Myth Busting: Water, Hydration, Muscles and Massage

You might have heard the old myth that the way a muscle feels or its tonicity, is an indicator of dehydration. Or maybe you’ve heard that water is required post massage to help flush out the system. Well, the good news is… that is not the case. Neither is true. Let's explore why and/or how these myths might have come about and what we can focus on instead!

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Through our years of experience working with the soft tissues of the body, massage therapists may feel differences in the soft tissues of the body from client to client. Many times, when working directly on the skin or even over clothing, we may make a mental note about the tonicity of the underlying structures, including the muscles. But it’s important that we don’t infer that there’s something wrong when those soft tissues feel hypotonic (having less tone or tension) or hypertonic (having more tone or tension). Because, until we work together with a client regularly though, we cannot know what your set point for your muscle tone or tension is. One person’s hypertonic is another person's hypotonic. Because we are all different and unique.

We cannot correlate a client's tonicity to pain, dysfunction or dehydration for that matter.

What we can do, is make note of your tonicity. At least initially, these notes should be done with neutrality. And then we can compare from session to session, along with other factors, that may or may not correlate.

The narrative of tightness or tonicity equaling dehydration, might initially seem reasonable. Because It's human nature to visualize what our hands feel and to compare that to others or feel the need to place a reasoning on it. But we know there is no strong correlation between muscle tonicity and pain, dysfunction or disruption. Tonicity varies widely from person to person.

This is not to say that the feeling of tightness or the feeling that a muscle is weak is not valid, when reported to us by a client. Quite the opposite. What the client is feeling, is very important... actually far more important most times than what I may feel under my hands. My goal as a massage therapist is to work with you to address that feeling of tightness or weakness you are reporting. But any feeling on tightness under my hands when its not reported as a concern by my clients, doesn't mean the muscles are dehydrated or that they are "too firm" or "too weak".

A good example of this, is when we work in the shoulder complex. The shoulder complex is an area where many muscles of varying tones, with varying fibers in varying directions, all come together, lay over one another and/or cross over each other. The soft tissues in that area might feel "ropy" or thick. (I like to think it's actually a testament to their purpose and function of creating that perfect balance of stability, strength, mobility and flexibility so our shoulder can do all the things from simple to complex). But, its understandable that someone might *feel* that ropiness and thickness and mistakenly interpret that as a dehydrated muscle since it could have a similar feel under our hands of Slim Jim or beef jerky (aka dehydrated meat). This is not the case though, the ropiness and thickness is not a cause for concern and doesn't mean the muscles are dehydrated.

So where did the muscle dehydration myth or the myth that water is necessary after a massage come from? We'll never know. But, I would gather these ideas probably started before we as a profession had readily available access to the study of anatomy and physiology.... when we were relying only on what our hands felt. Now that we work from a biopsychosocial model, which takes into consideration not only the biological and physiological, but also places emphasis on a client's thoughts, emotions, behaviors, culture, and beliefs, we are better suited to understand that structural changes from person to person don't always determine dysfunction, disorder or pain. A client's experience in their own body is important.

Even in sports medicine and exercise science, we are learning that older ideas assumed were true in the past, are not. In the study of hydration, the rise of over-hydration came about after a focus on hydrating during races became the trend in the 80s, 90s and still sometimes persists in sport. Those narratives of hydration are slowly fading away in the field of massage therapy. Sometimes, it seems its only fading very slowly. But truly, a large majority of massage therapists I know do not believe that water is a requirement post massage. We do have an assessment tool at our fingertips to help us assess risk of dehydration. The Skin Turgor test is a part of the skin integrity assessment. This test may helpful in assessing for dehydration as a whole, but it does not specifically to assess if a muscle is dehydrated. Also, in speaking with a few specialist focused on exercise science in different fields, while the body can be dehydrated, only through dissection could we see if a muscle was dehydrated. And if it was possible, you would really be far too dehydrated to come in for a massage certainly. In my state of Virginia, the Skin Turgor test could absolutely be used by a massage therapy as an assessment tool to see if dehydration might be a possibility. But because I do not diagnose under my scope of practice, I would refer the client out to a medical professional vs telling the client they are dehydrated. And believe it or not, I wouldn't recommend a treatment of drinking more water, as I do not prescribe.

Now all this being said, I do offer clients water and/or tea if they would like that pre-session or post session. Because sometimes, a glass of water or a cup of tea is just a nice thing to have.

Resources and further reading:

Ingraham, Paul. “Why Drink Water after Massage Therapy?” Www.PainScience.com, 1 Sept. 2018, https://www.painscience.com/articles/drinking-water-after-massage.php.

“Ask Healthy Living: Do You Really Need to Drink Water after a Massage?” HuffPost, HuffPost, 5 Nov. 2012, https://www.huffpost.com/entry/water-after-a-massage_n_2075604/amp.

“LAURAALLENMT on Toxins & Massage.” YouTube, Laura Allen, 15 Nov. 2011, https://youtu.be/gwTDw1kXpo8. Harvey, Ian. “Does Massage Flush Toxins? What about Lactic Acid?” Massage Sloth YouTube Channel, Massage Sloth, 29 Mar. 2017, https://youtu.be/HXqzo3F9ktI.

Aschwanden, Christie. “How Much Water Do You Actually Need?” The New York Times, The New York Times, 17 Sept. 2021, https://www.nytimes.com/2021/09/17/well/live/how-much-water-should-I-drink.html. Cha, Ariana Eunjung. “This Is What Drinking Too Much Water during Exercise Does to Your Body.” The Washington Post, WP Company, 26 Oct. 2021, https://www.washingtonpost.com/news/to-your-health/wp/2015/07/01/this-is-what-happens-to-your-body-if-you-drink-too-much-water-during-exercise/.