Faq - Dr Jay Rappazzo

Chiropractor

When should I see a chiropractor?

What are some of the benefits of chiropractic care?

What conditions do chiropractors treat?

What is a subluxation?

What is the “vertebral subluxation complex”?

What results can I expect from treatment?

How is chiropractic adjustment performed?

Is chiropractic covered by government health plans?

Is chiropractic evidence-based?

Is chiropractic regulated in Canada?

Is chiropractic treatment appropriate for children?

Is every patient’s treatment the same?

Is chiropractic treatment ongoing?

Can chiropractic treatment cure colds, earaches and other ailments?

Can chiropractic treatment provide a preventative function?

Are there many athletes who use chiropractic?

How many Ontarians use chiropractic?

What is the difference between physicians and chiropractors?

Do chiropractors refer patients to medical doctors when necessary?

Does chiropractic treatment require a referral from an MD?

Do chiropractors take a medical history?

Does chiropractic treatment require x-rays?

Why is there a popping sound when a joint is adjusted?

Acupuncture

Is Acupuncture Safe?

How does acupuncture work?

Is acupuncture painful??

How much exercise should I do?

What activities are to be avoided after acupuncture treatment?

What should I do before and after an acupuncture treatment?

Is acupuncture covered by insurance?

Orthotics

How are Orthotics Constructed?

How long will a pair of Custom Orthotics last?

Do insurance plans cover Custom Orthotics?

Do I need a Doctor’s prescription for Custom Orthotics?

Massage Therapy

How can massage therapy help me?

Can anyone receive massage therapy?

Is massage therapy a regulated health profession?

Do I have to remove all my clothing for massage therapy?

Why do Massage Therapists charge HST?

Does massage therapy hurt?

What happens on the first visit?

Is massage therapy covered under the Ontario Health Insurance Plan (OHIP)?

How do I become a Massage Therapist?

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Chiropractor


When should I see a chiropractor?

Eight out of ten Canadians will experience back pain at some point in their life, and at least one third of people in Ontario will have back pain at any given time. For many people, the pain can keep them away from work, school or even their day-to-day activities. If pain causes interruptions and restrictions in the activities of your daily life then you should consult a health care provider.
Chiropractors are regulated primary health care professionals, and they are one of only five classes of health care professionals in Ontario that are able to use the title Doctor, with its accompanying rights and obligations.
Chiropractors are highly educated and extensively trained to assess, diagnosis, treat and prevent conditions disorders of the spine, joints, muscle and nervous systems. These disorders may include back pain, neck pain, headaches, referring pain in your arms and legs, etc.
Many patients seek chiropractic treatment for wellness care. Others, like seniors, who find that treatment helps them to maintain mobility and good range of motion. Pain should never become a way of life, especially when there is qualified help available.
There are many reasons to seek chiropractic care: Work, accidents, sports injuries, household chores, even the stress of daily living can cause painful joint and spinal problems. Even if you do not have painful symptoms, chiropractic care can help you maintain healthy spine and joint function.

Here are some of the most common reasons why more than 4 million Canadians visit a chiropractor each year:

  • Back pain
  • Neck pain
  • Headache
  • Whiplash
  • Strains and sprains from daily activities
  • Repetitive strain injuries
  • Work and sports-related injuries
  • Arthritis
  • Restricted movement in the back, shoulders, neck or limbs
  • General health and well-being

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What are some of the benefits of chiropractic care?

Chiropractic care can:

  • Improve movement in your neck, shoulders, back and torso
  • Improve your posture
  • Provide relief from headaches, neck and back pain
  • Help prevent work-related muscle and joint injuries
  • Lead to enhanced athletic performance
  • Improve your flexibility and range of motion
  • Relieve pregnancy-related back ache
  • Correction gait and foot problems

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What conditions do chiropractors treat?

Chiropractors are experts trained in the neuromusculoskeletal system. They diagnose and treat disorders of the spine and other body joints by adjusting the spinal column or through other corrective manipulation. Chiropractors provide conservative management of neuromusculoskeletal disorders including, but not limited to, back, neck and head pain (over 90 percent of conditions treated). They also advise patients on corrective exercises, lifestyle and nutrition.

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What is a subluxation?

“Subluxation” is a term used to describe a problem with a spinal joint. The World Health Organization defines a “subluxation” as a functional problem related to a joint and the structures associated with the joint such as the muscles, tendons and nerves. Dysfunction can present itself in various ways such as pain, inflammation and restricted movement of the joint. Some types of dysfunction, such as sprain, will not appear on an x-ray. Chiropractors are trained to identify dysfunction that does not appear on imaging through the use of manual examination and non-imaging diagnostic tests.

