Massage Therapy

Massage therapy can be a welcome respite – complete with clinically proven, wide-ranging results. Massage therapy is manipulation of soft body tissues applied in a painless and comforting way to treat, heal and balance the mind, body and soul. Massage is deemed a complement to conventional medicine used primarily for well-being, comfort, pleasure, healing, relaxation and pain relief.

Massage therapy and Cerebral Palsy

Massage therapy is the manipulation of soft body tissues – muscles and connective tissues – for the purpose of relaxation, healing and rehabilitation. It is widely recognized as a complementary form of medicine that rejuvenates the mind, body and soul.

Mind

Massage can be helpful to those struggling with depression, attention-deficit, anxiety or stress. It can bring clients to a neutral state of momentary peace-of-mind, and leave them feeling happier, more focused, and ready to embrace life’s next challenge with a renewed sense of peace and vigor.

Body

Massage therapy has many clinically-proven therapeutic and rehabilitative benefits to the body’s musculoskeletal, lymphatic and circulatory system. Some deep forms of massage release fibrous bands that form between tissues and organs.
Light and superficial forms of massage can interrupt pain perception experienced in chronic pain.

Massage can aid the circulatory system by facilitating oxygen and nutrients to tissues and vital organs. This form of therapy is also thought to stimulate the lymph system into releasing toxins. Some believe massage can release endorphins, which aid the body’s natural pain killers.

Some massage techniques use passive exercise and stretching aimed at improving range-of-motion and stretching atrophied muscles. Massage is also believed to assist with bloating, inflammation, water retention, and sluggish metabolisms.

With so many positive effects, it comes as little surprise that, for many, massage has become an important part of warm-up, training, warm-downs, rehabilitation, well-being, and injury recovery.

Soul

Massage is said to impart holistic value. Holistic medicine purports balance through the physical, nutritional, emotional, and spiritual aspects of health. It is non-invasive, natural and pleasurable. The power of touch is delivered in a refreshingly tranquil, serene, and soothing atmosphere by trained professionals.

It is said to take individuals to a euphoric, natural, healthy state of contentment and pain-free relaxation. It is known for its healing, relaxation, and balancing powers.

To learn more about massage therapy:

• What is massage therapy?
• Why do people seek massage therapy?
• How does massage therapy affect the body systems?
• Who seeks massage therapy?
• Where do individuals go for massage therapy?
• Who performs massage therapy?
• What to expect during massage therapy
• What not to expect during massage therapy
• Is there any risk to massage therapy?

These are detailed below.

What is massage therapy?

The purpose of massage therapy is to improve muscle functionality through direct contact stimulation. Touch is applied with some degree of pressure and movement directly on the skin.

Massage therapists target various soft tissues of the body, such as:

• Body systems
• Connective tissue
• Joints
• Ligaments
• Lymphatic vessels
• Muscles
• Organs
• Skin
• Tendons

Through the power of touch, massage manipulates and mobilizes muscles and the body’s connective tissues in an effort to:

• Provide balance
• Enhance function
• Promote relaxation
• Increase range of motion
• Reduce stress
• Relieve pain
• Improve circulation
• Provide well-being

More than 180 massage techniques are recognized and used in various ways to achieve therapeutic results. Massage therapists employ hands, elbows, fingers, forearms, knees, palms or thumbs when performing massage, primarily to the client’s face, head, neck shoulders, arms, hands, back, legs, tummy and/or feet, depending on the client’s goal and preference. Professional massage by a licensed professional is never performed on the genital or breast areas of the body.

The different techniques used in massage include:

• Compressions
• Friction
• Gliding
• Holding
• Joint movement (active and passive)
• Kneading
• Percussions
• Pinching
• Pressure (structure, unstructured, stationary, motion or vibration)
• Rocking
• Rubbing
• Shaking
• Stretching (active, passive, resisted)
• Stroking
• Tapping
• Touching
• Traction
• Vibration

Manual or mechanical aids may be utilized to achieve results, they include:

• Hot or cold packs
• Aromatherapy
• Background sounds or music
• Oils, emollients, liniments, antiseptics and lubricants
• Massage tables or chairs
• Saunas
• Stones
• Vibration tools
• Warm towels or body wraps
• Water
• Nonprescription topicals

What are the benefits of massage therapy?

