Massage 101

Since I am a massage therapist (hear me roar…) and there are a lot of misconceptions surrounding this profession, I thought it’d be good to write a post (or several, depending on how many different directions this goes in) about what it is I do for a living.

What massage seems like on the outside: rich, celebrity, or fad-following clients pay extravagant amounts of money to get rubbed on for an hour.

What massage therapy actually is: an umbrella term that includes a plethora of different types of bodywork, typically done by the practitioner’s hands.  Not only does it feel great, but it is extremely therapeutic; sometimes, we can help prevent certain surgeries–for example, a retinacular release typically done to ease symptoms of carpal tunnel (numbness, tingling, and weakness in the hands/fingers).

There are a gajillion different types (referred to as modalities) of massage therapy, at least several hundred.  Some of the main types (referred to as “modalities”) include:

Swedish Massage: utilizes long, flowing strokes (always toward the heart!) using light to firm pressure in order to provide varying amounts of stress relief.  A basic full body massage requires at least an hour, if there are no particular tight spots to address.  An hour and a half is really the ticket, though.

Deep Tissue: means different things to different clients, and there is even debate among veteran practitioners as to exactly what Deep Tissue is.  Clients typically request deeper massage for two reasons: either they have a high pain tolerance and they think it has to hurt in order to help, or their last Swedish massage just didn’t cut it for them and they want the same relaxing full body massage they got before, just with deeper pressure this time.  Deep Tissue can be good for working out knots or especially stubborn tight/trouble spots, such as a crick in the neck after sleeping wrong.

NMT (Neuromuscular Therapy): utilizes full body alignment assessment to figure out which muscle groups are actually causing the tightness/pain (hint: the source of the problem may not be the site of the symptoms!  That pain between the shoulder blades may actually be caused by tight muscles in the upper chest) and apply specific targeted protocols to address the true source of the problem in order to restore biomechanical balance.  NMT is also known as clinical massage, medical massage, or orthopedic massage.

Hot Stone Massage: resembles many other types of massage except that the therapist uses warm stones in some form or fashion to release the tightness in the top layer of tissues first.  This allows the therapist to access the deeper muscle layers sooner.  Can be used as part of a new dimension in relaxation massage, or to assist with more clinical work for pain management and structural balance.

Lymphatic Drainage/Detoxification: utilizes slow global strokes of very light pressure for the purpose of assisting the drainage/emptying/clearing of congestion of lymphatic fluid out of the tiny lymphatic channels just under the skin.  Very popular among people who suffer from edema and lymphedema, for faster recovery from surgery and pregnancy, and those who wish to optimize their health through detoxification.  Also very beneficial for eczema – eases the itching and improves the appearance of the rash.

Sports Massage: utilizes various kneading, friction, stretching, and static/multidirectional point pressure in order to aid in recovery from various motion injuries, such as muscle strain.  May also be used in combination with ice, heat, active therapies, or electric modalities like TENS or Ultrasound.  Also good for rehabing or strengthening muscles.

Prenatal Massage: resembles mostly a Swedish massage, with elements of NMT and deep tissue techniques for working out the tight spots that accumulate in the ever-changing body of the mom-to-be.  Typically done completely lying on the mother’s side for the safety of both mother and baby to minimize pressure on both.  Prenatal massage avoids deep pressure, to avoid releasing any clots formed due to altered circulation during pregnancy.  Focuses a lot on neck, shoulders, glutes (buttocks), hips, knees, and feet.  Avoids the wrist and ankles due to reflexology points that could contribute to the stimulation of premature contractions.

Reflexology: performed by massage therapists but is not exactly massage, per se.  Utilizes pressure on different points on the bottoms of the feet and sometimes the palms of the hands that are said to be linked toward other body regions or organs in order to improve/restore normal function.  Allows benefits to trickle to other parts of body without that particular part being touched–for example, press around the toe joints to help with inflamed rheumatic finger joints that shouldn’t be worked.  Thus, is great for reducing pain and symptoms of inflammatory conditions like rheumatoid arthritis.

Chair Massage: performed with the client sitting fully clothed in a special padded massage chair, typically in the workplace or a public event.  Can address nearly all the areas of the body low back, wrists, forearms, hands, calves and feet, but is especially used to focus on the neck, shoulders, and upper back.  Typically uses little to no oil, as the sessions are brief and the client is clothed.  Sessions typically last 10 minutes or so.

