One
Thai Massage position involves having you sit, with the practitioner sitting
behind you, putting their arm under your arm then around the back of your
neck. In wrestling, this move is called a half-Nelson. This move is used
to bend your neck forward. From there, the practitioner may push your
back and neck forward, often leaning their weight to assist your forward
movement. Don't let people push your back or neck to round forward, whether
to stretch or to make a cracking noise. Avoid manipulation to the neck,
which has been found to sometimes tear the blood vessels leading to the
brain. There have been deaths and even Western chiropractors have been
cautioned not to crack the neck.
2. Forced Bending Forward With Twist
A
second assisted stretch to avoid is similar to the move above. In a sitting
position with the practitioner sitting, behind you or to the side, they
may put both arms under your arms then around the back of your neck, in
a move that, in the sport of wrestling, is called a "full-Nelson"
and is used to control and hurt your opponent. From there they may swing
you slightly to the side, then again with a wider swing, then a third
time with force. This sometimes makes a cracking noise in your back. Anatomically,
the greatest force you can put on your discs is bending forward (especially
under weight or assisted force) with a twist.
3. Snapping Elbows or Knee Backward
Sometimes
in the course of a massage, the practitioner may bend your elbow or knee,
then straighten it with a snap. For example, they may bend your knee toward
your chest, then hold your heel and let the leg drop straight, letting
the knee snap with force. They may push your elbow or knee backward at
the same time to assist the overly-extended position. The elbow and knee
joints are not shaped to hyper-extend more than a small amount in general,
and under force not at all. Hyperextension means to go more than a normally
straight position. It can damage the joint and cartilage. No joint should
be "snapped" or banged or forcibly pushed at the end range.
4. Pushing Elbows or Knees Backward
In
other Thai massage moves, the practitioner may not forcibly or suddenly
hyperextend the joint with snapping, as above, but press it backwards.
The intention may be to stretch a joint that does not fully straighten
so that it can get full range. For some people, the joint can be pushed
to where it pressures, crushes, abrades, or unseats the joint in various
amounts. Sometimes it is done intentionally, in the belief that any stretch
is good (even if not). Other times it is a mistake, for example, the knee
can be uncomfortably pressed passed the straight position in a move that
is supposed to only stretch the hamstrings. The client lies on their back.
The practitioner pulls the heel of one of the client's legs up in the
air, while pressing downward on or around the knee. The purpose is supposed
to be to help keep the knee straight to get a hamstring stretch. However,
the result is often to press the knee backwards past a healthy or comfortable
point.
5.
The Blood Stop
An
interesting and thought-provoking maneuver in Thai massage is the "blood–stop."
The practitioner may press their palms, knees, elbows, forearms, shins,
or feet over the big blood vessels that bring blood to your legs, or over
the arteries that conduct blood to your arms. They press enough to slow
or stop blood from flowing to your legs or arms as long as 30 seconds,
a minute, sometimes more, depending on the style and school where they
learned. When they release the pressure that was restricting the blood,
blood flows back down the limbs. Thai massage practitioners are taught
to never do the blood stop on anyone with high blood pressure, varicose
veins, heart or circulatory problems, or pregnancy. It also turns out
that the blood stop maneuver is not healthy for others.
It
is often taught in massage schools that the blood stop "helps unclog
arteries." The theory is that if there were deposits that block the
artery, the rush of blood returning would "unplug" the blockage
and carry it away, like cleaning a clogged plumbing pipe. This does not
work for several reasons. First, the rise in blood pressure from stopping
(or slowing) blood flow is small and not enough to dislodge anything when
flow is released. You increase your own blood pressure more from ordinary
walking and exercise. Next, most deposits are not like separate pebbles;
they are too attached, like paint, to be pushed away with blood pressure.
Even if a push could dislodge anything, anything that dislodges from your
big blood vessels can travel to a smaller place to become a foreign clog
there - in the same way that damage occurs from a brain clot (a kind of
stroke) or heart attack or phlebitis.
Another
idea taught is that slowing arterial blood helps draw away "stagnant"
venous blood from the limbs. This is not how circulation works, even if
it sounds good. Although the blood stop will not help circulation, you
can easily improve it with most exercise. When you exercise, the contracting
muscles squeeze your limb vessels to move blood that pools in the limbs.
Muscle "squeezing" from exercise is different and far briefer
than the "blood stop."
