When Did We Add “No Pain, No Gain” To Our Massage Approach?


Taya CountrymanWhen Did We Add “No Pain, No Gain” To Our Massage Approach?

by Taya Countryman LMP

Massage started with Swedish massage, beautiful strokes that induced deep relaxation. Then with Travell & Simon’s book on Trigger Points and Bonnie Pruden’s interpretation, deep pressure was used to release them. I never studied Rolfing because I heard the pressure was so deep, the client was expected to scream though all 10 sessions. When I heard about Heller Work, I learned it was also a very deep technique. But in the ‘80’s, I worked in theEverettProvidenceHospitalPainControlCenterwith clients who were in constant pain and I found that deep work caused them more pain. So, I kept looking for more gentle alternatives.

As massage became accepted in gyms, chiropractic offices, spas, PIP injury work, and more, each of these became a specialty and we developed new skills and took classes to find techniques that worked best for our clients. In the new mega-gyms, athletes and weekend warriors alike wanted more pressure leading to deep tissue as primary treatment. This was the time period where many of our massage instructors came from, so most massage schools set their model of treatment massage as deep tissue and trigger point therapy. Students believe their teachers, so when they started working, they would only do this deep work.

Over the years, I have noticed that we tend to do massage the way we would like it done to us. If you are young, athletic, and healthy, deep tissue and trigger point work feels great. If you are sensitive, then lighter work feels best. This also shows up in Facebook postings. The photos of those promoting deep pressure techniques are typically athletic, healthy, and/or active therapists.

Some massage therapists evolved based on their clients responses. Bruising, increased pain and/or symptoms, and clients not rebooking helped them to modify their treatments. They learned that deep work is not appropriate for many conditions and people. I remember talking with a therapist who had decided to become a physical therapist. When I asked him why he said, “I fix my clients in one session, so they are not returning for more treatment.” Later, I learned from several other therapists in the area that his work was so painful his clients were seeking other massage therapists for treatment.

I believe that pain is a form of communication from the body. This communication can escalate into increased pain, anxiety, burning, and aching. When we ask clients to, “breath through the pain,” we are ignoring this communication. It seems the general public who were first influenced by the “no pain, no gain” ads for exercise and sports have come to accept that massage must also be painful to be effective.

Now, our profession is using massage with many different conditions, and with trial and error, we have developed protocols and specific continuing education and certifications.   There are currently many advanced massage techniques which do not increase pain or create pain for our clients. As therapists we need to add some of these techniques to our tool box and also learn about other therapists in our area who specialize so we can refer our clients when needed. We also need better assessment skills so we can discern what treatment might be appropriate for the age and/or general health of our clients. Let’s teach clients and ourselves, “No pain, lasting gains.”

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