We sat down with Dr. Schoomaker and asked some questions regarding massage therapy and how to bridge the gap in research. 

Massage Today: When you think about what makes good research or a solid study design, what are some of the key elements?

Dr. Schoomaker: One of the critical features of any basic science or clinical investigations into medical massage--and for that matter, all complementary and integrative health & medicine (CIH/CIM)--is gathering good evidence for the underlying mechanisms for its utility; the efficacy under controlled conditions or the effectiveness in its application to patient problems. This research must be in compliance with good study designs--including inclusion and exclusion criteria; full transparency of the retention of patients; adverse outcomes; follow-up of sufficient duration to measure the length of an effect; patient-reported outcomes of the impact on pain, function and other emotional, social and personal impacts (in accordance with a biopsychosocial model); and statistical as well as statements of clinical significance (too many reports in the literature demonstrate statistical significance of an intervention that is not clinical significant or relevant). Finally, measures of outcome should strive to use commonly agreed upon tools for reporting the comprehensive impact of modalities on patients' function and experience of the intervention. These elements are often missing in research in the CIH/CIM world. It makes understanding the effectiveness, deciding when and on which patients to apply the treatment and making comparisons across different studies very difficult. The National Center for Complementary and Integrative Health (NCCIH) and the Uniformed Services University of the Health Sciences' Defense and Veterans Center for Integrated Pain Management (DVCIPM) are good sources for assistance with study design.

Massage Today: What excites you most about the research being done in the massage therapy profession?

Dr. Schoomaker: That studies are now being conducted that meet the criteria above so that massage therapy can be recognized for its effectiveness on appropriate patients in appropriate circumstances.

Massage Today: Where do you think research has made the biggest impact in the massage therapy profession?

Dr. Schoomaker: In providing firm evidence for the effectiveness of massage therapy as an important contribution to restoration, to health & well-being. Especially in injury prevention, acute and chronic injury recovery, especially deep massage in pain relief and muscle recovery, as part of a transdisciplinary, multi-modal chronic pain strategy. 

Massage Today: What is the biggest obstacle you find in bringing integrative health care modalities to more conventional medicine environments, and how does research help bridge that gap?

Dr. Schoomaker:  a. Convincing established conventional practitioners—through well-designed clinical trials—of the utility and effectiveness of massage therapy and of CIH/CIM in healing and in improving the well-being of those with chronic injuries and disease.

b. Changing the system of remuneration for comprehensive care to focus on optimal clinical outcome--relief of suffering, restoration of function, reducing pain and disability interference with well-being.

Massage Today: What skills and qualities do you look for in the massage therapists you work with?

Dr. Schoomaker:  Knowledge of human anatomy and physiology; listening and other communication skills; importance of the mind-body link (vs. separation of mind & body ala "Cartesian Dualism"); listening skills; mutual respect for others on the transdisciplinary, integrative team; incorporation of tailored music, olfaction and other known enablers of healing into their practice (e.g., my Shiatsu massage therapist always asks me what kind of music I might want to hear in each session).

Massage Today: Are there common misconceptions people have about pain management that prevent patients from trying integrative techniques like massage therapy?

Dr. Schoomaker: Perhaps the principal misconceptions are:1. that pain is a peripheral "event" linked exclusively to nociception and local tissue or organ injury, failing to acknowledge the profound importance of the brain in filtering, interpreting and translating pain through the lenses of experience and emotion.

 2. That pain can and should be entirely eliminated--what we call "chasing zero" on a visual analog scale of pain rating--rather than to be considered in terms of functional disruption and pain interruption with holistic well-being, such as sleep, mood, activity and stress 3. That pain, especially chronic pain, should be managed by a single modality that is "one size fits all" for all pain sufferers, such as operative procedures, drugs or device implantation.

For more information on Dr. Schoomaker and IMTRC, visit massagetherapyfoundation.org.