You understand the value of massage therapy. You’ve watched clients relax or feel relief from pain. You’ve helped them recover from injury or dial back the stress that might be contributing to other health problems.
Today, massage therapy is increasingly being recognized for the benefits it provides in a wide range of settings for a large variety of symptoms and conditions. This trend presents new opportunities, but many of them are going to require that you understand—and collaborate with—other health care professionals. In this article, you’ll learn more about what you need to know when working with professionals in other health care settings, from the knowledge you need, to what you can expect, to how to get your foot in the door.
Where You Are Needed
The cost of health care has long been a thorn in the side of both the patients receiving care and the physicians who treat these patients. Couple the cost with a better understanding of some of the risks involved when treating conditions that involve chronic pain, like opioid addiction for example, and the increasing popularity in integrative approaches in health care begins to make real sense.
For Dr. Lanie Francis, a hematologist and oncologist at Hillman Cancer Center, one natural fit for massage therapists is with oncology patients, a health care demographic she has a great deal of experience treating. “Massage therapists can be useful for oncology patients to help with relaxation and quality of life,” she says. “I’ve seen patients benefit from massage therapy for swelling, pain, neuropathy, insomnia and anxiety.”
And some recent research bears out these claims. Controlling pain, as well as other symptoms and side effects, is well-documented as being very difficult. A 2007 meta-analysis that pooled data from 52 studies found the prevalence of pain to be approximately 59 percent among patients undergoing active cancer treatment and 50 percent across all cancer types, with the highest pooled prevalence of 70 percent among head/neck cancer patients.1
More recent research that was published in 2016, however, is confirming the myriad benefits massage therapy can provide patients dealing with cancer. According to a collaborative meta-analysis of research on massage therapy for pain conducted by Samueli Institute, based on the evidence, massage therapy shows promise for reducing pain intensity/severity, fatigue and anxiety in cancer populations compared to the active comparators who were evaluated.2
Additionally, a 2014 study of patients with acute myelogenous leukemia who received 50 minutes of Swedish massage three times per week for seven weeks found all participants experienced stress reduction, increased comfort and relaxation, while another randomized study found massage resulted in significant improvement in short-term quality of life for patients near the end of life, with secondary benefits of pain reduction and improved sleep.3,4 “With the focus on physical touch,” explains Dr. Francis, “massage therapists provide a form of nurturing and support for patients that our conventional medical system misses.”
Along with integrative health care opportunities, massage therapy is also experiencing a surge in other health care arenas, too. Joellen Sefton, who is a certified athletic trainer and the director of the Neuromechanics Research Laboratory at Auburn University in Alabama, sees a great deal of potential for massage therapists who want to collaborate in the sports medicine environment—and not just with those individuals we traditionally think of as athletes. Sefton, for example, has worked with colleges and universities, symphony orchestras, Broadway show casts, semi-professional football teams, and local Olympic and serious athletes.
“Even though athletic trainers, physical therapists and other health care professionals all do some manual therapy, they don’t have the training or experience a massage therapist has,” she explains. “Likewise, massage therapists are expanding their skills but don’t have the training an athletic trainer or physical therapist has. So, when we have the opportunity to work together, we can all learn from each other, and that makes us all better health care providers.”
What You Need to Know
Be prepared.That you are going to need to be up-to-date on the latest research and have an above-average understanding of anatomy and physiology should not come as a surprise. Still, you need to be prepared to demonstrate your knowledge to the health care professionals you are looking to collaborate with. “You’ll need to demonstrate a solid educational background,” Sefton says. “Without proper credentials, you can’t touch athletes.” Francis agrees, explaining that anyone looking to work in integrative care will need to have—and be able to demonstrate—proper training and experience.
Related: Current Massage Therapy Research
But that advice cuts both ways, meaning you should also never overpromise or talk about massage therapy as a cure-all. “Don’t spread inaccurate claims about massage therapy,” Sefton says. “You need to know the current science behind your work and be able to discuss how massage therapy works. It’s also OK to say, ‘We don’t know why this specific technique is effective. We’re still researching, but available evidence indicates there is a positive effect.’”
