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21
1
 SPRING 2014 ISSUE

CONTENTS
Features
COVER
Championing athletes 14 p14
Of two minds 18

Trusting hands 22

Putting your foot down 26

p26

Departments
p22 From the Editor 5
Touch Points
Industry News and Events 6
RMT Tech Talk
Whats your exit strategy? 30

Columns
Few and far between 10
By Jules Torti
On the Cover:
The learning curve 12 Aurel Hamran, sport massage thera-
By David Zulak pist and 2013 recipient of the Queen
Elizabeth II Diamond Jubilee Award

MASSAGE THERAPY CANADA SPRING 2014 3

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Editor
Spring 2014 - Volume 13, Issue 2
from the editor
Mari Len DeGuzman mdeguzman@annexweb.com
(905) 726-4659

C
Publisher anadian philosopher of media and
Christine Livingstone clivingstone@annexweb.com
(519) 429-5173 (888) 599-2228 ext. 239
communications Marshall McLuhan was a man ahead of his time. He
theorized, back in the early 1960s, that electronic interdependence
Account Co-ordinator would bring together once-fragmented, individualistic humankind
Shannon Drumm sdrumm@annexweb.com
(519) 429-5183 (888) 599-2228 ext. 219 into a global village. This vision was realized with the advent of the
Internet, transcending geographic barriers and enabling real-time, global
Media Designer
Brooke Shaw
communication.
McLuhan is also more popularly known for coining the phrase, The
Group Publisher medium is the message, which means the way by which a message is
Martin McAnulty mmcanulty@annexweb.com
delivered puts a lot of weight on how the message is perceived.
President The phrase was first introduced in McLuhans book, Understanding Media:
Mike Fredericks mfredericks@annexweb.com
The Extensions of Man, published in 1964. In a later book that elaborated his
Mailing Address theory on the importance of the medium, McLuhan theorized that modern
P.O. Box 530, 105 Donly Drive South, media have become extensions of human senses, enabling people to expand
Simcoe, ON N3Y 4N5
their perception of the world to an extent that would not be otherwise
PUBLICATION MAIL AGREEMENT #40065710 possible without the media. The book, published in 1967, was titled The
RETURN UNDELIVERABLE CANADIAN
ADDRESSES TO CIRCULATION DEPT.,
Medium is the Massage: An Inventory of Effects. Its not a typographical error.
P.O. BOX 530, SIMCOE, ON N3Y 4N5 The title actually says, massage.
e-mail: cnowe@annexweb.com An excerpt from the book could provide an explanation why it was an apt
Massage Therapy is published four times a year: metaphor: All media work us over completely. They are so pervasive in
January, April, July, November. Published and printed by their personal, political, economic, aesthetic, psychological, moral, ethical,
Annex Publishing & Printing Inc., 105 Donly Drive South, and social consequences that they leave no part of us untouched, unaffected,
Simcoe, ON N3Y 4N5
unaltered. The medium is the massage.
Printed in Canada Todays massage therapists and massage therapy practices have at their
ISSN 1499-8084 disposal a vast array of mediums for delivering their key messages and promote
Circulation their practice to their community and the public, in general. Each medium
e-mail: cnowe@annexweb.com has its own strengths and weakness that can make or break your message. The
Tel: (866) 790-6070 ext. 207 key is finding the most effective vehicle that will serve your purpose.
Fax: (877) 624-1940
Mail: P.O. Box 530, Simcoe, ON N3Y 4N5 The health and wellness benefits of massage therapy is an excellent message;
the challenge is getting that message across in a way that will make the most
Subscription Rates
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impact and will result in positive perceptions and actions. The world today is
2 Years $49.95 in a state of information overdrive. With the advent of social media and the
3 Years $64.95 shift to a 24-hour news cycle, it is very important to ensure the vehicle used to
(includes GST - #867172652RT0001) deliver the message of massage is as great as the message itself.
For USA and Foreign rates please contact Cheryl Nowe
And what better way to promote the benefits of massage than a great client
Occasionally, Massage Therapy Canada will mail informa- experience and excellent results. A satisfied client will return and will likely
tion on behalf of industry-related groups whose products
and services we believe may be of interest to you. If you bring in new clients.
prefer not to receive this information, please contact our After all, as McLuhan puts it, the medium is the massage.
circulation department in any of the four ways listed above.

No part of the editorial content of this publication may be Mari-Len De Guzman

reprinted without the publishers written permission. 2013 Editor
Annex Publishing & Printing Inc. All rights reserved. Opinions
expressed in this magazine are not necessarily those of the editor
or the publisher. No liability is assumed for errors or omissions.
All advertising is subject to the publishers approval. Such
approval does not imply any endorsement of the products or
services advertised. Publisher reserves the right to refuse
advertising that does not meet the standards of the publication.

