Hormesis from a Massage Therapist’s Point of View — Part 2

By Boris Prilutsky

To Read

HORMESIS FROM A MASSAGE THERAPIST'S POINT OF VIEW — PART 1

Please click the link below.

https://www.medicalmassage-edu.com/blog/hormesis-from-a-massage-therapists-point-of-view.htm

From the Author

For many years, I have been practicing and teaching medical and sports massage. Of course, the schools we graduate from establish our professional fundamentals and provide us with some hands-on skills. But becoming a truly established professional massage therapist is a lifelong learning process.

We learn from our patients and from our clinical experiences. We learn from continuing education classes we choose, and we learn a great deal through professional discussions.

The discussion I described in Part 1 allowed me to look at what I teach and practice from a different professional angle and from a different point of view. I have a habit of rereading discussions and different posts, and even this process of rereading becomes a valuable learning experience that advances my professional thinking.

Dear colleagues and followers, we must remember that the work expressed through our hands comes from our insight, from our brain, from our heart, and from our soul.

A deeper understanding of what our hands are doing and what the goals of our treatments are is one of the main driving forces behind achieving results. We do not always remember that the goal of our treatments is to achieve sustainable results.

The moment we become distracted by new slogans, thousands of alternative names for massage therapy, or the tendency to view continuing education and professional gatherings primarily as social events, we become distracted from our professional purpose and, by ourselves, reduce our ability to deliver results.

The results of every healthcare professional can ultimately be reflected in measures such as fewer emergency-room visits, fewer unnecessary doctor visits, fewer surgeries, decreased medication consumption, and improved workforce productivity.

Are we fulfilling our duty?

The Question That Inspired This Discussion

I want you to read the original question that inspired this discussion and my writings:

In my opinion, this massage professional has enormous potential to develop his skills and to become even more capable of helping people who are suffering.

The question—“I don't even know if it's possible, but if exercise can stimulate hormesis, I was wondering about massage?”—is a very meaningful question.

Rereading all the posts, as well as the original question, before writing Part 1 and again while writing today, I keep asking myself—and I am asking you:

Why, in massage therapy literature, among thousands of different massage-related articles, do we—including myself—not really mention hormesis as a process?

Why is it that you will almost never find us using the term stressors when describing massage stimulation?

This is not our professional vocabulary. It does not seem to describe what we are doing.

Of course, I provided an extended answer to this question in Part 1 of this article.

Although I do not believe in accidents, perhaps we were simply meant to have this discussion at this time.

Healthcare, Including Massage Therapy, Has Changed

Healthcare, including the massage therapy field, has been changing —and perhaps these changes will continue to affect our profession permanently.

This is the link to my article:

“Demand for Massage Therapy Is Increasing, While Client Retention Is Dropping to Unacceptable Levels”

Read the article

Here is the paragraph from that article.

Let Us Review the Massage Therapy Field

Before the COVID pandemic, many spas and massage corporations sustained successful businesses employing thousands of massage therapists by offering pleasant full-body massages that often prioritized comfort over therapeutic outcomes.

Even when massage did not significantly help headaches, musculoskeletal disorders, or stress management, in most cases it did not aggravate the condition. Clients left feeling relaxed and satisfied, returned for additional sessions, and enrolled in memberships.

The same was true for many so-called “deep tissue” massages, where vigorous pressure was applied. Although these treatments often failed to resolve chronic problems, they generally did not create long-term aggravation.

Let’s understand something very important: any form of touch can become destructive therapy.

Yes, I intentionally use the word “therapy.”

Even destructive therapy may temporarily help people feel better. As I described previously, massage corporations and spas succeeded by providing massage therapy — but in some cases also by unintentionally providing destructive therapy through massage.

Today, that model no longer works the same way.

Post-pandemic stress physiology has changed dramatically.

