Saturday, February 22, 2014

What to do with ELAP???

What to do with ELAP???

My opinion is –accept it as the foundation (core) for entry level massage therapy training.  Finally! There are a few of us “elders” around that have wrestled with this issue for way too many years. I am ready to check it off my  “to do list”.   Now we can get on with other important issues that will influence the future of massage therapy.

Here are the definitions of massage and bodywork from the ELAP blueprint.

Bodywork: A broad term that refers to many forms, methods, and styles including

massage, that positively influence the body through various methods that may or may not

include soft-tissue deformation, energy manipulation, movement reeducation, and

postural reeducation.

Health-care-oriented massage: Massage performed in medical or health-care-oriented

environments to facilitate therapeutic change, condition management, or symptom


Massage: The ethical and professional application of structured, therapeutic touch to

benefit soft-tissue health, movement, posture, and neurological patterns.

Wellness-oriented massage: Massage performed in wellness- or relaxation-oriented

environments to facilitate stress reduction, relaxation, or wellness. ELAP Blueprint p 47.

One of the most vexing issues facing the profession is the relationship of massage to bodywork.  They are not the same but because the concepts are presented as a unit is confuses the issues especially the movement toward evidence informed massage practice.  And if you notice the ELAP definitions combined yet separated the definitions just as the Massage Therapy Body of Knowledge MTBOK did.  I hate to admit it but I think this is going to be an ongoing issue and point of confusion.

The confusion does not come from massage. Massage is actually a concrete and easily studied method. Now that the ELAP described the application in terms of methods that influence soft tissue by creating mechanical forces the ability to develop study protocols can be objectified.   For example:  Gliding with sufficient pull /push to generate a tension force on the superficial fascia for 30 seconds will result in….. Well we don’t know yet what the result will be but at least we can study it more objectively.

ELAP finial report p 168

● Present and discuss these terms:

o Soft-tissue deformation (e.g., the change in the shape of soft tissue as a result of

applied forces, etc.).

o Forces (e.g., something that internally or externally causes the movement of the

body to change or soft-tissue structures to deform, etc.).

o Tissue load (e.g., the amount of stress soft-tissue structures are under due to

forces; too much load and the tissue might fail and be injured).

● Present and discuss the way external forces create loads on soft tissue (e.g., forces

create external loads by pushing or pulling on the body in a variety of ways).

● Present and discuss the way internal forces create loads on soft tissue (e.g.,

misaligned joints or poor body mechanics cause soft tissue to shorten, tighten,

lengthen and/or weaken, which may load surrounding tissue; for example, a tight

muscle or tendon could compress a nerve running close by and cause pain or

dysfunction, etc.).

● Review the properties and characteristics of soft tissue that allow it to benefit from

deformation (e.g., thixotropy, viscoelasticity, piezoelectricity, adhesiveness, etc.).

● Present and discuss the categories of forces:

o Primary forces (e.g., compression, tension, and shear, etc.).

o Combined forces (e.g., two forces acting at the same time on a soft-tissue

structure: torsion and bending).


This foundation is a measurable, observable component of massage as now described by ELAP.  It is a familiar language in multiple disciplines from engineering to bio mechanics and human performance. No one made it up, it is not unique and explaining what we do in this way supports interdisciplinary communication as well as research. Here is an example

For those who like to get their fascia in a twist about intuition and artful application and empathic connection and compassion- just hold on--- these human connection elements are important and, by the way not, limited to massage therapist or bodyworkers.  The therapeutic relationship is essential in the benefit of any professional exchange.  

So---to answer the question posed—What to do with ELAP ???

Right now read it.  It is really long and detailed but start here:  Final Report  pg. 60-256.  

Make some notes. Compare and contrast the content with what you understand in the document and what you don’t. If you are an educator compare the content to the textbooks you use, your lesson plans and so forth. None of the textbooks have every single piece of content or the exact language used in the ELAP document and that is OK.  I compared the textbooks I have written and feel very confident in the relationship of the textbook content and the ELAP.  I am familiar with the other entry level textbooks (all of us authors read each other’s stuff ya know) and none of them are that far away from the information in the ELAP.  No one has to throw out their current curriculum. Just tweak it.  Compare the hours recommendations to your current program. You don’t have to change anything and likely will find that the way you are teaching the ELAP material is pretty close.

Scan through the Blue print document for teaching ideas. You don’t have to do everything the way the ELAP documents describe, but new ideas are good –right? 

For those of you that might be wondering what is next on my “ list” here is a preview—

ü  Standardized  entry level curriculum—done!

ü  Board Certification for those who want to differentiate from entry level—done!

ü  Board Certification used for college credit transfer toward academic degrees---done!

ü  Teachers standards for massage educators—done!


·        Teacher training for massage educators----next on list

·        Independent professional analysis of ergonomics and bio mechanics for massage practice---next on list.

·        Sorting out the continuing education issue for massage and –the confusing element bodywork—next on the list.


Ø  Combining meetings for educators through cooperation among the AMTA, ABMP, and the AFMTE so that instead of multiple meetings, which is a time and financial expense, one meeting presented as a cooperative venture is provided.

Ø  Having professional meetings presented in online webinar or similar platform as well as in person attendance so more people can stay informed.  We have the technology to do this people.

Ø  Specialty certifications through NCBTMB-on the list


There is more but I ready to concentrate on the goals for teacher training and, so very important, the issue of burn out and massage therapists leaving the field because they are unable to earn a sustaining income with one of the reasons being unable to do enough massage sessions without hurting themselves.   As a profession we must do something about this.


