Could Massage Therapy Improve Circulation?

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More Americans are getting massages each year, and they are not just getting a “body rub.” The American Massage Therapy Association (AMTA) states that about 43 percent of American adults who had received a massage between July 2011 and July 2012 did so because of medical or health reasons, such a soreness, muscle spasms, pain, and injury rehabilitation. Among that population, 89 percent agreed that massage can be effective for pain reduction, and 32 percent received a massage for stress reduction or relaxation. Clients may also hear from their therapist or from a massage website that massage therapy could improve blood flow and circulation, but does it really do so?

There are currently few scientific studies that examine the claim that massage therapy could improve circulation. The belief is most likely to have stemmed from an observation of the redness that appears on a client’s skin and the fact that the skin feels warmer. After a few minutes of massage, the tissues and the skin feel softer and more pliable, giving the illusion that there is better circulation. However, research shows that massage therapy has very little effect on blood flow.

A small 1995 study, published in the International Journal of Sports Medicine, from Wilfrid Laurier University’s Department of Physical Education in Waterloo, Ontario, showed that massage of the quadriceps muscles did not raise arterial or venous blood velocity much above resting levels. In fact, light voluntary contractions of the quadriceps had higher elevation of blood flow. Thus, the researchers concluded that massage therapy was not an effective way to improve muscle soreness recovery and the purpose of massage used in an athletic setting should be questioned.

In 2004, another such study that was published in Medicine and Science in Sports and Exercise was conducted to compare the blood flow of the quadriceps between two groups after they work out their legs: the experimental group received a massage (effleurage and petrissage work) while the control group did not. Researchers from Manchester Metropolitan University in the U.K. used a laser blow flow meter (laser Doppler flowmetry) to measure the amount of blow flow by sensing red blood cell motion. Massage did not significantly increase blood flow in the femoral artery, within the skin, or in the muscles when the results were compared with the control group. In fact, blood was “diverted” away from the quadriceps during the massage, which made the researchers question its efficacy in post-exercise recovery. Further evidence from a 2010 study from Queen’s University’s kinesiology department in Ontario that was published in the same journal showed that massage therapy could impede lactic acid and hydrogen ion removal from massaged forearm muscles.

Not all research indicate such findings since a few can be conflicting. A Japanese study from Tsukuba College of Technology that was published in Medical Science Monitor showed some increased blood flow upon the lumbar spine area after the subject had performed an isometric back extension exercise followed by either a short massage session to the lower back or five minutes of rest before doing another set of the same exercise. Even though the results showed some promise that massage could improve circulation, the researchers stated in the discussion part of the paper that “it is not clear as to whether the increase was due to massage, heat conduction from the therapist’s hands, or both.” They also stated that since this study used rest as a control, they cannot determine if “massage application is useful for increasing [muscle blood volume] compared to dynamic warmup exercise such as repetitive trunk rotation.”

“So basically, although we would like to think massage increases blood flow, there isn’t any definitive research to demonstrate as such,” remarked massage therapist Rajam Roose, who practices in San Diego, California. “Making the claim that massage increases blood flow should be avoided without evidence to show.” 

However, there is a slight possibility that massage may help postmenopausal women with type 2 diabetes increase their venous blow flow to the heart. A Spanish study from the University of Granada randomly assigned 65 subjects to an experimental group that received 20 sessions of myofascial release therapy with kinesiotherapy or to a control group that received no massage with the same kinesiotherapy. Researchers found that  basal metabolism, diastolic blood pressure, venous blood flow velocity, pain, and emotional role were significantly higher among those who had received both myofascial release therapy and kinesiotherapy than those without the former therapy. Even so, one study on a very specific population does not necessarily negate previous studies nor does this outcome apply for everyone.

“In general, we aren’t completely sure what goes on in the body during a massage. As more research is being performed, we are learning more,” Roose said in an online interview with Guardian Liberty Voice. “The effect of massage on stress and anxiety has been documented and these effects may be what is really is contributing to our clients feelings of reduced pain and better movement. Many of the phrases such as ‘massage increases circulation’ and ‘reduces scar tissue’ and removes toxins and other such are general assumptions placed on why people felt better after massage. These misinterpretations were handed down over the decades and taught to every massage student. In truth, it’s akin to being taught the world is flat because of how the landscape looks. If massage therapists want to be accepted by the general public and recognized as members of the healthcare system, then we need to start by letting go of statements about massage that have not been proven or fully studied. There’s nothing wrong with admitting that yes, our clients do feel reduced pain and notice better quality of life, but we don’t know why.”

While massage therapy does not significantly improve circulation for a majority of the population, there are many benefits of receiving a massage. The AMTA cited some scientific literature that massage therapy can be beneficial for those with low back pain, certain types of cancer, post-operative pain, osteoarthritis in the knee, and improving blood pressure. And no, AMTA does not say massage therapy improves circulation.

By Nick Ng


International Journal of Sports Medicine
Medicine and Science in Sports and Exercise 1
Medicine and Science in Sports and Exercise 2
Journal of Rehabilitation Research
Journal of Sports Rehabilitation
Interview with Rajam Roose, HHP
Medical Science Monitor
Complement Therapies in Medicine

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