According to the American Massage Therapy Association (AMTA), of those polled, an overwhelming number of Americans, 86%, agree that massage is beneficial for health, wellness and pain relief. A person does not have to be ill or sore to benefit; massage is popular for many reasons. Benefits fall into one of the following six categories:

• Physiologic benefits
• Emotional benefits
• Mental benefits
• Physical benefits
• Therapeutic benefits
• Well-being

As the number of techniques increase and acceptance of massage as a complementary procedure grows, the list of reasons a person chooses massage is also expanding. According to AMTA, 32% of those who had massage in the last five years did so for pain management, injury rehabilitation, migraine control, or overall wellness. Some common reasons include:

Pain management – Of those Americans who had a massage between July 2008 and July 2009, 85% agreed massage was effective in reducing pain; however, only 19% initially pursued massage to reduce or manage pain.

Stress management – Stress management was cited by 40% of Americans who sought massage therapy, according to AMTA’s 2010 consumer survey.

Complementary medicine – Massage therapy is increasingly accepted by both patients and the medical community as a valuable complementary component to conventional medical treatments. In 2009, two-thirds of massage therapists reported to AMTA that 1.5 referrals per month came from health care practitioners. An increasing number of studies aimed at determining the effectiveness of massage therapy are currently underway. In July 2009, the AMTA reported that 39 million American adults discussed massage therapy with a health care provider. Of those, 35% reported the health care practitioners strongly recommended massage. Those recommending massage to patients include:

• 55% Physicians
• 48% Chiropractors
• 42% Physical therapists

In 2007, 37.3% of hospitals offered massage therapy.

• 71% of hospitals offered massage to reduce patient stress
• 69% of hospitals offered massage to reduce employee stress
• 66% offered massage for pain management
• 57% offered massage for cancer patients
• 53% offered massage for pregnancy
• 45% offered massage for mobility and movement training
• 41% offered massage for palliative care

According to the AMTA, massage therapy is a clinically proven method of relief for symptoms related to the following conditions and/or the side effects of treatment:

• Anxiety
• Breast cancer
• Carpal tunnel
• Circulation
• Depression
• Heart bypass surgery
• Hypertension
• Immune system strength
• Low back pain

Health and wellness – The power of touch has long been cited as a basic human need. It is no wonder massage is considered pleasurable, calming, soothing and euphoric. Of those surveyed from July 2008 to July 2009, 85% agree massage can be beneficial to health and wellness, according to the AMTA. Some also report seeking massage for:

• Balance
• Comfort
• Contentment
• Enjoyment
• Escape
• Euphoria
• Happiness
• Healthy state
• High spirits

How does massage affect the body’s organ systems?

The human body contains 11 major organ systems, and massage can affect these systems in differing ways. Before beginning, a massage therapist should understand a person’s medical health, as well as any benefits the individual would like to achieve during the massage. A person does not have to be ill or sore to benefit; massage is popular for many reasons. Benefits often fall into one of the following six categories:

• Physiologic benefits
• Emotional benefits
• Mental benefits
• Physical benefits
• Therapeutic benefits
• Well-being

Following is a list of major organ systems and how massage can assist. Click below to learn more about how massage therapy affects the major organ systems:

• Circulatory System
• Endocrine System
• Gastrointestinal (Digestive) System
• Integumentary System
• Lymphatic system
• Muscular System
• Nervous System
• Reproduction System
• Respiratory System
• Skeletal System
• Urinary System

Who seeks massage therapy?

According to a 2009 consumer survey conducted by the American Massage Therapy Association, in the United States 40% of women and 25% of men sought massage therapy in the previous five years. Although those with health conditions, pain or injuries can surely benefit from massage, a person does not have to be ill or feel sick to benefit from massage. Those that are healthy and well, derive benefits, too. Massage therapy can benefit those who:

• Are healthy and well
• Have impairment or disability
• Are chronically, seriously, or terminally ill
• Are in pain
• Are injured
• Are in rehabilitation; recuperating from medical procedures

Massage can assist those of any age, from infants to seniors. Baby and infant massages are sometimes given to comfort and relax young children, especially if colic exists. Those being treated by a physician, psychologists, orthopedic surgeon, chiropractor, or other medical professional may also find massage therapy beneficial as a complement to other forms of treatment.

Women who are pregnant are strongly advised to seek a physician’s approval prior to undergoing any massage therapy. Even though massage therapy can be beneficial pregnancy, it can also be harmful if performed at certain stages of the pregnancy and in a particular manner. Doctor’s approval is recommended as massage can encourage premature labor.

