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.

Editorial Board of JMS


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.

Dr. J. Muscolino

Here are letters from our readers:

Dear Dr. Ross,

Just wanted to extend my gratitude for your help.Your research in medical massage has been greatly helpful and actually equipped us with strong foundation convincing the senior physicians in India.

Dr. Pawandeep Singh

I am sooooo happy to see this site. Dr. Ross has been a major influence in my massage career and I use his textbooks, charts and information all the time in my work as a massage therapist and holistic health practitioner.

Janis Sommers, LMT

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Heidi Burge Horton, LMT


I love your website, it is full of such usable information and I thank you for that. I am a medical massage therapist since 2005, I currently work with a chiropractor and our focus is centered on injury treatment and posture restoration.

Gina Scianimanico, LMT

I am catching up on reading and just read the awesome piece written by Boris Prilutsky in the 2012 #4 journal. After many years in the Massage Therapy field in the US, I have many of the same views and concerns that Mr. Prilutsky expresses so eloquently. Thank you for your journal and for this fine article.

Kathy Kyar, LMT

Great article every practitioner should read: “Is Massage Industry in Crisis?” by N. Norwick. 

Holley Eubank, CMT


I was thrilled to learn about Science of Massage. Thank you for bringing more wonderful education to us massage therapists!

Rose Gay, LE, LMT

Dear colleagues, 

Thank you for your wonderful magazine!

Damise Dru

I really appreciate your Journal. Looking forward to your next issue. 

Wilayne Vandevender

Great article on pneumonia! 

Karen Pasquini, LMT

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Karen White


Your journal has some excellent articles. I especially enjoyed Part 1 of the chronic headaches paper, Issue #3, 2012.

Shannon Collins

Category: Letter From The Editor