Issue link: https://www.massageandbodyworkdigital.com/i/72195
talk about touch WITH MARY ANN FOSTER AND MARY KATHLEEN ROSE FLUSHING TOXIC MYTHS MARY KATHLEEN ROSE: Some time ago I observed a massage therapist giving seated massage at a health food store. As he worked on his client's neck, she suddenly slumped down in the chair and her arms fell limp. The startled therapist attempted to catch his fainting client, but she dropped onto the floor. Panicked, he called her name. There was no response. After a few, long moments she began to stir. MARY ANN FOSTER: Whoaaaaa. Sounds intense! It must have been scary for that poor woman. What happened? MKR: That's what the disoriented woman asked when she finally opened her eyes. The therapist, relieved that the client was talking, explained that he must have released some toxins while working on her shoulders, causing her reaction. MAF: When in doubt, massage therapists too often blame those "nasty" toxins for any number of problems: fainting, muscle soreness, nausea, even bounced checks. MKR: There's no way to know for sure: maybe a sudden drop in blood pressure or a vaso-vagal response. The therapist told her to drink a lot of water to flush out the toxins. Hmmm. Recently, a doctor asked me, "Why do massage therapists always tell people to drink a lot of water after a massage?" I asked him what he thought of the explanation that water flushes toxins out of the body. He looked puzzled. I think it's time we flushed a 100-year-old misconception out of massage education. Lactic acid is not a toxin. 26 massage & bodywork july/august 2008 MAF: On a parallel note, many people believe that massage flushes lactic acid out of the muscles. I recently did a Google search for "lactic acid myth" and got 31,200 hits. I think it's time we flushed a 100-year- old misconception out of massage education. Lactic acid is not a toxin; rather, it's a fuel for the muscles that metabolizes within an hour of its production—with or without massage. MKR: The idea of flushing toxins from the body is interesting. It dates back to the medieval notion that unclean thoughts and actions manifest as disease. Historically, the heroic physician used various methods, including bloodletting, to drain the toxins causing illness out of the body. We now recognize that there are well-designed body mechanisms for detoxification and the maintenance of homeostasis. They involve the intestines, liver, lymph system, and kidneys, which are responsible for the normal elimination of metabolic wastes. MAF: It's absurd to think that a shot of water or a massage can flush toxins through the body, as though it were a simple plumbing system. MKR: For massage to gain acceptance in the medical community, we need to take a critical look at the language we use. In a recent workshop I taught, a massage therapist explained that her work was beneficia l because it "pushes toxins out through the blood and clears out negative energies." The physical therapist beside her said, "If you talk like that in our hospital, people will think you are crazy." MAF: It would be honest to say that, while we recognize certain benefits of massage, we still don't have definitive answers. We know that massage can evoke the relaxation response, which in itself promotes healing and reduces stress. We also know that massage can encourage the flow of lymph in the body, which can reduce the discomfort of swelling and edema. MKR: It would be fair to say that chasing your client around the block would do more to increase his circulation than giving him a massage! Loc al circulation may increase, but during a relaxing massage, systemic circulation actually slows down, as evidenced by lowered blood pressure, decreased body temperature, and slower respiration. MAF: Not only does massage trigger parasympathetic responses, thereby encouraging restorative processes in the body, there are also well- documented psychological benefits. Massage can alter mood, alleviating anxiety and depression, which enhances feelings of well-being and safety. MKR: So why should a massage therapist offer a client a drink of water? Perhaps the client is thirsty. Also, water does hydrate and nourish the body. But most of all, it is a refreshing gesture of hospitality. practicing and teaching massage and movement in the Boulder/Denver area since 1981. She has diverse trainings in movement and structurally integrating therapies, teaches at the Boulder College of Massage, and wrote Somatic Patterning: How to Improve Posture and Movement and Ease Pain (EMS Press, 2004). www.emspress.com. MAF: Let's drink to that! Mary Ann Foster, BA, CMT, has been background in shiatsu, integrative massage, and holistic health education. She is the developer of Comfort Touch, consulting to hospices and other medical organizations nationwide. She produced the video Comfort Touch Massage for the Elderly and the Ill and is the author of a textbook of the same title. www.comforttouch.com. Mary Kathleen Rose, BA, CMT, has a massagetherapy.com—for you and your clients 27 Saunders). By this very defi nition, lactic acid is a potential toxin to our bodies, as are many other substances when they are found to be excessive or defi cient. The accumulated lactic acid will eventually be converted by the liver, when the body has resumed a state of suffi cient oxygenation. However, in cases where people are in chronic pain with associated chronic muscle contraction and chronic oxygen debt, this natural conversion process will be diffi cult and the excess lactic acid will result in muscle fatigue, cramping, and pain (Shier et al., 2004). As massage increases local circulation by manipulation of muscle and connective tissue, more oxygen, which is carried by hemoglobin on red blood cells, is available to the local cells. Massage is not the only remedy for this situation. Anything that relaxes the muscle tissue and promotes local circulation will achieve the same result, including a bath or sleep. As the body is returned to homeostasis, accumulation of lactic acid is reduced due to availability of oxygen and the liver is able to do its job—converting lactic acid back into glucose. From this perspective, it is possible that massage, by aiding the local tissue circulation, is facilitating reduction of lactic acid accumulation in patients with chronic muscle contraction and decreased blood supply to that area. As always, more research is needed as to how specifi cally massage may infl uence this process. It may be that the myth of lactic acid and the uses of this myth by massage therapists should be laid to rest. However, it is imperative that if massage therapists want to be taken seriously by the medical community, we must be fl uent in the language of the medical community. This means not only understanding the physiology of the body, but communicating that understanding properly. RHEA COLMAR CHAPEL HILL, NORTH CAROLINA AUTHORS' RESPONSE We want to respond to comments made to the editor regarding "Flushing Toxic Myths." Some points that merit further discussion include: scope of practice issues; medical claims about the effects of massage (particularly in regard to circulation and toxin release); and a question regarding the need of massage therapists to be fl uent in medical language. Our comments about lactic acid are based on the research of a number of physiologists, notably George Brooks, a professor of integrative biology at the University of California, Berkeley, and his work debunking the lactic acid myth.1 Since massage therapists are not conventional medical practitioners, we question whether it is "imperative that we be fl uent in the language of the medical community," as stated by one reader, though we certainly need to know enough about anatomy and physiology to practice massage safely and effectively and avoid making false claims about its effects. Everyone reads through the lens of their own beliefs and understanding about how the body works. Obviously, massage has important benefi ts for people's health and well-being or none of us would have work to do, but massage therapists, and sadly, too many massage instructors, have passed along questionable claims about how and why it works. NOTE 1. G. Brooks, T.D. Fahey, and T.P. White, Exercise Physiology Human Bioenergetics and Its Applications, 2nd ed. (Mountain View, CA: Mayfi eld Pub, 1996); G. Brooks, "Lactate: Glycolytic Product and Oxidative Substrate During Sustained Exercise in Mammals—The 'Lactate Shuttle,'" in Comparative Physiology and Biochemistry: Current Topics and Trends, vol. A, Respiration- Metabolism-Circulation, ed. R. Gilles (Springer, Berlin, 1985), 208–18; among others. MARY ANN FOSTER AND MARY KATHLEEN ROSE massagetherapy.com—for you and your clients 15