If you keep up with the world of therapeutic massage, you will eventually observe that there are some new ideas and terms going around. Evidence based massage. Evidence based practice. Evidence informed practice. Science based medicine. What does everything mean?
Massage Based on Tradition
When I went to massage school, a lot of what we were taught was predicated on tradition or what was perceived to be good sense. We did certain things using ways because… well, because that was the way we were taught to accomplish them. Massage “improved circulation.” We should drink lots of water after a massage so that it would “flush out toxins.” It seemed to make sense, right?
My first introduction to the theory that science was starting to contradict some of our dearly held beliefs came when an instructor told me that research had shown that massage didn’t, as was commonly claimed, reduce lactic acid in muscle tissue. We’d always been told a buildup of lactic acid in the muscles was what caused soreness and that massage reduced its presence. People repeatedly experience that massage reduces muscles soreness. Therefore, massage must be reducing the current presence of lactic acid, right?
When someone finally did some research, it proved that, in fact, massage didn’t decrease the presence of lactic acid. How could this be? Did this mean what we’d been led to believe was wrong? Well, it’s true that massage does decrease soreness in muscles. Apparently, though, it isn’t because of lactic acid. How does massage decrease soreness? deweyshouse.com We don’t clearly know how it happens but we can say for certain that it does happen.
Although one of massage therapy’s sacred cows had just been slain, I liked it that particular instructor was watching science and research and was more interested in understanding the truth of that which was happening instead of defending a tradition that might not be supportable.
Shortly afterward I discovered Neuromuscular Therapy, sometimes known as Trigger Point Therapy, and the work of Travell and Simons. Drs. Travell and Simons spent many years documenting the phenomena of trigger points and writing both volume set Myofascial Pain and Dysfunction: The Trigger Point Manual. Studying their work gave me the various tools to work effectively with some typically common pain conditions. It also started to give me the data and vocabulary to speak intelligently to physical therapists and medical doctors about my clients and their patients. It started me down the path of an evidence based practice, a path that i strive to follow to this day.
Massage Based on Evidence
Evidenced based massage therapy is therapeutic massage founded on ideas and principles supported by evidence. There is scientific, documented evidence to support the existence of and treatment of trigger points. There’s documented evidence that massage relieves muscle soreness and will alleviate anxiety and depression.
Many of the claims made and practices used by massage therapists are founded on tradition instead of evidence. While there is not yet a large body of knowledge documenting the physiology of and ramifications of massage therapy, if we were only in a position to make statements strictly based on scientific studies, we’d be severely limited, indeed. Some individuals choose the term evidence informed practice as more accurate. An evidence informed practice takes under consideration scientific evidence, clinical experience, and careful observation.
I assumed this reliance on tradition was primarily confined to the field of therapeutic massage and was surprised 1 day when I found a big display about evidence based medicine in the halls of St. Louis University Medical School. Apparently, even yet in conventional medicine, many procedures are done because that’s the way they have always been done and are not necessarily supported by evidence they are the best way as well as effective.
In science, one always has to most probably to new evidence and become willing to change your mind when met with new information that contradicts formerly held beliefs. A different one of massage therapists’ dearly held beliefs was challenged last summer when researcher Christopher Moyer presented a paper that showed that therapeutic massage did not lower degrees of the strain hormone cortisol nearly around have been previously thought and, in fact, its effect on cortisol may be negligible. I’m sure I was not the only massage therapist who was startled by this news. However, once I got on the initial shock, I examined the data he presented. It took awhile for me personally to understand but in the finish it seemed he had very good evidence to support his conclusions. Does this mean that massage will not “work?” Well, it’s obvious that massage makes us feel better, we just don’t know why or how.
Does it really matter if we understand? I believe so. To start with, as a therapist, I would like to be certain that the claims I make to my clients are truthful. I do not want to mislead them by making unsubstantiated claims. In addition, I really believe that the more we are able to understand, the more effectively we may maintain our work. Finally, I believe that the more we can document the ways that massage therapy are a good idea, the more accepted it’ll become.