Therapeutic massage is expensive but popular and pleasant, with obvious subjective value, and proven benefit for anxiety and depression but no other clear biological or medical effects. Most notably, the evidence that massage can help back and neck pain is sketchy, and there is no reason to believe that massage can help much with any other common musculoskeletal pain problem. 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). And yet some medical benefits are plausible despite the lack of evidence. For instance, many apparently successful treatments may be due to the effects of pressure on “muscle knots,” which are a likely factor in many common pain problems, but poorly understood (and difficult to treat).

The aim of this paper is to report a novel intensive therapy of gynoid lipodystrophy (cellulite) based on a new hypothesis. The patients were submitted to a 4-hour daily treatment session that consisted of manual and mechanical lymph drainage and cervical stimulation by the Godoy & Godoy technique. During the intensive phase patients are instructed by the therapist in the individual components of self-management, which include self-manual lymph drainage (self MLD, or simple MLD), a skin care regimen, home exercises, and the application of compression garments (and bandages). The self-manual.

And regardless, the effects on mood and mental health are so profound that patients can’t really lose — it’s a valuable service whether it “works” for pain or not. Full article 16000 words. Does massage therapy “work”? What do massage therapists say that they can do for people and their pain, and is there any scientific evidence to support those claims?

Massage is a popular treatment for,, and — can it actually treat them, or does it just pleasantly distract patients and maybe take the edge off? In this article, I examine massage therapy in the light of science — not “objectively,” but fairly. I go out of my way to be critical of my former profession — I consider it an ethical duty. Health professionals must be self-critical and critical of each other: that is how we improve. And, alas, massage therapists are guilty of. Although there is a lot of negativity — also known as realism — in this article, I also still recommend massage.

It has some plausible medical benefits, even if they are inconsistent and unproven. For instance, patients may get at least temporary pain reduction from any kind of stimulation of “muscle knots,” which are a likely factor in many common pain problems — but poorly understood, controversial, and certainly treatment is unreliable in any case. (I summarize this topic below, but it’s such a huge topic that I have several other large pages devoted to.) But, most importantly, the emotional value of touch and the effects on mood and mental health are so profound that patients really just cannot lose — good quality massage therapy is a worthwhile service for anyone who can afford it whether it “works” for anything in a medical sense or not. I saw a few chiropractors and acupuncturists. But despite some initial short relief, their work seemed to lose effectiveness after a few visits. I went to a massage therapist, whose treatment actually was the opposite of my experiences with neurologists: It was enjoyable.

This was the beginning of what I called a foray into “recreational medicine.”, by Paula Kamen, p. Many massage therapists have almost no training & are not qualified to treat any kind of medical problem.

Unfortunately, such massage therapists are quite rare. Most are poorly trained and uncertified. Most work in spas or resorts and on cruise ships, doing treatments that are infamously fluffy and skin deep, with little therapeutic value other than the comfort of a quiet hour of touching (even though many patients find skin-deep massage to be more annoying than anything else). Most of these therapists are earnest and view themselves as medical semi-professionals, despite their comparative lack of training. It’s actually inappropriate to call them “therapists” at all, and in some places (here) it’s actually illegal — they have to use terms like “bodyworker” or “masseuse.” Interestingly, the most pleasant massages I have ever had were done by therapists of this type! Compassionate and emotionally mature people are drawn to the work and usually think of it as a bit of a calling — perhaps this affects the sensory quality of the experience more than technical training. If medical doctors saw even a tenth of the discussions on some of the FB massage groups, they would never take us seriously enough to refer a patient to any of us., author of.

Massage can be studied: we don’t have to know how something works to find out if it works. Do people who are sick or broken get better when massaged? But logistics, economics, and devilish details get in the way. Not many scientists are interested in studying massage, while massage therapists don’t have scientific training.

It’s an expensive and overwhelming challenge for a massage therapist to make room in their career for some research — few do it, and hardly any have ever done it well. Even when they do, you’d be amazed how hard it is to even find 100 people with the same problem, so studies of that size are almost never done: instead you get studies of 20 or 30 patients, which isn’t generally enough to prove much. Another challenge is that “massage” can mean so many things that it’s hard to know what is even really being studied (lack of standardization of treatment). More technically and most seriously, massage research is plagued by a “stark statistical error”: the error of reporting statistical significance of the wrong thing, or the wrong comparison. Is a psychologist and a rare example of a real scientist — someone trained and expert in research methodology — who has chosen to focus on massage therapy: I have been talking about this error for years, and have even published a paper on it. I critiqued a single example of it, and then discussed how the problem was rampant in massage therapy research.

Based on the Nieuwenhuis paper, apparently it’s rampant elsewhere as well, and that is really unfortunate. Knowing the difference between a within-group result and a between-groups result is basic stuff. That error afflicts massage research in particular for the simple, ironic reason that massage is so much “better than nothing” — patients tend to be satisfied with massage regardless of whether it has a medical effect or “active ingredient.” This makes massage study results seem much more medically impressive than they would be if you subtracted all that satisfaction and other “nonspecific” effects.

There is so much uncertainty that it is fair and reasonable to ask if we can really say much of anything about massage based on such incomplete and imperfect evidence. We can, in fact, but it all must be done with our eyes wide open and a lot of qualifiers and hedging of bets. We can’t be certain of anything but we can certainly be informed by the evidence so far. Research in the massage therapy field is still in infancy partly due to a lack of research infrastructure and a research tradition. The result is that most registered massage therapists are not accustomed to reading, analyzing, conducting, writing case studies or applying research in their own practice.

Harriet Hall, RMT, PDP, from (Dr. Moyer thinks it’s even worse than “in its infancy” — he’s called massage therapy research “stunted”! Nevertheless, let’s make of it what we can). Massage for low back pain is the most studied massage question, but not enough: the answer is still fairly clearly “more study needed.” Massage for trigger points is also fairly well studied, but also not enough: science has still yet to confirm that pushing on sore spots makes them less store.

I discuss both of these in detail in their own sections below. And that’s where the evidence is the most plentiful and relevant what people want from massage. Most other evidence about massage benefits is indirect and/or so weak it’s meaningless.

For instance, there are a few scraps of evidence — not nearly enough, but better than nothing — that rubbing and stretching soft tissue can reduce joint pain and stiffness. Some research helps us to understand why people like massage, or why it’s likely that there are numerous minor or general health benefits. But there are no smoking guns, no “proof” that it “works” — that is, we have no clear evidence of clinically significant therapeutic efficacy for a good variety of health problems. Many things that work may not yet have evidence, but that’s no excuse for overselling them.

