MET to Levator Scapulae Versus MET to Anterior Scalene: Comparative Effects on Craniovertebral Angle and Cervical Joint Position in Forward Head Posture

Background: Forward head posture (FHP) results in an accentuated posterior curve in the higher thoracic vertebrae and an accentuated anterior curve in the lower cervical vertebrae. Dysfunction leads to muscle imbalance, where one side of the neck and scapula muscles become weak and the opposite group of muscles become tight. Strategies to correct this imbalance by treating flexibility and improving strength are the need of the hour. Purpose: The aim of this study is to assess the effectiveness of muscle energy technique (MET) to levator scapulae versus MET to anterior scalene in improving craniovertebral angle (CVA) and joint position sense. Setting: This study was conducted at the outpatient department of Dr. D. Y. Patil College of Physiotherapy, Pune, India. Participants: Both males and females aged between 18 and 30 years with a CVA <48° were included. Research design: This was an experimental study. Intervention: A comparative experimental study was done on subjects aged between 18 and 30 years with CVA<48°. Group A (n = 15) received MET to levator scapulae muscles with conventional treatment and group B (n = 15) received MET to anterior scalene muscles with conventional treatment for 4 weeks, three sessions per week. The outcome measures assessed were CVA and cervical joint position error, pre- and post-intervention. Main outcome measures: CVA and cervical joint position sense. Results: MET to levator scapulae and anterior scalene significantly improved the FHP (p = 0.001 for both the groups) and cervical proprioception (p = 0.001 for both the groups) using the Wilcoxon signed rank test for pre–post comparison. However, on comparison between groups using the Mann–Whitney U test, MET to levator scapulae was better in improving the FHP (p = 0.002). No significant difference was found in the cervical joint position sense between both the groups. Conclusion: Levator scapulae and anterior scalene flexibility should also be considered in FHP. Applying MET to these two muscles is not only beneficial in realigning the FHP but also in improving the cervical joint position sense

Deep Front Line Myofascial Release Versus Novel Soft Tissue Kinetic Chain Activation Technique (K-CAT) on Pain, Radiological Patellar Position and Dynamic Knee Valgus in Knee Osteoarthritis: A Randomized Clinical Trial

Background: Knee osteoarthritis (OA) is the most common degenerative condition, afflicting large number of people globally. Fascia is a three-dimensional network of connective tissue that helps in force transmission along the myofascial chains to bone level causing malalignments and movement dysfunctions. Myofascial dysfunctions have been identified in osteoarthritis of knee as a pain-causing component. Recently, clinicians have aimed a variety of therapeutic techniques at fascia. There is a lack of literature to determine the effect of kinetic chain activation technique (K-CAT) as well as deep front line (DFL) release technique in OA knee. Purpose: The current study aimed to determine and compare the effectiveness of DFL release and K-CAT in knee OA. Methods: The study was a randomized clinical trial conducted in an outpatient department of a tertiary care hospital. Thirty-two (n = 32) participants between 45 and 60 years of age with knee osteo-arthritis (grades 2 and 3) were included and randomized into two groups based on selection criteria. Group A received DFL myofascial release and Group B received K-CAT, along with common conventional therapy (modality + exercises), three sesions per week for 2 weeks. Pain intensity using Numeric Pain Rating Scale, skyline view of knee radiographic parameters including lateral patellar tilt angle (LPTA) and bisect offset (BO), dynamic knee valgus (DKV) by single leg squat using Kinovea software and quality of life using Knee Injury and Osteoarthritis Outcome Score on day 1 and day 14 of intervention were assessed.Results: Within-group analyses showed significant improvements in both the groups for pain, BO on x-ray, DKV, and Knee Injury and Osteoarthritis Outcome Score (p < 0.05). LPTA showed statistical significance only in the DFL group. However, between-group comparisons showed no statistical difference in all the outcomes (p > 0.05). Conclusion: Both DFL myofascial release and K-CAT were found to be equally effective in alleviating pain, improving quality of life and knee malalignments. Trial registered under Clinical Trial Registry of India (CTRI/2023/11/059388)

