compared to here in the UK. We have no regulations on educational standards or who can practice as a therapist, a large disparity in training institutions and a decreased respect from the public about what massage and bodywork has to offer the public in the modern era. For these reasons, I feel that we are not achieving the level of professionalism in the UK that could be achieved in massage therapy. We can have a unique approach to the treatment of pain, postural conditions, rehabilitation, trauma and wellness care. This approach can be separate to the work of physiotherapists or osteopaths and their perceptual paradigm. I see not only benefit through comprehensive soft tissue treatments but also through the realm of touch and communication. I have seen through working within a hospital in the USA that the role of therapeutic touch and the use of active listening skills can foster greater security in patients with chronic pain. This security and essence of touch, outside clinical care, can optimise the rate of recovery in many individuals. I believe that remedial massage must also be relaxing at some level otherwise it is going to be unlikely to optimise its therapeutic benefit. In my experience of physiotherapy,

both NHS and private, during recovery from injuries and surgery I have never received any massage. I have received excellent strength and conditioning advice which is fundamental to recovery but have had little direct touch, manipulation and massage. Is this because soft tissue work is time consuming? Is it because there are limited people qualified to apply it? Is it simply because massage can be physically hard work? Are we still sceptical about the benefit of using this modality? Why has massage fallen from favour in the last twenty years? There are many questions that are hard to find clear answers to. In the USA it’s a similar case in

physical therapy clinics, but with a marked difference being that soft tissue manipulation is carried out by specialist massage therapists who are being referred to by the physiotherapists. It is this application of specific skills and recognition of expertise in different disciplines that perhaps serves the patient to the greatest effect. The role of massage is deemed to be essential to management of injuries and

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rehabilitation.

There are some very marked differences between the role of massage in North America and the UK. How these have developed has much to do with the social healthcare model that we have in the UK, but also I feel that we have yet to ask ourselves some difficult questions here in the UK both within the massage profession and as a healthcare community. There has been a drive to professionalise the bodywork field in the USA during the last 25 years that has been met with much approval from with the medical fraternity. Licensure has led to minimum educational requirements and a national exam to be taken on completion of education courses. The rate of advancement of massage skills and professional stature is growing rapidly there. They have really met the challenges facing them by developing a vision for the future of their profession. At the moment I see measures in the UK such as the project by the Sector Skills Council for Active Leisure and Learning which are developing Occupational Standards in “Prevention, management and treatment of injuries sustained by active individuals” as positive steps. They are consulting physiotherapist, sports therapists, the FA and massage therapists to agree national skills and competencies required for specific goals. The Sports Massage Association approve educational institutions for sports massage, and we have a new regulatory body called the Complementary and Natural Healthcare Council which is there to set minimum standards for qualifications in such areas as massage. In the UK I feel we lack the training breadth that promotes a level of competency within our field. With specialist training in one area such as sports massage, we are missing out on a whole range of other skills that are essential to working with patients. We do not train doctors from day one to be neurologists. They train as junior doctors and then they specialise. The same is of physiotherapists and osteopaths. The training is general and then later specific areas of expertise are developed. I think that this is a very important aspect of any training and profession. I think that a broad education and skills base followed by divergence into specific fields is a much

better way to develop our profession. I find it hard to accept that sports massage for example can be practiced with full competency by students who have covered massage skills as part of a personal training certificate. We will not garner respect or provide first class treatments if we continue to allow programmes to teach massage as an add-on rather than like a profession like osteopathy or chiropractic. I also see that we are doing little to enter the medical fold with our lack of research, scarce communication and dialogue with the medical profession and lack a vision the years to come. I do not think that there are enough individuals who are passionate about the role of massage in healthcare and its diverse applications. We are crucially missing out on a national professional massage association which is there to promote the use of massage to the public and make a commitment to our future. Could we have a multi-level system of education and licensure like they are considering in Canada? Do we need licensure here? Are the educational standards high enough? I think these are interesting questions that demand some hard answers through developing a sense of a diminished ego. This will I hope lead to an open dialogue amongst practitioners, educators, doctors and public to establish a vision for the future.

THE AUTHOR

Humphrey Bacchus is a clinical massage therapist and neuromuscular therapist. He trained in the USA and worked at the

Boulder Centre for Sports Medicine, The Mapleton Centre for Neurological & Orthopaedic Rehabilitation and for Colorado University Sports Medicine. He now works in private practice in Oxford and London. He writes freelance articles on massage and bodywork, continues studies in nutrition and somatic psychology as well as running a company called MTB Works which provides support to endurance athletes and extreme sports at events and in private clinics.

sportEX dynamics 2009;19(Jan):20-22