resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
A House Divided?
The American Chiropractic Association's House of Delegates voted on 30 resolutions at its annual business meeting in Washington D.C., but two in particular took immediate center stage due to their controversial nature.
5 Tips for Using Pinterest to Market Your Practice
Pinterest is a very popular, but often under-utilized, social media platform where people can bookmark, or "pin," fun and interesting things from all across the internet.
Functional Hip Impingement (Part 1)
Every time I sit down to write an article, I realize how much more there is to know about musculoskeletal pain. I also learn something new every time. (I want to give special thanks to Lucy Whyte Ferguson for assisting with this article.)
How Much Do You Know About the Benefits of Birds Nest?
Edible bird's nest is the nest made by the Swiftlet bird of Southeast Asia that is usually prepared as a soup and prized in Chinese culture as a healthful delicacy.
The Acupuncturist's Problem
I want share with you some observations and insights into what seems to be the most common problem my colleagues in the acupuncture profession struggles with. If you also struggle with this problem, I hope you get a valuable "aha" moment from reading this.
Term Limits: What's in a Word?
It was the French historian and philosopher Voltaire who once declared the Holy Roman Empire was neither holy nor Roman nor an empire.
PCOM Granted Regional Accreditation
Pacific College of Oriental Medicine (PCOM) recently announce it has received regional accreditation from the Western Association of Schools and Colleges (WASC). This achievement reflects five years of hard work on the part of faculty, staff, and students.
Marijuana, Apathy and Chinese Medicine, Part 1
This article was written in response to the unheeded acceptance of marijuana as a harmless substance that potentially does good when used for the medical relief of pain.
Applying the Thin Skull Principle
The "thin skull" principle, also known as the "you take your victim as you find them" principle, is a legal principle that can be summed up by the following statement.
A View From the ER
The University of Western States has inked an innovative agreement with local nonprofit health system Legacy Health whereby UWS sports-medicine fellows can experience observational clinical rotations in emergency-room settings within the Legacy system.
Animal Acupuncture: A Case Study in the Treatment of Traumatic Injury in the Equine
The rise of animal acupuncture in the U.S. began in the early 1970's as a result of the work by members of the National Acupuncture Association in Westwood, Calif.
Optimism = Compassion = Trust
A randomized clinical trial recently published online in JAMA Oncology examined how patients viewed their doctor based upon how the practitioner presented bad news to the patient.
The Tide is Rising in the Acupuncture Profession
Former President Ronald Regan said, "When the tide rises all boats float." The tide is rising for the acupuncture profession. Many forces outside the profession are helping the tides to rise.
Talking to Patients About Lumbar Facet Denervation (Medial Branch Neurotomy)
Lumbar facet denervation, more appropriately termed medial branch neurotomy (MBN), is a procedure that may be considered when patients suffer from recalcitrant non-radicular axial back and/or leg pain.
Sleep, Less Sleep or No Sleep?
I had a dream I wasn't getting enough sleep. It was a very realistic dream, even though I was probably slightly awake and not really deep dreaming. Most likely I had been dozing, caught in that twilight of sleep and wakefulness.
Integrating Art with Clinical Practice for Patients with PTSD: The Artemis Project
Are you restricted by those one-on-one clinic dynamics? Why not join colleagues and clients in experimental group settings? Three of us volunteered to do just that in Austin on behalf of women veteranss from all branches of the service.
5 Simple Steps to Create an Effective Marketing Calendar
In the educational experience of most healthcare practitioners, business and marketing are overlooked topics.
Medicine is Clumsy, Don't You Be
All medical systems have clumsiness in them. If the technique isn't, the practitioner is. Everyone in every form of medicine is striving to improve. That is why we call it practice.
The Challenges of Integrating Eastern and Western Medicine
My Masters thesis was titled, "The Challenges of Integrating Eastern and Western Medicine," which highlighted several reasons why it is hard for these two worlds to mix.
Low Back Pain in Professional Golf: A Common Muscular Relationship
Every sport creates its own unique demands on the body. Some sports require such a myriad of body positions that assessing pathology is often difficult and unpredictable.
January, 2013, Vol. 13, Issue 01
Dosage Affects Immune and Endocrine Response to Massage
By Massage Therapy Foundation Contributor
Contributed By Derek R. Austin, MS CMT, Jolie Haun, PhD EdS LMT, Sandra K. Anderson, BA, LMT, ABT
If a weekly massage is helpful for stress relief and immune function, then two weekly massages must be twice as beneficial, right? The results might surprise you.The Massage Therapy Foundation's previous monthly research columns have reported research suggesting massage may reduce pain, stress, depression, anxiety and cortisol levels, and enhance certain immune function parameters. However, how massage produces these outcomes remains a largely unanswered question. In a new study published in The Journal of Alternative and Complementary Medicine, Dr. Mark Rapaport and his colleagues investigated the mechanisms of repeated massage.