Another
of the theories of the blood stop that is sometimes taught in massage
schools is that it helps counter the phenomenon of "legs falling
asleep" during long sitting or meditation. The mistaken belief is
that "legs falling asleep" is caused by lack of blood flow,
and the blood stop will strengthen or increase circulation to alleviate
that problem in the future. A little knowledge of physiology is helpful.
When a limb "falls asleep" it is not lack of blood flow, but
nerve compression. There is no reduction in blood flow when you get the
tingling and the "pins and needles" feeling of a limb falling
asleep. The tingling is called neuropraxia, which just means a temporary
interruption of sending nerve signals resulting in pins and needles feeling.
During the blood stop maneuver, there is no pins and needles feeling,
and when you stand up after your legs "fall asleep" there is
no warm rush of blood as after the blood stop. They are two different
things. Next, compressing arteries to slow or stop blood does not cause
any increase in the number or size of blood vessels, or ability to pump
blood, any more than having clogged arteries improves circulation. The
blood stop does not reroute the blood or encourage the body to find new
pathways which give circulatory benefit. Exercise will increase all these
good things, but doing the blood stop does not, even if we wish it does,
or were taught that it does.
When
you stop blood to an area for long enough, it is not healthy for the area.
Cells starve. Nerve cells are more sensitive than other body cells to
lack of oxygen. Thai Massage practitioners are sometimes taught that it
is not stopping blood but "opening the wind" to "release
stagnant blood or energy." However, in arteries there is no
stagnant blood to "release." No matter what you call it, cutting
off blood flow is not great for any body area. Sometimes people hear a
true bit of physiology and misinterpret it to support their belief in
a harmful practice. An example is that there are specific instances where
decreased oxygen supply initiates growth factors. This should not
be misinterpreted that you can strangle someone, or stop blood to their
limbs and make them generate beneficial compounds. When does insufficient
oxygen supply compared to demand cause growth factors to be generated?
Exercise. When you exercise hard enough to get out of breath, your body
isn't able to extract enough oxygen from the air to supply your needs.
This does not mean you are suffocating or cutting off blood flow. It means
that your body notices that it would benefit if it generated - over time
and repeated exercise - a larger supply of all the enzymes, and red blood
cells, and cellular and circulatory structures that take oxygen out of
the air, and that make your body able to use it, so that you do not get
as out of breath for the same exercise. The Thai Massage move of the blood
stop may not help an injured leg or arm recover, as much as we wish
it did. It may hurt it. It is better to use exercise and movement, which
is known to create the needed growth factors without the risks of the
unmeasured general "blood-stop" maneuver.
Then
an even more interesting paradox occurs: When blood
flow, called perfusion, is restored to any body area that was deprived,
oxygen flows back into the area. That would sound helpful, but the oxygen
itself causes a second injury. It floods the area with a kind of oxygen
that is not healthy called oxygen free radicals, along with other
harmful products. A new serious injury occurs called a reperfusion
injury. This same kind of injury occurs with heart attack or in a
limb that may have been crushed or caught under something, depriving it
of blood. First, areas of the heart or the limb that are shut off from
oxygen begin to die. When blood flow is restored, oxygen flows back into
the area and with it, and the cascade of oxygen free radical damage,
plus just too much oxygen which is not good by itself. A sudden oxygen
reperfusion injury from releasing a blood stopping event is too much for
your body's natural defenses against too much oxygen, and injury occurs.
You may have heard about anti-oxidant vitamins. Your body naturally produces
anti-oxidants to stop normal daily damage from oxygen. Even regular levels
from breathing create oxidative chemicals in your body. Many people also
take supplementary anti-oxidant vitamins, hoping to stop oxidative damage
from oxygen. It is turning out that anti-oxidant vitamin supplements may
not be as helpful as hoped, and do not help in the way the more complete
spectrum of anti-oxidant compounds your own body provides. Free radicals
damage to the body depends on levels. Low levels are needed to fight disease
(to damage those germs that harm us) and also help vascular tone, cell
signaling, muscular activity, and more. More oxygen free radicals do not
make those functions work more or better - that is key to know. Like radiation
and sunlight, which are beneficial up to an amount, then turn harmful
or even deadly, higher radical and reperfusion product levels are associated
with more atherosclerosis (more blood vessel "plugs") not less,
diabetes, some types of arthritis, cancer, and other problems. "Oxygen
is a dangerous friend." Much interesting work in high pressure
oxygen science deals with trying to understand and avoid the paradox of
too much oxygen, free radicals, and oxygen reperfusion injury.
