{"id":2121,"date":"2019-10-23T09:00:40","date_gmt":"2019-10-22T22:00:40","guid":{"rendered":"http:\/\/blog.amt.org.au\/?p=2121"},"modified":"2019-10-22T11:18:29","modified_gmt":"2019-10-22T00:18:29","slug":"mythbusting-massage-removes-lactic-acid","status":"publish","type":"post","link":"https:\/\/blog.amt.org.au\/index.php\/2019\/10\/23\/mythbusting-massage-removes-lactic-acid\/","title":{"rendered":"Mythbusting: Massage Removes Lactic Acid"},"content":{"rendered":"\n

By Daniel Wonnocott<\/strong><\/h2>\n\n\n\n

Lactic acid is about as popular as a rattle\nsnake in a lucky dip. <\/p>\n\n\n\n

When it comes to the art of removing that\nnasty lactic acid, massage therapists have long proclaimed to be the experts at\ngetting the job done. <\/p>\n\n\n\n

But is lactic acid simply misunderstood?<\/p>\n\n\n\n

And does massage remove lactic acid?<\/p>\n\n\n\n

What is Lactic Acid?<\/strong><\/h4>\n\n\n\n

Lactic acid, or lactate, is a compound that is\nproduced during glycolysis.<\/p>\n\n\n\n

OK, so what is Glycolysis?<\/strong><\/strong><\/h4>\n\n\n\n

Glycolysis is a constantly occurring process\nwithin the liver and muscles that works to replenish and supply our body with\nglucose. Given that glucose (a form of sugar) is the primary source of energy\nfor every cell in the body and lactate is produced during glycolysis, it\nalready sounds pretty important. But even important people can be arsehats, so let\u2019s\nnot let lactate off the hook this easily.<\/p>\n\n\n\n

Glycolysis can be split into two categories:<\/p>\n\n\n\n

1. Aerobic Glycolysis<\/strong><\/p>\n\n\n\n

\"\"<\/figure><\/div>\n\n\n\n

Think of the Tour De France cyclists or the\nrecent efforts by the likes of marathon runners Eliud Kipchoge and Brigid\nKosgei, who were able to produce energy for a long sustained period. Their\nmuscles require a constant source of adenosine triphosphate (ATP) to fuel their\nbodies, and when there is enough oxygen available during exercise, their body\nutilises aerobic glycolysis to produce the ATP.<\/p>\n\n\n\n

Say we attempted to keep pace with Kipchoge\nfor just a single kilometre of his record breaking (sub 2 hour) marathon, with\nevery single kilometre split being between 2:48min\/km to 2:52min\/km. <\/p>\n\n\n\n

It is a pretty fair assumption that our demand\nfor oxygen would very quickly exceed its availability.<\/p>\n\n\n\n

This would force our body to undergo anaerobic\nglycolysis, which produces less ATP.<\/p>\n\n\n\n

2. Anaerobic Glycolysis<\/strong><\/p>\n\n\n\n

Initially, stored glycogen is converted to\nglucose. Glucose is then broken down by a series of enzymes.<\/p>\n\n\n\n

As glucose is broken down to synthesise ATP,\nit results in the creation of a substance called ‘pyruvate’ and hydrogen ions. <\/p>\n\n\n\n

As more hydrogen ions are created, the muscle\nbecomes increasingly acidic.<\/p>\n\n\n\n

This results in pyruvate binding with some of\nthe hydrogen ions and converting them into a substance called lactate.<\/p>\n\n\n\n

Somewhere around here,\nthe rumours that lactate was some sort of devil juice began, but we are yet to\nget the whole picture. <\/strong><\/p>\n\n\n\n

Lactate is then quickly removed from the\nmuscle cell, protecting the cell from becoming too acidic, so exercise can\ncontinue for a little longer.<\/p>\n\n\n\n

Lactate that is removed from the muscle is\ncarried to surrounding muscles that have oxygen available. <\/p>\n\n\n\n

It is also carried to the liver, where it goes\nthrough various chemical reactions to convert it back to pyruvate and\/or\nglucose for further glycolysis and energy production via the aerobic energy\nsystem.<\/p>\n\n\n\n

As the name \u2018anaerobic\u2019 suggests, there isn’t\nexactly an abundance of oxygen available to break down pyruvate and continue\nsynthesising ATP. <\/p>\n\n\n\n

So, despite copping such a bad rap for all\nthese years, poor old lactate realised that hydrogen ions were filling up the\nplace like a centipede\u2019s sock draw and was just trying to buffer\/prolong the\nenergy production process. <\/p>\n\n\n\n

