Fit'n'Well Massage

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The benefits of massage
What does the research say?

A large body of empirical evidence supports the established effects of massage therapy for the following conditions and populations:
Musculoskeletal pain, including low back pain
A significant body of evidence, including systematic reviews, supports the effectiveness of massage therapy in the treatment of a range of musculoskeletal presentations.

There are five systematic reviews of massage and low back pain, including a Cochrane Systematic Review in 2008, which was updated in 2009.3 The most recent review, published by the Ottawa Panel in 2012, concluded that massage interventions provide short-term improvement of sub-acute and chronic low back pain symptoms and decrease disability at immediate post treatment. Massage therapy provides short-term relief when combined with therapeutic exercise and education.4

There are five systematic reviews of neck and shoulder pain, including a Cochrane Systematic Review in 2012 which concluded that massage therapy provides short-term relief of mechanical neck pain.5 A systematic review published by the Ottawa Panel in 2012 reached a similar conclusion.6

A 2013 meta-analysis and systematic review also showed that massage therapy is an effective intervention that may provide immediate relief of neck and shoulder pain.7

A large body of research exploring the connection between active myofascial trigger points and various kinds of myofascial pain and dysfunction, provides underpinning evidence for the use of trigger point techniques, including myofascial dry needling. A team of Spanish researchers in the Department of Physical Medicine and Rehabilitation at the Universidad Rey Juan Carlos have established a substantial body of work in this area, with a particular focus on headache, neck and shoulder pain.8

There is also modest evidence for the effectiveness of massage therapy in ameliorating the symptoms of fibromyalgia. A 2010 review revealed short-term benefits, with one single arm study reporting longer term effects.9
Pre/Post operative
A significant body of RCTs demonstrate the efficacy of massage in the management of pre- and post-operative pain, anxiety and tension, and post-operative nausea. A 2009 Cochrane Systematic Review found that acupressure stimulation of the P6 acupoint significantly reduced post-operative nausea and vomiting, and the need for antiemetics.11
Pregnancy/Labour/Post-natal
A significant body of evidence supports the efficacy of massage throughout pregnancy, and particularly during labour. A 2012 Cochrane Systematic Review found evidence that massage improves the management of labour pain with few adverse side effects.12 Another 2012 Cochrane review found that massage may have a role in reducing pain and improving women’s emotional experience of labour.13
Mood
Anxiety reduction is one of the most well-established effects of massage therapy with evidence for this crossing multiple presenting conditions and populations. In a 2004 meta-anaylsis of 37 studies, reductions in trait anxiety and depression were identified as massage therapy’s largest effects.10 A number of studies also show that massage therapy increases oxytocin, which may be one of the mechanisms by which it mediates anxiety.
Arthritis
A number of promising RCTs support the efficacy of massage therapy in treating both osteo and rheumatoid arthritis. One recent RCT of Swedish massage for osteoarthritis of the knee revealed significant improvements across a range of measures compared to usual care.21 This dose-finding study built on an earlier study that produced similar results.22

A study released in 2013 found that twice weekly, self-massage of the quadriceps muscle improved pain, stiffness, physical function and knee range of motion in adults with diagnosed knee osteoarthritis.23
Hypertension
Some preliminary evidence, based principally on case series, indicates that massage has a moderating effect on blood pressure and heart rate. One specific study provides evidence that the style of massage therapy can influence blood pressure, with increases in blood pressure noted for potentially painful massage techniques.24
Headache and migraine
A 2010 systematic review of manual therapies for migraine found that massage therapy, physiotherapy, relaxation and chiropractic spinal manipulative therapy might be as effective as propranolol and topiramate in the prophylactic management of migraine.20 A number of RCTs investigating headache and migraine also report positive results for massage.
Athletes/Sports/Exercise
Systematic reviews show that massage therapy is effective in reducing delayed onset muscle soreness and enhancing recovery after strenuous exercise.19 A number of RCTs have also shown positive effects of massage on pain and recovery after strenuous exercise.
Older adults
A body of RCT evidence supports the efficacy of massage in treating a range of conditions associated with aging. A Cochrane Database Review of massage and touch for dementia found that massage therapy may serve as an alternative or complement to other therapies for the management of behavioural, emotional and other conditions associated with dementia.18
Infant/Paediatric
A 2004 Cochrane Systematic Review found that massage of pre-term or low-weight infants improved daily weight gain by 5.1 grams and appeared to reduce the length of hospital stay by 4.5 days.14 A 2006 Cochrane review also found evidence of benefits in connection with mother-infant interaction, sleeping and crying, and on hormones influencing stress levels.15

