Relaxing? Or scary?
Yoga classes are allegedly relaxing — in reality, they can be emotional pressure cookers, inflicting intense performance anxiety & self-consciousness about fat & fitness on the participants.
Mindfulness and contortions on a thin foam mat are not everyone’s cup of tea, and (I know this will shock you) these activities are not as scientifically validated as the hype suggests — especially as treatments for back pain and other common musculoskeletal issues, where yoga looms particularly large.
The reputation and popularity of yoga and meditation are oppressively immense, eclipsing other options in many people’s minds. People feel that they “should” try them to reduce stress and contribute to a healing process, and have trouble thinking of any other way of responding to pain and stress.1 They actually feel guilty for not trying them or for not liking them. Tyranny!
Yoga and meditation obviously appeal to lot of people for a lot of reasons. Yoga in particular may be good for our general health and fitness.2 But rest assured that they are not the only options — particularly for relief from stress and pain — and no one should be feeling guilty about passing on them. You have my permission to ignore them. And I think some people need that permission.
Do yoga and meditation work?
Not all that well, no, and there are some risks too (more on that later). Yoga and meditation are hardly slam dunk cures for any kind of chronic pain. There’s a clear pattern in yoga science of benefits so modest that it’s not even clear that it’s better than nothing, let alone other forms of exercise. Indeed, research has now more or less proven that yoga is not better for low back pain (the most popular treatment goal) than any other common kind of exercise or therapy.34
Quite the blow to yoga pride.
A few people undoubtedly get some objective benefit. Yoga, meditation, and pain itself are all too multifaceted not to occasionally go well together. For example, a diligent meditation practice can improve sleep quality, which in turn can help chronic pain, because sleep deprivation is one of the sneakiest factors in all kinds of chronic pain.
On average, however, almost all of the allegedly “proven” benefits of yoga and meditation are overstated by people selling classes and books.
Most people don’t need to worry that they are missing out on much. If you’ve never been interested in yoga or meditation before, it's not a great idea to try them out just because you’ve got a new pain problem. Someone with low back pain who already has experience with yoga and/or meditating might find it more useful. Or they might not!
People just cannot resist suggesting their favourite remedies to people who say they are in pain. Yoga & meditation may actually be the two single most popular choices.
Many people are poor candidates for yoga and meditation
Many productive, energetic people find it difficult — almost alien — to invest in subtle or indirect methods of self-improvement, and find the quiet challenges of meditation particularly exasperating. Many are allergic to the many bogus claims associated with it (like reprogramming your DNA? sheesh).
Mindfulness is particularly a mess: excitement about its potential reaches far beyond the evidence.5 Even for those who can get past all the bullshit and New Age nonsense may still have a personality conflict with the slow pace and calmness required, and their learning curve will feel steep; climbing it while coping with chronic pain, or acutely stressful life events, may not be a practical solution — and yet these are the very conditions when people are most likely to think they should “try yoga.”
But many people never liked the idea to begin with! You know who you are, and you’re not alone. Plenty of you suspect that all “that flaky stuff” is a cure that’s worse than the disease. You are more likely to be successful reducing stress the standard “Western” way, by “blowing off steam” with exercise! Which can be a great idea, except that blowing off steam is often not an option if you are struggling with pain and injury. In fact, one of the biggest stresses in your life may be the loss of exercise, which was the only stress-management strategy you took seriously.
Many people have noticed this exasperating catch-twenty-two: they noticed that stress aggravates their pain … yet they have to solve their body problem before they can exercise again as a way to reduce their stress! Exercise can’t be the solution to stress (or pain) when you’re in too much pain to do it.
That’s frustrating. Stressful, even!
Are yoga and meditation popular? Yes. Mainstream? Not so much
As popular as yoga and meditation are in the world today, they are still not quite mainstream.6 (Indeed, they are part of the “popularity myth” of alternative health care.7)
Even most of my massage therapy clients — several hundred of them from 2000–2010, and a “skewed sample” if there ever was one — had only dabbled in them, at best. (Nor did they ever report any success more significant than “taking the edge off” their stress or their aches and pains.)
When corporations start prescribing yoga and meditation
Y&M may not be truly mainstream, but it’s certainly not for lack of trying! This is a truly perfect example of what I mean be the “tyranny” of yoga, so good that I knew the second I saw it8 that it would have to be prominently added to this article (which hasn’t change much in years):
EVERY COMPANY: We’d like to promote mental health in the workplace.
