AD 1776: Jean Joseph Marie Amiot, and Pierre-Martial Cibot, French missionaries in China translate summaries of Huangdi Neijing, including a list of medical plants, exercises and elaborate massage techniques, into the French language, thereby introducing Europe to the highly developed Chinese system of medicine, medical-gymnastics, and medical-massage.
Well, so much for controversy! Massage probably has many interesting physiological effects … but getting rid of acid in your blood is certainly not one of them. Nor is drinking extra water going to help. On the contrary, as mentioned above in the myths section, massage is probably modestly “toxifying,” not detoxifying. Other articles delving into detox myths:
A satisfying sensation doesn’t necessarily imply successful treatment, unfortunately. Scratching mosquito bites feels great… but it’s not helping them! Trigger points may be like mosquito bites: it may feel terrific to massage those mysterious sensitive spots in soft tissue, but it may not be doing much to actually “release” or resolve them. It may be a purely sensory experience, the satisfaction of dealing with an “itch” that we cannot easily reach on our own.
I agree with almost every detail of the article and wrote a letter of support to Dr. Barrett, which is published as an addendum to it. That said, the article does neglect some nice things that can be said about massage therapy, and it contains a few minor errors. But I applaud the intent and embrace and welcome most of the criticism. I wish it weren’t mostly true, but I believe that it is.
Massage reduces inflammation. Um, no. The opposite, if anything.60 According to a sensationalized science news item in early 2012, supposedly massage “reduces inflammation” and “promotes muscle recovery.” But this was a small and technical gene profiling study, several steps removed from clinical reality, trying to explain a phenomenon that doesn’t clearly exist: we already knew that massage doesn’t do much for DOMS.61 All of the evidence about this and DOMS is explored in detail in a separate DOMS article.
Pre-event sports massage is done to help prevent serious athletic injury. It helps to warm up the muscles, stretching them and making them flexible for optimal athletic performance. A pre-event massage stimulates the flow of blood and nutrients to the muscles, reduces muscle tension, loosens the muscles, and produces a feeling of psychological readiness.
When you are looking for massage therapy, be sure to check which type of massage a practitioner can provide. Match that with the benefits you hope to get from the massage session. You may want to chat with several different practitioners to find the one who understands your needs and is used to working with people with similar goals. Be sure also to discuss any allergies, such as to scents or plant oils, so your massage will be relaxing and beneficial without that concern.
The Thai Ministry of Public Health's Department for Development of Thai Traditional and Alternative Medicine regulates Thai traditional massage venues and practitioners. As of 2016 the department says 913 traditional clinics have registered nationwide in Thailand. As of 2018, of the 8,000 to 10,000 spa and massage shops in Thailand, only 4,228 are certified by the Health Ministry's Department of Health Service Support (HSS).
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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).
Ugly pain in massage therapy is, by my definition, never okay. Ugly pain is often caused by things that are not going to offer even minimal, delayed benefits, and may even be dangerous. It’s important to be able to spot ugly pain for what it is and completely eliminate it from any therapy you’re receiving. What kinds of handling may cause “ugly” pain?
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Continual improvement is the reason you train in the dead of winter, hammer up the hills on the bike, do track work, and train in the pouring rain. Well, that is the same reason you should get a good sports massage. After a massage you'll feel lighter, more powerful and more flexible, and all those nagging aches and pains can be addressed, helping to reduce the likelihood of injury.
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.
Thank you so much for your article The Pressure Question in Massage Therapy. I just read it all. I went for a sports massage two weeks ago as I was recommended to have one as it was suggested it might help with tight calves, a side effect of some other injuries I have. I’ve been for sports massages many, many times before over the years. This one was one of the most painful experiences of my life — when I got home I was almost sick and felt in shock. My right achilles tendon was raging and it’s been bad ever since. It hurt so much when it was done (like someone was sticking knives in) and I kept asking if it was meant to hurt. I wish I’d just stopped the session or objected but I didn’t. It used to be a bad injury that affected me walking for about 6 months so I’m just devastated about this. I can hardly bear to put shoes on and its all this time on. I know there are good practitioners out there but experiences like this just make me want to stay away. I wish I’d gone to a “gentle” one.
