SPEAKER_00 0:16

Welcome to Practically Fit, Real Fitness Over 40. I'm Jen Chamberlain.

SPEAKER_01 0:20

And I'm Alex Johnson.

SPEAKER_00 0:22

And today we're going to talk about bodies a broad category of therapeutic practices including massage, acupuncture, and acupressure, cupping cryotherapy, and my favorite myofascial release. But before that, let me just say I am recovering from a cold, so I might sound a little bit rougher than usual.

SPEAKER_01 0:40

Yeah, you you can definitely hear it.

SPEAKER_00 0:42

So anyway, we're going to talk about bodywork today. What are the benefits? Does it work? And of course, we'll share some of our key takeaways in case you want to give it a try. So, Alex, I feel like you're kind of a regular. I mean, you get a massage, what, like twice a week?

SPEAKER_01 0:55

Not twice a week. Uh, but yeah, I do I do go pretty often. It's something that I've enjoyed for many years since my late 20s. Um, I will say I've been able to like increase the frequency of them over time. So yeah, I I do go pretty often and I have, you know, a lot of uh experience with the massages.

SPEAKER_00 1:17

Yes, I I know you do. And one time we were recording for this podcast, and you had these like weird round lesions, and I'm like, what is that about? And then you told me it was this cupping, which I I tried one time, but you know, I really thought it was bogus to be honest, until recently a vet tech told me that, you know, there's actually something to it scientific. And that's really one of the reasons I wanted to take a deeper dive for this podcast. So yeah, so we'll talk about that. We'll talk about massage, we'll talk about my favorite um forms of body work, which are deep tissue massage and the also the myofascial release and the occasional plunge into an ice bath.

SPEAKER_01 1:55

Oh, yeah. Now, so now on the cupping, you're being hard on. It's not like lesions, it's just sort of marks. It looks, it looks like bruising, but it doesn't hurt. It's yeah, it's interesting. We'll talk about it. Uh yeah. I've kind of turned around my viewpoints on the whole cupping thing so we can talk more about it.

SPEAKER_00 2:12

Yeah. But as always, we wanted to take a look at the science behind some of these practices. So, Alex, what did you find scientifically?

SPEAKER_01 2:19

Yeah, so we thought we'd start with massage, since that's something we both have some personal experience with. It's also something that has been practiced for a very long time. So, according to an article that we found in American psychology, quote, massage therapy is older than recorded time, and rubbing was the primary form of medicine until the pharmaceutical revolution of the 1940s. And I shouldn't be laughing, but that's just freaking hilarious.

SPEAKER_00 2:45

I know it's funny. And also, I mean, yeah, before medicine, we just had rubbing. That's it's pretty sad, too.

SPEAKER_01 2:50

Like, no, massage is great. It just does not strike me that that should be our only form of medicine. So yeah, and and according to the same article, massage has, quote, empirical support for facilitating growth, reducing pain, increasing alertness, diminishing depression, and enhancing immune functions. Wow, lots of benefits. Yeah, and these benefits are really on the more on the mind-body side of the equation, but massage has also been shown to have direct physical benefits as well. Um, so we found an article dating all the way back to 1994. That's one of the older articles that we've cited from the Journal of Sports Medicine, which is a well-respected journal, titled Massage, the Scientific Basis of an Ancient Art, Part 2, Physiological and Therapeutic Effects. So some of the effects that this article highlighted included the dilation of superficial blood vessels and increase in the rate of blood flow that you get with gentle massage. Forceful massage, which is what I like, increases both local blood flow and cardiac stroke volume. The amount of blood your heart can pump out to meet demand. And so this sounds bad when you hear stroke. But this is the uh the amount of blood your heart can pump out to meet demand, so it's a good thing and it can accelerate healing. Yeah, exactly. I gotta say, this whole like gentle massage, that's not that's not my thing.

SPEAKER_00 4:13

You need the deep tissue.

SPEAKER_01 4:14

You gotta go deep. That's right. Fascinatingly, research cited in this review found that when massage is applied to one limb, one limb, blood flow also increases in the other, which could be useful if you have an injured limb that's too sensitive for direct massage. So that's really interesting. Yeah. Uh massage decreases the incidence of deep vein thrombosis by 82%. Uh yeah, that the only time I've ever worried about that was when I broke my leg and had to fly. But um, yeah, so massage is beneficial in cutting that.

