In Issue #3 of 2013 of JMS in Good Apples/Bad Apples, we reviewed Dr. J Muscolino’s article “Working the Hands in Concert-The Force Couple Technique” published in 52(2), 2013 issue of Massage Therapy Journal. We considered Dr. Muscolino’s article to be a very good educational piece but expressed some reservations about the techniques discussed in the article since some of them seem crossing the line into the field of chiropractic medicine. Here is our quote from our initial publication:
“The only problem we have with the article is its topic in regard to massage practitioners. The author is a very skillful chiropractor and he shares his expertise with the readers who don’t have same level of training. Despite that the article warns that this treatment must be conducted only after special training, we still believe that it belongs more in the chiropractic field rather than massage therapy. Besides the need to have extensive training, this approach may put massage practitioners who practice it in legal conflict of interest with local Chiropractic Boards.”
We received an e-mail from Dr. Muscolino with additional clarifications from a legal point of view. We are happy to publish it to put everything in the correct perspective.
The force couple technique is one method of directing force into the client for maximal efficiency of manual therapy. As presented in the article, it can be used for deep pressure (deep tissue) soft tissue manipulation as well as joint mobilization. It seems that your review confuses the force couple technique of using the hands in concert for applying force with joint mobilization, which was one of two examples on how it could be used. If your concern is with joint mobilization, please make that clear instead of implying that the force couple technique presented is not within the scope of massage therapy.
If we are then discussing joint mobilization, then we should be clear. It is a Grade IV mobilization that is legal and ethical for LMTs (according to the AMTA) in 40 of the 50 states. And of course, they should have appropriate training, which was clearly stated in the article. There is no fast thrust added, which would make it a Grade V mobilization and would make it illegal for LMTs and would concern the Chiropractic Boards.
Mobilization of intrinsic joint tissues can and should be an extremely valuable addition to the tools of a massage therapist (in 40 of 50 states). It empowers the massage therapist to do excellent clinical orthopedic massage, or as you term it, medical massage. Your blanket stance is very unfortunate because it limits the clinical potential of the field, which is ironic given your position as an advocate of medical massage.
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Category: Letter From The Editor