What Is Evidence Based Massage Therapy?

If you maintain with the world of massage therapy, you will eventually notice that there are a few new ideas and terms going around. Evidence based massage. Evidence based practice. Evidence informed practice. Science based medicine. What does it all mean?

Massage Based on Tradition

When I visited massage school, much of what we were taught was predicated on tradition or what was perceived to be common sense. We did certain things using ways because… well, because that was just how we were taught to accomplish them. Massage “improved circulation.” We have to drink lots of water after a massage so that it would “flush out toxins.” It appeared to make sense, right?

My first introduction to the theory that science was starting to contradict a few of our dearly held beliefs came when an instructor told me that research had shown that massage did not, 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 should be reducing the presence of lactic acid, right?

When someone finally did some research, it proved that, in fact, massage didn’t reduce the presence of lactic acid. How could this be? Did this mean what we’d been led to believe was wrong? 부달 Well, it’s true that massage does decrease soreness in muscles. Apparently, though, it is not because of lactic acid. So how exactly does massage decrease soreness? We don’t clearly know how it happens but we can say for certain that it does happen.

Although among massage therapy’s sacred cows had just been slain, I liked it that particular instructor was paying attention to science and research and was interested in understanding the truth of that which was happening instead of defending a tradition that may not be supportable.

Shortly afterward I discovered Neuromuscular Therapy, sometimes referred to as Trigger Point Therapy, and the task of Travell and Simons. Drs. Travell and Simons spent many years documenting the phenomena of trigger points and writing the two 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 began to give me the knowledge 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 which I strive to follow even today.

Massage Based on Evidence

Evidenced based therapeutic massage is massage therapy founded on ideas and principles supported by evidence. There’s scientific, documented evidence to aid the existence of and treatment of trigger points. There’s documented evidence that massage relieves muscle soreness and can alleviate anxiety and depression.

A lot of the claims made and practices used by massage therapists are founded on tradition instead of evidence. Since there is not yet a large body of knowledge documenting the physiology of and ramifications of therapeutic massage, if we were only able to make statements strictly on the basis of scientific studies, we’d be severely limited, indeed. Some individuals prefer 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 massage therapy and was surprised one day when I found a large 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 is the way they have been done and are definitely not supported by evidence that they are the best way and even effective.

In science, one always has to be open to new evidence and be willing to change your mind when met with new information that contradicts formerly held beliefs. Another one of massage therapists’ dearly held beliefs was challenged last summer when researcher Christopher Moyer presented a paper that showed that massage therapy did not lower degrees of the stress hormone cortisol nearly around had been previously thought and, in fact, its effect on cortisol may be negligible. I’m sure I had not been the only massage therapist who was startled by this news. However, once I got over the initial shock, I examined the evidence he presented. It took awhile for me personally to understand but in the end 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 much better, we just don’t know exactly why or how.

Does it certainly matter if we understand? I believe so. For starters, as a therapist, I wish to be sure that the claims I make to my clients are truthful. I really do not want to mislead them by making unsubstantiated claims. Furthermore, I believe that the more we are able to understand, the more effectively we might maintain our work. Finally, I really believe that the more we are able to document the ways in which massage therapy can be helpful, the more accepted it will become.