Massage Therapy, Scope of Practice

Massage is limited to the treatment of disorders of the human body by the systematic external application of touch, stroking, friction, vibration, percussion, kneading, stretching, compression and passive joint movements within the normal physiologic range of motion; and adjunctive thereto, the external application of water, heat, cold, topical preparations and mechanical devices. OAC § 4731-1-05  (A)

A practitioner of massage shall not diagnose a patient’s condition except as to whether the application of massage is advisable.  In determining whether the application of massage is advisable, a practitioner of massage shall be limited to taking a written or verbal inquiry, visual inspection, touch and the taking of a pulse, temperature and blood pressure. OAC § 4731-1-05  (B)

A practitioner of massage may treat temporomandibular joint dysfunction provided that the patient has been directly referred in writing for such treatment to the practitioner of massage by a physician currently licensed pursuant to ORC Chapter 4731, by a chiropractor currently licensed pursuant to ORC Chapter 4734, or a dentist currently licensed pursuant to ORC Chapter 4715.   OAC § 4731-1-05  (C)

Massage does not include:

(1)        The application of a high velocity-low amplitude force;

(2)        The application of ultrasound, diathermy and electrical neuromuscular stimulation or substantially similar modalities; and

(3)        Colonic irrigation. OAC § 4731-1-05  (D)

As used within the Medical Board’s rule:

(1)        “External” does not prohibit a practitioner from performing massage inside the mouth or oral cavity; and

(2)        “Mechanical devices” means any tool or device that mimics or enhances the actions possible by the hands. OAC § 4731-1-05  (E)

The above scope of practice was effective as of 1992.  The Massage Therapy scope of practice has been altered by earlier revisions.

In order to provide a historical perspective on the practice of Massage Therapy, the original scope of practice of massage, effective January 4, 1916, is reproduced below: 

“Massage is hereby understood to be a systematic friction, stoking, slapping, kneading, tapping or manipulation of the body for therapeutic purposes.  [Massage includes] Medical Gymnastics, which is hereby understood to be systematic therapeutic muscular exercises. Vibro-Massage, which is hereby understood to be massage by rapidly repeated light manual or mechanical percussion.  Helio-Therapy, which is hereby understood to be the exposure of the body to the sun’s rays for therapeutic purposes.  Thermo-therapy, which is hereby understood to be the application of heat for therapeutic purposes.”

The scope of practice of massage remained constant from 1916 until 1975.  In the 1975 revisions, several sections were deleted.  The scope of practice of massage, effective 1975-1992, is reproduced below:  “Practitioners of any of the following listed limited branches of medicine or surgery shall not examine patients except by verbal inquiry, and visual inspection and observation, and such practitioners shall not diagnose a patient’s condition except as to whether or not application of the limited branch in question is advisable…

Ohio has allowed townships to regulate “non-therapeutic massage” separately. As used in the township regulatory authority, ORC § 503.40 to ORC § 503.49, non-therapeutic “Massage” means any method of exerting pressure on, stroking, kneading, rubbing, tapping, pounding, vibrating or stimulating the external soft tissue of the body with the hands, or with the aid of any mechanical or electrical apparatus or appliance.  ORC § 503.40  (A)

Massage Therapy, Scope of Practice