Clinical Case Reports

By Michael Hamm

Tell me if this rings a bell. You’re talking to another healthcare professional about bodywork. You’re telling her about treating injuries, increasing body awareness, or transforming a slumped frame into a buoyant one. Yours is a beautiful craft. But your colleague seems less than enchanted. She doesn’t live in your world, and she will need more than mere anecdotes to be convinced of your efficacy.

If that sounds familiar, you’re not alone. A great challenge lies before us all: to find a common language with other healthcare disciplines. We need to be able to communicate more easily, and we need the evidence to back up our assertions.

That brings us to the “S”-word: science. There is precious little of it in massage and bodywork. We desperately need more quality scientific writing in our field. But when called on to contribute, most bodyworkers scoff: “I can’t do that. Science is for scientists.”

Not true. Science is just a big conversation, and just about anyone can speak up. For clinicians, the easiest (and most important) way to join the conversation is by submitting a clinical case report. If you have observed interesting things in your practice, don’t keep it a secret.

You already have the most important tools in hand: your techniques, your assessments, and your charting. The remaining tools are readily available, and the following sections are meant to give you a first look at how to join the conversation.

What’s In It for Me?

You have a lot to offer the research world. But you also have a lot to gain from it. Here are some reasons why people get involved:


Professional advancement. Become an expert in something.


Improve your own field. Promote higher-quality training and better-informed clients.

Collaborate with other healthcare professionals. Ever feel lonely in that massage room? Build an academic community.

Empower your work. Gain confidence and specificity in your clinical decision-making.

What Is a Case Report?
If science is a conversation, then a case report is a short story. It’s how clinicians tell their colleagues and other scientists about interesting things that happened in their practices. It’s a fancy way of saying: “Hey guys, check this out. I think this may be important.” But for all their simplicity, case reports are essential for the research world.

First, they bring us to the very edge of scientific knowledge. Theories not yet proven, diseases not yet named, and treatments not yet tested can all get their first sounding in the form of case reports. In one famous example, the mysterious disease that later became known as AIDS was first described in a case report in 1981. What if that author had written nothing? The vast clinical research into AIDS might have taken another year or more to get off the ground. Not only can case reports identify new fields of inquiry, they can also shape the kinds of questions that get asked and the way research is conducted in the field.

This aspect is especially important for the massage field. Let’s face it: research can be boring. It can miss the point. It can be unintelligible, and its assertions can be just plain wrong. If you have read massage research and felt this way, it’s not because you are stupid. It’s often because the wrong questions are being asked. Case reports identify the right questions, and thus make research more meaningful to regular clinicians.

Structure of a Case Report
Case reports all follow a similar pattern. This pattern allows the paper to be read easily by other clinicians and scientists. Here’s the most common sequence:


Abstract/Keywords. A quick synopsis of what’s to come.


Introduction. Set the plot: a balanced literature review, relevant background information, etc.

Methods. Lay the specific groundwork: a detailed client profile, a well-supported treatment plan, and the assessments/measures you decided to use.

Results. Summarize what happened in the course of treatment and what the assessments/measures showed. Just give the facts; don’t interpret them yet.


Discussion. What do you think it means? How do the results connect back to your literature review? How should future researchers study this condition/technique?


References. Show that you’ve done your homework, and make it easy for your readers to find the same information. (Save yourself some time: keep track of your references when you first read them.)

Things to Measure
Don’t get hung up on this. Many researchers use fancy gizmos for precise measurements, and those are great if you have access to them. But your normal assessment tools are perfectly adequate. Just ask yourself this: what would another interested practitioner want to know? Here are some broad categories:


Functionality. Range of motion testing, exercise performance, etc.


Pain. Numerical/analog pain scales, pain duration, etc.


Visual/Palpatory Assessment. Precise tools are great, but not essential.


Imaging. Photographs, X-rays, magnetic resonance imaging, etc.


Qualitative Questionnaires. What hopes do they have for the treatment series?  Do they perceive a change? Any interesting observations?

Further Resources
If this subject intrigues you, you might need more guidance. Here are some good places to get familiar with massage research:


Google Scholar.


Journal of Bodywork and
Movement Therapies.


• PubMed.


The Massage Therapy Foundation.


Touch Research Institute.


And check out these books:
McEwen, I. (2001). Writing case reports: A how-to guide for clinicians. (2nd ed.) Alexandria, VA: American Physical Therapy Association.


Menard, M.B. (2003) Making sense of research: A guide to research literacy for complementary practitioners. Toronto, Ontario: Curties-Overzet Publications Inc.

Parting Words
Case report submission can be a straightforward and routine part of our work. We can no longer afford to leave science just to the scientists. They need to know what we do—and how we think.

  Michael Hamm, LMP, CCST, is an instructor at Cortiva Institute—Seattle and was the winner of the Massage Therapy Foundation’s 2005 Student Case Report Contest. Mike brings a fun-loving teaching style to several CE courses, including “Case Reports: Why They’re Important and How to Submit Your Own.” When not teaching or practicing massage, Mike is a composer and singer. Contact him at or