Massage Therapy: The Rub that Heals
Until recently, most people considered massage an indulgence primarily undertaken for release of tight muscles. Today, massage – which is actually an age-old healing treatment — is appreciated for its effectiveness in relieving everything from lower back pain, nervous anxiety, and circulatory problems to insomnia, headaches, and recovery from surgery and sports injuries. Humanity’s earliest healers understood the power of “laying on of hands,” both to allow the practitioner to sense the body’s condition and for the touch and its warmth to relax the nervous system and stimulate blood circulation. In 460 BC Hippocrates, the father of Western medicine, wrote, “The physician must be experienced in many things, but assuredly in rubbing.”
Massage allows the body to enter a relaxing rest-and-recovery mode, an effect that lingers long after the massage is over. In fact, massage triggers a host of brain chemistry responses that can result in lasting feelings of relaxation, lowered stress and improved mood. Yet regular massage not only helps alleviate stress, but can naturally increase the immune system’s cytotoxic capacity (the activity level of the body’s natural “killer cells”) and decrease the number of T-cells, which improves the body’s immune functioning overall.
The actual therapy involves acting on the body with pressure – structured, unstructured, stationary, or moving – and can be applied with the hands, fingers, elbows, knees, forearm, feet, or specific devices. There are more than 20 different types of massage techniques, each to be chosen for its appropriateness to a physical or mental condition. They are listed at then end of this article.
HOW MASSAGE THERAPY WORKS
The human body was designed to respond to perceived danger by either fleeing or fighting. Both those actions require the generation of extra levels of cortisol, known as the “stress hormone,” which suppresses the immune system and increases blood sugar levels to keep our muscles ready for fight or flight. When these conditions are not alleviated subsequent to the dissipation of their stimulus, steady discomfort and, ultimately, dis-ease occur. Regular massage not only helps relax the muscles and increase the production of endorphins (the “feel good” chemical), but it also increases the immune system’s cytotoxic capacity and decreases the number of T-cells, improving the body’s immune functioning overall. Long-term studies have shown that a consistent massage program can increase the body’s levels of oxytocin, dopamine, and serotonin, which results in lowered stress; decreased diastolic and systolic blood pressure (thus staving off high blood pressure); decreased salivary and urinary cortisol stress-hormone levels; and slower respiration. Not surprisingly, deep sleep becomes easier to achieve because the muscles remember the relaxing sensation of massage vividly enough to recreate it.
Massage can be as significant to the treatment of mental conditions such as depression and anxiety as it can for dealing with such physical problems as arthritis, sports injuries and carpal tunnel syndrome. Migraines, likewise, respond to massage therapy. In the United States alone, more than 60% of the 45 million Americans who suffer from chronic tension related headaches or migraines which often result from high stress levels and/or lack of sleep. Massage has two roles in treating these: In a proactive role, regular massage treatments help the body maintain an optimal level of relaxation, significantly reducing muscle spasms and easing trigger points. In a comfort role, massage is focused on the neck, shoulders, and head where tension is centralized. A recent study showed that massage therapy recipients exhibited fewer migraines and better sleep quality during the weeks they received massage, and the three weeks following, than did participants who did not receive massage therapy. Another study found that in adults with migraine headaches, massage therapy decreased the occurrence of headaches, sleep disturbances and distress symptoms. It also increased serotonin levels, believed to play an important role in the regulation of mood, sleep and appetite.
The benefits of improved relaxation as a result of massage therapy include these:
- Improved mental outlook
- Better handling of pressure
- Reinforced positive attitude
- Increased relaxed states of mental alertness
- Enhanced calm and creative thinking
- Reduction of muscle spasms and trigger points
MASSAGE IN POST-SURGICAL RECOVERY
An important aspect of any surgical procedure is the post rehabilitation recovery process when natural movement is re-learned and freedom of movement is re-enforced. This process is significant as a supplement to standard rehabilitation procedures. Massage is effective in helping to bring blood and nutrients to the affected area to repair the soft tissue. It also can help break up scar tissue and keep the muscles supple so that less scar tissue develops. By increasing circulation while relaxing the muscles, massage can help the body pump more oxygen and nutrients into tissues and vital organs. It aids in improving joint movement and allows the surgical rehabilitating area(s) to become more flexible and heal at an accelerated rate.
MASSAGE IN THE TREATMENT OF SPORTS INJURIES
Massage treatment can help athletes of all levels improve their flexibility and muscle suppleness. It can also stretch the muscles in trouble areas, promoting increased flexibility when the body is warm and more elastic.
