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Are you still thinking of massage therapy as being a self-indulgent luxury? For some it may well be, but for others it is a not-to-be-missed powerful healing tool that improves health and well-being. From easing body aches, injuries, and tight muscles to soothing anxiety, stress and depression, massage therapy has excellent benefits for mind and body. This article is dedicated to helping you understand the benefits of massage therapy, the various types of massage, and how it might be able to help you.
Despite the prevalence of those who think that massage therapy is self-indulgent and a luxury, millions of people across the globe are seeking out its healing effects. In the U.S., massage therapists are second only to chiropractors in the frequency of visits to alternative medicine practitioners. In Germany, doctors often prescribe massage therapy rather than pharmaceutical medications.
What is Massage Therapy?
The simplest definition of massage therapy is “the manipulation of soft tissue for the purpose of producing physiological effects.” But it is so much more than that. The massage therapist will take a detailed medical history from the client, to ensure that massage is the appropriate treatment for them. The therapist may employ different diagnostic methods to ascertain which muscles or parts of the body will benefit from massage therapy.
When treating a client, the massage therapist may employ a variety of manipulative techniques, ranging from light and superficial stroking to more vigorous pressing and kneading of deeper muscles and tissues. These may be applied with hands, fingers, forearms, elbows, and sometimes even feet, knees or an electrical device, depending on the practitioner and the type of therapy they employ. These techniques are used to relieve painful, contracted muscles, to help rehabilitate repetitive stress injuries, to alleviate soft tissue injuries incurred in, say, a motor vehicle accident or a nasty fall – the possibilities are endless.
Why Do We Need Massage?
Seemingly mundane activities like looking at our phones, craning our necks to see our computer screens, sitting for hours at work, driving in rush-hour traffic, stressful situations… even a game of golf – all can create patterns of muscle tension that, if allowed to take up residency in our bodies, may accumulate and have a bad effect on both body and mind.
Persistent tension in the musculoskeletal system can restrict the circulation and flow of blood and nutrients to the body’s organs and tissues. We have connective tissue known as fascia that covers our muscles and organs, rather like a web. When the fascia gets tight and dense, which can happen for many different reasons, it decreases range of motion and mobility, and can negatively affect things like breathing, posture, and the ability to move freely. Habitual muscle and fascia tension contribute to a wide range of biochemical, neurological, and even hormonal imbalances. And it can also contribute to anxiety and tension in our minds.
Massage therapy interrupts this muscle tension and stress, helps to relax muscles, tendons, and ligaments. Even the deeper tissues of the body, while not easily accessed by a therapist, can be affected. This happens because the release of the more superficial layers of muscles also affects deeper muscles, allowing both the superficial and deeper muscles to find better alignment and balance. This gently nudges the body back into a more natural, balanced state known as homeostasis.
The Physical Benefits of Massage Therapy
1 | Reduces pain and tension in muscles and joints and reduces nerve impingements.
Soft tissue injuries recover more quickly, including sporting injuries, repetitive movement injuries, and injuries from car accidents.
There are a few theories as to why pain is reduced by massage therapy, most notably the gate control theory, put forward by Ron Melzack and Pat Wall in 1965. In a nutshell, the gate control theory proposes that pain signals to the brain are interrupted or eased by competing stimuli. Because pain travels on smaller diameter nerve fibers and massage stimulates larger diameter nerve fibers, the larger nerve fibers relay messages to the brain more quickly than do the smaller nerves. So the more pleasant sensations of massage get to the brain faster than sensations of pain. Also, massage therapy relaxes knotted up muscle tissue, thus reducing painful spasms and contractions.
A 2011 randomized, controlled trial of volunteers with chronic low back pain of at least three months’ duration found that massage therapy could be an effective short- and longer-term treatment for low back pain.
Massage can also ease nerve impingements. When muscles are tight and contracted, they can often also be compressing nearby nerves. When a therapist releases muscles, this can also relieve nerve compression. That means nerves can get back to their normal functions of transmitting messages to and from the brain which, in turn, improves the function of muscles and organs. Overall circulation and blood flow improvement allows increased nutrition to the tissues.
2 | Organs also benefit from massage
Massage therapy affects, either directly or indirectly, nearly every organ of the body, but especially the nervous system and the cardiovascular system. Massage relieves tension in muscles and fascia and also relieves nerve impingements, allowing for improved nerve conduction to and from the various organs of the body, increasing their function.