A Qualitative Scoping Review of Massage and Massage Therapy on the Mental Health and Well-being of Individuals Living with a Serious and Potentially Life-limiting Physical Illness

Background: Serious illness “is a health condition that carries a high risk of mortality and either negatively impacts a person’s daily function or quality of life or excessively strains their caregivers.” Purpose: The aim of this review was to explore the contribution of massage and massage therapy to the mental health and well-being of individuals living with a serious and potentially life-limiting illness. Methods: A scoping review was conducted following Arksey and O’Malley’s six-step scoping review framework and the PRISMA-ScR guidelines. The electronic databases PubMed, CINAHL, MEDLINE (OVID), PsychINFO, CENTRAL, Web of Science, PROQUEST Dissertations and Theses, and Scopus were searched to identify qualitative or mixed-methods studies. The qualitative data were coded from the studies and themes emerged. For the final stage of analysis, a thematic synthesis was utilized. Findings: Sixteen papers were included from eight countries. The overarching theme was “the effable and ineffable impacts of massage” informed by the following themes: massage as a transcendent experience, existential respite, massage helping to preserve dignity, increased inner resources, well-being and relaxation as part of the individualized and personalized vocabulary for massage for the seriously ill, and varied outcomes of the effect of massage on physical symptoms. Conclusion: Good mental health and well-being are important aspects of living well with serious illness. The review found there is a considerable body of research which points to the value and impact of massage on outcomes of well-being and mental health and, broadly, on patient experience

Therapeutic Massage and Homecare to Reduce Dissociation in Post-traumatic Stress Disorder: A Case Report

Introduction: Dissociation is a transdiagnostic phenomenon common among trauma survivors. Key characteristics include depersonalization, derealization, absorption, and amnesia. Chronic dissociation is correlated with autonomic nervous system hypoarousal and other neurophysiological adaptations that impact survivors’ ability to make gains in conventional psychotherapy. Therapeutic massage has demonstrated stimulatory effects on cortical regions that exhibit functional dysregulation in dissociation and post-traumatic stress disorder (PTSD). This case study explored whether therapeutic massage and homecare could reduce persistent dissociation in a client with PTSD. Case presentation: The study participant was a 35-year-old Indigenous female who was diagnosed with PTSD at age 18. Intake assessment via the Dissociative Experiences Scale-II (DES-II) confirmed pathological levels of dissociation consistent with PTSD. Intervention comprised 10 sessions conducted by a massage therapy student over a period of 12 weeks. Each session included an initial interview, therapeutic massage, homecare prescription, and closing interview. Manual techniques were selected to promote parasympathetic tone while providing tactile stimuli; homecare techniques were selected to promote conscious proprioception. Dissociative progress was evaluated using four discrete DES-II samples, while somatic awareness was assessed during structured, 15-min massage periods in each session. Both tracked indicators showed improvement with intervention, with DES-II scores decreasing by 53.7% from initial baseline, and real-time awareness of somatic stimuli improving by 78%. These improvements were consistent with the participant’s subjective reports of increased somatosensory awareness. Discussion: As a low-risk intervention, therapeutic massage shows promise as an adjunct therapy in PTSD recovery. While the participant demonstrated improvements in tracked indicators, further research is needed to isolate the effects of massage from those of homecare exercises and the data collection process itself. Collaboration with psychiatry would enhance future study rigor by incorporating diagnostic assessments beyond the scope of massage therapy

Research as a Pathway to Advancing Interprofessional Integration

Interprofessional collaboration enhances health care by fostering communication, improving patient outcomes, and integrating diverse expertise. For therapeutic massage and bodywork (TMB) practitioners, engaging in interprofessional practice remains a challenge due to professional silos, limited research engagement, and other barriers to integration within health-care teams. This article explores the potential of research as a mechanism for strengthening interprofessional collaboration, positioning TMB practitioners as active contributors to evidence-informed health care. By fostering a stronger research culture, TMB can enhance its role within health-care systems, create new opportunities for integration, and contribute meaningfully to interdisciplinary patient care

