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Prenatal, or pregnancy, massage uses gentle techniques to help alleviate some of the ailments associated with pregancy, including lower back, neck and shoulder pain; fatigue; joint tenderness; and stretch marks. Prenatal massage can help improve circulation, promote stress reduction and relaxation, and much more. Practitioners should be well-trained in prenatal massage in order to deliver safe and effective care, and patients should check with their doctors prior to receiving treatment.
Fibromyalgia (FM) is a chronic musculoskeletal condition expressed in widespread pain over the entire body. FM patients (a higher percentage of whom are women than men) also suffer from tension headaches, fatigue, stiffness and sleep disorders. It is estimated that 7 million Americans are afflicted with fibromyalgia -- their pain and fatigue in some cases being so severe that the individual spends entire days in bed.
As recently as 18 years ago, the U.S. medical community recognized FM largely as a psychosomatic disorder, not a physical condition. Physicians would conduct lab tests and X-rays to find evidence of rheumatoid arthritis, osteoarthritis and other pathologies that produce pain in muscles and tendons. Of course, with FM the ultimate culprit, these tests showed nothing. In most cases, the patient appeared to be physically normal, hence the psychosomatic diagnosis.
Today, FM is diagnosed in most cases of fatigue, insomnia and other sleep disorders, regardless if "algia" (pain) is present or not. Even though the last 18 years of scientific research has added a wealth of information to the discussion of FM diagnosis, it has not clarified an already existing confusion -- what causes FM onset?
There is an evolving theory that attempts to explain a chain of pathological events responsible for the development of FM. This theory (the supporters of which believe it is not an abnormality of the muscular system) states that the concentrations and activities of neurotransmitters are changed as a result of an unknown trigger such as trauma, sleep disorders, hormonal changes, stress, chemical exposure, etc. These changes mark the first step in the development of FM. Numerous studies have confirmed that FM patients show a decrease in their serotonin concentrations. From this point of view, only one reasonable approach is recommended: serotonin reuptake inhibiting medications (Prozac, Paxil, etc.), sedative medications, muscular relaxants and exercises to increase natural endorphin production. Years of such treatment, however, have failed many individuals. FM has now reached pandemic proportions and patients caught in this web sooner or later may find their lives ruined.
We believe that FM is actually a fibromyositic pathology. Fibromyositis is a chronic, low-grade inflammatory condition of the muscle, fascia and other connective tissue. The main cause of fibromyositis is the accumulation of pathological hypertonus in muscles over a prolonged period of time. This can be triggered by post-traumatic phenomena, stress, sleep disorders, hormonal changes (thereby explaining the high incidence of women), toxic chemical exposure and other factors.
Finding a New Theory:
In order to better understand how massage can help in cases of FM, a short discussion of anatomy and pathology is appropriate. As we all know, muscles are surrounded by fascia. This connective tissue plays an important role in the determination of the extent of muscle stretch and contraction. It is very important to understand that fascia also provides pathways for nerves and blood vessels. In cases of FM, due to the prolonged pathological hypertonus in muscles, fascia becomes tense causing compression of muscle fibers, nerve tissue and blood vessels. This kind of irritation first initiates, and later brings about the development of, fibromyositis. The condition of constant muscle tension in FM cases creates an overload (strain) on muscles and tendons. Strain always leads to the development of inflammation. The persistence of this inflammatory condition prompts calcium deposits in muscles and tendon attachments to the periosteum -- in other words, fibromyositis. A chronic inflammatory condition of the skeleto-muscular system causes secondary changes in neurotransmitter levels and activities in the central nervous system. The changes appear after the patient starts to experience chronic pain. In such a case, the initial trigger is in the skeletal muscles where local, pathological abnormalities were developed. Authors of many studies have detected significant depletions of adenosine tri-phosphate (ATP) concentration, as well as other high-energy phosphates in the skeletal muscles of FM patients (Bengtsson et al., 1986; Larsson et al., 1988; Bennett, 1991; Park et al., 1998). ATP is a major energy source for muscular contraction. When a nervous command arrives through a motor neuron to a skeletal muscle to produce a contraction, ATP molecules are used. This energy causes the actin and myosin to attach to, and slide past, one another during muscular contractions. When a muscle needs to relax, it again uses ATP molecules to detach myosin from actin. It is important to remember that constant (chronic) muscular hypertonus uses and exhausts the stores of ATP.
