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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!

I have been doing a lot of reading and learning about massage therapy research. I actually am having a difficult time deciphering it all and even being interested in it. I think one of the problems is that it is just too hard to read and you have to do a lot of research to understand the research! I also have never been asked to prove if massage would work at all in my 21 years as a massage therapist.

I would like to see more doctors really get what massage does. I have had so many doctors refer people to surgery before massage and am always amazed that people even go and get surgery before trying anything else – and that is in WA State that is pretty open to alternative therapies. I just recently had a guy with carpal tunnel in both arms that the doctor recommended surgery. This guy did his research and couldn’t find any concrete research on the effectiveness of surgery so he looked for other options. Of course a few months later with massage and he’s fine. Another client had a herniated disc in his neck or so they thought. They went in and did surgery but when they got in there couldn’t find the disc with the problem but they fused his neck anyways! Of course he was still in pain and then he came for massage and of course the pain is gone!

Some of the things I don’t understand about research though are things like:

• How do they control the method of application?  10 people could learn the same technique from the same teacher at the same time and it will come out in 12 different ways.
• Just having one or two studies does not really prove anything.  How many do we need to say without a doubt that massage works for whatever they are studying?

Then as I said there is reading the research.  It can also be interpreted in different ways by different people.  I really don’t feel like I have the time to look into research since there isn’t any driving motivation to do that really.

I would love to see the Massage Therapy Foundation and other massage research groups do that for us!  Is it being lazy?  Yup probably.

I don’t use research though  – OK  I did refer people to a few studies on my clinic website but that is more for ‘looks’ than really believing in it all – that is just my personal opinion.

I also have been reading all I can and trying to learn about it but it just doesn’t seem to be going anywhere.  I am actually going to the Research Conference here in Seattle in May but it is mainly because it is only a block away from my office!  I didn’t really know what the whole title of the conference meant until Ruth Werner explained it to me.

Here is what the website says:

The Massage Therapy Foundation is pleased to present the second “Highlighting Massage Therapy in Complementary and Integrative Medicine (CIM) Research” conference. This three-day conference brings together massage and manual therapy practitioners, educators, CIM researchers, allied health professionals, and others interested in massage research. Current research related to massage and manual therapies will be presented, with a special focus on translational research and public health.

What the heck is translational research??

Here is Ruth’s answer from my Facebook Page:

Translational research: creating and strengthening the feedback loop between researchers and practitioners– so that practitioners can apply findings in real-world settings, and so that researchers can ask questions that really matter. In other branches of health care this is called “bench to bedside” communication: Bench refers to the laboratory, bedside to the caregiver and patient.

I would write:
A special focus on strengthening the bond between researchers and MT so that we can make more sense of research and researchers can make more sense of us!

I’ll be of course writing about what I learn at the conference…So see you there?!

One of the big issues in the massage profession has to do with the number of hours of education that one needs to become a professional, licensed massage therapist. While many states have adopted 500 hours of training as the basic amount of hours of massage school, there doesn’t seem to be any proof of what is really needed.

There seems to be two schools and probably many in between but the two basic versions are:

• 100 hours of basic massage training focusing on giving massage
• 500+ hours of extensive training in anatomy, physiology, orthopedic massage or some advanced systems of massage

When I went to massage school back in 1987, the basic requirements in WA State were 250 hours of massage school which did include anatomy, physiology, pathology and treatment massage for working with various basic conditions such as sprains/strains, headaches and common conditions. I was in the last group that was let in under those requirements of 250 hours. The number of hours of training that was required was going up to 500 hour of massage school where it stands now. I was very glad to be in the last class at 250 hours because I didn’t want to spend the extra time and money. The reasons for the increase in the number of hours of training was just an arbitrary thing that the state board seemed to come up with at the time. The massage schools were actually requesting it for no other reason than that they could make more money by getting students to stay longer. Keith Grant in his white paper on “Issues in Massage Governance” which he wrote in 2002 described this situation exactly. I have spoken about it here and really recommend that anyone who is interested in the future of the massage profession read it. It is quite lengthy and I have summarized this before on the blog.

Basically what he says is the same thing – that 100 hours of massage school is enough training to do massage and become a massage therapist.

People who think differently seem to have such an extreme reaction to this statement but don’t seem to have any proof or references to back themselves up other than statements like:

• People can’t do medical massage with only 100 hours of training
• People can’t give a good massage with only 100 hours of training
• People need much more anatomy and physiology than could be fit into a 100 hour training class

There is a whole other controversy over the issue of medical massage. Does medical massage require extra training or is it just the ability to be able to bill an insurance company for massage services which only requires knowing what paperwork is needed and how to show improvement in a massage session. Anyone who can do basic massage and can create a change in a muscle can show improvement in a condition.

