Beyond Loosening Tight Shoulders: Holistic Benefits of Massage Therapy

Massage therapy provides holistic support for the mind and body. But what are the specific benefits you can expect to derive from massage therapy? 

Many folks come in for a massage for either a luxury relaxation experience or help relieve physical pain. While both of these reasons are valid and massage is widely known to provide relaxation and pain relief, what may not be as widely known are the ongoing preventative, regulatory, and mind-body benefits that massage therapy can provide. Similar to other holistic lifestyle factors such as diet, exercise, and quality sleep, receiving healthy safe social touch in the form of massage therapy may play a wider role in overall health maintenance. Below I’ve compiled just a short list of some of the benefits of massage therapy, as we currently understand them through some of the research literature that is available. 

Massage supports mental health.

Massage therapy has been shown to decrease stress, anxiety, and depression. Massage therapy can also help improve the quality of sleep, and create dedicated time in your schedule for deep relaxation. 

Massage supports the body’s self-regulatory processes.

Mechanical pressure stimulates the release of chemical signalers and nervous system state changes which support overall physical health via the body’s natural self-regulatory processes.

Massage supports a healthy immune system.

By helping to manage physiological stress responses and promoting the body’s natural immunoregulatory processes, massage supports a healthy immune system.

Massage promotes prosocial behavior. 

Repeated massage therapy sessions have been shown to increase oxytocin levels, which is a ‘feel-good’ hormone associated with prosocial behavior such as parent-infant bonding.

Massage improves proprioception & interoception.

Proprioception, the ability to know where your body is in space, and interoception, the ability to sense internal body sensation (including emotions) help us to be aware of and respond to our bodies needs and avoid injury. Both can be challenging for some individuals, including neurodivergent populations. Massage can help improve both by offering gentle sensory and kinesthetic feedback in a safe environment.

Massage supports healthy skin.

Massage stimulates the lymphatic system, circulatory system, cell regulation and regeneration processes, and can help reduce the appearance of scar tissue over time. The application of lotion and oil can help the skin maintain moisture.

Massage reduces pain.

Chemical signaler IL-6 increases after massage, which helps regulate inflammation and may result in anti-inflammatory effects similar to NSAIDS. Massage promotes changes in levels of neurotransmitter hormones that influence pain perception including dopamine, endorphins, serotonin, and endogenous cannabinoids.

Massage improves muscle tone.

By promoting circulation, proprioception, nervous system changes, and myokine & cytokine stimulation, massage can help promote optimal balanced muscle tone.

Massage therapy research is really just beginning to understand the mechanisms through which the application of massage impacts the body systems. This dearth of research is one of the reasons my business is named ‘lacuna’. For the sake of embracing nuance, I want to add that I don’t believe we always require research to understand if something is generally safe and beneficial. For example, massage, palpation, and other forms of manual and/or touch therapy have been a form of traditional medicinal practices world-wide for thousands of years and are generally considered safe. However, seeking a more granular understanding of the mechanisms of massage and its effectiveness may allow us to be more precise in the future with both techniques and dosage. In the case of massage therapy, dose refers to how many sessions, and of what duration, are sufficient for various issues that the client would like to address. While the picture of the benefits of massage therapy is certainly becoming clearer, there is still a lacuna in the literature regarding dose. This is one of the reasons it is difficult in our current healthcare system for doctors to recommend massage therapy and therefore to have massage therapy covered by insurance. 

There are many tangents I could spin off on here, but I’ll save those for future writing and leave you with a parting thought:  

It seems to me that one of the more miraculous and cool parts of being alive, and embodied, is that we are designed to interact with each other and our environment. We are not meant to just interact socially through language, or to simply procure foods and materials to survive. Certainly we are not designed for interactions primarily with and through screens. We are designed to literally feel our environment and each other. Our regulatory systems appear to have evolved to receive sensory input, which is beneficial to our overall health. We are meant to feel the earth underfoot, the wind in our hair, the sunshine on our skin, and the kind caring touch of our fellow humans. This is not simply mechanistic, it is chemical and energetic in the endocrine and nervous systems. How cool is that?

References

Bialosky, J. E., Beneciuk, J. M., Bishop, M. D., Coronado, R. A., Penza, C. W., Simon, C. B., & George, S. Z. (2018). Unraveling the mechanisms of manual therapy: Modeling an approach. Journal of Orthopaedic & Sports Physical Therapy, 48(1), 8–18. https://doi.org/10.2519/jospt.2018.7476

Chen, Y., Li, Q., Zhang, Q., Kou, J., Zhang, Y., Cui, H., Wernicke, J., Montag, C., Becker, B., Kendrick, K. M., & Yao, S. (2020). The effects of intranasal oxytocin on neural and behavioral responses to social touch in the form of massage. Frontiers in Neuroscience, 14. https://doi.org/10.3389/fnins.2020.589878

Field, T., Diego, M., Hernandez-Reif, M., Medina, L., Delgado, J., & Hernandez, A. (2012). Yoga and massage therapy reduce prenatal depression and prematurity. Journal of Bodywork and Movement Therapies, 16(2), 204–209. https://doi.org/10.1016/j.jbmt.2011.08.002