Imagine a situation where the concentration of ATP is decreased. The motor commands arrive from the central nervous system to the muscles, and muscular contraction is achieved using available ATP. However, when the muscle needs to relax, ATP is in short supply, as most of it has been used in the contraction. In such a case, some of the muscle fibers remain in the contracted state, even during periods of relaxation. New nervous commands arrive, and again, all available ATP is used to produce a contraction. This is how tension starts to build. The more tension builds up in skeletal muscles, the more tension we can find in the fascia, aponeurosis and other soft tissues. Tension causes a decrease in elasticity, and it starts to affect microcirculation. A mismatch between motor nervous commands and insufficient arterial blood supply initiates changes in the local pH, followed by the activation of pain receptors. It's at this time the patient starts to feel pain.
After several weeks or months (depending on the individual) of such bombardment of the central nervous system with chronic pain, changes in neurotransmitter activities and concentrations become apparent. The level of substance P (a neurotransmitter responsible for the slow or chronic pain conduction through the spinal cord) increases and the level of serotonin decreases. Serotonin is a very important neurotransmitter, mediating basic bodily functions such as smooth muscle contraction (especially digestive system musculature) and blood coagulation. Additionally, serotonin acts as a neurotransmitter in the brain. It is responsible for our wakeful state and excitement. Patients with clinical depression, which frequently accompanies FM, show a significant decrease in the concentration of serotonin in the brain. All examined FM patients exhibit an increase in the concentration of substance P in the spinal cord, which in most cases is the result of a decreased pH level in muscles.
Important findings supporting this theory are pathological changes found in the muscle cell mitochondria (Bennett, 1991), as well as a decrease in magnesium concentration (Abrahams and Flechas, 1992). Mitochondria are the power plants of the cell, synthesizing ATP (magnesium is a mediator in ATP synthesis). Numerous mitochondria are found within each cell. When ATP is depleted in the skeletal muscles of FM patients, an "energy crisis" (Eisenger, 1992) is created, triggering the entire clinical picture.
Comparing Fibromyalgia and Myofascial Pain:
As you see, this concept has a completely opposing approach to the pathogenesis and the treatment of FM that is currently practiced. The key is in the skeletal muscles that have developed pathological abnormalities. The abundant clinical picture of FM is a secondary reaction, triggered by chronic pain followed by changes in the neurotransmitters. From this point of view, the initial target of the treatment is skeletal muscles, fascia and other connective tissue. Very frequently, myofascial pain syndrome (MPS) is misdiagnosed as FM. Therefore, it is important for the massage practitioner to understand the difference between these abnormalities.
The clinical picture of MPS is usually much more acute. In the areas of the trigger points, the pain is more intense with a radiating pattern along the same muscle or muscle group. The patient complains of a decrease in the range of motion, as well as a significant weakness in muscles containing active trigger points. The patient feels better when the muscle is at rest, and the intensity of the pain increases as soon as the affected muscle starts to contract. One of the main clinical differences between FM and MPS is the distribution of pain. In MPS, the pain has local character and if it radiates, the patient feels it along the same segment. MPS affects all age groups and both genders. There are no accompanying syndromes. Please note that sharper levels of pain do not bring about a decrease in serotonin level. Rather, a low-grade persistent pain such as in FM, is the causative factor in serotonin level decrease. The clinical picture of FM is much more complicated. The intensity of the pain in FM is much lower, but it is persistent. Pain is present regardless of contraction or relaxation of affected muscles. Low-grade, persistent, psychologically-exhausting pain is one of the main symptoms of FM. Another difference is poor localization of pain, which seems to affect other soft tissues as well (e.g., skin, fascia and periosteum). Finally, the FM patient may exhibit pain either over the entire body or have patchy localizations of pain. In the case of the latter, affected areas are separated by unaffected areas. For example, the patient will complain of headaches, pain in the lower back and gluteal areas, and in the plantar fascia of the feet.
Contrary to MPS, FM carries a very strong psychological component. The patient is usually depressed, suffers from mood swings, easily bursts into tears, has significant sleep disturbances, and is mentally and physically fatigued. Additionally, the patient may have many related physical complaints: migraines, bruxism (teeth grinding), TMJ problems, irritable bowel syndrome, pelvic pain, tachycardia (increased cardiac rate), Raynauld's phenomenon and chronic rhinitis.