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What is the “vertebral subluxation complex”?

VSC is a term used to describe the kinds of issues that may be associated with a joint that is not functioning properly. For example, there may be loss of motion. changes in the muscles that attach to the spine, irritation or injury to the nerves that radiate out from the vertebrae, degeneration of the disks or inflammation of tissues in the spinal region. Chiropractors are well trained to identify the components – or complex – of problems that may accompany a joint problem. Some of the indicators include tenderness, soreness and stiffness, spasm, tightness or weakness, headaches, and reduced mobility. Pain may or may not be felt. Chiropractors typically use a combination of imaging such as x-ray, manual examination, patient history, and non-imaging physical tests to determine what is taking place physiologically.

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What results can I expect from treatment?

That depends on your condition. The length of time you have had the problem, your age and the degree of your disability all affect the length of your treatment. Your chiropractic doctor should tell you the extent of treatment recommended, and how long you can expect it to last.
One of the main reasons people choose chiropractic is that they often get quick results. Individual cases vary and chronic conditions obviously need more treatment, but Workers’ Compensation Board studies show that people with low back pain get back to work much faster with chiropractic care.

You might also consider the benefits of regular chiropractic adjustments even when you feel healthy. Sometimes you won’t know you have a disorder of the neuromusculoskeletal system until it becomes acute and painful. So, just as you see your dentist to have your teeth checked and your optometrist for eye exams, regular visits to your chiropractor can catch related health conditions early, often preventing them from developing into major problems. Remember, your spine is every bit as susceptible to wear and tear as your teeth and your eyes so you should look after it.

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How is chiropractic adjustment performed?

Chiropractic adjustment or manipulation is a manual procedure that utilizes the highly refined skills developed during four intensive years of chiropractic education. The chiropractor typically uses his/her hands to manipulate the joints of the body, particularly the spine, in order to reduce pain, and restore or enhance joint function.
Chiropractic manipulation is a highly controlled procedure that rarely causes discomfort. The chiropractor adapts the procedure to meet the specific needs of each patient.

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Is chiropractic covered by government health plans?

Chiropractic care is covered extensively by third party payers. These include the federal public service, worker’s compensation boards, the automobile insurance industry, private health care insurers, large employers, the RCMP, and Veteran’s Affairs Canada. Chiropractic services are also partially funded by the provincial health plan of Manitoba.
Is chiropractic manipulation a safe procedure?
Chiropractic adjustment or manipulation is a drug-free, non-invasive approach to common musculoskeletal conditions such as headache, and neck and back pain. As such, it is a low risk therapy. Complications arising from adjustment are rare. It has an excellent safety record. However, no health treatment is completely free of potential adverse effects. Even common over-the-counter medicines carry a risk.

Most patients experience immediate relief following an adjustment, however, some may experience temporary pain, stiffness or slight swelling. Some patients may also experience temporary dizziness, local numbness, or radiating pain. However, adverse effects associated with spinal adjustment are typically minor and short-lived.

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Is chiropractic evidence-based?

Chiropractic is a healing discipline firmly grounded in science. Few other health care interventions have been assessed as extensively as chiropractic manipulation, both in terms of safety and effectiveness. There have been at least six formal government studies into chiropractic worldwide over the last 25 years and all have concluded that contemporary chiropractic care is safe, effective, cost-effective and have recommended public funding for chiropractic services. In addition, there have been countless scientific clinical studies assessing the appropriateness, effectiveness, and/or cost-effectiveness of spinal manipulation or chiropractic manipulation, most notably for low back pain. The Canadian Institutes for Health Research (CIHI) now offers research grants in partnership with the Canadian Chiropractic Association to chiropractors and other scientists for high quality, chiropractic research.

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Is chiropractic regulated in Canada?

Like medicine and dentistry, chiropractic is a self-regulating profession, and each provincial chiropractic regulatory body has the authority to grant a license to practice chiropractic. There are Chiropractic Acts in all 10 provinces and the Yukon Territory which establish a self-regulatory process which includes extensive testing for licensure. In all provinces, licensure requirements include university studies followed by graduation from an accredited chiropractic institution, and passing national and provincial board examinations.

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Is chiropractic treatment appropriate for children?

