic stretch are diverse, making it a powerful tool for registered massage therapists

BY PAUL ELLIOTT | PHOTOS BY MICHAEL SLOBODIAN

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ctive isolated stretching (AIS) is a powerful stand-alone platform for the resolution of many common pathologies. However, as an AIS instructor, therapist and athlete, I find its title something of a misnomer. In massage, we can never truly do anything in isolation. While we do isolate muscle groups to achieve change for specific structures, in stretching an isolated muscle we’re working one aspect of one system among a myriad of synergistic patterns in the body. As such, I prefer to call this technique active therapeutic stretching (ATS). However you call it, it’s a safe and effective form of stretching and a wonderful tool to have. As professional therapists, we all understand that overuse of muscles is the most common cause of muscle tightness, resulting in restricted movement and restricted postures. These constrictions contribute to muscle weakness, muscle strength imbalance and reduced flexibility – all of which lead to injury. For several decades, experts have advocated a prolonged, static stretch of up to 60 seconds – this has been the gold standard that governs our stretching. However, there are problems with holding a static stretch for so long. One of the keys to therapeutic stretching lies in the understanding that only relaxed myofascial structures will allow themselves to be fully stretched. This is achieved through the active contraction of an agonist muscle, which sends a neurological signal to the opposite side antagonist muscle to release and lengthen in preparation for stretching or movement. In other words, a muscle cannot stretch and contract at the same time. Importantly, an active therapeutic stretch lasts no more than two seconds – the amount of time it takes the targeted muscle to fully lengthen without triggering the

myotatic reflex, which, after two seconds, inhibits the muscle’s stretch potential. This two-second stretch also allows the muscle cells to be loaded with the necessary oxygen and nutrients to replenish the “isolated” muscle group and eliminate any accumulated toxins. After two seconds we release the agonist contraction and allow the area being stretched to return to its neutral position – no myotatic reflex, no pain. Another key to ATS is the stabilization of the joint in question, which reduces the chance of compensation of surrounding/supporting structures. With the joint more or less immobilized, the muscles can be stretched in a more complete manner. Additionally, the importance of the “out breath” during active stretching can’t be overstated. As we exhale, our bodies tend to release any residual tension held in the muscles, allowing for further range of the tissues we’re targeting. The amount of assisted pressure applied during ATS is also important. But how do you assess “gentle persuasion?” At first you’ll want to apply less than the recommended half-pound of pressure: about six to eight ounces. Imagine you have a raw egg between your hand and your patient’s body. You must apply enough pressure to assist the stretch without breaking the egg. This pressure applies to every stretch everywhere on the body. And, while the active stretching police won’t arrest you if your applied pressure is over the limit, your patient will let you know if you’re pulling too hard. Repetition warrants mention as well. As a general rule, the body adapts repetition and improves at whatever it practises. Through a series of six to eight active stretches, the brain can begin to associate the movement as positive and create new neural pathways for that movement. At the same time, fear of movement and the physical deconditioning that accompanied it tends to dissipate in favour of new confidence.

For several decades, experts have advocated a prolonged, static stretch of up to 60 seconds, [but] there are problems with holding a static stretch for so long

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COVER | A DIFFERENT APPROACH TO STRETCHING IMPORTANT TIPS WHEN WORKING WITH ATS

> The active mov ment on the part of the patient should be a smooth and easy effort – if they’re shaking in their exertion, they are working too hard. > When assisting your patient through a difficult or restricted structure, your assisted pressure should be light and nurturing.

Hamstrings: assisted stretching

With therapeutic stretching, the hamstring stretch is a three-phase protocol because, in order to gain access to the belly of the hamstrings, we must open the distal and proximal tendons first. The following photos illustrate the distal, proximal and belly phases. The first protocol demonstrates the assisted stretching;

the second set of photos illustrates the self-stretching technique – stretches you’ll want to teach your patients as a self-care tool. In either case, it’s important to work bilaterally. With the hamstrings, work the distal hamstrings then move up to the proximal hamstrings and finally on to the belly of the muscle. The images below provide a stepby-step demonstration of the technique. RMT

DISTAL HAMSTRINGS, ASSISTED

Do two sets of 6-8 repetitions

Position 1: The patient’s thigh is lifted to a height at which she can safely achieve full extension

Position 2: The therapist helps stabilize the thigh from any anterior/ posterior movement as the patient lifts her foot above her knee to full extension

