October 09th 2019 - We all know that therapeutic massage is good for you. But do we really know why? In fact, the benefits are so profound that massage therapy is among the alternative treatments mentioned in CT House Bill 7159 which addresses the opioid epidemic.
Governor Ned Lamont signed this bill into law and it went into effect on October 1, 2019. The bill requires MDs to discuss non-opioid pain control measures with patients whose treatment plans are 12 or more weeks in length. Massage therapy is mentioned in the bill as one of the safe solutions to address short-term and long-term pain.
CT is not the only state passing legislation about non-opioid pain management which includes clear endorsements of massage therapy. In July 2019, Florida passed a law requiring their Department of Health to create and publish an online educational pamphlet including massage therapy as one of the non-prescription alternatives for pain management.
Other states are following suit and massage as an alternative to opioids is a current news topic nationwide. Yet, massage is one of the oldest among all methods of healing and the idea that it relieves pain has been noted since ancient times. As far back as the 4th century B.C., Hippocrates, known as the "father of medicine," sang the praises of this hands-on therapy, saying that “healing begins with an aromatic bath and daily massage.”
The original physicians of our times knew that touch was a primary method through which pain relief and many more health benefits could be achieved. The myriad positive effects of massage have long since been researched and documented. And this hands-on art has evolved into a highly specified science that combines touch with a wide array of specialized techniques to relieve pain and bring the body back into balance.
Massage Benefits: Beyond the Miracle of Touch
The cumulative effect of receiving a massage goes beyond the simplicity and miracle of just being touched. There are physical, mental and emotional benefits keyed into action through the millions of sensory receptors in the skin. The relaxation response prompts the body to reset its inner equilibrium and return to greater health and well being. And this all translates into a significant number of tangible results.
The physical benefits of receiving therapeutic massage are rich and varied: a deep sense of relaxation, reduced stress, relief from muscle tension and pain, greater joint flexibility and range of motion, faster recovery from muscle strains and sprains, deeper, easier breathing, healthier, better-nourished skin, improved blood and lymph circulation, reduced blood pressure, improved immune function, increased disease prevention, increased capacity for clearer thinking and a greater ability to monitor and respond to stress signals.
The emotional rewards of massage include a feeling of well-being, ease of emotional expression, and fulfillment of the need for caring and nurturing touch. Enhanced self-image, reduced levels of anxiety, and increased awareness of body-mind connection produce a feeling of being unified and in harmony with self and the world. Who doesn’t need all this to simply navigate each day in our tension-filled, on-the-go culture?
If this description hasn’t convinced you of the value of therapeutic massage, then perhaps a tour through some clinical results will: Though every bodily system is positively affected by this therapy, the circulatory system is one the main beneficiaries. As tension is kneaded out of soft tissue, circulation is improved, delivering fresh blood and nutrients system-wide. As blood supply and delivery is improved, there is an increase in the interchange of substances across cell walls, heightening tissue metabolism.
Fresh blood, oxygen and nutrients flush the cells of debris. Connective tissue is stretched, improving its circulation and breaking down the formation of adhesions. Muscle tone is also improved, helping to prevent or delay atrophy resulting from forced inactivity.
Massage benefits the digestive system by encouraging absorption of nutrients and easy elimination of waste. Acting as a ‘mechanical cleanser,’ massage also mobilizes lymph and hastens its elimination from the body. Inflammation is on the list of beneficiaries too: massage disperses edema, alleviates pain and facilitates improved tissue and joint movement, especially as a part of post-injury care.
The urinary system benefits as the kidneys are stimulated by enhanced circulation, increasing the renal excretion of fluids, nitrogen, inorganic phosphorus, and salt. And let’s not forget the heart itself: massage supports the return of venous blood, easing the strain on this vital organ. This compensates, in part, for lack of exercise incurred as a result of injury, illness or age. Finally, massage just makes you feel relaxed; a positive result of the sedative effect it has on the nervous system.
Statistics: Who Receives Massage
Perhaps due to this wide array of benefits, the general public has increasingly turned to massage therapy as a method of preventative care. Here are some statistics about massage that were catalogued in the American Massage Therapy Association’s 2018 Consumer Survey: Between July 2017 and July 2018, an average of 19% of adult Americans received at least one massage. Within this timeframe, roughly 50 million American adults had also discussed massage therapy with their doctors or health care providers. And 62% of those who had massage received it for medical or health reasons such as pain management, injury rehabilitation, or overall wellness.
Cedars-Sinai Research: Massage Improves Immune Function & Stress Reduction
Research drives these impressive statistics and confirms massage therapy benefits. One example is a study featured in the October 2010 issue of The Journal of Alternative and Complementary Medicine entitled “A Preliminary Study of the Effects of a Single Session of Swedish Massage on Hypothalamic–Pituitary–Adrenal and Immune Function in Normal Individuals.” The study synopsis indicated that massage has positive effects on both immune function and stress hormone production.
The study was conducted at Cedars-Sinai Medical Center in Los Angeles to determine the effects of a single massage session on neuroendocrine and immune function. Fifty-three healthy adults, ranging in age from 18–45, were split into two groups. One group received Swedish massage, while the other received what was described as light touch. Blood samples were taken immediately before and up to an hour after receiving the therapies.
