resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Work Stress and Musculoskeletal Health: Do Your Patients Get the Connection?
Most people underestimate the impact their job has on their health, especially if that job isn't particularly physically demanding. Big mistake.
International Congress on Integrative Medicine
"Bridging Research, Clinical Care, Education and Policy" was the theme for the International Congress on Integrative Medicine and Health 2016 (ICIMH).
Don't Ignore the Lower Half of the Pelvis (Part 1)
When your patient complains of lower back or pelvic pain, but your usual treatments are not getting the job done, what do you examine and treat? You may be missing important structures in the lower half of the pelvis.
Illuminating the Hidden, Freeing the Source
Amongst the Primary Channels, from a classical point of view, the small intestine is perhaps the most important channel to understand. It is one of the least used acupuncture channels in modern acupuncture, yet it within it can be found a wealth of theories from the Ling Shu.
What are the Meridians?
The meridian and collateral system (jing luo, hereinafter referred to as "Meridians") is comprised of the main meridian channels (jing mai) and the collateral vessels (luo mai). Jing takes from meaning of the Chinese word pathway (also jing) and are the main branches of the system.
Know Your Research: Tips for Evaluating Literature Reviews
Clinical and experimental studies are not the only types of published research we might encounter as we look for evidence to inform our practices. One of the most useful types is the literature review, which summarizes a group of studies.
Adventures with the Pericardium
My previous column on the San Jiao deserves equal time for SJ's loving partner, the pericardium. I nicknamed SJ the travel meridian – but pericardium can also play a crucial role in air travel.
Overuse Injuries in Young Athletes (Part 1)
More than 45 million children ages 6-18 participate in some form of organized athletics, and 75 percent of American families with school-aged children have at least one child participating in organized sports.
Let's Talk About Biceps Injuries at the Elbow
While most muscles cross over only one joint, the biceps crosses two joints: the elbow and the shoulder. Injuries to the lower biceps cause considerable elbow pain. Here's how to assess and treat an injury to this area conservatively.
The Professional and Practice Benefits of Political Activism
Welcome to election season, a vital part of our American culture. Every two years, without fail, we are bombarded with TV, print materials and phone messages seeking our vote.
Guidelines for the Use of Modifier -52
Modifier -52 identifies that a service or procedure has been partially reduced or eliminated at the physician's discretion. This is to indicate the basic service described by the procedure code has been performed, but not all aspects of the service have been performed.
The National Institutes of Health (NIH) lists more than 80 common autoimmune diseases including asthma, Crohn's disease, Guillain-Barré syndrome, multiple sclerosis, myasthenia gravis, psoriasis, rheumatoid arthritis, and lupus.
Time to Fight for Your Medicare Right
I have heard a lot of noise and a lot of debate about what is going on with Medicare. As an ACA delegate, I often get asked: 'What is the ACA even doing?'
Less Time Than Required
Q: When is it appropriate to use a modifier -52? Can I use it for a timed service when I do less than the time required by the code?
What's New in the NCCIH Strategic Plan
The NIH National Center for Complementary and Integrative Health (NCCIH) released its draft strategic plan 2016-2021 for public comment in early spring of 2016.
Lessons from Functional Neurology
Chiropractic neurology, also known as clinical neuroscience or functional neurology, is moving the chiropractic profession forward by leaps and bounds.
MPA Media Wins More Publishing Awards
The American Society of Business Publication Editors (ASBPE) has honored Dynamic Chiropractic with a national award and two regional awards for editorial excellence, and sister publication DC Practice Insights with two regional awards for graphic design excellence.
Are Probiotics Doing More Harm Than Good?
Considerable controversy exists concerning the efficacy of probiotic supplements. Very few human studies show any real positive impact on the microbiome or health. The "promise" of probiotics is based on the few animal studies that suggest a positive effect.
Chiropractic in the Eyes of the Public: 2nd Gallup-Palmer Poll
The second Gallup / Palmer College poll has been completed, yielding significant additional data regarding Americans' experiences with and perceptions of chiropractic care.
Traditional Chinese Herbal Medicine in Taiwan Hospitals
This spring, a team of Western medical doctors and TCM practitioners from Cleveland Clinic traveled to Taiwan to visit Kaiser Pharmaceutical Co. (KP), and China Medical University (CMU), Taiwan's leading integrative medicine hospital.
A Study of Relationships
Sa-Ahm's five element acupuncture method is known to be one of the most effective acupuncture techniques in Korea because it gives an instant response at the time of treatment and has a high success rate in resolving chronic problems.
March, 2016, Vol. 16, Issue 03
Telling the Truth About Massage Therapy
By Tracy Walton, LMT, MS
Google "benefits of massage therapy," and you'll bring up 3.5 million web pages. Spend an afternoon checking out a bunch of them, and you'll find a few dozen benefits of massage therapy, along with a hundred or so conditions that massage is expected to help.
Among the many beneficial effects of massage, you might pick out a few focused on common cancer symptoms and side effects of treatment. In particular, you'll see references to the "Big Five" in cancer care: pain, nausea, fatigue, anxiety, and depression. These are compelling problems, familiar to oncology massage therapists and clients alike. Research has found growing support for effects on these symptoms and the strongest support is for easing pain and improving mood in people with cancer.
