Manual Therapy and Therapeutic and Recovery Modalities
Exploring Policies that Protect
Athletes rely on their bodies for strength, accuracy, endurance, and skill. However, because so much stress is placed on athletes’ muscles, bones, and joints—from repeated to explosive movements—therapies are performed to prevent or treat injuries.
The Minor Athlete Abuse Prevention Policies (MAAPP) recognize this, which is why the policies set clear guidelines and requirements that Adult Participants1 must follow when performing these types of treatments on Minor Athletes2 within the U.S. Olympic & Paralympic Movement.
What Are Therapeutic and Recovery Modalities?
Manual therapy and therapeutic and recovery modalities are essential for keeping athletes feeling rested and prepared for practice and competition. So, what are they and how do they impact athletes?
From baseball to badminton, manual therapy and therapeutic and recovery modalities exist within each sport but can be different in how and why they’re performed.
Examples of these therapies are: first aid, massage, taping, cupping, stretching, cryotherapy, neuromuscular stimulations, electrical stimulation, and others.
How Does the MAAPP Apply?
Like coaches, health care providers are Adult Participants who play an important role in a Minor Athlete’s sport experience. Whether preventing an injury or responding to one, physical therapists, massage therapists, and others routinely help an athlete prepare for competition.
When a Minor Athlete visits a health care provider for manual therapy, therapeutic modalities, or recovery modalities (like the examples listed above), there are several mandatory requirements that must be followed.
The first mandatory requirement is that:
- All In-Program Contact during manual therapy and therapeutic modalities and recovery modalities with Minor Athletes must be observable and interruptible.
For a refresher on what observable and interruptible means, check out our third MAAPP series article, Observable & Interruptible: Making One-on-One Interactions Safer Between Adult Participants and Minor Athletes.
Below are the additional mandatory requirements that Adult Participants must follow when performing therapies on minor athletes:
- Have another Adult Participant physically present for the modality or manual therapy
- Have documented consent (see note below)
- Perform the modality or manual therapy while the Minor Athlete is clothed
- Allow parents/guardians to be in the room and observe (except for competition or training venues that limit credentialing)
- Narrate the steps in the modality before taking them, seeking assent from the Minor Athlete throughout the process
Note: Health care providers performing manual therapy, therapeutic modalities, or recovery modalities must obtain consent from the Minor Athletes’ parents/guardians before providing any form of therapy. This consent must be given annually and can be withdrawn at any time.
Important! While other MAAPP polices have several exceptions, for manual therapy and therapeutic modalities and recovery modalities, only the emergency exception applies. Read our second MAAPP series article, How to Know Who the MAAPP Applies to and When, for a refresher on the emergency exception.
Applying the Policy to Sport: Examples
Let’s explore some sport-related examples to understand how this MAAPP policy applies to Movement sport.
Example: A USA Diving athlete has torn a muscle in their shoulder. To help the muscle heal, they attend weekly massage therapy sessions. The massage therapist, who has received documented consent from the athlete’s parent/guardian, performs the treatment in an open room where several other athletes are also undergoing various types of therapies with Adult Participants. The massage therapist tells the minor athlete what they will do before performing the therapy and receives assent. The athlete is fully clothed for the treatment.
This interaction is in compliance with the MAAPP’s policy. The interaction takes place in a public space, with additional Adult Participants present, which makes it observable and interruptible. The athlete is clothed, consent has been given, therapeutic steps are narrated before being performed, and the athlete has provided assent.
Example: A USA Track & Field athlete has sprained their ankle during competition and requires care. The health care provider performs first aid on the field. Other Adult Participants and minor athletes are present, and the health care provider narrates what they will do, receiving assent from the athlete. After the emergency situation has passed, the health care provider documents the applicability of the emergency exception per their organization’s protocols.
Because this is an emergency with the athlete requiring timely care, not all of the MAAPP policies are followed. For example, the health care provider did not obtain consent from the athlete’s parent/guardian before performing first aid. However, even in an emergency situation, the health care provider follows the remaining requirements: the interaction is observable and interruptible, the athlete is fully clothed, the health care provider narrates their actions and receives assent, and additional Adult Participants are present. After care was given, the health care provider documented the emergency exception.
Narrating Medical Care & Modalities
Explore more information around the MAAPP’s manual therapy and therapeutic modalities and recovery modalities policy. Check out our video below.
Disclaimers
1 Adult Participant: Any adult (18 years of age or older) who is: a. A member or license holder of an NGB, LAO, or USOPC; b. An employee or board member of an NGB, LAO, or USOPC; c. Within the governance or disciplinary jurisdiction of an NGB, LAO, or USOPC; d. Authorized, approved, or appointed by an NGB, LAO, or USOPC to have regular contact with or authority over minor athletes.*
*This may include volunteers, medical staff, trainers, chaperones, monitors, contract personnel, bus/van drivers, officials, adult athletes, staff, board members, and any other individual who meets the Adult Participant definition.
2A Minor Athlete is an amateur athlete under 18 years of age who participates in, or participated within the previous 12 months in, an event, program, activity, or competition that is part of, or partially or fully under the jurisdiction of, an NGB, USOPC, or LAO.†
†This term shall also include any minor who participates in, or participated within the previous 12 months in, a non-athlete role partially or fully under the jurisdiction of an NGB, USOPC, or LAO. Examples include, but are not limited to: officials, coaches, or volunteers.
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