The Healing Power of Massage
by Dr. Andrew Weil
In the 1970s I spent a lot of time traveling in remote areas of Latin America, collecting information about medicinal plants and traditional methods of healing. Whenever I arrived in an Indian village in the Colombian Amazon, people would stare in amazement at my bald head and beard and without any self-consciousness begin rubbing my head and twining their fingers in my beard. These and other hands-on encounters in my travels caused me to realize just how touch-deprived we Americans are, and studies corroborate my observations-showing, for example, that French couples in a café casually touch each other an average of 110 times an hour, while American couples touch each other only twice.
Human beings need to touch and be touched. A great deal of animal and human research shows that individuals deprived of physical contact are insecure, poorly adjusted, and more prone to illness. Fortunately, our rising acceptance of “alternative” health care has brought a surge of interest in healing touch, making therapeutic massage the second most popular alternative modality in this country. Massage therapy encompasses a wide range of therapeutic approaches (see the box below for a brief sampling), all of which use hands-on manipulation of muscles and soft tissues. Once perceived as little more than a luxurious form of relaxation, massage therapy has emerged as a powerful means of treating not only stress-related ailments such as insomnia, headaches, and irritable bowel syndrome but also countless health conditions ranging from sciatica to sinusitis, from dermatitis to diabetes and depression.
The Magic Touch
How can the simple act of touch promote so many health benefits? For one thing, the skin is the body’s largest organ, containing more than five million touch receptors that send messages to the brain. Research shows that the rhythmic pressure of massage lowers your heart rate and blood pressure while improving blood circulation, ferrying oxygen and other nutrients to the cells and removing waste products (such as lactic acid) from the muscles. It also promotes the flow of lymphatic fluid (enhancing immune function), lowers levels of stress hormones, and boosts production of endorphins, the body’s natural painkillers.
While the health effects of massage therapy have been studied scientifically for more than 120 years, a surge in research over the last two decades has resulted in more than 100 published studies, many of them conducted by the University of Miami School of Medicine’s Touch Research Institute. Among the findings:
o Preterm newborns. A groundbreaking study of 40 preterm infants found that those given a gentle, 15-minute massage three times a day for several days gained 47 percent more weight, became more responsive, and left the hospital six days earlier than controls (Pediatrics, May 1986).
o HIV and immunity. A controlled study of 20 HIV-positive men who received a 45-minute massage five times weekly for a month showed that natural killer cells increased (suggesting positive effects on the immune system), and that anxiety, stress, and cortisol levels were significantly reduced (International Journal of Neuroscience, February 1996).
o Asthma. Thirty-two children with asthma received either massage or relaxation therapy from their parents for 20 minutes before bedtime for 30 days-and only the massage group experienced increased peak air flow, improved pulmonary function, and decreased levels of stress hormones. What’s more, levels of anxiety decreased in the parents as well (Journal of Pediatrics, May 1998).
I’ve prescribed massage for people with neuromuscular disorders and stress-related ailments as well as patients in rehabilitation from injury or those who are simply lacking human contact. Generally I’ll tailor my recommendation to the needs of the patient-suggesting shiatsu for someone with chronic neck and shoulder pain, for example, or Swedish massage for first-timers whose main goal is relaxation.
Rubbed the Right Way
While massage therapy has enjoyed a rise in acceptance in recent years, I still encounter a fair number of patients who resist the idea-saying they can’t afford it or are afraid of being touched by someone they don’t know. Whatever their reason, I find that explaining what to expect goes a long way toward melting their resistance.
Generally, an initial visit to a massage therapist begins with a brief interview, during which the therapist asks you about your physical condition, medical history, stress level, any painful areas, and your goals for the massage. Feel free during this exchange to let your preferences be known-if there are parts of the body you don’t want worked on, say, or whether or not you want to talk during the massage.
Before the massage begins, you may be asked to remove as much clothing as you’re comfortable with and given a sheet, towel, or gown to drape over yourself while lying on a specially padded table or chair. In many forms of massage, oil is applied to your skin. Once the massage begins, you can make it more enjoyable by taking deep, relaxing breaths and giving the practitioner feedback (let him know, for example, if you feel any discomfort). I’ve had many types of massage and have found that I benefit most by being totally passive and surrendering to the work of a skilled therapist.
Note that there are some conditions for which massage may not be recommended: According to the American Massage Therapy Association, you should consult with your physician before getting a massage if you have inflammation of the veins (phlebitis), any infectious disease, some types of skin conditions, certain cardiac problems, or some forms of cancer. Be aware that this last restriction is a controversial one, however: I myself have not seen any evidence that massage poses a risk to cancer patients, while its benefits in cancer cases-including a significant increase in immune-boosting natural killer cells-are well documented and continue to be studied.
Finding a Practitioner
As with many modalities, your experience with massage will depend greatly on the skill of the practitioner. You might start by asking your friends if they can recommend a good massage therapist, or you can call the American Massage Therapy Association (contact information below) and request a list of practitioners in your area.
While even the most impeccable credentials do not guarantee skill, I would suggest looking for a therapist who is licensed (massage therapists are currently licensed in 25 states and the District of Columbia) and has graduated from a training program approved or accredited by the Commission on Massage Training Accreditation (COMTA). Certification from the National Certification Board of Therapeutic Massage and Bodywork (NCTMB) is another sign that a practitioner has the highest credential in the field.
The cost of a massage will vary with the type and length of treatment, the experience of the practitioner, and your geographic location, but you should expect to pay between $30 and $100 for an hourlong session. Some insurance companies are beginning to extend coverage to massage therapy-especially if patients are referred by their physicians-but check first with your own plan. For more information, contact the American Massage Therapy Association at (847) 864-0123 or http://www.amtamassage.org/.
What Type of Touch?
There are many forms and variations of massage therapy available-too many to list here. Just to get you started, however, here are brief descriptions of five major types. Many massage therapists draw from a repertoire that mixes more than one style.
Swedish massage. The most common type of Western massage, this gentle therapy uses a classic series of long strokes, kneading, and other techniques. It may be used to help reduce pain (such as tension headaches), speed recovery from injury, keep unused muscles from atrophying, relieve insomnia, stimulate alertness, and most of all, promote relaxation and reduce stress.
Sports massage. You don’t have to be an Olympic contender to benefit from the vigorous, deep-tissue work of sports massage: It can be used by anyone to promote greater flexibility, loosen muscles, and relieve muscle swelling, as well as to diminish pain and restore full range of motion after injuries such as tendinitis and ligament sprains.
Trigger-point therapy (a.k.a. myotherapy or neuromuscular therapy). This technique applies concentrated pressure to “trigger points”-areas of irritability in the muscle that are palpable as lumps or knots, and which may refer pain to another part of the body. The goal of therapy is to apply sufficient pressure to specific trigger points to release their chronic contraction (you may feel some pain in the process), then to stretch the surrounding muscles to help prevent recurrence.
Shiatsu. This traditional healing art from Japan makes use of firm finger pressure applied to specific points on the body, with the intention of balancing the flow of chi, or vital energy. The client lies (clothed) on a padded surface on the floor, with the therapist seated alongside. Shiatsu has been used successfully to treat a wide range of ailments, from low back pain and nervous disorders to sinus problems and constipation.
Thai massage. Also done through light clothing on the floor, this form that is growing popular in North America combines stretches with hand pressure in a meditative, dancelike session that most people find pleasant.