Ahhh . . . just thinking about a massage can be relaxing.
For many people, the hands-on therapy is a simple cure for everyday ills, aches and stresses. It's become so popular, in fact, that we can have our kinks worked on or worked out, not just at posh resorts, but at the airport or grocery store too.
And yet a lingering stigma dogs the profession, leaving some tense, aching Americans nonetheless reluctant to bare their body parts to strangers.
A new law could bring peace of mind and guidance to those who hesitate, as well as some welcome regulation to massage therapists who say it's about time.
Lucy Wojskowicz, owner of Laguna Canyon Spa in Laguna Beach, looks forward to the day when she and other massage therapists can get their credentials to practice massage therapy without being associated with the adult entertainment industry.
"In the past, when I applied for city permits, I got grilled as if I were running a massage parlor," the 41-year-old spa owner said. "They don't consider what I do health or therapy. I'm the same as a prostitute. It's embarrassing."
State laws across the country, including one in California that went into effect Jan. 1, aim to legitimize the profession, crack down on prostitution rings masquerading as massage centers and better protect the public.
"We want to put the unsavory past behind us," said Bill Brown, director of government and industry relations for the American Massage Therapy Assn. "One goal of getting states to regulate the practice of massage therapy is to curb prostitution and stop unethical practices that occur with no repercussions."
The California law creates the Massage Therapy Organization, which by fall will be ready to grant state certification to massage therapists who've had 250 or more hours of training and who pass an exam on ethics, anatomy and methods.
"The law lets those who want to receive the services of a massage therapist know with certainty that the massage therapist has met certain training criteria to become certified," said California state Sen. Jenny Oropeza (D-Long Beach), who fostered the measure.
Massage therapists and law enforcement agencies welcome the law. "The law protects consumers from financial and physical harm, and from people who have a different agenda in mind once they get you on the table," said M.K. Brennan, a massage therapist and AMTA president, adding that a properly trained massage therapist has a knowledge of anatomy and understands appropriate draping, boundaries and ethics.
In recent months, undercover officers have cracked down on prostitution rings posing as massage parlors throughout the Los Angeles Basin, and the resulting headlines may have left many members of the general public skeptical of the massage business.
Brown called the law "a good first step," but wishes it were tougher. Though the law provides massage therapists a chance to prove they have met a higher standard, it falls short of requiring that they be licensed -- a goal the AMTA has for all 50 states. So far, 42 states plus the District of Columbia have some statewide massage-therapy regulation.
In California, regulations vary widely among cities. "Some cities require a license, proof of training, and a background check. Others have no requirements at all," Oropeza said. For consumers, that means a massage in one city could be a lot safer than one in the next town, where regulations and oversight don't exist.
"It's chaotic and costly," said Wojskowicz, who has a permit to practice massage therapy in Laguna Beach. But if she wanted to be paid to give a massage in nearby Aliso Viejo, where she lives, she would need another permit.
State certification will supersede all local laws, relieving practitioners of multiple permit hassles and giving consumers a state stamp of approval for which to look.
Law enforcement agencies see the measure as a tool to help distinguish legitimate massage businesses from disreputable ones. "If they can eliminate two-thirds of the operators off the bat because they're state-certified, that makes their efforts to control vice more manageable," said Oropeza.
The health benefits
Beyond having a new way to separate reputable practitioners from disreputable ones, wary consumers may still wonder whether massage offers any benefit besides brief relaxation. The answer is: maybe.
Though research is limited, some studies indicate that therapeutic massage can reduce anxiety, depression, pain, high blood pressure and headaches.
It can boost both your immune system and your mood, contends Gail Ironson, professor of psychology and psychiatry at the University of Miami, who has conducted several massage-therapy studies.
"Depression and stress do accelerate disease," Ironson said. "Because massage therapy in turn reduces depression and stress, we expect it could also have a protective benefit on slowing disease progression."
* Ironson and her university colleagues have conducted several small-scale human studies on the effects of massage on biological measures of mood. The studies looked at levels of the stress hormone cortisol in participants before and right after massage -- finding that the therapy lowered cortisol levels by 47%. Massage also increased serotonin by 36% to 60%, and dopamine by 26% to 59%. Serotonin and dopamine are neurotransmitters that promote improved mood.
* In a study published in a 2004 issue of the Journal of Pain & Symptom Management, researchers at Memorial Sloan-Kettering Cancer Center surveyed 1,290 cancer patients before and after receiving massage. They asked patients to rate their levels of pain, anxiety, nausea, depression and fatigue, and found that reported symptoms were reduced by half after treatment and that they stayed low for a couple of days afterward.
