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Obstacles

What do you think is the major obstacle preventing massage therapy from becoming evidence based?

Replies to This Discussion

Permalink Reply by Keith Eric Grant on October 9, 2009 at 1:48pm

Culture. In a profession that on both an organizational and individual level is woven from threads of magical and cargo cult thinking. That is rapidly developing a "body of knowledge" inclusive of such thinking both in content and in approach to competency management. That, at least south of a certain border, is in a country that has been referred to as Unscientific America with a stream of anti-intellectualism extending well into the past.

I'd likely settle for the last nail being tacked solidly home through the lactic acid myth. Despite good research, despite technology and communication, I'm not expecting that nail to be driven home anytime soon. Howard Gardner refers to the naive preconceptions of "The Unschooled Mind", partly based on research such as that recently compiled by Frederick Reif into a new book on education and cognitive science.

It is also difficult to take people who drift into massage, partly as an explicit rejection of scientific thought, and expect them to cotton to evidence-based thinking. My wife, in her days as a fire-fighter, noted that fire-fighting was based on 200 years of tradition largely unimpeded by progress. Massage therapy, on many levels, is too often of this mold, but in that is also a microcosm of the world around it.

Permalink Reply by Rajam K Roose on October 29, 2009 at 9:53am

I would also like to see more EBR taught in massage schools. If I had known the money and time that I would have to spend for that information after I finished massage school, I might not have pursued a massage career. (Actually, I do enjoy the continued learning!)

One thing I noticed when teaching for a short time at one of the generic massage schools (owned by a corporation and taught nursing, crime scene investigation, bookkeeping, etc.) I noticed that most students, if not all, had a lot of misconceptions about what massage really was. Many students were bummed out in my business class when they learned all the licenses and taxes they would have to pay. And they were equally bummed out in the anatomy course, where they had to learn the A., I. O. of all the various muscles. Most of them seemed to think they would just be rubbing on people with some nice music playing and get paid $100/hour.

Another thing I notice is that when I have spoken with therapists here in my city about bringing in a quality educator for providing a good CEU course, every single one of them have said they have learned enough in massage school and they didn't need to know any more.

I also find that many therapists whom I've spoken with about this topic feel like they don't need research to back up what their intuition tells them. Sure, we all know massage feels good and relieves stress and don't need research to back it up but when someone comes in for a specific thing that massage can help, the therapist who isn't using EBR will not be able to help them fully. If the therapist really understood that concept, it seems they would welcome EBR as it would enable them to use massage at its maximum potential, instead of something that could be effective but seems vague and out of reach.

So, obviously the public's perception needs to change, but I think it would start in massage school as was stated by previous posters. Like the idea of introducing a two tiered education system, where all students would be taught basic massage education but those that want to just provided solely relaxing massage could continue their education in that direction and the others who prefer to utilize massage therapy for pain relief and such could go the other direction. I think it would be easier to make licensing happen through the school system of massage, rather than all these massage regulations in each state. For instance, you wouldn't be able to get a business license unless you went to a certified and recognized school. Education starts in the classroom, otherwise it just goes round and round between the public perception and the student perception.

Permalink Reply by Marla Barrett on December 12, 2009 at 2:34pm

All of you have great points. As a licensed massage practitioner I am so ready and open for massage therapy becoming evidence based and that there should be a tier in the profession. I definately like to think outside the box. Thanks for all the great comments. I love reading and learning from those who have been in practice for years!! Myself, I have been practicing for almost 9 years:) Cheers

Permalink Reply by Jason Erickson on July 23, 2010 at 12:43am

I think part of the problem lies in the fact that "massage" means different things to different people. I came to massage because I experienced good medical massage and relaxation massage from a number of practitioners, and wanted to be able to help others in the same way I was helped. I had realistic expectations of the income, how to build a practice, etc. Others in my massage class were attracted by a "spiritual calling", a "desire for a fun side job", or "because it was something I just always wanted to do", and even "because I didn't want to go to REAL college." *sigh*

I think this is also a major reason for the difficulty of establishing more uniform MT licensing (if any - Minnesota is still lagging due to the opposition of some MTs) and of a MTBOK. It would behoove us to move towards a clearer definition of "massage" and also of "bodywork", as those terms come preloaded with preconceptions that vary from person to person. If we don't have a common understanding of our core terminologies, how can we come to broadbased agreement on narrower definitions of those terms?

