massage - just lie down and take it

THE HUMAN CONDITION In the stressed-out Nineties, the ancient science of massage is back in demand

the days when medicine was prescribed strictly in the form of pills or liquid from the other side of a doctor's desk are over. Since 1991, GPs have been allowed to recommend "complementary" medicine on the NHS; a doctor may now send a patient for a touchy-feely session with a therapist who, a few years ago, would have been seen as highly "alternative", if not thoroughly cranky. Today, however, hands-on massages of all kinds are hailed as effective relievers of virtually everything from constipation to labour pains or road rage.

Massage is often lumped in with the huge range of New Age remedies that are currently fashionable, but its history goes back much further than the Nineties fad for "alternative" therapies. Ancient Greek, Arab, Chinese, Indian and Egyptian civilisations were all aware of its beneficial effects as far back as 2700 BC. Modern massage techniques were developed in the 18th century in Sweden, and by the turn of the century massage was widely used by surgeons, doctors and physicians. Shell-shocked soldiers were treated with massage during the First World War.

Massage began to fall out of favour when modern physiotherapy developed, and drugs and machinery became more fashionable than simple touch therapy; it developed a rather seedy reputation when "massage" services became a euphemistic way of referring to prostitution.

The triumphal comeback of the massage over the last few years is due to increased stress related to recession, says Wendy Kavanagh, director of the London College of Massage. "The mix of students has changed too," she says. "We have seen a lot more men coming in as massage has become more mainstream, and a lot of our trainees are career changers - we have had several from advertising, who found they had had enough of their highly pressured careers."

Isabelle Hughes, principal of the college, explains its current resurgence as "a rediscovery and re-acceptance of touch therapies, because we can now find scientific and instinctive reasons for accepting them."

As with many "alternative" therapies, though, formal scientific research into the effects of massage is still rudimentary. Like most reputable practitioners, Kavanagh acknowledges that more facts and figures are needed to give massage total medical credibility. It is already sufficiently accepted by the medical establishment to form part of degree courses, such as the Master's in Therapeutic Bodywork at the University of Westminster, and become widely used in NHS hospitals.

But statistics on the number of qualified massage practitioners working in Britain, or the number of hospitals, clinics and hospices that use massage therapy, are impossible to find. There are many training institutions (again, impossible to say how many); anyone can set themselves up as a massage practitioner or trainer; and there is as yet no standard qualification or register.

Massage professionals are already working towards upgrading and unifying nationwide standards. The British Massage Therapy Council, founded in 1992, has around 900 practitioners on its database, and is starting to establish a national register; the council seeks to maintain good technical, professional and ethical standards, as well as up-grading massage training in general. According to Wendy Kavanagh: "Massage is currently undergoing a revolution in terms of setting up recognised standards. This will filter out less reputable 'learn massage in a weekend'-type courses and lead to a nucleus of very good training centres."

Should the lack of formal medical research worry the prospective client? Perhaps not. "This lack of research is true of all so-called alternative or complementary medicines, but it's also true of 80 per cent of orthodox medicines," says Vincent Marks, professor of clinical biochemistry at Surrey and spokesman for Healthwatch, a watchdog group which is concerned with ensuring the quality of information on medical matters.

"Medical intervention has little effect on most illnesses in the long run - the vast majority of them get better of their own accord. Done correctly, by someone deft, massage is very good for aches and pains, stress-related illnesses and when we are uptight. Nobody is denying the benefits of massage - though all of the high-falutin explanations of why it benefits people are the sort of thing that give a good treatment a bad name. I've got a book in front of me now that says we get stiff because lactic acid that doesn't get washed away by the lymphatic system turns into crystals in the muscles and these can be shifted by massage - crystals? Total gobbledegook."

Not all massage practitioners attempt to blind us with science. Clare Maxwell-Hudson is one of the pioneers of British massage; she has been teaching it for 30 years, and founded one of the first massage schools in Britain.

