July 10, 2024 • 22 mins
When is a tool a robot?
Join your host, Corey Rivera on the meandering development of tools used for massage (but not necessarily massage therapy). We'll talk about:
- Tools that help
- Tools that don't
- Tools that are robots
- Tools that are fish
Cathy Ryan, The Fascia Nerd also stops by to explain cellulite! Stay tuned after the outro to hear bonus Cathy.
Take a class with Cathy Ryan!
You can't break fascia (Threlkeld 1992)
National Library of Medicine TENS Article
Tool-Making and Tool-Using in the Northern Blue Jay
The definition of massage therapy (Kennedy 2016)
Send us an email: podcast@healwell.org
Leave us a voice message: 703-468-1799
Check out our interview-style podcast: Interdisciplinary
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:06):
Welcome to the Rub, a podcast about massage therapy.
I'm your host, kori Rivera,licensed massage therapist and
information magpie.
In today's episode, we're goingto talk about massage tools and
massage robots.
Before we jump into the worldof robots, I'd like to explain a
(00:30):
change I'm making to thispodcast.
From now on, any massageactivity that doesn't meet the
definition of massage therapywill, as published by researcher
Dr Anne Blair Kennedy in 2016,using data gathered from 32
experts in the massage therapyprofession and as paraphrased by
me is.
(00:51):
Massage therapy consists ofrubbing, and it also includes
health promotion and educationalmessages.
It is for both self-care andhealth maintenance.
The results of massage therapydepend on therapeutic
relationships and communication.
The results also depend on thetraining, skill and experience
of the therapist.
The setting of the treatment,such as a spa, hospital or
(01:12):
shopping mall, may have aninfluence on the results.
In short, massage therapyincludes rubbing, but rubbing is
not necessarily massage therapy.
I first heard someone expresstrue concern about massage
robots in October of 2023.
I can be precise because it wasan interview and I have a
(01:32):
recording.
Speaker 2 (01:34):
It was one guy there from California.
He was in the beauty world, buthe dropped some gems too.
He told us that they're alreadylike working on ways to replace
massage therapists with robots.
Speaker 1 (01:50):
I was a little surprised and honestly kind of
brushed it off.
Massage therapy is too complexfor a robot.
But then I heard concern aboutrobots again about a month later
, and then a study titledRobotics in Massage came out of
Mayo Clinic.
And when a major hospitalsystem that takes pains to be
seen as a leader in their fieldpublishes about massage robots,
you've got my attention.
(02:10):
So this is the first episodeabout what people are calling
massage robots.
Let's start simple.
All robots are tools, but notall tools are robots.
I looked up several definitionsof tool and my favorite is the
use of physical objects otherthan the animal's own body or
(02:30):
appendages as a means to exertthe physical influence realized
by the animal.
The definition says animalbecause it's from a 1973 paper
called Toolmaking and Toolusingin the Northern Blue Jay, which
immediately brought to mindimages of blue jays wearing tiny
construction helmets and highvisibility jackets.
So a tool is a simple machine.
It doesn't have sensors orelectricity.
(02:53):
It's usually designed for aspecific job, but versatility is
great too.
My favorite tool is a nice setof tongs to use in the kitchen.
I'm a short human and reachingacross a hot stove with my
little T-Rex arms can behazardous Bonus.
With tongs, you can click themat people to get them out of the
kitchen while you're working.
Humans have been using tools toassist with rubbing for
(03:13):
thousands of years.
China was using jade, marbleand basalt stones for hot and
cold treatments, at least as farback as 2000 BC.
Nowadays, thanks to modernmanufacturing, we have a wide
assortment of options, many ofwhich look like small pieces of
modern art.
Some of these tools are forself-rubbing.
There's a flock of wooden footrollers that look like giant,
chunky Pandora bracelets orsomething your toddler might
(03:34):
pull around on a string.
There's the Theracane andBackknobber, both curvy plastic
sticks with balls on the ends tohelp the people who are trying
to use that door jam to reachthat really awkward place
between their shoulder blades.
Other rubbing tools exist tomake a massage therapist job
easier.
The Thumb Saver, which lookslike a bright red plastic
(03:56):
holster for your thumb, helpedsupport my ligaments until I was
able to figure out bettertechniques to protect myself.
Eventually, my elbow gamecaught up to my thumb game
better techniques to protectmyself.
Eventually, my elbow gamecaught up to my thumb game.
My admittedly pointy elbowswere just as sensitive and
controlled as my thumbs, andwhile elbows are not very useful
for delicate places like necks.
They are dynamite for largermuscles.
Until my elbows were up to thejob, the Thumb Saver really did
(04:18):
save my thumbs.
The cool thing about thesemanual tools from the Thumb
Saver to hot stones and eventools unrelated to rubbing like
knitting needles or pencils isthat the more you practice with
them, the more you can feelthrough the tool.
When you first begin workingwith a rubbing tool, it's like
you put on a pair of heavy workgloves and you really have to
focus, like the way you did atthe beginning of your massage
(04:39):
education.
Eventually, your nervous systemfine-tunes itself to the tool.
You can use it as an extensionof your hand, including feeling
tissue changes.
The science on how this worksis pretty split.