A 2007 review established the efficacy of paediatric massage for a range of conditions; however, significant reductions in state anxiety were identified as one of the strongest effects.16 A 2013 meta analysis concluded that massage therapy may be a safe and cost-effective practice to improve weight gain and decrease the hospital stay of clinically stable preterm infants.17
Cancer
Over the last six months, evidence for the positive effects of massage therapy in the management of cancer patients has continued to burgeon, with several new Level 1 and 2 studies being published. Although massage therapy is clearly not a treatment for cancer itself, it is effective in the management of symptom distress and palliation. It can also ameliorate the mood effects of a cancer diagnosis, such as stress and depression.

A substantial body of systematic reviews supports the efficacy of massage therapy in treating the side effects of cancer, including a Cochrane Systematic Review in 2004, which was updated in 2008.1

The largest single study of massage and cancer was conducted at Memorial Sloan-Kettering Cancer Centre, where 1290 patients were treated with massage therapy over a three-year period.2
HIV/Immune Function
A number of studies report findings that massage therapy has a positive effect on immune function. A 2010 Cochrane Review found evidence to support the use of massage therapy to improve the quality of life of people living with AIDS/HIV.25 A 2013 clinical trial showed massage therapy to be effective in the treatment of depression in HIV patients.26

How to get the most out of your massage appointment

Prior to your appointment

If it is your first appointment
Please complete the online screening form well before you attend your massage consultation. This will allow your therapist more time to plan for the session and thus more time spent on the massage itself!

Arrive a few minutes early
Plan ahead so that you are not running late. Give yourself time to clear your mind and not feel that your appointment is rushed. If your job is physical, take the time to shower and change before your appointment. Expect that your appointment will always end at the scheduled time regardless, so if you are late you only short-change yourself. Getting there a few minutes early will give you a chance to calm and centre yourself before climbing on the table, allowing you to unwind further in your massage.

Hydration
Drinking water after a massage treatment is important to help your body eliminate the waste products that massage is 'releasing' for processing. Making sure you are well hydrated prior to your treatment means less viscous blood and therefore the process of eliminating toxins begins as early as when your muscles feel those first glorious strokes of your massage!

Use the bathroom
If you don’t get the chance to do this at home or work before you arrive for your treatment, do yourself a favour and do it when you get to the clinic. Anything that draws your attention away from enjoying the bodywork is going to restrict the benefits to some degree. If you find yourself lying on the table with the urge to go, don’t be afraid to excuse yourself! A five-minute delay is better than 60 minutes of discomfort.

Turn off your mobile phone
Is that phone call or text message really worth the distraction?

Remove jewellery
Earrings, necklaces, watches and rings can all make it difficult to work around those local areas. Take them off and be sure to place them in a safe place where you won’t forget to put them back on or take them with you when you leave.

Honest & clear communication
You and your therapist should both have a clear understanding of what is going to be worked on during your treatment. Communication is a very important key to an effective massage. Your therapist should be made aware of any concerns, health issues or questions you may have which could affect your treatment. Special requests are always welcome with regard to room temperature, lighting and music selection or volume. You should always feel comfortable that you know what items of clothing to remove, how you should be positioned on the table and what will happen with towels/draping. Your comfort is paramount!

If this is NOT your first appointment.
Be sure to inform your therapist of any situations that may have changed since your last appointment. In particular, any new medications that your doctor may have prescribed.
During the appointment

Focus on your breathing
You can notice how your breath naturally falls into a deep rhythmic pattern the more you let go of thoughts that might be going around in your head. When your therapist finds areas of muscle tension many people have a tendency to hold their breath without even being aware of it. Muscle tension often releases during an exhale, so when your therapist finds a tight or 'sore' spot, remember that your breath is your best ‘healer’ and can support you to release whatever you are holding in your body. Let your body lead the way – as while you may want to ‘get rid’ of tension, the body has its own rhythm and it is the breath that can work with your body to release tension.

Hand pressure
At various stages of the massage, your therapist will ask you the question “how is that pressure?” Everyone has areas of the body that are more sensitive than others so your therapist needs to check the pressure from time to time. Please remember that there is no right or wrong answer to this question. If the pressure is fine please say so. If the pressure needs to be more or less intense please tell your therapist. As a guide, the pressure should never be so soft that you feel nothing and conversely never so firm that you are in pain.