EMPLOYEES: How about hiring more people so we feel less pressured? And maybe increase our pay a bit so we can keep up with the spiraling cost of living, so we’re not so stressed out?
EVERY COMPANY: No, not like that. Try yoga and meditation.
Hilarious and all-too-true. Don’t get me wrong, yoga can be great, but all normal people know it’s an irritating and inadequate default prescription for stress.
The potential harm of yoga and meditation
This is basically an article about why you shouldn’t feel obligated to try yoga and meditation, especially as rehab for your injury, or medicine for your painful problem. How’s “it could make things worse” for a reason?
Yoga in particular isn’t entirely safe, and even meditation has risks! Yes, seriously.
Independently of the direct safety issues, yoga and meditation instructors also aren’t exactly known for their love of science, medical knowledge, or staying in their lane — so you can get some pretty bad advice from them.
But of course the most likely risk is simply wasting your time and money on an activity you don’t actually even like, but you pursue anyway because you think you “should.”
Yoga and safety
People do actually get physically hurt in yoga classes, which is hardly surprising for an industry so polluted with pseudoscience and myths. True story.
I have seen and heard about a great many (mostly minor) yoga injuries in my career. And people who go into yoga classes with a problem probably get hurt more often, and may have more faith in the safety of the class than it deserves — many yoga instructors portray themselves as health professionals competent to do yoga “for” conditions like low back pain, but this is nonsense. Safe and competent care for low back pain is simply way beyond the competence of yoga instructors.
For a while in 2011, the New York Times’ most-shared article was a “yoga bashing” article by William Broad, How Yoga Can Wreck Your Body9 describing potentially serious yoga hazards, such as stroke. Many yoga apologists10 thought Broad’s piece was "sensationalistic." It’s not a perfect article by a long shot,11 but it raised legitimate concerns about a gap between a popular belief (“most yoga is safe and beneficial”) and the more likely reality: some fairly common postures and practices are a little dangerous, and there not be enough yoga-specific benefits to justify even small risks. He also makes a very good point that many more extreme forms of yoga have truly ridiculous rationales.
All athletic activities have both rewards and risks. The problem here is that yoga’s benefits for back pain patients are uncertain long shots — and people also have many other sketchy ideas about what yoga can supposedly do for them.
The mild but real safety issues are well worth considering. Plus, you could crush your cat. So be careful!
Meditation perils? Really? The “dark night”
Meditation is potential harmful for people with some psychological problems.12 Not hard to understand why someone with obsessive-compulsive disorder, for instance, might have trouble with it.
For the average healthy person, though, admittedly meditation is much safer than playing in traffic or •shudder• running with scissors. It’s probably safer than taking a shower.
However, it’s still not without its hazards. At least a few meditators will succumb to an unpleasant psychological experience known as a “dark night,” which is like a bad drug trip: an emotional, existential crisis brought on by the mental rigours of seeking an altered state of consciousness. Blogger Gianna Kali explains that this “can be misconstrued as psychiatric issues,” which can lead to some tragic outcomes.
It’s an unlikely fate for the dabbler, of course, and I do not wish to sensationalize a trivial risk. Tord Helsingeng, a Norwegian massage therapist, points out that
‘dark nights’ are relatively rare even for practitioners who are ambitious with their practice, going to silent retreats with 8+ hours of meditation every day for many days or even months etc. If someone has come to such a stage that this would occur — which is essentially an integration problem with the no-self — they would have already managed a whole tool-box of techniques to deal with chronic pain.
“This sort of thing generally happens with more serious pursuit,” Kali concedes, “but the fact is one often doesn’t know who might become serious.” Her article on the risks of meditation is worth a look. It makes for an interesting contrast with the widespread belief that meditation is totally safe and the only real option for trying to learn to cope with stress.
And then of course there’s the much more prosaic hazard of just wasting your time and money.
There are lots of different types of meditation. Don’t trust anyone who says that their special brand has been proven scientifically to be better for your health than the other flavors. Watch your wallet.
Robert M Sapolsky, Why Zebras Don’t Get Ulcers, 2004 p. 402
Weirder hazards of yoga and meditation: you might join a cult (oops)
“Maybe people who meditate for an hour/day are happier because they live a life that affords them an hour/day to meditate.”
