Virtually every document promoting massage contends that massage improves circulation. It’s what I was taught in massage school, it’s what I read in countless other sources—it’s what I put it in my private-practice brochure. An article that recently appeared in the New York Times, however, calls this claim into question, reporting that a study by Michael Tschakovsky published in the June issue of the journal Medicine and Science in Sports and Exercise found that not only did massage fail to increase blood flow to tired muscles—it actually decreased it.
Does this mean that I, and every other massage therapist, have been misleading our clients, albeit unintentionally? Yes and no. It depends, it would seem, on where and how that blood flow is measured. An earlier article, published in that same science journal (August 2004), determined that while massage did not increase blood flow to the femoral artery in the quadriceps it did increase blood flow to the skin. The latter effect is, in fact, easily verifiable with the naked eye: look at anyone’s skin after a vigorous massage, and you can see the redness brought on by the increased circulation of blood to the surface. So massage does increase circulation.
But—but—that same article concluded that any increase in blood flow to the skin “is potentially diverting flow away from recovering muscle. Such a response would question the efficacy of massage as an aid to recovery in postexercise settings.” That seems fairly clear, right? But yet another article published that same year, in Medical Science Monitor, concurred with the findings about increased blood flow to the skin but also detected increased blood flow to the muscle and a decrease in muscle fatigue, as subjectively evaluated by the experiment’s subjects.
So how is one to reconcile all of this conflicting information? And what does it mean for the efficacy of massage for relieving muscle soreness? To begin with, according to an article by Whitney Lowe, LMT, in Massage Today (September 2009), “rarely do these studies investigate circulation through small capillaries in muscle tissue and skin. Increases in small capillary blood flow bring fresh oxygenated blood to muscle tissue.” The study reported on in the New York Times, for instance, measured blood flow by “catheter inserted directly into the deep vein that drains the muscle”—that is, not in the capillaries. So perhaps there are, in fact, circulation benefits to massage as has been claimed.
In any case, massage provides other benefits that aid in the reduction of muscle soreness. A 2005 study in the Journal of Athletic Training, for instance, suggests that massage can help reduce delayed-onset muscle soreness (DOMS) and swelling associated with certain kinds of high-intensity exercise. Massage also clearly can release very tense muscles. I have felt this happen in my own work, with muscles that were once tight as piano wire becoming soft and pliable. In addition, recent studies indicate that massage may “improve the rate of healing in damaged tendons and reduce the symptoms of tendonitis.”
Scientists concur that there is much yet they don’t understand about how and why massage works and that more research is needed. And even as more data is released concerning the efficacy of massage, it will likely take time before the results of such findings are incorporated into the practice of massage. As Lowe notes, “A recent study investigating knowledge translation in medical practice noted that it takes about 20 years for advances in medical knowledge to be incorporated into clinical practice.” Plus, the sheer volume of work being published and the difficulty with understanding scientific jargon make this task even more formidable.
It may be that in the long run I and other massage therapists will find it prudent to strike “improves circulation” from the list of massage’s benefits. Or we may find that we can let that claim stand. But in the meantime, it bears keeping in mind that, as Tschakovsky stated when he presented his findings at a May sports medicine meeting, massage “feels good, that’s the truth of it. A lot of performance is psychological-based so if you feel better, if you feel you’re in a better situation to do something, it probably has the ability to affect performance.”