Training and certification standards for massage therapists are all over the map, and most practitioners have barely scratched the surface of musculoskeletal medicine. The profession is rife with pseudoscience like crank theories about the causes of pain, the myth that massage detoxifies, or that painfully “deep tissue” massage is needed to “release” tissues (which is stressful or even harmful for many patients).
Spend time with yourself. Stay away from electronics for a bit, play a soft music and lay down, forget all the troubles and think of good and beautiful things. For example: imagine a cozy beautiful fall forest in your mind. Also you may cook your favorite treat or make a cup of tea and read a book or write in your journal things that you love about yourself, your goals, what makes you happy, etc.
The road to intellectual dishonesty is paved with good intentions. When I worked as a therapist, there were times when — confession! — I didn’t bother to explain to a patient that I was selling them a dubious approach to therapy . Sometimes it seemed okay because the atmosphere of experimental treatment was thick already, with a desperate patient who had low expectations and was pretty much there to try anything. But it was still dishonest, and I’m ashamed of those times. After all, if patients were my experimental research subjects, shouldn't I have been paying them?
Think about how easy it is for a baby or small child to fall asleep. We're born with the instinct to relax and sleep when our bodies or minds need a break. Over the years, it becomes necessary to control and even suppress these natural urges to rest, because we must remain alert as we attend school, learn professions, go to work, or care for a family. Many people spend years conditioning themselves to perform well despite feelings of tiredness. While no one would argue that suppressing tiredness can be a necessary skill, it can impair our ability to actually "let go" and relax when we do find the time.
At certain times during the massage, you may feel some discomfort or even some pain as the massage therapist works on areas where there are adhesions or scar tissue. Pain isn't necessarily good, and it's not a sign that the massage will be effective. In fact, your body may tense up in response to pain, making it harder for the therapist to reach deeper muscles.
Over time, deep-tissue massage therapy can help break up and eventually erase scar tissue in the body. It does this by improving lymphatic circulation and drainage to improve flexibility and range of motion in the affected area. Scar tissue is often associated with ongoing pain and stiffness, so deep-tissue massage can improve these symptoms. Massage therapy is often recommended for people who are recovering from surgery.
No question: actually boosting performance would be a big deal, a humungous deal! But the cited evidence doesn’t remotely substantiate such a mighty claim. Even if we take that evidence at face value, it’s a huge and oversimplified reach to conclude that “a little increased range of motion” constitutes a meaningful effect on athletic performance as a whole. I can increase my ROM with a few seconds of stretching, too … and stretching does not enhance performance (look it up).
In 2010, my wife is recovered from serious injuries she got in a car accident, including a spinal fracture. Guess what exercises she has to do? Early mobilization and range of motion exercises! This is just mainstream, standard post-injury care. If a massage therapist prescribes it, does that make it massage therapy? Is massage therapy is working for that patient? In a sense, yes …
4. Erase Optional Stressors. Some experiences that cause anxiety can't be avoided. For instance, if you don't get along swimmingly with your boss or if you're struggling to deal with a medical condition, there isn't too much you can do about that. Some stress, on the other hand, is purely optional. So identify things that rile you up that you can nix. Does Facebook—or even a certain “friend”— always spike your blood pressure? Ban yourself from logging in, or at least un-follow friends whose political rants always make your shoulders get tense. Say no to coffee with that toxic frenemy. Don’t watch the evening news. You get the idea!
Job’s body: a handbook for bodywork, a book by Deane Juhan. amazon.com If you can manage the density of the language, Job’s Body is thick with creative insights into physiology and healing. Perhaps too many of them, and perhaps too creative — but very stimulating! Juhan tries to explain why bodyworkers often seem so uncannily effective. This is a job that certainly needed doing. In trying to explain bodywork, Job’s Body is a philosophical introduction to the science of the human body — a physiology textbook with a heart. Many chapters are devoted to pure science — just barely accessible to the hard-reading layperson, and mainly offering perspective for the health care professional. Still more chapters are devoted to pure philosophy. Juhan frequently dares to ask (and answer) the hardest questions in the health sciences: why and so what? I took a workshop with Juhan many years later. I’m sorry to say that he seemed cocky and jaded. My main impression was that he was bored and had drunk to much of his own Kool-Aid. And the introductory chapters of this book do a better job of explaining some of the possible subtle benefits of massage therapy than anything else I’ve ever read. Read an excerpt.
