Publication date 11 February Available to CSP subscribers only Log in to download this publication. Professional and legal framework Physiotherapists owe a duty of care to their patients, colleagues and employers. This includes treatment involving manual handling, delegation of treatment, and the provision of manual handling guidance, advice and education. Health and safety legislation provides a framework that can assist the physiotherapist through the process of risk assessment and risk management.
The law recognises that it would not be reasonably practicable to eliminate all potentially hazardous work. In considering the reasonable practicability of avoidance, the utility — or potential benefit — of the act in this case, treatment involving manual handling is one factor to be considered.
Utility alone is not a sufficient rationale to proceed with hazardous manual handling interventions regardless of risk.
There is an absolute requirement to assess the risk arising, and reduce it so far as it is reasonably practicable. Balancing the potential benefits utility to patients arising from physiotherapy interventions involving manual handling with the potential risks to themselves, the patient and colleagues, as well as family and other unqualified workers, is central to physiotherapy practice.
Employers including physiotherapist employers eg owners or directors of private physiotherapy practices have a duty to provide physiotherapists with a safe system of work and to provide appropriate health and safety-related training.
Risk management in treatment handling When treatment programmes are devised that involve manual handling, physiotherapists must assess that part of their work which is potentially hazardous and reduce the risks so far as is reasonably practicable. This must be recorded.
Staff working in different specialisms will have differing skills. In proprioceptive neuromuscular facilitation PNF , range of motion and flexibility are gained by passively stretching a muscle while engaging in an isometric stretch. This method follows a specific protocol of contract-relax-stretch, as well as hold times and is recommended to be performed after a warm-up. The massage therapist passively stretches the intended muscle to its comfortable end range while offering resistance to contraction, said Myers.
The client uses approximately 25 percent of their strength. After a count of eight to 10 seconds, the client relaxes, and takes a breath as the therapist stretches the muscle a bit further, holding for 10 to 15 seconds. This is generally repeated three times. It is often included in sports massage training programs or certification courses. Active Isolated Stretching is a gentle assisted-stretching method that holds a stretch for no longer than two seconds and is then repeated.
The antagonistic muscle is contracted while the targeted muscle relaxes. Aaron Mattes, developer of Active Isolated Stretching, performs his technique on a young client. Active Isolated Stretching uses specific techniques to increase mobility and flexibility of a muscle or group of muscles. Courtesy of Stretching USA. Stretch Therapy is a system that includes stretching, fascial remodeling, strengthening, neural re-patterning and relaxation.
Stretch Therapy is floor-based and performed on a mat versus a table. Stowers conducts a thorough assessment of each client and develops a specific program of stretches to teach clients what it feels like to stretch on their own.
Learn more about Stretch Therapy through Apex Bodyworx. Judy Stowers, developer of Stretch Therapy, teaches her technique to clients and massage therapists. At the start of her career more than 20 years ago, personal trainer and fitness professional Loretta McGrath noticed her clients were requesting stretching more than personal training, and so she soon shifted her professional focus.
She created the Dynamic Body Stretching method, a style of active isolated stretching, that includes easy-to-learn stretching sequences to improve the range of motion, flexibility and strength of a client. McGrath is also the author of Body Alignment for Life. The report gives the therapist a visual picture of the muscles that are weak or imbalanced, what sports might be hindered and what areas represent a high risk for injuries. Then once we get all the data, it allows us to apply our own knowledge to correct their imbalances.
Courtesy of Dynamic Body Stretching. Ann Frederick, co-founder with her husband, Chris Frederick, PT, of the Stretch to Win Institute in Chandler, Arizona, said their assisted stretching method creates greater movement in the body and addresses joint decompression. We work more globally. The Fredricks co-authored the book, Fascial Stretch Therapy. Ann Frederick, developer of Fascial Stretch Therapy, performs her technique. Fascial Stretch Therapy is based on stretching the body from the core out with gentle, smooth, rhythmic movement.
Courtesy of Stretch to Win. Franchise massage clinics and at least one app-based touch-on-demand company are also meeting client demand for stretching. Massage Envy clinics feature the Streto Method, a total-body stretch that combines static stretching and minimum hold times of 30 seconds to bypass the stretch reflex and induce relaxation. The method begins with the neck and shoulders and moves down the body to the feet.
It rests on over 15 years of massage expertise combined with the latest stretch research. It also incorporates PNF stretching. The Streto Method is a combination of the latest stretch research with relaxation techniques inspired by yoga and meditation, said Massage Envy therapist Stacy Stevens, CMT. Soothe on-demand company now offers a stretch program for the workplace, Soothe Stretch, with which individuals can receive assisted stretching while at work. People whose employers are not subscribed to Soothe At Work can also request assisted stretching via at-home massage if they select the sports massage option.
As a massage therapist, you are poised to integrate assisted stretching into your practice. First, for established massage therapists, the client base is already there. You also have the anatomy background and the manual therapy experience to work with clients one-on-one and create tailored programs. One way you can include assisted stretching is to offer combination sessions that include shorter massages and short stretch sessions that are 30 to 45 minutes each, in order to stay within the to minute time frame clients are used to.
Or you can simply offer sessions that comprise equal parts massage and stretch. Stowers offers one-on-one stretch therapy sessions and also gives her clients the option of a minute stretch with a minute massage. Her private practice is 60 percent stretching and 40 percent massage, which she said is the right combination to give longevity to her career and additional health benefits to clients. Mattes agreed. While his practice is mainly focused on stretching, he works closely with massage therapists who have had success adding stretching into their services.
A SMT must be able to discuss the law as well as future lifting techniques to reduce future injury. Health and Safety First Aid Regulations regulates that there must be appropriate first aid treatment, along with a first-aider at all times, in the event of an emergency. The minimum first aid provision includes:. This meaning a mobile SMT would need to be a fully qualified first aider, along with carrying their own first aid kit. Data Protection Act regulates the processing, usage and storage of personal data recorded electronically or on hard copy.
SMT organisations will most likely have to register with the ICO, as they work with many external clients and process personal data in both paper and electronic formats. SMT client records must be:. Control of Substances Hazardous to Health Regulations ensures employers must take precautions against the risk of hazardous substances.
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