Yes, children may benefit from chiropractic care. Children are very physically active and experience many types of falls and blows from activities of daily living as well as from participating in sports. Injuries such as these may cause many symptoms including back and neck pain, stiffness, soreness or discomfort. Chiropractic care is always adapted to the individual patient. It is a highly skilled treatment, and in the case of children, very gentle.

While there is some clinical evidence that musculoskeletal treatment of infants may have positive effects, well-controlled studies are required to verify the benefits that are seen in clinical practice.

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Is every patient’s treatment the same?

The treatment a patient receives is related to the specific condition diagnosed by the chiropractor, and will vary from person to person depending on each persons unique situation.

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Is chiropractic treatment ongoing?

The hands-on nature of chiropractic treatment is essentially what sends patients back to the chiropractor a number of times. To be treated by a chiropractor a patient needs to be in his or her office. A chiropractor may provide acute, preventative and/or maintenance care thus making a certain number of visits necessary.

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Can chiropractic treatment cure colds, earaches and other ailments?

Chiropractic care cannot “cure” these conditions, but there is some evidence to indicate that adjustment may have a beneficial effect on a variety of conditions. Chiropractic adjustment may alleviate some of the secondary, or referred pain, arising from the response of the musculoskeletal structures to the primary cause. For example, research conducted in Denmark resulted in chiropractic treatment being recommended for the relief of infantile colic. Similarly, a recent U.S. study concluded that the application of manipulative techniques in children with recurring ear infections can prevent or decrease surgical intervention or antibiotic overuse.

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Can chiropractic treatment provide a preventative function?

Clinical experience suggests that individuals with chronic conditions such as degenerative joint disease (osteoarthritis) or recurrent neck pain, back pain or headaches may experience less frequent and less severe symptoms when under regular chiropractic care. This also applies to individuals in highly stressful situations and those who experience repetitive physical and postural strain from their daily activities. Whether ongoing chiropractic treatment can prevent back pain from occurring in the first place, or prevent a previous condition from re-occurring, requires further study.

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Are there many athletes who use chiropractic?

Yes. Many amateur and professional athletes use chiropractic treatment as part of their overall health care, fitness and maintenance program. Chiropractic is often used to improve muscle and joint conditioning, which has a direct effect on an athletic performance. Treatment works to improve biomechanical function and enhance overall conditioning, important in situations where there is continuous repetitive movement. Chiropractic care also helps athletes fine-tune their muscles and joints for high-level performance, and may reduce long term wear and tear. Finally, treatment can be used to prevent, and sometime shorten, the healing time of injuries.

Athletes most often select treatment to improve their performance, where as the average consumer will select chiropractic care to help manage aches and pains. In some cases treatment will be similar, but in all cases a treatment plan will be developed according to the goals and condition of each patient. In the case of professional and elite athletes, chiropractors often work in conjunction with other health care professionals, including medical doctors and/or sports medicine doctors, massage therapists and physiotherapists.

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How many Ontarians use chiropractic?

Chiropractic is one of the largest primary-contact health care professions in Ontario, with more than 3,100 practicing chiropractors. Almost 2 million Ontarians use the services of a chiropractor each year to help them get back to work, and back to doing the things they love.

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What is the difference between physicians and chiropractors?

That’s like asking the difference between a physician and a dentist: they are different professions within the health care spectrum. Both chiropractors and physicians are legally entitled to use the title “doctor”. As the appellation MD means “Doctor of Medicine”, so DC means “Doctor of Chiropractic”.

The role of chiropractic is complementary to other areas of primary health care. Chiropractic is not, for example, a replacement for medical care, but may offer an alternative to medication and surgery in appropriate circumstances.

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Do chiropractors refer patients to medical doctors when necessary?

Yes, like medical doctors, chiropractors refer patients to other health professionals when they feel it is appropriate. Chiropractors are well trained to recognize risk factors as well as individual disease patterns and will not hesitate to make a referral when it is in the best interest of the patient’s health.

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Does chiropractic treatment require a referral from an MD?

No. A patient does not have to be referred. Chiropractors are legislated as primary contact health care professionals in every province in Canada. This means that patients can consult them directly.

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Do chiropractors take a medical history?

Like MD’s, the chiropractor will take a detailed health history during the first visit, prior to initial treatment. This will include details on lifestyle and risk factors to give the chiropractor a full picture of the patient’s health in order to determine the best treatment. As well, a detailed health history is important to rule out any contraindications to treatment and to fully investigate risk factors before a diagnosis and treatment recommendation can be reached.