Trigger Point Therapy: a subset of clinical/medical massage that specifically addresses a special type of knot in muscle or connective tissue that refers pain to another area (either by itself all the time or only when pressed on).  Proposed to be the root cause of about 70% of all pain, trigger points are overlooked by the medical establishment because there is little knowledge of them, and little diagnostic testing for them.  Very good for pain management.  Can be included in a long unclothed massage or a short chair massage, or stand alone as an isolated session.  The length varies, depending on how fast a trigger point releases.

Myofascial Release: also a subcategory of clinical/medical massage, but can also stand on its own.  Two main types exist: 1) gentle sustained stretching using no lubricant, and 2) fast, hard scraping motion against the skin using blunt tools and lubricant.  Each achieves good results, but people generally respond better to type 1.  Releases restrictions in connective tissue, thus unbinding the muscles and organs underneath, and helping to reduce pain and stiffness.

The above is not an exhaustive list!

Misconceptions (let’s talk about what Massage Therapy isn’t):
Myth #1: Massage is a frivolous luxury just for the elite.
Fact: Massage is for everyone. I’ve had people from all walks of life in my studio, from age 6 to age 91.  I’ve had the big Harley Davidson aficionado, the pro hockey player, the retiree, the cancer survivor, the paraplegic, the young kid ejected from a nasty head-on collision who spent his next 13 days unconscious and has severe dystonia, the ADD child, the stay-at-home mom, the stressed out sales executive, the pilot, the non-English speaking lawn care worker, the police dispatcher, and just about everyone else.  Massage therapy is healthcare. It’s especially good for aches and pains, stress, lymphatic congestion, and various muscle compression issues like carpal tunnel and thoracic outlet problems.

Myth #2: Massage is too expensive.
Fact: Massage can be a little pricey, depending on where you live, but let’s take a look at that.  Depending on where you go and what technique you request, massage can be as little as $30 to as much as $90 per hour.  However, it’s usually a lot cheaper than a doctor’s visit, and instead of walking out with a slip of paper in hand that gives you permission to obtain drugs with side effects and the capability to destroy your liver and kidneys, instead you might actually start to inch closer to addressing the cause of your problem.  Bonus: little to no negative side effects, and lots of potential positive ones!  So even though insurance does not usually contribute toward the cost, it’s an investment in the one thing you can’t replace: yourself.

Myth #3: No pain, no gain.
Fact: Even though this mentality is how deep tissue practitioners were taught back in the day, we have come to realize that this is actually not true.  Some of the most profound results actually come from some of the lightest pressure techniques.  On the other hand, too much pressure can actually cause trauma to tissues (like muscle, nerve, and connective tissue).  How do you know when it’s too much pressure?  Well, it’s different for everyone.  Different people can tolerate different amounts of pressure.  You know it’s too much if you start to notice yourself doing things like having to grit your teeth, tighten up to resist the therapist’s pressure, wiggle your toes, or hold your breath to bear it.  Or if you start having thoughts like wondering when this’ll be over or trying to convince yourself you can “take it”.  Being a little sore for 1-2 days after a good deep massage is normal; any more sore than just a little, or being sore for any longer than the 1-2 days usually is not.  If you’re not the easily-bruised type, ask your therapist to lighten the pressure.

Myth #4: Massage is just a cover for “other” services offered in a Red Light district.
Fact: Au contraire!  Although many “ladies” use “massage” as a decoy or cover or code word for what it is they’re actually offering, this is not what massage therapy is all about.  Some of them gotten good at marketing their craft; sometimes it’s tough to tell the legit from the non-legit.  Some ads that carry a hint of sleaze are legit therapists who simply don’t know how to market themselves or design an ad.  But what’s even more confusing is the fact that a few licensed practitioners actually offer “other” services, either as the mainstay of their practice or on the side upon request.  All this does is give the rest of us a bad name.  If this applies to you, you’re scum!  The vast majority of therapists, however, have integrity and self-worth and stick within the therapeutic scope of their practice.

Myth #5: Massage therapists do chiropractic adjustment/manipulation.
Fact: Not.  If they do, they need to be reported.  File a complaint with the regulatory board in your state/province/country.  Massage therapy is the manipulation and therapy applied to soft tissue only, not bones or joints.  Massage can be done near or at the location of a joint, but it is directed towards the muscle tendons that attach near that site.  Massage therapists lack the proper training to do a chiropractic adjustment, and while chiropractic is overwhelmingly safe, adjustments performed by untrained practitioners are dangerous and can result in a major injury.  For a great and safe adjustment, go to a licensed chiropractor!

Well, that about does it for now.  More massage stuff to follow!


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