The International Massage Therapy Research Conference (IMTRC), sponsored by the Massage Therapy Foundation, was held April 25–27 in Boston. This conference touched hearts and minds unlike any scientific meeting I have ever attended. From the opening Native American blessing to the closing small-group discussions, speakers and participants shared touching stories, heartfelt concerns, and meaningful data that were directly applicable to massage research and practice.

Each morning, plenary sessions consisted of one keynote speaker followed by a panel focused on a particular theme—Day One: Mechanisms; Day Two: Community Health; and Day Three: The Future—regarding massage and health care, and massage research. Afternoon and evening sessions included research presentations, workshops, and video presentations. Here is a rundown of the conference highlights.

Wednesday—Shifting modes 

It all began Wednesday night with “movie night.” As people arrived, video clips from the 2012 International Fascia Research Congress in Vancouver played on the mezzanine level. A variety of speakers on topics of interest to massage, including a Tom Myers-produced cadaver dissection video, provided a casual opportunity to shift into research mode. Popcorn and Junior Mints added to the movie night ambiance. 

Thursday—Blessing, Dosing, and More

The conference officially opened with a blessing from Luata Bray, Choctaw, assisted by Donna Edmonds Mitchell of the Wampanoag Nation of Massachusetts. Bray’s words spread a blanket around attendees that created safety and community, and invited us to listen with our hearts, tell the truth of our findings, embrace new thinking, and remember that we are not alone: that when one is healed, we are all healed. 

Massage research expert Jeanette Ezzo, MPH, PhD, LMT, provided the first keynote, “Mechanisms and Beyond: What is Needed to Prove the Effectiveness of Massage?” The language of research was discussed, terms were defined, and a context for the conference was created, with an invitation to question the profession’s emphasis on mechanistic research. Ezzo put things into perspective, saying that the massage profession was “off the hook” for demonstrating mechanisms for the time being as we focus on accumulating effectiveness data; that we have joined the ranks of many branches of medicine that have learned things work, but do not yet know why. Additionally, she presented research on dosing (one time per week for 60 minutes for chronic conditions for 6–10 sessions),¹ study design (factoral design is preferred to allow for combination studies—massage and exercise, as well as massage or exercise), cost-effectiveness (we need more data), and therapist experience. She emphasized the difference between efficacy and effectiveness: efficacy asks if the intervention works under ideal conditions, and effectiveness asks if the intervention works under everyday conditions—if you can prove something works under ideal conditions, then you can infer that it works under everyday conditions. 

The panel “How Does Massage Work? Potential Mechanisms,” moderated by Cynthia Price, PhD, LMP, explored both mechanisms of action (biochemical) and mediators (intervening variables such as anxiety). 

Joel Bialosky, PhD, PT, discussed the strong placebo effects present in drug trials for pain and depression, results suggesting that communication is key to helping people feel confident about the treatment they are receiving. While we don’t know what a good placebo (or control) is for manual therapy interventions—yet—we can use his information to increase our clinical results by enhancing communication with our clients.

Geoffrey Bove, DC, PhD, studied neurobiochemical markers and found evidence that massage supports nerve regeneration. 

Lisa Hodge, PhD, showed through her studies that passive movement (massage, compression) increased lymph flow, and that white blood cell count increased from 150 million cells to 800 million cells with 4 minutes of abdominal pumping at a rate of 1 pump per second. 

Mark Rappaport, MD, shared studies that looked at proteins associated with inflammation and found that massage increased white blood cells and decreased the number of proteins associated with inflammation, thereby altering the stress response and immune response, including allergic reactions. 

Afternoon sessions included two research breakouts, “Basic Science: Biological and Psychological Models of Massage,” and “Massage Therapy for Specific Conditions.” Michael Hamm, moderator of the Basic Science breakout session, shared that “Thursday morning’s plenary made a case for focusing on massage outcomes, as those are easiest to study, and often lead most directly to the integration of massage therapy into health-care teams. However, the case for understanding the basic science of massage therapy was equally compelling. Whereas outcomes bolster our ability to practice in more settings, basic science allows us to rethink how we actually practice and what we think we’re working on.” 

Other highlights included:

• Leon Chaitow, DO, ND, summarized decades of fascia research and reminded us that compressing or stretching any part of the body has widely distributed results. Understanding how load is transmitted often leads to understanding restrictions—not always in obvious places.

• Bove spoke about his experiments showing the potential for massage to treat postsurgical ileus and thus dramatically reduce hospital stays.

• Kimberly Stevenson, MS, LMT, demonstrated that massage effects on posture, anxiety, and sympathetic tone can be statistically correlated. 

• Glenn Hymel, EdD, and Grant Rich, PhD, NCB, provided a conceptual model of massage therapy as part of health psychology, and discussed implications, including the need for education that promotes an awareness of and sensitivity to areas of mutual concern amongst health psychologists and massage therapists.

Friday—The Intangible Nature of Massage

Leslie Korn, LMHC, MPH, PhD, NCB, RPE, used storytelling for her keynote “Somatic Empathy: Restoring Public Health with Massage.” Korn captivated attendees with stories of her work collaborating with tribal communities in Mexico and the United States to restore touch therapies and nutrition from traditional foods, traditions that had dropped off in response to complex and historical trauma. “Their bodies told stories their minds longed to keep quiet,” she said. Without breaking from her storytelling style, she fed the audience data from many studies, shared techniques for healing that were evidence-driven, and made recommendations for future studies. It was a rare treat that set the mood for the day, acknowledging the intangible nature of massage alongside the evidence.

