Issue link: https://www.massageandbodyworkdigital.com/i/81195
Resources Aickin, M. "Conceptualization and Analysis of Mechanistic Studies." Journal of Alternative and Complementary Medicine 13, no. 1 (2007): 151–8. Dawson, K.A. et al. "Effectiveness of Regular Proactive Massage Therapy for Novice Recreational Runners." Journal of Orthopaedic & Sports Physical Therapy 12, no. 4 (2011): 182–7. Lee, Y.H., B.N. Park, and S.H. Kim. "The Effects of Heat and Massage Application on Autonomic Nervous System." Yonsei Medical Journal 52, no. 6 (2011): 989–989. US Department of Health & Human Services Agency for Healthcare Research and Quality. "What is Comparative Effectiveness Research?" Accessed March 2012. www.effectivehealthcare.ahrq.gov/ index.cfm/what-is-comparative- effectiveness-research1/. lifetime of experience and wear and tear, and then throw in a complicating condition or two, it becomes much harder to say, "We fully understand that massage does this, but it doesn't do that." For instance, we see that most people become more relaxed when they receive massage, but we still aren't sure whether that reflects an increase in vagal activity, a decrease in sympathetic response, a neuroendocrine reaction, a response triggered by something happening entirely elsewhere, or a combination of all of the above. Why do we need to know how massage works? Simple: so we can make choices that aim for the best possible outcomes. If we can narrow down some of the mechanisms for how manual therapies affect human function, then we can work with purpose and intention, instead of with best guesses. That knowledge allows us to apply specific techniques or modalities to their very best advantage, and ultimately to the benefit of the client. Further, consider your own personal choices: would you rather pursue a health-care strategy if you know how it is intended to work, or simply on the basis that because it works for a lot of people, it might work for you? Having a rudimentary understanding of the mechanisms of the interventions we choose—from diet, to medication, to exercise regimens— gives us the power to support those choices with other behaviors. As a person interested in pathology, I am especially invested in understanding how massage might impact factors contributing to illness, but even more, how we might impact factors contributing to healing or prevention. Here are some examples of fields of inquiry that I find especially thrilling: SCAR TISSUE: A pilot study of burned children found that those who received massage had better range of motion than those who didn't.1 A larger review found that the evidence for massage in treating scar tissue is generally better for postsurgical situations than for burns, but that the research to date leaves much to be desired.2 DIABETES: A study of massage with type 2 diabetes patients found that leg circulation was so significantly better among the massage group that an argument could be made for massage therapy as a strategy to delay or prevent the development of peripheral artery disease.3 Poor circulation also leads to diabetic ulcers on the feet and a high risk of amputation. If this can be applied on a larger scale, just imagine the impact that could make on this community. CENTRAL NERVOUS SYSTEM FUNCTION: A study using nuclear magnetic imaging captured some physiologic responses to massage among cancer patients.4 They found that massage had an immediate effect on local fascia, muscles, and nerves, but a delayed effect on the central nervous system— including some observed remodeling of plastic (that is, changeable) neuronal connections. The implications of this for "intractable" pain situations are huge: if massage can help build new neural pathways, then we may be able to address pain patterns that 40 massage & bodywork march/april 2012