What to Expect During a Therapeutic Massage

What to expect during a Therapeutic Massage

What to expect during a Therapeutic Massage

This is a great question and one that I often assume people already know the answer to.  For those of you wondering what to expect, who have never had a Therapeutic Massage and still wonder what that means exactly, I apologize for my assumption and will explain how I see a Therapeutic Massage from the clients perspective.  Here’s a basic list of what to expect:

  1. Friendly Massage Therapist who explains every step
  2. Clean office space
  3. Get ready alone to your comfort level of undressing
  4. Plenty of comfortable sheets & blanket to cover you
  5. The Massage Therapist knocks when they come back in
  6. The Massage Therapist should communicate with you for your requests/pain/comfort level
  7. If there are painful areas, your pain tolerance is respected
  8. If there is not enough pressure, you can request more…or leave
  9. Your aches/pains/tensions are addressed
  10. You feel safe, comfy, happy & relaxed
  11. Your time is honored and accounted for
  12. Payment is taken, (tips are encouraged)
  13. You reschedule 🙂 At least 1 massage per month for life (just think how this investment in your health could change your patience level, sleep, relaxation, effectiveness, peace & calm, etc….just sayin’)

First of all, keep in mind that the phrase and act of giving a “Therapeutic Massage” is as broad a term as asking an art class to paint the picture of a house.  For the art students, they are shown in the same way how to outline the frame of the house, where to put the windows and doors, maybe even what colors to use, yet each student will paint something very unique.  Their painting will still have the house frame, some doors and windows, and possibly similar colors as their classmates, but each painting is as individual as each painter.

The same is true for “Therapeutic Massage.”  The hours of required classes of “how to” in any massage school world wide are basically the same.  Students are taught the same framework of a basic massage.

I can remember learning to do 3 circles on each part of the arm, then each part of the leg, then the foot, then the other foot, then the next leg, etc, until the entire sequence was finished. And we’d practice this basic “square” until it was memorized.

Like an open canvas is to a painter, so is a massage to a Massage Therapist.  Each session can have different tones of light or dark colors, soft or hard pressure, starting on the feet or neck or back, starting face-up or face-down.  What type of lotion, oil, aromatherapy to use? Should you add hot rocks, hot towels, different music, heated blankets? Are you going to stay standing or use a chair? How much breathing or stretching will be involved?  The way the massage goes is lead by many factors of how fast the client relaxes with different tools from our pallet of massage moves.

What should you expect during a Therapeutic Massage…

Your therapist should greet you happily, with a form for you to fill out of your basic medical information as it pertains to having a massage.  This is because certain medical conditions, some obvious, some not so obvious, can be affected negatively by the rubbing of skin, lymph, muscles, etc.  You could see questions like, “do you have any open wounds?” (the more obvious problem for massage), to “do you have blood clots” (a less obvious but very serious contraindication…which means….massage could make this condition worse).

After you finish your paperwork, your therapist will lead you to your massage room and explain what to do.  It could go something like this: “Have you ever had a massage before? How can I help you today? This is the massage table. When you lay down, you should be between the bottom sheet and the top sheet/blanket.  Your face goes into this headrest. You can put your belonging and clothes over here on this chair.  For me to work on the pain on your back, I suggest that you take off at least your shirt.  You may also take off all your clothes or just leave your underwear on.  You should know that you will always be covered by this sheet and blanket.  Do you have any questions?  I’m going to leave the room and wash my hands.  You go ahead and get ready.  I will knock when I come back in.”

You can make the best choice for you of whether to get undressed or not.  Truly, as Massage Therapists, if they have worked on several 1000 clients, then they are used to anything.  I work on nuns who cannot take off their clothes, on clients who need an chaperone in the room for religious reasons, and those very used to massage who start getting undressed before I close the door…and everything in-between. Lay down, relax, breathe, get comfortable.

You need to be comfortable.  That’s what matters.  We will work with whatever makes you comfortable.

During your Therapeutic Massage, you should expect communication from your therapist: if the pressure is too hard, hard enough, are you comfortable, are you warm enough, is the music ok for you, etc, etc.  When you have a special request, for example, “neck pain”, then the therapist should ask you about your pain tolerance in certain “trigger point” areas.  What does “trigger point” mean.

