Real Bodywork Massage Blog

This image shows how to stretch the quadriceps muscles on runners.

Massage Post-Workout: A Quick Update

    Massage after exercise, especially for athletes, is no new phenomenon. A Google search of “massage post exercise” brings up an ad from the retailer Kohl’s, selling at-home massagers as “exercise massagers.” Magazine articles entice readers with headlines about muscle recovery through massage; a Men’s Fitness article explains that just ten minutes of massage post-exercise can reduce sore muscles. But the science goes beyond this – Best and Crawford (2016) penned a short article, almost a meta-analysis, describing the advancements made in the world of sports regarding massage.
    The authors elaborate on what is an effective massage post-workout, as well as why massage may help athletes so much. The authors describe the ideal massage for muscle recovery as taking place almost immediately after exercise, and lasting for a short session (between 5-12 minutes).
    The authors note that massage may be an effective recovery tool considering it provides both physical and psychological benefits. Physical benefits include demargination of leucocytes, reduced muscle oedema, and a decrease in damaged muscle fibers. Psychological benefits can be an increase of relaxation and a decrease of stress biomarkers.
    However, the authors note that there is still much left to study. The authors mention that many of the studies do not have a standardized physical protocol that participants engage in during the exercise portion of studies. In animal studies studying massage on muscle recovery, many studies have begun using standard protocols when the animals are exercising. In addition, variables such as amount of pressure during massage, frequency of massage, and athlete’s experience may affect massage’s effectiveness. That is, an athlete who has regularly exercised daily for a decade may not have as much pain and soreness post-exercise, and thus may have less effective results, than a new athlete who’s only begun training.
    In addition, the benefit of the post-exercise massage seems to be most effective immediately following the intervention. Studies have shown that the best results occur about five to ten minutes following the massage, and begin to decline after only an hour has passed.
    More research is underway about post-exercise massage, such as molecular changes in skeletal muscle post-massage or ideal frequency in massage following workouts. The authors suggest future research also look into a combination of recovery strategies (i.e. cold water immersion, compression) with massage.
    While more research continues, the existing research seems to paint a clear picture for athletes – massage may not be the all-in-one solution, but it undoubtedly provides benefits for your sore muscles!


Best, T. M., & Crawford, S. K. (2016, September 18). Massage and postexercise recovery: The science is emerging. British Journal of Sports Medicine. doi:10.1136/bjsports-2016-096528

Traditional Thai Massage for Short-Term Back Pain Management

    Traditional Thai massage, or TTM, is part of traditional Thai medicine. This massage includes deep pressure massage with sustained compression on a muscle. Passive stretching is included at the completion of the massage. Previous research on TTM has found a variety of benefits, ranging from increased flexibility and decreased muscle tension, to reduced pain. The traditional massage is guided by lines on the body, called the Sen Sib. These imaginary lines serve as directions for the massage therapist, who applies pressure to points across these lines. The Sen Sib, however, falls on most of the trigger points on the body, which may explain its effectiveness.

    Researchers Buttagat, Narktro, Onsrira, and Pobsamai (2016) wanted to look into the effectiveness of TTM, specifically concerning myofascial pain syndrome. Myofascial pain syndrome (MPS) is not an uncommon condition. It is characterized by localized pain and may include a decrease in range of motion, problems with sleep, and the presence of myofascial trigger points. Skootsky, Jaeger, & Oye (1989) found that MPS occurs most often in the upper body, and Rachlin and Rachlin (2002) elaborated further, explaining that the most common areas affected are in this order: the trapezius, levator scapulae, and axial postural muscles.

    While previous research has looked into the effectiveness of TTM on myofascial pain syndrome, the researchers felt like there needed to be more concrete evidence on its efficiency. For their 2016 study, they used electromyography (measurement of muscle energy) to measure the effect of TTM on muscles.

    The researchers conducted a single-blind, randomized clinical trial consisting of 50 participants. These participants had to have suffered from upper back pain for at least three months prior to the study, with the presence of at least one myofascial trigger point in the upper trapezius muscles. The researchers noted that, “the criteria used to diagnose MTrP described previously by Buttagat et al. (2016) was as follows; the presence of a tender nodule that causes a referred pain within taut bands of muscle in areas which the patient identified as painful.”

    The 50 participants were randomly assigned to one of two groups, TTM or control. For the TTM group, participants lay down on their side while fully clothed. For 30 minutes, the massage therapist used the thumb or another digit to apply body weight onto different points of the upper back, slowly increasing pressure for a duration of 5 to 10 seconds per point. At the end of the massage, the massage therapist would passively stretch the participants’ muscles. The control group did not receive any actual treatment. The researchers set up a micro-wave therapy machine next to the participant. The machine was turned on, but was kept in standby mode as a form of placebo therapy. This intervention also lasted for 30 minutes.

    The researchers measured EMG activity as well as participants’ ratings of perceived muscle tension and pain intensity. These variables were measured both before and after intervention.