For instance, in a 2017 clinical trial, patients in intensive care units (ICU) were given abdominal massage to improve digestive function. Researchers were concerned with the fact that ICU patients often suffer from malnutrition, lying immobile for long periods. It was posited that massage therapy of the abdomen might help. At the trial conclusion, researchers stated that abdominal massage did assist and could be “considered as a caring method in the daily care program for these patients.”
3 | Increases flexibility, improves range of motion and posture
In a 1984 study, 34 participants aged between 18 and 35 were given a simple 9-12 minute massage to the hamstring muscles (posterior upper thigh). Passive range of motion of both legs was then measured. Researchers noted immediate post-massage increases in range of motion for those receiving the treatment. Posture often improves with regular massage therapy, although it may take a few sessions to retrain and lengthen muscles, along with some specific stretches for the client to undertake.
4 | Lowers blood pressure
Massage clients often find that their previously high blood pressure is reduced after a massage session. The effects linger, too. In a 2013 single-blind clinical trial, researchers found that massage therapy could serve as an effective intervention in controlling the blood pressure of pre-hypertensive women. Participants had immediate results of lowered blood pressure post-massage which lasted up to 72 hours. Another 2013 study had similar findings. Participants that received regular Swedish massage over a period of four weeks had significantly decreased blood pressure than those who did not have massage.
5 | Fewer headaches
A 2002 study found that massage therapy reduced the frequency of chronic tension headaches for sufferers. In a small 2012 study, ten male patients with migraine headaches had significant pain reduction after neck and upper back massage and spinal manipulation.
6 | Reduces cortisol, released in response to stress
A 2015 clinical study investigated the effect of 60 minutes of massage applied by a nurse or by patients’ relatives on blood cortisol levels among 90 patients hospitalized in a coronary care unit (CCU). The median blood cortisol level, pre-massage, for the patients receiving massage by a nurse was 281.90 nanomoles, and it decreased to 197.00 post-massage. Interestingly, the median blood cortisol level, pre-massage, for the patients receiving massage by their relatives was 303.90 nanomoles, and it decreased to only 211.55. This led researchers to state “The difference seen in this case might be relevant to the difference in massage givers’ skill.” The control group, receiving no massage, enjoyed no decrease in cortisol levels.
In reference to cortisol and massage therapy, Dr. Tiffany Field, a researcher at the Touch Research Institute, University of Miami, has stated, “No matter how we measure cortisol, in saliva or urine, or how often, we always find that massage has a beneficial effect.”
7 | Better sleep
Dr. Field has also studied the effects of massage on quality of sleep. “Massage helps people spend more time in deep sleep, the restorative stage in which your body barely moves,” Field has stated. A 2014 study of women who had just given birth and were experiencing insomnia agrees with that. The mothers who received a 20-minute back massage each evening for five consecutive days by a massage therapist had significantly improved quality of sleep.
Further, a 2017 study investigated the effectiveness of massage therapy for patients with heart failure who had difficulty sleeping. Researchers found that just three 20-minute sessions of massage daily significantly improved sleep quality for most of the patients.
8 | Improved immune system function
A 2004 study of women with Stage 1 and 2 breast cancer found that massage therapy increased numbers of natural killer cells, important immune cells involved in destroying cancer cells. Massage also decreased depression and anxiety in these women.
A 2010 study also looked at the effects of massage therapy on the immune system. Researchers found that 45 minutes of Swedish massage resulted in significant increases of immune cells that help to protect the body from viruses, cancer cells, and other pathogens.
A 2001 study on HIV-positive adolescents found that 12 weeks of bi-weekly massage sessions significantly enhanced their immune function.
9 | Eases inflammation after strenuous exercise
A 2012 study found that massage therapy activates signaling pathways in the body that mitigate or ease the release of inflammatory chemicals that are normally released after strenuous exercise, thus alleviating stress to muscles.
10 | Cancer patients also benefit from massage
Among patients receiving care for cancer, a number of studies have noted multiple benefits from massage therapy, including improved relaxation, sleep and immune system function, and decreased fatigue, pain, anxiety, depression, and chemotherapy-induced nausea.
The Mental Benefits of Massage Therapy
1 | Increases mental alertness and concentration
A number of studies have demonstrated that massage therapy increases concentration and mental alertness. The reasons are unclear, but may be due to improved blood flow and nerve conductivity, as well as easing of stress and tension.
2 | Eases tension, anxiety, stress and depression
The results are in from many studies and they all agree that people who receive massage have lower levels of tension, anxiety, and stress.
Even just 15 minutes per day makes a difference. A 2015 Turkish study evaluated the effects of back massage on the levels of anxiety and cortisol, and systolic/diastolic blood pressure, pulse rates, and sleep quality in family caregivers of patients with cancer.