One study found that fluencywith a tool only happened when
you were doing the task specificto the tool.
If you used a tool forsomething new, say if you used a
(05:02):
knitting needle to dig a hole,the connection wasn't the same.
Another study looked at partsof the brain that process vision
and unexpectedly found that themore people used a tool, the
more their brain identified itas something different from
their hand.
People regularly report thisfeeling of oneness with tools,
but figuring out what happens inyour brain is another matter.
I'd like to make a very specialhonorable mention to a tool that
gained a lot of popularity afew years ago the Fascia Blaster
(05:25):
.
The Fascia Blaster, whichretails at 140 bucks, is a white
rod with a row of four plasticflower shaped pieces.
Fascia itself is a wonderfullycomplex topic, but the short
version is that it's a web ofconnective tissue that runs
through your body in acontinuous network.
In order to properly talk aboutthe Fascia Blaster, I enlisted
(05:45):
the help of HealWell friendKathy Ryan.
Speaker 3 (05:49):
I am Kathy Ryan.
I'm a registered massagetherapist and self-proclaimed
Fascia nerd.
Speaker 1 (05:54):
Kathy is the author of Traumatic Scar Tissue
Management Principles andPractice for Massage Therapy.
She's attended everyinternational fascia research
congress since the first one in2007.
Fascia is Kathy's jam.
Kathy had this to say abouttools in general.
Speaker 3 (06:10):
So I mean for me as a practitioner, anytime I'm
trying to make a clinicaldecision about how to use my
hands or a tool or whatever, ora tool or whatever, I always
begin with trying to figure outwhat the situation is and having
(06:31):
a good pathophysiologicalunderstanding of what it is or
what the situation is, before Itry to decide what I'm going to
do about it.
Because without thatunderstanding, it's kind of like
, you know, poking around in thedark trying to find the light
switch or whatever the case maybe to.
(06:52):
You know, figure out what Ishould be doing.
Speaker 1 (06:55):
The Fascia Blaster's marketing makes claims about,
quote, regenerating fascialtissue and quote bringing fascia
care to the world and oh, bythe way, casually mentions it
will get rid of the cellulite onyour thighs.
You use the blaster by draggingor scraping the plastic flowers
across your skin with a fairamount of pressure to quote
break up the fascia.
Please don't try to break upfascia.
(07:16):
Deforming fascia by even 1%takes over two tons of pressure.
Breaking it requires a scalpel.
Both of these things will causetrauma to the tissue and a
massive amount of pressure.
Breaking it requires a scalpel.
Both of these things will causetrauma to the tissue and a
massive amount of inflammation.
Kathy had this to say aboutcellulite.
Speaker 3 (07:32):
I think the most common thing that's agreed upon
out there is that we don't fullyknow yet what exactly causes
cellulite.
So if we don't know exactlywhat's causing it, I think it
makes it more challenging for usto come up with effective ways
of treating it.
Because I think the biggestthing out there is that there
(07:54):
are different ways of treatingcellulite, but it doesn't seem
like the effects are very long,lasting, so there's a
sustainability component to it.
Speaker 1 (08:04):
If you or someone you know has a fascia blaster, I
recommend you repurpose it,maybe to hang wind chimes or
tenderize those chicken breastsyou're having for dinner.
If talking about tissues issomething you'd like to do more
of, kathy would like to extend adirect invitation for you to
Hewell Homecoming this September.
Speaker 3 (08:21):
Well, HealWell Homecoming is coming up and
lovely HealWell people haveprovided me with an opportunity
to just do my fascial blah, blah, blah for four hours at
Homecoming and then, on theheels of that, follow up with a
two day scar tissue workshopwhere there will be some more
(08:43):
fascia chat, you know.
So people have questions, morequestions about cellulite and
fascia blasting.
Well, we can probably chatabout it in September.
Speaker 1 (08:54):
Also, I've put Kathy's extended description of
cellulite and inflammation atthe end of the episode for all
you other fascia nerds.
To hear Back to tools A bitfurther down the path towards
robots are electrified tools.
The electrified tool thatprobably comes to your mind is a
percussion rubber, the mostpopular of which is the Theragun
, which debuted in 2008.
Theraguns are a triangle-shapedhandheld device with a blunt
(09:18):
jackhammer-like knob, and thefirst Theragun sounded like a
jackhammer too like a jackhammertoo.
There was a lot of customerfeedback about the noise, and
now they sound like this.
The first percussion tool wascreated in the 1950s by a man
(09:38):
named Dr Robert Fulford, who wasan American osteopath.
The idea was that the toolwould mimic to popement, a
technique that's often seenduring massage and movies,
because it involves using yourhands to create rhythmic
whacking motions and thus isvisually interesting.
Percussion tools can befine-tuned to pummel people with
specific speed and pressure,and the tool can whack much
faster and for longer than ahuman can so much faster that
(10:00):
percussion therapy performedwith an electric tool is
sometimes discussed as vibrationinstead of percussion.
The main difference betweenvibration and percussion is how
deep the tool presses into themuscle, so a percussion tool
will push inward toward the bonemore than a vibration tool.
Just what physical effectspercussion results in is kind of
up for debate.
People who are interested inathletic performance are very
(10:21):
keen to find out.
