Key Point

• A recent study is a step in the right direction toward quantifying the efficacy of massage therapy.

“Oh, massage! That’s so nice,” the patient’s nurse says. 

“I love massage. My massage therapist really gets in there,” brags your new friend at the picnic as they wing their elbows wide in an exaggerated demonstration of kneading. 

“Wait. You mean, you guys go to school for that?” the medical student in a new collaborative education program wonders aloud. 

And on it goes. 

We’ve all heard these limiting, poorly informed, insulting comments about the work that fulfills us. We sigh, cross our arms, and dismiss these perspectives as groundless, throwaway quips offered as small talk. The truth is we are the only ones who can truly close this chasm between perception and reality. 

A New Study

The state of massage therapy research is less than amazing, and lest you think I’m wandering off in a different direction, stick with me. As a profession, we have done very little to debunk the misunderstandings that underpin those scenarios above. We have let other people, other disciplines, other forces attempt to define and limit us. Certainly, there are outliers in the body of research, but generally, “efficacy studies have . . . been unclear, and methodology reviews, systematic reviews, and meta-analyses have outlined many criticisms of the methodology used in massage research.”¹  

Even so, there are glimmers of hope that we can and will take back this narrative. Massage therapists are directly and thoughtfully involved, with increasing frequency, in the conversation about what massage is, why and when it works, and how we should measure it. 

I want to applaud a recent article published in the International Journal of Therapeutic Massage & Bodywork. In March, four researchers from Australia published a study called “What Is Effective in Massage Therapy? Well, ‘It Depends . . .’: a Qualitative Study of Experienced Orthopaedic Massage Therapists.” This study is encouraging on multiple levels. One reason is because the researchers weren’t massage therapists. It probably sounds strange to read that I am encouraged by this fact, but hear me out. These researchers work in public health, rehabilitation science, and other adjacent disciplines. They were interested enough in the discipline of massage therapy to conduct a study about its effect—and they asked actual massage therapists about their perspectives on the matter. Most of what is often referred to as “massage therapy research” does not involve massage therapists. Many massage studies are designed and executed, and the results are published without the support or input of a single clinician who is trained or experienced in practicing the discipline of massage therapy.²

The study aimed to explore the perspectives of orthopedic massage therapists as they considered the aspects of their work they feel contribute to its effectiveness. Another aspect I loved about this is that it exposed my own bias. I often think of “orthopedic massage” as very protocol-based and—I’ll just say it—aggressive. Yet, the experience and perspective of these therapists invited me to consider a different way of thinking about this work and, yes, even about these practitioners. In fact, these are perspectives that are shared by my palliative, oncology, and hospice massage colleagues. And that, my friends, probably gives me the most hope of all. We struggle as a discipline to come together because we are convinced that our differences mean we simply can’t, or shouldn’t, come together. 

Redefining “Effective”

Three themes were interpreted from this data: (1) how they individualized treatment based on differences between clients, (2) how they managed the challenges of working with that reality, and (3) the problem-solving processes they used to target each treatment to meet the client’s needs. I did the happiest of dances when I read that the six massage therapists interviewed for the study also “did not identify specific techniques or modalities as ‘effective’ or not. Rather, a therapist’s ability to provide effective treatment was based on an iterative process of treatment and assessment that allowed them to focus on the individual needs of the client. In this case, ‘effectiveness’ could be considered a process rather than a specific massage technique.”

We are so much more than hands, my friends. I know some part of you probably knows that, but as a profession, we continue to fall down on highlighting and prioritizing what this study would argue are the most important skills when it comes to whether our work is effective—assessment, critical thinking, listening, and real-time adaptation to the needs of the ever-changing humans in our care. 

Massage therapists have a lot to say about our work—what it is, what it isn’t, and what makes it valuable. The questions asked and the perspectives revealed in this paper are an excellent start to a conversation that I hope gathers steam. 

Notes

1. Jennifer L. Stewart-Richardson et al., “What is Effective in Massage Therapy? Well, ‘It Depends . . .’: A Qualitative Study of Experienced Orthopaedic Massage Therapists,” International Journal of Therapeutic Massage & Bodywork 17, no. 1 (March 2024): 4–18, https://pubmed.ncbi.nlm.nih.gov/38486839.

2. Cal Cates et al., “Massage Therapy in Palliative Care Populations: A Narrative Review of Literature from 2012 to 2022,” Annals of Palliative Medicine 12, no. 5 (September 2023): 963–75, https://pubmed.ncbi.nlm.nih.gov/37599559.