By Mary Beckman
Swedish massage is the kind you're most likely to encounter at the gym or at a spa. You lie unclothed on a padded table, draped with a sheet, while the therapist applies oil or lotion to his hands or your skin and then uses gliding and kneading strokes and even tapping or shaking to relax your muscles and loosen your joints. All this rubbing and kneading can really boost your circulation, which can help reduce swelling from an injury. Massage can also induce a state of mind called the relaxation response, which has been shown to minimize the effects of stress and may boost your immune system. Sessions are usually 30 to 90 minutes long and can cost from $60 to $100 per hour.
You don't have to be an athlete to go in for a sports massage. This variation on the Swedish technique can increase your range of motion and speed recovery of sore muscles whether you're a seasoned jock or just starting an exercise program. Get one before a workout to loosen you up and help protect against injuries. Or get one just after to reduce soreness. A sports massage therapist uses the palm of his hand to bear down on the muscles in your legs and back to separate and relax them and his fingers to put direct pressure on a muscle in spasm, which can be painful but will reduce your pain later. If you're a runner, he might concentrate on your legs; if you're a swimmer, he might spend more time on your upper body. Prices are similar to those for Swedish massage.
Acupressure or Shiatsu
Acupressure is a form of bodywork that works on the same premise as acupuncture does but without the needles. The therapist uses his hands, elbows, knees, and feet to apply pressure to certain points on the body that the Chinese believe are connected to various organs by way of channels or "meridians." This pressure is said to improve your wellbeing by stimulating or unblocking the flow of a life force called Qi (pronounced 'chee') along those channels. Western researchers think acupressure triggers the release of endorphins, the body's natural painkillers. Acupressure is most widely available in the form of a Japanese therapy called Shiatsu. During a shiatsu session, you lie fully clothed on a mat on the floor while the practitioner applies pressure in gentle or invigorating strokes. He may also move your limbs around to stretch your muscles. A session may last from 30 to 90 minutes and can cost $60 to $100 per hour.
Sometimes called zone therapy, reflexology is based on the idea that massaging specific "reflex zones" on your feet can relieve tension, ease pain, and even improve circulation in corresponding parts of your body. During the session itself, you'll generally sit or lie on a padded table -- fully clothed except for your bared soles -- while a reflexologist uses his thumbs and fingers to relax your feet and stimulate the reflex zones that target areas where you might be having problems. To loosen a knotted shoulder, for example, he'd rub the outside edge of the ball of the foot. Proponents claim the technique is especially successful in treating stress-related disorders such as low-back pain, chronic indigestion, and headaches, but there are no good studies to back them up. If a reflexologist diagnoses you with a serious illness, it's a good idea to get a second opinion from a physician. Although reflexologists generally work on the feet (your feet have a high concentration of nerve endings and are easy to manipulate) they can switch to your hands if you have a foot injury. Expect to pay up to about $100 for an hour-long session.
Trigger Point Therapy (or Myotherapy)
Trigger point therapists (who are usually osteopathic physicians) use finger pressure to release tension in muscles that have become chronically tight from trauma, overuse, or poor posture. Many of these "trigger points" can cause pain in other areas of the body and are the same as those used in acupressure. For example, a therapist might work on your trapezius muscles (the ones between your shoulder blades and your neck) in order to relieve tension headaches. During a session, you'll lie unclothed under a drape on a massage table while the therapist warms up and relaxes the contracted muscles with kneading strokes. He'll then press directly on the tender points for eight to 12 seconds. This may feel uncomfortable but shouldn't be painful, since pain will just cause the muscle to contract further. Once he feels the trigger points release, the therapist will continue to work on the surrounding muscles so that they won't tighten up again. You may feel soreness in the area for a day or two afterward. A few studies have found trigger point therapy effective in easing low-back pain. Sessions typically last an hour. Prices are comparable to other forms of massage.
Myofascial release is a form of massage aimed at easing tension in your "fascia," the soft connective tissue between muscles and bones. The theory, developed by a physical therapist, holds that trauma, illness, or stress can cause your fascia to tighten up and pull bones and muscles out of place, causing pain and stiffness. During a session, you'll lie on a massage table in your underwear while your therapist uses his fingers, palms, elbows, and forearms to "stretch" your fascia with long, firm strokes lasting between 90 seconds and five minutes. The pressure is gentle and should not be painful. Few studies have tested this technique, but one small trial found that myofascial release reduced pain and numbness in patients with carpal tunnel syndrome. Sessions last 30 to 90 minutes and cost about the same as other massage therapies. You may require several sessions before feeling relief. About 20,000 practitioners in this country have been trained in the technique.
Rolfing, also called Structural Integration, is another method of manipulating your fascia, the soft connective tissue which intertwines with your muscles and forms a continuous web throughout the body. Biochemist Ida Rolf, who developed the technique, maintained that, over time, your fascia can be pulled out of alignment by accidents, poor posture, and emotional stress, causing muscle pain and stiffness. During a session, you may lie on a massage table, or stand or sit in your underwear as the Rolfer employs deep, often painful pressure with her fingers, forearms, and elbows to stretch and realign your fascia in an effort to restore flexibility and relieve chronic pain. Rolfing is generally conducted in a series of ten sessions lasting 60 to 90 minutes, spaced one to two weeks apart. Expect to pay $75 to $125 per session. Only those who undergo at least 600 hours of study and training at the Rolf Institute in Boulder, Colorado, can become certified Rolfers. There are currently about 700 of them throughout the world.
Garvey TA, Marks MR, Wiesel SW. A prospective, randomized, double-blind evaluation of trigger-point injection therapy for low-back pain. Spine 1989 Sep;14(9):962-4.
Rolf Institute. Steps to Becoming a Rolfer.
Sucher BM. Myofascial release of carpal tunnel syndrome. J Am Osteopath Assoc 1993 Jan;93(1):92-4, 100-1.
National Center for Complementary and Alternative Medicine. Massage Therapy as CAM. December 2, 2010.
Last Updated: March 11, 2013
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