resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Sleep, Less Sleep or No Sleep?
I had a dream I wasn't getting enough sleep. It was a very realistic dream, even though I was probably slightly awake and not really deep dreaming. Most likely I had been dozing, caught in that twilight of sleep and wakefulness.
Optimism = Compassion = Trust
A randomized clinical trial recently published online in JAMA Oncology examined how patients viewed their doctor based upon how the practitioner presented bad news to the patient.
The Dietary Supplement Research Dilemma
I do not care what the truth is, one way or another; I just want to know it. And when it comes to dietary supplements, the truth can be hard to find for a number of reasons.
TCM Congress in Rothenburg is Largest in Western World
In the medieval town of Rothenburg, deep set within the Bavarian countryside in Southern Germany, the TCM Kongress Rothenburg each year draws around 1.200 participants from more than 40 different countries to attend the biggest TCM conference in the Western world.
Functional Hip Impingement (Part 1)
Every time I sit down to write an article, I realize how much more there is to know about musculoskeletal pain. I also learn something new every time. (I want to give special thanks to Lucy Whyte Ferguson for assisting with this article.)
An Excerpt from TCM Case Studies: Pediatrics
This excerpt is reprinted with permission from Jamie Wu. TCM Case Studies: Pediatrics was released in 2014 by People's Medical Publishing House.
A Well-Kept Secret: 5 Element Acupuncture, Part II
Supervising acupuncture interns at a TCM college, it has always struck me how funny it is to hear the clinic manager tell the patients that the Five Element clinic specializes in treating emotions, as if patients with physical pain have no emotions!
The Way We Are Designed: A Conversation with Gil Hedley, PhD
I was first introduced to the work of Gil Hedley by Tom DiFerdinando. He gifted me Gil's DVD series.
Converting More Patients to Your Practice
In 2013 and 2014, the theme was "the money is in the list." This meant that if you had a big email list, you were really making some "cha-ching." Unfortunately, having thousands of emails doesn't equate to thousands of dollars in profit.
Recreational Cannabis Use and TCM
Many people are drawn to cannabis for its effects physically, mentally and emotionally. Medically, cannabis has some legitimate uses, however the scope of this article is limited to the recreational use of cannabis.
A House Divided?
The American Chiropractic Association's House of Delegates voted on 30 resolutions at its annual business meeting in Washington D.C., but two in particular took immediate center stage due to their controversial nature.
Treating Beyond Pain
More often than not, when a patient presents to the office, it is for a pain complaint. Headache, neck pain, low back pain, sciatica, carpal tunnel... The pain is often the focus of the patient's mindset, and they don't often have any thought of what comes after the pain.
There Really is No Room for Sexism
Recently, Matteo* (a transgender male) approached me during a break in an advanced shiatsu class in Berlin where he was one of two men in a group of 20 women. "Pamela. Don't forget to remind the translator to include male endings."
Applying the Thin Skull Principle
The "thin skull" principle, also known as the "you take your victim as you find them" principle, is a legal principle that can be summed up by the following statement.
A View From the ER
The University of Western States has inked an innovative agreement with local nonprofit health system Legacy Health whereby UWS sports-medicine fellows can experience observational clinical rotations in emergency-room settings within the Legacy system.
Talking to Patients About Lumbar Facet Denervation (Medial Branch Neurotomy)
Lumbar facet denervation, more appropriately termed medial branch neurotomy (MBN), is a procedure that may be considered when patients suffer from recalcitrant non-radicular axial back and/or leg pain.
Turning a Blind Eye to History – and Reality
The American Medical Association is taking the Supreme Court's Feb. 25, 2015 decision exactly as it always does – by turning a blind eye to history, legal precedent and reality.
Will You Be an Amplifer or a Mute?
These times are changing, and changing quickly. There have been many challenges to this profession throughout the past few years. The challenge is to talk, then talk and talk some more about this medicine.
Synergy Doesn't Happen in Silos: Acupuncture in Hospitals and Other Healthcare Settings
As acupuncture and traditional East Asian medicine continue to intersect and integrate with biomedical approaches, the conversation about integration expands and becomes richer.
Term Limits: What's in a Word?
It was the French historian and philosopher Voltaire who once declared the Holy Roman Empire was neither holy nor Roman nor an empire.
The Need for a New Medical Model: A Challenge for Biopsychosocial and Ecopsychologica Medicine
Chinese medicine speaks of alignment between humans, heaven and earth. It is a complex view with a focus upon relationship. These are comprehensive ideas with no specific terms in contemporary medical practice.
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.
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