Archive for Julie Onofrio

To the Massage Researchers

One of the problems I see from attending the research conference and thinking about research is that there seems to be more than just a vocabulary problem in understanding research and using it to create evidence based practices and to use research to get and keep clients.

Whitney Lowe touched on it in his closing keynote address. The big thing is motivation – what is in it for me (the intuitive, caring, empathetic, massage therapist?) What is in it for my clients?  How will it make their lives better or make me a better massage therapist?   After attending the conference and seeing many great research studies (half of which I don’t know what they were talking about) I am not going to be changing anything in the way I do massage or talk to people about massage in my efforts to get and keep clients.  Whitney also talked about his passion for taking research and trying to implement it into his practice. It did make me want to learn more about that as his passion is really contagious!

To me I don’t have any interest in doing that.  I have been doing massage full time for 23 years and like what I am doing and it seems to work fine for most people.

The biggest question that I have for researchers is SO WHAT?  Why do I need proof that massage works for back pain or reduces anxiety?  I already know that and see the evidence in my practice everyday.   I also use this question when working with massage therapists who are trying to explain what it is that they do -the so called benefits of massage.  Clients don’t care about the benefits of massage which are usually nicely listed on their websites – reduces inflammation, increases circulation. (Tracy Walton also once said that the benefits of massage are not really scientifically proven to be valid!  You also can’t say that things are proven because one or two or even 20 studies doesn’t make it so!)

The whole time during the conference I kept thinking of a really good book I am reading for the second time “Made to Stick” by Dan Heath.  He talks about something he calls the Made to Stick: Why Some Ideas Survive and Others Die
- you forget that you used to know nothing about something and all the knowledge that you have gained makes you sound so smart but it doesn’t help you connect with others and ‘make your idea stick’.  Once you know something it is hard to imagine what it was like before you didn’t know.  Sharing knowledge is difficult and nearly impossible when you are not able to put yourself in the listeners shoes!  Of course you can’t unlearn what you now know but I can’t help but think that you could reach more massage therapists and the general public when you keep that concept in mind.

I know there is also a lot of talk and efforts going into teaching research methods to massage therapists and how is that going to happen.  There are more and more classes being taught on that and massage schools are trying to figure out how to put it into their curriculum.  But I still say So What?  Will taking 50 hours of research methods help people get and keep clients?  They won’t be able to take the classes in a CE format unless they are making enough money to do so.  Yes I am making this all about money but it seems to be the challenge of many massage therapists – just trying to get by and make a living.

So my challenge to the many massage researchers, people talking about research is to start at the beginning and start telling and showing people why research is important.  How will having research help the average intuitive, empathetic, caring massage therapist be more successful?  Or I guess maybe it isn’t the researchers job to make their work more applicable but maybe more of the profession – the  Massage Therapy Foundation and other massage research groups and other people who are not researchers but just love research. ( I met a bunch at the conference!)

Ok and the other thing is where are all the researchers blogs or websites?  I couldn’t find any anywhere which is another interesting thing.  That seems to me like they are just doing the research for themselves and not even wanting to connect with the people who they are doing the research for.  So if there are websites out there let me know.  I do know of a few sites being done my people who are massage therapists and are interested in research- www.mt-researchonline.com and a Bodhi Haraldssons Blog on Evidence Based Practice and this massage research blog who I can’t quite figure out who is the author.

The best site to find research related to massage is at the Massage Therapy Foundation’s website but it doesn’t help break it all down into usable information.

My favorite study in massage is the Meta Analysis of Massage Research by C.A. Moyer (who I got to meet and didn’t even really get that it was his research until now when I started writing this post!) It came out in 2004 but at the time there were a lot of people talking about it and there was also a good article about it in Massage and Bodywork Magazine that helped me understand what it really meant for the profession.  You can read the whole study on www.anatomyfacts.com

So maybe this isn’t so much to the massage reseearchers because they are busy doing massage research – but to the massage profession:  Can you please make massage research more understandable?

