“Well … THAT sure looks risky!” I started to envision the potential consequences of doing something that could cause a huge legal headache. If it’s proper, I say something. I started as an Attorney in 1995 (I still am one, by the way). It was such an ugly business, that I decided to transition into my true passion of helping people move better and feel better in their bodies — through Massage Therapy (in 2001), Pilates (in 2008), Franklin Method® (in 2011), Haase Myotherapy™ (in 2017), and Graston Technique® (in 2018). That legal experience, however, guided all future business decisions.
I worked on many Personal Injury and Commercial Litigation cases back in the day. Picture this: the old law firm held the Corporate/Tax people — the deal-makers – on the upper level. Litigation was on the lower level. There was an ornate staircase connecting our floors. Halfway down hung a painting of a hunter throwing a fox to the dogs. We were the dogs, expected to tear the other party apart when the deals broke. That, we did. This experience was valuable — learning to spot common mistakes and potential problems. I learned that managing risk is one of the best things you can do for yourself and your Business.
That leads me to the subject of SCOPE OF PRACTICE, and why this is so critical. Litigation is aggravating, exhausting, and expensive. Relationships often never recover. It is best to avoid being placed in that situation by staying within our Scope of Practice. Simply put — venturing outside of this scope places a Pilates Teacher at a great risk, because:
- You won’t be covered by your Insurance Policy. The liability and legal bills will fall on you and the Studio if a client gets injured. That gets expensive — proverbially losing that “arm and a leg.” Your assets (house, car, bank account, stocks) could be at risk of being lost — or subject to attachment before a judgment, pending resolution of the case. Settling a case can cost tens of thousands.
- That Plaintiff is now your former Client, likely to write scathing one-star reviews and tell their friends to go to another Teacher and Studio (which might terminate you as well); and
If an activity requires a License that you and the Studio lack, such as if it falls under the statutory definition of massage, you risk hefty fines — even jail — depending on your state laws and Administrative Rules. (You’d be surprised at the things I’ve seen). Is it really worth the risk?
What does working within the SCOPE OF PRACTICE mean for Pilates teachers?
How can I best protect myself? It’s a professional guideline that requires us to do only those things for which we have the required training; certifications; competency; and (if applicable) licensing.
Your Teacher Training Program likely provided a document with your Scope of Practice. The NPCP posts its Scope of Practice online. In my opinion, it serves as a good model.
Essentially, Pilates Teachers Can:
- Design and teach Pilates programs for clients;
- Receive additional exercise guidelines from a client’s Physical Therapist, Chiropractor, Osteopath, Physician, etc.;
- Promote Pilates for health;
- Discern when someone is/is not a good candidate for Pilates; and
- Use appropriate touch when granted permission by the client.
We cannot diagnose; “prescribe” exercises; claim to heal or cure; provide counseling; provide services for which we are not licensed; or misrepresent our qualifications. It’s important to remember all that when deciding if a particular practice or decision would be covered by your Insurer IF a client experiences an injury or other sort of loss.
We cannot proclaim to a Client, for example, “Aha, you have Scoliosis!” We might instead say something like, “I see that your spine has a lateral curve, and the shoulders and hips are a little uneven. We need you to go get a Diagnosis so I know what specific Pilates protocols I can use, and also see if I need to refer you to a specialist, like maybe this great PT, or Chiropractor who’s just down the street.”
Also, we are bound to observe Laws and Administrative Rules within our jurisdiction. Please note the general rule that “Ignorance of the Law is Not An Excuse” (ignorantia juris non excusat), so it’s your duty to do the research.
Statutes and Administrative Rules are often found online. It can be a bit overwhelming if you’re not used to doing legal research. It can save time and energy to have an Attorney licensed in your jurisdiction help you understand it fully.
There is much we can do. We can level up our Pilates career and stay within the Scope of Practice through Continuing Ed. We can take a deep dive into Anatomy and Kinesiology, and learn modified Pilates programs developed by Chiropractors, Physical Therapists, Physiotherapists, etc. If your certification program has its own CE courses, or if the course is approved by a well-regarded organization, it gives you the confidence that you’re following the manual; and that these are Pilates protocols, developed for Pilates professionals. That doesn’t automatically protect you, however. You have to be realistic about your skills.
That said – can we all agree that Pilates itself does not contemplate manual therapy? I bring this up because I have an email for a workshop in a type of “release” work that appeared to advertise manual therapy — especially based on the Teachers’ website. I asked the Host if this was a Manual Therapy class and mentioned that practitioners would need to be licensed in Massage. The Teacher then replied that the hands-on “release” techniques were optional. Hmm. I chose not to attend. A colleague who took the workshop emailed me that manual release was taught but that she would never use it on a client.