Position 3: The therapist continues to stabilize the knee with one hand while adding a gentle assisted pressure with the other. It’s important that the patient continues to actively contract her quadriceps during the assisted phase

Position 2: The patient contracts her hip flexors, aiming her knee toward her shoulder

Position 3: At end range the therapist can assist the stretch by applying pressure on the active leg at the foot, while the unexercised leg can be isolated from movement either by the therapist or with the aid of a stabilizing belt

Position 2: Have patient lock the leg at the knee and then raise the leg to end range

Position 3: At end range (Position 2), patient continues to contract her quads and hip flexors, reaching her thigh gently back toward her sameside shoulder as she and the therapist apply gentle assisted pressure, while stabilizing the unexercised leg

Proximal hamstrings, assisted

Do two sets of 6-8 repetitions

Position 1: The patient holds her thigh at 90 degrees to the waist, with her knee also flexed to a 90-degree angle

Hamstring belly, assisted

Do two sets of 6-8 repetitions Paul Elliott is a Montrealbased muscular therapist who lectures about and teaches AIS across Canada. He has studied AIS since 2003 under Aaron Mattes, who developed the technique. Watch for an AIS course in Vancouver this fall at www. stretchingcanada.com.

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Position 1: The patient should tighten her abdominals with each lifting of the exercised leg – if there is a known or suspected lumbar issue, it’s wise to have the patient bend the unexercised leg so that the foot is flat on the table

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CONFERENCE COVERAGE

THE BEST FROM BOSTON Highlights from the International Massage Therapy Research Conference

BY CATHY RYAN

T

he International Massage Therapy Research Conference (IMTRC), held April in Boston, came on the heels of the Boston Marathon tragedy. The day of my arrival I stood in silence on the street as the funeral procession for the security officer killed in the line of duty passed. I stood with strangers but, as is the case with tragic events, we stood in unity. It was palpable. Similarly, but for very different reasons, connectedness defined this year’s IMTRC. Lured by a common passion for our profession, 250 attendees from around the globe gained a fresh appreciation for massage therapy (MT). The conference, presented by the Massage Therapy Foundation (MTF) with support from the American Massage Therapy Association, was a research event, so science and data were in no short supply.

Mechanisms and beyond

Keynote Jeanette Ezzo, a practising massage therapist for 30 years, discussed what’s needed to prove the effectiveness of massage, asking us to consider the following: ■How does MT work? ■Does it work under controlled conditions? ■Does it work in everyday/real-life conditions? ■What does MT effect? Indicating that outcomes matter most to clients, Ezzo said generating more robust “effectiveness” research is in order, as are more trials for special conditions like fibromyalgia. Even without understanding etiology, researchers can design good trials to substantiate MT outcomes – if outcomes measure how the patient feels/ functions vs. changes in biochemical/structural elements.

She also touched on the issue of effective and costeffective. In Canada there’s a tendency to view provincially covered medical as “free care.” But a true dollar-for-dollar comparison of such care (doctor visits, diagnostics/tests, drugs, referrals for other care, surgical interventions, etc.) vs. the cost of a series of MT treatments would show the former can far exceed the cost

MTF president Ruth Werner with Alberta MT Beth Barberree

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CONFERENCE | THE BEST FROM BOSTON Additionally, public spending speaks volumes. MT is now the most widely accessed complementary alternative medicine in Canada, with $1.5 billion spent annually on MT across the country. So how can we better construct, amass and apply research to substantiate MT effectiveness contribution in order to improve access to available funding/coverage and make effective care more widely accessible? To quote MTF president Ruth Werner, “Let’s keep gathering that ‘yes’ data about the effectiveness of massage therapy.� Public health

Marvin Mohring, Emile McKay and Pamela Fitch, RMTs and educators from Ontario

of the latter. Further, is the current spectrum of covered care more or equally effective for musculoskeletal/softtissue presentations? When it comes to MT and low-back pain, evidence is accumulating. According to Ezzo, MT has been shown to be 40 per cent less costly (over longer time frames) than the standard medical route in treating low-back pain.

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Keynote Leslie Korn discussed the issue of restoring community health with massage. Sharing aspects of her work within the tribal communities of Mexico and the U.S., this specialist in behavioural health, public health and health psychology stressed the importance of restoring traditional health practices as well as inclusion of touch therapies to address issues linked to historical trauma. Noting the staggering association between chronic disease and childhood trauma, and the high incidence of attachment disorders associated with trauma, Korn suggested MT can provide many benefits for issues seen in conjunction with diseases of dissociation (e.g., improved body awareness and sense of self). As such, MT needs to be more accessible to vulnerable populations.

