Massage & Bodywork

September | October 2014

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I t p a y s t o b e A B M P C e r t i f i e d : w w w. a b m p . c o m / g o / c e r t i f i e d c e n t r a l 53 WHAT AREAS OF RESEARCH ARE MOST INTERESTING TO YOU? PORCINO: I love research methods—the theory behind how and why we do what we do in research. More specifically, I think practitioner-based and service-based research in complementary and alternative medicine, and in therapeutic massage, needs more refinement and advocacy. In practice, these treatments are usually individualized, while most classic research trials depend on nonindividualized protocols. Of course, this is a blanket statement, but it truly is a vexing issue, and research methods that allow for variability are only now gaining traction. I also like research that focuses on the practitioner, such as the development of expertise and competency, or treatment ethics. At the other end of the spectrum, my own practice was focused on chronic pain—I had a lot of thoracic outlet and fibromyalgia patients, along with car accident patients— and I would enjoy being involved in trials in these areas. CHAITOW: As editor of JBMT, I read a great many research submissions—and similarly, when I am working on a book, the amount of material that needs to be read is amazing. English essayist Samuel Johnson said, "A man will turn over half a library to make one book," and obviously this process itself is research! IN YOUR OPINION, WHAT ARTICLE (OR ARTICLES) HAS MADE THE BIGGEST IMPACT ON THE MASSAGE AND BODYWORK FIELD? PORCINO: This is a tough one for me for two reasons: (1) I have my favorite articles that are relevant to me because of my interests, and (2) what do you mean by impact? Most therapeutic massage research has been for specific issues; so, for example, the work showing that massage is safe for cancer patients has been really important, as has all the research on massage and stress and depression—for those fields. These have indirect, far-reaching consequences, helping to move massage to the forefront of the public perception. But so have [David] Eisenberg's work in the United States and that of his colleagues in other countries, which showed that massage was among the most common complementary and alternative medicines being used by the public. This helped focus the public's awareness on therapeutic massage, as well as providing proof that more research money should be focused on massage research. Importantly, the 1999 Massage Therapy Research Agenda put therapist-led research on the map. 2 CHAITOW: I have no idea to what degree I've influenced the massage profession, despite being involved in teaching groups since the early '80s. I hope I have encouraged the concept of working with innate self-regulating processes rather than simply prompting LMTs to use safe manual techniques that derive from my osteopathic background; although that seems pretty important to me, as does the importance of paying attention to the breathing patterns of clients. Examples of my contributions to the field include: • "Neuromuscular Techniques in Orthopedics," published in Techniques in Orthopaedics. 3 • "Breathing Pattern Disorders, Motor Control, and Low Back Pain," published in the Journal of Osteopathic Medicine. 4 • "Chronic Pelvic Pain: Pelvic Floor Problems, Sacroiliac Dysfunction and the Trigger Point Connection," published in the Journal of Bodywork and Movement Therapies. 5 • Recognizing and Treating Breathing Disorders, published by Elsevier. 6 IN YOUR OPINION, WHAT AREAS OR TOPICS WITHIN MASSAGE AND BODYWORK NEED THE MOST RESEARCH? CHAITOW: Demonstration of the mechanisms involved in achieving the obvious benefits deserves focused attention. What are the physical, circulatory, biochemical, and psychosocial effects of applying different degrees and models of massage to tissues in different states of functionality? One area that I am currently investigating relates to the fact that in massage, no single method, modality, or approach is used in a treatment session. Rather, a cocktail of approaches is used depending on patient need. This makes deciphering outcomes extremely difficult. It's one thing to apply, say, a single modality in a particular setting and record the effects. But if that modality is followed or preceded by others, how can sense be made of the outcomes? It may be that we have to accept that selecting a variety of methods in any particular clinical setting is what "works"—even if that conclusion becomes unsatisfactory for other, more medically oriented researchers. PORCINO: I'm not a physiology person. However, I recently helped design an acupuncture trial, and studying pain and nerve physiology and how different types of acupuncture needling activate different physiological responses really helped me understand why massage physiology research is also critical. Massage has multiple styles, depths, and speeds. If we want to achieve specific

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