“Trigger Points” to you mean a sore spot when it is touched.  One of those “I-didn’t-know-that-hurt-until-you-pushed-on-it” type points.  We are looking for these in certain areas because “pain patterns” often have a “trigger point” associated with them. This means that we may be able to stop the associated pain by rubbing on the “trigger point” instead.  The body is REALLY all connected.  I’m never shocked anymore with where a client will feel “referred pain” from a “trigger point”.

What is “referred pain”? This can happen, for example, when we are pressing on a “trigger point”, but instead of feeling pain at that point, you could feel pain down your arm, up your neck, in your chest, etc.  Sometimes it’s on the other side of the body, sometimes down the legs, arms, etc.  Everyone is different and every trigger point is different.

Your therapist should use several different styles or “modalities” of massage to relieve your pains, tenderness and tension.  This may include different oils or lotions, first checking if you have any sensitivities, aromatherapy, hot towels, deep tissue, lighter work, rocking, myofacial work, etc.

So, in general, if you only have a few areas of tension that need extra time, then your massage will usually go something like this:  You start face-down and the massage therapist starts on your back, shoulders and neck, by rubbing oil/lotion along the muscle next to the spine, neck and out to the shoulders for about 10-15 minutes.  Sometimes the hips are included, even under your underwear, if that’s ok with you.  Next, the legs and feet. (for the massage I give, I usually work on the legs and the back at the same time…because often back pain is relieved from relaxing the legs.  By working on them at the same time, I can tell which part of the leg “causes” different parts of the back to relax…fyi”  After both legs are massaged, then usually the back is worked on briefly one more time, then you are asked to turn over.  You are always covered when you turn over.  Once face-up, your legs and feet are massaged again, then both arms (I always work on the stomach here, but not every therapist does), and finally the neck, shoulders, jaw, head, etc. with the therapist working from the front of the table.  This part usually takes the bulk of the “face-up” time. To end, usually the feet are massaged one last time and you are asked to relax and get up when you are ready but to take your time.

The pain you could feel during a Therapeutic Massage should not be past your tolerance, period.  Given that you are telling them the truth of what really hurts, the therapist should not hurt you.  Sometimes “trigger points” can hurt, but usually not for long and the pain should not last for more than 24 hours.

Signs that the massage was too Deep:

  • You have bruising
  • It hurts to move after the massage
  • You feel soreness past 24 hours
  • You are uncomfortable during the massage

If the therapist is not using enough pressure and you feel like a Salad from having so much oil kindly rubbed on you, you can request more pressure and end the massage if you don’t feel like you are getting your money’s worth.

Don’t get trapped getting a “Fluff & Buff” from a non-experienced therapist with no hand strength.  That is a common complaint, though.

Payment for your massage should be painless and understood beforehand.  Some Massage Offices/studios only take cash/check.  Not all take credit cards, so plan ahead.

And, a note for tipping.  Please tip.  It’s common practice and really appreciated.  Remember that the average career of a Massage Therapist is only 5 years mostly because it’s hard on our hands.  So, keep that in mind, and if your therapist did a good job, let them know with a $10-$20 tip per hour.

Lastly, after your massage, after paying, if you enjoyed the massage, please reschedule.  Many therapists can be shy and might not prompt you to reschedule.  This is about YOU, and having a good massage once per month is really worth the time and money.  Just imagine how this world would be if each adult had a relaxing massage each month…

Should You Choose Deep Tissue Massage?

When you are about to make an appointment for a massage, should you have a deep tissue massage or some other style of massage?  Good question.

It really depends on 3 things:

  1. What type of Massage Office are you going to:  If you are going to a national chain, or a place hiring only new graduates with less than 2 years of experience, just remember that a beginner can HURT you with deep pressure.  Another point to remember, though, is that if you don’t ask for a “Deep” massage, your massage could be a weak “Fluff & Buff” wet noodle oil application.  So, find experienced therapists. At our office, even if you ask for a Deep Tissue Massage and that turns out NOT to be what you need, we will figure it out for you.  Also, not everyone who requests “Deep Tissue” actually needs or will benefit from “Deep” work.  Again, this is something an experienced massage therapist will be able to determine from how your muscles respond to deep pressure.  
  2. Have You Had a Massage Before?  If you have never had a massage, then we suggest not trying a Deep Tissue massage first.  Try a Relaxation Massage first.  If you are a referral from another athlete or someone who likes Deep Tissue, and you are not coming to our office, tell the massage therapist that you “think” you like deep pressure, but you don’t want to be hurt.  Each person responds differently, even those people who think they like the same style of massage.  If you are coming to our office, we will take care of you and will know from a few questions what your best massage style will be.
  3. What result from the Massage are you looking for?  If you want to leave relaxed and ready for rest, then choose a massage for relaxation.  From a Deep Tissue massage you are looking to have problem areas “fixed” or to get the “kinks out”.  You could feel like you just did a hard workout.  You could be sore for 24 hours.  Your painful areas may be more sore for a day and then much better.  If you are not wanting to feel this “soreness”, then a relaxation massage is better for you. If you are sore for more than 24 hours…your massage was TOO hard and it caused more damage than healing.

Another thought about whether you need Deep Tissue or some other style of bodywork:  When your mind is saying “Press as hard as you can!! You can’t hurt me!” yet when the massage therapist uses pressure and your body flinches, your toes curl, your hands make a fist and/or one of your legs starts kicking…may we suggest that you may need some more calming or lighter work.

If lighter work makes you ansi and uncomfortable, this is almost a sure sign that you are ready to make major changes…possibly letting go of some old pain patterns, possibly ready to let go of some old anger or sadness.  Often times, these types of patterns come out with very gentle massage styles like polarity, core synchronism, or even light Myo-Facial Release. It’s quick and pain less to get patterns out of your body this way…it just feels a bit “scary” right before it’s about to happen.

For those who have massage on a regular basis, this cycle of healing happens very quickly because their body gets used to this form of healing and lets go of pain patterns or emotional patterns much faster.

When pain patterns are released this way it is quick and sometimes permanent.  If the pain returns in a few days, then the pattern needs to be addressed at a different angle.

When emotional patterns are released this way, the person can feel more patience, calm & peace.  Getting angry at drivers and talks with family members can be much smoother and less reactive than they once were.

As always, if you have any questions, email us at info@athletictouch.com

Runner’s Edge: Stretch Problem Calf in Different Directions

As a runner with chronic foot/leg pain, or as a massage therapist working on a client with this issue, you may need to be creative to find relief.

I’m going to address this article to the massage therapist, so if you are trying this on your own leg or foot, just keep that in mind.

First, try myofascial release (MFR) from the bottom of the foot all the way past the knee, deep stripping, petrassage and cross fiber friction.  Next, Stretch the effected area and do MFR and deep stripping again.  Go past each joint with your work, being mindful of the area behind the knee and the possible tender areas around the ankle.

If these techniques are not getting the job done, and the pain or tightness is still there, make sure you are stretching the effected area in different angles.  We were taught that the gastroc flexes the foot, but you must flex and move the foot in many angels to pinpoint the specific strand of the muscle that is feeling pain.

Usually, you must try several different angles of stretching to find the angle you need.

First, find the specific area that is bothersome. Hold your finger in the middle of the most painful or most tense area.  Have them flex their foot.  Have them push against your hand, with pressure on the big toe, little toe, side of their foot, etc, one at a time until you get the effected muscle to contract.

Once you find the problem spot, stretch it in the opposite direction, do MFR, compressions and deep stripping. You can also do ice massage and heat, which I discuss in another article, “Self-Care for Bruises,” and “Ice Massage”.

If you ever have any questions, email me and we can try to find a solution.

Hand Update

I saw Dr. Bernstein last week to check my hand, and see if he had any ideas for the pain I’ve been feeling.

The appointment started right on time at New Mexico Orthopedics, I was checked in and my hand x-rayed. After a non-rushed, very thorough exam of each finger, action, movement, etc, Dr. Bernstein’s tests kept finding good news.

My hand, fingers and wrist are very strong. He found no broken bones, no nerve damage, no tendon damage. Possibly some chronic muscle soreness that could be helped with physical therapy, stretching, strength exercises and rest.

My best news: there is absolutely NO arthritis! He wished he had more he could say to help me, but he suggested rest, ice, and strengthening.

All good news! It was good to find out for sure what is NOT going wrong. Knowing that the tendons, bones and nerves are healthy, I feel more comfortable causing more pain with physical therapy and strengthening. Before, if my hand hurt more, I was afraid that I was causing more damage. This information is very liberating for me.