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FALL 2013

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CONFERENCE | THE BEST FROM BOSTON

Let’s seize the moment!

Final keynote Janet Kahn, principal of Integrative Consulting in Vermont, made a presentation about massage in 21st-century health care. Though her sobering data was U.S. based, the issues Kahn identified don’t stop at the border. Despite the enormous amount of money being spent, North Americans are not procuring the best health care in the world – nor are we necessarily seeing meaningful value for our dollars. Health-care expenditure has risen, yet there’s a growing trend toward shorter and less-healthy life spans. In addition to poor diets, inactivity and other lifestyle issues, the quality of health care being provided, not to mention accessibility to quality care, are significant mortality factors. As a unified front, practitioners must push policy makers to recognize the value of complementary alternative medicine and consider its inclusion in future health-care funding. Citing the U.S. Affordable Care Act, Kahn said the moment of opportunity is now; inter-professional collaboration as well as formulating a research agenda that will well position therapeutic massage for the 21st century is more important than ever. A recent article by Don Dillon, RMT and author, underscores her point perfectly: “As no single [complementary alternative medicine] profession or association has the resources to position well against – or in alignment

with – the medical and pharmaceutical establishment, we need to align resources to better position ourselves in the open marketplace – a forum much larger than any health/wellness profession, the insurance industry, the health-care system or even government combined. “Combining resources and know-how gives [complementary alternative medicine] professions the best option in establishing themselves favourably in public-health

250 attendees from around the globe came away from the conference with an invigorated appreciation for massage therapy | MASSAGE THERAPY FOUNDATION

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CONFERENCE | THE BEST FROM BOSTON LOOK, LISTEN & LEARN

> The MTF supports o u r p ro f e s s i o n i n a multitude of ways. You can support its efforts by attending the next International Massage Therapy Conference in 2016. Meantime, many presentations from this year’s event are available at www.mtrc2013. conferencespot.org and www.massagetherapyfoundation.org.

Cathy Ryan is a practising RMT, massage therapy educator and writer with a strong interest in evidence-based practices and life-long learning.

be aided by amassing more evidence to support increased/improved third-party coverage and healthcare funding. Also, physicians and health-care administrators need clear guidelines for MT referral and, to better substantiate MT as safe and effective, more protocol and dosage studies are needed. There is also a need for MT to be provided in hospitals to deal with, say, post-surgical care or scars related to burns. Simply put, MT needs to be more accessible. Personally, I believe massage therapy to be the answer to world peace. No, really, think about it: if everyone regularly engaged in giving and receiving respectful, compassionate, nurturing touch … what a wonderful world it would be. RMT

policy. Evidence and experience shows the existing politico-health-care culture is not waiting to embrace us.” As per Kahn, health care must shift from a sicknesscare system to a wellness-care model. It makes no sense to push to be embraced by a flawed and failing healthcare culture. What is truly needed is health-care (cultural) reform. Next steps

An chorus of “oohs” and “aahs” followed MTABC research department chair Bodhi Haraldsson’s presentation on what our association’s been up to and what it has planned. In the words of the woman sitting next to me: “You Canadians, you have it so good.” In its efforts to support the profession, the MTF has identified these key goals to inform ongoing research: ■awareness and utilization: MTs want the population at large and other health-care professionals to realize the benefits of massage and utilize MT for prevention, treatment and improved well-being and quality of life; ■mechanistic understanding: MTs want to understand more clearly how and why the work, well, works, and what is effective/ineffective under what circumstances; and ■accessibility: MTs want to see improved ability for those in need to have access to care, and this can

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Q&A

FUNCTIONAL FASCIAL TAPING Ron Alexander talks about how his FFT technique can help treat most musculoskeletal conditions

BY NOA GLOUBERMAN

R

ecently, we sat down (virtually) with Ron Alexander to discuss a taping technique he designed and developed to treat injuries, called functional fascial taping. Find out more about FFT, and discover how therapists can use it to help their own patients heal. RMT: What have some of the highlights of your career been so far? RA: I started my career with the North Melbourne Football Club, which is one of the Australian Football League teams. That’s where I first learned to tape. As a result of being exposed to lots of injuries, I became quite proficient at taping footballers. I also worked at one of Melbourne’s leading sports medicine clinics on a variety of athletes, which further increased my exposure to injuries and their treatment. But it was my participation at regular multi-disciplinary professional development sessions that proved truly invaluable, exposing me to ideas, concepts and training beyond that of the massage industry and giving me a deeper, broader understanding of athlete conditions and treatments. The depth of this experience gave me the confidence to apply for a full-time therapist position with the Australian Ballet, which is the second-highest-performing ballet company in the world. I got the job, and thus began a very steep learning curve. I was responsible for treating over