The soul of scientific, ethical health care is that we don’t promote a treatment until there’s good evidence that it really works. For instance, basic research has shown that touch is neurologically complex and probably has many physiological effects.

Skin is fantastically rich in nerve endings — about 100,000 per square centimetre. — and in 2009, Swedish researchers identified specialized nerve fibers that respond only to light stroking of a certain speed. This reinforces the obvious: massage can provide people with a rich and novel sensory experience, which could be a major mechanism for pain relief and other therapeutic benefits. If massage works, it’s mainly because of the neurology of touch (as opposed to, say, changing tissues). For instance, we know that chronic pain in particular tends to get increasingly disconnected from reality (), and safe, pleasant, interesting sensations may help us get back on track. Such a benefit is both highly plausible and highly speculative.

Sadly, there is an absence of useful evidence on the topic. We know many chronic pain patients are drawn to massage like bees to flowers, but we don’t know how much relief is actually possible. Another interesting indirect example: stretching massages muscles with movement, and so it may feel good for some of the same reasons and share some of the same benefits. And indeed a 2011 study of simple, static stretching showed a clear, good effect on heart rate regulation — just from pulling on muscles, which may not be very different from pushing on them.

It’s not much of a leap to guess that rubbing soft tissues could also have systematic regulatory effects. Flow The Psychology Of Optimal Experience Audiobook Torrent. While many benefits of massage are still disconcertingly uncertain and hotly debated (by some), there are two truly proven ones. Massage researcher and psychologist Dr. Christopher explains that the only confirmed benefits of massage are its effects on mood (“affect”), specifically: • massage reduces depression • massage reduces anxiety Dr. Moyer believes that more importance should be placed on these effects, and that they should even be the basis of “a new subfield for MT research and practice: affective massage therapy (AMT).” Building on what is already known about the effects of massage therapy on anxiety and depression, everything possible should now be done to better understand and to optimize the ways that massage therapy influences affect, the observable components of an individual’s feelings, moods and emotions.

Christopher A Moyer Perhaps one of the reasons massage reduces depression and anxiety: it’s relaxing. While not proven as well as you might think, it is a pretty safe bet, and the idea is further supported by evidence that massage therapy may reduces blood pressure and helps people to sleep, even when they are under the unusual stresses of hospital care. These are all unsurprising and unremarkable.

Relaxation is an important component of wellness and pain management, and I do not underestimate its value, but it is hardly curative. And, as many critics have pointed out, massage is a super expensive way to relax.

On average, professional massage therapists charge about a buck a minute — vastly more than millions of people can afford on a regular basis. This economic perspective is often completely ignored in discussions of whether or not massage works. It probably does but does it work well enough for the price? A nap is also quite relaxing, and a lot cheaper.

If massage is to be considered a more cost-effective treatment for any medical problem than napping, we really must establish that it does more — quite a lot more — than just mellow people out. Many studies done by the — although almost certainly of generally low quality and strongly biased in favour of massage — show many other broadly defined modest benefits to massage therapy in many circumstances — everything from rheumatoid (bad) arthritis to cancer to autism. In a recent study in, both massage and ordinary, simple touching have been shown to help cancer patients — indicating that massage was helpful and yet unremarkable at the same time.

(A more recent and better-designed Korean study was even more encouraging, showing that massage was quite a bit more helpful for patients with the deep, grinding pain of bone cancer than simply receiving compassionate attention.). In 2010, my wife is recovered from serious injuries she got in a car accident, including a spinal fracture. Guess what exercises she has to do? Early mobilization and range of motion exercises! This is just mainstream, standard post-injury care. If a massage therapist prescribes it, does that make it massage therapy?

Is massage therapy is working for that patient? In a sense, yes, for instance, will be taught by competent massage therapists to clients with cervical injuries, because they help people get better faster. In fact, the evidence strongly suggests recovery from nearly any injury or surgery is greatly facilitated by early mobilization. But “massaging with movement” is not “massage therapy,” of course — it’s something that a few well-trained massage therapists prescribe, and only in specific circumstances. Lymphatic drainage is an interesting example of a specific massage technique, allegedly good for one thing and not much else: it’s purpose is to reduce swelling. By reputation, it’s the best treatment option for patients suffering from lymphoedema, a serious complication of mastectomy and other surgical procedures. But it’s also obscure, technical, and practiced by no more than a few hundred therapists globally.

It’s not “massage therapy” per se; just a specialized tool that a tiny group of professionals specialize in, some of whom happen to be massage therapists. Oh, and bad news: there’s also recent evidence that it does not work, or not nearly as well as we’d like.

There are several examples of plausible, evidence-based advice and treatments that better-trained massage therapists will know about. But there are also many manual therapy techniques that are surprisingly un-proven, including some extremely popular ones. Traction is a great example — pulling on the spine. Often used by massage therapists to treat low-back pain and neck pain, it might be an effective technique for a few patients, but I wouldn’t count on it, or advise anyone to spend much money on it. Like many popular therapies, the evidence is a mess.

The absence of conclusive evidence is significant: if traction worked well, it probably would have shown up clearly by now. If traction works at all, it’s certainly not reliable. I discuss traction in considerable detail in both my and tutorials., another specific type of massage, mainly as a treatment for tendinitis, was pioneered by physiotherapists and adopted unquestioningly by massage therapists. Unfortunately, although it’s a reasonable idea, it has yet to be satisfactorily supported by the evidence (undermined by it, if anything). Yet the profession clings to friction massage, mostly due to the assumption that it must be good if better-trained physical therapists do it — which is not a safe assumption. As dubious as these methods are, massage therapists routinely use techniques that are even more questionable.

— which involves no actual touching, but hovering over the body and manipulating the patient’s “aura” — is a prominent example. It’s not massage, and I think it’s in the same category of credibility as astrology or dowsing. Some massage therapists believe, while many others believe it’s nonsense. 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. And yet it is sold with overconfidence by countless manual therapists as though it were proven effective. There are many other examples of weird and silly treatments.

See the further reading list at the bottom of this article. So “massage therapy” is often not limited just to Swedish massage. The other things that massage therapists do are a real mixed bag of standard manual/physical therapies along with many, many other things. This topic is covered much more thoroughly in PainScience.com’s detailed.

If you really want to understand massage for low back pain, that’s what you need to read. This is an abridged excerpt. Low back pain is a huge health problem, and massage therapists claim to get good results when treating low-back pain. Indeed, low back treatments are the bread and butter of the profession.