The pain-causing physical expressions of chronic inflammation consist of mild swelling of the soft tissue, tension in fascia, pathological hypertonus of muscles, significant decrease in blood supply and calcium depositing in the soft tissue
Because poly-fibromyositis is a chronic condition, one must remember that the first three to four treatments can possibly aggravate the clinical picture. For an unclear reason, only 10 percent of FM clients react with aggravation of pain. In any case, we recommend that the FM client be informed of the possibility of reaction. The reason for this aggravation of pain is the intense stimulation of oxygen supply to the "hungry" cells and the excessive release of toxic waste products from the tissues into the circulatory system. Usually, however, during the first 10 to 15 correct massage therapy treatments, the client can, in fact, notice clear, significant positive changes. One must keep in mind, however, that the healing process requires time. We recommend beginning the first 10 massage therapy treatments on a two procedures per week basis. Remember that FM clients complain of sharper levels of pain in certain regions (such as neck and upper back, or lower back, including the buttocks regions, etc.). We believe that in such cases, massage therapists must focus on those regions. However, the full-body massage treatment should be considered after the first three to four treatments. Also keep in mind that lying on the stomach for more than 12 minutes at a time is not recommended for the FM client, because the pressure on the rib cage transmitting to the rib attachments can cause additional tension in the muscles. Therefore, consider treating the neck and upper back region in a side-lying position, with a towel placed between the neck and pillow. When the client is prone, we recommend placing one pillow under the stomach and two pillows under the chest. Do not treat FM clients using a massage chair.
We also maintain that exercise is very beneficial for FM clients. It is important to keep in mind, however, that the exercise program should not begin prior to the first 10 sessions of massage therapy. Many clients have severe reactions to exercise if not prepared for active movements by a series of massage procedures.
After the first 10 treatments, the client has to begin a combination of exercise (at least two to three times a week), with special massage therapy for FM (five additional treatments). After a two-week break from massage therapy (keep in mind that the exercise program does not get a break), it is important to come back for a series of 15 massage therapy procedures (at least twice a week) and continue the exercise program (at least four times a week at this point). Usually, after the first 30 massage therapy procedures and continued exercise, FM symptoms (such as pain all over the body, sleeplessness, tension headaches, chronic fatigue) become much less severe. Even though the client may think that she feels better, she must still continue to receive treatments and maintain her exercise program. After a three-week break from massage therapy, the client must return to at least one massage therapy procedure every week and, of course, still continue to exercise at least four times a week. This is the only way to prevent re-accumulation of tension in muscles.Some experts have recommended that FM clients employ various types of aerobic and stretching exercises for their condition. From our knowledge and experience, we can say that the most beneficial exercise program for FM clients revolves around rehabilitative exercise routines (making sure that the neck, shoulders, upper back, lower back, hips and knees are exercised separately). Clients should be advised not to force any movements when they exercise. If, for example, a left head rotation produces even the slightest pain, the movement must stop, and the head must be turned toward the center. It is also important to advise the client to perform the exercises slowly, as any aggressive exercise may aggravate the symptoms significantly.
In 1968, in Dnepropetrovsk, Ukraine, in the former Soviet Union, workers of a large industrial complex started developing fibromyalgia symptoms in epidemic proportions. The Soviet government assigned a group of scientists to find the causes of this epidemic. It was clear to everyone that psychosomatic disorders should be ruled out. The group of scientists eventually found that an adjacent lake, heavily contaminated with toxic waste, was causing muscular tension. Over time, this led to the development of fibromyalgia. What these scientists learned was that individuals suffering from myofascial pain syndrome have a higher risk of developing fibromyalgia. But those who develop fibromyalgia are almost guaranteed to develop chronic fatigue syndrome.
During a study and clinical treatments, these scientists concluded that the development of fibromyalgia and chronic fatigue syndrome can be prevented by medical massage treatments (for more on medical massage, see Boris Prilutsky's medical massage article in Massage Bodywork, August/September 2003). As we mentioned here, the persistence of low-grade pain bombards the central nervous system and causes a decrease in serotonin level. Restoration of ATP, neuromuscular function and stabilization of metabolism will decrease the pain sensation. The elimination of low-grade pain will allow the central nervous system to restore the level of serotonin and chronic fatigue syndrome development will be prevented.
The Way Forward:
In our decades of practical experience, we have treated many cases of classic fibromyalgia. We can report that in most cases, symptoms such as fatigue, general body pains, headaches, stiffness and sleeplessness were significantly reduced following a series of massage therapy sessions. We strongly believe that a correctly formulated medical massage protocol is the main tool in effective control and elimination of FM symptoms. Proper nutritional support, exercise, psychological assistance and other types of therapy are equally important components. But they should be employed later when the pain sensation and stiffness are significantly reduced.
It was almost three decades ago in the former Soviet Union that scientists researched and established the theory of fibromyositis development as a main cause of FM. They also developed a method of massage therapy treatment that we've described here. The main goal of this article is to share with practitioners the optimal protocol of medical massage in treating fibromyalgia cases and to enable massage therapists to share this concept with other healthcare practitioners.
