The Power of Touch: Snuggling = Better Performance?
by Kelly Erickson, MD 2010 | erickson@myhousecallmd.com
We, at House Call, MD, are big fans of the “snuggle.” There are few people on this planet who will not benefit in some way from a hug, massage or simple back rub. A recent New York Times article suggests that we may be on to something (1). While outright snuggling may create interesting and awkward scenes in the workplace, recent studies are showing that positive interactions involving touch may increase in human performance.
Before we dive into the details of the research on this topic and the science behind them, let’s start with some simple logic: If touch makes us “feel better” and “feeling better” makes us work harder, then it follows that positive or cooperative touch can improve performance. Seems fairly reasonable to us. Now on to the science behind the theory.
First, we must show that touching someone is a means of communicating—right? Some of the most compelling studies regarding the role of touch in communicating emotion are currently being performed at UC Berkeley. The most recent study sought to show that a wide array of emotions could be conveyed between two complete strangers using only touch. What is interesting to us is how they conducted their study…
Imagine you are a freshman in college taking a Psychology course and, as part of your grade, you are required to participate in a study currently taking place on campus. 
As part of the study you are taken to a small room and blindfolded (and yes, this does sound like the opening scene of a cheesy horror film, but stick with us). After a minute, an individual enters the room, slaps your wrist, and walks out. You are then given a list of emotions and asked to identify the emotion the other person was trying to convey to you. You circle your answer (What would you answer, by the way?), re-blindfold yourself and wait for the next assault. An individual walks in for the second time, hugs you, and leaves. You are given the same list of emotions to choose from…etc.
The experiment showed that touch, independent of words, sounds or facial expressions, functions as a distinct means of communicating emotion. The emotions that were successfully communicated in this study include: anger, fear, disgust, love, gratitude, sympathy, happiness and sadness. Pretty impressive, right?
You may still be thinking “OK, so how is snuggling supposed to make me perform better?” This is where the fun comes in. Michael Kraus of UC Berkeley conducted a study examining the role of “tactile communication” (a.k.a. touching) and its effects on the performance of NBA players (2). The study hypothesized that players who touched fellow teammates more often throughout a game would be more successful on the court. 
They believed that the same would be true for entire teams as well (i.e. the more high-fives and butt pats, the better the team would play). They watched each individual player in the NBA for an early season game and tallied the number of times the player touched a teammate. “These celebratory touches included fist bumps, high fives, chest bumps, leaping shoulder bumps, chest punches, head slaps, head grabs, low fives, high tens, full hugs, half hugs, and team huddles.” Can you imagine a bunch of scientists sitting around a television tallying “chest bumps”? Welcome to the wacky world of UC Berkeley. After assigning each player a score based on the number of touches throughout the game, the researchers quantified each player’s performance throughout the season in terms of points scored, rebounds gained, successful passes completed, and a number of other parameters that make a player valuable. The researchers found that the more a player touched his teammates in that early season game, the more successful the player was that season. Teams that had the highest number of positive touches between players were also the most successful teams in the NBA!
According to the study, the Boston Celtics and the Los Angeles Lakers were at the top of the list of the touchiest teams, while the Sacramento Kings and Charlotte Bobcats were the least touchy teams in the league (1). And the league’s most touchy-feely player? Kevin Garnett of the Celtics (see photo of picture-worthy hug at left). While the study showed a correlation between touching and performance, they did not prove that touching causes improved performance.
This observation has been studied in other settings as well. Tiffany Field, one of the more prolific touch researchers, studied women with prenatal depression. In the study, they compared participants whose partners gave them a regular massage to a control group in which the subjects got didily-squat (isn’t that sad?). Guess what they found?
Yep, those receiving regular rub-downs reported both a decrease in pain as well as improved relationships with their partners (3). The same group of researchers studied autistic children and showed that touch therapy (which consisted of 15 minutes of physical contact two times per week for four weeks) was associated with less touch aversion, off-task behavior and stereotypic behavior and improved attention, behavior regulation, social behavior and initiating behavior (4). Put simply, autistic kids were able to more easily control their behavior (this is one of the biggest challenges of the disease).
What is the science behind these observations?
Lets look at two hormones the body produces in relation to touch: oxytocin and cortisol.
Oxytocin
Oxytocin is the ultimate snuggle hormone. It is best known for its action in pregnant women and is particularly responsible for milk “let-down” (a.k.a. allowing the milk made in the mammary glands of the breast to move to a “holding chamber” so that when the baby sucks on the nipple, milk is actually released). Interestingly enough, the very act of suckling causes an increase in release of oxytocin by the pituitary gland (we have no political position regarding that statement. Use this newfound knowledge at your own risk). It is a self-perpetuating cycle to make sure babies get the food they need! In terms of pregnancy, oxytocin also prepares the cervix for the birthing process (“Pitocin”, as oxytocin is called in this setting, is used as a topical gel to move things along and get the baby out faster).
Oxytocin is not only found in pregnant women…no need to feel left out, gentlemen. Both men and women release oxytocin in relation to touch. Studies have even found an increase in its release with warm contact on the skin. Increases in oxytocin levels have been correlated with an increase in trusting behavior and decrease in fear. It has also shown to be associated with generosity, empathy and even sexual arousal. All of these emotions contribute to the formation of a bond between individuals.
