What is the difference between physical therapy and therapeutic massage?

Physical therapy treatment and therapeutic massage are often quite similar in practice. The difference between the two, however, lies predominantly in the definition and scope of practice for each profession.

As a licensed physical therapist in Texas, my practice is defined as providing evaluations and utilizing rehabilitative procedures such as exercise, joint and soft tissue mobilization/manipulation, massage, the use of mechanical devices, the provision of soft goods and assistive devices, and splinting/taping to aid in diagnosis and treatment of physical conditions.

As a physical therapist, I evaluate one's range of motion, strength, postural alignment and movement patterns as they relate to a specific condition. My client and I develop an individualized plan of care and measurable therapeutic goals that are addressed regionally (ex., "I want decreased pain and improved range of motion & strength for my right shoulder following my injury", etc.) or for the entire body (ex., "I want to progress from walking with crutches to returning to running following my knee operation", etc.). These goals also reflect the plan of care established for the client by the referring healthcare practitioner. Once goals are attained for a specific plan of care, our work together in physical therapy concludes.

The Massage Therapy Licensing Program Rules of Texas define massage as the manipulation of soft tissues of the body, the use of hydrotherapy, and the use of Swedish gymnastics (i.e., passive and active joint movements, non-specific stretches and passive and active exercise). Therapeutic massage is a health care service that does not include diagnosis or the treatment of illness or disease.

Therapeutic massage sessions often work with the entire body and address the well-being of the entire individual- with or without a specific physical condition or measurable therapeutic goal. Therapeutic massage sessions do not require a referral from another healthcare practitioner.

Most of my clients see in my practice of physical therapy and therapeutic massage the influence of my training and licensure in both professions. However, if a client comes wanting joint-specific manipulation, I cannot provide any without a referral for physical therapy from a qualified healthcare as required by TX PT Practice Act. Similarly, if a client comes to my practice without a referral, I can only offer therapeutic massage- I cannot perform specific joint manipulation and will practice solely within the scope of practice as defined by the Massage Therapy Licensing Program Rules of Texas.