The Science of Abhyanga
/“अभ्यङ्गमाचरेन्नित्यं स जराश्रमवातहा।
द्रुष्टिप्रसादपुष्ट्यायु:स्वप्नसुत्वक्त्वदाढ्यकृत्॥८॥
“Oil massage should be performed regularly. It destroys aging, exhaustion, and vata. It improves vision, nourishment, longevity, sleep, health of skin and makes the body strong.””
““Abhyanga is an ancient practice which predates the Vedic period. Early humans practiced life sustaining ways of manipulating the body to produce strength, mobility, flexibility and fluent memory, memory which interlaced with the cosmos.
Vitally linked to the profound harmony of the earth, the ancients knew every movement in the cosmos to be filled with the universal abhyanga. The leaves and bark of the trees are continually massaged by the wind: the rocks and pebbles are rubbed by the streams and rivers: the animals, brushed by space, wind and the forest, are forever toned by abhyanga.” ”
What can we do to make ourselves healthier? This has become an international focus, escalating in 2020 on the tails of a pandemic. The quest to achieving optimal health has no one answer and can vary greatly from person to person. Yet, there are some core, universal aspects to health. These aspects, these essential tools and resources, we are finding, are rather simple. We can even say they are about simplicity.
Simplicity. In the insanity of an ever-growing complex modern, technologically driven world we are coming back to the simple things. Good, plain food and water. Routines that don’t swallow every minute of our lives in activity. Movement practices that strengthen and enliven the body and mind. Getting consistently good sleep is essential. With so many of us trapped indoors, under stress of uncertainty and constant readjustment, routine and physical care has become one of our top priorities. So, the more simple the better. But what do we choose? With limited resources, so many choices and the ever-mounting confusion generated by the wellness industry – how can a person objectively land on a product or a practice with confidence?
Enter abhyanga. Ayurveda, India’s ancient system of medicine, offers abhyanga therapy as a basic and immediately effective modality as part of a self-care routine. Abhyanga is the traditional therapeutic massage of Ayurveda. It is often used in dinacharya (daily routine) practice as a self-massage technique. It is also a core therapy in Panchakarma (the main detoxification process of Ayurveda). The health benefits of abhyanga have been known for thousands of years. At the end of this essay, I will give some resources for learning how to do this for yourself at home. But first, let’s look at some science.
As Western medical knowledge reaches new depths, it is rediscovering the ancient wisdom of the East. Western medicine is finally recognizing what many cultures over generations have known to be useful and effective. Through this recognition science is adding a new dimension of understanding to these ancient therapies and techniques. This is important because we need to scientifically “legitimize” these otherwise “woo-woo” practices in order to bring them into the forefront of care. In doing so we can make new and more effective standards in modern health practices.
This is rather like eating an elephant. But how does one eat an elephant? One bite at a time. Here, we examine the known science supporting the practice of abhyanga.
The word abhyanga is derived from the Sanskrit roots anga, meaning movement and abhi, meaning different, against or contrary. Abhyanga is, simply, the act of applying oil to the skin with simple massage techniques. In Panchakarma, the oil is often medicated with multiple herbs infused, specific to patient therapy, and applied warm with a variety of stroke, percussive and pressure techniques (1). Each generates a therapeutic effect. Abhyanga administered during Panchakarma is often done with two people, massaging in tandem. But Abhyanga can be as simple as using a plain oil (often sesame), self-applied liberally to the skin, massaging the extremities, head, face, back and abdomen.
Abhyanga has many reported benefits – both physical, emotional and energetic. Oiling of the skin maintains skin integrity and hydration. Stimulation of the underlying deep tissues such as muscle and fascia generates relaxation, pain reduction and an overall sense of wellbeing that improves fatigue recovery and general muscle function. Abhyanga provides a massage of the lymphatic system creating an effective mode of deep tissue detoxification. It is deeply relaxing, as are most massage techniques. However, abhyanga also stimulates splanchnic circulation, the blood flow via a fine network of small blood vessels to the gastrointestinal tract and abdominal organs (1,2). Abhyanga is a mainstay of treatment for anxiety related issues (3).
There has been little scientific research done to objectively examine abhyanga therapy. Abhyanga, however, is a form of massage and therefore can be examined as a part of this general practice. As there is a great deal of scientific exploration on the general topic of massage it is reasonable to begin to validate abhyanga therapy through this lens.