I found a study that saidpercussion tools could increase
range of motion but not increasemuscle contraction.
Another said that the toolincreased muscle strength,
explosivity and flexibility.
A third said a percussion toolcould help with recovery and
muscle stiffness, but wasn'tactually great for increasing
performance.
All of these studies were under20 people, so it's not
surprising the results werevaried.
(10:43):
The research on vibration isquite different, but before we
talk about that, we need to talkabout why research on vibration
is tricky.
There are a lot of vibrationtools on the market and they all
run a little bit differently,which means it's difficult to
compare studies if they aren'tusing the same device.
There are two importantmeasurements when you talk about
vibration Intensity, which issometimes referred to as
(11:03):
magnitude, and frequency, intand frequency.
Intensity and frequency.
If you've ever driven on a roadthat made your teeth chatter
because it hadn't beenresurfaced for a while, you felt
both frequency and intensity.
Frequency is how often your carhits a bump.
Intensity is how jarring it is.
You might have noticed that ifyou speed up because you're
trying to get through that badpatch of road, the intensity
(11:25):
gets worse.
We know that certain kinds ofvibration are bad for humans.
High-intensity, low-frequencyvibration can be harmful.
That's vibration that is slowbut very powerful.
This kind of vibration is oftenfound in handheld construction
tools and can be considered awork hazard.
Low-frequency vibration canalso cause motion sickness.
But low-intensity, high-, highfrequency vibration so fast but
(11:48):
less powerful is used in medicaltreatments.
Vibration might be applied by ahandheld device or it might
involve the patient standing ona platform that vibrates their
whole body, handily known aswhole body vibration.
These treatments are beingstudied for a wide variety of
uses, including pain management,but the one I think is really
cool is to simulate exercise.
Our bodies need exercise for alot of reasons, but when it
(12:09):
comes to bones and muscles weneed the controlled stress
called loading that exercisecauses to maintain bone and
muscle strength.
But if you're medically frailor have problems like balance
issues, it can be difficult andeven dangerous to exercise.
Whole body vibration therapycan simulate the loading of that
muscle and bone that happensduring exercise and it's been
shown to increase oxygenconsumption and blood flow.
(12:30):
One study showed an increase injumping ability in patients
after the vibration therapy.
You can find these whole bodyvibration machines at some gyms
and of course they're advertisedfor weight loss, because really
what isn't?
But I don't believe that claim,and there's a lot of debate
about commercial vibrationplatforms using the harmful kind
of vibration.
(12:51):
Honorable mention in thenot-quite-a-robot category goes
to electric muscle stimulation.
So I found this article thatsaid the ancient Egyptians and
later the Greeks figured outthat electric fish could create
shocks to relieve pain.
Have a muscle ache, rub a fishon it.
The most well-known electricmuscle stimulation device today
is not a fish, it is a TENS unit.
(13:13):
Tens stands for TranscutaneousElectrical Nervous Stimulation.
A TENS unit is a small devicethat sends out a low voltage
current through electrodes thatare lightly glued to the skin.
Tens units treat pain, but wedon't know for sure just how
they do it and they don't workfor everyone.
The top two theories arecausing a release of endorphins
or possibly blocking nervesignals.
(13:34):
We're not going to go deep intoit today because it involves me
saying things likevoltage-gated sodium channels
and muscarinic receptors andmethionine and kafalin, and
that's just boring.
It's boring If all those wordsmade you curious instead of
bored?
You can read the NationalLibrary of Medicine's TENS
article link in the show notes.
Tense units used to be veryexpensive and bulky, but my
(13:56):
local pharmacy has ones thatwill fit in your pocket for
about $40.
Like all treatments, they aren'trecommended for everyone.
Particularly people who arepregnant, have heart issues,
cancer, deep vein thrombosis,epilepsy or bleeding disorders.
So before you use the thingthat delivers electrical shocks
to your body, you should checkwith a physician, even if the
device is sold over the counteror is a fish.
And speaking of risks, nothingis perfectly safe, and that
(14:21):
includes rubbing.
Adding tools of any kind,particularly electrified ones,
can increase the possibility ofharm.
There is a report of avertebral artery dissection in a
patient's neck after they hadbeen using a percussion rubbing
tool for a few weeks.
Your vertebral arteries runthrough the outer parts of your
spine and the word dissectionmeans there's been a tear.
Tears cause blood clotting andblood clots can cause strokes,
(14:44):
which makes this a very seriousconcern.
The case study said the patientreported neck pain, headache
and dizziness, while percussionrubber disclaimers say you
should not use these tools onyour head, neck or near your
genitalia.
The people who make thepercussion rubbers aren't very
good at defining neck.
A lot of their officialdemonstration videos show people
using the device on what couldanatomically be considered a
(15:06):
neck.
Now let's get to the robots.
What exactly is a robot?
So a robot is a tool, but atool is not necessarily a robot.
As I said before, a tool is asimple machine designed for a
set of tasks that don't havesensors or electricity.
Okay, the term robot is superduper debated, especially right
(15:32):
now with the advent of usable AI.
For my purposes today, rightthis second, I'm going to say
that a robot is a complexmachine that does have sensors.
Robots can move or manipulateobjects, and they are at least
semi-autonomous or maybe don'tneed human direction at all.
