Everyone I know, including myself, is busy and distracted on an infinite loop. It’s a curious conundrum, considering we’re all armed with more than enough information on how to de-stress. But the “surprising benefits” of exercise, meditation and work-life balance, documented ad nauseam, are beginning to feel like drawn-out humblebrags. Sometimes, they just seem insurmountable. And try as we might to convince ourselves that binge-watching TV helps, I don’t know anyone who feels refreshed after two+ episodes.
If scientifically unsupportable practices are surprisingly common medical massage therapists, they are close to universal among barely-trained and untrained bodyworkers. Many of them aspire to greater skill, but usually don’t do so by studying orthopedics and physical therapy — a project that could occupy anyone for a lifetime — but instead by increasing their repertoire of certifications in proprietary hands-on techniques, most of which are either silly and/or medically unimportant (i.e. pleasant and harmless, but producing no significant therapeutic effect for any important health problem — hot stone massage would be a good example of this).
According to research done by the American Massage Therapy Association, as of 2012 in the United States there are between 280,000 and 320,000 massage therapists and massage school students. As of 2011, there were more than 300 accredited massage schools and programs in the United States. Most states have licensing requirements that must be met before a practitioner can use the title "massage therapist", and some states and municipalities require a license to practice any form of massage. If a state does not have any massage laws then a practitioner need not apply for a license with the state. However, the practitioner will need to check whether any local or county laws cover massage therapy. Training programs in the US are typically 500–1000 hours in length, and can award a certificate, diploma, or degree depending on the particular school. There are around 1,300 programs training massage therapists in the country and study will often include anatomy and physiology, kinesiology, massage techniques, first aid and CPR, business, ethical and legal issues, and hands on practice along with continuing education requirements if regulated. The Commission on Massage Therapy Accreditation (COMTA) is one of the organizations that works with massage schools in the U.S. and currently (Aug 2012) there are approximately 300 schools that are accredited through this agency.
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."
To put it bluntly, it’s not clear that massage has any musculoskeletal benefits at all. It probably does, but mostly quite temporary and highly unpredictable. There’s not nearly enough science, and therapists are hopelessly biased assessing their own efficacy. See Does Massage Therapy Work? A review of the science of massage therapy … such as it is. BACK TO TEXT
Craniosacral therapy is another classic example — popular for decades, it is a touch therapy, not “massage,” and it has never enjoyed any respect from the majority of doctors or scientists. It has even been criticized by many alternative health professionals.36 And yet it is sold with overconfidence by countless manual therapists as though it were proven effective.
When we face stressors in life, we can carry physical and psychological tension, and these tensions can feed off of one another. Feeling physically tense can increase your psychological and emotional tension and vice versa. Conversely, relaxing your body physically can help relieve psychological stress, and relaxing your mind can help you to physically relax and release tension in your body. When your stress response is no longer triggered, it becomes far easier to approach challenges in a proactive, peaceful way.
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But when you take a pill, the side effect is usually unrelated to the problem (i.e. it doesn’t make the problem you’re treating worse), you are generally trading those side effects for some pretty clear benefits, and it’s usually cheap. In manual therapy, most adverse events are backfires — that is, you go for a neck adjustment at the chiropractor, and you come out with more neck pain instead of less. Other data shows this is 25% more likely than if you did nothing at all (see Carlesso). And you pay through the nose for this! Manual therapy is much more expensive than most drug therapy.
Not everyone should receive a deep tissue massage. Some people simply enjoy the sensation of deeper pressure to their muscles and others prefer a more gentle touch. Someone who has never experienced a massage before may not want to request a deep tissue massage. It is the responsibility of the massage therapist to determine if a deep tissue massage is necessary by way of a thorough health history and evaluation. A massage is only effective when the person on the table is comfortable and relaxed.
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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.
When you get off the table, your calves may be screaming at you, but don’t get upset and run home to your foam roller, says Denunzio. Soreness is normal and can even help reveal areas of weakness that should receive future attention. Within 48 hours, the tightness should dissipate, and if the massage was administered correctly, you may even feel like you’re in a new body.
Sports massage is a good option if you have a repetitive use injury to a muscle, such as what you may get from playing a sport. It’s also a good option if you’re prone to injuries because it can be used to help prevent sports injuries. You may also use sports massage to increase flexibility and performance. Additionally, sports massage can be used to relieve pain, anxiety, and muscle tension.
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.
And it’s a tepid mix. The conclusions aren’t wholly negative, but they are way less positive than they should be. There is some promising evidence here that suggests MLD probably helps some of these patients at least a little bit some of the time, but even that “needs to be confirmed.” And a couple studies showed some modest swelling reduction — but really not that much, or not even a statistically significant result.
Negative thoughts and feelings usually stay away when you are a good time. Schedule some time with your closest friend(s) or family regularly. Go out to dinner, listen to music, take a walk or just sit and have a cup of coffee. The activity is not as important as the shared experience. Such activities often help you take your mind off your worries!
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