Communicate
Make the session feel just right for you. Let the massage therapist know how you are feeling and what you want out of the massage. It can simply be that you want to relax and let go of some tension you are holding, or it could be that you want specific pain or tension addressed in a particular part of your body. Your massage therapist appreciates feedback during the massage. If a particular part of the massage feels good, please tell your therapist. Conversely, if an area being massaged feels very painful or uncomfortable, your therapist also needs this feedback. Talking during a massage is fine to share something important with the massage therapist about what you are feeling in your body, however 'general chit-chat' can also be a distraction and disturb the enjoyment of the massage.

Set-up
Your massage therapist follows strict body draping procedures to protect your privacy at all times. During the massage, only the part of the body that is being massaged will be uncovered. If at any time during the massage you feel uncomfortable with the draping procedures please bring this to the attention of your therapist. If you find your position on the table isn’t quite comfortable, or the room temperature needs to be adjusted, or anything else is drawing your attention away, speak up. These things are easily remedied and the more comfortable you are the more you can relax.

Let go
Do not be afraid to fall asleep on the table. It has been shown that many non-physical benefits of massage can happen at this time, such as your energy balancing and clearing. It can also be a compliment to a therapist to note you have fallen asleep during a relaxation massage treatment! So think twice the next time you find yourself resisting falling asleep during your massage.
After the massage

Take your time getting up off the table
Sit up slowly and allow yourself to adjust to your body which is in a new state. With decreased tension, increased blood circulation and lymphatic flow, it is important to take great care with how you move your body. Monitor how you feel and in particular, do not get up from the massage table if you feel dizzy.

Plan for relaxation time
Avoid doing anything too strenuous for 24 hours after the massage. Gentle exercise is OK but strenuous exercise may undo all of the good effects of the massage.