Ginny Hogan, Twitter, Dec 17, 2021
Ginny made a good, basic point about self-selection and confounding factors. But the defensive and condescending responses! Yikes! They demonstrate the problem this article is about: too many fans of meditation are far too easily offended, ideologically overzealous, almost cultish. It’s a huge turn-off for most normal people. And it gets worse.
In early 2021, Cécile Guerin reported for Wired that the yoga world is riddled with anti-vaxxers and QAnon believers: “In my day job, I monitor the spread of online disinformation and conspiracy theories. I never expected to find them at my yoga class.”
Seems like one of the most obvious places for them in the world, based on my direct experiences with yoga classes, not to mention all the yoga nuts in my inbox over the years, demonstrating their spiritual sophistication by shrieking at me in all caps — the “Fuck you, Namaste!” phenomenon.
When you open your mind too far, all kinds of crap can get in there, and that’s why New Age bullshit is not harmless. Guerin’s findings are a textbook example of how magical thinking is a slippery slope to much more dangerous and all-consuming beliefs. If a place is badly polluted with pseudoscience, it’s not a “healthy” place — it can’t be. And it’s downright hard to avoid the flaky nonsense in yoga studios.
Yoga and meditation alternatives abound
I think it is important for people to realize that movement and a bit of quiet time are what everyone needs to feel their best. Often yoga and meditation dogma gets in the way of just basic healthy lifestyle concepts.
Byron Selorme, Shavasana Yoga Centre, Ontario
Motion is lotion! “Mobilizations” are a nice alternative to yoga for many people. And they certainly don’t come with all the philosophical, spiritual and cultural baggage of yoga. See Mobilize!
For some people, a simple stretching program avoids that whole “cult of yoga” atmosphere, but can feel just as nice and may well have essentially the same benefits, whatever they may be. Consider: a 2011 study showed that a program of static stretching alone — just pulling on muscles — had a nice clear benefit for heart rate regulation, a common way of measuring fitness.13 Bodies probably need constant sensory feedback for optimum function — again, “motion is lotion” — and this evidence is probably a nice demonstration of that principle.
And some people find that strong breathing exercises like bioenergetic breathing are a great way to more literally and directly “blow off steam”: see The Art of Bioenergetic Breathing. There are some excellent methods of reducing anxiety: see Anxiety & Chronic Pain.
Or breathe slowly with extended exhalations. This might be the only active ingredient in meditation: spending more time exhaling than inhaling is measurably more relaxing than the reverse. No new age claptrap here, just leveraging well-known biology:
Whenever you inhale, you turn on the sympathetic nervous system slightly, minutely speeding up your heart. And when you exhale, the parasympathetic half turns on, activating your vagus nerve in order to slow things down (this is why many forms of meditation are built around extended exhalations).
Robert M Sapolsky, Why Zebras Don’t Get Ulcers, 2004, p. 48.
As nice as massage is, it’s only two clearly proven benefits are: reducing depression, and reducing anxiety.14
Curing insomnia is one of the most obvious methods of reducing stress: see The Insomnia Guide There is also a lot to be said for pursuing personal growth: see Pain Relief from Personal Growth. If you have low back pain, there are many other options to consider. In fact, I wrote a whole book about them. There’s also quite a lot more information in the book about the science of yoga as a treatment for low back pain. See:
This image is a recreation of a popular “viral” image from a wellness guru, widely and uncritically shared on social media in 2015. Obviously there’s something to be said for the style of advice given in the image, and by no means am I saying that doctors shouldn’t discuss these options with their patients. However, my colleague Alice Sanvito saw the same problem I did: it’s a great example of “shoulding” on someone who may well have serious socioeconomic challenges that make such advice tone deaf and trite at best, the tyranny of wholesome expectations, or downright offensive at worst (sexist, racist). Here’s Alice’s full, brilliant rant about it:
You know, some people see this and think oh, yeah, this is how [the doctor/patient relationship] should be. I look at this and I see an older, patronizing white male authority figure dispensing a prescription for failure to a young woman whose life is probably so different from his own that he can barely imagine her problems.
What are the circumstances of her life? Does he know? I thought homeopaths [holistic doctors] were supposed to treat the source of the problem, not the symptoms.
