Practitioners and researchers from manual therapy fields including massage, osteopathy, chiropractic, structural integration and physical therapy met recently to collaboratively discuss the latest insights into manual therapies and to help shape future collaboration and research.

Practitioners and researchers from manual therapy fields including massage, osteopathy, chiropractic, structural integration and physical therapy met recently to collaboratively discuss the latest insights into manual therapies and to help shape future collaboration and research.

The first International Consortium on Manual Therapies (ICMT) conference took place online from May 4-June 3.

“[This conference] will most likely change the future of the massage therapy profession as we work toward defining what we do with our hands, so more research can be done across all professions that use manual therapy methods,” said attendee and massage therapist Julie Onofrio, LMT. “I got to see and be a part of the beginning of real integrative health care—[of] collaboration across many professions that used to have turf wars. Those times are behind us. The future is brighter now.”

ICMT is forming membership options to continue the discussion in webinars, group networking, social media space and, conference proceedings.  The massage therapy community needs to be engaged with ICMT. This is the silo-collapsing organization that has been talked about for years.

“The ICMT is a unique collaboration. It is exciting to see practitioners from around the world and multiple disciplines working together to more effectively develop research to provide evidence-informed care,” said attendee, massage therapist and Reiki practitioner Jeffrey Montoya, DHPE, LMT, BCTMB.

3 Key Topic Areas

In preparation for the conference, three key topic areas, felt to be fundamental in establishing a productive collaborative community in manual therapy, were explored: 

1. Manual therapy procedures;

2. Physiological theories behind the procedures, and;

3. Measuring physiological effects of manual therapies.

We collaborated to create an integrated mind map, comparison charts, technique templets and the very beginnings of a Rosetta Stone of nomenclature listing of terminology used in various professions. All are works in progress. The massage therapy documents

“It is an honor to work alongside brilliant leaders of the various manual therapy professions and to witness the passion, integrity and commitment within each profession along with the desire to bridge the gaps,” said massage therapist Erin Kelley, LMT, BCTMB. “The experience has been truly remarkable.”

Massage Research is Not Lacking

The scientific working group reviewed hundreds of research papers. (The librarians that assisted developed a poster presentation describing the process and how difficult it was to search various databases for relevant research because of terminology issues.)

The research was screened to support the focus of the inaugural conference related to biomechanical-based manual therapy research. As one of the research reviewers, it is clear to me that there is not a lack of research supporting manual therapy and massage-therapy-specific research is well represented.

This perspective was acknowledged by the keynote speakers from the National Institutes of Health (NIH), Helene Langevin, MD, director of the National Center for Complementary and Integrative Health (NCCIH); Partap S. Khalsa, DC, PhD, director of the Division of Extramural Activities, NCCIH; and Alex H. Tuttle, PhD, program director of the Basic and Mechanistic Research Branch, NCCIH.

The research now needs to pivot as outlined in the NCCIH Strategic Plan and a major initiative for funding is the Neural Mechanisms of Force-Based Manipulations: High Priority Research Networks (U24 Clinical Trial Optional).

To achieve the goals of the NCCIH Strategic Plan, collaboration is necessary among neuroscientists, manual therapists (chiropractors, physiotherapists/physical therapists, osteopathic physicians, massage therapists), physiologists, mathematician, and engineers to advance cutting-edge research related to force-based manipulations. A major issue in the collaboration is the need for common terminology.

“We know manual procedures are done by many professions and by numerous practitioners,” said Brian Degenhardt, DO. “However, there is no place where practitioners and researchers can collaborate in an open‐minded, supportive, progressive and respectful multi‐professional environment to discuss ways to advance the practice.”

How the ICMT was Created

When something new immerges, you can be sure that years of work preceded the event. That is the case with the ICMT. The seed was planted in 2007 at the first Fascia Research Congress at Harvard Medical School in Boston.

At that congress, Paul Standley, PhD, of the Department of Basic Medical Sciences, University of Arizona College of Medicine, stood on the stage and said that he did not understand what we were talking about and, as a result, could not understand what we were doing—and therefore he was limited in designing and conducting research related to manual therapies.

I was in the audience in Boston as Standley spoke. Many of the current massage therapy leaders and educators were also there. Yet, as we all returned to our daily life, little progress occurred.

Again and again, at various disciplines’ conferences, a core group continued to identify that a unique collaboration of multiple manual therapy disciplines needed to work together to break down professional silos and begin to talk, and especially share research development, funding and integration into clinical practice.

