Lactic Acid: You can’t Handle the Truth
Maybe your high school sports coach talked about it. Perhaps your personal trainer at the gym mentioned it. Maybe even your friend of a friend’s medical professional said lactic acid gets moved around with massage and needs to be flushed out. I have my own personal policy I follow. If I can’t explain why I’m doing a thing then I will seek out information about the thing before asking someone to follow the thing! This brings me to the controversial body toxins stance I take. I could continue to perpetuate the misunderstanding that manual tissue manipulation ( massage therapy) can break up the lactic acid or other “toxins” and then drinking a ton of water afterward will clear that all out and your muscle soreness and pain will let up (after you spent 12 hours peeing and groaning when your beat up body has to keep going to the bathroom.) Or I can shut that sh*! down. Or shall we say… flush it.
When I was in school my massage instructors taught us the standard routine of wrapping up a session and waiting patiently on the other side of the door for the client with a glass of cool refreshing water. We were taught to keep our voice lower, gently place your hand on their back, stomach, root chakra, whatever, then leave for them to get dressed and reoriented to the world. Since in Oregon the scope of practice is pretty strict about what we can say or do our aftercare advise is limited to the generic , “Drink lots of water, get some rest, apply ice or heat as needed, and reschedule your next massage!” I asked my instructor why the almost aggressive emphasis on water if there is no evidence of lactic acid being flushed out by massage and water and he left me with a simple but perfect reply. “People get thirsty don’t they?”
He continued by explaining that in a spa setting or personal business you never want to leave a client empty-handed and you want to make them feel taken care of and it’s a great way to secure another massage out of them if you’re able to delay them with a distraction. Like a nice glass of cucumber infused water or chamomile tea. It just adds a nice touch. You’ll find that a lot of LMTs are starting to skip the toxin water shpeel and instead just give the water.
For quite a long time lactic acid has been accepted as a predominant cause of fatigue during exercise. This has been disproven and we actually know now that it can help to prevent this feeling of fatigue. Muscle soreness after working out most likely comes from actual muscle cell damage when the body went beyond its limits of strenuous activity.
Don’t try to drain me of my lactic acid!—Sauerkraut
What is lactic acid? It’s a naturally occurring acid found in the human body, animals, food, and made synthetically for its usefulness in a variety of products and medical treatments. For example, the chemical lactate is given to trauma patients experiencing blood loss until they can rebuild it on their own. It has a part in brain development and metabolism in animals and humans.
Lactic acid was discovered in sour milk by German chemist and physician Karl Wilhelm Scheele (1742–1786) in 1780. In 1843 it was first discovered to occur in deceased and dying human blood. Experiments were also conducted upon animals, specifically a dog, and in women dying after childbirth from septic and hemorrhagic shock where the treatments of the day were often blood-letting. It was in 1848 that it was first demonstrated to occur in the blood of a living patient.
What is lactate? Lactate and lactic acid are different and can be mistaken for the other. Just remember that lactic acid is the chemical joining of lactate with a hydrogen ion. That is the sour taste in yogurt and sourdough bread. So, we’ve always got lactate within us and it’s a good thing!
The beginning of this lactic-acid-buildup-in-muscles myth can be attributed to German biochemist Otto Meyerhof. He was given a Nobel Prize in Physiology and Medicine in 1922 for cell physiology research and the use of energy by cells. It was accepted at that time in history his evidence for the idea that fatigue in muscles was caused by lactic acid which was caused by a lack of oxygen. He used frog legs in an air-tight jar, found that lactic acid was formed from muscle glycogen in the absence of oxygen. The experiments used frog legs receiving electric pulses to make them contract, which produced lactic acid in the muscles, then stopped contracting after repeated stimulations. This is what lead to the idea of lactic acid being the cause of muscle fatigue. This was true for disembodied amphibian muscle but not so for live mammals. Nevertheless, it was a very popular idea that grew legs (pun intended) and soon became an unstoppable machine and a new industry of detoxing products and snake oil cures. Only seven years later this was disproven. Squeezing lactic acid out of the muscles seemed like a good idea at the time…Although he happened to be wrong about the role of lactic acid in muscles, his other work laid down the foundations for cell physiology and the ways to observe how energy is produced.
Rumors can stick around for a long time. Grudges can be held and outdated medical misinformation can stick around for a hundred years. But do you want to know what won’t stick around? Lactic acid in your body. Studies as old as 1907 have shown that when a muscle is activated and presents with anaerobic formation of lactic acid, it is removed aerobically, at a rate depending on the level of exposure to oxygen. Even after heavy activity the lactic acid levels go down to a normal baseline within an hour. It can be even faster with walking but also goes away if you do absolutely nothing. The relationship between tissue hypoxia and the event of increased lactic acid in the blood has been further studied in more recent times and what we’ve learned is that under most circumstances the big bad lactic acid isn’t the cause for muscle fatigue but rather a fuel for muscles and the heart, and just one small part of the cause. If all this is going into one ear and out there other so to speak, just try to remember that when a body is experiencing anaerobic responses, the body then uses stored sugar (glycogen) without needing the oxygen. This process is how lactic acid is made.
What is lactic acidosis? Lactic acidosis is a rare but dangerous medical emergency where the lactic acid can build up in the blood. Treatment includes increasing oxygen and giving IV fluids to lower lactic acid levels. Mortality rate is 50% and symptoms can include trouble breathing, muscle aches, nausea, stomach pain, confusion, weakness. If you are on my massage table exhibiting any of these symptoms you are going to the hospital. I can do nothing for you in terms of massage.
There are two types of lactic acidosis and what was summarized is Type A. Type B is not related to tissue hypoxia and can be related to health conditions involved with the kidneys and liver and certain cancers. Chronic alcoholism and liver disease can cause it but so can medications used to treat type 2 diabetes and HIV. Most cases of lactic acidosis are not caused by tissue hypoxia or a super intense workout. The myth of lactic acid and massage isn’t going to go away anytime soon but I will fight the good fight of putting this rumor to bed and in the meantime enjoy the raised eyebrows when I recommend not drinking your body’s weight in water after a massage or workout.
Here is your body if you’re an emotional sponge ready to be filled up with lactic acid and the trauma of your own birth. Let me just squeeze those outta you and then we can begin the healing process.