resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Low Back Pain in Running Athletes
After 7 million years of adapting to upright postures, the lumbar spine and pelvis have become remarkably adept at managing ground-reactive forces associated with running.
Shoulder Rehab: Start With the Scapula
The scapula is an incredible display of elegance and movement within the biomechanics of human motion. It's evolved for mobility and stability in the scapulo-thoracic region, giving us the ability to do things that are uniquely human, such as throwing with accuracy.
We Get Letters & Email
Our Country Needs Us Between Elections, Too; Continuing Care: We Aren't There Yet; Our Associations Need to Do More.
The Case Report: A Valuable Tool
Case reports are a valuable form of descriptive research. The most basic form of practice-based research, a case report is a detailed account of the history, presenting symptoms, assessment, observations, treatment and follow-up of an individual patient, discussed in the context of prior and potential future research.
Qigong for Substance Abuse
It is commonly believed that substance abuse, in addition to harming one’s physiological state, hurts the spirit. There is also a belief that one’s spirit does not weaken due to substance abuse, but rather, the person finds solace in addiction due to an already weak spirit.
Five Branches University Has First Hospital TCM Residency
Established in 1984, Five Branches University (FBU) has campuses in Santa Cruz and San Jose, Calif., which serve the communities of Santa Cruz, the Monterey Bay, and Silicon Valley.
Scar Reduction With Acupuncture & Microneedling (Part 2)
Protocols & treatment Timing
An Opportunity & a Responsibility
Nearly 80 Americans die from an opioid-related overdose every day, and spine-related pain is one of the principle drivers of opioid use. This unfortunate situation creates both an opportunity and a responsibility.
Let's Clear Up the Collection Confusion
This is an often-misunderstood practice swirling with misinformation. First, a few basics: Insurance is a contract between the patient and the insurance company. The insurance company is simply making a payment for services or care on behalf of the patient.
Nutrition for Menopause: Front-Line Therapy for All Phases
Of all the changes women experience during their reproductive life, there is no doubt the most dreaded are the three phases of menopause. This is not surprising since all of the symptoms associated with menopause are replete with unpleasantness.
A Conversation With Dr. Betty Edmond
This month's column is an exclusive interview with Betty Edmond MD, newly elected CEO/President of the AOMA Graduate School of Integrative Medicine in Austin, Texas.
True Practice Mobility for the Chiropractic Profession
When natural disasters occur, chiropractors can literally travel to the other side of the world to offer humanitarian relief in less than a day. The chiropractor's license to legally practice, however, can't make it past the state line.
Flirting With Alternative Therapies
There are about as many adjunct therapies being marketed to acupuncturists as there are acupuncturists. While some may remain purist in their application of traditional Chinese medicine, others choose to explore new horizons of treatment.
A New Year and Vision for the ACA
Inadequate pain management coupled with the epidemic of prescription opioid overuse and abuse has taken a severe toll on the lives of millions of people in the United States. Every day, more than 1,000 people are treated in the ER for misusing prescription opioids.
Another Step Forward for Chiropractic
Chiropractic is now available to 86,000-plus Latter-Day Saints missionaries and you are invited to become a provider. LDS membership in not required; our only concern is that our missionaries get the best quality care available.
News in Brief
Updated Neck Pain & Whiplash Guideline; Attention, IHS DCs; New VP of Institutional Advancement At Palmer; N.J. DC Interns At U.S. Olympic Training Center; Chiropractic Society Of R.I. On The Front Lines.
An Education in Gluten Sensitivity
A relatively new syndrome officially documented as non-celiac gluten sensitivity (NCGS) or gluten sensitivity (GS) was officially recognized and published in the new list of gluten-related disorders in 2012.
Anti-Aging With Dr. Ping Zhang
Jennifer Waters, TCM practitioner and writer of the Acupuncture Today column, "Talking With the Masters" sat down with Dr. Ping Zhang to discuss aniti-aging with acupuncture.
