Have you ever asked yourself how long a massage should be to be effective? Or, what can be tolerated when contraindications are involved? What exactly is the optimal massage “dose?”
In hospital-based massage, where budget constraints have to be considered, the answers to these questions can be used to figure out how best to allocate massage services across the hospital. How can massage therapy help the highest number of patients, and have the greatest impact hospital-wide?
A Spoonful of Sugar
Most of the time, research on massage dosing is not available, so practitioners do their best with clinical observations. At MD Anderson Cancer center, where massage has been provided to patients since 1999, therapists have made some interesting observations of massage effects with thousands of patients.
Sat Siri Sumler, a massage therapist with 13 years of experience at MD Anderson, notes that compromised health means inpatient massage sessions need to be shorter than the average outpatient session of 45-60 minutes. In its early years of the massage program, they began inpatient massage sessions lasting up to 45 minutes.
Over time, however, Sat Siri and other MTs recognized that the potential for “overtreating” (or exceeding dose tolerance) is greater when a massage lasts 30 minutes or more, and especially as it heads toward 45 minutes.
They observed that 20 minutes of massage seemed sufficient for relaxation, whereas just 10-15 minutes would meet with, “That’s all?” from the patient. For these reasons and others, they shortened the sessions. By shortening sessions, therapists could see more inpatients and still have an impact.
Measuring Outcomes in Gratitude
Massage staff also provide on-site (“chair”) massage to patients and caregivers in waiting rooms for surgery, radiation therapy, ICU and Critical Care, inpatient units, and other areas of the hospital. Even though chair massages in many settings last 20 minutes, the hospital team found that 10-minute chair massages were sufficient. According to Sat Siri, they saw that people were relaxed and very grateful after 10 minutes. A 10 minute massage was often followed by many tears and appreciative hugs from patients and families.
By keeping those sessions to 10 instead of 20 minutes, each therapist could see four people per hour, and help more people than a 20-minute standard would allow.
Most of us would prefer longer massage, but in both these cases, keeping sessions short stretched the value of the program, optimizing use of the massage budget.
Massage Dosing Gets Real
Dose-finding studies for massage therapy are currently in progress. Go to www.clinicaltrials.gov, a database of government-funded trials, completed and in progress. There, do a search for “massage” and “dose.” There you’ll find a dose-finding study of massage for neck pain, headed by Karen Sherman of Group Health in Seattle. There’s more there, too.
Try this “dosing” experiment: Check in with clinicaltrials.gov at the above link, or for published research, go to www.pubmed.gov, the US National Library of Medicine. Type in “massage therapy dose” (no quotes). There you’ll find a few completed massage dosing studies, as well as those in progress.
Your Weekly Dose of Research
Repeat this search 1x/month to see research emerging over time. It is guaranteed to be interesting. Who knows what we will discover about massage dosing?
Sat Siri Sumler is featured in our Hospital-Based Massage Therapy webinar series, where she shares insights, advice, and even sample massage protocols from her years maintaining MD Anderson’s popular massage therapy program. MD Anderson provides free massage to inpatients, families, and caregivers.