    Participants in the TTM group showed a significant decrease in all three variables – EMG activity decreased, as did reported muscle tension and pain intensity. The control group had almost no change to EMG activity or reported pain, but the control group participants did surprisingly report a decrease in muscle tension.

    Traditional Thai massage seems to provide beneficial results for patients with upper back myofascial pain syndrome. These results support the findings of existing research on the benefits of TTM. The researchers indicate that long-term studies on the effect of TTM would be ideal, but that based upon the results of the study, TTM is “a useful intervention for promoting physical relaxation and decreasing muscle tension and pain in MPS patients.”

Buttagat, V., Narktro, T., Onsrira, K., & Pobsamai, C. (2016). Short-term effects of traditional Thai massage on electromyogram, muscle tension and pain among patients with upper back pain associated with myofascial trigger points. Complementary Therapies in Medicine, 28, 8-12. doi:10.1016/j.ctim.2016.07.004

Buttagat, V., Taepa, N., Suwannived, N., & Rattanachan, N. (2016). Effects of scapular stabilization exercise on pain related parameters in patients with scapulocostal syndrome: A randomized controlled trial. Journal of Bodywork and Movement Therapies, 20(1), 115-122. doi:10.1016/j.jbmt.2015.07.036

Rachlin, E., & Rachlin, I. (2002). Chapter 11 – Trigger Point Management. In Myofascial Pain and Fibromyalgia (2nd ed., pp. 231-258). St. Louis, MO: Mosby.

Skootsky, S., Jaeger, B., & Oye, R. (1989). Prevalence of myofascial pain in general internal medicine practice. Western Journal Of Medicine, 151(2), 157-160.

Massage Therapy as Complementary Treatment for Parkinson’s Disease

    Parkinson’s disease (PD) affects approximately 1 million Americans, with nearly 60,000 new cases diagnosed each year. Worldwide, about 10 million people have been diagnosed with this disease. PD occurs when the brain begins to slowly stop the production of dopamine. This will affect a person’s ability to control his or her body and its movements, as well as emotions. The chances of developing PD increases with age and symptoms may not be too apparent at first, as this disease progresses slowly. PD’s physical symptoms can have a strong effect on a person’s quality of life, and may affect family members as well.
    Complementary medicine is often used in the treatment of PD, with massage therapy being one of the most popular. 54% of PD patients in the United States reported using complementary medicine, and cited massage therapy and aromatherapy as the most commonly used (Ferry, Johnson, & Wallis, 2002). A study by Japanese researchers Donoyama and Ohkoshi (2012) may provide positive insights for those affected by PD and considering complementary therapy.
    The researchers gathered 10 adults who had been diagnosed with PD. These participants had expressed interest in pursuing massage therapy in conjunction with their standard treatment. The researchers wanted to measure the participants’ walking disturbance and speed, range of motion for those suffering from frozen shoulder (pain and restriction of movement in the shoulder), hypophonia (difficulty speaking loudly or clearly), as well as other physical symptoms such as muscle pain and fatigue.
    The 10 participants received a single intervention consisting of a 30-minute full body massage. The massage consisted of traditional Japanese techniques by mainly using kneading (less stroking/pressing) with moderate-pressure while the participants were clothed. For participants suffering from frozen shoulder, a shoulder joint massage was incorporated. Attention was paid to both the more severe and less severe sides of the body.
    Results showed significant improvements for all measurements. Walking speed and ability both increased. The researchers noted that one of the participants took 95 seconds to walk 10 meters pre-test, but post-massage was able to walk the same distance in 21.5 seconds. All of the participants suffering from frozen shoulder had an almost full range of motion restored immediately following the massage. Hypophonia was also decreased in participants, with a difference of 18.8 points pre- and post-massage. Additional physical symptoms such as muscle pain and fatigue decreased as well.
    While the results provide significant improvements for the participants, it is important to note that the sample size for the study was very small. A larger sample size is needed to support the findings of the study. In addition to a larger sample size, a longitudinal study, or increasing the time of the study and amount of interventions, may shed light on the long-term effects of massage for those with living with PD. Lastly, a quality of life measurement should be incorporated so as to measure any emotional benefits PD patients may achieve.
    Nonetheless, this study has found that massage therapy does provide immediate physical benefits for those diagnosed with PD, and that massage therapy combined with standard treatment may provide significant alleviation of symptoms.
Donoyama, N., & Ohkoshi, N. (2012). Effects of Traditional Japanese Massage Therapy on Various Symptoms in Patients with Parkinson’s Disease: A Case-Series Study. The Journal of Alternative and Complementary Medicine, 18(3), 294-299. doi:10.1089/acm.2011.0148
Ferry, P., Johnson, M., & Wallis, P. (2002). Use of complementary therapies and non-prescribed medication in patients with Parkinson’s disease. Postgraduate Medical Journal, 78(924), 612-614. doi:10.1136/pmj.78.924.612