60 dancers, touring within Australia and overseas for seven months a year. For the first four years I was the only medical staff to tour with the company in Australia, the only one they took with them to English-speaking countries. After eight years I left the ballet to pursue the development of FFT. Since then there have been several highlights, including presentations made to the International Olympic Committee World Conference, the World Congress on Low Back & Pelvic Pain and the International Fascia Research Congress. I was also co-investigator of a randomized double-blind placebo controlled study (PhD) at Melbourne’s Deakin University. RMT: How did you discover and develop the FFT technique? Ron Alexander, FFT expert

RA: I really discovered FFT while working at the ballet. I found that using the restrictive type of athletic taping I’d previously used with footballers wasn’t suitable for the dancers, who needed their full range of movement. In order to be uninhabited, they would simply pull the tape off and continue to dance – in pain if necessary. This meant that I had to rethink how to tape. I began applying the tape in a functional position, with a gathering technique. The objective was to restrict the harmful range while allowing full range of movement to the undamaged areas. I was doing this to various joints in the body and it stopped the dancers from removing the tape while, at the same time, offering protection to the harmful range. I noticed that if I applied the tape

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Q&A | RON ALEXANDER

with this same gathering technique directly over the pain in a specific direction, I could actually reduce pain and increase range of movement in a similar manner to treatment. This technique yielded a high success rate with a large number of injuries. RMT: How does FFT work? RA: The complete mechanism of how any taping method in the world works is unknown. Although this is a seemingly simple question, unfortunately, at this stage, there is no simple scientific answer. Originally I thought that pain was being treated and stretched through the fascia, but I had to rethink this explanation due to the work of Schleip, Stecco and Findlay. A PhD research project on FFT commenced at Deakin University in 2006. The goal was to study the effects of FFT over placebo on chronic (non-specific) low-back pain. Although the research showed that FFT had a significant effect on pain, it didn’t aim to show how it worked. The exciting thing is that all the participants who remained in the project experienced reduction in symptoms and reduction in their worst pain. The change that took place was at a two-week period. This is where we’re at right now, still not knowing how FFT affects the body. However, we are discussing further studies, though it may take several years to find the answer to this question.

ample, during a workshop I was running in Brazil, I taped a physiotherapist who had, 21 years prior, been in a motorcycle accident with a truck that resulted in five exposed fractures of the leg. I have kept in contact with this man, who tells me that he has returned to martial arts and his surgeon is very positive in regard to the changes that have occurred – although he doesn’t understand how they have occurred.

We are currently discussing bringing FFT to Canada in May 2014

RMT: What are the top benefits of FFT, in a nutshell? RA: It’s a fast and effective treatment that is relatively simple to learn. It decreases pain, increases range of movement, assists function and allows rehabilitation in a pain-free environment. We are currently discussing bringing FFT to Canada in May 2014. The workshop would be suitable for all massage therapists who treat musculoskeletal injuries. The training gives therapists the ability to be more effective in treating their patients in a shorter period of time. RMT

Learn more about Ron Alexander and view dates for upcoming workshops at www.fft.net.au.

RMT: How is FFT different than the regular taping/bandaging of a joint or muscle injury that a regular doctor may do? RA: Regular taping offers compression and support of joint and range limitation. It is used around the structure, not just the affected area. Generally it’s used primarily in an acute situation or as injury prevention for sports people. FFT, on the other hand, can be used at any stage of injury and is taped at the point of the pathology and then away from this area, in the direction of optimal ease. FFT is the only form of rigid taping that follows this process in the world. Although the tape is applied with tension, it has a fascilitory effect on range of motion. The action on the body, therefore, is different from any other taping method, because it is increasing tension to the area. RMT: What type of condition would benefit most from FFT? A: Virtually any musculoskeletal condition generally responds to FFT. However, it works best in conjunction with standard treatments. There are many successful case studies; for exRMT MATTERS