If you were certified to do Assisted Stretching, Myofascial Release, or other Bodywork on a person, it would be prudent to consult Statutes and Administrative Rules in your jurisdiction to determine if any of them fall under the definition of Massage or any other practices that require Licensing, and potential penalties. I cannot say if someone would complain about you — but I can explain how to manage risk. And that’s to know the regulations. One resource that could help you understand all the rules in your jurisdiction, is the American Massage Therapy Association. They have a main website and state chapters. I recently served on one chapter as a Board member.
If you instead got Certified to teach other types of movement, then a fusion class could be within your Scope of Practice. What if you were trained but not certified? That’s a gray area. Basically, that certification provides helpful evidence that you are within your Scope of Practice. Not having that piece of paper doesn’t prove that you’re unqualified. You could document your proof of competency elsewhere.
Sometimes you need specialized training to know what you’re doing. This brings me to the subject of Pilates classes which include self-massage. I’m not dictating what to do or giving you legal advice. I’m just saying that this is a gray area, where Scope of Practice really needs to be addressed. But, what are the chances that people could get hurt? Can’t they do it at home? I have two responses.
1. It depends on what you’re doing.
Some things are more likely to cause harm than others. Licensed massage therapists and manual therapists learn about “endangerment zones” that require caution and specialized training to work in the area. For example: There are many delicate structures including nerves and blood vessels that are affected if you touch the anterior neck, including the Scalenes and Sternocleidomastoid. (See examples here.)
If you don’t have advanced palpation skills, it’s not a good idea to massage your own anterior neck or direct someone else to massage theirs. It could end up with a whiplash injury, nerve injury, etc. What if your client is self-massaging their Scalenes in class and then feels sharp pain or numbness down the arm? Also, there are strong precautions overall, with Prenatal clients.
2. It also depends on the client.
Some people are more easily hurt. Have you ever heard of the “Eggshell Plaintiff?” It’s someone who is particularly susceptible to injury based on a pre-existing condition – and if you are outside the Scope of Practice, that’s a problem.
“You go legal real fast.” Heard that one recently. Oh, I’ll save THAT particular story for another time. I’ve also heard, “You’re just being paranoid/pessimistic.” Well, no – I’m just being practical from professional experience. I couldn’t tell you whether someone would get injured or complain. But every Litigation case I’ve ever worked on started with people thinking that nothing bad would happen – and then, things happened. So it bears repeating: Litigation is expensive, aggravating, and exhausting. Relationships often don’t recover. It’s best to avoid that potential outcome — and staying within our Scope of Practice makes that a lot easier.
DISCLAIMER: THIS ARTICLE IS NOT INTENDED AS LEGAL ADVICE AND NOT INTENDED TO CREATE AN ATTORNEY-CLIENT RELATIONSHIP — NOR SHOULD THE ARTICLE BE TAKEN AS SUCH. IF YOU HAVE LEGAL QUESTIONS ABOUT YOUR OWN SITUATION, YOU SHOULD CONSULT AN ATTORNEY LICENSED TO PRACTICE IN YOUR JURISDICTION.
About the Author
Lahela Hekekia is a mixed-ethnicity Native Hawaiian (Kanaka Maoli), born and raised in Hawaii, and happy to call Hawaii home, still. She has been a Licensed Attorney since 1995, a Licensed Massage Therapist since 2001, and a Certified Pilates Teacher since 2008. Lahela is in addition, a Certified Franklin Method® Movement Educator (level 3); a Certified Graston Technique® Specialist; and a Certified Medical Myotherapist.
Lahela received her BA and JD from Georgetown University, where she learned Journalism from award-winning investigative journalist Ted Gup (he wrote for TIME as well as the Washington Post). Lahela took her initial Pilates training through STOTT PILATES®, found a Classically trained Mentor in 2011; and loves to take workshops because there’s always something valuable to learn, and many gifted teachers to meet. Lahela is also currently pursuing a Doctorate degree in Clinical Acupuncture and Oriental Medicine.
In 2018, Lahela was brought on to the Board of Directors for The Pilates Initiative, a 501(c ) (3) nonprofit dedicated to education and community outreach; and she has written some articles — from a legal standpoint — for the newsletter as well as participated in Zoom conferences with teachers and studio owners during the 2020 shutdowns. Lahela is passionate about Pilates because of how much it has helped her with her own Scoliosis, and she loves to teach people how modified Pilates and Bodywork can help them change too. She collaborates with Chiropractors, Physical Therapists, Massage Therapists, and others to help clients feel better and move better in their bodies.
Her website is LahelaFit.