Volume 1 of Massage and Pain
This post and its contents are based mostly upon my own experiences giving and receiving massage. I will use two different client experiences to illustrate some of these points. Client 2’s experiences can be found here.
Jane and Her Lower Back Pain
Client 1, I’ll call her Jane, came in one day complaining of lower back pain mostly triggered from bending over. Putting shoes or socks on was a painful process. Watching Jane walk into my office I was struck by how awkwardly she moved, and how she held herself. She couldn’t seem to stand up straight. During the intake process we formulated a plan of action for the session. This included working the lower back into the hips and also included working the quads (quadriceps: muscles running down the front of the thigh) as there are connections to tightness here and lower back tension/pain.
The session progressed nicely. She was able to withstand a fair amount of pressure and I was able to feel that some of the tighter muscles had relaxed and no longer caused her as much pain when touched. On a scale of 1 to 10 with 10 being the most painful, her pain went from a 7-8 to 2-3.
After the massage I recommended that she be vigilant about the changes she felt in her body from the session. I said there might be some soreness as the work was very specific. In the event of soreness I explained that applying heat and cold to the worked areas would be ideal to alleviate some of the aches. Adding heat to an already inflamed area is not a good idea, which is why I recommend both hot and cold.
I also discussed with her what she normally did when she had stiff or achey muscles. Did she take ibuprofen or Tylenol? Ride out the pain? I advocated whatever worked for her but stressed the importance of being proactive regarding her discomfort. Don’t wait so long so that when you do decide to do something about it your relief will take longer to achieve.
The Next Appointment and a Rude Awakening
Jane’s next session was 3 days later. She said she almost cancelled the appointment. She said that hours after the massage she was in a lot of pain in the hip area especially, to the point that her knees almost buckled. This pain went into the next day but by the 2nd day after the massage she felt much better. Her range of motion was back to normal. She was feeling slight twinges but no pain. She felt that her daughter’s friend’s 3 doses of 800mg of Ibuprofen was very helpful to her to get through the pain.
Hearing about a client in pain from something a massage therapist did during the session is something not he or she ever wishes to hear. However, even if all precautions were considered and appropriate action was taken from the client’s feedback during the session, this situation still occurs.
DOMS: Post massage pain
I’ve read that the pain from a massage can be likened to what is called delayed onset muscle soreness (DOMS). Pain, aches, and stiffness from doing a fair amount of infrequent exercise where the muscles are used in a way that is unusual. The pain and stiffness from DOMS usually dissipates within 24-72 hours with good hydration and wet heat application. The same can be said for post-massage soreness.
The bigger issue, for me anyway, is whether the massage therapist is exposing the muscular issues/pain or inflicting muscular pain. Exposing the pain is working through a series of techniques on an area that was already in distress, with the intention of easing the pain/stiffness with appropriate pressure and technique. Inflicting the pain is exactly what it sounds like- using too much pressure or an inappropriate technique on an area that may or may not have been distressed.
Massage Limitations and Communication
When dealing with a specific issue like Jane’s I am very careful in explaining what I’m going to be working on and why. I always say that if I’m using too much pressure or an area is just too sore to the touch to please tell me so I can adjust it or move on. Communication is absolutely vital here. I cannot stress enough to people that the massage session is yours, you paid for it, so you definitely have a say as to what goes on during it. Some aches and pains are normal. This may explain the soreness, or feeling sick. Yes, sick. With flu-like symptoms. See more about this in this post.
After a Bad Massage Experience…
An option for those who may have had bad massage experiences before: tell your massage therapist about your past experiences. Good massage therapists are more interested in making the massage work for you rather than going about the massage with their own results in mind.
Or, if you’re trying someone new ask specifically for a Swedish massage which is a more superficial, flowing and relaxing type of massage.
As for Jane, her next massage was a reworking of the affected areas and a new awareness of how a massage can affect the client.