What is sexual misconduct?

Sexual misconduct is an umbrella term that includes any unwelcome behaviours that are sexual in nature. In the massage therapy industry, this can include the following:

• Sexual assault
• Sexual harassment
• Sexual relationship
• Inappropriate relationship
• Inappropriate treatment
• Therapist self-disclosure

The act of sexual misconduct can involve inappropriate touching, rude or suggestive comments, and sexual abuse and violation. Additionally, videotaping or photographing a massage without client consent can be classed as non-physical sexual misconduct.

It’s important to remember that sexual assault can occur without physical touch. If a therapist, co-worker, or a client feels their safety and wellbeing has been threatened or that a boundary has been crossed, they can file a formal complaint. The code of conduct requires all general healthcare providers, including massage therapists, to provide and encourage safe and ethical healthcare practices.

Behaviours of sexual misconduct in the massage industry

Both sexual misconduct and sexual harassment can create serious problems for a massage therapist, particularly if there has been an abuse of power. Additionally, therapists are also at the risk of being the victims of sexual harassment if a client crosses patient-therapist boundaries.

Any exploitation of the relationship between therapist and client for the gratification of the therapist is an abuse of power. Therefore , massage therapists must have the knowledge to conduct themselves professionally and prevent exploitative behaviours.

Some behaviours that may be classed as sexual misconduct in the massage industry include:

• Inappropriate personal conversation
• Inappropriate body contact
• Informal comments (for example, “your eyes are so beautiful”)
• Trips or encounters outside the clinic
• The offer of dinner or alcohol to a client
• Personal phone contact, SMS contact, or social media contact outside of a business context (for example, a business email regarding your services is appropriate, however an email containing a joke and of no business relevance may not necessarily be appropriate)
• Giving of an inappropriate gift
• Poor, inadequate, or lack of draping being provided to the client.

Inappropriate behaviour can also be directed at the therapist from the client. However, because health professionals hold a position of power and also the right to refuse to service the client, the law ultimately holds the business provider responsible for their behaviour. As a therapist, be mindful of keeping interactions with clients professional. If an at-risk situation occurs, you can refer the client to another practitioner, seek professional or legal advice, or contact your preferred Massage Association or insurer for advice.

Things to be aware of as a massage therapist

Due to the vulnerable and often intimate nature of massage therapy, massage therapists have an important duty of care to set and maintain boundaries. Such boundaries for ethical safety should always err on the side of caution.

Here are some common vulnerability factors to be aware of:

De-robing & draping

There is no rule that a client must be unclothed to have a massage. If the client is happy to do so, that’s fine, but if a client feels more comfortable leaving their undergarments or clothes on, then this should be respected. It’s a therapist’s job to ensure that clients are aware of this before their massage. The clinic should have clear procedures outlined for the client to see before their massage – for example, providing a note on their appointment confirmation or a sign in the massage room or change room.

Additionally, a therapist should know the correct draping techniques and be assessed by a knowledgeable supervisor before conducting massage therapy on clients. Protocols require that the genital regions of both males and females must be covered (this includes female breasts). And the therapist’s hands should never go beneath the drape when performing a massage.

Attention to sensitive areas of the body

The female breast should always be draped during the massage. Sometimes the drape is lowered so that the top half of the breast and pectoral muscles can be worked on, but this must only be done with the client’s permission. In certain circumstances breast massage is acceptable, such as in the case of nursing mothers or treatment of injuries, however this should be discussed with the client on each occasion.

In massage therapies, the upper inner thigh should never be touched unless specified by a client who has a sporting injury that requires access to this part of the leg. In these instances, the genital area should always remain draped, and therapists must never move their fingers up toward the private genital region.

Placement of hands

As a therapist, try to ensure that your client’s hands aren’t in a vulnerable position. For example, if a client is lying face down with their arms along their sides and palms facing upwards, they may come into contact with the genital region of a therapist. Therefore, it’s best if the client keeps their hands tucked under their hips.

For therapists, it’s essential to avoid using very light touch on a client unless it’s required due to an injury. Even without sexual intent, this type of touch can feel sexual to a client. With good, proper training, therapists can learn the difference between therapeutic light touch and a potentially sexual touch.

Preventing sexual misconduct: what’s my role as a massage therapist?

