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MASSAGE affects the body as a whole. To understand how massage therapy works, some of the physiological effects of massage need to be briefly examined. Massage is known to increase the circulation of blood and flow of lymph.

TTHE DIRECT MECHANICAL EFFECT of rhythmically applied manual pressure and movement used in massage can dramatically increase the rate of blood flow. Also, the stimulation of nerve receptors causes the blood vessels (by reflex action) to dilate, which also facilitates blood flow.

LYMPH. A milky white fluid called lymph carries impurities and waste away from the tissues and passes through gland-like structures spaced throughout the lymphatic system that act as filtering valves. The lymph does not circulate as the blood does, so its movement depends largely on the squeezing effect of muscle contractions. Consequently, inactive people fail to stimulate lymph flow. On the other hand, the stimulation caused by vigorous activity can be outstripped by the increased waste produced by that activity. Massage can dramatically aid the movement of lymph in either case.

CELLS. For the whole body to be healthy, the sum of its parts -- the cells -- must be healthy. The individual cells of the body are dependent on an abundant supply of blood and lymph because these fluids supply nutrients and oxygen and carry away wastes and toxins. So, it is easy to understand why good circulation is so important to our health and why massage can be so beneficial for the entire body due to its effect on circulation alone.

Massage is also known to:

* Cause changes in the blood. The oxygen capacity of the blood can increase 10-15% after massage. Affect muscles throughout the body. Massage can help loosen contracted, shortened muscles and can stimulate weak, flaccid muscles. This muscle "balancing" can help posture and promote moreefficient movement. Massage does not directly increase muscle strength, but it can speed recovery from the fatigue that occurs after exercise. In this way, it can be possible to do more exercise and training, which in the long run strengthens muscles and improves conditioning.

* Massage also provides a gentle stretching action to both the muscles and connective tissues that surround and support the muscles and many other parts of the body, which helps keep these tissues elastic.

* Increase the body's secretions and excretions. There is a proven increase in the production of gastric juices, saliva, and urine. There is also increased excretion of nitrogen, inorganic phosphorus, and sodium chloride (salt). This suggests that the metabolic rate (the utilization of absorbed material by the body's cells) increases.

* Affect the nervous system. Massage balances the nervous system by soothing or stimulating it, depending on which effect is needed by the individual at the time of the massage.

* Enhance skin condition. Massage directly improves the function of the sebaceous (oil) and sweat glands which keep the skin lubricated, clean, cooled. Tough, inflexible skin can become softer and more supple.

* Affect internal organs. By indirectly or directly stimulating nerves that supply internal organs, blood vessels of these organs dilate and allow greater blood supply to them.

Knowing about the physiological effects of massage makes it possible to better understand the health and fitness benefits of massage. What takes place under a massage therapist's hands has profound importance for those interested in health and fitness -- in "tuning up" their bodies. In every sport or form of exercise, massage can help. By helping to reduce physiological fatigue and aid recovery from the exertion of working out or playing, massage enables training better, with longer, more effective workouts, thus facilitating better performance and preventing injury.

The people of ancient Mediterranean civilizations knew this. After bathing and exercise, they included a full body massage. The ancients understood that education involves equal development of mind and body. The modern public's interest in physical fitness, holistic health, wellness and human potential represents a bid to revive a time-honored philosophy.

For most people embarking on a fitness program, often the spirit is willing but the flesh is not. When regular exercise is begun almost every part of the body changes. Of interest to massage therapists is the way blood vessels become more intricate in order to meet the body's demand for more oxygen, to supply more nutrients, to permit more elimination.

This takes time. While the muscles are getting into shape, they have trouble getting enough oxygen and nutrients, and wastes back up and stagnate.

Unfortunately, many exercise programs regard aches and pains as the inevitable price to be paid. This is simply not true because massage can be used as the Greeks and Romans used it -- to increase endurance, control fatigue, and feel better as part of a regular health program.

Massage acts to disperse the accumulated byproducts of muscle action that irritate muscles and nerve endings. Lactic and carbonic acids build up in muscle tissue shortly after exercise begins. These acids are waste products that contribute to causation of the pain and occasional cramping that exercisers, athletes, dancers, etc., suffer during and/or after workouts or performing.

These acids are formed when the glycogen stored in the liver and muscles is burned to produce the energy expended during exercise. The acids must eventually be reconverted to glycogen and stored again, or drained out via the lymph and circulatory systems. Pain and fatigue persists until this process of reconverting or excreting is completed.

Massage can help eliminate the irritation caused by these wastes, thus increasing muscle recovery rates. When massage has been substituted for rest, an increase from 20-75%, even 100% muscle recovery has been recorded. For example, this is why boxers are massaged rather than rested between rounds.

Joints are critical to exercise because joints are moved by the muscles to produce movement. All joints are complicated, and their parts have a way of settling and stiffening when not used. A sluggish, numbed feeling in the joints discourages exercise. A massage therapist counteracts this by using massage strokes and passive movement to release the muscle tension and free the connective tissue found around the joints that can bind the joints.

Massage also aids recovery from soft tissue injuries such as sprains and strains. This is possible because the growth and repair of tissue are accelerated by efficient circulation in the injured areas and appropriate stimulation of the healing tissues.

Many soft tissue injuries are not serious enough to cause one to visit a doctor or hospital for treatment, or are only treated with some first-aid, but still cause some discomfort and disability. Massage therapy can often help speed and improve recovery and reduce discomfort from such mishaps. In this way, massage helps bridge the gap between common neglect of injury and major medical intervention.

Increased health awareness has also increased nutrition awareness. The most carefully planned diet is partly wasted if blood vessels are not developed and open so that nutrition can reach the cells. Massage can aid internal nutrition rates by improving circulation.