Prepare for the End, From the Beginning: Wealth Building and Retirement with the Tao
Yin and yang flow into and out from one another continually. Beginnings become endings and endings become beginnings again. Wholeness and cycles are the nature of Tao.
The winter season is upon us and offers unique challenges for the clinician and patient alike. To effectively navigate through the winter season there are two main TCM medicinals, Huang Qi and Gan Jiang, to consider, as well as two important formulas which feature these two TCM treasures.
Acupuncture Points: Broadening Our Scope and Diagnostic Work
As every practitioner knows, the correct diagnosis is everything. Most healing disciplines rely on the use of symptomatology for their treatment implementation. Beyond symptomatology, we have clinical tests to provide more objective findings.
Crow Like the Rooster
As we welcome in the Year of the Rooster, we look at some of its major characteristics: confidence and communication, which suits the image we have of the Rooster...strutting in the farmyard, crowing to the others that it's time to wake up.
July, 2014, Vol. 14, Issue 07
Forced Work Reduction for Massage Therapists
By Massage Therapy Foundation Contributor
Contributed by Derek R. Austin, MS, CMT, BCTMB, CSCS, MK Brennan, MS, RN, LMBT, and April Neufeld, BS, LMP
This month's Massage Therapy Foundation research column looks at the factors that lead to the reduction of work hours for massage therapists and bodyworkers due to injury, referred to as injury-forced work reduction (IFWR).Massage therapy and bodywork are considered to be very physically demanding professions. The authors cite that 80% of people who begin careers as massage therapists and bodywork practitioners drop out after two years. Previous research has shown a high risk for musculoskeletal disorders among massage therapists, including carpal tunnel syndrome and low back pain. There has been little research to date, however, on what demographics, work attitudes or perceptions make a massage practitioner more likely to become injured. This new research from the team at Temple University hopes to illuminate some of these issues.
The article, "Correlates of Injury-forced Work Reduction for Massage Therapists and Bodywork Practitioners," was published in the International Journal of Therapeutic Massage and Bodywork (IJTMB) in 2013. (Free full text is available from IJTMB.) The authors define injury-forced work reduction as a "work-related injury adversely affecting the hours worked or number of clients treated." The authors tested two hypotheses. Their first hypothesis (H1) was that accumulated costs – the amount of time, personal effort, education, money and training that a practitioner has invested in their occupation – would be associated with injury-forced work reduction. The authors further hypothesized (H2) that physical exhaustion – including body fatigue, low energy, tiredness and work exhaustion, mental frustration, feeling overwhelmed and being emotionally strained – would both be associated with injury-forced work reduction.
An online survey was conducted in the fall of 2006 by the Federation of State Massage Therapy Board (FSMTB) about Career Patterns (CP) along with their Job Task Analysis (JTA). The JTA required approximately 45 minutes to complete followed by 15 minutes for the CP survey. There were 2,089 massage therapists and bodyworkers who completed the CP survey, making up approximately 3% of the 75,000 practitioners contacted across the United States. The survey was made up of questions organized into five groups: 1) Control/demographic variable set; 2) Work attitude/perception variables set; 3) Accumulated cost variables set; 4) Exhaustion variables set; and 5) Injury-forced Work Reduction (IFWR). IFWR was measured by two questions: "I can no longer work the hours I previously worked due to occupational injury," and "I can no longer treat as many clients per day due to work injury (e.g., carpal tunnel syndrome, lower back pain)." Most items were measured using a Likert scale, where 1 = strongly disagree, 2 = disagree, 3 = slightly disagree, 4 = slightly agree, 5 = agree, and 6 = strongly agree.