I’d guess that about 70% of massage purchases are for back pain. The amount of money that patients around the world spend on massage for back pain must be simply huge, at least in the tens of millions annually, and probably much more. As with chiropractic care, massage therapists might not have much of a business model if people didn’t have low back pain.

So it had better work! But know one actually knows if it does, because the evidence all boils down to this: error!

Insufficient data! 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.” 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.” 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. Furlan et al.

In 2008: “massage is beneficial” in 2015: “very little confidence that massage is an effective treatment” The change from optimism to pessimism is fascinating, and caused some angst in the small community of massage therapists who pay attention to research. Furlan et al. Suffers badly from the “garbage in, garbage out” problem. It was not a tidy apples-to-apples review, not by a long shot.

Most of the studies had almost little in common except that they were all experimenting with some kind of massage-like therapy for some kind of back pain. It is not remotely conclusive. Sometimes “more study needed” is a bullshit cover for the fact that the research so far has simply failed to produce the good news that someone wants, but sometimes more study really is needed, and I think this is a great example. Can I cherry pick my way to a happy ending?

What do the best studies say? One of the best, a Canadian experiment conducted by Michele Preyde way back in 2000, was a test of “comprehensive massage therapy” as delivered by well-trained Ontario therapists, in six sessions in a month for 25 cases of sub-acute low back pain (non-chronic, but not brand new cases either). This treatment regimen was compared to massage alone, remedial exercise and posture education alone, or some useless laser therapy.

Massage alone had “considerable benefit,” just enough to be considered clinically significant; adding exercise prescriptions (and posture education, but that probably wasn’t a difference maker) improved on those results even more, pushing them comfortably into clinical significance. Sounds great, right? But it has a critical flaw: the frustrebo effect, a “frustrated placebo,” caused by a lack of blinding. That is, everyone recruited for this study knew full well that it was a massage study and so the folks assigned to the non-massage group were likely frustrated by that, which can cause a negative placebo effect People love massage, and being left out of it in this experiment would have been a bummer(plus they’re also suffering and actually hoping for help). And low back pain is notoriously sensitive to expectations! So this is a recipe for statistical disaster for the study: the massage patients are happier and the non-massage patients are less happy, and that could easily skew the results enough to explain away the modest benefits that Preyde supposedly found. And that would actually covert it into a negative study, finding confirmation of no effect of massage for back pain.

And that was the sad conclusion reached by Dr. Lloyd Oppel in a short response paper for the Canadian Medical Association Journal: “this paper's most powerful findings indicate a lack of effect for massage therapy when compared with nonmassage controls.” The frustrebo effect is a great demonstration of how tricky science is. This kind of thing is what happens to all the “best” studies when you look closely, including the. It wasn’t blinded either, and their optimistic conclusion was at odds with their own data. So that’s two studies now that seem good but have serious flaws. If you do the homework, it turns out it’s actually impossible to cite any evidence that is clearly, unambiguously promising. And so the conclusion is still just null: science has yet to confirm that massage can help back pain, and it probably won’t for a long time.

Once again, this is all considered in much greater detail in my. In the summer of 2009, I attended the conference and The Amazing Meeting 7 in Las Vegas: a huge gathering of skeptics, scientists, and critical thinkers. I was the only alternative health care professional at the conference that I know of.

I introduced myself publicly to a couple hundred doctors and scientists as a “skeptical massage therapist.” They were delighted, and for the next four days, skeptics approached me regularly to say, “Hey, that was brave! But massage isn’t quackery, is it?” It's a fair question. Despite the lack of direct evidence, massage generally seems to get a stamp of approval from medical experts. For instance, you can probably trust the opinion of back pain expert Dr. Richard Deyo: he is openly skeptical about most other back pain therapies, but acknowledges that “promising preliminary results of clinical trials suggest that research on massage should be assigned a high priority.” Patrick Wall, the eminent neurologist and pain researcher, writes only a single word about massage therapy in his seminal book about pain: “Delightful.”, a chiropractic “heretic” and author of, writes, “We know that massage may be as effective as cervical manipulation in relieving tension headache.” (p147) Dr. Homola is extremely critical not only of chiropractic, but of many other alternative health care practices as well, and he clearly does not tolerate irrational claims of therapeutic efficacy.

And yet he is content to make this positive statement about massage therapy. That constitutes a good endorsement! Is a prominent anti-quackery activist. In an article on his popular website,, Barrett condemns common non-massage practices in massage therapy, but not massage itself: “ordinary massage and the legitimate practice of massage therapy should not be categorized as quackery.” That’s surprising tolerance from such a fierce critic of questionable health care.

The approval of skeptics doesn’t mean that massage “works,” and they may actually be giving massage more credit than it deserves. At TAM7, I repeatedly explained to horrified skeptics — who were trying to give me the benefit of the doubt — that my colleagues routinely either sell or endorse virtually every imaginable form of alternative health care, including the silliest:,,, (look it up!) you name it, there’s a goofy therapy that many massage therapists “believe” in. But the general approval of smart, critical experts does indicate that the value of massage itself is strongly plausible — and that simply isn’t true of many other common therapies in the marketplace. In contrast, consider how much anti-quackery activists object to chiropractic! Is a condition of widespread body pain, severe fatigue, and mental fog.

It’s very existence used to be controversial, but no longer: it is a widely acknowledge phenomenon. Now the mysteries and controversies swirl around its nature and treatment. But it seems like a massage-friendly condition. Massage is reputed to be helpful, and certainly many fibromyalgia patients seek it out (while others avoid it, finding it too intense and exacerbating). Like low back pain, it seems like massage “should” be able to help with fibromyalgia. Surely massage can help soothe the frazzled nerves of a uninjured patient whose primary symptom is pain?

And if it can’t, what good is it? A 2014 Chinese review of studies by Li et al 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: The massage therapy for fibromyalgia that epitomizes the “garbage in, garbage out” problem with meta-analysis. There was virtually no research on this topic worth analyzing to begin with. Trying to pool the results of several weak studies is basically meaningless.

To the extent that the study results are generally inconclusive and ambiguous, the conclusions of any review are going to have more to do with the authors’ opinions and biases than hard data. This review is somewhat novel in that it includes some Chinese research, but it doesn’t really help. The introduction curiously boasts that “traditional Chinese massage is one of the most ancient massage therapies,” but there is not enough distinctive about Chinese massage that makes it worthy of any focus, and massage is ancient in every culture.