Be realistic. Similar to being able to demonstrate the depth of your knowledge, you’re also going to want to set realistic goals for what you and massage therapy can do in health care environments. “These expectations can come from physicians, patients and massage therapists,” Francis explains. “If we can find a common language and frame realistic expectations, then I believe holistic care can truly move into the conventional medicine realm.” In her own practice, for example, Francis trains and mentors integrative therapists so they have the language to work with cancer patients. “Our framework is clear that our goal is to improve symptoms and quality of life. We are guided by the literature as much as possible,” she says. “The physician plays a role of gatekeeper, supervisor and educator for the therapists, and the therapists are a valued part of the care team, creating levels of support for the patient.”
Being clear on what massage therapy can accomplish in an integrative care environment will often be a matter of ethics, as well. “It is very important in our program that all providers abide by a code of ethics that states we are focused on symptoms and quality of life and not treating or curing cancer with our integrative therapies,” Francis stresses. “Look to the physician to guide in terms of tone and expectations, and ask if something is not clear.”
Communicate. Perhaps in no other environment will clear and concise communication—both verbal and written documentation—be as paramount to your success as when collaborating with other health care professionals. Francis suggests keeping your communication clear, organized, simple and timely. “Nothing overly long or involved,” she cautions.
“Communication is vital,” says Sefton. “You need to be able to communicate effectively with patients, athletic trainers, physical therapists, team physicians, parents and coaches, to name a few.” Know, too, who you are talking to and tailor your communication style to meet their needs. “Being able to explain injuries and treatments at the level of the person you are talking to is important so they understand,” she adds. “You don’t normally want to explain the injury to the physician in the same words you would an athlete’s parents, for example.”
Also, says Sefton, there is going to be a lot of required documentation and notes, as well as insurance concerns to deal with, so be sure your intake and SOAP note skills are sharp when looking to work with other health care professionals.
Getting in the Door
Francis likes to be contacted via email by massage therapists who are looking to collaborate with her, and she has some expectations of that outreach, too. “The email needs to be professional and well-written,” she explains. “No typos! Provide me with your credentials, why you want to work in integrative care and a reference.”
She also looks for information that demonstrates your dependability, as well as an understanding of the importance of patient care. “I need to know that they will respond to inquiries from me and my staff,” Francis says. “Like any professional, they need to answer emails in a timely way and be able to schedule patients in a timely way. This is extremely important.”
Francis admits that today’s medical training and residency don’t typically include any training about massage therapy, so many physicians in traditional medical environments likely don’t fully understand the demonstrated benefits of massage, that there are different types of massage therapy or that massage therapy may be contraindicated in some situations. For these reasons, she often asks massage therapists who are first reaching out to her if they’d be willing to do some pro bono work to help her better understand their own strengths and what they have to offer.
Remember, too, that some cancer patients aren’t going to be familiar with massage therapy—and may find adding the cost of massage sessions to what they’re already paying for other treatments a strain on their budget.
Francis is quick to say, however, that massage therapists shouldn’t interpret her request for some pro bono work as a devaluation of what they have to offer an integrative health care setting. “Massage therapy is an expertise that deserves compensation,” she says. “Other methods, particularly to help those patients who might be financially strapped, might include creating massage packages and sliding scales, when possible.”
The opportunities opening up to massage therapists today mean that you have more control in terms of deciding where you want to work and in what career setting—or multiple settings—you find the most value.
Massage & Health Care Resources
FREE Massage Career Guide: Working in a Health Care Environment
Research: Talking With Physicians
Growing Your Massage Practice: Sample Intro Letter to Physicians
1. van den Beuken-van Everdingen MH, de Rijke JM, Kessels AG, et al. “Prevalence of pain in patients with cancer: A systematic review of the past 40 years.” Ann Oncol 2007;18(9):1437–49.
2. Crawford C, Boyd C, Paat CF, Price A, Xenakis L, Yang E, Zhang W, Evidence for Massage Therapy (EMT) Working Group. “The Impact of massage therapy on function in pain populations—a systemic review and meta-analysis of randomized controlled trials." Pain Med. 2016;May 10.
3. Taylor AG, Snyder AE, Anderson JG, et al. “Gentle Massage Improves Disease- andTreatment-Related Symptoms in Patients with Acute Myelogenous Leukemia.” J Clin Trials. 2014; 4:1000161.
4. Toth M, Marcantionio ER, Davis RB et al. "Massage Therapy for Patients with Metastatic Cancer: A Pilot Randomized Controlled Trial." J. Altern Complement Med. 2013 Jul; 19(7): 650-656.