1 Abraham, G.E., and J.D. Flechas. Management of Fibromyalgia: Rationale for the use of Magnesium and Malic Acid. Journal of Nutritional Research, 3:39-59, 1992.
2 Bengtsson, A., F. G. Henrikson, and J. Larsson. Reduced High-Energy Phosphate Levels in the Painful Muscles of Patients With Primary Fibromyalgia. Arth Rheum, 29:817-821, 1986.
3 Bennett, R.M. Myofascial Pain Syndromes and the Fibromyalgia Syndrome: A Comparative Analysis. J Manual Med, 6:34-45, 1991.
4 Bland, J.S. Fibromyalgia and Myofascial Pain. Applying New Essentials in Nutritional Medicine, HealthComm Intern, 1995.
5 Eisinger, J., K. Mechtouf, and A. Platamura. Anomalities Biologiques Au Cours Des Fibromyalgies: I. Lactacidemie et Pyruvicemie. Lyon Mediterranee Med, 28:851-854, 1992.
6 Goldberg, D. Fibromyalgia Syndrome: An Emerging but Controversial Condition. Journal of the American Medical Association. 257(20):2782-2787, 1987.
7 Goldberg, D. Fibromyalgia and Its Relationship to Chronic Fatigue Syndrome, Viral Illness and Immune Abnormalities. J Rheum, 16 (Sup19):92, 1989.
8 Larsson, S.E., A. Bengtsson, and L. Bodegard. Muscle Changes in Work-Related Chronic Myalgia. Acta Orthop Scand, 59:74-78, 1988.
9 Moldofsky, H., P. Sasskin, and L. Salem. Sleep and Symptoms of Postinfectious Neuromyastenia and Fibrositis Syndrome. Sleep Res, 16:492, 1987.
10 Park, J.H., P. Phothiamat, C. T. Oates, M. Hernans-Schulman, and N. J.Olsen. Use of P-31 Magnetic Resonance Spectroscopy to Detect Metabolic Abnormalities in Muscles of Patients with Fibromyalgia. Arth Rheum, 41(3):406-413, 1998.
Traditional Chinese medicine is one of the oldest continuous systems of medicine in history, with recorded instances dating as far back as two thousand years before the birth of Christ. This is in sharp contrast to the American or Western forms of health care, which have been in existence for a much shorter time span (the American Medical Association, the largest health care member association in the United States, was formed in 1847, some 3,800 years after the first mention of traditional Chinese medicine).
Chinese medicine is quite complex and can be difficult for some people to comprehend. This is because TCM is based, at least in part, on the Daoist belief that we live in a universe in which everything is interconnected. What happens to one part of the body affects every other part of the body. The mind and body are not viewed separately, but as part of an energetic system. Similarly, organs and organ systems are viewed as interconnected structures that work together to keep the body functioning.
Many of the concepts emphasized in traditional Chinese medicine have no true counterpart in Western medicine. One of these concepts is qi (pronounced "chi"), which is considered a vital force or energy responsible for controlling the workings of the human mind and body. Qi flows through the body via channels, or pathways, which are called meridians. There are a total of 20 meridians: 12 primary meridians, which correspond to specific organs, organ systems or functions, and eight secondary meridians. Imbalances in the flow of qi cause illness; correction of this flow restores the body to balance. Other concepts (such as the Yin/Yang and Five Element Theories) are equally important in order to have a true grasp of traditional Chinese medicine.
Many people often equate the practice of acupuncture with the practice of traditional Chinese medicine. This is not entirely true. While acupuncture is the most often practiced component of traditional Chinese medicine, it is simply that – a component, an important piece of a much larger puzzle. Traditional Chinese medicine encompasses several methods designed to help patients achieve and maintain health. Along with acupuncture, TCM incorporates adjunctive techniques such as acupressure and moxibustion; manipulative and massage techniques such as tuina and gua sha; herbal medicine; diet and lifestyle changes; meditation; and exercise (often in the form of qigong or tai chi).
Traditional Chinese medicine should not also be confused with "Oriental medicine." Whereas traditional Chinese medicine is considered a standardized version of the type of Chinese medicine practice before the Chinese Revolution, Oriental medicine is a catch-all phrase for the styles of acupuncture, herbal medicine, massage and exercise that have been developed and practice not only in Asia, but world-wide.