The relationship of stress and illness is of interest to anyone maintaining their health. We all have stress in our daily lives relating to work, family, environment, society. Mental tensions, frustrations, and insecurity are among the most damaging.

Stress causes the release of hormones that create vasoconstriction -- vessel shrinking -- and reduced circulation. Affected by stress, the heart works harder, breathing becomes rapid and shallow, and digestion slows. Nearly every body process is degraded. Psychosomatic studies show how stress factors can cause migraines, hypertension, depression, some peptic ulcers, etc. Researchers have estimated that 80% of disease is stress related. Soothing and relaxing massage therapy can help by counteracting stress effects.

Massage has a definite psychological effect. Since massage animates the tactile sense, the body's primary sense, it brings people into the here and now and away from tension generated by constant preoccupation with problems. Also, loosening of muscle tension or "armoring" -- the physical counterpart to how we defend and protect ourselves from psychological pain -- can lead to freeing of repressed emotions.

Users of massage therapy as a healing tool quickly realize that they have found a form of drugless therapy. Headaches, insomnia, digestive disorders including constipation and spastic colon, arthritis, asthma, carpal tunnel syndrome, sinusitis, and minor aches and pains are some of the problems that can respond to massage therapy. Massage can have an excellent effect on nervous people who have been dependent on their pharmacy for rest and relaxation.

Simply stated, the foundation stone of the therapeutic effect of massage is what Hippocrates, the Father of Medicine, defined as vis medicatrix naturae, or the body's natural recuperative powers, the life force. Massage therapy essentially promotes health by boosting the body's own processes.

While this article has focused on how massage can help tune the body, and on its concrete scientific effects, it should also be mentioned that massage can be seen as a healing art as well as a science. The theories of therapeutic massage are scientific in character, but the actual application of these theories is an art, for it involves the healing sense, sensitivity of touch, insight, and intuition.

It is a unique way of communicating without words, sharing energy, enjoying pleasurable relaxation, and experiencing peace of mind. Massage is often attributed to have ethereal spiritual effects akin to those of meditation.

The past ten years or so have seen a proliferation of different terms, titles, and systems of massage such as: Therapeutic, Holistic, Swedish, Sports, Neuromuscular, Bodywork, Oriental, Shiatsu, Acupressure, Esalen, Reichian, Polarity, Reflexology, etc. For the sake of clarity, the term massage or massage therapy as used in this article refers to the scientific manipulation of the soft tissues.

The thing to keep in mind is that every healing art that employs massage therapy should include some form of kneading, pressing, or stroking with the use of pressure and movement, no matter how slight the touch or how often it is used.

The best way to find a massage therapist is to get a referral from a friend who gets massage therapy, or from a health professional who is knowledgeable about forms of complementary and alternative health care such as massage therapy. For a referral in Silicon Valley, CA try the American Massage Therapy Association's Online Directory . For other areas in California, email:

AMTACA@earthlink.net. For a national referral contact the AMTA at (847) 864-0123, write to 820 Davis Street, Suite 100, Evanston, IL 60201, send e-mail to info@inet.amtamassage.org, or check out the AMTA website at American Massage Therapy Association.

Since there are many styles of massage, you may want to shop around to find someone who practices the style of massage most suited to your needs. For more information on some of the different modalities available, try What is .....Acupressure to Zero Balancing . You should be able to find a massage therapist who is right for you, though you may or may not need to try a few massage therapists to do so.

Whenever interviewing a massage therapist you should always feel comfortable asking if they have graduated from a school that is accredited or approved by a credible accrediting agency such as the Commission for Massage Training Accreditation/Approval (COMTAA), are licensed if licensing is required in your area (as of 6/25/97, 25 states and D.C. regulate massage therapists), are nationally certified by the National Certification Board for Therapeutic Massage and Bodywork (NCBTMB Home Page) This is the only professional certification program that has been recognized by an independent, outside agency), belong to a credible professional association such as the AMTA, experience, and styles of massage used.

In terms of what to expect during a massage therapy session, they generally are an hour in length. Clients are usually asked to remove as much clothing as one is comfortable with and rest on a padded massage table. To respect personal privacy and provide adequate warmth, the client is covered or draped with a sheet or towel so that only the part of the body being worked on is exposed at any given time.

Whether or not you would expect to talk during a session depends on your need at the time. Some clients need to talk. Some need silence. Massage therapists will usually try to accommodate what the client needs. However, sometimes talking detracts from entering a state of relaxation or experiencing the physical or nonverbal dimensions of the massage. In any case, feel comfortable giving feedback about your needs and what you like or do not like during the session. Good communication enhances the massage session.

The massage therapist will likely use a high quality oil or lotion, but if you have an allergic response you should let the massage therapist know. Some massage therapists offer to play music during a session, others may feel it is distracting. It is best not to have eaten just before a session. Your massage therapist can answer many other questions you may have. If for any reason you must miss a massage appointment, your massage therapist will surely appreciate being notified as soon as possible.

To enjoy the benefits of massage which have been discussed, it is best to receive a therapeutic massage from a practitioner who has blended a thorough knowledge of anatomy, physiology, kinesiology, and massage technique with a sensitive, powerful touch and the healing sense.

To your health!

Elliot Greene, M.A., NCTMB, served from 1990-1994 as national president of the American Massage Therapy Association. He has 25 years experience as a massage therapist and is Nationally Certified in Therapeutic Massage and Bodywork. He was a major contributor for the NIH publication Alternative Medicine: Expanding Medical Horizons and has been an expert advisor on massage therapy for publications by Time-Life Books, Rodale Press, Warner Books, Consumer Reports and other publishers.

He has a private practice in Silver Spring, MD, and he may be contacted at (301) 680-0770, or elgreene@aol.com.