What if the real problem is that she’s a divorced single parent in a crummy job that barely pays her basic expenses and all that entails? Like, how about a prescription for decent wages, working conditions, benefits, childcare, healthcare, public transportation?
Does the good doctor have a prescription for the gender gap in wages? Which is even higher for physicians, where women earn, on average, 62% of their male counterparts, significantly less than the 77% of men’s wages they tend to average overall.
I’m sorry, but this comes across as so simplistic and patronizing and it just makes me cranky. Here’s what many real women might say:
Doctor, I don’t feel well and I’m not sure why. I hate my job as a checker at Walgreens. I have to stand in one place all day. My feet and my back are killing me, they won’t let me sit on a stool. They keep me at just under 35 hours a week so they don’t have to pay benefits. I don’t get a regular lunch break and I have to listen to that awful canned music they play all day, plus deal with customers who don’t know what they want and take it out on me. They change my schedule from week to week so I can’t get another part-time job. My kids’ father isn’t reliable about picking them up from school. My boyfriend refuses to use condoms. I don’t want to go back on hormonal birth control, I didn’t like the way it made me feel when I did, but I really don’t want to get pregnant again.
I suppose I could get up extra early and meditate in the morning before I have to get the kids up, make their breakfast, get them to school, before I start my shift at the drug store. Yeah, I guess I could try to get in some exercise on my half hour lunch break or after work, but I’m so tired from being on my feet all day and then I need to get the kids, get to the grocery store, make dinner. Yeah, I’m trying to make from scratch and avoid the prepared stuff but I don’t know, that organic stuff is awfully expensive. The kids are complaining cuz I won’t let them have Fruit Loops for breakfast like the other kds. Shoot, after dinner, I’ve got to stay on them to get their homework done while I”m cleaning up from dinner and doing laundry and trying to get the bills paid. I just found out my rent is going up and the gas bill was really high the last month, though if I don’t pay the whole thing, they can’t turn me off yet because it’s still winter.
I suppose after I get the kids bathed and read them a story and finally get them off to sleep, I could try meditating then, if I can stay awake, but when I do, I keep thinking about when I’m going to get the car to the mechanic because those brakes are getting a little soft and I’m worried about that. Yeah, I guess I shouldn’t worry about things I can’t control.
I guess I could try to get outside more on my days off - I gotta work most weekends - but I’m so tired, I don’t get enough sleep most of the time, and if I have a day off during the week, I use it to run errands because the kids are in school and I can get some things done.
Oh, by the way, my mom may be moving in with us. She had a heart attack and isn’t dong too well. She really shouldn’t be living alone.
Yeah, you’re right, I should meditate and eat organic food and exercise outside, I’ll work on that. And I gotta stop worrying about things I can’t control. You’re right.
You know anyone who’s hiring? Full time? With benefits?
Wait a minute … why am I spending money to see a holistic doctor who’s telling me something I already know and recommending useless homeopathic remedies and herbal supplements? I can’t afford to be wasting money on placebo medicine!
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About Paul Ingraham
I am a science writer in Vancouver, Canada. I was a Registered Massage Therapist for a decade and the assistant editor of ScienceBasedMedicine.org for several years. I’ve had many injuries as a runner and ultimate player, and I’ve been a chronic pain patient myself since 2015. Full bio. See you on Facebook or Twitter., or subscribe:
- “The Dark Truths Behind Our Obsession With Self-Care,” Shayla Love, Vice.com.
- “The Mindfulness Conspiracy,” Ronald Purser, www.theguardian.com. “It is sold as a force that can help us cope with the ravages of capitalism, but with its inward focus, mindful meditation may be the enemy of activism.”