Overall, the researchers found "high levels of job satisfaction (5.47/6) and affective occupation commitment (5.44/6); low levels of accumulated costs (2.76/6), continuing education costs (2.77/6), and physical exhaustion (2.46/6); and very low levels of work exhaustion (1.75/6) and IFWR (1.84/6)." Affective occupation commitment was measured with questions such as, "I strongly identify with the massage/bodywork/somatic therapy occupation." Continuing education costs were measured with questions such as, "It costs too much for me to take required continuing education." In general, massage therapists and bodyworkers, or at least those who responded to the survey, are satisfied with their jobs and identify with their occupations. They also have generally low levels of costs invested, costs associated with continuing education, mental and physical exhaustion and injury.
The authors used a stepwise regression model to evaluate their hypotheses. In other words, they added each variable set to the model one at a time in order to control for demographic and other variables. Among the control/demographics variables set, being female and having more years in practice were significantly associated with IFWR. None of the individual work attitude/perception variables were significant. Having more continuing education costs but not accumulated costs was significantly associated with IFWR, partially supporting the authors' first hypothesis (H1). Physical exhaustion and work exhaustion were both significantly associated with IFWR, supporting the authors' second hypothesis. Overall, 34% of the variance in IFWR was explained by all of the variables that were studied, and physical exhaustion was the single greatest contributor to IFWR.
The authors note that their finding of physical exhaustion relating to IFWR had the strongest support and was consistent with other research on the physically demanding nature of massage therapy and its occupational risks. Work exhaustion had a significant independent positive association with IFWR. Thus, both physical wear and tear and the mental fatigue of work exhaustion appear to increase injury risk for massage therapists and bodyworkers. The authors speculate that such mental fatigue may be related to particular work factors, including isolated work settings, physical concerns and possibly public misconceptions about the nature of massage therapy or bodywork. The authors conclude that taking breaks between patient appointments and varying the techniques used could improve a massage therapist's physical and mental energy and thereby limit these risk factors.
The authors compared this research to their previous research on massage therapists and bodyworkers. They write, "None of the four work attitude and perception variables that each significantly impacted being forced to stay in occupation (i.e., job satisfaction, affective occupation commitment, occupation identification or limited occupation alternatives) had a significant impact on IFWR in this study." IFWR appears to be a separate variable that is highly influenced by certain types of accumulated costs (specifically, the perception of high continuing education costs), physical and work exhaustion, being female and working for more years.
There are several important limitations to this research study. Chief among them is that correlation cannot be separated from causation because this research is a cross-sectional study. In other words, it is possible that higher IFWR causes higher physical exhaustion, and not the other way around. The authors also did not identify specific injuries among the massage therapists and bodywork practitioners surveyed. Finally, the respondents were self-selected, and participants could possibly have different characteristics than the overall population of massage therapists. For example, a massage therapist who has reduced his or her work hours due to carpal tunnel syndrome may not volunteer to complete a one-hour online survey.
For massage therapists and bodyworkers, it is worth further investigation as to the short career span for practitioners and what preventative measures can be taken. Addressing IFWR and any of the contributors to it would be beneficial, especially as the authors also cite an expected growth in massage therapy and bodywork by 20% between 2010 and 2020.
Not sure what to make of a regression analysis, correlation, confidence interval, p-value or t-test? The MTF offers an easy-to-use online course, where you will learn basic research vocabulary and concepts, how to use various databases to look up research, evaluate published research articles for their validity and apply research findings to massage practice to improve outcomes. Basics of Research Literacy is an online, 8-hour, NCBTMB-approved workshop that teaches massage therapists and educators how to incorporate the principles of research literacy into your practice and teaching.
To learn more about the effects of massage therapy, you can review the Massage Therapy Foundation article archives, read accepted MTF Research Grant abstracts, or search PubMed for massage therapy studies.
Click here for more information about Massage Therapy Foundation Contributor.
Join the conversation
Comments are encouraged, but you must follow our User Agreementcomments powered by Disqus
Keep it civil and stay on topic. No profanity, vulgar, racist or hateful comments or personal attacks. Anyone who chooses to exercise poor judgement will be blocked. By posting your comment, you agree to allow MPA Media the right to republish your name and comment in additional MPA Media publications without any notification or payment.