This weird, prominently placed statement is a red flag: biased interpretation ahead! (And only one study of traditional Chinese massage made it passed the selection criteria anyway.) Unsurprisingly, the conclusions here are superficially positive: massage “significantly improved pain, anxiety, and depression in patients with FM.” But that’s statistical significance only, not a clinically significant degree of improvement: the size of the effect is trivial (much smaller than amplitude of the noise in the data). As usual, is technically correct and defensible, but otherwise misleading to all but the most alert readers. Also, the conclusion is based in large part on the data about depression and anxiety, which are likely to improve with massage regardless of any effect on fibromyalgia — the one truly evidence-based effect of massage, as discussed above.

And more bad news: despite the seemingly strong positive conclusion, the data is just silent on longer term effects. Only two studies had any follow-up data at all.

Without promising data about long-term effects, it would be hard to say massage “works” even if the short term data were much more clearly positive. Both sides of this research question are highly problematic: fibromyalgia is hard to diagnose or define, and massage is hard to study. Even using official diagnostic criteria, which changed significantly in 2010, there’s a lot of wiggle room.

(, “One doesn’t either have fibromyalgia or not have it. There is a gradual transition from the mild to the severe. The point at which we classify an individual as having fibromyalgia is arbitrary, but reasonable.”) The types of massage reviewed here were generally vague and all over the map, from the straightforward (Swedish massage) to trendy-but-meaningless “connective tissue massage” (the idea of isolating or even emphasizing connective tissue in massage is a biological absurdity, like trying to eat the gristle out of a steak without masticating anything else) to rank quackery like “therapeutic touch” (which is ).

So here’s my conclusion: whoopty-do. There’s really nothing here, except maybe massage for fibromyalgia being damned by faint, ambiguous praise.

So does massage work for fibromyalgia? The only honest answer to the question is, “We don’t know, but probably not very well. Maybe for a few patients.”.

People think of massage therapy as a “safe” therapy, and of course it mostly is. But things can go wrong. Serious side effects in massage therapy are rare, however, and common side effects are minor. A 2007 survey of 100 massage patients found that 10% of 100 patients receiving massage therapy reported “some minor discomfort” in the day following treatment. This would mainly be a familiar slight soreness that is common after a massage — I’m surprised only 10% reported it.

The massage must have been quite gentle. Interestingly, 23% reported unexpected benefits that had nothing to do with aches or pains. (Also interesting is that this means that most of these patients experienced no noteworthy effect at all, good or bad! Hopefully they enjoyed the massage at the time ) Another article covers this subject in more detail.

Massage therapists, and others in the holistic arts seem to be a particularly gullible bunch. And there are a lot of people who have seized upon that, and marketed their products, their classes, their modalities, and their wild claims to us and many of us have fallen for it, hook, line and sinker and unfortunately, gone on to convince our clients to buy into it, as well.

Our profession has turned into the snake oil medicine show., by Laura Allen In addition to the many not-really-massage therapies that massage therapists may offer, there are also many claims that massage therapists make about massage itself that are all-too-questionable. The scientific case against massage largely consists of debunking the list of lame claims that define it to a surprising degree — and if you take them away, there’s not a great deal left. Most are just carelessly perpetuated minor myths. Some are not entirely or definitely wrong, but when presented to patients, are often misleading exaggerations and oversimplifications. For instance, massage probably does sometimes modestly increase circulation — just too little and too erratically to matter. It all adds up to a pattern of intellectual laziness in the profession that undermines its credibility and legitimacy. Tightness matters.

“You’re really tight” is a predictable phrase in massage therapy, but it’s mostly meaningless, or just illusory, and yet it is often the major rationale for therapy. Tissue texture correlates poorly with pain and other symptoms, and therapists have failed tests of detecting the painful side of low back or neck pain by feel — it’s actually an understandable and unimportant failure, but it also flies in the face of the popular mythology that therapists can zero in on tissue problems with uncanny accuracy. For more information, see. Massage increases circulation. Massage therapists are particularly fond of claiming that massage “increases circulation,” but it doesn’t, really — certainly not consistently.

It’s kind of a silly claim. It doesn’t really matter if massage increases circulation, because even a modest boost would be clinically trivial, dwarfed by the effect of any amount of exercise. Metabolic demand is clearly the primary driver of circulation. The most optimistic perspective — and it is actually good news, albeit with some caveats — comes from a study that showed that a lot of massage improved “venous insufficiency” over several weeks. Unfortunately for the good news, regular brisk walking is very likely still better and cheaper. Or you could give a massage, instead of receiving one — it’s quite a lot of work!

Massage detoxifies or flushes lactic acid from your muscles. Detoxification myths are among the most embarrassing of all massage myths. “Detoxification” sounds good and means little or nothing. There are such things as toxins in the world, but not only is massage unable to “flush” any that matter from the body, it likely produces a mildly toxic state known as rhabdomyolysis. But if you challenge massage therapists to name a “toxin” that they are “flushing,” most will name lactic acid, not rhabdomyolysis. And again, the truth is ironically the reverse of to the myth: evidence has actually shown that massage interferes with lactic acid elimination.

Massage treats delayed onset (post-exercise) muscle soreness. Supposedly, massage therapy can stop that awful soreness that develops after an intense workout, known as delayed-onset muscle soreness (DOMS) — which is ironic, because massage is also well-known to cause a little next-day soreness. Although some studies have shown that massage can take the edge off DOMS, that’s about as good as it gets — perhaps a 30% temporary pain reduction when the planets align. It certainly doesn’t restore your strength any sooner. As with increasing circulation, it’s important to maintain perspective: it wouldn’t matter much even if massage did cure DOMS.

Although DOMS can be pretty unpleasant, it’s one of the most trivial of all pain problems, guaranteed to solve itself within three days. On a closely related note Fascia matters. Many massage therapists are selling “fascial therapy” to patients. The main idea is that fascia — sheets of tough connective tissue found throughout the body — can get tight and restricting, and needs to be “released” by pulling on it. Fascia science is considered an exciting frontier in manual therapy.

Unfortunately, although some fascia biology is interesting, the stuff does not seem to have any properties that are actually relevant to healing and therapy. Key examples of fascia research either fail to support fascial therapy or actually undermine it. Enthusiasm about fascia seems to be an unjustified fad.

Some readers may not get this joke. It’s a; it means, “I’m so sick of hearing about ‘release’ I might shoot the next person who says it.” The term has reached annoying buzzword status when paired with faddish excitement about fascia. While many therapists may find the frustration hard to understand, many professionals really are that fed up with hearing about fascia in general & release in particular. Massage reduces inflammation. The opposite, if anything.