- “How Yoga Can Wreck Your Body,” William Broad, NYTimes.com. This “yoga bashing” piece was the New York Times most-shared article for a while in early 2011. It’s an excerpt from a forthcoming book, and describes potentially serious yoga hazards, such as stroke. Broad raises a legitimate concern about a gap between a popular belief (“most yoga is safe and beneficial”) and the more likely reality: some fairly common postures and practices are almost certainly at least somewhat dangerous, and there may well not be enough yoga-specific benefits to justify even small risks. Plus, the rationale for some extreme yoga is just total bollocks, and certainly deserves to be challenged. It makes me I wish I’d been meaner to yoga in the past, and I don’t think Broad’s piece is particularly “sensationalistic” (as many yoga apologists have asserted, of course). It’s a given that any athletic activity has both rewards and risks. (Look no further than head injuries in football for a prime example.) The problem is that risks are a really rotten price to pay for many of the more ridiculous motives for bothering with yoga in the first place. It’s not a perfect article by a long shot. After a too-positive initial review on Facebook, many of my readers pointed out valid science-based criticisms, primarily that Broad relies quite heavily on anecdotes, and in particular concludes the piece with a doozy based on pure speculation: that decades of yoga was the direct cause of a severe case of spinal stenosis, which is really not a safe assumption at all (stenosis happens, with or without yoga). The worst case scenario is that the article is fear mongering based mostly on a handful of nasty anecdotes without citing much in the way of real risk/benefit data. For instance, for all we know, average yoga injuries per hour may be less than soccer, or even showering ... and we can't do a real risk-benefit analysis without that information.
More about back pain
- Nerve Pain Is Overdiagnosed — Our cultural fear of neuropathy, and a story about nerve pain that wasn’t
- Don’t Worry About Lifting Technique — The importance of “lift with your legs, not your back” to prevent back pain has been exaggerated
- Chronic Low Back Pain Is Not So Chronic — The prognosis for chronic low back pain is better than most people realize … especially for Australians in Australia!
- The Mind Game in Low Back Pain — How back pain is powered by fear and loathing, and greatly helped by rational confidence
- 6 Main Causes of Morning Back Pain — Why is back pain worst first thing in the morning, and what can you do about it?
- The Bath Trick for Trigger Point Release — A clever way of combining self-treatment techniques to self-treat your trigger points (muscle knots)
- Does Posture Matter? — A detailed guide to posture and postural correction strategies (especially why none of it matters very much)
- Wobble Cushions for the Chair Bound — Why and how people who have to be in a chair all day should sit on a stability cushion like the Disc o Sit or SitFit
- The Trouble with Chairs — The science of being sedentary and how much it does (or doesn’t) affect your health and back pain
- Get in the Pool for Pain — Aquatic therapy, aquajogging, water yoga, floating and other water-based treatment and injury rehab options
What’s new in this article?
Four updates have been logged for this article since publication (2007). All PainScience.com updates are logged to show a long term commitment to quality, accuracy, and currency. more
Like good footnotes, update logging sets PainScience.com apart from most other health websites and blogs. It’s fine print, but important fine print, in the same spirit of transparency as the editing history available for Wikipedia pages.
I log any change to articles that might be of interest to a keen reader. Complete update logging started in 2016. Prior to that, I only logged major updates for the most popular and controversial articles.
See the What’s New? page for updates to all recent site updates.
Oct 9, 2022 — Major revisions and improvements. Over the years, this article had gotten to be a bit muddled and meandering, and it lacked citations for some key points about efficacy/safety. Unacceptable! Some formatting glitches had even crept into it. I had a bunch of fresh yoga science in my head after writing a new yoga chapter for my back pain book — a perfect time to reboot this page.
2021 — Added section about the links between yoga and pseudoscience, anti-vaccination, and Qanon, and another about the “Fuck you, Namaste!” phenomenon.
2019 — The first update to this article in more than three years is minor but hilarious: snarking about the corporate yoga prescription thing.
2016 — Science update: added a citation to Bower et al, which is very positive about the health benefits of mind-body therapies — a welcome injection of optimism into this article.
2007 — Publication.
- A great example from my mail bag: a young reader with harsh back pain asked me if the answer to his pain is to study yoga. Full time. For a year. In India! I’d say no. Probably not. Unless he’s Indian. Unless studying back pain full-time in India was a genuine dream for him before the back pain, for other reasons. It is not clear that yoga deserves an investment of four hours a week … let alone a complete lifestyle overhaul.
- Bower JE, Irwin MR. Mind-body therapies and control of inflammatory biology: A descriptive review. Brain Behav Immun. 2016 Jan;51:1–11. PubMed #26116436 ❐ PainSci #53640 ❐
This is a qualitative review of 26 randomized controlled trials of the biological effects of mind-body therapies like Tai Chi, Qigong, yoga, and meditation. The studies show “mixed effects” on inflammation (CRP, IL-6, stimulated cytokine production, etc), and more consistent results for “genomic markers.” Based on this evidence, it seems likely that these activities are meaningfully good for you, and probably helpful for some kinds of chronic pain.
