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Stress hormone production reduced by massage therapy ? where is the proof ?

Please see chris moyers article below.
http://www.ijtmb.org/index.php/ijtmb/article/view/30/39
Some interesting info re affective massage therapy.
What do you think.
Regards steve

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It is a medically accepted and proven fact that when the recipient of a relaxing massage (one that relaxes them emotionally and then physically) is given that the production of endorphins goes up while the production of cortisol and other stress hormone activity goes down. A great video that explains it in detail is "Stress - The Silent Killer" available from PBS.com
Thanks Dustin the PBS.com site looks good although would appreciate a direct link as cant find vid at mo. What did you think of the article ? did you see anything of personel intersest?
Regards steve

Dustin T. Fox, CMT said:
It is a medically accepted and proven fact that when the recipient of a relaxing massage (one that relaxes them emotionally and then physically) is given that the production of endorphins goes up while the production of cortisol and other stress hormone activity goes down. A great video that explains it in detail is "Stress - The Silent Killer" available from PBS.com
Good Morning Steve,

I had to read it twice to get it all but found the areticle that you referenced very interesting since it addresses the effects of hormone production and the emotional effects of massage on hormonal release and production. The site for pbs is http://www.shoppbs.org/search/index.jsp?kwCatId=&kw=stress&origkw=stress&sr=1 The subject of the video is based in over 30 years of research that centers around the study of hormonal changes due to stress under a variety of circumstances. It is amazing and somehow humorous how closely related baboons are to humans when the sympathetic and para-sympathetic nerve responses are kicked in.
Hi Dustin. I'm pleased to make your acquaintance.

You stated "It is a medically accepted and proven fact that when the recipient of a relaxing massage (one that relaxes them emotionally and then physically) is given that the production of endorphins goes up while the production of cortisol and other stress hormone activity goes down."

I won't comment on production of endorphins going up as I have not researched that, but I can comment on the widely-reported assertion that cortisol decreases in response to massage, as I have done research on this. I have quantified the effect in adult massage recipients, and across the research literature the average reduction of cortisol that results from massage is not significantly different from that of control procedures. The same appears to be true in pediatric recipients. If you'd like to see the evidence for yourself, you can view the adult research review here...:

http://www.anatomyfacts.com/Research/Massage%20Journal%20Club/Janua...

...and the pediatric research review here:

http://ecam.oxfordjournals.org/cgi/reprint/4/1/23

More recently, my students and I revisited this issue in a research review that is focused only on the question of whether massage reduces cortisol. We addressed some of the shortcoming found in previous reviews (including some from my own that I just cited) and drew on the largest possible collection of studies. The results are very consistent - massage has little to no cortisol reduction effect when compared with controls. The research that I am referring to here is currently in review with a research journal.

The phrase "when compared with controls" is very important. In uncontrolled examinations, it may appear that massage does yield a small reduction of cortisol; however, this could also be the result of other factors which are uncontrolled in such research (e.g., placebo effects, changes as a result of time alone, natural healing processes that are independent of treatment, or a statistical phenomenon known as regression to the mean). Therefore, it is essential to make comparisons with controls to get an accurate picture of what massage (or any treatment) actually does.

-CM
This is where "medical" and "complementary" treatments start to blur around the edges and go to war. Science can not explain everything. There are too many "unexplained" occurrences in this delightful world to suggest otherwise. Let this be known here and now: I am not picking and or choosing either side. Remaining politically neutral on this. Controlled factors, uncontrolled factors, as long as it works for that particular individual, who are we to judge? The mind is a powerful motivator. What may work for me could be completely debunked with a scientific study, and "knowing" those scientific results could very well cause complete melt down. Again this is where the medical community is struggling to accept something that can not nor ever will be placed in it's tidy little hole. And this is where the complementary treatments are unable to sufficiently state a solid "truth" in statement. Stephen, Reiki... Some things are explained, but it is not uniformly accepted. Am I making sense? I can hear it, see it, but not explain it suitably!
Hi Marissa.

The issue we're discussing isn't one of medical vs. complementary. It's just a straightforward question that can be answered by evidence: Does the stress hormone cortisol decrease in response to massage therapy?

Several studies have taken measurements of this, and when you average them (which is a justifiable thing to do in this instance, though it is worth asking if this is the case - I can expand on this point if you like), the net effect is practically zero.

This is not at all the same as saying massage doesn't work, or some such thing. It is simply an examination of one possible mechanism. Quite a few people have asserted that massage therapy reduces stress hormones, which on the face of it is a plausible thing to expect. The evidence, however, disputes this claim. Massage must produce its benefits (some of which, I hasten to add, are scientifically validated) by some other means.