Levin, J., & Bradshaw, M. (2024). Prevalence and determinants of massage therapy use in the U.S.: Findings from the 2022 national health interview survey. EXPLORE, 20(6), 103015. https://doi.org/10.1016/j.explore.2024.05.013

Rapaport, M. H., Schettler, P. J., Larson, E. R., Carroll, D., Sharenko, M., Nettles, J., & Kinkead, B. (2018). Massage therapy for psychiatric disorders. Focus, 16(1), 24–31. https://doi.org/10.1176/appi.focus.20170043

Schleip, R. (2003a). Fascial plasticity – a new neurobiological explanation: Part 1. Journal of Bodywork and Movement Therapies, 7(1), 11–19. https://doi.org/10.1016/s1360-8592(02)00067-0

Schleip, R. (2003b). Fascial plasticity – a new neurobiological explanation part 2. Journal of Bodywork and Movement Therapies, 7(2), 104–116. https://doi.org/10.1016/s1360-8592(02)00076-1

Severinsen, M. C. K., & Pedersen, B. K. (2020). Corrigendum to: “muscle-organ crosstalk: The emerging roles of myokines.” Endocrine Reviews, 42(1), 97–99. https://doi.org/10.1210/endrev/bnaa024

Stenbäck, V., Lehtonen, I., Mäkelä, K. A., Raza, G. S., Ylinen, V., Valtonen, R., Hamari, T., Walkowiak, J., Tulppo, M., & Herzig, K.-H. (2024). Effect of single session of Swedish massage on circulating levels of interleukin-6 and insulin-like growth factor 1. International Journal of Molecular Sciences, 25(17), 9135. https://doi.org/10.3390/ijms25179135

‘How often should I get a massage?’: Some Guidelines for Massage Frequency

This question seems like such a simple one. It’s a question I receive often in my practice, and I wish there was a straightforward scientifically backed answer. While emerging research on massage therapy may offer some helpful guidance, the lacunas in massage science are still many. The guidelines in this post are based primarily upon my professional opinion as a massage therapist of with over eleven years of experience.

Massage frequency will depend on a various factors including your budget, your schedule, and your current health needs.

Like other holistic lifestyle factors such as diet, exercise, and sleep hygiene, recent research and collective wisdom in the massage therapy field indicate that the effects of massage therapy are likely cumulative (Stenbäck, et al., 2024). Consistency over time promotes beneficial results. I’ve seen this again and again with my clients and experienced it with my own experience receiving massage.

Like other holistic wellness care that requires working with a professional (e.g. mental health care, physical therapy, chiropractic care, personal training, working with a nutritionist, etc.), more than one session is often necessary to receive the most benefit. Not only are the results cumulative, developing a therapeutic relationship with a new provider takes time. The most effective massage practitioners will use your feedback from previous sessions to tailor the experience to your needs and preferences. Unless you have a lot of massage therapy experience, it may also take you at least a couple of sessions to learn what feels best in your body to be able to communicate that to your massage practitioner.

If massage is a new part of your wellness routine, plan to get more than one massage. It may take time to to adjust to a new experience and to train your body to receive massage therapy for optimal benefit. People absolutely gain skill at receiving massage over time. This is not dissimilar from training your mind to meditate or training your muscles when starting a new exercise routine. Consciously relaxing while experiencing sensations that are potentially unfamiliar or intense may feel very foreign at first. If you have prior training in adjacent modalities (e.g. yoga, certain styles of meditation) this may help you transition to receiving massage with ease more quickly. Establishing trust between yourself and your massage provider and gaining familiarity with a new space may also require a bit of an adjustment period when working with a new provider.

For all these reasons, I recommend that folks plan to receive massage more than once and at regular intervals with the same provider to gain the most benefit from the experience. This is especially true if massage is a new part of your wellness care routines, or you are working with a new massage provider.

Receiving massage infrequently may not result in cumulative benefits. Like working out infrequently and consequently not being able to gain strength or endurance, receiving massage too infrequently could result in feeling like you are ‘starting over’ each time. Not only do people gain skill in receiving massage, massage results in changes in the state of the tissue (e.g. muscle, fascial) that can be maintained and even built upon from session to session.

No matter how often you choose to receive massage, the goal in every case should be to feel better. The frequency should be determined primarily by what makes you feel the best. Learning what feels good in your body and how long you feel the benefits are maintained can help you decide how frequently to schedule. Ultimately, we also need to feel good financially so it will likely also be a balancing act with what feels good in your body and what feels realistic with your schedule and your budget.

My Frequency Rule of Thumb

Number of Sessions: As a starting place, I would plan to receive massage more than once (ideally 3-5 times) from the same massage provider at a regular interval. While it is certainly possible that you may also benefit from the first (or a single session), this gives you a chance to start to feel cumulative effects and to get a sense of whether massage is helpful for your goals.

Making Progress Schedule: Plan to receive massage once every 1-3 weeks for at least 3-5 sessions if you want to build upon previous sessions and make progress on an issue.

