Why do I sometimes feel "beat up" after a good massage?
It turns out that massage may cause a mildly toxic situation in the body, but don't worry, exercise does too, it doesn't last long, and it's worth it.
Massage clients often experience varying degrees of mild soreness and malaise following a massage — post-massage soreness & malaise, or PMSM. It can manifest as body soreness, exhaustion, even feel like a touch of the flu. After a day or two, especially with some mild stretching and plenty of fluids, we usually feel even better than we did prior to the massage, and that's the whole point, right? So, what is going on in the body that causes this?
When muscle is injured, cellular guts are spilled into the blood, most notably myoglobin molecules, which messes with blood chemistry a bit, and affects the kidneys as they clean it out. In extreme cases of severe body trauma, earthquakes, car accidents, etc., the medical term used is Rhabdomyolysis. In these cases, doctors will prescribe intravenous fluids to dilute the wastes in the kidneys. This helps explain the post-massage advice we often receive, to “drink lots of water”.
Rhabdomyolysis, the medical emergency, really has nothing to do with massage though. There is no way that normal massage forces can cause the type of threatening damage caused by severe accidental traumas. But what about mild rhabdo? Massage can cause mild, non-emergency rhabdo symptoms, as muscle and fascia are stretched and released, and this may help explain that PMSM feeling you experience.
Ironically, in addition to “liberating” toxins in your body, massage may be creating some mild ones too, as by-products of muscle manipulation. Before you get worried though, it's important to note that this type of muscle damage and mild toxification is natural and represented by a broad spectrum of symptoms brought about by activities that stress muscle tissue.
Varying degrees of rhabdomyolysis-type symptoms are actually common, especially among recreational athletes (look up “white collar rhabdomyolysis”). Also, consider that the levels of toxins in your blood after a massage would rarely reach the same levels brought on after a couple of good scotches, or a bottle of wine. Talk about a poison that starts out pleasurable.
So, if relatively normal people like runners can get middlin’ rhabdo, then it is virtually guaranteed that less extreme stresses can temporarily cause less extreme rhabdo. Much of this would fall well below the threshold of what would ever be diagnosed as rhabdomyolysis. Indeed, at the lowest end of the spectrum we simply have other names for it… “Soreness,” for instance. Extreme soreness even has it's own acronym, DOMS (delayed onset muscle soreness), sometimes called "muscle fever".
What does this mean? Well, all physical exertion creates breakdowns in muscle tissue and in fact "poisons" us a little bit. So what? The body is equipped to flush itself out daily. It’s been doing this your whole life. Good massage is beneficial on so many levels, from the physical to the psychological, and like good exercise, it may sometimes cause soreness associated with muscle healing.
If your massage treatments leave you feeling more PSMS than you are comfortable with, you need only consult with your massage therapist and suggest a gentler treatment. This should lead to less muscle stress and consequently less toxicity in your bloodstream the day after. There's every reason to believe that the results will be just as satisfying, and the day after may leave you less crummy-feeling. After all, massage is about feeling good and loving yourself, and your therapist is there to help you, not "beat you up."
Paraphrased from "Poisoned by Massage". Published 2012 by Paul Ingraham, in painscience.com