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. All of the evidence about this and DOMS is explored in detail in a separate Massage gives you an endorphin rush. The word “endorphin” reached buzzword status a few years back and is now often invoked carelessly. Endorphins are a class of neuropeptides that act on the nervous system to reduce pain and increase euphoria.

But although massage therapy may reduce pain by a variety of mechanisms, it probably doesn’t do it by putting more endorphins into the bloodstream. And, yet again, it wouldn’t be that big a deal even if it were true. Like relaxation, endorphins are good, but they can only do so much — at best, such an effect would mostly just explain the pleasantness of massage itself. Massage reduces cortisol. This is a much more specific idea than “massage reduces stress.” Cortisol, the “stress hormone,” is justifiably perceived as a villain, and reducing it is often touted as a meaningful rescue from being run-down, chronically anxious or depressed, or in pain. Unfortunately, the evidence that massage actually does anything helpful to cortisol production is conflicting and inconclusive at best, and commonly cited research to support it has major flaws.

Even in the unlikely event that massage actually does reduce cortisol levels, the phsyiology of stress is much too complex to assume cortisol reduction is in itself a meaningful, good thing. Cortisol levels after a massage do not give a meaningful picture of the organism, and there is no direct relationship between a temporary cortisol reduction and any health benefit. What matters is cortisol levels over time, but even that isn’t exactly straightforward: stress and cortisol have a complex and chaotic relationship regulated by many variables out of our control.

• These myths barely scratch the surface: massage therapists say and believe many much more bizarre things, living up to their reputation for flakiness. Dozens of bizarre and hilarious example are compiled here:. Which is in turn just a small slice of the larger problem of.

It’s worth devoting a bit more attention to this particularly classic controversy in massage therapy: that massage can aid muscle health and recovery from exercise by some means, usuallu described as flushing metabolic wastes from your muscles. Other “toxins” and unspecified metabolic wastes are often lumped into the myth, but lactic acid is by far the most famous and likely to get mentioned, so that’s what I’ll focus on here. So, does massage “flush lactic acid”? This is not a hard thing to test — the principle is science-fair simple. Just compare metabolic waste products with and without massage involved. Researchers at Queen’s University in Kingston, Ontario, did exactly that in 2010.

Wiltshire et al subjected 12 people to intense hand-gripping exercises to boost blood levels of lactic acid and other waste products of muscle physiology. Then they measured those substances with and without the subjects receiving basic sports massage. Their data showed that massage significantly “impairs lactic acid and hydrogen ion removal from muscle following strenuous exercise by mechanically impeding blood flow.” Massage actually slowed down recovery from exercise, as measured by lactic acid levels. That’s the opposite of what everyone wants to believe. That’s quite a surprising result that applies a firm push to the side of this classic sacred cow of massage lore. It’s only evidence, not proof — but look at that data! Read the abstract!

It ain’t subtle. And then these findings were backed up in 2012 by a rather high-tech study. Massage does not reduce lactic acid levels. In any case, the whole notion that you want or need to get rid of lactic acid in the first place is just bogus. Lactic acid is not the cause of muscle pain at any time except the immediate aftermath of intense exercise (and probably not even then). Recent (2008-2010) research has shown that muscle fatigue and the “burn” that you feel as you exercise intensely is probably caused by calcium physiology, not an accumulation of lactic acid.

In particular, lactic acid does not cause soreness the day after exercise — yet another myth, and a particularly bad one that will just not die! So presenting lactic acid as some kind of metabolic bogeyman that massage can purge from the flesh is wrong on many levels. This is another nail in the coffin of the daft notion that massage “detoxifies,” and yet another reason to be suspicious of any therapist who talks about “detoxification” — as is sometimes unethically done to rationalize adverse effects of therapy that actually have other causes, including potentially serious conditions. What stinging rebuttal do sports massage therapists have to all this, particularly the Queen’s study? Here’s a highlight from their direct reply: Notably, CSMTA Sport Massage Therapists are trained not to use deep tissue massage in an immediate post event environment.

Years of sport massage practice have demonstrated that it does not improve recovery and generally leads to soreness. In fact, this study confirms this position as results showed exactly that response., Burchat et al ( CSMTA.ca) 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. Another serious general concern about the quality and effectiveness of massage therapy is that there is so much emphasis placed on specific, branded “techniques” and styles. The massage world is fragmented into dozens or even hundreds of these, depending on how you count. It is especially troubling that so many proprietary techniques are hyped as “advanced” and taught in place of genuine continuing (academic) education.

This is the serious problem of certification rackets or “modality empires” — selling credibility to therapists in the form of certifications for a treatment method. These techniques are proprietary and profit-motivated, and usually championed and promoted by a single entrepreneur who gets treated like a guru and has legions of dedicated followers (who tolerate criticism rather poorly).

Both therapists and patients tend to get ripped off by modality empires (branded treatment methods). Is there any evidence that any of them actually work better than ordinary Swedish massage? They are all unproven and mostly based on shoddy, self-serving clinical reasoning. We can’t even start to judge any of the lesser massage techniques based on the results of good tests (that is, careful comparisons with other treatments, and fake treatments, to see what works best).

Such data is thin even for the most prominent massage modalities, and the rest have not been studied at all, or so poorly that it barely counts (eg: “”). For now, and maybe forever, we can only judge these methods on the basis of the the strength of their defining idea.

What’s different about it from other common massage methods? What can it do that supposedly other techniques cannot? You’d be surprised how many barely count as more than a slight variation on Swedish massage. Even if it is distinctive, is the big idea any better than a pet theory? Most are not. The history of medicine is littered with pet theory corpses.

Most treatment ideas even really good ones. And almost everything that is worthwhile about massage is probably thanks to being artfully touched, which you’ll get from most methods. Next: the bankruptcy of the big idea that is the beating heart of many massage methods, probably most of them. A great may of the massage modality empires are based on a basic guiding principle or school of thought I call “structuralism” — an excessive preoccupation with biomechanical and postural factors in pain problems, AKA the biomechanical bogeymen. Structuralist techniques are all fixated to some degree on straightening or improving your meat, because they believe that you are crooked or unbalanced in some way. This notion is easy to sell, but the entire school of thought has little merit. It is debatable at best — and debunked nonsense at worst.

This is another topic I have covered in (great) detail in another article:. There are dozens of lines of evidence showing that structural treatment concepts of all kinds have failed to deliver the goods over the decades (see the structuralism article). But one recent large study of massage — the big back pain one described above () — produced particularly clear evidence that structuralist-style massage does not work. (And yet again, there’s covering this in greater detail: the remainder of this section is just a summary.) Researchers compared the effects of garden-variety relaxation massage — classic Swedish — with allegedly more advanced “structural” massage, consisting of an assortment of typical treatment methods.