www.massagetherapycanada.com

@MTCanadaMag

MASSAGE THERAPY CANADA SPRING 2014 5

 Touch Points
Lewarne assumes CEO post at Ontario association
T he board of directors of the
Registered Massage Therapists
Association of Ontario (RMTAO)
has announced the appointment of
Andrew Lewarne as its new executive
director and CEO.
Lewarne succeeds former
executive director and CEO Bryn
Sumpton, who resigned his post last
November due to personal reasons.
Lewarne assumed his new role
on March 3, according to RMTAO
board chair Krystin Bokalo.
Andrew is a registered massage
therapist and comes to the RMTAO
with significant experience with
the College of Massage Therapists
of Ontario, Inter-professional
Communication Committee
(University of Toronto Medical
What RMTs need to know about professional liability insurance
W hether youre new to
practice or a seasoned
professional, the decisions you
make about purchasing or
renewing professional liability
insurance can make a world
of difference if a claim is ever
made against you.
The College of Massage
Therapists of British Columbia
(CMTBC) Bylaws define the
minimum requirements for reg-
istrants: Each Active Registrant
must obtain and at all times
maintain professional liabil-
ity insurance coverage in an
amount of at least $2,000,000
per claim or per occurrence, in
a form that is satisfactory to the
College.
For many, professional liabil-
ity insurance matters can take a
back seat to more tangible con-
cerns, observes Kevin McIntyre,
vice-president of the Insurance
Brokers Association of B.C.
People are typically
focused more on protecting the
$10,000 worth of stuff in their
6 MASSAGE THERAPY CANADA SPRING 2014
INDUSTRY NEWS AND EVENTS
School), Medical Council of Canada
and the Association. Andrews experi-
ence will prove to be an asset in his
role, Bokalo said in a statement sent
to RMTAO members.
She added the board is very
excited about Lewarnes selection.
We look forward to working
with Andrew in his role as ED and
CEO. The wealth of knowledge he
brings to the position both as an
RMT and with his involvement
with the regulatory college is an asset
going forward for the association,
Bokalo said.
In an e-mail sent to Massage
Therapy Canada Magazine, Lewarne
said he is looking forward to serving
the profession as the new executive
director and CEO.
office. He advises his clients to
consider the real risks.
An $800,000 liabil-
ity claim would wipe you out
financially if you didnt have
coverage, he cautions. You
need to take it seriously.
In B.C., many RMTs pur-
chase their professional liability
insurance through the Massage
Therapists Association of BC
(MTABC), which offers group
insurance packages to its mem-
bers. Others choose to work
with an independent insurance
broker who specializes in health
professional liability insurance.
Either way, its important to do
your homework first to ensure
youre adequately protected
throughout your professional
career.
Its not uncommon for RMTs
to have breaks in their active
status with CMTBC whether
for leaves of absence (maternity,
family caregiver), extended trav-
el or other reasons. And while
the College does not require
He said he is currently reviewing
a number of avenues and poten-
tial advocacies to support RMTAO
members.
From publications to ongoing
education, one of the priorities of
the association will be to continue
to offer high quality of resources and
opportunities for continuing educa-
tion units., Lewarne said.
One of the first orders of business
for the new executive director is to
meet and engage in discussions with
members of the RMTAO board and
other stakeholders.
There are of course many chal-
lenges ahead with regard to advocacy
at the local, provincial and national
levels of the profession. I am excit-
ed by the opportunities that I will
you to carry professional liability
insurance during these gaps in
practice, you may still be at risk
for a claim against you.
There are two types of
professional liability insurance
available to RMTs claims-
based and occurrence-based.
While MTABC offers an
occurrence-based package,
many other health profes-
sions favour a claims-based
approach, according to
McIntyre.
With occurrence-based
insurance, your coverage is
tied to the date the injury alleg-
edly occurred, not the date the
claim was made. Therefore, if
you treated a patient in 2005
and she brings forward a claim
against you in 2012, the claim
would be covered by your
policy from 2005.
On the other hand, if you
purchase claims-based insur-
ance, your coverage applies
to the date the claim is first
brought forward. Therefore,
Andrew Lewarne
explore to foster growth and further
development. This is an interesting
time for the profession and I look
forward to advocating in any way
that I, and the association, are able to
do so, Lewarne said.
the claim brought against you
in 2012 for a 2005 treatment
would be covered by the policy
you purchased for 2012. If you
are inactive in 2012 and have
not arranged for insurance dur-
ing this time, you will not be
covered. This issue also applies
if youre leaving practice or
retiring. Youll need to purchase
tail coverage to protect your-
self against any future claims.
Getting clear on the dif-
ference between occurrence-
based and claims-based
insurance isnt the only thing
to consider. Different aspects
of the way you practice could
affect the kind of coverage you
need.
When considering the
insurance thats right for you,
its important to ask as many
questions as you need in order
to satisfy yourself that you truly
understand the policy youre
being offered.
College of Massage
Therapists of British Columbia
McMaster study on team-based health care gets $6.5M federal boost
T he federal government is
allocating $6.5 million
to fund a project led by
McMaster University to study
the use of team-based care
as a way to achieve better
health outcomes for patients
and make the system more
cost effective.
The announcement was
made by Parliamentary
Secretary Eve Adams on
behalf of Health Minister
Rona Ambrose, in a recent
visit to the Hamilton, Ont.-
based university.
The project, Teams
Advancing Patient
Experience: Strengthening
Quality (Tapestry), will exam-
ine how changing the way
a primary health-care team
operates and interacts with
its patients can improve the
quality and efficiency of pri-
mary health-care services.
By integrating resources
Manitobas massage therapy association appoints new
executive director
T he board of directors of the
Massage Therapy Association
of Manitoba (MTAM) has
appointed Sheila Molloy as its
new executive director.
The MTAM said Molloy, who
has more than 20 years of experi-
ence in business and marketing, will
be tasked to lead the association in
its efforts to advance the massage
therapy profession in Manitoba and
serve its 850 members.
Molloy brings over 20 years
of experience in strategy, marketing
and operations to the MTAM, the
association said in a statement. Her
previous post includes serving as the
executive director of the Associates
of the Asper School of Business, a
such as community volun-
teers, eHealth technologies
and system navigation, the
project will support patient-
centred care and stronger
connections to community
services, the health ministry
said.
Innovation is critical to
improving the efficiency of
the health-care system but
also to helping Canadians
maintain good health. This
project is looking at innova-
tive ways that health profes-
sionals can work together to
provide care to Canadians,
said Adams.
The Tapestry project is
expected to provide valu-
able information regarding
ways to increase access to
primary health-care services.
The initiative aims to gener-
ate evidence and develop
tools to assist provincial and
territorial governments in
membership-based, external foun-
dation of top Canadian executives
who support the school.
She holds a bachelor of com-
merce (honours) degree with dis-
tinction from the University of
Manitoba and a diploma in creative
communications, with a major in
advertising and minor in public rela-
tions from Red River College in
Winnipeg.
For more than 15 years,
Molloy has been the owner and
principal consultant of Molloy &
Associates, a marketing and busi-
ness development consulting firm
that works with clients in Canada
and the U.S. She is also a partner/
owner of In This Corner Boxing
addressing ongoing primary
health-care challenges.
Were finding ways to
combine the personal touch
of community volunteerism
and the latest technologies to
improve primary health care.
The Tapestry project will con-
nect citizens with their health-
care team to encourage early
identification of potential
health problems. This is
important for Canadians
and for the efficiency of our
health-care system, said
Dr. David Price professor
and chair, Department of
Family Medicine, McMaster
University.
The Canadian govern-
ment invests more than $1
billion annually on health-
care research. It has also
increased health transfers to
the provinces and territories
to unprecedented levels,
according to the federal
Fitness Centre in Winnipeg.
In 2004, she was inducted
as a lifetime member to Beta
Gamma Sigma, the interna-
tional business honour society.
She has served as director on the
board of the Manitoba Amateur
Boxing Association, and cur-
rently is a director on the board
of the Western Canada Aviation
Museum.
Molloy is an active mem-
ber of the Canadian Association
of Family Enterprise, Winnipeg
Chamber of Commerce,
AssentWorks MakerSpace and
Prototype Facility, and the Women
Business Owners of Manitoba.
She has been a volunteer with
MASSAGE THERAPY CANADA SPRING 2014
healthy ministry,
adding that this
funding will continue
to grow
to $40 billion
by the end of the
decade.
The Tapestry project is an
ideal platform for advancing
patient health through col-
laboration. Combined with
access to evidence-based
information, such as through
the McMaster Optimal Aging
Portal, Canadian citizens,
clinicians, public health
professionals and policymak-
ers will be able to make
informed decisions and sup-
port older adults to remain
healthy and engaged as
long as possible, said Dr.
Susan Denburg, director of
the Labarge Optimal Aging
Initiative and associate vice-
president, faculty of health
sciences at McMaster.
Sheila Molloy
the United Way Winnipeg since
1992, including campaign cabinet
in 2010.
Molloy replaces George Fraser,
who served as MTAM executive
director for more than 10 years.
7
Touch Points
Assuring quality of massage therapy through research
F or the massage therapy
profession in Canada to
continue developing as a health-
care profession, the body of
knowledge informing practice
must advance through research.
The College of Massage
Therapists of Ontario (CMTO)
has been committed to support-
ing research on massage therapy
through the Massage Therapy
Research Fund (MTRF). It is the
first and, to date the only, research
funding source specifically dedi-
cated to massage therapy.
The MTRF, a national fund-
ing competition, was established
in 2005 and initially supported
through contributions from the
Massage Therapists Association
of BC, the Ontario Massage
Therapist Association (now the
Registered Massage Therapists
Association of Ontario), indi-
vidual massage therapists and
the public. Since 2010, the
Digital communities for pain management eyed
T he U.S. National Pain
Foundation (NPF), based
in Golden, Colorado, plans
to create global digital
communities for people
suffering from pain in an effort
to increase understanding
of pain, its treatment and
management.
The NPF also announced it
is being reformed as an inde-
pendent, not-for-profit organi-
zation to transform the way
pain is fundamentally under-
stood, assessed and treated
for every human being.
We are resurrecting The
National Pain Foundation
because of the continued and
unmet need for significantly
more patient input into how
pain is diagnosed and treat-
8 MASSAGE THERAPY CANADA SPRING 2014
INDUSTRY NEWS AND EVENTS
MTRF funding competition has
been administered through the
IN-CAM Research Network.
IN-CAMs mission is to enable
and support investigation of com-
plementary, alternative and inte-
grative practices through research.
It is one of the few places with an
inter-professional focus encour-
aging collaboration and learning
across professions.
Prior to 2010, the MTRF
was administered by the Holistic
Research Foundation of Canada
(HHRFC) a federal charity that
has since ceased its operations.
Thats when IN-CAM became
the fund administrator.
Council wanted to ensure
that research funded through
the MTRF was of high qual-
ity and had appropriate ethical
standards, said Corinne Flitton,
registrar and CEO, CMTO.
Council was pleased to select
IN-CAM to carry out this func-
ed, said Dr. Daniel Bennett,
MD, of Denver, Colorado,
who founded NPF in 1998.
The foundation will give
voice to 1.5 billion people in
pain by creating digital com-
munities where they can share
their experiences and needs
through surveys, forums and
data collection means what
the foundation calls the digi-
tal footprint of pain.
We will effectively create
the worlds most comprehen-
sive observational database
of people in pain, their
behaviours, their treatments
and their needs. This will
allow pain patients to actu-
ally participate in advancing
how pain is understood and
treated, versus being the
tion. IN-CAM...is led by rec-
ognized researchers in the field,
is inclusive of massage therapy,
and has experience administering
funding competitions.
The MTRF provides oppor-
tunities for massage therapists
to undertake research to answer
important questions relevant to
their practice. To ensure that
MTRF-funded studies are con-
ducted in a rigorous way, grants
are awarded to individuals or
teams with research creden-
tials and based at a recognized
Canadian research institution
(e.g. university, college or research
hospital). Massage therapists
undertaking graduate studies to
complete a Masters degree or a
PhD can also apply for fund-
ing for thesis projects focused on
massage therapy.
Its a very unique oppor-