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LEGAL MATTERS

RECEIVING A LAWYER’S REQUEST FOR RECORDS BY SCOTT MARCINKOW

I

n the course of providing legal advice to registered massage therapists (RMTs) and other health care professionals, I regularly get asked about the disclosure of medical records, particularly in response to requests made by lawyers. The advice I give many of my clients includes certain key questions to ask when receiving these types of requests. The College of Massage Therapists of British Columbia’s (CMTBC) standards of practice state, in part: > a registrant shall maintain confidentiality of patient information (subsection 1); and > notwithstanding subsection 1, a registrant may disclose relevant patient information verbally or by a copy of the health-care record when: (a) the patient has directed the registrant, verbally or in writing, to make that disclosure; or (b) required by law. In light of these obligations, you should consider the following. First, has the lawyer enclosed a court order stamped as entered in the court registry? If so you are generally “required by law” to produce the records specified in the order, as per (b) above. Carefully read the terms of the order to determine which of your records you are required to produce and where you are required to send the records. For example, the order may be limited to records from a certain time period and will often specify the party who should receive the records. Second, if there is no court order, ask yourself whether the request clearly indicates that you have your patient’s written/signed authorization to disclose some or all of your records. In considering this question, it’s best to first review the letter to identify whether the lawyer is representing your patient. If the lawyer is representing your patient, he or she is generally acting as an agent for your patient and has the same access to the records as your patient does. As a best practice, look for some confirmation of his or her representation of your patient. A sufficient confirmation

often takes one of two forms: > ideally, the lawyer will enclose an authorization recently signed by your patient and specifying the records that you are authorized to disclose to your patient’s lawyer; or > if there is no recently signed authorization, you should at least obtain some form of communication (ideally in writing) from your patient indicating that he or she is represented by the requesting lawyer and that you are authorized to disclose his or her records to said lawyer. If the lawyer is not representing your patient – for example, the lawyer is representing an insurance company or the opposing party in a legal action – be very careful in disclosing your records, even if the lawyer has enclosed an authorization signed by your patient. Consider the following questions: 1. Have I been provided an authorization recently signed by my patient? If not, you are not entitled to disclose your records. 2. Does the authorization specify which records I am authorized to disclose and to whom I am authorized to disclose them? If not, you should seek clarification from your patient about the scope of his or her authorization. 3. Does the authorization seem to authorize me to disclose records that contain sensitive information irrelevant to the focus of the request? If so, you should seek clarification from your patient about the scope of his or her authorization. Ultimately, if you have not received a court order and you have any doubt about whether you are authorized to disclose some or all of your records, you should contact your patient to determine the scope of his or her authorization, as it is that authorization that you are relying on. RMT

Scott Marcinkow, Harper Grey

Scott Marcinkow is a lawyer at Harper Grey LLP, where his practice involves providing advice to various health professionals (including RMTs) about complaints made to their regulatory bodies. He can be reached at 604-895-2846 or smarcinkow@harpergrey.com.

If the lawyer is not representing your patient – for example, the lawyer is representing an insurance company or the opposing party in a legal action – be very careful in disclosing your records

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INDUSTRY BRIEFS For fraud’s sake The Canadian Health Care Antifr aud A s so c i at io n (C H C A A) wants to prevent massage therapists from becoming inadvertently involved in insurance fraud. In a white paper released last May, CHCAA members identified cases where non-massage therapists provided receipts for massage therapy, where the actual services provided were sexual or spa services – neither considered massage therapy under a group benefit plan.

“The association reminds massage therapists that … intentionally misrepresenting the services provided on a receipt to receive payment from an insurance plan fits the definition of fraud and, therefore, would be a criminal offence,” according to the CHCAA, which offered these tips: Ą never sign blank receipts and allow others to fill in the details; Ą never let anyone convince you to write a receipt with false details;

Ą always sign receipts, as this makes them harder to copy and easier to validate; Ą avoid receipt books, or consider using a uniquely designed stamp;

Ą Google your name, work address, phone number, clinic name, etc. to see if anything concerning comes up; and Ą contact your regulatory body or the police, CHCAA or applicable insurance carrier if someone suggests or tries to convince you to do something you feel is wrong or if you believe someone is using your name or credentials to commit fraud. For more tips and to read the full report, visit www.chcaa.org.

driver’s head before automatically adjusting the headrest to fit his or her body perfectly. “Whiplash injuries account for more than 70 per cent of all bodily injury claims for vehicle collisions,” according to the CIRPD, which had chosen four finalists for

the contest at press time. “Most people don’t know that appropriate positioning of head restraints can reduce the chance of serious injury by 35 per cent.” For more details and to watch the winning videos, visit w w w. whiplashprevention.org.

