4 Questions with Ruth Werner: Why is Massage Research Important?

An interview with Massage & Bodywork columnist Ruth Werner on the role research plays in massage therapy. Werner is also the past president of the Massage Therapy Foundation.

Be sure to check out the latest issue of Body Sense magazine and share it with your clients. Our summer issue illustrates how massage research is progressing our profession.

Darren Buford: Why is research for massage and bodywork so important?

Ruth Werner: A lot of massage and bodywork has evolved out of ancient traditions that build on our experience that touch feels good. It might seem redundant or unnecessary to do high-level research to confirm this basic truth. But research that looks carefully at massage therapy can help us understand how it works, and for whom, and what circumstances are likely to give the best results. 

Research can help massage therapists be more effective and more accurate—if we know the evidence shows that massage for an hour once a week helps people with knee pain from osteoarthritis (and a study has indeed determined that this is the optimal dose), then we can make that claim and know that research backs it up.

Research allows us to question some traditions that have not served us well. For instance, we used to assume that massage would speed up the process of cancer development, so we were taught, “Massage and cancer don’t go in the same sentence.” When some brave researchers challenged that assumption, we learned that massage therapy has many benefits to offer cancer patients, and many people find that their journey through this condition is made easier because they can receive appropriate, safe, educated massage in this context—something that would have been impossible without research.

Research can also help us to avoid making mistakes or making false claims.  

And finally, research helps massage therapists and bodywork practitioners build working relationships with other health-care providers; it is the language every person in the medical field uses. When we are able to integrate with health-care teams, clients get the best possible outcomes massage therapy can offer.

DB: How is massage research moving the field forward and enhancing clients’ sessions?

RW: If massage therapists are aware of what research says about massage therapy and clients’ personal goals, they can deliver the very best care.

Health care and other professions use a model called evidence-informed practice. It is based on the premise that to provide the very best service—in health care, in teaching, in many other professions—it is necessary to balance three things: what the client wants and needs; what the practitioner brings through his or her education and judgment; and what the current research says. Traditionally massage therapists have been good at addressing the first two: what the client needs and what their skills can provide. But the third leg has been deficient, so each massage therapist has essentially had to reinvent the wheel with each client. That is no longer necessary. We have a deep enough evidence base in massage therapy that therapists can find input—ideas that have worked, or not worked—in order to build the very best strategies to help their clients meet their goals.

DB: How are MTs applying research findings into their practices?

RW: MTs apply research findings in many different ways. When they read a case report (this is a very small-scale project that describes what happens with one therapist and one client), they may find ideas from their peers that they can bring into their session rooms: a protocol to help with scar tissue, for instance, or some suggestions that seemed to work for a client with fibromyalgia.

Larger-scale studies can do that, too, but they also help massage therapists create beneficial connections with their target populations. If you are a member of a running club, and someone comes to talk about how great massage therapy is for runners, wouldn’t it help their credibility if they could cite a clinical trial about massage and runners that backs up their claims?

Finally, research should—and sometimes does—influence policy and legislation. It is difficult to make the case that massage therapy should be covered by insurance if no research demonstrates its effectiveness. As our evidence base grows, we are learning more about how massage therapy can be helpful, both as a free-standing intervention and as part of an integrated health-care approach to wellness. 

DB: What findings have been most relevant in the past few years?

RW: The answer to this depends on what you’re interested in. From my perspective, I fall back on half a dozen important projects:

1. The Massage Therapy Foundation (MTF) recently commissioned three systematic reviews and meta-analyses (these are top-level compilations of high-quality research projects) investigating the role of massage therapy on pain and function for general populations; for cancer patients; and for surgical patients. The findings were clear in favor of massage therapy, with some important caveats and explanations. 

http://painmedicine.oxfordjournals.org/content/early/2016/05/06/pm.pnw099

http://painmedicine.oxfordjournals.org/content/early/2016/05/06/pm.pnw100

http://painmedicine.oxfordjournals.org/content/early/2016/05/06/pm.pnw101

2. A recent systematic review of massage therapy for pain among cancer patients came to some different conclusions, probably because it had some different inclusion/exclusion criteria than the MTF project. It is also a very important piece of work.

www.ncbi.nlm.nih.gov/pubmed/25784669

3. Another recent systematic review compiled findings about massage therapy for fibromyalgia patients. It found that massage was helpful for several fibromyalgia symptoms, but it became most useful when patients received massage at least once a week, for at least five weeks. This could be important information for a person with fibromyalgia who is discouraged and ready to quit trying massage.

www.ncbi.nlm.nih.gov/pmc/articles/PMC3930706/

4. This dates from 2011—a lifetime ago in research, but still very important: a study on massage therapy for back pain compared three groups. One group got “usual care”; one group got “full body relaxation massage”; one group got “structured massage” specifically designed for low-back pain. Both of the massage groups had better results than the usual care group, and those benefits lasted for several months after the conclusion of the study. The surprise was that the general relaxation massage group and the targeted massage group had practically the same results. This opens the door for many other fascinating questions.

www.ncbi.nlm.nih.gov/pmc/articles/PMC3570565/

—Darren Buford is the director of editorial, design, and digital strategy for ABMP.

Click here to read Ruth Werner's latest Pathology Perspectives column in Massage & Bodywork magazine.