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Massage as 'Mechanotherapy'


Hands on massage is an extremely ancient medical technique for treating joint and muscle pain. According to Wikipedia,[1] the practice (and even the language) of massage dates back to at least 2000 BC.

Massage is clearly a modality of choice for many individuals looking to recover from pain or injury. However, what exactly does massage do, and how does it work?

The answer to such a question is indeed very complex: massage works in a multiplicity of ways to make a positive impact on pain, range of motion, flexibility, etc.

One relatively new line of thought concerning massage is that it works via a mechanism known as ‘mechanotherapy.’

Study: “Massage as a Mechanotherapy for Skeletal Muscle.” Van Pelt et. al, Exercise and Sport Sciences Reviews, 2021.

In this review article the authors review recent research showing how massage stimulates positive cellular adaptations in response to its application, through a process once again called, ‘mechanotherapy.’

Although (surprisingly) the authors do not define mechanotherapy, elsewhere it has been described as the process by which, “Mechanical forces direct cellular activities influencing the tissue-level processes of growth, modeling, remodeling, and repair, with the ultimate outcomes being altered tissue mass, structure, and quality.”

More simply, mechanical forces lead to changes in the body.

Resistance training is the most powerful demonstration of mechanotherapy. A mechanical force is provided (a weight, for instance) that leads to tissue adaptation: a larger, stronger muscle.

Stretching would be another example of mechanotherapy: in response to the mechanical tension placed on the muscle, the muscle changes and becomes more flexible.

The relatively new insight that the authors of the article under consideration point out is that massage can, like resistance training and stretching, be a mechanical stimulus that leads to positive change in the body. They provide several examples of where this has been demonstrated in the research:

- Following strenuous exercise, muscle damage and inflammation was much less in rabbits who had their muscles massaged compared to those that did not.

- Following a period of immobilization and atrophy, the muscles of rats recovered much faster when they received massage compared to rats that did not.

- After strenuous biking exercise, (human) legs that received massage had much less inflammation compared to those that did not.

The authors review several other studies showing how massage produces significant, positive changes in both human and animal studies. Furthermore, I am aware of other studies (curiously not cited in this article) that demonstrate improved tissue healing with massage. [2]

The authors summarize their findings: “Thus, the use of massage as a mechanotherapy after muscle damage is highly effective at accelerating recovery of muscle structural integrity and function.”

It has been known for a long time that massage can be an effective treatment for pain. The research reviewed in this article contributes to our understanding of how massage works (in one way at least!). Massage, as a mechanical stimulus, promotes positive changes in the body (through the process known as ‘mechanotherapy.’)

While some health care practitioners may scoff at the benefits of massage, mounting evidence supports its usefulness.

While massage coming from the hands of a skilled practitioner is likely to be the most precise method of application, this is almost certainly not required. There are numerous ways that massage can be applied to one’s own body. Foam rollers, lacrosse balls, massage sticks, and even your very own hands are often times more than adequate to get the job done. Such methods are also much more convenient, cost-effective, and can be performed with much greater frequency.

If you would like to learn self-massage techniques to leverage the benefits of massage for your health, I would be more than happy to assist you.
[1] [2] See “Instrument-Assisted Cross-Fiber Massage Accelerates Knee Ligament Healing” by Loghmani.
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