Massage has been a core therapeutic tool in medicine for millennia. Evidence of its use as a therapy is seen in China, Egypt and India starting around the second century BC. Hippocrates simply defined medicine as “the art of rubbing” (6). This highlights the notion of touch therapy as a core medicinal tool. When you stop to think about it, every human practices massage therapy. Ever painfully bang your knee and reflexively start to rub it? There is something inherently comforting about touch in general. But what sort of clear benefits are derived from massage? A review of literature finds a wealth of international studies on the benefits of massage as a medical therapy.
There are many benefits of massage. If I had to pick the most important one, it would be stress reduction. By now, I think most people are becoming aware of how incredibly detrimental stress is to the body-mind. Stress tears down body tissues. It also drives poor decision making. When a person is stressed and doesn’t know how to deal with it they can tend to lean on addictive substances and ultimately self-destructing behaviors as coping mechanism. Cigarettes, food, drugs, prescription valium…. Stress alters the physical chemistry we live in moment to moment, prematurely aging the body and generating disease states. Chronic stress is bad for you.
Abhyanga massage therapy has been directly shown to help modulate stress. A simple study done in a Korean nursing school administered foot massages for a brief period of time to a group of lucky nursing students in order to examine the effect of massage on subjective stress. The experimental group (the ones getting the massage) reported improved mood, decreased fatigue, and had lower blood pressure readings (systolic and diastolic) as compared to the control group (those who did not receive foot massage)4. Another simple yet elegant study with a group of nurses demonstrated a significantly reduced perception of stress at work when given a 10 min chair massage during their shift versus those who just received a break (5).
Abhyanga has been given to infants as a long-standing tradition in India to promote health and well-being right at the start of life. Science has shown that massage does indeed help babies thrive. Repeated studies have demonstrated improved growth and vitality in infants who were preterm or drug exposed (6.7). Massage of full-term infants demonstrated the same. Additionally, these studies also measured increased alertness and less fussiness in the massage group. Newborn massage showed cognitive benefits at one year of age. This result has also been shown in animal models. Rats regularly deprived of touch were shown to have higher circulating stress hormones (glucocorticoids) and signs of impaired memory (8.9). Research of this sort is supportive to abhyanga practice as a method for vitality and longevity.
Abhyanga has been traditionally reported to alleviate pain. This is thought to occur in massage therapy by activating the ‘pain gate’ mechanism. Touch uses a faster, larger set of nerves than pain does, so touch sensation is transmitted ‘over’ pain. Also, massage triggers discomfort pathways that activate areas of the midbrain that in turn stimulate the spinal cord to release endogenous opiates (10,11,12,13). This is the physical basis of how something can “hurt so good”. If you have ever been the recipient of a deep tissue massage - or two-person abhyanga - then you understand this. The massage can be, uncomfortable, even painful, but the after effect is usually amazing.
Abhyanga, especially when administered during Panchakarma or done regularly during a dinacharya, is used to help build healthy tissue. This has been demonstrated scientifically in studies using massage therapy to prevent denervated muscle from atrophy and contracture (14,15). These are old studies. We have long known that physical manipulation of muscle tissue can help maintain its bulk, even if the nerve to that muscle is severed.
Abhyanga offers a bounty of other benefits seen directly in massage therapy. It addresses insomnia caused by emotional and medical conditions (16). It promotes increased blood flow, improved lymphatic function and therefore serves a major detoxification modality (17,18).
I believe more scientific study into abhyanga therapy would reveal even further benefits. Abhyanga not only incorporates many different stroking, kneading, and other stimulatory techniques but it is often done with medicated oils, heat, acupuncture and the use of marma point stimulation. Marma points are areas on the body that allow cutaneous access to deeper structures and energy pathways. This is beyond the scope of this essay, but it is mentioned to highlight of the grander scheme of complexity that is rolled into this one therapy.
For those of us who practice therapeutic modalities like massage, we don’t really “need” science to tell us how beneficial they are. However, as modern medicine begins to shift towards a more holistic approach that aims to actually heal chronic conditions, the necessity for a practice to be scientifically backed becomes increasingly important. Imagine a world where you go to your doctor for anxiety, depression, pain or insomnia and instead of (or perhaps in addition to) an antidepressant or Valium, you were offered acupuncture or massage as part of your treatment?