Robots can often execute simpledirections known as programs or
protocols.
Robots can use their sensors toadjust their programs to their
(15:55):
surroundings.
For example, a rubbing robotwill have sensors that relay
information about how muchpressure it is exerting and will
have a limit on how much forceit's allowed to use.
Due to their price tags, whichcan range upwards of $10,000,
most rubbing robots of the pastmade their appearances in places
like shopping malls andairports.
The first working rubbing chairis widely credited to Nobuo
(16:16):
Fujimoto, a Japanese bathhouseworker.
He invented it in 1954.
It was made of wood and massageballs that made a kneading
motion and moved up and downyour spine.
It was controlled using ahandle on the side of the chair.
His company, now calledFujiroki, still exists and is
still making rubbing chairs.
Modern rubbing chairs have newerfeatures that earn them the
(16:38):
robot title.
The massage balls can rub yourback, spine and maybe your arms,
which is marketed as 3Dtechnology.
A few can change speed, whichis marketed as 4D technology,
and since time is the fourthdimension, I guess that makes
sense.
But I was a little disappointed.
The modern rubbing chair lookslike it's designed to envelop
you.
Honestly, they look more likestasis pods on a spaceship than
(16:58):
a chair.
The other rubbing robot youmight have seen at the mall is a
large human-sized blue tubewith water in it, known as the
dry water massage machine.
Far from the almost accidentalsci-fi look of a modern rubbing
chair, the dry water machineleans hard into the futuristic
aesthetic.
The water is fully containedwithin the tube and in order to
(17:18):
get inside, the tube rises up,much like the doors of the
DeLorean in Back to the Future.
The client slides onto thetable beneath fully clothed and
an attendant lowers the tube ontop of them.
What proceeds is essentially ahuman car wash.
The water tube contains jetsthat pummel your body much like
(17:40):
they would in a jacuzzi, butwith you clothed and probably
within smelling range of AuntieAnne's pretzel store.
A relatively low-end rubbingchair costs about $5,000.
If a one-hour massage a weekdone by a human costs $100, a
client could get a massagealmost every week for a year for
the same price.
But there are certainlybenefits to owning a chair.
(18:02):
It's located in your home, youcan sit in it for a few minutes.
At the end of the day you don'tneed an appointment and if
you're really enterprising youcan charge your friends to use
it when you throw parties.
The tools that don't bother metend to be the ones designed by
massage therapists or used bytherapists to do the job they're
trained for.
The thumb saver doesn't give meany bad feelings.
(18:25):
The Theragun makes me jumpywhen a client uses it on
themselves, but it seemsperfectly sensible when wielded
by a professional whounderstands the nuance of their
work.
Rubbing chairs and dry watertubes are novelty toys For all
their complicated moving parts,programs and price tags.
Up to this point, rubbingrobots have just been big toys,
and a toy can't provide care.
(18:46):
And this is the part of theepisode where I admit to you
that when I started on thismassage robot journey, I thought
it would be a matter ofinterviewing some people making
robots and seeing what the robotcould do and then explaining it
to you.
But in trying to answer thequestion on everybody's mind
will a massage robot take my job?
I started running smack intoideas I've been grappling with
for a while, ideas that I willnow have to face head on instead
(19:08):
of putting them aside foranother day.
Ideas like why are some massagejobs so different from others
and who is controlling thenarrative of massage therapy and
why is it them?
And what makes massage therapyso special, and could a robot
imitate that?
I have a lot of ideas and Idon't have answers for you yet,
(19:29):
but I've decided that beingconfident in my words is more
important than releasingepisodes on a schedule, so I
will continue to release newsupdates each month to keep you
informed about the massagetherapy profession.
However, topical episodes willbe released when they're ready,
because both you and I deservebetter than hasty conclusions.
I'm Kori Rivera, massagetherapist correspondent and
(19:50):
information magpie.
Thank you for listening andstay tuned.
I didn't forget about all youfascial nerds.
(20:13):
Here's a special moment fromKathy Ryan.
Here's a special moment fromKathy Ryan.
Speaker 3 (20:17):
But if one of the issues with cellulite is
fibrosis of the septa, sothere's like these little
vertical type strands of tissuethat go from the dermis down to
the superficial fascia, downinto the deeper tissue, kind of
(20:40):
connecting all the way down.
And when it's really fibrotic,meaning that the collagen is
very stiff and unyielding, ithas a tendency that that's
what's kind of causing thatpuckering or dimpling that we
see.
So if fibrosis is kind of what'sdriving part of what the issue
is with cellulite, in additionto a higher percentage of larger
(21:02):
types of fat cells and itappears that the larger type of
fat cells are there's usually abit more of a definite
separation between the dermisand the subcutaneous or the, you
know, adipose layer of tissueand you see these larger fat
cells that are betraying intothe dermal layer and you see
(21:24):
this pulling down of those septaand that's what creates the
dimpling and puckering.
That's kind of what the morecurrent science seems to imply.
So you know, if fibrosis is oneof the issues you know from the
work in scar tissue that I do Iknow that in order for us to
treat fibrosis we have to figureout who the influencers are,
what causes fibrosis to happenin the first place.
(21:45):
That's, I think, a moreeffective way of going about
working with the tissue.