Athletes and those in rigorous health and fitness routines may benefit by massage in many ways from well-being, to warm-up, relaxing muscles, rehabilitate post-operatively, to treat sore problematic areas, and for warm-down sessions.

Seniors often seek massage therapy for aches, pains and relief from chronic health conditions.

Where do individuals go for massage therapy?

Massage therapy is offered in various types of facilities from spas, to sports facilities, health centers and, in some cases, in a person’s home. Some employers have a massage therapist visit their office to provide 10-15 minute stress reducing shoulder massages for interested employees. Sports facilities and senior centers may also provide massage therapy services at their facilities to accommodate their clientele’s needs. According to a July 2009 consumer survey, 24% of those who had a massage received it at a spa.

There are over 180 types of massage therapy, each specializing in different techniques with varying results. The type of massage, the practitioner’s ability to perform that type of massage and the time it takes to perform that type of massage should be verified at the time the appointment is made.

Forms of massage therapy are often performed in the following types of facilities:

• chiropractor’s office
• hotels and resorts
• medical and health care facilities (chiropractor’s,
  hospice, hospitals, physical therapy, and health
  clinics)
• occupational setting
• private home
• private office
• Retail centers (mall kiosks, beauty shops, and barber shops)
• Senior centers (nursing homes, assisted living, and short/long-term care facilities)
• Spas (privately owned and franchised owned)
• Sports centers (athletic clubs, professional sports locker-rooms, and fitness centers)
• Weight loss facilities

Who performs massage therapy?

There are approximately 90,000 massage therapists in the United States.

Training- Approximately 1,500 massage therapy training programs exist in the United States, according to the National Institute of Health. Practitioners are awarded a certificate, diploma, or degrees after expending 500-1,000 hours of training. Training will typically include:

• Anatomy and physiology
• Kinesiology
• Pathology
• Assessment and treatment planning
• Treatment documentation
• Business practice, laws and regulations
• Ethical boundaries
• Body mechanics and self-care
• Massage techniques
• Therapeutic modalities

Licensure – In 2010, 43 states and the District of Columbia enforced laws regulating the massage therapy industry. In some cases, the regulations are locally established.

The Commission on Massage Therapy Accreditation (COMTA) is a nationally accepted independent agency that accredits schools and training programs. The National Certification Board for Therapeutic Massage and Bodywork (NCBTMB) nationally certifies massage and bodywork practitioners. Not all practitioners are nationally certified, though. Common certifications or licenses held by massage therapists include:

• LMT – Licensed massage therapist
• LMP – Licensed massage practitioner
• CMT – Certified massage therapist
• NCTM – Duly licensed to practice therapeutic massage through the National Certification Board for Therapeutic Massage and Bodywork
• NCTMB – Duly licensed to practice therapeutic massage and bodywork through the National Certification Board for Therapeutic Massage and Bodywork

What to expect during massage therapy

Facilities that provide massage therapy usually provide a serene and comforting environment for the massage. Often, the facility will display special permits and therapist licensure on or around the reception area. Helpful tips include:

• Arrive a little early to fill out any necessary paperwork without infringing on allotted therapy time.
• Use the restroom prior to massage for bladder and bowel comfort, cleanliness, and to clear nasal passageway.
• The massage therapist will escort the client to a room equipped with either a massage chair or bed.
• The therapist will conduct a brief consult to review the symptoms, medical history, and expectations of the massage.
• The therapist will leave the room for a short period of time so the client can disrobe to his or her level of comfort and crawl under the covers where they will remain modestly covered at all times.
• The therapist may employ soothing music and aromatherapy. They may employ the use of warm towels or other aids necessary for the chosen massage technique.
• The client is urged to be receptive, relax and to not feel like they need to communicate during the process. The therapist will gently guide or instruct throughout the massage, when needed.
• The client should feel comfortable telling the therapist of any discomfort or concerns at any time throughout the massage.
• The massage will last 40-90 minutes and allow for changing out of, or into, clothing.
• After the massage, the therapist may instruct the client to lay still for a few minutes, get up slowly, and drink water.
• The client usually pays for services after the massage takes place. A tip to the massage therapist for good service is common practice.
• In the United States, a massage can range from $35-$60 per one-hour session. Some insurance providers will provide insurance benefits to cover massage therapy under certain circumstances. The cost of the massage should be agreed upon prior to the service. Insurance coverage should be investigated prior to the appointment being scheduled.
• Some insurance providers require the practitioner to be either certified or licensed. Check with the insurance provider to see if prior authorization is required.
• Massages can be contracted for 10-15 minute chair massages, or up to 1-1.5 hour massages.
• Massage therapy appointments can be prescheduled. Some may like a weekly massage, while others feel they only require a massage 1-2 times per month, or as needed.

