To put it bluntly, it’s not clear that massage has any musculoskeletal benefits at all. It probably does, but mostly quite temporary and highly unpredictable. There’s not nearly enough science, and therapists are hopelessly biased assessing their own efficacy. See Does Massage Therapy Work? A review of the science of massage therapy … such as it is. BACK TO TEXT
Manual lymphatic drainage is a technique used to gently work and stimulate the lymphatic system, to assist in reduction of localized swelling. The lymphatic system is a network of slow moving vessels in the body that carries cellular waste toward the heart, to be filtered and removed. Lymph also carries lymphocytes, and other immune system agents. Manual lymphatic drainage claims to improve waste removal and immune function.
Reflexology is an alternative medicine system that claims to treat internal organs by pressing on designated spots on the feet and hands; there is no anatomical connection between those organs and those spots. Systematic reviews in 2009 and 2011 found no convincing evidence that reflexology is an effective treatment for any medical condition. Quackwatch and the NCAHF agree that reflexology is a form of massage that may help patients relax and feel better temporarily, but that has no other health benefits. Our own Mark Crislip said, “The great majority of studies demonstrate reflexology had no effects that could not be replicated by picking fleas off your mate…And it has no anatomic or physiologic justification.”
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Sports massage has antecedents in earlier periods of history. The ancient Greeks and Romans combined massage and exercise in their athletic training. Various Asian cultures also developed forms of massage for dancers and for students of martial arts . As a formal practice, however, sports massage began in the Soviet Union and Communist bloc countries in the 1960s. Soviet teams were the first to have a massage therapist travel with them and work on their athletes on a regular and ongoing basis. Through sports and cultural exchanges, the concept of sports massage moved to Europe and the United States in the 1970s. Over time the benefits of sports massage became accepted, and sports massage became a part of the training regimen, first of professional athletes, then of college and amateur athletes. Today sports massage is recognized as a specialty by the American Massage Therapy Association.
Flushing. If massage can “improve” any tissue — unknown — one way it might do it is through simple hydraulics: physically pumping tissue fluids around, and/or stimulating the circulation of blood and lymph. I won’t get into the evidence about it here. Suffice it to say that it might be true, and if it’s true then it may not much matter if the process is uncomfortable. While gentler massage may feel pleasant and satisfying, it is possible that more biological benefits can only be achieved hydraulically — whether it’s comfortable or not. This is even more plausible because of trigger points: it’s likely that the tissue fluids of a trigger point are quite polluted with waste metabolites, and the need for flushing is greater, but it’s especially uncomfortable to squish those polluted patches of tissue.
This is not only an inaccurate and potentially harmful picture of this type of therapy, but such misguided practices can bruise muscles, elicit a defensive reaction in a client’s body, and worsen pain cycles. Properly executed deep tissue work should not cause the client to grit their teeth in agony as the therapist coerces the body into submission! If you find yourself clenching, shortening or holding your breath, or gritting your teeth, then it’s TOO DEEP. Even when it gets intense, it should not go above about a 7 on the pain scale: enough to “hurt so good,” but not enough that you want to leap off the table (and never come back).
Interestingly, many patients and therapists swear by massage as a way to reduce constipation or digestive upset, since the increased circulatory benefits and relaxation of the abdominal and lower back muscles can help relieve symptoms. In fact, a 2014 study from the British journal Nursing Standard highlights a number of the ways abdominal massage encouraging muscle contraction, nudging the gut to move things along.