In the light of recent press about a death following manipulation (www.bbc.co.uk/news/uk-england-york-north-yorkshire-50397867) and the publication of research last year on the dangers of head and neck massage if practised by improperly trained salon employees (“Crick” in Neck Followed by Massage Led to Stroke …), we at the British Association for Performing Arts Medicine, along with our clinical colleagues, thought it would be useful to provide guidance on Laryngeal Manual Therapy (LMT) and Head and Neck Massage, which is often used by professional voice users.
We recommend that manual therapy techniques applied to the head, neck and larynx should only be performed in clinical environments by the following registered professionals:
Physiotherapist – registered with the Chartered Society of Physiotherapists (CSP)
Osteopath – registered with the General Osteopathic Council (GOC)
Speech and Language Therapist – registered with the Royal College of Speech and Language Therapists (RCSLT)
Chiropractor – registered with the General Chiropractic Council (GCC)
Sports Therapist –registered with the Complementary and Natural Healthcare Council (CNHC), Federation of Holistic Therapists (FHT) or British Association of Sports Rehabilitators (BASRAT).
Massage Therapist –registered with the Complementary and Natural Healthcare Council (CNHC) or Federation of Holistic Therapists (FHT). Massage Therapists should be qualified to diploma level and registered with the CNHC or FHT, which are the only Registering bodies for Massage Therapy that are accredited by the UK Professional Standards Authority. While there are many organisations that provide training in massage, only some of them provide training at a level that provides a route to registration with CNHC or FHT.
Membership of a registering body accredited by the Professional Standards Authority is a guarantor of professional standards. It indicates that the practitioner operates within a structure that oversees qualifications, working practices, ethical behaviour etc. and can investigate complaints and impose sanctions on practitioners who fall short.
The BAPAM Directory also lists BAPAM-Registered Vocal Rehabilitation Coaches (VRCs). A VRC is a type of specialist voice coach who works as part of a multidisciplinary team that includes clinicians such as Speech and Language Therapists and Laryngologists. BAPAM-Registered VRCs have undertaken training to carry out palpation assessment. This is to assess tension only, and for onward referral, not to perform manipulations. Training in palpation assessment should be provided by a clinically qualified practitioner such as an Osteopath or Physiotherapist. Like clinical professionals, VRCs require clinical supervision from a Laryngologist, Speech and Language Therapist and sometimes a Psychotherapist.