HI Lainey,
Yes there are some key studies that massage therapy rests upon. One of these the study you cite in your report with the finding:
Findings indicated massage therapy reduced inflammation through production of inflammatory cytokines; and promoted mitochondrial biogenesis, promoting enhanced recovery. However findings did not support the popular notion that massage therapy clears lactic acid from muscle tissue; nor did glycogen levels change.”
You also provide the link to painscience.com which is an excellent blog written by a massage therapist as you will probably know and dedicated to the critical evaluation of massage science.
Paul Ingram also provides a critique of the Crane et al study.
https://www.painscience.com/articles/research-crane.php
Providing this link to by David Gorski:
https://www.sciencebasedmedicine.org/massage-therapy-decreases-inflammation/
So what does David Gorski have to say about the Crane study?
Thus, the proper conclusion of this study is that there was little or no significant effect in inflammation-related gene expression from massage. That would have been perfectly fine as a conclusion. After all, negative studies happen and should be published.
Yet that’s not what was concluded. They did not report what was in essence a negative study.
Instead, the authors concluded that they had found that massage was anti-inflammatory, and that that’s how it “works.” They concluded that it “promoted mitochondrial biogenesis” without showing any evidence for anything other than the thinnest of thin evidence, a small increase in one signaling protein that promotes mitochondrial formation. And the news media ate it up.
None of this is to say that massage is useless or that it might not have therapeutic benefit in some circumstances. What this is to say is that this study, contrary to how it’s being portrayed, is not slam-dunk evidence that massage is some sort of “non-drug” treatment for inflammation that can replace non steroidal anti-inflammatory drugs. Unfortunately, whether because the authors were naive or desperate to salvage something from a study that didn’t show very much, that’s not how it was sold. The media might be guilty of overselling this study, but at least one of the authors was either complicit or didn’t realize how his words would be represented. Now this study is out there; look for massage therapists who are into woo to be pointing to this study for years to come as “proof” that massage is anti-inflammatory and “regenerates mitochondria.”
I find massage therapy seems to be a meme complex, which has "self replicating and mutating patterns of information that are assumed to be relevant for scientific study."(thank you Wikipedia).
The assumption is made that mechanical manipulation of the tissues is beneficial and that mechanical manipulation of the tissues is the mechanism of any benefit that results from a treatment session.
What studies are actually showing is that the therapeutic alliance between practitioner and client is in fact the number one consistent factor which influences client and patient outcomes. This is across the board, massage, physiotherapy, medical practitioners, psychotherapists everyone.
So what is actually going on. Why does massage feel so good when you find a good massage therapist. And why do we crave deep tissue painful massage? For one thing pressure shuts down the muscle tension resulting from the Hoffman reflex. But it will and does come back if that is the only component employed. A good massage will combine a variety of therapeutic ingrediants keeping in mind the care and attention by the therapists plays a big role.
Now we can weave together how the vagus nerve is stimulated by human communication resulting in rest and recovery. The sensory experience described by Diane Jacobs as dermoregulation causes a relaxation response also. Myofascial release (MFR) by a forceful stretch can be ruled out and painscience.com also does have a good list of articles that discuss this. However fascial unwinding may well be a key phenomenom in bodywork. Ideomotion is perhaps a better model that describes whats happening here.
From my last report:
Various theories exist to explain MFR: neurobiologic, ideo-motor action and consciousness model. These combine to present a reasonable hypothesis that explains MFR as a tissue response to sensory input which is mediated by the central and autonomic nervous systems (28).
MFR is possibly a mechanism that reduces pain. A randomised controlled trial (n= 120) involving adults with either neck pain or non-specific low back pain used ultra sound screening to show increased organ mobility within the myofascia of the neck and abdomino-pelvic region after application of both direct and indirect fascial release techniques. Fascial gliding of the organs increased and this was correlated to reduced pain scores (29). A randomised controlled trial involving nurses with chronic low back pain (n=74) investigated the effects of MFR plus specific back exercises on the thoracolumbar and posterior muscles of the pelvis, compared to sham MFR plus SBE. At eight weeks MFR participants experienced a 53.3% reduction in pain and a 29.7% reduction of disability scores. The control group experienced compared 26.1% and 9.8% drop respectively (30). Movement of and between tissues is the key concept of MFR.
What is ideo-motor movement?
Ideo-motor movement is defined as automatic movement not consciously directed. Or actions that can be described as expressions of dominant ideas (31, 32). For example thoughts becoming speech or tasks originating from sequential learning such as tying a shoelace. These actions can be intentionally induced or are elicited when a desired movement inhibitory control is relaxed (32, 33). Movement phenomena that have historically been attributed to para-normal activity are comprehensible as reflex functions of the brain expressed as ideo-motor actions (31). It has been proposed that the facilitation of fascial unwinding in indirect MFR is better explained as a ideo-motor expression rather than the release of stored potential energy in the fascia (28, 34).
How does ideo-motor movement help chronic pain?
It is proposed ideo-motor movement allows the body to reduce the experience of painfully stressed tissues due to tension (33, 34). One example of this therapy is named “Simple Contact”. In its application gentle contact is made by the therapist with their hands to stressed areas of the body which does not introduce movement rather follows and supports it (34). Other examples of therapy’s that utilise ideo-motor movement are “Authentic Movement”(35) and “Trauma Release Exercise” (36). Simple Contact was used in a single case design study of a 40 year old female with a ten year history of cervical pain (37). An absolute reduction of pain intensity at the conclusion of the study was demonstrated which was more pronounced during the three week treatment phase. The advantage of ideo-motor therapy is that it enlivens muscle tissues and activate myofascial
28. Minasny B. Understanding the process of fascial unwinding. Int J Ther Massage Bodyw. 2009;2(3):10-7.
29. Tozzi P, Bongiorno D, Vitturini C. Fascial release effects on patients with non-specific cervical or lumbar pain. Journal of bodywork and movement therapies. 2011;15(4):405-16.
30. Ajimsha MS, Daniel B, Chithra S. Effectiveness of Myofascial release in the management of chronic low back pain in nursing professionals. Journal of Bodywork & Movement Therapies. 2014;18(2):273-81 9p.
31. Stock A, Stock C. A short history of ideo-motor action. Psychological research. 2004;68(2-3):176-88.
32. Knuf L, Aschersleben G, Prinz W. An analysis of ideomotor action. Journal of Experimental Psychology: General. 2001;130(4):779.
33. Rickards L. Ideomotor Movement in Pain Management.
34. Dorko BL. The analgesia of movement: ideomotor activity and manual care. Journal of Osteopathic Medicine. 2003;6(2):93-5.
35. Wyman‐McGinty W. The body in analysis: Authentic movement and witnessing in analytic practice. Journal of Analytical Psychology. 1998;43(2):239-60.
36. Berceli D. The revolutionary trauma release process: Transcend your toughest times: Namaste Pub.; 2008.
37. McCarthy S, Rickards LD, Lucas N. Using the concept of ideomotor therapy in the treatment of a patient with chronic neck pain: a single system research design. International Journal of Osteopathic Medicine. 2007;10(4):104-12.
38. Levine PA. Waking the tiger: Healing trauma: The innate capacity to transform overwhelming experiences: North Atlantic Books; 1997.