tunity for the profession as a
whole, and allows for building a
misunderstood sufferers they
have been for so long, Dr.
Bennett added.
Through data collec-
tion and analyses of the
digital footprint of pain The
National Pain Foundation will:
bring about a true under-
standing of what pain is
and whom it affects
educate the public
and bring about better
understanding of people
in pain so they may be
treated more fairly
enable researchers to
advance pain treatments
across socio-economic
and ethnic differences
develop true best practic-
es for health-care provid-
ers to deliver better care
solid foundation of knowledge
and critical inquiry to support
what massage therapists do on
a daily basis, said Ania Kania-
Richmond, acting director of
the IN-CAM Research Network.
Kania-Richmond is also a massage
therapist who recently completed
her PhD. Her thesis work on
hospital-based massage therapy in
Canada was supported through a
MTRF grant during its adminis-
tration under the HHRFC.
To date, more than $200,000
in grants have been awarded
through the MTRF, benefitting
17 researchers and research teams
from across Canada.
The most recent MTRF fund-
ing competition is close to com-
pletion. Individuals awarded with
the 2013/2014 MTRF grants will
be announced in May 2014.
For more information about
the MTRF, visit CMTOs web-
site: www.cmto.com.
to people in pain
uncover reasons for
increased vulnerability
to pain due to income,
education, age, gender
and race
provide intelligence
to industry on what
products and treatments
people in pain want and
need
The foundation expects
to attract funding from foun-
dations, industry and indi-
viduals who have interest in
improving the lives of those
who suffer in pain.
According to statistics, pain
affects 1.5 billion people glob-
ally and is the number one rea-
son people see a doctor.
PR Newswire
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Few and far between
Salt of the earth
A sprinkling of the natural healing properties of salt
Growing up, our family lived in the country and had a well,
which meant water usage was constantly being monitored by my
dad. We longed for the urban excess of seemingly endless city
water and all the joy that it entailed. We had no such luxuries,
and bath time meant sharing bath water with two siblings and my
parents.
Im not sure if we knew about Epsom salts back then. The 70s
and 80s seem to revolve around those greasy bath oil beads that
smelled like grandmothers: rose and lavender balls that melted
away as you soaked and left your body feeling like youd spent
time in a deep fryer. When we were out of our pearly bath bead
stock (usually a few months after a Christmas gift replenishment),
Palmolive was a common go-to.
A few months into the massage therapy college curricula (circa
1997), we were inundated with home care and the likes of
remedial exercise and hydrotherapy. Epsom salts were kingpins
in post-massage recovery and, by the power of persuasion and
chemistry, I joined the marketing department. Heres a refresher
on why you should be nudging your clients to soak it up.
COSMIC POWERS OF EPSOM SALT BATH
Advising clients to take an Epsom salt bath post-treatment should
be the default setting of every massage therapists home care spiel.
Long praised for being an accessible and affordable detox for
clients, there is scientific merit behind a hot bath. A beautiful
blend of purpose and pleasure, an Epsom soak facilitates the
healing properties of magnesium and sulfate.
Epsom salts are easily absorbed through the skin, allowing the
body to replenish magnesium stock lost to chronic stress, which
elevates adrenaline levels. Magnesium also helps to boost serotonin
and ATP (adenosine-triphosphate) production. The surreptitious
soak decreases irritability, reduces inflammation and aids muscle
and nerve function all encouraged by the best outcome: a
sound sleep.
Scrolling back to sleepy, pre-coffee break Hydrotherapy 101
classes, you may recall the cheerleading of magnesium and its
tag team work with calcium, the main conductor of electrical
impulses in our bodies. Teamed with magnesium, sulfates help
flush toxins and heavy metals, and a simple bath is really a
concrete lesson in reverse osmosis.
Epsom salts deserve lots of applause beyond the bathtub. It is
also known to aid with constipation (taken internally), soothe
athletes foot and remove splinters, among other things.
TRENDING NOW: #SALTCAVES
Salt is an organic wonder that is 100 per cent drug-free. When I
began exploring the saline theme for this feature I was surprised
10 MASSAGE THERAPY CANADA SPRING 2014
BY JULES TORTI
to learn how the halotherapy (salt therapy) industry is making a
surge in Canada. But, halotherapy is no trend its an age-old
secret that Europeans have long relied upon. They have even
bigger bragging rights the salt caves.
Dating back to the 16th century, the unique microclimate
of salt caves were discovered in Poland. Locals, curious and
receptive to natural healing, were drawn to the grottos
where the mineralized air (calcium, sodium, potassium,
magnesium, copper, bromine, iodine, fluorine) aided
respiratory conditions, dermatological issues and allergic
responses.
Naturally, always keen to emulate our fashion and foodie
forward European friends, North America is finally getting
on the salt cave bandwagon.
The man-made salt cave concept marries tradition, natural
remedy and geology in the creation of inhalation chambers.
Cave temperatures generally hover around 20 to 21 degrees
Celsius. Clients are booked for 50-minute sessions that
involve nothing more than breathing easy in a communal
room/cave. The complementary approach to western
medicine has provided an economic alternative for those
with asthma, hypothyroidism and cystic fibrosis. Sessions
at the salt cave in Mississauga are $15 to $35 (prices differ
for children, adults and seniors). One can even schedule a
massage inside the cave ($150) to enjoy the microelement-
enhanced service.
At The Rock Spa in Waterloo, Ont., dry salt aerosol has been
used for over 30 years in salt rooms that give a kick to cold
and flu symptoms, sinus infections, emphysema and hay fever.
The anti-inflammatory and antibacterial properties of the dry
sodium chloride aerosol have also proven to be effective with ear
infections, psoriasis, eczema and asthma. In Canada alone, over
three million residents have asthma a prevalence that has been
climbing steadily in the last 20 years due to factors like chemical
irritants in the workplace, tobacco smoke and smog. Prevalence
rates are rising by 50 per cent every decade worldwide, according
to the Asthma Society of Canada.
UNDERGROUND CLIMATOTHERAPY
Also known as speleotherapy, the notion of salt cave therapy
is attributed to the observations of a physician in 1843, who
found remarkably low incidences of respiratory issues in salt mine
workers. Was the air saturated in saline dust a hidden, therapeutic
connection?
In man-made salt caves like The Rock Spa, halogenerators
(micro processors of dry saline aerosol) crush pharmaceutical
grade salt grains into a breathable micrometer size. The walls and
floor of the inhalation chamber are covered in rock salt (acting as
moisture buffers and aseptic aids). The halogenerator (nebulizer)
pushes air with the micro-crushed dry saline aerosol particles
into the room, creating a super-saturated chamber of negatively
charged particles of sodium chloride.
In Pathology 101, remember mucocellular clearance
disturbance? The root pathogenic mechanism of obstructive lung
disease gets a trifecta knock-out by halotherapy with its mucolytic,
anti-inflammatory and immunomodulating attack.
While halogenerators monitor temperature, humidity
and aerosol concentration in a simulated cave environment,
speleotherapy (underground climatotherapy) relies solely on the
natural salt environment and is widely used in Russia and Eastern
Europe as a complementary respiratory treatment. In Wieliczka,
Poland, there is a long wait list for a respiratory hospital located in
a giant salt mine. In Bochnia, Poland, there is a speleotherapy unit
with an underground basketball court and sports field. A salt cave
in Cluj County, Romania has a full-sized football pitch.
One treatment per day for a period of two weeks allows for
optimal results. A treatment that involves reclining in a zero-
gravity chair in a cave-like room saturated with salt aerosol seems
like a convincing approach to respiratory and systemic woes to
me. But, maybe youd rather soak?
CANADAS DEAD SEA
Canadas best-kept secret is a natural saltwater lake. Little Manitou
Lake, near Watrous, is 100 kilometres southeast of Saskatooon.
A few months ago, I attended Robin Esrocks book launch
at a local Chapters. His book, The Great Canadian Bucket
List, harnesses the quirky and unknown experiences that
Canada offers. As he narrated his adrenalin-laced encounters
while researching the book, he instantly had me taking
mental note as my inner GPS purred. Swimming with
spawning salmon in B.C.? Eating $100 fish n chips at
Bullocks Bistro in Yellowknife? Riding horseback with bison?
Floating on Canadas Dead Sea? How did I miss the memo
on these geographic gems?
The healing properties of the lake (formed by a glacial spillway)
are found in huge sodium, magnesium and potassium deposits.
In the early 19th century, Assiniboines suffering from smallpox
were purportedly cured by drinking the waters of and bathing in
Manitou Lake.
Manitou Springs Resort and Mineral Spa has capitalized on this
buoyant idea. Unique to the Western hemisphere, but akin to
the Dead Sea in Israel and Karlovy Vary in the Czech Republic,
the lake has a gravity that is 10 per cent higher than regular water
(but still half the floating powers of the Dead Sea). You cant sink.
The European-style mineral spa entices visitors to the resort with
three soothing temperature sections from 94 to 102 degrees
Fahrenheit. Braver, outdoorsy souls can jump right in the lake and
enjoy the beach, while being smack dab in the Prairies.
URBAN SALT
In downtown Toronto, Body Blitz offers a therapeutic
hydrotherapy-based circuit that also revolves around the
nourishing benefit of sea salt and sharing communal waters.
Utilizing unrefined Dead Sea salt, both Body Blitz locations are
warehouse conversions that house hot Epsom pools, salt water
pool, cold plunge, Eucalyptus steam and infrared sauna facilities.
Owners Laura and Rena Polley latched on to the studies
of the Father of Medicine Hippocrates. He discovered
the therapeutic quality of seawater in the injured hands of
fishermen. Seawater appeared to halt infection and encourage
pain relief. Since then, the rest of the world has come to equate
seawater with restored equilibrium, the elimination of toxins
and replenishing the body with essential minerals.
WHATS SHAKING?
Himalayan sea salt is another term for rock salt, or halite.
Mined from Khewra Salt Mines in Pakistan, 300 kilometres
from the Himalayas, the salt is used for bath salts, curing
fish and meats, and serving dishes. Larger crystal rocks
are routinely turned into lamps for incandescent bulbs or
candles. Though the scientific jury is out, salt lamp believers
say heated salt crystals emit negative ions, giving some
positive energy waves to the air.
Regardless of how you choose to embrace salt truffles or
tartare, on your margarita rim with lime, to soak in after a
punishing run, or as the ultimate therapeutic chill-out session in a
cave it is a viable, multi-tasking ancient healing element at your
disposal.
Pass the salt please.
Jules Torti has been an RMT since 1999 and a
freelance writer since age six. In between massage
engagements, she travels to Africa to be with
chimpanzees and writes about her zany travels for
Matador Network.
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MASSAGE THERAPY CANADA SPRING 2014 11
The learning curve
A profession thats all grown up
Orthopaedic assessment and the education, practice of massage therapy
There are numerous dimensions to the practice of massage
therapy: not only is there a vast spectrum of techniques, but
inherent in these are issues concerning the intention and
purpose of massage therapy. One need only to look at the CEU
offerings across this country to know that who we are and what
we practice is not that easily defined.
There are numerous advocates for many differing schools of
thought concerning our purpose as manual therapists and our
role in the well-being of a person and a community. We are a
profession currently undergoing great changes. Some of what
drives this accelerating change is the move to gain legislative
recognition of our place in the health-care system across this
nation. This need for recognition, in turn, has given rise to a
sense of urgency to define the practice of massage therapy.
The danger of defining ourselves within a strictly evidenced-
based model of practice is that, ultimately, we will become
confined to orthopaedic issues. This is happening because
such an approach easily lends itself to current medical research
models of investigation. My fear is that many in our profession
believe that we can only claim legitimacy as health-care providers
by seeking approval from the general medical community by
adopting that models view of health and what it considers
acceptable practices.
But within such model what can we possibly be, for example,
other than baby-physiotherapists?
Given the relatively short time we spend in educating
our profession compared to others in the various medical
professions how can we not be seen as less well-trained
therapists within the field of orthopaedic issues (with a side-
line in stress-reduction)? When all comparable professionals are
university graduates, those of us with college diplomas will have
difficulty being taken seriously on an otherwise level playing
field.
One thing is for sure: any definition of massage therapy will
not be done well by abandoning our historical roots. If we do
so, we will inevitably be molded into something else, something
that comes from another professions view of health and well-