What not to expect from massage therapy

There are misconceptions surrounding massage therapy ethics and scope of practice. Following are some items that do not fall under the role of massage therapy (however, this is not a conclusive summary). Massage therapists:

• Do not dispense medical advice or diagnose orthopedic conditions or illnesses.
• Do not perform surgery or any type of treatment that requires a medical license.
• Do not prescribe medications, advise changing your medications, administer drugs, or dispense them.
• Do not manipulate any part of the body for sexual arousal or gratification.
• Do not touch genitalia, private crevices, or female breasts.
• Do not prescribe diet or nutritional counseling.
• Do not provide hypnotherapy, psychotherapy, psychological counseling, or guided imagery.
• Do not perform cosmetology or skin beautification.
• Do not perform colonic irrigation or internal hydrotherapy.

Is there any risk to massage therapy?

Massage therapy seems to have few serious risks if performed by properly trained practitioners who utilize appropriate precautions, according to the National Center for Complementary and Alternative Medicine (NCCAM), a division of the National Institute of Health (NIH) at the U.S. Department of Health and Human Services (HHS).

Most will advise that every person considering massage therapy do so with their primary care physician’s knowledge so health conditions can be considered and treatment is not jeopardized. Those in the medical field will likely make their decision based on clinical studies, their experience, and upon whether the use of massage may cause harm. Before a massage, a massage therapist will ask the client if they have any health conditions that need to be considered. It is important to be honest and open about your health.

Every form of treatment comes with some level of risk; however, the risk of harm from massage therapy is considered relatively low. The following cautions should be considered:

• Blood disorders – Those with bleeding disorders, low blood platelet counts, or taking blood-thinning medications, should avoid vigorous massage. Those with hypertension (high blood pressure) should consult a physician when considering massage treatment.
• Injuries – Massage should be avoided around blood clots, fractures, dislocations, damaged tissue, open or healing wounds, rheumatoid arthritis flare-ups, goiter, or weakened bones (osteoporosis or cancer).
• Infections – Those with a skin disease or experiencing a rash should refrain from massage.
• Surgeries – Massage should be avoided immediately after surgery.
• Cancer – Those with cancer should consult their oncologist before massage, particularly if the massage involves deep or intense pressure. It has been advised that any direct pressure on or around a tumor is not recommended, however some forms of massage appear to be safe and helpful when coordinated with conventional medical oversight. Massage is not recommended immediately after chemotherapy or radiation treatments. In some situations, massage is thought to accelerate the spread of a tumor or tissue damaged due to chemotherapy, radiation or other treatment.
• Pregnancy – Those who are pregnant should consult with their OBGYN before any massage is performed. Massage during certain stages of pregnancies, performed in certain ways or on certain parts of the body may prematurely induce labor. On the other hand, some forms of massage therapy can be helpful during a healthy labor to relax and comfort the mother to a more peaceful state. A massage therapist certified in pregnancy massage is highly recommended if a massage is given during pregnancy. Massage is not recommended in the first trimester or with high risk pregnancies. It is also not recommended to massage the wrist or ankles of someone who is pregnant.
• Health conditions – Do not replace or postpone conventional medical treatment for massage. If you have a health condition, or suspect one, consult your medical provider before pursuing massage therapy. If your massage therapist recommends supplements or special diets, discuss with your doctor before pursuing. Provide your primary care physician with a full picture of what you do to manage your health. Likewise, inform your massage therapist of any health conditions you may have, before treatment. For more information on how to talk with providers regarding treatment options, see NCCAM’s Time to Talk campaign.
• Non-verbal – If a recipient of massage cannot communicate clearly with a massage therapist, arrange a set of nonverbal signals the individual can deploy to ensure the massage therapist's work is welcome and freely accepted at all times.
• Mental conditions – Those with impaired perception should avoid massage.