Although the principles of traditional Chinese medicine may be difficult for some to comprehend, there is little doubt of TCM's effectiveness. Several studies have reported on traditional Chinese medicine's success in treating a wide range of conditions, from nausea and vomiting to skin disorders, tennis elbow and back pain. Many Western-trained physicians have begun to see the benefits traditional Chinese medicine has to offer patients and now include acupuncture — at least on a limited basis -- as part of their practice. More Americans are also using acupuncture, herbal remedies and other components of traditional Chinese medicine than ever before. The reasons for this vary, but the increasing interest in, and use of, TCM is due in large part to its effectiveness, affordability and lack of adverse side-effects compared to Western medicine.
Listed below are some of the most well-known concepts in traditional Chinese medicine, along with information on TCM and acupuncture schools, titles and organizations. Clicking on a term will direct you to a new page with information on that particular subject.
Generally regarded as the most common form of massage, Swedish massage involves a combination of five basic strokes and concentrates on the muscles and connective tissues of the body for improved circulation, relaxation, pain relief, and overall health maintenance and well-being. Swedish massage is also one of the less demanding techniques for massage therapists to practice as it usually does not involve deep-tissue work.
Aromatherapy is a natural adjunct to massage and bodywork. The effects of pure essential oils have been well documented in research conducted for the cosmetic and food industries -- the largest users of botanical extracts.
But the essences also work on the mind and, thus, the emotions, and have an effect on the spiritual level, as well. Massage therapists can positively affect many levels during a massage or bodywork treatment by adding essential oils to our cold pressed massage oil, or have a blend that is diffused into the air. Remember to always dilute essential oils before applying to the skin.
Some of the most commonly used essential oils and suggested blends are described below:
CHAMOMILE (Anthemus nobilis). Distilled from dried flowers, chamomile's familiar apple-like scent is found in herbal teas and cosmetic products. Chamomile is used for pain, inflammation, headache, insomnia, stomach distress, skin irritation and infection, and relieves symptoms of PMS. It is an extremely calming oil in the sedative category that is useful to relieve anger.
EUCALYPTUS (Eucalyptus globulus). Distilled from a tree indigenous to Australia, eucalyptus is a powerful decongestant. It is good for flu and sinus conditions, protection from bacterial and viral infections, and it cools the emotions and clears the mind. Use in low doses. One drop in boiling water is a powerful inhalation for congestion due to colds and flu.
GERANIUM (Pelargonium graveolens). Another scent familiar from cosmetic products, Geranium is an anti-inflammatory that assists circulation and relieves anxiety. It relieves neuralgia, stress related conditions, is helpful for both menopause and PMS, and has numerous applications for skin. Geranium is also a pleasant mosquito repellant.
GRAPEFRUIT (Citrus paradisi). Expelled from the rind of the fruit, this essence is known for having a euphoric effect. It also stimulates the lymphatic and digestive systems and relieves simple water retention. Grapefruit will ease the desire to overeat and helps in detoxification.
JUNIPER (Juniperus communis). Distilled from the berry, juniper is a powerful detoxification agent. It relieves simple water retention, overworked and overstressed muscles, and is uplifting to the spirit.
LAVENDER (Lavandula angustifolia). Often considered the one essential oil to have if you can have only one, lavender has extensive properties, including relief of pain, muscle spasm, high blood pressure, insomnia, headache, anxiety, depression, burns, colds and flu. Lavender is the principal sedative oil, but overuse can cause it to become a stimulant.
PEPPERMINT (Mentha piperita). The refreshing, familiar aroma of peppermint is clearing to the mind and emotions. Peppermint relieves headache, muscle pain, sinus, colds and flu, painful feet, and digestive difficulty.
ROSEMARY (Rosmarinus officinalus). Known as the principal stimulant, the essential oil of rosemary relieves pain, headache and promotes circulation while it assists digestion and detoxification.
Chamomile, geranium and grapefruit - Soothing and uplifting; helps relieve PMS.
Chamomile, lavender and grapefruit - Relieves pain, anxiety and insomnia.
Grapefruit, juniper and rosemary - Stimulates circulation and digestion; relieves jetlag.
Lavender, rosemary and juniper - An all purpose blend for pain relief and detoxification after sports massage.
Peppermint, rosemary and geranium - Relieves pain; uplifts and strengthens.
- Davis, Patricia. Aromatherapy, A-Z.
- Lawless, Julia. The Illustrated Encyclopedia of Essential Oils.
- Mojay, Gabriel. Aromatherapy for Healing the Spirit.
- Sheppard-Hanger, Sylla. The Aromatherapy Practitioners Manual, Vols. I and II.
