Incorporating Research into Practice
Massage therapy continues to be more common in new environments: hospitals, sport medicine clinics and long term care facilities. These settings require massage therapists to work directly with physicians and allied health professions, this requires a sound understanding of the latest research findings.
Massage therapists that are able to understand and incorporate research into their clinical practice will be well positioned to transition into these multi-disciplinary clinical settings. This involves reading research articles, brushing up physiology and analyzing the evidence on both sides of the debate.
Even if these new findings do not revolutionize the way you practice, it will change the way you communicate with other healthcare professionals. Over the last five years there have been major changes to the scientific knowledge about pain science, myofascial trigger points and myofascial release, here is a look at the latest research evidence:
Pain science - "The experience of pain does not always correlate to severity of the injury"
Scientific research has changed the way we view injuries, we now know the brain is a neuroplastic structure that is capable of changing over time. Long after the tissue has healed patients may feel pain due to changes that take place in the nervous system. This has important implications for assessment and treatments-essentially the experience of pain does not always correlate to severity of the injury.
Myofascial Release - "Research helped me move to a mindset that is inclusive of the nervous system"
Before reviewing the literature on myofascial release, I used a heavy handed approach to invoke a mechanical ‘tissue release’. Then I came across a research paper by Robert Schleip Fascial Plasticity - a New Neurobiological Explanation. In short, this paper suggests massage therapy stimulates fascial mechanoreceptors, which may, in turn, trigger tonus changes in connected skeletal muscle fibers. These muscle tonus changes might then be felt by the therapist. This paper was an easy to understand review of his research, complete with cartoon illustrations. This research paper helped me move from a mechanical mindset to one that is inclusive of the nervous system. For me Robert Schleip was a starting point, his papers cited other useful articles that were relevant to myofascial release, this ‘citation chaining’ lead me to read papers from Carla Stecco, Thomas Findley, Helene Langevin and Leon Chaitow.
Trigger Points - "With over thirty plus years of research there is still no consensus to what these sore spots are"
There has been a monumental shift in knowledge about the pathological entity that we call myofascial trigger points. In the March 2015 edition of Rheumatology A critical evaluation of the trigger point phenomenon was published, this article served to deconstruct the known etiology of myofascial trigger points. The authors suggest that researchers move their search for myofascial trigger points from muscles to nerves, or others structures. This was followed up in summer of 2015 by another paper on the topic of myofascial trigger points Myofascial Trigger Points Then and Now: A Historical and Scientific Perspective, this was a narrative review that provide perspective on the topic of myofascial trigger points; however, It may surprise you to know, with over thirty plus years of research there is still no consensus to what these sore spots are, theories include: nerve inflammation, fascial densification and central sensitization.
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