The authors compared once and twice-weekly Swedish massage to two equivalent doses of light touch. Fifty-three participants were randomized to one of four intervention groups: five weeks of Swedish massage once-weekly or twice-weekly, or control light-touch once-weekly or twice-weekly. Eight of the 53 participants did not complete the five-week protocol for reasons unrelated to the study intervention, leaving 45 participants (22 male and 23 female). Therapy sessions of 45 minutes were performed by licensed massage therapists using a standardized, specified protocol with nonaromatic oils. The light-touch condition followed the same protocol as the Swedish massage except that the therapist used only light touch with the back of the hand. Blood neuroendocrine and immune samples and salivary cortisol samples were collected prior to and following the therapy sessions.
The twice-weekly massage group demonstrated greater changes in oxytocin, arginine vasopressin, ACTH, and cortisol than the twice-weekly touch group. Twice-weekly massage also increased mean pretreatment levels of CD56+ cells, but decreased all other circulating immune markers. Changes in pretreatment levels of cytokines in the once-weekly group were similar to the authors' previous study showing sustained decreases in many pro-inflammatory and other cytokines. Interestingly, these decreases in markers of inflammation were not observed in the twice-weekly intervention groups. The authors note that the weekly massages were separated by 7 to 8 days, while the twice-weekly sessions were separated by 3 to 4 days; therefore, observed differences may represent differences in length of time between sessions. Heart rate variability was also measured, but no differences were found between the groups. This is not surprising, since young, healthy (i.e. relatively unstressed) sample participants were studied.
Overall, the results can be summed up as follows: once-weekly massage demonstrated patterns of change in circulating lymphocyte markers and cytokines similar to what was observed after a single massage session. Once-weekly massage increased immune changes that were identified after a single session of massage, but had minimal effect on neuroendocrine function. By contrast, twice-weekly massage increased neuroendocrine changes with little effect on the immune markers studied.
These results are consistent with the authors' initial hypothesis that the positive effects of massage therapy might be mediated through oxytocin and arginine vasopressin. The authors conclude these may be sustained, cumulative, biologic effects caused by the massage and light touch interventions. As a whole, the current findings suggest that while these effects are sustained for several days, they were not merely additive; they effects are different depending on the dosage of the intervention. Another intriguing finding of this study is that the light touch condition, involving gentle, systematic, and comprehensive stroking of an individual for 45 minutes, does have impact on biologic activity. This finding calls into question the use of a light-touch group as a "placebo" for research.
These findings are compelling, but study limitations should be noted when interpreting results. The most pressing limitation of this study is the small sample size of the groups. However, this is often the nature of pilot studies. What is important is the results of this small sample warrant a larger follow-up study, which may provide findings that are more conclusive. The authors note that further investigation of dosage, length of treatment, and different massage techniques are needed. Another limitation is this study did not report measures of sympathetic and parasympathetic function, which could have been helpful for interpreting the findings.
These findings make a significant contribution to advancing the science of massage therapy research. Most therapists, and people in general, are aware that massage works but how it works and which dosages are optimal are questions that have remained largely unanswered and are continually being debated in the field. However, published data findings such as these are starting to provide some direction for finding answers to these massage therapy mysteries. These data provide a glimpse into the biological mechanisms of massage therapy and an indication of dosage response. Also notable from a research perspective, light touch does have a biological effect and is not the "placebo" it was believed to be in previously reported research. These findings can inform future studies use of biological outcomes measures, dosage protocols and the re-evaluation of what is an appropriate placebo.
So, what's the take home message? In general, these findings provide justification of repeated massage to promote sustained cumulative effects. However, it is important to be aware that different dosages of massage may result in different changes in biologic activity. Because of this, massage dosage may need to be adjusted based on the desired effect. For example, if immune function is a priority, once-weekly massage may be optimal for desired effect whereas, if neuroendocrine function is a priority, twice-weekly massage may be the best option. Massage therapists, and clinical providers who recommend repeated massage to their patients, can refer to research such as this article and other related research, to inform their dosage recommendations.
To learn more about previously reported research on the biological mechanisms and dosage effects of massage therapy, you can review the Massage Therapy Foundation website, read our previous articles in Massage Today, read accepted MTF Research Grant abstracts or search Pub Med for related massage therapy studies.
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