Likewise, the phrase "evidence-based" is relatively new to many. It would help for us to educate people on the various forms/levels of evidence and how to differentiate between them. This is key to developing the requisite critical thinking skills needed to appreciate the growing body of research literature.

In short, those of us who understand the differences and the ramifications of research evidence are pretty much automatically on board with EBP because that's just how we think. It makes sense to us because it's familiar, rational territory. Those who do not understand the differences and/or do not have a desire to develop their critical thinking skills (related to massage/bodywork) won't appreciate what we are saying, and may even be opposed to it.

Permalink Reply by Ron Carter on September 4, 2010 at 5:33am

First and foremost or profession has no standard of care, doctors have it and we don't. As long as NCB and AMTA are fighting over who has the more creditable test, there won't be any agreement on standard of care either.

Permalink Reply by Jason Erickson on September 8, 2010 at 2:15am

AMTA and NCBTMB aren't fighting over "who has the more creditable test" - AMTA simply recognizes the NCETMB and NCETM for what they are. The alternative test you might be thinking of is the MBLEx. This was developed by a completely different organization, and is intended to serve a different purpose from the NCBTMB exams.

That said, I agree that we lack any sort of standard of care, let alone uniformity from state to state.

Ron Carter said:

First and foremost or profession has no standard of care, doctors have it and we don't. As long as NCB and AMTA are fighting over who has the more creditable test, there won't be any agreement on standard of care either.

Permalink Reply by Truc Dinh on December 11, 2010 at 5:48am

you're absolutely right.
Rajam K Roose said:

I would also like to see more EBR taught in massage schools. If I had known the money and time that I would have to spend for that information after I finished massage school, I might not have pursued a massage career. (Actually, I do enjoy the continued learning!)

One thing I noticed when teaching for a short time at one of the generic massage schools (owned by a corporation and taught nursing, crime scene investigation, bookkeeping, etc.) I noticed that most students, if not all, had a lot of misconceptions about what massage really was. Many students were bummed out in my business class when they learned all the licenses and taxes they would have to pay. And they were equally bummed out in the anatomy course, where they had to learn the A., I. O. of all the various muscles. Most of them seemed to think they would just be rubbing on people with some nice music playing and get paid $100/hour.

Another thing I notice is that when I have spoken with therapists here in my city about bringing in a quality educator for providing a good CEU course, every single one of them have said they have learned enough in massage school and they didn't need to know any more.

I also find that many therapists whom I've spoken with about this topic feel like they don't need research to back up what their intuition tells them. Sure, we all know massage feels good and relieves stress and don't need research to back it up but when someone comes in for a specific thing that massage can help, the therapist who isn't using EBR will not be able to help them fully. If the therapist really understood that concept, it seems they would welcome EBR as it would enable them to use massage at its maximum potential, instead of something that could be effective but seems vague and out of reach.

So, obviously the public's perception needs to change, but I think it would start in massage school as was stated by previous posters. Like the idea of introducing a two tiered education system, where all students would be taught basic massage education but those that want to just provided solely relaxing massage could continue their education in that direction and the others who prefer to utilize massage therapy for pain relief and such could go the other direction. I think it would be easier to make licensing happen through the school system of massage, rather than all these massage regulations in each state. For instance, you wouldn't be able to get a business license unless you went to a certified and recognized school. Education starts in the classroom, otherwise it just goes round and round between the public perception and the student perception.