Massage- what does it really do?

Everyone always wants a damn massage, and they always ask me, especially my family. Even though I studied physical therapy and massage is only a tiny little piece of what we do, everyone associates physical therapy with massage. So, of course, I get asked all the time for a massage. The worst thing about it is that no one ever gives me a massage, so I don´t even know what it feels like anymore, but I do know the benefits of a massage. So what does a massage really do? Lets find out.

Massage reduces depression and massage reduces anxiety, and it does this because it is relaxing (1-2). It is also said to reduce blood pressure (3) and help people to sleep, even when under stress. Massage also helps patients with sub-acute or chronic lower back pain, but not with acute back pain!(5). And that´s about it, folks. Scientifically, those are the only things that massage has been proven to do, nothing else! (It may help with other diseases but it´s usually due to one of these factors I just mentioned) But, what about all those other things we always hear massage is good for? Like, for example, it helps with circulation, it detoxifies and so on. Well, they are basically myths!! So let´s start talking about those myths.

Circulation – massage helps with circulation but very, very, very, VERY little!! If you want to improve your circulation go for a walk, it´s cheaper and MUCH more effective in increasing circulation (6-7,10).

Detoxifies or gets lactic acid out – Massage doesn´t do either of these, in fact it could do the opposite! When we give a massage we produce a mildly toxic state know as rhadomyolysis(8-10).

Massage helps with muscle soreness – Like I stated in my last post (https://sports-diet-pain.com/2013/11/17/stretching-is-it-useful/), almost nothing helps with muscle soreness and that includes massage.

Massage helps you recover after an exercise – Actually it doesn´t!! This may surprise more than one (including me), but the evidence says that ¨massage significantly impairs lactic acid and hydrogen ion removal from muscles after strenuous exercise by mechanically impeding blood flow¨(9-10).

Massage releases ¨fascia¨-  First let me explain what fascia is. Fascia is the connective tissue that wraps around all of our muscles and is heavily interconnected with muscular function. Fascia is also very, very, strong. In a study done in 2008, Chauldhry found that forces outside the physiological range would be required to produce just 1% compression and 1% shear of the fascia lata and plantar fascia. In another study done in 2012, Simmons and Martinez found that the relatively low level of forces used by manual therapists is not enough to cause significant deformation of collagen in the fascia. In other words, massage does not release or change fascia, fascia is too tough for that to happen! What may happen, and this is still a hypothesis, is that myofascial release is thought to stimulate intra-fascial mechanoreceptors, which cause alterations in the afferent imput to the central nervous system, leading to a reduction in the activation of specific groups of motor units. So, in plain English what this means is that whenever we touch a patient we are giving information to the central nervous system, and how the central nervous system perceives this information will affect the fascia.

And the last myth about massage is when the therapist giving you the massage tells you ¨You are really tight¨. I have also done this lots of times, but research tells me I was wrong. First, tissue texture correlates poorly with pain(11)  and second we, therapists, are bad at detecting the painful side just by feel (12). So, next time you get a therapist and he tells you how tight you are…..just play along with it…..because we all do it 🙂

In conclusion: a massage is GREAT and probably helps us with a lot of our physical problems, including stress, anxiety and may even help with pain.  There are also things that massage doesn´t do and that I mentioned in this blog, but the good thing with a massage is that you can almost never go wrong. Even if the therapist tells you that he will ¨detoxify¨ you (which he won´t), you probably will come out feeling great!! So go out and get yourself a massage but please don´t ask me 😉

1. Hernandez-Reif et al. High blood pressure and associated symptoms were reduced by massage therapy. Journal of Bodywokr & Movement Therapies.199
2. Cady et al. Massage therapy as a work place intervention for reduction of stress.Perceptual & Motor Skills 1997.
3. Shulman et al. The effectiveness of massage therapy intervention on reducing anxiety in the work place. Journal of Applied Behavioral Science.1996
4. Moyer. Affective massage therapy.. Int J Ther Massage Bodywork 2008.
5. Furlan et al. Massage for low-back pain. Cochrane Database of Systematic Reviews.2008
6. Hovind et al. Effect of massage on blood flow in skeletal muscle.  Scandinavian Journal of Rehabilitation Medicine 1974.
7. Ramos-González et al. Comparative study on the effectiveness of myofascial release manual therapy and physical therapy for venous insufficiency in postmenopausal women.  Complementary Therapies in Medicine,2012.
8. Wiltshire et al. Massage Impairs Post Exercise Muscle Blood Flow and “Lactic Acid” Removal. Medicine & Science in Sports & Exercise.2009
9. Cheung K, Hume P, Maxwell L. Delayed onset muscle soreness: treatment strategies and performance factors Sports Med. 2003;33(2):145-64.
10. http://www.association.quebec.aqtn.ca/files/scientific-literary-review-massage.pdf
11. Andersen et al. Increased trapezius pain sensitivity is not associated with increased tissue hardness. Journal of Pain 2010. PubMed     
12. Maigen et al. Lower back pain and neck pain: is it possible to identify the painful side by palpation only? Ann Phys Rehabil Med.2012