They found that just 15 minutes of back massage per day for one week significantly improved anxiety, cortisol levels, blood pressure, heart rate, and sleep quality in these caregivers.
3 | Promotes release of feel-good endorphins
Most people report feeling much more optimistic after a massage. It just kind of seems to take the rough edges off life. It helps to promote feelings of trust and connectedness, as well. This has to do with those feel-good brain chemicals that are released in response to massage, including:
Dopamine – a neurotransmitter with a myriad of functions, the most important of which include memory preservation, attention and concentration, and perception of pleasure. Dopamine is sometimes called the “molecule of happiness”.
Serotonin – a neurotransmitter that sends messages to every part of the body. Serotonin works better than Prozac in the brain, it helps to make you feel more emotionally stable, happier, and calmer. Serotonin is responsible for stimulating parts of the brain that control sleep and waking cycles, it increases libido, among many other important functions.
Oxytocin – in addition to its function in the childbirth process and sexual reproduction, oxytocin also plays a large role in social bonding – that’s why that feeling of connectedness occurs after massage.
Massage Therapy Comes in Many Forms
There are many different types of massage and bodywork. Here are the most popular:
1 | Acupressure
Similar to acupuncture but without needles. The practitioner applies pressure to certain points on the body to stimulate these points, release congested energy, and open the body’s energy pathways, known as meridians.
2 | Alexander Technique
Not specifically massage therapy, but a technique wherein the practitioner observes the way their client moves in their daily activities and work. The client is taught to become more body aware, and how to move so that aches, pains, and injuries can be addressed and eased. It is an active exploration that changes the way the client thinks and responds in activity.
3 | Chair Massage
Usually done in public places (which can be distracting) but great if you just need a quick neck and back rub and don’t have time for a full-body massage. The practitioner employs a blend of techniques to help relax muscles of the neck, shoulders, upper back and lower back and, often, hands.
4 | Cranial Sacral Therapy
An extremely gentle, and deeply relaxing, non-invasive technique in which the practitioner uses a light touch to relieve compression and balance energy in the bones of the head, sacrum, and spinal column. More energy work than massage, it can be beneficial to treat headaches, temporomandibular joint dysfunction, whiplash, and other injuries.
5 | Deep Tissue Massage
As the name suggests, the practitioner uses a little more pressure than with Swedish massage, while striving to stay within the client’s pain tolerance. The goal is to release pain and tension in muscles and tissues, and patterns of holding resulting from injuries, accidents, strains and sprains, etc.
6 | Feldenkrais
Named for its creator, Moshé Feldenkrais. More a movement therapy than massage, the practitioner teaches their client how to improve posture, breathing, coordination, flexibility, and movement. The goal is to ease chronic pain and restricted movement and reorganize connections between brain and body.
7 | Hawaiian Huna or Ka Huna Massage (also known as Lomi Lomi)
Originating from ancient Hawaiians, this style of massage utilizes rhythmic motion; flowing strokes using hands, forearms and elbows; and hula movements, often combined with particular music. The goal is to relax, rejuvenate, rebalance, and stimulate the natural flow of energy within the body to effect change physically, emotionally, and spiritually.
8 | Hot Stone
Smooth stones of varying size are warmed and placed on specific points of the body so that the heat will penetrate and soothe tense muscles, helping the client to relax and de-stress.
9 | Infant Massage
Performed with infants to help treat colic, constipation, weight gain, and assist with sleeping problems.
10 | Lymphatic Drainage
A gentle and non-invasive technique which helps to drain excess fluids and waste from the lymphatic system. Very useful for anyone who has lost lymph nodes due to cancer, surgery, injuries, etc. It is very relaxing to receive and beneficial for overall health, detoxing and immunity. In France, women get this done to help rid themselves of cellulite.
11 | Myofascial Release
“Myo” means muscle, and “fascia” refers to the connective tissue that surrounds our muscles, bones, nerves, and organs. Restrictions in the myofascial system can result due to injuries, surgery, inflammation, etc. The practitioner’s goal is to balance fascia and muscles by engaging and releasing restrictions using a light, sustained pressure and long stretching strokes without oils or lotions.
12 | Myotherapy
In myotherapy, the practitioner assesses a client’s movement and mobility and treats them with a blend of techniques including massage, dry needling, thermo- and electro-therapeutic techniques. Beneficial for muscle pain, headaches, occupational injuries, TMJ disorder, and many other conditions. The practitioner may also prescribe to the client exercises and/or education about pain management, activity modification, and/or lifestyle modifications.
