Online Program

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

Monday, November 2, 2015

Ann Blair Kennedy, LMT, DrPH(c), Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, SC
Jennifer Trilk, PhD, Biomedical Sciences, University of South Carolina School of Medicine - Greenville, Greenville, SC

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.


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.


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.


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.


Learning Areas:

Implementation of health education strategies, interventions and programs
Other professions or practice related to public health
Planning of health education strategies, interventions, and programs
Public health or related research

Learning Objectives:
Describe the barriers to implementation of a massage program for a decentralized paracycling team..

Keyword(s): Disabilities, Quality of Life

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been a massage therapist for 15 years and this project grew out of my practicum work for my DrPH degree. My scientific interests include the impact of massage therapy on health and health behavior as well as massage therapy for disabled athletes.
Any relevant financial relationships? Yes

Name of Organization Clinical/Research Area Type of relationship
American Massage Therapy Association study funder I volunteer for 2 national committees of the AMTA

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.