What can we blame the burn on then? <\/strong><\/h4>\n\n\n\n

One could point the finger at those hydrogen\nions that accumulated and created the acidic environment \u2013 what a bunch of a*holes!\nOr we could shout profanities at that damn aerobic system that couldn’t keep up\n\u2013 what a slacker!<\/p>\n\n\n\n

But really, pointing the finger of blame isn’t\ngoing to help our clients. <\/p>\n\n\n\n

\"\"
Unless you’re pushing these up, your body is removing lactic acid all by itself.<\/figcaption><\/figure><\/div>\n\n\n\n

Assuming you can breathe, your body will bring itself back into balance rather quickly and, if you cannot breathe, a bit of a burning sensation in your muscles probably isn\u2019t going to be your primary concern. <\/p>\n\n\n\n

But wait … what on earth have massage\ntherapists been doing all this time?<\/strong><\/h4>\n\n\n\n

Well, this Wiltshire et al study<\/a> decided to take a look at exactly that.<\/p>\n\n\n\n

What they did:<\/strong> Twelve subjects\nperformed 2 min of strenuous isometric handgrip (IHG) exercise at 40% maximum\nvoluntary contraction to elevate forearm muscle lactic acid. Forearm blood flow\n(FBF; Doppler and Echo ultrasound of the brachial artery) and deep venous\nforearm blood lactate and H+ concentration ([La-], [H+]) were measured every\nminute for 10 min post-IHG under three conditions: passive (passive rest),\nactive (rhythmic exercise at 10% maximum voluntary contraction), and massage\n(effleurage and p\u00e9trissage). Arterialized [La-] and [H+] from a superficial\nheated hand vein was measured at baseline.<\/em><\/p>\n\n\n\n

What they found: <\/strong>Massage impairs La(-) and H+ removal from muscle after\nstrenuous exercise by mechanically impeding blood flow.<\/em><\/p>\n\n\n\n

What does this mean: <\/strong>That massage is not\nhelping to remove lactic acid and our attempts to remove lactic acid are\nactually impeding what is a normal function of the human body. <\/p>\n\n\n\n

So how do I apply all of this in the clinic? <\/strong><\/h4>\n\n\n\n
  1. Stop making lactic acid out to be the bad guy.<\/li>
  2. Even if your client had sprinted to your clinic door and was using anaerobic glycolysis for energy production, by the time you conduct your assessment and they get on the table, the body has likely taken care of itself (i.e. removed the lactic acid).<\/li>
  3. If you happen to be waiting at the finish line ready to immediately treat your client, you must understand that (a) you are weird and (b) treatment may impede blood flow and actually delay your client’s recovery. <\/li><\/ol>\n\n\n\n

    Why does this myth persist?<\/strong><\/h4>\n\n\n\n

    There are a few reasons:<\/p>\n\n\n\n

    • It is heavily ingrained in the public’s mind and most of them feel better having something to blame their pain on. For post-exercise pain, lactic acid is the cultural go-to culprit of choice. As long as people feel better after a massage, they are happy and likely don\u2019t care what it is we did.<\/li>
    • People feel smart when they get to use fancy words. If they wanted to learn the ins and outs, they would. <\/li>
    • Lactic acid is still blamed by massage therapists, personal trainers, old guys at footy clubs, young guys at footy clubs, all the way to those honest Instagram influencers selling magic water. But keep in mind that these are all people; they too feel and look smart when they get to use fancy words, specially if they’re selling stuff. <\/li>
    • Most courses skim over this stuff and most teachers are happy to do so because it\u2019s the easy option. Otherwise, they would be making the effort. <\/li>
    • Like most careers, we learn more on the job than we do at college. However, most therapists just pass down what they do and why they think it works and get defensive when pushed for further insight or, god forbid, evidence or even a valid explanation of concept. <\/strong><\/li>
    • Most therapists just want to help people and the thought of having to unlearn and relearn everything is overwhelming. Therefore, they continue to dish out the common catchphrases and figure that as long as clients are happy, who cares? And the profession remains in the dark ages yet again. <\/li><\/ul>\n\n\n\n

      Rumour has it if you put a silicone cup to your ear, you can still hear massage therapists removing lactic acid.<\/em><\/p><\/blockquote>\n\n\n\n

      \"\"<\/figure><\/div>\n\n\n\n

      How are you going to change the narrative, and\nstop perpetuating the myth that massage aids the removal of lactic acid?<\/p>\n\n\n\n

      About the Author<\/strong><\/h4>\n\n\n\n
      \"\"<\/figure><\/div>\n\n\n\n

      Daniel Wonnocott <\/em>is a RMT based out of Brisbane & Ipswich. He believes the best part\nof a cucumber tastes like the worst part of a watermelon and is mindful that\nsome cats are actually allergic to humans. For what it’s worth, he is an ENTJ.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