13 | Neuromuscular Therapy
A form of deep tissue massage, the goal of which is to treat acute and chronic pain involving muscles and nerves. The practitioner locates tender points in muscles and, using various techniques, works to lengthen tight muscles, improve circulation, decrease nerve compression, mobilize restricted joints, address postural issues and biomechanical dysfunction.
14 | Prenatal Massage
Especially for pregnancy, this is a gentle, non-invasive style of massage. It promotes wellness in the mother-to-be by relieving many of the normal discomforts experienced during pregnancy, such as low back pain, leg cramps, stiff neck, headaches, stress, and edema (swelling).
15 | Raindrop Technique
An aromatherapy technique that employs a combination of certain essential oils being dripped along the spine, along with a type of reflexology and gentle feather strokes along spinal muscles (first used by the Lakota people). Raindrop Technique helps to realign and balance energy centers, ease muscle pain, reduce stress, support immunity, aid detoxification, and many other benefits.
16 | Reflexology
Based on the principle that parts of the body are reflected and correspond to certain spots known as reflex points on the feet, hands, face and ears. These points are said to connect directly through the nervous system and affect the organs and glands. The practitioner applies pressure to these points in order to stimulate the body’s natural healing processes and assist the flow of energy through meridians.
17 | Rolfing
Named after its creator, Ida Rolf, this is a highly specialized technique of soft tissue manipulation and movement education. Rolfing is generally quite deep work and is typically performed in a progression of ten 60-90 minute sessions, each of which is focused on a particular part of the body. The goal of Rolfing is to lengthen fascia in order to ease tension patterns, to restore function and movement.
18 | Shiatsu
An ancient Japanese form of bodywork, shiatsu means “finger pressure”. The practitioner manipulates soft tissue using thumbs, fingers and palms, working certain points on the body, similar to acupuncture points. The goal is to improve energy flow along meridians, which increases wellness and eases stress. Shiatsu is generally performed on the floor rather than on a massage table.
19 | Sports Massage
This is a particular application for massage therapy and the type of technique utilized depends on the recipient’s stage of training or competition, and whether they are dealing with injuries. Sports massage utilizes a blend of techniques that aim to warm up muscles pre-performance to prevent injury. It is also used to rehab overworked or injured muscles post-performance to aid in quicker recovery, to reduce inflammation, and keep muscles and joints flexible and in peak condition.
20 | Strain/Counterstrain
Not so much massage as a type of gentle positioning of a client’s limbs to ease muscle and joint pain and dysfunction. Difficult to describe, the practitioner treats the client by placing the sore or injured limb toward a position of comfort or tissue ease that compresses or shortens the injured muscle. This shortening relaxes aberrant reflexes that create muscle spasm, gently allowing muscle tone to return to normal levels. It allows the joint influenced by the now-relaxed muscle to function more optimally.
21 | Swedish Massage
In one of the most common styles of massage, the practitioner uses hands, fingers and forearms to perform a combination of long, gliding strokes (known as effleurage), muscle kneading (petrissage), friction, and rhythmic tapping (tapotement) techniques. It is excellent for stress relief, easing sore muscles and headaches, improving circulation, and many other benefits.
22 | Thai Massage
Performed on the floor with clothes on and no oils, Thai massage involves being stretched in different positions. The practitioner rigorously manipulates the client, using every part of their body including hands, knees, feet, and legs (sometimes even walking on the client), to stretch and loosen constrictions in muscles and joints. Thai massage is quite invigorating; you would not choose it if you wanted to just relax.
23 | Trager
Dr. Milton Trager developed this style of bodywork which has two parts. In the first, the client is passively lying on a table while the practitioner moves their body in ways they naturally move during daily activities and work, in order to mobilize and relax tissues. In the second part, the client is reeducated to perform active movements that help to release deep-seated patterns and free up restrictions. A session usually lasts from 60-90 minutes and no oils or lotions are used.
24 | Trigger Point Therapy
A form of deep tissue therapy beneficial for both acute and chronic muscle pain. A trigger point is a tight spot in a muscle that creates referred pain to another part of the body. For instance, you may have a trigger point in your neck but feel the pain in your head. The TPT practitioner strives to work within their client’s pain tolerance to locate the trigger point causing the pain and using various techniques to release them. The client can usually experience a significant decrease in pain after just one or two sessions.
26 | Tui Na
From ancient Chinese tradition, Tui Na means “push and grab” or “pinch and pull”. The practitioner employs vigorous friction, pushing, rubbing, rolling, and manual stimulation of acupuncture points. The goal of Tui Na, as with other Eastern forms of bodywork, is to open up energy meridians to stimulate the flow of energy through the body. Tui Na is invigorating – not the therapy you would choose for pleasure and relaxation, but rather to address specific patterns of pain and dysfunction.