Can you start with why is research important to the massage profession?  I am sort of getting an idea why but am still very mixed about the whole thing. I’ll probably write another post on that later today or this week.  But now off to the spa and the far infrared saunas which there is some research on that looks promising (or so they say – I couldn’t find anything with a 2 minute search! ha!)  But I still love it and will go!

MTCIM May 2010 Seattle

This is an overview of the conference and the various speakers.
HELENE M. LANGEVIN Research Associate Professor Department of Neurology Univ. of Vermont.  – Studies Connective Tissue and Acupuncture talked on Connective Tissue Physiology and Its Relevance to Manual Therapies.  From Twitter feeds other studies he talked about.
Effectiveness of therapeutic massage for generalized anxiety disorder: a randomized controlled trial.
Dan Cherkin, Senior Scientific Investigator with the Group Health Research Institute in Seattle. Is Massage Effective for Back and Neck Pain? — Applying the Research to Your Practice.  This is a link to the paper he was talking about.

From tweets links to pubmed:

Effectiveness of therapeutic massage for generalized anxiety disorder: a randomized controlled trial.

Unanticipated benefits of CAM therapies for back pain: an exploration of patient experiences

Randomized trial of therapeutic massage for chronic neck pain.

Panel Discussion: William Meeker, DC, MPH – Moderator The Role of Massage Therapy in Public Health: A Panel Discussion Panelists include: Cynthia Price,; Marissa Brooks,  Deborah Senn and John Weeks

Great overview of WA States Every Category law by Debra Senn our former insurance commissioner and now lawyer with  and how she created it.  Lori Belinski, a well know local massage therapist and political advocate helped create the law and fought off 11 law suits and later 5 attempts to appeal it.  It is always being challenged.  In WA State we are able to become contracted providers for Major Medical Health insurance companies such as Regence Blue Shield, Aetna and all health ins. companies.  Other states could really learn from us.

One of the questions for the panel was “Is Massage a Health Care Profession”.  Debra Senn answered Yes! We are here in WA State because of her work, but I think the rest of the US lags far behind us and Canada is farther ahead.

MTCIM – Day 2

Talk about brain drain… but the wine and cheese party helped debrief!

Personally I didn’t understand any of the talks in the am.  So if any one else did please share.

I went to the breakout session on massage and anxiety/depression and had some great experiences.  My favorite was between Dawn Donovan and Chris Moyer.  Dawn presented her research on Use of Massage Therapy to Reduce Anxiety and to Improve Sleep in Clients Participating in an Inpatient Withdrawal Management (Detox) Program: A Randomized Controlled Pilot Study

What I loved most was that it was real.  She started with saying how many billions of dollars are spent in the US and Canada on drug and alcohol rehab and issues each year.  Her study did show that massage was successful in reducing anxiety in people who were getting off of their substance.   I loved that she intuitively decided on the massage protocol which was totally different from her usual form of bodywork.  Taking into consideration the clients needs , combining intuition and science is what we need more.   I also think it was just the idea that it was on a topic that could actually be useful to massage therapists in getting and keeping clients or creating a job in massage.
Chris Moyer isn’t a massage therapist but is a researcher who loves massage.   He is another great example of being able to take massage and measure what it is doing.  He did a literature study on whether or not massage helps reduce cortisol.  Interestingly he found that it does not reduce cortisol which is very contradictory to most of the research already done in this area mainly by Tiffany Field at the Touch Research Institute.
Making research understandable is the main reason I am attending this conference.  I am also learning about why research is so important and what it can do for the massage profession.  I think one of the big challenges is taking research and turning it into something that massage therapists can use to apply to their practice which is really just about getting and keeping clients.

I was later told by Ruth Werner that I was also witness to a rare phenomenon in research with one presenter, Ross Turchinov being intensely challenged.  (I personally didn’t understand what he was trying to say or show.  The studies he did refer to were all done in the 50′s-70′s and the challenger didn’t think that there was any prior proof of what he was talking about.  His talk was “Impact of Massage Therapy on Electrophysiology of the Soft Tissue and Cellular Function”.   I might try to talk to him tomorrow to see if he could explain it more.

There are so many well known people there from all aspects of massage- Les Sweeney (ABMP), Sydney Duncan (Massage Today), someone from COMTA but I can’t remember her name right now, AMTA presidents/officers,  but hmm…. no sign of anyone from Massage Magazine.