Inflammation, excessive orprolonged inflammation, is known
to be one of the primarydrivers of fibrosis.
If that is a factor incellulitis, why would I want to
pummel tissue to the degree thatit's bruising and inflaming?
(22:08):
And if there's something goingon in that individual that
they're predisposed to thatanyway, you take the risk of
making the problem worse ratherthan helping the situation.
Welcome to the Rub, a podcast about massage therapy.
I'm your host, kori Rivera,licensed massage therapist and
information magpie.
In today's episode, we're goingto talk about massage tools and
massage robots.
Before we jump into the worldof robots, I'd like to explain a
(00:30):
change I'm making to thispodcast.
From now on, any massageactivity that doesn't meet the
definition of massage therapywill, as published by researcher
Dr Anne Blair Kennedy in 2016,using data gathered from 32
experts in the massage therapyprofession and as paraphrased by
me is.
(00:51):
Massage therapy consists ofrubbing, and it also includes
health promotion and educationalmessages.
It is for both self-care andhealth maintenance.
The results of massage therapydepend on therapeutic
relationships and communication.
The results also depend on thetraining, skill and experience
of the therapist.
The setting of the treatment,such as a spa, hospital or
(01:12):
shopping mall, may have aninfluence on the results.
In short, massage therapyincludes rubbing, but rubbing is
not necessarily massage therapy.
I first heard someone expresstrue concern about massage
robots in October of 2023.
I can be precise because it wasan interview and I have a
(01:32):
recording.
Speaker 2 (01:34):
It was one guy there from California.
He was in the beauty world, buthe dropped some gems too.
He told us that they're alreadylike working on ways to replace
massage therapists with robots.
Speaker 1 (01:50):
I was a little surprised and honestly kind of
brushed it off.
Massage therapy is too complexfor a robot.
But then I heard concern aboutrobots again about a month later
, and then a study titledRobotics in Massage came out of
Mayo Clinic.
And when a major hospitalsystem that takes pains to be
seen as a leader in their fieldpublishes about massage robots,
you've got my attention.
(02:10):
So this is the first episodeabout what people are calling
massage robots.
Let's start simple.
All robots are tools, but notall tools are robots.
I looked up several definitionsof tool and my favorite is the
use of physical objects otherthan the animal's own body or
(02:30):
appendages as a means to exertthe physical influence realized
by the animal.
The definition says animalbecause it's from a 1973 paper
called Toolmaking and Toolusingin the Northern Blue Jay, which
immediately brought to mindimages of blue jays wearing tiny
construction helmets and highvisibility jackets.
So a tool is a simple machine.
It doesn't have sensors orelectricity.
(02:53):
It's usually designed for aspecific job, but versatility is
great too.
My favorite tool is a nice setof tongs to use in the kitchen.
I'm a short human and reachingacross a hot stove with my
little T-Rex arms can behazardous Bonus.
With tongs, you can click themat people to get them out of the
kitchen while you're working.
Humans have been using tools toassist with rubbing for
(03:13):
thousands of years.
China was using jade, marbleand basalt stones for hot and
cold treatments, at least as farback as 2000 BC.
Nowadays, thanks to modernmanufacturing, we have a wide
assortment of options, many ofwhich look like small pieces of
modern art.
Some of these tools are forself-rubbing.
There's a flock of wooden footrollers that look like giant,
chunky Pandora bracelets orsomething your toddler might
(03:34):
pull around on a string.
There's the Theracane andBackknobber, both curvy plastic
sticks with balls on the ends tohelp the people who are trying
to use that door jam to reachthat really awkward place
between their shoulder blades.
Other rubbing tools exist tomake a massage therapist job
easier.
The Thumb Saver, which lookslike a bright red plastic
(03:56):
holster for your thumb, helpedsupport my ligaments until I was
able to figure out bettertechniques to protect myself.
Eventually, my elbow gamecaught up to my thumb game
better techniques to protectmyself.
Eventually, my elbow gamecaught up to my thumb game.
My admittedly pointy elbowswere just as sensitive and
controlled as my thumbs, andwhile elbows are not very useful
for delicate places like necks.
They are dynamite for largermuscles.
Until my elbows were up to thejob, the Thumb Saver really did
(04:18):
save my thumbs.
The cool thing about thesemanual tools from the Thumb
Saver to hot stones and eventools unrelated to rubbing like
knitting needles or pencils isthat the more you practice with
them, the more you can feelthrough the tool.
When you first begin workingwith a rubbing tool, it's like
you put on a pair of heavy workgloves and you really have to
focus, like the way you did atthe beginning of your massage
(04:39):
education.
Eventually, your nervous systemfine-tunes itself to the tool.
You can use it as an extensionof your hand, including feeling
tissue changes.
The science on how this worksis pretty split.
One study found that fluencywith a tool only happened when
you were doing the task specificto the tool.
If you used a tool forsomething new, say if you used a
(05:02):
knitting needle to dig a hole,the connection wasn't the same.
Another study looked at partsof the brain that process vision
and unexpectedly found that themore people used a tool, the
more their brain identified itas something different from
their hand.
People regularly report thisfeeling of oneness with tools,
but figuring out what happens inyour brain is another matter.
