Massage Therapy: Magic or Medicine?

From Harvard Men's Health Watch

We don't know who gave the first massage or why. But we do know that massage is an ancient art that dates back to the dawn of civilization. The name is derived from the Greek word meaning "to work with the hands, as in kneading dough," and in 400 B.C., Hippocrates wrote, "The physician must be experienced in many things, but assuredly in rubbing."

Medicine has come a long way in the ensuing 2,400 years, and doctors no longer rely on the laying on of hands to heal their patients. Massage has come a long way, too. Masseurs are no longer viewed simply as high-priced locker room specialists (much less as shady ladies who need dough of a different sort), but as therapists.

Massage is respectable, but is it therapeutic? An estimated 25 million Americans visit about 90,000 practitioners 60 million times a year. Many feel better, but are they actually healthier?

Modern Massage
Massage therapy gained a foothold in American medicine in the 1850s when two New York physicians introduced the technique developed by Per Henrik Ling in Sweden. Over the next decade, many hospitals and clinics offered massage to their patients, and physicians themselves often performed the procedure. As medicine grew more complex, nurses and physical therapists took over the task. In time, they, too, turned to other tasks, and massage was all but abandoned in the 1930s. Since the 1970s, however, it has staged a comeback, this time in the domain of alternative medicine.

Techniques
Practitioners define massage as the manual manipulation of the body's soft tissues to reduce discomfort and stress and promote wellness and health. It's a broad definition, and it covers at least 80 different systems of massage.

Swedish massage still relies on Ling's basic work, and it remains the most widely used method in the United States. The typical Swedish massage is performed with the client lying on a special table, either disrobed or wearing undergarments. The therapist will generally ask if the client wishes to leave some parts of his body untouched: if so, those regions, along with the genitalia, are covered with a towel or sheet at all times. The body is usually coated with oil; dim lights, soothing music and scented candles are common but optional.

Swedish massage uses five different techniques. Effleurage (stroking) can be gentle or forceful. Petrissage (kneading) uses the fingers and thumbs to exert pressure in a circular pattern. Friction is more vigorous, with the therapist using his palm, the heel of his hand, or even his forearm or elbow to apply force. Tapotement is a rhythmic percussive slapping or tapping motion designed to stimulate deep tissues. Vibration is the rapid trembling motion of both hands that is intended to facilitate relaxation.

Massage therapists have a variety of backgrounds. Many are trained according to standards set by the American Massage Therapy Association (www.amtamassage.org; 877-905-2700). Groups such as the National Certification Board for Therapeutic Massage and Bodywork provide accreditation, and many states require therapists to be licensed.

A full Swedish massage is usually performed in a private area of a spa, health club, athletic facility, or clinic. Therapists can also set up portable tables in their clients' homes. A typical session lasts 30 to 60 minutes and costs $30 to $100. Briefer, less costly partial massages are offered in a broad range of settings, from airports and hotels to offices and shopping centers. In these circumstances, clients are seated on a massage chair wearing normal clothing.

Many other types of massage are available, each with its own goals and claims; they include neuromuscular massage, sports massage, deep-tissue massage, myofascial release and myotherapy. Related soft tissue manipulations are also incorporated into many other systems, including Rolfing, the Trager and Alexander techniques, and shiatsu.

Goals
Enthusiasts believe that massage strengthens the body, enabling injured tissues to return to normal and heal themselves. Many theories explain how massage might accomplish these goals; they include an improvement of the circulation, the removal of toxins, stress reduction, better sleep, and benefits for the metabolism and the immune system. The most passionate advocates assert that massage can help improve the function of nearly any part of the body.

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