increases the available levels of dopamine, serotonin, and endorphins while simultaneously reducing cortisol levels. All these physiological effects combined will lead to a reduction in a client’s experience of pain both immediately following their session and in the long term with consistent care. While it is widely recognized that chronic stress can cause pain, it is also important to note that the reverse can be true—chronic pain can cause stress, as we see in the case of clients suffering with long-term generalized pain conditions like fibromyalgia and chronic myofascial pain. Clients who have been dealing with chronic pain conditions for a long time may not be able to recognize any separation between pain and stress anymore, and it no longer matters which is the chicken, so to speak, and which is the egg because the two things are deeply intertwined. Even though our treatment approach to both might be the same, it is useful when building good client relationships to understand their experiences of pain so that we can better meet their expectations. In addition to improving the duration and quality of sleep, manual therapy can also improve the digestive system's function. The first issue to address is what stress can do to our eating habits, along with the consequences of consistently making poor choices. We are all guilty of the occasional “stress eating,” which typically involves indulging in processed foods that are high in fat and sugar when we are feeling particularly stressed. Eating food that we know is bad for us feels good when we are under stress. However, we know that diet plays a vital role in overall health, and even though it may not be as satisfying to make healthier choices in the moment, the payoff of a much healthier digestive system, healthier heart, lower blood pressure and cholesterol, and better maintained blood sugar levels is worth it. How can we help our patients make better choices, since nutrition counseling can be outside of the scope of practice for most of us? Simply by doing what we do. Regular therapeutic massage can help curb those cravings by influencing the nervous system and the body’s chemistry to help the client feel better. When perceived stress levels get lower, the tendency to placate stress with junk food should come down with them. While much of our clients' gut health will be influenced by their lifestyle choices, we can still improve digestive health by relaxing the body to allow for better functioning of the digestive tract. Even if we eat the right foods and live a healthy lifestyle, chronic stress can still give us digestive discomfort because of the digestive system’s reduced ability to function properly, either from lack of sleep or too much time spent in the fight-or-flight response. Remember that during a therapeutic massage, the parasympathetic nervous system, or the rest-and-digest response, is activated, which works in opposition to the sympathetic nervous system, or the fight-or-flight response. When the parasympathetic nervous system takes over, it stimulates the peristalsis reflex, which is a series of involuntary muscle contractions along the digestive tract that allow the body to process the food we eat. When the body is in a relaxed state, the digestive system can function normally and without compromise, and when the digestive system functions normally, the body can better absorb and utilize nutrients more efficiently, making them readily available for cellular growth and replenishment. Abdominal massage specifically can increase peristaltic movement and changes the pressure of the abdomen,
make sure we understand how therapeutic massage works for pain reduction. The reduction in pain that clients experience during and after a manual therapy session is caused by a few factors, which we will examine from the outside in. First is the effect of manual manipulation on soft tissue. On the muscular level, manual therapy loosens tight, restricted muscles and connective tissue to reduce hypertonicity, and it relieves nerve compression that can be caused by muscle tension. Relieving muscle tension can also improve joint function and range of motion because the joint will be able to move with less muscular restriction. On the circulatory level, therapeutic massage increases blood flow to ischemic tissue and increases lymphatic flow, allowing the tissues to dispose of metabolic waste more efficiently. On the neurological level, manual therapy triggers the relaxation response noted above, during which the brain sends messages via the central and peripheral nervous systems to the body to tell it to relax by reducing the number of signals sent to induce muscle contraction. On the chemical level, manual therapy Rest, digest, and recover As discussed in Section 1 of this course, sleep is often the first body function to be affected by both acute and chronic stress. Over time, a constant level of stress can cause a sleep deficit from either not getting enough sleep or not getting any sleep at all. Even those who get some sleep may hover in the lighter stages of sleep during the night and may not be reaching the deeper stages of sleep that offer the most restorative benefits. An article on the website for an organization called Tuck describes the stages of sleep and sleep cycles, stating, “During deep sleep, human growth hormone is released and restores your body and muscles from the stresses of the day. Your immune system restores itself. Much less is known about deep sleep than REM sleep. It may be during this stage that the brain also refreshes itself for new learning the following day” (2018). As we have seen previously in this course, therapeutic massage increases the available amounts of serotonin in the body, which is what makes it such a pleasant experience, but serotonin is also critical for inducing sleep. Serotonin is essential for melatonin production in the body. Melatonin is a hormone that regulates the sleep–wake cycle in the body, and a lack of it can cause an inability to sleep. Manual therapy can help, especially in the long run, by consistently increasing serotonin levels and melatonin production and thereby potentially reducing the need for dietary melatonin supplementation and/or pharmaceutical sleep aids. Some would even say that manual therapy and exercise should be considered as an alternative to, or replacement for, sleep medications. “Therapeutic massage is a smart, healthy, and drug- free option that has helped many people overcome insomnia. Because melatonin influences the sleep stage of an individual’s circadian rhythm, a natural way of boosting serotonin is a positive sleep-inducing option...A growing number of healthcare professionals recognize the benefits of taking a multidisciplinary approach to patients to better identify the source of illness - rather than simply treating the symptoms. At the same time, sleeping pills and pain killers should take a back seat to complementary and alternative forms of medicine, including therapeutic massage, for treating the whole person and improving outcomes.” (Kibler, 2014) Therapeutic massage should, ideally, be higher on the list of physician-recommended treatments for insomnia.
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Book Code: MNJ0626
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