being, rather than from our own. Our fate will be taken out
of our hands. If that happens, much of what has been part of
massage therapy will be amputated in such a process. That is
certainly not something I want to see happen. Its not what I
signed up for twenty years ago.
We need to turn our attention squarely onto the issue of
who and what we are. This will be difficult because it is such
an enormous issue and elicits such divergent answers. But
it is necessary to ask the question and essential to seek an
answer if we are to maintain a place as independent registered
12 MASSAGE THERAPY CANADA SPRING 2014
BY DAVID ZULAK
professionals. We need to accept this task and in doing so accept
ourselves and our ancient heritage. This means it is time for us
to celebrate our history, our diversity, and begin the discussion
on what massage therapy has been, where it is now and what we
want it to be in the future. Yes, we will butt heads over this. But
we can also take the time to respect and celebrate each others
uniqueness, celebrate our diverse goals and passions for this, our
chosen profession.
Training in orthopaedic testing is a necessary component
of our curriculum, for both schools of massage therapy and
for continuing education. Learning the skills involved in
orthopaedic assessment, from classic case history taking and
range of motion testing to the special tests, provides us with
essential knowledge, skills and understanding of those clients
who see us for all manner of complaints. Equally important is
the fact that it provides us with a common language with which
we can both understand and communicate with each other
and with other health-care practioners. Further, orthopaedics
provides us with a window not only to many aspects of our
own profession, but to help us understand and appreciate other
health-care providers who also work within the orthopaedic
scope.
Historically, however, assessment skills for massage therapy
are not just about orthopaedic testing nor, for that matter, are
massage treatments only about orthopaedic issues. Assessment
in massage therapy has traditionally been about how the body
works together as a whole, biopsychosocially, as a totality.
Unfortunately, many therapists and many schools of massage
therapy have forgotten or abandoned this perspective.
Our attempt to be accepted by the popular kids has resulted,
in some circumstances, in a reliance on orthopaedic testing and
treatment plans based exclusively upon them.
No one was more guilty of this than I was. Early on in my
career as a therapist and as an instructor of clinical assessment
I was obsessed with orthopaedics. As a result, my treatments
became very specific and limited to the tissues directly involved
in the specific complaint or a region of the body. My focus
became smaller and narrower.
It seems many massage therapists have ended up fragmenting
the body into separate biomechanical structures or regions.
In a way, that results in ignoring the interdependence of all
structures, systems and functions and fails to recognize the
existence of a complete living organism. Assessment often
becomes reduced to performing one or two tests to confirm the
diagnosis already given by a more recognized professional. It
leaves us as second-class professionals with no role to play other
than performing a prescribed treatment protocol handed down
to us by someone higher up in the food chain.
I was saved from my limited focus when I started to use an
impairment-based model of assessment that avoided honing in
on conditions and syndromes. I again started looking at an ever-
widening area in order to draw a more complete picture of what
brought the client in to see me. Also, I was looking for a way to
figure out what could be interfering with, for example, a specific
clients healing, or to explain why a treatment, that should be
addressing a specific dysfunction, all too often fail to produce
the expected results.
A thorough regional exam would go a long way to answering
some of these questions. I came to appreciate that the source
for all those answers lies within the context of the whole
person. Slowly, but surely, I came back to a much more holistic
approach. In a way, I have come back to the view of massage
therapy that attracted me to the profession in the first place.
I see my profession continuing to move toward, and begin
to define itself as, a profession that is evidenced-based. Research
is essential for our profession. Evidenced-based treatments are
an invaluable component in the education of new therapists
and for assisting practicing therapist to re-appraise their current
practices. This can only elevate our profession in the eyes of
other health professionals. So I am right there in the cheering
section for research.
It is the defining part that concerns me.
Massage therapy does not just treat injuries. We do not just
treat muscles, joints or soft tissue; we treat people. We treat
the whole body with all its compensations and complexities.
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We treat it without relying on machinery; we treat it with
touch. We treat it ourselves, without an assistant, medication
or technology. And we are the last medical profession to do so.
We have not changed our principles of treatment all that much
since Hippocrates (with whom, I would argue, we have more in
common than any other current field of medicine).
Though many in our profession seem to be acting like we are
the new kid on the block, it is the current medical institution
that is, in historical terms, new. We have, in one form or
another, been around for a long time. We need to start acting
as such, take the long view and teach our history and principles
with pride.
So, to begin the discussion of what I would say massage
therapy is. Very similar to what it was when Hippocrates
talked about it: a profession that does no harm. I want it to
be a profession that treats the whole person. I want it to be a
profession that values, not just the similarities of each human
body, but also the uniqueness of each person. I want it to be a
profession that values the potential and the actual healing value
of human touch.
Its time we started learning about who and what we are.
David Zulak is an RMT, author and educator. Majority
of his teachings focus on clinical assessment, treat-
ment and advanced techniques. He is the author of
the textbook Comprehensive Assessment for Massage
Therapists. He works in a busy group clinic in
Brantford, Ont.
MASSAGE THERAPY CANADA SPRING 2014 13
Cover
Championing
athletes
Aurel Hamrans contributions to the Canadian sport
community earned him the respect of his peers and
honour from the Queen
B
ehind some of the greatest athletes in the world is a team of health-care practitioners ensuring
these contenders compete at their greatest physical condition. Often, these practitioners operate
on the sidelines, waiting behind closed curtains, ready to deliver their care to an athlete in need at
a moments notice.
As vital as their role in the team is, these health-care prac-
titioners seldom share the spotlight with the athletes they
care for. They dont typically seek such accolades, anyway. For
many of them, seeing their team excel and perform to the
best of their abilities is testament enough of their hard work.
This is why Aurel Hamran, a sport massage therapist based
in Edmonton, was surprised to receive a call last year from
Marcel Aubut, president of the Canadian Olympic Committee
(COC), telling him of the good news: he was to receive the
Queen Elizabeth II Diamond Jubilee Medal for his invaluable
contribution to the Canadian sport community.
Hamran was one of 41 members of the Canadian sport
community to receive the prestigious award in 2013. The
Queens Diamond Jubilee medal was created in 2012 to com-
memorate the 60th anniversary of Queen Elizabeth IIs acces-
sion to the throne.
Throughout his 30-year career, Hamran has participated in
five Olympic games, four Commonwealth Games, three Pan
Am Games and several other national and international com-
petitions. He is the team therapist for the Edmonton Keyano
Swim Club and runs his own massage therapy clinic at the
Kinsmen Sports Centre in Edmonton.
Hamrans work is not limited to the massage table, how-
ever. He is also an active member of his professional com-
munity: he has served as president of the Canadian Sport
Massage Therapists Association (CSMTA), an active member
of the Massage Therapist Association of Alberta, and has pre-
viously been a member of the City of Edmontons licensing
committee for massage services. He currently teaches sport
massage at McEwan University.
Being awarded with the Queens medal may have come as
a surprise for Hamran, but not to those who knew him well.
14 MASSAGE THERAPY CANADA SPRING 2014
BY MARI-LEN DE GUZMAN
I had an opportunity to expand my knowledge about
sports injuries and had a chance to meet this famous
Olympic massage therapist, recalls Anita Grof, who took
Hamrans sport massage class in 2010 and now works along-
side him as massage therapist for the University of Albertas
swim team.
He not only changed my way of thinking about the body
but he sparked a passion about massage and the benefits of
massage and how it can assist athletes, Grof says, describing
her mentor as a true master of his craft.
Of all his accomplishments, Hamran finds teaching one of
the most fulfilling.
My greatest achievement? It has more than one compo-
nent, and one of them is that I am able to pass on my knowl-
edge and sport massage techniques to students for the last
20 years, Hamran says.
Learning, he tells his students, must be a continuing experi-
ence that does not stop when one graduates. In fact, it is only
the beginning.
Expanding ones knowledge outside massage therapy is
key, he says.
For me, learning massage was not enough. Thats why I
went to Sheridan College in Oakville (Ontario) to learn sport
injury management, so I could work with and help athletes
more, Hamran recalls.
FROM MUSIC TO MASSAGE
From the moment he decided to become a massage therapist,
Hamran knew he would spend most of his career in sport mas-
sage. Growing up in Hungary, he was always involved in sports:
first in boxing, then later on, in wrestling.
It was during his wrestling years that he was introduced to
Aurel Hamrans career as a sport massage therapist spans 30 years. He was instrumental in instituting changes within the Canadian Olympic
Committee that would raise the profile of massage therapy among the sport community.
athletic massage. A supporter taught him and other wrestlers
on his team how to do massages, so they can help each
other when they compete out of town.
Sport was not the only thing Hamran pursued when he
was in Hungary; he was also part of a musical trio, with him
as the drummer. His musical performances would take him to
Canada at age 32.
We played in different places from Vancouver to Toronto
(until) our bass player decided he wanted to settle in
Edmonton. He went to university and became a teacher. Our
piano player went to the U.S. and played at different hotels,
Hamran recalls.
With his musical team disbanded, he settled in Edmonton
and worked at the printing plant of a publishing company.
That didnt last long for Hamran wanted more than just
an eight-hour job. He wanted to pursue his athletic interest
and his resolve solidified in 1983 through an encounter with
a friend, a gymnast who had sprained both his ankles at the
time.
Two days later, I saw him jogging and asked, How come?
Hamran recalls, surprised that his friend could run so soon
after his injuries. He said they massaged the edema. I said I
want to learn this and I also wanted to work with athletes.
Shortly after, he enrolled in the massage therapy program
at McEwan University. After finishing the program, Hamran
took a course on emergency first aid for athletes, where he
met an instructor from Toronto who was a certified athletic
therapist.
His interest in continuing to advance his knowledge in
athletic massage led him to Sheridan College to study sport
injury management. His time at the Oakville, Ont., school
took him to various sporting events, as part of his curriculum,
exposing him to various aspects of sport massage.
Whatever you learned, you used it, Hamran says. At
that time they organized international meets in downtown
Etobicoke. So I went down there and volunteered to do mas-
sages and got to know the national swim coach.
Little did he know that volunteer work was going to bring
him just a little closer to the Olympics.
I told the swim coach I was interested to work with the
national team and he said yes. He took me to the Olympic
training camp in Los Angeles before the 88 Olympics. He
said if the swimmers liked me then I could work with the
national team.
Unfortunately, that coach was let go three months before the
1988 Olympics, halting any hope of Hamrans involvement in
that game. However, it did teach Hamran one important lesson:
Great opportunities may come from volunteering.
For starters, volunteering allows one to practice what has been
learned in theory, Hamran explains.
Not everything is about money, he notes. Its your passion
that takes you further in your career. Volunteering is good to get
MASSAGE THERAPY CANADA SPRING 2014 15
 experience and meet other people too.
Its this belief in the power of volunteerism that would open doors for
him in professional sports. In 1986, he began volunteering as team thera-
pist for the Edmonton Keyano Swim Club. He worked without pay, but it
eventually paid off.
After the first year, the injury rates went down 90 per cent, says
Hamran. The coach realized the value of what his volunteer massage thera-
pist brings to the table, so he took him on as the official team therapist
this time, with proper remuneration.
Hamran travelled with his swim team to various national and regional
competitions and this started a series of fortunate events that took him to
five Olympic Games and several other major national and international
competitions.

