Massage Therapy vs. Physiotherapy

The professions of physiotherapy and massage therapy are closer than you think.

The current scope of practice for Physiotherapy in Ontario is:

“The practice of physiotherapy is the assessment of physical function and the treatment, rehabilitation, and prevention of physical dysfunction, injury or pain, to develop, maintain, rehabilitate, or augment function or to relieve pain.”

The scope of practice for Massage Therapy in Ontario is:

“The practice of massage therapy is the assessment of the soft tissue and joints of the body and the treatment and prevention of physical dysfunction and pain of the soft tissue and joints by manipulation to develop, maintain, rehabilitate or augment physical function, or relieve pain.”

The two professions have virtually the same scope of practice.  It should be known that as of January 2012, physiotherapists will have a new scope of practice that enables them to order MRI’s, X-rays and further tests with the accompanying right to diagnose.  However, at current, massage therapy and physiotherapy have essentially the same scope of practice.

Let’s consider how massage therapy is carried out.  For the purposes of this article, we will be looking at massage therapy in a therapeutic, clinical setting.

While many consider massage therapy a wonderful way to relieve stress or tight muscles, massage therapy is in fact quite effective at helping people find relief from the following (to name a few):

Tension & Migraine Headaches, Strain, Sprain, Tendonitis, Tennis Elbow, Tingling or Numbness in Your Fingers, Tingling & Numbness in Feet, Motor Vehicle Accidents, Whiplash, Torticollis/Wry Neck, Peripheral Nerve Lesions, Nerve Impingements, Thoracic Outlet Syndrome, Dislocated Shoulder, Frozen Shoulder Syndrome, Rotator Cuff Injuries, Patello-Femoral Syndrome, (ITB) Iliotibial Band Syndrome, Scoliosis, Degenerative Disc Disease, Prolapsed/Herniated Disc, Ankylosing Spondylitis, Carpal Tunnel Syndrome, Plantar Fasciitis, Flat Feet, Conditions such as: Parkinson’s Disease, Osteoarthritis, Rheumatoid Arthritis, Fibromyalgia, TMJ Pain

As you can see from the list, there is more to massage therapy than relief from stress and tight muscles.

A therapeutic massage session can be a very powerful experience.  For example, in treating a rotator cuff injury, a massage session could include:

1. Fascial Techniques such as: Active Release Technique (A.R.T), Myofascial Release Technique (MRT), Rolfing, Myofascial Release or Frictioning to release scars or fascial adhesions that develop as a result to tears on the tendons or muscle bellies of the rotator cuff muscles.  These fascial techniques can also be used to free muscles that become stuck together as a result of fascial adhesions.
2. Acupuncture to stimulate nerve functioning, activate the release of endogenous anti-inflammatories, analgesics and endorphins.
3. Advanced reflexive techniques to reduce muscle spasm or trigger points such as: muscle energy technique (MET), Trigenics, and Post Isometric Relaxation.
4. Strengthening and Stretching Exercises to resolve muscle imbalances in the rotator cuff and promote strength and stability in the joint.
5. General massage techniques to increase blood flow to the shoulder increasing oxygen and nutrient supply while improving waste removal
6. As well, many RMT’s are qualified in the use of ultrasound, interferrential current, and TENS (transcutaneous electrical stimulation).
7. Hydrotherapy applications of hot and cold to reduce inflammation or increase blood flow to an area

If this seems like an effective,  complete treatment protocol, it is because it is.  It might be expected from a physiotherapy session and can also be provided in a massage therapy session.  Looking at this, it is easier to understand that the scope of practice between massage therapy and physiotherapy are very similar.  Both professions offer a flexible framework that allows for the practitioner to design an effective treatment plan for their client.

In choosing between massage therapy or physiotherapy for your injury, consider the following:

• How much “face time” do you want.  A 1 hour massage therapy appointment means that you will spend 1 hour with a massage therapist (inclusion of acupuncture or other modalities will mean less “face time”).  A physiotherapy appointment can often mean very little time with your physiotherapist after the initial assessment.
• If looking for a massage therapist, it is important to consider which modalities and techniques they are familiar with.
• Ask your physiotherapist how much face time or hands on time can you expect to receive during your treatment plan.  Will it be a one on one experience or will you be led from machine to machine?
• There is no real need to choose.  Massage Therapy and Physiotherapy work very well together.  In fact, in many physiotherapy clinics, you can find a registered massage therapist as well.