Interprofessional collaboration is the key to stemming the tide of chronic pain and immobility plaguing our species.
New theories, new ideas and new understanding of the benefits and shortcomings of manual therapy can confuse even the most seasoned therapists — yet, the landscape of physical medicine is changing. New and emerging research continually paints an ever-evolving and fluctuating landscape for any person in the health, fitness and medical industries.
Furthermore, multiple professionals sharing the manual therapy space can lead to unnecessary competition between massage therapists, physical therapists, athletic trainers, acupuncturists, chiropractors and fitness professionals.
For years, manual therapists of all kinds have claimed to fix, re-align and reform tissues, and “undo” the wrongdoings of human existence. Science, however, paints a very different picture.
First of all, we are not doing all of these things with our hands like we used to, which means narratives of old are changing. We know now that physical tissue change is a minute portion of how and why bodywork is effective for pain. Many, in light of this evidence, maintain that manual therapies “donʼt work” because the results can vary, may be difficult to repeat, and very-little-to-no structural change is evident in a single session.
So, why has massage been a part of human culture for thousands of years? If it indeed “doesnʼt work,” why has it stood the test of time?
There is no denying the power of human touch, but the narrative has evolved into a much more neurological and psychosocial explanation, meaning the effect of touch does more to the mind and spirit than the body. This change has been difficult for many therapists to adopt.
Hereʼs what hasnʼt changed: Chronic pain and obesity affect more people in the US than cardiovascular disease, diabetes and all cancers combined — and despite a growing research base, the latest technology and the newest techniques, the incidences of low-back pain, neck pain and athletic injuries continue to rise.
If we want to see these circumstances change, we, as health care professionals, must also change — not in modality, but in approach.
For years we remained divided, professions competing with each other and in litigation with each other, all in an effort to prove there is one supreme physical medicine provider, a potential title that means nothing — especially because, as far as the statistics go, it would mean the victorious profession would own the responsibility of a nation whose health is in the worst condition in modern history.
The answer? Interprofessional collaboration.
Health Care’s Magic Bullet
Interprofessional collaboration is the key to stemming the tide of chronic pain and immobility plaguing our species. A multidisciplinary approach has been one of those medical pipe dreams that is slowly coming into the mainstream fold for one simple reason: Necessity.
Touch is medicine. Drug-free, natural, holistic medicine. However, like all other medicines, the result is temporary. It doesnʼt permanently fix the ailment, it just transiently modifies the symptoms.
Therefore, as manual therapists, we are not fixers, we are facilitators — and there is one type of facilitation that effects change above all others.
Getting temporary results to stick requires movement. Movement is our magic bullet. No other modality can affect physical health, mental health and social health the way exercise can.
Each profession falls short in one way or the other when it comes to understanding how best to integrate massage and movement. Either we get a lot of massage training or a lot of exercise training — and in some cases, a small amount of both. While many practitioners seek continuing education to fill in gaps in their expertise, a weekend course can simply never replace years of experience in the trenches.
It doesnʼt matter which educational program you come from; there are pitfalls to all of them, and no one person can know, or be a master of, everything. Therefore, the only reasonable course is to integrate. When we throw aside the credentials and come together as a team, amazing results are possible, repeatable and sustainable—and these three things are required for lasting change.
This should be easy, since our common goal is to help people. Yet, we still see a divide among professions.
So now to the final thought. The formula, if you will.
Interprofessional Collaboration in Action
If we truly wish to defeat chronic pain and obesity and get people feeling better, moving better and ultimately moving more, a multimodal approach is the solution.
Take this basic logic: If pain is the result of poor nutrition, exercise and lifestyle habits, then the solution is habit modification. Changing habits is one of the single hardest things to do as a human being. “We are creatures of habit,” said some wise person at some point in time.
How do we change a habit? Altering repeated, conscious efforts over a long period of time can do the trick, but it is a hard, frustrating and sometimes a never-ending road. What do you think the success rate is for someone in chronic pain? While acute pain is a symptom, chronic pain presents very much like a disease, as it affects multiple body systems and processes simultaneously.
Physical, mental, emotional, social — think you can inspire somebody to start exercising despite what could be years of suffering and fear — simply by stating that exercise will fix their problem? Yeah, good luck with that.
The other way to influence change in habitual behavior is through powerful emotional experience or a reward stronger than prior reward for said habit.
Here at The Movement Underground, a multidisciplinary team of massage and movement professionals works in interprofessional collaboration to identify the physical, mental, emotional and social variables that would be beneficial to change. On any given day, clients here work with a massage therapist, athletic trainer, physical therapist, and strength and conditioning coach.
Many people begin their journey with symptom modification through manual therapy aimed at improving pain and mobility while stimulating the nervous system through touch. This also creates an opportunity for social interaction and education, in an intimate setting. Research tells us that touch activates emotional centers of our brain; therefore, a massage session is as much an emotional experience as it is a physical one.
Here is where we get someone to buy in. We show them that feeling better and moving better are possible. With a renewed spirit, off to the athletic trainer or strength coach they go. Feeling better and moving better, they begin training on exercises safe for their condition and goal-oriented to the individual, ensuring slow, sustainable progress to lessen any setbacks or risk of re-injury.
Now you may note that in this last section I didnʼt mention which provider does what part. Why? Because it doesnʼt matter. If you have a license to touch, then touch. If you have a license to coach, then coach. If you can, and prefer to do both, then do both. The bottom line is that the combination of manual therapy and movement is greater than the sum of its parts, and its actions are far more significant when combined with empathy, education and consistency.
Bring Clients on the Ride
In this article I’ve laid out a plan to help Americans feel better and get healthier. Now I’ll tell you what not to do: Stop credential measuring. If we truly want to help people get better, we first have to be better ourselves. We must come together and work side by side as equals, and inspire as many people to come with us as possible.
If you are a massage therapist and do not have a strong exercise background, go find someone who does and collaborate with them.
Remember, a person’s mind can be convinced, but their heart must be won, and weʼre going to need their hearts along for this ride.
About the Author: Mike Stella, ATC, PES, CES, is a Certified Athletic Trainer, Corrective Exercise Specialist and Performance Enhancement Specialist who is dedicated to helping all athletes and people overcome injuries and functional limitations. Stella has rehabilitated and reconditioned athletes from a variety of levels and sports, helping them return to competition and increasing their resilience to future injury. He wrote this article on behalf of ROCKTAPE.