Get up off your chair and walk around the desk. Take a quick but deliberate walk to the water cooler and drink a sip of water. This will help increase circulation and get your body moving more during the day. It can be calming to break up the tension that can come from sitting in one place especially since we spend so much time in front of screens!
Not the sit-and-zen-out type? Here's an exercise from Morgenstern that still gets you in the moment and out of your head: As you stroll, engage your senses. Note what you see (buildings with interesting shapes), what you hear (the rustling of leaves), and what you feel (the breeze on your face). Bonus points if you're out in nature; it's more likely to decrease rumination than being in an urban area, per a study published in Proceedings of the National Academy of Sciences.
Recovery. Therapeutic massage helps the body recover from the stresses of strenuous exercise, and facilitates the rebuilding phase of conditioning. The physiological benefits of massage include improved blood and lymph circulation, muscle relaxation, and general relaxation. These, in turn, lead to removal of waste products and better cell nutrition, normalization and greater elasticity of tissues, deactivation of trigger points, and faster healing of injuries. It all adds up to relief from soreness and stiffness, better flexibility, and less potential for future injury.
Tests of overall effectiveness (clinical trials) are not difficult to cook up in principle: just take a hundred people with a certain kind of problem, give some kind of reasonably appropriate massage to fifty of them, give a neutral treatment to the other fifty, record the results, and report them. It’s not perfect, but it doesn’t have to be perfect to detect what should be a reasonably strong effect — if those massaged 50 people aren’t better off, how good can massage be? A great deal more precision is required to answer exactly what kind of massage works how well for what — more on that in a moment — but in broad strokes, it’s not a difficult problem. Not in principle. BACK TO TEXT
The light-touch, free massages often offered at finish line festivals can help calm the nervous system by allowing the body to commence its natural repair state quicker, explains Rosemarie Rotenberger, an orthopedic massage therapist in Mertztown, Pennsylvania. And Denunzio says that racers can schedule a recovery-focused sports massage within several hours up to 48 hours after an event, although she recommends massage newbies wait three to four days, as they may be too sore within the first few days fully benefit from (and appreciate) the experience.
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American Heart Association: "Four Ways to Deal With Stress."; PubMed Central: "Psychosocial and Psychophysiological Effects of Human-Animal Interactions: The Possible Role of Oxytocin."; NIH News in Health: "Can Pets Keep You Healthy?"; Cleveland Clinic: "Want a Healthy Heart? Laugh More!"; HelpGuide.org: "Laughter Is the Best Medicine."; Association for Psychological Science: "Power Posing: Brief Nonverbal; Displays Affect Neuroendocrine; Levels and Risk Tolerance."; Harvard Business School: "Power Posing: Fake It Until you Make It."; IZA.org: "The Effect of Sexual Activity on Wages."
There are a few “medical” massage therapists out there with some training in orthopedics and rehabilitation. My education in massage therapy here in British Columbia, Canada, was three years long — the longest massage therapy training program in the world. There are also a few other places with two-year programs. A massage therapist with this level of education is certainly the kind that patients should seek out if they want massage as a treatment.
A boyfriend or girlfriend is okay, but they’re (usually) not furry enough. After a rough day, snuggle up with a pet for an instant slobbery smile, since pets can boost self-esteem and even ease the sting of social rejection Friends with benefits: on the consequences of pet ownership. McDonnell, A.R., Brown, C.M., Shoda, T.M. Department of Psychology, Miami University, Oxford, OH. Journal of Personaality and Social Psychology 2011;101(6):1239-52..
It’s just a theory: no one knows if this is actually effective.11 However, it may explain why so many massage patients report a “gets a bit worse before it gets much better” response to quite painful treatments: motor end plates are (painfully) destroyed by strong pressures, and then that tissue is quite sensitive and a bit weak as it heals over a day or two … and then you finally feel much better after that!
