Complementary Alternative Cardiovascular Medicine

Chapter 10 / Massage Therapy and CVD 157
sage increases systolic stroke volume via a decreased heart rate, thus
increasing diastolic filling. The reduction in heart rate is effected by a
decrease in stimulation of the sympathetic the increase in parasympathetic
activity. One small study demonstrated a reduction in systolic and
diastolic blood pressures after 30 min of massage on the back area. The
systolic pressure was reduced from mean values of 142 to 133 mmHg.
After massage, the patients scored significantly lower on anxiety, depression,
and hostility scales and had a decrease from premessage levels in
salivary and urinary cortisol hormone levels (25). Another recent study
of 52 people demonstrated a significant decrease in blood pressure after
a 15-min chair massage (26).
THE EFFECTS OF MASSAGE
ON THE CIRCULATORY SYSTEM
One of the most widely recognized physiologic effects of body work
is an increase in peripheral and central blood flow. Studies dating back
to the 1930s described increases in blood flow resulting from massage,
with a dilation of superficial blood vessels and a consequent decrease in
peripheral vascular resistance (27).
Studies that have examined the increase in the number of open capillaries
and the rate of blood flow before and after massage have noted
an effect similar to exercise, with an enhanced amount of open capillaries.
The peak open capillary count per mm 2 of muscle was 1400 after
massage and 3500 after peak exercise. Resting capillary counts were a
mean of 37. This effect was noted to last for approx 24 h and, as with
exercise, the more frequent and intense the stimulus (massage) the longer
the capillaries stayed open at rest. In addition, massage has been reported
to increase lymph circulation (28,29).
Pain Reduction
Massage therapy is often effective in reducing pain and can help to
reduce muscle tension and muscle contraction, which is generally present
in a pain-type condition. The author has found that often, when there is
a complaint of pain, it is accompanied by contracted skin, fascia, and
muscle. When moderate therapeutic pressure is applied directly on the
skin, the tissue is softened and normalized and discomfort eased. This is
important, because the underlying tissues must be kept healthy. It is
believed that tight contracted tissues “squeeze” pain receptors, blood
vessels, and nerves, resulting in pain, fatigue, and weakness. Massage
decreases pain by releasing endorphins, enkephalins, and other painmodulating
neurochemicals. In addition, the general relaxation brought