Spreading the word about whiplash A video contest launched earlier this year aims to spread the word about whiplash. The Whiplash Prevention Campaign contest asked participants to create short films depicting how motorists can use existing technologies to help prevent

injuries caused by rear-end collisions. Researchers at the Vancouver-based Canadian Institute for the Relief of Pain and Disability (CIRPD), which organized the campaign, are working on a device that measures the position of the

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MTABC NEWS Pain Management Conference 2014 March 28-29 @ Delta Vancouver Airport Hotel, Richmond, B.C.

One in five Canadians suffers from chronic pain. In fact, estimates place direct national health care costs at $6 billion-plus per year and productivity costs related to job loss and sick days at $37 billion per year. Astoundingly, veterinarians receive up to five times more training in pain than medical doctors and three times more training than nurses. The 2014 Pain Management Conference (PMC), presented by Pain BC and the MTABC, features two days of exciting speakers, keynote sessions, interactive workshops, networking oppor tunities and more. Open to health-care professionals who wish to increase their skill in the management of chronic pain effectively and safely

through manipulative and movement therapies, this year’s conference is not to be missed. Watch as international pain experts present work on the latest available pain treatments; attend post-conference workshops to pursue aspects of pain that appeal to your interests; and discover the knowledge, attitudes and skills necessary to respond effectively, safely and with empathy to those living with chronic pain. Keynote speakers include: ■Jan Dommerholt, PT, DPT, MPS, DAAPM, on the current scientific understanding of myofascial trigger points and the implications for clinical massage therapy practice; ■Diane Jacobs, PT, on the difference between operator models of manual therapy and interactor models, the phenomenon of pain perception and pain

science; and ■Neil Pearson, MSc, BScPT, BA-BPHE, CYT, RYT500, on changing the paradigm through which patients with persistent pain are educated. MTABC members who register by September 15, 2013, pay the special early-bird rate of $425 – a $70 savings off the regular $495

conference rate. Post-conference workshops, only available to registered PMC delegates, will be held March 30, 2014, at a $250 fee. With limited space available, be sure to register early at www. pain2014.ca. Conference details, including speaker bios, FAQs and hotel-reservation instructions are also available on the website.

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MTABC NEWS Call for presenters: Share your experience and knowledge at PMC 2014

Massage Therapist Association of Alberta turns 60, sponsors new research grant

The MTABC is looking for RMTs working in the challenging field of pain to present their work and help inform allied health care practitioners about the power of manual and movement therapies at the 2014 Pain Management Conference, March 28-29 at the Delta Vancouver Airport Hotel in Richmond, B.C. We are looking for 15-minute (max) case-study presentations, anecdotal reports and/or synopses of preferred treatments with an emphasis on your philosophical approach and what makes your approach uniquely successful in the management of chronic pain. Please send your application, including your personal details (name and contact info), a CV noting education and professional

Since 1953 the MTAA has represented massage therapists across Alberta and supported the advancement of the profession provincially and nationally. “It’s a pretty incredible time,� said MTA A president Pamela Kats, who recently announced her association’s sponsorship of a massage therapy-specific research grant through the Canadian Interdisciplinary Network for Alternative Complementary Medicine. The grant, which aims to advance the profession’s credibility by creating a larger evidence base, is just one example of work the MTAA has done over six decades to drive massage therapy toward recognition as a formal health profession.

designations and two paragraphs on your approach to MTABC rese arch co - ordinator B odhi Haraldsson at research@massagetherapy.bc.ca. Deadline for applications is September 30, 2013.

To celebrate 60 years, the MTAA is hosting a special Diam o n d A n n i ve r s a r y C o n f e rence, November 1-5, 2013, in Kananaskis, Alberta. For details visit www.mtaaalberta.com.

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RMT Matters is now using “augmented reality� to further improve the contents of our magazine and offer our readers a chance to win a great prize! This exciting new technology allows users of Apple and Android mobile devices to scan specifically created pages within this book to see additional “pop-up� content, like videos related to a stor y, relevant websites or background material, and information about the MT experts we interview. To enter the contest , install Layar on your smartphone (see page 4 for step-by-step instructions), read this issue of RMT Matters, which is packed with relevant news and information for RMTs in B.C., and find the correct answer to our skill-testing question: Where was Ron Alexander working when he discovered functional fascial taping?