SPEAKER_00 4:47

Oh, yeah. So you had both risk factors at the same time. I didn't think about that because um injury or anytime you're debilitated is one and the other's flying for deep vein thrombosis.

SPEAKER_01 4:57

Yeah, that was that was not a fun flight. Yeah, I should have gotten a massage before I got on the plane. Uh, it also reduces swelling. And according to this uh journal article, the mechanism by which it does so is uncomplicated, but we found it too complicated to explain. So we'll just take their word for it. And uh, massage can help alleviate connective tissue damage, uh, which, according to this article, many people suffer from failing to warm up properly before exercise. Who would that be? Practicing their mobility. And what they term deep friction massage helps maintain or improve the mobility of joints, tendons, and muscles, and prevents adhesions from forming in your muscles. So, in fact, deep frictions used to treat athletes suffering from overuse injuries to the knee provide a more effective for reducing pain than rest, eye stretching, or ultrasound, which I can say I've experienced that same phenomenon with uh my knee, for example, when I was having issues with my T-band and so forth.

SPEAKER_00 5:59

Really? That's cool.

SPEAKER_01 6:00

A couple more um findings from the study massage can ease the pain from muscle spasm, which the article notes is extremely uncomfortable. And finally, massage has been scientifically demonstrated to alleviate pain by activating the quote pain gate mechanism. Basically, this is the idea that non-painful stimulus can close the gates to painful stimulus. Although I will say my massages are often painful, so I'm not sure what they were looking at when they came up with that finding. Clearly, not deep tissue massage on somebody who has a lot of stress knots in their shoulders. Uh so the article concludes that massage is safe. Low technology therapy, again, this was our only medicine up until the 1940s, so that provides a valuable treatment option in sports medicine.

SPEAKER_00 6:45

Wow. I mean, if I wasn't a believer before, I definitely am now. I'm gonna feel a lot better about splurging on a massage from now on. You know, I found particularly good results uh recovering from injuries through deep tissue massage and also this uh myofascial release, which I wanted to talk a little bit about. So this is massage that specifically targets the muscles and the muscle fascia, as well as uh foam rolling, which is supposed to target the same areas. So those are the foam rollers we've talked about that you can use to kind of do some self-massage. So I decided to look into some research around this specifically, and I found an article in the Journal of Body Work and Movement Therapies titled Effects of Self-Myofascial Release, a systematic review. And it found similar benefits for myofascial release as for massage in general, all the things that you just mentioned, Alex. Right. Um, found that it seems to increase flexibility and reduce muscle soreness, and that it can uh lead to improved arterial function. So that's kind of like the blood flow we talked about, and also increased parasympathetic nervous activity. And so that's um when this is activated, it's an interesting response. It slows our heart rate and breathing rate, uh, reduces our blood pressure and improves our digestion. And all of these can aid in recovery. So all really good things.

SPEAKER_01 8:04

Yeah, I've always heard that about the blood pressure as well. So that's another benefit if you have high blood pressure. Um, it can be very helpful.

SPEAKER_00 8:10

Yeah, it was one interesting note when I was researching this. They said in terms of the um side effects, one was uh reduced blood pressure. So for people with very low blood pressure like me, you could actually get like a little bit lightheaded because of um because it reduces it even further. So that makes that makes me realize why they tell you to like get up slowly from the table, you know. So you didn't Yeah.

SPEAKER_01 8:35

Have you ever had that where you feel lightheaded after a massage?

SPEAKER_00 8:37

I haven't, but it just made me think about that. So the interesting side effect. So do get up slowly from the massage table. Um the verdict was less clear on foam rollers, I have to say. And you know, Alex, you and I have been like big users of these for a while. So I found a 2019 article in sports medicine, which I didn't buy because it cost $50. But according to the abstract, it said there's insufficient evidence to support that the primary mechanisms underlying rolling and other similar devices are the release of the myofascial restrictions. Thus, the term self-myofacial release is probably misleading. Womp womp.

