MASSAGE Magazine

The unique and non-descriptive language used in massage therapy creates confusion among massage therapists, other health and medical professionals, and the general public.

As a textbook author for massage therapy training, I have grappled with massage-related terms for years. Even a discussion of terminology has terminology issues:

terminology: the system of terms belonging to or peculiar to a subject; Nomenclature.

nomenclature: a system of names used to classify an art or science or other field or subject.

taxonomy: the science or technique of classification.

The best word for this discussion is nomenclature. The lack of an agreed upon massage therapy nomenclature makes it difficult to ensure a solid entry level education and prepare graduates to succeed in licensing exams.

Often massage styles with different names are essentially the same. The unique and non-descriptive usage of language in massage therapy creates confusion among massage therapists, other health and medical professionals, and the general public.

This problem plagues manual therapy in general, including osteopathy, chiropractic and physical therapy, and massage therapy. Each discipline has created its own language.

To add to the confusion, groups within a single discipline use unique terms. This is particularly prevalent in the massage therapy continuing education market, where numerous massage styles have been developed and taught by individuals who use jargon to describe their approach.

A large number of manual therapy methods from other disciplines, above all osteopathy and a large number of cultural healing systems, were also adopted, renamed and integrated into massage therapy. This practice makes a meaningful discussion of massage methodology almost impossible and makes interdisciplinary communication difficult.

attemptts under definitions

Two professional attempts have been made to describe massage therapy:

• Massage Therapy Body of Knowledge (MTBOK) in 2010

• Entry Analysis Project (ELAP) in 2012

Both projects led to recommendations for a uniform definition of massage therapy and a proposed nomenclature. But neither received support from the massage community, although massage therapy organizations funded each project.

Another problem is that the massage therapy community lacks a consistent definition of massage. Based on the article “Clarifying Definitions for the Massage Therapy Profession: the Results of the Best Practices Symposium” by Ann B. Kennedy, et. al., published in the International Journal of Therapeutic Massage & Bodywork:

massage: Massage is a patterned and targeted manipulation of soft tissues performed through the use of fingers, hands, forearms, elbows, knees, and/or feet with or without the use of emollients, ointments, heat and cold, hand tools, or other external apparatus , for the purpose of therapeutic change.

message therapy: Massage therapy consists of the application of massage and non-hands-on components, including health promotion and educational messages, for self-care and health maintenance; Therapy and outcomes can be influenced by: therapeutic relationships and communication; the education, skill level and experience of the therapist; and the therapeutic setting.

Massage therapy practice: Massage therapy practice is a client-centered framework for delivering massage therapy through a process of assessment and evaluation, care plan, treatment, re-evaluation and re-evaluation, health messages, documentation, and closure to improve health and/or well-being. The practice of massage therapy is influenced by the scope of the practice and professional standards and ethics.

Nobody knows what we’re talking about

For years, the massage therapy community has talked about being part of an interdisciplinary health and medical care system. The Massage Therapy Foundation’s research agenda and funding has supported advances in scientific support for massage therapy.

One of the challenges of researching massage, like all manual therapy professions, is the lack of consistent terminology. Several researchers have told me that they have little or no idea what massage therapists are talking about when those massage therapists describe their work.

Unified terminology must be easily understood by professionals from diverse backgrounds and should not reflect any particular history or legacy. The ability to communicate clearly and accurately is essential if the diversity of manual therapy practitioners is to incorporate collaborative research into practice and work together successfully.

A new approach: The ICMT

There are some encouraging developments. The International Consortium on Manual Therapies (ICMT) is taking on this question. When I was recruited to be part of this group over two years ago, I felt like this was an opportunity to make a difference.

We don’t have to prove the benefits of massage therapy, nor do we have to prove ourselves to other professionals. Existing research has done that. Joint research will expand the information base. This is a big focus of ICMT – common language so scientists can expand their research that benefits us all.

This cannot happen without cooperation. Massage therapists are equal at this table. Opportunities for a paradigm shift are rare, but I firmly believe that the International Consortium on Manual Therapies is an important development. We must not miss this opportunity.

It is important that the massage community engages with ICMT initiatives and does not ignore the impact of this interdisciplinary global collaboration among those using manual therapy in professional practice. Brian Degenhardt, DO, Paul Standley, PhD, and Francesco Cerritelli, PhD, DO (Europe) founded the ICMT after collaborating on several conferences on osteopathic manipulative medicine.

Standley particularly impressed me when he presented at the 2007 Fascia Research Congress at Harvard University when he described the problems associated with ambiguous terminology used in massage therapy and other forms of manual therapy.

Standley is among a select group of people around the world studying how manual therapy affects gene expression. His research at the College of Medicine-Phoenix focuses on the biomechanical regulation of gene regulation and cell growth in bioengineered tendon, bioengineered fascia, and skeletal muscle cells.

Degenhardt, Standley, and Cerritelli understand that to truly advance the field of manual therapy, both scientifically and clinically, 20th-century silos between professions must be broken down and communication and collaboration established. To begin this process, they decided that fundamental but critical issues must be overcome, such as: B. Differences in nomenclature systems within and between professions, and build a platform to improve communication between clinicians and basic scientists. The ICMT’s first conference program was developed from this perspective.

The ICMT Massage Therapy Working Group, in collaboration with the other ICMT working groups including Structural Integration, Physical Therapy, Osteopathy and Chiropractic, prepared documents as a starting point for an interdisciplinary conversation. The goal is to promote understanding between the professions that practice manual therapy and to arrive at a language that scientists can use in research to benefit all involved in the practice of manual therapy.

For massage therapy, the basic language that can be used to describe how massage methods are applied and described is taken from the Entry Level Analysis Project (ELAP). This document can be found at When creating the ICMT documents, only the recommended language was used.

Other factors related to curriculum recommendations were not relevant to the ICMT project. The scope document is drawn from multiple sources to reflect the most commonly described scope in state licenses and the Federation of State Massage Therapy Boards Model Practice Act.

The goal is to reduce massage therapy terminology to basic, objective, observable, and reproducible descriptors, and to avoid specific terms related to the different forms and styles of massage therapy that are named with culture-historical terms, eponyms, as well as brand-based terms or abbreviated names will. The other professions involved work towards the same goal. The vision is to identify a nomenclature that researchers can use across disciplines. The massage therapy community is invited to view and comment on these documents via this link.

get engaged

The ICMT conference will be interactive. At most conferences, attendees only watch and listen to the presentations—but at ICMT, attendees actively participate in the entire program. You will work with distinguished peers and peers from many manual therapy disciplines to jointly discuss the latest findings on manual therapies and help shape future collaboration and research. Importantly, the scientific community is involved by supporting evidence-based practice and identifying gaps for future research design.

[Click here to visit the ICMT Discussion Forum video presentation.]

Articulating what we do as massage therapists can present some challenges, but I believe we can do so in a way that encourages the growth and development of the profession and conveys a cohesive message of our nature and value . I strongly encourage you to be part of the conversation by registering for the virtual conference, which will be uniquely presented over a 30-day period. Find out more and register for the conference here.


About the author

Sandy Fritz is a founding member of the Alliance for Massage Therapy Education and the author of massage textbooks including Mosby’s Fundamentals of Therapeutic Massage; “Mosby’s Essential Sciences for Therapeutic Massage: Anatomy, Physiology, Biomechanics and Pathology”; and “Sports and movement massage: Comprehensive care for athletics, fitness and rehabilitation”. Her articles for MASSAGE Magazine include Old Myths Die Hard: The Truth About Toxins and The Massage Profession Needs to Face the Future – United.