The results were the same, showing clearly that a typical selection of structuralist massage techniques was not one stitch more effective than simple relaxation massage. A course of relaxation massage, using techniques commonly taught in massage schools and widely used in practice, had effects similar to those of structural massage, a more specialized technique. All that pretension!

All those assumptions and lovely-sounding structural theories. All those expensive technique workshops those therapists went to, and all the extra money they charge real patients for their “expertise” to help pay off their investment in the workshops. It all added up to nothing.

They could have done relaxation massage instead and their patients would have been just as well off. These results make typical so-called advanced massage really look bad, and they make the popular modality empires and structuralism as a paradigm look ridiculous. The technique gurus push and sell the idea that their methods are dramatically more effective than humble Swedish techniques. If they were even half-right, these “advanced” therapists should have gotten results at least 50% better than their lesser-trained comrades — not just better by a statistically significant margin, but much better, impressively better, decisively better, undeniably better, argument-stopping better, better with bells on Instead, it’s like the New York Yankees accepted a challenge from a beer-league softball team and couldn’t do better than a tie score.

The gap between the pretension and the carefully measured results is a nasty condemnation of a huge chunk of an industry, of at least half of all massage the way it is actually being practiced (probably much more). Not-so-magic hands Thanks to reader SKY (her actual initials) for sharing this cringe-inducing tale of low palpatory intelligence: A massage therapist was giving a massage to a middle-aged man, and started working deeply on his upper ribs below his clavicle. She couldn’t get the knot relaxed at all, and kept working harder until he told her she had found his pacemaker. I’m sure plenty of therapists wouldn’t have made that mistake, but unfortunately it doesn’t surprise me. For all the talk of “magic hands” and the much-touted palpatory prowess of massage therapists, this is hardly the only counter-example I’ve witnessed and heard of. It’s just the worst.

So the imperfect evidence shows that massage can maybe help low back pain, and yet the world has certainly not been saved from back pain. What’s wrong? Why isn’t massage immediately, completely, and permanently fixing lots of back pain clients?

Because there are many kinds of both massage and back pain. Results of therapy vary widely with the skills of therapists, and with the specific kinds of back pain brought to them. And so, on average: • benefits are modest • benefits are temporary • benefits are inconsistent It’s not surprising, then, that some studies show that low-back pain is not helped by massage therapy.

It’s actually surprising is that massage even works as well as it does. I have a theory about what massage has going for it. Massage’s primary therapeutic effect on tissue and pain — if any — is not relaxation, toxin removal, or increased circulation, but instead some relief from muscle “knots” — myofascial trigger points.

Modest relief. Temporary relief. Inconsistent relief. But some relief. Your mileage may vary. “Trigger points” are an awkward notion.

They certainly describe a real phenomenon — sore, stiff, aching spots in muscles — but their true identity is unclear, and the science of trigger points is incomplete at best. Trigger points may respond to massage, and that is certainly my impression from three decades of rubbing my own trigger points and trying to help other people with theirs. It’s also what legions of massage therapists believe. But don’t ask science for confirmation — it’s playing hard-to-get here. I get dorky in detail about the science of trigger point massage in the, but here’s the bottom line Trigger point masssage is still 100% experimental. It has rarely been directly tested and it has never been done well (and never for back pain specifically, which is probably of the greatest interest). If you squint optimistically, you could call the best of the evidence “promising.” You could say that where there’s smoke, there’s fire.

But it’s like the smoke from last night’s campfire — more of a smokey smell than a smoke where any fire might be hiding. Dial up even a mild cynical impulse, and the evidence collectively looks more like a damning failure to produce any clearly good news.

But mostly there’s just no conclusion at all. Science just has no idea if it works. Myofascial trigger points — muscle knots — are increasingly recognized by all health professionals as the cause of most of the world’s aches and pains. This detailed tutorial focuses on advanced troubleshooting for patients who have failed to get relief from basic tactics, but it’s also ideal for starting beginners on the right foot, and for pros who need to stay current.

175 sections grounded in the famous texts of Drs. Travell & Simons, as well as more recent science, this constantly updated tutorial is also offered as a free bonus (2-for-1) with the low back, neck, muscle strain, or iliotibial pain tutorials. Bmw Fsc Code Keygen Torrent. But, done with humility, informed consent, and some caution, it can be a safe, cheap experimental treatment that is at least pleasing. Nothing in massage is more satisfying than a good trigger point rub: it is the ultimate example of whatever it is that makes people crave massage.

The phenomenon is common and particularly tends to crop up as painful complications of many other kinds of painful problems. And so many such problems seem to be at least partially helped simply by rubbing muscles in the area, creating some illusion that all problems are muscular problems. Back pain is the classic example.

If this theory is correct, or even half-right, it would go a long way to explain the strong appeal of massage — maybe it actually can take the edge off a great variety of problems — but also its inability to work miracles. If trigger points are the main reason massage seems at least a little bit helpful in so many cases, they are also the reason that the results are so unpredictable. The best ways to treat trigger points are simply unknown, and it may be next to impossible.

All trigger point therapy is guesswork. Therapists have greatly variable education, skill, and luck in this process. Most simply aren’t that good at it — they can’t be, because muscle pain physiology is obscure, complex, and basically way out of their league. For instance, the average therapist is probably not even able to reliably find trigger points, and it is tricky to treat what you can’t find. Even when you have found them, we have no idea if they can actually be treated by any well-known method, none of which has ever been clearly shown to be effective.

There are many kinds of treatments for trigger points, and not one of them is much more than an educated guess. And every patient seems to respond differently (for instance, some patients have clear cravings for brutal intensities of treatment that would cripple another patient).

On the other hand, hands-on experience is valuable too, and anyone who’s had a good massage is certainly familiar with the seemingly magical way that a therapist can find the and “.” An inability to reliably find something does not mean it can’t be done. And the main reason no treatment has ever been proven effective is mostly a lack of good science on the subject — it’s just unknown. Countless known and unknown factors influence the outcome of any massage — far too many. The result is a weird mix of genuine potential with therapeutic unpredictability and mediocrity. Massage is a profoundly valuable service regardless of what specific effects it does or does not have on pain, tissues, or pathologies. A pleasant, relaxing experience may have any number of minor therapeutic benefits, such as bringing your blood pressure down.