SPEAKER_01 9:14

Uh, I mean, I think more study is needed. Uh you know, it it don't you you feel, you know, sort of the release sometimes when you're using those foam rollers, especially like on the IT band. So um I think they need to do more study on this.

SPEAKER_00 9:32

Well, you know, my theory on that too is I I feel like it might be hard to control the results because you and I talked about before, there's like varying levels of these foam rollers, and it probably depends on the technique the person's using. So I'd agree with you, probably more study is needed. But Alex, what about that painful looking cupping theory that we talked about? Is there any actual science behind that?

SPEAKER_01 9:53

Yeah, I as a matter of fact, there is. Um, so an article in the Journal of Acupuncture and Meridian Studies titled Cupping Theory, an overview from a modern medicine perspective, tells you everything you wanted to know and more about this practice.

SPEAKER_00 10:07

Let's hear it.

SPEAKER_01 10:08

Yeah, so it's been around a long time. It's like much like massage, it goes all the way back to ancient Egypt, circa 1550 BC. There was a medical text called Ebers Papras, and it was actually one of the oldest medical texts to mention cupping therapy. And so there are various theories about how this works, but according to the article, quote, there's no clear identified mechanism of action of cupping therapy. Nevertheless, it concludes that there is growing evidence of the potential benefits in the treatment of some diseases, especially pain-related conditions.

SPEAKER_00 10:42

Yeah, very cool. And that's kind of what my vet tech was saying is that basically it stimulates your body to send, you know, certain enzymes and chemicals to the area to where you heal faster. So that's why it would be useful in areas where you're particularly tight or sore. So very interesting, but it still looks pretty awful, I have to say. But while we're talking about things that look or maybe seem awful, prior to moving to San Francisco, my favorite form of self-torture was plunging into an ice bath after a particularly hard run or a race or a marathon, etc. As it turns out, there's not much scientific support for that one. And I looked at several articles actually, but I'll just cite one in particular in the Journal of Physiology that was titled, Is the ice bath finally melting? Cold water immersion is no greater than active recovery upon local and systemic inflammatory cellular stress in humans. A clever title for a research publication, I have to say. But it found, well, basically the title says it all. It's no greater than active recovery.

SPEAKER_01 11:42

Yeah, I you know, I don't, I don't, I've never done an ice bath, never, but I have done I've been doing the cold shower lately.

SPEAKER_00 11:50

Yeah.

SPEAKER_01 11:50

Uh I so for the listeners, I think the cold shower is awesome. But um, like my advice on that if you do it, because I do it more for like, it's I think it's good for your muscles. You know, I've read both hot and cold showers can be good for your muscles, but also my big thing is like it's a great anxiety reliever. So if you're feeling kind of like that stress or that cortisol feeling fight or flight, like that cold shower can really get you out of it. Um, so if you what I like to do is rather than just like having a cold shower, which is just miserable if you're used to hot showers, like I'll do my normal like hot shower and then I'll stand under the water and I'll slowly turn the dial on the shower until it's like the heat starts to go out of it, and then I'll let it sit and then it'll get a little colder, a little colder. I don't know, it it's still really cold when you get to the cold side of the dial, but uh I found that that's an easier way to do it. And if you're able to take that for just a few minutes, like I feel so relaxed when I come out of the cold shower. So plug for cold showers on the podcast.

SPEAKER_00 12:51

Well, I have to say though, you also still live in Texas, and I took a lot of cold showers when I was in Texas, and it wasn't that uncomfortable because for one thing, your water's not that cold in the middle of the summer, and then for another, if you've been out on a hot day, it does feel a lot more um refreshing. So that's why I said prior to moving to San Francisco, it's a lot less appealing when you know it barely gets above 55 on any given day. But to your point, Alex, there is actual science behind the relaxation um relaxation properties of cold showers. So definitely good for anxiety and for just maybe making you feel generally relaxed.

SPEAKER_01 13:27

Yeah, absolutely. And so you're saying if you live in like Colorado or Canada or Norway, you don't want to do it, it's just miserable, it's not even worth it.

SPEAKER_00 13:35

It's yeah, it's just psychological. It's like you've just you know spent an hour being cold, and do you really want to be more cold?