Regular Maintenance Schedule: Plan on getting a massage once every 4-8 weeks (unless you desire to and can afford to come in more frequently).

Longest Interval for Cumulative Benefits: This will be different for everyone depending on other lifestyle and health factors. More than 8 weeks between sessions is probably too long if you are interested in cumulative benefits. Closer to every 4-6 weeks is probably a better estimate for most people.

Most Common at My Practice

Once a week, or every other week.

This is the most common massage frequency for folks with chronic issues who find great benefit from massage therapy and are utilizing massage as a primary therapeutic modality to improve mobility, relieve pain, reduce stress, and improve sleep. Yes, insomnia is one of the most common reasons people come in for massage! Whether primary or as a side effect of chronic pain, lots of folks find massage helpful to get some sleep (both on the table and off).

At least once a month.

This is most common for people who may be in a fair-to-good place with their health but want to have a robust maintenance routine in place. This frequency is also common for people who have chronic pain or chronic illness and use massage therapy in conjunction with other healing modalities to help manage or reduce symptoms.

Once every 4-8 weeks.

This is great for folks who just want a regular ‘check-in’ with themselves and their body, and/or as a part of their regular maintenance routine for otherwise healthy folks. Planned relaxation.

As needed/as able.

Folks who have health concerns that flare up occasionally. This cuts both ways, causing some folks to be unable to receive massage during certain symptomatic periods or while receiving other types of treatment and others to seek out massage during flare-ups to help calm symptoms. Often this looks like a vacillation between the 3 frequency camps above, changing frequency as needed.  

Using myself as an example of this, I try to receive a massage every 4-8 weeks unless something is ‘up’ for me. If what is ‘up’ can be alleviated by massage, I try to get massage more often until the issue is resolved or trending better.

Certain times of life have also seen medical issues that had me receiving massage less often than every 4-8 weeks while healing. Once the acute healing phase passes, I resume my regular 4-8 weeks pace.

Regardless of your goals for massage therapy, I hope that these guidelines help you as you consider you adding massage therapy to your health and wellness journey!

Reference

Stenbäck, V., Lehtonen, I., Mäkelä, K. A., Raza, G. S., Ylinen, V., Valtonen, R., Hamari, T., Walkowiak, J., Tulppo, M., & Herzig, K.-H. (2024). Effect of single session of Swedish massage on circulating levels of interleukin-6 and insulin-like growth factor 1. International Journal of Molecular Sciences, 25(17), 9135. https://doi.org/10.3390/ijms25179135

Massage Therapy and Tipping

I've been talking about massage therapy a little bit more on my IG page (@lalalalauralee), if you are interested. Below is a short bit of writing about tipping from a recent post. 
 

I am in a privileged place in my massage therapy career where tipping is ‘never required but always appreciated’. Maybe you have no nervousness around tipping. But in case you do, let's talk about it.

Tipping in the massage industry stems from its association with spa and chain massage business culture, where massage therapists are often hired at low hourly rates or make only a fraction of the ticket price of the massage service. In this context, tipping is both expected and extremely helpful to the massage therapist’s total income. Tipping in this context is similar to tipping at a restaurant or other service industry job. Often $20 or 20% of the service fee is the expected rate.

What do I mean when I say tipping is 'never required'? I mean that as a self-employed person with lower overhead, I am lucky to be able to set my rates to what is needed to run a business and pay my bills without the need for tips. I am very fortunate to be in this position. I cannot stress that part enough. It allows me a little bit of wiggle room to consider finding cost-effective solutions to help folks afford massage therapy services.

I have tried to do away with tipping, but the fact is that some of my clients want to tip. And I am appreciative! This allows me to offer services at lower rates than I could otherwise. I see tipping in this private practice context as a kind of ‘paying it forward’. Nice, if you can, but not necessary. I have clients who have never tipped me. And this is totally fine!

If tipping is the determining factor between whether massage is affordable for you or not, I would personally much rather you get a massage than avoid it because you cannot afford to tip.

Likewise, if massage feels a little out of reach even at the base rate price, I would rather you talk to me about a solution (barter, sliding scale, payment plan, etc.) than simply not receive massage!

I do not speak for all massage therapists, obviously. Some love tips, others won’t accept them. If you are not sure about the policy of someone you are interested in working with, just ask. But at least on my table, know that you are welcome to do what feels best for you.

I just want you to get massage if you want to, and enjoy it! 

Ask A Hag: Animism; There's science for that sh*t

A few months ago I had the pleasure of sitting down with Leslie and Alison, dear friends and hosts of the ‘Ask A Hag’ podcast. We had a lovely conversation about dream work, plant magick, animism, and even a touch of aliens.

Check out the episode, and their delightful podcast!

lobelia inflata

Pictured is the plant I mention in the episode, lobelia inflata. It has the common names Indian tobacco and puke weed.

Ask A Hag Website: https://www.askahagpodcast.com/askaquestion

Link to episode: https://podcasts.apple.com/ca/podcast/animism-theres-science-for-that-sh-t/id1473708595?i=1000466361718