Massage therapists should first and foremost be members of the International Institute of Complementary Therapists or the Massage Association of Australia to stay informed, and be supported and represented. And massage therapists are required to adhere to the Code of Ethics and Standards of Practice.

Ethical behaviour and maintaining and following clear boundaries aren’t simply legal requirements. It also extends to the behaviour and character of yourself and how you uphold and present your services to fellow staff members as well as clients. Performing your work with honesty, equity, integrity, and social responsibility at all times should be your main role as a massage therapist.

Receive proper training to prevent sexual misconduct in massage therapy

Discover Massage is an industry-recognised and privately-owned massage college that holds ethics and codes of practice to the highest standard. We offer in-depth and informative training in all areas of massage therapy, including the importance of safe practices. Browse our course list today to begin your journey as a massage therapist.

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Here we look at the most common injuries to affect massage therapists, and how to avoid them as a through correct techniques, preparatory exercises and simple lifestyle precautions.

What are the common injuries for a massage therapist?

There are several injuries which occur more frequently than most in the massage therapy industry.

These are:

• Inflammation of the tendons – repetitive stress can irritate and inflame your tendons.Symptoms include pain, tenderness, swelling and difficulty moving the affected joint.
• Saddle joint of the thumb injury – overuse of the saddle joint in your thumb, which allows for back and forth and side to side motion of the thumb. This can lead to pain and discomfort.
• Carpal Tunnel Syndrome (CTS) – compression of the median nerve at the wrist can cause pain, numbness and a burning, tingling or itching sensation in the hand.
• Tendinosis – repetitive and extensive overload in the tendons of your wrist can cause pain.
• Trigger thumb or trigger finger – irritation of the tendon sheath from overuse causes pain, inflammation and stiffness in the thumb or finger.
• Nerve impingement injuries – overuse of tendons or muscles causes irritation, pinching or compression of nerve plexuses and their roots by surrounding structures.

How to avoid these injuries

There are three important ways you can help to minimise your chances of being injured as a massage therapist.

1. Correct massage techniques

To maximise your safety and comfort, pay attention to these tips regarding your body mechanics while working;

• Work at the correct table height – a massage table that is too low can cause you to bend over more than you should, moving your centre of gravity forward and putting pressure on your lower back. Correct table height should be roughly half your height, or slightly higher if you have longer legs. As a general rule, set the table slightly lower if applying pressure with thumbs, knuckles or fists, or when working on higher areas of the body, such as glutes and thoracic back.
• Use the correct strokes – and when repetitive strokes are required try to keep your wrist, hand and fingers relaxed. As a rule, your upper arm should never be more than 45 degrees away from your body, so step forward if you need to make longer strokes, rather than reaching out further.
• Keep your back straight – always use your knees rather than bending at the waist and, as the massage progresses, keep repositioning your body rather than staying in the one position.
• Use the weight of your body – when manipulating a muscle, and use your body weight behind each stroke, rather than pushing only from your shoulder or hand.
• Use your thumbs sparingly – trigger thumb is a common injury for massage therapists, caused by using the thumbs repeatedly to apply pressure. However if you use your body correctly you will minimise any risk.

Warm up and strength training exercises

The risk of injury to massage therapists has been well documented, and there are now a number of recommended exercises for practitioners that focus on those areas of the body most prone to injury.

These include warm up and stretching exercises for the hands and wrists, which are the tools of a massage therapist’s trade and the body parts most in the firing line. Warming up and stretching before beginning a massage session loosens muscles, tendons and ligaments and gets fluids flowing in the joints.

There are also strength training exercises for every part of the body including fingers, hands, wrists, arms, neck, shoulders and back. Exposing these areas to regular low impact exercises not only strengthens them, but makes them more resistant to injury from repetitive use.

Simple preventative measures

Day-to-day precautions you can also take to reduce your chances of being injured include:

• Only take on as much work as you can handle – in other words, calculate how many sessions you can safely and comfortably perform in a day and don’t exceed this amount.
• Take plenty of breaks during the day – decided on an appropriate break time between each client, and use the time to rehydrate and relax.
• Try using hand held tools where practical – consider the use of effort-saving tools such as an adjustable massage table and tools such as finger splints that can take the pressure off your body, while still providing the necessary treatment.
• Practise self-care – get plenty of sleep, eat a healthy diet, stay well hydrated, and make sure your own massage therapy needs are being attended to.