"There is the pain gate theory, that massage blocks the nerve impulses that cause pain, and the theory that it releases endorphins into the blood - but there isn't much hard evidence, and some of it is contradictory anyway," she says. "If people feel better, that speaks volumes in itself."

She was one of the first practitioners to work alongside orthodox NHS doctors. "I started working in hospitals in the early Eighties, and it was very innovative at the time; now I lecture regularly at the Royal College of Nurses and run workshops in hospitals."

She is also the author of The Complete Book of Massage (Dorling Kindersley pounds 9.99), which has sold nearly a million copies world-wide. Her enthusiasm is convincing. "There is so much diversity with massage - you can work really hard on a muscular, burly footballer at the peak of fitness, or be extremely gentle with someone who is very ill in a hospice. Although there are only a few basic movements, it is the foundation of hundreds of techniques and different treatments. It really is mainstream now - everyone can benefit, and everyone should know how to do it. In this country we're not good at touching each other, and this kind of formal touching gives us permission to do it."

The Health Education Authority's Guide to Complementary Medicine and Therapies, which claims to be a definitive guide, assesses various forms of massage treatment. Criteria are popularity, medical credibility, availability, and the amount of scientific backup. The HEA awards between one and four stars in each category. Touch therapies score well; out of a possible 16 stars, massage scores 15, aromatherapy 14, rolfing 11, and shiatsu 10.

If you are thinking of finding a therapist, the most important thing, says Clare Maxwell-Hudson, is to find one you can trust and get on with. There are few contra-indications. "Anyone with a medical condition or who is pregnant should get their physician's permission. If you have acute back pain, or any inflammatory condition such as thrombosis or varicose veins, your therapist should avoid the affected area. You should take care during the first three months of pregnancy and avoid any heavy abdominal work. If you are self-massaging, the golden rule is, 'When in doubt, don't do it.' " Self-massaging? "Oh yes, you can do it to yourself."

Expect to pay around pounds 20 for a massage; self-massage is, of course, completely free.

HOW TO AVOID THE OTHER SORT

Advice to men who really want a plain old massage, no sex involved: the reputation of massage still lingers, for good reason. Plenty of so- called massage parlours could be more fairly described as brothels. If a man wants a bona fide back rub to alleviate tension and no sexual extras, linguistic carelessness may cause confusion. How does the honest punter tell a natural therapist from a remarkably coy prostitute? Common sense is a good starting-point. An obvious method is to inquire through an official organisation, such as the British Register of Complementary Practitioners, a local complementary health centre, or the London College of Massage. Isabelle Hughes says: "If you reply to a dubious advertisement which includes the girl's name, in a shop window or a telephone kiosk, or go to a massage parlour or sauna or establishments open till midnight, the likelihood is you are going to be offered a naughty massage."

an a-z of touch therapies

ACUPRESSURE: Applied pressure to various points along the energy lines of the body of which there are more than a hundred. Very similar to acupunture but uses finger pressure rather than needles, and the points are either stimulated, toned or dispersed, depending on the way the practitioner moves the fingers on the points.

Dr. Mark Yu: 0171 485 7493

AROMATHERAPY: Uses essential oils as main vehicle of treatment, which are applied to the body through massage. According to research, essential oils possess medical properties, are antiseptic and capable of adjusting a person's mood via the olfactory nerves. An aromatherapist will select a blend of oils with different properties to suit the condition the patient wishes to deal with.

Gemma Lipman: "I had a bad cold and my glands were swollen. I had a Swedish massage by a practitioner qualified in sports massage, with lavender, thyme and pine oils. I felt like it was mobilising my body's ability to heal itself. At first I felt groggy but then the ache disappeared and the congestion dissipated. It was just bliss."

British School of Complementary Therapy, Harley Street, London W1 0171 224 2394.