I'd like to make a very specialhonorable mention to a tool that
gained a lot of popularity afew years ago the Fascia Blaster
(05:25):
.
The Fascia Blaster, whichretails at 140 bucks, is a white
rod with a row of four plasticflower shaped pieces.
Fascia itself is a wonderfullycomplex topic, but the short
version is that it's a web ofconnective tissue that runs
through your body in acontinuous network.
In order to properly talk aboutthe Fascia Blaster, I enlisted
(05:45):
the help of HealWell friendKathy Ryan.
Speaker 3 (05:49):
I am Kathy Ryan.
I'm a registered massagetherapist and self-proclaimed
Fascia nerd.
Speaker 1 (05:54):
Kathy is the author of Traumatic Scar Tissue
Management Principles andPractice for Massage Therapy.
She's attended everyinternational fascia research
congress since the first one in2007.
Fascia is Kathy's jam.
Kathy had this to say abouttools in general.
Speaker 3 (06:10):
So I mean for me as a practitioner, anytime I'm
trying to make a clinicaldecision about how to use my
hands or a tool or whatever, ora tool or whatever, I always
begin with trying to figure outwhat the situation is and having
(06:31):
a good pathophysiologicalunderstanding of what it is or
what the situation is, before Itry to decide what I'm going to
do about it.
Because without thatunderstanding, it's kind of like
, you know, poking around in thedark trying to find the light
switch or whatever the case maybe to.
(06:52):
You know, figure out what Ishould be doing.
Speaker 1 (06:55):
The Fascia Blaster's marketing makes claims about,
quote, regenerating fascialtissue and quote bringing fascia
care to the world and oh, bythe way, casually mentions it
will get rid of the cellulite onyour thighs.
You use the blaster by draggingor scraping the plastic flowers
across your skin with a fairamount of pressure to quote
break up the fascia.
Please don't try to break upfascia.
(07:16):
Deforming fascia by even 1%takes over two tons of pressure.
Breaking it requires a scalpel.
Both of these things will causetrauma to the tissue and a
massive amount of pressure.
Breaking it requires a scalpel.
Both of these things will causetrauma to the tissue and a
massive amount of inflammation.
Kathy had this to say aboutcellulite.
Speaker 3 (07:32):
I think the most common thing that's agreed upon
out there is that we don't fullyknow yet what exactly causes
cellulite.
So if we don't know exactlywhat's causing it, I think it
makes it more challenging for usto come up with effective ways
of treating it.
Because I think the biggestthing out there is that there
(07:54):
are different ways of treatingcellulite, but it doesn't seem
like the effects are very long,lasting, so there's a
sustainability component to it.
Speaker 1 (08:04):
If you or someone you know has a fascia blaster, I
recommend you repurpose it,maybe to hang wind chimes or
tenderize those chicken breastsyou're having for dinner.
If talking about tissues issomething you'd like to do more
of, kathy would like to extend adirect invitation for you to
Hewell Homecoming this September.
Speaker 3 (08:21):
Well, HealWell Homecoming is coming up and
lovely HealWell people haveprovided me with an opportunity
to just do my fascial blah, blah, blah for four hours at
Homecoming and then, on theheels of that, follow up with a
two day scar tissue workshopwhere there will be some more
(08:43):
fascia chat, you know.
So people have questions, morequestions about cellulite and
fascia blasting.
Well, we can probably chatabout it in September.
Speaker 1 (08:54):
Also, I've put Kathy's extended description of
cellulite and inflammation atthe end of the episode for all
you other fascia nerds.
To hear Back to tools A bitfurther down the path towards
robots are electrified tools.
The electrified tool thatprobably comes to your mind is a
percussion rubber, the mostpopular of which is the Theragun
, which debuted in 2008.
Theraguns are a triangle-shapedhandheld device with a blunt
(09:18):
jackhammer-like knob, and thefirst Theragun sounded like a
jackhammer too like a jackhammertoo.
There was a lot of customerfeedback about the noise, and
now they sound like this.
The first percussion tool wascreated in the 1950s by a man
(09:38):
named Dr Robert Fulford, who wasan American osteopath.
The idea was that the toolwould mimic to popement, a
technique that's often seenduring massage and movies,
because it involves using yourhands to create rhythmic
whacking motions and thus isvisually interesting.
Percussion tools can befine-tuned to pummel people with
specific speed and pressure,and the tool can whack much
faster and for longer than ahuman can so much faster that
(10:00):
percussion therapy performedwith an electric tool is
sometimes discussed as vibrationinstead of percussion.
The main difference betweenvibration and percussion is how
deep the tool presses into themuscle, so a percussion tool
will push inward toward the bonemore than a vibration tool.
Just what physical effectspercussion results in is kind of
up for debate.
People who are interested inathletic performance are very
(10:21):
keen to find out.
I found a study that saidpercussion tools could increase
range of motion but not increasemuscle contraction.
Another said that the toolincreased muscle strength,
explosivity and flexibility.
A third said a percussion toolcould help with recovery and
muscle stiffness, but wasn'tactually great for increasing
performance.
All of these studies were under20 people, so it's not
surprising the results werevaried.
(10:43):
The research on vibration isquite different, but before we
talk about that, we need to talkabout why research on vibration
is tricky.