Shellie Enteen has been an aromatherapist for more than 12 years and teaches continuing education courses in aromatherapy for massage. Shellie is a South Florida regional director of the National Association for Holistic Aromatherapy (NAHA), author of Inside Aromatherapy: How to Recognize and Offer High-Quality Aromatherapy, and owner of Aroma Magic, Inc., which provides pure, therapeutic essential oils. Contact Shellie via her Web site www.astralessence.com or e-mail firstname.lastname@example.org .
Chair massage, also known as seated massage, is fast becoming one of the most popular ways in which to practice. Generally, chair massage is administered onsite at various locations, including health fairs, airports, shopping malls and in corporate settings. Clients remain fully clothed and treatments generally last from 15-30 minutes. Chair massage is usually limited to the back, neck and arms.
For more on Chair Massage, read Lee Chaffee's article "Stuck in Seated Positioning with Chair Massage?" in the August issue of Massage Today at
Like humans, animals are susceptible to injury, debilitating disease and stress, and can benefit from massage. Massage therapists have built entire practices around horses (equine massage), dogs and cats; some practitioners even work with birds and domesticated reptiles.
In addition to making house calls, therapists that work with animals work in veterinary offices, and with police departments, animal shelters and breeders. Working animals -- such as horses, and police and show dogs -- can benefit from massage on a regular basis; however, massage is also beneficial for house pets, and can ease arthritis and muscle pain, and increase flexibility and range of motion. Other benefits include detoxification, increased mobility, improved performance and decreased anxiety
Study Shows Massage Therapy Improves Blood Flow in Aching Muscles
By Massage Therapy Foundation Contributor
Contributed by Jolie Haun, PhD EdS LMT, Pualani Gillespie, MS RN LMT, Beth Barberree, BA RMT
It is a natural tendency to rub the injured area when someone has overexerted a muscle. This stress on the muscle tissue and related injuries is known as "exertion induced muscle injury." Individuals often seek massage therapy to relieve the soreness in these muscles. For example, this is a basic concept of sports massage, as athletes have a tendency to over exert themselves and often experience much relief from receiving massage therapy.
The Massage Therapy Foundation and the massage therapy profession have a great deal of interest in understanding the mechanisms of muscular injury phenomena, and the role of massage therapy in improving function and recovery. In fact, the Foundation recently supported the work of a group of researchers, Franklin and colleagues, to examine the role of vascular endothelial function in exercise-induced muscle injury and recovery supported by massage therapy. The purpose of this study was to: investigate the mechanisms of systemic endothelial dysfunction of the brachial artery, which develops after exercise-induced muscle injury of the lower extremities; and determine if treatment of the lower extremities with massage therapy reduces endothelial dysfunction. The authors hypothesized that a massage therapy treatment performed after exposure to exercise-induced muscle injury would protect against impaired endothelial function.
Franklin and colleagues conducted a randomized, blinded trial with 36 sedentary young adults in a clinical research setting at an academic medical center and laboratory. Each participant was randomly assigned to one of three groups: treatment following exposure to 75 exercise-induced muscle injury (exercise-induced muscle injury + massage therapy); a control intervention of exercise-induced muscle injury without MT treatment (exercise-induced muscle injury only); or a 76 control intervention of massage therapy treatment without exercise-induced muscle injury (massage therapy only). The exercise-induced muscle injury was induced by a single bout of bi-lateral leg press exercise.
The massage therapy protocol was provided by one licensed and certified massage therapist. The treatment included a 30-minute bilateral lower extremity (legs) massage using Swedish techniques varying in depth from superficial to deep.
Participants were screened in an initial visit. Approximately one week following the initial screening, participants who met all inclusion criteria returned for baseline assessment of endothelial function. Participants provided data at five time points before (baseline) and after (90 minutes, 24 hours, 48 hours and 72 hours) the intervention. Several measures were taken, all after a 12-hour fast. The primary measures, determined by ultrasound, were brachial artery flow-mediated dilation and Nitroglycerin-induced dilation.
Findings indicate brachial (upper extremity) flow-mediated dilation increased from baseline in the exercise-induced muscle injury + massage therapy group and the massage therapy only group at 90 minutes remaining elevated until 72 hours post treatment. In the exercise-induced muscle injury only group, flow-mediated dilation was reduced from baseline at 24 and 48 hours returning to baseline after 72 hours.
Interpreting the Findings
Results indicate that massage therapy has systemic effects on endothelial function; such that massage therapy lessens impairment of upper extremity endothelial function resulting from lower extremity exercise-induced muscle injury in sedentary young adults. Dilations due to Nitroglycerin were similar over time. Authors suggest this is the first study to determine that massage therapy protects against reduced upper extremity endothelial function following lower extremity exertion.
