A good massage therapist will never force pressure into the muscle. They will continue to apply pressure until the muscle pushes back against them. The muscle will then slowly begin to release and allow the therapist to move along it. The pressure used should not be painful, but should walk a fine line between pleasurable release of tension and a pain-blocking response from the body (tensing up).
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For example, I worked on the Indiana Sports Massage Team starting in 1989, as well as the NCAA Swimming & Diving Championships and National Championships. I coordinated massage for the 1992 Olympic Trials and was on the 1996 Olympic Massage Team for the Atlanta Olympics—the first time massage therapy was part of the medical staff for the Olympics. These were all volunteer positions, but I loved it!
With no lotion or oil to cause sliding, it becomes possible to fully get a hold of the shortened fascia; this is necessary in order to lengthen it. Slow, sustained strokes are what can change this tissue from a short, hardened state to a lengthened, fluid state. The process is not unlike stretching salt water taffy. You’ve got to get a hold of it, warm it up, and work it very slowly. The work may sometimes be intense, eliciting moderate discomfort as old adhesions and chronic dysfunctional patterns are altered. But that leads to a much more fluid, easy sense in the body.
Some of the scientific research on massage therapy can be conflicting, but much of the evidence points toward beneficial effects on pain and other symptoms associated with a number of different conditions. Much of the evidence suggests that these effects are short-term, and people should keep getting massages for the benefits to continue. Researchers have studied the effects of massage for many conditions. Some that have been studied more extensively are blood pressure, general pain, cancer, mental health, fibromyalgia, headaches, HIV/AIDS, infant care, autism, anxiety, and diabetes. Massage therapy appears to have few risks if it is used appropriately and provided by a trained massage professional.
Massage used in the medical field includes decongestive therapy used for lymphedema which can be used in conjunction with the treatment of breast cancer. Light massage is also used in pain management and palliative care. Carotid sinus massage is used to diagnose carotid sinus syncope and is sometimes useful for differentiating supraventricular tachycardia (SVT) from ventricular tachycardia. It, like the valsalva maneuver, is a therapy for SVT. However, it is less effective than management of SVT with medications.
Swedish massage was invented by a Swedish fencing instructor named Per Henrik Ling in the 1830s. When he was injured in the elbows, he reportedly cured himself using tapping (percussion) strokes around the affected area. He later developed the technique currently known as Swedish massage. This technique was brought to the United States from Sweden by two brothers, Dr. Charles and Dr. George Taylor in the 1850s. The specific techniques used in Swedish massage involve the application of long gliding strokes, friction, and kneading and tapping movements on the soft tissues of the body. Sometimes passive or active joint movements are also used.
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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
Although a lot of Bastian 2014 is certainly relevant to the concept of “good pain,” strictly speaking I don’t think they are writing about the good pain paradox, which is defined by simultaneous pleasure and pain. They are writing about pleasure following pain (relief from pain). This is more comfortable scientific ground: it’s pretty straightforward that relief from pain might be “associated with positive consequences” or lead to “activation of the brain’s reward circuitry,” for instance. Lance a boil, then feel better, right? Of course. But that’s definitely not what we mean by “good pain” in massage. BACK TO TEXT
Peer-reviewed medical research has shown that the benefits of massage include pain relief, reduced trait anxiety and depression, and temporarily reduced blood pressure, heart rate, and state of anxiety. Additional testing has shown an immediate increase and expedited recovery periods for muscle performance. Theories behind what massage might do include enhanced skeletal muscle regrowth and remodeling, blocking nociception (gate control theory), activating the parasympathetic nervous system, which may stimulate the release of endorphins and serotonin, preventing fibrosis or scar tissue, increasing the flow of lymph, and improving sleep.
According to the Neuromuscular Therapy Center, NMT is one type of deep massage technique that focuses on applying manual therapy to soft tissue with “quasi-static pressure” in order to stimulate skeletal striated muscle. (17) In addition to massaging a painful or inflamed muscle, the area around the affected muscle that normally supports it is also massaged in order to release tension. NMT therapists often focus on several factors that can add to muscle or tissue dysfunctions, including joint pathologies, postural positioning, disruptive habits of use, nutritional components, emotional well-being, allergies and neurotoxins.
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The purpose of the practice of massage is to enhance the general health and well-being of the recipient. ‘Massage’ is used as a general term to describe manual manipulation of the muscles and joints to help relieve pain and stress in the body. This generalized term can be broken down into many subcategories such as: deep tissue, trigger point, prenatal/pregnancy massage, hot stone, sports massage, Thai massage, myofascial release, lymphatic drainage, crainiosacral, lomilomi, shiatsu, reflexology, Hellerwork, looyen work, polarity therapy, tui na, and connective tissue massage, just to name a few.
Massage has been shown to reduce neuromuscular excitability by measuring changes in the Hoffman's reflex (H-reflex) amplitude. A decrease in peak-to-peak H-reflex amplitude suggests a decrease in motoneuron excitability. Others explain, "H-reflex is considered to be the electrical analogue of the stretch reflex...and the reduction" is due to a decrease in spinal reflex excitability. Field (2007) confirms that the inhibitory effects are due to deep tissue receptors and not superficial cutaneous receptors, as there was no decrease in H-reflex when looking at light fingertip pressure massage. It has been noted that "the receptors activated during massage are specific to the muscle being massaged", as other muscles did not produce a decrease in H-reflex amplitude.