Massage

September 17, 2011

Massage is derived from the Arabic word mass meaning to press and has been defined by Westland (1993) as the aware and conscience manipulation of soft tissues of the body for therapeutic purposes. Many ancient cultures developed various systems of massage to promote health and healing. Contemporary approaches of massage have included bodywork techniques such as strain-counterstrain, myofascial release, craniosacral therapy, shiatsu, acupressure, Rolfing, and applied kinesiology.

Some women may consider massage to be a luxury; a form of self-indulgence to deal with tension and feel more relaxed. Others may think about massage as a way to manage more specific conditions such as pain, swelling, scar tissue adherence, and muscle or tendon tightness. Knowing and distinguishing between the different benefits that can be derived from various massage approaches can help women determine the best intervention for their given condition or goal. Women will also find it helpful to be familiar with the wide range of practitioners who are skillful in applying massage for a variety of purposes and conditions. Examples of such practitioners include physical therapists, nurses, chiropractors, osteopaths, athletic trainers, and massage therapists.

For the purposes of this entry, massage will be limited to classical Western massage, which includes techniques that have ancient roots, but have been used traditionally in Europe and the United States since the 19th century. The application of massage may produce multiple and/or simultaneous effects. The benefits of massage and the effects of massage have been well described in the scientific literature, and are summarized in Table 1.

Table 1. Benefits and effects of massage
Effect Description Benefits/outcomes
Mechanical Movement of body fluids, such

as blood and lymph Movement of soft tissue, such as muscle, scar, tendons

↓Edema (fluid accumulation)

↓Swelling

↓Pain

↑ Flexibility of tissues

↑ Mobility

Physiological At the cellular level, increase flow of nutrients and removal of waste products ↑ Mobility

↓Edema

↓Swelling

↓Pain

↓Muscle spasm

Psychological/emotional Promotion of relaxation, decreased anxiety, decreased depression Relief of pain

Relief of stress

Release of tension

Increased body awareness

Immunological Enhance immune function and improved cell function ↑ Relaxation

↓Anxiety

↓Pain

↓Cortisol

Women should be aware that the effects depicted in Table 1 do not necessarily occur with every massage session and individual results may vary based on age,
health status, and receptivity. Women, therefore, should be clear about the benefits they are hoping to achieve through massage. It is recommended that a woman choose a practitioner who not only can examine a client’s status, and is skillful in applying massage techniques, but is also able to determine if massage will help the client achieve her goals.

Massage has been used as an intervention or approach to address a wide range of health issues prevalent in women. Some of these health concerns include stress, anxiety, depression, and headaches; gynecological issues such as fibroids and pregnancy/ labor and delivery; and premature or low-birthweight infants.

The most compelling benefit of massage is in the area of stress reduction and health promotion. Stress can be defined as a general feeling of fatigue and tension. Psychological consequences of stress can include decreased coping behaviors and alteration of mood patterns. Physiological changes associated with stress include hypertension (high blood pressure); increased respiratory rate and heart rate; changes in levels of glucose, cortisol, adrenaline/noadrenaline; and alterations in blood flow rates to muscle.

In addition to cognitive and behavioral therapies, effective stress management often includes massage as a strategy that can promote relaxation by heightening body awareness and increasing sensory feedback. In several studies, massage has been demonstrated to be effective in reducing both hypertension and rapid respiration. Anxiety and depression are conditions that are distinct from stress, but frequently accompany stressful situations. Symptoms common to anxiety are muscle tension, heart palpitation, sweating, and insomnia. Symptoms common to depression include decreased concentration, irritability, and insomnia. Often a combination of symptoms is presented. As anxiety, depression, or stress become chronic, women are likely to respond to muscle tension, pain, and fatigue with abnormal sitting and standing postures as well as changes in movement patterns. Massage would then be used as a tool to produce the additional changes needed for proper body alignment as well as the necessary physiological and psychological changes.

Researchers have investigated massage as an intervention for depression in subjects with a history of sexual abuse, eating disorders, and postpartum depression. In these studies, massage appears to be helpful in reducing depression and anxiety associated with the given disorder. In some instances, positive changes in body awareness and body image, and a reduction of stress hormone levels have been noted.

Many women suffer from recurring tension and migraine headaches, which may or may not be associated with stress. Several researchers have demonstrated that massage, when administered as part of a pain management regimen, is beneficial for reducing the severity and duration of headaches. Although the mechanism as to how massage can affect headaches requires additional investigation, researchers suggest that massage can directly affect the soft tissue impairments that lead to abnormal muscular tension and irregular blood flow patterns commonly found with headaches and migraines.

Pregnancy, along with labor and delivery can be responsible for trauma and disorders of the female musculoskeletal and urogenital systems. Back pain during pregnancy, which is often due to postural changes and joint laxity, can frequently be improved with a combination of massage, exercise, posture training, and proper positioning. Historically, massage during labor was used to assist in uterine contractions and movement of the baby’s position. Today, the purpose of massage during labor and delivery is to promote relaxation and pain reduction. Researchers have demonstrated that women receiving 20-minute massages every hour during labor report fewer depressed moods, less stress, and less pain compared to women not receiving massages.

Perineal massage is a specific type of massage performed directly to the perineum, the area between the vulva and the anus. Many obstetrician/gynecologists advocate the use of perineal massage to reduce the risk of tearing the perineum during delivery as well as to reduce the need for an episiotomy, a procedure in which the obstetrician surgically cuts the vulva to prevent it from tearing. During pregnancy, women are taught perineal massage and are encouraged to practice it on a regular basis. At the time of delivery, her obstetrician further performs the massage. At present, there are conflicting findings regarding the benefit of perineal massage, although women often report satisfaction with the technique in preparing both physically and psychologically for birth.

For new mothers of premature infants, massage has been demonstrated to facilitate the infant’s growth and development. In several studies, premature infants who receive massage have shown improvement in motor function, greater weight gain, and better sleep cycles. The positive effects of massage frequently found in adults, such as a lower heart rate, decreased respirations, and a reduction of stress hormones, are also found in the infants who receive massage. Often the newborn’s mother is trained to perform massage with her baby both in the hospital and at home.

There are additional gynecological disorders for which massage may be clinically applied. The effectiveness of massage application for scar management of fibroids, infertility due to scar adhesions, and cosmetic breast scars has yet to be expanded and explored. Further research is needed in these areas. It should be mentioned that massage does not produce changes in subcutaneous fat distribution, cellulite, or change in body contours.

The benefits of massage have been well documented in the scientific literature. To reduce stress and improve overall health, women should consider working with a practitioner who can administer therapeutic massage as part of a health and wellness program. Women who are pregnant should explore massage for its physiological and psychological benefits. Regardless of one’s condition, however, it is important to find a practitioner who can examine your condition and assist you in determining if massage will help you reach your desired outcome or goal.

SEE ALSO: Anxiety disorders, Depression, Headache, Migraine, Pregnancy, Stress

Suggested Reading

  • Andrade, C., & Clifford, P. (2001). Outcome based massage. New York: Lippincott, Williams & Wilkins.
  • Freeman, L. W., & Lawlis, G. F. (2001). Mosby’s complementary & alternative medicine: A research-based approach. St. Louis, MO: Mosby.
  • Giovanni, D. D., & Wood, E. (1997). Beard’s massage. Philadelphia: W. B. Saunders.
  • Holey, E., & Cook, E. (1997). Therapeutic massage. Great Britain: The Bath Press.
  • Westland, G. (1993). Massage as a therapeutic tool: Part 1, British Journal of Occupational Therapy, 56(1), 129—180.

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