SPEAKER_01 13:42

Yeah, that's a good point. Although it might actually feel less cold than being outside. I don't know.

SPEAKER_00 13:47

I have to try. No, I just take my word for it on that one. Um, so I want to talk about one more thing before we talk about some of our own stories and experiences. So a friend suggested that I include acupuncture and acupressure in this episode. Um, I don't have any personal experience, but I did want to talk briefly about it from the scientific perspective. So, like cupping and massage, acupuncture has been practiced for thousands of years, but it's only been studied from a scientific perspective relatively recently. And uh there's a solid body of literature that supports acupuncture, particularly for pain management, especially for the back uh for back or neck pain, knee pain associated with osteoarthritis and post-operative pain. One of the theories is that it works on that pain gate mechanism we talked about earlier, um, where basically the idea is that you have an intense stimulus. So, to your point about the you know, deep tissue massage, that sort of shuts off the pathway to pain, which is also an intense stimulus. So it's it's interesting. I yeah, I can't say a hundred percent understand scientifically, but it's pretty well recognized.

SPEAKER_01 14:53

It's a dumb question. Does acupuncture I've always wondered this actually, so I'm glad we're talking about talking about this. Maybe you know or saw it in your research. Does acupuncture actually hurt?

SPEAKER_00 15:02

Um, my friend who does it says it does not. Uh other others have said mildly, but it's more almost a way of I uh this is probably an unscientific way of putting it, but like tricking your body into like this sensation that maybe you don't actually read as pain, but it gets right to the to the nerve point where it would be pain. And so your body reads it as pain and then shuts off the gate to future pain, if that makes sense. That's from what I understand, how the what the mechanism is. Interesting. Yeah, it's really interesting. Uh she's said she she's had really great success with this for a lot of different conditions, both physical. Um she had the dreaded piriformis injury that I've struggled with. It's so hard to treat. She said acupuncture really helped for that. And then also with some like stress relief anxiety issues. So just wanted to get put that out there. Uh also wanted to cite there's an article in the National Library of Medicine that had similar results for acupressure, and um, that's often an alternative for people who have a fear of needles or maybe just don't want to try acupuncture. And I'll just quote from that article said as a whole, acupressure is a manually operated, needle-free, non-invasive, cost-effective, and non-pharmacological healing intervention to promote patients' well-being. So something to consider. You might give it a try if uh you're dealing, especially with these pain conditions, right? So I thought we'd uh talk a little bit about our own experiences in this area. Um, you know, do's and don'ts, that sort of thing. So what about you go first, Alex?

SPEAKER_01 16:35

Yeah, I mean, I think people should be open to trying different things when it comes to body work. Like I think a lot of people just think of the massage as like again that Swedish type massage, which is just supposed to be very relaxing and like sort of rubbing of your body. But you should be open to the deep tissue massage. I mean, I really think that's where the benefit comes in. I get that pretty frequently, as Jen mentioned, and it really helps me a lot, you know, with all the knots and stuff. Because you get, I mean, if you're active, you're going to, you know, cause knots and things in your muscles if you have a lot of stress at work, which both of us often do. Um, you will get knots and things in your neck if you're working from home a lot and sitting, like all these things compound upon each other. So um, I'd be open to the deep tissue if you have that kind of situation in your life.

SPEAKER_00 17:28

Yeah, I have two things to add on that. So, in terms of the knots, um, that's the adhesions that I was talking about earlier in the research. And there was uh one study specifically that looked at this condition of frozen shoulder, which my mom had uh briefly, but it's where you lose range of motion in your shoulder and actually can't move it beyond a certain point. It happens to a lot of people for a variety of reasons. And a massage is one of the best ways to alleviate that, so it really works. Those knots that you feel uh when they work those out, it's really helping uh prevent further immobility down the line. And then I also wanted to mention one very specific um incident I had with massage. I was in a car accident when I was in my 20s, and it was the classical thing where it didn't hurt at first, and then three days later I had like the neck pain um that like you get from whiplash. And I went to a massage therapist, and with about three sessions, she was able to completely work it out. Um it's just really impressive. So, you know, I didn't have to call up one of those ambulance chaser lawyers.