ADVANCING THE PROFESSION

Hamran always tells his student that sport massage is the best promotion
for massage therapy, because it is normally performed in an open area for
all to see. During competitions, massage tables are set up as part of the
backdrop, accessible to team members.
As an instructor, Hamran seizes every opportunity to expose his students
to competitions and see massage therapists at work.
I just want to teach whatever I know, he says, adding he is always find-
ing ways to make the learning more interesting for the students.
Its not everybodys cup of tea, because sport massage is demanding,
physically, you have to have endurance, stamina... You have to have a goal
and keep yourself updated and take courses.
In all his work, Hamran is always thinking of and trying to implement
ways to raise the profile of massage therapy within the professional sport
community. He was instrumental in establishing the CSMTA national
sport massage curriculum and certification program.
Hamran also developed and introduced the sport massage curriculum
for McEwan University (Grant McEwan College then), which he teaches
today.
My basic instinct is that I know something which I would like others to
know too so they could serve the athletes. That was the whole intention,
he says.
Looking out for the interest of the athletes has always been a priority for
Hamran. He recalls an incident during the 1992 Olympics that may have
led to the realization within the Olympic community how vital massage
therapy is for the athletes, not just for treatment of injuries but also for
overall physical health.
During the 92 Olympics, Hamran worked as the team therapist for the
Canadian swim team. He narrates: In 92, I worked alongside health-care
providers like physios, sport physicians and sport medicine personnel at the
Canadian team clinic. So everybody came for massages from the Canadian
swim team I overheard field athletes saying, We came for treatment
because we have tight muscles and its really difficult to use those muscles.
The field athletes were sent away and were told the clinic was only treat-
ing injured athletes. Two days later, those same athletes came back to the
clinic with injuries.
I wrote a letter to the Canadian Olympic Association (name of the
Canadian Olympic Committee at the time) saying that basically we are
doing disservice to the athletes not getting massage therapy which could
loosen up their muscles so they could train and compete better, Hamran
says.
He also urged the president then to include massage therapy in the
medical team. The president sent Hamrans letter to one of his directors for
consideration.
Before his letter, Hamran explains, massage therapy was not part of the

16 MASSAGE THERAPY CANADA SPRING 2014

 Olympic medical expert group comprising sport physicians, sport massage is more than just knowing various massage
physiotherapists, athletic therapists and chiropractors which techniques.
selects members of the medical team from a list of nominated, Sport massage is part of sport medicine. You have to get
qualified candidates. familiar and understand sport physiology, biomechanics,
The review on the process of selecting medical teams kinesiology, sport psychology, sport injuries, their treatment
instigated by Hamrans letter led to a series of events that and prevention.
set the process in motion for massage therapy to be even- To succeed in this profession, he adds, requires stamina,
tually part of the Canadian Olympic Committees medical dedication and passion.
expert group. One of those processes was the development Passion is exactly what Hamran has for his work with
of the CSMTA curriculum for certification. This certification athletes. Along with being the team therapist for the
allows certified CSMTA members to be considered in the Edmonton Keyano Swim Club and the National Swim Team,
selection process for members of the Olympic medical team, he also worked with the Edmonton Eskimos Professional
Hamran explains. Football Club from 1987 to 1989.
Officials at the COC, who nominated Hamran and oth-
HIS LIFES WORK ers worthy of recognition, believe the men and women
Hamran says helping establish the national curriculum and cer- who work in the background to support Canadian athletes
tification exam for sport massage therapists, recognized by the deserve their time in the spotlight.
Canadian Olympic Committee, has been one of his greatest We owe so much to those who work tirelessly behind the
achievements. scenes to advance sport excellence in Canada, says COC presi-
His contributions to the Canadian sport massage profes- dent Aubut in a statement. It is a true privilege to be able to
sion and the sport community spans 30 years, but his work is shine a spotlight on these 41 heroes who have given so much to
not done, according to him. He wants to continue to impart Canadian sport and asked so little in return.
whatever knowledge he has gained through the years to all
who are willing to learn. He believes through the work mas- Mari-Len De Guzman is the editor of Massage
sage therapists do, they are able to help all levels of athletes Therapy Canada and Canadian Chiropractor
reach their full potential and achieve their dreams. magazines. Contact her at mdeguzman@annex-
For aspiring massage therapists interested in sport, he says web.com.

