In its Comprehensive Accreditation Manual for Hospitals, The Official Handbook, updated in August 2000, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) suggests massage therapy can be used successfully in pain management. Some hospitals are including massage therapists in patient care teams to fight pain. Their teams may include a physician, nurses, a nutritionist, a yoga instructor, and a massage therapist. Hospitals are now including massage due to public demand. More research needs to be done to evaluate not only the effectiveness of such teams but to determine which combination of therapies works best for different types of patients and different types of pain.
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If you are dealing with a serious injury, and don’t have a diagnosis, definitely see a sports doctor. “Massage therapists do not diagnose,” says Denunzio. “It’s not part of our discipline.” And while a therapist can identify and attempt to alleviate any tightness and inflammation in the body, if a problem area doesn’t feel significantly better three days post-massage, you should likely consult a sports doctor then, as well. Once a diagnosis is given, your massage therapist can work with that information and use massage as a helpful tool in recovery.
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Deep tissue massage is a focused, therapeutic massage that targets muscle knots (also known as "adhesions") and specific problem areas in the deeper layers of muscle and connective tissue. Using deliberate, slow strokes or friction across the grain of the muscle, the therapist addresses chronic tight or painful muscles, repetitive strain, postural problems, or injuries.
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Massage developed alongside athletics in both Ancient China and Ancient Greece. Taoist priests developed massage in concert with their Kung Fu gymnastic movements, while Ancient Greek Olympians used a specific type of trainer ("aleiptes") who would rub their muscles with oil. Pehr Ling's introduction to massage also came about directly as a result of his study of gymnastic movements.
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Quick muscle knot orientation: Muscle knots — myofascial “trigger points” — are a factor in most of the world’s aches and pains. Their biology is still mostly mysterious: conventional wisdom says they are tiny spasms, but they might also be a more pure neurological problem. Regardless, they can cause strong pain that often spreads in confusing patterns, and they grow like weeds around other painful problems and injuries, making them quite interesting and tricky. Although they are well known to many specialists and researchers, most doctors and therapists know little about them, so misdiagnosis is epidemic. For more information about how trigger points might be involved in your own medical history, see PainScience.com’s best-selling tutorial:
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In a poll of 25–35-year-olds, 79% said they would like their health insurance plan to cover massage. In 2006 Duke University Health System opened up a center to integrate medical disciplines with CAM disciplines such as massage therapy and acupuncture. There were 15,500 spas in the United States in 2007, with about two-thirds of the visitors being women.
But the relief model is certainly tempting. There are many painful-but-relieving analogies in medicine and biology.15 That’s similar to what good pain in massage feels like, but it’s not the same: no one thinks that lancing a boil or popping a shoulder joint back in is anything but painful while it’s happening.16 And we can’t necessarily take the good pain sensation at face value and assume it means there’s actually going to be a positive outcome. Brains are not all-knowing. Sometimes they see danger where there is none, and sometimes they see help where there is none.
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Neck pain. Neck pain is tied with headaches as the second most common pain experienced by adult Americans (also 15 percent), and massage can typically help with this too. For instance, a systematic review and meta-analysis published in 2014 in Evidence-Based Complementary and Alternative Medicine analyzed 15 studies and found that there was “moderate evidence” that massage therapy helped provide relief.
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According to Robert Noah Calvert, author of The History of Massage, what we now call Swedish massage was never part of Ling’s movement system. Swedish massage, as Calvert asserts, is defined by its system of stroking, kneading, and other bodily manipulations. These he credits to a Dutch practitioner, Johann Georg Mezger, who lived and worked in the late 19th century. As a result, what Americans know as Swedish massage is called “classic massage” throughout most of Europe.
Research published in the Journal of Sports Medicine and Physical Fitness reported findings of a positive trend for deep tissue massages in regard to improved athletic recovery and performance. The most beneficial type of deep tissue massage for athletes is considered to be “sports massage,” which is commonly performed prior to athletic events to help warm the body and prevent injuries or immediately after to improve recovery.
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That is, regardless of all other considerations, a massage therapist must talk to you about pressure, respect your preferences (they are more important than any treatment ideology), and be careful about stumbling into areas that need much less pressure (for comfort) or much more pressure (for satisfaction). Far too many therapists make the mistake of setting a “default” pressure for a client early on, and then using roughly that much pressure everywhere.