Now, just to keep resting, try a few massages to see if I recover in a decent amount of time.

Can Lid-1 Hand-0

We use our hands for so many things. It is very easy to take them for granted!!

I hurt my right hand in October 2011, and I’m right handed. Not only was it hard to do normal things like brush my teeth with my left hand, put my hair in a pony tail, put on a shirt, but I use my hand in massage daily…until…I changed my hand forever…

My family had been planning a trip to see my brother across the country for several months. Let me rephrase that…”I” had been planning for months for my family to see my brother and his family. In the past, it was like pulling teeth to get my husband to travel or communicate about it happily. So, I was extremely excited when we had decided on a time/date etc, to see the Zimmerman family.

I got everything squared away…a rental house, a car, plane tickets, etc. If you do any travel planning, you know how many hours this takes. Plus, we were taking the kids out of school for 4 days, and their teacher’s had spent extra time packing them their homework to do while we were away.

Here I am in my house, alone, all packed, dog ready for the dog sitters, the house is clean for the house sitter, it’s 11:30 am and we are leaving at 2:30, my husband is doing last minute errands and the kids are at school waiting to be picked up. I have gathered everything by the back door, ready for the car. All I need to do is take out the trash. All is moving smoothly.

I’m telling you all of this history to better defend and justify my next stubborn move… (and there is detail of the injury, to warn you if this might bother you…skip down a bit)

I’m moving fast organizing this and that, so with quite a bit of force, I push my hand as hard as I can into the trash…right into a metal lid which is still attached to it’s can.

“Sh@#$”, was my first reaction as I pull my hand back out of the trash with the lid stuck in my palm. There wasn’t very much pain at first, more of a absolute shock…and a tinge of kicking myself in the a@#. “Really?? Did I just thrust my hand into a can lid?? Really?? WE ARE NOT MISSING THIS TRIP!!”

As soon as I pulled the lid out, with it came lots of blood, which almost made me pass out. I immediately grabbed my wrist to put pressure on the blood supply and looked for a phone. When I find the phone, I can’t push the buttons because my hands are married in a weird tourniquet.

All I could think about was, “Great, I’m going to pass out and my wrist will bleed and bleed and I’m going to die here on the floor…”

I wasn’t panicky or rushing, but realized I needed help. I opened the garage door with my chin and checked to see if my neighbor, Chris, was home. He’s an EMT and a fireman, so I figured he could help. He was home, he bandaged my hand and I was able to call John.

John jumped right into action. He called our Doctor/surgeon friend to see if he could stitch me up right away. We knew that if we went to the ER that we would miss our flight.

So, Dr. Steve Gough, said to come right over. The halls were lined with his nurses, watching me pass with great curiosity of the retarded woman with blood on my shirt and the open hand wound.

I was hoping that Steve would look at the cut and say, “oh this is no big deal, here’s a band aide.” But…no. He warned John that this could get loud, and John quietly left the building.

Steve prepared three numbing shots and put them right into my palm. OOOUUUCCHH! Man! That was WAY worse than the can lid pain!! I screamed and screamed and cried and cried. John was right to leave.

Steve’s nurse, Mary, held my other hand, or I should say, I gripped her hand with my left hand. She was very encouraging and calming as Steve stitched it up the hole.

Some Tylenol, Percocet and a big bandage later, we drop off the dog, pick up the kids and head to the airport. We made it.  The security officers decided that I may have a knife in my huge hand bandage and proceeded to pat it down with much force…so fun.  My “I’m killing you with my eyes” glare didn’t work to lessen the pressure.  And then some more officers decided to join the party of the huge hand bandage.  I was perfectly willing to share, but we were almost about to miss the flight.  We were with the family for 9 days and had a wonderful time.

The stitches healed and I was able to massage a few days after we returned. There was a bit of pain, but nothing serious, and I didn’t think anything of it. I assumed that the pain would get better in time.

But, massage after massage it didn’t get better, and here I am, 6 months later with pain that doesn’t go away for days if I don’t rest. And, I mean REST…no use of the hand at ALL. No gardening, no arts and crafts, no golf. Total Bummer.

I don’t rest well. Maybe that is my lesson this time….to rest.