26 | Visceral Manipulation
Sometimes referred to as organ massage. French osteopath Jean-Pierre Barral invented the technique to assist with specific problems that can occur around organs. For instance, scar tissue from abdominal surgery (like a C-section) can begin to create adhesions and constrict natural movement. The internal organs are connected through nerves and connective tissue to other parts of the body, including the skin, muscles and bones. Constrictions in any one of these structures can create dysfunction. Visceral Manipulation can help to release these constrictions.
Other forms of bodywork include energy techniques such as Reiki, Polarity Therapy, Bioenergy Healing, Pranic Healing, Therapeutic Touch, Healing Touch, and Shamanic Healing. While not considered massage therapy, these can also be highly beneficial.
When Massage Therapy Should be Avoided
There are times when massage therapy should be avoided, including (but not limited to) some of the following:
- Bleeding disorders
- Open or healing wounds
- Deep vein thrombosis
- Bone fractures
- Severe osteoporosis
- Thrombocytopenia, a deficiency of platelets in the blood which causes bleeding, bruising, and slow blood clotting
- Infectious diseases
- Pregnancy (prenatal massage is considered safe)
What You Can Expect During a Massage Session
Prior to a massage session, your therapist should ask you about any symptoms, take a brief medical history, find out what prescription drugs you are taking (because, for instance, a deep tissue massage would not be a good idea for someone on blood thinning medication) and what you hope to get out of the session. The therapist should explain the kind of massage and techniques he/she will use.
In a typical massage session, you undress or wear loose-fitting clothing. Undress only to the point that you are comfortable. If the therapist uses a massage table, you will lie on the table and cover yourself with linens. With chair massage and several other styles of massage, however, you would stay fully clothed. Your massage therapist may perform an evaluation through gentle touch to locate painful or tense areas and to determine how much pressure to apply. Your therapist may use oil or lotion to reduce friction on your skin, so be sure to advise if you are allergic to any ingredients. A massage session may last from 10 to 90 minutes, depending on the type of massage and how much time you both have agreed to. No matter what kind of massage you choose, you should feel safe and calm during and after your massage.
Getting the Most Out of Your Session
1 | It’s All About You
Remember that your massage session is all about you, not about what the therapist believes you might need. So, if you aren’t getting what you wanted worked on, be sure to speak up (which is not always easy if you’re in a super-relaxed state).
2 | Good Pain vs Bad Pain
Occasionally you may have an ultra-sensitive spot in a muscle that feels like a knot. It’s likely to be uncomfortable while your therapist works it out, but it should feel like good pain (some have described it as “exquisitely painful”). But if the pressure or technique goes past good pain to the point where you are holding your breath or gritting your teeth, that is counterproductive, so be sure to speak up. If a therapist is using too much pressure, or not enough, you have every right to ask for pressure adjustment. Some areas are just more sore than others and your therapist doesn’t want to hurt you.
3 | Remember to Breathe
In deep tissue massage sessions undertaken to resolve pain and discomfort (as long as your therapist is staying in that “good pain” range), it can be helpful for you to take a deep breath and envision the knot in that muscle melting away. It may sound weird, but when you enlist the power of your mind to help a muscle relax, it really does work more quickly and more powerfully.
4 | Self Care Post-Massage
Your therapist will no doubt tell you this, but if they forget here are some good things to do after your massage:
- Don’t be in a rush to get in your car and drive away. Your reaction time will be significantly slowed down. Take a 5-10 minute walk or sit somewhere quiet and just breathe.
- Be sure to drink plenty of water after your massage. Tight muscles hold in toxins and the massage has just released those toxins into your system, so you want to wash them through. Forget this part, and you might end up with a thumping headache! Also, try to avoid drinking alcohol that day.
- An epsom salt bath is excellent for post-massage muscle soreness. You may not encounter this, but if you do, one cup of epsom salts in your bath (not too hot) will work wonders.
Final Tip: If you have decided to grab some of the benefits of massage therapy for yourself, the best way to start out is to get a referral from your friends, family, local yoga studio, health gym, or chiropractor’s office. It’s good to be particular about who puts their hands on your body. It’s okay if you’re feeling spontaneous and schedule a one-time massage at the local health spa. But if you’d like to truly reap the benefits of massage therapy for your health and wellbeing, or if you have some long-standing problems with muscles and you believe you’ll need a series of treatments, talk to your connections and find out who they trust and why.
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