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."
The best we can say is that there is some reason to believe that painful pressures on muscles might be therapeutic for some people some of the time. Pretty decisive, eh? This is why it drives me nutters that so many therapists insist that strong pressures are “essential” to achieve “a complete release.” It really isn’t possible to know! It really does depend! Why would anyone pretend to “know”?
There are several types of massage that focus on different parts of the body or healing approaches. Massage is the practice of rubbing and kneading the body using the hands. During a massage, a massage therapist will apply gentle or strong pressure to the muscles and joints of the body to ease pain and tension. A massage therapist is a person trained in giving massages.
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For many years the best review of the science that was available, by Furlan et al., had a cautiously optimistic conclusion, declaring that “massage is beneficial.”37 But then, in 2015, Furlan et al. added another dozen studies to the pool of data, and actually changed their tune: now they have “very little confidence that massage is an effective treatment for LBP.”38 And nor should they. Although there are scraps of good news, the evidence damns massage with faint praise — just like all other “promising” back pain treatments.
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A 2014 Chinese review of studies by Li et al48 is a good example of what a shabby state massage therapy research is in. Let me be clear up front: I don’t think this paper actually proves anything one way or the other. I think it’s straightforwardly inconclusive. It has a positive sounding conclusion that isn’t really justified and there are major caveats. But it doesn’t mean that I wouldn’t go get me some massage if I had fibromyalgia. I probably would! But that’s another story. This is about the science, so here goes:
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I’ve often said that massage therapy research is in its early stages. And after thinking about that more today, I’ve realized it’s worse than that. Massage therapy research is stunted, and not showing signs that it is ready to progress. Some might disagree, and would point to the increasing number of massage therapy studies. (I’ve charted it myself in at least one paper I’ve published, and there is no doubt that the number of papers on the subject is increasing.) But I would counter by noting that there is no discussion in the field. The studies are conducted and published in isolation. They are not often being critiqued, and researchers with different theories and perspectives are not addressing each other in the literature or even at conferences.
Have you ever heard of power poses? These are body movements that increase your confidence and tend to be more powerful than traditional confidence-boosting exercises. Identify yours and make sure you practice holding that pose throughout the day. Also identify low power poses and remove them from your personal body language. Power poses basically trick your mind and tell it that you’re amazing! This feeds your subconscious mind, and increases your ability to be positive and anxiety-free.
I stayed there as the administrator and an instructor for five years after I graduated, and during that period of time, I could not possibly even name all the things I went through. I had a lot of psychic readings. I availed myself of EFT (Emotional Freedom Technique), an invention of Dr. Mercola, [sic]84 which basically consists of tapping on meridian points in order to relieve emotional negativity, food cravings, and pain. I tried Aura Soma, which is described as “color healing.” I got tuned up with tuning forks, and crystal bowls. I participated in one workshop called Matterspeak, which consisted of sitting around chanting random words, letters, and numbers for 8 hours, as in “1263supercalifragilisti789.” I don’t remember what the purpose of that was and frankly doubt that it had any purpose, other than to enrich the teacher’s pocketbook. If memory serves, she had “channeled” that information from the Atlanteans. I also used the chi machines, the detox foot baths and pads, biofeedback and all kinds of computer programs designed to balance your body, mind and spirit, and most New Agey-sounding things in existence at the time. If it was out there, I tried it. All kinds of “healers” came and went through the school.
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Watsu, developed by Harold Dull at Harbin Hot Springs, California, is a type of aquatic bodywork performed in near-body-temperature water, and characterized by continuous support by the practitioner and gentle movement, including rocking, stretching of limbs, and massage. The technique combines hydrotherapy floating and immersion with shiatsu and other massage techniques. Watsu is used as a form of aquatic therapy for deep relaxation and other therapeutic intent. Related forms include WaterDance, Healing Dance, and Jahara technique.