However, the subtler benefits of massage extend well beyond that, into the territory of emotional and psychological benefits that are virtually impossible to define or measure — and surprisingly potent. Recently, after a long interval without massage, I got a brief chair treatment. After 20 years of study, I still don’t understand why massage is such an intense sensory experience — only that it is, and that it matters.

Any massage therapist who has been working for more than a month has observed the curious way that touch provokes introspection, insight, and inspiration. The revelations of contact (“I had no idea I felt this way!”) transmogrify into revelations with broader significance. Intense and/or novel sensations can be a catalyst for personal growth.

Above all, massage reminds us what it feels like to feel good, and we often desperately need that reminder. We may then feel highly motivated to reclaim that sense of well-being in the rest of our lives.

Whether it is the clear goal of therapy, or simply a natural side benefit, the sensations of massage can change your sense of yourself, how it feels to be in your skin, and perhaps bump you out of some other sensory rut — which may give you some leverage on your emotional ruts. It is a well-established fact of neurology that posture and facial expressions are strongly coupled to emotional state.

It is likely that this phenomenon extends to the physical manipulations of massage: that being manipulated doesn’t just feel pleasant, but also has much more complex effects on emotions and cognition. And personal growth and emotional maturation probably have some clinical relevance to recovery and healing. Even in places with high training standards, massage therapists almost always have to sell themselves to clients who are paying hard-earned cash, so it’s not hard to see why massage therapists become habitually overzealous in promoting therapeutic services for which there is little evidence, no evidence, or only a mess of controversial evidence. The road to intellectual dishonesty is paved with good intentions. When I worked as a therapist, there were times when — confession! — I didn’t bother to explain to a patient that I was selling them a dubious approach to therapy. Sometimes it seemed okay because the atmosphere of experimental treatment was thick already, with a desperate patient who had low expectations and was pretty much there to try anything.

But it was still dishonest, and I’m ashamed of those times. After all, if patients were my experimental research subjects, shouldn't I have been paying them?

For the unwary, such dishonesty can become routine. And many are unwary and have no idea that what they are doing is unethical. The stereotype of massage therapy as “hippy health care” is still strong, because a large number of massage therapists, probably the majority in North America, are what many people would describe as “flaky” or leaning in that direction.

Such therapists are mostly ignorant of how science works, and actually hostile towards the idea of evidence-based care. They define themselves in opposition to the “mainstream” and distrust of The Man more than by their scientific and clinical knowledge and skills. 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). And that is why most people still go to a doctor or physiotherapist when they have an obvious injury. Hopefully it’s now obvious that this is not quite the right question.

Does it work for what? What kind of massage therapy? How do we even define the benefits? Is modest, unreliable, temporary relief from muscle pain a significant enough benefit to base a profession on?

Do a few subtleties like “relaxation” add up to “works”? Good massage therapists are the ones with more training and a bigger toolkit. They do what they can with the tools they judge to be the most useful, and they candidly discuss risks, benefits, evidence, and controversies. They don’t just pay lip service to humility as a general principle of alternative medicine — they make it a centerpiece, recognizing that they really are not trained enough to know much. Meanwhile, bad massage therapists oversell a narrow selection of less effective and mostly faith-based options, and generally lack the training or critical thinking skills to recognize their own limitations. This is no different in principle than any other health care profession. The explanation for the title of this section comes right at the end of the quoted passage below.

It’s a funny payoff — hang in there for it! Many times over the years I’ve been told by more rational massage therapists that I’m overstating how much massage therapy is polluted with quackery.

I wish I could agree. There are many reasons why massage therapists get this wrong. I think the true situation in most areas of the world is realistically described by this passage from Laura Allen’s excellent book, She reports a dizzying litany of nonsense attached to “massage therapy.” Note that hardly a stitch of it has the slightest thing to do with actual massage (hell, not even myths about massage). And note that she is describing the sort of things she used to buy into (literally).

Laura Allen is a self-described reformed flake. We took turns lying down on the classroom tables, closing our eyes, and running our hands over the bodies of our supine partners and then experiencing them doing the same to us. Whatever we felt was referred to as “energy.” We were taught a few techniques for “clearing negative energy” and “balancing the chakras” by “removing the congestion” that exists in the energy field. These involved a lot of muscle testing, and I’m not talking about orthopedic assessments. I’m talking about asking your arms (that was the terminology) if you should eat this or that food, or hire this or that lawyer, or marry this or that person.

My husband and I both ended up taking the advanced program in that, which was 120 hours of learning to read people’s faces and body language, and giving and receiving a lot of what was referred to as “emotional stress diffusions.” We also went on to do Reiki II, which was optional. That was where we learned how to do distance healing. Yes, I actually believed that you could be in Alaska, and that I could be sitting in my North Carolina home sending you a healing. The owner of the school collected (and sold) crystals, and used them for healing purposes. I ended up amassing quite a collection of my own, using them to do chakra balances on people, performing psychic surgery with them, and any number of woo procedures. I also purchased magnetic pads for my massage table.

I attended homeopathy workshops. I got heavily into essential oils, which I still love and use today—with the caveat that while I think many of them are useful as folk remedies for various simple ailments, I’m not going to advise someone with cancer that they can cure it with an oil, which unbelievably, I notice massage therapists doing all the time—and worse—on social media. 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] 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. While we were on a road trip out west, I collected some buffalo dung—I actually witnessed the buffalo relieving himself, waited until he ambled off, and I jumped out of the car with a zip-lock bag to harvest it for future ceremonial purposes.

Since it had come from a buffalo on the reservation I figured it was more powerful than your average cow dung. It was, indeed, powerful bullshit! AiM is popular with massage therapists, and the comments on the post were overwhelmingly positive, reflecting the strong tendency in the massage therapy community to uncritically embrace anything sciencey that makes massage sound good. Typical examples (with typical grammar and spelling) reflect rather poorly on the profession: • Keicher Payne wrote, “Stealing and sharing and going to shout it from the rooftops!” • Norma Leos: “Ohh, thank you very much, Im a massage therapist too.Im going to share!!

Thank you!” • Caterina Caravello: “Massage is a necessity for a crossfit athlete. Performance enhancement:)” • Christine Reid: “Ty so much for posting this!!! I tried telling my clients for 3 years this!!!!!!!!!!! I LUV IT!!” Unsurprisingly, there are almost no comments questioning or challenging anything about the image.

Julie Onofrio chimed in with one of the only genuine criticisms: “a few of the things on there are not correct — massage has not been proven to increase endorphins or decrease cortisol.” Agreed: most of the infographer features common scientific myths about massage. Another commenter complains that the infographic makes massage sound too much like an “indulgence” and not enough like “health care.” It’s clear that he wants to make grander claims for massage, regardless of the evidence. If there was stronger evidence to cherry-pick in service of promoting massage as medicine, it would have ended up on this infographic.

