What the public needs to know about the sports massage industry
The dangers to the public
You may go a sports massage therapist because you have a pain. The therapist might:
Not be able to spot the signs or symptoms that you have something very serious
Not refer you to the help you actually need
Assess things that don’t need assessing and arrive at spurious conclusions
Treat outside their scope of practice
Procede with a treatment that could harm you
Spout a lot of pseudoscientific bullshit
How can this happen? Here’s what the public need to understand.
We are not regulated
We have no national regulatory body, instead we can join professional associations, this is optional. There are maybe 18-20 associations. Many professional associations own their own massage school, so effectively validate their own courses, this is not good for the industry. This accounts for some of wide variability in teaching standards.
Standards vary
Some schools teach up-to-date evidence-based practice with good antomy, physiology, pathology and clinical reasoning sills, many do not. Many teach the same out-of-date rubbish year in, year out. Senior tutors often have no qualification higher then the one they are teaching, usually gained from the same school, as much good as an arse-to-mouth hosepipe.
My level 5 qualification gained in 2014 was full of nonsense that had no basis in research, it was dogma. Moreover, vital safety information was missing. When I reflect on the ethos, I would say that the school were aiming to create, was a group of arrogant twats, who think they can fix everything. I have since upgraded my education considerably.
Evidence-based care is not optional. When we see people with pain we are duty bound to be evidence-based, it’s an unambiguous ethical line.
Everybody passes (almost)
It’s virtually impossible to to fail these courses. Many courses have no entry requirements and boast 100% pass-rates. This gives some indication of how low standards can go.
Scope of practice
Many qualify with a level 3 sports massage. Since roughly 2009 this was reduced in scope and no longer qualifies therapists to treat any kind of pain, injury, pathology or condition. It is for pre- and post-event massage and available for anyone who likes a good massage. Many level 3 therapists advertise their services to people in pain. There is no legal recourse to stop this happening. Many with level 5 will also exceed their scope of practice, this represents a danger to the public.
Missing vital safety information
Many of the professional community social media groups reveal on a weekly basis that therapists are missing fundamental and critically important knowledge, including:
Red flags – signs any symptoms that a person may have a serious condition that needs medical, even urgent care
Contraindications – signs or symptoms that mean treatment may be harmful
When to refer – have clear methods to indicate a person needs referral to a medical professional
We regularly see therapists who are not trained in the assessment and treatment of certain conditions, going on facebook to ask what to do (yes, it’s that shit). The answers they get are even more disturbing than the questions. The groups effectively enable dangerous practice. Many of us who are dedicated to evidence-based practice have wasted many hours in these groups try to put out good information, and have given up trying. It’s too much of a shitshow and arguably getting worse.
Ongoing training that is not assessed
Many will have one qualification and a host of certificates relating to modalities such as dry needling, taping, cupping and all sorts. Most of these courses have little to no content regarding the evidence of what they teach. Many are pseudoscientific nonsense. It is very rare that these have any kind of assessment or exam. You get a certificate of attendance. You can sleep though these and get your certificate. There is a worrying trend where level 3 therapists are doing dry needling and neck cracking courses. These are verifiably, a group of dangerous idiots who shouldn’t be touching people.
Many of these courses are 1-2 days, not regulated, and willingly teach level 3 therapists. There is no mechanism to stop them.
Standards are lowering
There are now level 3 courses that can be completed in 1-2 days. This is utterly ridoculous. The people qualifying with these are oblivious to the harm they can cause. More and more quick’n’dirty courses are popping up to turn a quick profit and produce poorly trained therapists.
Don’t know what they don’t know
Often, therapists only really learn about muscles, bones, ligaments and tendons resulting in a tunnel-vision that all aches and pains are explained through these. This results in spurious ‘diagnoses’ and inappropriate therapies.
This industry produces great therapists and dangerous idiots who shouldn’t touching people, and everything in between. Unfortunately, the qualification tells you very little about the quality of their training, and their konwledge of evidence-based practice.
What can the public do?
This is difficult. Badly trained therapists are good people that don’t know they’ve been badly trained, they just wanted to help people.
Ask about their core qualification, not add-no certificates, including how many hours it was.
Ask if they are offering evidence-based approaches.
See if they offer any of the things an evidence-based practitioner would refuse to do, my list here.
If in doubt, look elsewhere
Stay safe.