As I described in my articles, the multisystem biological mechanisms involved in chronic stress disorders differ significantly from those associated with acute stress. Prior to the pandemic, many people were suffering from stress-related symptoms, yet most practitioners could still achieve relatively stable outcomes in cases such as:

• tension headaches,
• sleep disorders,
• musculoskeletal pain,
• stress-related muscular tension.

Now we are facing something much more complex.

Even if you have read this article, I advise you to reread it.

Hormesis and the Physiological Effects of Massage

Yes, part of our procedure involve triggering hormesis. Again, I really do not want to repeat everything I wrote in Part 1.

Instead, I would like to offer you several passages from another one of my articles, where I describe the powerful stimulatory and healing abilities of massage therapy and present what I call the Five Miracles of Medical Massage.

Five “Miracles” of Medical Massage

From the Article: FIVE “MIRACLES” OF MEDICAL MASSAGE

I summarize the clinical power of massage science as the Five Miracles of Medical Massage.

The First Miracle — Restoration of the Bioelectrical Properties of Soft Tissues

The human body is a bioelectrical machine. Everything—from our thoughts to muscle contractions and organ functions—is governed by bioelectrical events. Healthy tissues and organs possess a slightly negative electrical charge. As a result of trauma, poor ergonomics, or the formation of reflex zones caused by altered innervation, this normal negative charge shifts toward a positive state. This change is among the earliest and most fundamental pathological events in affected soft tissues.

Let me be completely frank with the readers: only the correct use of therapists’ hands, with properly applied Medical Massage (MM) techniques, allows us to change this pathological pattern in soft-tissue bioelectricity and to initiate the first critical step in local rehabilitation.

We restore normal bioelectrical activity in affected tissues by:

Mechanically compressing soft tissues and generating piezoelectrical potentials

Using proper drainage techniques to restore normal streaming potentials and prevent local edema

These two powerful clinical tools help restore the healthy negative charge within affected tissues. At the same time, the newly generated bioelectricity resets the patient’s central nervous system and initiates systemic physiological responses.

No other branch of medicine is capable of addressing soft tissue dysfunctions through such a variety of hands-on techniques that directly influence these intimate bioelectrical recovery processes.

The Second Miracle — The Power of Technique

The correct application of MM techniques determines the clinical outcome.

By applying different MM techniques during treatment, therapists activate various families of peripheral receptors within the affected tissues. These receptors generate bioelectrical activity in the form of action potentials (sensory inflow) that travel to the patient’s brain, forcing the CNS to reset its function and establish a healthier motor outflow back to the soft tissues.

Thus, through properly trained hands, therapists reshape and reset the patient’s central nervous system, initiating healing processes.

Here are several important examples:

The inhibitory regime of Medical Massage techniques helps eliminate the hyperirritability of nociceptors (a.k.a. pain receptors) by resetting the gate-control mechanism located within each spinal segment. By “closing” sensory gates in the posterior horns of the spinal cord, we reduce pathological ascending sensory inflow to the thalamus and cortex, preventing their overstimulation.

Targeted stimulation of soft tissues through properly selected MM techniques intensifies acetylcholine release. This becomes a critical factor in suppressing excessive sympathetic tone and restoring balance within the autonomic nervous system, which regulates all body functions.

While MM techniques mechanically stimulate soft tissues, newly released acetylcholine also supports mitochondrial biogenesis—the formation of new mitochondria from existing ones—thereby increasing ATP production. If bioelectricity represents the command system of the body, ATP serves as the fuel that powers its functions.

Thus, every massage technique developed through scientific and clinical research possesses its own specific goals, mechanisms of action, and therapeutic applications.

The Third Miracle — Restoration of Autonomic Nervous System Balance

Perhaps the most profound effect of Medical Massage is its ability to regulate the autonomic nervous system (ANS), which is frequently disrupted by chronic somatic and visceral dysfunctions.