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massage book spring 14.indd 1 2014-04-03 1:34 PM
Regional Focus
Of two minds
An in-depth look on the state of the massage therapy
profession in Western Canada
W
hat is the value of regulation? Its a question that sparks heated debate when massage thera-
pists address this key issue. With massage therapy currently regulated in only a few jurisdictions
in Canada (Ontario, Newfoundland, British Columbia and, most recently, New Brunswick), view-
points across the country diverge about what forms of regulations should be implemented, and
thats especially so among massage therapists in Western Canada.
Alberta has long grappled with this thorny issue. The problem,
according to Cathy Smith, manager of the Associate Massage
Therapy Clinic in Red Deer, Alta., seems to be that a large
number of massage therapists in our province do not under-
stand exactly what regulation will do for our profession.
Many are worried that the government will dictate our
every move, from client care to billing. Others worry that a
huge exam will be required of all 2,200 hour therapists and
they worry they will not be able to pass. They look at the pos-
sible problems that could arise (from change to regulations)
not at the positives. I believe that by becoming regulated, we
will have more credibility in the eyes of other health-care prac-
titioners, billing to insurance companies will become easier,
and we will fit into the new 2020 Vision Integrated health-care
plan our government has devised.
Although the movement to develop a made-at-home regula-
tory environment in Alberta slogs along at a glacial pace, at
least the provinces licensing massage associations continue to
dialogue.
And dialogue some more, quips Len Balogh, president of
the Remedial Massage Therapists Association (RMTA) head-
quartered in Red Deer, who sits on the transitional steering
committee (TSC) alongside the Massage Therapist Association
of Alberta (MTAA), National Health Care Practitioners
Association (NHPCA) and the Alberta Association of
Therapeutic Masseurs (AATM).
The RMTA wholeheartedly supports and endorses the
regulation of Alberta massage therapists under the Health
Professions Act, Balogh says.
In 2009, the Minister of Alberta Health and Wellness had
recommended to Cabinet that the Health Professions Act be
amended to include massage therapists as a regulated profes-
sion.
The government wants this to happen; so does the MTAA.
But after 20 years theres still no agreement among all the
stakeholders. Its a standoff. And by refusing to compromise
18 MASSAGE THERAPY CANADA SPRING 2014
BY JACK KOHANE
and come to terms that will benefit all MTs (in Alberta), we
could have the opportunity to become regulated taken from us
and freeze the development of our position within the health-
care profession, he says.
The MTAA (established in 1953, making it one of Canadas
oldest associations for massage therapists) is pursuing a viable
way forward in transitioning the massage therapy profession
into a self-regulating health profession under provincial legisla-
tion. The Entry to Practice standard in Alberta will be based
upon that which has already been established by the other
regulated jurisdictions in Canada, and the majority of people
practicing massage (in one form or another) do not necessarily
meet this standard at this point in time, according to Chandra
Kastern, massage therapist and spokesperson for the MTAA.
The Entry to Practice Examination Blueprint is based on the
Inter-Jurisdictional Practice Competencies and Performance
Indicators for Massage Therapists, which was finalized in late
2012 by the three regulatory colleges for massage therapy in
Canada (B.C., Ontario, Newfoundland and Labrador).
To the best of my knowledge we are the first jurisdic-
tion in Canada to have completed a psychometrically driven
blueprinting exercise using this document and the only
jurisdiction to have released a concise blueprint to an Entry
to Practice Examination into the public domain, remarks
Kastern.
Completion of the blueprinting exercise was the kick-off to
the redevelopment of the Entry to Practice Examination in
Alberta, which is currently underway, slated to be complete
summer of 2014. The MTAA has also launched a school/
program approval process for institutions offering massage
therapy education in Alberta. Going into 2015, it will be man-
datory for Alberta graduates wishing to challenge the Entry to
Practice Examination to have come from an approved school
or program.
A viable and fair substantial equivalency process is key in
transitioning the existing profession into the reality of being a
self-regulating health profession under provincial legislation,
Kastern says.
She explains this process was created to enable existing
massage therapists in identifying where their unique level of
competence is at, in relation to Entry to Practice standards, to
be able to best address deficiencies (if any) or be recognized
as substantially equivalent to that of a new graduate of a
two-year massage therapy diploma program in Alberta. It also
provides a pathway for practitioners to become eligible to chal-
lenge the Entry to Practice Examination, if they so choose.
Another Alberta-specific profession-relevant policy would
be our professional development program, Kastern continues.
We recognize that learning occurs inside and outside of a
classroom and that all learning opportunities, whether formal
or informal, have the potential to be of benefit to the massage
therapist. As such, we now use the words professional develop-
ment in place of continuing education or continuing com-
petence as the new terminology to more accurately reflect the
(professional) growth of a massage therapist.
There may be other means to regulate massage therapy, con-
tends Kathy Wilson with the Natural Health Practitioners of
Canada. She wonders if the government should make the ulti-
mate decision about any natural health profession.
Many practitioners believe this might not be the best way to
represent their practice, she opines, speaking from her office
in Edmonton. Our organization is governed by a code of eth-
ics, we have an effective complaints process, and liability and
malpractice insurance. We believe our members are satisfied.
Though Wilson admits there are challenges in any health
profession, she knows no hurdle is insurmountable.
There may be different perspectives on whether regula-
tions are needed or not, but there is no debate about the
good work massage therapists do. They are a force to be reck-
oned with.
Despite the divide among Albertas health associations,
provincial policy makers may be trying to nudge the matter
forward. Recently, the province met with the associations to
explore the possibility of sending out a survey to Albertas mas-
sage therapists, asking if they want to be regulated. No survey
or any official confirmation of a survey, however, has since
taken place at the time of this writing.
RMTAs Balogh is cautiously optimistic. Were rallying
our troops for the yes side, he says, adding theres enough
momentum to bring in a positive vote. But if less than 50 per
cent want regulation, he warns, the issue is dead.
Smith hopes that wont happen. This is a time when we
have a chance to make a positive change, a change that may
even make moving from province to province easier for those
who wish to relocate and stay within their profession, she
notes.
For the majority of massage therapists who are highly
trained, professional individuals, regulation will not change
what they do. In the background, it very well may open up
the doors to new jobs in multimodality clinics and health-care
facilities.
The insurance companies have already dictated that to bill
we must have 2,200 hours training and our clinic supports
this, so for us regulation will not be a problem.
20 MASSAGE THERAPY CANADA SPRING 2014
The number of RMTs in B.C. has grown from 800 in 1994, when
regulation was introduced, to more than 3,000 today.
FURTHER WEST
By contrast, British Columbia has designated massage therapy
as a health profession under the Health Professions Act since
1994, regulated by the College of Massage Therapists of B.C.
Practitioners here think regulations are generally a good thing.
The current regulations definitely impact my practice and
how I deliver my care, says Eugene Liang, a strength and
conditioning coach and registered massage therapist with the
Canadian Sport Institute Pacific (CSIP), a leading Olympic
and Paralympic training facility, based in Vancouver.
The largest impact is in patient care. Due to the fact that
massage therapy does not have a clear and defined directive of
care, many RMTs are left to their own devices.
Liang believes this can lead to what he characterizes as a
permeation of sham or niche treatment modalities into the
field. Further, he argues, even though the College of Massage
Therapists of British Columbia (CMTBC) specifically states
there are no specializations in massage, this does not limit
a massage therapist from creating a market for a niche or a
sham treatment.
In his eyes, its basically a free market. And its directly tied
to the limitless and wild-west environment of the continuing
education courses. As an RMT who wants to provide the least
invasive and most effective treatment for my patients, I spend
much of my resources educating patients and students on navi-
gating these pitfalls.
Liang says hes privileged to work in an environment surround-
ed by academics. He also views regulation as a positive thing.
Regulation, as I used to say to my students, is what makes
massage health care. Without it, we are a trade. Being regu-
lated, and being able to provide health care, is a privilege not a
right. With that thinking in mind, regulation is the ticket to a
professions growth and evolution.
Even though B.C. RMTs are often polarized on their view-
points on how they see the profession evolving, most if not all
agree to regulation. That says more than any one opinion.
Regulation also serves the public interest, says Annette
Ruitenbeek, registered massage therapist and deputy registrar
for the CMTBC.
We are accountable to ensure that each individual who hangs
up his or her shingle as an RMT is truly ready to begin practicing
as an entry-level health professional.
Continued on page 29
Practice BY CHRIS OCONNOR

Trusting hands
Massage therapy treatment for post-traumatic stress
recovery

P
ost-traumatic stress disorder (PTSD) is
increasingly being recognised in our com-
munities. PTSD is no longer a condition
specific to war veterans or those who
have had major trauma in their lives. It is now
widely accepted that any person who has suf-
fered any kind of trauma can experience PTSD
symptoms and its effects can be overwhelming.

Massage therapy offers a wealth of benefit for those going

through post-traumatic stress recovery. By gaining a better
understanding of the symptoms of PTSD, and the complex-
ity of the recovery process, massage therapists can provide
treatments that cater to the very distinctive needs of their
clients.

PTSD DEFINED
The word trauma may be defined in a strictly physical/
medical way, meaning simply a wound or injury. Trauma
may also involve the psychological realm and mean, a deeply
disturbing, frightening or disquieting occurrence.
It is now known that any person who has endured a trau-
matic event is susceptible to the disquieting effects of PTSD.
War veterans, victims of motor vehicle accidents, victims of
physical/sexual/psychological abuse, or natural disasters all
could suffer from PTSD. The Diagnostic and Statistical
Manual of Mental Disorders 5 now includes: those who
have directly experienced a trauma, those who may have wit-
nessed a trauma, close friends or relatives of trauma victims,
and those with repeated occupational exposure to traumatic
events, as potential candidates for PTSD.
PTSD is a serious clinical condition that must be diagnosed
by a qualified health-care professional, as its symptoms might
not be easily recognized, even by those suffering. Flashbacks,
nightmares, night sweats, altered sleep patterns, adrenal
fatigue, irritable bowel syndrome, memory loss, muscle aches
and general fatigue are just some of the symptoms that your
clients might be experiencing. Many individuals do not make
the connection between symptoms and trauma experienced
because of the diversity of symptoms, their vagueness and, Patients recovering from PTSD are taking a leap of faith in putting
often, because of delayed onset of symptoms. their trust in their therapists.

22 MASSAGE THERAPY CANADA SPRING 2014

 Although PTSD is a complex condi- nerable this position must be for our Hypervigilance is another common
tion requiring diagnosis and treatment clients. Recognizing the magnitude of symptom of PTSD. Being aware of
by properly trained medical profes- the leap of faith I was asking her to this and allowing the client to regain
sionals (far outside the scope of RMT take to trust a stranger taught me control of a triggering situation, while
practice), RMTs can learn to recognize a valuable lesson. also letting them be vulnerable can
PTSD and refer clients appropriately We come away from our massage be tricky but important. People in
when symptoms are evident. therapy training knowing that basic authority may have taken advantage of
marketing skills are necessary to build these individuals, imagine how impor-
TAKING CARE WITH a practice. I had not realized that it tant your role as a manual therapist
ASSESSMENT would be necessary to sell myself becomes.
When preparing to assess or treat even after a client was in the treatment
individuals with PTSD, it is impera- room. Trust is extremely difficult for TREAT THE PERSON
tive to have clarity about what is being those who have been traumatized, and I often tell people that I have never
assessed, how it will be assessed, how the quality of trust that is required treated a hand, a foot, an arm, a leg,
it will be treated, and what will be left may not be earned after one visit. a back or a neck. I usually get a per-
to the medical professionals. The key to the success of this plexed look until I clarify that I treat
After more than a decade treating particular initial informed consent/ people, rather than body parts in iso-
sensitive cases, it is still crucial for my assessment was making sure, beyond lation. I also do not treat conditions
clients and me to strictly maintain a doubt, this client knew and under- recorded in medical files.
treatment boundaries. More than just stood she was in complete control of One of the most meaningful
the obvious adherence to standards every aspect of the treatment. It was a encounters I have ever had with a cli-
of practice, treatment boundaries are very empowering event for this client. ent took place ten years ago. It was a
vital on a personal level for PTSD cli- As a result, she continued on with me very busy night, booked back-to-back,
ents and should not be compromised. and booked several more treatments. and I was rushing to ensure that every-
Many PTSD clients are learning how She also trusted me enough to refer one was getting their full treatment
to assert themselves for the first time, her to a therapist in her hometown times. I was streamlining my intakes
and may have a very difficult time rec- after her hospital stay was completed. and was reading the forms just enough
ognizing what their comfort levels are.
Alexithymia, or an inability to feel
ones emotions, is a common co-
morbidity with PTSD. Victims often
cannot discern what emotions they are
feeling, are skilled at not feeling, or
do not even know how their emotions
feel in their bodies.
Massage, executed carefully, can
play a very important therapeutic role
here. Care must be taken to ensure
treatment is led by the client not
by the therapist. Trust is paramount
with this demographic. Failure to gain
and maintain trust will jeopardize the
efficacy of your treatment and impede
your clients recovery.
I remember the first time I treated a
client who had suffered years of sexual
and physical abuse. Her emotional dis-
comfort was palpable the moment she
entered the room. This woman found
herself in a room with no windows, no
phone (just an empty phone jack on
the wall), no intercom, and a 240-lb
male massage therapist between her
and the closed door.
While I heard myself instructing her
to disrobe and lie face down under
three millimetres of sheets, as I had
done with hundreds of clients before, I
realized for the first time just how vul-