      Does a massage remove lactic acid? Or is that simply a myth? Daniel Wonnocott takes a look at the facts and history to give us the answer.<\/p>\n","protected":false},"author":1,"featured_media":2127,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[110,30,2],"tags":[507,508,403,506,505,504,197,510,509],"class_list":["post-2121","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-clinical-practice","category-massage","category-professional-practice","tag-adenosine-triphosphate","tag-atp","tag-daniel-wonnocott","tag-glycolysis","tag-lactate","tag-lactic-acid","tag-massage-myths","tag-myth","tag-myths"],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2019\/10\/CFS.png?fit=1200%2C628&ssl=1","jetpack_likes_enabled":true,"jetpack_sharing_enabled":true,"jetpack-related-posts":[{"id":2213,"url":"https:\/\/blog.amt.org.au\/index.php\/2019\/12\/05\/top-7-articles-of-2019\/","url_meta":{"origin":2121,"position":0},"title":"TOP 7 ARTICLES OF 2019","author":"admin","date":"05\/12\/2019","format":false,"excerpt":"Revisit 7 of the best articles we've featured on AMT's blog in 2019. Which was your favourite?","rel":"","context":"In "AMT"","block_context":{"text":"AMT","link":"https:\/\/blog.amt.org.au\/index.php\/category\/amt\/"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2019\/12\/top.jpg?fit=953%2C454&ssl=1&resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2019\/12\/top.jpg?fit=953%2C454&ssl=1&resize=350%2C200 1x, https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2019\/12\/top.jpg?fit=953%2C454&ssl=1&resize=525%2C300 1.5x, https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2019\/12\/top.jpg?fit=953%2C454&ssl=1&resize=700%2C400 2x"},"classes":[]},{"id":3608,"url":"https:\/\/blog.amt.org.au\/index.php\/2022\/05\/25\/meet-daniel-wonnocott-amt-board-member\/","url_meta":{"origin":2121,"position":1},"title":"Meet Daniel Wonnocott – AMT Board Member","author":"admin","date":"25\/05\/2022","format":false,"excerpt":"Think you already know a lot about the newest member of the AMT Board, Daniel Wonnocott? Think again!","rel":"","context":"In "AMT"","block_context":{"text":"AMT","link":"https:\/\/blog.amt.org.au\/index.php\/category\/amt\/"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2021\/08\/Meet-the-Board.png?fit=1200%2C628&ssl=1&resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2021\/08\/Meet-the-Board.png?fit=1200%2C628&ssl=1&resize=350%2C200 1x, https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2021\/08\/Meet-the-Board.png?fit=1200%2C628&ssl=1&resize=525%2C300 1.5x, https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2021\/08\/Meet-the-Board.png?fit=1200%2C628&ssl=1&resize=700%2C400 2x, https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2021\/08\/Meet-the-Board.png?fit=1200%2C628&ssl=1&resize=1050%2C600 3x"},"classes":[]},{"id":2396,"url":"https:\/\/blog.amt.org.au\/index.php\/2020\/02\/19\/mythbusting-does-massage-therapy-flush-toxins-part-2\/","url_meta":{"origin":2121,"position":2},"title":"Mythbusting: Does Massage Therapy Flush Toxins? Part 2","author":"admin","date":"19\/02\/2020","format":false,"excerpt":"You've heard it so many times, it must be true. Massage really does vanquish the toxin demons. With the aid of her trusty Vodkamatic2000, Rebecca Barnett gives us the real story.","rel":"","context":"In "Clinical Practice"","block_context":{"text":"Clinical Practice","link":"https:\/\/blog.amt.org.au\/index.php\/category\/clinical-practice\/"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2020\/02\/Toxin2.jpg?fit=640%2C408&ssl=1&resize=350%2C200","width":350,"height":200,"srcset":"https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2020\/02\/Toxin2.jpg?fit=640%2C408&ssl=1&resize=350%2C200 1x, https:\/\/i0.wp.com\/blog.amt.org.au\/wp-content\/uploads\/2020\/02\/Toxin2.jpg?fit=640%2C408&ssl=1&resize=525%2C300 1.5x"},"classes":[]},{"id":2230,"url":"https:\/\/blog.amt.org.au\/index.php\/2019\/12\/10\/mythbusting-massage-reduces-cortisol\/","url_meta":{"origin":2121,"position":3},"title":"Mythbusting: Massage Reduces Cortisol","author":"admin","date":"10\/12\/2019","format":false,"excerpt":"Massage reduces cortisol levels! Or does it? 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