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“Two and half years of massage school with the various techniques that didn’t have the same results as Applied Somatics. My colleagues shoulders were chronically tight, even after this time in school. After the weekend Stoops course, incredibly her tissues were relaxed and movement restored. Heather Fergus, RMT� “Look deeper at the mind/body relationship�

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with Heather Gittens RMT. Update your skill level and/or review material in a new and integrative format. Visceral Manipulation & CST focused One Day Courses for the busy RMT. Oct. 20, 2013: CST - The Spinal Column Mar. 22, 2014: VM - Digestion Apr. 20, 2014: VM - Femal Pelvis, Female Issues Sept. 28, 2014: CST - The Sphenoid Gateway 5 Credits Each, $125 + tax Max group of 12. 13+ years experience teaching Contact 778-574-1174 or www.bodhitreewellness.ca

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MTABC CEC Courses 2013 Registration at MTABC 604.873.4467 or mta@massagetherapy.bc.ca. Or mail to MTABC 180-1200, West 73rd Ave, Vancouver, BC, V6P 6G5. Provide name, phone and email. Cancellation within 3 weeks of a course results in 20% penalty; within 2 weeks, 40%; and within 5 days or “no shows�, no refund. All prices in Can. dollars

Fascia: Its Structure & Function - The Spine with Mark Finch, RMT - 14 Credits Nov 2-3, 2013 - Sat and Sun - 9 am to 5 pm Holiday Inn - 711 West Broadway, Vancouver Prices: MTA One Month Early $322 Regular $350 Non-MTA One Month Early $450 Regular $495 Mechanical Reduction of Pressure in Nerves for Bones/Joints/Cartilage with Dr. David DeCamillis, DC - 14 Credits Oct 26-27, 2013 - Sat and Sun - 9 am to 5 pm New Westminster

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Muscle Energy technique for the Neck - 15 Credits Oct 26-28, 2013 - Sat and Sun - 9 am - 5 pm and Mon - 9 am - 12 noon Holiday Inn - 711 West Broadway, Vancouver Prices: MTA One Month Early $345 Regular $375 Non-MTA One Month Early $480 Regular $530 Anatomy Trains with Sherri Iwaschuk, RMT, KMI - 14 Credits Oct 19-20, 2013 - Sat and Sun - 9 am - 5 pm Holiday Inn - 711 West Broadway, Vancouver Prices: MTA One Month Early $322 Regular $350 Non-MTA One Month Early $450 Regular $495

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CLASSIFIEDS Mastering Cranial Through Mentorship New extensive program in 2014 with Robert Hackwood, RMT For details: 604-418-8071 dynamictherapies.com

ADVERTISMENT ONLY. NO ENDORSEMENT BY THE MTABC INTENDED OR IMPLIED.

ANATOMY & YOGASANA I & II: Maui, HI Retreat December 1st to 8th, 2013 CEU Approved Relax on the island of Maui, learn and earn credit while studying the yoga body. Program combines anatomy, assessment, kinesiology, yoga practice and research you will be able to apply directly in your massage therapy client care or yoga practice. Combine 24 direct study hours with vacation time. You will be doing plenty of yoga and still have time to swim with the turtles. Fabulous meals and seven night’s accommodation included. Previous yoga experience an asset but not essential. Leigh Milne RMT, E-RYT500 is an experienced RMT, Iyengar certified yoga instructor and educator. For course and instructor details and registration information visit www.thesadhanacentre.com leigh@thesadhanacentre.com Leigh at 902-273-9642

Systemic Deep Tissue TherapyÂŽ Workshops (also known as SDTT) (Systemic Deep Tissue TherapyÂŽ should not be confused with high pressure treatments)