An Indian physician named Shivago Kumar Bhucca, a contemporary of the Buddha, is often credited with developing Thai massage. The impetus was to give monks and nuns the flexibility to sit for long hours in meditation. Whatever its genesis, massage was considered such a crucial aspect of medical treatment in Thailand that until the early 20th century, the Thai Department of Health included an official massage division. Thai massage is based on releasing blockages along ten lines of energy called sen, which are similar to the meridians of traditional Chinese medicine. The technique incorporates stroking and kneading of muscles, manipulation of joints, and pressure applied to specific points in order to balance the body’s four elements—earth, water, fire, and air. But there’s also rocking, breathing, and lots of stretching—Thai massage is often referred to as “lazy yoga.”
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.
Doctors think looking up health information online can be problematic because the computer doesn’t have the same diagnostic skills as a healthcare professional. Physicians determine whether an issue is serious by considering personal factors like a patient’s family history and age. (Wrinkles at age five isn’t normal— sorry, Benjamin Button.) On the other hand, when someone searches for “headaches” online, they may find several sources suggesting they are suffering from something much worse…
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“I decided to go into sports massage when I experienced its effects on me as an athlete,” says McElroy. “Despite having no experience as a competitive runner in high school or college, I joined a team and realized I was pretty good. I trained while working full-time and ran my first marathon, missing the Olympic trial qualifying time by 21 seconds.
On the other hand, hands-on experience is valuable too, and anyone who’s had a good massage is certainly familiar with the seemingly magical way that a therapist can find the perfect spots and “good pain.” An inability to reliably find something does not mean it can’t be done. And the main reason no treatment has ever been proven effective is mostly a lack of good science on the subject — it’s just unknown.
4. Coaching: once you have the breathing pace down, keep doing it while you move to this step. The key here is giving yourself positive, reassuring, and calm messages, rather than continuing with the tense, anxious, and angry thoughts. When I do this, I think things like "I can get through this. It will be OK. I can handle whatever happens. I am going to calmly do my best." Everyone will have a different way of doing this, and some people like to imagine this in the voice of someone they care about, or with the image of that person telling them those things. Keep doing this along with the breathing until you feel sufficiently ready to reconnect with what you were doing.
A licensed, traditional massage practitioner is required to complete at least 800 hours training. Massage therapists must acquire a professional license and must register at the Public Health Ministry's Department of Health Service Support (HSS). To qualify for a license, therapists must be trained in courses created by the HSS. The standard courses are provided free. Alternatively, students can go to one of the 181 schools nationwide approved to train therapists using standard HSS courses.
States (like Texas) that regulate massage generally require practitioners to graduate from massage school, pass a licensing exam, pay a licensing fee and earn continuing education units in order to maintain licensure. Most massage therapists purchase liability insurance as well. Strict codes of conduct must be adhered to, and therapists who are found to have acted outside the law can lose their license.
Full disclosure: I was a Registered Massage Therapist with a busy practice in downtown Vancouver from 2000–2010. Since then, I have made my living writing about musculoskeletal medicine and pain science, with a reputation for a skeptical perspective. This article is biased in the direction of debunking, but I also have a real soft spot for massage therapy, and still make a large percentage of my income from selling a book about trigger point therapy — a popular idea in massage that is maligned by many other skeptics (and with good reason). So I actually have competing, complicated biases. I try to compensate for them by sticking to what the evidence can support, and clearly identifying speculation and experimental therapy for what it is. BACK TO TEXT
The fact is, I do already do all those ideal things occasionally, but sometimes it feels as if being in the world is too much, and I need to disappear from it by losing myself in a screen. It is as if I crave that brain-dead feeling, even though I know it isn’t good for me. Having psychoanalytic psychotherapy is helping me to think about the reasons why I might do this – and for Morgan, therapy can be an important pathway out of being stuck in a screen-gazing rut, because it is somewhere a person is encouraged to use his or her mind. “The therapeutic space is the opposite of distraction – it’s concentration,” he says. “When people come into my consulting room, they often tell me it’s the first time they have ever felt they have had a space where they can’t run away from things.”