Eventually, a core group took action: Brian Degenhardt, DO, assistant vice president for osteopathic research at the A.T. Still Research Institute; Paul Standley, PhD, of the University of Arizona College of Medicine; and Francesco Cerritelli, PhD, neuroscientist-osteopath, president of the Centre for Osteopathic Medicine Collaboration; and

Over three years ago, the fledgling ICMT was formed and recruitment of international experts in manual therapy disciplines began. Professional experts included doteopaths, osteopathic physicians, chiropractic physicians, massage therapists, structural integration practitioners and physical therapists, with outreach to a broader group of disciplines including athletic trainers, manual medicine physicians, occupational therapists, physiatrists and importantly, researchers in these fields.

[Watch the manual therapy disciplines’ Discussion Forums conducted at the ICMT.]

An Important Collaboration

I was recruited over two years ago. At a time in my career when I am beginning to pull back, I initially resisted involvement. However, my gut instincts confirmed that this collaboration was going to be important to the massage therapy community in the future.

The initial ICMT working groups were an international and interprofessional group of clinicians, educators and scientists. We worked together to collect, compare and, when appropriate, integrate information and data to provide a foundation for interprofessional communication and understanding during the inaugural ICMT Conference.

Originally planned as an onsite event at the University of Arizona at the beginning of 2022, it became clear that COVID-19 pandemic travel limitations, especially for global participation, plus increasing costs in general, required out-of-the-box thinking on the part of ICMT leaders.

Geoffrey Franklin pivoted the gathering to a new virtual collaborative platform called. Gathertown. In this virtual environment, participants were able to engage in interactive discussion platforms that happened in short segments over a 30-day period, allowing practitioners and scientists to attend and still maintain work and family schedules.

Even the span of time zones was accommodated. All the speakers, panels, discussion groups, and special interest discussions were recorded. Each discipline posted video examples of methods used. There was a robust and excellent poster session that was one of the highlights of the conference. We tackled uncomfortable topics, especially related to discussions about the past. Led by Cameron W. MacDonald, PT, topics included “Skeletons in the Closet” and conundrums around “Licensed to Touch.”

Next Steps

The future of ICMT is exciting. For the next consortium, we intend to generate even more attendance. It is hoped that future participants will continue the work with us.

“The first ICMT conference is a treasure trove of knowledge and experience. Research has been done. Research is being done. Is calling for more research the answer? Or is studying current science more likely to give those in need, relief sooner?” Posed attendee and massage therapist Allissa Harter MT, of Sweden. “Let ICMT be a bridge. May ICMT be the doorway to allow Manual Therapists to cross—to speak with engineers and scientists.”

Future engagement is being planned, with projects focused on advancing the field of manual therapy (remember, massage therapy is manual therapy) through steady, reasonably paced engagement of thoughtful contributing members addressing fundamental issues that are currently inhibiting the advancement of the science and clinical practice of manual therapy.

Discussion during the conference and the new awards by NIH and NCCIH indicate that the conference themes and goals were right on target.

Membership in the ICMT is open to practitioners who provide manual therapy, including athletic trainers, chiropractors, doctors of chiropractic, doctors of oriental medicine, doctors of physical therapy, manual medicine physicians, massage therapists, osteopaths, osteopathic physicians, physiatrists, physical therapists, and structural integration practitioners, as well as researchers in the fields of anatomy, biomechanics, circulation, kinesiology, motor control, neurophysiology, pain, pathophysiology, physiology, and sociology.

This summer and through the remainder of the year, members within the ICMT will work on disseminating the work that has been accomplished over the past two years, continue to work on projects such as a unified manual therapy glossary of terms, and begin fleshing out the next ICMT conference. Click here to join.

Sandy Fritz

About the Author

Sandy Fritz is a founding member of the Alliance for Massage Therapy Education and the author of massage textbooks including “Mosby’s Fundamentals of Therapeutic Massage”; “Mosby’s Essential Sciences for Therapeutic Massage: Anatomy, Physiology, Biomechanics, and Pathology”; and “Sports & Exercise Massage: Comprehensive Care for Athletics, Fitness, & Rehabilitation.” Her articles for MASSAGE Magazine include “Old Myths Die Hard: The Truth About Toxins,” and “The Massage Profession Needs to Face the Future—United.”