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Does chiropractic treatment require x-rays?

X-rays can play an important role in diagnosis and are taken when a need has been determined after taking a patient case history and conducting a physical examination. Chiropractors receive 360 hours of education in radiology covering a full range of topics from protection to X-ray interpretation and diagnosis. Governments in every province have recognized the training and competence of chiropractors to take and interpret X-rays and have granted them this right.

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Why is there a popping sound when a joint is adjusted?

Adjustment of a joint may result in release of a gas bubble between the joints that makes a popping sound – it’s exactly the same as when you “crack” your knuckles. It is not painful. It is caused by the change of pressure within the joint resulting in gas bubbles being released.


Acupuncture


Is Acupuncture Safe?

Acupuncture is a safe technique, provided that practitioners are properly trained and follow appropriate techniques. Practitioners of acupuncture use single-use, sterile disposable needles and have been trained regarding precautions and contraindications to acupuncture.
It is important to notify the practitioner if you are pregnant or could possibly be pregnant, as acupuncture treatment may have to be modified or may not be appropriate.

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How does acupuncture work?

Acupuncture is the stimulation, by insertion of needles, of specific points on the body which have the ability to alter various biochemical and physiological conditions. Acupuncture stimulates the release of endorphins, which are the body’s natural pain-relieving neurohormones. Acupuncture affects the functioning of the hormonal system, promotes a decrease in inflammation, increased circulation and relief from pain.

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Is acupuncture painful? What does it feel like?

Acupuncture is usually a comfortable treatment. Needles are very fine, metallic and as thin as a hair, making them quite painless upon insertion. Everyone experiences acupuncture differently, but most feel no pain or very minimal pain as the needles are inserted. You may experience a mild aching sensation or warmth around the needle site.

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How much exercise should I do?

Exercise helps to improve blood circulation and recovery from illness depends on a good supply of nutrients and oxygen. Exercise as frequently as possible but never to the point of exhaustion. Rest between exercises and replenish the body with nutritious food and drinks.

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What activities are to be avoided after acupuncture treatment?

Strenuous physical activities including vigorous exercise should be avoided for at least 2 hours after treatment.

A good feeling after acupuncture must not be taken as full recovery and patients must avoid over-engaging in any activities they were unable to perform previously due to their condition until they regain their strength and stamina.

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What should I do before and after an acupuncture treatment?

You should make sure that you have eaten a light meal prior to having acupuncture. You should avoid consuming caffeine or nicotine for 90 minutes before and after treatment. Continue with all medications as prescribed.

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Is acupuncture covered by insurance?

Many insurance plans offer coverage for acupuncture treatment. To find out if your plan covers acupuncture, and any limits to the number of treatments covered, you should contact your insurance company directly. Acupuncture may also be covered if you sustained a workplace injury or were injured in a motor vehicle accident.


Orthotics


How are Orthotics Constructed?

A non weight bearing cast in subtalar neutral is first performed. The client’s clinical data is referenced to the normal population and abnormalities are corrected. A laser scans the negative cast that the health care provider has made from your foot impression to create a corrected positive. The mould is milled using the corrected casting from the computer then ground and posted as to the specific requirements of the patient. Then engineered copolymer with complete intrinsic memory and predictability postings made from carbon flex, polypropylene and/or bay comp carbon is vacuum formed over the positive. The shell material is applied. All orthotics provided by Dr. Jay Rappazzo have been hand made with 100% raw materials.

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How long will a pair of Custom Orthotics last?

With every-day use Custom Orthotics should last at least one year. Many patients do have multiple pairs, which extends the life of the Custom Orthotics, and they can last between 2 – 5 years.

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Do insurance plans cover Custom Orthotics?

Yes. The majority of Canadian workers have partial or full coverage for custom orthotics through their workplace health care plans. OHIP does not cover these medical appliances. To help make insurance reimbursement easy, the patient is provided with a detailed itemized receipt, upon payment at the time of purchase, listing the health provider’s credentials and registration numbers, as well as the cost and date of the order.

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Do I need a Doctor’s prescription for Custom Orthotics?

Some insurance companies may require a note from a physician explaining why has been recommended. It is important to check with your insurance provider.


Massage Therapy


How can massage therapy help me?

