Flushing. If massage can “improve” any tissue — unknown — one way it might do it is through simple hydraulics: physically pumping tissue fluids around, and/or stimulating the circulation of blood and lymph. I won’t get into the evidence about it here. Suffice it to say that it might be true, and if it’s true then it may not much matter if the process is uncomfortable. While gentler massage may feel pleasant and satisfying, it is possible that more biological benefits can only be achieved hydraulically — whether it’s comfortable or not. This is even more plausible because of trigger points: it’s likely that the tissue fluids of a trigger point are quite polluted with waste metabolites, and the need for flushing is greater, but it’s especially uncomfortable to squish those polluted patches of tissue.
One risk is clearly neurological and complex: some people are basically sitting ducks for the well-documented and nasty phenomenon of “central sensitization,” and indeed may already be in pain and seeking help because of it. A strong massage can severely aggravate that situation, with long term and extremely unfortunate consequences. It’s rare, but it happens. The typical clinical scenario here is a gung-ho under-trained therapist over-treating someone in, say, the early stages of fibromyalgia. Bad, bad, bad.
We cannot trust our eyes, or our pain. Pain is a lot like these amazing illusions — that is, it is warped by our expectations and point of view (see Pain is Weird). Unlike these clever models, though, we can’t turn it around to see what’s really going on. And trying to see through the illusion, trying to believe that there’s nothing much actually wrong with our tissues (often true), is even more difficult than seeing through these illusions. But that challenge is what recovery is all about: trying to change our expectations and point of view with interesting new sensations and movements. Massage therapy may be one of the very best sources of the sensory data needed to change our perspective. BACK TO TEXT
Myofascial Pain and Dysfunction: The Trigger Point Manual, a book by Janet Travell, David Simons, and Lois Simons. amazon.com The ultimate myofascial pain syndrome reference, the product of decades of extraordinary dedication by two doctors famously devoted to the subject of soft tissue pain. The two-volume set is also brilliantly illustrated. The introductory chapters constitute an excellent overview of the subject, albeit a dauntingly technical one. Note: although a landmark and important text, more recent information has been published in Muscle Pain: Understanding its nature, diagnosis and treatment by Siegfried Mense and David Simons.
BC 722-481: Huangdi Neijing is composed during the Chinese Spring and Autumn period. The Nei-jing is a compilation of medical knowledge known up to that date, and is the foundation of Traditional Chinese Medicine. Massage is referred to in 30 different chapters of the Nei Jing. It specifies the use of different massage techniques and how they should be used in the treatment of specific ailments, and injuries. Also known as "The Yellow Emperor's Inner Canon", the text refers to previous medical knowledge from the time of the Yellow Emperor (approx 2700 BC), misleading some into believing the text itself was written during the time of the Yellow Emperor (which would predate written history).
An urge to continually tidy up the house or yard may be a response to chaos all around you. According to Brigid Schulte, director of the Better Life Lab at the Washington, D.C., think tank New America and author of Overwhelmed ($10; amazon.com), "When you're strapped at work and stretched at home, having things in order can seemingly restore equilibrium." All together now: Yes. This. One sane way to tame that life-is-out-of-control feeling: Quit scattering tasks among your calendar, notepads, emails, sticky notes, and memory. Says Morgenstern, "Decide on a single, reliable system, and it will help turn off the ticker tape of to-dos in your brain."
Like massages, chiropractic care can be beneficial for lowering pain and improving recovery. It’s also been shown to lower stress, headaches and more. One way that chiropractors help treat pain is by lowering mechanical compression and irritation of spinal joints, which can send nerve signals throughout the body that increase inflammation and irritation.
Perhaps one of the reasons massage reduces depression and anxiety: it’s relaxing. While not proven as well as you might think, it is a pretty safe bet,15 and the idea is further supported by evidence that massage therapy may reduces blood pressure1617 and helps people to sleep, even when they are under the unusual stresses of hospital care.18 These are all unsurprising … and unremarkable. Relaxation is an important component of wellness and pain management, and I do not underestimate its value, but it is hardly curative.
Beyonce, Blondie, or the Biebster, sometimes belting out the lyrics to a favorite tune makes everything seem all right. If you’re in a public place (that isn’t the opera), just listening to music can be a quick fix for a bad mood Relaxing music prevents stress-induced increases in subjective anxiety, systolic blood pressure, and heart rate in healthy males and females. Knight, W.E., Rickard, N.S. Monash University, Victoria, Australia. Journal of Music Therapy 2001;38(4):254-72.. Classical music can be especially relaxing right before bedtime.
Thich Nhat Hanh says that when we relax, we "become calm water, and we will reflect reality as it is. If we’re not calm, the image we reflect will be distorted. When the image is distorted by our minds, it’s not the reality, and it causes lots of suffering." Relaxation is essential for accessing the tranquility and joy that lead to increased personal well-being. With sections on healing, relief from nonstop thinking, transforming unpleasant sounds, solitude, being peace, and more, How to Relax includes meditations you can do to help you achieve the benefits of relaxation no matter where you are.
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Note that this study compares a more vigorous sports massage style with more common Swedish petrissage techniques. Vigorous massage did indeed show significantly increased circulation! However, this technique is rarely used — the vast majority of Registered Massage Therapists in British Columbia rarely treat their clients with vigorous sports massage techniques, yet they still have a habit of claiming that massage increases circulation.
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.