Wednesday, June 17, 2009

Blog2 Professional practice

Professional Practice Blog 2 Treaty of Waitangi Hannah Howley

How the Treaty of Waitangi framework incorporates into Massage Therapy practice
In any sort of practice, culture and society must be established to promote a good ground basis of an understanding of other people and their beliefs. In this blog I will discuss the relevance of Maori culture to Massage Therapy.

Governance, authority, equity and respect are the four main categories we look at when establish cultural inputs into the clinic.

Governance to begin with is what we understand as ‘our role’ and being in charge of the practice you are doing. You must understand your role as a therapist, notice the treaty policy and legislation of the healthcare department, being aware of the treaty and knowing the cultural differences, be aware of the legislation of what you as a therapist are doing and of course policies and requirements. We must ensure the health and safety of our client at all times.

Authority, with regards to the scope of practice to MT, clients are allowed to have their own opinion about the therapists’ treatment plan and the way they go about delivering it. There is to be a partnership between client and therapist for each other to share their feelings and views. Communication is very important when there is someone with authorisations. The therapist always has rights to a client and must ensure these, but will not act as if they are higher or superior than the client.

Equity is a title we notice as ‘equal’. With regards to the Massage Therapy scope of practice, we must treat all clients equally, with the most utmost respect and total professionalism. MT’s must accommodate each individual client as they see fit, e.g. clients with disabilities. The significance of culture must be taken into account in this instance. Some cultures see touching of the head to be culturally insensitive. This is where communication is of importance, as some massage therapists tend to work into the head for neck treatments.

Respect. This is a title which is self-explanatory. The client is your client and you are their therapist. They have come to you for help and it is your position to maintain the respect and needs of your client. Understanding and appreciation of their needs, beliefs and wishes is something you have to be able to do.
The aim is to provide health care in an environment that is culturally sensitive to those who are using it. This is done out of respect for different cultural perspectives and needs. The client and the whanau must understand what is happening and what resources and support are available. (Timmins, K. Treaty Workshop, 2009)

Other considerations to think about with Maori clients are Taoka (Valuables). These are extremely important and have a lot of sentimental value. Therapists’ must be respectful of these and must discuss with the client before removing them e.g. necklaces, as they may be in the way of neck treatment. You must offer the client the opportunity to look after the Taoka when they have removed it if they agree to.

Four more elements I will look at are those from the 1988 Royal Commission on social policy for prerequisites for health and well-being.

Whanaungatanga –Family
- The family as an influence on health
- As a support system.
Taonga Tuku Iho – Cultural Heritage
- Access to Maori knowledge
- Access to family, hapu, iwi and the marae
- Intact Maori identity
Te Ao Turoa – The environment
- Physical environment
- Political environment
- Social-economic environment
- Social climate in terms of racial and ethnic equity
Turangawaewae – an idisputable land base
- Access to ancestral lands
- Self-esteem and self-respect


Bachelor of Midwifery/Diploma in Massage Therapy; Treaty Workshop. May 18th 2009

Durie,M.(1998). Whaiora: Maori health development(pp.69-74). Auckland, New Zealand: Oxford University Press.

My Own Thoughts

Thursday, June 4, 2009

Scope of practise

Assessment task 1
Due 8th May 2009
Scope of practise
Hannah Howley

Scope of Practice as defined by Massage NZL with relations to being a Massage Therapist.

"Scope of practice defines the knowledge base and professional parameters of a profession"
Fritz,(2004) (St. John, D, Assessment Task 1)

Now, this I found to be a good summarisation of what we know as ‘scope of practice’ in any area of work, namely, the healthcare profession. It is very important, not to mention, professional to have such guidelines to work from. Boundaries and such are very important when working hands on with another human being.

RMT’S must hold a National (NZQA) Diploma/Degree or equal in Therapeutic Massage. They must have a theoretical basis of knowledge in Human anatomy, Physiology, Pathology and the Theory of Massage. They must have completed a minimum of 30 supervised massage clinical hours during massage training or post graduation. Massage NZ,(2009)

RMT’S must comply with the MNZ RMT Scope of practice which is as follows

- Physical assessment
- Client history details forms
- Client reasoning and a treatment plan
- Delivery of soft-tissue treatments relevant to treatment plan and not missing out other strokes etc
- Evaluations
- Post treatment advice
- Professional presentation and behaviour according to MNZ ethics
- Referral of clients to appropriate healthcare professionals

Certified massage therapists also have a series of guidelines which they must follow and they must also hold a diploma or certificate in MT. They are as follows


- Gathering of client info specific to the client
- If relaxation massage is not appropriate, and need other treatment outside MNZ MMT Scope of practice, refer to an appropriate healthcare professional
- Client consent
- Delivery of treatments relevant to the treatment plan
- Delivery of soft tissue treatments according to industry accepted practices with regards to draping, communication etc
- Post treatment advice
- Professional appearance and ethics.

