Issue link: https://www.massageandbodyworkdigital.com/i/81195
PATHOLOGY PERSPECTIVES range from complex regional pain syndrome to ingrained migraines. CHRONIC LOW-BACK PAIN: Speaking of chronic pain, a study investigated the vicious circle of pain leading to lack of movement leading to fascial restrictions and pain, then compared massage to increased activity and changing movement patterns to see what had the best results.5 The conclusion was that a multidisciplinary approach is best, and now we are getting some clues about how to put those treatment options together for the most effective results. LIMITATIONS OF MECHANISTIC STUDIES One of the greatest problems with mechanistic studies about massage and other CAM interventions is that we lack two things: a comprehensive understanding of human function, and a widely agreed-upon rubric by which to evaluate mechanistic inquiries. The fact is, the human body is still largely a mystery. Until 30 years ago, we understood almost nothing about the immune system. The human genome project has only just begun to yield powerful information about how cells do their work and what positive and negative influences are carried in our genes. Other fields of exploration, from intestinal microbiota to neuroendocrinology, continue to change how we look at health and wellness from the inside out. What do microbiota and genetic expression have to do with massage? This is what is so exciting: we don't know yet! But with better imaging techniques, combined with people asking more sophisticated questions, we are in a position to begin to find out. Already we can predict some alterations in cellular behavior with the influence of welcomed touch;6 we can observe different biologic reactions with very light touch as compared to firmer touch;7 and we can observe changes in preterm infants' vagal nerve activity when they receive massage, which may influence their ability to gain weight.8 FACE TIME The lines of communication between massage therapists and researchers can seem tenuous, but researchers truly want to know our points of interest. The more we reach out to them with our priorities, the better they can serve our field. Three opportunities to have "face time" with people who do research about massage and other CAM interventions are coming up: • The International Fascia Research Congress in Vancouver, British Columbia, on March 28–30, 2012. (www.fasciacongress.org). • The International Research Congress on Integrative Medicine & Health in Portland, Oregon, on May 15–18, 2012. (www. imconsortium-congress2012.org/). • The International Massage Therapy Research Conference, presented by the Massage Therapy Foundation in Boston, Massachusetts, on April 27–29, 2013. (www. massagetherapyfoundation.org). These are your opportunities to let the leaders in bodywork research know what you want to find out in terms of mechanistic and other studies. Ultimately, mechanistic studies may ask questions that don't have clear-cut answers. That's fine; we still need to ask them. Whatever findings we come up with should be informing our work, and our work should be influencing future research questions. This is where our art meets our science, and it can be a beautiful partnership. Notes 1. A. Morien, D. Garrison, and N.K. Smith, "Range of Motion Improves After Massage in Children with Burns: A Pilot Study," Journal of Bodywork and Movement Therapies 12, no. 1 (2008): 67–71. 2. T.M. Shin and J.S. Bordeaux, "The Role of Massage in Scar Management: A Literature Review," Dermatologic Surgery (2011), doi: 10.1111/j.1524-4725.2011.02201.x. 3. A. Castro-Sanchez et al., "Connective Tissue Reflex Massage for Type 2 Diabetic Patients with Peripheral Arterial Disease: Randomized Controlled Trial," Evidence- based Complementary Alternative Medicine (2011), doi: 10.1093/ecam/nep171. 4. S.M. Sagar, T. Dryden, and C. Myers, "Research on Therapeutic Massage for Cancer Patients: Potential Biologic Mechanisms," Journal of the Society for Integrative Oncology 5, no. 4 (2007): 155–62. 5. H. Langeven and K.J. Sherman, "Pathophysiological Model for Chronic Low Back Pain Integrating Connective Tissue and Nervous System Mechanisms," Medical Hypotheses 68, no.1 (2007): 74–80. 6. L. Lindgren et al., "Pleasant Human Touch is Represented in Pregenual Anterior Cingulated Cortex," NeuroImage (2011), www. ncbi.nlm.nih.gov/pubmed/22100768. 7. M. Rapaport, "A Preliminary Study of the Effects of a Single Session of Swedish Massage on Hypothalamic-Pituitary-Adrenal and Immune Function in Normal Individuals," Journal of Alternative and Complementary Medicine 16, no. 10 (2010): 1079–88. 8. T. Field, M. Diego, and M. Hernandez- Reif, "Potential Underlying Mechanisms for Greater Weight Gain in Massaged Preterm Infants," Infant Behavior and Development 34, no. 3 (2011): 383–9. Ruth Werner is a writer and educator approved by the NCBTMB as a provider of continuing education. She wrote A Massage Therapist's Guide to Pathology (Lippincott Williams & Wilkins, 2012), now in its fifth edition, which is used in massage schools worldwide. Werner is available at www.ruthwerner.com or wernerworkshops@ruthwerner.com. Celebrate ABMP's 25th anniversary and you may win a refund on your membership. ABMP.com. 41