There are a lot of vibrationtools on the market and they all
run a little bit differently,which means it's difficult to
compare studies if they aren'tusing the same device.
There are two importantmeasurements when you talk about
vibration Intensity, which issometimes referred to as
(11:03):
magnitude, and frequency, intand frequency.
Intensity and frequency.
If you've ever driven on a roadthat made your teeth chatter
because it hadn't beenresurfaced for a while, you felt
both frequency and intensity.
Frequency is how often your carhits a bump.
Intensity is how jarring it is.
You might have noticed that ifyou speed up because you're
trying to get through that badpatch of road, the intensity
(11:25):
gets worse.
We know that certain kinds ofvibration are bad for humans.
High-intensity, low-frequencyvibration can be harmful.
That's vibration that is slowbut very powerful.
This kind of vibration is oftenfound in handheld construction
tools and can be considered awork hazard.
Low-frequency vibration canalso cause motion sickness.
But low-intensity, high-, highfrequency vibration so fast but
(11:48):
less powerful is used in medicaltreatments.
Vibration might be applied by ahandheld device or it might
involve the patient standing ona platform that vibrates their
whole body, handily known aswhole body vibration.
These treatments are beingstudied for a wide variety of
uses, including pain management,but the one I think is really
cool is to simulate exercise.
Our bodies need exercise for alot of reasons, but when it
(12:09):
comes to bones and muscles weneed the controlled stress
called loading that exercisecauses to maintain bone and
muscle strength.
But if you're medically frailor have problems like balance
issues, it can be difficult andeven dangerous to exercise.
Whole body vibration therapycan simulate the loading of that
muscle and bone that happensduring exercise and it's been
shown to increase oxygenconsumption and blood flow.
(12:30):
One study showed an increase injumping ability in patients
after the vibration therapy.
You can find these whole bodyvibration machines at some gyms
and of course they're advertisedfor weight loss, because really
what isn't?
But I don't believe that claim,and there's a lot of debate
about commercial vibrationplatforms using the harmful kind
of vibration.
(12:51):
Honorable mention in thenot-quite-a-robot category goes
to electric muscle stimulation.
So I found this article thatsaid the ancient Egyptians and
later the Greeks figured outthat electric fish could create
shocks to relieve pain.
Have a muscle ache, rub a fishon it.
The most well-known electricmuscle stimulation device today
is not a fish, it is a TENS unit.
(13:13):
Tens stands for TranscutaneousElectrical Nervous Stimulation.
A TENS unit is a small devicethat sends out a low voltage
current through electrodes thatare lightly glued to the skin.
Tens units treat pain, but wedon't know for sure just how
they do it and they don't workfor everyone.
The top two theories arecausing a release of endorphins
or possibly blocking nervesignals.
(13:34):
We're not going to go deep intoit today because it involves me
saying things likevoltage-gated sodium channels
and muscarinic receptors andmethionine and kafalin, and
that's just boring.
It's boring If all those wordsmade you curious instead of
bored?
You can read the NationalLibrary of Medicine's TENS
article link in the show notes.
Tense units used to be veryexpensive and bulky, but my
(13:56):
local pharmacy has ones thatwill fit in your pocket for
about $40.
Like all treatments, they aren'trecommended for everyone.
Particularly people who arepregnant, have heart issues,
cancer, deep vein thrombosis,epilepsy or bleeding disorders.
So before you use the thingthat delivers electrical shocks
to your body, you should checkwith a physician, even if the
device is sold over the counteror is a fish.
And speaking of risks, nothingis perfectly safe, and that
(14:21):
includes rubbing.
Adding tools of any kind,particularly electrified ones,
can increase the possibility ofharm.
There is a report of avertebral artery dissection in a
patient's neck after they hadbeen using a percussion rubbing
tool for a few weeks.
Your vertebral arteries runthrough the outer parts of your
spine and the word dissectionmeans there's been a tear.
Tears cause blood clotting andblood clots can cause strokes,
(14:44):
which makes this a very seriousconcern.
The case study said the patientreported neck pain, headache
and dizziness, while percussionrubber disclaimers say you
should not use these tools onyour head, neck or near your
genitalia.
The people who make thepercussion rubbers aren't very
good at defining neck.
A lot of their officialdemonstration videos show people
using the device on what couldanatomically be considered a
(15:06):
neck.
Now let's get to the robots.
What exactly is a robot?
So a robot is a tool, but atool is not necessarily a robot.
As I said before, a tool is asimple machine designed for a
set of tasks that don't havesensors or electricity.
Okay, the term robot is superduper debated, especially right
(15:32):
now with the advent of usable AI.
For my purposes today, rightthis second, I'm going to say
that a robot is a complexmachine that does have sensors.
Robots can move or manipulateobjects, and they are at least
semi-autonomous or maybe don'tneed human direction at all.
Robots can often execute simpledirections known as programs or
protocols.
Robots can use their sensors toadjust their programs to their
(15:55):
surroundings.
For example, a rubbing robotwill have sensors that relay
information about how muchpressure it is exerting and will
have a limit on how much forceit's allowed to use.
Due to their price tags, whichcan range upwards of $10,000,
most rubbing robots of the pastmade their appearances in places
like shopping malls andairports.