-CM
Well, Christopher you are quite correct in stating that there are research studies that indicate that massage alone doesn't reduce the level of cortisol and other studies that indicate that it does to some degree. Of course the only way to tell, i believe, is by drawing blood and calculating the cortisol and endorphic levels that are present. Regarding endorphin increase, it is my general understanding is that when the emotions are relaxed there is an increase in the flow of endorphins. I will do some more digging myself to relocate the source of that information. It is my observation that when a recipient is placed in a position that promotes emotional relaxation in combination with physical relaxation the outcome, based on a study done by Dr. Robert Sapolsky of Stanford University, indicates that there is a reduction in stress hormones when the subject is emotionally stable/content. The film "Portrait of A Killer" available from www.shopNGvideos.com documents his findings based primarily in the physcological and biological work he and others have done in the field of stress. In 2005I had an Oncologist, Dr. Ottillio Cantu' Gonzales, in my seminar who operates a medical spa in Monterey, Mexico. During the first day of class Dr. Contu' asked if I knew the name of the condition that we were discussing in class. He indicated that he sees indications of it in almost every patient he treats. Well, I didn't have a name for it because, although it was easy to discribe as something we see in almost every human in our society, I never found a name for it in the research that I had done for the seminar. Psycology Today and other sources focused on the subject of PTSD and I have heard off hand remarks from some local mental health pros that everybody has PTSD in some form. But based on my own experience with PTSD from my time in the war (Vietnam) and working with other vets, it just didn't fit the profile of PTSD. In class the next day I offered up a name for the condition that I call Accumulated Emotionally Reactive Stress Syndrome (AERSS) In my understanding of PTSD, it is a condition that is normally associated with a singular tragic set of circumstances, like loss of a loved one or the war and may include flashbacks and/or nightmares related to those specific events. AERSS is, in my view, something that begins when the input of our social environment (family-religion-government, etc.) begins to control the way we look at life and behave/react as a result. I personally feel that this 'programming" is why we end up doing what we do, believing what we have been educated to believe and accepting only that which our data filled brain indicates that we should accept. The accumulation of stress begins at that time and is normally emotionally reactive in that we are first taught what to fear. Imagine growing up learning what to fear! This would be especially true in a social environment where the father is an abuser or the dominate sibling uses drugs or the Mother who, out of fear for the safety of her children, never reports the abuse from her past or present. Low income in a society that rewards every achievement from a financial gain perspective of and by itself can cause the accumulation of stress within the physologyTrust me, I am not stating that any of that is bad, but, for example, I ask a recipient what style of music they would like me to play for our session, many from lower socio-economic lifestyles say they like rap, grunge, hard rock etc. This music frequently carries an anger/disruptive content and as a result dosen't resonnate with our soul frequency. But because of their perception of self worth (low) it is a method that allows them to relate to their own suffering and anger at the life that is holding them down and depressing their spirit. It does work within the mental realm because that is where we spend most of our time. We have been trained to think. People from upper middle class or upper class backgrounds select very different music that is almost always uplifting. But, having said that, there are those who, even though they want for nothing material, that have some serious emotional conflicts that place them in a very stressed out condition. Then there is the fear factor that we are exposed to almost constantly. Most of those that I interview prior to taking them on as a recipient of counseling or massage indicate that they are afraid to express themselves regarding their fears because of the fear of presenting the wrong image to others who they hold at a higher level than they do themselves and that may even include their therapist. Just having a feeling and belief in our own self worth may reduce the levels of stress hormone secretion and increase endorphin flow. Some years ago I approached Atlantic University which I believe is connected to Miami University about doing a study of the effects of music and massage when they are combined through the furnishing and touch. I did so because they had already done a study on the effects of music and massage as two separate forms of therapy. So even though the outcomes for both indicated that the subjects responded well, they didn't apparently see the need to respond to my request to expand the study. So I dropped it and began to form my own conclusions. Now, thanks to this group. I am becoming aware of all the areas that I have not more thourghly explored for my own sake and that of my recipients and students.


Christopher A. Moyer said:
Hi Marissa.

The issue we're discussing isn't one of medical vs. complementary. It's just a straightforward question that can be answered by evidence: Does the stress hormone cortisol decrease in response to massage therapy?

Several studies have taken measurements of this, and when you average them (which is a justifiable thing to do in this instance, though it is worth asking if this is the case - I can expand on this point if you like), the net effect is practically zero.