None
of this means that Thai massage is not good for other reasons, just that
it is best to avoid the blood stop and other moves that harm. It is easy
to avoid the pitfalls and hype of massage, and use Thai massage for the
benefits. Being educated to avoid the hype and myths helps in choosing
a beneficial massage.
Massage Myths
- False Claims
Many
claims are made for the different kinds of massage. Some true, many not.
Why
do people like false claims? As with other
commodities and practices, massage sellers and enthusiasts make false
claims, from modest to the most wild - to expand sales, to validate time
spent doing it, to increase their influence over others, or when they
really do not know that everything is not exactly as they heard.
Some claims are false but so often repeated that "everyone"
says so. People seem to like and repeat "urban legends" and
"old wives tales" and "fake news" more than truths.
Often the more complicated or mysterious the false premise, the more it
is fiercely defended.
Customers
may expect a long list of benefit, true or not, and patronize those who
say they provide it. Clients with great belief seem to benefit more from
the aspects they expect, and attribute any positive sensations and effects
to the massage (or whatever treatment). They may return repeatedly for
more even with random or small results. If they feel worse, some see that
as proof they need to return even more.
Some
claims are exaggerated from real body functions that happen anyway. Along
that line, you can point to massage study results that show massage does
enhance specific functions, but look further (if you understand research
design and statistics) to see that the amount may be small compared to
ordinary things like walking around, for example. Using scientific sounding
words does not make a claim into an actuality.
Preference
for fantasy and drama over simple truths is seen in daily entertainment,
all the way back to great works of literature and theater. People may
be swayed by charismatic practitioners with engaging shows. A good example
is the story,"The Emperor's New Clothes." The Emperor
was told by his persuasive tailor that the new clothes the tailor made
for him were so beautiful and exotically made that only the best and smartest
people could see them. The truth was they were not really there at all.
Because he didn't want to appear stupid, the Emperor went outside wearing
the non-existent "clothes" and was completely naked. The townspeople
all said that the Emperor's new clothes were indeed beautiful. They didn't
want to go against indoctrination, or "what everyone says."
Finally, a child who didn't know the propaganda shouted the obvious,
"The Emperor has no clothes on!"
There
are people who believe that the planets are flat not round, but what is
the problem with anyone saying anything they want? If it is a simple business
transaction, what is the harm? It's your money and your choice isn't it?
But having others take your money and give you lies in return while they
ask you to believe them robs your own rational thinking process. It harms
not only your wallet, but your mental health.
There
are more beneficial ways than false claims. The
massage community is usually sharply divided over what is real. Jill Kristin
Berkana LMT does a nice job stating various positions of the factions.
She summarized some of the "Science Group's" position that it
is unethical to make false claims and, "The public is hurt by false
claims and we (massage therapists) look ridiculous when associated with
them." She nicely states her own group of "Ethical Holistic
Massage Therapists" position that, "We know we must be knowledgeable
and stay appraised of, and integrate new scientific evidence that is being
introduced, and drop what we learned decades ago that has been proven
to be mythological." For myself, if I need to fix an injury for someone,
or do better training for myself, time needs to be spent advancing that,
not sidetracked on less effective or ineffective things that are wishful
thinking, fads, or marketing. Especially when you are paying for it and
need real solutions.
Here
are a few of examples, of many:
False
Claim: Massage removes lactic acid.
Actuality:
Lactic acid is only produced during hard exercise,
and the body very quickly removes it automatically. Even if you stopped
your run to rub your legs, no more would disappear than if you didn't
rub your legs. There is good evidence that keeping moving at a slower
pace will remove lactic acid more quickly than stopping to rest, or to
sit or lie down for a massage. Moreover lactic acid is not the cause of
stiffness or soreness post-exercise, and is not a bad thing that needs
improved removing. Most pertinent to massage, is that when you're lying
down for a massage, there is none needing removal.
False
Claim: Massage increases blood flow and
blood flow fixes things therefore massage will fix all those things too.
