July 20, 2011 in Massage Therapy, Wellness by empoweringwellness

Does Massage Have to Hurt to Help?

This is a reprint of an article that appeared in my e-newsletter, the Wellness Wire over a year ago.

Client “A” says, “I like really deep work. I don’t a like massage unless it hurts. I like to really feel it.”

Client “B” says, “I really don’t like deep tissue massage. It hurts too much.”

And that pretty much sums it up. Clients and therapists alike seem to be completely divided on the issue. I have heard stories from people who have given up on massage because their session was so uncomfortable. I have heard from people who have actually sustained injuries during a massage. I know therapists who definitely agree with Client “A,” and they want to work as deeply as possible all the time.

So let me provide my perspective and tell you exactly where I stand on this topic.

While some massage techniques may be uncomfortable, associated pain should NEVER be unbearable. Never. Ever.

Therapists today use many different techniques or modalities. Some techniques such as Swedish massage use light to medium pressure. There are deeper treatment techniques such as Neuromuscular Therapy and Myofascial Release. These modalities use very specific techniques for treating chronic pain. While these techniques may cause discomfort, the client should never experience unbearable pain.

When I was a student studying massage therapy, one of my instructors very aptly described the optimal pressure as working at the “sub-threshold of pain.” What does this mean?

One way to define this level of discomfort is to use a pain scale when communicating pressure. On a scale of 0 to 10 (0 is no pain and 10 is debilitating pain), the pressure must stay within a range of 5 to 7. This level of pressure may be uncomfortable when treating a trigger point or tender area, but the client should still be able to keep the muscle relaxed and not have to tense up. Again, the purpose of these treatments is to relieve pain and dysfunction in the muscles and fascia. So, while working to accomplish relief, some discomfort is expected, but it should be no more uncomfortable than the painful problem being treated.

Communication between a therapist and client is of the utmost importance. During deep tissue treatments, you should expect your therapist to constantly check with you on the level of pressure being used. As a client, do not be afraid to say that the pressure is too hard. Whatever level of pressure you are comfortable with is going to do you the most good. Too much pressure will cause bruising and will have no benefit. It will also cause your muscles to contract, in order to protect you from injury, so the therapist would be fighting against the muscle instead of working with it.

If anyone has received a painful massage and has decided not to try massage again, I urge you to reconsider. Ask around for input from family or friends that have had a positive experience with massage. Don’t give up on massage therapy because of one bad experience. If you have muscular pain or dysfunction that massage could help, give it a try. Go into your massage with confidence, and insist on appropriate pressure from your therapist.