Friday, February 14, 2014



As I monitor the massage profession’s response to important development I find it interesting that some push back is occurring around the confusion about what a massage school or massage practitioner has to do vs a choice about what individual and school and other stakeholders HAVE to do verses WANT to do for professional development. 

The only thing a massage educational program HAS to do is be incompliance with state laws regulating education

The only thing a massage therapist HAS to do is be licensed in the state or jurisdiction in which you practice. (minus the few state that still do not license)



The ELAP (Entry-Level Analysis Project) finial report in available at  Those responsible might WANT to use these documents to complete a curriculum review and make changes where it is appropriate.  It is time for standardization of entry level curriculum and yes the ELAP content is not perfect but is more than good enough.  Massage therapy schools and educational program have an obligation to prepare graduates for their future (not the past) of massage professional practice. 



The ELAP documents can guide us in the content that we should be teaching.  As massage educators we should WANT to advance our skills both in content as presented in the ELAP document in entry level education and for continuing education we should WANT to make sure the content is as evidence informed as possible and not blatantly invalid and at least logically explainable in terms of current knowledge of anatomy and physiology.  We should WANT to disclose when we are working from our own opinions and strive for student to leave with skills they can use to expand their ability to be a lifelong learner.  We should WANT to expose myths and continuingly update our own knowledge.

This goes for textbook authors in the profession as well and I am one.  My textbooks reflect ELAP content well but during my next revision cycle I will have content to upgrade, minor changes in terminology and always updating research.  I WANT to do this.  And if I am a responsible author I HAVE to do these things.


No one HAS to be Board Certified but during this time of rapid shifts in the massage profession I would hope you would WANT to support professional development with this credential.  I know the NCBTMB has had it’s problems.  I have been involve with these issue with the NCBTMB since it’s inception. The past issues do not mean that the current direction is wrong.  In fact it may actually be the very best thing for NCB and the massage profession.  I do encourage you to become board certified and at the same time demand accountability from the organization. The current board of directors has a big mess to clean up. It will take time.  Please be part of the solution.  Professional development requires a certification process.  We have the organization so let’s work to make it serve the massage community.

The BOARD CERTIFICATION CREDENTIAL provided by the National Certification Board for Therapeutic Massage and Bodywork launched in January 2013. This new credential requires fulfilling additional qualifications, including more education, hands-on experience and a background check. There is an exam that reflects the advanced level of practice. The intention of this process is to provide validation of professional development beyond entry level education and practice.  By increasing educational requirements and including a work experience component Board Certification is a way for a massage professional to validate that they support ongoing learning and professional advancement.

Those who were previously certified with the old national certification process have an opportunity to transition to Board Certification without taking the test.   By December 31, 2016 the transition process to Board Certification for those who were previously nationally certified under the old system will be complete.   From that point on to be board certified massage professionals will need to meet all eligibility requirements and pass the exam.  Those who have not been previously certified under the old NCBTMB system will have to meet all requirements and take the Board Certification exam. Here is a link to the knowledge content expected for Board Certification

New Certification Test Specifications are found on page 21.  For more information see



No one HAS to pursue a college degree but some may WANT to.  Especially educators.

Why would you WANT an academic degree?  I can think of lots of reasons such as additional validation for professional development, addition of skills over and above massage application including business and leadership, and maybe most important to me- teacher development.  I think we can agree that the massage educators need access to advanced training in the form of associate’s and bachelor’s degrees. AND IT IS AVAILABLE –WOW--------.

An associate’s degree is typically based on 2 years of college level study (60 credits).  Some community colleges and technical schools offer a diploma level massage training that can be advanced to an associate’s degree by adding general education courses and other massage related courses. This is really good and becomes a launch pad for the next step--- a bachelor’s degree.

In December 2013, a partnership with Sienna Heights University and the NCB was announced for the new NCBTMB Board Certification to be used for college credit.

A Bachelor’s Degree in Massage Therapy is available.  

NCBTMB Board Certificants are awarded 33 college credits toward the 120 credits required to achieve this degree. A 45-credit major in Massage Therapy is established through Board Certification and completing 12 credits of cognate/major-related study at Siena Heights. The 12 credits are designed to assist with the business/human relations aspects of a successful massage career. The entire degree requires 120 credits, 33 of which are awarded with proof of Board Certification. Additional transfer credit up to 90 credits total can apply toward the degree. Students may need only 10 courses (30 credits) to complete their degrees.  Siena Heights University offers upper-division courses in areas such as leadership and management, organizational behavior, marketing, health care management, professional communication, social science, liberal arts, and more. These are areas that have been identifies as the most lacking in current massage education. This is a real monetary value for board certification for those who want to take advantage of the opportunity.  Sienna Heights University is progressive and open to work with the massage community like they have with other occupations and health professional since the 1970s. If you have an associate’s degree in massage therapy for example, that can be another way to establish the massage therapy major.    AND—YOU CAN COMPLETE YOUR DEGREE ON LINE! The Bachelor of Applied Science Degree (BAS) is a career-oriented degree designed for professionals with allied health or technical training.  This degree is a BAS in Massage Therapy.  WOW.

This is a very exciting development for me because I have had a relationship with Sienna Height University for over 22 years for credit transfer from my massage theory school and now massage professional all over the country through the online program can take advantage of this career pathway. 

 For any additional information on Siena Heights University, please visit

So all—I hope that for the future of massage therapy as many an possible will WANT to move forward with career development.