Scope of Practice for the Fitness Professional: Massage Therapy

It’s not uncommon for fitness clients to request massages or trigger point release from their personal trainers. Personal trainers have a thorough understanding of the muscular system and, as a result, clients assume they can provide this service. However, personal trainers need to be mindful of their stated scope of practice and refer clients to a licensed massage therapist to address this kind of body work.

What is Massage Therapy

Massage is a therapeutic science focused on the safe manipulation of the soft tissues of the body (connective tissue, muscle tissue, tendons, ligaments, and skin). Through their training, massage therapists develop a robust and sophisticated knowledge of human anatomy and kinesiology.

A typical educational pathway to becoming a massage therapist involves coursework in anatomy, physiology, human biology, introduction to massage, palpation, business ethics, massage and special populations, reflexology, relaxation/stress management, various assessment classes, and clinical practice. Many massage therapy curriculums also include elements of aromatherapy and nutrition.

Although massage therapy and fitness education have elements that overlap, this does not mean that a massage therapist can practice as a personal trainer or that a personal trainer can practice as a massage therapist without the requisite training/education and clinical/practical application experience. Training, certification, and/or licensure are necessary – regardless of what national, state, or local regulations are absent.

Regulation of Massage Therapy

As with personal training and nutrition, regulations and requirements can vary by state. According to the American Massage Therapy Association (AMTA), most states regulate the massage therapy profession. Similar to the fitness profession’s NCCA, the field of massage therapy also has a National Certification Board for Therapeutic Massage and Bodywork (NCBTMB).

The bottom line – the field of massage therapy has standards of practice, a defined scope of practice, competencies, and a skillset unique to that field. This is true of the fitness profession as well. However, these two professions’ scopes vary greatly and those differences must be respected in order to prioritize client safety and avoid issues of legality.

Consequences for Personal Trainers

Practicing massage on clients without the necessary training can result in significant consequences for the fitness professional. The following represents only a fraction of the potential costs.

• Personal training liability insurance does not cover liabilities associated with massaging clients
• Risk of client injury
• Ethical issues raised by practicing outside of your certified scope
• Potential for lawsuits and claims of negligence
• Loss of personal trainer certification

Remaining Within the Scope

As a fitness professional, you are charged with assessing a client’s readiness and ability to participate safely in an exercise program. You are also responsible for designing, implementing, monitoring and progressing a client-centered fitness plan that aligns with each client’s goals. Unless you have a license to practice massage, it’s best to offer an alternative should a client request bodywork from you.

Here’s what you can do instead:

• Explain the scope of your practice and what your certification and training legally allow you to do.
• Teach clients self-myofascial release techniques using foam rollers and other self-massage tools.
• Refer the client to a licensed massage therapist in your professional network.
• Perform PNF stretching with clients to alleviate areas of tightness and improve flexibility. This is best done at the end of a workout during the cool-down.
• Integrate and prioritize mobility, flexibility and recovery in your program design.

If you are interested in becoming a massage therapist as an adjunct to your fitness certification, be sure to research educational opportunities in your area, but do not practice massage therapy on clients – even if they think it won’t become an issue. It most likely eventually will.