The Effects of Massage Therapy on Post-traumatic Stress Disorder: A Case Report

Objective: To observe the effects of massage on generalized anxiety stemming from post-traumatic stress disorder (PTSD). The patient was seeking massage for relief from the symptoms of PTSD with the primary symptom to be addressed in treatment being anxiety. Methods: The client was a 25-year-old female who experienced PTSD from domestic abuse. The Generalized Anxiety Disorder 7-item assessment was used to measure anxiety throughout the study at the beginning of each session. The patient received six sessions of massage using several different massage modalities based on education requirements and to explore the most efficacious treatment techniques for the client. The different massage modalities that were used were neuromuscular therapy, myofascial release, cupping, craniosacral, and hot rocks. Results: The client’s presenting concerns included anxiety, pounding heart, shortness of breath, nausea and abdominal discomfort, and sweating. The client experienced a decrease in anxiety which meet the criteria for a minimal clinically important difference. The client experienced a small reduction in PTSD symptoms over the course of the six sessions. The client’s preferred massage modalities were craniosacral and hot rocks as she perceived the most benefit from these massage modalities. Conclusion: Massage is a treatment option for individuals with anxiety and symptoms related to PTSD and different massage techniques, while all appearing to be helpful, should be utilized as per the client’s preference

Combined Efficacy of Foot Reflexology and Back Massage on Pain and Fatigue in Patients Undergoing Hemodialysis

Background: Multiple treatment modalities have been used to treat complications such as pain and fatigue in patients undergoing hemodialysis. However, the combined effectiveness of reflexology and back massage (BM) in relieving pain and fatigue in patients undergoing hemodialysis is limited and this study aims to fill this research gap. Materials and methods: A pre- and post-test experimental study design was adopted in which 60 patients (n = 60) undergoing dialysis were randomized into two groups of 30 each using a simple randomization technique. The subjects of experimental group I received foot reflexology (FR) and BM, while experimental group II received only BM. The intervention lasted 2 days per week for 4 weeks. To examine the effectiveness of the treatment both before the intervention and at the end of the fourth week, two variables were evaluated: (i) pain intensity, which was measured using the visual analogue scale (VAS) and (ii) fatigue experienced by patients, which was measured using the Fatigue Severity Scale (FSS). Results: Subjects treated with FR and BM showed better reduction in VAS (mean difference: 1.06, 95% confidence interval (CI): 0.299–1.834, p < 0.05) and FSS (mean difference: 6.61, 95% CI: 0.230–11.90, p < 0.05) than the subjects exposed to BM only, with a significance level of 0.05. Conclusion: The combination of FR and BM has been found to be significantly more effective than BM alone in managing the health risks of pain and fatigue in hemodialysis patients

Understanding Australian Massage Therapist’s Awareness of and Knowledge to Recognize Domestic and Family Violence: Findings from a Community Survey

The objective of this study is to investigate massage therapists’ knowledge, confidence, and awareness of domestic and family violence (DFV) in clinical practice. An online questionnaire methodology was used to collect data from Australian massage therapists who were 18 years or over. The study was open for participation for 6 months. The authors developed the questionnaire based on a previous massage therapy profession questionnaire; it included 64 questions in three sections. Two hundred and seventeen respondents formed the dataset. This study found respondents with prior experience of DFV were significantly more likely to have undertaken DFV training than respondents with no prior experience of DFV (p = 0.004). Almost two-thirds of respondents either strongly agreed or agreed that they would like some training to better understand DFV (n = 142, 65.4%) and to better understand their responsibilities around DFV (n = 149, 68.7%). Over half of the respondents were somewhat or very confident they would recognize the signs and symptoms of DFV (n = 126, 58.3%). Over half of respondents (n = 119, 54.8%) felt somewhat knowledgeable about DFV. The main theme from the qualitative analysis was absent resources. The subthemes were (i) without training I cannot help, (ii) prepare me, train me early, and (iii) support me with resources. This study concluded that there is a lack of resources and a deficiency in skills and knowledge among massage therapists to recognize and respond appropriately to domestic violence in clinic. Respondents indicated a desire to learn more about DFV in their practices as they deemed that without training, education, and resources they cannot provide the best of care for their clients