I believe this day is coming. The good news is that you don’t need a doctor, you can have all the benefits of massage therapy through self-administration. Learn to do abhyanga with these tutorials:
How to get started doing abhyanga: https://www.youtube.com/watch?v=_HQLsfZh5js
Again, simplicity is key here. After working with patients and clients for years, I have found some people are overwhelmed by getting themselves completely oily. So don’t. Start massaging your feet with oil every night before bed. Do your hands. Work up to doing your arms and legs. Try applying a few drops of oil to the top of your scalp. Go from there if you like, don’t if you don’t want to. You have permission to do what feels right to you, you do not have to follow any “rules”. When done even just semi regularly, at-home abhyanga has tremendous benefits. After years of “prescribing” abhyanga to people the feedback I get still surprises me: they start dreaming again, they have better sex, their digestion improves, their hair grows back, etc…. Amazing what a little inward attention (i.e. self-love) will do. As we learn over and over again in life, perfection is not required. You do not have to run from your life and join an ashram in order to heal and rejuvenate. Just dialing back on the stress-o-meter can get you far down the road. We all need to regularly get out of our heads and back into our bodies. Your ability to do this is as close as your two hands.
References
Kaushal, s. et al. (2017). Abhyanga: Different Contemporary Massage Technique and its Importance in Ayurveda. Journal of Ayurveda and Integrative Medical Sciences. May - June 2017, p 1-8.
Zimmerman, P. et al. (2019). Shackelford's Surgery of the Alimentary Tract. Chp Anatomy and Physiology of the Mesenteric Circulation. 2 Volume Set (Eighth Edition)
Gasler, A. Pilot Study Investigating the Effects of Ayurvedic Abhyanga Massage on Subjective Stress Experience. The Journal of Alternative and Complementary Medicine Vol. 17, No. 5. Published Online:19 May 2011https://doi.org/10.1089/acm.2010.0281
Won, Jong-Soon, et al. The Effect of Foot Massage on Stress in Student Nurses in Clinical Practice. Journal of Korean Academy of Fundamentals of Nursing. 2000;7(2): 192
Brennan, M & DeBate, R. The effect of chair massage on stress perception of hospital bedside nurses. The Journal of Body Work and Movement Therapies. Volume 10, Issue 4, October 2006, Pages 335-342
Field, T. (1998). Massage Therapy Effects. American Psychologist, vol 53, No. 12, 1270-1281.
Scafidi, F., et al. (1990). Massage stimulates growth in preterm infants: A replication. Infant Behavior and Development, 13, 167-188.
Wheeden, A. et al. (1993). Massage effects on cocaine exposed preterm neonates. Journal of Developmental and Behavorial Pediatrics, 14, 318-322.
Meany, M.J. et al. (1990). Neonatal handling and the development of the adrenocortical response to stress. In N. Gunzenhauser, T.B. Brazelton, & T. Field (Eds), Advances in touch (pp.11-20). Skillman, NJ: Johnson & Johnson.
Schanberg, S. (1994). Genetic basis for touch effects. In T. Field (Ed.), Touch in early development (pp. 67-80). Hillsdale, NJ: Erlbaum.
Bowsher D. Modilation of the nociceptive input. In: Wells PE, Frampton V, Bowsher D, eds. Pain: Managemenmt and Control in Physiotherapy. Ondon, UK: Heinemann Medical, 1988: Chp 13
Greive, GP. Common Vertebral Joint Problems. Edinburgh, Scotland: Churchill Livingstone, 1981
Bsabaum A & Fields H. Endogenous pain control mechanism: review and hypothesis. Ann Neurol 1978; 4: 451-2
Elizabeth C. Wood, A.M., A. J. Kosman, Ph.D., S. L. Osborne, Ph.D., Effects of Massage in Delaying Atrophy in Denervated Skeletal Muscle of the Dog, Physical Therapy, Volume 28, Issue 6, November 1948, Pages 284–285, https://doi.org/10.1093/ptj/28.6.284
Suskind MI et al. Effects of massage in delaying atrophy in denervated skeletal muscle. Archives of physical Medicine 1946; 27’ 133-5
https://www.amtamassage.org/about/position-statements/massage-therapy-can-help-improve-sleep/
Mesenteric Circulation Anatomy and Physiology of the Mesenteric Circulation.
https://www.pacificcollege.edu/news/blog/2014/07/15/massage-for-detoxification