The primary finding of this study is that massage therapy reduces impairment of brachial artery flow-mediated dilation resulting from exercise-induced muscle injury. The authors also reported the unexpected finding that lower extremity massage enhances brachial artery flow-mediated dilation even in the absence of exercise-induced muscle injury.
Franklin and colleagues mentioned several study limitations including the possible confounding of results by the absence of a true control group; the inability to test endothelium independent dilation to nitroglycerin before exercise-induced muscle injury and/or massage therapy because of the residual vasodilator effects of this compound on blood pressure; due to the small sample size this study was also unable to assess gender or racial/ethnic-specific effects; and differences in BMI may confound the effects of massage on flow-mediated dilation.
The authors indicated future research would benefit from a no intervention control group and larger sample sizes to validate these findings, as well as allow for sub-group analyses.
The results of this research suggest that exercise-induced muscle injury impairs systemic endothelial function; and massage therapy enhances endothelial function in both the presence and absence of muscle injury. These study results contribute to understanding how massage therapy promotes faster recovery from exercise-induced muscle injury and may have broader implications for the clinical use of massage therapy, especially in the context of endothelial dysfunction.
From a clinical perspective, massage therapy is a widely used. Annually, millions of Americans receive massage therapy for health reasons such as pain relief, injury recovery and rehabilitation, yet to date research provides little evidence for the effects of massage on blood flow. Findings in the current study indicate that a single massage treatment improves brachial artery endothelium-dependent flow-mediated dilation for up to 48 hours.
How do these findings apply to clinical practice? Franklin and colleagues suggest that since flow-mediated dilation correlates with cardiovascular risk, their study findings may support the use of massage therapy for reducing exercise-induced muscle injury and post-exercise hypo-perfusion in at risk populations, such as individuals with heart disease who are engaged in intense exercise regimens. As the field of massage continues to expand its application to the medical field, Franklin and colleagues also suggest massage-induced improvements in endothelial function may help to protect against vascular responses to other physical stressors such as acute hypertension, hypoxemia and wound healing.
Massage therapists commonly observe and state that part of the benefit of massage therapy is increased circulation, which promotes healing and wellness. The work of Franklin and colleagues make an empirical contribution to the growing body of evidence that supports these clinical observations and claims.
If you would like to learn more about the evidence based research that supports the benefits and mechanisms of massage therapy, you can review the Massage Therapy Foundation article archives, read accepted MTF Research Grant abstracts or search Pub Med. Also, take the opportunity to boost your research knowledge by registering for an MTF Basics of Literacy course. You can explore the basics of incorporating principles of research literacy into your practice or school curriculum at your own pace.
- Franklin NC, Ali MM, Robinson AT, Norkeviciute E, Phillips SA. (2014) Massage Therapy Restores Peripheral Vascular Function following Exertion. Archives of Physical Medicine and Rehabilitation.
Massage is one of the oldest healing arts: Chinese records dating back 3,000 years document its use; the ancient Hindus, Persians and Egyptians applied forms of massage for many ailments; and Hippocrates wrote papers recommending the use of rubbing and friction for joint and circulatory problems. Today, the benefits of massage are varied and far-reaching. As an accepted part of many physical rehabilitation programs, massage therapy has also proven beneficial for many chronic conditions, including low back pain, arthritis, bursitis, fatigue, high blood pressure, diabetes, immunity suppression, infertility, smoking cessation, depression, and more. And, as many millions will attest, massage also helps relieve the stress and tension of everyday living that can lead to disease and illness.
So What Is It Exactly?
Massage, bodywork and somatic therapies are defined as the application of various techniques to the muscular structure and soft tissues of the human body. Specifically:
Massage: The application of soft-tissue manipulation techniques to the body, generally intended to reduce stress and fatigue while improving circulation. The many variations of massage account for several different techniques.
Bodywork: Various forms of touch therapies that may use manipulation, movement, and/or repatterning to affect structural changes to the body.
Somatic: Meaning “of the body.” Many times this term is used to denote a body/mind or whole-body approach as distinguished from a physiology-only or environmental perspective.
There are more than 250 variations of massage, bodywork, and somatic therapies and many practitioners utilize multiple techniques. The application of these techniques may include, but is not limited to, stroking, kneading, tapping, compression, vibration, rocking, friction, and pressure to the muscular structure or soft tissues of the human body. This may also include non-forceful passive or active movement and/or application of techniques intended to affect the energetic systems of the body. The use of oils, lotions, and powders may also be included to reduce friction on the skin.