Actuality:
Walking across the room and other exercise will
increase blood flow more than massage. Blood flow itself does not fix
an injury for several specific reasons. One is that injuries like sprains,
soreness, cuts, fractures, blown discs, and others, are not suffering
from low oxygen states (they are not hypoxic). They have enough oxygen
to them already. Similar to trying to put more gas in a full tank, it
will not make your car go faster. Importantly, consider an injury that
is swollen. It already has more than enough blood and other fluids in
the area. You don't need more. You may ask, then won't massage help move
that unwanted blood flow out? A bit, and exercising the area (in healthy
ways that are possible for the injury) will mobilize fluids far more.
There are specific squeezing and mobilization techniques for specific
kinds of pathologic swelling that help temporarily push fluids out. They
are best combined with making sure the person is doing other needed things,
such as addressing causes, keeping moving, checking restrictive clothing
(many more). More oxygen does not make healing faster - except in gangrene,
when the oxygen kills those kinds of germs called anaerobes - those that
cannot live in an area that is oxygenated. The earlier section of Thai
Massage Pitfalls describing the "blood stop maneuver"
explains more of how science gets misapplied to believe things about blood
flow that sound good but don't work that way.
Some
claims are taken from basic normal responses to stimuli, then exaggerated,
and applied specifically to massage:
Claim:
Massage will increase or "improve
the nervous system." Then the claim will list impressive sounding
nervous system parts and chemicals that are "increased."
Actuality:
Even the simplest of activities, from looking at
things, to smelling them, to waving your arms around, involve an increase
in various nervous system inputs (which have long impressive names). They
are part of a long list of normal functions. Beside the fact that the
claim is so vague that it can mean anything or nothing, massage may increase
some function, but in such a very small amount that is not effective,
and merely walking, or even reading, may have the same stimulus effect.
Sometimes
practitioners say that they are fixing your tension or aches through some
exotically-worded technique that does mysterious effects on body parts.
systems, and functions that may or may not even exist, or that they are
stimulating impressive-sounding functions. In reality, they may be doing
a simple direct stretch that helps like any other stretch, or rubbing
and pressing in a pleasant way.
False
claims also come when benefits of one specific kind of application is applied
to anything else called massage. For example:
False
claim: Massage cures foot fungus.
Actuality:
A practice called "Fish Massage"
can possibly help reduce some of the causes or results of that. However
it is not a massage. It is putting your feet in a tank of a specific kind
of fish who like to eat dead skin. They do not have teeth. They use their
lips to nibble away the dead bad parts and do not hurt or remove living
healthy skin (although germs in the water might). The
word "massage" is used as the name but it is not a massage and
the effects are not from any massaging of the area. You cannot
truthfully say that "massage" in general fixes or treats foot
infections, and use made up claims about increasing blood flow or other
falsehoods as the reason.
False
claim: Massage improves post-exercise recovery.
Actuality:
As much as we wish, it really doesn't help.
If you like massage, then enjoy it. But not for false claims. Here is
a small study that includes the main concepts, which are also supported
by other work:
"A
Queen's University research team announced confidently last week that
the massage after exercise 'myth' had been "busted" by its research
team. Research on 12 males performing two minutes of isometric handgrips
found massaging the forearm immediately after exercise actually impaired
blood flow to the muscle, rather than improving circulation.
"This
dispels a common belief in the general public about the way in which massage
is beneficial," said Kinesiology and Health Studies professor Michael
Tschakovsky. "It also dispels that belief among some health professionals.
I have spoken with a number of health professionals in private practice
who, when asked what massage does, answer that it can increase muscle
blood flow and helps get rid of lactic acid. Ours is the first study to
challenge this and rigorously test its validity."
"Massage
After Exercise Myth Busted" www.sciencedaily.com/releases/2009/05/090507164405.htm.
E.
Victoria Wiltshire et al., "Massage Impairs Postexercise Muscle Blood
Flow and 'Lactic Acid' Removal," Medicine and Science in Sports
and Exercise 42, no. 6 (June 2010): 1062-71. doi: 10.1249/MSS.0b013e3181c9214f.
False
Claim: Massage removes cellulite or the
causes of it.
Actuality:
Massage cannot make someone slimmer or get rid of cellulite appearance.
Wishful thinking.
Misleading
Claim: Massage fixes hypertension.
Actuality:
If you are lying down and relaxed by a nice person
doing nice things, of course your blood pressure will lower for that time.
If a trained practitioner can teach you specific tension-reducing techniques
to use for other times, then you may gain one of the things that help.
Massage alone cannot cure high blood pressure as an ongoing condition.