The massage therapists at BodyRxMiami are trained in numerous forms of massage, including the treatment of sports injuries. J.P. Hernandez, LMT, is, in addition to being the office’s Practice Administrator and Patient Advocate, a professional massage therapist with a long held special interest in sports injuries. As a passionate athlete himself, he developed a concern for others who suffered from an inability to resolve physical issues caused during sports activity. “Pain relief is critical in the pursuit of sports, regardless of whether they are played for recreation or professionally,” he says. He stresses the significance of massage in sports medicine for these reasons: It improves posture; promotes deeper and easier breathing; improves flexibility and range of motion; improves blood circulation, and assists rehabilitation after injury.
OTHER CONDITIONS FOR WHICH MASSAGE IS BENEFICIAL
Massage therapy has shown marked success for myofascial conditions, frozen shoulder, tendinitis, and menstrual discomfort.
TYPES AND METHODS OF MASSAGE THERAPY
Active release technique
Active release technique (ART) is a form of deep tissue manipulation patented by P. Michael Leahy in which specified techniques are used to release what are presumed to be soft tissue adhesions
This is an alternative medicine technique similar in principle to acupuncture. It is based on the concept of life energy which flows through “meridians” in the body. In treatment, physical pressure is applied to acupuncture points with the aim of clearing blockages in these meridians. Pressure may be applied by hand, by elbow, or with various devices.
Some medical studies have suggested that acupressure may be effective at helping manage nausea and vomiting, for helping lower back pain, tension headaches, stomach ache, among other things, although such studies have been found to have a high likelihood of bias.
Further information: Aquatic therapy
Aquatic bodywork comprises a diverse set of massage and bodywork forms performed in water. This includes land-based forms performed in water (e.g., Aquatic Craniosacral Therapy, Aquatic Myofascial Release Therapy, etc.), as well as forms specific to warm water pools (e.g., Aquatic Integration, Dolphin Dance, Healing Dance, Jahara technique, WaterDance, Watsu)
In ashiatsu, the practitioner uses their feet to deliver treatment. The name comes from the Japanese, ashi for foot and atsu for pressure. This technique typically uses the heel, sesamoid, arch and/or whole plantar surface of foot, and offers large compression, tension and shear forces with less pressure than an elbow, and is ideal for large muscles, such as in thigh, or for long-duration upper trapezius compressions. Other manual therapy techniques using the feet to provide treatment include Keralite, Barefoot Lomi Lomi, Chavutti Thirumal.
Ayurvedic Massage known as Abhyangam in Sanskrit is one of the most common and important Ayurvedic therapies. According to the Ayurvedic Classics Abhayngam is an important dincharya (Daily Regimen) that is needed for maintaining a healthy lifestyle. The massage technique used during Ayurvedic Massage is known to stimulate the lymphatic system to expel the toxins out from the body. The Ayurvedic Massage also stimulates production of lymphocytes which play a vital role in maintaining the immunity in human body. Thus regular Ayurvedic Massage can lead to better immunity and also help in body de-toxification. The other benefits of regular Ayurvedic Massage include pain relief, reduction of fatigue, prevention of ageing and bestowing longevity
Biodynamic massage was created by Gerda Boyesen as part of Biodynamic Psychotherapy. Practised as a stand-alone therapy, it is a combination of physical and energy work and also uses a stethoscope to hear the peristalsis.
Craniosacral therapy (CST) is a gentle approach that releases tensions deep in the body by applying light touch to the skull, face, spine, and pelvis
While various types of reflexology related massage styles focus on the feet, massage of (usually) the soles of the feet is often performed purely for relaxation or recreation. It is believed there are some specific points on our feet that correspond to different organs in the body. Stimulation of these points during foot massage can cause significant reduction in pain. Studies also suggest that foot reflexology massage can reduce fatigue and promote better sleep
Lomilomi and indigenous massage of Oceania
Lomilomi is the traditional massage of Hawaii. As an indigenous practice, it varies by island and by family. The word lomilomi also is used for massage in Samoa and East Futuna. In Samoa, it is also known as lolomi and milimili. In East Futuna, it is also called milimili, fakasolosolo, amoamo, lusilusi, kinikini, fai’ua. The Māori call it roromi and mirimiri. In Tonga massage is fotofota, tolotolo, and amoamo. In Tahiti it is rumirumi. On Nanumea in Tuvalu, massage is known as popo, pressure application is kukumi, and heat application is tutu. Massage has also been documented in Tikopia in the Solomon Islands, in Rarotonga and in Pukapuka in Western Samoa.
Manual lymphatic drainage is a technique used to gently work and stimulate the lymphatic system, to assist in reduction of localized swelling. The lymphatic system is a network of slow moving vessels in the body that carries cellular waste toward the heart, to be filtered and removed. Lymph also carries lymphocytes, and other immune system agents. Manual lymphatic drainage claims to improve waste removal and immune function.
Medical Massage is a controversial term in the massage profession. Many use it to describe a specific technique. Others use it to describe a general category of massage and many methods such as deep tissue massage, myofascial release and triggerpoint therapy as well as osteopathic techniques, cranial-sacral techniques and many more can be used to work with various medical conditions.
