COVID-19 Update for Massage Therapists – Permitted Services in States and TerritoriesLast Updated: 06/05/2020 11:30 am
In this blog we seek to clarify the various Government Directions and advice issued across the States and Territories on the closure of non-essential businesses and services, and non-essential gatherings, as they relate to massage and manual therapy practice.
We have broken this post into two sections: Section 1 contains general advice to all practitioners of manual therapy and massage services; Section 2 is a State-by-State breakdown which aims to provide further clarification on which services may be provided in each State and Territory, and under what circumstances.
This is a summary of the various directions currently in force as they relate to massage and manual therapists only, to our best understanding at the time of writing. It does not aim to replace the Directions and advice issued by authorities in each jurisdiction. You must read and follow the Directions currently in force in your State or Territory and satisfy yourself that you are permitted to practice before doing so. If you are in any doubt as to whether you are permitted to practice you should seek further clarification from your State or Territory health authority.
Massage and manual therapy services fall into one of three distinct groups depending on the type of treatment or modality and/or the qualifications of the therapist. These groups are treated differently under the Directions:
1) Health services provided by health practitioners registered with the Australian Health Practitioner Regulation Agency National Registration and Accreditation Scheme. This group includes chiropractors, physiotherapists, osteopaths and occupational therapists. It also includes registered Chinese medicine practitioners and acupuncturists with Protected Titles under the Scheme.
Currently, these services are regarded as essential in all States and Territories and no business closure directions have been placed on them. However, directions on physical distancing and non-essential gatherings still apply, as do the directions around prohibited businesses and places including gyms, exercise, physical training, recreational and sporting facilities, and “wellness centres” (in some states). If you are a chiropractor and your practice is called a wellness centre, you may wish to seek clarification as to whether this term applies to your practice. For further detail on the directions that apply in your jurisdiction, see the summary for your State or Territory below.
2) Professional massage services that are therapeutic or remedial and provided as a healthcare service (as distinct from a personal service such as relaxation massage). The exact wording used to describe this group of services varies between jurisdictions. These services are permitted in all states and territories, subject to the directives and clarifications issued by authorities in each jurisdiction.
Directions on physical distancing and non-essential gatherings still apply to the extent possible, as do the other directions on closure of non-essential businesses and places. For further detail on the specific directions that apply in your jurisdiction, see the summary for your State or Territory below.
3) Relaxation massage and other types of non-therapeutic massage. These types of massage are considered personal services rather than healthcare services and are not permitted in any State or Territory at this time.
It is not our position to advise you on whether or not to practice in the current circumstances. If you are permitted to practice, it is still your choice whether to remain open or closed, and you must decide for yourself whether the services you provide are essential at this time.
If you do decide to practice, you should undertake a thorough risk assessment and management strategy for your practice with particular consideration to:
• Patient and practitioner screening for COVID-19 infection risk and co-morbidity risk• Scheduling strategies and waiting room procedures to ensure physical distancing requirements are adhered to• Cleaning and disinfection of surfaces including waiting room surfaces• Cleaning and disinfection of massage and treatment tables and equipment after each client• The potential use of PPE (face masks and/or shields)• Regular and thorough washing of hands and arms before and after each client
Australian Capital Territory
The Public Health (Closure of Non-Essential Business or Undertaking) Emergency Direction 2020 (No 5) specifically exempts “massage services provided by or for allied health services, such as remedial, sports, and lymphatic massage” from the list of businesses that must close.
The ACT Government has issued a Guidance for massage therapists, which outlines the evidence required to prove that massage services are of 'therapeutic value'.
It follows that exempted massage services are permitted in the ACT but may not be practiced within a non-essential business or place.
The Public Health (Non-Essential Gatherings) Emergency Direction 2020 directs that “a person who owns, controls or operates premises … must take reasonable steps to not allow a gathering [of more than 2 persons occupying a single space] to occur on premises.”
New South Wales
NSW Public Health Orders includes “remedial or therapeutic massage services” among the healthcare services that may remain open.
The list of non-essential businesses and services that must remain closed includes: Massage parlours; Nail, beauty, waxing and tanning salons; Spas (including where they are part of a hotel); Indoor sporting events; Local sporting competitions; Indoor recreation facilities (including gyms and health studios).