The first working rubbing chairis widely credited to Nobuo
(16:16):
Fujimoto, a Japanese bathhouseworker.
He invented it in 1954.
It was made of wood and massageballs that made a kneading
motion and moved up and downyour spine.
It was controlled using ahandle on the side of the chair.
His company, now calledFujiroki, still exists and is
still making rubbing chairs.
Modern rubbing chairs have newerfeatures that earn them the
(16:38):
robot title.
The massage balls can rub yourback, spine and maybe your arms,
which is marketed as 3Dtechnology.
A few can change speed, whichis marketed as 4D technology,
and since time is the fourthdimension, I guess that makes
sense.
But I was a little disappointed.
The modern rubbing chair lookslike it's designed to envelop
you.
Honestly, they look more likestasis pods on a spaceship than
(16:58):
a chair.
The other rubbing robot youmight have seen at the mall is a
large human-sized blue tubewith water in it, known as the
dry water massage machine.
Far from the almost accidentalsci-fi look of a modern rubbing
chair, the dry water machineleans hard into the futuristic
aesthetic.
The water is fully containedwithin the tube and in order to
(17:18):
get inside, the tube rises up,much like the doors of the
DeLorean in Back to the Future.
The client slides onto thetable beneath fully clothed and
an attendant lowers the tube ontop of them.
What proceeds is essentially ahuman car wash.
The water tube contains jetsthat pummel your body much like
(17:40):
they would in a jacuzzi, butwith you clothed and probably
within smelling range of AuntieAnne's pretzel store.
A relatively low-end rubbingchair costs about $5,000.
If a one-hour massage a weekdone by a human costs $100, a
client could get a massagealmost every week for a year for
the same price.
But there are certainlybenefits to owning a chair.
(18:02):
It's located in your home, youcan sit in it for a few minutes.
At the end of the day you don'tneed an appointment and if
you're really enterprising youcan charge your friends to use
it when you throw parties.
The tools that don't bother metend to be the ones designed by
massage therapists or used bytherapists to do the job they're
trained for.
The thumb saver doesn't give meany bad feelings.
(18:25):
The Theragun makes me jumpywhen a client uses it on
themselves, but it seemsperfectly sensible when wielded
by a professional whounderstands the nuance of their
work.
Rubbing chairs and dry watertubes are novelty toys For all
their complicated moving parts,programs and price tags.
Up to this point, rubbingrobots have just been big toys,
and a toy can't provide care.
(18:46):
And this is the part of theepisode where I admit to you
that when I started on thismassage robot journey, I thought
it would be a matter ofinterviewing some people making
robots and seeing what the robotcould do and then explaining it
to you.
But in trying to answer thequestion on everybody's mind
will a massage robot take my job?
I started running smack intoideas I've been grappling with
for a while, ideas that I willnow have to face head on instead
(19:08):
of putting them aside foranother day.
Ideas like why are some massagejobs so different from others
and who is controlling thenarrative of massage therapy and
why is it them?
And what makes massage therapyso special, and could a robot
imitate that?
I have a lot of ideas and Idon't have answers for you yet,
(19:29):
but I've decided that beingconfident in my words is more
important than releasingepisodes on a schedule, so I
will continue to release newsupdates each month to keep you
informed about the massagetherapy profession.
However, topical episodes willbe released when they're ready,
because both you and I deservebetter than hasty conclusions.
I'm Kori Rivera, massagetherapist correspondent and
(19:50):
information magpie.
Thank you for listening andstay tuned.
I didn't forget about all youfascial nerds.
(20:13):
Here's a special moment fromKathy Ryan.
Here's a special moment fromKathy Ryan.
Speaker 3 (20:17):
But if one of the issues with cellulite is
fibrosis of the septa, sothere's like these little
vertical type strands of tissuethat go from the dermis down to
the superficial fascia, downinto the deeper tissue, kind of
(20:40):
connecting all the way down.
And when it's really fibrotic,meaning that the collagen is
very stiff and unyielding, ithas a tendency that that's
what's kind of causing thatpuckering or dimpling that we
see.
So if fibrosis is kind of what'sdriving part of what the issue
is with cellulite, in additionto a higher percentage of larger
(21:02):
types of fat cells and itappears that the larger type of
fat cells are there's usually abit more of a definite
separation between the dermisand the subcutaneous or the, you
know, adipose layer of tissueand you see these larger fat
cells that are betraying intothe dermal layer and you see
(21:24):
this pulling down of those septaand that's what creates the
dimpling and puckering.
That's kind of what the morecurrent science seems to imply.
So you know, if fibrosis is oneof the issues you know from the
work in scar tissue that I do Iknow that in order for us to
treat fibrosis we have to figureout who the influencers are,
what causes fibrosis to happenin the first place.
(21:45):
That's, I think, a moreeffective way of going about
working with the tissue.
Inflammation, excessive orprolonged inflammation, is known
to be one of the primarydrivers of fibrosis.
If that is a factor incellulitis, why would I want to
pummel tissue to the degree thatit's bruising and inflaming?
(22:08):
And if there's something goingon in that individual that
they're predisposed to thatanyway, you take the risk of
making the problem worse ratherthan helping the situation.
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