Massage therapy can be highly satisfying work, but it can also be physically demanding. By using best practice massage techniques, exercising regularly and not overtaxing your body, you are more likely to avoid injury and enjoy a long and rewarding career.

If you have an interest in massage and have found yourself wanting to try it as a new career, make sure you have the correct technique first by enrolling in a Discover Massage Australia course? We have a range of courses designed for beginners that will teach you the correct techniques, as well as how to reduce the risk of repetitive strain injury.

Sign up for a Discover Massage Australia course here.

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While massage has evolved over the thousands of years it’s been practised, it still centres on the use of therapeutic touch to bring healing and relaxation.

How massage therapy has evolved

1. Acupuncture in ancient China

The earliest date of origin for massage therapy goes back to 2700 BCE in ancient China. During this time a book was written – “The Yellow Emperor’s Classic Book of Internal Medicine.” This book talked about acupuncture, detailing the practices and techniques used in Oriental medicine and how applying needles to the body’s meridian points help to promote better health and wellness. Acupressure was developed from this, which involved applying pressure using the hands where the needles would go – the first form of massage.

2. Reflexology in ancient Egypt

Around 200 years later in 2500 BCE, ancient Egyptians developed a massage technique that would shape massage therapy today. Early Egyptian art depicts pictures of people massaging the foot, which is now widely known as reflexology. In this technique, the therapist applies pressure to the reflex zones of the feet and hands with the overall aim of stimulating nerve function, increasing energy, boosting circulation, eliminating toxins in the body, and achieving an overall relaxed state of the body and mind.

3. Massage in Japan

Around the year 1000 BCE, Japanese Buddhist monks began to customise Chinese massage techniques. This is how the traditional Japanese massage technique of Anma (or Amma) was created. This energy-balancing, deep tissue massage is based on the principles of traditional Chinese medicine and works by restoring the body by loosening tight muscles, joints, and connective tissues. This then gave rise to the massage technique known as Shiatsu; a treatment aiming to raise the energy levels in a patient by applying pressure through the thumbs, fingers, and palms.

4. Deep tissue massage in Greece

From 800-700 BCE, the strong and notoriously athletic Greek introduced specific techniques to reduce knots in the body and relax sore, tightened muscles through therapeutic rubbing. This technique is much like what we would define today as sports massage therapy, as athletes in ancient Greece employed the art of massage to keep their bodies in peak performance. Physicians at the time would use herbs and oils in addition to massaging, which signalled the birth of aromatherapy massage.

In the fifth century BCE, Hippocrates prescribed the art of adding friction to treat physical injuries. He also promoted the use of massage in conjunction with a healthy diet, exercise, rest, fresh air, and music to achieve optimum health. This was a pivotal moment in massage therapy history, giving rise to many of the modern-day therapies used throughout the world today.

5. Modern massage therapy

Modern Western medicine and massage therapy were largely cultivated during the 19th century when Per Henrik Ling created what we now know as ‘classic’ or Swedish massage, which is the most well-known form of massage in the world. While techniques may have evolved and come to include a variety of healing treatments under the umbrella of ‘massage therapy’, the basic principles of massage haven’t changed much at all. Since massage treats common symptoms of pain and stress with the hands, it’s an art that still mimics its origins from thousands of years ago.

Massage therapy in the future

As long as the benefits of massage therapy remain, these traditional practices will continue to follow society into the future. And while these practices may be improved upon or altered, as seen in the past, massage therapy is likely to see a closing of the gap between conventional and alternative medicine, with massage being considered as part of an overall healthcare plan.

Given the advancements of technology, there may come a time where we see science and technology integrated into conventional massage to lift and improve the benefits it has on a patient. In recent years we have seen the emergence of massaging chairs being used in addition to massage treatment, while immersion techniques as seen in sense deprivation tanks may be incorporated into traditional massage practices to incorporate a multi-level sensory experience.

So long as society seeks relief from pain or finds comfort in relaxation, massage therapy will continue to be on the leading edge of holistic medicine and treatment.

Become part of the future of massage

At Discover Massage Australia, we teach many forms of massage techniques including ancient and modern treatments. From deep tissue to classic massage therapy, our industry-recognised courses can lead you into the future of massage therapy. Learn everything you need to know about massage today by enrolling in one of our massage courses. Or, check out our new online massage course today.

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