Re-hydrate after the massage
You will typically feel thirsty after your massage. Listen to your body and drink plenty of water after your massage. Not getting enough water after a massage treatment means that the toxins that your body has released, can get reabsorbed by the muscles and tissues rather than getting flushed out. This can result in muscle soreness, fatigue, or nausea. It is a simple and self-caring step to support your body to eliminate those toxins by drinking a glass of water. Most often your massage therapist will have one to offer you at the end of the massage.
1. Fellowes D, Barnes K, Wilkinson S. (2004). Aromatherapy and massage for symptom relief in patients with cancer. Cochrane Database Syst Rev. 2008;(2):CD002287.2. Cassileth BR, Vickers AJ. (2004). Massage therapy for symptom control: Outcome study at a major cancer center. J Pain Symptom Manage, 28(3), 244-249.3. Furlan AD, Imamura M, Dryden T, Irvin E. (2008). Massage for low-back pain. Cochrane Database Syst Rev. 2008 Oct 8;(4):CD001929.4. Brosseau L, Wells GA, Poitras S, Tugwell P, Casimiro L, Novikov M, Loew L, Sredic D, Clément S, Gravelle A, Kresic D, Hua K, Lakic A, Ménard G, Sabourin S, Bolduc MA, Ratté I, McEwan J, Furlan AD, Gross A, Dagenais S, Dryden T, Muckenheim R, Côté R, Paré V, Rouhani A, Léonard G, Finestone HM, Laferrière L, Haines-Wangda A, Russell-Doreleyers M, De Angelis G, Cohoon C. (2012). Ottawa Panel evidence-based clinical practice guidelines on therapeutic massage for low back pain. J Bodyw Mov Ther, 16(4), 424-455.5. Patel KC, Gross A, Graham N, Goldsmith CH, Ezzo J, Morien A, Peloso PM. (2012). Massage for mechanical neck disorders. Cochrane Database Syst Rev. 2012 Sep 12;9:CD0048716. Brosseau L, Wells GA, Tugwell P, Casimiro L, Novikov M, Loew L, Sredic D, Clément S, Gravelle A, Hua K, Kresic D, Lakic A, Ménard G, Côté P, Leblanc G, Sonier M, Cloutier A, McEwan J, Poitras S, Furlan A, Gross A, Dryden T, Muckenheim R, Côté R, Paré V, Rouhani A, Léonard G, Finestone HM, Laferrière L, Dagenais S, De Angelis G, Cohoon C. (2012). Ottawa Panel evidence-based clinical practice guidelines on therapeutic massage for neck pain. J Bodyw Mov Ther, 16(3), 300-325.7. Kong LJ, Zhan, HS, Cheng YW, Yuan WA, Chen B, & Fang M. (2013). Massage therapy for neck and shoulder pain: A systematic review and meta-analysis [Electronic version]. Evid Based Complem & Altern Med.8. See numerous studies by Alonso-Blanco C, Fernández-de-Las-Peñas C, de-la-Llave-Rincón AI, Zarco-Moreno P, Galán-Del-Río F and Svensson P.9. Kalichman L. (2010). Massage therapy for fibromyalgia symptoms. Rheumatol Int. Jul;30(9):1151-7.10. Moyer CA, Rounds J, Hannum JW. (2004). A meta-analysis of massage therapy research. Psychol Bull, 130(1), 3-18.11. Lee A, Fan LT. (2009). Stimulation of the wrist acupuncture point P6 for preventing postoperative nausea and vomiting. Cochrane Database Syst Rev. 2009 Apr 15;(2):CD003281.12. Jones L, Othman M, Dowswell T, Alfirevic Z, Gates S, Newburn M, Jordan S, Lavender T, Neilson JP. (2012). Pain management for women in labour: an overview of systematic reviews. Cochrane Database Syst Rev. 2012 Mar 14;3:CD009234.13. Smith CA, Levett KM, Collins CT, Jones L. (2012). Massage, Reflexology and other manual methods for pain management in labour. Cochrane Database Syst Rev. 2012 Feb 15;2:CD009290.14. Vickers A, Ohlsson A, Lacy JB, Horsley A. (2004). Massage for promoting growth and development of preterm and/ or low birth-weight infants. Cochrane Database Syst Rev. 2004;(2):CD000390.15. Underdown A, Barlow J, Chung V, Stewart-Brown S. (2006) Massage intervention for promoting mental and physical health in infants aged under six months. Cochrane Database Syst Rev. 2006 Oct 18;(4):CD005038.16. Beider S, Moyer CA. (2007). Randomized controlled trials of pediatric massage: A review. Evid Based Complement Alternat Med, 4(1), 23-34.17. Wang L, He JL, & Zhang XH. (2013). The efficacy of massage on preterm infants: A meta-analysis [Electronic version]. Am J Perinatol.18. Viggo Hansen N, Jørgensen T, Ørtenblad L. (2006). Massage and touch for dementia. Cochrane Database Syst Rev. 2006 Oct 18;(4):CD004989.19. Ernst E. (1998). Does post-exercise massage treatment reduce delayed onset muscle soreness? A systematic review. Br J Sports Med, 32(3), 212-214; and Best TM, Hunter R, Wilcox A, Haq F. (2008) Effectiveness of sports massage for recovery of skeletal muscle from strenuous exercise. Clin J Sport Med, 18(5), 446-460.20. Chaibi A, Tuchin PJ, Russell MB. (2011). Manual therapies for migraine: A systematic review. J Headache Pain, 12(2), 127-133.21. Perlman AI, Ali A, Njike VY, Hom D, Davidi A, Gould-Fogerite S, Milak C, Katz DL. (2012). Massage therapy for osteoarthritis of the knee: A randomized dose-finding trial. PLoS One, 7(2), e30248.22. Perlman AI, Sabina A, Williams AL, Njike VY, Katz DL. (2006). Massage therapy for osteoarthritis of the knee: A randomized controlled trial. Arch Intern Med, 166(22), 2533-2538.23. Atkins DV & Eichler DA. (2013). The effects of self-massage on osteoarthritis of the knee: A randomized controlled trial. Int J Ther Massage Bodywork, 6(1), 4-14.24. Cambron JA, Dexheimer J, Coe P. (2006). Changes in blood pressure after various forms of therapeutic massage: A preliminary study. J Altern Complement Med, 12(1), 65-70.25. Hillier SL, Louw Q, Morris L, Uwimana J, Statham S. (2010)Massage therapy for people with HIV/AIDS, Cochrane Database Syst Rev. 2010 Jan 20;(1):CD007502.26. Poland RE, Gertsik L, Favreau JT, Smith SI, Mirocha JM, Rao U, & Daar ES. (2013). Open-label, randomized, parallel-group controlled clinical trial of massage for treatment of depression in HIV-infected subjects. J Altern Complement Med, 19(4), 334-340.
Fitnwell Remedial Massage
Suite 2, 82 Argyle Street
Camden NSW
0406 429 959