Myths, Massage and Research

How massage therapists can help separate fact from "massage lore."

 By Martha Brown Menard, PhD, LMT, February 1, 2022

While massage therapy has existed for centuries, the profession is relatively young in terms of being a health care discipline in the United States. When its renaissance began in the 1970s and 1980s, there were few textbooks and little current research.

At that time, students in the handful of professional training programs established by experienced practitioners were likely to accept whatever information their instructors presented to them without critical evaluation, and a great deal of “massage lore” was handed down to the next generation of therapists. 

While there is much more research on massage today, the massage profession remains on the edge of the academic mainstream, with both for-profit and community college programs competing for students. And while massage is being integrated into more health care settings than ever before, there are still some practitioners who promote it as a panacea, with little to no evidence to support their claims.

Let’s examine a couple of persistent myths about massage and research to ensure you’re staying up-to-date on the latest information about the benefits massage therapy provides—and the myths you need to keep busting.  

Massage Myth

Massage releases toxins.  

When I was in massage school in the early 1980s, I regularly heard people say that the massage therapist should always offer clients a glass of water following a massage so they wouldn’t be so sore or feel sick the next day because of the toxins flushed out by massage. 

For clarity, there is absolutely no harm in offering a glass of water in case someone is thirsty. But does massage really release “toxins”? What are these mysterious toxins released by massage? Where do they come from? 

The dictionary definition of a toxin is a poison or venom produced by an organism. Toxin is also used in a rather vague way to refer to any substance that has a negative impact on health or well-being, as in the concept of detoxification—including metabolic byproducts such as lactic acid or environmental substances like endocrine disrupting phthalates absorbed by the body. The detoxification myth proposes that through the pressure and manipulation of soft tissue during massage, toxins are squeezed from the muscles and released into the bloodstream. 

There simply is no scientific evidence to support this idea. 

Canadian science journalist and former registered massage therapist Paul Ingraham has proposed that forceful deep tissue massage may actually promote the release of a toxic byproduct of muscle tissue breakdown. This condition, called rhabdomyolysis, occurs when muscle cells are traumatized, usually through a crush-type injury, and the protein myoglobin is released from the damaged cells. The myoglobulin disturbs the delicate balance of normal blood chemistry, and in large amounts damages the kidneys. A key symptom is dark brown urine. 

People who are physically fragile, such those who are elderly or have health conditions like Ehlers-Danlos, for example, may be more susceptible to having this reaction to overly rough or long sessions of massage using heavy pressure.

Ingraham is currently collecting case reports from massage recipients who have experienced flu-like symptoms and dark urine following massage.  

Research Myth

You can’t trust science because it can never make up its mind—first some food is good for you, then it’s bad for you, then it’s good again. Just pick one, already.

Science is a little more complicated than that because it’s built on a body of evidence that accumulates over time. “Body of evidence” means multiple studies, but often what is picked up in media are the interesting new studies that sometimes sensationalize results—and that’s what people see. 

It’s rare that a single study definitively answers a research question beyond a shadow of a doubt. Instead, most studies build upon previous research to expand the knowledge base. This is why the significance section of a journal article describes the “so what” of a study—why is this particular study important and what new information does it add to the body of knowledge on a particular topic or area? How does this study fit into the context of what we already know about a question?

The other important thing to keep in mind is that science is eventually self-correcting precisely because it can integrate new information as it is discovered and confirmed through replication. The history of science holds many examples of once widely accepted beliefs that were later demonstrated to be false. So, as we gain more new information, we develop a more nuanced and detailed picture of phenomena, and (hopefully) discard faulty or erroneous ideas. 

A research question that examines a complex topic like the effects of nutrition on human physiological processes often requires a program of research—a series of related studies that systematically investigates a big question, with each new study building on the results from the previous study. That’s pretty expensive, and there aren’t a ton of dispassionate funders out there willing to spend the money it takes to underwrite multiple studies over a long period of time. 

Often, it’s not unusual for a study to raise more questions than it answers, too. It’s common for different researchers pursuing the same question but using different methods to get different or even conflicting results. This is one reason why it’s important for studies to be replicated and why closely reading the methods section of a study is very important.

For example, one study on nutrition might ask people to remember how often they consumed a particular food over the past week, while another might have participants stay in a metabolic lab facility for a week, be given measured portions of a food at regular intervals, and have urinary metabolites assessed. 

Throw in what we are now learning about genetic variations and how these can influence an individual’s response to an intervention like a particular nutrient or food, and you can see why research on almost any dietary supplement or food can get complicated really fast. Sometimes

you just have to wait for enough evidence to accumulate, which is why so many journal articles conclude with the statement that can be frustrating but true: “More research is needed.”