By Markham Heid
January 3, 2018
TIME Health
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Go looking for proof that a massage will improve your health, and you’ll have no trouble finding research to back you up. From easing muscle soreness after exercise to reducing stress, dozens of studies—stretching back several decades—have linked massage with real physical and psychological benefits.

One Australian study found that a 10-minute muscle massage after a workout could reduce soreness by 30%. A separate review study on massage found that levels of the stress hormone cortisol dropped 31% following a rubdown, while levels of feel-good hormones like dopamine and serotonin increased roughly 30%.

You don’t even have to shell out cash for a stranger to perform your massage. Research on different forms of self-massage, including foam rolling, have found that giving yourself a good kneading can reduce muscle soreness and improve pain symptoms, even among people with osteoarthritis.

In fact, pain reduction—along with depression relief—is one of the benefits that research has most consistently linked to massage, says Tiffany Field, director of the Touch Research Institute at the University of Miami.

Some of her work has shown that massage may improve immune system function in people with breast cancer and leukemia, along with reducing their physical and emotional pain. Asked how massage could provide so many health perks, Field says several fMRI studies have shown that massage increases blood flow in areas of the brain associated with mood and stress regulation.

“Pressure receptors under the skin, when stimulated, increase vagal activity,” she says, referring to the vagus nerve, a major component of the human nervous system that plays a role in autonomic functions like heart rate, breathing and digestion. Increased activity in the vagus nerve could have—among other benefits—a meditation-like calming effect, which would explain the drop in cortisol and other stress-related symptoms.

When you bump your elbow or knee and experience pain, your first instinct is to rub the pain site, Field says. This plays into something called the “gate theory” of pain, which theorizes that your brain is unable to fully register painful stimuli when related touch receptors are activated. “This is another way pain might be alleviated by massage,” she says.

MORE: You Asked: Does Acupuncture Work?

In terms of improving immune function, she says the hormone and nervous system shifts that take place following massage may protect the immune system’s natural killer cells—a type of white blood cell that fights off viruses and helps prevent tumor growth.

But all of this is controversial. Some review studies have found only weak evidence that massage offers pain-reducing benefits. Also, when it comes to proving a massage is good for you, there’s one big hurdle Field and other researchers have trouble clearing: it’s almost impossible to design a massage study that eliminates the placebo effect. After all, there is no sugar-pill version of a massage that could be compared to a “real” massage in order to tease out the treatment’s non-placebo effects.

But most people only care if—not how—massage works. While the latter is really a question for medical researchers, the existing evidence indicates that, for a range of health conditions, it does. (Some studies on preterm infants have even shown massage can promote vagus activity and markers of growth.)

It’s still tricky to determine how much is ideal, Field says. “Most of the studies have looked at one massage a week,” she says. But there haven’t been many comprehensive studies comparing different massage frequencies. “I always say that it’s probably like exercise, where more is better,” she says.

Whether you can afford regular massages, or if you only have 5 minutes a day for some foam rolling, both should do you some good, Field says.

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