If you maintain with the world of massage therapy, you will eventually notice that there are some new ideas and terms on offer. 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 based on tradition or what was perceived to be good sense. We did certain things in certain ways because… well, because that was just how we were taught to accomplish them. Massage “improved circulation.” We should drink plenty of water after a massage so that it would “flush out toxins.” It appeared to make sense, right?
My first introduction to the idea that science was beginning 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 should be reducing the current presence of lactic acid, right?
When someone finally did some research, it turned out that, in fact, massage didn’t decrease the presence of lactic acid. How could this be? Did this mean what we’d been resulted in believe was wrong? 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 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 rather than 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 a long time 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 began 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 massage therapy founded on ideas and principles supported by evidence. There is scientific, documented evidence to aid the existence of and treatment of trigger points. There is 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 big body of knowledge documenting the physiology of and ramifications of therapeutic massage, if we were only able to make statements strictly based on scientific studies, we would be severely limited, indeed. Some individuals prefer the term evidence informed practice as more accurate. An evidence informed practice takes into consideration scientific evidence, clinical experience, and careful observation.
deweyshouse.com 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 in conventional medicine, many procedures are done because that’s the way they have always been done and are not necessarily supported by evidence that they are the best way or even effective.
In science, one always has to be open to new evidence and become willing to change your mind when confronted 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 stress hormone cortisol nearly as much as have been previously thought and, actually, its effect on cortisol may be negligible. I’m sure I was not the only massage therapist who was simply startled by this news. However, once I acquired on the initial shock, I examined the data he presented. It took awhile for me to understand but in the finish it seemed that he had very good evidence to aid his conclusions. Does this imply that massage will not “work?” Well, it’s obvious that massage makes us feel better, we just don’t know exactly why or how.
Does it certainly matter if we understand? I think so. First of all, as a therapist, I would like to make certain that the claims I make to my clients are truthful. I do not need to mislead them by making unsubstantiated claims. In addition, 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 can document the ways in which massage therapy are a good idea, the more accepted it’ll become.