Korn offered several recommendations for future studies, including:

• Self-massage in schools to decondition no-touch regulations.

• Massage and self-care behaviors for those with diabetes, along with massage to decrease blood sugar, inflammation, and neuropathies in diabetics.

• Massage to decrease violence in prisons.

Jerrilyn Cambron, DC, PhD, LMT, moderated the panel “Massage in the Community: Informing Public Health,” which reminded the attendees that public health isn’t about the public, it’s about individuals. She began with a quote from Ralph Waldo Emerson: “To know that one life has breathed easier because you have lived. This is to have succeeded.” There was not a dry eye in the house after hearing about the impact of massage on torture survivors, the severely burned, differently abled children, and obese children. 

Shay Beider, MPH, LMT, spoke of the importance of treating whole bodies, whole families, and whole communities; families are ecosystems. She said that kids are more likely to survive cancer than not (more than 70 percent of children diagnosed with cancer survive), but that families are less likely to stay together following treatment (more than 80 percent split in divorce). One dad who participated in Beider’s summer camp for at-risk children and their families said they could now handle anything after receiving massage and counseling as a family. 

Mary Fabri, PsyD, shared how the touch sensitivity of survivors of torture, as well as our physical proximity to the client, needs to be considered even before we apply touch, followed by considering the need to determine what body part is safe to touch first. She spoke of the absolute power of caring, compassionate, nonverbal human interaction to transcend language and culture, bringing comfort and nourishment to broken bodies and spirits. 

Nancy Keeney Smith, MLD, MT, NCB, shared her challenges experimenting with measures that would hold up to research rigor while working with a woman who, as a child, had pulled hot water into her crib, severely scalding her back. For her lifetime, the scars have prevented her from straightening her arm. After five sessions, she regained normal extension, and Keeney Smith had the measurements to demonstrate it. 

Elizabeth Sommers, PhD, shared outcomes of her work with obese youth in Boston, emphasizing that the following behavioral changes were associated with the massage therapy intervention, not caused by it: decrease in smoking, increase in healthy eating habits (choosing fruits and vegetables over salty or sweet snacks), and increase in exercise. One participant said she now thinks of massage as her reward for working out. 

The afternoon breakout sessions included research presentations on massage for communities and special populations, case reports, and hospital-based massage. Workshops on practice-based research networks’ (PBRNs) methods and best-practice guidelines ensured there was something for everyone. 

Saturday—Affordable Care Act and the Future of Massage Research

Janet Kahn, PhD, LMT, Presidential appointee to the Advisory Group on Prevention, Health Promotion, and Integrative and Public Health, and massage therapist for more than 35 years, gave a mobilizing keynote on “Massage in the 21st Century Health Care: Let’s Seize the Moment!” on this final day. She pointed to the footholds for massage therapy in the Affordable Care Act: 

• In Section 5101, the definition of the health-care workforce includes all licensed and certified complementary and alternative health-care providers. 

• Section 2706 outlaws discrimination based on a provider’s license. 

• Section 2301 provides coverage for freestanding birth center services, a potential worksite for massage therapists. 

She encouraged associations to rally around getting into the state’s insurance marketplaces early and being prepared to battle the American Medical Association, which is pushing a scope of practice protection movement bent on removing the nondiscrimination section and preventing nonphysicians from integrating into health-care reform. 

The panel following was on the future of massage research, designed to collect input from the attending stakeholders and update the current massage research agenda. It began with John Balletto sharing the history of the first research agenda convened and published by the Massage Therapy Foundation. Each panelist shared desires for future studies, and prompted discussion for the afternoon session.

In the afternoon, Kahn and Martha Menard, PhD, LMT, broke participants into 10 groups for additional brainstorming on new areas of research. Groups included stakeholder identities such as physicians, employers, and insurers, and types of research, such as clinical trials, PBRNs, and basic science. Each group was asked what studies they would want done according to the group topic, what their individual research priorities included, and what else should be included, such as research to facilitate education, massage’s standing in health care, and improvements to research infrastructure. 

The results of the discussions will be collated and reviewed by Kahn and Menard. Further data will be collected from any missing perspectives and a final agenda will be published, hopefully in a year’s time. 

Until next time, stayed tuned to www.massagetherapyfoundation.org for info about IMTRC 2016. 

Note

1. A. Perlman et al., “Massage Therapy for Osteoarthritis of the Knee: A Randomized Dose-Finding Trial.,” PLoS ONE 7, no. 2 (2012): e30248, doi:10.1371/journal.pone.0030248.

  A licensed massage practitioner since 1984, Diana L. Thompson has created a varied and interesting career out of massage: from specializing in pre- and postsurgical lymph drainage to teaching, writing, consulting, and volunteering. Her consulting includes assisting insurance carriers on integrating massage into insurance plans and educating researchers on massage therapy theory and practice to ensure research projects and protocols are designed to match how we practice. Contact her at soapsage@comcast.net.

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