MASSAGE THERAPY CANADA SPRING 2014 23


Ongoing education can help therapists increase their understanding
of PTSD recovery for better patient support and treatment.
to find the clients name, date of birth (it is always a good
practice to wish clients a happy birthday), the history of their
massage treatments, and the primary area for their treatment.
It may not have been my most professional night, but it for-
ever changed my way of treating.
The client came in, and it was obvious from her severe
scarring, and the eye patch she wore, that she had been
through a significant trauma. As I went through the consent
process she just nodded and said very little. Throughout the
treatment she was very quiet and was nearly inaudible when
I checked-in about pressure and comfort. The treatment
ended, she left as quietly as she had arrived and she rebooked
before she left. Our second treatment was much the same as
the first, but on the third treatment I decided to change the
treatment plan. I suggested that I work on her head and face
an approach that I felt would prove beneficial. She con-
sented and I went to work.
After the treatment, this client came out of the room cry-
ing. Worried that I had done something wrong, I immedi-
ately asked if everything was okay. She said that I was the
first medical professional in 15 years, since her bear attack, to
touch her face without asking what had happened.
I discretely picked my jaw up off the ground, made sure
she was fine to leave the treatment area, and returned to her
initial intake form. There it was in black and white: Reason
for treatment: bear attack.
24 MASSAGE THERAPY CANADA SPRING 2014
I often wondered if I would have treated her differently had
I known. I cannot ever know how different the treatment
could have been, but I do know that this case taught me two
things: read intake forms carefully, then forget what you read
and treat the person.
POWER OF TOUCH
Those with PTSD have survived traumas, and many have
lived for a long time since. Sadly though, many have been
missing significant parts of the human experience distract-
ed by their condition. Helping a client reconnect with their
physical body may also help them to overcome obstacles in
their emotional/spiritual selves.
It is quite common for clients to present with physical pain
connected to their trauma. Some of these traumas occurred
decades earlier. A client once reported that he was experienc-
ing inexplicable pain in the low back and gluteal region.
During his treatment he revealed that, in a group session ear-
lier that day, he had been retelling the story of being spanked
in his formative years. This is called intrusive re-experiencing
and is a core symptom of PTSD.
REACHING OUT
In all of our communities, there are people working through
a post-traumatic stress recovery process. As a medical profes-
sional with years of experience working with this population,
I hate to think of any sufferer going unnoticed. It should be
easy for each PTSD client to find, and network with, quali-
fied medical professionals. Just like those suffering from
addiction, these individuals need the highly skilled hands and
minds of manual therapists to help them become reacquaint-
ed in a healthy way with their bodies.
Once a client is diagnosed with PTSD, they may feel
labeled. A client diagnosed with PTSD, with such a wide
range of delicate and difficult-to-treat symptoms, may feel
helpless and destined to suffer in silence. When we reach out
to this group we can make a tremendous contribution to our
communities, and bridge the gaps that exist among health-
care professionals.
Ongoing education is the key to gaining a greater under-
standing of the process of post-traumatic stress recovery. We
live in a world with a wealth of information at our fingertips
that ignorance about a condition as prevalent as PTSD is
difficult to fathom. Keeping ourselves informed and sharing
information with colleagues can do nothing but broaden the
support network for people in need.
As massage therapists, sometimes we dont see ourselves as
sales people but sales are nothing more than asking questions,
providing a service and letting people know how to access it.
My hope in writing this series is that, as a profession, we will
start seeing areas in the population we treat that are being
under serviced, view them in a new light and take action to
remedy the situation. (Edited by Heather MacRae)
Chris OConnor is a registered massage therapist,
public speaker, osteopathic practitioner, provider
and instructor of contemporary medical acupunc-
ture. For more information, visit www.chrisocon-
norconsulting.com.
6 Canadian Campuses

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877-893-0367 Study with us and grow your practice!
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Our 5 year part time program is designed for health-care professionals to gain
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The practice of traditional manual osteopathy requires a fine touch, a gentle heart,
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www.osteopathy-canada.com hand transmission of traditional Osteopathy is preserved. Our lead instructors hold
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choice.
Technique BY NICOLE RAMIEN

Putting your
foot down
Ashiatsu Oriental Bar Therapy comes to Canada

T
wo parallel bars hang securely from the
ceiling. A body lies prone on a massage
table with the cervical spine neutrally
aligned in a face cradle. Meticulously pre-
pared, soft and hygienic feet glide slowly along a
tension filled muscle, sinking into the lubricated
tissues with precision.

To the body on the table, the sensation is as if huge hands

are engulfing its tissues with broad compressive strokes, fol-
lowed by the inevitable wave-like reperfusion, which brings a
rush of relaxation endorphins. As the foot moves, it perceives
information about muscle quality, texture and tension, send-
ing these messages back to the brain to form an appropriate
response to be applied using that same foot, achieving a
therapeutic goal.
This is Ashiatsu Oriental Bar Therapy (AOBT), also
known as Ashiatsu Deepfeet Bar Therapy.
In Japanese, Ashi means foot, and -astu means pressure.
Many forms of barefoot massage can be found in other coun-
tries throughout the world: Japan, China, the Philippines
and India, among others.
According to its founder Ruthie Piper Hardee, AOBT was
created as a fusion of all the best features of barefoot massage
modalities while ensuring a safe and therapeutic experience.
Founded in 1995, AOBT is currently practiced by thousands
of therapists in the United States who were taught by fewer
than a dozen carefully selected and certified AOBT instruc-
tors.

CLIENT EXPERIENCE
Many clients wonder what the feet feel like when used as a
massage tool. The broader surface of the foot means less dis-
comfort than with traditional deep tissue massage. Patients
who prefer deeper massages will likely enjoy the Ashiatsu
experience. For those who have been reluctant to try a deeper
massage because of the pain associated with it, Ashiatsu just
might be what changes their minds. Often, a patient on the AOBT is currently practiced by thousands of therapists in the U.S. and
table will completely forget the massage is being done with is now starting to gain traction in Canada.

26 MASSAGE THERAPY CANADA SPRING 2014

the feet and have no idea where on the table the therapist
is.
It doesnt have to be deep, however. Any stroke may be
modified to have one foot working on the patient, while
the other foot remains on the table supporting most of the
weight of the therapist. This, along with the overhead bars,
allows the pressure to be customized to the individual.
Current theories in manual therapy are exploring the con-
nection between pain and dysfunction and the brain and
the nervous system. Muscle is not inert tissue to be bullied
into change, but instead an innervated tissue to be coaxed
towards a modified state. Given the richness of receptors
found in the skin, massage, in its many forms, is an excel-
lent tool for facilitating the conversation between the ner-
vous system and other soft tissues.
Pain research has shown the intensity of pain diminishes
when one feels safe and at ease, and goes up when one feels
anxious. Massage and the power of touch can promote a
positive frame of mind that can change the way ones brain
responds to discomfort.
Given this revelation, a massage patient should expect to
have a pleasant sensory experience during treatment. The
complicating factor for the therapist is that this experience
may mean something different for every person on your
massage table.
For patients who prefer a deeper sensory experience, the
RMT traditionally uses small-diameter tools to achieve
depth such as an elbow, thumb or a knuckle. The result can
be uncomfortable or even painful for the patient, heighten-
ing the nervous system at the perception of threat.
The broad, padded surface area of the foot used during an
Ashiatsu treatment allows the deep tissue patient the oppor-
tunity to ease the nervous system without sacrificing the
depth of the treatment.
Due to the broader surface area of the foot, greater con-
sistency in the depth of pressure, length and flow of strokes
feels comfortable for the patient. The rounded and softer
surfaces of the heel and ball of the foot create less trauma
for the tissue and breakage of muscle fibers than when
pressure is applied using bonier tools such as the thumb,
knuckle or olecranon process. A therapist is able to achieve
the same releases using broad surface ischemic compression
and stripping, while producing less inflammation and con-
sequent delayed onset muscle soreness. The larger surface
area of compression allows for enhanced reperfusion and
helps to achieve a state of deeper relaxation for the client.