BABY MASSAGE: In India, Russia and South America it is common occurance for the mother or family member to massage the newborn child every day for the first year of its life. Russians massage to build strength, Indians to build internal strength. In America there is research which shows that premature babies who receive daily massage will make faster progress than those not massaged. A very simple technique, with vegetable oil, which takes about 15 minutes. London College of Massage: 0171 323 3574

CHAVUTTI THIRUMAL: Indian in origin. The patient lies down on a mat and the massage is applied to their whole body using oils, but the practitioner - hanging on a rope to take their weight and for balance - effects the masage with their feet. It works on the "prana", a form of energy that links the astral and the physical body. Recommended for headaches and digestive disorders. Ms Hughes says: "I've seen a facial massage done by foot and it is extraordinary how delicate these people can be. It's quite a sight."

Emma Field, Star St. London W2

0171 724 6582

REFLEXOLOGY: Stimulation of reflex points in the feet or the hands which relate to different areas and organs of the body. The reflexes extend from the extremities to the top of the head along ''meridians'' or ''energy lines''. By applying pressure on the reflex points the practitioner releases congestion along the meridians and improves the functioning of the body organs. Effective for internal, muscular and skeletal complaints, especially sciatica and back pain. The client keeps all his clothes on and sits with just feet exposed. Angela Smith, 40: "I went for migraine. Reflexology didn't help but it was exceptionally enjoyable and relaxing. It can be very painful, though. If they hit a point that corresponds to something that isn't right they meet resistance and have to knead it out."

Association of Reflexologists 01273 479020

REIKI: A reiki practitioner channels energy through their own body. Lays their hands over the person receiving massage. There may be no movement involved. It may be a feeling of energy coming through the practitioner's hands and warmth in the area on the body, a still, silent, quite powerful experience. According to practitioner Chris Jones (tel: 0181 675 1465): "It channels universal life energy in order for a person to heal themselves." He adds: "I use it on myself. It's transformational. It helps boost your own healing powers. It helps you deal with all your problems and express your emotions."

Association of European Reiki Practitioners 0181 992 5561

ROLFING: An extremely deep form of massage. It tears and re-structures the fascia - or binding tissue - of the muscle. To make somebody straighter the fascia may be torn and realigned. It's thorough and can be quite painful. It's normal to have a course of ten treatments. Clients may have postural misalignments like turned in toes and knock knees. The practitioner, who starts at the feet and works up the body, must have an encyclopaedic knowledge of anatomy and physiology. They go into everywhere: up your nose, in your mouth.

Grant Gilbert, 37: "I went because I had chronic back pain. I was deeply moved by the experience. It was so intense. To say it's a deep tissue massage is a mild way of describing it. I found the treatment painful in an acceptable and exhilarating way. It makes you want to scream in a relieving way."

Jenny Crewdson 0171 834 1493

Rolfing Centre, Judd St, 0171 388 6567

SHIATSU: an Oriental treatment which works on the pressure points of the body (like all Oriental treatments from acupressure to acupunture) to effect the balance of vital energy or ki in the meridians. The patient doesn't remove their clothes, and there are no oils involved. The client lies on a mat on the floor and the practitioner gives shiatsu by applying controlled pressure over the body with their fingers, thumbs, elbows, knees or feet. This directs the energy in the body - removing excess energy or improving energy where there is too little. Particularly effective as a preventive medicine or aid to convalescence.

Linda Burns, late twenties: "My masseur stood on my feet. He clicked every joint in my body, even fingers and toes. It was amazing. When it's done properly it's very deep, gentle and slow. My whole body lost all its tension and I fell asleep."

Shiatsu Society, Wokingham 01734 730 836

Veronica Howard, London School of Shiatsu: 0181 802 1493

SWEDISH MASSAGE: A general term given to the more

common type of massage. Uses oil and four basic categories of massage stroke known as efflurage, petrissage, tapotements and frictions. Named Swedish massage because it was introduced to Britain in the 1940s by a Swede, Professor Henry Ling, who was the first Westerner to show the direct physical and psychological benefits of massage. In the 19th century nurses and physiotherapists were all trained in Swedish massage.

Rima Hudson, 27: "This wasn't a very deep massage. It was more like someone rubbing my back. It didn't make me tired. It wasn't very relaxing. It was more like a little treat."

The Gentry, Canary Wharf: 0171 895 9929