It was such a great networking day too meeting many people who I have connected with on Facebook and www.massageprofessionals.com .   I can’t wait to show you a new project on massage research that will help you make sense of research that hopefully will be done in the fall!

MTCIM – day 1

Wow what a jam packed day at the Massage Therapy Foundations Highlighting Massage Therapy in Complementary and Integrative Medicine (CIM) Research conference.

There is too much to assimilate right now but the one thing I can say and already knew this – WA State is far ahead of all the other states in being accepted as a health care profession and perhaps others could be learning from what is going on here in WA.   Debra Senn was the insurance commissioner in the early 90′s who was instrumental in getting massage and other CAM providers to be a providers for health insurance companies.  She spoke at the conference today and I wish I had got a chance to meet her afterwards.   The current problem that  CAM providers (MT, Acupuncturists and others) in WA are now having is not being paid fair fees for services.  Her advice was to just hang on and bear with the system as they work things out.   It is taking time for insurance companies to really get the idea that massage can actually help save them money.  They still don’t see massage as being a replacement for things like surgery.   That is one of the main reasons I think that we need to have more research to show these companies just what it is that massage can do.   But then again WA State has accepted it without much research in place so I guess go figure…

I sat through some really interesting break out sessions of presentations of case studies and discussions that I am still trying to figure out what it all really means.   I think what case studies are used for is to help decide what research is needed next.

There were big posters in the lobby that I haven’t figured out what they are about – if they are case studies or actual research studies so hope to get to them tomorrow!

The other striking thing to me is that I think I heard the attendance count was about 350 people which is great and about 1/3 of them were from WA State.   Out of 15,000 MT state wide, that number is disappointing.  I am not sure if it because MT don’t care because we are already providers and accepted as health care professionals or what – but I do know that getting MT to rally is like herding cats.  It seems to be the same people in the leadership roles around the country.  I know most are just focused on getting and keeping clients and making a living but you could be in CA where  I here your careers are being really challenged with this Assembly Bill 1822 -For more info see Massage Today.

MT Foundation Conference begins

For the next three days I am going to be at the Highlighting Massage Therapy in Complementary and Integrative Medicine (CIM) Research” conference in Seattle!

It unofficially started tonight with about 50-75 people meeting to watch  the “DVD viewing party featuring highlights from the 2009 Fascia Congress that took place this past October in Amsterdam (www.fasciacongress.org).  It was sponsored by Tom Myers (Anatomy Trains). I unfortunately got there an hour late as I was working all day and then only stayed for less than an hour.  I was going to say I was late because I was reading the 25 page paper Bodhi Haraldsson posted on his Facebook page in response to my question about what was the MT Foundations Best Practices Symposium.  He was meeting for the last two days with that committee.  I haven’t gotten a chance to read it.  When I do I’ll try to tell you what it is in a paragraph or two!  That is one of my issues/concerns with all this focus on research – They talk like researchers – not massage therapists but maybe it’s just me.  I haven been in massage school in over 21 years and don’t really keep up on the science of it all.  I am more of the feeling type and it seems to work well for me and my clients.

It was already over my head.  I haven’t heard the words collalogen, epimysium, proprioception or fascicle in about 21 years.  From what I was able to gather is that there is some new science regarding muscle contraction but not sure what it really is all about or how or why I even really need to know about it.  I encourage anyone else there to share their comments and perspective on the evenings talk – or are we not supposed to be sharing!

I’ll talk to Ruth tomorrow for sure.

I ran into an old friend from massage school so hopefully we can sit together and talk about what we don’t remember from massage school! (or maybe she has and can fill me in!)

I was able to leave some brochures from Heal-wa.org there for the local WA State Massage Therapists.  We have this great resource here in WA where we can access some of the research databases and other resources online as a part of our licensing fees.  I’ll be writing much more about that too on my other site www.wa-massage-therapy.com/ce as I learn more how to use it and what it can be used for.  I did meet with Valarie Lawrence last week who is the manager of it all.  It is such an amazing resource!