The scope of practice for both, are relatively straight forward but also broad at the same time. If the MT association was to become a lot bigger and well-known for its benefits, I believe that the scope of practice would have to become a little more in depth and be able to bring attention to new things. A good point that Deb’s made in her blog was that although a MT is requires us to have attained certain qualifications; it surely doesn’t say anything about on-going education for MT. It is very clear in today’s healthcare profession that things are changing and we are becoming more aware of different things and more knowledge is brought to us, which shows us that we need to have continual training on standby to not only become a better practitioner but also be able to provide higher qualities of treatment to our clients.

To sum up my findings, I feel satisfied with the current scope of practice for both professions as they do touch on ethical considerations and professional practice which I think are very important. Although they do need to be made a lot more in depth to prevail our knowledge and professionalism that little bit more.


My Own Thoughts

Massage New Zealand. (2009). Retrieved May 8th 2009 from

Massage New Zealand, Remedial Massage Therapists Scope of Practice. Retrieved June 5th 2009 from

Pathology Condition 1.

Plantar Fasciitis
Condition 1
Due date.18 May, 2009 5 Jun, 2009 19 Jun, 2009
Hannah Howley

Plantar Fasciitis

• Description of the condition

Plantar Fasciitis is inflammation of the plantar fascia and surrounding myofascial structures. It is a condition of the foot which is very painful. The pain that is felt by PF is felt on the heel of the foot and is felt most severely with the first few steps of each day. Its main location, also known as the calcaneus, is the common location for the stimulation that causes the pain. It is generally caused by faulty biomechanics, bad footwear and heavy landings.

• Incidence

1 out of 10 American adults are presented with PF each year.
PF is most common in athletes, such as runners.

Equates for about 10% of runner-related injuries, and 11-15% of all foot symptoms requiring specialized care. It is considered to occur in 10% of the general population as well. It can also be present bilaterally in a third of cases

• Etiology

The etiology of this condition is not clearly understood and is probably multi-factorial in nature. Weight gain, occupation-related activity, anatomical variations, poor biomechanics, and poor footwear are contributing factors. PF is caused by too much wear to the plantar fascia (or aponuerosis) that supports the arch of the foot or by unusual posture that may influence structure. A lot of athletes suffer from this condition. "Both amateur and professional athletes are at a higher risk, and it is especially common among athletes who run and jump a lot. More young people are getting involved in sports at an early age and are therefore developing heel pain sooner than many other people who are not as active." (Franklin Kase, It occurs when the plantar aponeurosis is stressed over a period of time in which is beyond the ordinary which could lead to pain and inflammation and possibly bone spurs. PF can also be a result of an injury.

• Signs and Symptoms

Signs and symptoms for PF are limited but are gradual. It can often feel like a sharp pain in your heel and is more noticeable in the morning during your first few steps and can be triggered by long periods of time on your feet. Sometimes there may also be pain along the outside (lateral) border of the heel. This may occur due to offloading the painful side of the heel by walking on the outside border of the foot. It may also be associated with the high impact of landing on the outside of the heel if you have high arched feet.

• Indications for massage therapy

Acute phases of PF respond well to cyrotherapy (Ice) and rest. After the inflammation has gone, soft-tissue methods that address the connective tissue and sensible uses of stretching are valuable. Achilles tendon is highly irritable in this condition also as it attaches to the calcaneus as well so that has to be taken into account when massaging

• Contraindications for massage therapy

Not to be massaged if the foot has been aggravated or if it is inflamed due to overuse i.e. dancing. In the morning, it is bad for massage to occur because this is when the syndrome is most painful.

• Reference list
Marieb, E, N., Hoehn, K., (2007). Human Anatomy and Physiology, 7th Edition.

Sports Massage, retrieved June 5th, 2009 from

A client with PF

Franklin Kase, Athletes and Plantar Fasciitis (Heel Pain), Retrieved June 4th, 2009, from

Fritz,S (2009)., Mosby’s PDQ for Massage Therapists, 2nd Edition