Facilitators and barriers to implementing an evidence based national massage therapy program for elite paracycling athletes

Background:

Strong evidence exists for the physical and psychological benefits of massage therapy for able-bodied athletes; however, no evidence exists in disabled athletes. Studies do indicate that para-athletes experience more sports-related injuries than able-bodied athletes.  Soft tissue injuries in the upper body are the most prevalent for para-athletes, and massage therapy has been shown to help facilitate the healing of these injuries.

The Roger C. Peace para-cycling team includes athletes located across the United States who compete at a world-class level.  As part of a sponsorship of the team, a standardized evidence based massage therapy program was created to investigate the influence of massage therapy on performance, pain, injury rehabilitation, and quality of life both on and off the bike. This study looked at the facilitators and barriers to implementing this program.

Methods

The recruitment of massage therapists (MT) began by identifying whether athletes had a massage therapist with whom they were working.  Of the 10 athletes who are participating in the study, 3 identified massage therapists which they had a previous/current working relationship; the other 7 athletes requested assistance in finding therapists.

Athletes were asked to provide their zip code to facilitate finding therapists through a locator service.  The web-based service provides information including years in practice, modalities, and location of therapist’s practice. Therapists were contacted if they had been in practice for at least 5 years and listed sports massage as a modality. Identified therapists were then contacted by phone to gauge interest in working with the program.  Therapists were informed about study protocols and ensured they would receive their contracted rate.

Results

Of the therapists previously identified by the athletes, one chose not to work with the study, which required the research team to locate therapists for the 8 athletes.  A total of 25 therapists were contacted; 12 of those therapists did not return calls, 2 therapists did not have accessible spaces, 1 could not accommodate the study due to travel schedule, 2 were not interested in participating in research or taking therapists notes, and 1 was not in the area of the athlete. The research team subsequently identified 7 MTs who agreed to implement the massage protocols for the athletes; one of the massage therapists will work with 3 of the athletes.

Discussion

The barriers included lack of communication by the contacted therapists, lack of accessibility, lack of desire to participate in research, and lack of desire to keep therapists notes. Facilitators include excited athletes, enthusiastic therapists who met the requirements and had buy-in of the program, and a dedicated research and coaching staff who identified qualified MTs throughout the country. Next steps will be for the MTs to complete 2 training sessions on the instruments, protocols, and learning to relay information back to the research staff. Implementation of the massage program will subsequently commence.