Massage used in the medical field includes decongestive therapy used for lymphedema which can be used in conjunction with the treatment of breast cancer. Light massage is also used in pain management and palliative care. Carotid sinus massage is used to diagnose carotid sinus syncope and is sometimes useful for differentiating supraventricular tachycardia (SVT) from ventricular tachycardia. It, like the valsalva maneuver, is a therapy for SVT. However, it is less effective than management of SVT with medications.
A 2004 systematic review found single applications of massage therapy “reduced state anxiety, blood pressure, and heart rate but not negative mood, immediate assessment of pain, and cortisol level”, while “multiple applications reduced delayed assessment of pain”, and found improvements in anxiety and depression similar to effects of psychotherapy. A subsequent systematic review published in 2008 found that there is little evidence supporting the use of massage therapy for depression in high quality studies from randomized controlled trials.[
Myofascial release refers to the manual massage technique that claims to release adhered fascia and muscles with the goal of eliminating pain, increasing range of motion and equilibrioception. Myofascial release usually involves applying shear compression or tension in various directions, cross fiber friction or by skin rolling.
Shiatsu (shi meaning finger and atsu meaning pressure) is a type of alternative medicine consisting of the fingers and palm pressure, stretches, and other massage techniques. There is no convincing data available to suggest that shiatsu is an effective treatment for any medical condition.
Structural Integration’s aim is to unwind the strain patterns residing in the body’s myofascial system, restoring it to its natural balance, alignment, length, and ease. This is accomplished by deep, slow, fascial and myofascial manipulation, coupled with movement re-education. Various brands of Structural Integration are Rolfing, Hellerwork, Guild for Structural Integration, Aston Patterning,[ Soma and Kinesis Myofascial Integration.
The most widely recognized and commonly used category of massage is the Swedish massage. The Swedish massage techniques vary from light to vigorous. Swedish massage uses five styles of strokes. The five basic strokes are effleurage (sliding or gliding), petrissage (kneading), tapotement (rhythmic tapping), friction (cross fiber or with the fibers) and vibration/shaking. Swedish massage has shown to be helpful in reducing pain, joint stiffness, and improving function in patients with osteoarthritis of the knee over a period of eight weeks. The development of Swedish massage is often inaccurately credited to Per Henrik Ling, though the Dutch practitioner Johann Georg Mezger applied the French terms to name the basic strokes. The term “Swedish” massage is actually only recognized in English and Dutch speaking countries, and in Hungary. Elsewhere the style is referred to as “classic massage”.
Clinical studies report that Swedish Massage can effectively reduce low back pain and the effectiveness can last for as long as 15 weeks. One study reported that Swedish Massage caused reduction in salivary cortisol indicating its role in management of stress and improvement in mood.
Traditional Thai massage (Nuad Boran) is generally based on a combination of Indian and Chinese traditions of medicine. It combines both physical and energetic aspects and is a deep, full-body massage progressing from the feet up, and focusing on sen or energy lines throughout the body, with the aim of clearing blockages in these lines, and thus stimulating the flow of blood and lymph throughout the body. It draws on yoga, acupressure and reflexology.
Thai Massage is a popular massage therapy that is used for management of conditions such as musculoskeletal pain and fatigue. Thai Massage involves a number of stretching movements that improve body flexibility, joint movement and also improve blood circulation throughout the body. In one study scientists found that Thai Massage showed comparable efficacy as the painkiller ibuprofen in reduction of joint pain caused by osteoarthritis (OA) of the knee
Traditional Chinese massage
Massage of Chinese Medicine is known as An Mo (pressing and rubbing) or Qigong Massage, and is the foundation of Japan’s Anma. Categories include Pu Tong An Mo (general massage), Tui Na An Mo (pushing and grasping massage), Dian Xue An Mo (cavity pressing massage), and Qi An Mo (energy massage). Tui na focuses on pushing, stretching, and kneading muscles, and Zhi Ya focuses on pinching and pressing at acupressure points. Technique such as friction and vibration are used as well.
Trigger point therapy
Sometimes confused with pressure point massage, this involves deactivating trigger points that may cause local pain or refer pain and other sensations, such as headaches, in other parts of the body. Manual pressure, vibration, injection, or other treatment is applied to these points to relieve myofascial pain. Trigger points were first discovered and mapped by Janet G. Travell (President Kennedy’s physician) and David Simons. Trigger points have been photomicrographed and measured electrically, and in 2007 a paper was presented showing images of Trigger Points using MRI.These points relate to dysfunction in the myoneural junction, also called neuromuscular junction (NMJ), in muscle, and therefore this technique is different from reflexology, acupressure and pressure point massage.
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.