Massage. Just reading that word may whisk you away to a thought filled with relaxing aromatherapy, botanical blend massage oils and soothing music in the comfort of a luxurious day spa.

Most people still regard massage as a luxury expenditure - something done to pamper oneself. However, massage therapy has also proven beneficial for many chronic conditions, including low back pain, arthritis and bursitis.

Massage has actually been part of physical therapy since the inception of the field in the 1920s when massage played a major role in polio therapy.

And therapists are now getting back to their roots.

According to Tom Adams, LMT, medical supervisor at the Philadelphia-based Omega Institute, it’s not commonplace yet, but it is becoming more common for complementary medicine providers to work hand-in-hand with occupational and physical therapists to help provide pain relief for patients.

Case in Point

While massage is not a cure, it can help some people better manage their condition. Take Chris Saunders, for example.
 
For decades, Saunders played tennis to his heart's content. He didn't stretch nearly as much as he should have, but with no injuries to show for it after all that activity, Saunders carried on as he always had.

But, recently, the 32-year-old Newport, Ky. resident's luck ran out. He began to feel frequent discomfort in his left knee, which Saunders says eventually proliferated into chronic pain in all the joints on that leg.

His physician referred him to not only a physical therapist, but also a massage therapist. “The combination is truly a dynamic duo,” says Saunders. “Massage relaxes me and relieves tension in my muscles to a point where I can do my physical therapy exercises correctly and with better range of motion.”

Causing Friction

In his experience working with physical therapists, Adams says one particular type of rehabilitative-style massage has proven to be extremely beneficial: cross-fiber friction.

“With this technique, we rub across the fiber direction so that the fiber is still left intact while we get rid of extraneous connections to healthy tissue, which are called adhesions,” explains Adams. “Picture having cobwebs on a guitar string; you get rid of the cobwebs while the guitar strings stay in place.”

With any type of surgery where cutting of the body has taken place, fibrosis will naturally occur. The body lays down connective tissue to unite the ends that have been cut apart. The substance that connects the separated ends is sticky, and it glues down the tissue that’s injured. Massage helps to sculpt the repair, Adams says, because cross-fiber friction helps to create pliable scar tissue.

Adams has also worked with patients recovering from surgeries that are cardiovascular and skeletal in nature. “One of the great things massage does for any type of surgery is speed the healing by bringing more blood to the area,” he adds.

But massage doesn’t work alone. If someone gets massage by itself, and doesn’t go through a physical therapy program, they aren’t exercising that tendon or muscle. Connective tissue molded by the massage therapist will eventually lose its pliability and glue down healthy tissues.

“Then, when the person goes to move it, it’s stuck and they have a restricted range of motion. It’s the old ‘If you don’t move it, you lose it’ concept,” Adams says. “Massage therapy is fit, but it works much better when it’s linked to a quality physical therapy rehabilitative program.”

Minding the Body

Massage helps patients relax mentally and physically.

Mentally, a patient feels better because massage mutes pain signals by sending endorphins to the brain. Also, the influx of hormones and neurotransmitters causes a chemical impulse to feel good and relax.

Through techniques, such as compression, friction and kneading, the massage therapist can, literally, grasp tissues and gently pull the fibers away from one another to release tension.

“By doing this,” Adams says, “the nervous system relays a message to that tissue saying, ‘There’s really no cause for you to be so contracted right now. There’s no job to be done here, so let go.’”

Finding a Niche

Massage therapy students learn different strokes and techniques to target specific body areas, illnesses and injuries.

In common cases, such as Saunders’, rehabilitative-style massage loosened up his muscles to improve his range of motion and maximize his physical therapy. In less common cases, people who have had lymph nodes removed may require a specialized massage technique to relieve fluid accumulation in the limbs.

It's been shown that massage therapy improves functioning of the circulatory, lymphatic, muscular, skeletal and nervous systems – but what about the reproductive system?

Larry Wurn, LMT, director of clinical studies at Gainesville, Fla.-based Clear Passage Therapies Inc., is working to resolve that issue.

Fifteen years ago, Wurn recognized a niche of chronic pain patients that were unable to find relief with traditional medical care. His wife, Belinda, was one of them.

“She had cancer of the cervix,” Wurn explains. “But when she had surgery and radiation therapy to heal that cancer, adhesions formed in her pelvis.”

The adhesions caused pelvic pain, which caused Belinda to complain. Wurn soon noticed his wife wasn’t the only one expressing these same complaints.

To make a long story short, Wurn spent the past 15 years studying and developing an effective way for soft tissue therapy to address adhesion-related pain, female infertility and dysfunction.

“These adhesions make it as if someone is wearing a straightjacket inside or has had glue poured in their system,” says Wurn. “We help break that up so they can move and exercise again.”

Be on the lookout for these patients, cautions Wurn, and you could save yourself time and confusion. Infertility, incontinence, painful intercourse or tailbone, poor digestion or "unexplained pain” are common symptoms.

Typically, says Wurn, someone suffering from unresolved pain without a medical or hormonal explanation is the kind of patient that has adhesions and responds well to this type of therapy.

He adds, “Sometimes this pain can appear all over the body, and truly present with confusing patterns.”
 
Getting in Touch

Currently, massage therapists – in comparison to physical therapists – don’t have to undergo nearly as much training.

Aye, there’s the rub.

“Sometimes, we will get looked down upon because we simply haven’t gone through the professional standards that they’ve had to,” says Adams. “It gets under the skin of people like physical therapists.”

Adams says patients would greatly benefit from more integration between massage and physical therapists. But, he quips, “It won’t happen if people see those commercials that advertise a massage therapy career as being easy and a way to get rich quick.”

For the integration to happen, Adams says, there needs to be an increase in educational standards and the massage profession needs to better police itself.

If you are, or if your clinic is, looking to integrate massage therapy into a plan of care, do your research on the therapist, says Adams. Also, a teamwork mindset is important for a hands-on approach to improved patient care.

“I let my students know that they are part of a medical team and that at any time they could be working hand-in-hand with a therapist, someone in the psychological profession or any type of physician,” says Adams. “We’re all in this together.”

Amy Storer is the editor of TherapyTimes.com. Questions or comments can be directed to editorial@TherapyTimes.com.