* Another study out of the University of Miami, published in the Journal of Psychosomatic Research in 2004, showed similar findings in a study involving 34 breast-cancer patients who were randomly assigned to receive massage or to a control group. Those who had 30-minute massages three times a week were 46% less depressed, 25% less anxious and 50% less angry than those in the control group.
* In an article that appeared in the July 2007 issue of Evidence-based Complementary and Alternative Medicine, researchers reviewed dozens of published studies on Swedish-type massage's effects on different kinds of pain. They concluded that the evidence supporting the use of massage in the treatment of lower back pain was "robust." They found less support for massage in the treatment of other kinds of pain, including shoulder pain, neck pain, fibromyalgia and carpal tunnel syndrome. "Despite the growing popularity of massage, there is inconsistent empirical support for its effectiveness in chronic pain," the article stated.
* A study out of the University of Colorado Health Sciences Center, published in the spring 2008 issue of the Journal of Manual and Manipulative Therapy, followed 16 people who suffered from tension headaches. It found that participants who had 45-minute massages twice a week had fewer, less intense and shorter headaches. The number of headaches dropped from an average of five a week to four, intensity decreased by 30% and duration dropped from an average of four hours to fewer than three hours per headache.
Experts scrutinizing the studies warn not to read too much into them. The studies are small, few and not well-controlled, they say.
"The only thing I can say with certainty is that a lot of people receiving massage believe there's a benefit, but we don't have solid answers yet," said Albert Moraska, an assistant research professor at the University of Colorado at Denver, who has helped conduct many of these studies.
"We're not able to pinpoint the effect people say they are having, or the results practitioners claim they provide, but I believe that proof will come in time. How often, what type and for whom are all questions the field is working to answer."
And what people believe makes a difference.
"Participants enrolled in these studies and randomly assigned into control and treatment groups need to believe that either treatment could be equally effective," said Dr. Michael Irwin, professor of psychiatry and biobehavioral sciences at the David Geffen School of Medicine at UCLA. In fact, in most studies, one group has massage and the other group has nothing. That sets up what scientists call an expectation effect, which can skew findings.
In other words, participants say that massage helped because they think it's supposed to.
Belief in massage
Most people, however, don't need convincing. In a random survey conducted by AMTA in 2007, 85% of Americans surveyed believed massage had health benefits, and 1 in 4 reported having had a massage in the past year.
Linda Neumann of San Diego is one who swears by her massage therapy. Since age 7, the now 50-year-old marketing consultant has had chronic hip problems and pain, which has resulted in four surgeries. She's had to take anti-inflammatory or pain medication daily, until recently.
Six months ago, she started seeing a massage therapist who practices a rigorous type of Chinese massage called tuina. After a couple of sessions, she said, she was pain-free. She goes every three weeks, and for the first time in 40 years, is not taking any medication. "The pain had affected me my entire life, and now it's gone. I'm a total believer."
Success stories like those are what draw practitioners to the profession, therapists like Wojskowicz, who will continue to ignore the disparaging innuendoes, and do the legitimate therapeutic massage she was trained to provide.
"Although a few people give our practice a bad name," Wojskowicz said, "the wonderful part of what I do is that I get to help people and relieve their pain, if even for just a little while."
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Get the most from a massage
Don't eat right before your massage. Massage can stimulate digestion, and you don't want to have to get up.
Be early. If you're rushed, you won't be as relaxed.
Take off only as much clothing as you're comfortable removing. Although bare skin allows the therapist to apply oils, a competent therapist should be able to give a good massage through clothes.
Tell your therapist about any health problems and your reason for getting a massage. Also disclose allergies to skin products.
Don't hold your breath. Breathing helps you to relax.
Speak up if anything doesn't feel right, or seems improper.
-- Marnell Jameson
How to find a qualified professional
When the Massage Therapy Assn. gets its certification program rolling in September, consumers can ask whether a therapist is certified by the organization. Until then, people looking for a reliable way to size up a massage therapist need to use other criteria.
LOOK AT ASSOCIATIONS
Finding a massage therapist who belongs to the American Massage Therapy Assn. is one way. Go to www.findamassage therapist.org. Members have met the association's education standards and have agreed to adhere to a code of ethics; they also must meet continuing education requirements, said Bill Brown, director of government and industry relations for the organization.
A certification from the National Certification Board for Therapeutic Massage and Bodywork also indicates that the practitioner has met core education and ethics requirements.
Ask to see a massage therapist's credentials. Many will post their certificates in their place of business. If you go to a business that's part of a massage franchise, ask what criteria their therapists must meet and whether they must pass background checks.
-- Marnell Jameson
Styles of massage
Therapies target different areas of your body and different goals. Know the lingo to find what's best for you.