SPEAKER_01 18:33

Yeah, and I I want to go back to the shoulder thing because I have trouble with my right shoulder. Um I injured it doing like barbell bench presses about five years ago now, and um, so it's just been weird ever since then. Like um it gets sore sometimes when I lift weights. And you know, I feel that in the US there is just this bias towards surgery. Like, you know, tons of people who are like, go to the doctor, go to a specialist, oh, you need surgery on your shoulder. And it's you know, for little small things. And so I think, like you said, um, you know, I'd one up this idea that like massage can really help out your shoulder if you have problems with it. Like, I get some pretty deep intense stuff done on my shoulder sometimes, and it does really help loosen it up and make me feel more mobile in the shoulder again. The other thing I would say about like deep tissue is I would look for somebody who practices medical massage. Um, so that for me, like the last two people I've gone to have done that. Um the previous person I went to had had studied this in Mexico and and she was amazing, and I didn't know that that was like a discipline in massage, and it was totally different than even deep tissue massages that I had before. It's very much rooted in like sports medicine. So medical massage, I think, is the way to go. Um, if if you're doing massage. The thing I say is, Jen, have you ever tried any like different types of massage, like the Thai massage? You ever done that where they walk on top of you? I'm curious.

SPEAKER_00 20:02

Uh I've tried a few new ones here since I moved to San Francisco because we have a lot of uh range of options for massage. And um I I went to a Thai massage place, they didn't walk on top of me, but they did a lot of the stretching of my um limbs as they were doing the massage, which I thought was really helpful. I also did Shiatsu, which is a very intense deep tissue massage that they only work um on your back, basically. And that was super helpful for those knots that you're talking about. That was one of the more intense massages I've ever had, but I felt like it was really beneficial in terms of getting to some of those places that really needed to be worked out. Um, but that's a great tip about medical massage. I've been going to um a massage therapist here who's a sports massage therapist who's worked with some NFL uh teams actually, which is kind of cool. And so I I've had really great results with him. So I think that's a good tip that maybe, yeah, I didn't know that it even existed before I started researching it.

SPEAKER_01 21:02

Yeah, I like I like the stretching too often. Even they'll do this with medical massage sometimes, depending on what you're you know, what you're feeling in your body that we but they'll literally get up on the table and stretch you out. It's it's amazing. So yeah, the thing I did the tie as well, and they actually did the thing where they walk on top of you. I I didn't like that. So I'm just gonna I don't mind it on my legs, actually. That I think feels good, but they were like walking on, you know, I've had somebody walk on my lower back or my back, and it's just like it feels like it's like pressing your inner organs down. Oh, I didn't like that. Like I don't personally, I didn't like that, but the stretching part of it is amazing. I guess the other thing I wanted to go back to was the cupping.

SPEAKER_00 21:42

Yeah.

SPEAKER_01 21:42

Uh because I've only experienced that recently. I find it most beneficial like when I have some knot. I notice if I have a really deep knot, sometimes the person who does my massage will like use cupping on that knot. And I can definitely feel like when Um, she puts the cup on and then takes it off. Like I can feel that it's helped loosen up the knot. So um I definitely think there's something to it. Like I've had it on my shoulder when I'm having trouble with my shoulder as well. And the other reason I think it, you know, the evidence is going in the direction of it being beneficial is that like you see athletes who are doing this. Like Luka Doncic, who plays for the Dallas Mavericks, he's got cupping marks on him all the time. He's an elite athlete. Like if I see an elite athlete doing something, most of the time it's not, you know, nonsense, right?

SPEAKER_00 22:32

So right, exactly.

SPEAKER_01 22:34

Yeah, I've had pretty good experience with it. Although I don't necessarily the facial cupping feels really good and it's not supposed to leave marks, but I actually have two marks on the side of the last week. Yeah. Watch out for that one.

SPEAKER_00 22:48

So I'm curious, have you had any um bad experiences with any of the alternative therapies?

