If you maintain with the world of therapeutic massage, you will eventually notice that there are several 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, much of what we were taught was based on tradition or that which was perceived to be good sense. We did certain things in certain ways because… well, because that has been the way we were taught to do them. Massage “improved circulation.” We have to drink lots of water after a massage so that it would “flush out toxins.” It seemed to make sense, right?
My first introduction to the theory that science was starting to contradict some of our dearly held beliefs came when an instructor explained that research had shown that massage didn’t, as was commonly claimed, reduce lactic acid in muscle tissue. We’d always been told that 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 proved that, in fact, massage didn’t reduce 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 isn’t because of lactic acid. How does massage decrease soreness? We don’t clearly know how it happens but we do know that it does happen.
Although one of massage therapy’s sacred cows had just been slain, I liked it that this particular instructor was paying attention to science and research and was more interested in understanding the truth of that which was happening instead of defending a tradition that may not be supportable.
Shortly afterward I came across Neuromuscular Therapy, sometimes referred to as Trigger Point Therapy, and the work of Travell and Simons. Drs. Travell and Simons spent many years 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 tools to work effectively with some common pain conditions. It also began to give me the knowledge and vocabulary to speak intelligently to physical therapists and physicians about my clients and their patients. It started me down the road of an evidence based practice, a path which I strive to follow even today.
Massage Based on Evidence
Evidenced based massage therapy is therapeutic massage 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 may alleviate anxiety and depression.
Lots of the claims made and practices utilized by massage therapists are founded on tradition rather than evidence. While there is not yet a big body of knowledge documenting the physiology of and ramifications of therapeutic massage, if we were only in a position to make statements strictly based on scientific studies, we would be severely limited, indeed. deweyshouse.com Some people prefer the term evidence informed practice as more accurate. An evidence informed practice takes under consideration scientific evidence, clinical experience, and careful observation.
I assumed this reliance on tradition was primarily confined to the field of therapeutic massage and was surprised one day when I found a big display about evidence based medicine in the halls of St. Louis University Medical School. Apparently, even yet in conventional medicine, many procedures are done because that’s the way they have always been done and are definitely not supported by evidence that they are the best way as well as effective.
In science, one always must most probably to new evidence and become willing to change your brain when met with new information that contradicts formerly held beliefs. Another 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 strain hormone cortisol nearly around had been previously thought and, in fact, its effect on cortisol may be negligible. I’m sure I had not been the only massage therapist who was simply startled by this news. However, once I got over the initial shock, I examined the evidence he presented. It took awhile for me personally to understand but in the end it seemed that he had very good evidence to support 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. For starters, as a therapist, I want to guarantee that the claims I make to my clients are truthful. I do not want to mislead them by making unsubstantiated claims. In addition, I really believe that the more we’re able to understand, the more effectively we may be in our work. Finally, I believe that the more we are able to document the ways that massage therapy are a good idea, the more accepted it will become.