The Five Biggest Myths of Massage Therapy

For today’s post, I wanted to explore some of the common misconceptions of massage therapy and the supposed benefits that it can offer.

Now, before we get started, I just want to say that there are tons of evidence backed benefits to receiving massage, which we’ll be exploring more deeply in a future post. I do think it’s important though to understand the limitations of this practice so that we can be more informed when we shop for a potential therapist. I’m a huge advocate for health literacy - especially when the treatments we’re seeking aren’t covered by insurance and can often cost us a good chunk of change. It’s important to know exactly what it is we’re getting into, and what it’s capabilities are for enhancing our lives.

This rings especially true when we have pressing health concerns and are desperate for relief. There are far too many under-educated bodyworkers out there peddling outdated information. Fortunately, this mostly isn’t the fault of the massage therapist themselves, and it doesn’t mean they can’t provide an excellent and effective service. Rather, the blame (if there were to be any) should be levied at the institutions offering certification courses and the modality empire business model (that’s a topic for another time).

With that said, here are five of the most common myths that I tend to debunk for clients in my practice.


5. Massage Increase Circulation
One of the common advertising bullet points for massage (and many other healing modalities) is that it increases our circulation. Well, to start this list off, I’m going to say with a degree of certainty that it doesn’t- at least not to the degree that would make it clinically worth mentioning. In fact, massage actually tends to slow our circulation down as we settle into deeper states of relaxation. When this happens, blood gets shunted away from our muscles (since they’re not being utilized) and goes into our organs and skin!

We can also think about it this way - when does our circulation increase? Typically it’s as a response to an increased metabolic demand, ie. when we’re in motion. When muscles need more oxygen to operate correctly, the circulatory system will speed up to ensure that they have the proper fuel for their actions. So vice versa, inaction lowers the oxygen demand and allows the body to reallocate it to internal processes such as digestion. This might be one of the reasons why our stomach rumbles halfway through our massage!

If you want to increase circulation, try going for a ten minute walk around your neighborhood or pick up an exercise regiment. Beyond that though, it helps to understand that more circulation doesn’t necessarily mean better health. If there were a way to sit around and increase circulation by doing nothing, it wouldn’t have nearly the same effect as if we were to raise it by working out.

This is also backed by decades of research which I will link right below!

’Failure of manual massage to alter limb blood flow: measures by Doppler ultrasound’
https://pubmed.ncbi.nlm.nih.gov/9140896/

’Does Massage Increase Circulation?’ by Paul Ingraham
https://www.painscience.com/articles/massage-and-circulation.php


2. Massage Flushes Toxins out From the Body
Pretty much whenever you see this claim being made by a wellness product - it’s safe to turn around and walk the other way (or run). This is because the wellness industry’s fascination with ‘detoxification’ is largely predicated on a hoax. The fundamental premise of toxins slowly building up in the body and causing a wide ranging host of symptoms is wholly unfounded and largely dismissed by scientific and medical communities. With it’s earliest records dating back to the 1830’s, the modern wellness trend of detoxification really took root in our culture in the 1970s despite having no scientific basis.

Yet, the notion of a slowly accumulating toxic substance is one that has a visceral imagery to it, and it seems to make sense. With that though, the burden of proof is on the product creator or service provider, in which case, neither will be able to tell you exactly what toxin is being flushed out. This also carries over to fad restriction diets, fasting, saunas, and ionic footbaths, among other modalities.

Of course, that’s not to say that detoxification is not a real thing in the field of biology. Harmful substances can enter into our bloodstream or into our digestive system and do so all of the time! Lucky for us though, the body is very adept at removing these substances through the liver and the kidneys. As toxicologist and professor, Alan Boobis writes,

”The body’s own detoxification systems are remarkably sophisticated and versatile. They have to be, as the natural environment that we evolved in is hostile. It is remarkable that people are prepared to risk seriously disrupting these systems with unproven 'detox' diets, which could well do more harm than good.”

Wikipedia
https://en.wikipedia.org/wiki/Detoxification_(alternative_medicine)

Science Based Medicine
https://sciencebasedmedicine.org/the-detox-scam-how-to-spot-it-and-how-to-avoid-it/

3. You Should Drink Water After a Massage
As we’ve just discussed in the previous point, the notion that we need to drink water after a massage is often touted as helping the body flush out toxins. We now know that is a bogus statement so why might we need to drink water outside of that? Well, I’d argue that we really don’t. If anything, I do think people are chronically under-hydrated so if there is any takeaway from this point, it’s to drink more water on a regular basis, whether massage is involved or not.

4. Massage Therapists Can Feel Your Knots (Through Palpation)
One of the most common expectations that clients carry with them into a massage session is that a massage therapist has the ability to feel their tightness. Most therapists also carry this view and will validate a client’s claims of being ‘very tight’. The tricky part about this is that there’s actually been very poor results in research settings into whether or not this is a real phenomenon or not. While it may seem obvious to most people that if they feel tightness or a painful spot, it must translate to something physical happening in their musculature - in reality, it’s more complicated than that.

The way that I typically describe it to my clients is this: the sensations of tightness or pain that we experience are typically neurological/psychological in nature, and not an actual representation of what’s happening in our muscle’s tissue. This is because there are a lot of other non-muscle factors that contribute to the sensation of pain and tightness. The reality of our tension lies in the realms of biochemistry and neurology - not in small bound up lumps of muscle that need to be ironed out.

