Massage therapy Health Article

We don’t know who gave the first massage or why. But we do know that massage is an ancient art that dates back to the dawn of civilization. The name is derived from the Greek word meaning “to work with the hands, as in kneading dough,” and in 400 B.C., Hippocrates wrote, “The physician must be experienced in many things, but assuredly in rubbing.”

Medicine has come a long way in the ensuing 2,400 years, and doctors no longer rely on the laying on of hands to heal their patients. Massage has come a long way, too. Masseurs are no longer viewed simply as high-priced locker room specialists (much less as shady ladies who need dough of a different sort), but as therapists.

Massage is respectable, but is it therapeutic? An estimated 25 million Americans visit about 90,000 practitioners 60 million times a year. Many feel better — but are they actually healthier?

Modern massage

Massage therapy gained a foothold in American medicine in the 1850s when two New York physicians introduced the technique developed by Per Henrik Ling in Sweden. Over the next decade, many hospitals and clinics offered massage to their patients, and physicians themselves often performed the procedure. As medicine grew more complex, nurses and physical therapists took over the task. In time, they, too, turned to other tasks, and massage was all but abandoned in the 1930s. Since the 1970s, however, it has staged a comeback, this time in the domain of alternative medicine.

Techniques

Practitioners define massage as the manual manipulation of the body’s soft tissues to reduce discomfort and stress and promote wellness and health. It’s a broad definition, and it covers at least 80 different systems of massage.

Swedish massage still relies on Ling’s basic work, and it remains the most widely used method in the United States. The typical Swedish massage is performed with the client lying on a special table, either disrobed or wearing undergarments. The therapist will generally ask if the client wishes to leave some parts of his body untouched: if so, those regions, along with the genitalia, are covered with a towel or sheet at all times. The body is usually coated with oil; dim lights, soothing music, and scented candles are common but optional.

Swedish massage uses five different techniques. Effleurage (stroking) can be gentle or forceful. Petrissage (kneading) uses the fingers and thumbs to exert pressure in a circular pattern. Friction is more vigorous, with the therapist using his palm, the heel of his hand, or even his forearm or elbow to apply force. Tapotement is a rhythmic percussive slapping or tapping motion designed to stimulate deep tissues. Vibration is the rapid trembling motion of both hands that is intended to facilitate relaxation.

Massage therapists have a variety of backgrounds. Many are trained according to standards set by the American Massage Therapy Association (www.amtamassage.org; 877-905-2700). Groups such as the National Certification Board for Therapeutic Massage and Bodywork provide accreditation, and many states require therapists to be licensed.

A full Swedish massage is usually performed in a private area of a spa, health club, athletic facility, or clinic. Therapists can also set up portable tables in their clients’ homes. A typical session lasts 30–60 minutes and costs $30–$100. Briefer, less costly partial massages are offered in a broad range of settings, from airports and hotels to offices and shopping centers. In these circumstances, clients are seated on a massage chair wearing normal clothing.

Many other types of massage are available, each with its own goals and claims; they include neuromuscular massage, sports massage, deep-tissue massage, myofascial release, and myotherapy. Related soft tissue manipulations are also incorporated into many other systems, including Rolfing, the Trager and Alexander techniques, and shiatsu.

Goals

Enthusiasts believe that massage strengthens the body, enabling injured tissues to return to normal and heal themselves. Many theories explain how massage might accomplish these goals; they include an improvement of the circulation, the removal of toxins, stress reduction, better sleep, and benefits for the metabolism and the immune system. The most passionate advocates assert that massage can help improve the function of nearly any part of the body.

Results

Despite the widespread use of massage, only a small number of scientific studies have evaluated its effectiveness. The most common therapeutic uses are to reduce musculoskeletal discomfort and release stress. Although many people use massage to treat exercise-induced muscle soreness and stiffness, to improve athletic performance, or to rehabilitate from injury, there is little scientific proof that massage helps in these areas over and above psychological improvements and self-confidence. An objective review of eight individual clinical trials concluded that massage “might” be beneficial for persistent, nonspecific low back pain. Another study found that it was effective in reducing mental stress but was no better than relaxation tapes. Finally, a variety of small studies suggest that massage may help reduce the discomfort of fibromyalgia, the anxiety and apprehension associated with some medical treatments, and the symptoms of migraine. Claims have also been made for various pediatric and obstetrical benefits.

The lowdown on rubdowns

Much more research is needed to learn whether massage is effective in preventing or treating medical disorders. It’s not molecular biology, but these studies are important. Unfortunately, they are also technically difficult, slow, and expensive. Even with the renewed interest in alternative medicine, a full understanding of the benefits and limitations of massage therapy is a long way off.

But you don’t have to wait for scientific pronouncements to sign up for a massage. Stress, pain, and muscle discomfort are subjective reactions to internal and external events. Researchers may not be able to tell you if massage improves your body’s structure or function. But if it’s used in conjunction with regular medical care, massage has almost no potential to do harm. So if you can afford the time and money for a massage, give it a try. Many people feel better afterward; if you are one of them, you can sign up for a kneading whenever you’re needy.