Please note: Massage, bodywork and somatic therapies specifically exclude diagnosis, prescription, manipulation or adjustments of the human skeletal structure, or any other service, procedure or therapy which requires a license to practice orthopedics, physical therapy, podiatry, chiropractic, osteopathy, psychotherapy, acupuncture, or any other profession or branch of medicine.
What exactly are the benefits of receiving massage or bodywork treatments? Useful for all of the conditions listed below and more, massage can:
- Alleviate low-back pain and improve range of motion.
- Assist with shorter, easier labor for expectant mothers and shorten maternity hospital stays.
- Ease medication dependence.
- Enhance immunity by stimulating lymph flow—the body's natural defense system.
- Exercise and stretch weak, tight, or atrophied muscles.
- Help athletes of any level prepare for, and recover from, strenuous workouts.
- Improve the condition of the body's largest organ—the skin.
- Increase joint flexibility.
- Lessen depression and anxiety.
- Promote tissue regeneration, reducing scar tissue and stretch marks.
- Pump oxygen and nutrients into tissues and vital organs, improvingcirculation.
- Reduce postsurgery adhesions and swelling.
- Reduce spasms and cramping.
- Relax and soften injured, tired, and overused muscles.
- Release endorphins—amino acids that work as the body's natural painkiller.
- Relieve migraine pain.
A Powerful Ally
There's no denying the power of bodywork. Regardless of the adjectives we assign to it (pampering, rejuvenating, therapeutic) or the reasons we seek it out (a luxurious treat, stress relief, pain management), massage therapy can be a powerful ally in your healthcare regimen.
Experts estimate that upwards of ninety percent of disease is stress related. And perhaps nothing ages us faster, internally and externally, than high stress. While eliminating anxiety and pressure altogether in this fast-paced world may be idealistic, massage can, without a doubt, help manage stress. This translates into:
- Decreased anxiety.
- Enhanced sleep quality.
- Greater energy.
- Improved concentration.
- Increased circulation.
- Reduced fatigue.
Furthermore, clients often report a sense of perspective and clarity after receiving a massage. The emotional balance bodywork provides can often be just as vital and valuable as the more tangible physical benefits.
In response to massage, specific physiological and chemical changes cascade throughout the body, with profound effects. Research shows that with massage:
- Arthritis sufferers note fewer aches and less stiffness and pain.
- Asthmatic children show better pulmonary function and increased peak air flow.
- Burn injury patients report reduced pain, itching, and anxiety.
- High blood pressure patients demonstrate lower diastolic blood pressure, anxiety, and stress hormones.
- Premenstrual syndrome sufferers have decreased water retention and cramping.
- Preterm infants have improved weight gain.
Research continues to show the enormous benefits of touch—which range from treating chronic diseases, neurological disorders, and injuries, to alleviating the tensions of modern lifestyles. Consequently, the medical community is actively embracing bodywork, and massage is becoming an integral part of hospice care and neonatal intensive care units. Many hospitals are also incorporating on-site massage practitioners and even spas to treat postsurgery or pain patients as part of the recovery process.
Increase the Benefits with Frequent Visits
Getting a massage can do you a world of good. And getting massage frequently can do even more. This is the beauty of bodywork. Taking part in this form of regularly scheduled self-care can play a huge part in how healthy you'll be and how youthful you'll remain with each passing year. Budgeting time and money for bodywork at consistent intervals is truly an investment in your health. And remember: just because massage feels like a pampering treat doesn't mean it is any less therapeutic. Consider massage appointments a necessary piece of your health and wellness plan, and work with your practitioner to establish a treatment schedule that best meets your needs.
Why should us Ladies get Brazilian Landscaping???
Brazilian is not only for the comfort we give ourselves but the gift we give to others. Face it ladies, it's the latest thing that fancies the fellas. Get with it or get left behind. Don't let the horror stories scare you away from a wonderful thing. Its a win win situation for all. Here at Sunsetbodyworks we are an upscale Spa & Salon with knowledge and product to help waxing be a good thing and not a nightmare. You are in good hands.
Good reasons to get waxed NOW!
1. Expect the unexpected Be prepared and avoid embarrassments.
2. Exiting the vehicles With mini skirts there's always a chance for flashing
3. Slumber parties Lets not give anyone a reason to poke fun.
4. Bikini Season Waxing and bikini go hand in hand.
5. Waxing frequently will help diminish hair growth over time also becomes much softer less stubby.
6. Ingrown hairs will be a thing of the past.
Waxing is Sexy & is a BASIC NATURAL INSTINCT.
Article blog by Veronica Villalta