Massage & Myotherapy Australia, Australian Natural Therapies Association, Australian Traditional-Medicine Society and Myotherapy Association Australia have received further clarification from the NSW Government. Based on that advice these organisations have variously interpreted that remedial massage, therapeutic massage, soft tissue therapy, myotherapy and musculoskeletal therapy services are permitted in NSW but may not be practiced within a non-essential business or place.
The Four square metre rule applies for businesses that remain open in NSW.
The Directions to Close Public Places specifically exempts “massage services that are provided as allied health services… Examples: Remedial massage, sports massage, lymphatic massage” from the list of businesses that must close.
The list of non-essential businesses and services that must remain closed includes: A place that provides yoga, Pilates, barre, massage or other wellness services [except for the exemption above]; A place that provides beauty therapy…; a gymnasium…; an arena, stadium, sporting facility, amusement park, community centre, recreation centre or play centre, whether indoors or outdoors; a place that provides physical training activities indoors.
It follows that the exempted massage services are permitted in the NT but may not be practiced within a non-essential business or place.
In the Northern Territory, "All operating businesses must have no more than one person per four square metres".
As of 21st April, the Non-essential business, activity and undertaking Closure Direction (No.6) exempts “massage therapy for the management or prevention of a disease, injury or condition, provided by a qualified massage therapist, with social distancing observed to the extent possible.”
The list of non-essential businesses and services that must remain closed includes: Beauty therapy…; Spas and massage parlours [except for the exemption above]; Community and recreation centres; Indoor sporting centres, including gyms, health clubs, fitness centres, yoga, barre and spin facilities, saunas, bathhouses and wellness centres.
It follows that the exempted massage services are permitted in QLD but may not be practiced within a non-essential business or place.
The Home Confinement, Movement and Gathering Direction dictates that “A person who owns, controls or operates premises… must not organise or allow a gathering [of two persons or more in a single undivided space] to occur on the premises.”
"Massage parlours are closed. However, remedial or therapeutic massage and myotherapy services provided in a clinical or health care setting may continue."
The list of non-essential businesses and services that must remain closed includes: buildings used by social and sporting clubs; facilities used primarily for indoor physical recreation; premises at which boot camps and other personal training are offered; indoor sporting venues; beauty salons; saunas, bathhouses, wellness centres, spas and massage parlours.
It follows that remedial or therapeutic massage and myotherapy services provided in a clinical or health care setting are permitted in SA but may not be practiced within a non-essential business or place.
The total number of persons present at premises must not exceed one person per 4 square metres; and a person must attempt to maintain a space of at least 1.5 metres between themself and each other person present (having regard to all the circumstances).
The services cannot be provided from gymnasiums, health clubs, fitness centres, wellness centres, spas, massage parlours and other similar premises.
The Gatherings direction does not prevent health care services being undertaken at other locations aside from medical or health facilities, so long as the premises is not prohibited from opening or operating and it can comply with the remainder of the Gatherings direction and the Stay at Home directions.
The total number of persons present in any single undivided space must not exceed one person for every 4 square metres; and 3 in total.
The DHHS website states in answer to the question, “Which beauty and personal care businesses are currently prohibited?”:
“Spas and massage parlours providing relaxation massages as distinct from therapeutic or remedial massage”
DHHS have also issued a further clarification that myotherapy practices may also continue to operate at this time.
The list of non-essential businesses and services that must remain closed includes: A facility used predominantly for indoor physical recreation (Examples: a gymnasium, indoor swimming pool, health clubs, fitness centres, yoga studio, barre and spin facility, sauna, bathhouse, wellness centre and health studio); an indoor personal training facility; a beauty and personal care facility (a salon, a spa, a massage parlour).
It follows that therapeutic or remedial massage and myotherapy services are permitted in VIC but may not be practiced within a non-essential business or place.
The DHHS Stay at Home Directions prohibit gatherings of more than two persons in any single undivided indoor space.
“In Western Australia, massages that are provided through professional services like physiotherapists, remedial massage therapists and myotherapists are not currently prohibited by the Closure and Restriction (Limit the Spread) Directions made by the State Emergency Coordinator on 7 April 2020.”
The list of non-essential businesses and services that must remain closed includes: Beauty therapy services; a gym; an indoor sporting centre; a beauty parlour or salon, a spa, a massage parlour; a health club or fitness centre, including a centre offering yoga, barre or spin facilities; a wellness centre.
It follows that professional massage and myotherapy services are permitted in WA but may not be practiced within a non-essential business or place.
The Closure and Restriction Directions prohibit indoor gatherings where there is not at least 4 square metres of space for each person.