TRAINING
Launched in the spring of 2013, Ashiatsu Deepfeet
Bar Therapy Canada is now training Canadian thera-
pists through NRG Medicine in Toronto. All provincial
standards of practice have been met, making it easy for
Canadian therapists to fit Ashiatsu into their massage ther-
apy practices.
To ensure the standard quality and safety of the modality,
massage therapists who are interested in training must be
licensed in their province of practice or students of massage
therapy who have completed 75 per cent or more of their
program.

MASSAGE THERAPY CANADA SPRING 2014 27

 BENEFITS TO THERAPISTS
Ashiatsu offers therapists increased longevity, endurance and
physical fitness. Using the feet in practice as an alternative to
the hands and forearms helps to avoid repetitive strain inju-
ries (RSIs) and overuse injuries of the small joints in hands,
arms and lumbosacral issues from leaning over the table.
With Ashiatsu, the therapist is able to deliver the same
amount of work but spread over the entire body, this work
becomes a low-grade full body workout for the therapist. As
with any modality, proper ergonomics are paramount. To
ensure safe and proper setup to minimize ergonomic stress on
the therapist, bar installation and table height must be perfect.

A LOOK FORWARD
Ashiatsu is expected to start appearing more frequently on
spa menus, in massage colleges, clinics and massage supply
stores across Canada. Its popularity will initially be based
on its novelty and sheer intrigue. What will actually ensure
Ashiatsu practitioners must follow strict hygiene practices according to Ashiatsus staying power within the massage therapy profes-
regulatory standards.
sion are the clients who will see and feel its benefits and con-
When selecting a barefoot training program, it is important tinue to request it.
to consider the quality and depth of the curriculum as well as
the level of expertise and training of the person from whom Nicole Ramien, RMT, is the first fully certified
you will learn. This ensures that once trained, a therapist is AOBT therapist in the Greater Toronto Area. She
able to begin his/her practice in a safe, effective and sustainable has since then become the first and only certified
manner. AOBT instructor in Canada. She graduated with
The goal of each AOBT training class is for each therapist honours as registered nurse from McGill University,
to leave with the tools to critically think and use sound judg- and has been trained in naturopathic medicine at several clinics
ment when working with their clients. AOBT instructors are around the world. For information on the AOBT and for available
hand-picked from qualified candidates who have completed certification and training courses, visit www.nrgmedicine.ca.
an intensive application process and training program.
AOBT Canada conducts training in groups and in person,
with a maximum of eight students per class. Following grad-
uation, any needed support and resources will be provided,
ensuring therapists and their clients receive a safe and precise
practice for many years to come.
Certification courses include: Barefoot Basics, a 90-min-
ute full posterior routine with one foot firmly planted on
the table; Advanced Deepfeet 2, which includes two-footed
and transitional strokes that can be integrated with the one-
footed routine; and Ashi-Thai, a full-body 90-minute passive
assisted stretching routine, both posterior and anterior done
through clothing.

CMTO STANDARDS
As per College of Massage Therapists of Ontario Standard,
all skin surfaces must be washed with soap and water or
alcohol-based sanitizer for a minimum of ten seconds.
Each Ashiatsu therapist will have their own unique routine
to prepare their feet before going in the treatment room, but
each should ensure that provincial standards are being met.
Getting from the washbasin to the massage table is made
possible through the use of single use socks following the
washing/drying protocol and slippers or sanitized rubber
sandals. These socks are then washed to the same standards as
the table linens.
Draping techniques taught in all classes meet the expecta-
tions of the majority of Canadian massage therapy clients.

28 MASSAGE THERAPY CANADA SPRING 2014

 Of two minds
Continued from page 20

Noting the number of the Vancouver-based Colleges regis-
trant base has blossomed from 800 when the CMTBC opened
in 1994 to more than 3,000 today, Ruitenbeek says in order to
continually evolve the profession, the College is reaching out
across the nation. The CMTBC has adopted the newly developed
Inter-jurisdictional Practice Competencies, reflecting a joint effort
with other regulated provinces Ontario and Newfoundland
and Labrador to create a single, national standard for entry-
to-practice regulation. She explains that not only do the Practice
Competencies harmonize the three duplicate processes in each
of the jurisdictions, they offer a standard of regulation for other
jurisdictions to adopt as they move to self-regulation.
The approach enables regulators to confidently abide by
national labour mobility laws that require them to grant full
registration to active RMTs from other regulated jurisdictions
without additional assessment, testing or educational upgrad-
ing, other than testing for knowledge of local jurisprudence.
Working in high performance sport, Liang sees himself as a
pragmatist and a realist. He looks for options.
The way I would like to see it go is that it continues to
evolve politically, professionally and academically. As a 10-year
instructor, I definitely have seen a shift in the student body
coming into massage therapy education. The students are more
educated, more experienced, more worldly and more critical.
I see the profession diversifying within itself with registrants
being truly qualified to not only be clinicians but academics,
researchers and policy makers, he says.
In all provinces, regulated or unregulated, clients of RMTs
belonging to any reputable association have generally been
able to claim their massage treatments for reimbursement
by insurance companies. Insurance firms, such as Manulife,
Sunlife and Great West Life, have asked all RMTs regardless of
province to have a minimum of 2,200 hours of education and/
or belong to a recognized association that sets certain require-
ments at a level comparable to those practitioners who are
licensed in regulated provinces.
And he who pays the bills will have a big say in what hap-
pens and how our profession will evolve, Balogh cautions.
The bottom line: insurance companies will set the tone for
the profession moving forward.
Jack Kohane is a Toronto-based freelance
journalist writing for several national
health-care magazines and the National Post.

Donald Q. Dillon, rmt

Practitioner, Speaker
& Mentor
To anyone
thinking about
contacting Don for
practice advice, dont
hesitate...his advice is
worth its weight in gold.
K.S., RMT and business owner, Ontario

MassageTherapistPractice.com

Massage_DonDillon_Bizcard_Mar2014.indd 1 2014-04-01 2:08 PM

MASSAGE THERAPY CANADA SPRING 2014 29

RMT Tech Talk
Whats your exit strategy?
Through my day-to-day interactions with massage therapists
across Canada, I often meet practitioners who are winding
down or in the process of closing their practice. The reasons
behind the closures are common enough and range from
retirement to career change, relocation to disability but you
may find yourself as surprised as I was to hear how these health
professionals are closing their doors.
Many practitioners are simply closing their practices and
referring their loyal clientele to other health professionals free
of charge. You may wonder why anyone would simply give
away his or her client base after working so hard to establish
it. Surprisingly, many practitioners believe their practice is not
sellable. This certainly does not need to be the case.
The practice management systems you use inside your practice
could have a serious effect on your ability to sell your practice
and, ultimately, the size of cheque you receive for it.
Massage therapists mostly baby boomers are retiring in
increasing numbers every year. At the same time, new massage
businesses are entering the market. One group wants out of the
business and the other group wants in. This environment creates
a multitude of opportunities to sell your practice if you have a
business that has transferable value.
Many self-employed therapists may not realize in their early
years that they are doing more than providing essential health-
care services to their client base. They are also managing and
building a profitable business. Hard assets aside, the transferable
revenue opportunities your business offers, via your established
active clientele, is of primary importance to any prospective
purchasers. Likewise, the management system you put in place
to keep track of your clients and business will ultimately affect
the cash value you receive upon selling your business.
A friend of mine is an accredited business valuator. She says
historically, small and medium size businesses employed very
short-term strategies when it comes to electronic management
systems, and this negatively impacts the practices value for
resale.
Her eyes lit up when I asked her to explain the value a
potential purchaser would place on an automated practice
management system when considering buying a massage therapy
practice. She said it is essential that a purchaser be able to
efficiently access the client base and the individual client records
with treatment and client communication history. She believes
paper driven, filing cabinet/shoebox businesses offer the least
opportunity to successfully transition clients to a new business
owner.
She places a high value on the new owners ability to
electronically communicate with the purchased client base. It
is key to client retention. She says it is imperative the practice
30 MASSAGE THERAPY CANADA SPRING 2014
BY JESSICA FOSTER
management system includes permission-based and efficient
(automated) communication tools that have historically
provided two-way communication between the practitioner and
clients.
An example of communication tools for massage therapy
practices is a professional website with automated online
scheduling system clients who are used to booking
appointments online with their practitioner will be much
more likely to do so with the new owner. The website
must be transferable to the new owner. Another example is
efficient email utilities, including automated appointment
reminders and mass email clients who have permitted
electronic communications with the previous practitioner
would likely be willing to continue with the new one.
The branding value that a professional website offers
is vital in retaining clients and acquiring new ones in a
geographical area. Here are a few enabling technologies
purchasers or new owners will want to see operational in
your practice.
electronic database with client health-care information
electronic, updated client contact information, including
email addresses complete with client permission to use
client billing history
touch-of-a-button financial records, capable of being
consolidated by client, treatment type, date and revenue
periods
electronic record keeping that is 100 per cent compliant
with provincial and federal privacy legislations. No new
owner wants to be sued by clients over failure to comply
with the legislation.
It is recommended that if circumstances allow, the selling
practitioner should be active in introducing the new owner
to the clients. The selling practitioner should seek the clients
recorded permission to transfer client health-care records to the
new provider.
The best time to implement your exit strategy is from day
one. The next best time is as soon as possible. Fortunately, the
aforementioned practice management technologies are readily
available to practitioners, are easy to use and highly cost-
effective.
Until next time, be well.
Jessica Foster writes on behalf of mindZplay
Solutions Inc., a provider of massage therapy
websites and practice management solutions. To
learn more about mindZplay solutions for massage
therapists visit www.massagemanedger.com or call
toll free 888-373-6996.
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