By Erika Kruger

Building and maintaining ones own practice can become an all-consuming activity revolving around the business aspects thereof. This often leaves very little time to stay abreast of the latest research in the massage field. Professional bodies offset this dilemma by managing compulsory continued professional development programmes and the launch of such a programme by the Allied Health Professions Council of South Africa for massage therapists seems to be imminent. But until then we are left to our own devices to research the newest developments in our chosen field.

Thanks to modern technology, information is more accessible than ever before but it takes some practice to find ones way on the World Wide Web. Knowing that I regularly surf the Internet to find information for the blog Ingelyf / Somatalk and Facebook page (www.facebook.com/groups/121493759109/) which I administer for the Massage Therapy Association SA, the editor of In Touch asked me to share with the readers what I come across in this column.

The aim is not to regurgitate what is available on the Internet or in print. After all, reading the primary source is a fundamental principle of critical reading and the research process. In this column I would like to guide the readers to interesting and noteworthy developments directly and indirectly related to massage.

We have to always keep in mind that no single research study offers the final answer to a question or problem. Theory is build up bit by bit and a hypothesis is only considered the most valid explanation for a phenomenon once the experiment which originally ‘proved’ it, has been repeated successfully by other researchers. It is thus vital that as health professionals we foster our skills of discrimination and critical evaluation when reading for research.

Too often I still read outdated, unproven and unsubstantiated ‘facts’ in popular magazine articles and wellness websites spewed out by practitioners of a plethora of scientifically validated and not-validated therapies. More often these half-truths and blatant lies are repeated as gospel by patients. I make a point of mowing down these massage myths and misinformation as part of the informed consent process. There are stories like the one about a rubdown that can clear (unspecified) toxins from the body and the compulsory glass of water offered after a massage that assists in flushing it out. Or what about the tale about massaging the feet and ankles of pregnant women can lead to a miscarriage? I am sure you too have heard the one about the no-pain-no-gain approach being the only effective way of doing things. And then there is my all-time favourite: Massage can get rid of cellulite! Oh wouldn’t all of us have been wonderfully wealthy had that particular fairy story been true.

For a comprehensive list of massage myths, I suggest you have a look at American massage therapist Laura Allen’s award winning blog at http://lauraallenmt.com/blog/2011/04/12/more-myths-of-massage/ . If I  could find my notes from when I trained almost 15 years ago I know I would be able to find at quite a few of Laura’s list of myths mentioned in there … and I attended a particularly good training institution with a continually questioning lecturer. (No use pretending that I am objective in that regard). Admittedly I trained quite a few years before massage was declared a registered health profession built on scientific and evidence-based practices and training. But what if the principle of lifelong learning had not been drilled into us at college? For one, I might still be forcing water down my patient’s throat as a therapy enhancing tool.

There is another pervasive myth about massage that despite solid evidence from researchers, just never seem to get flushed out. In December 2007 I wrote an article for InTouch  (Lay it on lactic acid – full article is available on the MTA website) quoting a number of physiology and exercise experts debunking the idea of massage encouraging lactic acid elimination after physical activity to prevent muscle soreness and stiffness.

The ideas put forward in that article have been supported in more recent studies. A 2009 study conducted by Queens University’s Kinesiology and Health Studies professor Michael Tschakovsky and Kinesiology MSc candidate Vicky Wiltshire deals with “the myth that massage after exercise improves circulation to the muscle and assists in the removal of lactic acid and other waste products.” In fact the researchers’ article which appeared in Medicine & Science in Sports & Exercise journal of June 2010 (Volume 42, Issue 6, pp 1062-1071) and which describes their testing the hypothesis that one of the ways sports massage aids muscle recovery from exercise is by increasing muscle blood flow to improve “lactic acid” removal, declares that massage in fact impairs post-exercise muscle blood flow to muscles and lactic acid removal.

Says Tschakovsky: “All the physical therapy professionals that I have talked to, when asked what massage does, answer that it improves muscle blood flow and helps get rid of lactic acid.  Ours is the first study to challenge this and rigorously test its validity.”

A year later, in 2011 six Italian researchers presents a paper supporting the Queens study at a conference in Verona. This study titled Effect of different recovery modalities on lactic acid removal after a cycle exercise of heavy intensity, investigates the effect of five different recovery modalities (passive, active, sports massage, fascial release massage and passive stretching) on lactic acid removal and on maximum force output restoration after a fatiguing exercise on eight young active male participants using a cycle ergometer. No differences in metabolic, cardio-respiratory and EMG parameters were found among the five different sessions. Active recovery showed the lowest lactic acid values and the shortest recovery time compared to the other recovery modalities, among which no significant differences were found. Their conclusion? Although widely used after competitions or during training sessions, massage and passive stretching did not accelerate lactic acid removal, thus making questionable their administration instead of active recovery.

Do these studies spell the end of post-exercise massage? I don’t believe that is the case. Millions of cyclists, runners, dancers etc. will not be persuaded to give up massage as a result of research studies such as these. Massage does something for them and that is exactly the point. What exactly does massage do for them? Apparently not what we had thought it does. The common beliefs regarding lactic acid removal and restoration have reliably been shown to be false and anecdotal support does not equate to evidence-based therapy. Therefore future studies will have to investigate what massage does in fact do for athletes post-exercise.

As soon as I find the results of such research studies in cyberspace I will let you know.

References:

  1. Effect of different recovery modalities on lactic acid removal after a cycle exercise of heavy intensity http://air.unimi.it/handle/2434/166894
  2. Massage impairs postexercise muscle blood flow and “lactic acid” removal http://www.queensu.ca/news/articles/massage-after-exercise-myth-busted-queens-research-team
  3. Kolata, G 2006. Lactic Acid Is Not Muscles’ Foe, It’s Fuel http://www.nytimes.com/2006/05/16/health/nutrition/16run.html

Erika Kruger has been a massage therapist since 1998 and is currently studying towards an honours degree in psychology. She writes the Ingelyf / Somatalk blog ( http://somatalk.blogspot.com/ ) which explores ideas and examples of the body-mind relationship in a variety of fields including complementary and alternative health, the biomedical paradigm as well as in philosophy and psychology.