Cortisol
On the opposite end of the spectrum, cortisol is commonly referred to as the “stress hormone.” It raises blood pressure, spikes your blood sugar and suppresses the immune system among other things. The body naturally increases its levels of this hormone in times of stress and anxiety (Remember “fight or flight” from high school biology? 
This is a related chemical reaction). Interestingly, one of the actions of oxytocin is the inhibition of cortisol. One would think that a peak in cortisol levels in situations like an NBA game would help with performance. The research, however, shows that it may actually be beneficial to have some level of suppression of cortisol in this scenario.
Therefore, when an NBA player high-fives his fellow teammate, he is triggering a biochemical signal in his teammate’s mind and body that says, “You can trust me.” Perhaps it is this sense of security that allows players to push themselves physically and out-perform their rivals. So next time you are on the spot, whether it be before shooting the game-winning free throw or as you sit down to take that final exam, giving the person next to you a motivating high-five will make a lot more sense. It may be the “secret-weapon” you have been looking for.
Questions? E-mail Kelly: erickson@myhousecallmd.com
References:
1. Carey, B. Evidence That Little Touches Do Mean So Much. The New York Times. February 22, 2010.
2. Kraus, M, Huang, C, and Keltner, D. Running Head: Touch, Cooperation and Performance.
3. Field T, Figueiredo B, Hernandez-Reif M, Diego M, Deeds O, Ascencio A. Massage therapy reduces pain in pregnant women, alleviates prenatal depression in both parents and improves their relationships. J Bodyw Mov Ther. 2008 Apr;12(2):146-50. Epub 2007 Oct 2.
4. Field, T., Lasko, D., Mundy, P., Henteleff, T., Kabat, S., Talpins, S., Dowling, M. Brief Report: Autistic Children’s Attentiveness and Responsivity Improve After Touch Therapy. Journal of Autism and Developmental Disorders. Volume 27(3), June 1997, pp 333-338
With the Superbowl only days away, Colts fans across the nation are keeping their fingers crossed for Dwight Freeney’s return. The Colts’ All-Pro defensive end said he’s been walking around barefoot and along the sandy beach outside the team’s hotel to strengthen his sprained right ankle. The question is whether this game-changer, who recently suffered a severe ankle sprain, will be ready for the sharp cuts and quick footwork he will need on Sunday. As simple as this sounds, hard cuts followed by the unfortunate rolling of an ankle cause ankle injuries to numerous players (pro and recreational alike) each year, injuries that may have been prevented with proper footwear, ankle strength and coordination. Before we discuss those topics, let’s go over what an ankle sprain is as well as the main causes of ankle injury.
The most common type of ankle sprain is of the anterior talofibular ligament (which connects the talus to the fibula) and the calcaneal fibular ligament (connecting the calcaneus to the fibula) on the lateral side (aka the outside) of your foot. You can see this ligaments on the image to the right and imagine the type of ankle movement that would strain them. This type of sprain is caused by rolling your ankle downward and inward (exactly what you had imagined). There are many other ligaments in the ankle that can be stretched or torn in the sprain but the overwhelming majority of ankle sprains involve these two ligaments. In addition, there are three different grades of an ankle sprains: Grade I is a stretch of the ligament, Grade II is a partial tear and Grade III is a full tear of the ligament.
Wrap your ankle from your toes upward to your calf, but do not wrap too tightly or more harm than good can be done. Make sure you can still feel a pulse in your foot (blue toes are a bad sign!).
Ankle Braces: External ankle braces such as an Aircast or any semi-rigid external device is recommended during physical activity. This device should be fitted by a trained exercise specialist to make sure the device is working and fits properly. If properly worn the device will provide the support an individual needs to safely perform all of their sports needs (sounds like a good pitch if you ask me).
your ankle simultaneously. As you progress, you can perform these exercises with your eyes closed or on top of a pillow to make them more challenging. A Dyna Disc or Bosu Ball (see pictures) can also be used to improve strength and balance of your ankles. Squat, lunges and various other exercises can be used on these devices to increase the difficulty of the exercise.
Strengthening: Balance and strengthening go hand in hand as it is a critical aspect of rehabilitation for an active individual. Strengthening is usually performed with elastic bands and on a Dyna Disc or Bosu Ball. One exercise that can be used is called the elastic band clock and involves holding the band at 12 o’clock, 3 o’clock, 6 o’clock and 9 o’clock. I know this sounds like nonsense but if you loop the elastic band around your foot and hold the band directly above your foot, you are in 12 o’clock,
and if you hold the band in your hand on the outside of your foot you are in 9 o’clock similar to the picture on your left. Push your foot against the resistance of the elastic band and stretch the band as far as you can without moving your shin or any other aspect of your leg (you are moving your foot at the ankle). Movements in all these planes of direction will greatly strengthen your ankle and improve your balance. These exercises can be done for 3 sets of 15 repetitions and should not be terribly difficult. A little TV time makes them infinitely more enjoyable.
