Mythbusting: Does Massage Therapy Flush Toxins? Part 2

by Rebecca Barnett

I genuinely feel like this should be the first and last word on massage therapy “clearing” or “flushing” toxins:

It’s tough to compete with Laura Allen and the power of her words, delivered crisply in that hypnotic accent. And yet, here we are – 8 or 9 years down the track since Laura laid down that lore and this persistent toxin flushing claim still gets trotted out in countless mainstream media articles, on social media pages, and on websites promoting the benefits of massage therapy.

When you Google “massage and toxins”, you’ll get about 5,570,000 results in 0.82 seconds. That’s a shitload of flushing.

That Google search yielded this particular example, which is such a delightful mélange of whacky physiological claims I could sense myself secreting stressotoxins from my fury organs, and subsequently found myself dry reaching for my Vodkamatic2000 slow release existential angst detoxinator.* Actually, I feel heaps better now, thanks for asking.

By the time I reached page 23 of the Google search results, I had gone to a place beyond the help of the Vodkamatic2000.

I wonder if this particular myth is so intractable and enduring because it’s a bit tricky to bust: the claim that massage flushes toxins is so ill-defined, broad and vague that it’s difficult to know what the parameters are and where to start debunking. Better men and women than me have made cogent and compelling cases, which clearly show that the jury is well and truly in. For example:

• Old Myths Die Hard: The Truth About Toxins by Sandy Fritz
• Why Drink Water After Massage? by Paul Ingraham
• 5 Myths and Truths about Massage Therapy by Tracy Walton

There is no plausible mechanism or evidence that massage therapy flushes toxins.

But I guess I have to start somewhere, so to quote Laura Allen …

What Exactly is it We’re Calling a Toxin?

Wikipedia defines toxins as “a poisonous substance produced within living cells or organisms”. Basically, toxins are biologically produced poison. The term was first used by an organic chemist, Ludwig Brieger.

However, the term also gets more broad colloquial use to describe any toxic substance, including synthetic substances created by artificial processes and pollution, even though these should technically be called toxicants. The Wikipedia page on toxins rather witheringly describes this non-technical usage of the word toxin as referring to “any substance alleged to cause ill health. This could range from trace amounts of potentially dangerous pesticides, to supposedly harmful substances produced in the body by intestinal fermentation, to food ingredients such as sugar, monosodium glutamate (MSG), and aspartame”.

I suspect that the latter definition is the natural home of our toxin flushing claim. I further suspect we’re talking so broad a usage for the word “toxin” that it could conceivably encompass, amongst other things, most ingestible substances that have been shown to be bad for us or we think are bad for us; any kind of ingestion of drugs, be they prescribed, legal or illicit; a vague and ill-defined class of (inevitably evil) chemicals that are an endemic part of the perils of daily living; and a gigantic range of normal metabolic processes that the body will keep doing as part of homeostasis but we seem to want to give it a helping hand or speed it up somehow cause we want people to feel better.

It ultimately doesn’t matter which of the vast array of vaguely defined candidates that we’re trying to flush out with massage – whether it be metabolic wastes like carbon dioxide or environmental poisons or the byproducts of metabolising pharmaceutical drugs or the ugly aftermath of a hard night on the Vodkamatic2000 – we still need to think about what evidence there is to support the claim and maybe even inject a bit of common sense.

On the common sense front, can you recall the last time you re-certified in first aid and the advice for management of a snake bite or poisoning was to consult a massage therapist STAT to flush that nasty stuff right out? And last time I checked, people with hangovers craved bacon sandwiches stuffed with hot chips and a side serve of lard, not an urgent massage sesh. (Hmm, can we conclude that the cure for toxins is even more toxins?)

The Origin Story

Falsehood flies and the truth comes limping after it

Jonathan Swift

It is difficult to pinpoint precisely where and when this myth took off. What is certain is that, although the idea of flushing bad things from the body has been around for a looooong time, the concept was supercharged by the hydropaths of the 19^th century, who developed a huge set of tortures cures based on the premise that water could heal all bodily ills. (Erika Janik, Marketplace of the Marvelous, The Strange Origins of Modern Medicine, Boston 2014, page 111. )

Incidentally, the hydropaths were also responsible for the origin of the “drink 8 glasses of water a day” myth. (I highly recommend reading Marketplace of the Marvelous. It will give you a clear sense of just how many of our health habits and behaviours were borne out of the war between regular and irregular medical practitioners, which also helped to define modern medical practice. The ways in which we perpetuate the same narratives and divisions to this day are too numerous to count and intriguing.)

Although it is outside the remit of a humble blog post, you could mount a cogent case that the concept of flushing bad things from the body has its roots in religious beliefs that are thousands of years old. The metaphor of Christ washing away the sins of humanity is basically the apotheosis of this.

It seems pretty likely that we took our cue on toxin flushing from 19^th century hydropaths who, in turn, were influenced by religious beliefs. We then supercharged the flushing metaphor ourselves with a range of biologically plausible sounding mechanisms of action to support the claim (like massage increasing circulation which is also questionable).

So we’re basically steeped in water and blood here people.

The evidence

“That which can be asserted without evidence can be dismissed without evidence”

Christopher Hitchens

We literally have no evidence on which to base the claim that massage therapy flushes toxins from the body. It is basically a whacky hypothesis looking for an experiment, without the cool meta self-referentiality.

A search for massage and toxins in PubMed yielded 35 results. The majority of these concerned the various MSK uses for botulinum toxin and bore no relevance to massage therapy whatsoever. The only relevant citation is actually a 2009 case report of endotoxin exposure at a spa centre, involving two therapists who were poisoned by stored seawood they used in the course of a seaweed massage (and I didn’t even know that was a thing. Next time I am in the surf I’ll consciously collide with the seaweed). 

“Organic dust toxic syndrome was diagnosed for two workers who performed seaweed massages at a spa center at which aerosolized endotoxin was measured. In order to minimize entotoxin exposure during massages, it is important to use fresh seaweed or seaweed kept well cooled for no more than 2-3 weeks.”

Holm M, Johannesson S, Torén K, Dahlman-Höglund A. Acute effects after occupational endotoxin exposure at a spa. Scand J Work Environ Health. 2009;35(2):153–155.

I guess we’re not going to race to promulgate the message that massage therapy may increase endotoxin exposure on the basis of this case study though.

In the excellent article referred to earlier, Paul Ingraham discusses rhabdomyolysis, the metabolic process which may actually make massage a slightly toxifying treatment. I heartily recommend you read Paul’s article – it is a far more comprehensive overview of the terrain than I can manage in this brief overview.

And Dan Wonnocott has already explained why massage doesn’t remove lactic acid and why we wouldn’t want it to anyway.

Conclusion

Our clients seek out treatment for a lot of sound and wonderful reasons. I can’t recall a single occasion a client asked me to massage away their toxins. They may have asked for a hangover cure but only in jest. We don’t need this toxin myth keeping us tied to an odd 19^th century practice of dousing, steaming, dunking, immersing and potation. That particular episode of Nigella’s Kitchen was a cracker though …

*The author does not receive financial incentives from Vodkamatic2000.

About the Author

As CEO of AMT, Rebecca Barnett is excited by the opportunities that the massage therapy profession has to purge itself of persistent myths through evidence and education. She also acknowledges that her detox through cheese diet doesn’t work but is fun and rewarding regardless.