You need to address component causes. More importantly, if you have restricted
blood vessels, you need to address that first before you lower the raised
pressure that is necessary to push blood flow through the restrictions
to get to vital areas.
Misleading Claim: Massage fixes
back pain.
Actualities:
You may ache from fatigue and common aches
of daily slouching, then falsely attribute that to "imbalances"
and "toxins" and other vague or imaginary ailments. Lying
down with a nice person giving you a nice rub leaves you rested and recovered.
It had nothing to do with toxins and imbalances.
A
common kind of back pain comes from standing in a slouch called swayback
(hyperlordosis). People who slouch this way almost always feel quickly
better to lie down with their knees bent. The reason is that lying with
bent knees reduces the painful lumbar angle to a more neutral angle -
as long as you are lying down that way. Lying with knees bent over a massage
bolster with a nice person who talks all about how massage will help can
seem to "work" amazingly. Pain will stop, but not because of
the massage, and important to know, not the cause
of the pain. As soon as the person stands and goes back to the same swaybacked
slouch, pain creeps back. This creates a common situation of people who
insist they must have massage to get relief, and have it often. If they
didn't stand in this painful way they would not get this pain in the first
place or need to pay to lie down. Swayback is not a spine condition or
"just the way you are made." It is a slouch - a bad posture.
A quick and simple change in spine position from slouch to neutral would
stop the cause of the pain with no massage needed. (Summary of this kind
of pain and what to do is in my article. Back
Pain With Standing). Then you can get massage to feel good, not because
you feel bad and trapped.
Many
more:
Massage
cannot cure a sprain or hasten recovery.
Cannot
fix bad posture.
Cannot
make muscles or connective tissue stronger.
Cannot
improve blood flow to a developing fetus in a pregnant woman.
There
Is Enough Good Not To Have to Use False Claims
There
is no need to make false claims for massage. Massage is supposed to be
a nice friendly thing. It can do a few things and that is enough. Even
penicillin only does one thing and that is enough to fix, even save, lives.
If
you go to someone you like and it feels nice, that can be a worthwhile
and healthy thing to do.
If
you have a specific problem, and a specific kind of massage specifically
addresses it, for example, a sports massage or Thai Massage that stretches
your hamstrings or other parts in helpful ways, then you will gain that
amount of stretching. Some styles of Thai Massage don't use stretches.
Some only use pressing on "pressure points" so check to get
what you need and want.
If
you have painful spasm in a muscle, specific direct stretches will
relieve that. Then that issue is resolved nicely. No need for exotic claims
about energy points and toxins. Just a straight cramp release. Needed.
Quick. Effective.
If
you are in need of human contact and the massage person provides you with
validation and attention, then you filled that need.
If
you have "tension" in your muscles, and lying in a nice warm
room that smells pleasant, with someone nice letting you relax, while
they stretch and push those muscles in ways that lengthens and relaxes
them, then you will have that benefit until you tense up again. It would
be best to go to someone who can teach you direct ways to notice areas
where you hunch or tighten, and how to prevent doing that. Then you have
helpful long term reduction in pain and effects from hunching and tightening.
If
the massage person uses balms and rubs for your sore muscles, the concoction
itself may have anesthetic or counter-pain properties. For example, a
simple muscle rub like BenGay or Tiger Balm. These various
products act as a temporary counter-irritant to reduce sensations of local
pain, and can give a warming or feeling. Some practitioners use higher
strength anesthetic lotions. Many false claims are make for the effects
of feeling warmer or cooler. If you like the feeling and smell, and it
is applied in a nice way, that is great.
For
people who are not very mobile, or are bedridden, having their body and
limbs mobilized and moved is crucial for health.
Some Readings
That Help Understand Claims
It
is increasingly easy to find just about any reading that will support
or refute your cause. Educate yourself in basic science and analytical
thinking so that you can know how to question things presented more impartially
in order to gain useful and healthy practices.
Here
is an encompassing article distinguishing legitimate effects of massage
to feel good and temporarily lift mood and overall body, compared to disproved
claims and unsupportable exaggeration:
http://www.quackwatch.com/search/webglimpse.cgi?ID=1&query=massage
Here
is a short article on craniosacral therapy from the Skeptics Dictionary.
It covers key points and anatomy to show specifics on the claims:
http://www.skepdic.com/craniosacral.html
Here
is an article about claims made for a massage bed:
http://forums.redflagdeals.com/ceragem-scam-506913/
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