A New Standard of Practice: what are Sensitive Areas?

On May 30th 2017, The Ministry of Health and Long Term Care (who are responsible for the protection of patients) defined the following areas of the patient’s body as sensitive areas:

  • Chest Wall
  • Breast Tissue
  • Upper Inner Thigh
  • Gluteal Muscles aka Buttocks

This definition is provided by the passing of the Ontario Government’s Bill 87 into law, forming the new Protecting Patients Act (2017).   

In light of this legislation on September 21, 2017 the College of Massage Therapists of Ontario (CMTO) passed down a mandatory new procedure for all Registered Massage Therapists to follow in accordance with the Ministry of Health and Long Term Care’s new Act.

What does this mean for a client of any massage therapist in Ontario?

Whether you are a long time client or new to any massage therapist it is now mandatory that all RMTs obtain written consent to work on a client’s sensitive areas, as defined above.

When you come into Toronto Bodyworks you will be given a form and information sheet to look over that you can discuss with your therapist. The form encompasses assessment and treatment of sensitive areas. It is recommended you discuss any concerns with your therapist prior to the commencement of the session.

We are including information here you will find on the form. Please note on one side there is consent to assessment and the other side is for consent to treatment:

Informed Consent forms for the Treatment of Sensitive Areas

The College of Massage Therapists of Ontario (CMTO) has recently released a new mandate on maintaining professional boundaries for Registered Massage Therapists and their clients.

All Registered Massage Therapists are now required to receive written informed consent for the treatment of sensitive areas as defined by the CMTO; breast tissue, chest wall muscles, upper inner thighs and buttocks (glutes).

All clients must fill out this form whenever they see a different therapist or if a completely new assessment or treatment plan is required. Clients will update their forms regularly as needed or at least once per year.

Clinical Indications for the treatment of each area are outlined for your understanding below,


Clinical Indications for Breast Massage (including chest wall)
:

  • Lymphatic drainage issues including congestion, swelling or edema.
  • Breast pain and tenderness that has been confirmed by a physician as benign.
  • Pain associated with pregnancy or lactation issues.
  • Breast tissue impairments resulting from concurrent health diagnosis (ie., cancer) for which a physician has referred or approved massage therapy.
  • Scar tissue/post-surgical management.

Specific to chest wall:

  • Reduced range of motion in the chest, neck or shoulder areas.
  • Impaired muscle performance and function.
  • The presence of congestion, swelling or edema associated with soft tissue injury.
  • The presence of pain or tenderness of a benign origin.
  • The presence of soft tissue integrity issues in the region including trigger points, tendinopathies, and sprain or strain injuries.
  • Impaired postural control and function.
  • Impaired function of the muscles associated with respiratory function.


Clinical Indications for Treatment of the Gluteal Region:

  • Soft tissue impairments in the gluteal and posterior hip regions that have been identified as significant and relevant to the achievement of treatment plan goals.
  • Reduced range of motion in the trunk, spine, pelvis or lower extremities.
  • Impaired muscle performance and function.
  • The presence of congestion, swelling or edema associated with soft tissue injury.
  • The presence of pain or tenderness associated with benign origin.
  • Scar therapy management.
  • The presence of soft tissue integrity issues in the region including trigger points, tendinopathies, sprain or strain injuries.
  • Impaired postural control or function.


Clinical Indications for Treatment of the Upper Inner Thigh:

  • To reduce or eliminate soft tissue impairments in the upper inner thigh and anterior pelvic/groin areas that have been identified as significant and relevant to the achievement of treatment plan goals.
  • Reduced range of motion in the trunk, spine or lower extremities.
  • Impaired muscle performance and function.
  • The presence of congestion, swelling or edema associated with soft tissue injury.
  • The presence of pain or tenderness of a benign origin.
  • Scar Therapy management.
  • The presence of soft tissue integrity issues in the region including trigger points, tendinopathies, and sprain or strain injuries.
  • Impaired postural control and function.

The intention of this new mandate is to increase awareness and understanding for clients regarding the reasons your massage therapist would request to assess and work sensitive areas. Hopefully opening the discussion will also increase understanding that clients have the right to choose to have sensitive areas addressed, or not.

We will be updating consent for sensitive areas once a year for each client, the same as mandated by the government for Health History Forms. Additionally your therapist may also have you initial consent on your ongoing treatment form each session.

While there has been some discussion in the community for and against the new mandate we will continue with care for our clients as implemented by the CMTO unless we are notified of any changes. We will update this blog post as necessary to keep current with the College’s policies.

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