The Effects of Massage Therapy on Medically Induced Trauma and Touch Aversion: A Case Report

Almost 1 million US adults are diagnosed annually with post-traumatic stress disorder related to medical trauma. Individuals who experience life-threatening illness or injuries, frequent hospitalizations, and multiple invasive procedures are more likely to develop post-traumatic stress and touch aversion, making it difficult for them to relax and feel safe in health-care settings. Psychological and somatic symptoms can complicate recovery and decrease quality of life. While massage has been shown to offer a variety of physical and psychological benefits, little is known about the benefits of massage for those diagnosed with post-traumatic stress and touch aversion related to medical trauma. A 44-year-old female was referred to massage therapy for muscle pain and generalized weakness, symptoms of a chronic degenerative illness with limited treatment options. Complicated by multiple diagnoses, her long-standing anxiety and depression had worsened, and she suffered from post-traumatic stress and touch aversion due to significant medical trauma. The patient’s goals included relaxation, decreased pain and anxiety, as well as improvements in her aversion to touch when receiving necessary medical care. A wide variety of massage techniques were offered based on the patient’s physical and psychological symptoms, and her receptivity to touch. Over the course of 2 years, the patient’s anxiety and distress decreased as her ability to communicate her needs increased. A trauma-informed approach is essential when providing massage for those with post-traumatic stress and touch aversion from medical trauma. A pre-massage consultation and customization of the massage allowed the patient to provide consent and have control over where and how her body was touched, something that is often not possible with medical procedures. Further research is needed to determine how best to provide massage therapy to these individuals and measure outcomes related to effectiveness and symptom improvement

Evaluating the Effectiveness of Deep Transverse Frictional Massage Combined with Conventional Physiotherapy for Tendinopathies: A Systematic Review and Meta-analysis

Background: Tendinopathies are common musculoskeletal disorders characterized by pain and functional impairment, often requiring therapeutic interventions for effective management. This systematic review and meta-analysis aimed to evaluate the effectiveness of deep transverse frictional massage (DTFM) combined with conventional therapy for the treatment of tendinopathies. Methods: A study search of electronic databases including MEDLINE, Google Scholar, and PubMed databases, was conducted for randomized controlled trials, pilot study, and comparative study design comparing the combined application of DTFM with conventional physiotherapy (e.g., exercise, stretching, or modalities) to conventional therapy alone for the treatment of tendinopathies. Inclusion criteria were studies that reported clinical outcomes such as pain reduction and disability. Data extraction was performed independently by reviewers. A meta-analysis was conducted using random-effects models to estimate the pooled effect size, and heterogeneity was assessed using the I2 statistic. The risk of bias was assessed using the Cochrane risk-of-bias approach. Results: A total of 13 studies met the inclusion criteria. The combined treatment group (DTFM + conventional therapy) showed significant improvements in pain reduction (standardized mean difference (SMD) = −0.92, 95% confidence interval (CI): −14.50, p < 0.05) and elbow (SMD = −2.67, 95% CI: −3.38 to −1.96, p < 0.05) compared to conventional therapy alone. No significant adverse effects were reported. Conclusion: The findings suggest that DTFM, when combined with conventional therapy, offers significant benefits over conventional therapy alone in the management of tendinopathies, particularly in reducing pain and improving function. The exact physiological mechanisms through which DTFM works in combination with conventional therapies remain unclear. Research into how DTFM influences tissue healing, collagen remodeling, or pain reduction pathways could provide more insights into its effectiveness and guide its integration into treatment protocols