SPEAKER_01 22:54

No, I wouldn't say bad experiences. The close, the closest to a bad experience, like I said, was the the walking on my back. I just did not like that way that feel. That felt like it was doing more harm than good to me. So that's what I would I would say as far as like a bad experience. No, I just I think it's an amazing form of therapy and you know also cuts down on some of the self-myofacial release you have to do. Right. Yeah. Um I mean the one downside again is it it can be expensive. So, you know, yeah, that's the tough part about massage. And exactly. I don't know. Can will insurance cover this for some folks?

SPEAKER_00 23:30

It depends. But I would did want to talk about um the expense because I haven't had any bad experiences, but I've had some disappointing experiences where you know I wanted a deep tissue massage, and even though I communicated that I didn't really get that. So, you know, because it's expensive, that can be really disappointing. Um, another that was a kind of same similar situation. So, my, you know, like one of my tips is that you should get recommendations from somebody who's gotten a massage from that person who's had good results, if you can, you know, personal recommendation, or at least like read the Yelp reviews or something like that, because it is expensive and you know, you don't want to sort of spend your money and feel like you didn't get much out of it, I guess.

SPEAKER_01 24:12

Yeah, so you did you spurred in my mind one bad experience that I had forgotten about. It was like a groupon many years ago, it was like a couples massage, and it was just horrible. Like I it was just horrible. Like I think, you know, it maybe I just got unlucky with the therapist that I got, but uh, I'll never forget she was like intensely rubbing the top of my feet, like on the bones, and it was just pain. It wasn't, I'm like, what is this? This doesn't feel good.

SPEAKER_00 24:43

Right.

SPEAKER_01 24:43

There can't be much benefit to it. It was actually excruciatingly painful, and I felt like, okay, there's it's not like you're getting a knot out of the top of my foot. It's bone. You're rubbing bone. Yeah. So that was a bad experience.

SPEAKER_00 24:56

That doesn't sound good because I know the people who um have taught me about foam rolling have said always don't roll over the bones. Like you shouldn't really mess with your bones too much. It's supposed to be like your muscles and the tendons and the like the fascia. So that sounds like a really bad idea. Yeah, I wouldn't go back to that massage therapist.

SPEAKER_01 25:15

Yeah, I did not. Again, so maybe don't you know do your massages through a groupon would be my advice.

SPEAKER_00 25:22

Right. But I will say that you can sometimes save money if you buy a package, like if you find a good masseuse packages can cost less. I had a friend here in the city who shared a package with me, which was really nice. So then uh she bought, you know, like a certain number, and then we were each able to do it. So there are ways to save some money, but I would say get a recommendation. And um, you know, the other thing I learned through just researching this podcast is to have an open mind. Uh, I very close-mindedly, when you showed me this cupping thing, was like, oh, that's totally bogus. But so it turns out there's science behind it. And like you said, Alex, you know, our bias is so much towards in the United States, towards medication and surgery, when a lot of times there are other things that could help that could be an intervention beforehand, you know.

SPEAKER_01 26:06

Yeah, exactly. So, I mean, my my big takeaway on all of this research, which it just sort of reinforces the experiences that I've had, is that I think, you know, m massage and some of these other techniques are really amazing. Um, and there's a reason people have been doing them for such a long time. They can be beneficial in terms of your body. So uh highly recommended um if you have the chance to get massage, especially deep tissue.

SPEAKER_00 26:32

And tell us about your results. We'd love to hear it. Always open to stories. We're gonna be um having some special guests on soon. So we'd love to hear your stories on this topic or any others.

SPEAKER_01 26:42

Yeah, that's right. So that's our podcast on massage. Hope you learned something this week. Uh, maybe opened your mind to something new in terms of uh bodywork treatment. But uh until next week, remember you can always check us out over at practically.fit. Sign up for the newsletter. We've been getting a lot of new subscribers, um, so that's exciting on our sub stack. Uh, you can sign up, just put your email address in, and you'll get our great content every week in your inbox. And of course, the podcast will come directly to you as well. Uh, if you're enjoying the podcast, please feel free to go out and comment over at practically.fit if you'd like to share your story or comment. Uh, or you can also rate the podcast. It's really helpful if you do so on Apple Podcasts. We appreciate that. Uh, but until next week, remember fitness is for everybody.