O

riginated and developed by Armand Ayaltin DNM, RHT, RMT, and taught by him since the late 1980’s. It consists of its own scientiďŹ cally-based philosophy, therapist-friendly assessment and treatment. To reduce burnout, body and hand postures are ergonomically designed. Therapy takes its cue directly from the assessment. This innovative procedure is designed to minimize the mental and physical stress of the Tx room. In these Workshops we will teach: s Philosophy and background s How to treat the underlying cause of pain, often realizing quick and lasting results s How to Structurally Realign the body by collapsing the compensatorymatrix, using speciďŹ c SDTT techniques at the physical and energetic levels which are: s recognizing the compensatory-matrix s engaging the SNS s manipulating the Fascial-muscle-joint systems s therapeutic intent s treating the relevant meridians s stimulating the patient’s quantum ďŹ eld of healing If as a Therapist, gaining self-conďŹ dence, self-sufďŹ ciency and effectiveness with reduced chances of self-injury is important, taking these workshops and adopting the Systemic Deep Tissue TherapyÂŽ is for you. Testimonials: “Thank you so much for this amazing workshop. It will change my life!â€? W.M. RMT. “This course surpassed my expectations...â€? B.C. RMT. “Thank goodness there is a way to read the body and respond to its core needs.â€? J.W. RMT. “Great coverage of biomechanics and application. I like these instructors, cool guysâ€? J.L. RMT. “With 16 years of massage therapy experience I was still expecting to learn something new- those expectations were exceedingly met. The assessment approach alone was enough of a refreshing perspective- with the addition of completely new hands on techniques, this course was thoroughly worth my time and would recommend it to any seasoned therapist. Excellent course, nothing but praise for these innovative and effective techniques that match a thoroughly progressive treatment philosophy, this is truly Massage THERAPY!â€? Brad Dow RMT. Autumn 2013: Introductory: September 28-29, Cost: $399. Intermediate: October 26-27 Cost: $399. Winter and Spring 2014: Introductory: February 8-9 Cost $399. CEC points 14 Intermediate: March 1-2, Cost $399. CEC points 14 For more info and to register, phone: 604.984.2611 s web: systemicdeeptissuetherapycenter.com

BANYAN THAI MASSAGE CMTBC

CEU Approved Courses

M AT T E R S M A SSAG E TH E R A PIST S’ A SSOC IATIO N O F B RITISH CO LU M BIA

If you have a product, service or course to advertise call Victoria Chapman at:

1-604-741-4189 vchapman@biv.com

A teaching affiliate with the famous “ITM School� of Chiang Mai, Thailand Ă Thai Massage for the Table: 7 CEU’s (1-day course) Vancouver: 1-Thursday, Nov. 14, 2013 - 9:00AM-5:00PM Ă Traditional Thai Massage Level 1: ITM Chiang Mai Method, 18.0 CEU’s (2-days) Vancouver: Sat. Nov. 16 – Sun. Nov. 17, 2013 9:00AM – 5:00PM ea. day Ă Traditional Thai Massage Level 2: ITM Chiang Mai Method, 18.0 CEU’s (2-days) Vancouver: Sat. Feb. 8 – Sun. Feb. 9, 2014 9:00AM – 5:00PM ea. day Ă Thai Foot Reflexology Massage: 7 CEU’s (1-day course) Vancouver: 1-Thursday, Nov. 21, 2013 - 9:00AM-5:00PM Visit us on-line to see our complete 2013 Courses listings. Paypal registration available at www.BanyanThaiMassage.com More information / contact: Sharon Brown-Horton, Instructor at 604.773.2645 Interested in hosting a course at your own location? With a minimum of 6 participants, travel may be arranged for ANYWHERE in BC and ALBERTA!!

Human Kinetics is making it easier for Canadian Massage Therapists to earn CEU’s online! NEW ,

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An

efficient solution for your patients

Manual Practice Osteopathic studies “Osteopathy is a natural medicine which restores function to the organism by treating the causes of pain and imbalance…” Philippe Druelle, D.O.

Osteopathy provides the necessary therapeutic reasoning skills and manual treatment approaches to achieve optimal results. Osteopathy views the body as a whole. Osteopathic manual treatment focuses on detecting areas of restrictions at any tissue level. Osteopathy functions by assisting the body’s natural healing ability, allowing restricted areas to regain as much of their former mobility as the body will comfortably allow. The College offers complete training including myofascial, visceral, cranial techniques, specific osteoarticular adjustments and clinical methodology. Courses are geared towards guided palpation and practice in order for practionners to be able to integrate their new knowledge to the treatment of patients. The educational program is designed with busy health-care practitioners in mind. The 6 yearly seminars are held over weekends to minimize time lost from current employment, with a low instructor/student ratio.

itional The reference in Trad Practice Osteopathy Manual teaching since 1981

College of Osteopathic Studies Canadian College of Osteopathy — CCO Collège d’Études Ostéopathiques — CEO

6 Canadian campuses: Montréal | Halifax | Vancouver | Québec | Toronto | Winnipeg

For information / registration 1-800-263-2816 | info@ceo.qc.com | www.ceo.qc.com

RMT Matters_Fall 2013_Gill Sans.indd 24

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