- Anheyer D, Haller H, Lauche R, Dobos G, Cramer H. Yoga for treating low back pain: a systematic review and meta-analysis. Pain. 2022 04;163(4):e504–e517. PubMed #34326296 ❐
- Wieland LS, Skoetz N, Pilkington K, et al. Yoga treatment for chronic non-specific low back pain. Cochrane Database Syst Rev. 2017 01;1:CD010671. PubMed #28076926 ❐ PainSci #51437 ❐
- Farias M, Wikholm C. Has the science of mindfulness lost its mind? BJPsych Bull. 2016 Dec;40(6):329–332. PubMed #28377813 ❐ PainSci #53075 ❐
- People keep writing to me, “Tch tch, Paul, yoga is totally mainstream!” But I disagree. If you live in downtown Vancouver, it’s certainly mainstream. Yes, you can buy yoga mats at Walmart. But I grew up in a small blue collar town, and I can assure you, yoga still seems veeeeery weird to a lot of folks who aren’t living in the throbbing urban centers of our civilization. And there’s plenty of folks who moved to the big city not that long ago. Big Macs are mainstream. Yoga is not.
- Although alternative medicine is certainly now a substantial industry, it is still dwarfed by the size of mainstream medicine, and its popularity is exaggerated by the people selling the alternatives. Acupuncture, for instance, is nowhere near as widely utilized in North America as North American acupuncturists would have us believe.
- The kernel of this joke is not mine, but I can’t figure out where it came from originally: there are multiple variations from multiple sources.
- NYTimes.com [Internet]. Broad W. How Yoga Can Wreck Your Body; 2012 January [cited 14 Jan 6].
- There are people who apologize for yoga? Oh, yes. Seriously. Yoga has many characteristics of a religion, after all.
- After a too-positive initial review on Facebook, many of my readers pointed out valid science-based criticisms, primarily that Broad relies heavily on anecdotes. In particular, he concludes the piece with a doozy based on pure speculation: that decades of yoga was the direct cause of a severe case of spinal stenosis, which is not a safe assumption at all (stenosis happens, with or without yoga). The worst case scenario is that the article is fear mongering based mostly on a handful of nasty anecdotes without citing much in the way of real risk/benefit data. For instance, for all we know, average yoga injuries per hour may be less than soccer, or even showering ... and we can’t do a real risk-benefit analysis without that information.
- Farias 2016, op. cit.“… although some people may benefit from its practice, others will not be affected in any substantive way, and a number of individuals may suffer moderate to serious adverse effects.”
- Farinatti PT, Brandão C, Soares PP, Duarte AF. Acute effects of stretching exercise on the heart rate variability in subjects with low flexibility levels. J Strength Cond Res. 2011 Jun;25(6):1579–85. PubMed #21386722 ❐
This study of stretching found that
multiple-set flexibility training sessions enhanced the vagal modulation and sympathovagal balance [that’s good] in the acute postexercise recovery, at least in subjects with low flexibility levels. … stretching routines may contribute to a favorable autonomic activity change in untrained subjects.
This seems like a fairly straightforward bit of good-news science about stretching. It’s not a surprising idea that movement would have some systemic regulatory effects (motion is lotion, use it or lose it), but it’s nice to see some corroboration of that common sensical notion, and it’s also nice to know that perhaps just stretching did this (to the extent we can learn anything from a single study). If true, it makes for nice evidence to support a general stretching habit, yoga, mobilizations, really any kind of “massaging with movement,” and probably even massage itself.
- Moyer CA. Affective massage therapy. Int J Ther Massage Bodywork. 2008;1(2):3–5. PubMed #21589715 ❐ PainSci #54758 ❐
Dr. Christopher Moyer explains that the only confirmed benefits of massage are its effects on mood (“affect”), specifically depression and anxiety. “Together, these effects on anxiety and depression are the most well-established effects in the MT research literature. They are especially important for us to understand not only for their own sake, but also because anxiety and depression exacerbate many other specific health problems.” He proposes that “the time is right to name a new subfield for massage therapy research and practice: affective massage therapy.”