Although the effectiveness of massage to flush out lactic acid after exercise has been disproven, there are benefits to validate its use in sports. "In my own experience," said Keith Grant, head of Sports and Deep Tissue Massage Department at McKinnon Institute, "I've seen that massage is effective. How our body reacts to things depends on both the state our body is in (state of memory), as well as the input." Grant combines his knowledge as a scientist with personal experience as a massage instructor and runner to support his conclusions.
Pointing to a study by Tiitus and Shoemaker (1995) in which effleurage did not increase local blood flow, Grant said, "This is a mechanistic way of looking at what's going on." The difficulty, he noted, in interpreting research results comes from looking for direct, mechanical effects. "Clinically, we see a different story," he said. "Through our techniques we work with the nervous system to relax muscles, but that's not a direct mechanical effect. "I believe the effects of massage also involve the neurological and emotional. My reason for that is the neurological side controls the current (base) state of the muscle activation. The emotional controls the chemical messengers that affect the immune system. What seems likely is massage acts as a new input to a system with a memory. Massage stimulates the mechanoreceptors and can gate off pain receptors. It floods the body with new sensory input. We are using the nervous system to reset the muscle to greater relaxation.
"In my observation, fatigued muscles tend to remain hypertonic and shortened. When we cajole specific muscles to relax and lengthen via mechanical and neurological input, we reduce their metabolic activity. When the muscle relaxes, it's not using energy as much, not metabolizing as fast, not producing waste products and because it's more relaxed, it's not compressed and not exerting pressure on surrounding tissues. This means circulation is better. It's not because we're pushing fluid around. It's because we've put the body in a more optimum state, so the body naturally increases circulation on it's own. By massaging muscles and adding input to the nervous system, we are facilitating the body in recovering faster from exercise. It's not the massage that's doing the healing, it's the person's body."
In a British study of boxers, massage was reported to have a significantly positive effect on perception of recovery, giving scientific credence of its benefits as a recovery strategy. According to the authors, their results support arguments by some researchers that "the benefits of massage (in sports recovery) are more psychological than physiological."20 Grant takes that a step farther. "As a trained scientist, I use what I observe and what I know about physiology to come with a hypothesis. From my own experience in running, when you exert to the point of substantial fatigue, you come back feeling more fragile, in an emotionally vulnerable spot. To have the sense that someone is nurturing, in a sense taking care of you, is a very psychologically emotional thing. In supporting the person, we improve their immune function and their ability to heal, by influencing the chemical environment of their body. It has to do with psychoneuroimmunology, the whole chemical homeostasis of their body -- neurochemicals and the relationship between mood, or feelings, and the immune system.
"There is some evidence that following heavy exercise, both L-glutamine (an amino acid manufactured by the body) and the immune system take a dip. I look at the healing effect of massage as, in some way, counteracting that dip. When you provide support it has a positive effect on immune function. If the person doesn't feel supported and nurtured, it will have a negative effect on the chemical environment, opening them more to catching colds, not healing as fast and decreasing their ability to train. It ties into the whole emotional state of a person. The athlete has to stay healthy in order to continue training. With massage, they can train harder because they are able to recover faster."
Facts vs. Myths
Remember the old theory about the earth being flat? The more we learn, the more we realize how much we don't know. That's why research in massage is so important. "These concepts and ideas are firmly entrenched in our early training, and in the medical profession, said Lowe. "Things that have been disproved continue to persist. It takes a long time to trickle down. If we say there is no research that supports massage works for inflammation, there may not be research - or it may not be true. We don't really know yet and we need to investigate that further. This lactic acid concept illustrates the perpetuation of misinformation that can happen if we don't have the research base. When we are looking for credibility with others in health care, they want to know on what we base our opinions. A lot is passed along on hearsay, not on scientific information. What we need to keep our eyes on is how to reduce that as much as possible so we do have accurate information."
Shirley Vanderbilt is a staff writer for Massage & Bodywork magazine.