These claims are simple and fairly well documented. If we stopped there, with that last humble sentence about "growing support," we'd be on solid ground. But in the massage profession, we haven't stopped there, and some of our other claims are not so humble, and not solid at all. Go to some web sites, and you'll see long laundry lists of massage benefits. These don't apply to a specific population or problem. Instead, they are more generic. As we will see below, many of these generic claims are downright problematic.
All of us in massage therapy, not just those working with people with cancer, could do with a closer look at the generic list. I've whittled that list down to a short list of a few supposed massage benefits: claims of massage improving circulation, immunity, and endorphin levels. The likelihood of massage clearing out toxins or lowering cortisol levels.
You might have heard some of these claims repeated for years, starting with your first class in Swedish massage. They are mainstays in the massage therapy profession. Unfortunately, there are at least two problems with this short list.
Clients Don't Ask for These Benefits: Many of our claims about massage are focused on physiological effects, rather than clinical improvements. How many of your clients ask for an increase in circulation or endorphins? How many ask for detoxification or a smaller supply of cortisol coursing through their bloodstream? My guess is that, aside from an occasional request, most clients aren't focusing on these benefits. Our lists of benefits sound good, but they don't really address the primary reasons people come to us. People come to us in order to feel better.
Look back at the big five in cancer care vs. the generic lists of benefits and you'll find an important distinction: The Big Five focus on feeling better, improvements in pain, anxiety, and so on. In contrast, massage claims about endorphins and cortisol focus on complicated physiological explanations of how we might feel better. The former are clinical outcomes of massage therapy, the latter are mechanistic outcomes. Clinical outcomes are direct and relevant to the client. Mechanistic outcomes may not matter to a client at all. Many people take medications without questioning the way they work. In fact, many medications bring about positive clinical outcomes, while their mechanisms of action remain a mystery to consumers and medical providers alike.
This means that when our oncology clients (or really, any of our clients, regardless of health history) look for information about feeling better from massage, they are often met with a distracting list of mechanisms, focused mostly on cells or molecules in the blood going up, going down, or moving more swiftly through the body. These mechanistic claims might sound appealing, but they aren't usually related to the client's problem. And they come with other problems, too.
Our Claims Are Not Accurate: Many of the claims we've been making with such certainty are not at all certain. In most cases, we have no decent research to back what we are saying. For example, the claim about massage upping endorphins can be traced to only two tiny, primitive studies. Only one of those studies, fraught with design issues, reports an endorphin boost. Yet a Google search for "massage" and "endorphin" brings up tens of thousands of websites claiming massage will raise your endorphin levels.
Likewise, claims about improved circulation and immunity — mainstays of massage literature — have only a handful of studies behind them, with conflicting results. A body of research on cortisol has been analyzed and reported that massage does not lower cortisol. And there is no good evidence that I know of, anywhere in the English language, on the massage and toxin question at all.
The weakness in our claims about massage raises serious ethical issues for our profession. Health care providers have a recognized duty to tell the truth about their treatments. Even outside of health care, truth in advertising is a responsibility of anyone promoting a service or product.
When we offer massage therapy, people with cancer, health care providers and the public assume we are telling the truth about our services. In cancer care, patients may be especially vulnerable to false claims and oversold promises. They need to hear reasonable expectations about what massage will do for them. That's why the humble statement above, about "growing research support," for massage and cancer symptom relief is so important.
In particular, at least five of the generic claims we make about massage — effects on endorphins, circulation, immunity, cortisol, and detoxification — should be phased out of our literature, our websites, and our massage classrooms. Any time we tell someone, "massage does this," or "massage will help you with that," without good backing, we are making a false claim. Even with a few million websites repeating the same thing, we have a professional responsibility to question what we are told and what we tell our clients.
Telling the Truth, Discarding the Myths
To help MTs in this regard, the Massage Therapy Foundation has just released a free e-book, 5 Myths and Truths about Massage Therapy: Letting Go without Losing Heart (http://info.massagetherapyfoundation.org/5-myths-and-truths-about-massage-therapy).
In partnership with the Foundation, I wrote the e-book to help straighten out our stories about massage. I offer up a research summary of each claim about endorphins, immunity, cortisol, circulation, and detoxification. I also reference many of the small research studies behind each claim, such as the two tiny studies about endorphins, mentioned above. The results may be surprising, but will help all of us make fair, accurate, more defensible claims about our work.
Reporting the true benefits of massage therapy is just as important as discarding untrue claims. The Foundation offers free e-books on massage and pain research, pediatric massage, connecting with researchers, and even an e-book on connecting with physicians. These and other resources are referenced on the Foundation website www.massagetherapyfoundation.org/resources/general/. The e-books are just a sample of the many resources available at the Massage Therapy Foundation, which has funded research, education, and community service projects for 25 years.
In addition to the free e-book through the Foundation, I have listed 20+ highest-level massage research papers in a recent blog post, "One Massage Study Does Not Prove a Point, www.tracywalton.com/one-massage-study-does-not-prove-a-point/. Three of the papers listed are on massage and cancer. In that post, I also explain why a research review typically provides more useful and accurate information than the single massage studies we are told to promote.
All of our client populations deserve clear, accurate information about the benefits of massage therapy. Massage therapy is a wonderful intervention that is becoming more and more welcome in health care circles, and especially in cancer care. When we keep our claims true, humble and thoughtful, we strengthen the foundation of massage therapy for years to come.
Click here for more information about Tracy Walton, LMT, MS.
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.