If you maintain with the world of massage therapy, you will eventually observe that there are several new ideas and terms going around. Evidence based massage. Evidence based practice. Evidence informed practice. Science based medicine. What does it all mean?
Massage Based on Tradition
When I went to massage school, a lot of what we were taught was predicated on tradition or what was perceived to be common 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 ought to drink lots of water after a massage so 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 mass. 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 must be reducing the current presence of lactic acid, right?
When someone finally did some research, it turned out 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 is not because of lactic acid. How does massage decrease soreness? We don’t clearly know how it happens but we can say for certain that it does happen.
Although among massage therapy’s sacred cows had just been slain, I liked it that this 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 came across Neuromuscular Therapy, sometimes known as Trigger Point Therapy, and the task of Travell and Simons. Drs. Travell and Simons spent many years documenting the phenomena of trigger points and writing the two volume set Myofascial Pain and Dysfunction: The Trigger Point Manual. Studying their work gave me the tools to work effectively with some typically common pain conditions. It also begun 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 that i strive to follow even today.
Massage Based on Evidence
Evidenced based therapeutic massage is massage therapy founded on ideas and principles supported by evidence. There is scientific, documented evidence to support the existence of and treatment of trigger points. There’s documented evidence that massage relieves muscle soreness and may alleviate anxiety and depression.
Many 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 massage therapy, if we were only able to make statements strictly on the basis of scientific studies, we’d be severely limited, indeed. Some people choose 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 large 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 been done and are definitely not supported by evidence they are the best way and even effective.
In science, one always must be open to new evidence and be willing to change your brain when met with new information that contradicts formerly held beliefs. 대밤 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 levels of the stress hormone cortisol nearly just as much as have been previously thought and, actually, its effect on cortisol may be negligible. I’m sure I had not been the only massage therapist who was startled by this news. However, once I acquired over the initial shock, I examined the evidence he presented. It took awhile for me to understand but in the finish it seemed he had very good evidence to aid his conclusions. Does this imply that massage does not “work?” Well, it’s obvious that massage makes us feel better, we just don’t know why or how.
Does it certainly matter if we understand? I think so. First of all, as a therapist, I would like to be 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 may maintain our work. Finally, I believe that the more we are able to document the ways that massage therapy can be helpful, the more accepted it’ll become.