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Harvard Commentaries
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Harvard Commentaries
Reviewed by the Faculty of Harvard Medical School


Man to Man Man to Man
 

How Therapeutic Is Massage?


April 18, 2014

By Harvey B. Simon M.D.

Harvard Medical School

Massage is respectable, but is it therapeutic? An estimated 25 million Americans visit about 90,000 practitioners 60 million times a year. Many feel better, but are they actually healthier?  It's a particularly interesting question for athletic men, who are increasingly using massage to treat exercise-related muscle soreness and to prevent sports injuries.

Massage and Medicine

Massage is an ancient art that dates back to the dawn of civilization. The name is derived from the Greek word meaning "to work with the hands, as in kneading dough." And in 400 B.C., Hippocrates wrote that the physician must be experienced in many things, especially in rubbing.

Medicine has come a long way since the Father of Medicine wrote those words. Doctors no longer rely on the laying on of hands to heal their patients. But that wasn't always the case.

Massage therapy gained a foothold in American medicine some 150 years ago. That's when two New York doctors introduced the technique developed by Per Henrik Ling in Sweden. Within a few years, many hospitals and clinics began to offer massage to their patients. And doctors themselves often performed the procedure.

As medicine grew more complex, nurses and physical therapists took over the task. In time, they, too, turned to other roles, and massage was all but abandoned in the 1930s. Since the 1970s, however, it has staged a comeback, as part of alternative medicine. Masseurs are no longer viewed simply as high-priced locker room specialists (much less as shady ladies who need dough of a different sort). They're therapists.

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The Most Widely Used Method

Practitioners define massage as the manual manipulation of the body's soft tissues to reduce discomfort and stress and promote wellness and health. It's a broad definition, and it covers at least 80 different systems of massage.

Swedish massage is the most widely used method in the United States. It still relies on Ling's basic work. The typical Swedish massage is performed with the client lying on a special table. The client may be naked or wearing undergarments. The therapist will usually ask if the client wishes to leave some parts of his body untouched.  If so, those regions, along with the "privates," are covered with a towel or sheet. The body is usually coated with oil.  Dim lights, soothing music and scented candles are common, but optional.

Swedish massage uses:

  • Stroking
  • Kneading using the fingers and thumbs
  • Friction using the palm, heel of the hand, forearm or elbow to apply force.
  • Rhythmic slapping or tapping motion
  • Vibration using a rapid trembling motion of both hands

Massage therapists have a variety of backgrounds. Many are trained according to standards set by the American Massage Therapy Association. Groups such as the National Certification Board in Therapeutic Massage provide accreditation. Many states require therapists to be licensed.

A full Swedish massage is usually performed in a private area of a spa, health club, athletic facility or clinic. Many chiropractors' offices have a massage therapist on staff. Therapists can also set up portable tables in their clients' homes.

A typical session lasts 30 to 60 minutes and costs $60 to $100. Briefer, less costly partial "chair" massages are offered in a broad range of settings: airports, hotels, offices and malls.

Many other types of massage are available, each with its own goals and claims; they include neuromuscular massage, sports massage, deep-tissue massage, myofacial release, and myotherapy. Similar soft tissue manipulations are also incorporated into many other systems, including Rolfing, the Trager and Alexander Methods, and Shiatsu.

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The Goals of Massage

Enthusiasts believe that massage strengthens the body, enabling injured tissues to return to normal and heal themselves. Many theories explain how massage might accomplish these goals. They include:

  • Improving circulation
  • Removing toxins
  • Reducing stress
  • Improving sleep  
  • Aiding metabolism
  • Boosting the immune system

The most dedicated believers claim that massage can help improve the function of nearly any part of the body.  Unfortunately, though, there is little medical evidence to support these theories and goals.

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What Does the Research Show?

Despite the widespread use of massage, only a small number of scientific studies have evaluated its effectiveness. The most common therapeutic uses are to reduce musculoskeletal discomfort and reduce stress. Although many men use massage to treat exercise-induced muscle soreness and stiffness, to improve athletic performance, or to rehabilitate from injury, there is little proof that massage helps in these areas over and above psychological improvements and self-confidence.

An objective review of five individual clinical trials concluded that massage "might" be beneficial for persistent nonspecific low back pain. Another study found that it was effective in reducing mental stress, but was no better than relaxation tapes. Finally, a variety of small studies suggest that massage may help reduce:

  • The discomfort of knee arthritis and fibromyalgia,
  • Anxiety and apprehension associated with some medical treatments
  • Migraine symptoms

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The Bottom Line

Much more research is needed to learn whether massage is effective in preventing or treating athletic woes and medical disorders. It's not molecular biology, but these studies are important. Unfortunately, they are also technically difficult, slow and expensive. Even with the renewed interest in alternative medicine, a full understanding of the benefits and limitations of massage therapy is a long way off.

But you don't have to wait for scientific results to sign up for a massage. Stress, pain and muscle discomfort are subjective reactions to internal and external events. Researchers may not be able to tell you if massage improves your body's structure or function. But if it's used along with regular medical care, massage has almost no potential to do harm. So if you can afford the time and money for a massage, give it a try. Many guys feel better afterward. If you are one of them, you can sign up for a kneading whenever you're needy.

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Harvey B. Simon, M.D., is an Associate Professor of Medicine at Harvard Medical School and a member of the Health Sciences Technology Faculty at Massachusetts Institute of Technology. He is the founding editor of the Harvard Men's Health Watch newsletter and author of six consumer health books, including The Harvard Medical School Guide to Men's Health (Simon and Schuster, 2002) and The No Sweat Exercise Plan, Lose Weight, Get Healthy and Live Longer (McGraw-Hill, 2006). Dr. Simon practices at the Massachusetts General Hospital; he received the London Prize for Excellence in Teaching from Harvard and MIT.


Field, T. (2002). "Massage therapy." Medical Clinics of North America. 2002; 86, 163-171.

Drust B., Atkinson G., Gregson W., French D., Binningsley D. (2003) "The effects of massage on the intramuscular temperature in the vastus lateralis in humans." International Journal Sports Medicine 24. 2003; 395-399.

Hayley et al. "Randomised controlled trial of therapeutic massage in the management of stress." British Journal of General Practitioners; 2003; 53:20.

Perlman AI, Sabina A, Williams AL, Njike VY, Katz DL. "Massage therapy for osteoarthritis of the knee: a randomized controlled trial." Archives of Internal Medicine. 2006; 166:2533–2538.

Ernst E. "Massage therapy for cancer palliation and supportive care: a systematic review of randomised clinical trials." Supportive Care in Cancer. 2009 Apr; 17(4):333-7.

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