At Massage Sci, I provide evidence-informed massage.
That term has a few different definitions and approaches. I'll be sharing how I define it and how it influences my massage therapy practice.
I think of evidence-informed massage as a three-legged stool. Each leg is of equal importance. And each leg represents:
1: each client's story
2: professional expertise
3: scientific research
1: EACH CLIENT'S STORY
Massage is rather unique in the health-care industry. Massage therapists and clients spend a significant amount of time together during each session.
When addressing a specific issue during a massage therapy session, there's lots of time to talk about it...
- how the issue started, or when it was first noticeable
- how the issue effects daily life or certain activities - how long it's been going on, if it fluctuates - what makes it feel better or worse
- what the client would like to happen
- where it hurts when when doing this
- where it doesn't hurt when doing that
- where it screams the loudest
- who the client has talked to about it - who has helped and what happened - who hasn't helped and what happened
This is the first leg of the three-leg stool: each client's story. It's the sum of their history, circumstance, perception, and goals.
It's made up of what each person has been through, is going through, how they interpret those experiences, and where they'd like to go next. And that story is also changing and shifting as each day goes by.
Everyone has a complex and interwoven story involving many aspects of life: work, family, stress, sleep, diet, physical activity, past injuries, trauma, etc.
Obviously, massage therapists are not qualified to treat every part of the client's story, but truly listening to each client's story is important.
A story about pain and/or stress is like a big picture puzzle. Lots of various interlocking pieces.
Massage therapy may only be a couple pieces to that puzzle, but when we have an idea of what that larger picture looks like, it's much easier to identify adjacent and related pieces. It's easier to bring the other pieces together.
There are so many different techniques and modalities when it comes to massage therapy. But I believe one of the most important steps is simply listening to the information the client is providing - listening to their story. And THEN identifying obtainable goals together.
The goal might be to simply relax.
Or encourage greater range of motion after a surgery.
Or finally start addressing that an old football injury.
Or easing on- and off-again sciatic nerve pain.
Or feeling better after an intense workout.
And so on.
But once we've actually talked through and identified the goals, we can determine the appropriate techniques. Far too often in health care environments, professionals aren't listening to what their clients actually need or want out of the experience - why they made the appointment and what they want to change (or not change).
They select and preform techniques or use the tools they think will be best. Without asking what they are the best for?
We have to listen and hear the story to answer that question.
2: PROFESSIONAL EXPERTISE
Expertise, for any profession, is made up of many components. For a massage therapist it starts with initial schooling followed by obtaining a state licence, but should never stop there.
Professionals continue to grow through continuing educational courses, research, keeping a pulse on major publications, events, mentors, and mentoring.
Expertise also encompasses the experiences gained in practicing massage therapy over time, in various settings, and with many different types of clients. It is the ethical responsibility of every massage therapist to always be expanding their expertise. Without doing so, it's easy to fall far behind in the latest research and end up propagating myths and ineffective practices (like the requirement to drink water post-massage or the dangerous practice of ear candling) that are based on myths, rather than knowledge and results.
Once a client's story is heard, a massage therapist can then use their expertise to effectively pair strategies, techniques, and suggestions.
3: SCIENTIFIC RESEARCH
Science is hard work. It takes combined efforts of countless people many years to get one step closer to a greater understanding.
Historically, sound massage studies have been few. That's changing, but massage still faces challenges in research environments.
First, unlike many other healthcare professions, massage therapy lacks national educational standards. Pick any two massage therapists, and they may have vastly different education in terms of anatomy, pathology, and scientific literacy. Recently, nearly all states have adopted license laws. A big positive step forward, but lots more ground to cover in standardizing massage therapy education.
Next, the word "massage therapy" can encompass a wide variety of approaches and techniques. Massage therapy conducted in one study may look very different than in another study, or even within the study itself from session or session.
Lastly, there are different levels (strengths) of research to consider. Not all published studies are a high "strength level" (see diagram) and not all studies have the appropriate checks and balances in place for conclusions to be valid and without bias.
The body of scientific knowledge is always growing and changing. Even when studies may disprove long-held massage "sacred cows" - it's still another step forward.
Massage therapy makes people feel better. It can be a wonderful contribution to overall well being and health.
But it's really exciting exploring exactly why and how that happens, through the scientific method. It's important to remember that one study never "proves" anything, but a growing body of evidence will.
Alongside each client's story and the massage therapist's professional expertise, scientific research is the third leg that makes up how I practice evidence-informed massage therapy.
