One theory is that muscle knots may be caused by something that goes wrong at the “motor end plate” — where a nerve ending attaches to a muscle cell.9 We don’t know why this happens, or what exactly goes wrong, but there is circumstantial evidence that motor end plates are the “point” in trigger point. That evidence is too complex and controversial to review properly here. It is explored in detail in my book. Some research has suggested that it may actually be possible to physically destroy the motor end plate with strong massage, thereby inactivating the trigger point.10 When it regrows — these are microscopic structures, it doesn’t take them long to heal — the trigger point may be gone.
A traditional Swedish massage involves the whole body. You will begin on either your back or your stomach and flip over at the halfway point. If you have an area of particular concern, such as a tight neck, you can ask your therapist to spend more time in this area. Depending on your preferences, you can ask your massage therapist to use light, medium, or firm pressure.
About “tendinitis” versus “tendonitis”: Both spellings are considered acceptable these days, but the first is technically correct and more formal, while the second is an old misspelling that has only achieved respectability through popular use. The word is based on the Latin “tendo” which has a genitive singular form of tendinis, and a combining form that is therefore tendin. (Source: Stedmans Electronic Medical Dictionary.) BACK TO TEXT
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“Many athletes and weekend warriors put themselves under a great deal of mental stress in preparation for a competition,” says Pietrunti. “For many amateur athletes, this is exacerbated by other day-to-day stressors from their jobs, families and life. Sometimes, just setting aside an hour to relax and unwind can be a huge step towards better performance and quality of life.”
I’m on a padded floor mat wearing loose pants and a T-shirt (standard Thai-massage garb) while Pailin Winotaka uses her fingers, palms, elbows, knees, feet, indeed her whole body as ballast, slowly getting me into such familiar yoga positions as “bridge” (a backward arch) and “bow” (on my stomach, reaching back to grab her wrists rather than my own ankles for a deeper stretch). I actually feel taller when she’s done.
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You may also have your own unique trouble spots, perhaps from past injuries. A massage therapist can pay special attention to these areas, monitor them for developing problems, and help keep them in good condition. An experienced massage therapist can also compliment treatment received from other health care professionals for various injuries. You may also have your own unique trouble spots, perhaps from past injuries. A massage therapist can pay special attention to these areas, monitor them for developing problems, and help keep them in good condition. An experienced massage therapist can also compliment treatment received from other health care professionals for various injuries.
Of course, back in the day when people were mostly hunters and gatherers, these physiological changes would help our ancestors run from predators or environmental hazards. And maybe back then, people didn’t know how to relax. Maybe they weren’t really supposed to. But today, people aren’t asked to regularly respond to such great threats, and knowing how to relax may be a better modern survival tactic than a ready stress response.
Massage developed alongside athletics in both Ancient China and Ancient Greece. Taoist priests developed massage in concert with their Kung Fu gymnastic movements, while Ancient Greek Olympians used a specific type of trainer ("aleiptes") who would rub their muscles with oil. Pehr Ling's introduction to massage also came about directly as a result of his study of gymnastic movements.
Research published in the Journal of Sports Medicine and Physical Fitness reported findings of a positive trend for deep tissue massages in regard to improved athletic recovery and performance. The most beneficial type of deep tissue massage for athletes is considered to be “sports massage,” which is commonly performed prior to athletic events to help warm the body and prevent injuries or immediately after to improve recovery.
If this theory is correct, or even half-right, it would go a long way to explain the strong appeal of massage — maybe it actually can take the edge off a great variety of problems — but also its inability to work miracles. If trigger points are the main reason massage seems at least a little bit helpful in so many cases, they are also the reason that the results are so unpredictable. The best ways to treat trigger points are simply unknown, and it may be next to impossible. All trigger point therapy is guesswork. Therapists have greatly variable education, skill, and luck in this process. Most simply aren’t that good at it — they can’t be, because muscle pain physiology is obscure, complex, and basically way out of their league.80
Therapeutic massage is expensive but popular and pleasant, with obvious subjective value, and proven benefit for anxiety and depression … but no other clear biological or medical effects. Most notably, the evidence that massage can help back and neck pain is sketchy, and there is no reason to believe that massage can help much with any other common musculoskeletal pain problem.
“Some Zen teachers say that the way the body takes care of us, without our even being aware of it, is an example of the beautiful and continuous functioning of our Original Nature, the inherent goodness and wisdom of our being. Our hand pulls back from fire before we even register heat, our eyes blink before we are aware of a sharp sound, our hand reaches out to catch something before we know it is falling.”
Everything you feel isn’t necessarily correct or factual. Negative feelings bubble up sometimes with little warning. Remember fear is often F(alse) E(vidence) A(ppearing) R(eal). Remind yourself to go one step at a time. Be confident and replace the negative feelings by focusing on something you enjoy. Practice by noticing things around you that give you a sense of wonder and beauty. A painting in the hall…the cat sleeping in the sun…your dog’s cheerful greeting. Anything that creates positive feelings for you will work. Then when the negative stuff seeps up, counter it with a positive memory.
Zen gardens are created to represent different soothing elements of nature. These meditation gardens were first used centuries ago by Buddhists. However, anyone can use a Zen garden to find their inner peace. Small Zen garden boxes represent the same elements of traditional Zen gardens and they can help you reduce stress and anxiety in powerful, positive ways. Cultivate your Zen garden to develop quiet mindfulness and inner peace. Like coloring, this meditative practice enhances your ability to find and maintain your own inner strength and peace.
The approval of skeptics doesn’t mean that massage “works,” and they may actually be giving massage more credit than it deserves. At TAM7, I repeatedly explained to horrified skeptics — who were trying to give me the benefit of the doubt — that my colleagues routinely either sell or endorse virtually every imaginable form of alternative health care, including the silliest: ear candling, crystal therapy, iridology, gong therapy (look it up!) … you name it, there’s a goofy therapy that many massage therapists “believe” in.
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Yes, certainly it is a bit exaggerated. It could be a lot worse — hey, at least it’s got references! But it could be a lot better. Citing single cherry-picked studies to support broad treatment claims is weak sauce, even if the picks are good (and clearly not all of these are). The evidence and claims here that are stronger are also less important … and those that are more clinically important are also less sound.
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In fact, the history of Thai massage is more complex than this legend of a single founder would suggest. Thai massage, like Thai traditional medicine (TTM) more generally, is a combination of influences from Indian, Chinese, Southeast Asian cultural spheres, and traditions of medicine, and the art as it is practiced today is likely to be the product of a 19th-century synthesis of various healing traditions from all over the kingdom. Even today, there is considerable variation from region to region across Thailand, and no single routine or theoretical framework that is universally accepted among healers.
Unsurprisingly, the conclusions here are superficially positive: massage “significantly improved pain, anxiety, and depression in patients with FM.” But that’s statistical significance only, not a clinically significant degree of improvement: the size of the effect is trivial (much smaller than amplitude of the noise in the data). As usual, using the word “significantly” this way is technically correct and defensible, but otherwise misleading to all but the most alert readers.
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