The results indicated that Swedish massage produced increases in the number of lymphocytes; white blood cells that are part of the immune system. Lymphocytes include natural killer cells which defend against tumors and virally infected cells, as well as T cells and B cells which act to eliminate specific pathogens or pathogen-infected cells. Swedish massage was also shown to decrease the levels of the stress hormone cortisol, and arginine vasopressin, a hormone that can lead to increases in cortisol.
Cortisol is produced by the adrenal glands in response to stress. In times of crisis, cortisol generates what we know as the “fight or flight” response. After the crisis has passed, cortisol levels gradually return to normal. However, when one is under constant stress, the adrenals may be stimulated to continue to produce cortisol which delays bodily functions, such as blood pressure and heart rate, from returning to normal function.
If a single Swedish massage session can improve immune system function and assist the body in staying out of fight or flight mode, imagine the health benefits of regular massage. The evidence in this study corroborates the anecdotal findings of millions of consumers: massage is an antidote to stress, improves overall health, and just makes you feel good.
Massage Therapy Education & Training Requirements
Though the practice of massage therapy currently requires licensure or certification in most states, there is currently no national standard for massage therapy licensing. So, the level of training necessary to become a massage therapist varies by state. According to a massage regulation guide maintained by the Associated Bodywork and Massage Professionals and updated in March 2019, only 4 states do not have any regulatory requirements for massage therapy: Kansas, Minnesota, Vermont and Wyoming. It should be noted that within these 4 states which have no district-wide laws concerning massage therapy, there may be local requirements with which massage therapists have to comply in order to practice.
In the states that require regulation, passing either a licensing or certification exam is necessary to legally practice massage therapy. Each state that requires licensure also designates a mandatory number of educational hours necessary to qualify for the licensing exam. The number of required educational hours range from 500 to 1000, with New York, Nebraska, and Puerto Rico leading the charge as the only states currently requiring the maximum of 1000 hours of study.
Massage therapy coursework typically includes topics such as anatomy, physiology, neurology, myology or kinesiology, pathology, the theory, technique and practice of a wide variety of western massage and bodywork methods, the chemical ingredients of products that are used and their effects, the theory, technique and practice of oriental massage and bodywork methods, infection control procedures, laws and safety, hygiene, first aid and CPR.
Supervised, hands-on practice is also a central part of the mandatory educational hours. Most states require over 100 hours of hands-on practice to take the licensing exam. This clearly defined curriculum solidly prepares the student for licensing and offers invaluable experience in real-life application of skills.
Receiving Therapeutic Massage – What to expect
Though the level of training commands respect and consumer consumption of massage as an alternative to opioids is on the rise, there are still people who have never experienced it. So, it seems fitting to briefly describe what takes place in a session for those who are unfamiliar with this healing method.
First-time clients are asked to fill out an intake form which reviews personal medical history, current medications and reasons for scheduling an appointment. Therapists are trained to understand health conditions that may be contraindicated for massage and how to work collaboratively with their client’s physicians to determine the safest and most productive approach.
Most massage sessions are about 50-60 minutes in length, though 90-minute sessions are not uncommon, and 30 or 45 minutes of specific work can be productive for a very focused area of the body, such as a problem knee or shoulder. The session begins with the recipient lying face down between sheets on a massage table. The therapist commonly uses lotion or oil to massage tension out of the muscles, uncovering only areas being worked. Muscle tension can also be addressed with gentle compression offered through the sheet.
While lying face down, the areas addressed are the soles of each foot, backs of the legs, arms, the back, neck and shoulders. Then the recipient turns face up and the therapist moves on to work with the scalp, facial muscles, neck, shoulders, arms, hands, legs and feet again.
The relaxation response is deeply triggered, prompting the body to offload stress and tension. The result is a feeling of complete and total inner peace. In fact, falling asleep or entering a meditative state of mind is a common response to receiving massage. This mental break from daily stressors, combined with all of the physical benefits that are keyed into action produce profoundly healing effects that reverberate beyond the session itself.
How to Locate a Licensed Massage Therapist
At this point, you might be saying ‘Sign me up!’ If you’re wondering how to find a licensed massage therapist, there are many professional associations which list massage therapists by state. A few of these include the Associated Bodywork and Massage Professionals (ABMP), the American Massage Therapy Association (AMTA), and The National Certification Board for Therapeutic Massage & Bodywork (NCBTMB).
Please also check with your local massage school to see if they offer discounted rates for massage therapy at their public clinics. Whatever you do, don’t delay in treating yourself to this wonderful experience.
Professional Profile: Hallie Sawyers is licensed in therapeutic massage in both CT and NY since 1996. She is a well-known and respected educator with extensive training in energy work and body-centered therapies. Hallie is Board Certified in Therapeutic Massage, Nationally Certified in Holistic Aromatherapy, a Traditional Usui Reiki Master Teacher, Certified in Polarity Therapy, Reflexology, a Master Instructor of Integrated Energy Therapy, an approved continuing education provider for the National Certification Board for Therapeutic Massage and Bodywork and an instructor at Cortiva Institute in Cromwell, CT. To learn more, visit www.soulsong.abmp.com.
Hallie Sawyers, LMT APP BCTMB