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I've found myself being really taken aback by the number of people who have come into my clinic asking questions about massage, and stating that it hurts.

What are your feelings on whether massage hurts or not?

How do you respond when people insist that it should hurt or it's not effective?

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Being an educator, my main goal is to teach up and coming Massage Therapists proper warm up and molding their hands into the bodies of their clients. The main complaint of clientele these days is how much it hurts. They are amazed when they come to me for their massage, that there is a equal balance. One client recently said, " The reason I like your massages is it isn't what my daughter would give me or a "surgical massage." We recently had a client come in complaining of pain. When we looked at her back there was brusing all over to the point in one area, black. She couldn't move her neck. The massage therapist that did this has had very little work in the 4 yrs that she has been practicing. I will make it my mission to teach proper technique. My vast 27 yrs in this field enables me to palpaite gently, effectively, and progressively deeper as needed.
balance is the key. A therapist should aee with their fingers, elbow, shin, which ever part they use to get into the soft tissue. see and feel, then respond with learning and experience to bring relief to the client. this may bring some brief pain but not injury. Injury is what we are relieving not causing. Descriptions in this thread of bruised and further injured clients is shocking and distressing. I am guessing these bruises were not the marks left by cupping.

Linda Lewis-Weissinger NCTMB,CMT said:
Being an educator, my main goal is to teach up and coming Massage Therapists proper warm up and molding their hands into the bodies of their clients. The main complaint of clientele these days is how much it hurts. They are amazed when they come to me for their massage, that there is a equal balance. One client recently said, " The reason I like your massages is it isn't what my daughter would give me or a "surgical massage." We recently had a client come in complaining of pain. When we looked at her back there was brusing all over to the point in one area, black. She couldn't move her neck. The massage therapist that did this has had very little work in the 4 yrs that she has been practicing. I will make it my mission to teach proper technique. My vast 27 yrs in this field enables me to palpaite gently, effectively, and progressively deeper as needed.
This is an issue that comes up in my practice, time and time again. I am known for doing deep tissue work, and love it's capacity to change tissue. Lots of new clients are attracted to me assuming that deep tissue means very deep pressure.

To me, deep tissue is a methodology of tissue manipulation, and has very little to do with the pressure used. I feel that massage should feel effective, but never hurt. I educate my clients as best I can, with many of the same points that other therapists have mentioned here. The clients who are die-hard "no pain, no gain" people self select to another massage therapist. However, the vast majority stick around because their issue got resolved.

I find that the general public, and even die hard massage fans, don't understand one type of massage from another, regardless of how well massage types are explained. People honestly don't know what deep tissue means, and yes, there are lots of therapists out there who spread "no pain, no gain" misinformation. Because the playing field is so muddied, I feel that being a massage therapist means that I also must be a client educator.

And here's another factor: Most clients lack body awareness, and because of that, they have a hard time discerning between pain and the presence of sensation (in an area that they weren't previously aware of). The words "good hurt" are two that I try not to use... it can so easily be mistaken to mean that I expect a massage to be painful in some way. Instead I try to train clients to let me know when the massage "feels effective".

Communication is the number one tool we have for avoiding injuring our clients and avoiding dissatisfaction. I like to solicit feedback from clients during a massage using a 1-10 scale. (10 being more pressure than they can stand.) I tell them that I generally want to be working at a 7. And in follow ups, I ask clients about pressure in a way where they feel comfortable giving feedback: Instead of "How's the pressure?" where a "Fine" response is the expected norm for the client, I ask, "How are we doing on pressure: would more or less be good anywhere?" This leaves the client with the expectation that it's ok to say they want more or especially, less.

Thanks for bringing up this topic!
Just a quick part reply to this....I have in the past treated a patient with a Harrington Rod who had been previously treated by a therapist who 'hurt'!
I dont know what the therapist must have been doing as this patient was taking so many anelgesics he shouldnt really have felt it if he was struck by a bus!!!...Just a thought :)

AJ
Further...Pain exists when and where a patient says it does. Respect your patients tolerance.

Allan J Jones said:
Just a quick part reply to this....I have in the past treated a patient with a Harrington Rod who had been previously treated by a therapist who 'hurt'!
I dont know what the therapist must have been doing as this patient was taking so many anelgesics he shouldnt really have felt it if he was struck by a bus!!!...Just a thought :)

AJ
Andrea, thank you so much for your comments. I am sharing these commnets with my massage students come Monday night. I preach this but another voice is a great reenforcer!!!

Andrea Turner said:
This is an issue that comes up in my practice, time and time again. I am known for doing deep tissue work, and love it's capacity to change tissue. Lots of new clients are attracted to me assuming that deep tissue means very deep pressure.

To me, deep tissue is a methodology of tissue manipulation, and has very little to do with the pressure used. I feel that massage should feel effective, but never hurt. I educate my clients as best I can, with many of the same points that other therapists have mentioned here. The clients who are die-hard "no pain, no gain" people self select to another massage therapist. However, the vast majority stick around because their issue got resolved.

I find that the general public, and even die hard massage fans, don't understand one type of massage from another, regardless of how well massage types are explained. People honestly don't know what deep tissue means, and yes, there are lots of therapists out there who spread "no pain, no gain" misinformation. Because the playing field is so muddied, I feel that being a massage therapist means that I also must be a client educator.

And here's another factor: Most clients lack body awareness, and because of that, they have a hard time discerning between pain and the presence of sensation (in an area that they weren't previously aware of). The words "good hurt" are two that I try not to use... it can so easily be mistaken to mean that I expect a massage to be painful in some way. Instead I try to train clients to let me know when the massage "feels effective".

Communication is the number one tool we have for avoiding injuring our clients and avoiding dissatisfaction. I like to solicit feedback from clients during a massage using a 1-10 scale. (10 being more pressure than they can stand.) I tell them that I generally want to be working at a 7. And in follow ups, I ask clients about pressure in a way where they feel comfortable giving feedback: Instead of "How's the pressure?" where a "Fine" response is the expected norm for the client, I ask, "How are we doing on pressure: would more or less be good anywhere?" This leaves the client with the expectation that it's ok to say they want more or especially, less.

Thanks for bringing up this topic!
There is tons of good info in this thread & I won't repeat any of it. I just wanted to add something regaurding the 1-10 pain scale- I think that is too subjective especially when you are dealing with people who are expecting to be caused pain. I always ask clients to let me know before they get to the point of holding their breath or tensing up because if they do this then we are being counterproductive. Do they always tell me? No, there are times when I catch them tensing up & have to adjust my pressure. Another thing I tell clients is to be mindful of how they feel in the days after the treatment, not just how the feel during the treatment. After all, when dealing with clients that have pain the goal is to make the results last.
In one of the groups on this site is a question about what to do about a fatty cyst on a nerve without resorting to surgery. I have worked on about a dozen of these and every one of them disappeared. The method is painful but effective. If the cyst is palpable I apply pressure directly on it and wait for it to yield slightly. Then while maintaining the pressure I do a stationary circle on it. This is repeated every few days until the cyst disappears. It takes anywhere from 1 to 6 treatments. It is painful. But the cysts also cause pain.

So should I discontinue this effective treatment that avoids surgery because it is painful for a minute each time performed?

Pain without injury can be, in my opinion, a valid application.
There is an article is massage and bodywork magazine "Refine Your Touch" which was very helpful in letting me know that my massage does not have to hurt and why not. The article says that we want the body to feel good so that it will heal. Another good reason to start moderately and work gradually and why I recommend to my clients that with chronic pain three massages in sequence is usually best. After they receive the first they usually book again in the office or call to reschedule a couple weeks later.

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