Massage therapy can be beneficial to people of all ages and conditions and is widely used to help obtain relief from many specific problems, including:

  • Inflammatory conditions such as arthritis and tendinitis
  • Stress relief and associated conditions
  • Headaches and migraines
  • Muscle and related conditions such as spasms, strains and sprains
  • Back pain
  • Repetitive strain injury
  • Circulatory and Respiratory problems
  • Pregnancy and labour discomfort
  • Post-injury and post surgical rehabilitation

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Can anyone receive massage therapy?

Yes, massage therapy is appropriate for individuals of all ages, including infants, children, and the elderly; however, there are some conditions for which massage therapy is not appropriate. A qualified Massage Therapist (RMT) is trained to recognize these cases.
Many Massage Therapists treat a variety of diseases and disorders while other Massage Therapists concentrate on certain conditions (fibromyalgia) or groups of people such as athletes, performers, women during pregnancy (including labour and delivery), infants and children. When booking your first consultation, be sure that the Massage Therapist is the right choice for you.

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Is massage therapy a regulated health profession?

The practice of massage therapy is regulated under the Regulated Health Professions Act, 1991 (RHPA) and is therefore a Regulated Health Profession. Only individuals who have completed the requisite training and have met the strict competency requirements of the College of Massage Therapists of Ontario (CMTO) can call themselves a “Massage Therapist” or a “Registered Massage Therapist”.
When seeking massage therapy, look for an individual who uses one of those two titles and ask to see their registration with the CMTO.

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Do I have to remove all my clothing for massage therapy?

No. Your comfort as a client is of the utmost to all Registered Massage Therapists, whether that is in the context of the clothing you wear or the treatment you receive. Massage Therapists can provide important treatment whether you elect to remove any, some, or all of your clothing. All RMTs are trained in proper draping procedures to ensure that your privacy is completely respected at all times during treatment. Your comfort and ability to relax is paramount to effective treatment.

Registered Massage Therapists will also describe the treatments to be provided to ensure that you are comfortable with them. Your consent is sought before treatment is provided. If you are uncomfortable, your RMT wants you to let them know immediately, whether that discomfort involves the treatment, draping or any pain you may experience.

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Why do Massage Therapists charge HST?

Under the federal Excise Tax Act, massage therapy is a service to which GST was applied. While massage therapists are considered health care practitioners under Ontario Regulated Health Professions Act, 1991, massage therapy is not included in the definition of health services that are exempt from the application of the HST. The list of exemptions is controlled by the federal government and the federal Minister of Finance has made it clear that the current policies governing exemptions will remain in place. A health profession can be exempted if is it regulated in five provinces or territories or if it is paid for in the health plans of three provinces. Massage therapy does not meet either of these conditions.

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Does massage therapy hurt?

As with many treatments affecting the soft tissue, there are times when massage therapy can cause some light discomfort but it is not harmful. Discomfort usually diminishes and no technique of this nature is used without the therapist first discussing it with the client and obtaining your permission. A comfort scale will be established and the therapist will work to the client’s tolerance level. The client can stop or change the treatment at any time and Massage therapists will modify their techniques to meet their client’s needs.

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What happens on the first visit?

On the first visit you will complete a confidential health history as part of your assessment. This is important as the Massage Therapist needs to know if you have any medical conditions or are taking any medications. The Massage Therapist will listen to your concerns, assess your individual needs as well as other factors that may be contributing to your injury (lifestyle, nutritional status, etc.). The Massage Therapist will then develop a treatment plan with you to ensure you receive appropriate treatment that will help you return, as much as possible, to your normal activities.

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Is massage therapy covered under the Ontario Health Insurance Plan (OHIP)?

No. Massage therapy treatments are not covered under OHIP, regardless of whether the treatments are provided by a Massage Therapist directly, by a physician or required by a physician.
Most progressive extended health benefit plans do cover massage therapy treatments when provided by a Registered Massage Therapist and most do not require a physician’s order to do so.

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How do I become a Massage Therapist?

In order to become a Massage Therapist in Ontario, an individual must complete a 2200 hour educational program at an educational institution recognized by the Ontario Ministry of Training, Colleges and Universities.
Upon graduation, the individual must become registered with the College of Massage Therapists of Ontario (CMTO), the regulatory body for the Massage Therapist Profession. This includes the completion of Certification Examinations.
Certification Examinations include two components, Computer Adaptive Multiple-Choice Examination and Objective Structured Clinical Evaluation (OSCE). Successful completion of both components of the certification examination is a non-exemptible requirement for all candidates seeking registration with the College.