Episode 15: I had a massage today. I almost threw up.
Part 3 of the Massage and Fibromyalgia Series
"Based on our experience, the fact that you are feeling under the weather may indicate that your treatment has worked well"
says the blog writer for Fulham Massage in London. After experiencing some of the worst nausea in my life for the 2nd time after a massage, I am not sure I agree. In fact, although I love a good long deep tissue massage, since this last incident of nausea, I went on a fact checking journey and discovered that if I am experiencing this, the massage may be the poison.
What Do You Mean? Massage is Good for You! It Releases "Toxins."
First of all, lets dispel some of the myths around massage therapy and what it can do. The words "toxins" and "detox" are terms thrown around in the alternative treatment world including in massage therapy. These words are dog whistles to people seeking treatment outside of western conventional medicine.
Are We Toxic Waste Dumps?
Toxin: "a poisonous substance that is a specific product of the metabolic activities of a living organism and is usually very unstable, notably toxic when introduced into the tissues, and typically capable of inducing antibody formation" - Merriam Webster Dictionary.
I've heard, and even believed, that over time, toxins build up in our body: toxins from heavy metals, toxins from foods, toxins from the environment, toxins from breathing air everyday, and the like. By this account, we are nothing but walking toxic waste dumps.
Conversely, I have heard that we must "detoxify" our bodies with different alternative methods including liver cleanses, prebiotics and probiotics for the gut, taking "detoxifying" supplements, colonic irrigation and enemas,
all the fasting: juice fasts, dark green vegetable fasts, 7-14 day fasts, and then the bodywork: Rolfing, Reiki, foot baths, acupuncture, and yes massage as detoxifying methods. But is true? Can we "detoxify", or remove harmful substances (toxins) from our body with any one of these methods? Or, better yet, for the sake of this blog post, do alternative methods, specifically massage, promote harm - toxification, or healing - detoxification to the body.
We are Not Toxic Waste Dumps. We Have Livers and Kidneys for a Reason.
Second, as noted, my last massage made me sick. I was nauseous for 2 days, and for a minute, I thought this was a good thing - that it was my body detoxifying. But, perhaps there is another answer. According to the Equilibrio Massage Therapy Center in San Diego,California, "Your body does a pretty great job of flushing toxins all on its own". Our kidneys, liver, and intestines are built for and are masterful at "flushing" toxins from our body. Rene Wisely of the University of Michigan's Michigan Medicine confirms this. She explains, "The liver is smart. It knows when to detoxify, when to usher the toxins out of the body through urine or stool, when to store the nutrients and when to release them back into the blood." We do not need to help our bodies detoxify; the body, with the liver and kidneys, is uniquely built to do this quite successfully without assistance from faddish diets, supplements, or the latest "whole body cleanse".
PMSM vs "Rhabdo"
The question still remains: why did I get sick after my last massage? To say it simply, the massage I received was too deep and too hard. I was experiencing post-massage soreness and malaise, or PMSM, a condition characterized by soreness, fatigue, disorientation, and nausea. This is the result of too much pressure on the muscle.
In rare cases, the crushing pressure of the massage can injure the muscle causing a condition called rhabdomylosis, "a condition that causes your muscles to... [disintegrate], which leads to muscle death". When these muscles break down they release dangerous muscle proteins into the bloodstream. If this happens, it requires immediate medical attention. "Rhabdo", for short, has clear signs including flu-like symptoms and peeing dark, brown coke-colored urine. It is a serious and sometimes life-threatening condition that causes kidney damage and failure because the kidneys cannot get rid of the muscle protein fast enough. But can massage really cause such a serious emergency? Again, the science to date, In rare cases, has associated deep-tissue massage with rhabdomyolysis.
Is Massage the Poison?
Third, I don't believe I had even a mild case of "rhabdo". But perhaps I will not submit to a deep tissue massage again. The PMSM I experienced was unpleasant but not deadly. But then, does this kind of massage cause injury, therefore harm: is it the poison? It can be, but I don't believe it is in most cases. Deep tissue massage has is place in the world of alternative therapies - but, not in my world.
Fibromyalgia and Deep-Tissue Massage
Though I have neglected to mention it up to this point, deep tissue massage really has little place in the world of a person living with fibromyalgia and it may feel like poison, like it is toxic. and that it hurts the body. Fibromyalgia is a central sensitivity disorder characterized by all over body pain, fatigue, and brain fog. Although there is no cure for fibromyalgia, there are a number of well-documented and productive interventions one can do, including massage. But Fibromyalgia can make the body extremely sensitive to touch and it is inadvisable to undergo a deep-tissue massage.
For readers of this blog, you know that I have fibromyalgia and I am sure you are wondering why I would willingly receive a deep-tissue massage when my body is supposed to be so sensitive to touch.
The answer is, because I am not. And, although this is for
another blog post: because of my history with physical and sexual abuse, I am rarely sensitive to any kind of touch. I can feel touch, but it rarely goes beyond that. Pressure rarely affects me; heat rarely affects me; getting a cut while cooking rarely affects me. This makes it difficult to know my limits - because it doesn't hurt. When I hurt, it is deep inside, next to the bone, way under the skin. I hurt like I have an all over the body headache. So, it is easy to see how I didn't feel that this massage was "poisoning" me. Both of the massages I received from my therapist that made me nauseous did not feel, at the time, like they were too deep. It was only the nausea and the soreness AFTERWORD that lead me on a quest to discover why my massage made me sick.
To close, massage is not the poison. Deep tissue massage is not the poison. Massage can be an effective treatment option for many, including those with fibromyalgia.
And to speak to my "fibro" friends specifically, massage can be an effective part of a treatment plan, especially when combined aswith other therapies such as exercise and stress management techniques. However, for all massage recipients, it is important to be aware of the potential risk of developing PMSM and in rare cases rhabdomyolysis: a complication of deep tissue massage. To mitigate this risk, it is recommended to only receive deep tissue massage from a licensed and experienced massage therapist who can properly assess and monitor for any adverse effects. As with any medical treatment, it is always important to consult with a healthcare professional before undergoing massage therapy.
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Karen Palmen, EdD is a veteran educator in Saint Paul, Mn. She teaches Dance and English at Saint Paul Central High School. She has an active TikTok page that features humorous, political, mental health, and educational content (kickin it with karen). And a a dormant YOUTUBE channel with the same name, featuring fermented foods and other cooking oddities.
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