In a healthy body, the interaction between the sympathetic (“fight or flight”) and parasympathetic (“rest and digest”) systems must be balanced. According to Professor Hans Selye, the father of Stress Theory, nearly every pathological condition starts with an imbalance within the ANS. Modern science increasingly recognizes this imbalance as one of the earliest stepping stones in the development of disease, aside from trauma, infections, or congenital abnormalities. Restoring balance between sympathetic and parasympathetic activity is essential for healing.

Once again, I firmly state that no medication, exercise, or adjustment is capable of restoring this balance as effectively as the therapist’s hands when properly applying MM techniques to individual families of peripheral receptors on a layer-by-layer basis.

This restoration occurs through a variety of mechanisms, including:

• Lymph Drainage Massage
• Friction techniques
• Lateral Shift techniques
• Percussion techniques engaging the H-reflex
• Acetylcholine release and receptor normalization

The Fourth Miracle — Integration of Energy Work

Medical Massage should also incorporate elements of energy work.

As mentioned earlier, the human body is a bioelectrical machine. However, bioelectricity is not merely an internal phenomenon. Modern science demonstrates that the body radiates bioelectrical energy, forming an electrical field around us. In cases of chronic somatic and visceral dysfunction, disturbances within the body’s internal bioelectricity also affect this external field, altering our normal bioelectrical interactions with the environment.

If therapists are properly trained and continuously develop their ability to generate and concentrate bioelectrical energy during treatment, this additional energy may assist in recovery. In such cases, the therapist’s own bioelectrical activity becomes another clinical tool.

Scientists are now gaining a better understanding of the role of energy work—not only in enhancing therapeutic outcomes but also in protecting practitioners’ health.

The Fifth Miracle — The Power of Knowledge and Adaptation

Massage science relies on the cross-application of various techniques and modalities. The clinical solution does not lie in becoming confined to one or two treatment methods.

For example, no matter how effective Neuromuscular Therapy or Myofascial Release may be, each possesses its own specific clinical niche. The ultimate solution for complex cases lies in the therapist’s ability to creatively combine techniques and modalities based on a detailed evaluation of the patient’s soft tissues.

In this way, therapists create individualized treatment plans even for patients presenting with similar diagnoses.

Furthermore, every technique or modality presented to therapists should be independently examined, clinically tested, and supported by published scientific evidence.

To illustrate the importance of adaptation, let us consider Sports Massage. Pre-event Sports Massage increases blood flow velocity, stimulates mitochondrial activity, and enhances oxygen delivery to myofibrils, thereby helping athletes reach peak performance.

From a cross-application perspective in massage science, these same physiological principles can and should be incorporated into Medical Massage protocols for patients with somatic dysfunctions.

We must remain flexible in our clinical decisions—understanding what to use, what to avoid, and how to adapt treatment strategies to consistently achieve stable clinical outcomes.

From Clinical Experience to the Question of Hormesis

As I stated in my article “Demand for Massage Therapy Is Increasing, While Client Retention Is Dropping to Unacceptable Levels,” our profession is facing important changes.

In my instructional continuing education video program for chronic stress, Long COVID, I do not use the term hormesis as a central teaching concept. Instead, I demonstrate and emphasize the importance of the inhibitory regime and its spatial interpretation.

During my hands-on demonstrations, I verbally explain the adaptation process while performing the techniques.

Please read about the program for yourself:

Medical Massage for Long COVID & Chronic Stress-Related Disorders

In Part Two of this hands-on training, I teach and perform the Five Miracles of Medical Massage and demonstrate what I consider the real rehabilitative power of massage.

I also invite you to read about Program Number Two:

Medical Massage for Long COVID and Chronic Stress-Related Disorders — Program 2

No fancy words. No new theories or new slogans. Just simple-to-perform sequences of clinically proven massage protocols.

Conclusion

As I stated and explained in these writings, we are not singling out HORMESIS. We never did.

The purpose of this discussion is simply to explain why.

In Part One, I discussed the physiological effects of massage on the human body as a foundation. Here, I am discussing comprehensive stimulation, including triggering hormesis.

The other answer is found in the Five Miracles of Medical Massage.

Simple like this.