This isn’t to say that knots, or in technical terms, ‘Myofascial Trigger Points’ are not a real phenomenon. Rather that they’re not exactly what we feel or imagine them to be. The truth is…we still don’t really know what they are because they’re tricky as all hell to find in any sort of anatomical examination. It’s not that the muscle is contracting and forming a physical ball which is responsive to pressure. It’s more likely something on the microscopic level, maybe a buildup of metabolic waste or tiny tiny cramps. With that, it makes it incredibly difficult to diagnose or to sense through the hand with any clinical accuracy.

So why is it that massage therapists all around the globe make the claim to detect knots? Well there’s an interesting perceptual phenomenon called palpatory pareidolia which Google defines as " a psychological phenomenon that causes people to see or hear meaning in random or ambiguous patterns or images. It's a type of apophenia, which is a more general term for seeing patterns in random data”. This is the same phenomenon that causes people to see faces in the trees or clouds (or the Virgin Mary in a potato chip).

So when we train as massage therapists in a method which aims to “break up knots”; we go out into the world with expectation to find them in our clients. This in turn causes us to fall prey to this perceptual glitch and perceive knots when in reality we’re more than likely just not appreciating the uniqueness of every human body. More often than not, what it is we’re feeling are different levels of density in muscles depending on the lifestyle or genetics of a particular person - which does not translate to the experience of tightness someone may be having.

So while massage therapists may be skilled in the art of feeling the textures of muscles, what those textures mean is still entirely up for debate. I’ve personally had many experiences with clients who’s trapezius could have had a dime bounced off from it who report little to no sensations of pain or tightness. At the same time, I’ve had many clients who come to my office in a lot of pain but physically feel very loose and limber.

Here’s some further reading for the curious minded:

https://pubmed.ncbi.nlm.nih.gov/20015697/

https://www.painscience.com/articles/palpatory-pareidolia.php

5. It Has to Hurt to be Effective
One of the most perennial myths that I hope to re-contextualize with my practice is the idea of ‘no pain - no gain’ that plagues most bodywork modalities. I can’t count the amount of clients that find themselves in my office who tell me up front that they can take a lot of pain and that they’re looking for me to dig in and beat them up. While this is perfectly acceptable to have as a preference and sometimes can prove to be very effective, I just want to say: it doesn’t have to be this way! In fact, massage can be both a relaxing and ENJOYABLE experience while still maintaining the effectiveness of what people would expect from a more rigorous session.

The reason for this can be found in the past twenty years of scientific study into the causes and conditions of pain. To summarize: pain is a bio-psycho-social phenomenon that serves as a warning signal to POTENTIAL injury and is not a 1:1 representation of what’s happening in our tissues. Often times this warning signal can get triggered when an accumulation of variables (that aren’t necessarily physical) build up - things like stress, lack of sleep, lack of diverse motion, inflammation, etc. So in many cases, as we explored above, the tight shoulders that are causing you to schedule a massage very well could be coming from an overzealous warning signal system rather than misuse. (It’s more often than you would think!)

(More on that here: https://www.bkbodyworks.net/blog-1/what-is-pain-and-why-is-it-important-to-understand-for-massage)

So how do we calm that system? We communicate a sense of safety to it of course - in other words, we activate the parasympathetic nervous system.

This brings me to the most common motif that I share with clients, ‘Relaxation IS the therapy’. If tightness comes from stress (which is a huge part of it), then the alleviation of tightness is going to come from freedom from stress. Oftentimes we go months without properly allowing ourselves to rest, bouncing from task to task with a head full of worries and doubts. This builds up and expresses itself in the sensations of our tissues. Massage then, can serve as a counterbalancing force which introduces pleasant stimulation into the nervous system so that it has a wider spectrum of expression. It literally helps us to somatically REMEMBER what relaxation and ease feels like. This in turn, conditions the nervous system to be more readily able to let go of that tension organically and without outside force.

This state of deep rest can oftentimes be hard to access when the massage therapist we’re working with has an emphasis on there being something wrong with our tissues - and that they need to use invasive techniques to fix them. This tends to create sessions of gritted teeth, held breath, and days of soreness. This in turn creates a nervous system experience which actually VALIDATES the warning signal system of there having been a real threat. Even if we intellectually think that the session was beneficial (because our therapist convinces us of this), our body can log the experience as a moment of potential harm. This then steers us further away from cultivating the quality of restfulness which will make our system more resilient to stress and tension.

For the die-hard pressure junkies out there: don’t fret. It’s totally okay if you feel genuinely more at ease when you have somebody digging into the spots that hurt the most. A big part of what we perceive as safe and effective is going to be a subjective experience. It’s not wrong to seek out a deep tissue massage because it feels good to you. What I’m trying to convey with this point is this: if it doesn’t feel good to you and you don’t enjoy the experience, don’t feel like you need to suck it up because it’s what’s “best for you”. If your nervous system hates the treatment, then trust that and find a therapist who honors your boundaries and experience.


***There is a disclaimer I want to leave you with though: there is a well documented phenomenon of the nervous system becoming MORE sensitive to pain as it experiences more painful stimulation. That is to say, pain will beget more pain - even if we have positive associations of it. This is a process called sensitization, and it’s often the cause of the more severe chronic pain conditions. I’ll definitely cover this in a future article.

You can also read up on it here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3268359/ ***