This is not at all the same as saying massage doesn't work, or some such thing. It is simply an examination of one possible mechanism. Quite a few people have asserted that massage therapy reduces stress hormones, which on the face of it is a plausible thing to expect. The evidence, however, disputes this claim. Massage must produce its benefits (some of which, I hasten to add, are scientifically validated) by some other means.

-CM
If I remember right Emma, it only mentioned massage and not a specific technique. My guess would be swedish but it is only a guess. In response to Christopher's comments, I intend to revisit those sites that provided me with my internet research material and see if it is still being mentioned. I will post the results.

Emma Torsey CLMT said:
What modality was studied?
Thank You,Emma
Hi Emma.

Dustin is correct that most of the massage performed in the research studies could nominally be described as Swedish. That term, of course, is imprecise.

The best studies do a reasonable job explaining what massage consisted of, e.g., what the amount, duration, speed, and pressure of strokes was to various parts of the anatomy. Some of the weaker studies do not include this information, or at least less of it.

Massage therapy research would benefit from a usable taxonomy of massage therapy types and techniques, but no one has developed one yet. Making one is probably harder to do than it at first sounds. How does one describe all the important details of massage in a couple of paragraphs?

-CM

Dustin T. Fox, CMT said:
If I remember right Emma, it only mentioned massage and not a specific technique. My guess would be swedish but it is only a guess. In response to Christopher's comments, I intend to revisit those sites that provided me with my internet research material and see if it is still being mentioned. I will post the results.

Emma Torsey CLMT said:
What modality was studied?
Thank You,Emma
"you are quite correct in stating that there are research studies that indicate that massage alone doesn't reduce the level of cortisol and other studies that indicate that it does to some degree."

That's not exactly what I said. In fact, with few exceptions, the studies I have examined almost all show no reduction effect. The exceptions are not more frequent or larger than we would expect by chance alone. When all the evidence is considered together, it converges quite clearly, in my opinion, on the conclusion that massage does not reduce cortisol. Also, I failed to mention earlier that this is true for single sessions of massage, and for a series of massages performed across days or weeks.

"Of course the only way to tell, i believe, is by drawing blood and calculating the cortisol and endorphic levels that are present."

Correct - data from assessment of cortisol levels in blood, saliva, or urine are what we used to arrive at our conclusions.

-CM
Thank you Christopher for the response. I obviously need to update my research on the subject and include your findings and others that I discover.

Christopher A. Moyer said:
"you are quite correct in stating that there are research studies that indicate that massage alone doesn't reduce the level of cortisol and other studies that indicate that it does to some degree."

That's not exactly what I said. In fact, with few exceptions, the studies I have examined almost all show no reduction effect. The exceptions are not more frequent or larger than we would expect by chance alone. When all the evidence is considered together, it converges quite clearly, in my opinion, on the conclusion that massage does not reduce cortisol. Also, I failed to mention earlier that this is true for single sessions of massage, and for a series of massages performed across days or weeks.

"Of course the only way to tell, i believe, is by drawing blood and calculating the cortisol and endorphic levels that are present."

Correct - data from assessment of cortisol levels in blood, saliva, or urine are what we used to arrive at our conclusions.

-CM
You are correct Christopher regarding a weak study but I doubt that they were attempting to explain what massage does in detail to the anatomy but rather what it does to the brain. All the recipients in the study group were on an EEG at the time the massage and music therapy was being done in an effort to measure frontal lobe activity. From my perspective I have learned more about massage therapy research from this group in two days than from some research groups. We do, as a profession, need to have a body of research that actually studies the effects of the huge variety of techniques being placed in front of the public. It seems that the more "Medically Correct" they sound the more acceptable they are and yet the medical community officially recognizes any benefit from getting a massage. I remain confident that a some point they will realize that we have something to offer that really helps people.

Christopher A. Moyer said:
Hi Emma.

Dustin is correct that most of the massage performed in the research studies could nominally be described as Swedish. That term, of course, is imprecise.

The best studies do a reasonable job explaining what massage consisted of, e.g., what the amount, duration, speed, and pressure of strokes was to various parts of the anatomy. Some of the weaker studies do not include this information, or at least less of it.

Massage therapy research would benefit from a usable taxonomy of massage therapy types and techniques, but no one has developed one yet. Making one is probably harder to do than it at first sounds. How does one describe all the important details of massage in a couple of paragraphs?

-CM

Dustin T. Fox, CMT said:
If I remember right Emma, it only mentioned massage and not a specific technique. My guess would be swedish but it is only a guess. In response to Christopher's comments, I intend to revisit those sites that provided me with my internet research material and see if it is still being mentioned. I will post the results.

Emma Torsey CLMT said:
What modality was studied?
Thank You,Emma

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