I guess I must have my own personal definition of medical massage because I have been doing it since 1989 when I started my practice with 250 hours of massage school. From the very beginning I was able to bill insurance companies and be paid and was also very successful in working with clients. That doesn’t mean I didn’t get more training through the 20 years of being a massage therapist.

I am not saying that having more training is not good and that all of those years and thousands of dollars that are spent are not worthwhile. I am not saying that more education can improve your chances of being successful.

What I am saying that anyone can be taught to do a basic massage in 100 hours of training. How successful they will be depends on them, just as it does with someone with 1000 hours of training. There are so many massage therapists that do have training and still are not successful. ABMP reports that about 50,000 massage therapists leave the field each year and though they don’t say why, I would guess that most are due to being unable to make a living whether that involves getting injured or sick or what.

The thing is that we really don’t know what is required as far as education in creating a massage therapist who can be effective and successful. As a profession we have not created any studies that show that 100 hours or that 1000 hours is the best.

I don’t really know what the answer is to the issue but am really open to hearing about solutions such as studies that could help create more successful massage therapists. Keith Grant’s solution is apprenticeship programs which seem to be put on the wayside to make room for the big massage school conglomerates such as Cortiva, Corinthian Colleges and the like. And with the increase in massage franchises that only pay massage therapists $15 an hour, I just have to wonder what exactly is going on.

I have been trying to understand what this new call for evidence based massage is all about. There is a research Yahoo Group called the journalclubonline where I am learning about this.

The massage profession is just starting to understand the significance of research – doing research and understanding research. Most massage therapists lack the basic underlying knowledge and are unable to understand research and why it is important to the profession. Because of their focus on touch and the kinesthetic world, research that focuses on the techniques and science seem skewed and unimportant. With the world so focused on knowing more about something before trying it, how can we educate clients as to what massage can really do for them and build their trust in the massage profession?

Funded by big companies and flawed by researchers bias and filled with too many terms we can’t even begin to comprehend, how do we combine our love for the art of massage, the therapeutic relationship and the science of research into an understandable body of knowledge?

Confronted with clients who have herniated discs, muscle spasms, tendon tears and very stressful lives, we need to share what we know about massage and find out what they think is needed to heal their condition and create a plan that supports the client in their healing process.

Evidence Based Medicine uses the results of research to use as a guideline when forming a treatment plan in the medical setting. As more massage research is done we can start to apply it in our everyday practices and also educate the public as to what massage can do. While there are many aspects of massage that are immeasurable such as the relationship of the mind-body connection and healing, we can begin to teach people about the uses and benefits of massage from this totally physical, scientific manner as people usually like to base their first opinions on proof. It can also be of use in building a practice. By providing supporting evidence you may be able to work more with hospitals, corporations and other businesses who need more proof to be spending their money on massage.

From what I understand so far – evidence based massage is being able to provide research that will back up our claims that massage is effective for various conditions. Sean Slovik has created this website -www.massage-therapy-research.com to try to help explain it all.

I have also just read another article in the Massage Therapy Journal called Care With Confidence By Rebecca Birr, MSLIS, AHIP / Kathy Zeblisky, MLS, AHIP that also is helpful in explaining research and why we need it.

So much of what we learn in massage school is not really evidence based. We think it works because it has worked for us and we see it work for others. Our claims that massage and other modalities work seem to be mainly from our personal experiences which is often just that -personal.

From what I have been able to discern from all of this is that we need research if we want to have some credibility in the medial profession. Clients may also even be skeptical of massage and its usefulness for various conditions. People usually need proof that something works. They are skeptical to try things that may me unknown to them without evidence. One of the best methods of building a massage practice depends on getting current clients to refer their friends and family members. That is enough evidence for some people.

The problem is that most massage therapists are not versed in being able to interpret or understand research papers. Ted Nissen author of (anatomyfacts.com ) also working to make massage research more understandable and he says research should have some kind of rating system that can tell us more about the research – is is valid and how did they come to their conclusions.

The things I struggle with are how do we know how research is done. How do we actually measure what really happens in a session? I had a client who had a headache for a year and it went away the day she quit her job. I had a woman who was trying to get pregnant for a few years with no luck and then after 6 weeks of massage for back pain she is pregnant.
What does massage really do? Is it the technique we do? The relationship we develop with the client? The client finally being able to feel themselves more? What is it that happens in a massage session?