Reader and colleague Tony Ingram, who writes the excellent therapy/dance Blog, gave me a heads up about the infographic and asked, “What do you think of this? Exaggerated claims, or about right?” My reply 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.

Here’s an example of strong-but-unimportant: it’s highly plausible and fairly confirmed that massage is relaxing (shocker), but paying $1+/min for relaxation alone would be luxury wellness care, not “medicine.” Of course relaxation is a good thing and has some value, but it’s disingenuous to pitch it as “health care.” The constipation claim is another good example of something that’s probably as clinically trivial as it is certain. Who the hell thinks, “I haven’t had a crap in days: I guess I’d better buy a professional massage!” (I might rub my own belly.) In ten years working as an RMT, I think I did that kind of abdominal massage maybe a half dozen times — demand for the service was rather low. I’ve been writing about the science of massage even longer, and this is literally the first time the word “constipation” has ever appeared on this website — because who cares? Flipping it the other way, the infographic features a particularly obvious example of an important-but-weakly-supported claim: boosting “athletic performance.” No question: actually boosting performance would be a big deal, a humungous deal! But the cited evidence doesn’t remotely substantiate such a mighty claim. Even if we take that evidence at face value, it’s a huge and oversimplified reach to conclude that “a little increased range of motion” constitutes a meaningful effect on athletic performance as a whole.

I can increase my ROM with a few seconds of stretching, too and stretching does not enhance performance (). Now, think back to Caterina Caravello’s comment above, asserting that massage is a “necessity” for athletic performance.

What would all the athletes who win medals without massage make of that? • So obviously (duh) this infographic was designed to score medical credibility points for massage, and research was cherry-picked to support that goal, and there wasn’t any chance that any discouraging words or science was going to make the cut! But it something like this will get applause from almost everyone who sees it, because people love to love massage, because massage is a lovely experience for all kinds of reasons. But whether or not it massage is good medicine is still an open question, and this infographic is really just a bit of mild-mannered propaganda. Amatereurish boosterism never does a profession any favours.

Paying lip service to science for promotional purposes cheapens it and impedes progress and understanding. Enthusiastically approving of such poor-quality information is a disturbing sign of how far the profession of massage therapy still has to go before it can be taken seriously as a full partner in health care.

This article thoroughly discusses massage therapy in a way that is quite unusual in the profession: a skeptical, critical-thinking sort of way. This is normal in modern medicine, where critical self-appraisal is a formal part of the professional culture. And yet there are some skeptical massage therapists! For instance, the has quickly grown into the best discussion group available — although there’s not much competition!

— for massage therapists who also happen to be. Founder and moderator Brantley Moate: To be a member, you need to be a massage therapist and you actually know you’re a scientific skeptic. It’s not a place for massage therapists to find out what scientific skepticism is. Scientific skeptics are the kind of people who would go to an, or less-amazing nights with some other. We are used to being misunderstood. Almost no one really knows what scientific skepticism is all about. I doubt that I personally know any skeptical massage therapists who aren’t already there, if they want to be, but I may have readers who qualify.

Such skeptics are obviously a rarity in massage therapy, a profession. The kind of people who would happily pay through the nose for tickets to see Deepak Chopra talk and think Mercola.com is a good source of health care information. Modern social media excels at bringing together special interest groups with low-density populations. This is one of the best examples I can think of. This is one of the oldest articles on PainScience.com, with bits and pieces of it dating back to the late 90s (though all edited and revised at some point). The update log is woefully incomplete, but that it will probably improve in 2015 and beyond. November — Rewritten: I’ve changed my position from positive to unknown, “more study needed,” based on a thorough update and review of the science.

I updated the evidence for massage for back pain at the same time, with similar results. [Section:.] November — Rewritten: I’ve changed my position from positive to unknown, “more study needed,” based on a thorough update and review of the science. I updated the evidence for trigger point massage at the same time, with similar results. [Section:.] May — Science update: Added citation to Webb et al, plus related edits.

[Section:.] 2016 — Minor addition: Added a footnote linking to an interesting article about the neurology of touch as a major mechanism of massage. [Section:.] 2016 — Minor upgrade: Added an important point about the potential of novel sensory input to treat chronic pain. [Section:.] 2016 — Revised: An expanded and improved introduction, and a new.

[Section:.] 2016 — Science update: New bad news evidence about manual lymphatic drainage. [Section:.] 2015 — New section: No notes.

Just a new section. [Section:.] 2015 — Upgrade: Added a table of contents (finally). 2015 — New section: Added an appendix about the. [Section:.] 2014 — New section: New section about massage for fibromyalgia and.

[Section:.] 2013 — Science update: Updated several references, and added about massage for low back pain, which also spawned an entire new section about the failure of. 2013 — Minor update: Trivial but fun addition of the video. [Section:.] 2013 — Science update: Important good-science-news additions about the effects of stretching on heart rate regulation, and the effects of massage on anxiety and depression (it reduces them). [Section:.] Legacy updates from before 2013 2012 — Minor update regarding DOMS.

2012 — A new item at the end of the myths section: “fascia matters.” And improved information about detoxification myths. 2012 — More on “tightness matters”: interesting evidence that massage therapists cannot reliably find the side of pain by feel. 2012 — Added a new massage myth that “tightness matters,” with an interesting footnote about palpatory pareidolia. 2012 — Beefed up my explanation of how massage can be psychologically and emotionally important.

See “” 2012 — Added references to the widely reported study showing that massage supposedly “reduces inflammation.” It does not. 2011 — Added a list of “” to demonstrate how hard it is to study what you can’t define. Also a few tweaks of related content.

2011 — Added reference to a new article explaining common statistical errors that particularly afflict massage therapy research. Thoroughly revised the section, “The trouble with studying massage,” right near the top of the article. 2011 — Added reference to new research showing that. 2011 — New section: “Personal growth: a massage benefit that may be impossible to define or measure.” 2011 — Updated several references, and added about massage for low back pain, which also spawned an entire new section about the failure of.

2011 — Added an amusing. 2010 — Some updates to the recently added section,, especially concerning evidence that lactic acid is not responsible for muscle pain and fatigue. 2010 — Added a nice quote from. 2010 — New section based on fascinating new scientific evidence,. 2010 — Major revision, with focus on adding evidence about the effectiveness of massage therapy for back pain, updating numerous citations, and better explanations of how massage research works (or doesn’t).