Our work as massage therapists helps millions of people. By integrating exercise into their treatment plans, we can take their healing an important step further. All exercise programs should start with a thorough assessment. There are two types of assessments that are important to getting your client well and keeping them that way. The first is an injury assessment, which we have discussed many times in this column. The second is a movement or exercise assessment--and here is where we move into new territory. Very few massage therapists are skilled at assessing movement and prescribing exercise. This is unfortunate because movement assessments can provide valuable information about why your client got injured by identifying predisposing factors. Clients are often in pain because of an underlying weakness, instability, lack of mobility, and a poor understanding of how to move properly.

For example, let's say a client is experiencing low back pain. Normally, a massage therapist would perform soft tissue work around the hips, low back, and perhaps the psoas muscle and send the client on their way feeling a sense of relief. A few days may go by with minimal pain until suddenly the person begins to feel the same symptoms that initially led them to seek treatment. In contrast, if the therapist had the ability to perform an exercise assessment they could design a specific mobilization and stretching program (based on a range-of-motion assessment), teach the client how to execute a proper bend, squat, and/or lunge pattern, then teach them how to condition their body to support the demands of their work and/or sport environment.

Understanding Movement and Functional Anatomy

Understanding movement and functional anatomy will give you greater insight into how to address issues related to repeated injury, neurological dysfunction, inefficient motor control, lack of coordination, and overall weakness. The gift of exercise also has the added value of getting the client actively involved in the healing process.

It's important to figure out which form of exercise is appropriate for the client at the present moment, and which may be appropriate as the person gets stronger. If an exercise is too easy, the client will be bored and not progress. If an exercise is too hard, they will get discouraged and quit. Think of Goldilocks -- only if the program is just right for a client will they overcome the initial challenges and take to the program.

The integration of massage and exercise is important for the long-term health of our clients. So how can you gain enough knowledge about exercise to be able to incorporate it into your practice? The best way is to become certified as a personal trainer. There are a wide variety of certification programs available, and some are more helpful for massage therapists than others. If you'd like specific recommendations, feel free to contact me directly; I'd be happy to help you find one that will work well for you.

It's also important that massage therapists exercise themselves. This profession can be demanding, and if practitioners don't develop very specific kinds of strength and flexibility, they're likely to get injured - especially in their backs, wrists, and hands. There are many strength benchmarks that all massage therapists should meet to ensure success and longevity. With sufficient strength, flexibility, and knowledge of exercise and fitness, we will be better equipped to prevent injuries both in our clients and in ourselves.

Note: In some states, massage therapists are not legally permitted to prescribe exercises - another good reason to become a certified personal trainer.